She has not been officially diagnosed, but Alzheimer's is highly suspect per the neurologist (couldn't do the MRI because she has a pacemaker). Logically, I know she will not be able to live alone in her own house (she is defiant against any rules that she'd have to follow with in home care), but I feel that I'm dragging my feet getting her house ready to rent (for the income to cover the cost of the assisted living); my heart keeps saying "what if....?" I feel bad because she hasn't seen her home since Easter (took her to ER the next day because she wasn't eating & not taking her BP & diabetic meds ). It's so hard because sometimes she seems so absolutely fine and goes along with the program; other times she repeats herself, gets angry, is paranoid, and wants to know exactly how long she will be there.
If it seems like mom is really better going into a NH, will the rent paid be enough to private pay in full for the NH as well as all the costs related to renting out the home? NH can run from 5K - 15K a month, so really get a hard cost estimate on all this. If rental won't cover private pay, then carefully speak with a Medicaid caseworker as to just how your states Medicaid program deals with rental property owned by a Medicaid recipient. Make sure that the tax assessor value of the property is within Medicaid's rules too. Depending on just what you can realistically rent it for, you may find that you or other family members end up having to pay for many of the costs associated with the property and that you will have to do this for the property for the rest of mom's lifetime and then seek reimbursement of these costs as your own claim or lien against your mom's estate in probate later on after she has died. Also check with mom's insurance to see what is allowed for rental once the property owner has moved out - you likely will have to get a separate policy for rental property. Mom's homeowner policy will not be valid once she rents it out. Make sure rentals are OK for mom's neighborhood too - both as whatever is in city statues or HOA but also what the vibe is from the neighborhood association viewpoint as to rentals.
If mom's likelihood of being in AL is maybe just a couple of months and she is best in a NH and could be there for several years, then think hard if dealing with rental property or moms empty house is really something you want to take on both physically (like having to do things at the property) and financially (roof needs replacement and cannot be rented till done and mom's income is going towards her payment at the AL/NH so its all on your purse to pay). Good luck whatever path you decide on.
I'm taking her back to primary care again next week (my Mom says she likes her) to get one last supportive opinion :) and then I'm going for it on the house! The alf is not cheap!
I don't think your indecision is unreasonable; you don't know what will happen and you don't want the house to be unavailable if she does come home.
Was she sent directly to an ALF from the hospital? What were the justifications? It sounds as if this is going to be her permanent home and that she won't be returning to her private residence. But I think it really depends on the justification for the ALF placement and whether or not that can be reversed, similar to remediation from skilled nursing placement for physical issues.