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slsankey Asked November 2012

How can we convince our father that he needs to put money aside for his own medical expenses?

Our father lives with my twin sister in GA. He has been diagnosed with Alzheimer's and Parkinson's disease. He is 80 years old. He wants to take whatever little money he makes on Social Security and use it for "fun" things and for gift giving. He doesn't want to put any money aside for his future....like to help pay for home health aides. In GA, they don't have many governmental services for poor elders with health problems. He is highly stubborn. My twin is afraid that he will bleed her of her hard earned savings for her own retirement and for her daughter. And I am here in Phila. I am not able to afford to pay for our father's care myself. How do we protect our life savings? He never paid into a Long Term Care policy. He blew all of his money over the years on vacations.

crystal1224 Nov 2012
You have to speak up on this if you could. I have the same thing and have been paying everything electric, food, toiletries etc. Sometimes I will get a little money but it is not consistent and as we were raised to take care of our own there comes a time where you have to speak up on things. I just recently had to do that with my own father. They maybe do not realize this and if you tell him maybe he will understand it. My father also has no money set aside for his final expenses and when he lived with his significant other spent money buying her diamonds and he is still paying the charge bills. I know he has a good heart that way but his check is not much and he does pay his bills each month. I just wish he would of saved for the rainy days ahead as neither us children have any extra monies. It is something that I worried about for years what we will do if something happens to Dad. Right now I pay everything and I am on a limited income myself so yes I do that out of love but two years later..something has to change. Be assertive right off the bat and try and make him understand - if he could spend his money on this and that he can contribute to his well being and the household he is living in. I am sorry if I sound too rough but I am only speaking from first hand experience on this one and what I am also going through at this time. It is amazing I found this site today as I see so many in the same situation as myself...Signed off..Loving and worn out daughter..

jeannegibbs Nov 2012
slsankey, thanks for providing a little more detailed picture. I can understand why you are worried. But you are not financially responsible for your Dad's care. He should be paying his own way now, and when the time comes, he will have to apply for Medicaid.

By the way, I think that you have Medicaid and Medicare confused. You and your sister might want to look into Medicaid a bit, to have a clearer and more reassuring picture of the most likely scenario for Dad.

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geewiz Nov 2012
Frankly, I would NOT contribute to his care (perhaps if I was a billionaire). It sounds like he will qualify for a medicaid bed in a skilled nursing home. They will take all of his social security check towards his care. He can use his bank account to prepay a funeral -- if there is enough for that. Your sister should be urging him to get eyeglasses, dentures, and suitable clothing now with his social security check. (BTW I totally agree with Jeanne that he should be contributing to your sister's household. I am a firm believer that adults don't live in other adult's home w/o contributing).

I've learned that those who live hand to mouth think anyone with a thousand dollars in the bank is filthy rich. I urge you --- DO NOT SPEND your money on his care. It will never be enough to take him through this final stage of his life. If he was out of money and on death's door, I'd say yest, kick in for the last few months. But my Mom is in her 90s and has been in an ALF for memory care for 13 months. The bill so far--- $98,000 +. Few people have this kind of money for their own care, clearly even fewer can pay for another's care plus their own. My Mom had her own resources. And at this age, I'm guessing her investments will take her to the end. But if she was 80, I would know that it would likely run out. I'd be looking for a nursing home for him now. Neither you nor your sister should be paying for his care or caregivers. Keep in mind, dementia affects decision making capabilities and from your description, this wasn't your Dad's strong point before the diagnosis.

slsankey Nov 2012
Thank you both for taking time to respond to my plea for guidance on this issue. Our father has gone through thousands of dollars over many years choosing deliberately NOT to save for his retirement and medical care. Because of his addiction to spending money, his previous three wives often were weary from trying to get him to be reasonable in spending his money wisely. Often he spent his ex-wives money on foolish things over the years. We are frightened that he will force us, his children, who he has spent very little time with over our lives, into spending OUR hard earned savings to take care of his end of life needs. I have been unemployed for the last 3.5 years and we have no children and need to save for our own end of life issues. I am 57 and my husband is 60. My twin has a full time job in GA and can't leave her job. She has step children and grandchildren in addition to one teen age daughter that she is responsible for distributing her money between. My father has never considered the costs that his lack of planning to his children. He has been a master at manipulating the women in his life to do his bidding and has made mention that taking care of him will be a droplet in the bucket of my sister's financial holdings to take care of him. He is ignorant of how expensive it is to support an Alzheimer's patient who has concurrent Parkinson's disease. He went through all of his savings. He lives off of his social security money. He is not able to live on his own because he went through all of his money on his "fun" times for years and years and years. If he just went wangchung this year but was responsible with his money prior to this age, I, too, would urge him to have his fun. But he went through thousands of dollars (much of the money was not his own, but his previous wives' money) and now he has no money left to take care of his medical expenses. We are afraid of home health aides from Medicaid stealing from my sister's home. From what I understand, Medicaid will only provide home health aide services to someone who has been hospitalized and then only for five weeks as part of a transitional care process. How do we keep ourselves financially solvent and not go down the tubes right along with our father and make sure that we can take care of our own end of life issues so that WE won't be a burden on anyone. My sister has a daughter whom she can turn to for elder care assistance when she gets older. But I will have no one to look in after me...so our little bit of money that my hubby and I has to stay in the bank to take care of our own end of life expenditures. My sister has just got Dad to sign a medical and financial POA. But there is one little bank account that he has that he doesn't want my sister to have access to. This is the left over money that can be put aside for his medical care expenses down the road. What to do? I was told that we could get him to sign a Care Taker agreement, then his hand would be forced to pay some money to put into this savings for this. But how can we force him to sign such an agreement if he emphatically refuses?

jeannegibbs Nov 2012
I'm sure I'll get flak for this, but if I were 80 and had very limited income/assets I think I would want to use it for fun things, too (what is left over after I'd paid for my room and board and care where ever I was living, including at a relative's if applicable.) Saving out of very little income would be a drop in the bucket toward dementia care if/when I needed it. Why deprive myself now when it would do very little good down the road? Age 80 is just too late to start to prepare for serious care needs.

I hope Dad is first paying the daughter he lives with. If that isn't happening, then add a personal care agreement to the documents that should be drawn up while he is still in mild dementia.

Whether he saves now or spends his "excess" funds on fun things, he will most likely need to apply for Medicaid at some point. That would cover skilled nursing care facility if/when he needs it or in-home care (usually under and Elderly Waiver program.) I would recommend that before he spends on fun he spend on consulting an attorney who specializes in Elder Law. The daughter he lives with and/or the POA (if different) should be present. What is the best way to prepare for applying for Medicaid? An Elder Law attorney can guide you.

Be careful about "gifting" -- the attorney can provide some guidelines. Giving money away within 5 years of applying for Medicaid has some penalties attached.

GA may not have generous programs for elders, but Medicaid is a federal program. Check it out thoroughly (with the help of the lawyer) starting now, not when Dad needs in-home aides.

Neither you nor your sister should spend your own retirement money on your father. And Dad should be paying his own way at your sister's. Sister should charge enough so she can put a little aside for respite care. Especially as the dementia advances she is going to need to get away on a regular basis and needs to be able to pay for that.

Good luck to all three of you. Dementia is a cruel disease. I urge you to do fun things with your Dad while he can still enjoy them!

geewiz Nov 2012
First of all, has your Dad prepared the proper legal documents, now before his illness progresses any further? Power of Attorney, health care proxy, Will, etc. Does he have any assets at all? Income? Truly, if there are no assets and limited income, at some point, he may qualify for a medicaid bed in a skilled nursing facility (nursing home). There are several posts on this subject on this board. If you and your sister wanted to contribute to his care, you could pay for in-home assistance or an assisted living facility. Personally, I would not recommend this (unless you are independently wealthy). You are likely in your 50s and have your own years ahead of you.

Some assisted living places will accept medicaid after the resident has done private pay for a minimum length of time (2 full years at one of the ones I visited!). IT was over $8,000/month So there would have to be some considerable amount of assets . The challenges are many . . .

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