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My dad is 83, mom is 81. Dad is rapidly declining in memory/cognitive ability as well as needing assistance physically. Mom also has early dementia. My sister lives with them in a rented house and takes care of them 24/7. Mom helps with dad too, but my sister does most of it. Mom has to bathe and clean dad when he loses bowel control. He is to embarrassed to let sis do it. They are seriously sleep deprived because dad sundowns and tries to get out of bed.he hallucinates and keeps them awake at night. We know he needs a nursing home, but Humana will only pay for one week, after that it is 50.00 per day. The three of them live on 2,400. Per month and at the end of the month there is not even any money for food. They were told they make too much money for Medicaid ..or Medicare . How can they pay for a nursing home for dad and find a place to live for themselves on mom's $610.00 per month which is all she will have to live on if they take dads SS for the NH. someone, please help. We can not get answers from any local senior services. Also, how do I approach a POA for both parents? I live in MA, they live in Fla. My sister can not work and has no income. She tried to get EBTassistance and was declined. There is serious depression going on there bc of the circumstances. How disgusting is it that AMERICAN senior citizens are reduced to living this way. I think growing old in America is sad and my parents are only 18 years older than me! HELP! I send money when possible but it is a bandaid, not a solution.

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If your father enters a nursing home, his check would go to him there. The nursing home couldn't grab it. Humana would pay except for the $50 a day and if the check would not be large enough to pay for his share- which would be $1,500- he would not be allowed in in the first place. If your sister is legitimately unable to work and she has worked in the past, she can apply for social security disability. You could go to www.caredotcom and find someone or a couple of people who could come daily and help with Dad's needs for a lot less than $1,500 and many of the people are certified as nursing assistants or retired nurses looking for extra cash. They might need to change Medicare companies.
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The only other thing is a life insurance policy for burial expenses. The 33.57 per month is the only pension money received. There would be no extra $ beyond that. Mom doesn't even have a life insurance policy on her for burial. One problem is I am in MA and they are in Fla, which makes it difficult to navigate the system. Thank you for your helpful input, all of which I will continue to research and keep on pursuing.
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If FL is a 2k/2k state (2 thousand in income and 2 thousand in assets), then combined they are at $ 2,274.57 a month in income. If mom stays as the community spouse and dad goes into NH, he should qualify financially as she gets to keep additional income above the 2K limits to enable her to be living in the community. On the face of it, he should qualify financially for Medicaid. So what do they have in assets? Maybe this is the problem? Assets are more than a house or a car (which are exempt for their lifetime by & large), is there savings or insurance with a cash value; annuity or pension with a cash-out value that is keeping them from being qualified financially? He still needs to qualify medically for NH.

The first day at the NH for couples is called the "snapshot" day and is fixed, set, finite as far as spend-down on assets. If they have assets, you need to get them spent-down on stuff for their future needs before that day: a prepaid NO CASH VALUE funeral or burial or cremation policy; new glasses or hearing aids OR dental work - these have spotty or no coverage on Medicaid. If your sister needs the car, then I'd look to selling it and getting a newer more inexpensive but more reliable car in mom's name with whatever assets they may have in the spend-down.

NH cost 4K - 15K a month, whatever $ you spend on a elder care attorney to get them qualified will be well worth it. Most law schools have pro-bono clinics that they could go to for help. If it comes out that he needs to do a MIller Trust for the income he is over for Medicaid, you kinda need to find the $ to pay an attorney to structure a Miller Trust for you. It will only be a few hundred dollars for fees to get thousand upon thousands of Medicaid dollars of care in the long run. You have to get out there and ask and ask again to make it work. Call their Council of Government Area Aging program to find meal resources, like Meals on Wheels.
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thank you for all helpful answers. May be only a metter of weeks before dad needs placement. The sundowning and hallucinations are worse and more frequent. He is eating less. Still we can not get assistance to help pay for his care. As mentioned, they live in Flagler county Fla. They have Humana Gold (seriously? it covers nothing but all they could afford) They have medicare part D. Dad gets 1631.00 SS and 33.57 pension per month. Mom gets 610. SS per month. That is the only income they have. When applying for dad for medicad they want combined income, this puts them over the limit for any help. There are no assets at all except a 13 year old car. They rent and my sister lives with them and is their 24/7 caregiver. She has no income because of this. All resources that are supposed to be there to help seniors who are this desperate are no help. After paying rent, utilities, meds and essentials like food there is literally no money left at the end of the month. Cant find cheaper housing where sis can be with them for care, cant find senior affordable housing for them alone, and where dad is going to need placment shortly, and with no funds to pay for a NH we are looking at dire situation. Can not afford elder lawyer to sort through all this. Cant even afford anything thing but simple cremation when time costs. Are there food pantries in Palm Coast to help with food? They dont even qualify for an EBT card. We are frustrated and disgusted with the way seniors have to spend their final days...don't think I want to live that long to go thru this in a few years.
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If mom is going to be able to continue to live in the community (in her home or with you or anyplace other than a NH), then she will qualify for assets and income at a much higher level of the 2K/2K that the NH on Medicaid spouse would. Some states have the community spouse asset based at 109K other states are lower. Really an eldercare attorney will know how your state legally views all this.

Also mom will qualify for MMMNA - monthly maintenance. Whether it all comes from his SS and retirement, will depend on what mom can draw from her own SS, retirement etc. For couples where 1 goes into NH and the other stays home, there seem to be 3 issues: the monthly maintenance (which is set on state standards and tends to be on the low side); if they still have a mortgage and once the mortgage is paid, there is no real $ for mom to live on; insurance and other assets if she should predecease him - this is the sort of thing where mom is still in her home & dad is in the NH and on Medicaid. All seems fine financially, but mom is in a car accident and dies and now dad has acquired the pay-off of her life insurance policy so no longer qualifies for Medicaid. You kinda need to move ownership of stuff so it keep that from happening.

At 2,400 a month in income, dad on his own makes too much for Medicaid. But hopefully once mom is paid, it takes him to below 2K. But if it doesn't, then dad can do a Miller Trust. Miller is done all the time and totally legal. How Miller works is say John get's $ 1,500 from SS and then 2K from retirement. John's income is 2,500 a month, no matter what. He can't lower it and may in the future increase. What John does is a Miller Trust that each month get's the excess $ 500 a month.
So his monthly income is now at Medicaid level of 2K (or whatever the amount is in your state).
The $ 500 a month is what funds the trust and upon his death the full amount in the trust reverts to the state. It will not become an inheritance for family or dealt with in probate. Miller is not a DIY project, you need an attorney to do it as it needs to be according to you state laws on death/estate and flexible so it doesn't have to be redone if SS increases or decreases. Good luck.
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Thank you, I will look into this.
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I apologize.....it's called the "spousal impoverishment law", not "protection act". We also employed an elder lawyer, which was invaluable in getting the Medicaid application completed correctly and in a timely fashion.
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Thank you to,all,who,responded to my question. I will look into the various resources you all have provided . Dad was not a veteran, so that avenue is closed. I pray each night for help and guidance and every little,bit helps. Thank you and I pray for each and every one of you and your loved ones as well.
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I think to clarify that if they have Humana they probably have Part C rather than original Medicare. So they wouldn't qualify for MediCARE because they have a replacement type of coverage. I agree that in their state the rules are different than another, so they need to get more information. I would turn to SHINE (Florida's health insurance assistance program -- which provides personal help from trained counselors on all Medicare issues, free of charge). Another resource is floir, Florida's insurance commissioner's office. These two resources can provide a lot of information for seniors and their healthcare. God bless.
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Please consult an elder care attorney who deals with getting people approved for Medicaid. I live in Texas and I know that I was in almost the same situation. The attorney will know all the ins and outs of this. My dad was going to be able to keep Mom's SS. If they make too much the attorney can set up a trust to help qualify your dad for Medicaid. Sometimes these consultations are free....sometimes they cost, but the attorney will be able to say I can help you or I can't. But from experience I bet the attorney can help you with all your problems.
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Please google the "spousal protection act" and it may help provide some answers. We just went thru the same thing with my father.......
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Was your father a veteran and did he serve during a war? If so he may qualify for some benefits for his NH care even if he wasn't in actual combat.
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They make too much money for Medicaid, but not Medicare as you have mentioned in your question. There are no income limits on Medicare. If your father goes into a nursing home they will take his SS, NOT hers.
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As you line up the DPOAs remember there are two - one for health care decisions and the other for financial. Do this asap for both of your parents in order for you to keep up to date and organized with the bills and medical care when either of them can't do it. If you can help them now while they might still be able to answer questions you might have, then you will hopefully be able to slide smoothly into doing those tedious things even while you handle the stresses that will surely come with the momentary emergencies. Also, if you have a good relationship with your sibling(s) then agree between the two of you who will do best handling the details, often that is a first born. Then one of you could be named the DPOA. This makes it easier to expedite the decisions rather than wait for papers to be double signed etc. especially since there is a traveling distance to factor in. This doesn't mean that person has to make all the decisions though hopefully siblings can discuss the matters but then just one has to sign as things happen.
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I do not know why your parents would not qualify for Medicaid. Call Area Agency on Aging but also your state Dept. of Human Services, the department that handles elderly issues. The income guidelines are different in each state, so maybe they are over the income level in Fl. It is very sad that elderly like your parents can not get help and yet need nursing home care. This country is heading for a crisis quickly as the population is aging. Was your dad a veteran? Call Veteran's Administration to see if they can help.
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No. When your father passes, your mother will receive his S.S. money......regardless of where he lived, or what condition he was in. She will then forfeit her own S.S. check. I would find out why the Nursing Home is taking your father's money NOW.
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You poor dear, call your local or state Agency on Aging and/or you nearest Ombudsman; they will be better able to assist you. It does not have to be this way, you have been ill informed.
As for the DPOA, find an elder lawyer to assist you with this. It should not cost you more than $50 in most cases. They may be able to get you in touch with the proper people to assist your parents and sister in FL too.
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