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Crim2009 Asked February 2018

We won't be able to afford to take care of wife's parents. What are our options?

So, my wife’s mother is 64 and her father is 66. We know they will not be able to work in the next ten years. They have no pensions, or retirement saved what so ever, and have no long term plan to take care of themselves. Her father has worked numerous hard labor jobs and has taken very poor care of himself. Her mother has never worked other than some part time jobs here and there. She doesn’t believe she suffers from mental illness, though her sisters and children have requested she see a doctor multiple times regarding it. Almost all of their children have been diagnosed with complex PTSD due to some act of negligence, abuse, or combination of the two on their mother’s part. One of the brothers had a mental breakdown a few years back and had to be hospitalized. Most of the children don’t want anything to do with the parents and/or can’t afford to pay for the future health care of the parents. What are our options?

freqflyer Feb 2018
Crim, my gosh your wife's parents are still very young but it sounds like they had a very hard life. When incomes make it hard to make ends meet, it is almost impossible to save for retirement. And with jobs here and there, pensions tend to have been given out to those who worked in large companies and union jobs for many years.

What your wife's parents can do is call the County agency on aging to see what is available. Depending on where they live, meaning in a city or suburb area, there is Meals On Wheels that they could sign up for. Thus giving them each one good meal per day. In a rural setting, might be more difficult to obtain.

Once your wife's parents become very dependent on others for their daily care, such as walking, bathing, cooking, cleaning, then there could be a chance that the parents would be ready for Medicaid [which is different from Medicare]. It's only if the nursing home deem that one or both are ready for skilled care.

Also with Medicaid, depending on the programs that the State offers [each State is different], an Aide could come over for a few hours each week to help with certain tasks.

commutergirl Mar 2018
Medicaid will pay their nursing home care. If they have assets, such as a house, it's a good idea to change ownership as I believe they have like a 5 year back rule as far as re-titling assets. Often times people feel being related forces your hand to become a caregiver. Everyone isn't cut out for such a challenging position. Best of Luck.

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Sunflo Mar 2018
First, its admirable of you to even be thinking about it. But, it's not your problem -- its your in-laws problem and their "plan" shouldn't be "having the kids take care of us".

The best thing you can do now while they are younger is to ensure they have paperwork in order and I mean all of it: DPOA - naming someone to have financial and/or medical autonomy to make decisions when they are no longer able; Advanced Medical Directive, Will, etc. (even if they don't have anything of real value; they still need a will if they own property (car, house, bank accounts).

Next, start having conversations with them about what their plan is, what they wish -- do they want help in the home, residential care, together? or are they willing to place one or the other if needed, etc. The conversations will at least start them thinking.

No money. There are residential care such as senior apartments that are subsidized for those elders with no money; there is medicare facilities (nursing homes, some memory care beds (though not many and you may be on waiting list), home health aides, visiting nurses (that can treat chronic and acute problems with doctors request) for elders who stay in home. There is meals on wheels, senior centers where they can go for free or reduced lunch and free activities -- buses will even pick up the seniors and disabled seniors and bring them to the center.

So as long as they can afford their living arrangement - there are some options to help them remain in their homes and manage. ONce they can't -- then there are options even without money. Admittedly not as "cushy" as those places where your parent has money to cover.

If they own home, they could sell it and move to a lower rent apt to make that money go further. Most healthcare will be medicare covered -- though a supplemental policy is recommended -- they should have that now at their age so a hospital visit doesn't bankrupt them.

Also consider reversed mortgage which can help.
Sale of home -- though consider that many assisted living, memory care that you see advertised or in your area may be $4k-8K/month -- and they ususally want to see financial records that can support 3 years before admission.

My mom and dad saved and lived in a home that had wildly appreciated over 40 yrs -- so she was finally moved to memory care (she has dementia and is 95 and could no longer manage herself or home) and was placed in a very nice facility at $8K/month.

I have a friend who picked up her mom's tab and she and sister each contributed $3K each monthly to keep her mom in a nice senior apartment -- but that went on for 2 years and alot of financial burden for my friend and her sister out of their pocket.

I have another friend doing same and splitting care costs among 4 siblings -- but that is alot of burden and money that my friend could be using toward his own long term care planning.

I honestly don't know what I would do if my mom hadn't had the money. For along time I wasn't sure how much she really had. We did at least look at a subsidized senior living apt and it wasn't too bad really and guess that was where she would have gone if that were the case. There are staff visiting nurses, etc. that look in on the resident. But if they need alot of one on one care for bathing, toileting, cooking, cleaning, etc. -- then you will need 24/7 residential care facility -- which with no money -- is medicaid/medicare bed and sometimes depending on where you live the wait could be a year or more and you'll need to figure out something else in the meantime.

I don't recommend having parents living with the children -- you have no idea how much things change and you find yourself 24/7 caregiving -- sacrificing yourself, your kids, social life, vacations, etc. when a parent is disabled, chronically ill, incontinent, immobile -- getting someone to come in an help a parent can be $20/hour (4 hr min) -- adds up fast. Behaviors that annoy you now are often excerbated as they age -- so hurtful things said come out over and over; dementia means loss of reasoning -- are you both prepared for that?

I would never have taken my parents in my home. I love them -- but they were tough and as my moms dementia progresses -- the common elder dementia behaviors escalated -- accusations, stealing, hurtful comments, mean spiritness, stubborness, all got worse and worse. Now she's in memory care and I can visit at will; leave when she gets agitate and not worry because she is safe, fed, cared for and secure.

TNtechie Mar 2018
At 66 your FIL should soon be eligible for Social Security benefits (retirement or SSI). In my home state of Tennessee, there are a number of programs that assist the elderly financially. If they don't own a home and SS is the only income source, they may well qualify for public housing (where there's no lawn care responsibilities) or rent assistance. Additionally there is income based assistance with utility bills, internet access, Medicaid, prescription medicines, and food (Meals on Wheels and SNAP). Most senior citizen centers offer VAN service to/from the center and many offer a Meals on Wheels meal at the Center too.

In addition to helping them get all the financial assistance that's available and appropriate, I would recommend:
(1) Strongly encouraging them to get involved with the senior citizen center and/or their church. People who have a social life are generally happier and healthier. Many senior citizen centers offer exercise programs for people who arthritis and can serve as a conduit to other programs/opportunities.
(2) Look around your in-laws home and determine what things you and and your wife could do to make the space more accommodating. My family has worked the construction trades for generations and I understand that often a man who has worked hard labor jobs for decades usually has some serious aches and pains by age 60. Devices that make opening jars easily, large handle can openers, a good stepping stool, grab bars in the bathroom, an ADA toilet, a set of non-stick pots and pans, a dishwasher, a comfortable recliner or chair with arms, new light fixtures, etc are relatively inexpensive but can improve life quality and extend the time people remain independent. After my mother's replacement the therapist told us all sitting surfaces should be at least 18 inches high, so my family installed new toilets, put new feet on couches, added lift cups under a bed, and purchased a couple of padded armchairs (like you often see in waiting rooms). Looking back I wish we had done those things a few years prior to the surgery.

Older people are often resistant to change so you and your wife may need to compromise or make extra promises for some changes. I got my parents a new ceiling fan for an anniversary present and promised to take it down and put the old light back up if they would just try out the ceiling fan for a month. After it was installed they loved it and didn't resist at all when they got a second ceiling fan a couple of months later for Christmas.

Katmar Mar 2018
You must have had a difficult life. So sorry you are going through this. I have cared for my husband for 8 years and now Dad has been with me for 4. It is a very hard journey. If they have a very low income, that may provide them with more services than you think. I agree with freqflyer-contact the agency on aging and find out what options there are. Also, contact state social services. They may qualify for food stamps and other assistance. When my Mom went into a nursing home, she qualified for Medicaid. She was able to get dentures and hearing aides and glasses that she couldn’t afford before that. And, her nursing home care was paid fot- relieving us of exactly the anxiety you are going through now. You don’t say if Dad is still working ( or if Mom currently is working part time) so depending on their current financial situation, they might qualify for some benefits now. Good luck. You may even want to contact an elder attorney for guidance. Good luck

AT1234 Mar 2018
The most important detail was left out of your post. Who has authority to make legal decisions(POA) for them? If you and your wife don’t, all you can do is offer advice. Even calling the County will be their call. This is will be Medicaid.
If they own a home, it’s doubtful they would put it in anyone else’s name (based on the family history you shared).
The person in mental field who said you’d benefit from counseling is probably correct but I did not detect any of the crap she was describing in your question. Jmo

Isthisrealyreal Mar 2018
10 years is a long time. If they don't need help now you could be wasting time getting details. Get a list of resources that help the elderly, that probably won't change, or not much but, qualifying, regulations, benefits etc. Can change dramatically depending on laws, funding etc. So I personally would not spend the time unless they are in need today. If mom doesn't work she could make phone calls and get the info.

Based on what you posted, DO NOT EVER let these people move into your home, it would be devastating to your family. Unless a person is willing to admit there is a problem, nothing can help them, they have no problem that needs help. Frustrating and heartbreaking but it does not create an obligation on their children.

Best of luck getting this all sorted out and finding the resources that can provide help when it is needed. I also don't recommend retitling their home so tax payers can pay more of their bills. You and your children are the tax payers, abuse like this leaves less money for the truly needy. Not saying you would, I just saw that another poster recommended doing it.

Upstream Mar 2018
Dacrowz- I gave up my life, or put it on hold or however you want to say it, to care for my parents. My Dad passed over a year ago, am blessed to still have Mom. My life is nothing I had planned or work towards.
It truly is a hard thing, there are times I feel like I am not strong enough. But I draw strength from God, and make it through each day.
This is not a light decision you are trying to make, and you will have to live with the choice that you make either way. You seem like a very loving and caring person. You must do what your heart thinks is the right thing.
Only you can truly decide what the right thing is for you to do.
I can tell you that even on my most difficult day, I do not regret it one bit. I am blessed to have this opportunity to give back what I was given. Pray about it.
May God bless you in this difficult decision.

dragonflower Mar 2018
Both of your parents are old enough for Social Security - and in their situation, I would recommend taking it NOW. (You don't say if they have taken it yet or not.) The father who is 66 should already be on Medicare, and the mother who is 64 can sign up as soon she turns 65.

As others have suggested, get them signed up for every possible assistance program for which they might qualify. Is their income so low with few assets that they might qualify for Medicaid?

I'm guessing that their health might not be very good if they say they are unable to work. I know so many people in their mid 60s through 70s who are STILL employed full-time where they have access to health insurance and a 401K plan.

Are either of your parents capable of working part-time? Unless they are quadriplegics, surely at least one of them should be able to hold some type of employment to supplement their Social Security.

janevir Mar 2018
Hard situation, indeed. And so much good advice given here. I just want to emphasize that there is nothing wrong (in fact, everything RIGHT) in your in-laws “laying the bed” that they made (aka REALITY) which may involve selling their house to pay for their own care and finally going on Medicaid. We came to that realization with my in-laws. They are wonderful people but didn’t plan for their old age, and then they both got dementia. I, thankfully, started helping them get their “affairs in order” before they were too far gone. Everyone else in the family was in denial. They were in Assisted Living while they could pay for it (sold their house and had no long term care insurance). Then I had to do all the work to get them on Medicaid. They are in the nursing home now and don’t like it (“we aren’t nursing home people”) but they are receiving good care and are safe. Sometimes we just have to let things take their natural course and it’s ok. Their life isn’t fancy but it is enough. And it is in their best interest. I don’t believe that you should have to try to protect their home from being an asset to pay for their care. That’s what it is for. Blessings to you as you embark on this difficult journey.

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