Dad may need nursing home or alternate solution

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genjix
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Dad may need nursing home or alternate solution

Post by genjix »

My father's mental health is deteriorating where he takes random walks, goes to supermarket without a wallet, yells at random people. Unfortunately he doesn't qualify for Medicaid and the cost of a nursing home is too much for us. Anyone have ideas or options we can explore?
stan1
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Re: Dad may need nursing home or alternate solution

Post by stan1 »

Spend down his assets until he qualifies for Medicaid.

Does he have a spouse? If so seek out an elder care attorney.
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RickBoglehead
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Re: Dad may need nursing home or alternate solution

Post by RickBoglehead »

He should be assessed for dementia / Alzheimer's.
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123
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Re: Dad may need nursing home or alternate solution

Post by 123 »

Contact your local adult protective services or your local police department. They will make any necessary arrangements for his care and likely conserve his income and assets to prevent exploitation or financial abuse.
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genjix
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Re: Dad may need nursing home or alternate solution

Post by genjix »

stan1 wrote: Fri Jul 23, 2021 12:12 pm Spend down his assets until he qualifies for Medicaid.

Does he have a spouse? If so seek out an elder care attorney.
He has a spouse. Attorney said they look at past 5 years of income and asset so he won't qualify even if assets were spent
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genjix
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Re: Dad may need nursing home or alternate solution

Post by genjix »

RickBoglehead wrote: Fri Jul 23, 2021 12:15 pm He should be assessed for dementia / Alzheimer's.
If he is diagnosed for one of these, would he qualify for nursing home?
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Re: Dad may need nursing home or alternate solution

Post by Mlm »

genjix wrote: Fri Jul 23, 2021 12:48 pm
stan1 wrote: Fri Jul 23, 2021 12:12 pm Spend down his assets until he qualifies for Medicaid.

Does he have a spouse? If so seek out an elder care attorney.
He has a spouse. Attorney said they look at past 5 years of income and asset so he won't qualify even if assets were spent
Not true. Find a qualified elder care attorney
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genjix
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Re: Dad may need nursing home or alternate solution

Post by genjix »

123 wrote: Fri Jul 23, 2021 12:16 pm Contact your local adult protective services or your local police department. They will make any necessary arrangements for his care and likely conserve his income and assets to prevent exploitation or financial abuse.
Is APS for someone who is at risk from his own family? Just to clarify family members wouldn't be of any threat to him, physically or financially.
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Re: Dad may need nursing home or alternate solution

Post by RickBoglehead »

genjix wrote: Fri Jul 23, 2021 12:54 pm
RickBoglehead wrote: Fri Jul 23, 2021 12:15 pm He should be assessed for dementia / Alzheimer's.
If he is diagnosed for one of these, would he qualify for nursing home?
If he's diagnosed with dementia or Alzheimer's, then you should be able to get a doctor(s) to determine if they feel he is able to make his own medical and/or financial decisions. If they certify that he cannot, then if he has a medical POA or financial POA, the person noted in those documents can take things over. If he doesn't have those documents, then you can petition the courts to be appointed his Guardian. This protects him from financial predators, as well as assigning responsibility for his care decisions to someone capable of making them.

As for where he should stay, if he doesn't qualify for Medicaid, then the financial burden falls to his assets. That's what people save money for, to care for themselves in retirement.
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Re: Dad may need nursing home or alternate solution

Post by anna.day »

I would highly recommend consulting with an Elder Care Coordinator or Geriatric Care Manager. I would call several (like, at least 5, maybe more) to get a sense of whether you are a good fit personally, and their background and experience. A competent Geriatric Care Manager will likely charge by the hour, and will be able to offer advice on what level of care is needed, suggestions on how to arrange for that care, etc. etc.

From what you describe, it may be that your relative can be cared for at home with professional help; may benefit from an adult day care; or some other solution that is much cheaper that full care at a nursing home. Consulting with a Geriatric Care Manager will not be cheap, but it will be well worth it to get a sense of your options.

Edited to add: I would also absolutely get very good medical advice to determine what exactly is happening with your relative. A correct diagnosis will be very important to mapping out what the future looks like. If you live near a major university hospital, they may have a geriatric care program that is a wrap-around program, to provide a full range of services. Even if you do not, I encourage you to be proactive about insisting your relative be thoroughly assessed to determine what is causing these symptoms. There are many, many factors that could cause what you are describing, and it's *very* important to understand what is happening with his health before making decisions about how to proceed.
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JoeRetire
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Re: Dad may need nursing home or alternate solution

Post by JoeRetire »

genjix wrote: Fri Jul 23, 2021 12:04 pm My father's mental health is deteriorating where he takes random walks, goes to supermarket without a wallet, yells at random people. Unfortunately he doesn't qualify for Medicaid and the cost of a nursing home is too much for us. Anyone have ideas or options we can explore?
One he spends down his assets enough (by paying for his care), he'll qualify for Medicaid.

I'm assuming he doesn't have any Long Term Care insurance?
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genjix
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Re: Dad may need nursing home or alternate solution

Post by genjix »

JoeRetire wrote: Fri Jul 23, 2021 1:22 pm
genjix wrote: Fri Jul 23, 2021 12:04 pm My father's mental health is deteriorating where he takes random walks, goes to supermarket without a wallet, yells at random people. Unfortunately he doesn't qualify for Medicaid and the cost of a nursing home is too much for us. Anyone have ideas or options we can explore?
One he spends down his assets enough (by paying for his care), he'll qualify for Medicaid.

I'm assuming he doesn't have any Long Term Care insurance?
He has medicare but unfortunately that doesn't cover nursing home
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genjix
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Re: Dad may need nursing home or alternate solution

Post by genjix »

anna.day wrote: Fri Jul 23, 2021 1:17 pm I would highly recommend consulting with an Elder Care Coordinator or Geriatric Care Manager. I would call several (like, at least 5, maybe more) to get a sense of whether you are a good fit personally, and their background and experience. A competent Geriatric Care Manager will likely charge by the hour, and will be able to offer advice on what level of care is needed, suggestions on how to arrange for that care, etc. etc.

From what you describe, it may be that your relative can be cared for at home with professional help; may benefit from an adult day care; or some other solution that is much cheaper that full care at a nursing home. Consulting with a Geriatric Care Manager will not be cheap, but it will be well worth it to get a sense of your options.

Edited to add: I would also absolutely get very good medical advice to determine what exactly is happening with your relative. A correct diagnosis will be very important to mapping out what the future looks like. If you live near a major university hospital, they may have a geriatric care program that is a wrap-around program, to provide a full range of services. Even if you do not, I encourage you to be proactive about insisting your relative be thoroughly assessed to determine what is causing these symptoms. There are many, many factors that could cause what you are describing, and it's *very* important to understand what is happening with his health before making decisions about how to proceed.
Thanks. Yes he has been seeing a doctor and they are trying to determine the root problem
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Re: Dad may need nursing home or alternate solution

Post by JoeRetire »

genjix wrote: Fri Jul 23, 2021 1:51 pm
JoeRetire wrote: Fri Jul 23, 2021 1:22 pm
genjix wrote: Fri Jul 23, 2021 12:04 pm My father's mental health is deteriorating where he takes random walks, goes to supermarket without a wallet, yells at random people. Unfortunately he doesn't qualify for Medicaid and the cost of a nursing home is too much for us. Anyone have ideas or options we can explore?
One he spends down his assets enough (by paying for his care), he'll qualify for Medicaid.

I'm assuming he doesn't have any Long Term Care insurance?
He has medicare but unfortunately that doesn't cover nursing home
No Medicare won't cover much in a nursing home. Based on this, I assume he doesn't have LTCi.

Once his assets are depleted sufficiently, he'll become eligible for Medicaid. Make sure his target nursing home understands that and accepts Medicaid payments.
Last edited by JoeRetire on Fri Jul 23, 2021 1:58 pm, edited 1 time in total.
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gwe67
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Re: Dad may need nursing home or alternate solution

Post by gwe67 »

Medicare doesn't cover nursing homes, but medicaid does. Read this and also learn about your state's rules.

https://www.investopedia.com/articles/p ... -rules.asp
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Re: Dad may need nursing home or alternate solution

Post by Colorado14 »

Rarely is this a great idea, but possibly a reverse mortgage in this particular situation may be an option?

Could he tap the cash value of a life insurance policy, if he has one?
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genjix
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Re: Dad may need nursing home or alternate solution

Post by genjix »

gwe67 wrote: Fri Jul 23, 2021 1:57 pm Medicare doesn't cover nursing homes, but medicaid does. Read this and also learn about your state's rules.

https://www.investopedia.com/articles/p ... -rules.asp
Unfortunately he doesn't quality for medicaid at the moment
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Re: Dad may need nursing home or alternate solution

Post by TN_Boy »

anna.day wrote: Fri Jul 23, 2021 1:17 pm I would highly recommend consulting with an Elder Care Coordinator or Geriatric Care Manager. I would call several (like, at least 5, maybe more) to get a sense of whether you are a good fit personally, and their background and experience. A competent Geriatric Care Manager will likely charge by the hour, and will be able to offer advice on what level of care is needed, suggestions on how to arrange for that care, etc. etc.

From what you describe, it may be that your relative can be cared for at home with professional help; may benefit from an adult day care; or some other solution that is much cheaper that full care at a nursing home. Consulting with a Geriatric Care Manager will not be cheap, but it will be well worth it to get a sense of your options.

Edited to add: I would also absolutely get very good medical advice to determine what exactly is happening with your relative. A correct diagnosis will be very important to mapping out what the future looks like. If you live near a major university hospital, they may have a geriatric care program that is a wrap-around program, to provide a full range of services. Even if you do not, I encourage you to be proactive about insisting your relative be thoroughly assessed to determine what is causing these symptoms. There are many, many factors that could cause what you are describing, and it's *very* important to understand what is happening with his health before making decisions about how to proceed.
You definitely want to get a good medical workup; some things that look like dementia are reversible (over medication, some vitamin deficiencies, etc). And it sounds like that is what is being done.

That said, from the description in the OP, it sounds like he needs 24x7 supervision, which is cheaper in a facility (versus staying at home with paid help) unless the family can .... always .... have somebody there.

You say you cannot afford a nursing home. Are you familiar with the differences between assisted living, memory care, and skilled nursing? What sort of help can you afford? And of course, I presume he and his wife have some assets and income. When you say "the cost of a nursing home is too much for us" who is us? The whole family, just you, just his spouse?
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genjix
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Re: Dad may need nursing home or alternate solution

Post by genjix »

TN_Boy wrote: Fri Jul 23, 2021 2:21 pm
anna.day wrote: Fri Jul 23, 2021 1:17 pm I would highly recommend consulting with an Elder Care Coordinator or Geriatric Care Manager. I would call several (like, at least 5, maybe more) to get a sense of whether you are a good fit personally, and their background and experience. A competent Geriatric Care Manager will likely charge by the hour, and will be able to offer advice on what level of care is needed, suggestions on how to arrange for that care, etc. etc.

From what you describe, it may be that your relative can be cared for at home with professional help; may benefit from an adult day care; or some other solution that is much cheaper that full care at a nursing home. Consulting with a Geriatric Care Manager will not be cheap, but it will be well worth it to get a sense of your options.

Edited to add: I would also absolutely get very good medical advice to determine what exactly is happening with your relative. A correct diagnosis will be very important to mapping out what the future looks like. If you live near a major university hospital, they may have a geriatric care program that is a wrap-around program, to provide a full range of services. Even if you do not, I encourage you to be proactive about insisting your relative be thoroughly assessed to determine what is causing these symptoms. There are many, many factors that could cause what you are describing, and it's *very* important to understand what is happening with his health before making decisions about how to proceed.
You definitely want to get a good medical workup; some things that look like dementia are reversible (over medication, some vitamin deficiencies, etc). And it sounds like that is what is being done.

That said, from the description in the OP, it sounds like he needs 24x7 supervision, which is cheaper in a facility (versus staying at home with paid help) unless the family can .... always .... have somebody there.

You say you cannot afford a nursing home. Are you familiar with the differences between assisted living, memory care, and skilled nursing? What sort of help can you afford? And of course, I presume he and his wife have some assets and income. When you say "the cost of a nursing home is too much for us" who is us? The whole family, just you, just his spouse?
The whole family. Some quotes we got was $13,000 per month.
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Re: Dad may need nursing home or alternate solution

Post by RickBoglehead »

genjix wrote: Fri Jul 23, 2021 2:24 pm
The whole family. Some quotes we got was $13,000 per month.
You should seek more quotes. For people with mild dementia and Alzheimer's, they can usually stay in independent living where meals are provided and perhaps daily medications provided. Next step is assisted living, and then memory care. $13,000 is absurd.

We had two people in a MCOL area, and paid $4,500 for the first and $4,000 for the second (quantity discount). They were not in memory care. We used a significant amount of their savings to pay for this care from 2014 until the second one passed in 2017. 3 years for one, 4 years for the other. That's ~ $350,000.

Unfortunately, too many people don't plan for the inevitable that many will face - significant care bills later in life. In our retirement budget, starting at age 75, I've budgeted $100,000 per year, per person, growing at 5% per year. That may not even be enough.

In short, you'll need to use his assets to pay for his care, until you deplete them to the point where he qualifies for Medicaid or VA assistance (if a veteran). You should not let it drain other relatives' assets, but that's a personal choice.
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Re: Dad may need nursing home or alternate solution

Post by Bearlurker »

What state are you in? I'm in SF Bay Area and found a good home for my mom, now in the final stage of Alzheimer's, for much less than that.
You should shop around.
I'm sorry this is happening to your dad, it's heartbreaking to see and also sorry to hear that finances are an issue.
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Re: Dad may need nursing home or alternate solution

Post by TN_Boy »

genjix wrote: Fri Jul 23, 2021 2:24 pm
TN_Boy wrote: Fri Jul 23, 2021 2:21 pm
anna.day wrote: Fri Jul 23, 2021 1:17 pm I would highly recommend consulting with an Elder Care Coordinator or Geriatric Care Manager. I would call several (like, at least 5, maybe more) to get a sense of whether you are a good fit personally, and their background and experience. A competent Geriatric Care Manager will likely charge by the hour, and will be able to offer advice on what level of care is needed, suggestions on how to arrange for that care, etc. etc.

From what you describe, it may be that your relative can be cared for at home with professional help; may benefit from an adult day care; or some other solution that is much cheaper that full care at a nursing home. Consulting with a Geriatric Care Manager will not be cheap, but it will be well worth it to get a sense of your options.

Edited to add: I would also absolutely get very good medical advice to determine what exactly is happening with your relative. A correct diagnosis will be very important to mapping out what the future looks like. If you live near a major university hospital, they may have a geriatric care program that is a wrap-around program, to provide a full range of services. Even if you do not, I encourage you to be proactive about insisting your relative be thoroughly assessed to determine what is causing these symptoms. There are many, many factors that could cause what you are describing, and it's *very* important to understand what is happening with his health before making decisions about how to proceed.
You definitely want to get a good medical workup; some things that look like dementia are reversible (over medication, some vitamin deficiencies, etc). And it sounds like that is what is being done.

That said, from the description in the OP, it sounds like he needs 24x7 supervision, which is cheaper in a facility (versus staying at home with paid help) unless the family can .... always .... have somebody there.

You say you cannot afford a nursing home. Are you familiar with the differences between assisted living, memory care, and skilled nursing? What sort of help can you afford? And of course, I presume he and his wife have some assets and income. When you say "the cost of a nursing home is too much for us" who is us? The whole family, just you, just his spouse?
The whole family. Some quotes we got was $13,000 per month.
13k a month sounds like skilled nursing. That's why I asked if you were clear on the differences between memory care, assisted living and skilled nursing. A person with dementia does not require skilled nursing (absent some other issues). Also, you can't really get a quote without a definitive diagnosis ... facilities will only take patients that fit their care level.
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Re: Dad may need nursing home or alternate solution

Post by TN_Boy »

RickBoglehead wrote: Fri Jul 23, 2021 2:33 pm
genjix wrote: Fri Jul 23, 2021 2:24 pm
The whole family. Some quotes we got was $13,000 per month.
You should seek more quotes. For people with mild dementia and Alzheimer's, they can usually stay in independent living where meals are provided and perhaps daily medications provided. Next step is assisted living, and then memory care. $13,000 is absurd.

We had two people in a MCOL area, and paid $4,500 for the first and $4,000 for the second (quantity discount). They were not in memory care. We used a significant amount of their savings to pay for this care from 2014 until the second one passed in 2017. 3 years for one, 4 years for the other. That's ~ $350,000.

Unfortunately, too many people don't plan for the inevitable that many will face - significant care bills later in life. In our retirement budget, starting at age 75, I've budgeted $100,000 per year, per person, growing at 5% per year. That may not even be enough.

In short, you'll need to use his assets to pay for his care, until you deplete them to the point where he qualifies for Medicaid or VA assistance (if a veteran). You should not let it drain other relatives' assets, but that's a personal choice.
Once they start wandering independent living and even assisted living care facilities generally don't work. Neither the patient's family nor the facility is willing to take the risk of having the patient wandering around on the streets. You require a locked facility. That is unfortunate, but that is what happens.

Some people with mild dementia are not prone to wandering and can stay in a wider range of places. A lot of people in assisted living have some dementia. But wandering and the other mentioned behavior, yelling at people ... I suspect only memory care can manage those problems.
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Re: Dad may need nursing home or alternate solution

Post by RickBoglehead »

TN_Boy wrote: Fri Jul 23, 2021 2:54 pm
RickBoglehead wrote: Fri Jul 23, 2021 2:33 pm
genjix wrote: Fri Jul 23, 2021 2:24 pm
The whole family. Some quotes we got was $13,000 per month.
You should seek more quotes. For people with mild dementia and Alzheimer's, they can usually stay in independent living where meals are provided and perhaps daily medications provided. Next step is assisted living, and then memory care. $13,000 is absurd.

We had two people in a MCOL area, and paid $4,500 for the first and $4,000 for the second (quantity discount). They were not in memory care. We used a significant amount of their savings to pay for this care from 2014 until the second one passed in 2017. 3 years for one, 4 years for the other. That's ~ $350,000.

Unfortunately, too many people don't plan for the inevitable that many will face - significant care bills later in life. In our retirement budget, starting at age 75, I've budgeted $100,000 per year, per person, growing at 5% per year. That may not even be enough.

In short, you'll need to use his assets to pay for his care, until you deplete them to the point where he qualifies for Medicaid or VA assistance (if a veteran). You should not let it drain other relatives' assets, but that's a personal choice.
Once they start wandering independent living and even assisted living care facilities generally don't work. Neither the patient's family nor the facility is willing to take the risk of having the patient wandering around on the streets. You require a locked facility. That is unfortunate, but that is what happens.

Some people with mild dementia are not prone to wandering and can stay in a wider range of places. A lot of people in assisted living have some dementia. But wandering and the other mentioned behavior, yelling at people ... I suspect only memory care can manage those problems.
We put one person in a locked assisted living facility (which is the price I listed). No one could get in or out unless they were buzzed in/out.
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TN_Boy
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Re: Dad may need nursing home or alternate solution

Post by TN_Boy »

RickBoglehead wrote: Fri Jul 23, 2021 2:57 pm
TN_Boy wrote: Fri Jul 23, 2021 2:54 pm
RickBoglehead wrote: Fri Jul 23, 2021 2:33 pm
genjix wrote: Fri Jul 23, 2021 2:24 pm
The whole family. Some quotes we got was $13,000 per month.
You should seek more quotes. For people with mild dementia and Alzheimer's, they can usually stay in independent living where meals are provided and perhaps daily medications provided. Next step is assisted living, and then memory care. $13,000 is absurd.

We had two people in a MCOL area, and paid $4,500 for the first and $4,000 for the second (quantity discount). They were not in memory care. We used a significant amount of their savings to pay for this care from 2014 until the second one passed in 2017. 3 years for one, 4 years for the other. That's ~ $350,000.

Unfortunately, too many people don't plan for the inevitable that many will face - significant care bills later in life. In our retirement budget, starting at age 75, I've budgeted $100,000 per year, per person, growing at 5% per year. That may not even be enough.

In short, you'll need to use his assets to pay for his care, until you deplete them to the point where he qualifies for Medicaid or VA assistance (if a veteran). You should not let it drain other relatives' assets, but that's a personal choice.
Once they start wandering independent living and even assisted living care facilities generally don't work. Neither the patient's family nor the facility is willing to take the risk of having the patient wandering around on the streets. You require a locked facility. That is unfortunate, but that is what happens.

Some people with mild dementia are not prone to wandering and can stay in a wider range of places. A lot of people in assisted living have some dementia. But wandering and the other mentioned behavior, yelling at people ... I suspect only memory care can manage those problems.
We put one person in a locked assisted living facility (which is the price I listed). No one could get in or out unless they were buzzed in/out.
State laws may vary here as well. I'm not sure that in my state, assisted living facilities can lock you *in*. I.e. people can't just wander *in* but residents can wander *out* more or less at will. It isn't until you get to memory care licensed facilities that patients might be in a living situation where they cannot leave without punching in a keycode. Certainly any facility calling itself independent here will allow the residents to come and go as they please. I guess I was partly reacting to "For people with mild dementia and Alzheimer's, they can usually stay in independent living" and in my experience, "independent living" facilities are pretty iffy for people who have progressed to a dementia diagnosis. Such facilities have things like stoves in their rooms (not a good idea for a dementia patient) and generally less supervision. And they won't be locked down.

In my part of my state, $4,500 will get you assisted living or a lot of independent living facilities but memory care is more like $8k per month.

But either way, if the OP's description of his father's behavior is accurate, *in my state* the doctors are going to strongly suggest a lockdown memory care facility. Which I mention not to a make a medical diagnosis but as a guideline for the expected type of facility and thus monthly cost.
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Re: Dad may need nursing home or alternate solution

Post by ScubaHogg »

- you need to consult a better elder law attorney. I think you got either bad advice or misinterpreted the 5 year look back

- $13k for even memory care is exceptionally expensive. Shop around and you can find something better that is probably equivalent in terms of “niceness.” In our MCOL area memory care runs in the $5500-$7000 range

*my father moved into memory care 7 months ago and we’ve been dealing with memory issues for the past 5 years
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Re: Dad may need nursing home or alternate solution

Post by Longdog »

genjix wrote: Fri Jul 23, 2021 12:48 pm
stan1 wrote: Fri Jul 23, 2021 12:12 pm Spend down his assets until he qualifies for Medicaid.

Does he have a spouse? If so seek out an elder care attorney.
He has a spouse. Attorney said they look at past 5 years of income and asset so he won't qualify even if assets were spent
You may have already figured this out from some of the references, but basically what they are looking for is transfers of assets in the 5 years preceding the Medicaid application. If there were any such transfers, then the total amount of the transfers would be used to calculate a penalty period (a period of Medicaid ineligibility). So while it's likely true he is not currently eligible for Medicaid, that doesn't mean he never will be. You definitely should consult with an elder care attorney to fully understand your options in that regard.

So sorry you and your family are going through this.
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Re: Dad may need nursing home or alternate solution

Post by GmanJeff »

Independent living is by definition inappropriate for people with dementia. Assisted living may be suitable, depending on the extent to which the resident requires assistance with the activities of daily living whether due to physical limitations or cognition issues. Memory care is designed expressly for people with appreciable deficits in cognition, and is typically staffed with more and differently qualified employees than are found in assisted living.

$13K/month is not inconsistent with my experience with a family member who required memory care, which was admittedly provided by a relatively "high end" facility.
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Re: Dad may need nursing home or alternate solution

Post by TN_Boy »

GmanJeff wrote: Fri Jul 23, 2021 7:18 pm Independent living is by definition inappropriate for people with dementia. Assisted living may be suitable, depending on the extent to which the resident requires assistance with the activities of daily living whether due to physical limitations or cognition issues. Memory care is designed expressly for people with appreciable deficits in cognition, and is typically staffed with more and differently qualified employees than are found in assisted living.

$13K/month is not inconsistent with my experience with a family member who required memory care, which was admittedly provided by a relatively "high end" facility.
The staff ratio might be better in memory care than assisted living, but I don't think there is a large difference in training. The staff will probably have some training in dealing with dementia (they get good at redirecting, etc) but we are still talking CNA level for most-of the hands-on employees. A larger memory care facility will have activities better tailored to people with dementia than an assisted living facility.

Dementia can manifest itself differently; some patients can manage in a lower level of care longer than others, if they are not disruptive to others and don't aggressively wander.

13k a month is more than you'd spend in my area for memory care, whether at a larger facility or a group home equipped to deal with such patients. I could see 13k a month at the best skilled nursing facility in my area. 8 to 9k is what memory care would cost me. That's in a medium+ cost of living area.

So as we've said, the OP needs to finish getting a full diagnosis/prognosis, and then consider options in his area. My condolences on the situation; dementia is an awful thing.
island
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Re: Dad may need nursing home or alternate solution

Post by island »

What state does he live in?
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Shackleton
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Re: Dad may need nursing home or alternate solution

Post by Shackleton »

Just to give you perspective on prices, my mom was in independent living at a top rated facility in Colorado Springs for $4000/mo. Then moved to the Assisted Living there when her dementia progressed, which was about $5500/mo. As soon as she started to wander, I got a call that she had to move to memory care, which for her level of care was $7000/mo.

What is the wife’s opinion in all this? It sounds like a second marriage (not the OP’s mother)? Most likely, she is the person legally able to make decisions for him if he is diagnosed with some form of dementia.
“Superhuman effort isn't worth a damn unless it achieves results.” ~Ernest Shackleton
TN_Boy
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Re: Dad may need nursing home or alternate solution

Post by TN_Boy »

Shackleton wrote: Sat Jul 24, 2021 7:43 am Just to give you perspective on prices, my mom was in independent living at a top rated facility in Colorado Springs for $4000/mo. Then moved to the Assisted Living there when her dementia progressed, which was about $5500/mo. As soon as she started to wander, I got a call that she had to move to memory care, which for her level of care was $7000/mo.

What is the wife’s opinion in all this? It sounds like a second marriage (not the OP’s mother)? Most likely, she is the person legally able to make decisions for him if he is diagnosed with some form of dementia.
Consistent with my experiences.

Wandering is one of the "disaster" behaviors that require continuous supervision. A person exhibiting that problem has more limited care options.

And yes, presumably the spouse has the legal decision making abilities. We haven't asked if all the POA paperwork and such has been done.
retired@55
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Re: Dad may need nursing home or alternate solution

Post by retired@55 »

genjix wrote: Fri Jul 23, 2021 2:20 pm
gwe67 wrote: Fri Jul 23, 2021 1:57 pm Medicare doesn't cover nursing homes, but medicaid does. Read this and also learn about your state's rules.

https://www.investopedia.com/articles/p ... -rules.asp
Unfortunately he doesn't quality for medicaid at the moment
As others have said, please consult with an experienced elder care attorney. Although each states has its own rules, I assumed my mother did not qualify for Medicaid because of her income / assets even though they were clearly insufficient to pay for a nursing home. What I didn't know is that the state (NYS) would approve her for Medicaid after: (1) she spent down her assets to the Medicaid maximum and (2) she contributed her "excess" monthly income to the cost of the nursing home. I learned that Medicaid qualification is not a hard "yes" or "no" in many cases, and someone can become eligible even though their financial situation may seem to fall outside "eligibility requirements". Please note, however, that if your parent has gifted substantial assets away during the 5-year look-back period, Medicaid will assess a coverage penalty equal to the amount of the gifts - meaning that they will only pay for nursing home care once the penalty amount has been paid privately. Perhaps that is the current issue?
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