Mom clears about $4K/month from a combination of Social Security and a military pension. She has been living by herself with an occasional caregiver (20 hours per week) but her condition is getting worse and the social worker at the hospital said she needs 24/7 supervision because she is legally blind and a fall risk. She fell and broke her wrist which is how she ended up in the hospital to begin with.
We increased her care level to 40 hours per week, which was the limit of what she could afford, but truthfully it hasn't made much difference and seems like a waste of money because she is still home alone a lot and most of her restlessness happens once the caregiver leaves (in the middle of the night).
We have been looking at memory care for her and the prices are really high: $8500 and up. She can't afford that. The social worker says she's not safe. I agree. I asked her for a solution. Her suggestion was to move her in with me. Yeah, that's not gonna happen.
The VA says that she may qualify for A&A benefit which is $2300 per month but that's still short of what it will cost. We live in California and applied for Medi-Cal and she was denied because her income is too high for a Medicaid Waiver.
Adult Protective Services keeps coming to check on her after the fall (3 times now) to make sure she is being cared for but they don't provide any solutions.
We have visited a lot of facilities but she can't afford any of them. She has no assets at all to sell. She doesn't need skilled nursing yet. Now what?
A few things worth exploring that might not have come up yet:
PACE Program: This might be the most important thing I can share. The Program of All-Inclusive Care for the Elderly provides comprehensive care, including supervision, medical services, and social support for people who need nursing home-level care but want to stay in the community. In California, it is covered by Medicare and Medi-Cal for eligible participants at zero cost to the family. It is specifically designed for situations like your mother's. Search "PACE program California" with your mother's county, eligibility is based on need level, not just income.
Medi-Cal Spend Down: Being denied because her income is too high doesn't necessarily mean she's permanently ineligible. California has a spend-down provision where income above the limit is applied to medical costs first. An elder law attorney or Medi-Cal specialist can often find pathways that the initial application process misses. Many offer free consultations specifically for this.
VA A&A Application Support: If the $2,300 A&A benefit hasn't been formally applied for yet, a VA-accredited claims agent can help navigate the application at no cost to you. Many families leave this benefit unclaimed simply because the paperwork is overwhelming.
On the nighttime restlessness specifically, this is one of the hardest parts of caring for someone at this stage. The transition period after the caregiver leaves is when anxiety peaks for many elderly people. Sometimes, consistent evening phone companionship, a familiar voice that calls at the same time every night, can genuinely reduce that restlessness even when it can't replace physical supervision. It's not a solution to the larger problem, but it can make those hours safer and calmer for her and less terrifying for you. For nighttime restlessness, I can assist you. Can share details with you if you'd like.
Wishing you and your mother real solutions very soon. This community is here for you. Also, you can ask me anything whenever. 💙