Making long-term care decisions based on finances. Any advice?

Maybe you could cut back on hired home care and take over some of the chores yourself or with family, thusly leaving her in her home till the very end, if she is there now at 92, and has been, a move to a NH of any sort, is going to most likely be her end if she still has her wits about her. Also maybe look into a reverse mortgage??? Just an idea.

All NH's are horrendous, some just wear better wrapping paper.

My father did better than expected in an MC he resisted entering. After just a few weeks of adjustment, he was healthier and happier in the MC. Dad's income paid about 65% of the MC cost so I sold his house and drew down against those funds to make up the difference. I estimated that would fund 10-12 years which I thought would be beyond his life expectancy (the facility would have kept him on with Medicaid after 3 years of private pay). Although you should consider that Mom may need NH at some point, it may never come to that. My father with vascular dementia and CHF did well in the MC for over 3 years until his fluid retention increased and he entered the hospital to balance his CHF medications. He resisted standard treatments like fluid and salt reductions and worked himself into such a state that the long anticipated major stroke occurred and he died a few hours later. I would place her where you believe she will be safe and the most content even if you anticipate she may need to move in 3 years or so to a Medicaid facility. Let her enjoy what remains of her life as best her health allows; at this age a rapid decline is very possible. By the time she needs the Medicaid facility, her health may be such that she wouldn't be able to enjoy the amenities of the private pay LTC anymore anyway.

Thanks, everyone! Just to clarify she has home care with me doing about 27 hours a week of care. I'm the only one doing EVERYTHING and cannot do more. So moving somewhere is the only option. But the 2 choices are to go straight to a Medicaid facility or go to a "better" memory care first and hope she never has to relocate to a Medicaid facility. Thanks in particular, mollymoose. Since I posted this, I met with an attorney. Their fee is $8,000 (!) and I feel like their focus is to try and preserve assets...but not necessarily for her care. I have no designs on ANY of her assets. I just want to manage her money/care the best I can. Your answer was very comforting.

We just went through this with my mom. Met with different two attorneys regarding mom’s money and ALL they wanted to do was set my brother & I up with my mom’s money for our personal gain, while they found the loop holes to put mom in the nursing home on Medicaid! That’s NOT even what we were looking for! Attorneys suggest that Because that is how they make their money!!! My mom didn’t scrimp & save all of her life for me to steal her money & slap her into a nursing home!

We sold her house & used the money for as long as possible for her care. She is now in the nursing home, but we kept her out of one as long as possible because that is what she wanted. And I have nothing to feel guilt or remorse over.

My recommendation is if she has her wits, find a nice AL where they keep the MC residents in a separate area. Sell her house but if you ever think Medicaid will be involved, it must sell for Market Value so have it assessed. The money you spend on her care now and no house to keep up should help with paying for an AL.

I think it would be better to sell the house. She is 92. You don't know how much more time she has. Some facilities have options if a resident has private paid for a period of time. I would have thought the Medicaid process would have needed to start but perhaps I am missing something.