Am I misinformed?

Thanks for all the responses. I’m grappling with a variety of emotions, scenarios and thought processes. I can’t seem to find a way to phrase it or break it down into several different posts.

Right now, what my Mom needs is a Girl Friday with some medical experience…or a tolerance for the occasional adult diaper and more frequent pee pad.

But, if you asked my mom, she wouldn’t think she needs one of those at all, no point in spending money on that. Why should she spend money when she can manipulate me into doing all the errands and a majority of the cleaning/organizing?

I do live 3.5 hours away and I’m tired of adulting and working for myself and then every three weeks having to do her stuff as well.

Just about the time I think I have accepted there will be no inheritance (if she goes for AL care), I will remind myself of the number of times I’ve had to clean up when she hasn’t been able to get to the toilet on time. Or when she makes me go to the pharmacy (hate the damn pharmacy) because she doesn’t want to pay for delivery.

Hey - save that money to pay to the nursing home!

I know, I’m long past burnt out.

Please be aware that assisted living facilities do not take Medicaid. That means all of the monthly bill must be paid in cash out of mom's estate. Therefore, if mom needs assisted living she (or you as POA) needs to liquidate all her assets and then determine how many months of AL she will be able to afford. The condo would need to be sold to help with the AL payments. When her funds do run out she will need to go to a facility that accepts Medicaid AND she will need to medically qualify for LTC Medicaid. You will need to apply her for Medicaid just before her money is about to run out. Some assisted living facilities have a SNF within their community and allow their residents to transition there under Medicaid when the time comes, so you want to do research and meet with the facility director to see if that is the case.

Have you looked into board and care homes?

Where I live, 3k a month will get you a private room and all the care you need.

Leaving her all of her savings intact for her lifetime care.

She should not be paying to keep the condo so you all have a free place to stay.

When she enters a facility, that is her new home. She should be encourage to accept the reality of what her needs require.

My parents SOLD their home to finance their lives in Independent Living, then AL later on. That's how life works, although I think sp's take on things is jaded. We all need money to live, that's life in the world and has been all along! My parents lived to 91 and 95, weren't made wards of the state, and I managed to make their OWN money last for their entire lives.

I would have applied for Medicaid for my mother had she run out of money and needed it, but it didn't work out that way. She wound up having enough money to private pay her way thru AL and Memory Care AL until she died at 95 with advanced dementia. And at that stage of the game, she couldn't use a cell phone, TV or iPad.

Don't borrow trouble, that's my suggestion.

Your mother has a decent monthly income to begin with, owns cars and a condo, so she may have many YEARS of AL life ahead of her before she needs to apply for Medicaid and worry about iPads and TVs.

What I did is what I suggest you do: Go sit down with a Certified Elder Care Attorney and get ALL the details about how to get mom taken care of for life, in the most prudent way possible. S/he will also guide you about Medicaid and the 5 year look back, etc. It's very good information and worth its weight in gold.

Yep that's how the world works. You save all your life and in the end everything is taken basically making you a ward of the state when it's all gone.

No money = no choices and no freedom to make choices and decisions for your own life. It's a bitter reality for people as they find themselves in this position with death being the only way out.

If the condo is in her name and there's no spouse living that shares it, if she goes into AL or a nursing home, it will have to be sold. All the proceeds from the sale will have to be spent-down before Medicaid considers her for eligibility.
Also, Medicaid does not pay for assisted living in some states. Some states require that a person be private cash-pay for AL for a certain period of time before they will accept Medicaid and let them remain in AL.
I'll tell you now, if her income is $3,000 a month she will probably not qualify for Medicaid to pay for services in her home.
I'm in Connecticut and this is a very expensive state. A person with that much income does not qualify for Medicaid unless they are in a facility. The care facility takes their entire income and Medicaid will pay the rest of their care bill. In a facility. Not at home.
Mom may have to tighten her belt a bit and do without some luxuries like pedicures and getting her hair done every six weeks. She may have to have a cheaper cellphone. Doing without these luxuries really isn't hardship. Many people are doing without their medications or are getting evicted because they can't pay their rents. So if the tv and the iPad go kaput in the same month, mom replaces one or the other and should be grateful she has one.
The utilities in her condo get paid for out of her income. Even if she is in a facility. Whoever is her POA has to pay these bills until the property gets sold.

Lets talk AL first. Your Mother can't afford it if she only gets $3000 a month so yes, she will need to offset the cost with her savings and investments. I would sell the Condo. Better she use the money she needs to keep it up on the AL. If she drives keep the better car and sell the old one. If she doesn't drive, sell them. But the cars and the Condo must be sold at Market Value if Medicaid is in the future.

"She will want cable TV, Wi-Fi, a haircut every six weeks and a pedicure monthly." In my Moms AL cable was not included, that was a separate expense for the resident. Not sure about WiFi since Mom did not use it. There is usually a hairdresser at an AL. But a pedicure she would need to be taken to someone who does it. In my state, Medicaid can be filed for once you have paid privately for two years at least. This depends on if the AL excepts Medicaid and if they do, if they have reached the number of Medicaid recipients they allow.

Now Medicaid. In my State $3000 in monthly income is over the approximately $2300 cap that is allowed. So a Miller/Qualifying Income Trust has to be set up. Not all States allow this. The 700 overage goes into the trust to help qualify the person. Upon their death, the trust reverts to Medicaid. As you said, they are allowed 2k in assets and a small amt of their SS goes into a personal needs acct for their personal use. Cable TV where I live is included in the cost of the NH but very limited. Not sure about WiFI. You will need to pay for her phone or find a cheaper plan that her PNA would cover. I use Tracfone. She can still have her hair done but then again, pedicures will have to be done outside the facility. Once on Medicaid Mom should have Dental, Vision, prescriptions plus health insurance. Check this out with your state. A podiatrist will come in every 10 to 12 weeks to cut toenails only. Medicare pays for this. Nurses and aides are not allowed to cut fingernails or toes. Moms Condo is exempt as is one car. But, there will be no money for the upkeep of either. If you have never lived with Mom as her Caregiver, then yes upon her death the Condo will need to be sold by you so Medicaid can recover what they have put out on Mom. If you were her live in Caregiver, thats a different thing. You may be able to continue to live in the house.

Hope this helps.

You already kind of answered your own question!

You know mom needs to sell the condo and cars to help pay for her care, which is what is normal and expected. In fact, if family covers her basic needs, I think it messes with potential Medicaid. (not sure, we're not there yet).

OK, so she wanted a convertible. And she had one for some time. She's not driving it now and the way the supply chain is right now for cars of ANY kind, she would likely get top dollar for it.

Is she trying to hang on to things for the kids' inheritance? My mom has a very skewed idea of what she has that is worth something and what isn't. (99% of what she owns is not going to be 'fought' over. It's important to HER, but, shoot, I am in the 'toss it' stage of life and she's still collecting crap at age 92.

If she needs more money to pay for the little luxuries, in life, family can help out. Usually, it's best if it's all paid for out of mom's nest egg, but she'll likely run out pretty quick.

Keeping those 'luxuries' will go a long way towards making her feel less 'institutionalized' and more her old self.

Best to start looking for places for her to live now, while she can make the decision.

And whatever you do, DON'T save and store all her stuff. Storage pods run upwards of $500 a month--and in a few months you don't even know what you're storing.

And golden boy can pay for a hotel room for a couple nights. Good grief, keeping an entire condo 'alive' for him is beyond ridiculous!

Baseball, are you your mom's Power of Attorney for Finances? Healthcare? Is anybody?

These are issues that MOM, with her umimpaired mental acuity, needs to start thinking about. You can raise them, gently, and say that you are happy to do research with her and discuss her choices, but don't think that in any way these are your problems to solve.

Think about why you think it's your job to keep mom happy, figure out how to pay for what HER resources won't support and keep peace among the siblings.

My mother does have an iPhone and an IPad. She is able to use them to an extent. She is in a running group chat with my brother and his family, so has daily contact with the grandkids.
This is a small town. The place she wants to go (if she has to) does transition from private pay to Medicaid. I used to doggy sit and regularly brought dogs there. The Great Dane was a huge hit. The social worker was a client and is a friend. I think it is a good place and am okay with that choice. I don’t know if they provide cable (must have HLN and LMN) and wi-fi.
I really don’t think it will be her mental acuity that leads us to this. It will be physical limitations.
Oh - she has two cars because her lifetime dream was to have a convertible. I was not exactly included in this purchase. I’m quite certain the used car place with the 20+ year old convertible saw her (and mechanically useless brother coming). So, she has a convertible that only she can drive because the seat is broken and can only be left in the position for someone barely 5’1. Then she has her regular car.
As long as she is mentally alert, she’s going to want the luxuries I stated, such as a pedicure and a road trip to her hairdresser. She’s going to want to go out for lunch with friends. My early prediction is roughly $200-300 a month.
What I’m seeing is, she won’t have the money to do it. Which means a battle with my siblings as to whom is going to supplement her income.
I don’t know if I can explain my thought process as to why we would keep the condo if she was still alive. I guess I was thinking we wouldn’t fight over family heirlooms until she was gone. None of us live in town, so I was thinking we would still have a place to stay when we visited. The favorite child lives four hours away. He would possibly visit more and longer if he wasn’t paying for a hotel room.

Assisted Living will include cable and utilities… landline for my mom was $12 a month. She never grasped the cell phone use..

How much your mom gets to keep of her monthly income varies. I thought it was $50 a month too. My mom didn’t make it to the Medicaid Process As she passed just before our appointment. My Medicaid specialist from the county told me the $$ vary.

when looking for a place be certain they will eventually take Medicaid. I found facilities have different self pay requirements. Google care advisors and find someone local who can meet you at facilities for tours, this person will know what’s available, cost, your needs, and amenities. I placed using a local care advisor 3 times, and an invaluable service.
Also I would want someplace that has a memory care if transition is needed.

Your mom will need to use her assets as her nest egg.

I want to put in a "plug" for good facilities: they give elders social exposure and mental and physical activity that they will not be getting cloistered by themselves in their homes. My MIL is in a lovely place on Medicaid and even has a private room. It is run by a faith-based organization that has many facilities throughout our state. Faith-based facilities mainly see the care as a mission, and not a business. My MIL's care has been stellar and she loves the interaction with the staff and being taken to their activities and outings. She'd never be getting that in her home or ours. People of her generation and older have very terrible memories of very terrible nursing homes. But things are very different nowadays -- there are many excellent newer ones to be found.

Just a ps to add to my note to you already:
When choosing a ALF or NH you need to be discussing with them if they accept medicaid after the person has no longer any private pay funds. The fact that there is SS AND a pension will make your Mother more "wanted". But some ALF are private pay only, and the resident must seek other places that accept medicaid if they need to go on medicaid.
Do know also that that condo you are hoping to keep for her to "return to" is a pipe dream, and speaking of pipes, they leak, burst and do all that good thing. If you are POA and wish to manage it as an asset for her, renting it out and etc then that is good income for her, but it is also a pain in the neck for you or any other Fiduciary.
You are correct in that now is the time to be deciding on all this, getting papers in order so a POA is yours and is strong enough you CAN sell the condo should you need to for her care. Exempt is one thing for a car and condo, but they require keeping and care. As I said, insurance goes way up on an empty condo; it is a sitting duck for problems.
Best of luck again, and congrats on trying to think all this out.

Mom, when she is on medicaid, will not have cable and wi-fi, so hopefully will be in communal living where she can access such things. Foot care will be through medical insurance. Pedicures are luxuries that will go. And yes, if she keeps that "exempt condo" when she is in care, that will cost SOMEONE to keep it up. And an empty home costs more to insure.
You have the basics correct for most state. I believe in California we have only a two year look back, a car can be kept (but, why?) and we can keep 130,000. That is a brand new law, as we used to be able to keep only the usual 2,000 of so most states allow before medicaid kicks in. Everywhere, what medicaid DOES kick in they will attempt to claw back upon sale of that condo. If Mom isn't returning to it you may as well sell it now and that's off your back.
Basically you have it right, and your own state, YES, has its own rules, benefits and drawbacks, so check those out for yourself.
Best out to you.

Some adjustment can be made. If she goes in AL, most include cable, buy a burner phone for $35 a month she can have unlimited service. The homes my LO's are in have Wi-Fi, it is included in the rent. Elect, water and so are also paid by the home.

We sold both my mother's and step-mothers home, partially, the funds are what they use to supplement the AL rent. Sell the home before she dies, use that money to pay the AL cost.

What does she need two cars for? We sold both of their cars as well, not needed in AL, the facility has buses that take them around for shopping, lunches and so on, as do we.

I read your previous posts. I applaud your plan to get her into AL. You don't sound like the sort of person who will end up being Mommy's 24/7/365 caregiving slave, after some of the experiences you wrote about previously.

Are you her POA/HCPOA? Although you don't have contact with your 2 abusive siblings, your mother does. Do they do anything for her? You moved farther away from her (yay!). How close are they?

"If she ends up in assisted living…"

We start off dependant on our family, grow up & become independent adults.

Then old age arrives...

Once we are semi-dependant on others for everyday help, assistance is required. Either in home (eg aides, cleaning, meals, other home services) or in a residentail care facility.

If we live long enough to become fully dependant, 24/7 care is required - either at home or NH/MC.

I have no idea where I will "end up" but I intend to keep changing & adapt where & how I live to keep up! I only need one home, so if I need AL, I won't need a condo anymore.

It is a big life adjustment, but a normal thing, to downsize.

If mom is in care, why would you not sell the condo to help pay for her care. In most states ALL assets need to be spent down. Her resources can not be used to pay for anything for the condo if she is on medicaid. It would be considered a gift to whoever is listed going there, making her ineligible for Medicaid. Are you living there?

Does she have her POA's, will, DNR, all the necessary documents drafted and in place? If not, she needs to see an elder law attorney to set these things up.

Medicaid is administered by each state, therefore the rules can vary.

In most states, Medicaid only pays for LTC, which means qualifying financially AND medically as needing that level of care as assessed by a doctor. Most states have a 5-year financial look-back for the financial application, so your mother or her FPoA needs to be informed about what types of money management and transactions would endanger her ability to qualify.

Since this is a global forum, I recommend you make an appointment to talk to a Medicaid Planner for her state.