My husband and I have been my elderly brothers' caregivers for 5 years and are looking to put him in a facility. My brother has mental disabilities along with balance and memory issues. We don't have family that are willing to help out, and we are burned out. Any advice or assistance would be greatly appreciated as we are in uncharted waters here. Thank you.
If your brother has a care coordinator or case manager through his health plan, this could be Medicare, Medicaid, or other, then that person may be able to guide you to suitable care services. They can also narrow your search to care facilities that are contracted with the insurance provider.
There are different levels of care facilities; Residential Care homes, or Group homes, Assisted Living, Memory Care, and skilled nursing facilities. Start with what you think is appropriate, and a discussion with the facility admissions advisor will help you to determine the right type of care.
I'm going to assume he's on Medicaid and that there is someone (maybe you or another family member) who has POA or conservatorship over him.
The first step would be getting him to his doctor and getting him assessed to find out what kind of care facility would be appropriate for him. After this you start checking out care facilities. They have to be Medicaid-accepting from day one if your brother doesn't have money or LTC insurance. That has to be the first thing you ask. Then check them out. I'm going to level with you here. You're probably not going to get him into a great nursing home if he's going in on Medicaid, especially if he needs memory care too. It is what it is though. You cannot take care of him anymore and other family won't take him in. Even a not so great place is better than nothing.
Get him to his doctor and take it one step at a time.
What state are you in?
Are you your brother's PoA or legal guardian?
Did your parents ever create a trust for him?
I put your question into ChatGPT5 and used my home state (MN) as a specific. Here is what it found:
The big buckets of help (MN):
1) Medical Assistance (MA / “Medicaid”) for long-term care
Pays the medical and custodial costs in a nursing facility if he meets financial rules and needs a “nursing home level of care.” There’s a 5-year “look-back” on gifting assets and estate-recovery rules later.
2) Home & Community-Based Services (HCBS) Waivers (for assisted living, memory care, or services outside a nursing home)
If he qualifies for MA and a MnCHOICES assessment says he needs that level of care, a waiver can pay for services in the community or in an assisted-living setting (“customized living”).
Elderly Waiver (EW) if he’s 65+.
CADI Waiver if he’s under 65 with a certified disability and nursing-facility level of care.
DD Waiver if he has an eligible developmental disability and ICF/DD level of care.
If he’s 65+ but not yet MA-eligible, Alternative Care (AC) can help pay for similar services short-term.
3) Room & board help in certain facilities
Housing Support (formerly GRH) can help cover the room/board portion in approved settings (some assisted livings, board-and-lodges), often paired with a waiver for services.
4) Monthly income supports
SSI (federal) and Minnesota Supplemental Aid (MSA); MSA Housing Assistance adds an extra monthly amount if housing costs exceed 40% of income (useful with waivers/transition).
5) What Medicare does not do
Medicare covers short, post-hospital skilled rehab—not ongoing custodial care. Long-term costs normally require Medicaid/waivers, private pay, or LTC insurance.
Exactly how to start (simple checklist):
Call for a MnCHOICES assessment (this is the gate to MA-waivers/EW/AC services). Call your county human services and say, “We need a MnCHOICES long-term care assessment for my brother.” (Any county can schedule it.)
Apply for Medical Assistance (MA) for long-term care (nursing home) or MA + Waiver (assisted living/community). Your county worker will tell you which form; gather IDs, income statements, bank records, and any trusts. (Mind the 5-year gifting rule.)
Ask facilities whether they accept MA/EW/CADI and Housing Support. Not all assisted livings do; confirm before moving or signing anything.
If he’s 65+ but over MA limits right now, ask the county about Alternative Care (AC) as a bridge, and about MSA/MSA Housing Assistance to stretch income.
Talk with a benefits navigator who lives in this world daily:
Minnesota Aging Pathways (formerly Senior LinkAge Line): 800-333-2433 (options counseling for older adults & caregivers).
Disability Hub MN: 866-333-2466 (benefits and waiver navigation for disabilities, any age).
Practical tips (so you don’t get tripped up):
Timing: MA/waiver approvals can take weeks. If you’re leaning assisted living, line up a setting that will hold a spot and accepts MA/EW (or will convert after private-pay).
Assets & gifts: Don’t move money around without advice—the 5-year look-back can delay eligibility. An elder-law attorney can review spend-down options (e.g., permissible purchases, pooled/special-needs trust), and explain estate recovery.
Room & board: Waivers generally pay for services; Housing Support or his income covers room/board in many settings. Ask facilities how they structure this.
I hope this helps.