How do you push the issue of assisted living?

Did the modifications you made to your house increase the property value? If so then that was for your benefit.
What I would do is propose paying back what they "gave" you to make the modifications that way you are no longer "beholden" to them.
If you begin looking for Assisted Living make sure it is one that will accept Medicaid. And one that has Memory Care.
If there is a possibility that they may have to apply for Medicaid it is even more important that you pay back any funds that they gave you to do home modifications.

I personally think Fear is #1 reason an AL convo can go nowhere.

I have met people who decided to move to AL & pre-decided they would like it too! Rare specimens indeed!!

But often people want what they are used to, dislike or fear charge.

As to the money spent... Upgrading their own house, upgrading your house, moving from one rental to a more suitable one, heck, living on a cruise ship - it always costs something to keep a roof over your head, right? They could have moved to AL so many years ago.. just saying.. but they didn't. (Look at the money they saved!)

Maybe try asking what they DO want? What their 'wish list' for their next-stage-of-living look like.

A nice room? Nice garden? Decent meals? Activities they may like? Close to you?

Or is there a level of denial here? A 'wishful thinking' list eg living in their own home again, being young again ☹️

Refusing to choose our own path can be a choice too.. but it can result in someone else choosing for us. (Like a hospital discharge social worker choosing a NH after a bad fall..)

I'd recommend keeping the chats ongoing. If going nowhere, consider adding a third party. This can help everyone have their say & be heard too. Try an elder service, social worker or faith elder.

Ebhmom, I gave up trying to get my Mom to leave their home which had too many stairs to deem it safe for them. Dad was willing to move. At that time my parents were in their very late 80's. I even brought to them a booklet about a complex which just down the road I thought would be great for them. On-site the complex had a quite a few condo buildings, had 3 restaurants, a bank branch, barber shop, beauty shop, gift shop, swimming pool which I knew my Dad would love, walking paths that they would enjoy, and even a walk-in doctor's office. Heck, I was ready to sign up myself :)

Mom thought the place looked too "snooty" as per the people featured in the booklet. They could even purchase a condo with the same square footage as their house. Yes, it was expensive, but they had saved. Dad liked the idea he could call the condo's handyman to get a ceiling light bulb changed. Yes, the condo was high, but there were so many pluses.

Years later, once my Mom passed after numerous falls at their house, Dad sold the house and wanted to look at senior living. Wish Mom was that easy. The first place I pulled up to, Dad said "where do I sign up?". Dad loved the place, he felt so safe there. He started out in Independent Living, and later moved to Memory Care. Oh how he enjoyed being around people closer to his age.

I hope you and your parents can find a win-win solution.

It doesn’t get better from here.

I made scheduled tours that offered lunch to visit. Even if the place is above the cost of what they can afford, it opens the door. That’s how I got my mom to at least consider it. You will have to tell them with conviction, that it is time for change in the interest of their care.

ideally look for a place that has a memory care for step up care and one that will take Medicaid. My moms required a year of self pay before Medicaid. They were good to us as my mom was going to be short on the funds by a couple of months. They took her anyway.

Google care advisors… they are similar to a realtor.. find someone local. I have placed 3 times using a care advisor. These wonderful people know the area, openings, cost , your needs, amenities,… they are paid by the facility when placed. They will meet you for tours.

I used care patrol … it’s a franchise, maybe there is one in your area.. I can’t stress enough about getting someone local . With my mom in another state , while I was searching , the care advisor directed me to what looked like a motel 6 , converted. I can’t say for certain as the picture taken so far away was not clear. She obviously was just scrolling thru her list.

They either did not increase the value or marginally did. For example, the ramps were surprisingly expensive and added not value, and may have even detracted from the value. We ended up replacing the flooring in their room which may have increased the value however we did so because my dad soiled the carpet to the point it wasn't cleanable and we replaced it with laminate at their request. Unfortunately, we don't have the ability to pay it back as it is tied up in the house and the cost of supporting everyone for the past 4 years has taken a toll on our finances as well.

You don't 'convince' them to leave. You tell them they are leaving or you will serve them with eviction.
When your mother starts up with the nonsense of how they gave you all their money, shut her down. Tell her that you refuse to discuss that ridiculous lie and that the ramps and entry modifications certainly was for their benefit, not yours. Doing this work to your house has actually decreased its value. Then tell her that for four years her and your father have been living rent-free, eating for free, using utilities for free, and being cared for - once again for free. So really, any money they spent modifying your house so that they could live there is a drop in the bucket of what's been put out for them by you and your husband. Do not tolerate one moment of complaining or fussiness from either of them anymore.
Offer to take them to tour different AL facilities. Try to look for facilities that also have a separate area that offers skilled nursing and memory care if needed. DO NOT pay for any of their care.
Do not put up with this **** for one more day. Make your meaning plain that they are leaving whether they agree to or not.

Like you said, she hates living with you. Can present it as it being her chance to be out of your house!

You wind up the arrangement. Sell the house, divide the proceeds pro rata, your parents go their way and you go yours.

Getting parents to agree to moving to Assisted Living is generally harder than it should be. They think things are fine as they are, even when they're not. They will ignore all the parts that aren't working. Since they are in your home it will be even harder to get them to move. Often the strategy is to withdraw help and support to make it clear that the parent is not living as "independently" as they claim. It's a strategy of waiting for the inevitable crisis. Hard, but often necessary. In your case, you'll have to basically make them move out. Visit some Assisted Living facilities without them to see what they are like and find out the associated costs and availablility. Once you have found a couple that you think they can afford let them make the final decision about which one they will move to. They will be unhappy, and angry, and hurt but you have to hold firm that they MUST move out. Do your best to NOT offer to provide any financial help as you need to recover financially from supporting them for the last 4 years. Only stick to the facts: because their care needs are more than you can provide; this assisted living facility can provide for their needs; they must move. Be prepared for the excuses and the fight. But after it is all over it will be so much better for everyone. (although your mother may never admit it.)

I think Countrymouse hit the nail on the head, frankly. You can't 'convince' your folks to move to AL, not gonna happen. Sell the house, split the proceeds, giving them back the money they 'gave' you to fix it up FOR them, then go your separate ways, making it CRYSTAL CLEAR from the get-go that you will NOT be cohabitating again. Period. Serving them with an eviction notice would not be something I'd do to my parents; that's over the top in my book. If you can't convince them to move on their own, or you can't come up with the cash to 'pay them back' for their investment, then you'll have no other choice *the way I see it* than to sell the darn house and move. That settles a bad situation once and for all.

The only other thing I can think of to 'pay them back' is to take out a home equity loan (if there's equity built up in the house) and give them their cash back that way. Of course, you'll be paying interest on that LOAN of the money, don't forget. But it could be a way to get them out of your house......maybe, maybe not.

Furthermore, I would not offer to pay ONE RED CENT towards the cost of THEIR Assisted Living. That's on them entirely.

Good luck!

Will the small savings and SSI pay for at least a year in the ALF?
If so you should be able to get them on Medicaid in one more year with a five year look back not affecting their being eligible. This might be an issue if you have to prove they weren’t gifting when they invested money for the house. With your moms ability to spin the narrative you should be prepared for this.

Not sure If your state allows an ALF to be paid by Medicaid. Most states don’t but some do. Make some phone calls.
To qualify for Medicaid for LTC they must meet financial and medical requirements.

Not everyone finds it necessary but I would seek the advice of a certified elder attorney well versed in Medicaid to discuss their unique situation. Their funds should pay for this but to get them placed, I would consider paying for it myself. I wouldn’t pay anything on the ALF until I had gotten legal advise from a CELA level attorney. You could be delaying the inevitable with great cost to your family.

The problem with convincing someone is that you are taking yet another burden on that doesn’t belong to you.

Stories
*Sell your house or rent it out.
I had to move one time when I let a family of 5 move in. (DH sister). I made it clear that our move was happening. They were gone the next week.

*Repairs/Disaster
When DH aunts home flooded, I had no choice but to move aunt. No discussion. Here we go.
She moved to ALF and now in a NH. And even though aunt has dementia severe enough to be on hospice, she saw that it was a done deal.

*Legal remedy
Squatters moved into an empty house next door to an elderly uncle. He tried to force them out. He got into trouble with the law for terroristic activity.
He had to evict them. If he had started with the law, he would have been done in 6 weeks instead of 6 months. check your state laws.

Of course no one wants to be harsh or a bully with our elders. Firm, kind, legal with good boundaries will actually move things along with less stress. Don’t over discuss. Find out what your legal options are and make it happen.

Come back and let us know how it is going. We learn from one another.

@cover999
I was not talking about a ramp specifically. What about modifications like zero entrance shower, a main floor bedroom that might be considered a second main bedroom, another main bathroom, waterproof flooring (LVP) any number of things that make a house accessible

I agree with don't get into a discussion of who owes who, what if, you should...Do see a lawyer. It is worth a couple hundred dollars to know what an elder specialist says is possible. He may also be aware of funding possibilities, is one of them a veteran, for example? I suspect you will be shocked by AL costs. There are sites on line that give you info about various prices and places. They are marketers, don't sign any contracts, but do use their info. If you call any AL places in your area, they also have marketing people who will deluge you with information. Find out the best possible choice and present to your parents as a done deal due to family needs. Your Mom probably will be difficult, you describe her as always so. Don't respond other with "Just the facts, M'am" as the Dragnet detective said. This is an argument for clear contractural arrangements when one cohabits even with reasonable people. All sorts of strange events can lead to complications about splitting the arrangement up.

Your mother sounds like she was unpleasant long before she moved in with you. I would tell her frankly that the arrangement has been fraught from the beginning but it is now no longer tenable. If your parents aren’t sharing any of the costs of their upkeep, it is they who are exploiting you not the other way around.

Unfortunately, assisted living is an expensive private pay affair in most states and I don’t see how your parents could afford the cost if they are on SSI. I also don’t understand how they could have substantial reserves.

In any event, it sounds like you need to put your foot down with your mother. Her bitterness over having to contribute to improvements that were designed to benefit them suggests that she might not be a good influence on your children. I am wondering if your father shares her obvious resentment. Regardless, despite what’s going on with your mom, it sounds like bringing in some daytime help while you are working is a more financially realistic alternative until your parents qualify for a more skilled level of care which Medicare and Medicaid will pay for. If you force them out of your home now, your mother may hate you as much as she hates living with you. A formal family conference regarding the entire matter seems overdue.

You need to give them their money back-refinance ,get a job, but you must do this.

I feel like there are a lot of details missing here. What was the arrangement made prior to them moving in - were they invited or did they contribute to the purchase of the house? Are they on the deed as co-owners? It seems like your parents gave up their prior home or apartment based on your plan. Your parents, like it or not, have a stake in the house in my opinion. It's unfair to move them in, only 4 years later trying to move them out. Something isn't kosher to me. It sounds to me like you had good intentions, but didn't take into consideration their medical limitations.
That said, if the house isn't in their name, and they have limited assets - consult with a well regarded elder care attorney for your best options. Bring your parents with you so it becomes a group effort and they don't feel excluded. Many attorney's consultations are free. This is a good place to start. For the time being, it would help if you can hire some part-time help to help your parents at home. This is an expense that seems to be essential while you are working, based on your mother's lack of mobility and predisposition to falling. Even in assisted living, it seems by the amount of falls you report - she would not last very long. Realistically, how would they manage on their own now? Install wifi cameras in common areas so you can keep an eye on them through your cell phone while you're away. Find ways to make your home safer - it helps you in the long term.
It sounds like there is a lot of tension in your home - and I urge you to find ways to let the anger and resentment go on both sides. Come from another angle - your parents'. They are both not as independent as you thought they were; and now are being asked to leave. This is an overwhelming situation for any elderly person. Put yourself in their shoes.
Once your parents feel "safer" and wanted by the rest of the family, hopefully the tensions will slowly unravel and they will be more open to alternatives. Please get good professional advice from an elder care attorney & in addition, make sure all of you get your financial assets, health directives & POA's in order NOW. I truly wish you the best.

Can you obtain a social work or hospice assessment from pcp? I’m not sure their age yet it seems like there is a need for advanced care or more care than you can oblige. You and your family come first.

Just to make the point here that SSI is Supplemental Security Income which is for poor people who do not qualify for Social Security Benefits based on their taxes paid on earnings. The people in this case do not sound poor and are probably receiving Social Security not SSI.

If money they have given you for house upgrades is their claim to staying in your home, you need to give them back that money, perhaps less a percentage for the time they have benefited from those upgrades. Then assess their resources and find an AL you and they can afford. If they legitimately have few resources, oversee their application for Medicaid and placement in a Medicaid facility. It may not be upscale, but if that's all they can afford, that's what they get.

Forget any un-reimbursed money for upgrades and a larger house. trying to collect that back from your parents is unnecessarily small-minded. You now own a house with higher market value when you sell.

I think no one has advised having a geriatric care manager in to assess both parents and the home situation. Someone from outside, who also is not associated with a specific facility, will be most helpful to come up with suggestions for the next step for these parents. The geriatric care manager can take into account the environment they are in now, their health history and issues, their finances, etc. And then could help find an appropriate placement, apply for Medicaid, etc. This is a lot for any family member to handle, and a professional will help ease tensions and might make the outcome seem more like it's needed and not just daughter's idea.

If they are on SSI, they cannot possibly have 'decent reserves' leftover. I think the savings limit is still $2000. Perhaps you mean they get Social Security based on old age.

You might want to check the price of AL facility. It is quite costly. Unless they have a very tidy sum of income plus savings, it's not likely for them to go there. Also, there is the medical needs for each of them. AL means they can manage on their own and need very little in the way of hands-on care. If mom is falling all the time and dad has Parkinson's - there's a good chance they need more hand-on care. Which leads to where they are most likely to be accepted - a NH.

Go visit a few AL places so you can find out if parents would even qualify for that low level of care and if they can afford to live there with you helping.

Another choice would be for them to use their monthly income and reserves to pay for in-home care where they are now. Their finances will last much longer and it would relieve a little burden off you. As you say, they aren't using their money for anything else anyway.

I gather there was an implied “until death do us live with you” when they gave you money to modify the house.

I would think selling is problematic. Moving is disruptive and the mortgage could double with today’s rates — but you could have a substantial profit. That said, you’d have to buy in a hyped market free paying closing costs and moving costs.

Before going that drastic, I’d work to deflate their argument with math: say the in-laws are 20% of the family and calculate 20% of the mortgage, utilities, food x 4 years. Calculate DH labor cost as part of the equation. Deduct the total against the renovation money they gave you. If there’s money left, offer to return the balance as monthly payments to help with AL costs.

Then calculate the costs for the 4 years they were with you and not paying AL fees. Use a conservative $40,000/year x 4 yrs = $160,000. So how much was their contribution? Less than $160? If yes, give them the balance as monthly payments.

If either scenario shows the money they gave you would have been spent to meet their needs, you have a logical argument to say, “We all tried. It’s not working out. You NOW need assisted living. To be safe. To be happy.” And before you start using your money to fund their care, the elder lawyer I met said that the elders should exhaust their funds first, then apply for Medicaid if it’s needed.

Good luck.

When my Mom got to that point,I sat her down and explain that I could not take care of her both mentally and physically. Explain like if she was a kid that it will be to expensive for me to quit working to be with her 24/7.That home care was much expensive than a home where she has help 24/7. Then took her to several homes so she decided which one she prefer.She saw the activities games,excersise routing etc. She falls in love with all the things to do.She was there till the day she died but she left me a letter thanking me to put her there for her own good. She extended her life spam for 15 years over the 5 the doctors have gave her.Just take her around the different places and let her see how much better her life will be there instead of been in a bed doing nothing.

Perhaps it is time to sell the larger home and set up a group meeting with an Elder Law Attorney who can walk you, and them, through the financing process and other legal issues.

It would benefit you and your parents because one day you will be heading for placement and it can be a lot less stressful if you have planned for it and not left it to your children to figure out what to do about you.

Many answers, which I have skimmed, so apologies if this has been covered. Have you checked with your county’s area agency on aging (AAA)? They were infinitely helpful for me when I was caring for my dad. He lived with us until his medical needs became too much for the limited medical services in our semi-rural county, and I had to get him closer to care. But while he lived with us, the County subsidized a respite worker - they paid 60% and we paid 40% for the respite worker to come in for 4 hours at a time, twice a week. If our need had been greater, the respite worker would have been there more frequently. I think there are other services that could be tapped into. This is most likely a stopgap measure, considering your folks’ medical needs, but it could be just the ticket for getting them used to other care while you’re evaluating AL and NH situations. And it’s helpful to you - the respite care worker allowed me time to think, take a nap (I desperately needed sleep, as I was only getting 4 hours on average a night). I wish you good luck. This is never easy.

I think you have at least 3 issues:
1. Your parents need more care than you can provide right now
2. Your mother and you do not agree on their current financial resources
3. Your mother believes that she gave you a lot of money, hence you are in her debt

To address #1. I would start visiting places to see what is acceptable and available near you and if practical, a different state. Some of the smaller facilities are much more affordable than the larger facilities and would allow your mother to be in the same room as your Dad. It also might provide the coziness that your Mom would like and provide a better patient/caregiver ratio. I would do this immediately as older residents are starting to move back into managed care facilities after COVID. I believe it is safe to say that your Mom is a fall risk. By chance, could she be in the early stage of dementia? That would be important because if she or your Dad are in some early stage of dementia, you do want to narrow your choices in living down to places that care for memory impaired individuals. In addition, her belligerence could be an early sign that pieces of her memory are missing and she is losing self confidence.

To address point #2: Is your Mom willing to share her financial information with someone? If anything, it is to get an idea what steps it would take for her to qualify for Medicaid, if she really is that close to the edge.

To address point #3: Do you have records of all the money she has given to you? I'm assuming that you wouldn't have been able to afford the house you are in, if they haven't given you some of their money. There was one person who suggested buying a place for your parents and staffing it with caregivers. That is one alternative. Another alternative would be for you and your family to sell your current place and move into a smaller place that does not have room for your parents, and return their equity portion back to them, therefore forcing them to move into either assisted living or memory care. With this alternative, your Mom has some money for assisted living and you can honestly say that she no longer has equity interest in your house.

I am a little concerned that during these last 4 years, you have used your own money and sweat effort in their care. However, your mother doesn't not seem to recognize the value of the sweat equity. If you buy a place just for them, in her mind, you are still owing her money. I don't think she recognizes how much effort and time you and your husband are putting in "free of charge". Hence, I would actually give her back her money (and make sure that you deposit it in her bank so that you have record of giving her back the money).

...and take her to the doctor to get evaluated for mental and physical health.

A couple....Call Bridge Home 614 809 0886....Its like still living at home with more help than Assisted Living can provide and cost less.

This is an easy fix with a third party.
The money they gave covered the place to live.
It does not cover the cost of maintenance nor care which is the core of the problem. So what is the monthly value of the addition to the house if you rented their section to someone else? Thats the value of the money they gave you.
Find out the monthly cost associated with Assisted Living and the alternatives.
Work out clearly how SSI and possibly gov't agency could help. You pay the cost of the accommodation. Make it clear that what they would be paying for is care and possibly meals. It must be re-enforced that they are now needing care which you cannot provide. Returning the money they gave is not a good idea. It will blow out very quickly and you will not be able to turn your back on the parents that you love. Instead show them what you did $ for $ and treat it as an investment from which they can get monthly earnings. They may be able to understand this and you stand a chance of working this out. Remember to include a respected third party who knows how to mediate.

Ebhmom: The cost of your parents' assisted living bill is their's in its entirety. One answer to your query is to sell the home as others have said.

You say, "Thanks for the suggestion country mouse, unfortunately, we are not in the position to move at the moment with children still in school and the housing market as it is. We have taken a significant hit financially in covering the increased costs of supporting a household of this size. We have taken on all costs of food and utilities (which are sizable with 6 in the house), taxes, interest, and all maintenance. We have not asked them to contribute even during the period my husband was laid off thanks to covid."

You now say you "can't move" and "can't afford" to go on like you are, yet haven't charged your parents a penny to eat the food you're paying for or to chip in with the bills. How does this make sense? You'll wind up in foreclosure soon if you're not careful and then ALL OF YOU will be homeless!

Get your folks to pitch in a sizable amount of money each month towards keeping a roof over your heads! You can't ask them to leave a home they've chipped in to pay for and that you can't afford to buy them out of. They have a right to stay put if you can't sell the house and pay them back.