My otherwise healthy mom is 74 with MCI. Her mom died at 92 of AD. How can we afford memory care for 20 years if necessary?

Hi, Wriggley. I haven't seen another post from you regarding your question but forgive me if it's already been answered elsewhere. (This is an older thread and I don't want you to get lost in the shuffle.)

I would start with the website for your parents' county, and find the phone number for the Area Agency on Aging (sometimes it has a slightly different name) for their county,

Another question. Was your mother, or your father a veteran? Veterans of a state that has a veteran LTC facility have an entire different set of rules than medicaid. IF this is the case, be checking with them on their terms. In our state of NE there is the 2 year rule, not 5 year as for medicaid. Personal exemptions is much higher than for medicaid. Thought you should know this. Most people think veteran homes are for veterans only. They are for the surviving spouse as well. At least here in NE

Find an elder law attorney who will help you pay down and save some of her assets. They can advise you on gifting etc. They will truly help but they do have a fee. I most certainly advice to get one recommended by Dave Ramsey as you know they are legit and can be trusted.
Or look for an agency on aging in your area. (A prepaid funeral plan in place is a must )

My husband and I retired at age 62 and lived solely on Social Security quite successfully, enjoying our retirement together for several years. Then he began to show symptoms of Alzheimer's (his mom died of it at age 79). He was at home with me for 6 years as his health deteriorated from Alzheimer's, CHF, and eventually prostate cancer. Late in 2017 our children helped me realize that I was risking my own health by trying to continue caring for their dad at home. So in October 2017 we applied for Medicaid benefits for him, and he was approved in December. Fortunately, I had already put the necessary documents in place giving me Power of Attorney, and other documents that are important. After Medicaid approval, I searched for a couple of months to find a Memory Care facility that would accept a Medicaid resident, finally finding one that is 40 miles from home. The distance makes it difficult for me to visit more often than once or twice a week, depending on weather conditions, etc. But I am so grateful for Medicaid because there is no way we could ever have afforded the cost of long-term care in a facility.

Please consult with an elder law attorney in your state. Find out how she can become eligible for long term care with Medicaid. This is not a do it yourself project. The rules differ between states and are very specific. The penalties can be severe. In California currently, a person can transfer to a nonrevocable trust $7000 per day When the money's all been transferred, they become eligible for Medicaid. (This is how the middle class depends on Medicaid.) The money can be spent on her care, but doesn't effect her eligibility for Medicaid. Again, check with an elder law attorney.

With my husband (dementia and then a couple of strokes), I also was overwhelmed, but hired a really good Michigan elder law attorney to get him on Medicaid. He spent 1-1/2 years in a nursing home. We were by no means broke, but in order to keep money for me in my own old age it was certainly worth it and cost me about $10,000, but saved me thousands and thousands. As the primary wage earner, still working, I had to divest him of everything in both of our names (my 401k, bank accounts, will, etc.). It was heartbreaking but it can be done, and you have to provide the attorney with mountains of paperwork, but it worked and it is legal. He passed away on July 9 of this year and I miss him, but am grateful every day for the actions I took.

You don't have the legal right to save your mother's money. This will be used for her care if it becomes necessary.

But, you also don't have the legal responsibility of paying for her care - she will be required to "spend-down" for the much needed Medicaid if she needs to be in a Memory or Nursing Home.

You'd better be keeping receipts and records for where her money is going.

Planning with an atty will be very worthwhile. If you want to do things a bit more creative I’d suggest you get a NAELA or CELA level of elder law atty. Sadly 110k isn’t that much $, but means you can move it into a couple of things. At a minimum imo you should have a personal care contract done between you & her that means she pays for staying with you. It will have to be on the legit with a properly drafted contract and taxes paid. So your taxes increase but it will build your own eventual SS check. And if you can, try to put that $ away in its own pitiful interest bearing account and have it for an fund to pay for in-home care for her IF needed to get her to get totally beyond the 5 yr lookback. So no Medicaid issues when she applies in 2023/24. You may want to look at a Medicaid compliant trust for her to be able to buy things not covered by LTC Medicaid, atty will have suggestions as to how to do these.

I imagine she’d like to do something for the grandkids, whatever happens will be subject to 5 yr lookback. So doing this runs risk but at 74 to me it’s a worthwhile risk. If your kids are still young and your not facing doing FAFSA, college trips & applications etc this fall, I have a couple of suggestions (we have a kid in college):
- make them get summer or part time jobs even if just a 3 week holiday job so that they file taxes while in HS & can have taxes on file to do their own lil’ FAFSA application.
- ask atty about feasibility of doing UTMAs with some of her $ with you as custodian. Not mom as custodian. UTMA done for this year and next year only, so you can get them both ready to drop in Dec & Jan. UTMA held by you as custodian till 21. Some states allow to hold till 25. It should not enter in thier fafsa when they are applying for financial aid as it’s not theirs till the age of release in the UTMA. It’s not your $ so not on your fafsa. Once of age technically theirs but you as custodian use it in full to pay off their Stafford. If you not familiar with Stafford Loan, all students can get it no matter what, it’s solely their debt (not mom & dads) & starts at $5500 and increases 1k for each year to 7500 max (for that 2 yr senior “year” that seems to be the norm now, lol!). 2 years of UTMA max (14k) will wipe out a 4 yr Stafford. What we were suggested to do is to have kids get a Stafford even if their on full scholarships or parental income as determined by fafsa is such that they don’t qualify for any aid, so that the student has “skin in the game” and responsibility to learn to deal with debt for their education AND it allows them to have $ so that they aren’t constantly asking you as Bank of Mom for $. It drops into whatever banking the school has for student aid. It can go for tuition but if that’s being taken care of (like scholarship) then it’s stays in the bank account from them to draw from via debit card or student ID linked to banking (this is what our sons Univ. does). They need a way overpriced book for Accounting 101, they buy it from Stafford $, additional meal plan, it gets paid from Stafford.

Divesting assets to become Medicaid eligible can be done but it has to be planned years in advance. Whatever will run risk to get stuck in transfer penalty hell if they need care in a facility before a 5 years. So you have to be willing to run risk & why having that nest egg of $ for inhome help will be good to fall back on. One of the experts on site site, Gabriel Heiser has a book on all this “Medicaid Secrets”, really REALLY worthwhile to buy to understand the maze that is Medicaid.

& if yours are looking at schools that require “The Common Application” good luck, its a beast to get through.

I'm going to get political here -- how do you make sure your mother is cared for? You, and all of us, must pay attention to what are election candidates are saying. Medicaid is there to help you, to help all of us who need it and who qualify, but it won't be if we don't vote the interests of our aging loved ones and our family members. Medicaid MUST be a top political priority for all of us with aging parents. I never thought about politics this way until my mother's dementia. Our elderly are not a priority for politicians and they must be -- we have to vote to save Medicaid!
As of today, you will be able to get Medicaid for your mother once her assets are spent. However, I would start acquiring information about MC care facilities for NOW, so you have an idea about what's available for her. Make sure the facility takes Medicaid -- that's the first question you should ask, then go and visit. There are elder care navigators (a new field of social work) that can help you through the process as well. They are helpful. It seems overwhelming, but the more you know now, the better.

Addtionally you need to get a POA and a living will for her in place immediately. Medicaid is the way to go. 5 year lookback on how she spent her money, so you may need an eldercare lawyer if she created any penalties.

I am sure most People will agree irrespective how you plan for the future it very rarely pans out the way We intended as some thing unforeseen always seems to get in the way.

Go to an elder care attorney--the law is very complicated and it varies from State to State. If you plan to put her in a nursing home, there is a five-year look back law. In addition, Medicaid has an estate recovery law--anything that goes into probate Medicaid can seize. If you plan to put her in a nursing home, all of her assets go to them. $110K will not last long--it costs about $90,000 a year to care for a single person. Quite frankly considering you will sacrifice your life for that loved one for years and years, it is not worth that $110K. You also better establish who is Power of Attorney and get a legal document drawn up by an attorney to prove it. You absolutely NEED this. Once you get Medicaid involved you will discover just how dirty the government is when it comes to money.

AND very important, you do not intermingle money. Mom keeps her own accounts, does not share or co-own an account with anyone.

You find out about Medicaid. You do not use her money for anything that is not for her. If you are paid by her for her care or room and board you make sure you have written agreements in place. You document every expense of hers and she pays for it. Document, document, document!