Dementia and nursing home preparation, any guidance? Wow, we weren't prepared for this...dementia is an awful, awful illness!!

I agree that investing in a consult with an estate planner or some financial planning professional would be the wisest thing to do. Paying off his home may depend on how much he still owed and where the money would come from to do so. That money might be better placed in a more conservative and liquid investment. But a professional who will know more details of what he has will be far more qualified to answer this question.

Definitely see a CPA and also an Elder Care Attorney for advice. Your father is quite young at 71 and can live another 10 or 20 years or more, so his money will need to be extended as long as possible to be used for his care before Medicaid is applied for. Medicaid looks back over all financial transactions for a 5 year period (varies by state) to see if any assets were hidden before they grant your father approval for long term care coverage..........so there's that to keep in mind.

Also is dad a war veteran, by chance? If so, he may qualify for Veterans Aid & Attendance benefits thru the Veterans Administration. My father was a WWII vet (served in active duty) and the VA gave him $2300 a month for he and my mother until he died (to be used for Assisted Living or Nursing Home care); after he died, my mother gets $1244 a month in survivor benefits to this day (she lives in a Memory Care ALF). I've been using ALL of their life savings (nothing held back) to pay for their long term managed care and will do so until it runs out. Then I will apply for Medicaid to fund my mother's stay in a SNF if she's still alive. She's 94.5 now with advanced dementia.

Good luck!

If your father's retirement account is a pre-tax acct. like a 403b, 401k, pre-tax IRA or an annuity, there are significant tax issues you have to be aware of when making a withdrawal. I would seek a tax specialist, a local tax agency or CPA, to help you.