Financial obligations?

If it provides something that your mother could not do for herself then it is her cost. The alternative if that you get paid for what you do at a reasonable carer rate. It may make your life easier but it making mother's life possible, and if she goes into respite it keeps her safety possible - yes of course any assistance helps us because it means something we do not have to do, but it is still something mother needs in the way of care so all costs are hers.

I am no expert but under no circumstances should YOU pay for her expenses if she has the funds. It might help to document the finances but you do not pay them. Personally I feel if you have to do something that happens because of HER needs and her being in your home, she should pay - NOT you. I think you need to speak to a professional who can advise you better legally and otherwise. If you hire people to do things because SHE IS IN YOUR HOME, then she should pay. Isn't it enough that you care for her?

It seems to me you might ask yourself: is this product or service something I would want if mom did not live here? If you are considering it because of your mom living there, then I would say it is down to her, not to you.

Getting cleaning help for your LO is help for them, they pay for it. You are not supposed to do it all.
If they have anything not spend on bills each month you need to pay YOU for some of the time. I do all my mom's bills, taxes, repairs. I charge a flat amount each month, $1000 well below what would be spent hiring aides, cleaning people and an book keeper.

You have been comparing costs with Assisted Living, which is confusing as they include personal care costs which you don’t feel you are providing. Perhaps compare it with a hotel as well. That leaves out the food cost and personal care.

Our posters are quite clear that children have no ‘right’ to an inheritance from their parents. However you are an only child, so what you ‘save’ by under-charging your mother, is quite probably going to be left to you. It doesn’t make sense for these last years to be a real strain, just so that you inherit more at the end. You will do the best for your mother, yourself and your husband, if you can make these last years as easy and enjoyable as possible.

Yes, it’s important to document costs just in case mother lives another 10 years in 24/7 care and requires Medicaid. However it’s completely true to tell mother that you can keep her with you longer if you have some help and some fun. You might start the conversation about what did she enjoy when she was your age, then come back to it a couple of days later, saying it has made you think. She must know that your life is revolving around her at the moment, and that you will sooner or later regret the things that you weren’t able to do. Make it better now for both of you!

As several have mentioned, and I highly highly agree with them - please see an elder care attorney who has extensive experience with Medicaid (not all of them do, as I found out). In order to qualify for Medicaid, there has to be a certain progression in the spend-down of monies in order to qualify. And even if you document how much you are spending on her, it has to be a 'certain way' in order for Medicaid to accept the expenses. Also, some assets one can keep, many one can't and need to be crystal clear on these. So perhaps research Medicare and Medicaid rules on line; schedule an appointment with at least 2 different elder attorneys; and then you can start putting together your 'plan of action'.

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!

Belsnickles: Imho, those expenses are your mother's financial responsibility.

Belsnickles,
There are expert and/or experienced financial planners, budget makers, who can help you figure out how much to charge Mom for rent, groceries, housekeeping, etc. And to record same. Maybe in percentages.

How about hiring a housekeeper for the entire home and split a percentage for Mom. Then, she might not be as sensitive to having to pay for her rooms. She might come to understand that you are needing help in many areas, and having a housekeeper frees you in other areas.

I hope some others can help you figure out some details of Mom's budget.

For example, I have read on here that you can take the number of people in the household, divide that into the housekeeping bill. But this is not exactly correct.
Your Mom's rooms are @ 100% your care, and other rooms are done in part by others picking up their own rooms. So, adjust the figures accordingly?

I am so glad that you have stayed and become a member of this care giving community. The fact that you come back and discuss and answer is making it more personable, a pleasure to get to know you. Yes, welcome to the club, right?

Being a caregiver is difficult and you must give yourself breaks as much as you can. And congratulations to your mother who is able to do so much at age 93! Medicare will pay for some things. You can start by calling Medicare for advice, I think they do cover some home assistance and may also cover payments to you as the caregiver, but it may be best to get connected with a local social worker and senior care advisors in your area who can advise you on what your mother's options and benefits are and how to navigate the senior benefits. Make sure all of your mother's paperwork is in order so that you can take over full responsibility, if ever needed. She nees to have power of attorney set up for medical and financial matters, a living will (advance medical directives) so that you know her wishes, a will if she has assets, and financial institutions (banks, credit card companies, etc. also usually have their own POA forms). I'm assuming you are her POA. You also need to be on file with Medicare and Social Security to be able to speak on her behalf. You can do this with a phone call with her sitting next to you to agree to it. All the best to you both!

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 :)

Since she moved into your house, she should conform to your schedule. Separate meals for everyone is ridiculous. Set a schedule and meals are served at that time. And she should pay for cleaning services for her part of the house like you said she has the guest suite which you would not clean every day.

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.

Belsnickles I want to urge you to start getting paid for your services. This establishes a legal paper trail of the necessity, and it also takes the sting out of the burden. Then if the time comes when she cannot stay in your home, Medicaid will take over paying for it. You just have to do things according to what Medicaid has spelled out. She cannot give money away and her money has to spent on her care. You can even be getting paid for her room and board.
It won't change her situation at all, but will help you.

Dear Belsnickles,

DO NOT SELF-GUILT INDUCE. I wanted to be a hero and martyr when my Pop's condition began to deteriorate. Medication calls twice a day, running the errands to pay bills, if he didn't answer the phone for pills or otherwise, running to his house in costly Ubers in the middle of the night. When he went down hard with a spinal infection about 4 months ago, I have been running a goddamned marathon. He did 3 hospital stays, a SNF rehab recovery for 6 weeks in which I had to move him to a different SNF halfway through because of neglect and a nursing lying and failing to document a foley injury, I've advocated against neglectful treatment in both facilities (not entirely the CNAs faults, they're DEEPLY understaffed and everyone is from a rotating agency in these places now), I've blown SO MUCH of my own money on Uber because I don't drive, I've had my firefighter friend help with mobility assists. My mom (his daughter) helped for a total of 5 days and then ran back out to her vagrant life of substance misuse. I don't know what your age is---I'm only 33, and having been managing an 82 year old in quick decline for all of 2021, some of 2018, and then my grandma (who passed) in 2020. I have been in and out of hospitals caring for these people for 3 years. It compromised my attention given to finally finishing my bachelor's---I didn't make enough connections, and I was often grumpy, resentful, and burned out.

Now that my Pop is home, with a catheter, still mostly bedridden, retraining on a commode, having multiple physical therapy visits, NPs and occupational visiting, they all expect me to be there for every visit to counsel and update because he has rapidly progressing dementia.

So I hired a home health from an agency. And guess what? His sh*tty criminal sons and daughter struggling from addiction have done NOTHING but create an uphill battle. I have had enough. I have Durable POA, Medical POA, and am the estate executrix in the Will. And I have decided that this is too crucial a period of my life in my early 30s to keep putting myself on the back burner. I am spending about 3500 on care from his account. His pension and SS cover all but 1100 of that in a month. It is coming from his savings account. He has about 10k and probably some hidden money in the walls. This is what it costs. If he made proactive arrangements before the dementia, I would honor them. I am honoring his wishes to stay in his house, but it has to cost him. I'm already losing income from not being able to take meaningful work. I am lucky to have a very financially supportive boyfriend. I am not even taking the amount of hours a week I still need to be sane.

I am taking a 10 day respite in December. I am throwing 500 dollars in. The rest will be coming out of his account---because I am not only subsidizing his costs, but losing out on making my own money, compromising my relationship, friendships, youth. Do you think that the majority of men ever have to Caregive? No, most of them would never consider sacrificing their lives for another. 30 percent divorce their wives when they become terminally ill.

You owe yourself your own life, and you DON'T actually have the money to pay for hers. You are subsidizing. There are 168 hours in a week---how many do you want to be yours? You at least deserve 70 of those.

We're taking a home equity loan out ASAP. He will cost 50k to stay home for another year and a half. Then we will re-evaluate. His kids will be pissed, because they're greedy and think they're inheriting property---tough stones. I am happy to blow his assets on him for my own freedom rather than bank on an inheritance. You only get one life, and the arrow of time only runs in one direction. Don't feel an ounce of guilt, and keep an immaculate paper trail so Medicaid doesn't screw you over. Play the system, or it will play you.

We try to keep things separate by hers and ours. For example, we have a PSW that comes in 3 times a week. We ask that she cleans my MIL’s room, changes her sheets, vacuums and dusts her room only. The PSW’s pay is paid for with my MIL’s money, because it’s HER care. We are also going away for a weekend, and will have to figure out care. That care, we are still paying for with HER money, because it’s HER care. She is not paying for our vacation.

Right now we don’t use her money for her food (we buy her specific kinds that is always available on her shelf in the fridge), because it’s more important right now that her money is being spent on her care.

Rule of thumb: her needs are paid for by her money.

I recall when my husband had had his stroke the VA was quick to say it was important for me to have respite time. They insisted I place him for two weeks twice a year into care in a hospital so I could take a much needed vacation. The theory being that if I wasn’t taking care of myself, what good would I be to him? I do think my SIL and BIL thought I was a horrible person for
“abandoning “ him like that, but I really needed the rest. Oh, I never did take the full two weeks, but it did help me. So a break may be what you do need!

Your mom can pay her share of costs for the house and hire a housekeeper.

Any respite would be paid by her.

Interesting answers. What did your mom do for you the first 18 years of your life?

You should get help rather it's a Sitter, Caregiver, House Cleaner, ect and the funds can be paid with mom's money.
If mom has the money, you should order dinner in once a week.

Since she eats lunch at a different time, you should consider frozen meals like Lean Cuisine they are the right amount, tasty and easy to microwave.

Are you getting any payment for caring for her or room and board?

If she can't afford it is one thing, but if she can afford it then you should be paid for your services.

Anything that is for caring for your mom, she should pay out of her resources: cleaning her rooms, meals for her, respite care... You are incurring these costs because of her care.

Kudos for "doing it all" for 3 years, That is a lot of work!

Something to consider: get help now.
If you get sick or injured, you will need somebody else to help with your mom, Please ask family, friends, members of your faith community - and consider paid help - so that you have a few "others" who can do everything your mom needs and give you much needed breaks.

I have yet to get to my elder law appt.

But I have learned here that states have different rules and it was best to ask an elder law attorney your States rules.

I saw some mention here that certain states require a caregiver contract? In case she runs out of money and does need Medicaid -there has to be a caregiver contract stating what is paid out and to whom? Again this is all new to me and why I reached out to an elder law attorney - and I’m still at step one as it really is overwhelming.

I would reach out to an Elder Law Attorney and or as someone else suggested to hire additional assistance from and agency that can do these additional things and free up some of your time.

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.

"...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.

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.

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.

If you weren't living there, who would "do" for her?

These are services that SHE should be paying for, not you.

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.

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