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My sister has early onset Alzheimer's and lives with my elderly father in a home that he owns. She pays him no rent, no bills, no groceries, and is completely dependent on him. As a result, she has accumulated a decent sum of money in the bank due to unused SSDI. Her condition has worsened very suddenly and I wanted to help her apply for a long-term care waiver (as I heard this takes a long time for approval) but the look-back would make this impossible. My father isn't rich and needs repairs to his roof. Can my sister legally pay for the roof repair, thereby spending down her bank account and "paying for her keep?" Or would this be considered a gift? If this is considered a gift, this is irritating since she would be destitute without my father's help.

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No, he owns the home not her. However, if she goes into MC now and possibly prepays for 6 months you can then apply for Medicaid to continue her care.

I would consult with an attorney in your area, rules vary by state.
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You need elder law attorney asap . They will devise a plan of action. Hugs 🤗
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I'm no lawyer or Medicaid expert, but could the person who has POA enter into a rental agreement with Dad for at least the time remaining when your sister will be living with him? It wouldn't be a lump sum ("gift") for a roof, but it might help his finances a bit. It could be some months before you all find a facility for her.
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JoAnn29 Mar 2023
She has a Dementia and cannot enter into a contract with Dad.
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Who has POA/conservatrship/giardianship for your sister? This person would be the one who has access to her bank account.
Unfortunately, the money was allowed to accumulate. There should have been cash withdraws every month that then get stashed.
Your father does not have to let the free rent and board arrangement continue.
There can be reasons to justify your father taking some of her money. Room and board. Caregiving services. Talk to the lawyer. They will help him.
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Please, look at that Special Needs Trust. If Medicaid there are stipulations that need to be met. Normally, no lodging or food can be covered. Just scanned my nephews. It does allow for aide care. Butva little sketchy about facility care. Seems only pays if there is another option, which to me is Medicaid. Understand it before you have to deal with it.
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Pshelper Mar 2023
I looked at the will, but it doesn't really provide a lot of information. Ultimately, would it be best for me to meet with my dad's lawyer who put it together?
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No, putting a roof on a house that Dad owns is considered a gift at this point which he profits from if he sells the house.

Sis is young. Did she live with Dad before her diagnosis? If so, yes a contract could have been done where she paid rent to help cover expenses. But if she moved in after the diagnosis and receiving SSD because of it, IMO she was not competent to make a contract.

I would see an Elder lawyer. I would take what money she has and place her in Long-term care. Depending on how much that is will depend on how much she has. In my State you only have 90days from date of application to find a place, spend down money and get info needed to Medicaid. With my Mom, she had 20k. I started the application in April, she paid for May and June, I confirmed in June with the caseworker Mom was spent down and he had all info needed, Medicaid started July 1st.

The other thing you may be able to do thru the Elder Lawyer is set up a "Special Needs Trust" to protect the money she already has. But its limited in how it can be spent and when she passes, it will revert to Medicaid p, they will take what they paid for in care and the beneficiary gets the rest, if anything. So maybe better spending it on her care because paying privately for even the 2 months Mom did, gets you in the door.

I did not suggest Memory Care because they are private pay and limited in the care they give. If sister is declining fast, better to place her in LTC with Medicaid paying for her care when her money runs out. I placed Mom in an AL hoping her house would sell, it didn't. So 8 months later I got her into a nice LTC. With her decline, should have started with the LTC.
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Pshelper Mar 2023
Thank you so much for your reply. It made me feel so much better and it's literally the most informative thing I've heard yet. She was already diagnosed before she moved in with my father. Her son is now her POA, but you're right, it's kind of too late for any rental agreements. The roof is definitely out.

This part is interesting: "In my State you only have 90days from date of application to find a place, spend down money and get info needed to Medicaid." Wow, that is quick, but it makes sense. So finding the place first is important. She actually has a bit more than your mom. I'm in the process of pre-paying her funeral expenses, but it's looking like around $40K. After that is expended, I hope that the LTC facility can help us apply for the waiver to get the timing right. Do you think a place with an "Alzheimer's wing" would be "memory care? or LTC?"

My dad thought ahead and got a "third-party special needs trust" for her when he passes. I'm still not sure about the specifics, but I'm hoping that this pays for her care.

Thank you again.
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You sister has dementia, so it is too late for her to make a care contract with father for "shared living expenses" which would include repair costs, rental sharing, utilities and etc.

The question now is whether Sister has a POA acting for her and what the POA stipulates the POA can do.

You are saying that her condition has worsened SUDDENLY. Was this discussed with her MD? She should have a physical to rule out UTI or other problems.

Now on to spending Sister's monies on Dad's house. Not really morally a good to my mind. If sister has saved funds they stand to pay for her care in long term care facility. Once spent down then she is free to apply for Medicaid.

I would see an elder law attorney to discuss with him, because there are a lot of questions here, and I think we cannot know all the options for this case, or who can make decisions about those options. I sure wish you all the best of luck.
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You may want to contact your county office of aged and disabilities.. they may have some input for you…
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Great, I was afraid so. It would be too easy and make too much sense.

My sister is in the 6th stage of Alzheimer's and is RAPIDLY declining. I had no idea it would go so fast. I guess we all figured that my father would pass away before she got this bad off. He's 85 and not in great health. He has assets and so I'm not worried about him to be honest. Poor planning on our end. I guess we just have to figure out some way to keep her in the house until something happens.

I guess I should call around to Memory Care Facilities. If it's around $8000 a month and she can pay for 6 months, will they take her?
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Ps, go see a lawyer who is expert in Medicaid in your state. Some states DO pay for MC through waiver programs.

You may need to get guardianship of your sister. A lawyer can advise you better than we can.

Also, a sudden decline can be caused by a UTI. Please get that checked.
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Pshelper Mar 2023
She was checked. No UTI. Also, her son is her POA and we're all in agreement, thankfully, about her care. That's one good thing about all of this.
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Most Medicaid program applications have a 5-year "look back" period on the financial portion. Someone can easily and innocently manage her funds in a way that could delay or disqualify her. Also, most state Medicaid programs only cover LTC, which requires a medical assessment by a doctor. So, MC would not be covered. Please consult with a Medicaid Planner for her home state to get the best and most accurate strategy for her future.
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Pshelper Mar 2023
This is not good. We didn't plan ahead because none of us understood Alzheimer's and now we're stuck. I'm assuming that if my father charged her "room and board" that she would be eligible.
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PShelper, welcome to the forum!

Since Medicaid is a state-specific program, your best bet is to use some of sis's accumulated funds to take her to an elder law attorney (www.nelf.org) and get a plan in place for her and Das.

This is not a diy project.
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It would be considered a gift to your father.

What is the medical condition of your father? Sister?
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