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Hi, everyone. I'm new here. My 93-year-old mother moved in with us almost three years ago. I'm actually feeling a bit overwhelmed at this point, even though she's still doing all of her own self-care: showering, dressing, toileting, even putting on her own compression socks! I am responsible for cooking all her meals which, except for our communal dinner, are eaten at different times throughout the day, which means I am preparing meals much of the day. I clean up after her, including her bathroom, laundry, and bedroom. I take care of all her financial, tax, and investment issues. I manage all of her appointments, health care, and medications. There are MANY things I could ask questions about here, but today this is my question: How do we allocate paying for things that are principally a help to ME? If I want to get a bi-weekly cleaning service to take care of her bath- and bedroom areas, who pays for that? These are guest areas that didn't require frequent cleaning before she moved in, but getting help wouldn't really benefit my mother, only my sanity. Similarly, if I want to take a trip with my husband and have my mom go to respite care for a couple of weeks, I assume the onus of paying for that is mine, not hers? I know so many people here are in much, much more difficult circumstances than I, so I hope this doesn't sound too trivial. My grip on things feels very brittle right now (the dog recently got sick, and that was enough to destabilize the fine balance I've worked out). I really no longer have a life that doesn't revolve around my mom's needs (welcome to the club, right?). Any advice is much appreciated.

All care for your Mom is paid by her, including respite care.
A cleaning service-yes.
A portion of the rent-yes.
A portion of the utilities-yes.
Food, her portion of monthly expenses plus her own special needs-yes.

If you cannot manage doing her laundry-she pays for a laundry service or cleaners-yes.
If you need a CPA to help with her financials-she pays, yes.

It is so much easier to collect a percentage of her income monthly, stating what is included. For example, rent can be budgeted as 1/3 to 1/2 her income. Room and board can be her income less (a personal needs allowance). Keeping in mind that a NH holds about $30-$50 out of their income for a personal needs allowance.

If you say, for example, "Oh I could never charge her rent", you are shooting yourself in the foot trying to appear magnanimous, when a rent budget paid to you can cover all these smaller expenses you have trouble charging her for.

I don't expect everyone to understand my advice, but it is basically calling it rent, or room and board to cover what it costs you for everything else.
It basically gives you a budget to better care for her, imo.

She is an adult, and adults pay their way. It helps with their dignity.
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Belsnickles Nov 4, 2021
Thanks. I didn't make clear that she does pay "shared expenses" (legalese for rent, utilities, food, etc.), so we are not bearing the entire burden of extra cost. It was her idea to pay something each month; I would not have felt comfortable asking for that, but it does make sense. In some ways, the fact that she pays a monthly "fee" (which, in our area, is probably 1/4 - 1/5 what an ALF would charge monthly) makes me loath to "ask for more." I am really appreciating the advice here - I will need to adjust my mindset.
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If you weren't living there, who would "do" for her?

These are services that SHE should be paying for, not you.
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Belsnickles Nov 4, 2021
This is true. I've really not thought of it in this way, for whatever reason.
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Mom pays for cleaning help and I hope you get it started soon. Don’t believe that it doesn’t benefit her, it makes her areas clean and frees your time up to do other activities, both of those are to her benefit. Stop cooking all day! Make the meals no more than 3 times, if she doesn’t eat when it’s prepared it can be reheated later. And of course, take trips with your husband. This also benefits your mom as you’ll be refreshed in caring for her. And she pays for that also. Your mom sounds pretty capable, back off doing so much and see what she may be able to handle. What you’re describing is burnout, not good for either of you so take steps to change the dynamics
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Belsnickles Nov 4, 2021
Thanks. I don't want to be someone who simply complains and doesn't take steps to change things. I appreciate the push.
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Anything going to your moms care and support should come from moms funds including cleaning her living areas. You may even look at rent payments.

I was a remote caregiver for my folks for a few years, made a long 12 hour drive dozens of times. I used their funds for gas, motels, all the stuff I bought for them while I was there and all repairs etc.

Its important to keep very detailed records of all such expenditures in the event someone should make accusations about how the money is spent.
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Belsnickles Nov 4, 2021
Thanks. Well, I've been feeling like being an only child in this situation makes it harder, but maybe the upside is that there's no one to ask for an accounting! I do clear every purchase for her with her, though.
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I agree with the pervious posters! Mom should be paying for the things that make YOUR LIVES life better and often that comes down to 'if we didn't have mom here, would I even need to entertain the thoughts of hiring help?'

You are giving mom 40+ unpaid hours a week plus the actual fact that you are 'there' 24/7 for all the 'little stuff'. If you had her in an ALF, you could be paying upwards of $12,000. And that's conservative.

While I recovered from major foot surgery, I got a maid service, grocery delivery and a yard crew. I'm NEVER going back!

Mom lives with YB, She pays for the cable and wi-fi and I do not know how they found the incredibly SLOW internet/cable. It's awful. Probably saves a few bucks. She pays for her own groceries (maybe $100 a month) and nothing else.
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Belsnickles Nov 4, 2021
Thank you. She does pay some shared monthly expenses, so that is definitely a help. It's just that these "extra" things seem like luxuries, and I guess I feel guilt asking her to foot the bill. All the advice here is so helpful, and causing me to rethink things.
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When Windyridge said:

"Its important to keep very detailed records of all such expenditures in the event someone should make accusations about how the money is spent."

He might have also meant to keep records for the future if and when Mom might need to qualify for a Medicaid bed in a NH, MC facility.

There is a five year look back at finances to make sure her money was spent only for her. That is what the accounting is for.
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Belsnickles Nov 6, 2021
That makes sense. Wow, I haven't been doing that at all. I feel as though I've been pretty scrupulous in spending her money, but I haven't kept any sort of detailed record. I'm not sure how things like her share of the rent, food, utilities, gas, toilet paper, etc. would even be calculated. Maybe I do need to see an elder care attorney.
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Oh, and one more thing to consider:

Greatest Gen are EXTREMELY financially secure compared to how Gen X and Millennials will be en masse when our time comes. I’ll problem burn in a climate change inferno anyway if I make it to 90. These people had unions and pensions, and if they served in wars, they’re covered for A LOT. I’m not bitter against them, I’m just saying that the earlier iterations of social security were kind to them.

Don’t get me started on Boomers, and I apologize if you are one, but you guys will age into a labor crisis in healthcare for the aging, and younger people aren’t jumping at the opportunity to make 12 dollars an hour when we’ve been financially screwed over as soon as we graduated high school. If you are a Boomer, you need to do EXTENSIVE planning for yourself, including stacking those bundles for when younger people hit their stride to demand living wages. You guys might be more padded than others and generally blamed for the greed of the 80s and fossil fuels etc, but your costs are going to SKYROCKET for decent care. You REALLY need to take care of yourself, because this wave of workers when you’re 80 plus just aren’t going to put up with the way aides are paid now. I encourage you to consider these global scopes for your own life, even if it sounds tumultuous. You owe yourself a decent golden era.
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Debstarr53 Nov 6, 2021
Hmmm...My husband's parents paid into social security for years, then both died in their 50's. Never got one cent of all that they paid into the system.
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You ARE overwhelmed, aren't you! So much so that you're standing on your head.

It doesn't help your mother if her bathroom gets cleaned? It isn't your mother who will be cared for and catered for in a respite facility?

These are services which are wholly and exclusively of benefit to your mother. You are currently providing them free of charge, which is very nice of you, but they are FOR her, and when/if they need paying for SHE pays.

Do her the courtesy of assuming she will prefer to pay her way, and propose practical solutions. May it go well :)
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"...I'm actually feeling a bit overwhelmed at this point, even though she's still doing all of her own self-care: showering, dressing, toileting, even putting on her own compression socks..." I think you need a reality check. Your mother is not capable of doing her IADLs or independent activities of daily living. She doesn't cook or clean for herself, she doesn't do her own laundry, she doesn't manage her own financial affairs, etc. She relies on you to do it and you're doing all that extra work for free even though it's not free to you.

Your mother's needs are only going to increase. Either get her to agree to hire in-home help for herself now or tell her it's time to move to a senior living community where she will pay for the services she needs and be around people her own age. Another option would be for her to go away for a month at a time on a regular basis and give you a much-needed respite from caregiving.
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Belsnickles Nov 4, 2021
Thank you. I never thought of regular respite, so that might be a good idea. It's just so insanely expensive. But it would definitely help!
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I am a community based aging services professional. This is a common concern raised by caregivers that we talk to. My mom was also a caregiver for my grandmother for 10 years, who passed shy of 101. The short answer is yes, she should pay for services that support her care, if she is financially able. And yes, you should take a trip with your husband and have her pay for respite stay. She sounds very independent at 93. Is she socially active or just remaining at home? Is she able to prepare her own breakfast or lunch? Can she manage her own laundry if someone carries it for her? If so, allow her to do these things in a modified way. It gives her purpose and she can do it on her own schedule and give you a little break.

Contact your local senior center or regional area agency on aging (AAAs) for some guidance and referrals. In our state every community has a municipal senior center but this varies by state. Talk to their social worker, outreach worker or SHINE/SHIP counselor to determine if she has a Medicare plan that pays for what is called custodial care. Standard Medicare doesn’t cover the cost unless it’s medically necessary, but some Medicare supplemental (Medigap) plans do. Supplementals are private companies like BCBS that contract with Medicare and coverage varies by State. If she has such a plan you can also contact them directly.

Depending on her income, she could be eligible for home care assistance for low or no cost. Your elder services agency can help you determine that too and refer you to the appropriate resource. Services could include meals on wheels, laundry, medication management, bill paying assistance and housekeeping. Ask them if your state has a personal care payment program for family caregivers and how to apply,

Is she the widow of a veteran? If so contact your local VA office to see what services she may qualify for. It could include financial support to help pay for services.

If you have a local senior center, encourage her to participate in their social programs and lunches. It’s typically low cost, provides you a short daily respite and her engagement with peers. Many will also provide transportation. I recommend a family member join their loved one the first time. No matter our age, no one is really comfortable walking into a strange place alone.

Definitely seek the help of an elder law attorney, preferably one affiliated with NAELA (Nat’l Assoc. of Elder Law Attys). They will help you with evaluating her legal/financial status for future planning should she need skilled nursing care.

Document everything and save receipts! Keep them together in a folder with her other important documents. This may be important later if she applies for Medicaid or if she receives services that are income dependent. Sometimes you can deduct expenses from income to qualify for assistance programs.

Respite facilities are usually private pay unless she has long term care insurance. She may find that she enjoys being there for a week or two. Be sure to ask what is included in the fee so there are no surprises. For example is laundry included or an additional charge? Ask about after hours care, how are they staffed if she has an emergency?

You need to care for yourself or you can’t help her. As she ages, it is likely she will require more care so definitely research support services now. Rely on friends, family, faith communities, etc. for support - don’t be afraid to ask for or accept help from others. That is hard for most people to do, but people are typically willing to help but need to know how, It could be as simple as making a periodic meal for your family, running an errand for you or staying with her so you can have a couple hours to yourself. Faith communities often will help support elders in the community, even if they are not affiliated directly with the church or synagogue.

Stay connected to a caregiver networks. You’ve got this! We’re cheering you on. Enjoy your getaway!
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