affording elder care?

[Anonymous]

My mom doesn't have a lot of money and she's on her own. I think she's going to need some kind of assisted living in the next three to five years. How do people pay for this? It's expensive and medicare doesn't cover it. Mom doesn't have a lot of money- just a small retirement, social security, and a townhouse that isn't worth much and might be hard to sell.

I'm reading all of these threads and everyone is saying "just hire this kind of aid, or live here" and the costs are exorbitant. My DH and I are comfortable but we want to retire some day too and we need to send our teen to college in a few years.

Are people who aren't rich just expected to hand over their life savings or quit their jobs to deal with these situations (okay, that was a little bit of a vent, but really?). What are the regular people who don't make a ton of money and don't come from money supposed to do?

[Anonymous]

She may qualify for Medicaid or would after spending down her assets.

[Anonymous]

Yes, she will need to spend down her assets and then qualify for help that way.

You and dh should not risk your kids college funds or retirement. Help her look into qualifying for Medicaid.

[Anonymous]

Anonymous wrote: Yes, she will need to spend down her assets and then qualify for help that way.

You and dh should not risk your kids college funds or retirement. Help her look into qualifying for Medicaid.

OP here- thank you. Yes, this is the reasonable answer. I tried to have a conversation with her last night about her wishes, planning, living situation and it deteriorated quickly with her saying some things, and me saying some things... She already has anxiety and some toxic personality traits that I expect to get worse with age.

Aside from the logistics and finances, she's within her rights to refuse help that she needs -- I'm seeing that play out with other family members and it's a living nightmare for their kids.

[Anonymous]

Try to get her to just look at some options...for the future if she needs it. It may alsy her fears.

[Anonymous]

Medicaid is the answer. It’s a lot of paperwork and she has to make sure she spends down carefully as one cent out of place and they can deny. I am fortunate enough to be working with a hospital social worker who is helping me navigate all the steps.

[Anonymous]

Thing is that usually you have to spend your own assets to cover pre-nursing home care. In most states, Medicaid does not cover assisted living. Other things that people do are to move their elderly parents into their own house and to pay for their care. Not lots of options at all.

[Anonymous]

Anonymous wrote:Try to get her to just look at some options...for the future if she needs it. It may alsy her fears.

OP here- thanks. It's hard. She seems to expect that I'm going to personally take care of her like she did her mother- but my circumstances (job, kid, husband who would move out if I moved my mother in, living in a different city) just aren't going to allow for that. Plus, we have a far different relationship than she did with her mom, and that's a story for a different forum.

[Anonymous]

Medicaid is the answer, though that is only for nursing home, as has already been stated. And basically, she'll have to qualify for nursing care first, then go into a facility that will eventually take Medicaid once her assets have been spent down to the required amount.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Try to get her to just look at some options...for the future if she needs it. It may alsy her fears.

OP here- thanks. It's hard. She seems to expect that I'm going to personally take care of her like she did her mother- but my circumstances (job, kid, husband who would move out if I moved my mother in, living in a different city) just aren't going to allow for that. Plus, we have a far different relationship than she did with her mom, and that's a story for a different forum.

If she has that expectation now it will only get worse the more her health and ability to care for herself falters. You probably should start looking into her nursing home options now so that if something happens she'll have a place to go.

I also know people who have their parents in group homes, though in both of those cases the parents had non-violent dementia.

[Anonymous]

Anonymous wrote:Thing is that usually you have to spend your own assets to cover pre-nursing home care. In most states, Medicaid does not cover assisted living. Other things that people do are to move their elderly parents into their own house and to pay for their care. Not lots of options at all.

When you say spending down “own assets” are you talking about OP’s assets or her mom’s? OP shouldn’t have to spend a cent of her own assets. She will need to spend down her mom’s. OP should get POA over her mom now (health and financial) should her mom lose her cognitive abilities or need assistance in applying for Medicaid. Most states do cover LTC with Medicaid (not Medicare).

[Anonymous]

Anonymous wrote:

Anonymous wrote:Thing is that usually you have to spend your own assets to cover pre-nursing home care. In most states, Medicaid does not cover assisted living. Other things that people do are to move their elderly parents into their own house and to pay for their care. Not lots of options at all.

When you say spending down “own assets” are you talking about OP’s assets or her mom’s? OP shouldn’t have to spend a cent of her own assets. She will need to spend down her mom’s. OP should get POA over her mom now (health and financial) should her mom lose her cognitive abilities or need assistance in applying for Medicaid. Most states do cover LTC with Medicaid (not Medicare).

Just her moms assets. OP doesn’t need to spend down to get her mom Medicaid.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Thing is that usually you have to spend your own assets to cover pre-nursing home care. In most states, Medicaid does not cover assisted living. Other things that people do are to move their elderly parents into their own house and to pay for their care. Not lots of options at all.

When you say spending down “own assets” are you talking about OP’s assets or her mom’s? OP shouldn’t have to spend a cent of her own assets. She will need to spend down her mom’s. OP should get POA over her mom now (health and financial) should her mom lose her cognitive abilities or need assistance in applying for Medicaid. Most states do cover LTC with Medicaid (not Medicare).

Correct, the assets belonging to person being admitted into the nursing home and who will eventually need Medicaid assistance. Not OP.

And agree on POA as well as a Medical POA.

[Anonymous]

I’ve been in your shoes with my Dad, OP. If I were you, I would talk to a good elder law attorney. Ask friends and neighbors for recommendations. Make sure you have all the paperwork you need to take over and make decisions for your Mom if she is unable to handle things for herself - POA, living will, etc. If you aren’t already, get her to add you to her bank accounts, safe deposit box, etc. and have her name beneficiaries for insurance, retirement accounts, etc.

I would also consider selling her home and renting an affordable senior apartment. You will need cash for her care. Having non-cash assets like real estate can complicate matters and make her ineligible for government assistance. Then, if she needs a nursing home, get her into a facility that accepts Medicaid. Usually she would need to pay out-of-pocket for a certain number of months before Medicaid would kick in. Keep in mind that you can prepay funeral expenses to help “spend down” her assets. Once all of her cash and assets are depleted, she would qualify for Medicaid.

Please consult an elder care specialist for advice long before you think she will need help.

[Anonymous]

Anonymous wrote:I’ve been in your shoes with my Dad, OP. If I were you, I would talk to a good elder law attorney. Ask friends and neighbors for recommendations. Make sure you have all the paperwork you need to take over and make decisions for your Mom if she is unable to handle things for herself - POA, living will, etc. If you aren’t already, get her to add you to her bank accounts, safe deposit box, etc. and have her name beneficiaries for insurance, retirement accounts, etc.

I would also consider selling her home and renting an affordable senior apartment. You will need cash for her care. Having non-cash assets like real estate can complicate matters and make her ineligible for government assistance. Then, if she needs a nursing home, get her into a facility that accepts Medicaid. Usually she would need to pay out-of-pocket for a certain number of months before Medicaid would kick in. Keep in mind that you can prepay funeral expenses to help “spend down” her assets. Once all of her cash and assets are depleted, she would qualify for Medicaid.

Please consult an elder care specialist for advice long before you think she will need help.

I know you mean well, but I just love how you (and not just you, but other pps) just assume that OPs mother is going to go along with this willingly. If your parents did, that's really great and I'm happy for you! But so many elderly people refuse to give up control and insist that they are just fine and don't want their adult children "meddling in their business."
OP states she has other relatives that have done this and has concerns her mom might in her post at 5:58.