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my 92-year-old father, who had been living alone since my mother died 7 years ago, fell last Sunday and was found the next day lying on the ground unable to get up. Before this, we had had numerous discussions about his moving out east to live near me (he lives on the West Coast; I live on the East Coast; I am an only child) but understandably he wanted to stay put in the small college town he'd lived in for the past 40 years or so and where he has very good friends and a great support system. And as he always likes to add, "I can't leave because this is where your mother is." My father was diagnosed with kidney cancer last July and he decided that he didn't want to be treated for it (operating was not an option), as he wanted to enjoy the quality of his life in the remaining years. So far the cancer seems to be progressing slowly, and he is not showing any debilitating symptoms yet.

Since my dad's fall last Sunday I've had to make the decision to put him (sounds so mercenary) in an assisted-living facility--a very beautiful one, at that--a place that we'd looked into much earlier but I'd just assumed was not going to happen since my dad was dead set on staying in his home up to the end.

Needless to say, I'm feeling particularly stressed right now, even more so today as the financial reality of the situation has begun to sink in. Within days I have already received a whopping bill from the facility; I never expected it to be cheap, as it is a private residence. When my mom had a cerebral hemorrhage and we had to keep her in various private nursing homes over 3 years, my father's savings were severly depleted and now that he needs money for himself there's not a lot left. And so I am feeling stressed about that because I don't want to begrudge my dad anything that I can pay for. The place I'm talking about has a basic room rent--and my dad is getting the cheapest room, which is a studio, and the rate includes meals; the only thing that makes me nervous is its "point system" of care, which is $60 per point; I don't have the breakdown yet but my dad is using 35 points this money or $2,100 worth of services. When I asked it there was a cap, I was told there was no ceiling. I have no real way of planning his finances, which are, as I said, limited.

I'm not sure what my options are after my dad's funds are depleted. I will never leave him destitute, and if comes down to my helping him I will but because of my own family responsibilities it's going to be real tough. My dad will probably be kicked out of the facility he's in once we can't pay and I not sure what to do next because he'll definitely need specialized care. Would a nursing home accept my dad after he's run out of money? I think that's what I've heard; that Medicaid will kick in when that happens?

Anyway, I just needed to tell my story; maybe hear from others who are going to through similar experiences. I know I'm not alone by any means; it just feels like it as I'm pretty much alone to face all this right now.

Thank you for reading. Any words of wisdom and support would be much appreciated.

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Dear bedutz,

I do know that the assisted living facilities are very expensive. I have never heard of the point system and know several people in assisted living. We are going through something very similar with my husband's mother right now. She can no longer stay alone and my husband and his 3 brothers are taking turns with sitters to keep her home. It is getting to hard on them, so they are looking into the nursing home thing, because she is not a candidate for assisted living.

From seeing an estate attorney, I know this much. Once your father has depleted his savings and has not much left, he is allowed to go on medicaid. They will take his monthly social security check to subsidize the expense. He is allowed to keep his home, because the home does not usually know if this is a permanent situation. The lawyer says as soon as you apply for medicaid the government, so to speak, takes a picture, of your finances at that time. If you have hidden money away per chance for the last 5 years, that money is safe. It used to be 3 years.

My husband is having a hard time because his mother owned a lot of properties before Hurricane Katrina. They have redone the properties since that time, but the properties are still in her name. Nursing homes in New Orleans are about $4200 a month. So they will keep taking the rent from her properties to pay for the nursing home. They are damned if they do and damned if they don't. If they take the property out of her name they have to pay for the home for 5 years before she would be eligible for medicaid.

Do a little research on the internet. Most of my experience comes from my own parents. My dad is disabled and my mom is still alive. So most of the law I know pertains to if there is a spouse still living. So, I might not have everything right.

Good luck to you,

Marylynne In New Orleans
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