My mother is in assisted living. Her Alzheimer’s is getting worse and she's out of money. She doesn’t qualify for Medicaid. What do I do?

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My mother is in assisted living. Her Alzheimer’s is getting worse and she's out of money. She doesn’t qualify for Medicaid. What do I do?

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My mother has no assets, nothing left but her social security and VA payments she gets. She’s just short of qualifying for Medicaid. The qualification limit is $2,349 and her income is $2,457! Her monthly expenses come to $4,823 each month.

Her Alzheimer's is at the stage where she is paranoid, aggressive and aggravated most of the time.

My mother is 96 and physically healthy.

Part of her problem is she’s been spitting out her pills because she thinks they are trying to poison her!

Of course, most of those pills are to calm her emotional state, so they brought in Hospice Palliative Care to be a part of her care now. The goal is to find a way to administer her meds to make sure she’s getting them in her. Temporarily they are using injections and creams to try to get her back to the point she was just two months ago when she was mostly calm and happy. Recently she’s been going into rages and she slapped two nurses! That is not my mom. She wouldn’t do that in her right mind.

Anyway, she needs much more additional care and at the same time she’s out of money. The last of our resources was cashing in her life insurance policies.

So now she can only afford half of the cost to stay there. I’ve exhausted my research resources trying to find financial help. Up until just a few weeks ago Medicaid allowed subtracting a quarter of the VA money as “non-income“ which would have let her qualify. The government just took that option away. This has been their policy for at least a few years if not more, because I checked on all this a year ago so I wasn’t worried about her qualifying.

The Medicaid person I spoke with said they were all shocked when this order came through a few weeks ago. They have many people on Medicaid who use that system. So....I’m stressed to the hilt...she only has one more month she can pay and I don’t know what to do.

My mother must be in a facility with 24 hour care. Living with me would not be possible.

She lived with me for 7 years before Assisted Living.

Have any of you gone through not qualifying and desperately needing financial help? If so, what did you do?

I appreciate any comments and info.

thank you.

Alzheimer's & Dementia Behavior Change Paying for Care Violent Behavior

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Hi, I had a similar problem with an elderly relative as to VA benefits. See if you can up her benefits, first of all. Contact Cindy at CodeofVets on Twitter at: @CLWAL02. Let me know how it goes!
Lisa

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What we had to do for my husbands mom was create a irrevocable trust and have her monthly payments deposited into a bank account tied to that trust. That way it is not considered her money and she can qualify for help. Talk to a lawyer familiar with elder care issues, the one we went to charged us a flat fee to create the trust and advise us on how much of her money to transfer to the trust account, etc. Best thing we ever did.

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I was told that if Mom’s was a hundred or two over to just buy her a gown, a top, pair of pants, shoes, get her nails done or whatever to drop it below the base amount required and keep receipts. I did and there came a time that I took those receipts to DHHS and they scanned them in. This was when they were doing the final approval. Pay somebody to sit with her for a few hours and pay them. It is legal and a good solution and Medicaid representative is the one who told me to do this because they know she still requires clothes and care that nursing facility does not provide.

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Hopefully you've made an appointment with a good elder attorney or someone who can set up a Miller trust, because she definitely will qualify for LTC Medicaid. The person in the business office and social worker should be aware of the procedures in your state as well. I'd be surprised if they're not offering assistance, because they should know, they should have had residents before that have been in similar situations. If they are not helpful, please see an attorney and have the Miller trust set up. She will qualify for Medicaid.

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She needs long term nursing . You spent her savings now apply at a nursing home and let them accept her under Medicaid

they will evaluate monthly income vs assets ...

she will be placed

sad part COVID ! We can’t see our moms

BUT MEDICAID SHOULD COVER YOU

IF THE GOvenor world get rid of t

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Once she’s run out of money ,Medicaid pays for a place .

you did your fair share spending her money ....on her healthcare

I get it!!!

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Have you met with the facility's social worker or talked with their financial department? I have a couple suggestions for resources but I don't have any real answers to your situation. If you haven't done so already, you might consider calling: the Area Agency on Aging, Alzheimer's Association, 2-1-1 (in CT anyway), a case/care management company, or an elder care law attorney. Heck, I'd even consider calling my Congressman/woman to see if there was anything they could do for you.

If it's an outside (not from within the facility) Hospice or Palliative care team that has come in to take over her care, they usually pay for medications and I'd check to make sure that the facility isn't continuing to bill for services which are now being covered by palliative care. It might bring her bill down somewhat.

Good luck!

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Find yourself an Elder attorney asap. I can't figure out IF she is OUT of money, why does she not qualify for Medicaid. If her expenses are more than she makes, she is below what she is allowed. something don't seem right here. When my father went into NH we paid one full month, after that he qualified for Medicaid. We got in touch with an Elder attorney and they helped us get thru the mess. I am the POA for both parents so I took care of the bills (still do for my mom), I had to keep my fathers assets down to $2400 a month. The house was in mom's name so he didn't have much. when he got his pension, I would write out all the bills out of his checking account and if still too much, I would withdraw and give to my mom for her groceries, etc. PLEASE contact an Elder attorney. I am wishing you luck

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Imho, perhaps she could she "spend down" some of her funds, e.g. prepay funeral, et al so that then she was qualify for Medicaid.

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Like JBryan I thought the VA benefits and Medicaid were mutually exclusive, but the question would be are the "VA payments" your mother gets part of the VA Aid and Attendance, or is it a pension, either her own or from your father?

I did find the following online, BUT the rules may vary from one state to another (this one might be GA - recheck = yup):

"If a person is receiving VA Aid and Attendance Benefits, he/she may still be eligible for Medicaid. VA Aid and Attendance Benefits do not count as income for Medicaid purposes, so he/she may meet income eligibility criteria for Medicaid.
Once approved for Medicaid, though, the VA benefit is reduced to $90/month for most recipients."

More can be read at (just for info, not signing up with them!!!):
https://hurleyeclaw.com/2018/12/05/how-medicaid-and-va-benefits-work-together/
I also found:
2020 Indiana Medicaid Long Term Care Eligibility for Seniors
Type of Medicaid Single
Income Limit Asset Limit
Institutional / Nursing Home Medicaid $2,349 / month* $2,000

It is baffling why so many states have such a low threshold for the income limit. Apparently whoever makes these rules has never had to place a LO in a NH!

So, if mom's VA benefit is A&A, it shouldn't count, but if approved, most of that goes away - that just means Medicaid has to pay more! Seems rather silly.

Perhaps someone has made an error? Consult with EC attorney, have them review the application (perhaps get an appeal going first?) Consider the Miller Trust others suggested (EC atty can help with that too.)

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It is all taxpayer dollars, so it is either out of the left pocket or right pocket. What difference does it make what it is called, A&A or Medicaid still taxpayers.

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My mother's income was just a bit to high for her to qualify for community Medicaid. I set her up with a Medicaid spend down. I just had to produce expenses each month that brought her income down to the Medicaid level. I could use the cost of her health insurance supplement, medical bills and any Part D copays and her depends and pads, kleenex and over the counter vitamins and even her tylenol. Once she qualified she was eligible for lower copays for her medications and even to have her Part D insurance paid for. The assisted living that she was living in even charged a lower amount based on her income. Once she qualified for a Nursing Home the application for Chronic care was easy since I had everything together from applying for community care. Just know you need 5 years of back bank statements for Chronic care. Your local Office of Aging can help you with the application.

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A Medicare buyout and a new place. Call the county eldercare helpline-- (211) . If her late husband was in the military she can get Aid and Attendance-- call congressman and County VA rep-- right now-- $1127/mo.

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Possibly more -- she can also apply with a Medical Expense Report to the VA to get money for the last two years for a caregiver or carehome place.

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Sounds like the administration has not been very good for your mother.

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Troll.

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National Academy of Elder Law Attorneys, www.naela.org

even though counter-intuitive, an even better source to find an attorney, the Special Needs Alliance, www.specialneedsalliance.org.

You need an attorney in the state that your mother lives in. Although the states need to comply with the general federal program, Medicaid rules vary state by state.

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It's worth the few hundred dollars it will cost to get some advice from an Elder Law attorney who is well versed on spending down for Medicaid.

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ONe friend I know uses the excess $$ to prepay her funeral expenses , thud coming in under the limit. Check with the person reviewing her eligibility.

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What did the elder law attorney advise? They know exactly what to do and charge about $200.00 for a one hour consultation. I went 3 times over a 4 year period. Worth EVERY dime. Go see a good one and get references before you choose. Wishing you luck.

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I am so sorry that you are going through this stress! We found a solution to my mom spitting out her pills - we grind them up twice a day (pill grinder from CVS or Walgreens) and mix them with a tiny bit of CBD honey and put them in a croissant or cookie. She sees what we are doing, and still willingly takes the "treat". We have 1 pill that was recently added at night that can not be crushed, so we have to talke her into swallowing it first before getting her "treat". So far it is working.

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I just wanted to say that I'm disgusted, living in the richest country in the world, that we have beg, borrow and steal to take care of our elders. Shameful.

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Also feels like we have to do that for ourselves because if you’re a primary caretaker of both parents and your in your 40-50’s you can’t get health insurance at a decent
rate. Health care shouldn’t financially cripple us or make us choose worse conditions for our aging parents.

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I wasn't aware you could have both Medicaid and VA at the same time (it's been a couple years and I know it changes). But, if that's the case, would it be possible to drop one or the other ~ qualifying her?

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Sounds like you have not been talking to the right people.
See an Elder Care Attorney and he will stear you in the right
direction. Their are all kinds of legal ways your mother can
qualify for assistance even though it may appear she does
not qualify. Take someone you trust when you visit the lawyer.

Pay the attorney, Believe me you will get back more than you
pay him. He knows the legal ways to get people qualified. Their
are always exceptions to the general rules.

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afterthought, veterans will only if in wartime service. My husband was in Berlin Crisis and he does not qualify for benefits.

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Not necessarily -- he should ask the White House VA hotline about talking to someone, as the VA has drastically changed under the current Administration. It's faster, more informative and much more streamlined.

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First some meds can be put into put into food or drink so you may have to make an extra effort to crush the med into powder form or take it out of the capsule. This seems to help with the idea that she is being poisoned. As far as the additional funding needed, if her husband was a Vet or she was a Vet, apply for Aid and Assistant Benefit through the VA. It could be a helpful extra $1200 towards homecare assistance. Lastly, look into CBD oils or tinctures as an aid towards a better mood. This has helped with sundowners or aggresiveness. Check with her doctor first.

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Quick query-do you know of a brand of CBD oil that is effective? There’s just so many and they’re unregulated so I’d love a recommendation. Thanks!

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Great advise above. Take heart an elder law attorney with expertise in medicaid is very necessary. You will get her situated and her care paid for.
Mom sounds as if she needs more caregivinģ than given in assisted living.
This will work out.

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https://www.medicaidplanningassistance.org/medicaid-eligibility-indiana/

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You have to do a Millers Trust. Contact an Elder Law Attorney and they will help you get it set up. It is a pain in the a** but it's what is required when ones income exceeds the Medicaid limit.

Take care.

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Unlike Social Security and Medicare which are purely federal programs, Medicaid is a shared expense between the individual states and the federal government. Miller Trusts do not work in every state.

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Have you reached out to an eldercare attorney? Dont go by what your state Medicaid offices tell you, a good eldercare attorney can find a way most of the time

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Great advice below!
As for her meds, my dad did the same so we crushed his meds and added to applesauce and he willing took meds this way.

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I was a Minnesota County level nursing home financial worker as part of my career, and unless things have changed entirely ( I doubt that), she can have what is known as a "spend down". You pay bills after checking in with the local agency and applying for MA on her behalf, save the bills and receipts for payment, and when her income gets low enough within the month, she should qualify. Check also if she can have any assets such as a small savings account prepaid burial, etc.
Rules vary by state. If she owns her own home, they may put a lien against Medical Assistance (Medicaid) payments made for her care. Study the MA pamphlet they can give you and consult with a Financial Worker there (free) before you hire an expensive lawyer. God bless yo for looking after her. KBHKBH

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I have to be quite honest, I am surprised with her funds so low, Medicaid will not take her. Not sure why. Talk to the Social Worker in this Facility or maybe in another Facility...The laws in this could not have changed this quickly because of COVID. It has been this way for a long time where if you ar eprqactically broke, you can get Medicaid....

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My mother is in assisted living. Her Alzheimer’s is getting worse and she's out of money. She doesn’t qualify for Medicaid. What do I do?

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