affording elder care?

[Anonymous]

Anonymous wrote:

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.

OP here-- I do appreciate what needs to happen (ideally) - this is the kind of practical planning that should occur. Yes, I think my mom might be obstructive about receiving any outside assistance. To be honest she wants attention and perceives herself as a victim. I think she would love to have me over a barrel where I have to come running for every daily emergency. I'm sorry to say that this is her real personality that is getting worse as she ages. I don't think this is uncommon as difficult people get older.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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.

OP here-- I do appreciate what needs to happen (ideally) - this is the kind of practical planning that should occur. Yes, I think my mom might be obstructive about receiving any outside assistance. To be honest she wants attention and perceives herself as a victim. I think she would love to have me over a barrel where I have to come running for every daily emergency. I'm sorry to say that this is her real personality that is getting worse as she ages. I don't think this is uncommon as difficult people get older.

Agree with PP who says it's not so easy to sell mom's house, etc. My mom doesn't want to be difficult, swore she wouldn't be, but now as she is closer to needing assistance (and not very much at this point) she is starting to sing a different tune. She is afraid of losing control of her life. (Frankly, understandably.) We've managed to get POA, Medical POA (two very different things, and Medical POA is hugely important) and on checking account. But nothing else. No way is she selling her home until she is ready, and she really is hoping some miracle will happen and she can age in place and die at home.

There is simply no way to force the issue unless you have everything in place before they get to the elderly anxiety/paranoia stage.

The worst is, if you don't have those things in place and something happens and they end up in the hospital, you have zero say or control. The purpose of this is so that no elderly without the ability to care for themselves isn't put on the street post hospital stay. But there are some who use it as a way to fill a bed in a nursing home. They'll take the 90/100 days pay from medicare, then take the assets, then apply for medicaid. End of life is scary if you don't have the means to control and/or pay for it. BTDT with my dad.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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.

OP here-- I do appreciate what needs to happen (ideally) - this is the kind of practical planning that should occur. Yes, I think my mom might be obstructive about receiving any outside assistance. To be honest she wants attention and perceives herself as a victim. I think she would love to have me over a barrel where I have to come running for every daily emergency. I'm sorry to say that this is her real personality that is getting worse as she ages. I don't think this is uncommon as difficult people get older.

Definitely common for elderly folks to become difficult. The only thing I can say is mind your boundaries and don’t allow yourself to be coerced into doing something you don’t want to do. Not only will the elder be demanding, medical personnel will also coerce you into taking your parent into your own home. I had to hold my ground after my dad was hospitalized for months and they wanted to discharge him to my house. I made the social workers aware that was not an option and they found a nursing home for him that accepts Medicaid. He hates it there (it’s actually a pretty nice facility) and wants to live with me so you can imagine the guilt trip.

[Anonymous]

Yes, I've got two parents who really really really should be in assisted living...they refuse (and only Mom is cognitively enough to decide).

They spent the summer in the hospital/rehab after Dad with parkinsons fell on Mom and broke her hip. I work fulll time , commute 2 hrs a day and have a dc with sn. It was...something... anyhow you can't make them sell their house and get into assisted living if they/one of them are of 'sound' mind. 'Sound' mind doesn't mean 'make GOOD decisions' I found out!

But no, OP, you do not pay-it goes on her assets-and you have to put yourself and your own family first. That was hard for me to realize...but I get it now.

[Anonymous]

Just keep pushing occasionally for your own sanity. I pushed my mom for years and she just kept refusing to talk about it, calling me bossy, saying she had time, etc. She collapsed and is in hospice, assisted living care at an out-of-pocket of over $10K a month. She was a teacher and is likely to burn her life savings. I sleep at night by knowing I did all I could do to avoid this situation.

[Anonymous]

I actually used staying in control to my advantage. I told my Dad that if he wanted any control of what to keep or give away or where he will live, he needs to do it now while he was still healthy enough. I said The last thing you want to have to do after a stroke or cancer diagnosis is be forced into assisted living and have me going through their stuff and selling the house.

Luckily, my Mom’s dementia was getting worse and my Dad realized they had to move into something more manageable. They moved to IL in an CCRC near me.

[Anonymous]

Anonymous wrote:

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.

No, the 7:36 poster was talking about *the OP's assests* because they were talking about *pre-nursing home care*, NOT nursing home care. Yes, the mother would spend down her own assets for nursing home care to qualify for Medicaid. But if the mother is not impaired enough to need a nursing home, there are not a lot of options. As the PP said, Medicaid does not cover assisted living, and in many states does not cover any in-home care. If her mother needs help but does not need a nursing home the reality is that the OP will need to kick in for it because there is not a public program for that level of care.

[Anonymous]

Anonymous wrote:Just keep pushing occasionally for your own sanity. I pushed my mom for years and she just kept refusing to talk about it, calling me bossy, saying she had time, etc. She collapsed and is in hospice, assisted living care at an out-of-pocket of over $10K a month. She was a teacher and is likely to burn her life savings. I sleep at night by knowing I did all I could do to avoid this situation.

My mom is 75, her Parkinson's is progressing. I have had several conversations with her regarding elder care, that we need to start planning for when she can no longer live on her own. Her only source of income is social security which is about $2,500/month. She has a living willing (doesn't want to be on life support). Other than the living will, she has "no idea" about what she wants other than she wants me to make all her decisions or comments like "I'm sure my doctor will make recommendations." When I brought the issue up again, she's started acting irrational making comments like "do you know something that I don't know", calls my sister and tells her she thinks her neurologist had a secret conversation with me that she's dying and that's the reason I'm pushing the issue. Unfortunately, this is my mom's personality. For as long as I can remember, she's had a helpless personality, doesn't want to make decisions, and then goes on and on about how the angels are watching out for her, and that whenever something has happened in the past, "someone always saves" her which 90% of the time is my sister and I.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Just keep pushing occasionally for your own sanity. I pushed my mom for years and she just kept refusing to talk about it, calling me bossy, saying she had time, etc. She collapsed and is in hospice, assisted living care at an out-of-pocket of over $10K a month. She was a teacher and is likely to burn her life savings. I sleep at night by knowing I did all I could do to avoid this situation.

My mom is 75, her Parkinson's is progressing. I have had several conversations with her regarding elder care, that we need to start planning for when she can no longer live on her own. Her only source of income is social security which is about $2,500/month. She has a living willing (doesn't want to be on life support). Other than the living will, she has "no idea" about what she wants other than she wants me to make all her decisions or comments like "I'm sure my doctor will make recommendations." When I brought the issue up again, she's started acting irrational making comments like "do you know something that I don't know", calls my sister and tells her she thinks her neurologist had a secret conversation with me that she's dying and that's the reason I'm pushing the issue. Unfortunately, this is my mom's personality. For as long as I can remember, she's had a helpless personality, doesn't want to make decisions, and then goes on and on about how the angels are watching out for her, and that whenever something has happened in the past, "someone always saves" her which 90% of the time is my sister and I.

PP here. If she wants you to make all decisions, you need to have a medical power of attorney. If she wants you to make all decisions, you also need a general power of attorney.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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.

No, the 7:36 poster was talking about *the OP's assests* because they were talking about *pre-nursing home care*, NOT nursing home care. Yes, the mother would spend down her own assets for nursing home care to qualify for Medicaid. But if the mother is not impaired enough to need a nursing home, there are not a lot of options. As the PP said, Medicaid does not cover assisted living, and in many states does not cover any in-home care. If her mother needs help but does not need a nursing home the reality is that the OP will need to kick in for it because there is not a public program for that level of care.

No i was not talking about OPs assets. I was saying her mothers assets and I clarified in a later post. Her mother can spend down by buying AL care. When her money runs out, if she doesn’t qualify for SNF care, then you are right. Someone else will have to step in or she will be evicted.

[Anonymous]

Medicaid is the answer and it does sometimes cover home-based care. That depends on the state and the person. You may want to transfer assets now so she qualifies more quickly. It is a 5 year look back. But that would require her being open to that idea.

[Anonymous]

Anonymous wrote:Medicaid is the answer and it does sometimes cover home-based care. That depends on the state and the person. You may want to transfer assets now so she qualifies more quickly. It is a 5 year look back. But that would require her being open to that idea.

Coverage of in-home care may require a waiver. There maybe a years-long list for that waiver. You do not need to currently need it to get on the list. You can look into the situation in her state now.

[Anonymous]

Anonymous wrote:Medicaid is the answer and it does sometimes cover home-based care. That depends on the state and the person. You may want to transfer assets now so she qualifies more quickly. It is a 5 year look back. But that would require her being open to that idea.

In Maryland, I was told by the hospital social worker that there is a 7 year waitlist for home based care. My parent is in an SNF on Medicaid and wants to come home, but there is no option to do so because of the unavailability of home-based care.

[Anonymous]

Anonymous wrote:

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.

Most people don't like the idea of spending down assets so that they can go into a medicaid home.

[Anonymous]

My mom owned her home and was able to buy into Asbury Methodist which was $200K for a 1 bedroom about 10 years ago.

Her social security goes to paying her monthly cost.

She gets 1 meal a day.

If she gets sick or too old to care for herself, she can move to the nursing home, they get all her SS and her 1 bedroom apartment but can't kick her out.