Help: Talking to Mom About Dad's Care $$

Subject: Help: Talking to Mom About Dad's Care $$
From: wysiwyg
Date: 25 Feb 04 - 08:27 AM

How would you go about helping your mom (my maw in law) understand that it is OK to use the great savings they have for your dad's (my paw in law's) longterm care? I know a lot of it is sticker shock-- they do have some pretty nice extended care insurance, but she's just realized it's not going to be enough. She seems to be stuck on the idea that it's more important to leave a nice estate than to use the funds now.

Where is that paradigm shift located?

????

~Susan

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: Wesley S
Date: 25 Feb 04 - 01:48 PM

Convince her that the best "estate" she can leave you is the memory that the two of them were well taken care. Now - when it matters. Their estate will be worthless if it's founded on memories of the suffering they endured to provide it.

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: AllisonA(Animaterra)
Date: 25 Feb 04 - 02:12 PM

Here, here, Wesley!

Far more important than laying up treasure on earth is the satisfaction of knowing that Stan had the right care when he needed it!

Light and love heading your way...

Allison

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: dianavan
Date: 25 Feb 04 - 02:15 PM

Convince her that you care more about your dad than you do the $$$$

d

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: GUEST,MMario
Date: 25 Feb 04 - 02:24 PM

and if that fails - get out the two-by-fur and whomp her upside the head.

there are sometimes when the older generation needs to have about more of the "me generation" attitude. Longterm care is one of them.

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: maire-aine
Date: 25 Feb 04 - 02:26 PM

I had a whole long reply typed up but I lost it. Anyway, how about trying to get her to be explicit about what she wants to give to whom and why. For example, is there someone who is ill or has a disability who needs extra help? Or grandchildren who she wants to help with college? Maybe with the help of a banker (or better yet, a financial advisor who specializes in elderly clients), you could set up a couple of trust accounts (with you as the trustee); if the money is needed for his/her care, as trustee you could re-direct it. If not, she'll know that it's set aside.

Good luck,
Maryanne

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: wysiwyg
Date: 25 Feb 04 - 03:48 PM

Under Medicaid rules, you cannot divert funds to a trust within 36 months in order to reduce the amount that can be spent before applying to Medicaid... and since he may outlive the extended care insurance max benefit, Medicaid may be necessary at some point. I think she is wishing now that when they set up the trusts they do have set up, they had segregated the funds differently and/or increased the insurance.

Most of what you all are posting is just what I have been thinking-- the problem is, tho, she's not listening. Should I just assume this will resolve itself as she continues to absorb the info that's sitting underneath the shock?

(Pass me the 2 x 4 just in case)

~Susan

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: GUEST
Date: 25 Feb 04 - 05:04 PM

Why not tell her that it would mean so much more to you that he had the proper care now, that you are willing to make sacrifices yourselves to pay towards it? The thought of you struggling to help, when the means are there, may sway her?

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: Deckman
Date: 25 Feb 04 - 06:06 PM

I know a LOT about this subject. I just went through it with both of my parents. First of all ... WHAT COUNTRY ARE YOU IN? Bob(deckman)Nelson

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: Deckman
Date: 25 Feb 04 - 06:07 PM

I'm sorry ... what country and what STATE, if you are in the United States? Bob

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: maire-aine
Date: 25 Feb 04 - 06:23 PM

I think she's in Pennsylvania (US)

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: LilyFestre
Date: 25 Feb 04 - 06:28 PM

So what are the alternatives? I mean, if she isn't wanting to spend savings on longterm care and his insurance will max out, what does she plan to do? Or is it a situation of making a choice of one really REALLY nice care facility (which would require the extra savings) or an okay care facility that likely not exhaust his current extended care insurance? Do you think your MIL is concerned about having an estate to care for her children after she is gone or is she needing that savings to make ends meet now or for just in case? Is your FIL able to verbalize coherently what he wants to happen or has he lost his power of attorney at this point? Outside care is always hard for everyone involved. I don't envy you, Hardi or his parents.

Michelle

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: Jeanie
Date: 25 Feb 04 - 06:53 PM

I'm writing from the UK, so I have no idea of the financial technicalities involved in the States, but from my experience, the big obstacle here may have little or nothing to do with the actual money. People (of all ages) use the spending and not spending of money to express all kinds of unspoken fears and needs.

I can see why old people are often so stubborn, not only about finances, but about everything, major and trivial. Behind it is the fear of a time coming when they may no longer be in control, no longer able to make decisions for themselves. So they make decisions and have strong demands and expectations of people, and cling to this tenaciously, in order to prove to themselves that the feared time of no longer being in control has not yet come. I see this in my own mother (who is 85). My seeing it that way hasn't changed her strong willpower one jot - but it helps me to try finding different ways to react to it and, hopefully, to say something helpful and reassuring to her. Not easy, though ! Bloomin' frustrating at times !

A lot of old people are very scared of spending money, no matter how much they have in the bank. I see this in my mother and from what she tells me about her friends in the old people's apartments where she lives. They give themselves (and others) all kinds of reasons for not spending, but underneath it all, I feel, is the big fear of life coming to an end. "As long as I have money in the bank, I have a place in the future." This may be why your Mom is so insistent about the leaving an "estate". This may be the illogical "logic" of it.

With every good wish to you and your Mom and Dad,
- jeanie

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: wysiwyg
Date: 25 Feb 04 - 08:51 PM

Thanks, all, keep it coming.

Deckster, I am in PA but they are in IL.

~S~

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: Deckman
Date: 25 Feb 04 - 09:21 PM

O.K. You asked serious questions about serious issues, and I feel very strongly about the subject. I live in Washington State, (beautiful place) but the laws in my state are NOT the same in your state. For example, it's NOT true that your parents cannot "gift" money toward the closing of the life. But, and this is very important, the rules of how much, when and how, are unique to your state.

Here's my adice: GO to the phone book and look up attorneys that specialize in "Elder Law." That's how it's listed in my state. Then, try to contact people, nursing homes are a good call, and try to get a personal referral on an attorney specializing in "elder law," that is GOOD!

Let me explain, I did this exercise. The first four I called wanted $1,200 for me to walk in the door. True! But, I lucked onto a caring attorney who had his hat on straight. I spent dollars for two appointments, wherein he explained the state rules and regs regarding my situation. By the way, my situation was just as you have described. For the two appointments, I think I spent maybe $150.

I do hope this helps. Please feel free to PM me if you want. Bob Nelson

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: wysiwyg
Date: 25 Feb 04 - 10:12 PM

Thanks, Bob. I may not PM right away but you will probably hear from me.

~S~

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: maire-aine
Date: 25 Feb 04 - 10:21 PM

Deckman's right about getting an elder law specialist. When my mother took ill last year, I worked with a geriatric care manager who is also a lawyer. She helped with the practical work of getting her into a nursing home, but she had also giving my very good advise about financial (read Medicaid) planning.

M.

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: harpgirl
Date: 25 Feb 04 - 10:56 PM

She should consult an attorney. But, Susan, I think you should honor your mother-in-laws wishes. That is the most respectful thing to do. Don't try to make her think like you do. It's one of your faults.

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: artbrooks
Date: 25 Feb 04 - 11:50 PM

Susan, get together with your sibs (if any) and put together a written statement for your mother that states that your preference as potential heirs is that any money they have be applied to his (and her) medical care rather than be left as an inheritance. Sometimes (and you know her better than any of us do) a written statement means more than verbal assurances.

Did somebody already say it? A large balance in the bank will prevent Medicaid from kicking in, and they have already paid (through their taxes) for that program.

Good luck.

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: Deckman
Date: 26 Feb 04 - 12:25 AM

Gargoyle ... With all due respect, and I don't know how much respect you deserve ... I found your posting extremely ugly and insulting. Bob

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: LilyFestre
Date: 26 Feb 04 - 06:42 AM

Susan,
I understand that you live in PA and your inlaws are in IL but do you think if you contacted the senior center in Wellsboro that they could connect you to some help/resources in IL? I know that the senior center in Wellsboro was a great resource for me when I had to tend to my grandmother in regards to long term care, insurance issues, additional financial, etc.

Michelle

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: wysiwyg
Date: 26 Feb 04 - 10:16 AM

Update:

Knowing I would get good input here, I let go of the worry and started THINKING, which is what I had wanted my maw in law to be able to do. I began to realize that one thing I could do was help reduce the overwheliming detail of the info she has been getting-- by providing a good overview on which she can organize that detail. So I spent yesterday Googling, and gathered a good set of Illinois pages summarizing the legal, financial, and neighborhood aspects of the various options she has been considering.

I sent these to Hardi's office so he could review them himself. Since he had spent most of Tuesday afternoon talking to a friend of ours here who administers a facility, getting his own overwhelming orientation, he found the material helpful in his own conversations with his mom. I also sent them to the son who is living with her now and who has been accompanying her as she gathers information and options.

I also called her yesterday afternoon. We have a unique relationship; she's a lifelong stay-home mom, didn't drive, totally home-focused, till my Paw in law's strokes about 12 years ago. Since there she's been his primary caregiver, and only recently has been getting paid help in that.

My role in the 10 years I've known her is to see and affirm her strides in independence... to see and affirm the slow but steady pace of personal growth that I believe has fitted her for her changing role in his life. We talked about the nature of their relationship, and I reassured her that even though she has been taking care of him at home for several years, it's his physical state that is so deteriorated, not his mind, and that he can actually contribute to this decision as her partner.... since I have twice spent time there while she vacationed, filling in for her for weeks at at time, she knows that I do know something about how he functions, and she listened to me.

I said enough that she began to talk about the adventure it will be, possibly selling the house and moving to a new community where he can get the care she wants him to have... the fear she has that she says also feels very intriguing, about whether she will be able to adjust. I told her all the ways I can see she has been getting equipped for just that adjustment.

We did not talk about what options she will choose, at all. I could hear that she had begun to recover her thinking process, and said so; she replied that she had actually fallen apart completely since we had last talked, and that while it had been scary it had also been cathartic and she was feeling much calmer, much more able to take small steps while considering the larger ones that are to come.

Her plan now is to move him next week from the rehab facility that has to discharge him, to a nearby, excellent facility on an interim basis as a privately-paid/insured patient, while she considers the longer-term options. This means he will be able to receive slower-paced rehab nearby, and either make progress back toward home care or realize on his own that home care is not going to remain an option. He will be better able to make the adjustment to a future in a facility, while still being in his home community, and have a safe base of operations himself from which he can partner her in the process of making the next round of decisions. And she will make better decisions because she also will be "home" while thinking about a possible move for herself.

All the input here was extremely helpful, to me and to Hardi, and we will have lots of time to incorporate it as we continue helping from a distance. Thanks, Mudcatters.

~Susan

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: Deckman
Date: 26 Feb 04 - 10:52 AM

Good for you. It seems like you're asking the right questions and getting good information. Hang in there. Bob

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: wysiwyg
Date: 26 Feb 04 - 11:25 AM

Thanks, Bob.

~S~

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: beadie
Date: 26 Feb 04 - 11:41 AM

WYSIWIG;

I am an attorney working in a state elder advocacy agency in enighboring Wisconsin. Although you correctly surmise that the laws differ from state to state, there are some (federally mandated) similarities. For instance, the "look-back" time limit for gifting is not the same as the time for creating a trust acocunt. Most states use a 36 month window for gifts and a 60 month limit on trusts. In other words, if you give assets to a person (or sell the asset for less than its market value) and then, 24 months later, need to utilize Medicaid to finance care in a nuirsing home, the state MA agency will delay beginning of benefits for a period that is determined by the average monthly cost of nursing home care divided into the value of the asset given away.

An authoritative source for local information is the Area Agency on Aging in the county that your in-laws live in. This is a state agency (or private entity under contract to the state) and their number should be in the local phone book. Most AAAs either will have someone on hand who knows this stuff or they will know where to refer you to find the info you need.

   Good Luck

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: wysiwyg
Date: 26 Feb 04 - 11:54 AM

beadie, that's VERY interesting. And yes, we have referred her to their AAA.

~Susan

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: beadie
Date: 26 Feb 04 - 12:30 PM

Happy to help.

   You might also try checking out this website:

    http://www.nasmd.org/eligibility/default.asp

This is a national association of state MA Directors that provide some really good information, advice, and other resources.


(sorry that it didn't show up as a blue clicky, it must have exceeded the limits of my internet literacy)

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: wysiwyg
Date: 26 Feb 04 - 12:51 PM

Cool, thanks.

I might add that as a pastor's wife, I often end up doing a fair bit of social work with parishioners and walk-ins. They often need help knowing how to approach whatever system they have to deal with-- how to sort out their interests and use the system effectively. Or sometimes they just don't know where the starting point is-- and like me, are upset enough to have trouble spotting it themselves. Over time, I am gaining an overview of the basic resources for a variety of life-passage issues. So this will all be helpful in the future, as well. Some of the advice above, if it does not apply in our particular situation, will no doubt be helpful at another time. Perhaps it will also be a reference for other Catters, sometime.

~Susan

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: Stilly River Sage
Date: 26 Feb 04 - 01:45 PM

To put in a word for the elders involved, I have watched several of my elderly relatives and their immediate kin (children) struggle with the problem of what to do about this kind of care at the end of life. For those who have worked hard all of their lives in order to leave a legacy to their family, it galls beyond belief to have the state and the federal government whittle it away until they are with nothing, stripped naked of resources, before the government will step in. Once you have trod that path there is no way to recover from it if the state or feds fuck up. You put yourself in the most vulnerable position possible at a time when you're likely to fully understand your vulnerability (unlike infancy when you're equally dependent).

To have to choose a strategy in which everything you worked for is taken from you, in order to receive the puny largess of this great nation of ours--it's a horrible form of torture we put our elders through.

SRS

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: beadie
Date: 26 Feb 04 - 01:50 PM

As an aside, and perhaps now may not seem the time to bring it up . . . but it is, . . . talk to both the in-laws about advance directives if you haven't already done so. Naming a power of attorney for health care and creating a "living will" is a terrific way to avoid many presently unforeseeable problems later on. And don't just fill in the blanks, . . . take a few hours to really think about what they want to say and then discuss it so that everybody (and I mean EVERYBODY) knows what they want done or not done should it become necessary for someone else to make the decisions.

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: beadie
Date: 26 Feb 04 - 01:57 PM

Sage:

Not to dispute your assessment, but my own sainted Mother, until her death, was absolutely opposed to any form of assistance on the grounds that she and my Dad had amassed that estate "for a rainy day," not to give it to the kids ("hell, the kids will just squander it anyway, if they aren't turned into lazy, shiftless so-and-sos by receiving all that wealth without having worked for it").

Of course, that was the Depression-Era concept of personal wealth talking. People should spend what they earn, not what they are given.

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: Deckman
Date: 26 Feb 04 - 03:44 PM

I am VERY impressed with the quality of the advice you are getting on this thread. Everything that "beadie" says certainly rings true. And also, I can't help but echo what "Stilly River Sage" said. It came as a heart breaking shock to my Father when he realized that the fortune he had managed to squirrel away was NOT enough to take care of his wife and him until their deaths. And as was mentioned previously, he was a product of the depression.

I absolutly know that this subject is going to become increasing important in the next very few years. I'm 66 years old, and was a member of what I call the "sandwich generation." This is where I was "sandwiched" between the needs of my aging parents and my own children. No wonder I've got grey hair ... what little of it is left.

The maddening thing to me, and I guess this is a thread creep, is to realize what little the various governments, State and Federal, are actually doing about this problem. Bob

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: Rasener
Date: 26 Feb 04 - 05:25 PM

Hi I live in the UK and have just spent the last 6 months dealing with my parents issues they are both 87.

My mother became quite ill and it was obvious that my father coudn't look after her anymore, so I reluctantly allowed social services to put my mother into a home.
My father was not accepted into a home because they said he was OK. He was so upset - phone calls everyday, crying the lot. Very stressful
I took the issue up legally and fought social services on the grounds of seperation and human rights. I won before having to go to court.
They are now in the same Care home near to me. I insisted that they could no longer handle their affairs properly and they accepted that.
I am now Enduring Power of attorney for everything. I am making sure that they spend their money and enjoy life as best as they can. They seem to be settled now, although my mothers life expectancy is very short.
Non of the children are interested in their money. We want them to spend it.

Sometimes you have to bite the bullet and get on with things no matter how sad/hard or traumatic they may seem. I can put hand on heart and say that I have done everything in my power to help keep them together for as long as they live. Not doing anything, even though at times it was a big battle, would have been failing them.
I am not proud that I had to make the decisions, but somebody had to.

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: Charley Noble
Date: 26 Feb 04 - 05:42 PM

As someone who is the primary caregiver to my mother who still lives at home at age 86, I appreciate the thoughtfulness of many of the posters above. My father died last year at age 98 and we're still in transition until his estate is settled. I am impressed with how much thinking and planning my parents did about planning for their retirement years. Even spurred my wife and me to do some planning ourselves.

Don't forget to do your own, Susan.

Charley Noble

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: Deckman
Date: 26 Feb 04 - 05:43 PM

To: "The Villan,"

Thank you for your posting. It's obvious to me that you are missnamed. The "HERO" seems more fitting.

It's very difficult to talk about personal matters, as you have, on line. It's 'kinda like taking your clothes off in public. Yet, as I'm sure you know, when you do dare to expose yourself on such sensitive subjects as this, you know that you help countless numbers of people.

As I've often said to the nursing staff that helped my parents and myself: "God must have a special pair of wings ... JUST FOR YOU! Bob

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: Rasener
Date: 26 Feb 04 - 05:54 PM

Thanks for the comments Bob.

I just feel that if people can say what has happened to them, it can sometimes help others.

I am like you a bit. A sandwich. 58 with wife and children and the situation with my parents. But you just have to get on with it. :-)

Incidentally to be a Villan is to be an Aston Villa soccer supporter. If you are in the UK you will know what I mean. :-)

Les

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: wysiwyg
Date: 26 Feb 04 - 06:07 PM

Talk about thread creep-- now it's about taking our clothes off? Don't we have enough of those threads already?

:~)

Just kidding.

~S~

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: Deckman
Date: 26 Feb 04 - 06:30 PM

O.K. I'll put my clothes back on now! Bob

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: Stilly River Sage
Date: 26 Feb 04 - 06:48 PM

Good thing! I was going to tell folks in another thread that I'd posted a recent photo of you, Bob, but they might get the wrong idea about what I was sending!

In the "for what it's worth" department, I've been trying to set things up so that years from now they are all taken care of as far as helping myself and helping the kids. They know they have to do a lot for themselves now, including paying for much of college, because as a single-mom-state-employee, I'm not in a great position to crank out the dollars. I'll provide room and board if they go to school locally, and I'll do what I can if they go elsewhere. They are getting the information now about saving and investing so that they can achieve a level of comfort as far as owning homes, having money to travel, etc. When what I have goes to them, I want the move to be peaceful and easy for everyone. And though it may be a bit insurance-heavy now, I have both short- and long-term care insurance. (If you get in when they first offer it, you don't need to get a physical, etc. Since I had cancer surgery a few years ago, if I waited, they might exclude me later, even though my surgery completely took care of the cancer.)

I wonder what stories my kids will be telling about how I tried to take care of everything--if I succeeded or not? My parents both did, but that's partly because neither of them outlived any of the benefits they were receiving as retirees.

SRS

Subject: RE: Help: Talking to Mom About Dad's Care $$
From: Deckman
Date: 26 Feb 04 - 08:47 PM

Stilly River Sage just posted: "Neither of them outlived the benifits they were receiving as retirees." There's the clue. If you can figure out how NOT to outlive those benifits, there is no problem. I predict that within a few short years, this issue is going to cause a HUGE problem for the American so called "Christian" culture." Bob