What to do when your parent does not meet ADL requirements, cannot afford assisted living, and is not safe living alone?
The national median cost of assisted living is $3,495 a month. Medicaid won't pay for assisted living, only for an aide in the home, which has recently become much more difficult now that 3 ADLs are required to be eligible and there is a longer wait time for processing (as in months) than before because of the new 2.5 year lookback. The other option for coverage by Medicaid is a nursing home. I have a parent who is 95 and there is no other money beyond social security at this point, which leaves a $1495 gap for assisted living. I can't assist with that financially. He has diabetes and is losing his ability to walk, uses a walker, can't feel his legs (but still drives!). He has nerve pain in his hands now too. He lives alone in the middle of nowhere. Those medic alert buttons don't work out there, no cell service. Anyway, at this point he would not be eligible for a Medicaid aide since he can do everything on the ADL list - just barely. I really don't want to move in with him, but I don't see another option. My husband and I live about 2 hours from him now. Where he lives there is very little support for seniors, it's the middle of nowhere. You cannot find a housekeeper, for example. I go up there once a week to clean. And I cannot imagine helping him with the bathroom, if it comes to that. The house is in horrible shape, very neglected, ugly inside. Needs a huge amount of expensive work. And I hate it there, so I am very worried about eventually (probably within the next 6 months) having to move in there. We live in a one bedroom in the city - moving to a two bedroom is not an option and he would not come here anyway. I have two siblings living within one mile of him who cannot help in any way, financially or otherwise. I only mention them because I am sure to get questions about siblings - so just consider me an only child. We own his home, having bailed him out of the loan he had on it, so he cannot sell that and we hope to get our money back eventually after putting a lot of work into the house. Any advice? I'm stuck with having to move in, I believe.
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You say "we own his home". Hopefully you bought it for fair market value, but if he still had a loan on that home, the profits from it will last only a very short time.
Medicaid WILL pay for his care in a nursing home. But you may not be well satisfied with that nursing home and it certainly will not be on a par with a good ASL place.
So here you are. The choices are as you say. A nursing home and medicaid. Or move in with you and be cared for by you. Your parent is 95 so that would last at most 5 years in normal circumstances. Some are looking at this with parents in their early 70s so they are looking at two decades of caregiving. There are no other choices now, at this point, when it has come to this. And given that in our nation some are paying Federal Student Loans they were lured into when they are on Social Security, I can't see things getting better.
I suspect your family may not want to give up their own lives in the care of an elder. So you are down to Medicaid and the kind of care it pays for in a Nursing home. This varies widely across our country.
And I am left with the helpless words we who answer anything on Forum are often left with. I wish you the best of luck. I caution you against using your own money, as you are going to need every single penny you can save for your own time in this position.
I am so sorry. But you got it all, and you got it right. And like so many things, there is no "fix-it" and there is no answer.
I caution you against "moving in there" as well. Often the people we see do this, sacrificing years of their lives in care, end up homeless, jobless, without job history and penniless as well as ending mentally unstable from attempting 24/7 care. You can read their stories all over the Forum.
If you already have DPoA, great! If not and he refuses to take this step then you will need to enlighten him to the reality called Ward of the County or guardianship. Please do not move in with him. This gives the false impression that he is still "independent" and able. He is not. You may want to consult with a reputable faith-based facility near you (if you will be managing his affairs going forward). Faith-based facilities are more flexible and understanding. They may allow him in to LTC and therefore he may qualify for Medicaid. They did this for my MIL. In my state the look-back is 5 years. My advice is to resist moving in with him. If you need to call APS then so be it, it will get him placed sooner. Also, please go into his state's DMV and anonymously report him as a dangerous driver so that he doesn't hurt others (this happened in my own family -- my uncle went through a red light and it killed his own wife and dog and injured the other party). Remove his car physically if that's what it takes. I wish you much success and peace in your heart as you move through this transitional time with him.
Right now it is self neglect but, as time passes and he needs more help than he is getting and you know this, that is when it becomes a situation for you and your siblings.
Call now so that he is on their radar and you have proof that you have been trying to help him with the situation. They also know about and can implement services that the public can not. They can also force issues that you can not. Call APS today. He is a vulnerable senior that needs help.
You dealt with Medicaid for your mom, what do you know about your dads finances that you are worried about? You can see a certified elder law attorney to get advice on fixing whatever you are concerned about or find that it is nothing to worry about.
Best of luck finding the best solution for your dad.
If it's just to "talk" to them about something, usually the person, dad in this case, can give the okay over the phone. Beware if he has hearing issues!
In order to manage SS, the only LEGAL way, per SS, is to sign up as rep payee. Not sure how it would be handled today, with the virus around, but it's best to start with a local office, not the main 800 number, unless you like phone menus and being kept on hold for a long time!
I called MY local office, which isn't in the state mom lived in, got an appt and filed. They just asked a lot of questions and submit it. They didn't ask to look at anything and I did NOT take my mother with me. They do send notice to both you and the party involved, so the person can object if they want to. By then mom was in MC, so mail was held by the nurse. Mom wouldn't really understand it anyway! I had to have the address change done, as we were selling her condo and you can't forward federal mail.
The LEGAL note is from THEIR paperwork that came with the approval. No one has the right to "manage" another person's SS and POAs don't work for federal entities.