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My mother has a lot of medical issues and it's very hard for her to do many things.It progressively gets harder and I am concerned about her safety.

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Jennifer - so is it the case that you are expecting the state or the feds or an agency in your city to pay you a full-time wage to move in with your parent to take care of them? If so, not gonna happen.

Although some states have funding programs for family caregivers - usually done through the Area on Aging (these are with your regional COG - Council of Governments and the COGs act as a funnel for all sorts of federal $, grants, state funds, etc & disperse within your planning district), the funds are pretty limited. When it does happen, it might be for 3 - 4 hours of caregiving paid for 2 - 3 days a week & at minimum wage. You will have to undergo a very minimal training program (for my mom's city this is done @ an OASIS site and is funded through United Way & the onsite is donated by a CCRC group) and do a CPR course (this one through Red Cross). If you are low income, there is no cost.

If either of your parents was a vet, the VA has a program called Aid & Attendance that pays for at home care. I think A&A is about $ 1,700 a mo.

If mom is low income and qualifies for Medicaid, she could get at-home services paid for by Medicaid through their community based program. But this is really designed to pay for home health agencies, PT, OT's etc to be paid by Medicaid. Often the at home caregiver can be hired by the agency to provide the care for their family member. It will be income and taxable.

Keep in mind, that if mom goes onto Medicaid and she has a home, that the home will have a claim or a lien placed on it required by MERP - Medicaid Estate Recovery Program. The home is an exempt asset during her life but once she dies, the property becomes non-exempt. If you will be needing the home to be able to have a place to live or want to keep the home for whatever reason, you need to pay attention to how MERP runs in your state, especially on what exemptions, exclusions and hardships are there for family to file or do in order to have the MERP claim or lien released or reduced. Otherwise the home will have to be sold and the proceeds from the sale paid to the state to offset the costs the state paid for her care through Medicaid.

Now if mom is really, really doing loco big time crazy stuff, you can call the police &/or APS - Adult Protective Services. They will come out and evaluate the situation and if mom is deemed a safety risk she will be sent to hospital for evaluation. The problem with this is that she can easily then become a ward of the state and the state takes control of all this. If you aren't already her DPOA, MPOA and have her will and other legal all set up before APS comes, you will have a very hard time in getting any of that after APS gets involved. APS is really the nuclear action, personally I'd avoid ever going that route.

The reality of aging in the US is that the elder & their family (which overwhelmingly means the women of the family) is expected to provide for &/or pay for caregiving till the point that the elder can qualify medically for NH and then go into one and hopefully financially qualify for Medicaid to pay for the NH. Otherwise they have to spend-down their assets till they financially qualify for Medicaid. Or family does the caregiving for free or private pays for the parents if they can.

It is not pretty. I cannot imagine what is going to happen in the US when the on coming tsumani of baby boomers start hitting needing caregiving & NH care.
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Just re-read my post, sounds pretty bleak, I know…..

Another thought, your mom has some sort of income - like SS & maybe a retirement. She also may have savings or investments. There is no reason that she cannot pay you for caregiving. It would be a "personal services contract" and has to be done by an elder law attorney so that it would be able to pass Medicaid vetting in the future if need be. It would be a true employer - employee situation. You pay taxes on the income but you also build up your own SS base.

You are probably going to get advise from others to get a reverse mortgage or a HELOC on the house. If you need the house to have a place to live in after mom dies or mom moves into a NH or want to keep the house, it will be very very difficult to do this under RM terms. If mom is very tight financially right now, she will likely not qualify for a federally backed HUD RM as she may not have the income to be able to pay the RM required items on the house (like taxes, insurance, maintenance, etc) that HUD requires for RM that they back.

If you don't know just what your mom's financial situation is, you really need to go over with her all the details. Then take that info and go to see an elder law attorney to see what your options are to best benefit both your mom & you for the long run.
Good luck.
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