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Our Mother is 70 and working from home now. She has asthma and eventually will not be able to take care of herself. She is bitter (divorced) and has no money or preparations for her next phase in life. We (her 3 daughters) are not wealthy, but know we need to come up with a plan (financially). Mom refuses to talk about it and could care less that the burden has fallen on us three. Where do we start in this process?

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You need to find out if mom's state's Medicaid program has a program by which they will pay for AL or in home care. Sometimes these are called Waiver programs.

It may be worth mom's while to get a consult with an eldercare attorney who is knowledgable about Medicaid in her state.

Remind yourself and your sisters that mom's lack of planning does not constitute an emergency for YOU.

When mom demands that you guys care for her or wants to move in with you, you need to remember to say firmly "no, mom, I can't possibly do that". Do not make excuses or dance around your "no". Make your position clear.

I'm sorry if this sounds heartless. It's called knowing your tolerance for craziness and having healthy boundaries in your life.
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ArtistDaughter Jul 2020
Good advice, except I would just like to point out that there are many people who work their entire lives on minimum wage and cannot make the sort of plans you refer to. It is not the responsibility of their children, I agree, to financially care for them in their later years, but it is also not necessarily the fault of those who do not have resources for their own care. It is not always a lack of planning, rather the circumstances they have been unfairly dealt.
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Please do not equate bitter with divorced.  It is insulting to women.   It may be your mom, it is not everyone  

YOU decide if burden falls on you, not your mom.  Agree with PP, look into state programs.  Also, if she takes advice from you, no more pets.
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Here is a useful site:

https://www.payingforseniorcare.com/south-carolina

With regard to being bitter and divorced, did your mother seek mental health treatment after her divorce, either individually or in a group? Would she consider it now?
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You can call a social worker to ask questions..and get an evaluation on your mom. Its a great beginning. The doors will then open to help your mom with immediate care that may be needed.
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Carmen, why do you think it's you and your sisters' responsibility to pay for your mother's care as she declines? SHe's had all her life to prep for it mentally, emotionally and financially (divorce or not). Paying for her care will break the bank of all 3 of you, not to mention the hands-on help you seem to be assuming onto everyone. It is loving of you to be so concerned but in reality it will be a dumpster fire. The most you can do is encourage her to assign someone (or more) as her durable PoA. This will allow you/sisters to legally manage her care. If she doesn't assign this then you will be forced to stand on the sidelines and watch her decline IF she is one of those seniors who slips into dementia and refuses all sorts of help that is obviously needed. With no PoA there are only 2 pathways forward: you/your sisters pursue guardianship through the courts, costing thousands of dollars and a lot of time/effort; or you call APS on her when things get really bad and then county takes guardianship and family has no more control over where she lives, what care she receives, any of her financial accounts, etc. This is the reality. In some state Medicaid does pay for some or all of AL, but she will need to research this and hopefully she will qualify. It is important to know that she should no be gifting you money or assets since the Medicaid "lookback" period can be as long as 5 years.

You are not responsible for her happiness. You shouldn't have any expectations that providing her care personally and financing it will make her less bitter. If she is currently depressed, this should be addressed by her doctor. At 70 and still working she can get the maximum amount of her SS. FYI if she was married to a husband for 10 years she can apply to receive HIS social security amount, even if he remarried. Call first to know the specifics. She will need to make an appointment at the SS Admin office near her and bring an original copy of her marriage certificate and divorce paperwork. There is much to know so poke around this forum on the different topics. I wish you much success in encouraging her to plan for her future wisely.
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Barb is 100% right.
Not knowing how well you and your sisters get along - hopefully well enough to do this - but were I you, I would start by having a (private) meeting with my sisters, in which we pledge to each other that NONE of us will assume mom's caregiving, nor expect EACH OTHER to, based on things that *usually* decide which child mom ends up living with - most money, emptiest house, most convenient to doctors, most accommodating spouse, etc.
Then, as a united front, confront mom and tell her where you stand. Your mom is only 70. That is not to old for her to take an ACTIVE part in planning for HER future. Granted, it's probably too late in the game for her to accumulate significant savings, but that doesn't knock her out of any future care BESIDES family. Make very sure she understands this. "Mom, you can either participate in finding out this information, or we will decide *together* without your input, based on YOUR financial means and availability of care facilities. You might end up in a place that we think is adequate, but you hate. But please understand that living with *ANY* of us is not even up for consideration. So it's really in YOUR best interests to take an active part in this planning.
This is not an easy conversation to have. It is even *harder* to do. You and your sisters need to be absolutely sure that whatever you say to mom you are all willing to follow through with. You will also need to be there for each other, in the event she starts a "divide and conquer" type of campaign. And to hold each other up if she starts with a guilt trip.
What you need to be assured of - and assure your sisters of - is that her failure to plan is HER failure, not yours.
Good luck!
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If your mother is in South Carolina & meets the income requirements then Medicaid will help pay for home care and/or assisted living. And Assisted Livings in SC DO take Medicaid.
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You don't need to pay for her care. When things get bad enough, you can call a state social worker, the social worker will assist in finding a place or in home services suitable for mom that Medicaid will cover, but you and your sisters do not have to pay from your money to cover mom's expenses. You can start now by contacting your local area on aging agency.
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XenaJada Jul 2020
Sadly, not every area has a "helpful" agency on aging. I've contacted one here in central Ga. Took days of calling and leaving messages to get someone to call me back. I was then led into a tail-chasing exercise in futility of one person putting me off to another one. I finally gave up.
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Dear Carmen 1950,

Back in 2014 when my mom was 89 and in the early stages of Alzheimer's, I had no idea what to do or where to turn which made me feel very overwhelmed and upset. I finally ended up calling our local "Area of Aging Agency" (it might be called something else depending on what state you are in) and gave the person who answered the phone a brief idea of what I was looking for and they found the appropriate social worker for my situation. Then, I set up an appointment to talk with them in person. They can give suggestions etc.

In my case my dad had passed away ten years earlier and my mom had continued to live in their home which was paid for. I already had been going back and forth from our house to hers for those ten years and could no longer do it. I tried every avenue to keep her in her home as those were her wishes. None of them worked for mainly two reasons: 1) She did not like having strangers in her home and 2) She couldn't afford help seven days a week and one day wasn't enough. So in our case the only option was to move her into an IL/AL facility, clear out her house and put it up for sale in order to be able to pay the monthly rent at the facility. She had several sources of income other than Social Security - some were from when my dad died and some were from having worked in the school system until 71 years old - it just wasn't enough as any facility is expensive. I've seen ranges anywhere from $3,500 to upwards of $8,000. Also, I had to find a facility that would accept ALTCS (our state's Long Term Care System) if she were to start running out of money. For us, we would have to have her in the same facility for a minimum of two years in order to qualify and apply for ALTCS and her money would have to dwindle down to $2,000. Since then, I've been able to put a large sum from the sale of her house into a Money Market so it would earn money each month but, yet I could have access to it as needed without a penalty which wouldn't be so with her CD's she had. We had her CD's staggered and when each one would come up for renewal, I would eliminate it and just keep it in her regular checking account.

Unfortunately it's not uncommon for a parent without a plan to not only be unwilling to discuss it but as in your case leave the burden to fall on you and your two sisters. My husband is the only one who works so we are not financially able to do things for her either. I sure hope you can come up with a plan in order to deal with the issues at hand and for what will come further down the road. I'm assuming you have all the proper paperwork i.e. Power of Attorney Forms - Regular, Durable, Financial, Health along with a DNR (Do Not Resuscitate) form and I have Living Will/Advanced Directive Forms as well. These will be needed as you continue to start taking the reins for your mom. I wish all of you the best as you begin the process going forward!
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Nobody, I'm impressed! You sure managed her money well.....
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NobodyGetsIt Jul 2020
Thank you Michael - I'm no financial expert by any means, I just want to be sure she can be in a good place so I don't ever have to apply for ALTCS because she would probably have to share an apartment/bathroom with someone else and that would be very upsetting for her. She likes her privacy!
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Stand back . . let her figure it out. It's HER life. Not yours. You do NOT need to come up with a plan for her. That's HER job. It's HER life.
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Medicaid will be her option. Everyone in the U.S. eventually ends-up on Medicaid, after all of their assets are depleted.
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dogparkmomma Jul 2020
Everyone in the U.S. does not end up on Medicaid. Lots of people planned for their old age, or at least to leave an inheritance to their children and it was spent on their care.
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Dear Carmen, no the ‘burden has NOT fallen on you three’. You DON’T ‘need to come up with a plan (financially)’ or indeed any other way. Your mother is 70, I’ve just turned 73. Planning this for me and my DH is no-one’s responsibility except for me and my DH. For your mother, still working, and from the sound of it with only asthma as a health problem, it’s HER responsibility. OK you DO need to tell her that she will not be moving in with one of you and you will not be funding her care. So many people seem to think that either they will die peacefully in their sleep with no prior problems, or that their children are their plan. She needs to know that’s not so. I’d suggest the three of you put it in writing and keep copies. Don’t provide any chance for her to think that you’re not serious.

While you are all a bit vague and worried about this, mother is not going to take seriously the fact that she needs to work on it herself. Be clear and be firm. Bitter or not, the sooner she knows, the better your chances of getting her to do something sensible.

In your shoes, I would research Medicaid and local facilities, so that if she does nothing you have some idea of what comes next. But keep quiet about it, and stick to the letter of your letters!
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Your mother doesn’t have dementia if she is working from home. Let her figure it out. Just let her know that none of her kids are going to take care of her in the future. If she has no money she can get Medicaid. My mother is 96 and lives in her hoarded house all by herself. Why? Because she wants to and she still has her mind. She’s competent. She gambled all her money away years ago. Not my problem. It’s her problem. She wants to die at home. Period.
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Sometimes, elders won't talk about it and the decision gets made by default. Picture an elder with two sons. Elder mismanaged money and assets more than what would even seem possible... but it didn't bother HER any because she assumed she would move in with one of her kids when the time came. In their defense, the kids DID try to get her looking at alternatives for when the inevitable day came that she could no longer live in her house. Elder would not discuss, but constantly dropped hints that she expected (free) lodging with one of her sons. If either son "owed" the mom anything, it was the older one and he also had an extra bedroom in his house. Perfect? No. This son was the first to say NO that mom could not move in. Mom was stunned. Younger son also said no. The very sad reality was that SO much time had elapsed with no decisions getting made and mother could no longer manage her home. She had deteriorated so much that even a small apartment or AL would not have worked either. She just waited too long and no decision got made until she needed 24/7 care. Very sad. Someone else put her in the NH since lady's sons could not. A salvage company assisted with getting the house ready to sell. There were no winners, but this is what can happen when there is no planning or fruitful discussions regarding one's future. Truth be told, even if she HAD moved in with a son, her medical needs would have eventually become too great. She was not allowing for that reality. By the way, sons did not pay for NH and I don't think OP should attempt to do so either. In my area, NH is around $8000+ each month. I don't know anyone who even earns that much in a month, so expecting kids to pay for parent's NH is not realistic for the long term.
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It depends on the state. Unfortunately we are finding out the hard way. Medicaid partners with the state and the state sets the rules as to who qualifies for assistance when the senior can't pay. In Arizona, even if the senior has dementia and no money left other than social security which is a fraction of the monthly fee, she doesn't qualify to get assistance. The only way she can stay is if the children pay. Because the senior can walk and use the rest room and dress herself, she can not get Medicaid assistance to stay in the assisted living facility in the dementia unit. In other words, if she had no family, she would be on the streets. It's a terrible thing that the states aren't all the same with regard to medicaid, but we are finding out they ate not.
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mstrbill Jul 2020
I can't believe that's entirely the case. Let's take a hypothetical situation. Let's say there's a senior who lives alone in an apartment complex. She has no family nearby. Neighbors become concerned as she starts to show demented behavior. Someone calls APS. Aps comes out to do welfare check. APS determines senior is clearly a danger to herself even though she is fully ambulatory. Do you mean to tell me APS will just let this senior rot in place if they determine it is unsafe for her to be alone anymore?
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Your mother is 70, not 90 and still working. It is true that if anyone lives long enough, they may need help, but if asthma is all she has wrong, she could live to be 95.
I am 67 and my husband is 70; he is still working by choice.
My suggestion would be first to read Being Mortal by Atul Gawande. It is not a book that gives answers but it is about how we are all mortal and how do we want life to be lived. Instead of discussing with your mother what her financial plan will be; since she does not have one, of course she refuses to discuss is, start by asking her the questions that relate to how she sees the rest of her life and how she wants it to be. Try to make her think of what she envisions. That will help you see what she thinks and envisions.
It is too soon to start looking for facilities or anything like that. It is not too soon to use that discussion as a place to start planning who will handle what when she is no longer able to. It would be a good idea to get information about what her assets are. Hopefully she deferred her social security until age 70 to get the maximum amount. A POA for healthcare and financial business is essential so that that person can speak for her when she is not able to. It does not give you the right to do whatever you want and you can reassure her of that. She should also complete a will. If she is not willing to discuss naming a POA and really will not even entertain a discussion of what she things the next 20 years looks like, then I would initiate a discussion to advise her that while you all love her and will help her when the time comes, that help will not include giving her money, or providing care in your homes.

We just spent the last 3 years initially supervising and then finally coordinating care for my inlaws. My husband had been designated their POA when the did their trust and will more than 20 years ago, when they were 70. Nothing was necessary until the last few years. They were in their own home until October 2018 when then went to independent living for 6 months and then memory care. As a result of this experience, which in our case went very well, we completed our own trust and will and informed our kids so they would know.
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My mom is 77. She lives independently in a condo 1 hour away from me. My sister and I talk to her several times a week. She can drive anywhere she needs to locally. Recently, her vision has gotten worse so she decided that long trips and highway driving were not a good idea. SO, I try to visit her once a week to run errands, have a meal together, and try to have a little fun. I have 2 sisters. I tells me she does not have the finances to take mom in but will take mom 2 times a year for extended visits. The other sister tells me it is "all on me" since she doesn't want to deal with any issues. My husband and I plan on buying a home in a couple of years and building a separate, small cottage for mom to live in when she can not live alone or I have to visit 3 times a week. We will encourage her to rent out her condo and use the money for her care. She really does better having her own place. If she becomes a wanderer or needs a sitter, we plan on using her finances to place her into adult day program with a sitter at night. She will have meals with us when we are home from work.

Talk reality amongst the siblings. Discuss what you could "reasonably do" to help your mother when she needs help: taking her on errands if she can not see well enough to drive, helping clean her home if she gets injured or develops mobility issues, having a meal together so she doesn't get isolated... Decide individually and let the others know if "taking mom into your home" is an option or not. If nobody is able to take mom in, then mom needs to know this. You do NOT have to finance her assisted living or nursing home placement. Your mom is probably many years away from needing your assistance, but having conversations with your siblings is always a good idea.
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The conversation with my parents about this subject typically goes like this-

Me: Mama, have you and Daddy given any thought to what you will do if one of you breaks a hip or gets seriously ill? Your house is not handicap accessible.
(and there are many steps to get into the house).

Mama: (with a joking/smirk on her face) Aren't you coming to take care of us if we need you?

Me: No. I live over an hour and a half away.

Mama: Aww. Well you can just come stay here for awhile. I think I hear someone outside. (she gets up to look out the window, knowing nobody is there)

Me: We need to discuss this

Mama: Oh look! A SQUIRREL!!!!

Daddy: Stares straight ahead, twiddles his thumbs and silent prays this conversation will end soon.

THE END
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jacobsonbob Jul 2020
I can picture this situation, and suspect it happens in a LOT of families.
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The burden has NOT fallen on you - your mom is responsible for her own future. She will have SS to live on and Medicaid if necessary. You do not have to fund it.
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You are going to be very very sorry if you try financially to take care of your mother. What then of your OWN elder years, may I ask? Because if you are counting on your own children to pick up the burden financially of caring for YOU, then you are likely to be sadly mistaken. It is on you now to work and save for yourself. Your mother will be dependent on the state for such care as it can provide her. She may be living in a room in someone's home, on social security. When she is unable to function on her own she will be in the care of the state, such care as it provides. She is not going to be alone. If you look at the statistics out there most people are unable to come up with 400.00 for an emergency. Most people live paycheck to paycheck. As the middle class disappears that will be only more a problem. She has told you that she doesn't wish to talk about it. You do not say whether she owns a home or has equity in one. If not, she is where she is, and this is where she will remain. It is quite honestly now impossible for her to save enough to live in comfort in an Assisted Living, or on Social Security.
I understand that this is very painful. I often miss the good old days of Dr. Laura on radio, who often said to people "Not everything has an answer; not everything can be fixed".
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polarbear Jul 2020
AlvaDeer - I like Dr. Laura, too. She's great. Always gives the best advice, except once or twice.
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If your Mom is still working, have her check into Long Term Care Insurance. I don’t know the cost, but it is a monthly payment, just like any other insurance policy. The older you get, the more expensive the policy.

I also wanted to mention that when the State, or whoever, figures out what assistance your mom qualifies for - only her assets are considered, not contributions from her family. Family is not expected to pay for the parents care.
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I totally agree with previous comments. My husband felt responsible for his mother, and it has been the biggest mistake of our lives. He thought keeping her out of low income senior housing was the best. Unfortunately after living with us for almost 3 years, our relationship with her is a 1 compared to a 7 before she moved in.
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Do some preemptive checking. I explored all these options for my parents who were in the same boat. Luckily they owned a house which we sold and used to pay the fees for Mom's AL and now NH care after Dad died.

1. Low Income Senior apartments that base the rent on income. We looked at these for Mom but the waitlist was 5 years so get your name in now. There are alot being build and the demand is high. The ones we looked at were very nice.

2. Medicaid, financial assistance for people with no assets. Most facilities are required to provide a set number of beds for Medicaid residents. She may have to share a room. Start the paperwork NOW, it is a long process. There are legal ways to spend down her assets to qualify. Call A Place for Mom for places near you that might be suitable.

3. is she a veteran or the widow of a veteran who served in wartime? Check with the VA about an Aid and Attendance pension. This is to assist with paying for in-home or residential care. Start NOW, it’s a lengthy process.

Good luck, it's a lot of paperwork and hopefully your Mom will cooperate.
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My parents refuse to talk about next stage of life plans and have said that some emergency will decide for them. Not okay with me as that basically means they expect me to be the emergency plan. Also have mentioned moving in with me which is a HUGE NO. Sooo the whole thing is a mess and I’m just kinda sick of it so I’m trying to focus on my health and stay out of their issues as much as possible. They don’t have dementia and there is no reason they can’t make some plans which other wonderful posters on this site helped me realize.
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I need to expand on my answer. Just because they won't talk about it does not default to you being the solution.

My mom never saved for retirement - no 401K, nothing, even though she earned a good income. Spent every $ she earned and MORE. Then moved in to senior housing and overspent - then expected me to give her rent money. I finally stopped and it was not until she was almost evicted that she started to be a bit smarter. All the years i tried to get her to do 401K - she laughed and said she'd live off SS. Now she realizes how little it is - she expects me to give her money. I laugh and say - no - remember - you were going to live of SS.

She also expects to move in with me. When she brings it up - i am direct - NO. She cries and throws a fit - saying i don't love her, might as well dump her on an ice floe. I tell her she doesn't live with me now and i love her so her reasoning does not make sense - then disengage.

I have told her flat out - i will help her look for a place, i will help her look for aid but i'm not her aging plan. I have warned her that if she chooses to do nothing and an emergency makes the decision - then the county will be making her decisions. She still does NO planning.

Ditto my in-laws.

So, my DH and i have decided to quietly look for places they can affort with medicaid or other assistance but not get ourselves in a swirl about it. we cannot control it. But we ARE in an agreement that their emergencies are NOT going to result in us taking them in "until they figure it out" or giving them money to "tide them over for now until they figure it out". they will never leave and never figure it out. We will be helpers but not the solution.

It is harsh - but they all had relatives live into their 90's and know that at some point we all need assistance with living if our bodies and minds age and wear down. If they choose not to face this - it is a decision they are making. My DH and i are early 50's but we include aging when we meet with our financial advisors for 401K and college savings plans.

Stop stressing about your mother - when the emergency happens -get help them.
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Imho, never use your own financials to take care of your mother.
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Medicaid
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People are living longer and longer. Modern medicine keeping people alive longer and longer. Pretty soon we will be retiring at 65 but living to 120 years old!! No more pensions any more. It’s hard for a lot of people to save. Especially save to live OVER 100.
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mstrbill Jul 2020
Agreed. Sooner or later all of us may be on Medicaid except for the very well off.
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I assume your mother is on Social Security. First I recommend that you'll check
to see if she is getting her own Social Security or your Dads. This will determine if your dads' social security may be more than your mother's. If your dads social security is more than your moms, she can file to get social security under your dad's social security because she has not remarried.
Two: if she still does not have enough to live on, try to see if she qualifies for some assistance from state social services.
Three: If she has not done it yet, Call SSA at 1-800-772-1213 to determine if she qualifies for extra help with Medicare premiums, annual deductibles and prescription co-payments.
The most important, have her go see the doctor for help on her depression.
I hope this helps.
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