What legal responsibility do my friend's sons and family have in caring for her? She's a disabled single parent.

A fellow caregiver asked...

Three years ago, a long-time friend (platonic) suffered a stroke. I was unemployed at the time, so I jumped in and started helping out. This friend has two sons, who are now 25 and 23. After three years, I am burned out, have a full-time job 30+ miles away, and I feel that my friend's two adult sons and her family (four sisters in close proximity), should be handling the responsibility for my friend. Unfortunately, they have all resisted doing that, preferring to use me, or fraudulently force my friend into a mental institution, rather than actually providing the sort of loving care you'd expect from most families. My first question is: what legal responsibility do these adult children and other blood relatives have for my friend's care? She owns a home but has little else in the way of assets. She receives some income from SSI Disability, and has a Medicaid Waiver, which provides her tens of thousands of dollars a year to pay for door-to-door wheelchair transportation to dialysis 4x per week, plus any doctor appoints. She also gets food assistance, as well as some in-home help 2x per week. My second question is: if she moves from her home to assisted living/nursing home, etc., will she lose her Medicaid, since her home is no longer her primary residence?

Expert Answer

Kay Paggi, GCM, LPC, CGC, MA, is in private practice as a geriatric care manager and is on the advisory board for the Emeritus Program at Richland College. She has worked with seniors for nearly 20 years as a licensed professional counselor, certified gerontological counselor, and certified geriatric care manager.

I do not believe there is a law requiring adult children or other family to provide care and support for a parent. You are an amazing and generous person for having volunteered for so long to assist your friend. I agree that the time has come for you to step back and let someone else provide care.

When you delegate responsibility, you cannot require that your surrogate perform the task in the same way that you do. When you step back and allow someone else to take over your jobs, they get to do it their way, even if it is different from your way. Their way may look like less to you but it may not to them. The adult children will have to live with their decisions for the rest of their lives. Once you step back, they may do better than you think.

Your friend may not qualify for a ‘mental’ institution but she probably will for a Medicaid nursing home. There she will have around the clock assistance and peers to talk to and activities that you cannot provide at home. Many prefer to live in a group setting because of these advantages. You can continue to add quality to her life by visiting when possible.

Medicaid may take her house after her death, as a way of recompense for the care provided during her life. It’s a fair deal. Or she can choose to sell her home and use that money to pay for care, and then go back on Medicaid when it is exhausted.