Can I still keep my house if mom goes into a nursing home?

Raine, this is a good question for an elder attorney. I had a friend in south Georgia who lived with and was taking care of her mother. The house was still in the mother's name, so when her mother went into a NH and they had to apply for Medicaid, the house was considered in spending down. This would have left my friend and her husband without the house they had lived in for over 10 years. They contested the inclusion of the house in recovery because they had lived there as primary caregivers for over two years. Their being there had enabled the mother to stay at home longer.

There are several factors, though, that may affect the outcome of your case. The house was signed over to you during the look-back period. I do not know how that will affect things. I also do not understand why sometimes the house is a "life estate" that can be used by the caregiver while he/she lives, but is not owned by the caregiver. If your parents signed the house over to you, it may be that she will not be qualified for Medicaid for a while. I would get some good legal advice on what is the best way to proceed.

There are some things you can do to dementia-proof your home. Take the knobs off of the stove. Hide or get rid of any potentially dangerous objects. Install locks on doors you don't want her opening (given that she will not destroy something in order to get the lock open). Put alarms on her bed that will alert you if she gets up at night. I hope that the elder lawyer gives you some good, positive news, but if not, there may be other ways you can work things out without putting yourself and son in danger.

I forgot to mention that my friend in south Georgia was able to keep her house. She and her husband still live there.

See an attorney who specializes in elder law. The fact that you have been living there and taking care of her and thus keeping her out of a nursing home will make a difference.

I know you are overwhelmed right now with dementia symptoms. As JessieBelle says, you may be able to learn to deal with these symptoms.

First you need to make sure that your mother is being treated by a specialist in dementia. This may be a geriatric psychiatrist or a neurologist. Very, very few GPs or internists have the knowledge or interest to treat dementia. Most throw up their hands and say good luck.

If visual hallucinations are among the first symptoms, that suggests the possibility of Lewy Body Dementia. If no one has mentioned that, Mom has the wrong doctor.

A specialist may be able to come up with a treatment plan to significantly reduce the symptoms. For example, there may be medications to help your mother sleep peacefully through the night.

By all means, move forward with preparing to apply for Medicaid for your mother. Even if you are able to keep her at home, being on Medicaid will be a huge help financially. But at the same time, look into medical help with the symptoms, and learn how others cope with the issues you are facing.

I am so sorry that all these tasks come crashing down upon the caregiver at once. It is overwhelming. (Been there. Done that. Lived to tell about it -- but I'm not sure how!)

Best wishes to you as you struggle with so many urgent tasks at once. Please come back often and let us know how you are doing.

I have to echo what Jeanne said especially on getting a gerontologist. You probably are out of the woods on the lookback because you have been providing care for the last 2 years and it also sounds like you & your son qualify as low income so that works in your favor too as you'd be homeless if not for the house.
It will be a stack of paperwork on the house, but not a worry imho.

For NH Medicaid eligibility, an individual must show that:
1) are 65+ (can be younger if qualified disability),
2) medical condition requires skilled level of nursing care, more on this below...
3) monthly income at or below their states max (about 2K),
This is the “income test”– how much $ do you make. Texas is $2,094.
4) all countable assets are at or below 2K
This is the “asset test” – how much $ do you own.
5) not gifted away anything of value during 5yr look-back period.

If you do, could be a “transfer penalty” when items are gifted. Penalty different for each state as it’s based on each state’s NH reimbursement rate. For Texas, it is $ 142.92 a day rate (2011).

Max look-back is 5 yrs. Most states require 3 – 6 mo. of financials with initial Medicaid application. Can require more financials if something pique’s interest. Financials are bank statements, social security and retirement statements, insurance policies, etc.

The financials are what most folks focus on. But remember that they also need to medically qualify for skilled care for Medicaid.

Most NH admissions come from a hospital discharge. If an individual covered by MediCARE is discharge from a hospital to a nursing home for continued care (rehabilitation) after an inpatient stay of at least 3 days, MediCARE will cover 100% of the first 20 days and MAY pay up to 100 days, subject to a co-payment by the patient of $141.50 per day for days 21 to 100 (for 2011). Medicare does not pay for the many months/years that some people reside in a NH for long-term custodial care. In general, Medicare is limited to short-term acute care. But this MediCARE paid period of time in the NH is when you need to get the documents together to apply for MedicAID.

ISSUES IF MOVING FROM HOME TO a NH: If they are living at home or in IL, and need to move to a NH, you will need to work with their MD to get the criteria in their medical history to show they need skilled nursing care. Just because they are old, or have dementia or incontinent, etc. is not enough.Often when they are living at home, there is no documented medical history. So often you will be told they just need Assisted Living, which is usually private pay except for some states that do AL Medicaid waivers.

My mom went from IL to NH and bypassed going to AL. She was able to do this as she had a critical weight loss (more than 10% in 30 days), critical H & H and some other conditions. Sometimes the MD will need to change their meds – like go from Exelon pill to Exelon patch (more “skill” to apply); or change a med to one that needs to be compounded daily which you can’t do at home. Each state has it’s own criteria for admission under Medicaid. They will be evaluated and often are denied because they don’t have enough “critical” conditions because there is no history when living@ home. You will have to work with NH and your parents MD’s to get whatever done to establish the need for NH if they are coming from being at home or IL. There is a whole medical appeals process in each state for this and separate from the financial appeals. For those still living at home without a huge disease history, becoming a patient of the MD who is the medical director of the NH (who will be a gerontologist) is good as they will know how to create & write up the health history chart so that it passes NH's Medicaid medical review. The gerontogists know what needs to be in a chart to pass the Medicaid review.

This would depend on whether or not the house was "sold" to you and legally registered as your property alone before the dementia. It could be said if it occurred after the dementia that you and the attorney took advantage of a woman who was in no condition to make such a decision and they could make out that you were only there to get the house. They could also decide that your mother signed the house over to you in order to try to be able to get Medicaid in the future and disposed of an asset. Do see a good lawyer about this before making any decisions. I tended to my grandmother who did the same darned thing (got up at night and turned on all of the stove burners with the burner covers on them!!!) and I urge you not to put her in a nursing home. You can always put her to bed at night and put a latch on the outside of her door to keep her from escaping and doing these things. She needs you now. They are also going to wonder why you have an adult son who does not work or if he does, they may wonder about his income. I would suggest keeping Mom at home until she dies or needs hospice.

JessieBelle - I think what you are asking about is why no actual property ownership by the caregiver when there is a life estate????

What some elders do is rather than a traditional real estate transaction to actually "sell" their home, is that they instead put the property into a "life estate" in which the elder is the "grantor" of the life estate and the adult child is the "grantee" of the life estate. A life estate allows the elder as the grantor to live at the property and because it's a life estate they pay the taxes, etc on the property at senior citizen rate. They can live at the property and do whatever they want with it short of torching it as it is their life estate to control until death. Also if it is a life estate, the grantee has NO right to possession of the property until after the grantor's (elder's) death. Life estate's can get kinda sticky when they go wrong when the elder becomes incompetent and does truly careless stuff.

Terri - 15 years of caregiving is a lot of time and Raine may just feel that mom needs another level of care and socialization than being at home. We just don't know her situation. Your "Put her to bed at night and put a latch on the outside of her door to keep her from escaping" as per your suggestion is not, imho, a proper way to provide for nighttime caregiving for a dementia patient living @ home. So you locked your grandmother in a room? As far as her son -- well at 18, he could be in HIGH SCHOOL or going to university rather than having a job outside of the help he probably does for his gran.

I am truly shocked that a caregiver would consider locking someone in a room while they blissfully slept. there are all kinds of alarm systems that are very inexpensive. If you have an electric range simply go to your switch box and cut the power to the range. Never lock someone in a room especially if they are having hallucinations. I'm sorry for getting off topic but this is too much!

Thank all of you for your helpful replies... I consulted with an elder care attorney that said in Georgia medicaid would not take the house from me but would penalize my mother for a year or longer and if she went into a nursing home I would have to raise the money myself or get it from other sources. He said that someone in my mothers condition would probably cost $5000 a month.

When I took my mother to her Doctor today he examined her and I told him that I didn't have the strength to continue taking care of my mother and that I needed to place her in a nursing home. He told me he would take care of everything and now I'm blessed with hospice care for my mother that will be paid through medicare. My mothers Doctor is truly a good man and he really helped me today.

Raine, this is wonderful. Your doctor had the perfect solution. We should have thought about Hospice. I called them in when my father was dying. They accept Medicare as complete payment. Yea! Are they going to keep her at their facility?

From my understanding or in my case hospice would probably be the best route to take and ultimately it is going to happen. My problem is I'm a male and it's my mother that needs changing and bathing. Even if I could it would be hard, I say could because I have a very bad back and can't lift much weight. Changing and bathing is the only thing keeping her from coming home, hospice would pay for someone to come in and do that, I think.

from what I understand Raine to say, hospice will be coming into the home; a friend of mine went through that just yesterday; brought her mil home to her (the mil's) own house with hospice

I am very disappointed that no one suggested for you to take your mother to her family doctor for a good ol' round of antibiotics. ANY infection in an elderly person will trigger the symptoms you describe: hallucinations, paranoid fear etc., etc. etc. I knew a sweet, cheerful man in his 60s who suddenly started babbling, stripped naked and became combative. It was a UTI (urinary tract infection).

This question is from 2012, I think the patient is long gone.

I know this is late but hospice is a good option for that; we brought my dad home on it

In my state, CT, there is a different look back period (2 years instead of 5) for the family caregiver whose only residence has been the house that was the parent's but has been given (quit claim) to the family caregiver. Although since then I think even the 5 year look back has been lessened.

Check with your local area agency on aging for other help to supplement hospice.

what if the house wasn't quit claimed to the family caregiver?

debdaughter, in Kentucky, once the patient is in a nursing home for six months, the house becomes subject to collection. If the spouse is still in the home, or a disabled child lives there, no estate recovery is made.

yes, have seen that happen many times; the house across from where son - dad's grandson - used to live before he moved in with dad - went up for sale - that he'd said he'd like to have - for that reason - and I was going to see about getting it for him - when I began to learn more about the POA I had of dad's; it wouldn't let me do real estate/property transactions