Taking Care of My Mother

[VincenzoG91]

... are you saying then that a "nursing home" would cost $80,000?

Have you talked to any people from social services about what you all can do and what kinds of supplements your mom would be entitled to? Surely there is something else available to her before her own net worth is depleted down to nothing? What if you were to sell the house and put the money in an investment in yours and your sister's name.. same with any savings.. She'd then have "nothing" in her name and would be eligible for assistance of some kind. No?

My sister was promised the house, and she recently sold her own house so she doesn't have any place to live except my mom's house right now. She and her fiance aren't good at managing money and have been struggling with maxed out charge cards since before my dad even got diagnosed with cancer. So they can't afford to move anytime soon, and they were counting on living rent-free with my mom as way to get out from under their debt and start saving some money.

That's why we need to talk to an attorney that specializes in estate law. I want to see if we can get the house set up in an inter vivos trust managed by my sister, so that my mom isn't required to sell the house before Medicaid would take over the cost of the nursing home. That way, my sister gets to keep the house as a reward for all the time and effort dealing with my mom. Otherwise, if my mom just gave the house to my sister or even sold it to her at a bargain price less than five years before my mom tried to go on Medicaid, they will refuse to cover her. If the trust is set up properly, the house is not an issue for Medicaid. The only other way to protect the house is if my mom doesn't end up in a nursing home until close to the end. My sister vowed that we would never put my mom in a nursing home, but I bet a lot of people make that kind of promise and then need to break it. But I'm an accountant, not an attorney, so I want to get expert legal advice in this matter.

[Wakeup]

"Assisted living" is what we refer to as Retirement Homes here. The resident basically looks after themselves, is free to come and go (after signing out) on excursions or shopping or whatever but all their meals are supplied in a common diningroom and for extra a month, their medications can be doilled out by the nurse on duty. There are workers that will also come up and help the resident shower twice a week if required.

I know with the mil.. she wasn't able to live in ^^^ that type of situation because she would have wondered off for sure and there is no personal there that would change her diaper. Violent residents would have been asked to leave.

[VincenzoG91]

Unless she is ill, she doesn't necessarily need a nursing home, because she may not need *nursing* care. In the states, the better option seems to be housing that is set up for patients with dementia. A social worker can help find these. They are often operated out of actual homes that provide 24 hr/day supervision. Another option is assisted living, or even adult daycare, if someone in the family will keep her at night.

I will look into this dementia housing angle, because that sounds better. We are currently doing the adult daycare thing, sort of, with a caregiver watching my mom in her own house eight hours a day.

[VincenzoG91]

Yes, I read that. Pray tell how did she wonder off then? Not once but three times now. (btw; when my mil started wondering off, is when we made arrangements to get her into a nursing home. Before a room became available (about 8 or so months later, she was incontenent).

The wandering off incidents happened last summer while she was here visiting relatives. It didn't happen while she was staying with me, but once at her youngest brother's house and twice at her sister's house.

[VincenzoG91]

My sister asked if everybody in the family could get extra door locks installed in their home before my mom visits again. These locks would require a key to unlock from the inside, so my mom wouldn't be able to sneak out of somebody's house in the middle of the night. My sister already has those locks installed in my mom's house.

[Wakeup]

My sister was promised the house, and she recently sold her own house so she doesn't have any place to live except my mom's house right now. She and her fiance aren't good at managing money and have been struggling with maxed out charge cards since before my dad even got diagnosed with cancer. So they can't afford to move anytime soon, and they were counting on living rent-free with my mom as way to get out from under their debt and start saving some money.

That's why we need to talk to an attorney that specializes in estate law. I want to see if we can get the house set up in an inter vivos trust managed by my sister, so that my mom isn't required to sell the house before Medicaid would take over the cost of the nursing home. That way, my sister gets to keep the house as a reward for all the time and effort dealing with my mom. Otherwise, if my mom just gave the house to my sister or even sold it to her at a bargain price less than five years before my mom tried to go on Medicaid, they will refuse to cover her. If the trust is set up properly, the house is not an issue for Medicaid. The only other way to protect the house is if my mom doesn't end up in a nursing home until close to the end. My sister vowed that we would never put my mom in a nursing home, but I bet a lot of people make that kind of promise and then need to break it. But I'm an accountant, not an attorney, so I want to get expert legal advice in this matter.

Tks for clarifying... I guess your best bet is to get a lawyer's advice or call a social services in her area and find out all you can. In the meantime, your sister needs a break and I don't know what eles to suggest on how she can get it.

Good luck.

Just one more thing. Start working on a suitable and permanent solution together with your sister because as I said, it gets bad, Vince. Sorry to say but there was some real messes my fil and sil had to clean up. Not to mention the acusations that my fil was selling her clothes (he had to throw them out because they were too soiled to even get clean) and the violence that followed. Your sister shouldn't have to deal with that and I'm sure neither your mom or your dad would want her to.

[Starnique]

There you go again Vince, making it all about you Dumping her off on you? lol..smh ok. Uhm anyway, Wakeup gave the best advice. I don't even think you should speaking to your Aunt and Uncle as it's not their problem. In actuality it seems as if you're trying to dump your own mother off on others. It's your problem. You and your sister need to figure this out. Vashti also gave you information on what you can do. So the first step is taking the initiative to find a home or whatever that can accomodate her. That's the least you can do.

[vashti]

My sister asked if everybody in the family could get extra door locks installed in their home before my mom visits again. These locks would require a key to unlock from the inside, so my mom wouldn't be able to sneak out of somebody's house in the middle of the night. My sister already has those locks installed in my mom's house.

You might want to consider getting regular deadbolts installed at the top of the door instead (the overhead door frame, not high up on the door); Alzheimer's patients have been known to accidentally start fires when cooking, and having to look for a key to get out might be dangerous.

[vashti]

as I said, it gets bad, Vince. Sorry to say but there was some real messes my fil and sil had to clean up. Not to mention the acusations that my fil was selling her clothes (he had to throw them out because they were too soiled to even get clean) and the violence that followed.

This reminds me: my mother-in-law, who had Alzheimer's, accused the nursing staff of stealing individual shoes (she had a prosthetic leg). It was kind of funny; it's not like both shoes were missing! lol

[dem862]

My ex-wife's step-father had Alzheimers. He was moved into a facility with varying levels of care. As his Alzheimer's progressed, his level of care progressed (and so did the cost). He eventually died of the disease. I think he was there 3-5 years. Toward the end, he didn't even recognize anybody in his own family.

I am hearing that your sister is unable or unwilling to continue to care for your mother. Medicare can void any financial transactions up to 7 years in the past in order to recover their spend-down. The time to shelter your mother's assets is gone. Your inheritance is likely already gone, if that is keeping you from making the decision. Your sister is not going to get the house. The house will be sold to pay for the long-term care sooner or later. Your primary concern should be your mom's health and well-being. Do not take her into your home, you are obviously unprepared for this responsbility. Make an appointment with a long-term care facility, go in with your sister, and have them explain it all to you. You can do the little tour they all offer. You may have more than one to choose from, depending on your area.

[VincenzoG91]

I really appreciate all the feedback. I have done some looking into the Medicaid situation, and it appears that the only way to keep the house is if my continues to live there. Medicaid could cover increasingly expensive in-home care costs, and my mom could even visit familly and/or do short stays in a hospital or nursing home situation as long we could demonstrate intent for her to move back home. That would keep the house shielded from exhausting my mother's assets. I want my mom to be able to live at home as long as possible, and I want my sister to get the house. I don't want anything for myself.

Another alternative is that my sister buys my mom's house at fair market value. The proceeds from the sale would go towards my mom's care until it's exhausted and then Medicare kicks in. My sister keeps the house, though now she would be stuck with house payments again and struggling to pay off those credit cards. But my mom could still stay there until my sister can't handle it anymore, and then she goes to a nursing home.

Or we stay on the present course of action as long as we can handle it, but there may come a point where my mom needs to be in a nursing home and we are forced to sell the house or else lose eligibility for Medicare coverage.

[misombra]

are you sure that your sister isn't just wanting to vent frustration with the situation and wants more of your support? or do you think she 100% thinks moving in with you is the best option. if she's in that much debt she probably wants to work to pay it off but can't because she's taking care of your mom. it's good that she has a helper, but she really is dedicating her life to your mom. tangible items such as a home really may not be worth it for her.

calling a lawyer in my opinion is just going to create more stress and drama for her at a time when she probably just needs you to step up and help her out. it is NOT easy by any means to care for an adult who is dependent 24 hours a day. when she is not home and the helper is in her care she is managing doctor visits, medications, and she is on-call if there's a situation. and situations are common. it takes a very special person to do this. not everybody can. i know i couldn't.

if i were you i would deal with your situation at work, then go to their house and try to work something out face to face.

[VincenzoG91]

There you go again Vince, making it all about you Dumping her off on you? lol..smh ok. Uhm anyway, Wakeup gave the best advice. I don't even think you should speaking to your Aunt and Uncle as it's not their problem. In actuality it seems as if you're trying to dump your own mother off on others. It's your problem. You and your sister need to figure this out. Vashti also gave you information on what you can do. So the first step is taking the initiative to find a home or whatever that can accomodate her. That's the least you can do.

Are you going to make my house payments if I lose my job next month? That would be great.

[VincenzoG91]

Talked to my sister last night. It turns out that is indeed her fiance who is the one who is cracking under the strain. When I asked my sister how she was holding up, she sounded fine and said that Mother's Day was just a little challenging because my mom bit her on the hand. When I asked her if she needed an immediate break from the situation, her reaction was tough and dismissive. Like this was nothing compared to dealing with our dad at his worst, when he was coping with cancer by getting drunk every night. She and her fiance are really, really close and affectionate, and the only reason that they haven't gotten officially married after being together 11 years is that he's one of those gun-shy divorced guys. She does recognize that the situation is hard on him, too, so she is going to temporarily step up the help from outside caregivers and also encourage him to get out of the house and spend more time visiting with his own aging mother across town. After the call, I sent out an email to the rest of the family, to try to coordinate for a prolonged visit from my mom later this summer.

The bad news is that it appears that the only way for my sister to keep the house is to delay getting Medicaid assistance for as long as possible. Since neither one of us wants to put her in a nursing home if it can be avoided, we should be able to handle the home care costs without Medicaid.

[michelle23]

Vince is there any way the house can be put in your sisters name now so it is legally her house? Would medicaid have to pay if your mom had no assets?

You should speak to a lawyer and a social worker. Find out everything you can and all your options.

I do not know anyone personally who had Alzheimers or dementia but I dont think anyone could cope towards the end. It would be very hard emotionally to watch her slip away bit by bit each day and the physical care and violence would be tough for any family to deal with. Nobody could do that 24/7 without a break. It sounds like the only break your sister gets is when she is at work. She may be coping okay now but as your mom gets worse-your sister will need more "me time"

My aunt died of cancer and it was very hard on us all to watch her slip away, getting weaker all the time and she was in a lot of pain. She went to a respite centre a few days a week for extra care and so she could rest. We visited a lot obviously and took her out shopping etc but everyone needed time to de-stress and unwind. Nobody could be there 24/7 coz its too hard emotionally. Even her partner needed regular breaks-even just going for a drive or calling to his mom for an hour helped him get away from it all. But we are a close family and all live in the same town apart from my aunt who lives about an hour away so we all pulled together and we could take turns.

Its the same with my grandad. Hes 80 and 3 years ago he had 3 strokes and a massive heart attack. He has been getting weaker and weaker but he still lives at home and theres plenty of us around that he always has visitors. He also has home help calling daily to help him shower etc but life is easier when you have a lot of family living near by

Its harder on your family because of the distance

Ignore the harsh comments you are getting here. Just focus on finding a solution. You know that your mom is going to need 24 hour care at some point and its best to be prepared early as WU said.