Pet Estate Planning- Caring For Your Fur Babies


“Bella is my baby I can’t imagine what might happen to her if I’m gone. And what if I just got in an accident and couldn’t make it home? Who would take care of her? Who would even know that she’s there.”

When You Live Alone

June lives alone. she’s been divorced for a while and has a grown daughter. But her daughter lives in another city. Furthermore, they don’t have the strongest relationship.


Plus, June told me Carrie doesn’t really like animals.  “I can’t understand that. But that’s the way it is. So, I have to think about other arrangements for Bella. After all, I’m her protector and she deserves the best.

A lot of people who live alone and worry about what will happen with their pets when they are gone. Unfortunately, all too often people have not made any plans or arrangements. They assume they will outlive their pets.

Let’s face it life is uncertain.

Whether you are 30 or 80, things can happen. And if you’ve taken on the responsibility of a pet then it’s your responsibility to make sure that they’re taken care of in the event that something would happen to you. And you can’t always expect the family to swoop in and take over.

“When my mother-in-law fell,” Kathryn said “We had to take in her cat. I really didn’t want or need another animal. But it was the right thing to do. And no one else in the family would do it. So, my husband and I took Callie and cared for her for the next 9 years. We really didn’t want to but we did.”


Not everybody has someone in their family who would do that. If you do that’s great. But have a talk with your family ahead of time. Make sure you know who is willing and who is not. And if nobody is really willing then you’ve got to think of other arrangements. Where would your pet go? Who would care for them?

When Keith Didn’t Answer His Phone




Elaine called Catherine concerned she hadn’t heard from her friend Keith in over a day.


“It’s not like him,” she said “We always call each other each morning. He’s not answering and I’m worried. I’m afraid to go over there” Elaine said


She was concerned that Keith might have passed away. At 89 years old it was definitely a possibility. So, Catherine got her husband, Bob, to go and check on Keith. Elaine had a key so he could get in.

Keith Was In Trouble

Keith wasn’t dead but he did have a stroke. He was laying on the floor in the hallway. And his two dogs were snuggled up next to him clearly distraught. The person they love was not doing well. An ambulance was called. But now came the question, what to do about his to beloved pets?

A Plan Was In Place


Luckily Keith had already made a plan. The place where he boarded them when he went on vacations had already agreed to take care of them. Furthermore, if Keith passed away or could no longer care for them they would find a home for both of his fur babies.  Keith even paid for a month in advance to ensure that is two sweet angels would be well taken care of.


Furthermore, he had set up a trust account. This would be for any medical bills they may have in the future. Whoever adopted them would not have to worry about the expense. He clearly thought of everything.

Peace of Mind

Keith spent the last 6 months in a nursing home. But he did not have to worry about his beloved pets. In fact, the couple who adopted brought them for visits once a week and made sure Keith had plenty of pictures and videos.


A Few Steps To Protect Your Pets (or Fur Babies)


  1. Make sure that you have information in your wallet to let people know that you have a pet at home. If you were in an accident, someone would need to check on your pet. Print something up on card stock. Make sure contact information is included for the person who can enter your home to take care of your pet.
  2. Does a friend, relative or neighbor have a key to get into your home? Luckily Keith thought ahead and gave Elaine a key. This made it easier for someone to check on him and his fur babies.
  3. Talk to your family. Do not assume they will take care of your fur friends. What other options are there? Who could help? Have a plan in place like Keith did.
  4. Have a sticker on your door and window to let EMS know there is a pet inside. Have contact information on your refrigerator so they know who can care for your pets.


Consider adding a provision to your estate plan. This is especially important if you have exotic animals or pets with special needs. After all, your fur babies are your family too. Make sure they are well taken care of.

Long Term Care Options

Making Sense of Long-Term Care: Know Your Options to Plan for Your Needs


We spend much of our adult years planning for retirement, but as that time approaches, our financial goals start to shift and other needs come into focus. Of course, it’s impossible to know for sure whether you will need long-term care or for how long, but there are some risk factors that can help predict the likelihood. Whether you’re approaching retirement or already retired, now is the time to think about those risk factors and start planning ahead.


What are Your Risk Factors?


Over half of Americans turning 65 today will develop a disability serious enough to require long-term care. According to HuffPost, the two most common reasons people need some form of long-term care are dementia and disability. You may not be able to predict these things, but you can ask yourself a few questions that affect your likelihood of needing long-term care.



  • Are there hereditary illnesses and conditions that could impact you? Dementia, Alzheimer’s, and stroke all have genetic components, so if you have a family history of any of these debilitating illnesses, your risk of needing long-term care may be higher.


  • What lifestyle choices are you making now? You can’t change your genetics, but lifestyle factors play a huge role in your risk of having problems later. For example, high blood pressure, diabetes, and smoking are just a few of the lifestyle factors that lead to a higher risk of stroke.


  • What other factors raise your risk? A few other factors that are out of your control may also raise your risk. Women are more likely than men, and single people are more likely than married people to need long-term care.


  • How close are you to retirement? The earlier you start saving for long-term care costs, the better. If you plan to get a long-term care insurance policy, AARP recommends shopping in your 50s or 60s. As you get older, premiums will be higher, and worse health could prevent you from getting the best coverage.


What Can You Do Now?


It’s never too late to change unhealthy lifestyle choices. Quitting smoking, exercising, eating a balanced diet, and managing stress can all lower your risk for stroke and other chronic illnesses. You can also reduce the risk of injury by doing a thorough safety check of your home and making any modifications that make mobility easier and safer.


What are Your Options When Preparing for Long-Term Care?


Most people use a combination of personal funds, government programs like Medicare and Medicaid, and personal financing options like long-term care insurance to pay for their care. There are also some commonly overlooked funds, such as VA benefits, so be sure to explore all options that are available to you. While government programs can help, most long-term care costs typically come from your private savings or insurance.


If you have the means and want to avoid paying for an insurance policy you may never need, one option is to put a substantial sum into savings. This isn’t an option for everyone, and it can be tricky to estimate the amount you should be saving. Another option is to purchase long-term care insurance; you can choose from traditional long-term care policies as well as life insurance/traditional long-term care combination policies.


Even with savings and insurance, it’s important to know your options if you end up needing help paying for long-term care. You may want to consider a life settlement as one option. Choosing a life settlement allows you to sell a life insurance policy you already have for a greater value than you would get surrendering the policy. Selling a life insurance policy can help pay for daily living expenses and medical care if you find yourself needing help paying for long-term care. Just be sure to do thorough research before making any decisions to avoid unwanted surprises.


Thinking about long-term care costs is often unsettling. When you’re ready to enjoy retirement, preparing for long-term care is probably the last thing you want to do. Just keep in mind that the peace of mind you will get from planning ahead will be worth it.




June is the co-creator of Rise Up for Caregivers, which offers support for family members and friends who have taken on the responsibility of caring for their loved ones. She is author of the upcoming book, The Complete Guide to Caregiving: A Daily Companion for New Senior Caregivers.



Photo credit: Pixabay

Scams Target Seniors

3 Financial Scams that Target Seniors


“My grandfather lost everything!” Sarah declared. “They took his life savings. And now when he needs to money to pay for a nice assisted living he doesn’t have it. I am so angry about this. I don’t know what we will do. I guess my mom and I will try to care for him as best we can. After all, he was always there for us. But it’s not what he wanted. He feels embarrassed and he is pretty depressed also.”

Targeting Seniors

Scams Target seniors

Financial scams are rampant. And the prime target is our senior citizens. The people running these scams are clever and convincing. They know which buttons to push. And they know how to trigger the emotions like fear and worry.

Furthermore, these scammers know that the risk is low. Many seniors are too embarrassed to tell others what has happened.  So, they often go unreported. The bad guys are counting on this.

But don’t think they just target the wealthy. No indeed. Seniors who are already struggling can fall prey also. Often losing what little they had.

The Grandparent Scam

Scams Target seniors

Yes, this one has been around a long time. And yet many seniors are still falling prey to this one.

A child will call ad usually ask Hi Grandma or Grandpa do you know who this is?  The victim of this scam will then usually say a child’s name giving the scammer the information they need. Then they will pull on the heartstrings confessing to the grandparent that they have gotten into some trouble and need some help. They beg the senior not to tell mom and dad because they will be in big trouble. Then they ask for money (for overdue rent, car repairs, etc.) They will ask that the money is sent by western union or Moneygram because ID is often not required to collect. The amount is usually in the hundreds and may be repeated.

Investment Schemes

There are a lot of different investment schemes that target seniors. Seniors are often concerned because they are no longer working. They are looking for ways to grow what money they have left to keep up with the high cost of living. Pyramid schemes like Bernie Madoff’s targeted a lot of seniors. And the Nigerian prince looking for a partner to claim inheritance money is still targeting our most vulnerable seniors.

You may have trouble believing that your parent could fall victim to one of these scams.

But it happens. Sometimes cognitive impairment or Dementia is to blame. Family members may not even be aware that Dad is having a problem with his memory and though process. Parents are often very good at hiding their problems from the children. And the adult child often does not want to see that there is a problem. Dad is just eccentric, they believe. That is until the money is gone.

Telemarketing and Phone Scams

Scams target seniors

It is no surprise that telemarketers target older folks. They are often home alone all day. As such they will gladly pick up the phone and chat with the nice person on the other end. These smart scammers also know that seniors make twice as many purchases over the phone than the national average.

And these scams are incredibly hard to trace. There is no paper trail and no face to face interaction. Furthermore, once a successful scam has taken place, the buyer’s name is then shared with similar schemers looking for easy targets.

“Luckily my sister decided to help mom with her banking. Unfortunately, it was too late to save her from losing some of what little money she had. Sharon noticed that Mom had an automatic withdrawal on her account. For the last 6 months someone was withdrawing $150 a month. When questioned Mom seemed confused.  The bank could not stop the transactions because the scammers had a recording of mom agreeing to the monthly withdrawals. Our banker said that most likely they engaged mom in a conversation and recorded it. They then spliced together the right words to make it sound like she had agreed. We ended up having to close out the bank account and start a new one somewhere else.” ~Kay

There are a number of different telemarketing scams that go around.

The key is to pay attention to what is going on in mom or dad’s life. Ask them if they would like some help with the finances. This can be a touchy subject. But it is smart to have someone on the account to monitor any unusual behavior. If you are able to go in weekly and look at the transaction you may be able to stop a problem before it gets out of control.

Make sure your children tell their grandparents that they will never call them for money. Furthermore, make sure they understand that this is a scam when it happens. They should tell the person on the other line that they will call them back. Then hang up immediately and call their grandchild.

Hopefully, this never happens to you or someone you love. But if it does tell others so they will not fall prey to the same problems.


Honoring Mom

Honoring Mom- 5 Ways to Really “Be There” For Mom



“I really want to be there for mom.” Beatrice said. “She did everything to help me growing up. Then later when I was in an abusive marriage she helped me and my children. She took us in when we had nowhere to go. And we lived with her for two years while I finished my degree. Mom is 80 now. She is very proud and wants her independence. I really want to “be there” for her and at the same time I do not want to take away her independence”


This is a slippery slope many adult children are learning to navigate. We want to honor mom’s wishes and yet we are concerned for their safety and well being. Where do you draw the line?

Here are 5 ways to really “be there” for mom.

1.Help Her Stay Social

Honoring mom

Loneliness can be deadly. Staying social will not just keep mom happy, it will keep her healthy as well. In fact, researchers have found that Late-life depression may increase the risk of incident dementia, in particular of Alzheimer’s disease and vascular dementia.

Additionally, if mom gets depressed she may not eat right, remember to take her medication or get any exercise. All of these things can affect her physical health as well.

So, What Can You Do?

Finding The Best care For mom

Find senior centers and organizations in your area of town. The local YMCA also offers a lot of special classes for seniors. Most people who join end up making a lot of new friends.

If your mother can no longer drive to attend these activities, arrange for transportation. A caregiver agency like Right At Home is partnered with LYFT to provide safe and reliable transportation for seniors in the Cypress, Texas area.


2.Hire home care or a housekeeper to help because she is worth it

senior woman with her home caregiver

Mom may tell you she doesn’t need any help. Tell her that she is worth it and you want her to have the best. If she is really hesitant just start with one day a week. Have a schedule of what you would like the care companion to help her do. Maybe making a grocery list, ordering them online and then picking them up later. You could also have the caregiver plan a week of meals and cook a few to freeze.

3.Call Every Day

Yes, even when you are incredibly busy! You do not have to talk very long. But a few minutes to check in can mean so much to someone living alone. If you live far away and cannot see mom often try doing video chats. If Mom has trouble with the technology to make that happen the caregiver could set up the call for her while she is there. Even better, have her set up the call right before she leaves. Make sure to mark this time off of your calendar so you can give mom your undivided attention.

Bob lives in Nevada and his mom is in Cypress, Texas. They do Facetime every morning while they are both having their coffee.

“It’s great! I get to see how she is doing. I know if she didn’t sleep well or is not feeling good. I can relay that information to friends and family close by so they can check in. I think she really enjoys seeing me also and hearing about my life.”

4.Help Protect Her From Scams

Sad but true, scammers prey on the elderly.  The grandparents’ scam (telling the senior that their grandchild is in deep trouble) is a common one. There are also people posing as representatives from Medicare, social security and the IRS and calls with offers for free or discount medication. For seniors that use the internet, they can be vulnerable to even more.

Honoring Mom

Most seniors are terribly embarrassed when they fall victim.

“I felt so stupid Athena told me. I can’t believe I fell for this.”

But the truth is these people are often savvy professional crooks. They know exactly what to say to push your buttons and get you to fall for their schemes. And women over 80 who have lost a spouse or moved in the last three years are most vulnerable.

So, What Can I Do?

Talk to mom about these scams. Don’t lecture or warn her. Nobody wants to be lectured especially by their children. You want to keep the conversation as open as possible. That way if there is a problem now or in the future Mom will feel comfortable talking to you.

Just talk about the different scams you have heard are going around. Ask if any of her friends have been targeted. Having a conversation is the first step.

Honoring Mom

Secondly, you might suggest that you be added to her online banking accounts as an added security. This way you can look for any unusual or large charges that may be a red flag. If Mom will allow you to take over her finances that may be the best option. But don’t expect it to happen. Much like giving up the car keys this is something most seniors want to have control over.

Third, take a look at the mail that she is getting. If she is getting a lot of mailings from promotion companies could indicate the elderly person is on a “sucker list”.

5.Take Mom to An Estate Planning Workshop

Ask her to go with you because you don’t want to go alone. After all, you both need this information. People are sometimes hesitant to talk about finances and future long-term care plans. But if you don’t talk about it now you may find yourself in a world of hurt down the road.


The Hilbun Law Firm offers these workshops free every month. We have both daytime and evening workshops. Rest assured you will not be pressured to do anything. And the information will be invaluable to both of you. get the updated workshop schedule here.


What If Mom Outlives Her Income?

“I am worried that mom may outlive her income. What will happen then?” Asked Claire


This is a common worry for many adult children. With the cost of living continuing to rise and the needs of an elder loved one increasing also, you are right to be concerned. After all, you need to be a good money manager.

Worried about college bound children

“Our goal was to keep Mom out of a Medicaid nursing home bed. Having worked in the industry I knew that once money runs out and you need to go on Medicaid your choices are very limited. Mom had dementia. The truth is there are not a lot of facilities who accept Medicaid and are trained in caring for someone with dementia here in Texas.” ~Emily


Emily is right. The truth is if you are looking for a secured facility for someone with Alzheimer’s disease or another type of Dementia you will probably have a hard time in Houston Texas. They’re just are not a lot of them that accept Medicaid.

Old woman with her son

Perhaps your mom doesn’t need a secured unit because she can no longer walk. You could still run into the problem that Lori ran into. The nursing home where her mom was insisted that Lori come every day from 4 in the afternoon till 10 at night to take care of her mom.

Her Mom suffered from sundowning. This is common in people with dementia. It causes behavior changes. Someone who has this will often become very agitated. This is what happened to Lories Mom. She would scream, “Help, help, help!”, over and over again.  If Lorie refused to come the nursing home threatened to throw her mother out. Unfortunately, this happens a lot. Most nursing homes are short staffed and someone with dementia may need a lot more attention and care than is available.


Sometimes planning ahead can make a big difference. Sitting down with an elder law attorney just makes sense if you’re concerned. Most attorneys offer complimentary workshops or consultations. See our workshop schedule here.


Also, an elder law attorney is very connected in the community.  They are connected to financial advisors, hospice and home care companies, elder care advisors and even nonprofits that may be able to help you. They will know about many different resources that you can use to help stretch your dollars.


Often what we see is that the children wanted mom to have the very best. So they put her in the most expensive and luxurious place they could find. Chances are they felt guilty placing her at all. And they wanted her to have the best. They may have thought that mom had just a couple of years left. But then they began to realize that Mom just might live quite a while longer. As the money began to drain out of her accounts, they began to get worried.


Sitting down with an elder law attorney in the early stages is the best option. This way plans can be made. And if there is little money and you know that eventually, mom will probably end up in a Medicaid facility you can plan for that. You can also find ways to stretch those dollars to buy more time.


When Robert and Carol brought their MIL to Houston after a broken hip they had choices to make. They could place her in a large assisted living facility with care 24/7 or they could place her in an Independent Living Community with a minimal amount of additional home care.

Since they lived close by they could visit often and help out. Carol could do her laundry each week and Robert could make sure she got to her doctor’s appointments. The community supplied all meals, entertainment and activities and some light housekeeping services.

Aging parent- reason to hire elder law attorney

For a few additional $$ they had the home care company help her get up in the morning. They helped her dress and made sure she took her medication. A caregiver would also come at night and help her change into her PJ’s. More services could be added as needed. And about a year later more services needed to be added. After 2 years, the time had come to move her to an assisted living facility. She needed someone to be available around the clock. But they saved about $50,000 placing her in the independent living community for those first two years.


Knowing what is available and where to go can make a huge difference. Planning ahead if a Medicaid bed is in your future can make sure that you are able to find one when the need comes. If you wait until the money is all gone you may be in for a shock. With proper planning, you will have time to visit and choose the best facility for your loved one. You will need to move in before the money runs out with the understanding that you will be given a Medicaid bed when you need it. Your attorney can help you work with the facility you choose.


The truth is nobody knows how long someone will live. And even though it seems like Mom has a lot of money it is important to be prudent and spend those dollars wisely.

4 Steps To Choose The Best Care Facility

One of the biggest challenges that families face in life is when someone they love needs extra care and assistance. The care may be beyond the scope that they are able to provide. Often this is for an elderly parent. However, sometimes it is a spouse who needs the care. There are a lot of emotions involved. Families may feel they are letting their loved one down by not providing the care themselves.

Care Doesn’t Pay For Itself

Caring for mom

Money has to be considered. Most likely you want the very best for someone you love. But you have to be realistic about your resources. How much is available? Is there a Long-Term Care Policy in effect? Was the person needing care a veteran? Do they own their own home? Are family members planning to provide some of the care?

What Do You Really Need

Sitting down with an Elder Law Attorney can help you to clarify your needs and your resources. Plans can be put in place to maximize Care For Momwhat money you do have.  A couple must consider the surviving spouse. Spending all of the money on care for one spouse may leave the other is a big pickle when they need assistance. Elder Law Attorneys are generally very well connected in the Elder Care Industry. As such, they are able to guide you in the right direction to get the best care possible. Having an outside source to talk to can help you to become clear on what you need to do. Your elder law attorney can look at your situation with an objective eye. They are not caught up in the emotions of the situation as you may be.



What Will Medicare Pay For? What is Medicaid?

Many people are confused about Medicare and Medicaid. Medicare will pay for short-term hospital and skilled nursing homes stay. These are usually to recover from an illness or accident. Medicare does not pay for assisted living, memory care or nursing home care long term. You will be on your own for this. It will also not pay for someone to care for your parent at home. Medicaid will pay for very limited care in the home. It will also pay for nursing homes but most assisted living facilities or memory care homes are not covered. In fact, your choices and options are very limited in Texas when you are on Medicaid.

Furthermore, you need to qualify for Medicaid. An Elder Law Attorney can walk you through the steps if this is your best choice for getting the care you need. But planning ahead is crucial. Applying for Medicaid and being accepted is a process.


Having A Plan Is Critical


That is why having a plan is critical to make sure you and your loved one get the care you deserve.  A lot of chronic illnesses can last for years. Things like diabetes, COPD, Dementia and Rheumatoid Arthritis can be debilitating. As such you may need assistance for a long time. If you run out of money you may need Medicaid.

However, if you start planning when you are younger there will be more options available to you. Purchasing a Long-Term Care Policy can ensure that your care options are greater when you need them.


Getting on Medicaid Is A Process

Senior Adults on Working on a Laptop Computer


Do not wait until you have no money left to apply for Medicaid. Work with an attorney to plan for your future needs. If you will likely need to rely on Medicaid in the future to pay for nursing home care you will want to be prepared. Making sure you have all of the paperwork filled out correctly can mean the difference between being accepted or not.


Placing someone in a nursing home on Medicaid is not as easy as it might seem. There are limited beds available in Houston nursing homes that are set aside for Medicaid patients. However, if you enter the nursing home as a private pay patient and then apply for one of the Medicaid beds you will have a much better chance of getting one in the nursing home you want to be in.


So How Do You Choose?

Find the best care for mom

There are a plethora of choices in the elder care service industry. And there is not one best choice for everyone. Each family has a unique situation. And yes, money and resources do play a huge role.

Once you have determined your true financial picture you can begin the search. If you have a lot of money and resources like long term care insurance available you will have numerous choices. If you will be on Medicaid now or in the future your choices will be more limited. An elder law attorney in your area will be familiar with the nursing homes. As such they can help you to find the best one to meet your needs. Here is what you should notice and consider when choosing a facility.


Step 1-Appearances Can be Deceiving

Find the best care for mom

When you are placing someone in a facility they are going there for care. This is the utmost importance. You are not buying ambience. You are buying care. Yes, you want the place to be clean and smell fresh. But, a new facility with beautiful chandeliers, does not mean that your mom is going to get better care.


There are some amazing residential care homes that are not fancy. In fact they are rather plain jane. But the care they give is amazing!!! Likewise, there are some beautiful facilities that also give amazing care. The key to remember is “buy the care- not the facility”.


Step 2-Look for The Smiles

Finding the best care for mom


Look at the caregivers. Do they look run down and exhausted? Or are they smiling and cheerful?  Are they rushing past residents without a word or do they take the time to say “hello.” Who would you rather have caring for you? A happy staff is the sign of good care. Pop in unannounced at different times of the day and take a look around.


Step 3-Do They Encourage Families to Get Involved?


Is it easy to communicate with the staff? Are they open to suggestions? Ask how often care planning sessions are held and if family members can attend. Are they receptive to your questions, and do they seem transparent in answering them?

This is very important. you want to know that you can be involved. After all, you are the advocate. your loved one is counting on you to help them. Residents with involved families will naturally get better care.


Step 4-Notice the Other Residents

Finding The Best care For mom

Are they clean and well groomed? Do they have their teeth in? Because of the nature of the illnesses people may be dealing with residents may not be able express how they feel. Notice what is going on. Are there any activities or are the residents lined up in front of the TV all day? Do you see residents that appear to be ignored? How many residents are in their beds all day?


While the chances are you may never find the perfect place. With planning and help you can make sure to find the best options to meet your needs. An Elder Law Attorney can help you to create a plan for your family.

Depressed, gloomy woman

Mom is Being Evicted From a Nursing Home?


Can they do that!! Lori cried. ” Where is the compassion? What am I supposed to do now?”

Most people have probably never given this much thought. They assume that once they place someone in a nursing home, the home will continue to care for them until the last day. Unfortunately, that’s not always the case.

Lori found out the hard way. Lori and her mom cared for her dad who had Parkinson’s disease. It was a long journey. When Mom started having problems, there simply wasn’t any money left. Lori’s mother had dementia, diabetes and a host of other problems. It was not the kind of job that one person could do and Lori seemed to be the only one stepping up to the plate.

Elderly Lady Moving To Nursing Home


So she placed her in a nursing home after qualifying her for Medicaid. It was pretty much the only option. They tried Medicaid home care for a while but that didn’t work out. Medicaid pays very low wages. So the quality of the person that was being sent to her home- well let’s just say it wasn’t the best. On top of that, many times, they didn’t even show up.

“I couldn’t count on them”, Lori told me. “I still have to work. I can’t be worrying about what’s going on at Mom’s house when I can’t be there.”


As often happens in families, Lori’s brothers and sisters were too busy with their own lives to help out.  So Lori made the difficult decision to place mom in a nursing home. “There just didn’t seem to be any other solution!”, Lori cried. Medicaid beds in Houston are often in high demand. She wanted someplace close so that she could visit often. As her advocate, Lori knew that she was still going to have to be very involved. She just didn’t know how involved she was going to have to be. She felt blessed to find a bed in a facility close by. But the blessings were short lived.

“It was a nightmare! There was never enough caregivers. And if I wasn’t there I know Mom would have gotten any care at all. I usually helped feed the lady that shared a room with Mom. The caregivers would put the food in front of her as if she could eat it herself. She’d had a stroke and was unable to eat unassisted. But I can’t totally blame the caregivers.  They’re caring for so many people. And I also know that they get low wages too. Some of them work two jobs to make ends meet. So on top of having too many people to care for they are also often sleep deprived.”

On numerous occasions, Lori’s mom ended up in the hospital. Lack of care on the nursing homes part was usually the reason.  Diabetics are prone to infections. As such infections that got out of control would land her in the hospital often. One time, Lori decided she’d had enough.

Finding A New Nursing Home

Elderly woman is assisted in nursing home

She wanted to switch mom to a new nursing home in hopes that she might get better care. This was the time to do it. Her mom was getting ready to be discharged. As such she would need rehabilitation care. Since Medicare would pay for that it made it easier to make the switch. A new nursing home would be happy to get those Medicare dollars. So she contacted several nursing homes in the area and the one that she was interested in came out to assess her mother.

The Assessment

Mom would be going to the nursing home on Medicare benefits. She needed some rehab after her Hospital stay and Medicare would pay for a short period of rehabilitation. The nursing home agreed that after her Rehabilitation she could have a permanent room as a Medicaid patient.

Lori was thrilled. The new nursing home was close to home. It looked much cleaner and more updated than the last one. And from what she could see, the care seemed to be pretty good. Oh, she knew should still have to stop by, after all, she was moms advocate. But she had high hope for a brighter future for her mother. So the transfer was made.

Adjusting To Change Is  Often Difficult

As is common, Lori’s mother had some difficulty adjusting to the new place. She moved from one nursing home to the hospital and now to a new nursing home. Someone with dementia has a lot of difficulty with change. So Lori was there helping her mother acclimate.

The Money Ran Out

But when the Medicare dollars ran out the nursing home administrator called her in. “We can’t continue to care for your mom”, she told her. She’s got dementia and she’s upsetting the other patients with her constant hollering.”

Lori was shocked. They had assessed her mom in the hospital. “They knew she had dementia!” Lori said. In fact, when the case manager came to assess her, mom was hollering, as usual, help me help me. It’s a typical cry people with dementia often have. They’re frightened and they just want reassurance.

And Now Here They Were Kicking Her Out.

Lori discovered the reason why. Nursing homes get up paid a lot higher dollar for Medicare patients than they do for Medicaid patients. Though they have to take some Medicaid patients  they really prefer not to.


By Law, there are 6 reasons that allow for transfer or discharge of a patient.

  • The resident needs a higher level of care;
  • The resident no longer needs nursing facility care;
  • The resident has endangered others’ safety;
  • The resident endangers other residents’ health;
  • A failure to pay; or
  • The SNF is closing.

The Reason They Used

And Lori’s case the nursing home was using the first reason. They said she needed Memory Care.  But the problem was, there were no memory care beds available for Medicaid patient anywhere in Houston.

In fact, there are very few nursing homes that specialize in memory care and those that do only take a handful of Medicaid patients. Lori’s mom did not need to be in a locked facility. She was unable to walk and could not move very far in her wheelchair. She had never hurt or threatened anyone at the facility. She simply became frightened and agitated in the later part of the day.

Reaching out to an Ombudsman, Lori was able to have some help. The Ombudsman helped her mediate with the nursing home to come up with a solution. It wasn’t ideal but Lori would do it.

The Compromise

Typical of dementia, Lori’s Mom’s behavior problems usually started in the late afternoon. It is often referred to as Sundowners. As the sun goes down many people with dementia suffer from agitation, anxiety and other stress-related symptoms. This can cause them to act out in ways that are not their normal personality.

So, Lori Agreed that she would visit her mom every day from 4 in the afternoon till 9 at night. She would be there to attend to her needs. It wasn’t easy. “ I felt like they were getting a free extra caregiver,” Lori complained.

Unfortunately, the situation is not uncommon in Houston. If you have additional questions about what a nursing home can or cannot do visit our website, set up an appointment, or come to one of our workshops.