Help me help my grandparents help my mother

August 9, 2006 7:15 PM

Six months ago, my 50-year-old mother had a serious stroke, and the nursing home that she's in now considers her recovered enough to move on to an assisted living or daily home health care situation. I'm trying to help my 75-year-old grandparents figure out what to do.

My mother and I are permanently estranged, and I'm not in a situation to help financially, so I want to at least do what I can to help the grandparents who raised me to find a place for her. Right now, they think their only option is to take care of her at home, but I know and I think they know that it won't work. The drug and alcohol addiction that indirectly led to her stroke is still evident, she begs for additional pain medication (loritabs) and threw a tantrum when a nurse mentioned that the doctor was probably going to start cutting back on the dosage. She is still seriously impaired in her speech and motor skills and requires physical help that my grandparents won't be able to provide for any real length of time, in spite of the fact that they are very healthy and active. From what I've read, Medicaid doesn't cover home health care or assisted living in Tennessee or Kentucky (they live about ten miles on the TN side from the border of those states). Where on earth do we start looking for ways to find this kind of care in other states, preferably states that aren't too far away? Is it even possible to move someone into another state for the sole purpose of taking advantage of their health care services? I've poked around on Google and it's hard to find anything that clearly explains the issues surrounding this. Information, links to information, and general ideas or advice from anyone with any experience with these issues will be greatly appreciated.

posted by cilantro to health & fitness (6 answers total)

How far have you looked into KY or TN services on this? Kentucky's medicaid program may cover some of the things your grandparents would need, but there are often huge budget shortfalls and people get left out. This page lists services KY medicaid sometimes covers. Home health services may be covered under some circumstances, and there's a Home and Community Based (HCB) Waiver Program
that looks like it could apply.

You might want to look for a lawyer or social services agency that handles disability issues - they should be able to point you at more resources.
posted by dilettante at 8:08 PM on August 9, 2006

Since you're in TN, you should take a close look at what TennCare has to offer. Despite all the cutbacks, I think they're still pretty good, especially if you know just how to present your needs.

But more importantly, these sorts of questions are perfect for a social worker. I'm sure the nursing home can hook you up with one.

By the way, keep in mind that there's (I assume) a very good reason that you're permanently estranged from your mother. Don't let yourself get sucked too far into the drama.
posted by nixxon at 8:36 PM on August 9, 2006

One phrase to google is "Independent Living Center", or "Center for Independent Living". The National Center for Independent Living might be a good one to start with. These groups work to make it possible for disabled people to live at home in the community, rather than being forced to live in an institution of some sort (nursing home or what have you). One of the major barriers to that, as you've noticed, is that Medicare will often pay for things in a hospital or nursing home that they won't pay for elsewhere.

Some states have what's called "money follows the patient", and there's a bill that's been floating around Congress for a while now called Micassa that would make all states do that, but that's a ways off. ILC/CILs would be the people to ask about the specifics of what is available now.
posted by spaceman_spiff at 8:51 PM on August 9, 2006

I second having a social services person come talk with your grandparents. When my mum had her first stroke, they came to the house, arranged, for an aide to come several times a week, helped with living wills, nursing home care, too many things to mention. They should be able to tell what is & is not available and how to tap into it.
posted by clarkstonian at 8:56 PM on August 9, 2006

Your 75-year-old grandparents probably feel duty-bound to care for their daughter. They are very unlikely to be able to do so on what seems like an extended basis no matter how they feel about putting her in an institution.
The advice to consult a social worker is probably best. The gpas will have to realize that they at their age they will not able to provide the most effective level of care, and that the daughter should be put where it is available.
posted by Cranberry at 9:34 PM on August 9, 2006

"Don't let yourself get sucked too far into the drama."

Rise above.
posted by oh posey at 9:43 PM on August 9, 2006