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Yes, this is an "age" old topic (pun intended), but still appropriate. I got all fired up after reading a 6 year old thread on the struggle of being too rich to qualify for Medicaid but too poor to afford care... being truly stuck in the middle.


My father is a disabled Veteran who was blinded in the US Navy. Thankfully, the military took pretty good care of him. He was able to get 100% disability since his injury was service connected and thanks to having friends in the industry, we were able to max him out on benefits. HELLO FOLKS!!! Aid and Attendance really isn't THAT much when you consider how much it costs to be in a facility (less than 1/3 in my Dad's case).


Yes, the VA has "free" facilities in Bum F***, and sadly, the care level is equal to or below a Medicaid facility. Trust me, I've done the research. There are some programs available for "Resident Care", but the waiting list is insane (except for the lady who has five young children... no thank you), and as I hear it, this program could be cut under the new administration.


Why am I going into all this? Because, despite my Dad getting what a healthy person would celebrate in benefits, it's STILL NOT ENOUGH!


Dad will get military benefits until he dies, so he will never be able to "spend down" to reach Medicaid level, nor would I want him in a Medicaid facility. They are depressing to say the least.


So, what choices do "Middle Class" folks have? Become poverty stricken so they can receive sub-par care or hope to win the lottery? It's sad that pharma companies and modern medicine have made it so life expectancy is well beyond what it used to be, but aren't they the only ones who benefit?


I'm one of the lucky ones. I have no idea what I would do without Dad's military benefits. I currently work a second job to make up the difference between his monthly expenses and military benefits. Yes, Dad has some savings, but that entire amount is less than a year's worth of rent in his AL.


Maybe I'm ranting, but HATS OFF to ALL caregivers that pick up the slack that our government won't cover, and to those who have no choice but to use what limited resources are available (Medicaid), hang in there.


This entire experience has opened my eyes about aging, and it is my hope that IF I should live into my later years, that I am relatively healthy. It's so sad when one can't afford to be old...

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Tiny, have you talked to an Eldercare attorney?

I don't know where you live, but my uncle got excellent care at the VA facility north of NYC.

If you private pay down assets, you should be able to get dad into a facility that will keep dad when he needs to apply for Medicaid.
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I will look into an Elder Attorney. Thanks.

I'm hoping it doesn't cost much.
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...one more thing. Dad doesn't have any assets... technically anymore.

He deeded his home over to one of his other children. He has some money in savings, but that's it.

My concern about Medicaid is that he won't qualify because he receives $4K a month from the VA for his disability and will get that until he dies.

$4K a month is more than I make at my full time job!!! That's nowhere near "low income" for most, but it costs $5K a month at his AL facility, and I work a second job to help cover food (he doesn't like the AL food), Adult Day Care three days a week, and other care-related expenses.

I can't claim Dad as a dependent, so I'm basically working myself to the bone (no dating / marriage / kids for me now. I'm 40, bitter and exhausted) to help him out. Not sure how much longer I can keep this up
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You're paying for your dad, yet he deeded his home over to one of his other children? That sibling contributes....what? (Nothing?)

Why does your father need Adult Day Care at his AL facility? Aren't there activities for him at the AL facility?
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Tiny. Stop. Just. Stop.

Dad has $4000 in VA benefits (you can get a lawyer to do a QIT to get him under the Medicaid limit, as above) and YOU are paying for Adult Day Care, additional food and other stuff?

Your dad set you up for a lifetime of abuse at the hands of others, didn't he?

He expects you to supply all his wants (not his NEEDS, dear, his WANTS) and expects you to jump at his every command, while he gifts away assets to others.

Tiny, you know what you're going to have at the end of the day, if you keep this up? Your dad will be dead and you will have no life, no savings and no prospects. And probably no health.

You know what you'll have if you start setting boundaries? Your dad will still be dead.

Perhaps that sounds cruel, but it's the bottom line. YOur father is dying and there is nothing you can do about that. It doesn't even sound as though all of your sacrifices are making him all that happy, just giving him more fodder for demands and complaints.

What would happen if he didn't go to adult day care? Or get all his extra foodstuffs? He'd learn to put up with it, and the AL would manage him.

Tiny, no one but you is going to stand up for you.
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Since starting my caregiving journey, I’ve read countless blogs, articles, books on narcissism. All of them describe it to a “t,” but few over any real solutions other than “take care of yourself first.” If you were groomed “parent first” the suggestions are contrary to your very being.

I’ve found the book, “48 Laws of Power” to be ever so helpful in reprogramming my thinking. The laws are prefaced with a quote from Machiavelli, “Any man who tries to be good all the time is bound to come to ruin amoung the great number who are not good.”

I want to be good. I am good, but I’m lowering my (parents) standards. You don’t have to flip to the dark side. You are your biggest advocate. Flip to your side.
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Just a FYI:

2017 FPL Guidelines: 48 Border States and D.C.
(For households with more than 8 persons, add $4,180 for each additional person.)

Persons in Household - 1

2017 Federal Poverty Level - $12,060

Medicaid Eligibility (138% of FPL) - $16,643

Premium Subsidy Threshold (400% of FPL) - $48,240

Source USDept Health and Human Services

So AL costs 60k
He gets 48k
Loss of 12k

His savings should be spent to cover the loss, then an elder atty *may* be able to QIT when he has less than $2000 in savings.

As far as food and adult day care, no one will pay for that, food and activities are included with AL costs. As my friend who works for medicaid.gov says, "He's in AL; he good; extra food, day care that's gravy. And the govt doesn't provide gravy."
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