Author Topic: Unique, Dire and Heartfelt situation. Advice needed  (Read 4689 times)

Tigerclaws

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Unique, Dire and Heartfelt situation. Advice needed
« on: May 31, 2018, 08:45:12 AM »
Hey Mustachian's!

I am new here as of this morning, introduced myself already, sorta.  I wanted to email Mr. Badass aka Mr. Money Mustache, instead I will try the forums like he suggested.  I would love some advice on ways to produce more income on my investments and a plan to move some to Vanguard with no idea where to start, I will leave my bonds at the bank with zero fees.  To summarize: My mother has terminal dementia, lives with me, I have absolutely no idea if or when she will need assisted living housing in the future but I would like to be prepared just in case.  My plan all along is to care for her at home until the end, but Mom is declining fast, her behavior is pure innocence but she gives me zero personal space.  I have enrolled her into an adult day care to start next week, possibly one to two days a week for now, $70 a day.  This is just the beginning.  Assisted living facilities are 4K to 6K a month.  But again, I have no clue if I will ever need to place her in one or not.  It hurts to say this next part, I am feeling the disease will take her down within 2 years.

I will give some details on financial situation as of now, I will be happy to add more later if needed or requested, I don't want to over do my first post.

I would like to be able to put money aside in a Vanguard fund to grow but have access to if needed for the aforementioned.  But I am not confident with my plan.  Hence why I am requesting help.

The info below is where I stand now, I moved the investments from two different firms into one firm, in October. I am very dissatisfied with mistakes made at the new firm, so now the accounts are, as I write this, in transfer process from that firm to my bank to hold with no fees until I decide where to invest the listed except the bonds and REITS will stay at my bank. 

I am 53
Own my home
Zero debt
Mom is 73
Mom's social security income and IRA RMD are included in the household income. 

$1,100,000.00 in investments =
    $311K - IRA  (30K of the IRA sitting in cash)
    $350K - Bonds, Tax exempt
    $120K - REITS x 3 Tax exempt total $120K (2 are upside down total $33K, original value $60K, not sure what to do with that!)
    $  23K - ROTH IRA
    $295K - Taxable investment account - stocks, mutual funds, etf's, etc.  (25K of the account sitting in cash)

Annual income =  61K roughly
    $ 31K - includes interest from bonds, dividends from 1 REIT and the taxable account
    $   9K - RMD estimate after taxes
    $ 21K - Mom's social security retirement

The 31K is investment income from $707K invested.  The total does not include the 25K sitting in cash, nor the 33K in REITS upside down.

Real Estate =
    $400K in home equity line, 0 balance, 2.9% interest for first year as of May 28, 2018.

Please remember, the goal is temporary and feels urgent in the sense of producing more income to set aside or using what cash is available, etc. for the unknown future of my mom.  My goals and needs will change in a couple of years give or take. 

Questions:  The 25K sitting in cash, do I invest to receive more income or should I toss it in a fund for short term growth and use when needed.

In the IRA and taxable accounts the firm purchased a few stocks late 2017, that failed.  The dividends are not great, one of the stocks is GE. FAIL

The 30K in cash in IRA - what to invest in for growth....  Vanguard something or another.... 

Do I use the home equity line before digging into the principal?

I have more questions but feel I have written enough for now, I will give more information later if needed.  I appreciate anyone taking the time to read my post and possibly guide me through this heartfelt temporary journey.

Thanks so much!  Robyn

EDIT:  Please understand my post's intent is regarding investing and income options for extra cash that I listed above and/or using HELOC vs principal if situation arises in future for caregiving costs. And Vanguard questions.  I appreciate the responses offering support and guidance regarding how to care for for my mother but I have that part handled.  Mom is not eligible for any type of assistance.  Hospice is not needed as of yet.  I have talked to attorney's, doctors, social workers, home health care, Medicare, Medicaid, etc.   I have been on a support group for almost 2 years.  I have been down this road already with ex mother in law Alzheimer's. =) 
« Last Edit: May 31, 2018, 10:08:26 AM by Tigerclaws »

patchyfacialhair

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #1 on: May 31, 2018, 09:03:00 AM »
I'd focus less on generating more from your existing income and investments, more on researching how what your mom's realistic options are for care. Only then will you really determine what the financial impact would be. It seems that she has small income from social security and not much in the way of investments (hard to tell how much of the IRA is in her name), so it's possible that her care could be free or low cost.

Once you figure out how to deal with that, then worry about the money. Sorry she's going through this illness, no fun and very sad to see.

RWD

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #2 on: May 31, 2018, 09:04:34 AM »
To summarize: My mother has terminal dementia, lives with me, I have absolutely no idea if or when she will need assisted living housing in the future but I would like to be prepared just in case.

Paging @Dicey

Tigerclaws

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #3 on: May 31, 2018, 09:22:02 AM »
I'd focus less on generating more from your existing income and investments, more on researching how what your mom's realistic options are for care. Only then will you really determine what the financial impact would be. It seems that she has small income from social security and not much in the way of investments (hard to tell how much of the IRA is in her name), so it's possible that her care could be free or low cost.

Once you figure out how to deal with that, then worry about the money. Sorry she's going through this illness, no fun and very sad to see.

I appreciate your response. I have researched and planned accordingly.  I have valid questions no matter the outcome. There is not assistance in the state of Georgia for assisted living nor in home full time care.  Unless a patient is sent to a nursing home which is not an option.  The adult day care at $70 a day is based on a sliding income scale.  My purpose for the post is to be as proactive as possible for the unknown future of care giving costs.

formerlydivorcedmom

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #4 on: May 31, 2018, 09:37:52 AM »
I'm sorry that your mom has been stricken so young.  I'm glad you are already taking steps to make sure that you get a break.  My grandfather had Alzheimers, and taking care of him was very hard on my grandmother.  When she finally put him in a home that specialized in dementia patients, he existed there for another 2 years, I think.  Note that "assisted living" residences are not necessarily the right option - a patient with dementia needs much more care than a senior who is frail.  It's the difference between helping the patient to and from the restroom vs providing enough oversight to make sure the patient isn't turning the water on high and removing the faucet to turn the sink into a fountain.  At 2 am. (been there, fixed that)  And, by the end of his time in the nursing home, my grandfather had to be fed and changed like a baby.  His body was healthy but his mind was gone.

In your shoes, I'd ask your mother's doctor for recommendations on who to talk to for making a long-term care plan for your mother.  You may need a social worker or other health care expert who can help you navigate the Medicare system and determine what she qualifies for as well as what she needs/may need. They can also educate you on when to get hospice involved.  Some nursing homes also provide this service - my grandmother was in a very good nursing home after suffering strokes, and they had a contract with a social worker who could help us figure out a lot of this stuff.  She was invaluable!


NV Teacher

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #5 on: May 31, 2018, 09:47:22 AM »
I'm sorry that your mom has been stricken so young.  I'm glad you are already taking steps to make sure that you get a break.  My grandfather had Alzheimers, and taking care of him was very hard on my grandmother.  When she finally put him in a home that specialized in dementia patients, he existed there for another 2 years, I think.  Note that "assisted living" residences are not necessarily the right option - a patient with dementia needs much more care than a senior who is frail.  It's the difference between helping the patient to and from the restroom vs providing enough oversight to make sure the patient isn't turning the water on high and removing the faucet to turn the sink into a fountain.  At 2 am. (been there, fixed that)  And, by the end of his time in the nursing home, my grandfather had to be fed and changed like a baby.  His body was healthy but his mind was gone.

In your shoes, I'd ask your mother's doctor for recommendations on who to talk to for making a long-term care plan for your mother.  You may need a social worker or other health care expert who can help you navigate the Medicare system and determine what she qualifies for as well as what she needs/may need. They can also educate you on when to get hospice involved.  Some nursing homes also provide this service - my grandmother was in a very good nursing home after suffering strokes, and they had a contract with a social worker who could help us figure out a lot of this stuff.  She was invaluable!


This is great advice.  There are lots of resources out there you just have to find the ones that are knowledgeable about your area.  It's not easy I know.  Best wishes for you.

MommyCake

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #6 on: May 31, 2018, 10:14:32 AM »
Went through this with my grandfather and my SO's mom.  In both cases needed an elder care/estate planning lawyer to guide us through the process of Medicare approval.  My grandfather needed Medicare for what ended up being years of nursing home care, unfortunately SO's mom passed away before we even applied for Medicare.  We also were worried about having to pay out of pocket for care and depleting our savings but the lawyer explained the payment is based on their income and assets, not ours.  This was years ago and an emotional time so I don't remember the details.  I would recommend seeing a lawyer though.  Good luck and hope you have happy years with mom still to come. 

AMandM

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #7 on: May 31, 2018, 10:27:09 AM »
You didn't give your annual spending, but I'm guessing that with a paid-off house you have more than enough income to cover your living expenses.  So if you are right about your projections of what your mother's care might cost and for how long, you can pay for it outright and still have enough to live on. Personally, I'd keep that money out of the stock market since you don't know what the market will be when you need it. I would not take on debt for that when I had the cash available.

Basically, in a situation where the need will arise in a fairly short time horizon, and since you have plenty of money, I think your goal should not be aggressive growth.

I'm sorry about your mother. All the best to you as you care for her.

Dicey

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #8 on: May 31, 2018, 12:11:55 PM »
To summarize: My mother has terminal dementia, lives with me, I have absolutely no idea if or when she will need assisted living housing in the future but I would like to be prepared just in case.

Paging @Dicey
Dicey here. I read Robyn's post, but her Edit gives me pause. Seems like she's got the ALZ part well in hand, well as much as that is possible. My immediate red flag is financial. Why are you combining your finances? They should be separate. If she spends down her assets, she becomes eligible for more assistance. If you, Robyn, spend down your assets, who will pay for your care when you need it? I hear alarms when I read you're pulling out of the market. 53 is far to young for such a conservative step. The axiom to put on your own air mask first is screaming in my head.

More details please?

Tigerclaws

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #9 on: May 31, 2018, 01:37:58 PM »
To summarize: My mother has terminal dementia, lives with me, I have absolutely no idea if or when she will need assisted living housing in the future but I would like to be prepared just in case.

Paging @Dicey
Dicey here. I read Robyn's post, but her Edit gives me pause. Seems like she's got the ALZ part well in hand, well as much as that is possible. My immediate red flag is financial. Why are you combining your finances? They should be separate. If she spends down her assets, she becomes eligible for more assistance. If you, Robyn, spend down your assets, who will pay for your care when you need it? I hear alarms when I read you're pulling out of the market. 53 is far to young for such a conservative step. The axiom to put on your own air mask first is screaming in my head.

More details please?

I must have conveyed my message incorrectly. I am not pulling out of the market. I am transferring in-kind to my bank to leave the new firm because of several mistakes, not to do with market fluctuation, without going into detail, they lost my business.

The bank will hold the bonds and two old stocks without fees.

My desire is to transfer IRA and the taxable account $$ to Vanguard.

Our money is not combined. I combined on my post to show the household income, it is no where near what is needed for possible future care costs. 

The only asset in her name are the two IRA's.  They do not count towards eligibility for assistance.  Any assistance in Georgia is through Medicaid for nursing homes.  Georgia has a 5 year rule for transferring assets to be eligible for Medicaid, the bonds were in her name as of a year ago.  The house is protected since it is mine.  Medicare does not pay for any assistance with any type of in home caregiving or assisted living memory care units. 

WalkaboutStache

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #10 on: May 31, 2018, 07:09:07 PM »
I am not sure if it helps, but since you are in GA, if you need any help with estate planning, I know a very good and compassionate estate attorney.  He developed his practice from dealing with his own parents so he knows what this is like from the inside.

lhamo

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #11 on: May 31, 2018, 09:10:52 PM »
I'm really sorry about your mom.

You should not be using your own assets for your mom's care.  One of the problems with ALZ is that you have NO IDEA how long the process will take.  There are many on these forums who have endured long, slow physical declines of their loved ones after the mental capacities were already diminished.  You need to conserve your own assets for your eventual aging needs. 

Can you delineate more clearly:

1)  Which assets precisely are in your mom's name still and
2)  When the bonds and any other assets were transferred to you

PLEASE PLEASE PLEASE do not use equity in your house, or any of your own retirement funds, to fund your mom's care.  That is a dangerous path to tread.


Abe

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #12 on: May 31, 2018, 09:25:11 PM »
I agree with using your mother's assets and returns for funding her care, then applying for medicaid to cover the rest. Keep in mind that a lot of the nursing homes that have majority Medicaid patients have limited resources and the care may not be as attentive as you may want. It is up to your discretion on whether the extra expense of a facility with more resources is affordable for you. As others note, it's important to keep in mind your retirement plans, as it is unclear in your post if you have relatives to rely on in your old age.

Dicey

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #13 on: May 31, 2018, 10:15:01 PM »
I agree with using your mother's assets and returns for funding her care, then applying for medicaid to cover the rest. Keep in mind that a lot of the nursing homes that have majority Medicaid patients have limited resources and the care may not be as attentive as you may want. It is up to your discretion on whether the extra expense of a facility with more resources is affordable for you. As others note, it's important to keep in mind your retirement plans, as it is unclear in your post if you have relatives to rely on in your old age.

It's fairly well known that people who have attentive family visiting regularly tend to get better treatment. This can help elevate the care your loved one receives at any level of facility. Being there for them really makes a difference. So does being kind to the never underworked staff.

And I totally agree with wise @lhamo. My MIL showed her first big warning signs way back in 2007. She has lived with us for five years and has never had so much as a sniffle. We hate to think about how many years of helplessness she still has to face. Ugh. And I third all the suggestions about keeping your own money separate and earmarked for your own old age. If I could scream at the top of my voice and shake your shoulders until you hear and understand this, I would. Your own airmask and all...

Tigerclaws

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #14 on: June 01, 2018, 11:03:07 AM »
I'm really sorry about your mom.

You should not be using your own assets for your mom's care.  One of the problems with ALZ is that you have NO IDEA how long the process will take.  There are many on these forums who have endured long, slow physical declines of their loved ones after the mental capacities were already diminished.  You need to conserve your own assets for your eventual aging needs. 

Can you delineate more clearly:

1)  Which assets precisely are in your mom's name still and
2)  When the bonds and any other assets were transferred to you

PLEASE PLEASE PLEASE do not use equity in your house, or any of your own retirement funds, to fund your mom's care.  That is a dangerous path to tread.

The only assets in her name are the IRA's - total roughly $350K
The bonds were transferred into my name in July of last year - total roughly $320K (too tired to look)
I will not use the HELOC for her care as suggested.  I applied for HELOC with intent to buy a rental property in future

I have moments or days of panic, like yesterday after having 4 hours of sleep, then creating this post.  I speak to bankers, they say use an equity line, of course.  I speak to investors, advisors, they say to sell house no matter what my mother thinks.  It is not about what she thinks, it is about disrupting her already hell bent demented ritual of not knowing how to turn on a shower or where the utensil drawer is.  I am the one that has to deal with her behavior due to any changes of "her world" environment. The advisor's suggestion to sell house then buy a cheaper house equated to invest more to bring in more income to pay for her care.  That is one of many reasons I transferred the portfolio last week. I have lost trust in banking & advisory firms. The attorney's said to move all assets in my name, I did as I stated above.  Medicaid says she is not eligible.  Medicare doesn't pay for any of this.  The adult day care (starting next week) will give me some relief to lessen days of panic and burnout.  I have not had a day by myself since Nov 2017.  I am an only child, I divorced last June.

@Abe
I agree with your comments.  I am trying to plan for the worst case scenario.  I have been down this road before with ALZ mother in law.  She was also not eligible for Medicaid.  She ended up in assisted living 1 year, then back home with 24 hour care, almost a year.

I have a 24 year old son whom I can rely on at any time. 

Side note:
My intent and question was to preserve principal and produce more income. I never said to use the assets to pay for her care. I did ask about HELOC but am hearing not to use.  In my mind, I felt if there is not enough income to pay for her care, pull some from HELOC, then once there is no need for care, the extra income would pay back HELOC. 

formerlydivorcedmom

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #15 on: June 01, 2018, 12:43:10 PM »
I totally understand not wanting to move her out of the familiar environment.  You may also want to include some form of in-home aide for at least a few hours a week, so she can be at the house and you can still get a break.  You have to take care of yourself - going straight from the trauma of a divorce to providing full-time care for an ailing parent is an emotional nightmare. 

Is there an issue with spending down the principal on the IRAs that are in her name?  If those aren't part of your retirement calculations, that would pay for a great deal of her care.  She has income of approximately $2.5k per month...spending an additional $3.5k per month of the IRA principal would mean that money would last 8 years, which, sadly, is probably more time than she has.  If exhausted, that may help her be eligible for other assistance.   

I fully expect my children to spend down my assets, if necessary, to pay for my care one day.


mxt0133

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #16 on: June 01, 2018, 12:58:46 PM »
Based on your mom's situation, I would not focus on growing her assets and instead focus on preserving them.  You are estimating that she might need to access her funds to the tune of potentially $72K a year for 2-3 years or longer.  Based on that the $350K in the IRA should be put in very short-term bonds or even CDs.

If your mother ends up depleting all of her assets while in a nursing home, Medicaid can then take over, even with her SS and RMD's.  Look into Miller Trust*, where even if you mom has too much assets and income to qualify for Medicaid to pay for a nursing home, once her assets fall below Medicaid qualifications, Medicaid would then pay for the difference between you mom's income and the cost of the nursing home.

Also consider before qualifying for Medicaid, the bonds or any other assets that you transferred to your name would have to go past the 5 year look back.

So for any assets that is in your mom's name or that was transferred out less than five years ago, they should be invested for preservation vs growth.

*https://www.agingcare.com/articles/how-to-use-a-miller-trust-for-medicaid-eligibility-207367.htm

Tigerclaws

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #17 on: June 01, 2018, 01:30:32 PM »
I totally understand not wanting to move her out of the familiar environment.  You may also want to include some form of in-home aide for at least a few hours a week, so she can be at the house and you can still get a break.  You have to take care of yourself - going straight from the trauma of a divorce to providing full-time care for an ailing parent is an emotional nightmare. 

Is there an issue with spending down the principal on the IRAs that are in her name?  If those aren't part of your retirement calculations, that would pay for a great deal of her care.  She has income of approximately $2.5k per month...spending an additional $3.5k per month of the IRA principal would mean that money would last 8 years, which, sadly, is probably more time than she has.  If exhausted, that may help her be eligible for other assistance.   

I fully expect my children to spend down my assets, if necessary, to pay for my care one day.

No ma'am, there is no issue with spending it down.  Not one professional has advised me to spend the IRA on her care.  All the advice I have been given by pro's seems to be for their best interest not mine nor hers.  To be honest, I tried to bring expenses so far down, that I could afford care just through income. I have saved extra income in a money market, obviously no growth there but it is put aside for future cost.  This is why I asked if there is a Vanguard fund of some sort to have a little growth but accessible.  Thanks for the math on IRA use.

I appreciate everyone's comments and support.

Sibley

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #18 on: June 01, 2018, 01:51:28 PM »
Have you talked to an elder care attorney? They would be the most familiar with the laws, requirements, etc in your area. Some of the things you're dealing with are highly specialized.

Re everything else - I understand that if you change your mother's environment her routine is going to go to hell in a handbasket with purple cushions. At some point, that is going to happen anyway. If selling the house becomes the most logical and advantageous step, then that's what you're going to do. If you can't care for her any longer, memory care facilities are not the end of the world.

Also, the way I read your posts, you sound harried, harassed, overwhelmed. You are NOT going to be able to make good decisions in that state. So get yourself some serious assistance and get away from your mother for a few days (or longer). Caregivers suffer worse outcomes than the people they're caring for - all due to stress. I don't care what it'll do to your mother for you to take a short vacation to the the hotel 2 miles away. What'll happen to her if you end up in the hospital and are unable to care for her for months?

former player

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #19 on: June 01, 2018, 03:50:08 PM »
I'm sorry for your situation, but as you have already found out there is good advice to be had on these boards.  Adding my 2 cents -

1.  As Dicey pointed out, you do not know how many years of care your mother will need.  From what I've seen from friends in this situation, I think planning for only another two years of care for an otherwise physically healthy 73 year old is probably far too optimistic.  It could easily be 10 years.

2.  If that makes you realise that you need to take the advice given above about looking after yourself, good.  Caring for someone is more than a one person job.  A normal job is about 40 hours a week with two days off at the weekend: I bet your caring takes significantly more than 40 hours in the week and you get no days off.  Even with just your few posts I and others can tell that you have been putting too much strain on yourself and need a break.

3.  On the subject of needing a break, well done on finding the adult day care for your mother.  Make it a minimum of two days a week to start with, and consider adding more.  I bet that as soon as you do start getting a little time to yourself, and have got over the phase of using it to catch up on your sleep and your daily life, you will realise what good value the day care is for both you and your mother.  You may also find that the day care has limits on the degree of dementia they can cope with: that also suggests to me that you should make as much use of them at the moment as you can.  Your mother's social security income alone would cover 5 days a week of day care at $70 a day.

4.  Once you have started to have those couple of days off a week and have recovered a little is the time to put some thought into investments.  As already advised, your mother's money needs to be mostly conservatively invested.  You then use her money to pay for her care - starting with those day care fees.  First you use her social security income, then you use the income from her investments, and if that isn't enough to pay for her care then you sell off as much of her investments as you need in order to cover the remaining expense of her care.

5.  You keep your own money separate from your mother's, and invest it according to your own expected expenses for the rest of your life.   Most of it should be in Vanguard index funds.  You have enough to invest that you may be able to get advice from Vanguard itself if you feel you need it.   The Investment thread may be able to advise on the REITs.

6.  You do not pay for your mother's care from your own money.   You do not borrow money to pay for your mother's care.  You do not sell your house to pay for your mother's care (you may sell it for other reasons if it suits you).  And, given the amount of money you have, you do not borrow money ever again for any purpose.  You are quite right that any adviser who suggested your borrowing money is a charlatan.

7.  My understanding is that the IRAs are your mother's and in her name, but that her bonds were transferred into your name a year ago?   That the IRAs are disregarded for Medicaid calculations, but that the transfer of the bonds to you is disregarded if your mother needs Medicaid within the next four years?  If that is right, then it would suggest to me that to the extent that you need to sell any of your mother's investments within the next four years to fund her care you should be selling from the bonds that were transferred to you rather than from the IRAs.  This would not spending your own money on your mother's care, it would be spending your mother's money on her care - for Medicaid purposes the bonds are your mother's even though they are now in your name.  Don't sell off the IRAs to pay for your mother's care if they are protected from Medicaid calculations.  If you do the sell off this way, you might end up spending the whole of the amount of the bonds but the IRAs would be preserved for you to inherit.

OK, that ended up as more than 2 cents.

pbkmaine

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #20 on: June 01, 2018, 03:59:28 PM »
Have you talked to an elder care attorney? They would be the most familiar with the laws, requirements, etc in your area. Some of the things you're dealing with are highly specialized.

Re everything else - I understand that if you change your mother's environment her routine is going to go to hell in a handbasket with purple cushions. At some point, that is going to happen anyway. If selling the house becomes the most logical and advantageous step, then that's what you're going to do. If you can't care for her any longer, memory care facilities are not the end of the world.

Also, the way I read your posts, you sound harried, harassed, overwhelmed. You are NOT going to be able to make good decisions in that state. So get yourself some serious assistance and get away from your mother for a few days (or longer). Caregivers suffer worse outcomes than the people they're caring for - all due to stress. I don't care what it'll do to your mother for you to take a short vacation to the the hotel 2 miles away. What'll happen to her if you end up in the hospital and are unable to care for her for months?

An attorney specializing in elder law should be your next step. It’s far more important than where you are investing your money. That person can guide you through the laws and resources available in your state.

lhamo

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #21 on: June 01, 2018, 05:18:45 PM »
I believe forum member @TVRodriguez is an estate attorney (and a lovely lady to boot!).  Batsignaling her in case she can point you to good legal resources in GA for planning how best to use your mother's assets to ensure she has good care, while maintaining your own for your own future.

And seconding the advice to practice good self-care first.  You are no good to your mom if you burn out.

Deep breaths.  Keep coming back.  Lots of people here willing and able to offer support with no vested interest in the outcome other hoping they can help you do better tomorrow than you are doing today.

Dicey

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #22 on: June 01, 2018, 06:58:44 PM »
I have been lucky that my bonus kid still lives at home and DH works nearby. I also have a babysitter in the neighborhood. But the babysitter's going away for the summer, the kid's got a JOB!, and DH 's schedule changed. He only works 4 days a week now, but they're longer days. My dear friend was at an event this weekwhere she met the Exec. Director of a program that offers daily respite care. Guess what? It's only $84 per day! In my HCOLA, I wouldn't have believed that possible. They also have a shuttle service (there's a waiting list at the moment for that, but I can deal for now). Holy cow, this is going to be great! My point: don't be like me and assume everything's going to be super expensive. See what services are available in the community. You never know!

GreenEggs

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #23 on: June 01, 2018, 09:26:48 PM »
Tigerclaws,

I'm very happy that you discovered the forums here.  I was in a similar situation as you about a year & a half ago.  Caregiving and very stressed out.  Things eventually reached the point where my dad needed to go into a skilled nursing facility and that was when I was finally able to calm down and not be on 24/7 duty & on-call.  He was hospitalized and discharged into a rehabilitation facility, which eventually led to being in a long-term care facility. 

I don't have any financial advice to add.  You've been getting great advice here and I can tell that you are feeling some relief from. 

Learn to relax however you can.  Look for happy thoughts to help deal with all the difficult emotions.  Just keep reminding yourself that things will eventually get better.


ltt

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #24 on: June 02, 2018, 03:00:48 PM »
I would spend more on adult day care.  If it's $70 per day, that would give you more days than 2 days a week.  $21,000 of her SS money would get you 5 days a week.  That way, I do believe you would be refreshed to care for her, especially if the personal space is an issue.

You could also consider a home health aide to come in your home to help with tasks. 


Lyngi

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #25 on: June 02, 2018, 04:10:48 PM »
Tigerclaws.  Another vote for making an appointment with an elder law attorney as soon as possible.  My mom has Alzheimer's and is only 71.  The attorney we use is a CELA (certified elder law attorney.)  Only one of three in our state.  Our first visit was free and my dad has used her services several times since then.   I really learned a lot and it is worth getting real answers. 
     PLEASE!  Make sure to take care of yourself.  Currently, my dad takes care of my mom full time, at home.  It is incredibly draining on him.  We tried to use an adult day care, but my mom is easily angered and gets violent.  He currently pays for a home health agency to come in for 4 hours a day.  He has looked at Memory care, but again, my mom is a danger to others.  The choice is limited because most centers won't take her once they learn her history.   
     Is your house easy to care for?  I mean, yard work and housekeeping?  Is it possible to "baby proof" it effectively?  All the kitchen cabinets at my dad's house are locked.  The Fridge is locked.  The stove controls are gone.  Gas grates are in the oven and the oven door is tied shut.  Rugs, pictures, lamps, knives, soap all gone or locked up.  Outside doors double key locked.  Backyard gates padlocked.  Stair heads blocked and locked.  Inside doors all locked.  My mom's bed is on the ground.  How about carpets and furniture?  It's not pretty, but the carpets in my dad's house will need to be replaced.  Furniture, too.  My dad has hurt his back with all the bending and lifting- getting the diapers on and off.  He used to have a baby monitor to listen for when she would get up at night.  He doesn't anymore.  He was exhausting himself and he couldn't get her back in bed anyway.  He will get up once in the night to check on her. 
     It has only been about 2 1/2 years that things have been really, really bad.  My  mom's mom is 92 and healthy.  Please, please take care of yourself.  The life expectancy of caregivers is significantly reduced. 
   

marion10

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #26 on: June 02, 2018, 04:23:27 PM »
I am going to second elder law attorney ASAP. Also donít rule out a nursing home in the future- it may become necessary- my MIL spent 6 years in one- 5 of those Medicaid. Do not combine or commingle your assets. Also see if you can find a support group. Alzheimerís is an awful disease- your mom may stay as she is for a long time or she may go down hill quickly- you just donít know.

WalkaboutStache

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #27 on: June 03, 2018, 08:49:44 PM »
I am going to second elder law attorney ASAP. Also donít rule out a nursing home in the future- it may become necessary- my MIL spent 6 years in one- 5 of those Medicaid. Do not combine or commingle your assets. Also see if you can find a support group. Alzheimerís is an awful disease- your mom may stay as she is for a long time or she may go down hill quickly- you just donít know.

My friend's firm is www.georgia-estatelaw.com.  His name is Paul Black.  Very thoughtful, smart and kind guy and, like I said, he has personal experience in these matters.  If you want, you can tell him that Alex referred you to him, but you don't have to.

Good luck!

wenchsenior

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #28 on: June 04, 2018, 07:05:32 AM »
You definitely need the help of an experienced attorney here. 

Medicare does not cover assisted living/nursing home care except for a limited period after a hospital stay.  And (generally speaking) you have to have very little in assets in order to qualify for Medicaid, which does cover those things.  If your mother recently (within 5 years before the need to qualify for Medicaid) transferred assets to you, those assets are likely still subject to 'claw back'.  Edit to clarify: While it is acceptable to spend down assets to qualify for Medicaid, there are rules governing this, and a simple transfer of money to e.g. heirs has special strings attached b/c of the claw back rules.

 In other words, even if she has no assets NOW, and hypothetically could qualify for Medicaid b/c of it, she probably would not qualify until she has paid out of pocket for care in the amount equal to whatever assets she transferred to you.  This is set up so that people of means cannot transfer all their wealth to others, and then qualify for Medicaid immediately and pay nothing for their own care.  It also means that people who don't fully understand their own liability can get themselves in trouble by transferring assets, thus making themselves poor and unable to pay for care, but then find they still might not qualify for Medicaid.

So, you need to be sure to keep the transferred assets intact, liquid, and available until an elder care attorney can advise you how to handle this.  You do not want to inadvertently disqualify your mother from any programs she is eligible for!

Good luck.
« Last Edit: June 04, 2018, 07:11:33 AM by wenchsenior »

Tigerclaws

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #29 on: June 04, 2018, 10:57:03 AM »
Wow! Thanks to everyone, lots of good advice and support, I am very grateful to all. I have officially completed enrollment as of today for adult day care. Tuesday or Wednesday will be her first visit, half day to acclimate her. Then we can start full days 1 to 2 times a week. 

After reading many suggestions from this thread, the first changes I will make is:

1.  Remove my name from her checking account, except keep POA on the account for signing. 
     Direct deposit Social Security into her account.
     Direct deposit annual Minimum RMD into her account
     Write checks from that account for day care, caregiving, etc. expenses.

2.  Find an elder law attorney. 

I met with attorney two years ago when creating the POA, Will, etc., he is the one who suggested transfer of bonds to my name.

pbkmaine

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #30 on: June 04, 2018, 11:22:20 AM »
Trusts and estates attorneys are great, but not all specialize in elder law. You want someone whose main focus is this area because the rules are quite complex.

TVRodriguez

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #31 on: June 04, 2018, 11:46:55 AM »
I believe forum member @TVRodriguez is an estate attorney (and a lovely lady to boot!).  Batsignaling her in case she can point you to good legal resources in GA for planning how best to use your mother's assets to ensure she has good care, while maintaining your own for your own future.

And seconding the advice to practice good self-care first.  You are no good to your mom if you burn out.

Deep breaths.  Keep coming back.  Lots of people here willing and able to offer support with no vested interest in the outcome other hoping they can help you do better tomorrow than you are doing today.

Thanks, lhamo, for flagging me here and for your kind words.

Tigerclaws, it sounds like you've gotten a lot of good information.  If I read correctly, you are in Georgia. 

1.  You can visit the Georgia Bar Association website, www.gabar.org and click on the Find a Lawyer tab and run a search for an elder law attorney.  I did and this came up:

https://www.zeekbeek.com/gabar/Search-Results#areas=179!Elder+Law+%26+Advocacy&region=GA

2.  Like someone else mentioned, estate planning attorneys (or trusts & estates attorneys) may or may not practice elder law.  I am an estate planning attorney and I don't practice elder law--usually referring to Medicaid planning. 

3.  As mentioned, do not comingle assets. 

3.  Also don't guess what will apply to your situation based on what you've heard or what seems "right" until you speak with an elder law attorney.  There is a lot they can do and not all of it is intuitive.  In fact, some things that people think are "smart" are going to make a mess of things if your parent needs the benefits Medicaid can offer.  Since Medicaid is a federal-state program, state law matters.

Best of luck to you.

Sibley

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #32 on: June 04, 2018, 12:28:57 PM »
Great news on the adult day care. Hopefully it goes smoothly, if there are challenges talk to the staff there about what you can do to ease them. Not going is not an option - you need that break. And the interaction will be good for her.

Good luck finding an elder care attorney. In my experience, there aren't as many of them, but you need that expertise.

Dicey

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #33 on: June 04, 2018, 06:31:05 PM »
Great report! I made an appointment for an assessment for day care for my MIL. It's five days a week, 9:30 -2:30 including lunch, for $84/day. She's going to summer camp, hooray!

lhamo

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #34 on: June 04, 2018, 06:55:18 PM »
Great report! I made an appointment for an assessment for day care for my MIL. It's five days a week, 9:30 -2:30 including lunch, for $84/day. She's going to summer camp, hooray!

Sincerely hope this works out for you!

Lyngi

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Re: Unique, Dire and Heartfelt situation. Advice needed
« Reply #35 on: June 06, 2018, 05:32:55 PM »
Great report! I made an appointment for an assessment for day care for my MIL. It's five days a week, 9:30 -2:30 including lunch, for $84/day. She's going to summer camp, hooray!

Makes me feel all giddy for you!!  That is fantastic.