If you work with an elder care lawyer, you might be able to organize things so that legal steps have been taken with finances to qualify one for Medicaid if their finances are limited.
But there is a 5-year look back period do planning needs to be done well before there is a problem. If you are looking at a couple, you need to have an understanding of how one can protect the assets of the healthier one, too.

Anonymous wrote:HCBS in Maryland was nearly impossible to get support through. Sure, there are programs and PDFs with information, but when it was time to apply, nothing was available. Every program was either a long waitlist, wasn't accepting applications or wasn't offering enough to be worth the effort.

What I learned is that Medicaid is seen as a "right" if you don't have the assets to pay for your care. All of these other programs are a community need and a lot harder to get (even if you qualify for Medicaid).

I wouldn't bother with any of these programs. I would decide if Medicaid is likely in their future, and then spend down and reorganize their assets if it is.

If you “reorganize” assets in expectation of Medicaid application and don’t get competent legal advice first you may be in for an ugly surprise.

HCBS in Maryland was nearly impossible to get support through. Sure, there are programs and PDFs with information, but when it was time to apply, nothing was available. Every program was either a long waitlist, wasn't accepting applications or wasn't offering enough to be worth the effort.

What I learned is that Medicaid is seen as a "right" if you don't have the assets to pay for your care. All of these other programs are a community need and a lot harder to get (even if you qualify for Medicaid).

I wouldn't bother with any of these programs. I would decide if Medicaid is likely in their future, and then spend down and reorganize their assets if it is.

How about a non-profit advocate?

Following because I am in the exact same boat. Feeling completely overwhelmed and lost trying to navigate this.

OP here. Have already worked with one attorney to establish POA and get basic paperwork together. However, I need advice re: how HCBS works in Maryland (Home Based & Community Services) and the attorney was not well informed enough to help. Very aware of the costs involved. This article summarized what I know well already: https://apnews.com/article/medicaid-spend-down-nursing-home-care-costs but need help navigating - this requires an elder care attorney to my knowledge.

Anonymous wrote:I agree with the PP. If you don't have considerable money, then you can't afford a care manager. Your mother needs to be in a memory care facility. It's hard. I know.

Those are outrageously expensive too. Like 10K a month.

Re: care management. I already reached out to the obvious ones and had an initial consult for about ~$300 with IONA. I thought that the research provided was minimal and likely not worth the money - they didn't tell me much I didn't know already. What I actually need is someone to take a look at our situation, and tell me what my mom needs objectively now and in the future.

I'm having trouble understanding what is best for my mom given her needs and her savings. She's sorta functional and sorta not, depends on the day and my outlook and biases. I KNOW she doesn't want a memory care facility and I THINK maybe it's not quite the right fit YET, but I'm not sure what array of services could bridge the gap. We manage a lot for her now, but as I'm a parent of very young children and work full time, I have very limited bandwidth.

I didnt hire a care manager, but I did call around and spoke to them. I can see how an initial consult (or couple of initial consults) would be very helpful. Its hard to know what the right thing to do is or what the options are.

My mother has dementia. Lived in assisted living for over a year and just moved to memory care. It was a hard decision but I'm hopeful it was the right one.

Look at be light care on Instagram. She has a lot of helpful advice.

A care manager initial assessment is probably at least $1000 and services $250 or more an hour. So it depends if that's feasible. So depends what you want.
Eval, setting up connections to service providers, a check in visit every few weeks, someone to call if there's a problem or snag inna service...this could be affordable.

Anonymous wrote:I'm looking for an elder care attorney and a care manager to help me navigate my mother's Alzheimer's diagnosis. Prefer someone who is not "deluxe" and works with regular middle/working class American families in the DMV.

Unfortunately, I'm not sure this exists.

It should -- there is such a big market for it. But I think it is just a very expensive service to provide, and involves recommending and coordinating services that are more expensive than those who aren't wealthy can afford to use or even consider.

What do you mean by "help me navigate my mother's Alzheimer's diagnosis"? What kinds of help are you looking for -- lots of things could fall under this. If you are more specific perhaps more folks her can help?

Attorney Erin Mahoney in Rockville is very experienced in elder law issues and trained under the late dean of local elder law practitioners.

My now-long ago experience with care managers was that their services were aimed at the more affluent market. Your mileage may vary.

I agree with the PP. If you don't have considerable money, then you can't afford a care manager. Your mother needs to be in a memory care facility. It's hard. I know.

A care manager will be very expensive because as those of us who did it for free learned it is very time consuming and draining and unlike those of who did it as family, the person usually has a lot of training. Ideally you want someone who works with many contractors and get a aide/driver/hospital bed/PT/OT/ST, doctor who does home visits on short notice.

If you cannot afford a care manager, it's better for the parent to be in a facility where they have people they contract with already. You could hire an advocate to take some work off your plate.

What do you want to care manager to do? If it's simply to check on the parent and that is it, you can do a geriatric social worker.

Elder care attorneys are not cheap either.

I'm looking for an elder care attorney and a care manager to help me navigate my mother's Alzheimer's diagnosis. Prefer someone who is not "deluxe" and works with regular middle/working class American families in the DMV.