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We are attempting to coax her into assisted living and think her assets should last for a few years. We know Medicaid will assist with her expenses if she moves into a nursing home. But what if her assets are depleted while she is still in assisted living and is not ready for a nursing home? As her guardians are we now responsible for her bills?

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Guardianship is a legal process whereby one party is deemed incompetent to handle their own affairs (the “ward”) and a court appoints another to provide decision making services (the “guardian”). Becoming a guardian is a serious matter involving many responsibilities however liability for a ward’s expenses is not one of them (unless, of course, the guardian accepts such liability). Simply make sure that you never sign personally for any financial obligation of your ward.

The activities of a guardian are court supervised and one would think that as a result it is difficult to commit malfeasance. The record of the guardianship profession points otherwise though of course there are many competent professional guardians. I say this only to point out that the courts can be tolerant of honest mistakes.

Just do your best and all will be fine.

Virginia has a Medicaid waiver that will assist with the cost of care in assisted living. Often there are waiting lists for these programs so you may wish to investigate soon rather than later. Here is the website: http://www.dmas.virginia.gov/Content_pgs/ltc-home.aspx

If your mother in law is the surviving spouse of a veteran she may also be eligible for a cash benefit known as Aid and Attendance. Do a search on this site for lots of info on this benefit or go to va.gov.
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I don't know the answer to your legal question. I hope someone will.

Some Assisted Living Facilities (ALFs) will accept Medicaid payments, especially from residents who have been private pay for a specified period, such as 3 years. Discuss this upfront when you are looking at options, and use it as one of the criteria for selecting a care center.

My daughter works in a lovely ALF. They require private pay initially, but she says that the majority of residents are on Medicaid or some other kind of aid, simply because they have been residents a long time and have run out of their own funds.

The lovely ALF that hosts my caregiver support group has a certain number of rooms set aside (worked into their budget) for Medicaid. These almost always go to long-term residents who have run out of private funds. On the other hand, we found a nice ALF for my mother that accepted Medicaid right from the beginning.

Financial considerations are an important reality to work into the criteria while you are searching for suitable placement.

By the way, since your MIL has dementia, another consideration is where will she go if/when the dementia advances to the point where she needs more care? At the place where my daughter works, they will continue to care for their residents well beyond the point described in their contract. (In other words, while they won't admit a new person with obvious dementia-care needs, they will do their best with established residents.) They also have a separate dementia care unit so that if they are well beyond what the staff can provide in the ALF they can be transferred there. These are important considerations. Many persons with early dementia can function fine in ALF, but as dementia advances that may no longer be true. Then what? Find out the answers as you research places.

I hope that you can coax MIL into assisted living and that you find a great place for her. Since you are her guardians, you can place her without her consent, but having her accept the placement will be much more pleasant if you can bring it about!
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Although my mother is doing better and is still in her home, I got some different information when I inquired about the ALF. I was told that the difference between a NH and an ALF was that NH would take Medicaid and the ALF would not. Maybe that is a state thing in LA. I was also told though that since this issue is becoming more prevalent alot of NH's are trying to be more like ALF's to attract more patients. Not sure if you experienced this in your search. The part we can't figure out is if my mother goes into a NH because she has run out of money, who is going to keep getting her the other things she needs (clothes, shoes, deodorant...). Medicaid will only let her keep 2k I have been told but that will not last long if she lingers in the NH. Wish I had a better answer for you but this is our experience. Thankfully she is well enough now to be in her own home with a little help from a neighbor that we pay.
Good luck!
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Thank you so much for your responses. I posed the same question to my MIL's social worker in Pennsylvania - who has been an angel — and she agreed that we will be responsible for managing her assets and care but we are not liable for her expenses once her funds are gone. We had started planning financially for her care ten years ago but we underestimated the staggering cost. Guardianship is a scary step but we've worked with the social worker and she has given us packets of information on guardianship — to include a handbook describing one's duties. The question of liability for her expenses was not covered fully which prompted my question. Thank you again for your answers — it makes a difficult task less of a mystery.
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I don't believe so. We are spending my mother down. Once HER assets are gone, and so long as she hasn't GIFTED you with any of those assets, you're fine. You are not conservators unless you are legally such, and you have no fiduciary responsibility - and even if you did, you would only have that responsibility over HER assets, not yours. I'm not an attorney, so maybe you should consult one, but I am speaking from experience and working with an attorney.
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