Ask Miriam – September 2024
Dear Miriam,
My brother and I are caring for my mom, who was diagnosed with dementia several years ago. We take turns staying at her home overnight, and then we would call every few hours to check on her while we were working. This approach seemed to be fine until now. But recently she wandered away from home, although she eventually found her way back. I am worried that we cannot keep on doing this. It is exhausting for me and my brother, and I don’t think she is safe alone anymore. She needs a caregiver during the day, and she can’t afford it. She has social security plus some investments, and owns her home, so I’m sure she doesn’t qualify to get any help from the government. We can’t afford it either. What can we do?
—Perplexed Sister
Dear Perplexed,
Taking care of a loved one with dementia can be very challenging and knowing that it is a progressive disease means that your mom’s care needs are going to change too. Many families struggle with the expense of affording a caregiver.
To help people with healthcare costs, the government has a program called Medicaid; in California, it is known as Medi-Cal. Medi-Cal is based on income, and you can apply online, by mail or on the phone. If you qualify, you also can receive what is called In-Home Supportive Services, in which the care needs of your mom would be assessed and financial assistance provided for a caregiver.
Some people think that they don’t qualify for Medi-Cal because they tried to apply before and were denied. However, in January of 2024, the rules changed, and it may be worth trying again. There is no longer a limit on assets owned, so that may make a difference for your mom.
People with dementia who aren’t able to keep themselves safe and need supervision are eligible for what is called protective supervision through In-Home Supportive Services, which can mean up to 283 hours a month of care. A worker will assess how many hours they think your mom needs, but if you don’t agree, or if her care needs increase, you can ask for a new assessment.
In-Home Supportive Services may be able to provide the assistance that is needed for her to stay at home. And to understand more about Medi-Cal, here is a helpful nonprofit organization’s website you can visit California Health Advocates.
Another potential resource that may help in keeping your mom at home is having her attend an adult day program during the week, which would provide her with structure, supervision, and activities while you and your brother are at work. Best of all, some adult day programs are paid for by Medi-Cal.
Your mom is very lucky to have you and your brother looking out for her. Please know that you do not have to go through the caregiving journey alone. Consult with a professional such as your mom’s doctor, an elder law attorney, or a social worker. Consider joining a support group, and make sure to take some time for yourself each day.
For more information on Medi-Cal, In-Home Supportive Services, and other community benefits, contact the Alzheimer’s Los Angeles Helpline at 844-435-7259.
Best,
Miriam
Questions for Miriam can be sent to askmiriam@alzla.org.