Just found out my aunt has significant dementia, and her husband passed away.

First off, thanks again for your support, suggestions, and prayers.

We got to town Friday morning, and our first stop was the ER where my aunt is. She didn’t recognize me, but when I introduced myself she responded, “of course you are!” I can’t be sure that she knows exactly who I am, but she understands that I’m family. When we came back on Sunday it was an immediate “you’re back!”

Beyond that, conversation cycles through the same questions and statements every few minutes, and she’s concerned about what her mom and dad are going to say about this. (They passed away 25-30 years ago.)

Physically she’s fine, and as far as we’ve been able to determine she’s not on any meds other than occasional pain stuff.

The plan right now, unofficially until my brother can actually give the go-ahead is to move her nearer her sister and more family. She won’t be able to get into the same facility as her sister for a few months, but they have an identical facility a couple of towns over that can accommodate her in the interim. We’re hoping to be traveling this weekend.

Her husband is currently in the medical investigator’s office, and they had prepaid funeral arrangements, so he’s taken care of for now. Based on the condition of the house, it appears he had been in decline and not taking his meds for several months.

My wife and I have been getting the house cleaned up and paperwork organized so that when my brother gets here tomorrow evening he can hit the ground running.
 
Larry in TN said:
One thing to consider in the comparison is that almost all living expenses are covered in an assisted living facility. Rent, utilities, food, etc. and it leaves open the possibility to sell the existing home, and some of the belongings, to help fund the care.

If I can afford it, however, I'd take the in-home care every single time.
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We tried the in-home care with my mother; it did not work. I was trying to manage it from 300 miles away. She did not like other people in her house. She/we found a nurse that at first, she liked. It finally overwhelmed the nurse and she quit. Mom lived in a town with a lot of elderly people, and it was difficult to find in-home care, none that mom would put up with. My wife spent 3 months with mom over the last 18 months mom was at home to help.

We moved mom to a place near us, and it took close to two years for her to be simi happy there. She is a little under 6' and weighed 108 lbs when we moved her, within 6 months she was up to the mid 120's and still there. She is about to turn 91. Last 2 months she was home she was in the hospital 7 times. In the two years here, it has been 4. We have been a lot happier since she has been close to us.

This is the cliff note version.
 
pfarber said:
This is some very problematic advice. If your parent is bedridden then being at home with in-home care is a WAY better option. Unless you have a WICKED good ultra platinum plan 24/7 care doesn't last long then you either self pay or use Medicare. If you start to use gov't money then they WILL come after their assets. There is a 3 year 'look back' where the gov't can undo asset transfers. So selling a house would be a problem.
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It's five years, and they're looking for giving away assets, so selling a home for market value and using the proceeds to pay for care--as suggested in the post you replied to--wouldn't be a problem. And the government can't undo the transfer, but it can penalize your eligibility.
 
MauleSkinner said:
Based on the condition of the house, it appears he had been in decline and not taking his meds for several months.
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That's why they need family checking in on them frequently. They don't know what they're missing. It can get quite bad without them asking for any help.

My wife and I have been getting the house cleaned up and paperwork organized so that when my brother gets here tomorrow evening he can hit the ground running.
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I had great succuss with an estate sale company with my parents house. The idea of sorting through everything and finding a way to sell it all was overwhelming. The estate sale company came in spending a couple of weeks sorting through everything in the house. They put anything that looked personal aside for me to go through. They researched the value of items and sold a few, like the better jewelry, outside of the estate sale so as to maximize the return. They held a 3-day sale that was crazy. The traffic was incredible and the vast majority of the stuff sold. At the end, they brought in somebody who'd carry everything that was left away, selling some of it himself and taking the rest to the dump. There were no fees for the service, just 30% of the gross went to them. I ended up with an empty house and a check for close to $10,000.

Plano Pilot said:
She did not like other people in her house.
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They know something is wrong, because of the holes in their memory, but they often atribute it to the malice of others. Something that they misplaced become a theft accusation against the caregiver. They can't be reasoned with, only diverted to other topics. It's not productive to try to correct them, or to teach them how to do the things that they can no longer do. They will not learn.
 
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Larry in TN said:
They know something is wrong, because of the holes in their memory, but they often atribute it to the malice of others. Something that they misplaced become a theft accusation against the caregiver. They can't be reasoned with, only diverted to other topics. It's not productive to try to correct them, or to teach them how to do the things that they can no longer do. They will not learn.
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So true!!
 
@MauleSkinner it sounds like things are being handled as well as possible. The fact that she will be able to eventually (albeit not immediately) get in the same facility as her sister will make things much easier for the family to take care of, and I'd expect nicer for her as well. Expect an initial decline when she's moved to each facility, as it's unfamiliar. It's very common and normal. But, glad to hear things are heading in what sounds like a good direction.
 
Gilbert Buettner said:
my wife was able to use her savings to pay the $5000+ each month,
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Burned through $3k+ a week for 24/7 home hospice. Since there was no real way to 'preserve' the cash we figured the best use was on mom and keeping her home.

Her major asset (house) was not put at risk but the only reason was hospice didn't last long.
 
Larry in TN said:
I didn't give any advise in that post. I pointed out that there are some savings in an assisted living facility, over living at home, that you might not realize when doing a cost comparison.
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Maybe advice was the wrong word.... but you cannot do this. Her estate, possibly the even the person who had power of attorney would be held liable to the gov't. You cannot liquidate assets if gov't insurance is used... they will come looking for compensation.

I don't think many people realize this. I didn't until the hospice advisor told us about it.

My view is that the nurses did thier job and I am fine with liquidating assets to pay them.
 
pfarber said:
Maybe advice was the wrong word.... but you cannot do this. Her estate, possibly the even the person who had power of attorney would be held liable to the gov't. You cannot liquidate assets if gov't insurance is used... they will come looking for compensation.

I don't think many people realize this. I didn't until the hospice advisor told us about it.

My view is that the nurses did thier job and I am fine with liquidating assets to pay them.
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Cannot do what? Sell assets to pay for her care? Maybe after going on Medicaid, but certainly not before when she's private pay.
 
pfarber said:
Maybe advice was the wrong word.... but you cannot do this. Her estate, possibly the even the person who had power of attorney would be held liable to the gov't. You cannot liquidate assets if gov't insurance is used... they will come looking for compensation.

I don't think many people realize this. I didn't until the hospice advisor told us about it.

My view is that the nurses did thier job and I am fine with liquidating assets to pay them.
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You absolutely can liquidate assets to pay for care and extend the time before you need government assistance. That's what they want you to do. What you can't do is give away assets in order to impoverish yourself. In fact, the home is likely exempt, while the proceeds would be countable.
 
pfarber said:
Maybe advice was the wrong word.... but you cannot do this. Her estate, possibly the even the person who had power of attorney would be held liable to the gov't. You cannot liquidate assets if gov't insurance is used... they will come looking for compensation.
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Of course you can. That's what the patient's assets are there for. To pay for their own care.

What you can't do is transfer the assets to others to preserve them from being used toward their care and to qualify for Medicate assistance.
 
Update for those interested…
I’m back home after 2 1/2 weeks. My aunt is currently at my younger brother’s house with my mom and older brother (who has POA). We have a memory care facility lined up, and her stuff is already moved in, but we’re waiting on a corrected med list from her PCP, which has been a total PITA. The original med list had one with “take one by mouth” with no frequency. My brother has been on the phone with them every day for the last week to get it corrected, and they can’t seem to get it right. Hopefully he’ll get that straightened out.

She hasn’t been enthused about moving into the care center, but she understands the need. It seems to be a good facility, and it’s got a couple of sun rooms that she really likes. I don’t think she’s figured out who my brothers and I are, other than somehow family (she hasn’t used our names at all) but she did recognize my cousin and used his name.

Once she’s settled and finances are stable, my brother can start to figure out the house and property issues, but that’s going to be a couple months down the road.

Thanks again for your support and prayers.
 
Wishing you best of luck, and glad you have some family help. Oh...and I read "has POA" as "has pilots of america", and wondered if that was classified as some sort of medical condition. Then I realized you meant power of attorney.
 
Half Fast said:
@MauleSkinner , any updates? Haven’t forgotten about you.
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Thanks. They got things squared away to get her moved into the care center shortly after we got home. Mom was up visiting my brother through December, so she made several visits to my aunt.

Since memory is one of the primary issues, she repeatedly packed her clothes and stuff to “go home,” which apparently is fairly normal, but Mom said she was starting to settle in after a couple of weeks.

As I mentioned previously, one of the reasons we moved her to the facility that we did is so that she’d have family nearby to look in on her. At this point it’s primarily my cousin whose mom is also in memory care, and he’s VERY good at both handling her condition and dealing with the facility management. My younger brother is close by, and I’ve got an aunt a couple of hours away who will visit periodically as well. And it seems quite likely at this point that my mom will be moving up to that area in the not too distant future…my dad passed away almost 5 years ago, and she’s about ready to move into a senior community instead of being largely on her own a couple hundred miles from nearest family.

We contacted a local church and they’re arranging someone to pick her up for Sunday services periodically. That’s always been an important part of her life, and she is still aware of her need and desire to get to her church.

So she’s safe and cared for, and hopefully she’s feeling more at home there.
 
On a humorous note, she was a schoolteacher, eventually got her Master’s degree in Library Science, and spent the last 15 years or so of her career as a librarian.

One day she started walking around the facility collecting up books and taking them to her room. The nurses’ desk had their logbook for people in and out disappear, and guess where they found it? Yup…in my aunt’s “library.” :D

The staff in the care center seem to have a good sense of humor.
 
MauleSkinner said:
On a humorous note, she was a schoolteacher, eventually got her Master’s degree in Library Science, and spent the last 15 years or so of her career as a librarian.

One day she started walking around the facility collecting up books and taking them to her room. The nurses’ desk had their logbook for people in and out disappear, and guess where they found it? Yup…in my aunt’s “library.” :D

The staff in the care center seem to have a good sense of humor.
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I've been following along and I'm thankful to the Good Lord that things have come about as they have.

I have the privilege of working in nursing homes and care facilities and have also viewed a few things that while sad in one way, were humorous in another. One day I had gone into a facility and was setting up equipment when a well dressed lady came by and asked if I knew where the manager was. Not knowing who she was I guessed that she had just come in the door soon behind me. When I found the manager I told her that a lady was waiting in the lobby to see her. The manager looked around the corner and said, "Oh she's new here and thinks she's checking into a hotel and waiting for someone to bring her bags inside."

On another note ... I meant a custodian one day in the hall and he asked how I was doing. I told him I had nothing to complain about. He said that no one listens anyway. I remarked that he didn't hear what I said and that I meant I had nothing to complain about. Then I told him, "look around this place, many of these can't even get out of the bed and most that can look in the mirror and don't have any idea who's looking back at them. I'm extremely blessed and so are you." He walked away in silence and appeared to be a bit stunned after considering the truth of the matter.

I guess all of that to say that we should really be thankful to God that we have the good health that we do ...
 
When my mother in law developed Alzheimer's we wanted to keep her in her own home for as long as possible. She wasn't computer literate, bit I set up an always-on computer and webcam that I could remotely activate in her kitchen. This let us look in on her, and my wife had daily videochats with her. We figure it gave her an extra 6 months of independence, that ended when a neighbor found her wandering the streets in her pajamas at 2am, looking for her son's house.

We brought her to live with us for a couple of years until we could no longer manage her frequent attempts to leave, thinking she would walk "around the corner" to her own house, which in fact was 200 miles away. Then a memory care facility until her money ran out, then a nursing home that had Medicad beds. That last place was just "OK", but by then she didn't really know where she was, and our daughter who is a nurse worked there and made sure she got the care she needed. Fortunately she was one of those dementia suffers who gets silly and goofy (as she was before, just much more so), instead of mean and combative like so many do, so all the staff loved her.
 
Dana said:
Fortunately she was one of those dementia suffers who gets silly and goofy (as she was before, just much more so), instead of mean and combative like so many do,
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My wife says that dementia simply allows the person’s real personality to stay at the surface. My aunt is a naturally sweet, good natured person, apparently.
 
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