Parents have reached crisis mode. Feeling overwhelmed

[Anonymous]

Parents are in FL. Mom with dementia, Dad was taking care of mom but he has gone downhill fast and can't even get around the house. Both are in denial about the situation and he has refused to go to the hospital when the neighbors called paramedics on him. He's had a huge mental and physical decline in the past couple of weeks. House has turned into somewhat of a biohazard zone. Sibling and I were somewhat estranged from parents for reasons too long to go into, but we are able to tag team going down there this week. They both clearly need to be in nursing homes, but can't afford it. Not only that, but they will likely furiously resist going to a facility. Brother and I are both extremely worried, sad, conflicted.

I have read that there is such a thing as medical spend down that could qualify them to get medicaid. They are above threshold for medicaid right now, but probably not by that much. Will it take a long time to apply for medicaid? They can't do this themselves in their current state. What if there are no spots available in nursing homes or facilities right now? What if they refuse to go even if a spot is available? Their doctor has called social services yesterday but social services has yet to be in touch. Wondering if anyone has been through this and can offer insight. I am worried about how long this will all take because they cannot function right now and we have to go back to our jobs and cannot stay with them for much longer. Brother went down there first and I will take over for a few days after him.

[Anonymous]

Sounds like they will need to go a facility eventually, but you will have to figure out what level of care is needed for each of them, costs of various options, etc. You don't say what specific health ailments your father has so below advice does not account for that.

In the short-term, can you find a home care agency like Home Instead? they can send out caretakers/caregivers to the home for a few hours per day and maintain some order/presence while you decide what to do. The hourly rates are high but still cheaper than a facility. You may start with a few hours a day/ a few days a week and see if that is enough. Increase hours/ days if needed.

I had a parent in very critical condition who has been in various settings including at home with a caregiver/ caretaker for a few days a week, in assisted living, and even in 24/7 care ($$$$) temporarily. I isolated what they really needed, took some time off to improve the health conditions that were still reversible.

They are back at home with someone coming a few days a week, with medicines delivered in daily dose packets, regular cleaning services, and grocery delivery. A home care provider can also clean lightly, buy groceries, etc.

There are also social service agencies who may send out someone like this if parents cannot afford it in the long run. If you can get services that way, that would be ideal.

If they need to be monitored throughout the day, of course you will need to seek out facilities. However, I highly recommend trying to figure out an at-home solution and seeing if you can handle it that way first.
This will also allow you to understand their specific need which is helpful when you search for a facility.

Do they need someone to prep meals a few days a week? Every day?

Do they need to be watched as they take medications?
Do those meds need to be pre-sorted?
Do they need regular cleaning services (caregivers can do light housework)?
Do they need groceries delivered?
Do they need regular exercise?

All of these may be handled at home with a little support and signing on to services.

Even someone coming in 7 days a week/2-3 hrs per day will be more affordable than a nursing home or assisted living, especially for 2 people.

Once they are in the nursing home/assisted living world, the costs add up fast. It is worth trying to support them at home and then looking for a facility if home doesn't work out.


You may need to have someone trustworthy nearby who can manage mail and some paperwork locally. Most bills can be managed online.

Good luck--while you or sibling are with them, try to organize their house with signs, specific places for item, etc. so someone coming to help them can have an easy time navigating. Buy a few locking cabinets to store sensitive items.

If you are truly busy and don't want to worry about your parents, a nursing home/assisted living situation does give you a more worry-free experience but not always a personalized or even healthy option. They may tell you that your parents needs services that they don't really need, etc.

[Anonymous]

There are two different kinds of medicaid. What you are asking for is long term care medicaid. Call aging and disability and see if the county has any help.

[Anonymous]

https://elderaffairs.org/resource-directory/aging-and-disability-resource-centers-adrcs/

Will they accept a hired caregiver in the house? It would buy you some time to figure things out.

[Anonymous]

PS you have my deep sympathies, OP, it is so disturbing when parents live in denial like this but it seems unfortunately to be the norm and then their middle aged children, usually the women, have to scramble and deal with all the stress, etc. It's hard and I'm sorry you're going through this.

[Anonymous]

Thank you all for your advice and kind words. Believe it or not brother and I do not even know the names of agencies to call because this all hit us two days ago and yesterday was the first day brother saw the situation in person. Even this simple tip to call aging and disability helps because we are so stunned. I also didn’t know there are two types of Medicaid.

We had been estranged due to their lifestyle choices that have made their condition worse financially than it needs to be. We didn’t know how bad things have gotten, but Dad needs help even getting to the bathroom. My brother has a hard time by himself moving dad around the house. He needs to find a wheelchair. No clue what his medical issue is but Brother took him to get blood work done yesterday against his will. Mom cannot manage on her own without Dad because of Alzheimer’s.

I hate to say this but neither brother and I want to support them financially nor can we really afford to do it. It’s hard to explain but there is some bad history between us due to their choices, but they now seem so helpless and frail that we feel really awful.

[Anonymous]

PS I am also surprised the paramedics could not just take them to the hospital when neighbors called 911. It seemed so clear that they are not in their right minds.

[Anonymous]

I’m a caregiver who recently cared for an elderly lady until she passed. Her family applied for Medicaid when I started working for her in September and it was finally approved the following May/June. I don’t know if they have an expedited process for people who urgently need to go into a facility - the lady I worked for was being cared for in the home by her eldest daughter who is a retired RN and with respite care from folks like me.

[Anonymous]

Anonymous wrote:I’m a caregiver who recently cared for an elderly lady until she passed. Her family applied for Medicaid when I started working for her in September and it was finally approved the following May/June. I don’t know if they have an expedited process for people who urgently need to go into a facility - the lady I worked for was being cared for in the home by her eldest daughter who is a retired RN and with respite care from folks like me.

Every state does it differently but here you have to be in a nursing home bed prior to approval and you go Medicaid pending.

[Anonymous]

This resource says the average application approval time is 90 days, but that benefits may not be immediately available because no spaces available at Medicaid facilities etc.

The website looks like it might be a good resource in general.

https://www.eldercareresourceplanning.org/medicaid-eligibility/approval-process-timing/

[Anonymous]

My one outside the box idea is to call the hospital for your dad the next time there is a crisis. Force it on him so he can get evaluated there. I don't know if they will admit him from the ER, but if they do, then you can access social workers at the hospital and see if he is eligible to go to rehab. Medicare will pay for 20 days but you need a referral. While he is at rehab the social worker there can help figure out next steps based on what his condition is.

For your mom, see if she is eligible for hospice. Not sure what stage she is at. Then see if the hospice social workers can help you further.

[Anonymous]

I’m so sorry for this situation. We need better infrastructure as boomers continue to age—imo it’s at crisis level.

Would calling the Florida department on aging be appropriate? Maybe they can send someone to do a welfare check and make sure they’re ok?

[Anonymous]

You (or your brother) needs to get POA for health and POA for finances. You'll need to find a lawyer to do this, your parents will have to agree to sign papers.

[Anonymous]

10:58 here. Also, you need to do it soon. There are plenty of awful people that take advantage of the elderly, and they stay two steps ahead.

[Anonymous]

My parents were in a similar spiral a few months ago with my dad going from functioning to bedridden over a three week period. Both parents were in complete denial. What I did was call the primary care doc with my dad and told them all of his issues (incontinent, can't walk, in pain, short of breath, etc) and we called an ambulance. While he was in the hospital being evaluated we were able to tap into resources to get him walker, wheel chair and hospital bed and put care in place for when he came home. I recommend this for you. Go to the ER.