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HI guys!!! Been lurking for a while as I've been here looking when my mom passed, then when my father got Alsheimer's I've been able to kind of navigate going thru all the questions and answers.
But now im stumped. My wife's moms' husband has been in the hospital for over a month now. We believe he will be released home(kicked out) in about 40 days as thats when Medicare hits its limit.
Hes in and out of sleep and unresponsive and they are not sure of his issues.
Her mom has i medical issues herself and will be unable to care for him.
They do own a home together and not sure where to go at this point, They live in California and we are on the east coast. We have called and left messages over the last month to elder care services and medicade over the last month and are getting no information.
sorry if this all seems garbled be she is at her wits end.. she has been staying with her mom the last month trying to navigate all of this. Thank you for any input you may have.. Only income is social security.

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Contact the social services department or case manager at the hospital. They can advise you of the type(s) of care that these folks qualify for and help with placement as well. They can also advise you of the steps you need to take on the issues you have listed.
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If there is no long term care insurance and insufficient assets, he will need to be placed in a facility that accepts Medicaid patients. If he is still in the hospital then have the hospital social worker find a SNF that will take him. If he is in a rehab facility, have the rehab facility find a suitable facility for discharge- or keep him if they take Medicaid patients. DO NOT ACCEPT DISCHARGE TO HIS RESIDENCE! That would be an unsafe discharge and there are prohibitions against doing that. Make sure your MIL is capable of standing up for herself and does not agree to accepting him at home. Your MIL cannot be kicked out of her home even though he is on Medicaid. However, once they are both deceased, Medicaid will seek to reimburse the cost of care from proceeds of the sale of their home. Consult with a qualified elder attorney to see if any financial strategies can be used to protect the assets if that is a concern.
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Get started on Medicaid (Medical) for Nursing Home application if you haven't started it already.
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Thank you for all the responses. I do have an appt with conservatorship attny Monday. I want to protect my moms home from all this mess. Can we just leave him in the skilled nursing facility he is in right now even after the primary health insurance stops paying? It seems the safest place for him.
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mstrbill Sep 2023
Yes! Do not take him home! In response to your response to me below, let them bill him for amount due after Medical. If they own a home together, they definitely need an elder attorney to help protect wife's mom's interest in the house. The attorney needs to get involved to set husband up for Medical, taking into consideration whatever property and assets they own, and protect wife's mother's share. I'm guessing Medical didn't approve the full amount because of assets? Or is it something else? The attorney needs to step in for wife's mother. In the meantime, do not let the release him, it would be unsafe. Let them bill and get the attorney involved.
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HI GUYS!! Thank you for all your help and sorry for not responding, I was hoping she would chime in with all the correct info as I only get bits and pieces.
She has an appt with an elder care atty on Monday, the hospital is calling her mom asking when she can come get him, her response of course is I can't IM 80 and just had a heart attack I can't take him, but they are pressuring her.
wife is having no luck with Medicare she cannot get a response.
I just told her(wife) that the thread has blow up with a lot of great info and to please reach out to the forum with an update, SHe replied she will at lunch.
like I said I may interpret some of the happing's wrong lol
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Check to see if your mom's husband was in the military, especially during a war time. There are quite a few options available to vets. However no one from the VA just tells you about them. Look for a VA advocate in your area. Maybe even the hospital where currently is may have someone to contact.
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stuckinarut Sep 2023
We have tried the va route and he would qualify. Problem is he never established care with a va doctor so they won’t help him.
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No matter which facility your loved one is in - hospital or skilled nursing facility or memory care - they have either a social services or case management department/representative. Ask to talk to this person. He/She can let you know of all the resources your loved one qualifies for as well as what you need to do.
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stuckinarut Sep 2023
All they keep telling us is his health insurance benefits are going to max out soon and apply for medi cal (Calif medicaid) which we did and got no where with as they gave them an outrageous out of pocket monthly
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stuckinarut: That would an unsafe discharge to home for your wife's mother's husband. Your wife should be working with a social worker. Also, retain an elder law attorney.
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Get a Geriatric Case Manager assigned to the case . This can be requested thru the hospital or the PCP. The Geriatric Case mgr is usually a licensed Social Worker who helps families navigate the myriad of needs, options in care for cases like your FIL and MIL. Glad to hear that your wife is physically out there. If the FIL is still in the hospital, there should be a discharge planner ( usually a nurse or licensed social worker) working with the family for FIL discharge planning care. Be sure that your wife has POA documents in place for decision making purposes. Conferring with an Elder Law Attorney may be beneficial also.
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Contact Adult Protective Services (in his locale) to evaluate him for placement.
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Try here first. They should be able to help or refer you.

https://www.aging.ca.gov/
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stuckinarut Sep 2023
Unfortunately when I called the aging dept of Calif they just forwarded me to adult social svcs. They said I could lodge a complaint about abuse but that’s all they handle.
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Talk to an aging care advisor, such as those associated with this site. Your wife can also try to connect with a local social worker in California, or with California's Department of Aging (it may be called something else) to find out what the options are for her mom's husband. California should have programs for low-income seniors who need dementia care. Having the asset of the house adds a complication. She may need to contact an attorney who specializes in elder law. A social worker may be able to recommend some pro bono attorneys to advise.
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TouchMatters Sep 2023
While this may be true, my companion-friend of 20+ years was low income, only soc sec and ended up in a nursing home.

I visited 3-5 days a week and 99% of that time, I had to bring to the attention of management and staff things that should be done, what was / was not being done. In essence, hold the facility accountable - even to ensure they gave my friend clean water. I mention this as when if a loved one is placed in a nursing home, it is imperative that someone visit / act as a liaison for the family living outside the area to ensure proper basic care is provided.

* I worked with an Ombudman and after several attempts to work through needs directly with facility, I reported to the nursing home licensing board. Unfortunately, they make two unannounced visits and if things appear 'okay' during those visits, there is nothing more they do.

There are several 'reasons' for lack of basic are at nursing homes (from my experience):

* Inept management / executive director (they know they will get reimbursed however this works regarding of quality of care); they may care or not how individual patients are cared for - they blame others when the responsibility is always on the executive director - the top management.

* Lack of accountability (communication directives) from the executive director down through the ranks of management, nursing, line staff.

* Inadequately trained line-staff

* Not enough aides / CNAs (many I encountered were from other states).

I don't say this to scare you. It is the reality. Be sure to have someone there during the time a loved one is placed in a nursing home.

Gena / Touch Matters
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They need to hire an elder care attorney to get him set up for Medicaid and protect MIL's income and half of the home. Do this ASAP, and if they need to take out an equity loan to pay the attorney, have them do so. Just as important though, do not (make sure your wife is on board) let the hospital release him home to MIL. Make sure they know it would be extremely unsafe for both of them. Make sure the hospital SW is clear on this, and NH or Memory care is going to be the only option for them to release him to.
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stuckinarut Sep 2023
We applied for medi cal (Calif Medicaid) and they were approved but with a $3400 out of pocket monthly due. That doesn’t help at all when they barely make a little over $4000 monthly together from social security.
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Your wife's Mom really needs to get with an elder law attorney. And she needs the help of family now THREE AND PRESENT to help her.

You say this gentleman is coming home in 40 days. How can that be when there is no one at home to care for him?

You say he has been in a hospital and I have to assume you mean a rehab at this point, as no acute care hospital will today keep someone for 100 days, with a basic failure the thrive dx, though a rehab may.

Whomever is the next of kin best placed to go to Mother and her husband now must do so and get her financial situation sorted and get legal advice how to proceed. There should be division and protection of finances for the Mom while the husband is placed.

Sorry, but family needs to be there. Mom needs HELP right now to get this accomplished in the next month.
1. A recognition that dad isn't coming home and now needs placement
2. notification to the social workers at the current facility that this is necessary.
3. A gathering of the couple's assets and finances and financial info and a visit to an elder law attorney for options and advice
4. During ALL OF THIS the person best able to assist Mom in doing this crucial work over the next month.

In short this gentleman now needs placement and long term care. There will have been any NUMBER of social workers both at hospital and rehab telling the mother this. And there should have been long term care placement done.
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welcome, Stuck!

Is your wife speaking with the Discharge Planning office at the hospital about next steps?

Will he be discharged to a facility for rehab? That gets paid for by Medicare.

There are social workers at the hospital who can guide your wife and her mom.

If dad is going to end up as a long term resident of a facility after rehab, mil needs to see an Elder law attorney to split their assets so she doesn't become impoverished.

Has your wife or her mom looked at any facilities? They should be figuring out where they want him placed.

Has wife been in touch with the local Area Agency on Aging?
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