JOYCE, Cumming, Ga.: My 85-year old mother has Alzheimer's and lives with me. I am single and have no other relatives to help, so am her sole caregiver and it is becoming more and more challenging. I currently have her in adult day care during the day while I am at work, which is paid for by Medicaid. However, I need to begin looking for permanent placement for her because as her disease progresses I know I will no longer be able to care for her. My problem is that there are very, very few facilities in my area that take Medicaid patients. Those that do have three beds in a room and are not where I would want my dog to live, much less my Mother! I can't afford to self-pay to get her in one of the local "assisted living" facilities, so I don't know what to do. If I keep her at home, there is a chance she could hurt herself, but I just can't bring myself to put her in one of those horrible places. Help!!!
MORRIS: You are on the right track, accepting your limits and planning ahead. Good work! If you haven't done it already, contact the Alzheimer's Association (www.alz.org) to learn all the options that are available in your area. Medicaid would rather give you the support you need to keep your mother home than have her go to a nursing home (because it's cheaper that way), so some states have programs to help people on Medicaid stay at home. The folks at the adult day care center should also know about local services and options. If she has to go into one of the nursing homes, then stay involved and vigilant to get her the care she needs. The National Citizen's Coalition for Nursing Home Reform can help you understand her rights and yours (go to www.nccnhr.org and click on the "Consumer Center" tab).
LAURA, Hartselle, Ala.: I have been taking care of my mother-in-law, who has advanced Alzheimer's, for the past 5 years. She can not fix her own meals, bathe herself without step by step instructions or get her own clothes to wear each day, and most days she does not know who my husband or I are. She does not wander off (we are thankful for that). Her monthly income is just over $2000. This means if we put her in a nursing home she would only be able to stay for the 100 days that Medicare will pay for because she makes too much for Medicaid to pay for long term care. But she doesn't make enough to pay the $5000 a month fee for the local nursing homes. I am a full time student and my husband works 60 hours a week. It is putting a strain on both of us to keep her the way we feel she should be cared for. I, like the woman's sister in your story, don't feel like any other family member would take as good care for her as I do, not that any of them have offer or even called to see how she is and if they could help. My question is, what can we do to get her long term care?
MORRIS: I'm afraid that Medicare won't cover nursing home care unless it is preceded by a hospital stay. However, if her assets (bank accounts, stocks, bonds, etc.) meet the state Medicaid limits (usually $2,000 to $3,000) then she will qualify. Generally, her income goes toward the monthly nursing home fees, and Medicaid covers the rest. But Medicaid rules vary from one state to the next. Talk with the financial folks at the nursing home, or the local Medicaid office to see what is possible in your state.(You can find your local office through the Centers for Medicare & Medicaid Services, www.cms.hhs.gov.)