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My dad passed away in Jan. He was my moms caretaker. My mom is 77, however due to a few medical issues she is in a wheel chair, cannot stand on her own, and is basically fully dependent on others for everything. She’s in assisted living right now but is miserable because all the residents have mental health problems like dementia and she says she has no one to talk to. I go once a week because I’m working, in school, and raising a family. Anyway, she is still mentally young and is just very unhappy. She makes just enough monthly for the facility she is at now. All the other places are too expensive. But I don’t know how long she will last there because she requires so much care physically. I want her to get into a long term care facility, but she can’t afford it and due to my dads pensions she is not in the poverty level. I’m not sure how to get her on Medicaid. I can’t have her live in my home because she also has OCD, depression, anxiety, and she also lashes out at caretakers. I won’t have that in my home around my young kids. I also have a back injury and can’t lift her. I am just looking for some advice, steps I can take to get her in a facility that better meets her needs and how we can navigate that financially. TIA

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It sounds like because of her personality, she won't be happy regardless of the facility (sounds like she wasn't happy at home either), so just leave her where she is if that's all that can be afforded. She sounds like if she doesn't need skilled nursing now, she will soon.
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Has the AL said anything as they she needs a higher level of care? If so, I’d ask for a needs assessment to be done, so you know exactly what type of place,ent she needs.

But if that hasn’t happened, so this is abt dealing with moms concerns... What are her medical issues..... she’s not ambulatory but can she “transition” on her own from bed to wheelchair or wheelcHair to potty?
can she do anything to dress herself?..... she can in her wheelchair use a grabber to pull together her clothes in a closet for the day and fix her face & hair? Can she pay attention to a TV show, read the newspaper and have a conversation on current events? Can she feed herself?
Will she on her own take her medications on schedule? & If she’s on psych meds or behavior meds, if she takes them as prescribed is she social and cooperative?

if yes on these, I’d try to look for a board & care home. They often fall in a grey area for having to be licensed by the state as they are too small - at 6-10 beds total - to require it and the higher # of reportable to the State nursing staff. So they won’t be on a statewide list of elder living options. Often board & care are found via word of mouth or in church bulletins. Your Area Council in Aging probably has a list somewhere on board & care homes. They usually cost less than AL but will be private pay. Most of them take residents who are just “custodial care” but some will take a younger resident with higher medical needs but otherwise are still very competent and cognitive.

as a tangent on this, all the facilities have activities & outings. Is your mom making any effort to be a part of them? Even if she’s in a wheelchair she still can be involved in things. Is she doing this? Did she get any type of grief / bereavement counseling after her husband’s death?
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Charcey Apr 2021
When she first got to the AL she came from SNF due to wounds. The AL said they didn’t realize she was so disabled, but wanted to accommodate her needs. They do the best they can. The SNF didn’t put much on her chart about her medical issues. She has very advanced RA, she never treated it after being diagnosed at 50. She would not admit she had anything wrong. And she only tried one medication and didn’t like the side effects, which were tolerable, but she didn’t want to see it through. All her doctors she felt didn’t know what they were talking about. She took supplements, which did nothing. Then she got osteoporosis. And has scoliosis. Which has curved her spine so much her neck is falling to the side. It is pretty bad, she basically refused to go to a doctor for anything unless she had a problem that she needed to go to the hospital for. She would literally say she would rather die than go to the hospital. But being that she was of “sound mind,” no one could force her to seek help. My dad did his best, but caring for her brought on his health problems. So, at this point she is unable to walk or stand up on her own. She needs to be lifted for every transition. She can assist someone who is dressing her minimally. She has very little strength, so can’t open things and has barely any grip strength, etc. She is hard of hearing. She can’t cook for herself. She pretty much needs someone around 24/7. Imagine laying in bed all day or in a chair and only being able to reach things about 10 inches away on your own. That is my mom. She doesn’t have strength for a grabber, we got her one years ago and she refused to use that cause she was embarrassed. She is quite vain and when she became ill refused to go out to even get the mail. I was 12 at the time and basically lost who my mom was then. She let her illness take over and became depressed and just didn’t want to fight. She refuses pain meds stronger than tramadol and won’t take anything that might help her psychologically. My mom is a difficult person in pretty much every way. I like the idea of a small home or group home. We have a couple in my town I could check out. But I’m not even sure if that would be a fit for her. She’d find something wrong no matter where she is. I just want to know her needs are being met. And for her to have a couple friends. It is a lot for me being her only outlet.
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I don't think ur Mom would like a LTC facility either. These people are worse than those in ALs. Some ALs have a MC attached. This separates the residents.
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Charcey Apr 2021
Yeah, I get that, I think that is the problem with the place she is at. The MC residents are not separate. But it is also very small. Like only 15-20 residents there. I live in a small town and wanted her close, it was basically the only option. But I might have to find somewhere else eventually. Thank you for your answer.
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Thank you for your answer. I am my moms POA and have been trying to find an elder care lawyer in the area. I’ll discuss it with my mom too, since my dad passed she seems more willing to cooperate with getting help for herself. When my dad was her caretaker she refused to seek medical care for her ailments. It wasn’t a good situation.
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A more expensive facility won't necessarily have fewer AL residents with dementia, but I understand what the concern is. I don't live in CA but am wondering if a group home for the physically "less abled" is something that exists? One for people of equal mental abilities. Also, I highly recommend a consultation with her and you (or her PoA) and an elder law attorney/estate planner who has experience with Medicaid for your state to discuss if and when she can qualify. It is a worthwhile investment that will take about 1 to 2 hours.
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Charcey Apr 2021
Thank you for your answer. I am my moms POA and have been trying to find an elder care lawyer in the area. I’ll discuss it with my mom too, since my dad passed she seems more willing to cooperate with getting help for herself. When my dad was her caretaker she refused to seek medical care for her ailments. It wasn’t a good situation.
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