Mom fell in March. Broke right pelvis in 4 places and broke 4 vertebrae. Stable breaks, so no surgery. In hospital a week then transferred to what was supposed to be a critical care rehab with 5x/week OT and PT. Long story - short they didn't do much of anything with her in that place. MAYBE PT 2x/wk and OT a few times/wk. Never saw the attending dr in person and only saw the pain dr once, and that was on day 2.
After 21 days, she was kicked out by some insurance snafu caused by the rehab place (because her insurance didn't put a limit on the approval). I lost the appeal to keep her in, God intervening because I didn't know how crappy they were. With COVID and her fragile state, we transported her home via EMS because after 21 days of "rehab" she's now bedridden where before the fall she was supervised assist. Now she's total assist.
She's weak as hell. more so that after her stroke 2 years ago and breaking her femur last year. She's bounced back before, but this time I don't think she will. Also, her will to live is worse than ever. I'll be shocked if she lasts 6 mos.
So, we're using all her money to pay for a private aide (2hrs/day) and incontinent supplies (she's not incontinent, she just can't get out of the bed to a potty chair) and OTC medicines that insurance won't cover (cause she has bedsores after being on her a$$ for a month).
The home therapists have gotten her to transition to her wheelchair by the end of the first week home, but I'm witnessing that this is done with extreme difficulty. It's painful and she can hardly bear weight on her right leg, which is also her Polio leg. She can't tolerate being in the wheelchair for more than 90 minutes because she can't hold her head up any longer than that. She's refusing to eat all her meals and drink her fluids. She's gone from 143lbs to 129lbs since she's been home. 143 is her normal weight and that was what the rehab said she weighed. Though idk how they weighed her since they didn't get her out of bed and their beds dont have scales.
We received notice that her name has moved to top of list to apply for Texas Star Plus Program, which incl applying for Medicaid. Going back 5 years to document "gifting" to/from her and her transfer/transactions of any assets is turning out to be a pain. The form asks about furniture or household items. etc, not just big ticket assets. Mom has gifted furniture to family, and my brothers and I have bought a lot of stuff for her. (is that stuff ours or hers?)
She has debt from a bed she no longer uses - do I report that? I know they want all this financial/transaction history so they can 1) qualify her with or without penalty, and 2) so they can seize whatever they can upon her death to recoup the govt expense.
Some items Mom has refused to let go of are family items passed to my dad, thus her since he's gone, and were to be passed on to the next generation. Some things are nice, but if I offered them on Ebay. Nextdoor or Facebook. we'd get peanuts for them. Is there a value threshold for reporting these items, gifted or not yet gifted?
Also, given her current condition, I feel like my time would be better spent investigating and planning for hospice care that may be needed sooner than later. If accepted, they SAY they'll pay for diapers, OTC supplies and custodial care aides to come to the house.
I'll believe it when I see it. I've been lied to about benefits only to find out these companies and orgs don't pay when the rubber hits the road.
Does Medicaid help with hospice expenses?
Is all this worth it?
Any experience/stories yall have had in applying for these type of programs and Medicaid would be appreciated. What would you do if it were your Mom and she is too tired to live, but not ready for hospice yet?
If a DNR is in place, you may be able to include no transporting to a hospital.
tried Rehab for 19 days -- also got bed sores because the NH didnt mess with her much- try hospice
Hi neighbor! I think about you and your grandmother. You’re still in my prayers.
You are a lovely granddaughter.
I adored my grandmother. She was the sweetest woman and certainty one of the best cooks in Louisiana! Just about everyone’s mom and grandma are excellent cooks, right?
They will continue with her medication because she is failing to thrive and that would be what qualifies her for hospice, so no meds will be taken away.
I am so sorry for your family, this is such a difficult time to go through and our elder loved ones fail so quickly.
I am a bit upset that they tried to rehab her to soon with so many breaks. That is just wrong.
My mom recently died in hospice. Hospice caregivers are angels. They went above and beyond for mom and our entire family.
Do one hesitate to utilize their services. If a hospice house is available, please take advantage of it.
Will keep you in my thoughts and prayers.
Also, keep in mind...you can contact Hospice, talk to them, see what services they will provide, etc, and still not engage their services. It doesn't keep you from calling them again at a later time, and it will provide you with more information as you go forward.
I had reached out to hospice about 1 month before I actually engaged them for my mom. When I first called them, her cardiologist wanted to try one more treatment for my mom to see if it would do any good for her, and since it was considered "life extending", mom didn't qualify for hospice at that time; but they spent over an hour on the phone with me answering all of my questions so I had the information going forward. It really helped my mom make the decision to stop the treatment plan without trepidation for either of us.
I can't give you any practical advice on applying for Medicaid, but I would encourage that you reach out to hospice and explain all of this to them. I think in your circumstances, the more information you're armed with, the better off you'll be.
So, she's getting better again.
I had a heart to heart talk with Mom last night and told her I was confused as to why she always states she wants to die. meet Jesus, etc., but then opts to take the bp pill to prolong her life. She said that lots of the time she wants to die and be done, but other times she doesn't want to die.
Bottom line is Mom is as confused and conflicted as I am. I did make a point of telling her lovingly that we're all ok if and when she choses to let go, it's really ok and we'll be ok, we love her. I know Mom, she's a fighter when she chooses. I've always said she'll go when she wants.
I'm still calling about hospice and making that plan.
And I think now it's worth completing the app for the program and Medicaid.
Every day is imperfect, but precious.
My mil transitioned to hospice from home health care within the same agency on the day she told the doctor, "I'm tired of trying to get better. I don't want to do exercises any more. I'm tired." He asked if she realized that with that statement she was choosing to let herself enter the dying process and she said yes. At that point, her care changed from the goal of getting better and returning home to acknowledging she wasn't going to get better or go home and keeping her comfortable and cared for until she passed. Mil loved the aides that came and gave her baths and kept her company for a short while (because she sure did get tired of seeing our faces all the time, lol). She'd get up in the morning and ask who was coming to see her that day. And I had the assurance that if something unsettling happened, hospice was only a phone call away. Between home health care and hospice, mil had their services for the last 7 1/2 months of her life.
My mom was also on hospice care because we discovered dad was unable to be as responsible for her as he should have been and that brought to light the need for outside involvement. They were both resistant but we (and mom's dr) encouraged them to do the interview and see if they qualified. When dad found out it was not going to cost him anything, his whole tune change. Mom did qualify and she was on hospice care for over a year before passing.
All that to say not to wait until the last moments of life to set up hospice.
If she can qualify for hospice care Medicare pays for it and whatever a person's secondary insurance is (even if it's Medicaid) will pick up the 20% that Medicare doesn't pay. What sometimes happens is a person graduates out of hospice because it gets determined that they are no longer in need of it. I've seen that happen. Not only with my own father who was a total invalid from a stroke and not able to live outside of a nursing home, but with a homecare client I had. She was completely invalid for years. Basically a vegetable. Then she went on hospice for a few months which was paid for. They graduated her out of it because custodial care was enough. She died almost three years after being in hospice care. Then private-pay caregivers had to return. It was better in the long run because the family didn't have to hand her home and her money over to a nursing home.
Your best bet is to keep anything state-funded or related out of your mom's life unless it becomes necessary to put her in a care facility. No matter how good they make some program sound, it is not free.
As for the state of Texas wanting an inventory of the interior contents of a house. That's outrageous. Let that be your cue about how serious the state will be about regrouping every cent spent on mom.
If I were you and mom has a house full of nice furniture and things that the state wants a record of, I'd take everything out of that house and put it into storage. Then go down to the Goodwill, some second-hand furniture store, or hit up tag sales and refurnish the house with whatever cheap crap you can find in case the state wants to come and look around.
Then you report this stuff to the state. Good luck.
Then you report this stuff to the state."
Nobody wants strangers poking around in their home but what you're describing here is fraud.
When my mil was in NH ,and passed away, we had to pay back Medicaid. Since there were 6 kids and the payback was divided by 6. We didn't have to pay back the full amount that Medicaid had paid but did repay partial. Or Medicaid would have taken her property. Any assess would have been taken by Medicaid..
Yes .Medicaid does pay for incontince supplies, medicine,etc. But you may have to pay Medicaid back.
It may be to late to sell her asesses .because there is a time limit between selling and passing.they will say you are selling in order to hide her assets..
Whhen you do sell her things you say some are nice. Have an antiques place come out and give you a price for there worth.maybe get two or three examples then take the best price. You may be surprised as to there worth or what is worth anything. Good luck.
However, I'm glad her situation has improved such that this isn't an issue, at least not for now!
The hospice diagnosis is covered by Medicare PT A. They provided dad with wheelchair, hospital bed, incontinent supplies, meds, bath aid, RN and LPN, and therapies - music. I loved each and everyone that dealt with dad, they dealt with him as a person with dignity. They answered questions. When I received a couple of bills I check with the adm of the hospice and they took care of one and said the other was dad's responsibility and explained why. As I was dad's POA, the RN or LPN would call me every couple of weeks to keep me up to date on dad's condition.
If anything is prescribed outside of the hospice diagnosis, then it will be your mother's responsibility. Dad had an upper respiratory infection and the meds prescribed were dad's responsibility.
I will say that dad ate and drank less as his life was coming to an end. Hospice told me this was not unusual as the life came to an end.
I'd do hospice first then work on medicaid. I don't know about TX but there was a lot of paperwork to collect to submit with the application. If I remember rightly regarding gifting we were asked about the amount of gifts given but only required to submit a year's worth of financial information. You will need to check with TX about any specific information required by them, or check with a medicaid or elder law attorney.
I wish you and your family the best.
Bank accounts - or other financial documents - are going to show bills she paid and money she gave away. Giveaway is the key word. That's what creates a penalty for her.
In Texas, the current penalty amount is 213.71 per day. So if she has given away $10K over the past 5 years, they will divide that by the penalty amt to determine how many penalty days count against her. She won't be eligible for services until after that penalty period. If you're aware of large gifts to others, just do the rough math yourself and figure how long a penalty period there would be. That might help you decide.
If she has adequate money to use for her own care then use it. Just keep track of where it is going each month - receipts, what it was for, etc. At least you will have the recording process started. It wouldn't hurt to go ahead and gather the 5 years of past financials so you have at least started the process in the even you do need Medicaid/Texas Star to assume the cost of care.
Here's a link about resources (banks, land, homes, personal). Go down to section 4222 - tells you about personal prop. https://hhs.texas.gov/laws-regulations/handbooks/mepd/chapter-f-resources/f-4000-liquid-nonliquid-resources
We have a video appt with Mom's PCP on Monday. I'm going to ask about what happens to her care if Mom goes on hospice.
The real fraud here is the state expecting an inventory of personal possessions (and home furnishings fall under being personal possessions) of a sick person in need so they can appraise them for sale like it's the Antiques Roadshow. That's disgusting. It's obscene.
Does the state of Texas send some official to an old grandmother's
house wearing a loop to appraise the value of her wedding ring too? Maybe they grease it off her finger first?
No, putting the good furniture into storage isn't fraud. It's letting a person and their family have some dignity so they won't have to be completely beggared by the state because an elderly person gets sick.
If this is how the state of Texas operates, this family would be better off borrowing from a mafia capo. They'd certainly get a fairer deal then what the state is offering.
So please. Take your self-righteous, sanctimonious BS and stick it where the don't shine. Or better yet, put it with the furniture.
If you hide assets and collect services based on false information it is fraud, whether anyone agrees with that or not doesn't make any difference, it is still fraud and should be punished. The system is not intended to pay for services so entitled people receive an inheritance, that makes it unsustainable and injures those that really need help.