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My mother suffered a massive stroke 12 years ago and suffered devastating physical consequences. I lived overseas but travelled home frequently 2-3 times a year for extended stays to help my father look after her. She finally passed away in January 2012 peacefully in her sleep. In 2010 I moved back to the US because my parents' situation was not getting any better. My employer at that time (a global company) agreed to a temporary transfer to allow me to work from our corporate offices and this allowed me to look after my parents. My father fell 2 months after I returned and broke his hip. He since has been able to walk again, has some minor health issues but does suffer from dementia. I do not live with him and arranged for around-the-clock care. I buy the groceries, pay the bills, arrange the staff, take him to doctor's appointments, etc but I don't live in the house because he is constantly called for me day and night and I can get no sleep and I must work. My father was a brilliant lawyer who apparently took care of everyone's business but his own. He had no burial arrangements for himself or my mother (which I've now taken care of), no insurance policy, no long-term healthcare plan. Nothing. My employer has now sent me a letter saying that my temporary contract is ending and I must report back to my place of employment by June 1st or lose my job (I'm in the meantime looking for employment here...good luck to me). What should I do? Stay? Go? Should I/can I force my father in to an assisted living facility even if he absolutely refused to go? Or should I leave him at home and spend every cent of money that he's set aside (which is quickly going) and risk having nothing if he does need to go into assisted living later? He's 89 but his family members have ALL lived extremely long lives (96+ years). I have an alcholic brother who is absolutely not help or support. Any suggestion anyone else who has been in a similar situation would be greatly appreciated.

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Just bumping up this question as I think it is a great one. Almost 3 years ago when I started the "intensive" part of taking care of my mom - age 91, dementia but healthy, living at home, with Home Instead almost around the clock - minus 24 hours a week when I am there - a friend's sister gave me great advice: She said, my mom and my dad saved all their lives to have money to take care of themselves. So spend the money. I hear her words in my head every time I write out the check. As I mentioned, I am coming up on the three-year mark of this kind of care. I estimate her money will last 5 years. So I just take it as it comes. Would welcome more info though on getting my mom on a list for a memory care facility. About how far out do you have to do this process? An elder care attorney told me to apply for Medicaid when her assets become under $100,000. As I mentioned, I estimate my mom will be fine financially at home till year 5 - but longevity runs in her family!!!! Thanks for any input.
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Hi, memsobelle

This question is one so many try to answer. However, know it is also the primary problem for so many doesn't help you and answers is why you have posted this situation here.

Let's take a quick answer and get to the bottom of the stress, so many of us face. Your parents worked hard all of their lives to save for a rainy day. That rainy day has arrived and now is the time to take care of them.

The reality is one, does your father have enough money for this illness and two, what does his insurance cover. It is likely you will need to find a financial planner to assisted this challenge. There are many ways to shave money off the expected care when a person is living in a structured living setting. An Elder Law Attorney is extremely helpful for cost planning and formulating a 'care plan.' This person can also help with the family situation brought about by siblings and others close to the situation. Your return trip for employment will be a question you must answer for yourself. Certainly having an income is preferable to not, you might also want to speak to the attorney about this also.

I know little about your situation. There are so many variables so my answer is to visit the website for Justice in Aging (justiceinaging.com). No fees are collected to answer questions or to refer you to help in your immediate living area. These people know the legal situation and how to come to a resolution within your locale and legal barriers which may present themselves.

I hope you will find a correct answer for you. Please bring back questions for this group whenever you like. It is my belief that your situation merits a more in-depth look to provide any answers.
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You would probably save money to put him in assisted living. 24 hour care here was $10/hr (I know, low by nationwide standards) which came to $240/day - almost $7000/month. The assisted living facility I put my mom in (which was very nice) was only $3000/mo.
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Have forms to mail for Medicaid eligibility. Home health was sent when they 'took' her to her house. Home health was to come for 60 days. She let them come in for 2 weeks. And as I kept going to check on her, I always stayed longer than I was advised to do. The more I came, the more I did.. now I am doing it all except I am not a nurse and don't stay 24/7. I just feel sorry for her.
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Is she on Medicaid? Are you getting some in-home help from them?
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What is APS? Is that DHR? I was told by NH to get Guardianship over her and they would keep her. But they let her leave and someone at the NH carried her to her house. But I have wound up caring for her because I know she can not and I can't just ignore that.. I do have siblings, and they know she needed to stay where she was at. They all live in other states and only visit when they get a "vacation", breeze in for a few days and then gone for the year. My heart aches because I know she needs more care than I can and already give her. She wants everything to be as it once was and has a hard time letting go of stuff and her house, which will be no more after her death; liens. Assests? SS and a small life insurance from my Dad's death, which she has to turn around and make a house payment with.. so no. nothing
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Psalms, does your mother have assets or do you have siblings?
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And you have the right to resign your poa and inform APS that you cannot care for her.
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I had my Mother in a nursing facility and safe. I have POA, but she voiced wanting to go home and the nursing home had to let her leave because "she has a right to die at home if that is what she wants". Rights.. she can not care for herself and I am now doing it all..
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i left my job o move to state where my mother chose fr asisted living. its price but trust me, its th children to do the assisting.. You will need someone with a dPOA in the smae city to admit your father. they aill lso need to have they health proxy.
Yopu can move away but , trust me, the staf let me kn ow regularly my four isists a week and weekend outings for adventures are thebare minimum I shoud be doing for my 93 year old mom with demenia. ( I qualify as a slacker.!!!) But, it is true, the more the stafff sees me, the better treatment my mother receives... the people who liv in the acility as "independents' enjoy th eplace immensely. But it simply never occurred to methat i was taking my mother away from a home she had lived in
forever, her neighbors and that being with dementia does not make it eassy to make friends, phone calls or change channels on the giant screen TV. On th eothr hand she lives her appertment with its view of th heted pool and all the extraodinary flower arrangement as well as the exceptionally simple washer and dryr in her new apartment. In the ned, its your life or hrs. i thought I could make it work for both of us ut that really is not the way dementia works. i will never get mother affiars 'in order.' and I will alwys miss MY old friends in NYC and my old life.
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It seems toe he would gteatly benefit from one of those very comprehensive continum care facilities where they handle everything. My dad has several doctors, and every service he needs. They can even skype with relatives on evalustioneetings. If he's well taken care of, you can go back to your job/obligations while you keep on checking on him. If he's in facility that accepts Medicaid, he can stay there after he runs out of funds.
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wstoner, pretty much all of his monthly income to use toward his NH costs, unless his wife is alive. As for assets, he will need to liquidate them and spend them on his own needs. (Medicaid doesn't "take" it -- but he must use it up on himself before he qualifies for aid.) He is allowed to keep a house and a car, but (assuming he is single) he is not likely to have the resources to maintain them. The state can claim the proceeds of the sale of his house after he dies.
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My father has to go into a NH, unable to self pay, need to apply for Medical Assistance, how much of what money he has will MA take?
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I imagine by now (3 yrs later) a lot has happened to you and this situation...since it's 2015... I wish I had read this back in 2012... I don't know the outcome or what others have advised you but I only have my experience to lean on... You need to work to survive this is true... You may have had that perfect career that you couldn't turn your back on but all in all, I say you should stay close to your dad and look for work there... I'm saying this now but I'm certain things have changed for you by now... I wouldn't trade in one moment of my father's time to be near him or with him... He too was our savior and everything to us and now he has dementia... I love him dearly and knowing work comes and goes but you're last moments with your father will be the last forever that you'll have in this lifetime... I hope things have worked out for you since and whatever decision you have chosen was the right one for you... Your friend Pamela...
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This is a classic case, so common among attorneys: a brilliant lawyer who took care of everyone's business but his own.

It is often difficult to help the person who was fiercely independent, and was so used to managing things for others. (My father was also an attorney, who slipped into dementia in his mid 80s).

But there can be some pleasant surprises. The person can realize how moving to assisted living, and then accepting supplemental help in order to stay there, removes a big burden from their daily living and opens up new opportunities for enjoyable interactions. (But the person is probably not going to admit that change of mind and heart to their adult child.)

How it comes about takes some courage and a few miracles. If I had more space, I would tell the full story of how my sister and I brought my Dad on a tour of the assisted living facility, and how he then just let us take care of the move. We faxed his health care proxy faxed over to the VA so they could get the health certification faxed over to the assisted living, and from there he enjoyed several years of daily bridge games and all the other amenities that gave us peace of mind.

It sounds like you are working alone on this. Have you considered a geriatric care manager? Getting more people on your team can help make more miracles happen. A GCM with the right personality could open up new paths to peace of mind.
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Find a good assisted living and don't quit your job!
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I am so glad everything worked out for you employment-wise. You are noble to consider moving him in with you- I would be careful about doing that unless you have the physical, financial and emotional support to make it work. I did that with my parents and my mom still lives with me after my father passed but it has taken a high degree of organization. You can hire an agency for caregivers or higher directly yourself and use a payroll service and a geriatric care manager to set things up. The house would need a walk in shower, rails everywhere, etc. As recommended, you can have groceries and meds delivered for convenience. A DNR order and essential documents in a packet by the door is a good idea in case of emergencies. I believe if you have a close relationship this is a very humane way to go if you can handle the stress. I feel good having my mother cared for downstairs and I can visit her anytime and monitor the caregiving situation. Setting up the trust is smart and making sure your brother does not interfere is also smart, as things can get really messy even if you have POA and your brother decides he wants some inheritance. Best of luck to you!
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I'd like to follow this question & answers received as I'm dealing with same situation, only thing this person in their question does not mention is how the father would be about going into AL, NH, etc. If the father would be willing to go, how to start that conversation, etc.
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Sometimes there is no such thing as "not spend all the money". That is what it's there for. It's hard to see it dwindle down to $0, but we have no choices in the US about how to do it. Unless you are super duper wealthy, then you have all kinds of choices at your feet.
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Get Medicaid right away. Don't try to hide assets, but you can keep a burial fund. Medicaid will supervise what paid caregivers are charging.
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This situation is not going to get better. As a parent, I would not ask my child to give up their life to take care of me. Your father has dementia and needs round the clock care. He needs skilled nursing IMHO. You need to keep your job for your future. Your parents would not want all the sacrifices they made on you wasted. IMHO, put him in skilled nursing and get on with life, so you can be ready for your senior years.
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Yes...I asked myself the same question many times. Mom didn't have a lot no assets to speak of. But a small amount in the bank. But enough that Medicaid wouldn't allow. If you choose to go the route of a nursing home. Just remember..the paperwork for Medicaid can be grueling and take some time. Make sure you have your ducks in a row. Check with the Area of Aging and Disabilities and find out your options. Sometimes they can find someone to come and give care to your father..based on his income. If you put him in a home..they will take it all...and if you take him home with you and then change your mind...make sure you leave enough of a paper trail that anything you do with his money is done for his care. Save receipts...they will look back 5 years of his spending..and if anything looks suspicious...they will deny him. I took my mom in and took care of her. She went downhill fast..and after 5 months with me...she passed away. As hard and frustrating as it was...I do not regret it. She died with the love surrounding her. But let me tell you...get yourself help...or respite when you can. Good luck and God Bless.
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Whether you have home care or put your father in a nursing home, all his money will be spent. You get no help from the govt (medicaid) until you've spent your father's assets except for what small reserve is allowed. If your father is comfortable and safe at home with his aides, you can leave him there. If the aides are not reliable or you feel uncertain of his well-being, then see a geriatric care manager to discuss the best placement for your dad. Good luck to you.
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It is so good of your to take the time for an update. It sounds like a lot of things have been resolved. May the path ahead be not too rocky!
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UPDATE....just to give everyone an update....I already had POA (health and financial from my father), HIPA, a will had been drawn up, etc. I consulted an elder care attorney and have since establish an irrevocabile trust fund for him with me being trustee. I also have removed every asset from his name (home, investments, bank accounts, ecc.) and have placed everything in the name of the trust. I have left him with one bank account in his name. He has also revised his will to make sure that I am the only executer thereby removing my brother (who is still an alcoholic and of no help, only a hinderance). The establishment of the trust and naming me the trustee does nothing to change the wishes in dad's will....my brother will still get his share but at least I don't have to deal with him to make any decisions once my father passes on and take care of business without interference.

On a happy note, I was able to find a great job here with my overseas employer. They realized they didn't want to lose me after all these years of service and really stepped up and found a great position for me. My boss is beyond wonderful.

I have recently purchased a home and am evaluating moving my father in with me once I get settled. In the meantime, I am continuing with his around-the-clock assistance and trimming back expenses where I can.

I will also investigate what financial aid/assistance I can get through the VA.

Thanks to all for your input. Hugs to all you caretakers out there.
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POA and then you can take it from there. Good luck with finding a good job here, I think the job depends on what you do. Has your father ever been in a nursing home, my mom didn't do very well there. What is the cost of assisted living, set up for his burial now. What agencies can you locate to help you with the cost of his care. Check out Senior Resources and see what the state has to offer. I do know how exspensive elder care is and because of an old life insurance policy she is not eligible for state aid and all of her social security goes into care not shelter, food, clothes or meds. Best of luck to whatever you decide.
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I strongly agree with above do not quit your job -he can be placed now with medicaide pending once his assests are depleated to what is allowed he will get on medicaide and will have been in a place where he will be able to remain-he may have to change rooms and have a roomate but will be cared for-getting another job may be impossible for you and you will find yourself probably homeless -no one who kept their job was sorry but those who did not wished they had had good advice-do not give up your job for any reason-one reason a lot of people do not think of is that your social security is based on your earnings and if you were to get another job it will probably be a a much lower salery-you have to protect yourself -he will he cared for but you may not be-just because he did not plan ahead is no reason to hurt your chances of a suitable life.
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If you quit your job, where will you be financially when his assets are gone? He will be able to qualify for medicaid. You will be in debt without a job and no visible means of support for yourself. Keep your job and use your father's assets for his support until he qualfies for medicaid. Your future is a priority for your own senior years.
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we are in a different awkward situation with long term care and mom at home . the LTC is paying $260 a day 24hrs, the rest comes from the family trust all together rough estimate is a whopping ;$17K. you need paper work trustee stuff in order. we picked the wrong one for trustee,.
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As for me...Mom does'nt have much money but she has more than the allowed 2000 in the bank. We are allowed to spend down that amount so that she my qualify for Medicaid then my choice would be to keep her here at home with me using the money to pay for a caregiver to stay with her until the money is paid down enough to qualify. I think that would be a valid reason for medicaid to accept for her to qualify for nursing home care. That's what I am looking at right now. Then it might take the money a little longer to pay down. But at least she is getting quality care. And I, as a caregiver will have rest and peace knowing she is getting the best care possible at home.
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