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2TornTwo Asked August 2017

How do we access mother's equity in her home to pay for in-home care?

She has advanced dementia, is about to use all of her cash assests and no longer has a credit score to apply for any type of mortgage. What will happen to her home if she qualifies for Medicaid?

igloo572 Aug 2017
How much is moms house worth? I ask cause the costs of in-home care can run often more than what a facility would. Pls, please re-read FreqFlyers excellent post..... 20k per mo for 24/7 caregivers. 240K a year. Even if you live in a lower cost of living state, it's going to be somewhere close to 6 figures for care at home PLUS mom still has property costs.

Is moms house fully paid off and worth over 700K? Cause probably the only way to get enough equity out is to do a reverse mortgage. Expect maybe 50% of value (so 350k of a 700k home) at best PLUS mom is still responsible for taxes, maintenance. 350k would cover 2 years or so of paid caregivers and property costs as she still has her monthly income coming in. Also insurance which will too likely be higher than she is paying now as all needs to be at mortgaged coverage. And the RM is debt that must be repaid in full either once she moves out of home or dies. If r
RM not repaid, the RM gets property and sells it. Family does not inheirit the house. RM to me are often just a band aid on a much bigger financial & medical problem that family is not being realistic about.

Community based Medicaid could provide some caregivers IF your state spends its Medicaid $$ this way. Like twice a week caregiver who does 6 hrs of in the home care. But all other time is on family. States are trending to go to funding on-site programs - like PaCE - where the elder goes to 2 -4 days a week then back to thier home later in the day with family then Doing all other caregiving. Pls keep in mind if medicaid is applied for that mom will need to be evaluated by the state (usually an RN & SW team) for level of care that she is "at need" for. Just having dementia may not establish enough "need". Private pay does not necessarily require the more specific stanard that the state will.

Really do as Barb has suggested and see an elder law atty (that mom pays for from her $) to see what the options are for your state.

2TornTwo Aug 2017
Thank you both for your answers and suggestions.
We would like to keep her in her home, with care so selling the house isn't an option. We would of course sell the home if she would move in with one of her children or go to a facility. The proceeds would then be used for her care.

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freqflyer Aug 2017
2TornTwo, since your Mom has advanced dementia, she wouldn't be able to read and understand all the paperwork involved to refinance or get a Reversed Mortgage. Her financial Power of Attorney [hopefully she has one] can sell the house, and Mom can use the equity for her care.

My Dad had in-home care, 3 shifts of caregivers per day, but the cost was $20k per month, yes per month, in my area. Dad was happy to find he would only need to pay $6k per month so he sold the house and moved into senior living.

But once the equity is gone, than your Mom would need to apply for Medicaid [which is different from Medicare]. If she doesn't sell the house, then Medicaid would put a lien on the house, and eventually the heirs would need to sell the house to pay back Medicaid for the cost of care, but only up to what equity can be had from the house. And Mom might need to move to a senior living facility that accepts Medicaid.

Life can get so complex once we age :(  Barb above is right, see an Elder Law Attorney for advice on what is the best route for Mom's house and care.

BarbBrooklyn Aug 2017
Start by going to a certified Eldercare attorney.

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