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Post by Deleted on Jul 3, 2019 10:05:10 GMT -5
Forgot to add-
I completely agree with your comment about countrygirl.
It is VERY stressful to think of your kids being disabled and you not being around to protect their interests or provide care.
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Post by Deleted on Jul 3, 2019 13:24:29 GMT -5
I think the point is the person left behind will be left with no savings and a decreased income forever. Try re-roofing that house if you can only have $2K in the bank because your ill spouse needs care. People have no idea what that becomes. The person needing care will get it either way, and the spouse gets completely screwed in the process. Which is why I'm unlikely to remarry unless the guy can provide for his own LTC. I get really irritated at the ads in my FB feed from attorneys wanting to help me "protect your assets from nursing home costs". As far as I'm concerned, that's what they're for and DS, my only child, agrees. I'm also concerned that there will be more stories such as the one you mentioned, in which patients dependent on Medicaid have very little choice in where they go- and they can be moved. There's a sad story right now in the Boston Globe about a few LTC places closing because they couldn't make it on Medicaid reimbursements; one very decent owner is taking some of them in but he says he's losing money on them. He's having a hard time getting decent help at wages that allow him to keep going. I saw my Aunt go through spending down (almost) to Medicaid level before my Uncle died from Alzheimer's. She doesn't have a lot left and she has macular degeneration. I hope her sons take good care of her.
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azucena
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Post by azucena on Jul 3, 2019 14:01:00 GMT -5
Rockhounder - I didn't know the beginning of your story and that your husband's disability started so young. My own DH was disabled all of our 20s, so I know how quickly an illness can affect one's finances.
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mollyanna58
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Post by mollyanna58 on Jul 3, 2019 14:07:07 GMT -5
At my father's wake, one of his long term clients advised me to distribute my father's assets between myself and my siblings, so that my mother wouldn't have any assets and would qualify for Medicaid nursing home care if needed. He had done that to his mother. I told him that my parents did not scrimp and save so that Mom could end up in a county facility.
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hoops902
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Post by hoops902 on Jul 3, 2019 14:59:01 GMT -5
At my father's wake, one of his long term clients advised me to distribute my father's assets between myself and my siblings, so that my mother wouldn't have any assets and would qualify for Medicaid nursing home care if needed. He had done that to his mother. I told him that my parents did not scrimp and save so that Mom could end up in a county facility. Just FYI, there are lots of places that will take Medicaid that aren't run by the county, or the government at all. Depending on where you're at, the facility you go into paying everything out of pocket and the facility you go into on Medicaid might be one and the same.
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Post by Deleted on Jul 3, 2019 15:55:20 GMT -5
Just FYI, there are lots of places that will take Medicaid that aren't run by the county, or the government at all. Depending on where you're at, the facility you go into paying everything out of pocket and the facility you go into on Medicaid might be one and the same. I agree but I think those places will become scarcer. My Uncle was in a private facility but immediately placed in a "Medicaid bed" even though he was self-pay for nearly a year (small, semi-private room with only a curtain dividing his space from his roommate's). They do that because they say that otherwise one might not be available when you actually require Medicaid. Just as they were getting close enough to spending down that my Aunt told me she was losing sleep over how little money she had left (and it was an inheritance from her family), the facility raised its rates on them by almost 50%. She found him another facility. A couple of months later the new facility said there wasn't much they could do for him and he was near the end. He died soon after that. He had Alzheimer's so it was a blessing in a way; he didn't even recognize my Aunt, who came to see him every day. But I can't help but wonder if the first facility wanted to get him out because they knew they'd have to accept Medicaid soon, and the new place decided not to do anything that would prolong his life since he was Medicaid. Just because you're paranoid doesn't mean they're not out to get you. I'm far from needing care for myself and hopefully my mom has a ways to go, so I probably shouldn't comment but I'm curious. I was under the impression that you could pay a one time premium to buy your way into a continuing care retirement community (CCRC). That premium would be based on age, gender, health - underlying it is an actuarial calculation of life expectancy - and would be in the hundreds of thousands of dollars per person. These types of facilities have independent living, assisted living, and some have memory care and the premium covers your transition from one type of care to another. The facility takes care of all day to day living expenses and maybe leaves some out of pocket medical care. So say my DH and I retire at 65 with $2M, we live on $1M for 10 yrs and then at 75 buy into a CCRC with most of the remaining $1M. If a couple moves into one together wouldn't that take care of leaving one spouse destitute? Yes, and this is an option I'd consider. My grandpa and his second wife moved to a very nice one in FL and she entered the LTC facility first, while he stayed in their apartment. Payment plans vary but I think most have ongoing monthly fees. That, plus the relatively steep entry costs, can make it out of reach for most people, especially couples, since the entry fee for couples will be higher.
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Post by Deleted on Jul 3, 2019 16:05:36 GMT -5
Rockhounder - I didn't know the beginning of your story and that your husband's disability started so young. My own DH was disabled all of our 20s, so I know how quickly an illness can affect one's finances. My DH was 10 years older than me. I was 19 and he was 29 when we got married. When we married he had a crushed arm from an industrial accident. He spent 2 years in therapy and having surgeries to regain part of its function. During the testing for a surgery he was found to be diabetic. Since it was Workman's Comp he was retrained to be an auto service adviser. He worked in the industry for a while then was promoted to managing an auto center for Montgomery Wards. We bought a house and then had our kids when we were both working good jobs, had good insurance, and could afford daycare. When my kids were 3 and 5 he got a massive infection in his legs that nearly killed him. Between his arm issue and his legs, he was put on SSDI on the first application but it took nearly a year of state disability then no income. When we married he weighed about 300 lbs. After 2 years of disability he ballooned up past 500. At the time of the long hospitalization he was over 600. Just pushing him in a wheelchair was a major workout and I had 2 small kids at the time. I was working a job that expected 6 day weeks and often more than 12 hour days because Kaiser was building a new building and we were doing all the IT infrastructure for it. I was diagnosed as being depressed and put on a high dose of Paxil. I should have just skipped that and got divorced like I wanted to at the time... I believe to this day the drug caused me brain damage. I went from being very motivated and working hard to struggling to function and simply not caring about anything. It's gotten a bit better over the years, but I've never had any motivation or ability to function in a work setting return. It took me 3 months of hell to stop taking the Paxil. I developed horrible anxiety and just can't deal with being around noise or people. DH was VERY fortunate he worked long enough and made enough money to get SSDI. My DS who has the seizure issue is fighting to make it to at least 10 years so he doesn't end up on SSI/Medicaid vs. SSDI/Medicare because there is a huge difference in both pay and access to medical care and it could potentially affect him for decades. The medical system in this country is broken. We also have societal issues that make it nearly impossible for people to care for ill relatives or their own children without two incomes. And, on topic for this thread, living spouses shouldn't have to either kill themselves trying to take care of an ill spouse or find themselves financially destitute to get them care outside of the home- especially when they are then too ill or old to "just get a job" to fix the situation. And, when people suggest their kids should be helping support the living spouse - what about their own childcare costs, student loans, mortgages, etc...? Where is all the magical money supposed to come from?
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Post by Deleted on Jul 3, 2019 16:51:10 GMT -5
This is on my mind a lot because of DH's medical problems. Most of the family "money" is in my retirement accounts. I tried hard to save so that I would have a decent retirement.
DH didn't. He does have about $20k left in personal savings that is pretty sacrosanct. But once that is gone, do they make me start liquidating my retirement savings to pay his LTC expenses?
It won't come to that. I can't afford it. I'll just take care of him. I told my sister, when we were discussing this, that things have changed a lot. There are grocery delivery services, for example. I can hire someone to sit with him one day a week even if it is expensive. We will manage.
But it does worry me. A friend of mine's mother died a month after the friend's father was placed in a nursing home (Alzheimer's). Her mother was so worried because they were spending their savings so fast. She had a heart attack, which the friend attributed to stress and worry about money.
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dannylion
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Post by dannylion on Jul 3, 2019 17:15:17 GMT -5
I'm far from needing care for myself and hopefully my mom has a ways to go, so I probably shouldn't comment but I'm curious. I was under the impression that you could pay a one time premium to buy your way into a continuing care retirement community (CCRC). That premium would be based on age, gender, health - underlying it is an actuarial calculation of life expectancy - and would be in the hundreds of thousands of dollars per person. These types of facilities have independent living, assisted living, and some have memory care and the premium covers your transition from one type of care to another. The facility takes care of all day to day living expenses and maybe leaves some out of pocket medical care. So say my DH and I retire at 65 with $2M, we live on $1M for 10 yrs and then at 75 buy into a CCRC with most of the remaining $1M. If a couple moves into one together wouldn't that take care of leaving one spouse destitute? My parents moved into a CCRC in their mid-80s. I think it was a sort of unicorn place as it was very nice and the cost was quite reasonable. In 2004, their buy-in cost was under $200,000 for a "villa" home (basically a SHF attached at the garage to another SFH). They paid $725 per month at the beginning, and that went up $25 to $50 or more per year, depending on inflation or whatever they were using to identify costs. The CCRC had independent living, where my folks started, 2 levels of assisted living, and a nursing center for skilled nursing care. The monthly fee was determined by the level of care they were receiving. Mom had a stroke a year after they moved and spent the next 3 years in the nursing center on the grounds of the CCRC, which was about a half-mile from their house, so it was easy for Dad to visit her every day. The total monthly cost for them while Mom was in the nursing center was about $10,000. Dad lived another 3 years after Mom passed away, most of it in his independent living house. He only spent about 4 months in the nursing center before he passed away, and most of that cost was covered by Medicare because he was admitted to the hospital several times for long enough to start the Medicare-pay time over each time. Dad still had the independent living house when he passed away, and the cost had risen to $1025 per month by then. Most of the CCRCs they looked at before choosing the one they moved to had much higher buy-in costs (around $500,000) and very high monthly fees ($5,000-plus). However, the cost was the same throughout the resident's time in the CCRC, regardless of level of care, so over time, it might actually have been a wash since Mom went into the nursing home so soon after they moved in. I expect there are lots of different models for the fee structures for CCRCs; those are just the ones I know about from my parents' experience. There were less expensive independent-living options at their CCRC, starting at around $50,000 buy-in cost and $400 monthly fee in 2004. They ranged from small apartments to mid-range townhomes in the older section, then the facility built the "luxury" villa homes in a new section followed by a "luxury" condo building. (The facility called them "luxury." They were very nice in comparison to the more modest homes, but not over-the-top luxurious.) The nursing center was not luxurious, but it was very comfortable and clean and the care was considered to be the gold standard in the area to the point that there was a waiting list to get in (people who were residents of the CCRC were guaranteed a bed in the nursing center, others could only get in if there was space). They accepted Medicaid patients, and if a CCRC resident ran out of money while in the nursing center, they had a fund that paid for their care. It was nonprofit and run by a Mennonite organization but it wasn't restricted to Mennonites. I think my folks were very lucky to have found that place at that particular time. The nursing center was able to get competent help because at that time, there were not a lot of job opportunities in the local area. There are now a lot of big retail distribution centers and some new light manufacturing and large retail businesses in that area that pay somewhat more than the nursing center does, so I have heard that they are having to use more agency personnel to keep the staffing in the nursing center at acceptable levels. When my folks were there, most of the caregivers were employees of the CCRC, so they had the same caregivers most of the time. I'd consider living there myself some day if I cannot find reliable caregivers here to enable me to stay in my house. I know it will be a lot more expensive by then, but I'm hoping it will still be more reasonable in comparison to the other CCRC fee models. I will definitely be checking out what is available over the next several years so I can have a choice already made and not have to made a decision in the midst of a health or other personal crisis.
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Post by Deleted on Jul 3, 2019 17:36:07 GMT -5
But once that is gone, do they make me start liquidating my retirement savings to pay his LTC expenses? (Why can't I type outside the damn box?) Yes, is the simple answer. I had a social worker quote "in sickness and in health" to me once when I mentioned living in poverty due to my husband's need for Medicaid to pay for dialysis... I found no one really gives a crap what happens to those left behind. That's your problem. It also seems many folks who could/should be paying for care legally move their assets and poorer folks don't.
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seriousthistime
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Post by seriousthistime on Jul 3, 2019 17:53:00 GMT -5
Don't try moving assets to save them, you are to late. They will look back 3 to 5 years depending on state. Is he a veteran? I got help for MIL but took over a year, but now she gets $1100 a month toward her assisted living. One problem if they have Medicaid they cannot get help from VA. It's now a 3 year look back and I believe their house can't be worth more then $80k. If he has health insurance don't drop it yet, wait on Medicaid. Contact your local VA rep, should be one in your city that can help you understand if he is eligible for any benefits. They need to only serve 1 day in a combat zone to be eligible. The nursing homes can help you a lot with this, but an elder care attorney can too that's who I went too. Also if your dad is ill its easier to transition from a hospital setting to a nursing home. If he is admitted for more then 3 days, then he can be moved to a nursing home and have 90 days of coverage under medicare, but that's all. They DO NOT pay for a nursing home, that just helps them transition into Medicaid if he can get it. An attorney is your best bet, there are so many missteps you can take that will cost you so navigate it carefully. A few things to keep in mind: 1. Inpatient versus outpatient or observation status in the hospital. Medicare requires a three-day qualifying stay in inpatient status before it will pay for skilled nursing facilities. Inpatient status is for a more intensive level of care. If you are relying on this to get into a nursing home, be very careful and make sure the patient's hospital records clearly reflect an inpatient level of care for every day of hospitalization. Don't decide you know this based on what kind of hospital bed or unit you're in. 2. Skilled care versus custodial care. Even if you have a three-day qualifying hospital stay at the inpatient level of care, Medicare will not pay for the nursing home unless the patient needs skilled care. The maximum nursing home costs that Medicare will cover is 100 days. Very few people need 100 days of skilled care after discharge from the hospital. At some point the nursing staff is doing more medication administration and monitoring for changes in condition, and physical therapy transitions to walking up and down the hallways with an aide. At that point, it's custodial care. Once that happens, the nursing home will issue a notice of Medicare non-coverage and give you about 48 hours to be discharged or become private pay or on Medicaid. It can happen at any time. Once the care is custodial, Medicare does not pay no matter how many of the 100 days are left. Medicare recipients get a booklet each year that explains a lot in plain language. Here is this year's booklet. www.medicare.gov/sites/default/files/2018-09/10050-medicare-and-you.pdfOpti, I'm tagging you. You work in a nursing home, right?
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jelloshots4all
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Post by jelloshots4all on Jul 3, 2019 18:14:40 GMT -5
What about A Place for Mom? According to their commercials they are supposed to have trained staff to help you navigate finding a place. I'd try that and see if they can help you get started. Teo good friends of mine work for A Place for Mom. Great company!
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Post by Deleted on Jul 3, 2019 18:27:47 GMT -5
But once that is gone, do they make me start liquidating my retirement savings to pay his LTC expenses? Yes, is the simple answer. I had a social worker quote "in sickness and in health" to me once when I mentioned living in poverty due to my husband's need for Medicaid to pay for dialysis... I found no one really gives a crap what happens to those left behind. That's your problem. It also seems many folks who could/should be paying for care legally move their assets and poorer folks don't. I SO agree with your last sentence. I knew a corporate lawyer who used to take scuba diving trips to the Caribbean with her husband; she told me once that they were in the process of moving all of their assets into the names of their adult children so they'd qualify for Medicaid when they needed LTC. And in a funny/sad story on another Board I'm on, a guy wanted help for his parents; they'd put down a deposit on a nice home in a retirement community and then found that since their assets were locked in an irrevocable trust (most likely to protect them from LTC costs since Medicaid won't count those assets) they couldn't complete the sale. Um.... what part of "irrevocable" did you not understand?
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Post by Deleted on Jul 3, 2019 18:34:03 GMT -5
Yes, is the simple answer. I had a social worker quote "in sickness and in health" to me once when I mentioned living in poverty due to my husband's need for Medicaid to pay for dialysis... I found no one really gives a crap what happens to those left behind. That's your problem. It also seems many folks who could/should be paying for care legally move their assets and poorer folks don't. I don't see your comment here, Athena.
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countrygirl2
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Post by countrygirl2 on Jul 3, 2019 18:48:59 GMT -5
Yes, the above poster is correct, you can't just be in 3 days for observation, it has to be for actual illness, so much to watch anymore, its mind boggling.
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Post by Deleted on Jul 3, 2019 18:57:30 GMT -5
I don't see your comment here, Athena. I may have been in the process of editing it. It should be up there now.
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mollyanna58
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Post by mollyanna58 on Jul 3, 2019 19:09:50 GMT -5
At my father's wake, one of his long term clients advised me to distribute my father's assets between myself and my siblings, so that my mother wouldn't have any assets and would qualify for Medicaid nursing home care if needed. He had done that to his mother. I told him that my parents did not scrimp and save so that Mom could end up in a county facility. Just FYI, there are lots of places that will take Medicaid that aren't run by the county, or the government at all. Depending on where you're at, the facility you go into paying everything out of pocket and the facility you go into on Medicaid might be one and the same. True. But one probably starts out in a nicer place if one can pay for it.
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Post by Deleted on Jul 3, 2019 19:14:54 GMT -5
So what you are saying, @athena53, is perhaps I need to see a lawyer about an irrevocable trust. I'll add it to my list of things to do. I actually thought about one for DH. He will never be able to navigate a roll-over IRA. My son is a CPA, and my daughter-in-law is DH's closest friend here. They will have to help him. Fortunately, my sister lives in Phoenix, where he lived before marrying me. If he insisted on returning there after I am hit by the proverbial bus, I think she will look after him. He has friends there, but friends and caretakers are two very separate entities.
DH may live 5 years or more. He's mobile and can basically do self-care tasks like bathing, toileting, etc. But he needs me to take him to have his hair cut, for example. He can get in/out of the car, but he couldn't get in/out of the stylist's chair. He needs me to be his advocate (we call it his ears/memory) for healthcare and pretty much everything else.
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Post by Deleted on Jul 3, 2019 19:21:09 GMT -5
So what you are saying, @athena53 , is perhaps I need to see a lawyer about an irrevocable trust. I'll add it to my list of things to do. I'm not a lawyer and I'm not sure at all whether that would be a good course of action. Medicaid may be allowed to ignore it if he needs LTC within 5 years after you set it up (the "lookback period") and it's nearly impossible to get assets out other than as specified in the trust document even if you need them. I have a revocable trust but Medicaid would count that among my assets (and I'm OK with that)- it just simplifies the distribution of my estate. It also specified how DH would be taken care of if I died first. This is definitely something you need to talk over with an expert.
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Post by Deleted on Jul 4, 2019 10:14:57 GMT -5
So what you are saying, @athena53 , is perhaps I need to see a lawyer about an irrevocable trust. I'll add it to my list of things to do. I'm not a lawyer and I'm not sure at all whether that would be a good course of action. Medicaid may be allowed to ignore it if he needs LTC within 5 years after you set it up (the "lookback period") and it's nearly impossible to get assets out other than as specified in the trust document even if you need them. I have a revocable trust but Medicaid would count that among my assets (and I'm OK with that)- it just simplifies the distribution of my estate. It also specified how DH would be taken care of if I died first. This is definitely something you need to talk over with an expert. I've been considering putting my next house and savings account (if possible) in a trust. For me, it's two-part. One, I want my kids to be able to quickly and easily sell my property after I die without dealing with the probate court. Two, I plan to become a ghost when I leave here due to the grower BS and a past boyfriend who threatened my life and stalked/harassed me. I know as soon as I purchase property under my name it will show up online. I'll start a new thread....
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dannylion
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Post by dannylion on Jul 4, 2019 12:53:21 GMT -5
I'm not a lawyer and I'm not sure at all whether that would be a good course of action. Medicaid may be allowed to ignore it if he needs LTC within 5 years after you set it up (the "lookback period") and it's nearly impossible to get assets out other than as specified in the trust document even if you need them. I have a revocable trust but Medicaid would count that among my assets (and I'm OK with that)- it just simplifies the distribution of my estate. It also specified how DH would be taken care of if I died first. This is definitely something you need to talk over with an expert. I've been considering putting my next house and savings account (if possible) in a trust. For me, it's two-part. One, I want my kids to be able to quickly and easily sell my property after I die without dealing with the probate court. Two, I plan to become a ghost when I leave here due to the grower BS and a past boyfriend who threatened my life and stalked/harassed me. I know as soon as I purchase property under my name it will show up online. I'll start a new thread.... Not sure what the requirements are for naming a trust. I wasn't looking for anonymity, so I didn't inquire about creative titling. Mine is just called "The [My Actual Name] Revocable Trust, [My Actual Name], trustee." If you find your trust has to include your name, it's probably not going to allow you become invisible.
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lund
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Post by lund on Jul 10, 2019 2:46:53 GMT -5
As to costs, I am of no help.
But some thoughts late at night:
You should consult a specialist on elder-care, Medicare/Medicaid, and Medicare spend-downs. If your mother is able to, she and you should be the ones to go. You need to know both the rules and any alternatives. (Preferably know your parents' wills, any POAs, and their assets beforehand.) You may also want to know, in addition to any options you have, what the level of care costs is where they live as well as wherever a nice other child/grandchild/other reliable relative of theirs lives. Good care probably is cheaper far from large cities.
(Also ask about any claw-back laws for your state. It is good-to-know information, for instance if the family helps repairing the home and/or are paying for the repairs. If the home will be sold by the state when not needed by the last spouse, the "OK temp fix" may be the way to do it and not the "ancient monument forever solid style".)
I also think: That your mother may keep a home with adequate furnishings, a car and of all valuable property she may own, one ring. That she and your father are also allowed to have prepaid burial plans. (Bought before a spend-down.) That she is allowed to keep a certain amount of their joint income, and a comparably small amount of cash. (The amount allowed is so small that it will be difficult to handle things like large home repairs, car repairs, or car replacements.) That if she is to stay in the marital home, it is a good idea to make sure that it is in very good condition before all savings and investments are spent in the Medicare spend-down which is likely to come. Make any needed and anticipated repairs and maintenance (which does not include redecorating nor updating, but things like repairing a bad roof or siding, roto-rooting a clogged drain, changing a worn-out kitchen floor, and similar necessary repairs and maintenance issues). Adding better light, grab bars in the shower, and similar safety-enhancing measures probably also are a good idea. If there is such a thing as a professional to hire to get suggestions on improvements to enhance safety for the remaining spouse and accessibility, it could be a good idea. Make sure that all the appliances work well (and are not barely hanging in with a lot of special tickling to work) and are serviced (furnace, a/c, car, lawn mower, snow blower,..). Don't forget to check the car's tires. Check weather-stripping too, as well as ducts. Heating or cooling the great outdoors is expensive and often also uncomfortable.
Also check your parents' clothing (it is alas not uncommon that old people shrink, get changed feet, and have difficulties going to the stores, and thus have too little everyday clothes (preferably easy care) in OK condition); don't forget underwear, also for winter, warming additional garments like cardigans, and shoes and outerwear. People of advanced age as well as those with mobility difficulties often are cold and want warm clothes in the winter. (They may also have difficulties with heat in the summer.) If laundry is done somewhere else, as in the nursing home, make sure that all garments and shoes brought there are marked with a permanent textile marker in such a way that it can't be removed (and not on easily removable tags). (And also any other items.) (I've had old relatives lose their clothing and some other things while living in homes. The nicely sewn in name tags were no help; probably got taken off and the garment taken to use or sell. The black pen, also in places where it might be seen, worked. And other items were marked both on the outside and somewhere inside, where it could be found if one looked for it.)
Also make a check of the home's necessary textiles (towels, sheets, mattress protectors,.....) and everyday furniture. It is not uncommon that a chair from which an old person can get up, a bathroom mat that stays in place due to working backing, or a new clean mattress are needs. And the textiles do get worn out.
Save the paperwork for everything that is paid for, in order to show that they have not hid/given away money but used it for needed and necessary expenses. In addition to the store receipts (and any additional paperwork), consider making a copy/scan of it (many originals get bleached and fade away very quickly) and save that together with the original, a photo or two of the item it replaced or repaired, and write a few lines on it describing why ("replacing XX years old/worn out/broken whatever").
Be prepared to, together with siblings, to split and buy out any existing valuables (such as jewelry, sterling, art,....) which have to be sold and you want with the exception of one ring. Remove the purchased items from the home of the now previous owner. Pay for them through the bank, and save the proof of the transactions. Also let a professional determine their fair values, and save that paper too (with a copy to each owner of items listed).
Following the rules is the correct way to go edited: IMO, in order to avoid later hassle (though I would guess that children getting small and/or less expensive valuables is not uncommon). But since your mother may survive your father living independently for quite a few years, it is important that she gets the best options to manage this financially.
And, for those not knowing, the money which those in nursing homes are allowed to keep monthly ($60?) is probably much too low for adequately covering the person's needs. It often is expected to cover hair care, foot care, shoes and clothing (if the home provides any, it is often not sufficient), communication (phone, stamps and stationery, if useful internet,....), some kind of fun (some sweets, an outing, gift for grandchildren, having a TV perhaps even with cable - the shared one usually shows something less interesting,...), personal hygiene items (after-shave, make-up, skin care items, ....),.....
The amounts left for this kind of spending has not been raised as costs have gone up. The same goes for the amounts left for the healthier spouse to live from, including the savings.
This is the reason why having at least one good Social Security income can be important. In situations with a spend-down and the passing of the sicker spouse, the remaining spouse probably has to live from the highest of a couple's SS amounts (with the possibility of a pension that has survived the spend-down, and of any still existing "non-surrenderable" life insurance money) and what home equity there might be. (Claw-back rules may apply though.) The home equity may be made available to live from through selling (with the options of downsizing to a smaller owned home, moving in with family, renting, or moving into a care situation), or possibly (which has another set of dangers) as a reverse mortgage.
These systems are made for situations where the remaining income (the bigger SS, any widow/er/'s pension, the sum of cash savings allowed (2k?), plus a furnished home and a car) would be enough to give the remaining spouse edit: a decent life for the remaining months or years. Today, it may not be enough to keep the spouse out of poverty - the cash savings allowed is too small, the widow/er/s' pensions don't exist, the retirement accounts meant to replace the pensions are spent, and a person widowed in their mid-seventies (not unusual) may have 20 more years to live during which they are not able to work.
Edited: My knowledge of the US system is to a large part second hand from the children of a US relative of mine. I want to issue a warning what my knowledge may be outdated or incorrect.
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Deleted
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Post by Deleted on Jul 10, 2019 7:23:44 GMT -5
As to costs, I am of no help. But some thoughts late at night: <snip> Wow- thanks for this. There are lots of things the average person in this situation wouldn't anticipate. One comment on the $60/month allowance- I'm guessing that the cost of adult diapers alone, if you need them, would use that up. Getting old- really old- is scary.
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TheOtherMe
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Post by TheOtherMe on Jul 10, 2019 9:16:56 GMT -5
When I was a rep payee, most of my clients wore adult diapers. All were on Medicaid. I was never asked to pay for those. I think that was part of what the nursing home covered. I had clients in several different nursing homes in this area over the years.
In Iowa, you only get to keep $50 per month. One of my clients would only wear one outfit so I only ever bought her underwear and a robe. Nursing home said she wouldn't wear any clothes I would buy out of her $50. Her $50 would build up. She had right at $200 to her name when she died. The summer before she died, she asked if she could have money to go to the dog track when the nursing home had an outing there. She had money she wasn't spending so we let her have the amount she asked for. I paid her bills for over 5 years and she had never asked for fun money before.
I was allowed to add to pre-paid funeral funds if their bank account was going to exceed $2000. The two funeral homes I dealt with on that made exceptions to their minimum payments for these people. Otherwise, they were going to be doing the lowest cost funeral possible.
What got paid to the nursing home was the Social Security minus health insurance minus $50. Several of my clients did have supplemental health insurance.
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Wisconsin Beth
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Post by Wisconsin Beth on Jul 10, 2019 9:23:46 GMT -5
I think the point is the person left behind will be left with no savings and a decreased income forever. Try re-roofing that house if you can only have $2K in the bank because your ill spouse needs care. People have no idea what that becomes. The person needing care will get it either way, and the spouse gets completely screwed in the process. My sister's MIL and FIL did something to separate assets, without divorcing, when she needed more care than he could provide at home. She was in a nursing home for a few years before she passed. He's just moved into assisted living. I know I asked my sister about the money situation after her MIL passed and she said there was some left but another year? and it would be gone. I want to say her ILs did trusts of some sort but I don't really know what/how they did it.
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Tiny
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Post by Tiny on Jul 10, 2019 10:27:34 GMT -5
At my father's wake, one of his long term clients advised me to distribute my father's assets between myself and my siblings, so that my mother wouldn't have any assets and would qualify for Medicaid nursing home care if needed. He had done that to his mother. I told him that my parents did not scrimp and save so that Mom could end up in a county facility. Just FYI, there are lots of places that will take Medicaid that aren't run by the county, or the government at all. Depending on where you're at, the facility you go into paying everything out of pocket and the facility you go into on Medicaid might be one and the same. This is true but the facility you start out in depends on how much $$ you when you first go in. So, if start out with only medicaid when you first need a facility your choice of facilities will be smaller. If you have something more you will have more facility choices - which means you may wind up in a nicer facility.
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