Joe Mitchell & Terall Blalock in their book Medicaid Married Solutions Manual  Pub: Financial Aid center for Long Term Care.  As I understand it, the car is exempt from the Qualifying countable resource. when determining Medicaid eligibilty.  So it is suggested that the purchase of a vehicle or trading-up for a reliable vehicle is a means of accomplishing any required "spend-down" of assets.  It is probably variable between states, so check with local someone who understands that-- not just any lawyer or accountant.

To PuddleJumper:

I agree with you:  Get the Power of Atty; Get a contract with the patient (parent); Take the payment each month;  .....and brace yourself for comments from siblings, heirs, and the parent themselves that you 'robbed' the parent.  There will be recriminations, more often than thanks, although the others shrink from providing their own time and attention.  The parent is in need, and it is our mission to care for their needs. 

Now, our acct advises that the payments be treated as gifts (up to $12,000/yr), else there could be some tax liability, and the contract should be between named persons-- i.e. not that we are operating a care facility that could require licensing, inspections, audits, credentialed staff, etc.

Perhaps the legal and taxes angle should start a new line of comments?

Here's a rub. What if, as in our case, a recent RAPID decline leaves the parent not competent for the legalities? Her sister has Pof A, and so does her brother.  They too are elderly, and not too interested in the daily grind we face.We live here, pay most bills and ALL food, and provide 24/7 care. We drive her to all appointments, do NOT take gas $$ from her. We also stopped paying rent when the care became 24/7. There is ALOT of work involved in all this. I think my husband should ask his Aunt to give him Pof A as well, because while we use her funds for her and her alone, his sibling (who has already helped herself to over 40 thousand ,yes 40) will be the first to cry foul at us.

Please check on the POA--all those I've seen:  A new one revokes any prior POA's, so there should only be one VALID poa at a time.  Move quickly on this because the RAPID decline of the patient is a signal for opportunists to act and claim anything available.  In time of family grief, it becomes difficult-to-impossible to reverse or nullify those shrewd actions.

Thankfully we got the patient AWAY from the opportunists ... they cant touch her $$ now. Thus her daughter  now does not even call, even send a card for Mom's 75 birthday. Even with the rapid decline , Mom knew the B**** skipped her birthday - it was SAD to see her run for the phone all that day and the next.

DAGDON,

Alot of us are dealing with small rural urban areas as I am.

In regard to the car that applies to married couples quite sure.  This is daughter and mother.  In regard to cking with the locals they even have grey areas.  They will make the ultimate decisions anyway and no choice but to abide.  The best thing is if there is nothing to go over. However, if there was refusal to cooperate with such an  arragement or limited cooperation litttle choices as I had and do what you can.  I have to be able to take her to appointments, etc. but they say a car is a grey area since she can take a senior van.  Well, she does not WANT to take a senior van.  Of course part of this is she will have me doing whatever she can and really does not realize it is a bit selfish as she can't think correctly anymore.  She never used to have an attitude like such.  Sometimes I think she is thinking just fine, however. and does not care of any inconvenience to myself.  The car was worth $800 maximum or less.  How can I get a car to replace that what a joke. 

In regard to getting a payment each month what if the dementia has made them unable to handle their bills and a guardian has been appointed?  Then I would think they would say she cannot agree to such a payment???   What do you think?  How do you determine a reasonable  payment do you base this on the amount of income?  Would you say a guardian overrules a power of attorney even if the same person had this POA?

When we encounter "attitude", stubborness, selfishness, obstinacy in the patient, then we remember that it is the nature of his/her sickness.  Guardians are appointed for pts who cannot make their own decisions anymore, and that would probably be the one with POA.  Regardless, if that isn't you, then that is the person to negotiate with for the terms of your contract, including the money part. 

My thought?  :: MINIMUM of 2/3 of any pension/SocSec Payments, plus all out of pocket for meds, transport, extraneous expenses.  Accepting the job for any amount is a vote for your own sainthood-- don't be talked-down in your price, because there probably isn't anyone else available except the nursing home.  If you are the guardian, then still write the contract, as a memorandum of record, and stick to it, because you will have to account for your guardianship.

And, so far as the elder-bus is concerned, just take it.  Patient may object, but you don't have other choices, and neither does the patient.

One awkwardness is that you might have troubles with insuring the car if the owner is unlicensed. This is an interesting situation. I have been told it is illegal.

I have the POA and have been made coowner on all of Mom's accounts with her sitting there signing the papers at the banks.   She is very stubborn and her saying is the Children are EXPECTED to help their parents=with my answer unless it can be harmful to their health.

I have tried to coax her into hiring someone to take care of her lawn and garden. She's 88 and has a trick knee and she seems feeble walking and standing.  She refuses saying she needs the exercise but then I plug the weed wacker in and leave as I have asthma and allergies. She starts in with her favorite line over and over again. I had someone come to the door to do the lawn and she sent them away.  She needs work on the house and she refuses.  When she goes; it will cost a fortune to tune the house back to code for the city to issue a CO to sell it.  She keeps saying what's wrong with it.   A Lot.  For one thing her toilet doesn't flush right and the enamel is off in places on the bowl from my late father's meds.  I think the whole toilet should be replaced and maybe cleaning around the pipes to check it out.  No  she'd rather use a pail and get the water out. 

The dog goes out on a string and she pulls her back before she's done.  The dog isa saint.  but I have to clean up the side walkway all the time because she won't let her go in the yard.  It would still need to be cleaned up but you could walk around it if you had to. Not now.  

dagdon,  Have you been a guardian or are you a current guardian?  The general air seems to be it is fine to wipe out the estate for paying for nursing homes, assisted living or in-home care but not for an immediate family  member to be reimbursed.  That is as far as actual  money for services. Any expenses for food, clothes, pills, etc. are ok but where this logic is ok is unfair.  As far as the van that is not possible for out-of-town trips.  There are many holes in these rules as many situations.  If you have experience with being guardian would you email me but if you're like me extra minutes are an extinct product.  They just get robbed of another undone task but that is part of the illness too. 

Imelda,

All that stress isn't good for you or your mother.  Is another living situation possible? 

I had an great aunt who got a new lease on life when she moved to a nursing home.  She had lived with her daughter, son in law and two preschool grandsons.  It was too much for her.  When she moved to the nursing home she made a few new friends and enjoyed the slower pace. (Those kids were too much for me and I was only 40 at the time.) The meals were to her liking and she enjoyed the card games and social activities.

We always hear about the bad nursing homes, but there are some good ones, too.  She didn't have a lot of money-so this wasn't an expensive home.

Just a thought. 

We are not legally appointed guardians per se.  What we are is more like inn-keepers of mother-in-law.  When it became apparent that this would be a permanent arrangement, we negotiated a monthly rate, and get the check from her each month.  We also have a written contract to that effect, that is to satisfy the sibs, when they will surely challenge where the money went.  It will also be material evidence if conversion to medicaid nursing home is in the future and the same question comes up. 

Realistically, it is a bargain rate for her.  Livein help is 3 times the amt; nursing home is six times the amount in our area, neither includes personal care of the type we provide--driving anywhere and everywhere, management of schedules appointments, shopping, bills, late night counseling, etc.  While neither of us has a job any longer, this helps our household budget significantly, so it's working for us, so far.  We only lost our personal time (sigh).

Its so sad for us too, KNOWING that those who refuse to care for Mom NOW will be nitpicking through all the finances later. These people even 'borrowed' a hefty 5 figure sum from Mom, yet run around to other relatives saying we sponge off Mom. Meanwhile they never even pay the interest on the mortgage they boonswaggled Mom into getting to help them.

Of course. Maybe not all parents are able to help but my mother sure is. She has Myasthenia gravis and requires 24/7 care. I would charge her only $400 a month for the increase in food and utility bills but consideering I buy her sanitary supplies ( Depends, Poise pad etc) I charge her $600. That is not a terrible lot but it does keep me out of debt so I can take care of Mom.

Potterycrone

All these posts just reforce the fact that I made the proper decision when I refused to have my mom come live with me.  As the only and now single daughter, it was "suggested"  3 yrs ago by my brothers that I have mom come live with me.  I am 57. She is 85, now uses a walker  fulltime and  is severely diabetic - insulin 4 times a day.  I just flat out refused to allow them or her to make me her world.  We had long term care insurance and some income.  In fact, with selling her house she had more money than she ever had before.  Now that the long term care insurance has run out and we will need to begin using her assets, the pressure was briefly on again for me to take her. They, and I admit it me too, see any inheritance draining away. Again I refused.   And said I would not entertain any more conversations about it. A small inheritance is not worth my sanity and emotional/physical health. Mom has enough money (not rich by any means) from the little pension, SSI and a small IRA that even at $4K a month (cost of assited living) she will probably not outlive the money, especially if I can convince her to put most of the money into a trust. If she does that, she will immedialy be eligible for the Veterns Assisted Aid benefit of another $1K per month.  If she does not do that she will be short at least $2K a month which will begin really drawing down her assets. For all of you looking for money to help support your parent please look into the Veterns benefit, which is available for  all honorably discharged veterns and their spouses. They can have up to a certain amount of assets and the amount above that you put into a Living Trust.  So it is not like Medicaid where you have to use up everything and you don't have to wait 5 years after putting the assets in a trust to apply for it either.  It takes 6 months or so to get but it is paid retroactive to the application date.  Get a elder law attorney to help you.  It will be worth it.  Mom now seems to be slipping into dementia.  She is fearful of spending a dime and seems not to trust me anymore in regards to her money.  She also says mean things that hurt me very much and damage our relationship beyond repair.  A lot of this is not even due to the dementia, which is in the early stages, as she has always treated me this way to some extent.  I have decided to begin limiting my visits to an hour or so instead of 3 - 4 hrs each most evey weekend.  I am also speaking to her about asking my middle brother to take over the day-to-day finances as she seems to no longer trust me with her money. Although I have done nothing to cause that.   Unfortuantly, that brother's wife has MS and he has his own business.  So his time and energy for this are limited. I hate to put this on him, and if he does not want to take it over, I will stay on as now.   giving the younger brother control of mom's money is out of the question. As is indicated by others elsewhere in these posts, my younger brother is always watching every penny and is afraid that some how he will end up with a dime less than the rest of else.  This is totally unfounded but his reasoning is that because I make less money than him or my other brother I am more likely to steal from mom!!!! I actually make an OK living and his thinking is very hurtful and is has contributed to my mom's money fears.  I think that is evident from these posts that the person so concerned about who gets what is often the one who cannot be trusted. I do have the support of my other brother though, when I can get his attention, which is hard to do because he wants to avoid all this with so much on his plate already.  I am more fortuante than many of you here.   This place gives me a place to vent and to thank my lucky stars and my mom's that we are not in the same boat as many of you especially in the money department.  If you parent has enough money to go into assited living and you want to preserve your sanity/health as opposed to your inheritance, you must find another living arrange form them preferably in one of the many good assisted living centers.  I can tell you that if my mother runs out of money her choices will be to go to an assited living that takes Medicaid or my younger brother's who has no children and is a nurse (his wife is one too). Once you get to the nursing home level of care it is really not a good situation anywhere. Nursing homes are meant for end of life care - say 3 - 6 months or so anyway.  These choices are so very hard and we will all be there if we live long enough. 

Its a 5 year wait for nursing home in relation to trusts. 1  MONTH for medicaid .

Perhaps what you are saying is that for Medicaid to pay for assisted living you have to have moved all your money into a trust 5 years ahead of time or wait until all your money runs out.  Of course, once you have no money at all you can apply for Medicaid, but most people would prefer to move what little they had into a trust and then get Medicaid and if you do that, it is 5 years before you need the Medicaid.  Who wants to wait until they have nothing left at all.

ITs 5 years for assisted living or nursing home. Social worker says its 1 month for medicaid to cover a home health aide.

If a child offers (or is forced) to take in an elderly parent who needs caregiving, the parent should definitely contribute financially.  The amount would depend on their monthly income and then the expenses, including the mortgage payment, food and utilities.  This should be discussed and agreed on by all, possibly witnessed and on paper.  We had to care for my 88 yr. old mother-in-law for almost 4 years in our home.  She was ok with giving us her $800 SS money and she banked her pension money.  We had to buy a larger home with a specific floor plan for her (no stairs, full bath on lower level & etc) so we did need her $800 SS to cover a new $5000 mo. mortgage pymt.   (Not a mansion, it was 2005 in No. CA)   She is always cold so she ran her heater almost all day and needed our thermostat set at 75+, which resulted in PG & E bills being $600+ a month during fall and winter.  Plus there were her several prescriptions, diapers, specific foods and medical supplies.  It really should have been more than $800 when you think of  our time you spend giving showers, running their errands, escorting them to doctors and other caregiving duties, but what can you do if you don't wish to put them in a nursing home.

Wow this has been very interesting reading.  Many of you need extra hugs and prayers.  My parents are in Oregon and I'm in Colorado.  I have taken over their bills, due to the fact that when I went out on an Emergency visit I found all their bills 2-3 months late.  I have a grasp on just about everything how and have started to set up bill pay to be on line.  Some weeks the parents are better than others, but I have hired an inhome care for each morning, their housekeeper comes every afternoon (also helps Mom with her showers) but Dad's getting a lot slower.  I have POA and it has helped greatly in setting up all this care and paying of their bills as a lot of companies wouldn't even change the billing address without it.  I'm going to start checking out the Vets and what help they give, not too sure what is available as they have pretty good pensions from being teachers in California, but it's worth a try.  After reading how some of you have trouble with your siblings I guess I'm glad that I only have myself to deal with and glad that my spouse is a great supporter.  But no matter how you look at it this is one hard job and I only hope that I learn from this so I  don't do this to my kids! :)

Good for you! I , too, am worried about my kids having to take care of me so I have purchased long term care insurance for myself from John Hancock. It is not cheap but I think it will be worth it.

Pottery Crone

Oh we had the long term care insurance.  But it was only for 3 years which is what the actuary tables show is the average time that someone stays in assisted living care.   Ha - that is off from what I am seeing.  People in at my mom's place have been there for many years in a lot of cases - like 7, 10 years. I know someone's mother who actually has LTC for life and boy are they going to need it.   That kind of insurance to far to costly for most of us though. John Hancock seems to be very good though.  My experience with them has been nothing but great.

My mom lives with my sister and pays her monthly rent to help defray costs. Mom also pays when I take her to her out of town appointments and when someone stays overnight with her. As family members, we do not charge mom what nursing homes or home care providers would so she is actually getting the care she wants at a reduced amount. Recently, we have been investigating caregivers for times when both my sister and myself are unavailable to care for mom. This usually occurs on weekends and we know what the cost would be. Mom receives approx. $900 per month from social security so we have to be careful with her money but she has few out of pocket expenses except for what her health insurance does not pay. If she were in a nursing home she would not have any money as they would take everything so at least now she has spending money. And she loves to give for birthdays, Christmas, etc.
It took me quite some time to ask for money from mom but after driving her 2 hours round trip every 6 weeks for more than 3 years, I decided I needed some help. I'm retired and living on a fixed income and the wear and tear on my car will necessitate my trading it in before I planned due to these trips so now mom at least pays for gas and I don't feel guilty because if she was somewhere else she wouldn't have the opportunity to go to the better doctors and would probably go blind. Mom used to buy lunches when we went but when gas prices went out of sight ....lunch was just not enough.
You just have to try to be fair when you know their income and what they can afford.

At one point I had my Mom's debit card to purchase a half of tank a gas a month and any other necessities that she needed me to pick up outside the weekly shopping trips the assisted living provides. She has plently of money, but she has never been comfortable with me having the debit card (older people just don't seem comfortable using a debit card) , which I had because I got tired of having to beg her to reimburse me for these expenses. I never used the debit card for anything other than as listed above. Not once. Yet due to complaining by my younger brother, I got tired to listening to them both, and I gave the debit card back to her. Now we go immediatly to the gas station next door to the assisted living and put in whatever it will take for the trip before we leave or I just refuse to take her. I also do not pick up things anymore using my own money. You have to draw some boundaries. I know it is hard but you have to do it.

I'm brand hew to this site and confused on how to ask a question? Can you point me in the right direction?