Assisted living and nursing homes are so expensive, does anyone have any suggestions for alternative places?

Bhenson I hear you. My mom has 'invested' much of her $$ in a Long-Term Care policy that w hen she purchased 9 yrs ago before she got PD she thought would serve her purposes in later yrs. Let's just say -- 9 yrs later -- it most likely won't. She put the house in a living trust to me a few yrs ago but seeing as her LTC won't cover her needs that house will need to be sold while she's still alive. Best laid plans won't mean squat. She doesn't realize it because mom lives in the "I'm going to get better and stronger and isn't it wonderful I'm leaving you an asset" world. It's so sad. She did all the right things -- so she thought.

My mom can't use her $36.000.000 credit she has with home health care anymore because she needs full time care now. She has a long trem care policy too for only 4 months, and will need to become medicaid after that if she continues to live (aged 94.5 now) so I am living some of what you are experiencing too.
Look back from DHS is 5 years so maybe you could change the ownership to protect the house and hope your mom won't need to go into a medicaid situation until the 5 years time limit is up? You might check with a lawyer about selling a house when no one is buying these days. That may be another way it could turn out that you wouldn't have to sell it if you can't! Or you could then sell it, use some of the money for her and be left with atleast some of the money to start a new life.
That's a hard one but really it was her house, if it's meant to be yours it will be, if not, you won't feel bad about taking care of mom with it. We all change as they change and we realize we could be like them someday, not having any $$ to have a roof over our head. Hope this helps, just keep asking around and you may be able to find a way to have your cake and eat it too.

Kedwards, why do you think I want to pay more taxes? I pay quite a bit. But because of the loopholes, pay far less than the past. It is what it is. But I don't understand why you would take offense at someone who basically wishes we had a system to help everyone who needs care. This would be you and alot of others. Just not sure why you were so hostile in your post.

Madge1 I don't think you or anyone who pay a lot in taxes should pay more. I'm just confused that on one hand you say you pay a lot but then you seem to feel that your loopholes have you pay less than in the past. YOU seem conflicted with this NOT me. Of course I want to live in society with a saftey net for those who will never be in the socio-economic classes that you and I are blessed to be in -- you higher than myself and God Bless You. I have NO class evny on that and applaud you on whatever you got to achieve your sucess. I just feel that middle class like my mother should be able to purchase their own long term care policies, should have to them so that all their assets aren't taken and should be able to use them to provide for their needs so that they don't end up being a waste and then middle class people are forced to 'beecome poor' so that they can get on Medicaid (which is how the system is rigged now) a system that is less than ideal . You know I think Ron Paul's kind of kooky on foreign policy but he said it best last night in the debate when he said before 1965 medical care wasn't so outrageously expensive until the gov't got involved. He's right. Sorry if I sounded hostile. I think that both of our posts are probably boring the hell out to th other readers of this site. Let's do THEM a favor and cease and desist. Thank you and have a nice day.

Oh just one last thing, Ron Paul was a doctor for over 30 years so he probably has some experience.

Robin166. I am so sorry to hear that about your mom not being able to use a credit she has on her LTC. THIS is the insanity I'm talking about. There is no reason why that credit should not be able to be transferred to provide for their care that she needs instead of being wasted so that she is FORCED into Medicaid. This is what happens when the gov't is too much in our business. Good point about the DHS. I need mom to contact an elder lawyer about the house but when I mention it to mom, all I hear are crickets chirping. I still haven't had the heart to tell mom what I think about her trick or treat policy. Found out what a crook it was when we found out it pays $50-100 a day for home care. She wants to pay me since I'm here 24/7 and gave up my job to help her. But mom is going to need more than just me at some point and that's more than $100 a day and this crackbox coverage ain't going to cut it.Anyway thanks Robin.

Kedwards, I do pay alot of taxes and I do pay less than in the past. The tax codes change. Often each administration makes some changes in the way we are taxed. And investments are taxed differently from income.

Ron Paul is interesting. I agree with some of what he says but am too old to really think it would work. If I was 20 again, I'd probably like him. But, unfortunately, I am not 20. Sad.

You know there are lots of nice people here who can give some great advice. I have had alot of problems with my Mom over the last few years. Just a nasty head case. Because of good advice and research, I have learned how to deal with her. I am at peace.

Hope you find some peace with all the stress of caring for your Mom. Take care.

Isn't this site a blessing? I cannot add to the answers above, for for those of us who still can: If you can get long-term insurance, it really is a good alternative. My mother took out long-term insurance 20 years ago when she was a probation officer. CalPERS paid for 1/2 of her AL (which in CA was $3,000) so CalPERS paid $1500. Unfortunately mom's AL did not have the staff/patient ratio to accomodate her needs and we did not feel she was safe there. Now that she is at a Conv/Rehab NH, the monthly rate is around $6,000 and CalPERS pays $3,000. Mom's other assests pay for the rest. We are renting her condo. and put that money in savings. The renter pays for everything except for homeowner's dues. At this time all seems to be running smoothly.

Hopefully those of us baby boomers can learn from the above situations. Modest homes, no debt, planning for the future, frugality, being content and counting blessings, not paying for things that are not needed--those are all wonderful traits to have. Most of our parent's generation (my own Dad and others excluded) were very wise in the way they lived. May we pay heed to do the same.

I am curious about the cost of care in other areas. In rural Iowa Nursing homes start at about $ 4000.00 a month, assisted living at about $2900 a month. We recently moved my Mother to what is called independant senior housing. She has a lovely apartment that is two bedrooms, she has one very generous meal once a day in the dining room and she gets weekly housekeeping. She is really happy she was very lonely after my Father's death. There are activities if she wishes to participate, games, cards, exercise, movies and Bible study but yet she can be in her apartment by herself if she chooses to be. She has her own furniture and pictures etc. I think it was the best thing for her! She will be 85 in April. My husband and I still see her frequently I set up her medication and take her to the Dr. However I don't feel so guilty leaving her now because she is not as lonely. This is only $1500 a month. If indeed she requires more "care" in the future, I will probably bring her to my house and care for her. I had the privilege of caring for my Father and my Grandparents. take care and I would encourage you to think about independant senior housing.

Madge1 Thank you for your kind words. Those I do appreciate. Sorry your mom was a head case. Mine is real sweet for the most part although this siamese twin existence that we share now as her 24/7 I would not recommend to ANYONE.. Mom planned for the futureor so she thought (welll she still thinks) I have my doubts after finding out about what the LTC does and doesn't do which was the true intent of my responses -- not tax codes and who pays what or who paid what past present and or future in taxes. My mother planned for the future but she did not plan for PD when planning which will more than likely land her in NH when I'm not longer able to care for her and there lies the dilemna. Maybe it will all work out -- who knows.

Sorry for the typos in the above!

Kedwards, I hope it does. I have been on this site for a couple of years. I don't know why this subject got so crazy. I feel people just suffer so. Maybe I am not as good at getting my point across as I would like to believe. Mom has prepared for her future, at the expense of everything else. It has become a sickness with her. She can't enjoy anything because it would cost her the money for her nursing home. :( So Sad and a little nutty. She has ruined her relationship with me and my brother. Just wait until you read some of the posts about dysfunctional parents!!!!! Geezzzz. They will make you glad yours is nice. I learned Mom has a personality disorder and is very narcissistic. It made me see that every barb and lie does not have to pierce my heart. :)

Wow, your Mom has Parkinson's? My Dad had that. He died four years ago not from the Parkinson's but Colitius. Just weakend him until he had a heart attack. Parkinson's is harsh. You do have a lot on your plate.

Madge1. Yes, PD. First she had br cancer 6 yrs ago and she came through that fine but then the PD diagnosis. (I think she's had PD for a long time) and the cancer just accelerated the progression. She broke her hip 2 yrs ago and that set her back. Mom is the eternal optimist (me not so much) that she's going to get better and stronger in every way. She is dead set against a NH (can't blame her) but she's going to need one as I her condition progresses and so will the need for more skilled care be needed. THAT"S why I'm worried. I love her phys therpists but sometimes I think they live in la la land too by telling her she's going to be able to walk on her own and do this and that. know if I'm just being negative but sometimes I feel I'm the only one living in reality. I love mom but I wish she were in a NH facility (a good one of course) b/c she's getting harder for me to transfer even though she weighs next to nothing (stiffness from the PD). Mom is sweet but she drives me nuts telling me that we have to figure out what we're doing wrong when I'm having trouble transfering her. I want to say "MOM it's wrong that I"m doing this and someone more skilled isnt' -- that's what's WRONG." But she doesnt' wan to hear it -- not yet anyway. I'm an only child. She's helping me financially and medically which on one hand is nice, but makes me more tied to her. I still think she needs more skiilled care. She thinks I just need more training. I want my life back or the chance to have one again. Ah, the trials of caregiving

Many look at the bills of their elders forgetting that they perhaps are getting regular wages in the forms of pension etc. My grandmother got old and we moved her to a Assisted Living Center and the amazing thing was when her gift giving, travel, lunches out, club activities, and other "fun" was replaced by good company every day at the dining hall-- the balance we had to cover was really quite reasonable compared to the freedom we all maintained, the time we had back to sell her house and sort her accumulated stuff, and the money we saved on remodeling our home to accomodate her escalating needs. We were able to sell her house in due time. And she died with $20,000 in the bank and everyone paid back who carried her for a month or two. For someone who went to zero assets in World War II she died proud.

Karenp - welcome to the world of the elderly and care giving! Basically, if your parents HAVE any assets and end up needing AL or NH care - there will be NO inheritance for the kids. I'ts gone - UNLESS advance planning is done - and well in advance. An elderly acquaintance went into a nursing home about 15 years and within 6 months - all his money was gone. He didn't have a lot, but they made certain they got it right away.

I just read that the average life expectancy in a nursing home is 6 months - 2 years. Mostly because people are in pretty poor condition before they finally end up there. But, you can see why the nursing home inflates things to use up the persons assets quickly.

Sadly, my hubby's folks never discussed anything about growing older and never even discussed death - with anyone - not even between each other! When he died - she didn't even know what is 'final wishes' were - they hadn't talked about it. They figured if they didn't think about it or talk about it - it wouldn't happen! We got our ducks in a row when we were 50 - wills, trusts, etc. Don't put your planning off!!

If you have time - at least 5 years - (still 3 in some states) - go see a GOOD elder attorney. and see what can be done to preserve the estate. Go see an elder attorney even if you don't have 3-5 years. They can guide you.

Why do you think so many people are caring for their elderly relatives? I think first of all, it is because we care. Secondly - there aren't enough funds to pay for good care or we are trying to preserve their assets. My MIL has no assets - we just think it would break her heart to have to leave here :0(

The baby boom generation will have even LESS choice and sadly, our kids just may not want to put their life on 'hold' to care for their parents. This is NOT a blanket statement - I know there are still plenty of caring children out there - but this is a difficult and often thankless job - not everyone can do it. And the economy doesn't make it easy. I am not even sure if I want my kids to try.

I believe that our kids may be FORCED to care for their elderly - the government is broke.

You will need LOTS of encouragement - this site can help. I am sure glad I found it. It doesn't always change anything - but a person sure can vent :0)

Oldcodger2, very good remarks. I just wish my parents had been so nice and considerate. Mom is 81, tells us her money is for a nursing home. Will not do estate planning. Does have a POA but I think it is a springing one. Does have a will and that is about it. On the POA, just my brother. So I am screwed if he dies and she is incompetent. I have explained all of this to her. In fact got really annoyed with her yesterday.

As my Dad always said, "My money is my money to burn if i want to." he has been gone for about 4 years, and, yes, no one misses him. Just hateful. Brother and I never asked for a penny, ever. All money in our family was for their care in their old age. So that is what it will be spent for. Don't care anymore.

Sad thing is Mom has close to 1 million dollars. Nothing I can do. She gives each of us 100.00 for Christmas and we turn around and spend it on her Christmas gifst. She was bitching yesterday about her cable bill, too high. Brother pays for her cell phone and she will not get a computer or internet.

You know, I intend to not do this to my kids. i may not have any money left, but I made sure my kids could support themselves. Mom and Dad were old fashioned Southerns where girls were to get married and have kids. No education either, that cost money.

I know alot of people say it is their money to spend as they see fit. I some what agree. But every action has a reaction. And when you treat your kids like they don't matter, well the kids treat you like you don't matter either. That is what you taught them.

My husbands family entirely different. Estate planning, trusts and a good bit of inheritance. Mom was treated like a queen because she was so good to her kids. Her daughter took care of her in the last year of her life. She had ALS. Not easy.

My Mom and Dad's only comment. "They didn't want to spend their inheritance." Sorry to Vent. It has been a bad week.

BEWARE if your parents are giving you money gifts!! When your parents get to the end of their lives; if they OUT LIVE their money, like mine has, they have to go to a DHS/Medicade situation, (if you take care of them and exhaust yourselves being the caregive resorting to a rest home). You will have to pay back any and all monies that were gifted to you, in their past, up to 5 years if you ever have to do a "look back". Be carefull!! Also, watch how you take care of ownership of your patents home!! You may think you will be inheriting it but if you parnets run out of money, again, during the lookback you will have to sell it to pay for her care.

I DO understand your RANT Karen, I am in much the same position. My parents worked hard took good care of their children and now we get somewhat punished. My Mother is in senior housing. It is a wonderful place she gets one meal a day and housekeeping. She has plenty of food for breakfast and supper too.. The main meal is lunch in the dining room with everyone. She has a beautiful apartment and seems fairly happy. She is sadly one of those woman who are never content. I may have to move her soon because of her restlessness and memory issues! take care and God bless...

Robin - you do not have to sell the parents homesteaded property. The home is exempt from the asset list. The only time it isn't is:
1. the home is valued at over 500K (750K in some states)
2. it is not a homesteaded property - it's income producing
3. mom is terminal under 3/6 mos (this is usual to have happen)

What imho happens is that once mom is in the NH, there is NO $ to pay for upkeep on the house, as all mom's income less whatever her state's personal needs allowance ($30 - 60) she get's to keep. So no real $ that she can use. If there is still a mortgage, this can be alot of $ due every month which has to be paid or home goes into default & foreclosure. So the family sells the house as they can't pay the mortgage. But many family do maintain the home and pay for insurance, taxes, utitlities, maintenance, etc and then in probate seek reinbursement from the estate for what they paid for. This is totally legitimate and done all the time.

igloo572 - Does someone else live in your mom's home, like your dad or her current spouse? I know it's different if there is a spouse there, but if just one kid(s) are living with mom, and are expecting to inherit the home, while mom incurs expenses she can't pay for, in Oklahoma, you would have to sell it. What is moms (asset) has to be liquidated to pay for her expenses while she is still alive and needing fulltime care, that you yourselves can't physically give. Care giving is very exhausting (took care of mom for 9 years before my own health began to fail). Unless the home is put in the children's name 5 yrs prior to mom running out of money, and doing a "look back", here she would have to sell it. Your family sounds like there is enough of you, and an estate, to take care of her. Sounds like we are comparing apples to oranges.
Some lucky parents never have to be taken to a NH. and let's hope your and my mothers are like this. Personally, I am looking forward to the blessing of making her exit, very sweet by surrounding her with the love and tenderness she never received during her childhood.

igloo572 - Also, my mom has out lived her money (95 now) and her home health care doesn't offer what her current needs are. Her long term care policy will cover 3 months of NH care and then she goes into a Medicaid situation. That is why I'm saying our cases are different. Who knew my mom would be outliving her money!! ;))

I was just trying to warn people that when a parent gives you cash in the past like; birthday, wedding, Christmas money, vacation trips, college cash, new born grandbaby cash, etc., your state may expect all of you to pay it back

What burns me is that my mom has thousands of dollars worth of home health and NH care policies that don't fit her current needs! Even she didn't realize that the control these companies have over her money will leave you out in the cold!! I'm just really glad my mom didn't give us any cash, I was just reciting what the NH employees have told me regarding what they've see happen to some families.

Moral of the story is that if you do purchase one of the senior care policies, be sure that it cover's all health scenarios in case you too, out live your assets.

karenp and igloo572 - We did find the "Residential Care Home's" here in OK to be helpful, which mom can afford and that takes care of all HER needs and MY HEALTH also. They weren't near as expensive and offer the environment of love your parnets would enjoy. Check that option in your state too!

Ro166-actually I've said on this forum that if they live long enough they will run out of money unless they are truly generationally wealthy. And if that was the case they & their family wouldn't be on this site.LOL.

My mom is mid 90's, could afford IL and the minimum expenses related to her home. Now she is in NH with income below her state's Medicaid income ceiling of $ 2,020.00 a month so she totally qualifies for & is on Medicaid. Her home (empty with homestead exemption) is an exempt asset under her state's Medicaid. She does not have to sell it to be on Medicaid. I've found that social services often recommend that the home be sold because they know it is likely going to be nothing but a problem for the family to deal with and a $$ tar baby in being paid in a timely manner. But it doesn't have to be sold. But someone other than mom will have to pay for all for the home.

The usual story is that mom has a home but now needs to move into LTC facility after being in the hospital with Medicare paying for the stay after a fall.Family is all dither. What to do? Where to get the money? Sell the house to pay for whatever. It can totally make sense to do so but I don't think they can be forced to sell the home in order to qualify unless it's the few exclusions I posted earlier.

Home does not have to be sold to qualify for Medicaid, but has to be under $ 500K in value (some states 750K). What matters is being under the state’s Medicaid financial ceiling for all other assets and income. The Medicaid application states that any assets are subject to MERP if they get on Medicaid. (Yes, I know 500K seems high but you'd be surprised at what property values are especially if your parents bought it in the 1950's and their taxes are frozen so they didn’t worry about it). MERP can then be done on their estate as a claim or lein depending on what your states view and laws are regarding probate.

Say they are in NH 4 years then die. Now after death, MERP can place a lien or a claim on the home through probate (this is how most states do it). So if the executor of the estate wants to transfer real property (house) to settle the will in probate the lien or claim from MERP has to be released in order to do so. But you can do your own claim against the estate for whatever expenses you paid for on the empty house but you need to let MERP know you plan to do this within the timeframe set by each state.

Remember, once they are in LTC there will be no $ to be used on the home as ALL money less personal needs of $ 30-60 a month MUST be paid to the facility. So someone will need to pay for parents house expenses. If the home still has a mortgage, this can be a lot of $$ every mo.

If you do this,. It is CRITICAL
that you keep track of every $ spent. Say you have paid tax, insurance, repairs for 4 yrs @ 8K=32K. Medicaid
paid NH, med’s, therapists, 70K over 4 yrs. House value is 90K which could net 81K max at sale.

But you let MERP know you are filing your own claim for 32K. The most MERP could get is 49K (81 – 32) but only if you did a sale quickly (fat chance) before maintenance and taxes etc continue. MERP declines to do a claim as not cost effective and gives a release to probate court. You finish out probate and get the house 100%. Happiness all around!

Some states have been aggressive with MERP. As states face $ shortfalls, MERP should increase. Imho MERP wasn’t well thought out. What are states going to do with a ton of homes with old people stuff in them that likely has a decade ++ of delayed maintenance? MERP came about 2000-2002 when housing was all a go-go. Totally different real estate conditions now.

Some states have super low MERP recovery rates. Other states are more aggressive. Imho all this is really dependent on each state's view of personal property ownership and probate laws and how the program is managed. Her state just gave out a contract to HMS (they do a lot of state's MERP), so recoup should get more aggressive. I think how it happens is very dependent on what the recovery prospect is - like MERP going after a 300K home rather than 100K home.

Her cognitive abilities really changed in 2010 or so - she probably has Lewy Body Dementia which seems to be quite different in it's run than Alz. There are a couple of others on this site who have family with LBD (and who have great insight in this type of dementia) - in some ways it's super scary because they seem just so competent and normal and then they have an episode that is so unreal but real for them. For her, the LBD episodes with hallucinations and false beliefs got to the point that she flat couldn't function in IL. Her gerontologist was also the medical director of the NH so she went from IL to NH. Bypassing AL. For us, the NH is better than a residential care home or board & care home, as her gerontologist - affiliated with a medical school - and their NP's are on-site regularly at her NH
and get the more specialized understanding of & care for her type of dementia.

Understood!

Omg and the sky is falling. What is a person suppose to do with our parents? take them over state lines and dump them ? We do need care from cradle to grave. God help us all,when its our turn.

Some friends of ours have found some wonderful caregivers from Fiji or from the Philipines. They believe in caring for the aged with dignity and respect. You can possibly find some names from AL's, SN's or on the bulletin board at Senior Centers for long-term overnight caregivers. Of course it is good to have a locked filing cabinet for all personals if the person is to be in the home, or what I have done, is buy a new 4 drawer locking cabinet and keep all of my mother's items in a room at our home. I hope you find someone--please keep us updated.

I've read a lot of the responses in this thread with interest. It is strange how we can become conditioned to think in certain ways. Throughout history, people have not only worked for themselves, they have worked so that they could leave things for their children. Men would buy properties in hopes that one day they would pass them down to their sons and their families. They accumulated family heirlooms that they planned to pass down to daughters. It is a very natural thing to want to build an estate, so that it can benefit a couple's offspring. This has been going on throughout history.

But now, people are being conditioned to believe that there is no right of inheritance. If the parents build up an estate, it is just a bad break if they live long enough for the health care system not to consume it all. From the looks of things, it will not be long before the health care system becomes the sole legal heir of all estates in the USA for people who are middle class and poorer. I like this thread because it asks the question why is health care so expensive in the USA? My wish is that people would resist becoming conditioned to thinking that the heirs have no rights to an estate their parents built up, but would fight the rising costs of elder care in the USA.

If you think about it -- why does it cost so little to put a baby in childcare, while it cost an arm and a leg to put Grandmother in one?

When we have had to place family in homes, we never have had to pay the entire bill from savings. In this current example the mother has $2500 in pension and she is being asked to pay $3500. So the cost to the family from savings will be $12,000 a year. Start Slow. Sell her car. There's one month. Sell some jewlery, thats the next month. Rent out her house and try and get $1500 a month....
Just keep breathing. The water will clear and you will see the way through.

Hello Karen
If a person is suffering from memory loss or disorientation, it is the care they need the most. When my mother caught herself with Alzheimer’s, we brought her to. I think it was the best decision we ever made. Their activities of daily living supported her very much. All their facilities were just in line with our budget. I hope it will be same in your case too. It was not just a matter of money; she is receiving the best medical care and emotional support to fill her days with precious moments. They adds a special meaning to "assisted living and nursing homes".

Maybe you have someone live free in her home, if they would take care of her.