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Curious. My parents don't own a home. I own the two family home they live in, so rent is "flexible" to say the least. My mom has three small pensions in addition to social security that put her about $300 month over what PACE and other community home based waiver programs will allow (those programs are based on individual income). My dad qualifies on his own (he just has his SS and didn't have as of good jobs as my mom) but doesn't need the level of care those programs require. Medicaid is based on joint income, so they don't qualify for that. So no compensation for a family caregiver. Also, there are no Miller trusts in my state.


Mom certainly has her medical issues, but not to the level of needing a SNF 24/7. I think she could benefit from the waiver care, though. The cost of assisted living well exceeds their combined income. Mom will need a SNF full-time well before Dad. But right now they just need an extra layer of help in addition to what I provide.


Anyway, the best I can come up with now is paying for caregivers without assistance which is a lot...


Am I missing anything? Other than a Medicaid divorce (and they're not likely to pursue that...)

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Wow. This QIT must be new in MA! Bc the attorneys I talked to it seems like maybe a little over a year ago didn't mention it but now it's all over their website 🙏🙏🙏. Looking into ASAP.
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chestershaba Apr 27, 2025
Just so you know for either of those, the extra money in that trust WILL go to the state after their death. Medicaid in cali does the same. No one gets to "inherit" what's left in the estate if any is owed to medicaid for benefitsreceived...they'll go after it.
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I once had a nursing student, looking for part time work ask me over the Nextdoor app, weather I needed any extra help caring for my dad. At the time, I was still working part time myself but covid was in play so my one daughter and husband were staying home, so I had no need for another person to just be sitting in the house (as senior activity facilities were also closed). Maybe you could check such through a similar community app, ask for references and/or do your own background check. There is also this site to check for independent caregivers: https://hallmarkhomecare.com/
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I would speak with an Elder Law Attorney ASAP. There are no Miller Trusts in your state which is a major problem. You are going to have to find a way around that fact. And I don't see that anyone but an attorney can help you to find that way.
I sure do wish you good luck. This can be so problematic in a state where there is no miller trust, and no QIT allowed.

I sure hope there is something you are missing, but I haven't a clue what that might be.
I am hoping Igloo is around on the site as she's very good at this sort of thing.
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Reply to AlvaDeer
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Casole, Google "Massachusetts QIT Trust". It is the Massachusetts version of a Miller Trust.
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If they were paying for caregivers out of their pockets, can that be deducted from their income to qualify for Medicaid? I "think" that can help for the Aid and Attendance benefit the VA provides, so it may also help with Medicaid.

In our state, I "think" Medicaid looks at each individual's income and/or divides the household income in half so the person not needing care is not left destitute.

If you have not asked these questions, or have not asked Medicaid directly, I would suggest to go to the Medicaid office to apply in person. You may find there is a different category or service available that you have not discovered and she may be eligible for another kind of help.
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I wrote a specific ad on Craigslist gig and asked each person to explain how their experience matched the job. 29 applications in 2.5 days and 6 good applicants which I could prioritize to 1, 2, 3, 4. The first choice was perfect and she is amazing with my MIl who has a hard time being nice. She was able to work for 14 months. The second ad (they are 10 dollars for 30 days each post) got us another wonderful person who had to leave after 5 months because her own family had medical needs. The third ad got us another wonderful person who is doing well and a joy to be around. My only concern is that my MIL will run her off with her nasty no filter opinions and accusations. We have cameras in her home. So far so good. I screened and interviewed on the phone, set up the face to face and called every reference, got a copy of the DL to add to insurance -the caregivers/assistants drive her car to appointments or outings. Each posting was filled in less than a week. The good people get hired quickly and if I didn’t move quickly-they would move on. My own mom has private caregivers I found from the assisted living facility. They work minimum of 6 hours a day and it is needed because facilities are not giving the care they say they are going to give and some of the caregivers give a lame excuse of that “she won’t let me”. I will only put mom in facilities that allow cameras and I see why mom resists…..rushing mom, yanking the covers off while she is sleeping, just rude behavior. I cannot hear what they are saying but mom smiles when she is approached with kindness.
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Reply to Tandemfun4us
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I have a mom with dementia. She’s has had day time care givers between 4-6 hours a day. We have to self pay. Mom lives in a house we bought her and pays rent.
She has too much money to get any outside financial help, but that’s understandable.

If I were in your shoes, I’d see about hiring someone to help with her/ them.

The care givers I’ve had are nice, but don’t cook well, need prompting to do their “light” housekeeping, so I leave notes or on the calendar.

They do give my mom showers and help in the bathroom and redressing, as Depends are almost useless. That’s in Sonora OK

ANYWAY, get some outside care you can afford. Look into agencies to come help, just know you’ll have to monitor them.

If your parents can at least pay for the property taxes on the house and their utilities and food, hopefully there will be a little more left for a caregiver. I am being charged 35 an hour. The caregiver receives $16. of that.

Our society is not well equipped for this kind of help as we get older.

My sister and I do the majority of care for mom. It’s very overwhelming.

I wish you all well~
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Patathome01 Apr 27, 2025
Talk with an elder attorney and Medicaid expert to find out what Medicaid can do to provide financial long-term help.
Dementia requires 24/7 supervision in memory care, and no one person can do it. Requires a team to do!

The care recipient pays, not the family, nor any other loving people, to self-pays for her care.

It costs so much to pay for care that minimal, or no funds are left over from recipients' pensions or resources to pay for their regular housing expenses, such as property taxes, utilities, upkeep and telephone, since most or all of their income goes to hired homecare or facility caregiving help. Costs $4k to $6k monthly! Our federal government is sooo broken that it makes it so unfair for a beloved family to pay for such costs just for Mom's long-term and care.
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I see no immediate answers for these situations. But, maybe we need to stop looking to state agencies to answer all of our basic needs and go back to being more self reliant. If we don't allow ourselves to become debt slaves and do our best to fight back against all the needless government bureaucracy so we aren't being taxed to death all our lives, maybe we'd be more able to take care of ourselves and our loved ones.
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olddude May 4, 2025
Wow, you actually think the cause of the elderly health care crisis is high taxes? I suppose if we just give more tax cuts to billionaires then all of the AL facilities will instantly become more affordable.
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I am in your same boat. Dad is paying for all her care and I pay for their living expensive because his ss plus hers is about 100 over limit. I do pay for 2 caregivers about total 6hrs a day. Enough to come change her (she is bed Ridden) she has hospice that comes and bathes her for 5years now and nurses. Then dad has a nurse hm health that comes. But my full time job is 75miles each way from their house daily. Which I have been with almost 15years. I am trying to sell my house to stay with them full time. I don't want to but what options do we have.
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Patathome01 May 4, 2025
You are planning to move into your parents' house after you sell yours? Not the best idea. You may end up commited to participate for their care even with caregivers and for years. Can you coordinate your work while supervising your parents' care?

Your parents funds, none of your funds, pay for your mother's or both parent's care.

It's best to counsel with an elder attorney for financial assistance since care is very expensive that could make your mom's payments for her care spend down to Medicaid level, likely in a facility, depending on her condition at the time.
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My husband with dementia was in adult foster care, costing $5000 per month: all of his Medicare and most of mine as well. They fired him over a year ago, so he is home, and I am his caregiver 24/7. I have had a recent heart valve replacement, so I have a part-time caregiver 4 hours 2 days a week to allow me to go to doctor visits. What I pay her is NOT deductible on my income tax unless I file as an employer and pay her taxes, unemployment, and social security deductions. Yes, I could get Medicaid in OR, but they would put a lien on our family home after I pass away for all accrued costs of his care, so my children would not be able to inherit their family home
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KPWCSC Apr 27, 2025
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