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Hi. I am new on here. I am an only child. My mom and I have pretty much no family. It is past time for her to go into assisted living because there are many things she cannot do including ADLs. I am her HCPOA. I am not her financial POA yet, but we are working on that, as she just had back surgery. My question is, can I research assisted living facilities without her being present? I have no idea what she can afford between her Medicare, health insurance, and SS. Does anyone know if this is possible without her being there? We have talked about assisted living a couple of times, but I can’t stand to see her live alone and incapable of taking care of herself. Anyone out there know? BTW, we live in NC if that matters. Thanks.

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Jorja - realize that some of decision making will be totally out of your hands as their placement will be interdependent on what their medical needs are and well documented in their health charts. For most families their elders placement into a facility is incident based, usual scenario is it’s they have a fall, get hospitalization and then discharged to a NH for rehab and end up staying as a LTC resident of the NH.

So for your mom, it may be that she is not suitable for AL.... that she cannot do her ADLs well enough for an AL. You mentioned she’s has back surgery. So is she currently in the hospital? Or is she post hospitalization in rehab? I’d suggest you speak with her MD or the discharge planner at the hospital as to what her level of care realistically needs to be. It could be she’s better suited to being in a NH. To me, if able to get placed into a NH from the get go, I’d go NH route.

NH - aka skilled nursing care - has dedicated funding through Medicaid. So if a NH takes Medicaid, your mom can spend down and become eligible for Medicaid and from that point on good between Medicaid & Medicare to having all her costs covered. AL is by & large private pay so unless your mom has a huge savings or other investments to private pay for AL, it’s going to be a financial crisis in the making. MediCARE does NOT pay for the daily room & board charges; MediCARE only pays for hospitalization or post hospitalization rehab for a limited time or for MD or direct health care vendor fees (like PT). Health insurance- like BlueCross - tend to follow Medicare guidelines on payments, so they too will not cover long term room & boards costs in a facility. 

Unless she can become eligible for Medicaid, it’s going to be private pay. At 6k-15k a mo for NH, unless your mom has a huge nest egg, she’s going to run out of money. 

Now if Medicaid in your state does AL (most do not), it’s funded on a waiver program so funding could change next year. ALs Medicaid beds often have long waiting lists, & this is why it’s a 2 yr private pay till your name comes up on the list for one of the limited # of Medicaid beds. ALs have just oh so much uncertainty for Medicaid. Imo if she can get into a NH and onto Medicaid, she’s basically good till forever. If she’s going to rehab, it gives her the window to stay in the NH and transition from rehab to LTC resident at the NH. For rehab, the first 20/21 days are a 100% covered by MediCARE post hospitalization benefit. If she’s “progressing” in rehab, Medicare will continue but at 80% till she’s not progressing anymore or hits 100 days. Now if she’s got a better 2ndary health insurance those cover the 20%, otherwise she / you pay the 20% (about $190 a day). For families, the Medicare paid rehab period can give you an period of time & opportunity to figure out her finances to either apply for Medicaid or spend down & then apply to Medicaid. You’ll need to be her DPOA to get access to her banking to spend down. Yeah it’s overwhelming but to me if she can go NH route things will be easier. good luck.
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Sure, families do it all the time, it is actually much easier on your loved one if you can narrow it down to your preferred 2 or 3.
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JorjaPine, welcome to the forums.  The main thing you need to do is find out how much Mom can self-pay to be in Assisted Living. Self-pay means money out of her own savings. Example, when my Dad moved to Assisted Living it was costing him $6k-$7k per month. Dad used the equity from selling his house.

For that monthly cost he got daily housekeeping.... daily linen service where he didn't need to use his own bed sheets/towels as those were supplied by the linen service.... three meals a day in the main dining room using a menu to choose what items he would like... an Aide to help him shower daily and help him get dressed.... 24 hour nursing services, etc.

If you find that Mom cannot budget for being self-pay, she can check out Medicaid [which is different from Medicare] as Medicaid will pay for room, board, and care if your Mom is eligible for such program. See if your State has a voucher fund which would pay part of the monthly fee so that Mom can be in Assisted Living.

Otherwise, Mom's only choice would be a nursing home that accepts Medicaid. If Medicaid is the only route, then put Mom on the nursing home waiting list. Most places have refundable deposits.

I was able to review the Assisted Living places on my own to get a feel of the place. I was able to narrow it down to two places that were pretty close to me. A lot depends if you live in a rural area where the choices are very slim or in a large metro area where there are so many places it would make your head swim. Then I took Dad to the first place on my list, and the appointment was set up so that Dad could enjoy a lunch. He loved the place :) Whew.

Let us know how this turns out.
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Have a needs assessment done so you know what type of facility would best suit her actual needs. That should be your 1st step and if she is in hospital or rehab still, they can get that done for you.

If you are worried about her being alone, you can get a shared room.

A poster commented that you would be required to pay the 20% Medicare does not cover, that is not true. If your mom does not have a supplemental policy that pays whatever Medicare doesn't, she would be personally responsible NOT YOU. Do not sign any financial guarantees for her, you can not legally be held responsible for any of her bills unless you sign saying you will pay. I think there is a misunderstanding with folks that they can be pressed for their parents bills, not true, if someone presses you to sign guarantee, walk away.

Also, if she is in a facility right now, you can tell them that she has no safe place to be released to. Your home is not safe, no need to explain why, just not safe. This will get the right people on your mom's side to help you find a place for her to go. By law they have to have a safe release plan in place for a vulnerable person, which your mom obviously is. They will try to push you and guilt you into taking her, don't fall for it. NO, I am not a safe release, PERIOD!

Best of luck finding the perfect place for your mom.
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Yes I toured the few that we have in our area, bringing my DH or SIL with me for another set of eyes and to help take notes. I selected the top 1 and then brought Mom there for lunch and an activity. Too many choices would have overwhelmed her, but I told her if she didn’t like the place I’d chosen we would keep looking.  The Assisted LIving facilities in our area are all private pay, by the way, with increasing fees based on increasing needs. We found they ran from about 3000-5000 per month, for much the same services.
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You state "what she can afford between Medicare, health insurance and SS." The only one of these that will be of help in paying for AL is SS. Other than that it is private pay or Medicaid (after private pay is exhausted). She may also qualify for A&A stipend from the VA if her husband was a war vet.
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Another thought, the AL in my area all required Mom be able to walk from her room to the dining room. No wheelchairs. We had selected a perfect fit for her in an AL, and had all her stuff moved in. The same day an emergency surgery put her in the hospital and rehab. When she was through with rehab she could walk but not far enough. So she never moved into the AL, and went to NH instead. In retrospect, a Igloo says she probably would not have been able to stay very long at the AL anyway, and it was for the best to go straight to NH without the disruption.
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Oops, forgot to address your question. Yes, you can research, visit and get all of the information needed to make a decision, you will have to know your mom's financial status ie how much SS, assets, etc. You would not want to pick a place only to find out it is unaffordable.
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When we had to find a place for my Mom rather quickly, we used a local service that had a social worker who helped find matches for people. In our case the AL places paid her fees, I assume because she offloaded a bunch of work from them and also brought them clients that were a good match.

THe social worker was excellent in knowing the strengths/weaknesses of the different AL places. She also met with us to discuss Mom's needs/abilities. She gave us a top through to start looking at and the first one was a great match. My siblings and I went to visit the places first, and when we found one that was a good match we brought Mom for a visit. It would have been way too much for Mom to visit multiple places, etc.

In our case we had a top choice AL we knew of that had no openings. They were the ones who referred us to this service.

I also did some research on my own for my MIL, and the people at the AL's were very happy to talk to me in great detail.

Good luck
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Wow. This has been so helpful and eye opening. I need to study up on how all of this works.
She will be going to AL tomorrow or Tuesday post L4/L5 sx last Thursday.
I guess I need to start googling.
Thanks for the help!
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