What to do when your parent does not meet ADL requirements, cannot afford assisted living, and is not safe living alone?
The national median cost of assisted living is $3,495 a month. Medicaid won't pay for assisted living, only for an aide in the home, which has recently become much more difficult now that 3 ADLs are required to be eligible and there is a longer wait time for processing (as in months) than before because of the new 2.5 year lookback. The other option for coverage by Medicaid is a nursing home. I have a parent who is 95 and there is no other money beyond social security at this point, which leaves a $1495 gap for assisted living. I can't assist with that financially. He has diabetes and is losing his ability to walk, uses a walker, can't feel his legs (but still drives!). He has nerve pain in his hands now too. He lives alone in the middle of nowhere. Those medic alert buttons don't work out there, no cell service. Anyway, at this point he would not be eligible for a Medicaid aide since he can do everything on the ADL list - just barely. I really don't want to move in with him, but I don't see another option. My husband and I live about 2 hours from him now. Where he lives there is very little support for seniors, it's the middle of nowhere. You cannot find a housekeeper, for example. I go up there once a week to clean. And I cannot imagine helping him with the bathroom, if it comes to that. The house is in horrible shape, very neglected, ugly inside. Needs a huge amount of expensive work. And I hate it there, so I am very worried about eventually (probably within the next 6 months) having to move in there. We live in a one bedroom in the city - moving to a two bedroom is not an option and he would not come here anyway. I have two siblings living within one mile of him who cannot help in any way, financially or otherwise. I only mention them because I am sure to get questions about siblings - so just consider me an only child. We own his home, having bailed him out of the loan he had on it, so he cannot sell that and we hope to get our money back eventually after putting a lot of work into the house. Any advice? I'm stuck with having to move in, I believe.
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If you already have DPoA, great! If not and he refuses to take this step then you will need to enlighten him to the reality called Ward of the County or guardianship. Please do not move in with him. This gives the false impression that he is still "independent" and able. He is not. You may want to consult with a reputable faith-based facility near you (if you will be managing his affairs going forward). Faith-based facilities are more flexible and understanding. They may allow him in to LTC and therefore he may qualify for Medicaid. They did this for my MIL. In my state the look-back is 5 years. My advice is to resist moving in with him. If you need to call APS then so be it, it will get him placed sooner. Also, please go into his state's DMV and anonymously report him as a dangerous driver so that he doesn't hurt others (this happened in my own family -- my uncle went through a red light and it killed his own wife and dog and injured the other party). Remove his car physically if that's what it takes. I wish you much success and peace in your heart as you move through this transitional time with him.
Right now it is self neglect but, as time passes and he needs more help than he is getting and you know this, that is when it becomes a situation for you and your siblings.
Call now so that he is on their radar and you have proof that you have been trying to help him with the situation. They also know about and can implement services that the public can not. They can also force issues that you can not. Call APS today. He is a vulnerable senior that needs help.
You dealt with Medicaid for your mom, what do you know about your dads finances that you are worried about? You can see a certified elder law attorney to get advice on fixing whatever you are concerned about or find that it is nothing to worry about.
Best of luck finding the best solution for your dad.
You say "we own his home". Hopefully you bought it for fair market value, but if he still had a loan on that home, the profits from it will last only a very short time.
Medicaid WILL pay for his care in a nursing home. But you may not be well satisfied with that nursing home and it certainly will not be on a par with a good ASL place.
So here you are. The choices are as you say. A nursing home and medicaid. Or move in with you and be cared for by you. Your parent is 95 so that would last at most 5 years in normal circumstances. Some are looking at this with parents in their early 70s so they are looking at two decades of caregiving. There are no other choices now, at this point, when it has come to this. And given that in our nation some are paying Federal Student Loans they were lured into when they are on Social Security, I can't see things getting better.
I suspect your family may not want to give up their own lives in the care of an elder. So you are down to Medicaid and the kind of care it pays for in a Nursing home. This varies widely across our country.
And I am left with the helpless words we who answer anything on Forum are often left with. I wish you the best of luck. I caution you against using your own money, as you are going to need every single penny you can save for your own time in this position.
I am so sorry. But you got it all, and you got it right. And like so many things, there is no "fix-it" and there is no answer.
I caution you against "moving in there" as well. Often the people we see do this, sacrificing years of their lives in care, end up homeless, jobless, without job history and penniless as well as ending mentally unstable from attempting 24/7 care. You can read their stories all over the Forum.
To give up your own life to move in with him, to live his life, in his home, his way without any thought to your own.
I am curious... What does your Father say when you ask about HIS future plans?
Sometimes you get surprising answers... Live here till I keel over one day... Go off to some nursing home I suppose..
Maybe you will get an idea of what he is willing to sacrifice. Afterall it is HIS life.
What does your H say about moving in with him?
Do you have any suspicions of problems there might be with Medicaid eligibility? Has he been giving money away to your siblings?
Since you bought the house over 5 years ago, it shouldn't be an issue. Definitely try to get a handle on his expenses, putting focus on any substantial withdrawals.
Dressing oneself, wearing the same clothes... My mother had enough clothes to open a store (along with matching purses, shoes, etc)!!! Yet when dementia kicked in, we tried the aides first, so some cameras were installed to be able to monitor things. It reached a point where this clothes horse was wearing the same hum-drum outfits over and over again. Once it was 6 days in a row! Not even the "nice" stuff! I will wear items more than once, but I wasn't into clothes like she was, and I could notice food stains on my clothes!
The process to place him in a nursing home will begin and he will stay in the hospital until a place is secured. This will be covered by Medicaid as he has no assets.
My advice to the OP is that there are too many POAs. Too many cooks in the kitchen with availability to Dad's finances. She said her father's finances are a mess. Is it any wonder? She's 2 hours away, yet the siblings down the road can't or won't help Dad with day to day living. It seems his well being is left to the only compassionate sibling left. It's sad.
I'm not familiar with APS but if Dad lives in a rural area without a lot of social services available, I doubt he will be able to avail himself of any of them without her help because the other siblings apparently don't have any inclination to see after their father's well-being.
As for moving in with him, DON'T GO THERE. Unfortunately, as others on this forum have found out, you just have to wait for a TRUE emergency to take him to the ER (i.e. a fall or illness). If siblings are concerned about his well being, have a "family meeting" without Dad to discuss options. Then and only then will you be on the same page as to his care. Discuss what would happen if Dad fell and needed to be taken to an ER. EVERYONE would need to be on the same page when speaking with the Social Worker/Discharge Coordinator. If even ONE sibling tells them he can live on his own or that they'll take care of him (when they really won't), the Social Worker will discharge Dad to home and then it begins all over again. The job of Discharge Planners is that -- discharge patients out of the hospital asap, especially during a pandemic.
It seems that in the majority of families with siblings, care of elderly parents is most ALWAYS left to one person. It's always easier for siblings to make excuses as to why ONE sibling should give up their lives, home, mental health so THEY can live their lives without interruption. Again, sad.
I hope every caregiver who is reading this right now has a plan for THEIR care. Don't wait until you don't have a say. Get your legal paperwork in order NOW. Find out NOW who you can depend on to carry out your wishes. Sometimes your children aren't those people.
ineligible for the grant. Your objective is to survive while using available funds to get as much for the house as possible. It will not last that long and be worth it! You can place in a Medicaid nursing home if need be when the time comes. It sounds like you are well positioned to obtain government services, including housekeeper or nursing support. And you haven’t said you don’t like him or have big issues with him. Think of it as an opportunity to perhaps improve your own position instead of a burden.
Is there any chance that you and your husband can take out a home equity line of credit on the house, get it habitable (no cosmetics - ugly doesn't matter - safe matters) and move your father out while it's being renovated? Tell him you need to have it tented for termites, for example, and then DO NOT MOVE HIM BACK IN but rather put it up for sale. Recoup your money because you and your husband will need it for your own retirement.
Find a nursing home or senior residence that accepts respite, get the Medicaid paperwork rolling, and then let that become his longterm residence. At least he will be safe. He will never be happy but at least he will be living somewhere that's habitable. Small care homes are usually cheaper and your father may be more suited to a smaller place.
You can start doing work on the home as you live there or you can sell the place and use his social to pay for ya'll to move in a 2 Bedroom Apartment.
We sold her house and used that money to pay the rest of her fees. You said you own the house but consider selling it and using the money for your Dads living expenses. It will be cheaper and much less stressful to you than having to move in with him. I can speak from experience that not everyone is cut out to be a full time caregiver.
I have watched a lot of YouTube home repair and improvement videos. Have learned more than I ever thought I would. Started small by replacing a deadbolt lock by myself. With each repair task have built more confidence in my abilities & knowledge of how plumbing, roofing, and electrical works in my home.
It’s not rocket science by any means. It’s basically following directions and knowing your limits - not strong enough, fear of heights, etc.
I have done patch jobs on leaky pipes and part of the roof to mitigate damage (buy time) until COVID is over. Am a short, skinny lady & my neighbors think I’m nuts. If I can do it, anyone can.
This may not help, but tackling a small item on your list, home repair or not, may give you a boost of confidence.
You father can't afford assisted living. The question is: Would he go to assisted living if he could afford it, or is he insisting on staying in his own home, decrepit as it it?
I like the idea of telling him he has to move out of the house so repairs can be made, or even selling it out from under him. Money-wise, I believe the only affordable option for him would be a senior group home. My understanding is that they are much cheaper than assisted living and perhaps you could find one that he could afford, maybe even closer to your location than he is now.
Since you've already ascertained that he doesn't meet the requirements for Medicaid, I don't think an elder care lawyer is what you need. I'd seek the advice of a geriatric manager manager, if I were you. Or, if you're good at internet research, look for senior group homes to evaluate. Some websites have them listed along with assisted living facilities but the number of beds will be less than a dozen and the owners will be private individuals, not a big corporation.
I don't think you have to, or should, move in with him. You would be putting your life on hold indefinitely, and the most likely would be overwhelmed with frustration and resentment.
Just my .02. Wishing you good luck with your decision.
If it's just to "talk" to them about something, usually the person, dad in this case, can give the okay over the phone. Beware if he has hearing issues!
In order to manage SS, the only LEGAL way, per SS, is to sign up as rep payee. Not sure how it would be handled today, with the virus around, but it's best to start with a local office, not the main 800 number, unless you like phone menus and being kept on hold for a long time!
I called MY local office, which isn't in the state mom lived in, got an appt and filed. They just asked a lot of questions and submit it. They didn't ask to look at anything and I did NOT take my mother with me. They do send notice to both you and the party involved, so the person can object if they want to. By then mom was in MC, so mail was held by the nurse. Mom wouldn't really understand it anyway! I had to have the address change done, as we were selling her condo and you can't forward federal mail.
The LEGAL note is from THEIR paperwork that came with the approval. No one has the right to "manage" another person's SS and POAs don't work for federal entities.
You never know what is going to happen until you start.
One thing I know is that the money is only a problem if he was giving it away. He could spend it how ever he chose, except for disposing of it to protect it from paying for his own care.