So...what do you do if neither you, nor your Mom can afford assisted living?

my parents live with us in PA. Called your county assistance office to see if she qualifies for the waiver program, which can provide caregiving as well as other services. It's not an end to end solution as they help and support but fully expect that the family is working to provide care. adult day care is another option that may help (the waiver program covers this too). It's income based and I'm sure her owning a home is going to impact whatever options you have available to you.

At 82, mom is still young and although diabetic, she could likely be around another decade plus! It's a new year and you need to just make it your resolution to get mom moved, house sold and make your management of mom what you can deal with.

The fact that mom wants to live with you is a huge huge plus. Honey take advantage of this as over & over on this site are kids dealing with parents who won't flat move out of their home or accept caregivers.

Where to start....my suggestion is to go with mom to her next endochrine doctor visit to see if mom is at the point where her doc will write orders for caregiving or skilled nursing needed. if she's not at that point, well it's good to know. if she's a brittle diabetic, she might qualify for community based program to deal with diabetics. American diabetic Association works with communities usually through your regional Area on Aging to get outreach programs done. This site has a drop down list of AOA by state.

HOUSE: have you tried to sell it? And no interest?
Or you want to sell it and are kinda overwhelmed at where to start?
Is there a mortgage, heloc or other debt service on the house?

What is moms financial situation? If she can afford caregivers - she gets SS, right? Probably has savings, right? - she can pay for sitters or caregivers to be with her while she is in her transition phase of saying in your home till house sold and she moves into AL or NH. Her diabetes management is kinda going to direct what type of place mom moves into as some AL just won't do insulin injection diabetes care. (Btw my dad was a diabetic, it can be quite the adventure)

If you & hubs or your other siblings are going to need to pay for anything to get the house on the market, please, please, please get an memo of understanding or promissory note between mom & you all as to how house related costs are to be reimbursed before house goes onto market. Mom may never need Medicaid but if she does you want to clearly be able to show there was no gifting of moms $ from the sale of her home. I'd suggest yiu take moms current legal and see an elder law atty to review, update as needed and get that memo of understanding done soon.

It's all a lot to deal with. You are going to be overwhelmed. Break stuff down into smaller projects and be organized. Good luck!

Just to add to the above, while searching for a nursing home for my Mom (and not being fully convinced that she wouldn't be able to survive in assisted living) I came across two assisted living centers in my area (Long Island, NY) that accept Medicaid. I don't know if this is part of a new trend, or what, but anyway, if you are ready, willing, and able to begin the "spend-down" process that is talked about so much here, you may be able to get her into an assisted living facility on self-pay and then keep her then when she qualifies for Medicaid. OR, she might be ready for a nursing home by that time.

Bottom line? As I and so many others have discovered here, the situation is NEVER hopeless. There are endless possibilities if you are willing to do some research.

Call your local human services and ask about their "options for long term care programs" There are several programs designed to keep the elderly in their home for as l ok ng as possible if the functionally and financially qualify. One in CO is called CDASS they basically alot you a certain amount each month and you hire who you want and pay them a wage you decide on. Its a fantastic program!

Look for Assisted Living facilities near you. Self-pay and/or Medicaid beds. You need to find out where she stands financially. Does she own the house in her own name? Does she have money in accounts? If she has money, she'll have to self-pay for AL until the money runs out. If the house isn't sold, it's handled differently. Talk to a lawyer who knows about elderly care (but be careful of the shysters out there) in her state to see how Medicaid eligibility is calculated.

The reason I'm telling you about Assisted Living is that it sounds as though you aren't in great shape to handle mom 24/7. What will you do when she gets sick? When she gets worse? Care giving is a full time job in itself, and you shouldn't feel guilty about not being able to do it.

Before you make any financial decisions on her behalf, research the laws. And right not, get paperwork so you have a DPOA and Health Care Proxy. Good luck!

Been there, done that... it's hell, but it gets better if you make good choices.

My cousin ended up in the same situation - single mom, long work shifts, and then her own mother moved in with her for a few years. Her mother had no assets and a very low monthly SS income. My cousin had her evaluated by some type of case worker, who came to the conclusion that my aunt was a fall risk and suffered from severe depression due to being left alone for so many hours a day. Anyway, she was approved to have Medicaid pay for an assisted living facility. My aunt seems truly happier there, and I believe it was beneficial for all involved. My cousin was stretched too thin to perform in her career (she works in the operating room of a hospital), be a mom to a young child, and take care of her own mother. Know your limits!

well its nice she wants to stay with you but maybe she is thinking you will quit your job and be there with her. if that is not possible, maybe a suggestion of assisted living where she can be around others and have activities to do but yet you can visit whenever. if you work more than an hour away, that means a lot of time alone for her......how depressing. sit down and discuss what can and cannot be done, check into office of aging for what needs to be done to get into assisted living. get the house up for sale and use that money for the assisted living. good luck

PapaTom's advice mirrors what I was going to say. My mother's monthly SS check is only $793 and she has no assets so the spend down process wasn't an issue. You do have to jump through all of the paperwork hoops but she will no doubt spend down most of her money as an initial private pay at an AL that will ultimately accept Medicaid once she is eligible. This is working well for my mother at this point. Hugs for strength and good luck!

Sunny, you can sell her house and use it for care at your house, or, get a reverse mortgage on it for care in her own house. I am not trying to be mean, but if it were you, alone and feeble, what would you want? Follow your heart. I know first hand how hard it is as my Moms with us also, but I wouldnt want to move out with strangers now at 59, never mind being old and ill. Good luck.

MY SOs folks just now in NH....long 10yr journey with my SO as POA and live-in caregiver. Library BOOKs helped me learn HOW to communicate with family and navigate thru all the "disfunctional family dynamics" and still stay on my side of the street too. It was definitely a "personal growth" process for me. Caregiving elderly parents has been going on a LONG time......those who have gone before us can help.....even if some of the details have changed along the way.....hope this helps?

See an eldercare attorney for your options. You have to be very careful how you proceed when it comes to Medicaid. If she is already on Medicaid no worries. Only Medicaid will pay for nursing homes (unless you have nursing home insurance). If you get her on Hospice Medicare will pay for that.

PapaTom & stargazer - about medicaid & AL. One thing to keep in mind is that medicaid paying for AL (AL & not NH) happens via a waiver. & waiver programs can start then stop or change. Waivers are diversionary use of federal funding allowed to the states to do within Medicaid. They are not dedicated funding. Medicaid for the elderly when initially done in the 1960's was written & placed into law (dedicated) to pay for skilled nursing services in a NH.

Over time, waivers started happening to off set the bigger costs of NH care. Some states have wide easily available waivers for AL that pay a good state reinbursement rate so facilities want to participate. Other states don't & for those an AL, if they even participate in waiver program, require a period of time (usually 2years) of private pay before they can get one of the set # of Medicaid beds. Like TX is a very very low reinbursement state so most AL do not participate in waivers, & due to this a lot of NH have residents who are might be ok in AL but are instead in a NH.

Waiver funding can change. What is trending now is that waiver funding is moving to PACE or expansion of other community based programs that keeps them in their home. There is a PACE center by us (Benson Center) that is medicaid waiver funded and seems to be going gangbusters (another is getting set up). But it's not all sunshine & champagne because what these programs do is shift some caregiving back to family either to do for free or private pay for outside of the elders time @ PACE or when the waiver paid inhome caregivers leaves. Most programs have a hour limit as to services provided. Once they go over the tipping point - maybe 32/38 hrs - its not cost effective so the waiver stops.

For family that works or has other priorities or just isn't cut out to caregive, or lives away, or the level of caregiving needed is too much for family to reasonably do, these programs aren't an option. I'm sure community based works for some. But it's not like have your elder being in an AL, NH or board & care home where there is 24/7 staff & oversight.

Since she owns the house (and I am assuming that she owns it free & clear, without any mortgage or leins), she can do one of two things:
1.) Get a reverse mortgage and pay for someone to come into the house & help her during the day, or;
2.) Sell the house altogether, move in with you and use the proceeds of the house sale to pay for someone to spend the day with her in your home while you & your husband are working.

Assisted living is not really an answer---they don't stay with you all day. They just give help when needed.

Older people are stubborn when it comes to selling their homes----that is their biggest asset and they have control over it. Selling it means that they no longer have their biggest asset under their control. My mother is the same way. I hope the day never comes when she needs to go into a nursing home, because they will take everything she has due to her stubbornness about putting the house in my name. If the situation ever necessitated total care for her, I'd have her take out a reverse mortgage to pay for help in the home before going into a nursing home.

Oh......yeh.....I meant with the "difficulty" of helping our elders do what's best for THEM AND US.....the books helped me with this. Those of us who CARE for others and yet WE have limitations too! Its a real challenge to switch roles too--like we (the off-spring) are becoming the parents now and they (our parents) are the ones who need the parenting......and it can happen so gradually too that it's hard to KNOW how FIRM to be and when or if they are just being stubborn etc. AND I didn't even have kids myself.....so I was taking a CRASH course in "parenting". So I'm speaking to the ways we can TALK and HELP them gently on a path toward ways to retain their INDEPENDANCE, as long as possible, yet helping them stay safe enuf too. AND YES, the Elder Attorney is also a great idea for the legal and financial OPTIONS.......not just any attorney knows how to NAVIGATE the complicated and ever changing LEGAL issues.......according to our Elder Attorney. Hope this helps....

Medicare does not pay for nursing home or assisted living. Medicaid pays for nursing home, but generally not assisted living. There are a few assisted livings that accept medicaid. What you need to do is visit different facilities, find 4 or 5 really good ones, and ask what forms of payment they accept. The admissions person can help you through this.

Be cautious about making all the financials happen so quickly. Consult AT LEAST THREE financial professionals FIRST. The windfall of money from a house sale is only a temporary fix. Maybe putting those assets into a type of annuity or investment to pay for a facility is a better option than having a big chunk of cash. Besides, there are capital gains taxes, etc. Primerica Financial offers free consults; Ameriprise is a $150 consult; of course check with government agencies re: qualifications and limits of assets. Elder lawyer is someone you should have for the full duration of the 'ride' you are about to 'board'. BE AWARE: Government program guidelines change frequently. ALSO: each branch/agency/department does not communicate with the other (in most cases not permitted). Do your due diligence, keep accurate notes. THEN do your 'Ben Franklin': single sheet of pro's and cons for each individual action plan you are considering. Best way to sort out all the financial muck and make a decision based on facts not emotions. If we (three siblings) had done THAT prior to my mother and sister (without brother or me) setting up a POA and selling her house to my sister, my life would be different. As others have said here, yes, your mom's personality style is also a factor. (Our mom can't be with anyone who is not family: she will hold urine and stay thirsty and hungry with a paid caregiver, and wait till I get home! OY!) Formulate the questions you have for the finances, and ask your professions to answer each the same ones. That way you'll have a broad spectrum, and see the consensus pro opinions; will help you understand truth of the matters and best case scenarios. Good luck to you- let us know how you made out.

Sunnyg, we were able to rent out mom's house and it made Assisted Living affordable. Example: mom gets $1600 in SS and $1000 in rents. Assisted Living was $2500 a month. Avoid getting a reverse mortgage, because it becomes due in full if she moves out of the house.

What state has Assisted Living facilities for only $2,500 a month? We pay double that

Excellent fleshing out of all of the in's and out's of the AL waiver program, Igloo572. I neglected to do that and it's extremely important information. Thanks!

Have either of you applied for Medicaid?

An elder care attorney is going to be expensive so since you say you can't even afford living accommodations, I doubt you could afford an EC atty as someone suggested.

Does anyone here have the medicaid waiver for at home care? I applied to get help with mom who lives with me and am still waiting. I wondered if anyone had it, how it was, how many hours etc. thx

Agree with some of the answers above. First contact your local Area Agency on Aging. They'll put you in touch with a social worker who can help you sort out the options. They should also have a list of facilities that accept Medicaid in your area, and home care agencies that could be paid for on a waiver. (They should also know which facilities & agencies to avoid, and that indignation is both priceless and something you'll never find on a website!) The one piece of advice I can give is to consider the timing of a move into AL, especially if Medicaid hasn't started yet. Any proceeds from selling the house would need to be spent on her care to avoid delaying the start of Medicaid benefits. Best of luck!

Oops, autocorrect got me there. "Indignation" above should say "information"! (Although a substandard facility can make one feel pretty indignant, LOL.)

The first thing you need to know is that Medicare is medical insurance and does not pay for any custodial care.

The next thing you need to address is whether or not your mom would qualify for Medicaid? If yes, then I suggest you contact your local Area on Aging to determine what if any type of benefit your state provides for Medicaid recipients for residential care. This varies by state since Medicaid is funded by both the federal government and individual states. Also, be prepared that your state may provide the benefit you want but call it something other than assisted living; for example, they may call it senior housing or adult group homes, etc.

Good luck!

I've been on this forum for over a year now and a term keeps coming up that I don't understand. I've never heard of an "Area on Aging." What, exactly is that?

Christine - The Area Agencies on Aging are funded by the federal govt to help states provide practical support for families who have elderly relatives with problems. There's an Area Agency on Aging for every county in the country, or at least for most of them. I've found them very helpful.

Wow. Thanks, HelperMom!

Christine & HelperMom - I'd like to add to HM great answer on Area on Aging. All over the US are council of governments. Some states have 1 COG that is the entire state while other states have many. COG are regional (by county) planning & clearinghouse entities for funding between the Feds and state /local governments and some private funding sources. COGs more often than not are called "area councils". Like TX has HGAC (Houston Galveston area council); San Antonio has AAC (Alamo Area Council) and there like 15 area councils for TX. All COGs have Aging as division as required by law.But over time, aging has grown & become its own almost freestanding "Area on Aging" entity in most areas.

In phase1 of my life, I was staff for certificate of review & other health issues for a really huge, huge COG in the regional planning sector in the 1980's. At the time AOA was in the same building. Now in 2016, this AoA has its own building, staff, 2 satellite offices, etc although is still a part of the COG for funding flow.

AoA is your tax $$ at work. The ombudsman resident & CHAP programs are usually paid by AoA as are Medicare benefits counseling. Some AoA are very well funded and have residential modification /repairs programs, transportation assistance. COGs & AoA can't advertise per se because of how their funded. That why many have no idea that they even exist. But AoA is an way underused resource. Your tax $ - use it!

I took my dad in and it was hell on earth for my kids and I and my dad. What I thought would provide structure and support for him was either too much stimuli or not enough. There was every reason in the world to think it would help him but it takes a village to care for a sick elder just like it does a child. It is too much to manage alone in your own home many times. Everyone's situation is different but a near by facility to your home is my personal suggestion. It takes a huge toll on your own health and ability to take care of yourself.