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I'm very depressed. I did the best I knew.


My Mom an I just saw an Elder Care Attorney. NIGHTMARE. For my Dad. He is getting where we can not physically care for him. There's several avenues we could take and don't even know what to do. Well we have done everything WRONG last 5yrs. Big time penalized. Then lawyer said in TX, after one is approved and in nursing home, there is a trial yr which Medicaid looks deeper into financial history. ANYTHING we forgot or missed to bring to attention they could find and automatically penalize and no longer be eligible. Dad would be kicked out (due to no money to pay NH to keep him there). Any months prior would have to be paid back to nursing home!! Unreal.


I have been their caregiver 7 yrs. I didn't or couldn't work due to their care. So my husband and I suffered financially and my 2 sons last 7yrs. So my Mom decided to start paying me for caregiving. Off and on. We thought since it was a check and we wrote "for caregiving and dates on memo" it was ok. It's proof! NOT OK IT TURNS OUT. GIFTING.


So every check she gave me so we could pay our bills counted as gifting. Then Mom has been withdrawing cash each month (old people like to have cash on hand. She wasn't doing it out of spite and we didn't know it was NOT ok) or I withdrew like $400-500 for her.This went on for yrs off and on. It looks like gifting or hiding money.


And we did not know it's not good for me to be " joint-owner" on their acct. A lot of elderly have children as joint-owner in case acct needs closing or moved and bank said that's usually how it's done. So 2015 I was put on as j.o. and have now last yr wrote bills for them as Mom can't keep up with it along with partially caring for Dad. Meals, lays meds out. They have $34,000 left. We are getting rid of professional caregiver end of this month. That's $1600 every mnth for only 4 hrs M- F since Nov of 2018 to give me a break.


I'm DPOA and MPOA. And never could get a job since both parents see Dr's a lot and their basic needs. Neither have driven since 2013 after Dad got real sick. So MANY sacrifices my husband I have done and we had 2 sons at home (at the beginning one 15 an one 10.) Marital issues and financial issues. We have no insurance due to husband self employed. I had insurance from working in hospital as surg assist. But haven't done that for 6yrs and certification has ran out for me on that.


Moved them 5 x's. They got down to barely anything in 2017 and I had to sell their 4,000 sq ft home by myself and clean it out. Dad hoarded. Got money in there acct. Nightmare. I have health issues now. Bad back, fibromyalgia, depression/anxiety and ADD. So I'm not good with organization, etc. Diagnosed at 50!! My sister, older, lives an hr and 20 away. New house with 2 spare bedrooms. Parents in a handicapp apartment to conserve rent. Own nothing now except junk in a storage unit. I'm to busy to clean it out and my back. But sister moved away at 19 and has "parent- child " relationship still with them. She's 54 married no kids at home, works full time cause she can! I stayed and grew up as adult and have a different kind of relationship w/parent's.


But she has never actually been caregiver daily to parents. Only a trip on weekend here for 24 hrs to give a little break once a month. So lawyer brought up moving parents to my sisters. I have no clue if she is willing and who would give diabetic shots since home health agencies have stopped per Medicare. So now I will be going over 3x a day to give Dad shots and right back to where I was pre Nov 2018. My family is not good financially like barely getting by. I've instructed Mom no more withdraws or checks to me. So I'm not making money for my family. So if application is done for $10,000 by lawyer due to penalty so high probably parents would be lower in funds and probably penalized for at least 6 months (and no guarantee penalty will be shortened).  I've already got bank (for free cause I begged) on 5 yr statements. They can't move in w/me. No rooms. Tiny house. And it will be a BIG task moving to another town, smaller than here, and sister and I can't just dump them!

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I am sorry that you are going through this.

Hugs!
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Lynn105 Aug 2019
Thanku. We may now have to put Dad on Palliative Care which with his so many conditions will fall into Hospice area quick. An then maybe a mnth to live. But it would be in home care . Until I guess we cannot control his suffering or not good enough care on our part. As I am sm frame an back probs an Dad is 59 an 230lbs. I dont know how that works if its gets to where pt is not getting rt care do they move them to a inpt hospice (hospice I would use has its own in pt care but how is that handled as far as Medicare covering?) under Medicare an what all would be covered at that point if Dad is unconscious? I dont know if I can care for my Dad who I love an caregived for 6 yrs watch him die an wipe his mouth out an roll him every 4 hrs. Lift legs on pillows alot. Give sublingual meds an watch for any signs he is suffering an chg routine of meds given tp cover breakthrough at any moment day or night. I would have to move in. Bath aides do come. But bulk of caregiving a dying pt falls on family.. I have seen death but in hospital an 2 aunts but was not actially "caring" an this is my Dad. An I feel im hasiniglng his death but then maybe aim not. He is miserable. Failure to thrive. Fell the 30th. Nothing broke. Refused ambulance. Doesnt want NH. Wants to be left alone. I just dont know. He has appt with lung Dr an if he cant go that will be my answer. If we go I will speak to N.P. on her take. Social worker coming out 7th to discuss discharge fr diabetic shots per Medicare not covering. Im so upset rt now. I want drive off a cliff.
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Lynn, I am so very sorry. Do you have a medicaid caseworker? What do they suggest you can do NOW, because there is no way to go backwards. Do know that the things you wrote here may warn others about how careful they must be with their own records, and with the records of their parents. Again, I am so sorry, and if I had a single clue as to what you could do I would tell you, but I don't. I just don't. And I have only another hug for you.
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Can you contact your state's Council on Aging to see if you can get objective (and maybe free) advice to help you feel your way through these problems? Or seek a geriatric advisor (which may be less money than an attorney)? Wishing you peace and solutions!
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Lynn, I don't have time right now to read your entire post, but something you wrote "jumps right out at me."

First, I'm not familiar with Medicaid specifics other than on a general basis, so I have only a general conception of the 5 year reach back.

However, I do know that "gifting" can require preparation of an IRS form 709.  I worked for an attorney who did dozens of those in November and December.

https://www.irs.gov/forms-pubs/about-form-709

If Medicaid has determined that your payments were gifts rather than compensation, I'm assuming you didn't get any 709s.   And I'm also assuming that the IRS didn't contact you b/c you didn't have them.

I don't recall the amounts that require issuance of a 709, so my information is qualified based on that.  

This is just the conception of a concept to pursue; you'd probably have to get legal advice on how to prove the funds were in fact payment and not gifts, but it might be an opening.
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Frebrowser Aug 2019
I don't think that you have to file form 709 unless the gift exceeded the exclusion amount. Also the exclusion is per giver and/or recipient, so usually you can double it if it comes from a married couple.

So unless you are looking at more than 28,000 a year it probably isn't an issue.

https://www.thebalance.com/annual-exclusion-from-gift-taxes-3505637

Did you pay self employment taxes on your caregiver "pay"? That might not be as good a proof as a caregiver contract but it is some evidence that it wasn't a gift. Do you have any other documentation of "shared" expenses or anything related to the cash?
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Even if you paid taxes on the income, that might not be enough to show that the payments were not divestments. That's because in some states, like mine (I live in Wisconsin), the caregiver agreement is a separate requirement. That is, the first question about the payments won't be "gift or income?". The first question will be "is there a caregiver agreement?", and if the answer is no, the Medicaid worker or administrative judge won't care what other proof you provide.
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Something about this Elder Attorney or the info you understood from them isn't sitting quite right with me. Maybe it's the $10,000 bill from this attorney "due to penalty so high" and perhaps I'm not understanding it clearly but it just sounds like a hefty attorney bill to me even if that number includes penalties paid to the state based on the numbers you have given. They may be self sufficient but it doesn't sound like your parents are especially wealthy or have been making you wealthy so the numbers just seem off to me and I would get some further advice from say another attorney that specializes in Medicaid applications, the state office/Agency for Aging and or Medicaid office (before submitting application you can ask questions) and maybe an accountant who specializes in family care giving situations even. Just do some more info gathering before forking over that kind of money to anyone.

Then I would sit down and have a planning session with your sister (and any other siblings if you have them) to figure out how to best manage mom's needs, it isn't for you or this attorney to decide that moving in with your sister might be the answer, that's for your sister to offer if she feels she can and then you all (mom included) decide from the available options if that's best. Your sister may simply know that for various reasons she just can't take on live in responsibility for Mom, it wont work and you need to respect that by letting her offer what she can and not hold what she doesn't against her.

As far as the insulin shots, if dad isn't capable of giving these to himself and needs 24/7 care the family isn't able to provide he probably needs to be in a facility but you already know that. His doctor may even be able to order some at home care for the time being to get this done with insurance paying so do talk to them about it, they might be another resource for option ideas too. One thing you don't mention is splitting up mom and dad, it doesn't sound like mom needs the care dad does have you considered moving dad and putting him on Medicaid but leaving mom where she is? Medicaid will look at them separately and maybe there is a doable medium if mom is in fairly good health that puts off the look back portion of her care/Medicaid qualification. I don't any details about the state your in but make sure you are both looking at all the options and considering whats best for each person. Also on that note is your sister in the same state? If not it might be worth looking at the rules and what's available for assistance in each state while deciding where it's best to place your parents.

I know this meeting with the lawyer has you in a bit of a panic and overwhelmed, I'm sure you were expecting things to be on a positive path, some positive help, going in which just adds to the panic but try to take a deep breath and collect yourself, you have dealt with setbacks in the past and you likely will again this is a marathon not a sprint. It's disappointing I know but once you have come down from the shock you just need to go to work gathering info and navigating through this, it may not end up as bad as you think. There are attorneys who's practice it is to give you the very worst case scenario, as the probably outcome without telling you that's what they are doing so they can be the hero. They keep your hopes and expectations as low as possible so whatever they do (working hard or not) seems like a miracle to you in the end, I'm not saying that's what's happening here but it happens.

Good luck, you will figure this out and don't take it all on yourself. Oh and don't use your own money to "fix" things or out of guilt because you think you created this, you didn't knowingly make these "mistakes" and you did provide a service over and above being a caring daughter, sounds like your family all agrees on this.
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