Hello-I have been caregiving for my mom with dementia for 13 years now. She is at a point where she needs Memory Care. She was denied Medicaid. My sisters help on and off on weekends with no consistency. I am told I cannot force their help. Mom's dementia has become a safety issue for herself and my family. She is violent at times with my kids. She is mean to us but very sweet to everyone else. I told my two sisters everyone takes mom for a month giving the other two a two month respite. They refuse. We decided we would pay out of pocket. I did all the necessary paperwork needed by mom's doctor, It took three appointments. I had mom assessed for a facility my sisters found, I sold my big house for a smaller one to insure I could make my share of payment. Then on the day they were supposed to sign her in, they decided neither of them wanted the financial responsibility. So here I am, in a smaller house. Mom is sleeping on a couch living out of a suitcase. I am burned out. Does anyone know anything I can do to get mom the help she needs and deserves, or if there is anything I can do to force my siblings. Thank you
I hesitate to say this because I have recommended it before and I loathe it. But you are down to what we call
THE ER DUMP.
You will have to take your mother to an ER. You will have to say she cannot return to your home, that she at this point constitutes a danger to your household. She will be admitted and assessed. You will get in touch with hospital Social Workers on DAY ONE and make it clear. No argument. No listening to the platitudes of "We can make this work" "we will get you help". They can't make it work and they won't get you help. Have the finances ready to give to Social workers. All Mom's assets and all her bills. Let them know you cannot take her and if they wish to have her put on State Guardianship through the courts that is fine.
Give your Sisters one week notice that this will happen.
This sounds cruel. But what you are going through cannot work and no, there is no way you can force your siblings. In fact I agree with them. I would not attempt to care for your mother in my home were I them. I would not spend my savings on your mother when I will need them (sorry. So sorry) for myself.
I couldn't be more sorry but you are down to bare bones reality now. This cannot go on. If you need to give over guardianship of your mother you will have no control on where they place her, but she will receive care. Many elders don't have children. Many people don't have sisters. That's about where your Mom sits now. Everyone has been all used up.
I am so very sorry. I hope you will update us. Please spare yourself further speaking with your sisters until you have a plan. They are not obligated to care for your mother. They do not intend to do so. Nor can you anymore.
Remember, the Social Workers and hospital want to/will do and say ANYTHING to make you take your mother back home to this life you and she have. Do not allow that to happen. 13 years. You have given up more than a decade of your life. This could go on a decade more if you allow it. What will be left of you? To say nothing of what will further attacks do to your children? Why must they live this way for no reason.
We all wish that there was some simple, peaceful, comfortable way to resolve conflicts, assuage guilt, provide humane care, all of that. THERE IS NO WAY, except as detailed above.
Your Mother has dementia and additional physical issues, of her three daughters you are the only one who has cared for you, you have paid your dues, it is time to MOVE TO A NEW PLAN.
Hopes and best of luck that you have the courage to make the only choice that will benefit all of you.
You absolutely should not have an unpredictable, abusive elder in your house abusing your kids.
Your mother shouldn’t be living with any of you at this point by the sounds of it and while I know how difficult that is to accept, especially for you who has been her primary caregiver, you said it yourself the current situation isn’t safe for your mom or your family, you might even want to consider putting mom in the hospital for observation (and safety) while you figure out the next step, this won’t give you much time but it will alleviate both the safety issue and the issue of mom on the couch for a few days as well while you find an attorney and make a plan. Only you know if this is the time to make the hospital move or not, it is not something you can keep doing so you might want to keep it in your back pocket too.
Check into a Miller Trust aka Qualified Income Trust.
This is what will get her income lowered to be approved for Medicaid.
Go to www.nelf.org and find a certified elder law attorney in your area, they will know exactly how to help you get her qualified. Please don't use your money to pay for mom. You and your family need this.
Best of luck and I would never trust those siblings again, that is rotten what they did.
I want to particularly stress that you are NOT to believe anything any hospital SW (or anyone else) says about they will help you "make it work." No, they will not. They just want her OUT of the hospital and to be YOUR responsibility. You see, when THAT happens, they are off the hook! And easier than making the many phone calls and arrangements to find her a facility. Do NOT let them guilt you into taking her back home.
There is nothing anyone can say to give you help on how to guilt your sisters into sharing payment for a facility for your mother. Most here agree that your sisters should NOT be paying....but neither should YOU be paying!
One question - you say your mother is violent towards your children. How old are they?
With a Miller trust, the extra money goes into it. When Mom passes, that money reverts back to Medicaid. I know, weird but thats what u would need to do.
Tiredmooma, it appears North Carolina has such a convoluted system! They don't do Qualified Income Trusts, but what have a deductible system in place for those that make too much monthly for Medicaid. Basically from what I'm reading it all works out the same, your Moms income goes toward her medical bills and the state will pay for the rest (as long as she is deemed medically needy). In your state, It is just set up in a weird way involving paying deductibles every 6 months that seems too complicated. But ultimately the state will pay the difference. You need a good county social worker to help you place Mom, but if that service is lacking then you may need to drop her at the hospital.
Also, another comment you made talks about spend down, etc. OP's mom has no assets to spend down - rejection was because mom's income (gross) is over the Medicaid limit in NC.
My mom was in a very nice facility for $2900/mo. Fortunately, her assets did hold out until she died so we never had to address filing for Medicaid.
Another option, find her a senior apartment, maybe one that accepts HUD payments.
OPs mom brings in $1400 month from SS and a pension. OP has her own children and retirement to think of. Making up the difference is a bad idea.
I took a minute to do some lookup out of curiousity. Wow, is NC cheap or what? WHO could live ANYWHERE for $1,005/month??? That was the limit I saw listed in the following (this link lists ALL states, updated 9/2/19, so could be useful to many of you):
For ANYONE:
https://www.policygenius.com/blog/a-state-by-state-guide-to-medicaid/
This provides a lot of information AND includes (as of 9/2/19) requirements by state. Check it out.
For NC, OP's home state:
"Income requirements: For the aged, blind or disabled, or caretakers of someone with those characteristics, your income must be within 100% of the FPL — $1,005 per month for a one-person household,"
How ANYONE believes 1k/month would cover LTC is beyond belief! Even the amount OP's mom has for income is not going to cover LTC. It wouldn't even cover expenses to live under a bridge or in a cardboard box! WHAT are they (government who makes these decisions) thinking and/or what rock do they live under???
P.S. reminder to all - mom has NO assets, so there is no "spend down" AND OP stated Miller Trust is not an option in NC.
Many EC attorneys offer an initial free consult. Try some others - not just a regular attorney, but those who only do elder care. Perhaps there is one out there who could guide you, rather than just telling you what isn't available to you for help.
Referring back to the link I posted, part of the problem is this:
"President Barack Obama’s health care law moved to standardize Medicaid requirements, specifically so any American making up to 133% of the poverty line could qualify. But that provision was challenged and overturned by the Supreme Court. States could expand Medicaid, but they no longer had to. Thirty-three states (plus Washington, D.C.) did; 18 didn’t. And eligibility across states has gotten even more diversified since the Trump administration announced it would allow states to impose work requirements for low-income and needy Americans receiving Medicaid."
Apparently NC is one of those states that suck in that the article says: "The state has not expanded Medicaid to cover all needy adults."
I found the following on the North Carolina Medicaid website. Look at what it says for the “medically needy”, which I assume your mother is. Yes, NC Medicaid will pay for a nursing home for your mother. They require you to pay what you can, then they cover the rest. She will get to keep $30.00 per month for personal needs.
I found this information on my first Google search. Have you contacted Medicaid yet? Please let us know. You sounded so desperate.
Income Limitations – The applicant’s income must be less than the cost of care in the facility at the Medicaid rate of pay. Medicaid must approve the level of care requested and the applicant must use part of their income to pay for care services. North Carolina calls this “patient monthly liability.” If single, but not medically needy, the applicant’s monthly income (wages, Social Security benefits, pensions, veteran’s benefits, annuities, SSI payments, IRAs, etc.) must be no higher than 100% the Federal Poverty Rate. If medically needy, however, Medicaid will pay all long term care costs exceeding the applicant’s countable monthly income. Income that is not considered countable includes a personal needs allowance ($30.00/month per individual); health insurance premiums and medical expenses not covered by insurance or other benefits; certain spousal or dependent family members’ allowance; and a home maintenance allowance if the long term care recipient expects to return home within six months, but there is no one living in the home.
National Academy of Elder Law Attorneys
https://www.naela.org/findlawyer
naela@naela.org
NAELA Council of Advanced Practitioners
1577 Spring Hill Rd., Suite 310
Vienna, VA 22182
703-942-5711
naela@naela.org
Personal recommendation in Colorado:
M. Carl Glatstein
Glatstein & O'Brien LLP
I have only read the first few answers, but as your mother has no assets and only $1400 income, she in NO WAY, should NOT qualify for Medicaid Long Term Care. I work in this field, and although it does vary state to state, basically the income limit is approximately $2000 monthly. If she owned a home or a car, that would not count. But as you said, she has no assets. It may be expensive but seeking help for an elder care attorney could help get the process started more quickly. An alternative is to contact the Area Agency on Aging for your area. Google it. Call them .... they will help you file the paperwork for Medicaid LTC. It needs to be filled out very, very correctly.... and is many times difficult to understand to try to do it on your own. It can take a long time to get onboard and in the meantime, if you need to get your mom out sooner, what Alvadeer posted at the beginning is the BEST and "only" way of getting things done RIGHT NOW.
If you won't think of yourself, then do it for your children. You have given of yourself for a very long time. It is now time for you to have the help of LTC so that you can still have a life, and your mother will receive care. Be strong. Do it now, so you can still live.
Not in NC, at least not on their main web page, however the site is geared more for getting insurance - I poked around but could not get any information as to what the LTC max income was - everything points back to the $1,040 listed. The only thing I could find is that they will "evaluate" your. The 2k you refer to is generally the maximum amount of assets you can have each month - mom has NO assets, no house, nothing but pension and SS.
Given that OP has applied and it was denied based on mom's income, it would appear that the $1,040 listed on the page applies for LTC as well?