What are some options when Mom starts to run out of money and has 24/7 care in-home?

You should certainly apply for medicaid and start to look for a facility that accepts it.

There are 2 types of Medicaid. Medicaid in the community, which would pay someone to care for her in your home (about 35 hours a week). The other is medicaid in the nursing home. As mentioned above, at a facility that accepts it. As long as she qualifies for medicaid (less than $2000 in the bank). Life insurance may have to be cashed out and used to prepay funeral expenses.

That's what Medicaid is for. Your mom may or may not be able to use Medicaid to pay for in-home care. In most states she won't, but some have programs like Money Follows the Person where you can do this.

Otherwise, look for a nursing home that accepts Medicaid. It's best if you can get her in one and pay the full price for a couple of months at least (again, depending on your state). But the main thing is that you need to start working on Medicaid for her now. It takes time to get on the program.

Good luck. Please keep in touch with us and let us know how you're doing.
Carol

This is where we collectively fail to care for the elderly who need 24/7 home health aides. Normally, Medicaid (the medical care program for the poor) does not pay for home health aides but will pay nursing homes twice that cost to "care for the elderly". It was mentioned the elder has to completely impoverish themselves to "qualify" for the help they need. Of course, becoming impoverished has a mental effect on the elder too, many only live a year and a half in a nursing home. Most nursing homes have Medicaid patients but they want to have a person come in with $250,000. or more then the will spend down the elders life savings, then they may (if they want to) "help" process the elder's Medicaid application to pay for the on going stay in the nursing home.
Each nursing home wants to get the end of the person's savings first so it will be very difficult to find a decent nursing home if you attempt a placement in a nursing home for your mother after spending most of her money.

If your mother was in the military or in some cases was married to a man who died in the military, you may qualify for a monthly allowance which might help you keep her in her home with aides.

Otherwise Americans need to have a long term care policy which they paid for independently to get any money for home health aides to stay where the majority want to stay, in their own home. Oddly enough it is also cheaper to stay in your own home but we are set up as a nation to "funnel" the elderly into nursing homes.

This is very difficult if you love your mother and know she can be handled out home but is just running out of her life savings. Other nations do better, unfortunately only the wealthy can "afford" to stay in their homes.

Good luck especially in the Christmas season, it is a tough decision to make.
However, we seem powerless to change this funding arrangement so just try to get the best nursing home she qualifies for under Medicaid. Shop and investigate all places in person and unannounced if possible. Check with their online ratings if rated by your state and the federal government.

The widow of any veteran, whether he died during service or later is eligible for the pension, as long as she/he has not remarried. I don't know if the benefits survive if the person has remarried and divorced or widowed the second time. My mother draws about $1100 per month which pays a "companion" for about 25 hours per week. We get doctors orders from time to time for skilled nursing, physical therapy and occupational therapy.These services are paid by medicare, not medicaid. Rather than let her go into a nursing home setting, we are choosing to keep my mother in our home. She is usually somewhat herself. Occasionally she has a bad spell with a fit of temper or paranoia. Her doctor says it is from TIAs (mini strokes). We do not have the challenges with her that many of you are dealing with. We are selling her home which is 3 hours from us to invest the money in a home near us that we can rent out for income to increase the hours that we have help. That should get us a full time person and a part time person. I don't know if this is an option for any of you or not. Right now it's working for us.

BTW some counties will offer respite care for the family for a limited number of hours per week. You might check this out too.

to get in home care for a purple heart veteran does the VA help out without one having to spend down all their savings?

Check out the pooled income trust for Medicaid spend-down. Not sure if this is just NY

The vet can get about $1800 per month as far as I know. There are specialists who will, at no cost to you, help you with this. One of my clients had just such a consultant help out with her dad's assets and how to place it in order to get the payment. In order to get this money, you must basically be broke. Her consultant is putting everything into a family trust with my client as the beneficiary. I don't believe the VA has the 5 year look back the way Medicaid does, but I'm not a specialist on this. The VA allows the vet to own their own home and does not count this as an asset.

The Aid and Attendance benefit is available to veterans who served at least one day during wartime and their wives or widows. The benefit for a widow is about $1100 per month and is paid when the widow's assets fall below $80,000 according to the veterans' service officer who I spoke to last year. Contact your county veterans' service office for application information.

talk to your local/regional VA. When I did, they told me that my mom would be eligible for monthly benefits (my dad was in WWII) when she "spent down" to $80000 in assets. ( as in the answer above) Ask about the residence (if she owns her own home/condo). They told me that was exempt. They also told me it takes about 3-4 months for the application to go through the system. They will need your father's discharge papers. said the benefit is between $1100-1300 a month That could pay for a HHA for some additional hours each week(depending on what you are paying them)
Re medicaid, I was told that in NY state you have to spend down to $6000 in assets before you can apply. Also if you have transferred a home to a relative, etc it has to be done 5 yrs. prior to applying for medicaid. I don't know all the details, but my brother has a friend whose parent applied for and got medicaid. apparently something was amiss with the house issue and medicaid came after the family and wanted them to pay back the money medicaid had given them for the care of the parent. So best to check with the rules and regs in your state. Or if you can afford it hire a social worker who specializes in these types of things or attorney to help you. In the long run it might be worth the money. You could also contact your county's Dept of Senior Services for advice or to give you some contacts in the community who might help you for free. You will end up doing the legwork ( ie forms to fill out and phone calls, meetings) but it will benefit the situation

Without a clear picture and accounting of all INCOME. ASSETS, PROPERTY,, How $$ has been spent/gifted, in past five years, Status of the veteran, (if a wartime veteran) Medical condition of the spouse/ was she divorced or is widowed,Status of House. No action can be taken. For instance while the VA may say a home does not matter; unfortunately that only means to apply, there are are many considerations, and you may be led down the primrose path due to misinformation and misconceptions

Is there anyway you can have your Mom in your home? Even if you work and have other responsibilities you could cut back on the 24/7 care and only have it at certain times. We have my 88 years old father with us and my husband and I both work full time but he works at night to stay up with Dad during the day. He is in our home because he wants to be with us so we agreed to have him with us. Despite having a two million dollar nursing home policy he doesn't want to go to a nursing home, he wants to be with us. Help only comes in a few times a week for him

Once your mom gets medicaid, she will probably be eligible for CBC ( community based care). That is care in the home for those meeting the criteria. There is an assessment to see if the client qualifies. Usually , they only get 6 hours a day...sometimes more depending on the level of care they need.....At least it is something.

Your State Home Health Care via local Area Agency on Aging and Council On Aging may be able to help.

When you no longer have money to pay for 24-hour in-home care, then you most likely can't have 24-hour in-home care. Medicaid will provide some care to keep you at home, but when the need is for 24/7, then it is more cost-effective to be placed in a nursing home, and that is what they will cover. If you are entitled to VA benefits and your income + benefits will cover the cost of in home care, great.

Hello everyone. After many years of helping families in the mid-atlantic stay in their homes, we are now helping in all fifty states. Here is how: in many, many cases the need for prohibitively expensive, private pay companion care is a result of not have a truly safe and accessible home for the senior to navigate/perform their ADLs (Activities of Daily Living - getting mail/food/dog out/toileting/cooking, etc.). Unsafe, high-risk fall conditions are easily mitigated with sensible, low cost home modifications that, when combined with new remote patient monitoring tools, increasingly well designed, can significantly reduce the caregiver burden/requirement. And the good news is, as a society, we are rapidly beginning to provide grants, credits and even reimbursement to pay for these resources. By far, the key is PREVENT THE FALL. It's all downhill from there for a family who will be in crisis as mom/dad will never be the same post fall in all ways, behavioral, cognitive, physical, mental, etc. We provide free home safety assessments nationally and in Canada and then also help find the money to pay for any modifications. Caregivers, ask yourselves - is there adequate lighting for night navigation, grab bars where needed (bathroom especially), safe entry to home with snow/ice, any stools in use in kitchen to reach tableware, etc.? Prevention is the key. Seniors, even if they have NOT YET fallen, have a fear of same, will not verbalize it, will resist help, but need home mods to live independently at low cost. Craig M.

Apologies, was trying to be helpful. The vast majority of people NEVER think prevention. The vast majority of caregivers end up in total family crisis and only then think about how to react on an emergency basis - immediately thrust into being a defacto geriatric care manager with no clue how to deal with dozens of life changing decisions. We see this everyday. A simple grap bar or decluttering of stairs could save society a 500k Medicare bill. If we as taxpayers are going to be compelled to pay for, in part, poor planning for aging in place, than society has a say in home safety just like existing building codes do for various design elements already. Our company does over 30% of our work pro bono and has a long history of saving families from rushing to hide/spend down money just to what...end up in a bad nursing home situation. Plan people. Be responsible please as a civic duty. Medicaid, the primary advice given in this thread should be a last resort. It ain't pretty, trust me...

If your mom owns a life insurance policy, she can sell it. A life insurance policy is an asset, just like your home. This transaction is regulated in 42 states and is now promoted by longtermcare.gov as a resource for long term care costs.

My mother has no income other than her small social security check. I was just successful in getting the NJ SLMB program to pick up the Part B part of Medicare, which had been previously deducted from her net SS. Also, my stepfather was a WWII vet and, since he served during wartime, the VA has a program that pays for 10 hours of in home aide care per week. Veterans Home Care helped walk me through the onerous application process and I was put in contact with them through Visiting Angels, the agency we had been paying out of pocket for the 8 hours per week aide assistance. You might check this out as I believe Visiting Angels is nationwide? Good luck!!

I didn't hear any monitory restrictions on the VA pension, but my Mom lost out because she remarried to a non-veteran. He did die after 17 years. We had asked before he died and was told "didn't matter". Didn't ask if he was a veteran.
What a disappointment for her and us! Dad had purple heart, was shot in the shoulder, has shrapnel and a bullet near his heart. Refused a partial pension.
He deserved this for his wife of 35 plus years. Blessings for all dealing with caregiving. We need it!

Does her home have equity in it? A cash out reverse mortgage could give a significant amount to be available for care. If she is facing a limited lifespan, use that cashout to fund an impaired risk immediate annuity to give a monthly benefit as long as she lives.
There may be students in healthcare or folks in need of housing in the area. They may be able to help w/ care for no rent or a reduced payment. Some communities have immigrants who may be willing to live in and care for her, too.
Does she have life insurance? It can repay a family loan after her passing, or she could get (for any type life insurance) cash now.

Personally I think reverse mortgages are of the devil. The bankster steal old people's homes and their life savings. I have a friend who is going through h*ll with her parents reverse mortgage now because they have to actually live in the house. If they are out for more than 30 days the mortgage is called due. How about renting out her house for income? That would bring in some cash. If not that, how about just selling the house. The reverse mortgage will expect for you to give them a big discount off the full value and you won't get what you should get.
Donna, that's awful for your mom to lose out. I will lose out on my Ex husband's VA as well since I married again. Maybe we should just all live in sin lol...

Sorry that the plan was faulty for your friend's situation. That is why I mention using the cash from the reverse for the impaired risk SPIA. The SPIA payment continues as long as the person lives, no matter where they decide to live. Because they are ill with a shortened lifespan, the payments are higher than for someone who is healthy. If they recover, or live longer, the payments continue, so there is reduced risk to the remaining assets. It is imperative to consider all the financial details with the family and trusted professionals. Reverse mortgages were dreadful some years back. That past abuse has created a lot of consumer protections today. It is sad to see someone need help and be beholden to available family members or forced into a nursing home on Medicaid when there is still value in their home and they could use that asset to live where they want..

Annuities are IMHO totally the wrong option for anyone over 80. They are going to die before they ever get the entire policy benefit. If they need the funds, the penalty for cash out is restrictive and severe. Ask in detail what the commission paid is and what the structure period is; ask what the penalty & fees are for withdrawal. I'd tell the salesman (& no matter what they say they are, annuities are an insurance product so they are insurance agents) that I'd consider buying the annuity IF they decease their commission by 50% for the life of the policy. That ought to clear the room.

Now a SPIA can be a good option (cause its simple & quick & you can do it for a specific amount) for a well spouse who needs to park 100K someplace fast so that their ill spouse can get their assets down to whatever your state has as its maximum allowed assets under Medicaid so the ill spouse is now impoverished.
For a much younger spouse, this type of SPIA solves the Medicaid extra assets problem & she is likely to outlive him & still work or acquire income so doesn't need the SPIA $.

Sherry - yeah RMs are the devil.

I found nothing good in calif.

Can you tell me more about the SPIA and how to go about it. I am a younger spouse and will need to shelter some of our assets safely, thanks

Are you wanting to shelter assets to put someone in a nursing home on Medicaid? Better get a good estate planner/attorney for that, as the rules are getting harder because of the cost to the government and the low amount given to the nursing homes. Most states allow the spouse to keep their home and the equity in it, a monthly amount of income, their auto and (at least in CA) about $100,000 in savings. The right attorney can shield just about any amount of assets to provide income for the at-home spouse. With the baby boomers coming, the Medicaid option will become problematical. The best bet for quality care at home or in assisted living for younger folks is to save, invest and insure for disability as early as possible.

We started with $18 an hour caregivers, then found private caregivers for $13 an hour, now found a woman who had come to us before to help who is skilled and experienced and willing to work for $10 an hour! My Mom and I are paying 24/7 caregivers since my 90 year old father who fell has only been home from rehab in the hospital 15 days. As we get him more on a schedule, we hope to watch him ourselves during the day whwen he usually naps. Yes, expensive, but cheaper than a nursing home.

To Craig at Give a Hug, just how do you convince an elderly person to do the modifications? I have suggested many of these things to my parents and they refuse to do anything. Grab bars, lighting, higher toilet, moving the laundry upstairs, nothing. I can't force it on them, even when my dad falls several times a week they say they don't need grab bars. They are so focused on keeping thinks unchanged they will not see the danger to themselves. Unless a medical practitioner suggests it of course, but I can't discuss that because I don't have permission.