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I know it's a 'what if' situation, but I lay awake nights worried about what will happen to my husband if my cancer comes back, and I end up passing away before he does. I take care of him in our home, and hope to do so until..... Our son says he will not have Dad come live with him. Our daughter has a full house of kids, and has no room. We really don't have the money for him to go to a 'facility'. Any advice on how to sleep at night would be appreciated.

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As said, if children not willing to take him in, then he will need to go to a NH.

Do you own ur home outright? If so, it will need to be sold for his care if u go first. I think consulting with an elder lawyer would be good.
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Helen4sure Oct 2021
Thank you JoAnn. I think now would be a good time to involve an elder attorney.
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Your son, as his next of kin will be contacted to be his conservator if he wishes to serve. If he does not the court will be his conservator and appoint a fiduciary who will take over his finances and his placement. I hope that you will be fine, but at least there is SOME family to be somewhat involved. I am so sorry you are facing this. There is no real money involved here so at the least you won't have greedy family making decisions for your dear husband.
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Couple of things for you to think about and you can do almost immediately, if you’re the kinda that needs to do something to feel ahead of the situation, is to
1. do a preneed funeral & burial / cremation plan and one that realistically you can buy in full for both of you
2. change any & all accounts (banking, life insurance, any investments) that currently have you & hubs as each other’s “beneficiary of” to instead go to whomever is your & hubs POA. Most married couples automatically have each other as their beneficiary and that make sense when we’re kinda still young and our kids are minors, but not necessarily good as we age. Like say you have a term life that pays 10k to hubs as he’s your beneficiary as policy was done back in 1990….. well he probably couldn’t even be able to do any filing to even get the paperwork started, I’ll bet. So doing a “beneficiary of” change makes sense.

Also By doing “beneficiary of” it allows that asset to pass / pay to the beneficiary without involving probate. Having stuff be beneficiary of removes it as a probatable asset.

The issue then becomes which kid is to be the POA? Unless you have an attorney or a close friend to be your & hubs POA, it’s gonna be one of the kids. Unless you know for sure that neither will step up to be POA. Also give that some thought if 1 will be all bent if you pick the other. The whole Smothers Brothers “mom loved you best” is unfortunately true in many families. I’m a only child and even then had could not help themselves wanted to interfere 2 older cousins that I had to tell & in writing to STFU. You know your kids best…..

As far as what happens if you predeceases hubs, it could be any of us. We all could get hit by a bus, then what? Actually imo your knowing the kids situation AND that he needs caregiving with some degree 24/7 oversight allows you to be way more realistic as to what his future needs to look like. He’s gonna need to go into a facility, and unless you have a ton of assets, like 500k-1M, excluding your home, there’s going to be LTC Medicaid in the future for him as there’s always the risk that you too will need in a facility care. So unless y’all are big $ assets that means Medicaid planning and it’s not ever, like never ever, imo a DIY. You would be a community spouse for how LTC Medicaid runs and you do not need to impoverish yourself for hubs to be Medicaid eligible for him to be in a facility. Only hubs needs to meet Medicaid LTC “at need”requirements. But just how to do this and do it so that it’s all legit for Medicaid in your state needs insight from an CELA level of elder care lawyer. There likely is a pretty smallish narrow list of CELA ones; 1 will be a good fit for you. If the kids truly won’t step up to be POA, the atty will have a suggestion as to how to deal with this. Good luck in your quest.
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It would be wise to research facilities near you, your son and your daughter. Choose a couple in each location that will take Medicaid clients as well as private pay clients. Give the lists to your children. Please, please, please visit a lawyer and take your husband with you. Have wills, powers of attorney for medical decisions and financial decisions, and advanced directives drawn up for both of you. Decide before this appointment on who will make medical and financial decisions for each of you if you can no longer make them for yourselves. I would suggest you be named as primary for your husband and probably the children as the secondary.

If you are so sick you would likely pass first, it would be best to place your husband into an assisted living facility that can "phase him" to memory care as his dementia progresses. Even if you are not likely to pass first, you might consider this possibility when his care becomes too much for you to handle alone. Please look up Medicaid and print out the paperwork, instructions, and qualifications for filing. Fill out as much as possible and keep list of your financial institutions and with account numbers with the paperwork. Then, let your children know you have filled out the paperwork as much as possible so that they only need to fill in details when/if it becomes necessary to file of Medicaid. Make it easy for your children to find all your financial records, health information, legal files... as possible. In case they need to take over for you if you are hospitalized for your cancer or other serious health issue.
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rovana Oct 2021
Very wise. Too often the kids need to act and have no clue as to parents' financial lives.
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He will apply for Medicaid and be able to move to a NH that accepts that as payment. He must have SOME money coming in.

You need to talk to your kids about this. They will probably both balk at the idea of having dad live with them (mine all did when I was doing cancer txes) and so I talked to DH about what he should do if I died first. It's completely possible, so he did need to at least think about it.
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Rick10 Oct 2021
He would go to a NH on Mediciare. The home will take his monthly social security and evaluate the value of any assets, other than a family home in most cases. If SS is the only cash asset, Medicare will cover the rest of his care. Medicaid in my experience with my mother and sister, will be handled by the AL center or the NH if needed. In so many cases, if he has the average monthly SS, Medicaid is not what you would apply for unless he has below the average SS or no SS at all.
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Get connected with a social worker in your area who can advise you of your options. You need a Plan B for the situation you are worried about, and it's better to plan for it than to be worried. Make sure all of your paperwork is in order with powers of attorney set up for medical and financial matters. It may be too late to do this for your husband, if his dementia is advanced. If you have assets, you should also have a will. The social worker can also advise if there are pro bono attorney services in your area to help set up these legal documents, if you need these services. There may be ways for him to go to a facility, even on limited budget. The social worker can advise you on whether he qualifies for Medicaid.
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TouchMatters Oct 2021
This is what I was going to recommend.
Or contact her county senior services dept.
I would hope that the son or daughter would come through to assist in making plans so the mother can relax (more) and not worry at night. I feel for her immensely.
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You must make provisions now to place him while you still can. YOU cannot carry this burden if he has Alzheimers and should not have to. I realize you don't have money but I assure you there is money out there for these cases - you just need help to find it, i.e. Medicaid. Talk to the local Office on Aging or a social worker and start finding out how to place him and how to pay for it. He cannot go home to the son or to the daughter - it would be impossible. These organizations can help you with this quest. Do it now - not later.
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I don't think you can, or should, try to force your children to house their father against their wishes. Does your daughter want her father to move into her home that's already full of kids? Most people are not equipped, or qualified, to deal with Alzheimer's on a full time basis for a parent and have no idea what all is involved. Expecting your daughter to take on THIS level of care in addition to what she already has to deal with, in my opinion, is asking too much (not that you ARE asking this of her; others here are insisting you do). It's emotionally very difficult for a child to care for a parent suffering the ravages of one of the dementias, too, which few people seem to understand! To then read advice suggesting you 'cut them off financially' unless they agree to these terms is nothing short of bribery and totally inappropriate, imo. Who DOES that to their own children? SMH. One of them can be assigned POA for their father if you were to predecease him, without having to move him into their home. They can then make care decision on his behalf instead of you.

Please follow igloo's sound advice and get the ball rolling now to see what guidance you can get from an Elder Care attorney about Medicaid, etc.

Wishing you the best of luck and good health for you moving forward.
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Do you own your property? If so sit down with your busy kids and discuss POAs and how they would arrange for your husband to be looked after. They may not be in a position to have him live with them, but they can reassure you as to how they will ensure he is cared for should the need arise. Best wishes for a long remission for you, and for finding a good solution with your children.
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He has Alzheimers so he most likely would have to go to a nursing home and Medicaid does cover that - they do NOT pay for assisted living.
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HisLittlePistol Nov 2021
I am sorry, but that is simply not true. Medicaid assistance for assisted living varies depending on your state. The same applies for independent living, assisted living that have a dedicated dementia/Alzheimer's "unit", in-facility hospice, etc. Rather assisted living (or any facility based care) is covered or not in YOUR STATE or not, is due to Medicaid being partly funded by the federal government AND partly by the state. The federal government has set some guidelines on how each state must spend their Medicaid funds. Yet still, the state is permitted considerable latitude within those guidelines to choose. This allows each state to have its own policies on how they manage/provide for those who choose assisted living (or again, and facility based care).

There are MANY types of Medicaid programs (also referred to as "plan" choices- IE where I live one of the most chosen is a plan under Blue Cross Blue Shield aka BCBS) that pay for services in assisted living. There are commonly used waivers by Medicaid, used by all states allowing care (HCBS aka Home and Community Based Services, 1115 Demonstration Waivers and 1915b Managed Care Waivers). Then there is your basic, "plain ol' Medicaid" (which is often referred to as State Plan Medicaid) that's also used in some states for assisted living services. There are definitely options to be explored with Medicaid, of course depending on your state and what it offers at the current time you seek those services.

Hope that helps!
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