Sunday a week ago, my mother was deeply sleeping, having the death rattle, etc. The hospice nurse with 30 years of experience thought the end was coming and asked me what funeral home we use.
We brought her dog to visit and she woke up a lot during that visit. The next day, she was very restless. And has continued to be Alert, no death rattle, etc., all week. Hospice has her on scheduled morphine, Ativan, risperidone, and ABH cream. The doses are not super close together, so they say there’s room for adjustment there.we stopped by last night and they had only just gotten mother to bed at 5:30 PM. They said she had been very up all day even able to stand at her bedside. At one point she had made her way down to the floor mat next to the bed. but at least she didn’t fall. And she did not try to walk or didn’t get anywhere anyway. They said they had trouble keeping clothes on her all day. I told him it looks like a medication adjustment is needed. They wonder if she’s developing a tolerance to the meds, which would not surprise me given her lifelong use of narcotics and benzodiazepines. Which I was very plain about this at the Hospice intake. She has a scheduled hospice visit this morning.
when I placed mother in the home, she had just come out of the hospital and being semi alert, not eating or drinking at all. Failing a swallow test. So of course she has rallied, can eat and drink some with someone feeding her. Puréed food. She might for example, eat 50% of breakfast and bites of another meal during the day. She went into this with a fairly solid body weight.
her upper arm circumference was 24.5 when she was admitted to the facility after several weeks in the hospital. As a Friday it was 22.8. I can easily pay for about six months worth of nursing home just from her checking account. If I get into some other assets, I can stretch it out to 11 or 12 months.
I met with the Medicaid lawyer on a phone call. He had already prepared her power of attorney documents, etc. two years ago. And really this was an appointment that had been scheduled when she literally looked like she was just about to die. And then it got rescheduled. So I kept the appointment just to see if I could learn more. I am absolutely fine with spending down her assets, which totaled about $24,000. This lawyer was extremely condescending and made snarky comments and seemed very determined to try to pull lawyer tricks to save her assets. I am looking for something more straightforward. Just tell me how to properly spend and document the money and then will apply for Medicaid when she is below $2000. The call did not go well. I do not think I can work with him. Her house is in a ladybird deed and I definitely hope to hang onto that. She’s got some way overdue credit card debt so I do have concerns about that. But right now I’m just focused on paying for her care and seeing if I can stretch out her money for as long as she needs it.
Mom was on Medicaid the last 3 months of her life. Because the house was up for sale, I contacted Moms medicaid caseworker and ask for a copy of the recovery letter and why. Mom owed 6000 for 3 months. I was able to sell the house for much less than the Market Value it was set at 4 years before. In that time the house had deteriorated much more. I got enough to pay back taxes, I stopped at time she went into the home. An outstanding water bill and the Medicaid lien. There was 10k left that I split between me and 2 siblings.
As to the Ladybird deed, I have seen Igloo, who is most up on this stuff, say that it often does not protect the home from recovery by Medicaid. I am hopeful that mom will pass still able to use her assets. That will insure the home is yours. Meanwhile, attorneys can be fired. Get another Certified Elder Law attorney is you wish. You seem to be able, however to "handle" this one.
If mother is now taking food again, she can live a long long long long time, even if she only weights 75#. And with a history of addiction, yes, the medications need to be adjusted in light of that.
Sorry this is going on and on. You and Wag, who often posts here, seem somewhat in the same boat; I can't see any answer to it but to man the helm.
Hope you are getting more rest. Thinking of you. 😊