affording elder care?

[Anonymous]

Anonymous wrote: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?

OP, you need to find your own retirement and teens college first. No, you don’t hand over your savings. Your mom will have to go to a Medicaid facility—a natural consequence of not planning.

[Anonymous]

Anonymous wrote:

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.

She has both, including a living will. My frustration is her inability or unwillingness to make decisions even though she is cognitively able to do so. She waits for my sister and I to "save" her (she actually used that word) but "doesn't want to be a burden".

[Anonymous]

OP it really is a nightmare. You’re not alone. Most people don’t plan ahead for this. They wait until there’s a crisis, often a fall. Then they end up in a rehab hospital and then go from there to assisted living or nursing care.

My advice would be to give up on convincing her to plan for her own decline and death. That’s just a really hard ask in our culture. The psychology of denial and avoidance is powerful and it’s kind of helping them cope, in a way.

What you can do is talk to her about giving you as much visibility into her finances NOW as possible. Maybe frame it as protecting her from fraud. See if she will work with you to gather a list of all of her insurance policies and bank accounts. As many numbers and passwords as you can get from her without making it about the future. Possible make a sample with your own info and talk about how helpful it is if anything goes wrong, like someone tries to log into your accounts. You can have this list available so when you call the bank, they can help you. Stuff like that.

Then, do as much of your own research as you can on local facilities. If she falls at home and breaks a hip, do you know what rehab hospital she would go to? If she then needs to move to nursing care, do you have a list of three you feel good about? Will those help her spend down her assets and transition to Medicaid, or will she have to move again? Do you need an attorney for her? Do you know who it is? You can do all of that without her cooperation.

[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.

Honestly if she is in hospice and has enough savings to pay for it, who cares if she spends it all? That means she had enough. You can’t take it with you. That’s what life savings are for.

[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.

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

Of course not, but some people don’t have the choice. My parent is currently Medicaid pending in a Medicaid SNF after a stroke. I have POA and have spent down assets to below $2500 and parent gets to keep $93/month of SS. My parent would be homeless and unable to perform any skills for daily living.

[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.

Honestly if she is in hospice and has enough savings to pay for it, who cares if she spends it all? That means she had enough. You can’t take it with you. That’s what life savings are for.

PP here. I care because she talked on and on about how much she wanted to leave money behind to help my kids with college and now cries (quite literally) about how she messed up. I reassure her that it's fine and don't ever bring up money on my end, but it is important to recognize that sometimes people don't want to spend every penny just on care and end up waiting too long.

[Anonymous]

Anonymous wrote:

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.

Honestly if she is in hospice and has enough savings to pay for it, who cares if she spends it all? That means she had enough. You can’t take it with you. That’s what life savings are for.

PP here. I care because she talked on and on about how much she wanted to leave money behind to help my kids with college and now cries (quite literally) about how she messed up. I reassure her that it's fine and don't ever bring up money on my end, but it is important to recognize that sometimes people don't want to spend every penny just on care and end up waiting too long.

Np. I think what you’re stating is obvious. Who would want to spend down their assets and then get Medicaid? Of course the preference for pretty much everyone would be to get free nursing care (paid for by tax-payers) so you can will your money to your kids. But how crappy, and unethical is that? Your mom is fine that’s she’s spending retirement money in elder care. That’s what it’s for. She didn’t plan badly if she has funds. But no way in heck is any person entitled to tax-payer funded elder care while saving and willing off their retirement funds.

[Anonymous]

Anonymous wrote:

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.

Honestly if she is in hospice and has enough savings to pay for it, who cares if she spends it all? That means she had enough. You can’t take it with you. That’s what life savings are for.

PP here. I care because she talked on and on about how much she wanted to leave money behind to help my kids with college and now cries (quite literally) about how she messed up. I reassure her that it's fine and don't ever bring up money on my end, but it is important to recognize that sometimes people don't want to spend every penny just on care and end up waiting too long.

But what were her alternatives. She collapsed. Are you saying had she made better plans she wouldn't have collapsed? If Hospice is involved, that means they have determined she is at end of life. Hospice (btw) is frequently covered by medicare. She must be in assisted living because she can't care for herself and has nowhere else to go. Sounds like she was going to end up in this situation no matter what given that she collapsed. And thankfully she has money to pay for it. Just because she wanted to help with kids' college, etc., doesn't mean that at the end she would actually have the money to help with that.