My father needs to go on medicaid for a nursing home but he has life insurance that has cash value and he is incapacitated mentally and physically and doesn't have a power of attorney. They have given him 4-6 months to live. What are my options. He does have social security and va benefits. His house has been reverse mortgaged. Thanks
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If it turns out that the insurance company wants either a court-appointed guardian or conservator in place (since there is no durable power of attorney), then you will have to secure that first. You probably will need an attorney to represent you, unless your county has a streamlined process available for you to do that on your own ("pro se"). Once you are appointed by the court, you can legally borrow against the policy, etc.
If it's the latter, you kinda are totally stuck in limbo till you can get guardianship or conservatorship of dad. In theory you can do this on your own, I'd go on-line to the courthouse to see what is required to go an guardianship hearing. It may be in the FAQ part of the probate court section of the county's website. Probate judge hears guardianships. But guardianship take a while to run their way through the county's legal system. You may be best served just forgoing getting guardianship and then trying to cash it out. You keep it in force and then when he dies, you can recoup your costs against the proceeds of the life insurance policy. You need to establish that this is to be done with whomever(s) are the beneficiary's of the insurance policy so no hard feeling later on.
HOSPICE!! Could he possibly be cared for & stay in his home for the next few months and paid for by his SS, VA check and the RM funds (if he did a line of credit or monthly payment RM)? Could you all make it work like this & maybe contributing to whatever else is needed financially and fill in time. Alot of this depends on what his level of care is needed. But if he is terminal then he can apply for hospice. His doc will have to write orders for this and be evaluated but it should be fine. Hospice is totally Medicare. MediCARE not Medicaid. Between hospice and his other funds & family pitching in, there may be enough money to make this work for a few months. this site has alot of good info on hospice. My mom went on hospice earlier this summer and she has a 4 person team: RN x 2 week; CNA x5 week and they bathe her twice a week out of those 5 visits; social worker & clergy X 1 a week for the first month and then as needed. If your dad needs serious pain meds (like Class 3 or 4 drugs), you really need to be sure that the hospice you choose has workers who have the ability to carry those on them to administer as needed. Not all hospice are alike. VITAS & Compassus are the bigger ones and the advantage with them is that they often have staff with ability to have the serious meds, can order and get whatever specialized bed, wheelchair, lift, pressure air bed, etc ASAP to dad; and in bigger cities often have a free-standing unit for the final, final, final days. If they have a serious cancer with other disease being able to move them to an free-standing hospice can be a good thing. In my mom's city, an old children's & women's hospital is now the VITAS unit. My mom probably won't go there as her issue is primarily bed-fast due to hip shatter with Lewy Body dementia, but my aunt went there as she was a mulitple cancers patient and they were able to monitor her pain meds at the unit.
You sound like you need to do something NOW, so how about finding a home health care agency to get this all started to help with daily needs for a couple of weeks. Ask his doc for hospice needed orders, call today to get this started. Go on-line to see reviews of hospice in your city. In my mom's city, some of the smaller hospice are run by old military medic's and if you could find one of those, that could be ideal as they can do the whole 'we're soldiers together" plus they understand how VA services can be. If you feel totally overwhelmed in finding hospice, call the NH you were looking at for dad and speak with the social worker there. All the NH have a short list of hospice they use. Be pretty specific about the level of care needed & I be the social worker can give you a list of 4 or 5 to contact. Hospice can do an evaluation and placement within days.
If you don't like the hospice group, you can switch to another. I did this with my mom and within the first 90 days period. It's Medicare and you can determine who the Medicare provider is. Also once on hospice, you can get respite care in which they go to a NH for a short stay to give you a break. Most folks don't use or know about this part of the Medicare hospice benefit. The hospice groups that have a free-standing facility can do respite care easily as he will already be in their system of care.
Once you get hospice going, maybe stop the home health care agency. It is going to probalby be too expensive to do an agency for 4 -6 months. Here is where you have to be creative. Many churches have lists of daily caregivers; ask around dad's neighborhood... if it's like my mom's there are lots of elders still living at their home and ask them for a caregiver they know about (somebody always has a sister or SIL who needs an extra day). Some want to be paid directly with no tax issues. Dad will likely pass away before he ever has to deal with IRS on this so it's a look-the-otherway situation.
Also by staying in the house, he will still be in compliance for the RM terms which require then to live at the property otherwise the RM comes due in full. And the RM will be a whole other set of paperwork to deal with......which you can avoid for a while. You will have to deal with the RM after he dies.
Good luck and try to keep a sense of humor in all this. It will be overwhelming but think of all the character building you will get. Be sure to take a break and do something for yourself. Whether its working in the garden or going to the movies.
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