MIL refuses to consider assisted living and she is 100% mentally competent. She briefly worked in a nursing home (she was an LPN and then went on to do in home live in aide work until age 66) and she made H and I promise we would never put into a home. We took her to visit the one my late aunt was at, which was very nice - assisted living, not a nursing home, and she refused to consider it. In addition, she really doesn’t walk much at this point and the ALF’s in my area seem to want you to be able to walk, even if with a walker or a cane. They don’t want wheelchairs. So we are stuck.
We may have an offer on MIL’s house from someone who doesn’t care if we fix it up, just empty it. If we can move the two of them closer to us, I will put SIL on the list for senior housing out here and when MIL passes (or sooner, if SIL makes it up the waiting list), I can move her. THere is no way I am going to be responsible for her in a house I own.
@techmom99, it’s tough when there aren’t many attractive options and there are complicating sibs as well. My folks insist there is only ONE SR community they’d consider. They’re on the waiting list and have been there for years. No idea if and when they’ll ever get off. No idea if they will still qualify to live there if they finally clear the waitlist.
Meanwhile, their health is slowly continuing to decline and their sense of time is getting increasingly vague.
Their house is way too big for them but they are used to it. They only want to move once and who know when and if that will happen.
@psychmomma Goodness! Thinking of you. In our experience, Medicare Advantage plans are the most difficult to work with when it comes to rehab. Usually, straight Medicare allows the full 90 days. With the Advantage plans, they have someone watching and rewarded with earlier discharges.
@techmom99, I understand this is a hard conversation, but why should she get to decide not to consider assisted living? She doesn’t get to dictate what everyone around does to take care of her. If she can’t take care of herself and can’t afford around the clock help, her options may include which AL or NH to move to, but not whether to move. I hope you and your DH can stay strong on that.
In my state, AL requires that the residents be able to transfer out of bed and get themselves to the meeting point for an evacuation within some time, a minute or 2 or 5, I don’t remember. That means remembering that they have to do that, and being able to hear the warning siren and instructions over the PA. If they can’t do that, then they can’t be in AL.
If one wants to avoid a AL or nursing home or similar, one has to be able to perform the tasks of independent living alone or by hiring help. If one doesn’t have the finances to pay to hire the help, one has to look at the other options realistically unless someone (like YOU) are willing and able to pay the bills as they pile up. 24/7 care is VERY expensive, even if the care needed initially is fairly minimal.
If I refused to take her, she would need to go into a nursing home, which requires prepayment for the month, has to have a bed available, and has to accept her (if they can handle whatever her issues are). Her money is in her house, which is the house I’ve been trying to clear out enough to have a realtor come through.
If the elder will be full pay, check into Board and care homes, they are often half the price of the SNF, assuming it is full pay for the senior’s entire life.
And I like what MomofJandL said, good for MIL for saying what she wants, as long as she can make that happen, but you are not bound by that if you have to become involved.
My MIL can’t do the transfers anymore and needs help bathing, etc. so she doesn’t really qualify for AL. I am not sure what a board and care home is, but she can’t be full pay. Her only income is $1100/month in social security and her savings, meager that they were, have been depleted by her daughter. To put her in a nursing home, Medicare has a 5 year look back and her house equity would become a lien. She has Medicaid in home which provides her with an aide 7 days a week, plus she has meals on wheels, Rx coverage and the like. Her health is pretty good except that she really can’t walk.
I would like to move her closer to us, which would entail selling her house and buying a different one. Due to the lookback, a nursing home is out even if she would agree to it. We are looking to sell the house, but SIL is the issue. We have evicted her so many times over the years (she is abusive, an alcoholic and a drug abuser) but mom keeps letting her back in. She tried to keep us from listing mom’s home by calling the police and trying to get them to tell H and I we couldn’t sell the house and evict her because she’s a senior citizen (she’s 63) - the officer told her, tough, your mom is a more senior citizen and she has every right to sell her home. H is a real estate attorney so, believe me, every aspect of this sale will be kosher and intended to protect mom’s interest and support her as long as she lives. We are looking to buy a cheaper house than what she has and to use the difference to cover the increased taxes and to give her some splurges. She has told me that she would like to give my kids some money for their birthdays, which she hasn’t been able to do for several years (since SIL moved back in with her). It was only $25 a kid but it meant alot to both her and the kids.
If it was only my MIL, I would take her into my home in a heartbeat, but she won’t part with her daughter and none of us want SIL in our house. She has tried to use my sons to pick up her meds and buy her liquor and cigarettes. She is verbally abusive. It’s sad. My two oldest children both used to have wonderful relationships with her but they now both avoid her. I no longer pick up the phone when I see their number show up on caller ID.
I feel badly about this because my MIL has been good to me, in fact, better than my own mother was. My SIL is a brilliant woman, amazingly well read and knowledgeable, a true beauty in her day and a talented singer and dancer. She is a waste of a life, it’s heartbreaking. She is a drug abuser. I don’t hate her, I pity her but I can’t have her in my home.
I hope that we can get a new home for MIL and that I am successful in getting SIL into separate low income senior housing. The two women are so co-dependent it’s not funny.
@techmom99 - I am amazed at the multitude of variations on this eldercare dilemma. Each family situation is truly unique based on the combinations of personalities, locations, physical/mental capabilities, and financial situations of the major players. I feel sorry that your MIL can’t break free of your SIL. It has to be heartbreaking to have a child (even a grown adult child) with substance abuse issues.
@techmom99, how about your MIL living in an apartment rental or a condo near you? That would leave more funds available to provide care for your MIL. I agree that your SIL needs to get into her own place and stop leaning on and mooching on your MIL.
@techmom99, I think every state is different, but if your mom has Medicaid in home help, wouldn’t they go after any profit from the sale of her home? Wouldn’t they consider it assets and would that put her over the threshold for eligibility?
Divestment and estate recovery are issues for Medicaid, not for Medicare. Medicaid pays for some types of long-term care and some types of community-based care. It has income and asset limits. Medicare pays for hospital care, outpatient care, and some in-home nursing services. It has neither income nor asset limits.
If Medicaid is paying for in home care services, (not Medicare), and a house is sold with a realization of increased assets, won’t Medicaid either go after those funds or drop the person from eligibility?
@ECmotherx2, some states will go after the estate when Medicaid benefits have been used. They do in my dad’s state (GA). Not sure about my FIL’s (NJ). This seems to be a relatively recent thing as a means to recapture payments made from the system.
At least in Georgia, there are some modest restrictions before they seize assets. They also don’t do it until after the recipient has passed away. Had to research this on behalf of a sibling and the impact a marriage would have on his spouse.
So I am at a new stage with my parents who both have dementia and are living at a CCRC. My mom, the least demented parent, was evaluated by the doctor and feels that she is not safe to make decisions in an emergency for herself, much less make decisions for her husband. She has ordered an evaluation for companion services. Has anyone had companion services for their very physically able but demented parents? Unless the companion is there for 24 hours, I don’t see how this will help. It’s not like you can re-orient someone with a 5 second memory. But 24 hour companion services seem silly for people who still walk to the dining room on time every day. But, it will be helpful to have someone check in once a day, maybe help them get lunch together, and make sure their needs are met.
I’ve tried to talk to them about wearing their necklaces with a button to push for help. Mom will, but the necklaces and their function confuse dad who doesn’t understand how they work.
Sorry this is a little rambling, but I can’t figure out what the companion would actually do and they, my dad actually, will really hate it.
We haven’t been in that situation, per se, @GTalum - but what is the downside in trying it? How many hours a day would it be? Maybe this person would be companionship for your mom (?).
GTalum, I’m so sorry. Just when you think everything is stable, it isn’t. All I can tell you is that my dad fought hard against having someone in the house with him and my stepmother, but it turned out that he really enjoyed the company and the release from feeling responsible but inadequate, 24/7. The aides were lovely people and knew how to make themselves as inobtrusive as possible.
Thanks all, I meet with the social worker next week to work on options and details. Quite honestly, I wanted an assessment to see if in home (really just an apartment) companionship was needed. It was nice that the doctor ordered it so I can say, “it’s not my decision, it’s the doctor’s.”