How to get a parent into a nursing home in NC who has severe dementia and is steadily declining daily?

Did they give you a reason she didn't qualify for Medicaid? Is she on Medicare? Just with the info you have provided I would start with her doctor. Does she see a geriatric doctor? There offices have been a fountain of information for me. Next I would go an online search on NH in your area and go talk to them. They can also help you set up funding. Another option could be calling your state Aging and Disability agency (check the State Dept of Health) they should also be able to give you some advice/ help.

Thank you very much for all your help. She only has Medicare. I wasn't told why she didn't receive Medicaid before and will try to get it for her again. Her doctor is a general practitioner who is also the medical director for the nursing home where I would like my mom to go. Her next doctor's appointment is in 3 weeks and I am going to speak with him personally about him writing up orders for her to go into the nursing home. Things are getting difficult at home with her now. Also, thank you for suggesting I contact my state's dept. of Aging and Disability. I will also contact Medicare to see what else I can find out. I love this website. It is so informative and it is wonderful to connect with people who understand my struggles and who provide support, information, and encouragement. It is amazing to see how many people struggle with the same things as myself.

Medicaid I would file an appeal (if you can refile, then appeal if you get denied again). Also, I learned that when my local Medicaid office gave me grieve (or just flat out confused me!) I called the state office. I don't live in NC but it worked wonders for me. I tried to be super polite and explained my situation. It drives people crazy sometimes but if I don't understand I will keep asking until I do.
Since you know which NH, set up an appointment with them. They might also help you and/ or give you some other options (for dealing with Medicaid and other funding possibly).

I'm also in love with this website. It's been a godsend!

Re - the land and the trailer in your moms name...

I'm going to have to try to take you at their word when you say "they have a deed".If that is truly correct, that would likely have been signed by your mom and notarized at a much earlier date, prior to her dementia. Sale or transfer of real property, as in real estate, always has to be verified by a notary. If this deed does exist, I believe it would be just a matter of recording it and you would have proof that your brother and his wife were the owners many months or years ago. The fact that it wasn't filed only means that your mother is still the owner of record. If the signature and the dates are valid, based on the notarization, I believe that date would prevail and your mother would not have owned the property since that time. That may make a difference to Medicaid.

The way to look back works is if your mom sold the property she would be expected to pay that money for her care for a certain amount of time. You may have to ask your brother to see this (supposed) deed and the date on it. If that turns out to be incorrect, to protect your mom, you may have to force your brother to buy the property so you can use the money for her nursing home care in lieu of getting Medicaid.

Also, you mentioned being guardian of person and representative payee. Somewhere in there are you also guardian of financial? If not, and you have to get a lump sum payment from brother (he would probably have to refinance a property, but that's HIS responsibility if they didn't take care of business), you will probably have to request to be a guardian of financial to receive other money on your moms behalf. That's how it is in California, not sure about NC.

Julidu is right about talking to the nursing homes. Nursing homes can be very helpful in getting things done. My DIL visited several when her mother's needs got to be more than she could handle at home. The mother had Medicare and also had property. The homes gave good advice, pointed her to the right person in social services, and even helped her fill out paperwork, applications, etc. After her mother broke an arm in a fall, the social worker at the hospital coordinated with the person at Medicaid my DIL had been talking to. They got her approved (well, "approval pending") for Medicaid and got her into a nursing home. We're in North Carolina. (BTW --- the fall was the triggering event. Call 911 the next time your mother becomes violent. If she were admitted to a hospital the whole thing may go more smoothly.)

Carol, julidu, and realtime, thank you all so much for your help and advice. I am definitely looking into the land situation. It's complicated but I am going to get my answers. Unfortunately, the next morning after I typed the above question, my mom took a severe turn for the worse, and I am now forced to have to seek nursing home care for her. Tomorrow, I am taking her back to the doctor to get her placed in a nursing home for respite care for a while until I can sort all this stuff out and go about keeping her there permanently. She needs care I can't give her and I can no longer continue to live like a prisoner in my home hiding all the sharp objects and other things that may harm her or myself. I really don't want to put her in a nursing home, but I have to do what is best for my mom and myself. Reading all the questions on this website continually amazes me at how many people are going through serious problems with loved ones who are facing these types of health and mental issues. I appreciate all your help and guidance. Thank you

Wishing you the best, I understand how crazy this time can be - especially on top of everything you've already dealt with

When I applied for guardianship of the body and estate, it was in NC. They were two different things, and we were advised the same person should hold both - if you don't have the estate, you have no way of paying for your medical choices. If you sign up for treatment, the other person may try to avoid paying for it if they are taking advantage of the money.

Adult protective services was WONDERFUL in mthr's county. See if they can get to the bottom of the land ownership. If she no longer owns the land, then she may be eligible for medicaid. If she owns it, it has to be sold to pay the bill, and you don't care who buys it, brother or a stranger. I imagine APS can find out. They are very convincing!

Surprise, APS here in my county in NC has been wonderful. My mom's social worker is an angel because she has fought on my mom's behalf and mine too. The only problem in that department is the supervisor--she is not as helpful as she could be and she has been a problem in the past. However, I am pressing on in my fight to try to get my mom the help she needs. Yesterday I tried my best to get her into the nursing home for a few days for respite care so that I could start the process of trying to get her to stay there permanently. My mom's doctor was a real pain because he was at the nursing facility but refused to sign the form to have her placed into the home (for reasons unknown--but he is aware that she needs serious help as she is not able to care for herself and is now a danger to herself and others). I was at my wits end yesterday but I re-grouped and pulled myself together. I have a plan in place that I am working on for the next few weeks and pray that it works out. This situation is very serious now and its hard to take care of my mom right now. I'm tired of other family members giving me death threats and threatening to harm me all because they can't have their way concerning my mom. Its time that I do what's best for my mom and myself. At the end of the day, that's all that matters. Thank you for your advice and help.

Death threats, you say? Call the law on them. I hope this all gets straightened out very soon...I understand dealing with an elder that you just can't handle anymore, whether you want to or not. And I'm in NC, too, btw... You're doing the right things, you're a great daughter. You're mom hit the jackpot when she adopted you...and so did mine when she adopted me.

And honestly, I'm not getting that doctor at all...I mean, what gives? Is the man blind to the situation? Or just plain stupid? He knows what's up. Does he want you to prove bodily harm before he makes a move? I'd have had a few choice words for him that would have left his ears ringing... Good luck!

StandingAlone, this situation is very hard for me. As for calling the law on them, I've gone to the magistrate several times to get restraining orders taken out and new harrassment charges filed against my brother (he's the one causing all this), and he has two felonies against him for crimes he committed against my mom in defrauding her, but because he hasn't put his hands on me or gotten in my face, no one will file anything new against him. I'm so frustrated, angry, and upset at all this. My mom is getting worse and he constantly thinks of new ways to aggravate me. He keeps sending family friends and church members to my house trying to find out information, he calls around trying to get information and have mutual friends call my house to speak to my mom so he can get them to talk to my mom and put false info into my mom's head--and then she will get upset and in a rage. I'm at the point of constantly monitoring my phone calls and looking outside my windows all day long to ensure that no one comes to my house. I don't know what else to do. I'm tired of being harassed on one end and being a stressed out caregiver on the other end. All I can do is hold on until my mom's next doctor's appointment to see if he will finally sign the paperwork to admit my mom into a nursing home. If he doesn't and he refuses, I am taking the last and final step and filing court papers to give up guardianship of my mom to the state of NC and the state of NC will then be forced to take ownership of my mom and place her into a nursing home because she needs the care and there is no other family members who are able to take care of my mom. One way or another, I am going to make sure that my last act as her caretaker is to see that she gets the care she needs. Once that is done, I am moving on with my life and away from all this pain and drama.....I've done my best, and now it's time to accept the facts and move forward.

About that doc... can you have another doc sign the form, perhaps changing docs in the process? The current one sounds like a jerk.

My mthr wanted to go see the man she thought was her doc, but she had been ugly to him in the ER 15 years previous. She was a hoarder, and stank bad. He had his receptionist tell us that there were no appts available in the next 3 mos. We had 2 of his personal friends call him up for us, and that got him to tell the ladies up front to see us at the end of the 4th month. We came in person hoping to see him/wait as the atty instructed, and the ladies were so embarrassed at his behavior. I can't blame him for not liking her, but what an attitude.

The atty finally thought about the doc in his rotary group, who is also a preacher. Guess who had us bring her right over! He went to Pembroke for college and UNC medical and was super fabulous and KIND.

Another thought about the house/land: If it has to be sold for medicare, the real estate lady you hire to do this will go tell the resident that it is about to be listed without you. If he has a deed, I becha he will find it really fast. She can tell him that he has to fax her a copy the next day with the stamp from the county clerk's office or she lists it. I bet that would get him moving.

I don't think you need to give up Guardianship of your Mom, although I know you would like to be rid of the whole situation. I think you need to get tough with that doctor and tell him you must have the NH referral signed because it is no longer possible to care for her at home, and it is affecting your health (and/or your job) as well. I'll bet he can't give you one valid reason not to sign the paperwork. I also believe you have the power to block your brother in more ways than one. You can change the phone #, or ask the phone co to block his phone # from going through to your number. In the meantime, when people call to speak to your Mom, just tell them she is not well or she is sleeping and cannot be disturbed to come to the phone. When his friends stop over, just tell them you are not receiving visitors today - Mom is not well, and thank you for stopping by. Don't let anyone in that you care not to. This includes unwelcome family, friends and neighbors. You might even go so far as to put a note on the door "no unexpected visitors please". You have Guardianship so you can dictate who Mom sees or speaks to, and who comes and goes in your home. With all the stress you are going through right now, you just need to concentrate on what you are going to do about your Mom and turn aside everyone else that is preventing you from taking care of business.

When things are at their worse call the Rescue squad and they will come and get her. Then the transfer to NH should be easier from ER.

MM, I feel you. I've been caring for my own mom for 10+ years, most of that time alone. I've been telling..and telling, and telling, and telling.. my older son, and anyone else that would listen that I was at the breaking point with care giving, that I didn't know how much longer I could go on. After a doctor's appointment, which resulted in finding out about blood pressure/heart issues, it scared the crap out of me, and I knew I was done. When my mom got out of respite this time, and for some reason we thought she'd be in there for longer, I KNEW I was done. She was here for 4 days...the first day was good, the last 3 she shrieked and screamed the house down, day and night off and on. I could feel how fast my heart was racing, I could literally hear my pulse in my ear, my face even felt tight and was red...I thought I was literally in danger of cardiac arrest my chest hurt so bad. That was it. I called 911 and had them come and get her and take her to the hospital.. Be prepared for a fight. I was told by authority that I 'HAD' to come and get my mom from the hospital. I was told I'd be 'reported' if I didn't. Really? Their point? I flat out refused, and told them, in their face, aggressively, that hell would freeze before I assumed my mother's care again, because I wasn't going to DIE for her, and that a nice, quiet jail cell was sounded like a much better option to me.

I still have no idea if I'm going to get into trouble, and I really don't give a damn. I'm NOT going to have anyone, even the good old state of NC, tell me that I HAVE to continue in a role I KNOW I'm no longer fit to handle, mentally or physically. 12 years is ENOUGH.

If that's the route you have to go, or anyone else, so be it. Better that than in the hospital myself, or on the floor after a heart attack. I will not be forced into this by anyone, I swear to God I'll go to jail first. And if they try and put me in jail, or get me in trouble with the law, I will fight back like a demon with my own lawyer if that's what it comes to.

I know my limits. I've reached them. And what all of these almighty authority figures think be damned.

I just did a little research...in the state of NC, you can NOT be forced to assume the care of anyone, period. Thank God.

Someone asked a question of a NC lawyer...

Lee - September 5, 2013 8:39 AM

Is there any legal obligation to care for an Aunt who had no children?

RESPONSE: No.

Thank you everyone for your responses. Let me try to answer everyone's responses. As far as the house/land situation, from what I have been told by my county's tax office is that no deed has been recorded in my brother or his wife's name and the land still officially belongs to my mother (who has been ruled incompetent by the court of this same county two years ago). So I know that she cannot sign anything over out of her name to my brother. Also, I cannot (and wouldn't if I could) sign any land or home out of my mom's name because I would be in trouble with the law for fraud(my mom's APS social worker told me this and also said for me to leave that situation alone). As for people visiting and calling, I have already begun the process of turning people away from my house. Also when they call, I tell them she is asleep. This morning I told one of my mom's meddlesome cousins (who is in her 80's and favors my brother over me and always believes his lies) that I didn't want her coming to my house to visit my mom anymore and that her phone number would be blocked from calling (which it now is). Today has been quiet thankfully, but I see now that I have to be extra vigilant in all that I do. My mom's APS social worker gave me some hope today. She told me she is going to write up a report on my mom and give it to my mom's doctor stating that she is in need of NH care and not able to be cared for by me at home anymore and she will handle the Medicaid paperwork and try to get her Medicaid. She also told me not to worry about the land/home situation because she is going to look into that and see what needs to be done about it. After talking to her, I have decided to keep guardianship for now...BUT, if all this stuff doesn't work out and my mom isn't able to get into a nursing home, I will THEN give up guardianship as a last ditch effort to get my mom care. If I give up guardianship, the state will have to place her in a nursing home because there is no one else to care for her. I don't want to give up guardianship because it will allow me to still have say-so over my mom's medical needs, and also allow me to make decisions on her whenever she does pass away from this earth. I am trying my best to stand strong--I started fighting back today and I am glad that I did. I'm tired of people feeling like they can run all over me and aggravate me because they feel like it. As was stated earlier, I don't have to allow ANYONE to see her if they are gonna be a nuisance to my mom and me. @StandingAlone, I will keep you in my prayers because I know exactly how you feel. I felt that way as well concerning my mom this past Friday because no one was helping me with my mom and the thought of bringing her back to the house and she continuing to be violent, wandering at night in the house, and not sleeping was just too much for me to bear....however, I re-grouped and also was given a prescription for Depakote to control my mom's mood for aggression and anxiety. So at her bedtime, I've been giving her Depakote and Aricept, and they are keeping her calm. She will sleep for 4-5 hours at a time and then wake up thru the night, but thankfully I hear her and see about her and get her back into bed--which is much better than her wanting to fight me and cuss me out like before. @JennyM, as far as EMS coming to take my mom to the hospital, the cops have always come before EMS and when they see my mom is elderly with a walker, they don't feel she's an emergency or a threat to me. I have been down that road before and it hasn't worked--that's why I am at the place I am---because the cops/EMS feel my mom's problem is NOT medical...but MENTAL and they refuse to come out to get her. I've gotten told "no" so many times by people I've gone to for help (magistrate's office, cops, my mom's doctor, nursing home, home care agency, mobile mental health services, etc...that its been frustrating and futile). However, now I feel that something will be getting done now with my mom's APS social worker. I have worked with this woman for the entire two years I've had control of my mom and even before I moved down here from NY to get control of my mom in the first place. I just have to somehow remain positive and continue doing what I am doing in turning the problem folks away from my house and monitoring my phone calls--even if it means unplugging my phone from the wall (I still have my cell phone). I want to thank everyone for their words of encouragement, advice, and help. It's nice to know I am not completely alone and that I have found a great resource in this website. I read a lot of the questions on this site and it shows me that millions of people are going thru similar things like I am....it's sad to see your loved one going thru dementia/Alzheimer's..but at least us REAL caregivers are doing our best to make the right decisions and make our relatives comfortable. I am going to continue to keep everyone updated on my journey to get my mom NH care. Thank you!!!

MariaMac, Congratulations!! It sounds like APS is really coming through for you this time. And you are so brave and strong to be turning away those callers. Way to go! I am so proud of you!!

Don't know if you are the praying type, but I am, so I'm going to pray for you over the next week. It sounds like everything is starting to come together. Yay!!

Well, I have bad news to report. Yesterday afternoon around 2pm, my mom got into another rage and came at me. She tore up my entire house and tried to attack me again. I called EMS and the cops and they came out. Because my mom refused to go to the hospital, EMS and the cops refused to transport her to the hospital and told me their hands were tied and that even though I am her guardian and my mom is legally incompetent, that she still had "rights" in the state of NC to refuse treatment. The EMS workers were SOOOO nasty and disrespectful to me. One was even the Paramedic Supervisor! While they told me all this, I finally got my mom's APS worker and the APS Director on the phone and they tried to get EMS to take my mom to the hospital--which they still refused. As EMS was about to leave, they tried to get my mom to sign the care refusal form--with me and my cousin screaming at them that my mom is incompetent and can't sign anything legally. The APS worker is screaming thru the phone to not let her sign anything. Both EMS workers get major attitudes and APS makes me get their names so a complaint with the county can be filed on them. As the cops and EMS leave, they tell me my only option is to get Therapeutic Alternatives (Mobile Mental Health Crisis) to come out to my house and have my mom evaluated so she can be IVC'D (Involuntarily Committed). I call them and it takes about 2 hours for them to get to my house and evaluate my mom. They evaluate my mom and go to the magistrate's office to get a warrant for my mom to be IVC'D. It takes another hour and still no police or EMS. At this time, my mom falls on the floor trying to get off the couch and I have to call EMS again. Who shows up as EMS? THE SAME DISRESPECTFUL EMS WORKERS WHO CAME OUT THE FIRST TIME TO MY HOUSE A FEW HOURS EARLIER! (I couldn't make this up if I tried). The police show up a few minutes behind EMS and they have the warrant to transport my mom to the hospital. It takes them TWO HOURS to figure out how to transport my mom to the hospital. When me and my cousin get to the hospital, they triage my mom and let me know it will be a while to get tests run on her and get her a CT Scan. I tell them we are leaving to go home and to call me at home to let me know what happens. I get home at 2am. The hospital calls at 3am to say my mom's tests are normal and that she doesn't fit the criteria for an IVC hold. Then the hospital says that their social worker will work to get her into a nursing home starting today. I tell them thank you and that I know the social worker at the hospital because my mom's APS worker called her the other day and that today they will work together to get my mom into a nursing home. I am leaving my mom in the hospital so they can get her where she needs to be. I pray she gets the help she needs because at this point I refuse to care for her like this in my home. Yesterday was a complete nightmare. No one should have to go through all the hell I went thru yesterday to get my mom help. She needs nursing home care and if she doesn't get it, I am walking away from all this craziness. Today I am starting to get a cold because of all this stress and from being outside in the cold air for hours waiting on EMS and the cops because I couldn't be in the house with my mom acting up and being violent. It's time I take care of myself. So now you see the craziness I went through with the "system." Let's see what the "system" does to get her some help in this way. Please pray for me.

My belief is that a person can own one home and one vehicle and still qualify for Medicaid. I was able to get my dad qualified for Medicaid in New Mexico even though he and my mom owned their home.
The issue is that when your mom does qualify for Medicaid, when she passes, Medicaid will want the money that they put out for your mom’s care in the nursing home repaid by selling that property. Essentially, the state would take your brother’s home and land to repay your mom’s nursing home expenses.
You mom is only allow to have $2000 in the bank in order to qualify for Medicaid. If she has more than that then you will have to spend that money down.
If the house that your brother is living on is a second home, then either he has to figure out a way to get that title in his name, or you need to sell it, as POA, to get the money to pay for your mom’s care, or sell her primary residence. I am hoping that is the only property she has left in her name.
If that is the case, give your brother a heads up. Let HIM figure out how to get the title in his name, otherwise, when your mom passes it will need to be sold.
Go to your local Medicaid office. Ask a caseworker what needs to be done to get your mom qualified for Medicaid. My mom has $1400 in social security and pension and she qualifies so I don’t see why your mom wouldn’t qualify. Medicaid will take all but $155 (in OR) to help pay for her nursing home care.
Also, the are usually a state Center on Aging that you can contact and one person can give you all the necessary information for your area on where to go.
Hope some of this helps.

Maria, sorry, I didn't see your post before posting mine. If your mom is in the hospital and she is transferred to a skilled nursing home, Medicare will cover up to 100 days of her care there. That will give you those 100 days to get her qualified for Medicaid.
I wish you luck and hoping that she gets the care that she needs at this point in time.
PLA

PinkLadyApple, (and everyone else), I have a WONDERFUL update. Yesterday morning, the hospital social worker and my mom's APS social worker combined their efforts and together, they helped find my mom a SECURE nursing home. It is about an hour and a half away from my home, but it is a great place! It has only 60 beds, and the residents cannot get out. This facility also specializes in dementia patients who are violent and/or have aggressive behaviors. Their staff is specially trained to deal with these types of patients. My mom was taken there yesterday straight from the hospital and she's already getting used to being there. She will be there long term and I don't have to stress out about her care anymore. I was told to go to social services and complete my mom's Medicaid application and to ask for "Special Assistance" (it's what the state of NC will pay towards care for elderly people in nursing homes who cannot fully pay). I am told my mom will qualify and that I don't have to worry about her being kicked out of the facility and that any other out of pocket costs (which should be very little, if any at all) can be paid on a regular basis.

My cousin and I toured the facility and we love it. It's very clean and the atmosphere is nice. We were told to not see my mom and let her get used to the atmosphere of the place and the residents. However, when my cousin and I went to the bathroom before we left, my mom accidentally saw us (but she was smiling and talking with the other residents--which made me very happy). On our way out of the facility, a nurse helped to distract my mom so she wouldn't see us leaving. I am sooooooooooooo thankful that my mom is placed where she needs to be. I went thru HELL to get her the help she needs. Now my focus is to get a job quickly so I don't lose my apartment, so I am presently looking and applying for whatever jobs I see in my area. Thank you all for your support, advice, and help in this situation. God knows I needed it. I'm very happy now, and I can continue on with my life---knowing that my mom is well taken care of.

I am so happy that you were able to find a place for you. Maybe now you can take care of yourself.
FYI, Medicaid will take a few months to get everything taken care of but the good thing is that they will go back 3 months of retroactive coverage. So, be sure to get that process going.
That is also good about them being qualified for dementia patients. That was one thing that I was aware of was that I needed to find an assisted living/memory care place because I didn't realize that some of them will kick them out if they aren't qualified for dementia. I was glad to see you mention that in your comments.

You sound relieved and happy. Good for you.
PLA

PinkLA, I am glad that my mom is in a place that is helping her. This place specializes in memory care and so far my mom is doing great. I am relieved and happy. I am presently looking for a job so I can go back to work and get my life back together. Thank you for your comments, advice, and concern. I truly appreciate all you have told me (and EVERYONE else too!!!). I will keep you updated as to how things go from here on out. If you have any questions for me on anything, please let me know. I won't hesitate to share information I know from my journey in finding my mom NH care.

Have you shown the guardianship papers to the doctor? Is he a partner or employee of the NH? If he is he might fear a conflict of interest by signing her in. Another MD would have to sign in that case. As far as death threats go, if they are serious intent, file a report and get an order of protection.

MM, kudos. You did the right damn thing. I went through something similar with my mom. She wasn't...couldn't....get violent with me, but she was completely out of control screaming the house down morning, noon and night. It just went on and on and on, and nothing would stop it, or sooth her. I called 911 and had her taken out of here. I did what I call 'premeditated craziness' when that dumbass medic told me that more than likely they'd release my mom right back to me that night...I threatened to blow either her or myself away if they tried it. Worked like a charm. Now they all think I'm a loon, but who cares? I couldn't deal another single second, or go another step. The end certainly justified the means for my situation anyway, and no, I'm far from crazy. It was the only thing I could think of to do to stop these professionals from dumping her right back into my own lap, when I knew I just couldn't handle her anymore.

Years ago, she was prone to violence, and threw a glass ashtray at my face. I jerked my head to the side and it hit me in the corner of my left eye. There's no doubt that had I not been fast enough, she would have indeed blinded me in that eye. I've dealt with more shit than anyone should have to in 100 lifetimes with the woman. Enough is enough is enough. I'm as done as you are.

Stay strong... *hugs*

Congrats on the nursing home! I still don't understand why the hospital refuses to move my own mom into one at this point... Get on with your life, and enjoy every moment of it! :) Today is a wonderful day!

Yes, I am moving on with my life. I am currently in the process of trying to get a job and rebuilding my life. We went to visit my mom today and she was a little sad when we first arrived, and then she perked right up and we all had a good visit with her there. The next thing I have to get clarification on is if I have to give the NH my mom's entire social security check in October. The NH told me I would have to turn it over, however, a good friend of my family told me not to do that and to just write them a partial check for my some of my mom's care, as the Medicaid will soon kick in, and for me to get a payment plan started. I don't know how true this is. I guess I will have to ask the Medicaid people tomorrow morning. If anyone truly knows the answer to this, please let me know....