My 86 year old mil has had 3 falls in 7 months. She lives alone. Last month’s fall resulted in a broken hip. This fall last week requires stitches in head and 2 weeks of rehab.
She has zero interest in nursing home and wants in house care.
The avg. cost in area for live in aid is 11k a month.
Today we found out how woefully little she has. 100k in cash and owns house valued at 200k. I am floored. Where it all went is anyone’s guess.
I presume she can refinance house to pay for care while living there? Any other thoughts I might be missing? She has Medicare of course I’ll call tomorrow for coverage but I’m guessing they don’t cover this.
Thx for any input or advice.
Does your MIL have a PoA? If she does, this is the person who should be pursuing solutions for your MIL. If you are not her PoA you have no power to do anything for her.
If your spouse is her PoA, this is the person with the authority. This person now needs to read the PoA document to see what activates the authority to act on behalf of your MIL -- usually it is 1 or 2 medical diagnoses of cognitive impairment.
Also, if your MIL is not cognitively impaired, her PoA's authority is not yet active.
If no one is her PoA then the next time she falls and needs a trip to the ER, talk to a discharge person or social worker there and let them know she lives by herself, has fallen several times and is now an "unsafe discharge". The social worker can then maybe begin the process of transitioning her directly into a facility -- but if MIL has all her mind then she still gets to call her own shots and can check herself out and go home -- if someone goes to get her (and it shouldn't be you).
The house will need to be sold. She will not be able to refinance if she is incompetent or not able to do things in person. Once in a SNF, consider this as permanent.
It's best to find a good place for her NOW while she can settle in and make some friends and get used to the place. If the doctor's evaluation after 3 weeks is she needs a nursing home then they aren't expecting her to benefit from any additional therapy and she is probably at her highest functional level. She may be able to qualify for an assisted living facility.
Typically assisted living places don't qualify for any Medicaid funding but she has enough assets to be able to live there for a few years. You need to talk to an elder attorney to get the full information on Medicaid qualification in your area as it varies by state, and to make certain that you don't inadvertently do something to make her ineligible (gifting money, large purchases, sale of house at less than full market value.)
She's not going to be happy with this but you can't enable her bad decisions. DO NOT help her in any way to be able to move home. If she can manage to do it all on her own then good for her, but you don't want to be the one that encourages or enables her bad decision making. Too many of us have fallen into that trap.
She is perfect mentally. ZERO forgetfullness. It is amazing honestly. As of now, she lived alone and covered her own bills. She pays a local man to cut lawn/plant flowers and she had a small policy of credits that had a housekeeper meal preparer come in over the last 2 years. Home is immaculate and in great condition. HOW she spent 4k a month I will never know. I am blown away from her lack of finances.
We live 5 hours away from her so we do not live with her.
If you could clairify the ability to have medicaid despite 4200 a month? THANKS!
Your MIL either uses what money for care in her home or she pays to go into an AL. I think you may want to make an appointment with Office of Aging and have them tell u what Medicare covers and what Medicaid can do. For now your MIL needs to spend down that 100k before Medicaid of any kind can be gotten.
I recommend encouraging the POA to have a consultation with a Certified Elder Law Attorney versed in Medicaid to know what is available in MILs state, not all states allow them and I found for my dad, he couldn't afford the trust set up.
Sometimes we have to back off and let the people with the power see how bad things are when we are not propping them up. That is a very hard move to make, just a heads up.
Why do you feel MIL should have more saved? How long has she been a Widow? 4k sounds like a lot but not if your carrying a Mortgage payment and a car payment. My Dad died in 2006 and I am sure my Mom could not survive now on what she was getting in SS and pension. My Mom had a house that needed more work done on it than it was worth and 48k from Dad's life insurance same with my MIL.
Since Medicaid is also Federal there is criteria States have to follow. But each State can have different income and asset cap amounts. Since the POA will be handling everything having to do with MIL than that person needs to find out Medicaid rules. POA can make an appointment at Social Services and talk to a Medicaid caseworker. POA can consult with an Elder Lawyer when a facility seems to be in the picture about setting up a Qualifying Trust.
Seems like u and in-laws are close. That's nice but as POA SIL should not be discussing her Mom's finances with other siblings. She is Mom's representative and it's between her and Mom. Actually, if Mom is competent and the POA is not immediate, SILs POA is not in effect. Most POAs need a doctor or more to say Mom's incompetent before a POA is invoked. Maybe SIL should consult with a Lawyer to see what her responsibility are as a POA. She needs to read the POA to see if immediate or needs a doctor/s to sign off. Even if immediate if Mom is competent, she still has some say. Immediate just makes it easier to help. No need for doctor signing off if principle is incompetent.
So your MIL has a LTC insurance policy that will provide 35 hrs per week. Is there a time limit on this policy or is it a lifetime benefit once activated? How sure are you her condition would allow activation? If she can use it, I think the steep payments stop but is this really the time to use it if she only has it for a couple of years benefit would be a concern for me.
She doesn't own her home but I assume she pays the taxes and insurance and maintenance. Plus I’m assuming she drives and has auto expenses, health insurance, diabetes drugs. By the way there is some thought that some of the diabetes drugs improve cognition.
She currently has a housekeeper and food prep and lawn maintenance so she has been taking care. All good things but add to her monthly outgo.
She’s competent and in good health aside from diabetes and falling. Is she also obese? Have mobility problems?
The broken hip can be a game changer for some but not so much for others. It can be considered maintenance. How did she do on the recovery? How is the other hip? Oh and know that the hip may have broken causing the fall. Was that discussed with her doctors?
I think I would do a deep dive on the falls to understand how/why they occurred and not assume this is a sign she needs 24/7 care. I say this partially because in my family experience the broken hips required surgery and rehab but there was full recovery. No one needed home help after rehab.
Also, how long ago was the title to the house transferred?
If she has been paying taxes, etc on the house it may appear as gifting since she doesn’t own the house if there isn’t some sort of legal contract. Did she retain a life estate? Whose name are the taxes in?
Have MIL and daughters been to a certified elder attorney in MIL state?
We all learn from each other so please do let us know how this plays out.
The single best investment I can think of is a few hours time with an Elder Law Attorney.
This will give you a check up on paperwork that is done or not done, POAs, wills, etc.
And will explain options that may or may not work on a home with valued at 200.00.
On the face of it I doubt that a reverse mortgage would get her enough to fund her care after her funds which will cover a year of care are gone. Do know also that having a caregiver in her home is not likely to prevent her falls, that she likely needs more than ALF which would mean memory care which would cost likely the 11,000 you quoted (cheap for in home 24/7 coverage, and I doubt you could hold it to that).
I think you need an attorney with options, estimates and etc.
At to where did it all go? Well, I have no idea what was saved up at retirement two decades ago. Do you? Was there some enormous fund stuck away. Because one cannot live on SS normally in this day and age. So I assume it went to living expenses. I don't know how much familiarity you have with her financial history.
Best of luck. Get attorney advice as to plan forward and make best choices you can. It may be to live at home while she can with the care, then apply for medicaid and go into are. My guess is there will be little other choice. But I could be wrong, am not an expert, and in this you NEED the expert as you cannot afford to be wrong, or guided in wrong direction.