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Mom is in an excellent AL & doing great. She has adjusted well since last summer & enjoys the perks of living there. I've handled her finances for the past 3 years, including sale of family home, getting her on V. A. Aid & attendance. I also got her on the Medicare Help with prescription costs. Between those additions to her Railroad retirement pension (from Dad) which is ever so slightly more than she would get from S. S., we can meet her monthly expenses by pulling $400/month from her savings. At this rate (praying no other large medical, etc.), she has enough to last 4 years. She will turn 88 this September, has A-Fib heart, slightly diabetic & mild dementia. Her vitals at checkups are always better than mine. She gets around decent with a walker. So, here is my concern. When we first got her moved to the AL, her health had gone through a few years of tough times so we figured she wouldn't outlast her funds. Now we wonder! And I want to know what to expect when that day comes & we will have to apply for Medicaid and move her to a NH. Can anyone enlighten me how to prepare? I honestly don't think I could go through all that stress again if it involves as much as what I've had to do thus far.. from feeling blindsided by the flood of paperwork that needed to be filed, weeding through the questions of who to call for what department, and all the legwork it took. I am 61, live 2 1/2 hour drive away from her AL, am exhausted, out of shape, diabetic, degenerating neck & spine, have to attend P. T. every 2 weeks just to keep from having debilitating daily headaches. I am currently on more prescriptions than mom. Well enough whining.. .any suggestions how I can get things lined up ahead of time?? I am very much aware of the "rules" as far as minimum assets, the 5 year look back, etc. Now...is there anything else I might not be aware of or can begin at this point? Thank you.

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Okay, this isn't the advice you asked for AND it's hilarious coming from me, The Worlds Biggest Obsessive Worrier - but seriously, take a year off from worrying about this right now. Not to be morbid but at 88 yrs old, every additional year is like aging in dog years. Things could change a whole heck of a lot, very quickly. And if it doesn't - you've still got three more years to worry about it then.  It sounds like you could use a break. 
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Before she completely runs out of money, you can hire legal services to help with paperwork paid from her expenses. You might want to line someone up around a year before. My MIL was in that situation. Family also hired a geriatric specialist to assist them in getting her into a really good NH that was Medicaid approved. She was moved in 7 months prior to when all the money ran out. Since she was already in a good facility that took Medicaid she could not be tossed out. She has been there for 4 years. Since you are a couple hours away you have time to plan this by finding your "team" and scheduling
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I wish I had some good advice for you, but unfortunately I am another caregiver in the same situation. When my dad died ten years ago and I started helping mom with her finances, it looked like she would have enough to last for twenty years, until she was 100. Then came the move to AL (and now memory care) and the drop in interest rates on her savings. The predicted $1,000 monthly drain on her savings became a $3,000 drain and now a $5,000 drain. Mom is 90, in good physical health with moderate to advanced AD. In the near future I will pre-pay her funeral and apply for Aid and Attendance. After that, it will be a quick slide to Medicaid. I am trying not to worry in advance, but it is almost always on my mind. I think caregivers are worriers and planners by nature.
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cr0105, I was in very much the same situation with my dad with A-fib, CHF, dementia, and some tough medical situations that nearly took his life. We moved him to AL after one of these events thinking it would not be long before the Father called him home and there would be no worries with money. While we have since moved from the AL side to the nursing side, dad at 93 is still with us despite the complications from the above. He has been on hospice now for a year, baffling lots of us, and burning through his money at $9000/month NH costs.

I strongly urge you to talk with an elder care lawyer now. Most provide a free consult so you can go to a few to see which one "fits" you. The money for the lawyer you hire (if you choose to do so) will come out of your mom's savings and IMHO it was one of if not the best uses of my dad's money. Our lawyer operates with "full disclosure," and these are key words and actions to be sure there's nothing "funny" that will come back to haunt you later. Otherwise, other than taking dad's paperwork to the lawyer and letting them sort through it all, I have had essentially no stress in the process of getting my dad started on Medicaid. They have taken care of it all, all the meetings with the county, all the organization, all the calls, etc., and for the flat fee that we paid they handled this initial start on Medicaid and will take care of the 1st year renewal if dad is still with us at that time. It was a lot of money, I admit- nearly $8000- but the lack of stress when I was already having major symptoms of being burned out was absolutely worth it to keep my health and to be able to be there for my dad emotionally and physically. I have read too many experiences on this site from others who have tried to do it themselves and have run into roadblocks. Talk about stress!

My only regret, in all seriousness, was that I did not go to an elder care lawyer when dad first when into AL so that I would know how to prepare. Every state is different, so what is required for me in OH may or may not be the same for you. You need to know what is needed for your particular situation and an experienced lawyer can help with that.
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I thought I was reading my own story. I love you guys. Up every night at 2:45 worrying about when money runs out. I have been handling parents for last 3 years in the home. 24/7 care last 2. Dad passed in July 2016. Mom dementia. She carries on about staying in her own paid off home. At one point house will have to be sold to supplement care and I will have to place my mom. Oh do I get sick thinking about it. She is very mobile and very good health. I am trying to give myself one summer off of thinking. But it's not that easy.
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I think you are worried without a lot of reason right now.

Last year, I worried over Mom's finances, and built spread sheet. Did look ups on the actuarial tables, etc. built a plan for 7 years.

Since these last 5 months, Mom has been going down hill. In the last 2 weeks the decline has been very dramatic! I doubt she will last till Christmas now.

Wait at least a year. Everything can change so fast!
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Good advice, Rainmom

We run out of money in 24 months and I say we since I'm contributing for private caregivers

I have decided to not worry about the money the remainder of the summer and then I will make a short list of nursing homes to visit so that when the time comes I will have a sense of the next move - something I don't want to think about as it will mean mom will no longer have her doctor of the past 25 years or her comfy full size bed or the couple of nurses who she now trusts etc at her memory care facility 
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You say that your mother is getting aid from the VA. Know that when your mother is in hospice the VA will pay in full for care at a VA contracted facility. Hospice is supposed to be the last six months of life but it can last longer than that. Also keep pursuing the aide and assistance. Ps it sounds like you have done a terrific job of keeping expenses down and I agree with others who say it's time to take care of yourself and quit worrying about the costs. 
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You have done. Terrific job of getting servicea and funds in place!!! It takes a village to make these things happen. As suggested by others: team of family members or geriatric counselor. Also find a support group, we must learn to live in today to maintain our balance so we can continue to be there for our loved ones !
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Well, what you never mentioned is whether or not the patient has a preneed at this particular age because they could go anytime, leaving the family to foot the bill if the preneed is not in place. The first thing you're going to need to pay close attention to is getting her preneed done at her choice of funeral home because you're going to one they need that when she passes. Too many times an unexpected death leaves the rest of the family burdened with the bill all because people don't take responsibility for their own mortality and end up burning the families they love or claim to love. I don't know if your loved one ever made a preneed with their local funeral home, but the time to do that is now and not later.

Find out what her final wishes are and make sure they are honored in the pre-need funeral plan. It would be a very smart move to use some of the money to pay for the preneed ahead of time before that time. Smart people are constantly thinking of this and actually save up the money and arrange their own funerals so they don't end up burdening anyone else with the bill. The worst time to be burdened with a bill is after a loss, which is why I said smart people plan ahead and this would be the perfect time to use some of her money and pay for her funeral ahead of time in the form of a pre-need. It may take a while to save that kind of money, but if she has it now, set that up now and not later. Also having the funeral home in your emergency contacts is another smart move. 

Having them as an emergency contact in case of death will assure the person is taken to the funeral home of their choice. 

One thing to remember is if you  put off your own preneed for long enough, someone else will end up making those decisions for you, and it may not be what you want done with you when you go. Be wise and set up your own preneed by making your own plans while you still can. If you run into money, that's the first thing that should be covered. Be wise and set up your own preneed by making your own plans while you still can. If you run into money, that's the first thing that should be covered. I know when my pending estate case is settled, I'm not only going to buy a well needed car with that money, but I'm also going to make my own arrangements and pay for them in advance so I don't burden anyone else with the bill if anything happens to me. 

A final thought is if you mentioned you've been handling your mom's financial affairs for a while. I hope you're keeping very good records and only spending the money on her. You're in a position of high responsibility and expectations, please be honest and don't fall into temptation like so many other people do. It takes an awful lot of trust to give someone else  responsibility over your finances because this is a huge risk these days and times where so many people fall right into temptation and end up taking advantage of the person for whom they are handling money. When people take advantage, the person the money belongs to ends up going without their own needs because someone has spent their money they weren't even entitled to. I have a pending case right now investigating a POA who exercised those powers after my dad died and no one contacted me until UniCARE ended up finding me. The very people who were supposed to have contacted me right after my dad died never contacted me. I just found this out recently after a little investigation and a little bit of digging. Between the funeral home and dad's former POA, someone was supposed to have contacted my local police department who was supposed to have contacted me  about his death didn't do so. This turns out to be very suspicious and pointing more and more to the fact that the POA may not have only broken the law in exercising POA after dad's death but may have also taken advantage of him when he was in an incapacitated state of alzheimer's for years before his eventual death. 

I send a strong warning, please, don't fall into temptation handling someone else's money, many people out there are grieving even more when they find out someone has taken their relative for a ride and this is often not discovered until after the person died. It's bad enough to lose a relative, even worse to find out someone took advantage of that person when they were incapacitated. 
I'm telling you as a survivor, please, do your duties well, and don't fall into temptation. If you ever start feeling burn out, turn for help and let someone else take over but make sure it's someone trustworthy and preferably someone without money troubles who has never gotten into trouble over taxes or any other financial matter. Make sure the person you turn to does not have a criminal record that involves money or any other serious crime if you must turn for help during a period of burnout. 
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