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My MIL was ordered by a judge into nursing home due to physical violence with FIL. She has dementia and untreated mental health issues. He was doing his best to take care of her, but after several 911 calls, the judge ruled that she go into nursing home or she'd be prosecuted for domestic violence as she has been physically hurting him.


Medicare covered 100 days, but that is now up and FIL can’t afford NH, but the doctor says she needs 24-hr care, which he can’t provide due to her non-compliance and his own medical issues. They are both in their 70s, have no assets except a mortgaged house, but both collect a total of $5,000 a month in SS benefits and VA benefits. Family can’t help in providing her physical care or financial help.


We are looking into qualifying her for Medicaid or maybe a Medicaid spend down (not sure even how that works), but can anyone think of any other options?

I would have suggested medicaid. The spouse does not have to give up their home.
I am not familiar with possible VA benefits.

Medicaid is the funding that covers the cost of medical care when an individual simply doesn't have the money for Long Term Care.
It will limit where she can go. But she can receive 24 hr professional care, and keep both of them safe.
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Reply to CaringWifeAZ
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Talk to the case manager/social worker at the nursing home to find out what options and resources are available. That is their job.
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Reply to Taarna
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DCSparky: Contact a social worker.
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Reply to Llamalover47
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She is in care now.
There will be social workers where she is now who are paid to help you with all of this and to place her directly from where she currently is. I believe their discharge planners will be in communication with you, but don't wait. Reach out to them on Monday and call discharge planning. Tell them all you told us so they can begin to get Mom qualified for Nursing home.

Is your mother currently a ward of the state? Because if you allow them to take this on they can get her qualified if you do not wish to act as guardian and feel you aren't qualified. Because your father is still alive it is important to protect his portion of their joint assets for his own care when it is needed.

This is complicated, and not really do-it-yourself stuff. You will need legal and social worker's help. If you don't feel up to it let them know you cannot be acting on your parents behalf as you are not qualified to do that, and ask that state take on guardianship if that is needed.

Best out to you and so sorry you're going through all of this.
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Reply to AlvaDeer
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In the state I live in married couples known to split assets in half, then have one go on spenddown to medicaid. I would find an adult family home that takes private pay spenddown to medicaid that specializes in dementia with violence. Call around to different hospice agencies, the ones with zero affiliations with hospitals the most liberal in what they take on in terms of the decline. Meaning no one has a crystal ball but violence and court orders like this make everyone more vulnerable, and the case would probably meet criteria. The social worker would help navigate this tough time. Has she gone to the geriatric psych ward yet? Try to get her in there stating she became a threat to everyone's safety they will have to get her violence under control with meds before sending her out for care like that.

From there, find an AFH (ask the hospice social worker or consultant or nurse, just keep asking until you find what you need!) that will take this kind of case the geri psych might know of options. Often they get put on hospice at discharge to an AFH at the same time under orders from the geri psych, but ANYONE may self refer to hospice including family ahead of that. Hospice benefit covers under medicare or other insurances. She has to have a home of some kind to go on hospice, whether in an AFH, but not in Skilled nursing or hospital as the definition of home and private pay starts to get "blurred". I work in hospice, Never seen 2 cases go downhill the same way, but violence so stressful for families, sign the brain shutting down even more, eventually she won't have the energy or memory for this. Sorry your family has to go through this. They might have to split house equity in half to use for spend down to medicaid as their own incomes won't cover all of the monthly costs. For example let's say afh says it will cost $6800 per month, they have 5,000 per month income = $1800 per month shortfall taken from her equity half from house, your dad's half protected from the spenddown. When her half of the money depleted, then medicaid pays the difference. Just USE ALL RESOURCES in your state available and try to access things like government funded programs, things they have paid into their whole lives.

If needed, blast some good music and just take care of stuff one thing at a time.. Don't let anyone nickel and dime them to death, and just keep asking for help. Also some of the courts have an advocacy office paid for by the government, ask them for help or advice. I don't recommend squandering money on fancy lawyers though as courts the same as a public library just need to know how to use them.
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Reply to PennyAmes
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Igloocar Feb 25, 2025
Penny-Ames, it doesn't sound like her MIL is eligible for hospice at this point--death does not appear to be imminent.
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