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Mom's strokes less than 2 years ago left her unable to function on her own and she needs help with all decisions because she cannot figure out what day or time it is. Her cognitive function is poor and aphasia makes it hard for her to communicate. She's in an assisted living and very happy now. She no longer fights with me and seems resigned to her shortfalls. Her health is good but her money will be gone before Medicare finally gets her off the wait list (2 years in Florida). Question: will she get much worse? She is only 87 and strong.
As it is I pay for private duty care. I can't put her in memory care yet. She loves her apartment and has friends where she is.

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Wow! In Florida there is a huge wait list. The funds become available whenever. I keep checking.....
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Maybe I'm misunderstanding you. If you mean MediCAID ... the two year waiting list is shorter depending on the persons need. My MIL only had to wait two weeks for benefits (including $1,100.00 toward Assisted Living) and she was not nearly as advanced as your mom.
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I've never heard of a waiting list for MediCARE ??? She should have already been on Medicare since she was 65.
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Medicaid not Medicare. In Florida you get $1,200 after a waiting period for Assisted living facilities. Nursing homes are different.
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We live in FL and my MIL was recently approved for Medicaid including Long Term Care through the HCBS Waiver. Right now she gets two visits a day from a Home Health Care aide, Meal Delivery, and Housekeeping Services, paid for by Medicaid. We are currently looking for an Assisted Living facility. I was told just last week that when we choose a facility, Medicaid will pay $1,100.00 per month to the facility. The remainder of the monthly cost will be covered by her Social Security check (1260.00). This is for a shared room with a roommate. If we wanted a private room for her we would have to pay out of pocket around 800-1000 per month. I would be happy to help you with details.
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Nikki, if your mother is qualified, there is a program called PACE that provides in-home care using a combination of Medicaid and Medicare. There is a bit about the program at http://elderaffairs.state.fl.us/doea/pace.php if you want to research more. The requirements of the program are fairly rigid from what I've read, but it sounds like a good deal if someone is able to work with the program.
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Nikki999, I'm not sure about that Medicare pay issue. I've never heard of that. Maybe, it's something new or it's a typo/mistake. I know that Medicaid pays for long term care, but it pays directly to the facility, not the patient. And, Social Security pays monthly money. Maybe, that's what she meant.
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I live in FL with my mother here as well. How can Medicare pay $1,200 when they told me I'm not entitled to any money or financial help at all for a live-in caregiver to keep mom in her house? Anyone know?
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My cousin (I'm her DPOA and HCPOA), went from running her own household to being unable to live alone or take care of her daily needs in less than 6 months. In just over a year, she became fully incontinent, unable to walk, and unable to do many things, such as putting on gloves, removing an item from a bag, and has trouble picking up her food. It's so odd the way things work. Things progressed with her rather rapidly. She now doesn't know she has a home. She thinks her room in Memory Care is her apt. and that she works there in their office part time. She still knows me and my parents, but not many other people. She can't give the name of anyone she is has met in the last 2 years. She doesn't know the name of her roommate, staff members, doctor, etc.

She eats fine, but recently I noticed that she had difficulty picking up her food. I had laid her biscuit on the plate and she was eager to eat it. (It's her favorite.) But, she just looked at it and was not able to pick it up with her hands. It's like she forgot how to do it. I then put the biscuit into her hands. She was then able to hold it and eat it. This is new behavior. I know that eventually she will forget how to chew and eat.

Of course, all patients are different. I would read as much about Vascular Dementia as possible so you will know what to expect,

From what I have read, Alzheimers usually takes a longer period of time to cause that degree of decline, but other forms of dementia, such as Vascular can cause it to happen much faster.
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Sunny I agree with you Mum has VaD and Alzheimers - it is very stepped and very haphazard too for Mum. Some days perfectly 'normal' as far as normal goes other days not at all and I can almost tell now by just looking at her when she wakes up which day it is going to be.

When the steps come it can be sudden and unexplained - I tend to find it comes after infections have set in BUT I have noticed some changes at a pre infection point. I mean by that, that when her urine just starts to smell a little stronger I pump liquids in as much as I can (fight time!) but even though I avoid the infection taking hold the step down occurs. Doctor says I imagine it but I am sure I don't
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It is difficult to say how quickly VaD will progress. It depends on how many and the size of the ischemic episodes in the brain. People who watch their blood pressure, blood sugar, and cholesterol can often go for a long time without much progression. As sunnygirl said, progression tends to be stepwise, with loss of function happening after small (or larger) strokes. The strokes may not be apparent except noting that there has been a cognitive change... or sometimes a fall that accompanies them. Giving a prognosis can be difficult, since a common cause of death is stroke or heart attack. The best we can do is try to keep the blood chemistry and pressure in check and provide supportive care when needed.

Schoff, I wondered if you meant there would be a wait for a Medicaid bed to become available at a certain facility.
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I wasn't aware that Medicare pays that way. And I wasn't aware that you had to wait for Medicaid. In NC, they give you an answer within 5 days and your card is mailed immediately.

Here's a site that might help with more information regarding resources in Florida. I wish you both the best.
http://www.floridashine.org/
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Medicare pays $1,200 a month in Florida. They pay 100% if you are in a nursing home. We pay bare bones in assisted living because we have aids in the morning and evening. I'm there most afternoons. It's sad but so many are waiting for Medicaid.
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I'm a little confused about your comment about her being on the wait list for Medicare. I wasn't aware that they paid for Assisted Living. Is she paying for the private duty nurse or you? I'd sort all of that out now, so you know what to expect down the road and all that she is entitled to. If you provide more details, some others around here that know more about it, could probably add more.

Regarding the Vascular Dementia progression. Often its progression is described as occurring in a "stepped manner" rather than a gradual progression. My cousin has Vascular mixed with Alzheimers and her has been that way. I have done research online about Vascular and found the prognosis for that type not to be very positive, though all patients are different. Your mom's case could be different.
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Yes, unfortunately she will get worse as the dementia progresses. Until it comes time for her to move into a memory care facility you can always increase the hours of her private duty care.
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