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Introduction, Needing Guidance, and a Little Venting
Hello. This is only my second post, my last being several years ago. My stepfather was diagnosed in 2012 and is in, I believe, early stage 6. Up until now my mom has been doing a wonderful job of caring for him, but we have reached a point where she is physically and mentally exhausted (and at 80 years, she has her own ailments to deal with), and his PCP is recommending placement. They have very limited funds and no assets, so I believe my first step is to see if he qualifies for Medicaid. I have a call into their county dept of aging and I am waiting for a callback, also from A Place for Mom.
My question is how do I handle transferring him out of state? I live about 25 minutes from them over the state line in MD (they are in PA) and would like him closer to me, as my mom will probably have to live either with me or my brother, who also lives in MD. Is this going to make an already complicated process even more complicated?
Any guidance is appreciated as I am doing this on my own, even though he has three children of his own, one of which lives right down the street from me but has nothing to do with him. And my brother, while acting concerned, tends to either take something off my hands only to drop the ball or swoop in after I've done all the work and change everything.
I have already had a couple of my questions answered by searching the forum, and this is a wonderful resource! But I am sure I will be coming back with more as I navigate through this process. Thanks in advance!
Just a couple of questions, the answers to which will also help anyone else giving guidance to you:
1. Who has your step-dad appointed attorney in fact for him should he be unable to make decisions for himself? If is your mom, then does she back your plan?
2. From reading your statement it sounds as if your mom will be with you or your brother. Then in the next sentence you state that your brother tends to drop the ball on things. Your mom is not a ball. Where will your mom live according to your plan, or are you still thinking about this?
1. My mother is POA for him and yes, she is on board. She has been reluctant in the past, but now realizes his needs exceed her ability. In the event she is unable to make decisions, I am appointed POA.
2. With all due respect, I am aware my mom is not a ball and never referred to her in that manner. I was talking about paperwork that he has promised to follow through on, such as when she had an issue with her life insurance and he promised to call and straighten it out, taking the paperwork right out of my hand, and never made the call. The situation is complicated regarding where she will stay, and it is something we will have to work out. She does not do stairs well, and all my bedrooms are upstairs. We can convert a room on the main level for her, but we have no full bath on the main level and no way to convert our powder room into a full. I also have school-aged children at home. My brother lives in a 3-story townhome, where bathrooms are either on the top or bottom floors. He does have a walkout basement with no stairs and could fairly easily convert his downstairs bathroom into a full bath, but access to the kitchen would require stairs. He has no children at home and his wife is an RN. I work from home, so am home all day and they both work outside of the home, with him working long hours. So there are pros and cons to both situations that will have to be weighed. At the end of the day, I see her most likely coming here.
I don't think you will have any issues with the "across state lines" as Medicaid is a federal program. Using the services of an elder care attorney is worth it in my opinion unless you have a lot of time to read the info online-I hear it is a bit tricky with the 5 year look back and division of the estate for the spouse's benefit
Good luck and I think your mother and father will be relieved to be closer to you and their families.
Of course it is possible to re-apply for Medicaid in another state, but if it is all possible it is a lot easier to just apply in the state where he will end up and he will need to be living there, ie, be a resident of that state to be able to apply.
So, say you apply in PA where both parents live now.... and 2 months or so after applying you get the notice that he is approved. How long before you were wanting to move him to MD? Because, while it IS a federal program, in practice the states administer the program and there can be different eligibility requirements (although they are very close) and different states have different waivers. There are basically 3 parts to Medicaid, one part gives low to no-cost Healthcare if using medicaid facilities. Another part is low income food stamps (which many retirees won't qualify for if they get social security) And the last part is the waiver programs, which as I said can differ in eligibility requirements and even availability. Some states have a "waiting list" for waiver programs.
When you want to move him to MD, you then have to apply there on their forms and they will NOT care that he was approved in PA. They will make you jump through all *their* special hoops. This is what we had to do for my mom with AZ and then CO. My sister, who was doing all the financial stuff, was very frustrated .
So what is a waiver program? There are a slew and you'll need to research each states, but for us it was the blind, elderly, and disabled waiver, which gave my mom in home help(caregivers), paid for adult day care, and even, if I wanted to go through the extensive amount of hoops involved, would have paid for and gotten a stair lift installed. They did not take a penny from her social security, just provided it all! Then when she needed to go into a facility, they are paying the difference between what her facility charges and what she gets in social security.
So bottom line, is if you want him in a facility near you, I would move them both now, apply in your state, and while you are waiting, find a facility that will accept Medicaid without a spend down.
Wow, you are all so helpful, I really appreciate it! This is exactly the information I needed. I feel like they make the information you need so difficult to find, and I have always worked in a field that requires great research skills, so either the information is truly not easily accessible or I am not as good as I thought. lol
MPSunshine, re-reading your post, I may have been a bit oversensitive, and for that I apologize. It has been a difficult day, and I am focusing on my irritability over my siblings rather than what needs to be done
They are renters, so we do not have to worry about sale of a house, which is a blessing and a curse, I suppose. I wish I had known about waivers before, but we have been hindered in our efforts to get help by his refusal to have the Dept of Aging come to the house for an assessment and my mom's reluctance to rock the boat where he is concerned. I have toured facilities for them and requested a referral from the DoA, only to have her put a stop to the process. It's been very frustrating, but she now understands that it is inevitable and needed, so at least we are moving in the right direction.
We had a very difficult, tearful conversation this morning and I feel like my thoughts are all over the place
Take a deep breath and try to relax. None of this is ever easy. But you are moving in the right direction for everyone's sake.
Let us know how this all comes out. Your experience may help others as well.
Hi! So glad you reached out! I don’t have any experience and what you’re dealing with, but I just wanted to say that the other posters have given great advice and have thought of good questions to ask.
It made my heart smile to see your response! It’s amazing how many people care and really want to help others on this board. I’m so glad you were able to get some information to help you and I hope things are going well for you and your stepdad & mom as well as brother and all family.
Let us know how things are going for you, and know that there are many people who care about you and what’s going on. Sending you lots of prayers, cyber hugs, and your favorite summertime dessert
Always be VK