Author Topic: Paying for our Parents Care  (Read 6663 times)

goatmom

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Paying for our Parents Care
« on: November 20, 2014, 06:35:25 AM »
My Mom has dementia and is getting to the point where being left alone in not an option.  I work part time and have kids still at home I am caring for. Mom has no money or assets. She lives with my sibling.  I have been through several caretakers this year and they are unreliable.  I just hired one through an agency but it is $21 an hour! The person coming only gets 11 of that! Mom gets about 1200 in ss each month. We are trying to get our hair on fire issues taken care of and have been paying for mom's care.  Also, how much do we realistically need to make sure we are taken care of when we reach her age? what is the plan for people here who are ER?   I guess I am just frustrated at the lack of good and reliable and affordable home care. 

Louis the Cat

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Re: Paying for our Parents Care
« Reply #1 on: November 20, 2014, 08:59:15 AM »
I'm so sorry that you're dealing with this! I used to work in home health care and it really feels like a racket from both sides. I also only made about half of what was being charged to work in some very stressful situations. (One of my clients died in front of me after a long, brutal battle with dementia.) I know for child care, a good nanny can be a great find and relatively inexpensive. I don't know if there are similar options for elder care but you might be able to find a nursing assistant who is looking for a different kind of work that you can hire directly. You would pay a little less and she would get a little more than going through an agency. There would be tax implications but it may be worth it in your situation. As for how to avoid this situation yourself: long term care insurance. As I understand it, your mid 50s is the time to look for it and it would absolutely be worth the peace of mind. Depending on your policy, it would cover some or all of your care needs from an aide that looks in a couple times a week to full time nursing home care as you age and would give you far more flexibility than Medicare.

bogart

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Re: Paying for our Parents Care
« Reply #2 on: November 20, 2014, 09:07:56 AM »
I too am sorry you are dealing with this.  I can tell you that my dad has dementia and is in a nursing home on Medicaid; the out-of-pocket cost for tolerable (not good) nursing home care in our community is about $6k per month, and (for the poor elderly) it is covered by Medicaid.

I don't have any particular insights into home care.  It may be worth trying to find a senior care specialist in your community (either paid or a volunteer) to learn what's available.  Though my dad wouldn't be a candidate for it (he is not mobile enough to get there/back), my community has an "adult daycare" facility that seniors who need assistance can go to just during the day at I think relatively low cost.  Finding out if those kinds of things might exist where you are could be useful.

Milizard

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Re: Paying for our Parents Care
« Reply #3 on: November 20, 2014, 09:44:29 AM »
Since she has no assets, you should look into what Medicare or Medicaid will pay for care.  My mother has a private pay lady coming in to help her, but that lady was actually paid by the government to care for her own dying father.

Jessa

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Re: Paying for our Parents Care
« Reply #4 on: November 20, 2014, 10:00:09 AM »
If it isn't safe to leave her alone, you should look into getting her into a nursing home. Does she have a house or an apartment? If she has a house, you will need to sell it and use the procedes to fund her care at first, once her assets are down to $0 (which may be the case already if she is renting), then she can apply for Medicaid and Medicare. A lot depends on what state you are in, I think the rules vary a lot. You probably want to look into getting a social worker or some other kind of advocate to help you figure out what your options are and what the best plan is.

As for planning for your own future...there's a lot of it depends. Long term care insurance is an option, but there was a discussion on these boards a while back where some articles were suggesting that it may not be a feasible option going forward. I would also point out that it does NOT cover all of your care, at least not in MA. I suspect there will be some changes in legislation and long term care and health insurance in the next 10-20 years...so that will change what you need to do to prepare. Each person will need to balance their assumed risk of required long term care vs what they need to save. If you have a family history of early onset Alzheimer's and longevity, you might want to be more prepared than someone whose relatives are still sharp and mobile in their 90's.

goatmom

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Re: Paying for our Parents Care
« Reply #5 on: November 20, 2014, 11:06:47 AM »
She has no house so not an issue. I guess I just assumed I would pay for her care. She is not safe at home but I wanted to get home care for her.  Getting paid to take care of your own parent? No wonder my taxes are so high.  What do most people here plan on? Going on Medicaid? Fading into the sunset? Saving up enough? Long term care insurance? Generous and kind offspring?

Pigeon

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Re: Paying for our Parents Care
« Reply #6 on: November 20, 2014, 11:17:03 AM »
Unfortunately, for lots of people there are no good answers and it's a combination of different things.  I'm dealing with this with my elderly inlaws and parents.  Long term care insurance is typically only good for a few years, in FIL's case, four and I think that's the usual situation.  And these policies may be very difficult to come by going forward. 

My MIL is trying to age in place, but she refuses to make any modifications to her home or her routine that make this safer.  But she is an adult is in good enough shape that we cannot force her to do anything.  She will not have anyone in to help her, although she has enough money to do that.  At this point, we try to visit as much as we can and we worry a lot.

Jessa

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Re: Paying for our Parents Care
« Reply #7 on: November 20, 2014, 11:19:18 AM »
I'm hoping that I won't require intensive long term care. I hope if I end up requiring that level of care it's only for a short time. I assume that my stash will be able to fund it long enough for me to pass away. Honestly, though, unless you are Bill Gates or Warren Buffet, if you live a long time requiring full time constant care, you'll go broke and end up on government assistance. Many people (luckily?) who require high levels of care don't last very long, but for an otherwise healthy dementia/Alzheimer's patient...that's really expensive. There aren't really good solutions. Work until you are put in a home from dementia? If you live 20 years after that, you still won't have enough.

https://www.genworth.com/corporate/about-genworth/industry-expertise/cost-of-care.html

this website gives averages by state on the cost of home care, adult day care, assisted living, and nursing home care. If she lives with your sibling, does she only need care in the daytime? Adult day care may be the best option, if there's a facility nearby. But (at least in my area) none of these options are affordable if I were to pay for my folks' care. They're all more than I make in a year. Nursing home care is more than SO and I make combined. Paying yourself is probably going to be out of the question.

Milizard

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Re: Paying for our Parents Care
« Reply #8 on: November 20, 2014, 11:49:37 AM »
She has no house so not an issue. I guess I just assumed I would pay for her care. She is not safe at home but I wanted to get home care for her.  Getting paid to take care of your own parent? No wonder my taxes are so high.  What do most people here plan on? Going on Medicaid? Fading into the sunset? Saving up enough? Long term care insurance? Generous and kind offspring?

My mom was in a rehab facility/nursing home briefly.  Private pay for the nursing home was over $8000/month.  Do you have that kind of money?   That's more than my husband and I made combined when we were both working full-time.  So, imagine a parent that needs round the clock care, and you want to keep them at home to save money.  Somebody's got to quit their job, unless they're making > $21/hr net to play for that.  Then, they're still working 24/7, just at 2 different jobs.  Caring for a parent at home saves the government a lot of money over the $8000/month nursing home.

goatmom

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Re: Paying for our Parents Care
« Reply #9 on: November 20, 2014, 12:11:51 PM »
Yes, social security doesn't go far.  I just helped mom buy hearing aids for 2700, now she needs new glasses, not to mention all the depends! 100 per month.  And hearing aid batteries.

goatmom

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Re: Paying for our Parents Care
« Reply #10 on: November 20, 2014, 12:39:45 PM »
Yes, social security doesn't go far.  I just helped mom buy hearing aids for 2700, now she needs new glasses, not to mention all the depends! 100 per month.  And hearing aid batteries.

Dicey

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Re: Paying for our Parents Care
« Reply #11 on: November 20, 2014, 01:10:06 PM »
My MIL and her pal, Al Z. Heimer live with us. My own parents are slipping and will both need LTC before the year is out. Luckily, I am FIRE which is a tremendous help. Remember the airline announcement about putting on your own oxygen mask first? You must keep this in mind in your situation. Since your mom has no assets, she is eligible for Medicare/Medicaid. Get on this right away so you don't over tax your own family's resources. She is entitled to this, it's not a handout. You did not drain her estate to cause her to need aid, so be vigorous in pursuing it. There is aid available, but it's not all obvious. Contact your local Alzheimer's Association. Our city's Senior Center has a directory of services which has been helpful. Do not wait until you are desperate to reach out for help!

The second part of your question is trickier. LTC is an imperfect solution. It's expensive and doesn't pay anywhere near all of the cost. It typically only lasts for a few years. If you have a caregiver come in before your loved one needs skilled care, they will cover it, but deduct it from the policy limits. My MIL has LTC, but it's only good for a couple thousand a month and only for three years, which is typical. She is otherwise completely healthy and just turned 80. She could last for another decade. She is not without substantial savings, but how do you manage it to make it last, even with LTC? Our solution is to save like mad. When DH retires, we will be able to live on SS and his pension alone, so our investments will serve as our LTC fund. We also try to be mindful that we may not ever get that far and to enjoy the days that we are given.

There are no easy answers. This sounds harsh, but sometimes we have to remind ourselves that she has lived a full life. Your family's needs are perhaps more important than your mom's. Help is out there, so start seeking it right away. Feel free to PM me any time.





goatmom

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Re: Paying for our Parents Care
« Reply #12 on: November 20, 2014, 01:32:44 PM »
Thank you all for your kind help.  I guess my prides gets in the way. I have it in my head that Medicaid is like welfare and she won't find a doctor if she goes from medicare to Medicaid. I just don't see too many people caring for their parents at home in my circles. Grandma is always in a nursing home.

Jessa

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Re: Paying for our Parents Care
« Reply #13 on: November 20, 2014, 01:42:14 PM »
I just don't see too many people caring for their parents at home in my circles. Grandma is always in a nursing home.

There is a reason for that, and it's not that families don't love Mom or Grandma. It's that full time care of an adult is a LOT of work. It's a lot of difficult, frustrating work, more so if it is your own family you are watching slowly disappear.

I admire your thoughts of taking care of your mother with your own money, it's not as common as you'd think. I work for a life care community, and we often see adult children bickering over paying Mom's bill out of Mom's estate because it's taking away from their inheritance. Not even kidding you. Your heart is in the right place, but this is not a case for your pocketbook.

Pigeon

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Re: Paying for our Parents Care
« Reply #14 on: November 20, 2014, 02:37:27 PM »
Thank you all for your kind help.  I guess my prides gets in the way. I have it in my head that Medicaid is like welfare and she won't find a doctor if she goes from medicare to Medicaid. I just don't see too many people caring for their parents at home in my circles. Grandma is always in a nursing home.

I know a number of women who have quit their jobs to take care of elderly parents or inlaws.  These aren't people who are FIREd, it's an economic hardship for the families, but they feel that they don't really have a choice.  It's also extraordinarily hard on the caregiver stress-wise.

goodlife

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Re: Paying for our Parents Care
« Reply #15 on: November 20, 2014, 07:19:04 PM »
My parents will very likely need LTC in a few years as well and I have promised myself NOT to be the primary caregiver. I love my parents dearly, but I saw what it did to my mum when she was caring for her mother (my grandmother) who had dementia for a few years. It was terrible on my mother (and on me and my sibling too). It is emotionally draining to see someone you love getting worse on a daily basis, slowly slipping away and sometimes saying terribly hurtful things, not recognizing anyone etc. Physically it is also very draining. Cleaning your own parent after they soiled themselves...lifting them on and off the toilet...I don't want to get more graphic here, but it can get very very bad. If you are caring for a stranger, you can somewhat detach yourself mentally from it as one of my friend's who works in a nursing home explained. But if it's your own parent, you can't. You have it 24/7 and I know those years were the most terrible years for my mother. When it comes to this point, then I will not put myself through that. I will make use of every government program out there and I will spend my own money if necessary, but I will not care for them myself if they get to such a state. I applaud people who do it, but personally, I know I can't do it and I wouldn't want to put my own family through it.

Personally, I am not buying LTC insurance for my parents or myself. I have studied those policies quite closely and the premiums are very high and the conditions for actually paying out are quite strict. In my parents' case, they have zero assets, savings or income, so the government will pay for some of their care. I just hope that they won't need it too long if they should reach such a point. As for myself, pretty much same strategy. My stache should last for quite some time and if my old age slowly dying body finishes it off before I kick the bucket, so be it. I want to live a good life while it's good...it's impossible to plan for everything.

As to the OP, definitely look into any government funded programs and only use your own money when absolutely necessary. Put yourself first would be my honest advice. If I think about how I would feel if I was old and - inevitably - dying, then for sure I wouldn't want my children to deplete their savings. I know my parents wouldn't want me to do that either. If there are government programs that you can take advantage of, then do it. Get someone (even maybe pay someone) who can help you in this process, I know the bureaucrazy of this can be daunting. I am sorry you are going through this, make sure you take good care of yourself as well.

Also, make sure to get a DNR (do not resusciatate) for your mother (not sure how this works if she is mentally not capable to sign this herself anymore). Thankfully my grandfather did this in good time...otherwise a hospital may be obligated to preserve life...which can drag out the inevitable for years (as was the case with my friend's grandmother).
« Last Edit: November 20, 2014, 07:40:35 PM by goodlife »

goatmom

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Re: Paying for our Parents Care
« Reply #16 on: November 21, 2014, 08:00:49 AM »
I guess much of this makes me sad.  I wish there was a better way.  We do have a medical healthcare proxy in place so we can make decisions.  There is no money so no one is bickering over that.  Thank goodness. I work part time so I pop in to check on her. Now we have the assistant we are paying for 32 hours a week out of pocket. Ouch.  She bathes her and changes sheets, etc.  But it will get more as time goes on.  Mom helps by doing spelling lists with my kids, folding mismatched socks, timing music practice for my kids, and occasionanally teaching them inappropriate names for ethnic groups and other things that are just plain inappropriate.  Her filter is completely gone at 90. She had me later in life.

Cassie

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Re: Paying for our Parents Care
« Reply #17 on: November 21, 2014, 02:14:50 PM »
I had 2 grandma's-one that had quite a bit of $ & one that only had SS.  In the end they both ended up in the same decent nursing home. The only difference was that the poor one went on medicaid right away & the one with $ had to use all savings, etc & then went on medicaid.   My Mom cared for my Dad for 14 years after a major stroke at 59 & it was hell.  I helped her a lot.  My Dad also lost his filter so I taught my kids that Grandpa said some things that they could not because of his injury.   It was tough on everyone so I do not recommend this option. 

MayDay

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Re: Paying for our Parents Care
« Reply #18 on: November 21, 2014, 02:36:13 PM »
and occasionanally teaching them inappropriate names for ethnic groups and other things that are just plain inappropriate.  Her filter is completely gone at 90. She had me later in life.

This is so my grandmother! Oh man, I had no idea how rascist/from a different time until she had dementia and started blurting things out!

I have only gone through this with a grandparent, not a parent, which is much different of course. As she declines, ask hospice to evaluate her periodically. My grandmother wasn't a hospice patient until the very end, but my uncle (medical POA) still made decisions like not to treat a UTI except for pain management, etc. At that point her mind was gone so only things that caused pain were treated. This shortened her life no doubt, but that's a good thing IMO once someone's dignity and mind are gone.

goatmom

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Re: Paying for our Parents Care
« Reply #19 on: November 21, 2014, 03:00:14 PM »
Well, I don't see hospice in the near future.  She is in fairly robust health and can go to the mall for a few hours using a walker.  She loves to go out every single day if someone will take her and keep an eye on her.  She has tried to talk people into giving her store credit cards with a drivers license that expired 15 years ago.  She also loves to eat out and gets several invites out each week.  But she thinks Jimmy Carter is the president.  She can be awfully pleasant and charming when she is not pointing out how fat someone has gotten.  She has also set herself on fire several times with the gas stove and has also wandered off.  The mind is really complex.

It is ironic that when looking at financial aid for colleges and looking at nursing homes, having not planned or saved serves you well. 

Cassie, sorry you had to go through that with your Dad. He was young.  It can be so hard on the caregiver especially when you perceive you are the only one not putting granny in a home but some days you really want to do that.




Cassie

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Re: Paying for our Parents Care
« Reply #20 on: November 21, 2014, 03:17:00 PM »
I would see if there is a daycare center that would take her.  Here we have them for seniors with Alzheimers.  I am not sure if medicaid pays for it or not.  At least that would give everyone a break all day long &  be fun for her with all the activities.   Although, eventually she will end up in a nursing home because her needs will become too great.  It also is hard on the children in the house.  My Dad went from being a person that never swore to horrible words coming out of his mouth.  He was a wonderful grandpa & fun loving person who would call us all terrible names once he had the stroke. Of course it hurt everyone's feelings but we would just need to remind ourselves that this was the part of his brain that was damaged.  Also eventually people with Alzheimer's forget how to swallow to eat which causes choking,etc.  I have a good friend that got it at age 52 & now at 62 she can only talk about the past, can't order from a menu, etc. However, because she won't cook she can still be left alone during the day but not sure how much longer that will last.  She either eats cereal or forgets to eat. It is such a sad disease.

lizzzi

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Re: Paying for our Parents Care
« Reply #21 on: November 21, 2014, 08:37:28 PM »
The OP should not be using her own money to pay for the mother's care. With an income of $1200/month the mother is close to being Medicaid-eligible. She will not lose her Medicare by going on Medicaid, and Medicare/Medicaid is a pretty good insurance package. Don't for a minute feel embarrassed or feel that the mother is going on "welfare." Medicaid is not Public Assistance. It is a health insurance program funded by the state and federal governments for people with incomes at a certain (low) level. I agree with those who have suggested some kind of Adult Day Care program. Also, the OP needs to find out whether Medicaid will pay for personal care aides in her state.  Medicaid benefits vary from state to state.  Medicare benefits are the same nationwide. If the mother is going to continue to live with the sibling, there are adaptations to the house that can be made to maximize the mother's safety. (Take the handles off the stove so she can't turn it on. Put locks on the doors so she can't get outside and wander away. Get an ID bracelet for her in case she does wander.) Reach out to the local Alzheimers Association and Office for Aging. Both should be able to help in putting together a better, safer home care plan for the OP's mother.