My 86 yo mother lives with me, due to dementia. She is still cognitive sometimes, but short-term memory and sentence structure are challenging. She has to know where I am at all times, or panic sets in. Not only do I do all the scheduling and administrative work for my husbands' company, but I am the sole and full-time caregiver for my mom. If I don't keep her engaged during her awake hours (7 am to 9 pm), she slips into her depressed brooding state. I feel like I have to entertain and/or manage her activities all day. She constantly asks "what do you want me to do?". If I give her a task, I have to monitor to be sure it is done correctly, or sneak in after the fact and re-do it, creating even more work. How am I supposed to find time to document everything for Medicare purposes, on top of what I already do? I can only claim 147 hours of work per month according to my Elder Care attorney. I reach that in the first 10 days on "companionship" alone. If she goes into a NH and ends up drawing Medicaid, is it common for them to audit?
Sit down, make a list of what you can do and hours that it takes, Then a list of additional needs and hours needed and who can be paid to deal with those issues.
Stop trying to do everything, and thinking everything must be done your way, and apply your accounting organisational skills to the care for your mother.
" I live in Missouri and am the sole caregiver for my mother. A contract was arranged through Elder Law that pays me $17/hour, but not more than $2500/month. That is what they advised."
So, guess the question is how much documentation does Medicaid require to show that this was paid for caregiving and not "gifting".
I would make up a time sheet with hourly blocks. Each meal is one hour. Dressing and toileting at least one hour each AM. Getting ready for bed, at least one hour. That's 5 hours of each of 30 days each month.
Medicaid looks at bank statements so do everything for Mom thru her bank account. They look for an inconsistencies and large amounts of money. If I paid with my credit card or out of pocket I kept the receipts and once a month wrote myself a check from Moms account, put the receipts in an envelope and put the check # on the envelope. Medicaid never questioned these checks but they were never much more than $100.
pay the bank to get them.
What role do you enjoy more? Being an adult daycare organiser or being an accountant?
Is it possible to either engage an in-home aide for some daycare relief? Or engage an accountant? (you just hand over the shoebox...) Or maybe a mixture of both?
When my kids were young, I choose to use daycare for 2 days a week. It was a good compromise, although we were not in a world pandemic & mixing with others was a safe thing to do. I am a bit of a 'one thing at a time' person. I could get my housework done with littlies crawling around (but drove me slightly mad), but I was so much more efficient when they were out. I then enjoyed my time with them so much better when they got home too.
You wrote:
"I feel like I have to entertain and/or manage her activities all day. If I give her a task, I have to monitor to be sure it is done correctly, or sneak in after the fact and re-do it, creating even more work. "
This raised a potential red flag for me. What kind of tasks are you giving here that have to be done "correctly"? Perhaps tasks that don't require that standard would be more appropriate. This isn't intended to be a criticism, so please don't take it as such, but I think you're seeing her more as an employee than a mother.
I also question the effect of redoing and correcting her work. Is she aware of your feelings on this? If so, I think that would really undercut her confidence, and perhaps that's why she's become so reliant on you for directions.
Think about that issue and consider other tasks or not requiring them to be to your level of satisfaction. That's not an intentional criticism, but rather an observation. She needs to have a morale boost; can you think of tasks that provide that?
Even two days a week would give you some breathing room.
What do you mean by "documenting for medicare?" I did all my brother's POA and Trustee of Trust, bill paying and record keeping. I had a separate folder for everything. I kept all medicare payment notices in one folder, all supplemental insurance payments in another, phone in another, and kept a running monthly documentation of all assets he had, increases in and payments out. Once established it was easy to keep up.
Might your mother's funds go now to hire a beneficiary to help with bill paying and document keeping (only about 90.00 an hour, and not much time needed monthly after monthly routine is established. Your mother's funds go to pay this.
I am wondering if you are speaking of something other, such as applying for mediCAID. If so, that is burdensome, as Igloo suggested, some one hundred pages in her case. Your monthly expense in and out will really help you here, as you have ALREADY thereby documented her assets, her income, her expenses. You will also keep her account, which I assume you are the POA of. You will keep all receipts in individual folders.
If you are financial POA for your mother you have to do this ANYWAY. You also keep a folder with all her bank statements, one with last 7 years of taxes and so on.
Originally I had one wine box for my brother's "file" folders. I branched into a nice black file box eventually. But once all this was established, with all his mail and bills coming to me and with POA handed in to all entities it was a somewhat smooth flow.
And no, if you are doing in home care you will never receive financial recompense to be certain.
And yes, if you are meaning entering a nursing home, going on MEDICAID, all of this will be audited. ALL of it. And if anything looks like gifting it won't be good news, so I am thrilled to hear you have your elder law attorney. Do allow your Mom's funds now to hire a fiduciary if that is needed. If Mom's funds stretch to do so she can pay both you, the attorney, and the fiduciary for the care she needs. And you will have the documentation you need all ready to go, the fiduciary there to help you apply. Do remember, you want a fiduciary that is hired to do this, not to invest money (that's a financial manager or some such.) Your elder law attorney works with fiduciaries you can bet and will have a recommend for you, as often courts need to appoint them when there is no family, or a family-at-war.
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