I have questions about Medicaid eligibility and the 5-year look-back period.


My father passed away a few months ago at the age of 80. A few months before he passed away (he was healthy at the time) He and my mother paid off student loans for their grandchildren, and bought me their only child a car. They had struggled financially through my entire childhood and pleaded with me to let them do something for me and the grandkids.

Shortly after Dad died passed away my mother started showing signs of dementia. This is progressing somewhat quickly. Within days after Dad's passing she insisted that I have durable power of attorney for both her finances and healthcare. I suspect she knew things were not going well with her mental state.

Her monthly income is 1,600, her savings approx. 100K. Her house is paid for and also worth about 100K.

She lives an hour away and I can't be there as often as needed. Her Dr. has told her to quit driving. She is desperately pleading with us to let her sell her home, and buy a larger house in the town where we live, so that my husband and I can live with her.

Our house is paid for but tiny, and in the 30 years we have lived in it the neighborhood has gone down to the point it is not worth spending on an addition.

If we can sell our house it will bring very little because of two or three bad neighbors.

My questions are if things progress to the point she needs Medicaid how will all of the above events factor in?

We are willing to take care of her as long as possible, but know that the time may come when we can't. She is already to the point I am not always comfortable with her living alone.

If she uses all of her resources before the five year look back how will the car and student loans my parents gifted affect her eligibility? Also if we sell our home to help care for her will the state lay claim to the house she wants to purchase so that we can live with her?

I do not want her to put a house in my name as there is always the possibility I would pass away before her and she would have no assets for her own care.

One final question. Let's say a senior grandparent has ten grandchildren and decides to give each one a birthday gift of $1,000. Two years later they need ltc/snf. By the end of year four they need Medicaid? Will they be denied because of birthday gifts from four years before?

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my aunt never leaves her apt anymore, she has become paranoid and anti-social...she has a bird that she adores but don't know how much longer we can let her have it...her judgement is off and I am afriad she may hurt the bird unknowingly.....THAT will be hard to do...take her only thing she loves and stays near her.....

I have health POA only for my aunt...my name and my moms is on her bank accounts...she doesn't have much, she started out with $54000 in AL, she has been there 18 months and her savings is down to $43000, I think I have done great by her as far as her finances, she is 95 now, and at this rate she should not outlive her money in this AL facility....but if we have to move her, it won't last long....I too wonder about weather they would look to me if she had to go on Medicare and enter a nursing home since I handle her finances etc...

I am so grateful to have found this site. I am so new at this that I probably don't have any information to help any of the other CGs at this time, but am grateful for the support.The irony of Mom's situation is that her Dr. of 20 years is certified in "Family Practice and Geriatric Medicine". I have taken her in multiple times since April, called and left messages and sent emails asking for a full evaluation of her mental status. All he ever does are a few memory related questions the three word test etc. which she fails in varying degrees each time. He has never offered to talk to me alone, even though he has her permission and knows I have Durable POA.

At the advice of the elder care attorney I am going to see after the holidays I called this afternoon to ask what is listed on her records as diagnosis and all it says is "memory impairment and anxiety". I believe she has had undiagnosed but major life altering ocd rituals, and probably could be considered slightly schizophrenic or maybe extremely manic her entire adult life. (Did not realize this until well into my adult life). Her younger siblings have described episodes from her childhood and teens, with this behavior as well.

Now the confusion and memory issues are making all of that worse. I have described in emails and on the phone to his nurse some of her bizarre thoughts, ideas, paranoia and rituals as well as the obvious memory problems and all he can come up with is memory impairment and anxiety?

She practically worships this Dr. He can do no wrong in her opinion. The only thing she has ever balked at with him is taking antidepressants or anxiety meds. She took the meds long enough to realize they were calming her too much to continue her rituals and ocd, and went off of them completely. She will not even consider a psychiatrist, or geriatric assessment. She is far too shrewd to manipulate, and so paranoid sometimes she thinks she is being manipulated when she is not.

Her odd way of seeing the world will probably make her an outcast in assisted living as she has made very few friends in her entire life. If I take charge through poa it will break her heart and mine. I just don't think I am capable of hurting her in this way while she is so vulnerable, but want to protect her, as well as my husband and myself.

I am hoping we can keep her calm and subdued enough that she can continue to stay in her AL....but with dementia, you never know....

please don't make the mistake I did, we put my aunt in an AL that doesn't have a memory care unit....now it is getting so bad I may have to move her again....I was hoping this would be her last stop.....but if I move her now to another private pay AL with memory care and she runs out of money (about 5 months worth) we will have to move her again to a NR and she will have to go on Medicade.....

Two very different issues here, Donna. The financial side of things is easier to address. See a lawyer specializing in Elder Law. Some of the answers might be difficult, but there will be answers.

Bringing your mom into your home is a whole different kind of question, and I don't know where you can go for definitive answers.

Maybe your mother will be somewhat better living in the comfort and safety of your home. And maybe not. Dementia is very difficult to predict. And if she is better at first that may not last. Or rather as the dementia progresses she may be better at your house than she would be elsewhere but that still may be very bad.

The only way to know if she'll calm down and be better is to try it, and a "trial" that involves selling and buying houses is tough. If you go that route here is some advice: do NOT promise her that you will never place her in a care center. You cannot foresee the future. Here are the promises I made to my husband: "I will never abandon you." and "I will do my best to see that you have the care that you need at the highest quality level."

If I were in your shoes I would insist on a geriatric assessment and I would switch her doctor to someone who would address her mental state, probably a geriatrician. (The assessment could be presented as part of a routine physical upon switching doctors.) If your mother won't go along with you for this, you're going to have lots of frustration with her living with you. If she wants your help and then won't accept your help, that is going to be very tough. And the starting point for helping her, in my opinion, is getting information about her medical status.

Establishing some boundaries and some ground rules before she even moves in can head off some of the difficulties that often arise.

I can see that being an hour away is a problem. If she were in a care center (at whatever level she needed) close to you, so that you could spend time with her each day, would that be an improvement for her without being so challenging for you?

After you've talked to an elder law attorney, that may narrow down your options somewhat.

Keep us informed. We care, and we learn from each other.

assited living is so nice although expensive but sounds like she can afford one for quite some time. Now about the giving money to family members. My mom is adamant in giving her five grown children $5000 a piece. She is 83 and although in good health-I have tried explaining to her what would happen if she should need to go into a nursing home within the next five years. She keeps saying that she dont want to give it all to a nursing home but because she wouldnt do this years ago, its really too late. But I do have a question that I did post on another subject here. If lets say she gives us the 5 grand and within the 5 years would need to go to a nursing home-and her money runs out-who is responsible for stay in the nursing home? She does get over $2000 a month in ss and pensions. Can they just kick her out? My husband says no-my brother says they cannot come after the family for the balance per month. just trying to get some answers here.

Thanks so much for your input. My husband is less reluctant than I about her coming to live with us. He thinks she will be some better when her fears and anxiety about living alone are relieved. My mother is desperate to come live with us, pleading, and more.

I am more than a little concerned. Her Dr. is not addressing her mental state very aggressively despite multiple calls on my part. My mother adamantly refuses to go for a geriatric assessment. I am fearful of what she will do and of what it will do to her if we say no. It will break her heart. She at this stage would be totally miserable in assisted living, and her finances (especially if she buys another house) would not be such that she could stay in assisted living indefinitely. Her judgement is impaired enough that her safety is in question living alone.

Both she and my father years ago told me when the time comes not to feel guilty about a nursing home or assisted living. My mother stopped saying this about 15 years ago and started talking about living with us. My father stuck to his original opinion. He died peacefully in a hospice facility 42 days after diagnosis so we never faced these decisions with him.

I have not had a single person say it is a good idea to live with her, but don't know how I can refuse her. I will look for an elder care attorney.

Think seriously about having your mother live with you. I didn't think that one through it has been a nightmare and turned my entire life upside down. Is that really something you want and can handle, your husband wants etc...? If so, great. I applaud you. Will she receive the best care under the same roof? I went through all of this. Consult an elder care attorney. Every state is a little different. The peace of mind it brings far surpasses the cost. Seriously. They will have all the answers.
Good luck.

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