Who is responsible for paying for my mother's care?

1 answer | Last updated: Sep 02, 2013
Cindy asked...

My mother married a man after my father died and all of us were grown. This man does not have any children of his own. He does however have neices and nephews. We do not have any contact with them. My mother has been diagnosed with Altzheimer's and requires extra care. They are living in an assisted living facility that is able to give my mother the extra care that she needs. However, it is very expensive. We have control of her money but not his. Even though they have been married for 30 years, they have kept there finances separate. He has told us about his various stocks, annuities, CD's and banking accounts but never how much the total of all of his assets. When and if my mother's money runs out, who is responsible for her care? My brothers and I or her husband?

Expert Answers

Barbara Steinberg is the CEO and founder of BLS Eldercare Financial Solutions, which specializes in helping families pay for long-term care for their loved ones. A registered financial gerontologist, she speaks regularly on the topic of paying for long-term care and is a financial expert for Caring.com.


If your mother runs out of money, her husband is responsible for her care. If you haven't already discussed the matter with your step-father, I urge you to have this conversation as soon as possible. He may be willing to pay and then you do not have an issue.

If he refuses to pay for her care because he hopes Medicaid will cover it, let him know that to qualify for Medicaid, their joint assets would be divided in half. He will only be able to keep an amount determined by the state where they live, and the rest will have to be spent on your mother’s care before she will be eligible for Medicaid. Depending on his financial position, this may encourage him to take responsibility for her care.

There is a loophole in the Medicaid regulations called “spousal refusal”. This would enable your mother’s husband to refuse to pay for her care and force her onto Medicaid. However, with the financial challenges facing the entire Medicaid program, most states no longer permit this.

The government cannot use your resources or your brothers’ to determine your mother’s eligibility for Medicaid. Only her and her husband’s resources can be counted. That said, there are laws called “filial responsibility” in about 30 states. These laws say that adult children are responsible for taking care of their parents if they are in financial difficulty. These laws are rarely enforced.

If your mother’s husband is not forthcoming with his financial situation, you should contact a professional -- such as a financial planner or an elder law attorney -- to assist you in making sure your mother gets the quality of care she deserves.