Elderly in-laws are house-rich and cash poor. What are their options since they won't sell the house?

70 isn’t that old, they arent even at actuarial table for death! They could go decade plus..... Its good to get concerned now & think Medicaid planning.

my crystal ball sees 2 big issues:
1. - property is pretty high value, at 600-700k. For most states LTC Medicaid program, property value has a max limit 500k -575k. Over that your toast on eligible for Medicaid. A few east coast states have this higher, like 700/750k. You need to find out ASAP just what their state has as property max limit. Cause IF it’s over the Medicaid limit, they will never NEVER ever be eligible and will be a true panic inducing crisis when they need to go into a facility.
Perhaps use this as part of the rationale to sell the house.

2. - HELOC this May not be exactly what is promised......
Yes your folks are limited in what they can get as they are not working so repayment ability can’t be determined via regular sources (like fico score which I think doesn’t count SS$ income). But you need to review HELOC requirements very carefully, as there’s fine print in what’s required for LOC. Since it’s securized lending with property used as collateral, they may need to have updated insurance on property. Depending on where they live, could be quite $$ costly. And not at all what they are paying on their current mortgage free home, which may be low & based in value last millennium without 2019 rebuild costs factored in. Where I live (New Orleans Area), HELOC will require usual homeowner at rebuild coverage amt, and likely ALSO flood & windstorm. NFIP flood limited to 250k, ($500-$700 yr) so a 700k home will need $450+ private flood insurance extra coverage which will have a comma in its costs. Windstorm too will have a serious comma in costs. Bank may want pest control/ termite free document. For our area, most have to have a current elevation certificate and verified plat from courthouse and go onto a specific federal form with inspectors seal and state registration info.

And for more fun, banks here do NOT do the tax assessor value & drive by house by 2-step system to determine property value. But actually have an outside independent appraiser physically do a on site measurement of house, land, & do interior walkthrough with photos and use to do a appraisal report to the bank. (Your folks should get a copy btw and you want this cause if house should sell for under tax assessor value that appraisal may help support why it was not able to sell at FMV, which is what Medicaid is gonna want....).
My point in the above is you need to carefully review the heloc as your folks may be hearing what they want to hear and not truly realizing the costly details needed of and ongoing to get HELOC.

For where we are, some who rebuilt post Hur. Katrina & now dz+ years later retiring are finding increasing insurance aren’t supportable once on a fixed income even if mortgage free. Having to get a Heloc to pay taxes & insurance is still debt to be repaid, but better than a RM.

If you’re paying for things, please speak with atty regarding some sort of Memo of Understanding or Promissory Note between you & folks to be repaid from house sale or as debt / claim against their estate. It will need to be witnessed & notarized but should be able to be there to be used / filed should house be sold & you are repaid your lending or as a secure claim against their Estate. Should they ever actually get impoverished enough to be eligible for Medicaid, Medicaid tends to look at whatever $ or time kids spend or do for parents as done for free & for familial duty. Having Memo helps offset that. Should They actually outlive their $ even if they sell house and apply for Medicaid.

To me, FA is not what you need 1st, a NAELA or CELA level of atty would be first stop. They will know FAs who understand Medicaid planning & how it’s different than like selling annuities nonsense. I agree with other on fee for service FA too. & good luck with in laws!

Also on the HELOC, look at the interest and how it’s structured. Some do this first 6 mos at 0% or other low and then it goes to whatever variable to what prime is at. You want it fixed rate for your in laws.

Bank may want an estoppel certificate. Fun!

And bank may want for all insurance to have them listed as lien holder...... that’s a butt burn cause say there’s hail damage and it’s 20k for roof work.... well the 20k check from ZXC insurance will be in folks AND banks name. So if it’s like this, usually they have to sign it and then it goes to bank and they have to get estimates to get the bank to release insurance $ to pay the roofer.

We we watched the disastrous Saints game with friends & 1 couple was looking for HELOC to cover increased insurance costs as property value reassessed and over NFIP 250k limits and higher wind pool. They both draw FRA SS. The HELOC paperwork was quite involved. They were expecting what was the norm of check last tax assessor value and do a drive by or Google Earth to see house actually there. She was beyond over the bank.... the needing termite certificate was her “enough” point. They ended up with a better deal on $ lent and interest rate through a credit union. Now the credit union required their SS to be moved over to them for direct deposit but did it as a personal loan with property as collateral. Also they are challenging the assessment and will get it reduced so insurance coverage and taxes will be less.

As an aside on the above, if your in laws house has decades of delayed maintenance, it may actually be way way less than it’s assessed value. Usually you challenge the value in the spring when tax assessor sends out the 2020 notice. You take photos, etc to show it is not what the comperables are. If their place is in an area with lots of tear Downs & rebuilds, the comps are gonna be much MUCH higher. That it’s over assessed may not matter too much for the in laws as their property taxes are fixed for homestead exemption or/& senior rates, but it will matter when they go to sell it or go to have it correctly insured. I’ve challenged assessments and if you bring in documentation or even estimates of what like new to code electrical will cost, you’ll get a reduction. Usually there’s a equation the tax assessor office staff uses.

Have you looked into a property tax freeze and are they getting all of their homestead tax credits? This may help lower their tax bill. When was the last time the home was properly assessed? It sounds as if when the assessment went up, maybe they did not question it or appeal it? This may solve part of the problem but not all. Many times there is a way to lower it especially if they have a limited income. I personally do not like reverse mortgages. They charge a big fee up front so even if you don't need to use it right away you're still accruing interest on the balance that is due. Lots of residency rules that could put the loan in pay in full status or lose the house to foreclosure. For some this helps them stay in place but with the amount of equity your parents have in the home it just doesn't make sense. Sounds like they need to downsize and it may take all of the siblings to get together to help them with the overwhelming project. Pitch, sell, donate, keep. If they have enough items to sell, consider an estate auction. Easier said than done, just went thru this this past summer, wasn't easy and if your parents are like my MIL don't be surprised if you get what I call the poor me attitude. You will have them pushing back at every turn, trying to manipulate you by using guilt, they know exactly which buttons to push to make you feel sorry for them, many memories are involved in their "stuff" so it's hard to get rid of. Help them find and view smaller, easier to maintain homes. Townhouse, condo, smaller home that has been updated so no major repairs needed anytime soon. Smaller home still allows them to putter in the yard if they enjoy gardening and yardwork. Townhouse offers outdoor space without the upkeep, usually with garage space for their vehicles. Get a good investment advisor to help them with money left over from sale of the home to help supplement what income they have now. Expenses will be much lower than with current home, new home and investments can be locked up in a trust, prepay funeral expenses. Did either parent serve in the military and are they eligible to be buried in a national cemetery? They can both be interred together. You've got a big job to do and it's not going to be physically or mentally easy to do. Sell the home as is, do not do any more major repairs, if you repair it, just gives parents another reason to think, gee this is fixed, we can stay longer. Best of luck to you. Get ready to count many more gray hairs when this begins, make sure all siblings are on board, have a sibling meeting, all it takes is one to side with parents to "validate " their staying in a home that is too expensive to maintain.

MEP1965 - any updates? I found your thread while looking for ones related to my FIL living above his means. Fortunately, he already is in an independent living community. Unfortunately he refuses to downsize to a one bedroom. Last I checked, he's $5k-$6k in the red every month but those are old calculations and I am worried. FIL is spending his retirement savings at an eye watering speed. My husband also won't push his father and it's becoming a sore point with me because it's my husband whose job it is to make the numbers work every month and transfer money from his retirement fund into his checking to pay his bills.