From everthing I've read, it seems like vascular dementia, after a stroke, is the most likely dx. Mom is 90, was most recently living in IL but had a stroke July 1, is now in subacute rehab. She is increaingly suspicious, a bit paranoid and not reasoning from facts. The AL facility does not accept patients with dementia, what are the choices/options here ? She's got enough funds for 10 years in al but only 3 or 4 in a skilled nursing facility.
Also what are her medications like? She may not yet be on the better dementia meds as still recovering from a stroke. If she can be moved, I'd take her to a gerontologist for a full evaluation to see what probably type of dementia and where she is on the scale for it.
How is she doing in rehab? In order to stay in rehab and have it paid by Medicare, they need to be "progressing" in their care. So if they are there from hip surgery, they have to be getting up and increasing in their PT time and walking on their own time. Most elderly don't do the "progressing" needed in order to stay in rehab. Ask the floor nurse to connect you with her therapists to see what she is like for rehab. continuing for her. Medicare seems to do the first 21 days in rehab always, then another 7 days maybe but rarely the full 100 days that Medicare rehab can go.
Since she still has the funds to private pay, you all will have lots more options on where she can move into. But I would look into a facility that takes Medicaid with limited # of Medicaid beds. Most facilities that are somewhat nicer often structure Medicaid beds to be "self-selected" from their existing residents. So if you are there on private pay for 2 or 3 years, then you go on the list for the next available Medicaid bed. Evenutally your name comes to the top of the list. Understand? This way she can stay in the same place, although once on Medicaid she will need to share a room but being there a couple of years she may buddy-up with a resident so they want to become room-mates.
Oh make sure you have all her legal updated and her funeral planned. Most facilities will require that you have the funeral planned and in her chart & also many now require an advance directive done and also in her chart.
I will try to give feed back from time to time.