Should I build an in-law suite and move mom here?

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Mom has been through a lot this year. Her husband my step dad of 35 years diesd in January. She and he were in and out of the hospital so much before that that it seemed moving them into an assisted living place was a good idea. My step dad died shortly thereafter and mom got very sick. But, low and behold she recovered and is doing very well. They take great care of her at the assisted living place. I bet you can guess what I'm going to say next. Yes, she is running out of money and the assisted living place does not accept medicaid. Even if they lower her rent she still has all the other fees. So my husband and I are thinking seriously about taking some of the money that she has left and building an inlaw suite so we can take care of her as she continues to live well. I would much rather her stay where she is doing so well but she will run out of money in about a year and then she will have to move into our house anyway. If that happens it will be much more difficult than if she had her own unit attached. We all need some space and privacy. There are so many "what ifs" that I can't seem to make any decisions. What if it all costs way too much and then by the time she moves in there is no money left for care or anything else? Then we start spending our own money which we would like to avoid. What if she gets sick in the midst of moving her in? All that stuff makes me so anxious. What if I can't care for her very well? Med management, wound care, sundowners....Anyway, your thoughts?

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Talk with an Elder Law Attorney and a Geriatric Care Manager in your state, to get realistic views on whether you and your husband could match the level of care being provided by the Assisted Living Staff.

If a home care plan is possible, the Elder Law Attorney can explain how you can be paid for the services you provide to your mom. To budget for any home improvements you need to make to accommodate your mom, ask about these planning tools:

Caregiver Contract
Rental Agreement
Home care reimbursement from Medicaid programs in your state

If the arrangements are made properly now, your mom won't become subject to Medicaid penalties caused by disqualifying transfers of money.  You and your Elder Law Attorney can also check on the zoning regulations in your city or town that may restrict what you do with your house. 

Whether the home care option can work will depend on how much care your mom will need, and how much money she has to work with.
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Find a place that accepts Medicaid. Make application and get her enrolled.

This question, move mom/dad in with us and build an addition comes up a lot.

I can tell you from many years in the building trades that the project will be much more expensive and disruptive than you ever imagined. Just a proper elder bath remodel is huge money.

You don't say much about her condition but your fears are correct, she could take a turn for the worse and need skilled nursing care before you've finished the project or shortly thereafter.

And this could go on for many years and her care will only become more difficult.

There are other options.  Think about this very carefully.
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"thinking seriously about taking some of the money that she has left " is not a good idea.

If she needs medicaid, and it sounds like she will soon, that will not be considered money spent on her care and medicaid would deny her until that amount of money was spent on her care.

Don't spend your own money for you will need that one day.

Also, please read the stories here about those who have taken an elderly parent into their house.

Another important question is how does your husband truly feel about the idea of bringing your mother into ya'lls house? What is his relationship like with your mother?

I would start looking for places that would take her "medicaid pending" and start the process of getting her on medicaid.
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"...then she will have to move into our house anyway."

No, she won't have to.

The best way to develop your mother's care plan is to take yourself out of the picture and look at her as an independent unit. So then the question becomes: "Lady X in 12 months' time will no longer be able to afford her current accommodation. What are her options?" - and the options don't include "move in with her daughter" because you're not there, for these hypothetical purposes.

I have to agree that embarking on major construction projects doesn't sound like the best bet. It might at some point have been a nice idea, but there are now so many uncertainties and it's not like there's money to play with; so give it a final wistful look over and then shelve the idea.

So you've already tried negotiating with the ALF?
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Hillarious; Welcome! I'm glad to have a social worker on the site, because we often get questions about social workers.

The first thing that you need to remember here (and CM points it out very succinctly) is that MOM's resources should be used to fund MOM's care.

You, as her child, are in no way responsible for housing, clothing, feeding for caring for your mother. (It may sound cruel or cold, but since this is the assumption the gov't is going on, you need to adopt it too). If mom runs out of money, Medicaid funds her care. But only if her money has been used for her CARE (not for an extension on YOUR home).

Best bet? Get to a certified Eldercare attorney who understands Connecticut Medicaid and get this all planned now.
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Using her money to add value to your home by building an addition opens up a whole can of worms. Unless she dies suddenly at home she WILL need a higher level of care at some point in the future, and this co-mingling of your assets will make the medicaid application a mess. And what about after her death, how will you divide her estate when she owns a share of your home? Then there is the whole deal of actually cohabiting amicably and the stresses of becoming her full time caregiver as she ages and her health declines. Will she pay you for that care?
I'm not gonna say don't do it, but if you go ahead you need to structure this in a way that covers all the legal bases and with a clear understanding of the issues.
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Bring mom home can work... My mom has been with us through her entire Alzheimer's journey. We have not had paid caregivers.

That said, you still need to heed the advice the others have given, especially about Medicaid.

For perspective, I will tell you what it is like to be my mom's full-time caregiver. She is in stage 7 Alzheimer's at this point. My husband helps me and has always agreed to this care plan. My mom is double incontinent so I have to change her every 2-3 hours. It is not too difficult because my mom is only 5'2" and 89lbs. But sometimes it takes two of us to get the job done. Mom can't walk, she "forgot" how a few years ago. She is a dead lift to move from her bed to the wheelchair to her recliner. As time goes on her legs contract more and more making the moving tougher. She has lost control of her hands and arms so we hand feed her and offer her water all day. (We will never do a feeding tube and do not force feed her). She is developing a delayed swallow so she needs to be prompted to swallow sometimes...we have to watch to see if she swallow or not. To prevent bedsores, we need to reposition her every 1-2 hours. We give her baths and shampoo her hair in bed 2-3 times a week. I work full-time from home, with meetings in the office once a week. We are blessed to have 4 daughters that help when they can... They all have careers and families too. My husband and I take turns going to family functions, (I send him more often than I go but I go to school things for the grandchildren). We have only gone on one trip together in a few years, an overnight to our son's university graduation. My mom was diagnosed in 2009.

If you are up to all of that, you can consider moving her in. If not, don't mess with her ability to get Medicaid.
I wish you all peace on your journey and I'm sorry you have to travel this road.
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I know my brother (who built on to his house and moved mother and dad in 18 years ago...) would answer this with a resounding "NO!!!!!!!". It has been one drama and nightmare after another. In retrospect, an ALF apartment would have been better. They HAD long term care policies--never used them and never will.

Brother's life has been turned into a circus, his health is terrible, likely mother will outlive him. Daddy passed 13 years ago, mother has steadily gone downhill and the opportunity to move her to ALF has come and gone and she is going nowhere now.
Brother's 5 kids have grown up with an often petulant, angry grandmother on site, every day. She inserts herself into their day-to-day. I am shocked my SIL has not blow a head gasket---but EVERY SINGLE person in that house (EXCEPT mother) is on anti-depressants and antianxiety meds. That could be a coincidence, but 7/7 people having to deal with anxiety and depression? Nobody was on anything when she moved in. I myself have to "drug up" to spend more than 15 minutes with her.

However, having said all that--if you want mom to live with you and you can handle the inevitable decline that comes to us all---go for it.

GrammyTeacher hit it all on the head. That's how it becomes, more often than not.
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Hillarious, my heartfelt sympathy to you and your family for the passing of your step-Dad.

I see from your profile that your Mom has Alzheimer's/Dementia which you know will only get worse not better. Thus, you need to keep that in the back of your mind if Mom does move in. She will eventually need around the clock care. Working more than one 8 hour shift can be overwhelming, so it would be good to have caregivers come in to work the other two shifts. Otherwise you will crash and burn from the lack of sleep. Hiring two shifts of caregivers can get expensive.

Keep shopping around for a continuing care facility that takes Medicaid. This would be your best choice among the limited choices you do have. Moving Mom from an Assisted Living place that she has learned and made new friends, won't be easy.
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Please don't do that! It will put some much pressure on you, your marriage, your body, and you will never know a minutes peace until she either passes away or goes to a Nursing home, and then she won't have the money to pay for it, and you will be in a real mess!

I definitely agree to go the route of applying to a Medicaid approved Nursing home, for when that time comes, and the sooner the better.

My husband and I had his Dad living with us for 13 years, and it was H*ll on earth until we got him into Assisted living, and that only lasted 9 weeks, until he came down with Pneumonia and Sepsis and a whole host of other health issues, add on top of that a New diagnosis of Advanced Lung cancer which had already spread to his chest wall and rib bones.

So you see, you cannot predict the future of what is to come at any given moment. We have now chosen to bring him back to our home on Hospice care, and now 14 days into this downhill spiral of his deteriorated disease, and our own decline in life's enjoyment, as there is none. We are exhausted every evening, and the next day, the whole exhaustive process begins over and over again, like Groundhogs Day.

We did this only because we Love him so much, and we  know that there is an end in sight, otherwise we would have chosen the Nursing home route. And his Dad really wanted to be with us and die at home.

Speaking with an Elder Care Attorney is a great idea, to find ways to legally stretch and naked the most sense of the money has left.

You being able to visit her as often as you choose, will keep your mother daughter relationship so much nicer than the caregiver route. I'm quite certain that you already do a heck of a lot of that as things stand with her current living situation.

It would be lovely if things magically turned out in the perfect scenario, but they seldom do when it comes to advanced caregiving. I think you know what your answer is.
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