My mother (87) fractured her pelvis in August. After 2 weeks in the hospital, she was in rehab for 8 weeks and currently home in a hospital bed for nearly 6 weeks. She was not cleared to put any weight on her left leg until a few weeks ago, so any PT has been very slow and painful. My dad has been caring for her, using a combo of paid-for VNA services and private care (8 hours/wk).
She apparently had two "episodes" of talking nonsense. Not garbled, more of a word salad which appears to be consistent with dementia. That freaked him out, but it has not happened since 11/23/23. (I understand this can be a symptom of a UTI).
I think the likelihood of her being able to get in and out of wheelchair, unassisted, with her level of strength is zero. She was very weak to begin with, and had a fall earlier this year (legs just give out) and now bedridden for 4 months. I am beyond greatful for VNA support, but that won't last much longer.
My dad expressed concern about how to pay for her care outside of their home. He is under the assumption that going to AL/NH means "they take all your money". My parents have about $40K in liquid accounts, and then the biggest asset is their house.
One of the issues is that my father does not want to go to AL with my mother, although she probably needs a NH now. He is also reluctant to sell the house, because of the work involved. I hope the attorney steers him in that direction... it does not involve "spending down their money", frees up money for mom's care, and a condo or apt. for him.
I can't attend the meeting next week, and would appreciate your advice. FYI, they live in MA, which apparently is HIGH on the scale for NH costs.
Hospice does not ALWAYS mean 6 months or fewer. After my Husband fractured his hip he was on Hospice for almost 3 years. (He also had dementia)
But with Hospice I got a Nurse that would come in and check on him weekly.
I got a CNA 2 to 3 times a week.
I got all the supplies I needed to care for him (incontinent supplies, gloves, creams, ointments, medications)
I got the equipment that I needed to care for him (Hospital bed with an alternating pressure mattress, wheelchair then later a Broda Chair, Sit-To-Stand, then a Hoyer Lift all delivered to the house and set up.)
And if I needed anything I could call 24/7.
What I could not do was call 911 for transport to the hospital. (I did call 911 for Lift Assist)
All that was covered by Medicare (Hospice is also covered by Medicaid and most other insurance)
Let Hospice be an option to help with some things. (If she is not progressing with PT It will not be covered after a certain point and Hospice does not cover PT but it can be paid for "out of pocket")
To qualify Dad we transferred the title of their home to Mom, and since their assets were in shared accounts and totaled less than the allowed amount Dad did qualify for Medicaid. If Dad had been moved to a facility Medicaid would have paid the fees less his share of Social Security.
Mom would have been able to continue to live in the house. If she died or moved out and the home sold Medicaid would have been repaid out of half of the proceeds of that sale, the rest going to Mom. If Mom had outlived her share of the sale and assets then we would have applied for Medicaid for her.
The important thing here is the government shouldn’t have to pay for senior care if that person holds assets that can be used instead. Medicaid will not “take the house”, there are rules to follow on both sides. You would be wise to consult the Medicaid office in your area. It took me 6 weeks and LOTS of paperwork to get things filed for Dad.
Best wishes.
Can you update us on how this meeting went with your Dad and attorney, and if he was helped? Were you able to attend by zoom or speak with the attorney and your Dad?
I often asked my father these types of questions (e.g. bank accounts) and his response was always "the attorney has that information" I sent her a long email asking to prioritize what information she needs. I think she needs to change their wills, etc. I also asked her what information she has. I eagerly wait for her response.
If my father suddenly passed away, I would not know where to start! Now my father has to gather documents such as social security statements, brokerage account statements, etc. This has somewhat given me some peace of mind that it is being collected.
I realize that many people don't have their financial affairs in order, which makes it a huge burden on their children. This is so unfortunate. Yes, it's a lot of work to do it... but? I think there should be a class called "getting your financial affairs in order". I think some have accountants and financial planners, but most do not.
Going through this, it's really hard. We're fortunate that we can afford the attorney fees, but it's still so much work and stress.
Thank you for your concern and comments.
While there is still time, talk to your father about including you in a zoom call or a conference call
Frankly, the better idea might be to help him find a place with independent, AL, and skilled nursing all in one place, get them both moved in, then deal with the house.
Most larger real estate companies now have programs where they'll font the money for repairs to the house, they get repaid out of the proceeds. That way you get the most possible for the house within the scope of a fairly quick "lipstick on a pig" fix-up. Hire an estate sale company, and they'll hold the sale, then they'll bring in someone to haul off the rest.
Many Realtors these days specialize in estates and handle everything from the sale, the clean-out, and the repairs for a small cut of the proceeds. That'd be the ideal person to use, especially if you're out of the area and Mom and Dad are out of the house.
Start with the attorney visit first, then go from there. He'll likely have contacts for those types of Realtors, too
With facilities costing at a minimum 4K a mo for AL on the lowest of the low side to 20K for private pay for a SNF, paying for a CR to do a transcript for you will be worthwhile. And they may charge you less as it’s not legal for a trial or a deposition.
I sure wish you luck and hope you will update us on what you learn. You are likely correct that Mom will require some placement, and that division of assets is crucial now to save what can be saved here. With this much in assets the money will go very very quickly once any care is needed. The home came of course be saved until both have passed, even if Medicaid care is needed eventually for both. There will be Medicaid recovery on the home after its sale.l
Best to you. Call that atttorney today.
Dad needs to be reassured that selling the house can be accomplished without killing himself in the process. BUT - I'm sure he's attached to the place and you'll meet with resistance all the way.
As for assisted living taking all his money, who knows. Someone needs to take care of his wife. He needs to step up and take responsibility for finding a place where professional caregivers can do that. He also needs to be realistic about his own situation. Clearly mom will never be able to take care of him. If he doesn't go to AL and gets sick, who will? He'd better start understanding that!
Good luck, I hope it goes well.
He is kind of "stepping up", just very reluctantly. He can't force my mother into AL or NH (that's what he tells me).
For years he has been saying "we'll cross that bridge when we come to it" and avoid any kind of discussion or planning which has created so much stress and worry for me. I worry about them both, and I am also very frustrated.