What happens when the spouse runs out of money, can't make it on social security, and the other spouse is in a nursing home?

We are right to be worried.
To everyone who is not working and is caring for your parents in their home.... what are you doing to secure your future and not create the same scenario for yourselves? I know it seems like good money after bad but opting out of the system and putting a single relative before your own needs is always risky. Example last year i spent $3000 a month on day care for my kids and my mom and I only took home $4000, so we were living very simply. BUT I was accruing years in my pension and social security quarters, my kids had full medical; we got everyone fillings in their teeth and glasses and I had disability insurance. These are all important things my employeer provided. This year I do not have that. I lost my job and the math works out (for my brothers) for me to stay in mom's home and care for her, but I have lost disability insurance. If I throw out my back lifting mom and we have to hire a caregiver for all of us, there is NO ONE who will cover it. We are all just one illness from poverty. Please everyone think seriously about the hidden risks you are taking. Mom's pension will only be here for us when she is alive. Mom's home will be sold out from under us and where will we be?

Wow, your story sounds a bit like mine. I am taking care of my mother in her home but she (like your parents) has run out of money. The money she saved was not enough to last into her 80's. I don't work and she gets a small pension. My brother is very wealthy but won't help in any way. Physically or with money. I am really worried.

I don't see where the legalexpert has responded on this one. Please don't take any steps until you know for certain you are following the guidelines. This may mean consulting an eldercare attorney--if money is an issue maybe your parent can seek pro bono assistance?

Medicaid rules are dependent on each state's legal. How assets are viewed and what the ceiling is depends on each state. If your dad went into NH and your mom stayed at their home (homestead and her primary residence), then she becomes the "community spouse" and is entitled to a certain % of assets that cannot be counted as an asset or subject to "spend-down" to have your dad accepted financially by Medicaid. All these things are sticky and you really should have an elder care attorney look at their situation for a realistic approach of what to do.
Medicaid review of community spouse situations do a "snapshot" of the couples assets the day 1 of them go into the NH. This can be very good or very bad.

There are things you can do that can benefit them but need to be done in advance.
Say they are 50K over the asset limit. If they have a home, you can use the money to pay down the mortgage, do expensive repairs, buy funeral/burial policies, renovate the house so mom can stay there on her own (ramp, grab bars, etc).
So you have spent the 50K before dad goes into the NH and the "snapshot" is done. Dad qualifies for Medicaid and mom has a better financial & living situation.
You should get advice based on their situation and state from a elder care attny.

If mom never worked and her income is from dad SS or retirement, a portion of it will go to her and not the NH. The amount is kinda low and often she will have to go to court to get increased, which is best done by an attorney. Good luck.

Dont Guess.
Hire an ELDER LAW ATTORNEY.
The stay at home may be able to get a bump up in his/hers/ ss benefits. Put the house into a Irrevocalbe Trust TODAY. There are many legal things to consider.
Hire and Elder Law Attorney....They are worth the money.

Thank you to all. Neither paretn is a vetran so forget that. The house is already sold and the money placed in a trust. the trust was created in 1995 so the money is safe as long as they don't break it. But they will have to break it to live off of within a year or two as their liquid funds are running out.

Absolutely Assisted Living is the right environmnet for them as they need a lot of help but can still get to the kitchen, the bathroom and back again. That's about it though. Assisted living is not an option where I am as every facility is private pay ONLY. I asked, believe me. If I put them in AL, we'd have to break the trust in the first six month. When they outlive their money, the AL facilities say this, "Just give us a month's notice so we can fill the bed." That was a bad day for me. Nice.....

There is a huge range between being able to take a shower by yourself and being able to live alone in a house and maintain it. That is why assisted living is such a great option. Much like my daughter (age 7) managed herself at summer camp, my aging mother did great in an assisted living program. It was a few weeks of heavy learning for her. She had to learn all new appliances and how not to get lost on the way to the dining hall. Neither my mother or my daughter can truly live on their own. Another great option is renting an apartment or house in the same block as caring a relative. The elder can come over for dinner every night, you can send a family member over to mow or take out the garbage cans etc.

I'm sure a 'salient' person would be able to do quite well on his own! : )

If either of your parents is a veteran, check out veteranaid.On the left side go to "A&A program". That will give you information on the Veterans Aid & Assistance Program. As a veteran, you can get financial help with monthly expenses of a nursing home, assisted living or home care. The spouse of a veteran also qualifies. There are certain rules - the veteran must have served during a "war time" period. Once application is made it can take from 6-12 months for approval; however if approved the payments will be retroactive to when the applicant applied. This money can assist with paying an assisted living, nursing home or home care. Contact the Veterans Administration Offices directly or check your local county government - sometimes they have a veterans dept. and they will assist you with the application. Many times you will hear, specifically through assisted living & nursing homes, about "special seminars" put on to assist you with the veterans aid & assistance application. Yes, they will help you but they are also trying to get you to invest money in their companies. Just go to the veterans administration - they will have all the answers and will give you all the assistance you need and help you fill out all the forms. Good luck!

Get some advice on how to split the estate into two pots. One for each parent. They only have to spend down the one half before social services kick in for that individual. It is practical to sell off large assets and move into a more practical housing "for one and a caretaker" now, when the parent is salient enough to learn a new routine and now shower knobs and washer dryer protocols etc. Get one with wide door ways and a roll in shower that is all on one level while you are making the change so they only have to move once. Buy it and it will "store money" for you later.

As far as I know, in most states, if one half of a couple goes into a nursing home, the other cannot be forced to sell the home to pay for nursing expenses. I have seen it happen in several cases, the person who stays at home can keep their own retirement/pensions/social security, etc. Any of that payable to the nursing home patient will go towards their care. It would be grossly unfair to put someone out of their own home, if they own it together. It would be different if it were, say a child living in a home that belongs to the parent. There should be social services available in their community to help out with living expenses for the one at home who can't pay all the bills. The electricity, heating, etc. can often be reduced depending on the situation if you check with the companies providing those services. I hope this helps.

Many city, state, & county governments have social service offices that deal with helping find places for indigent elderly to live and they work with families getting social security or medicaid. Inquire about social services at your physician's office, church, United Way office, or look up senior assistance numbers in the phone book. * In many states, dialing “211” provides people
and families in need with a shortcut through what may be a bewildering maze of health and human service agencies’ phone numbers. By dialing 211, you can receive assistance, get referred, and sometimes connected, to appropriate agencies and community organizations.

You mentioned a trust. I'm not sure that your parent(s) would qualify for Medicaid while there is money in the trust and I'm not understanding why the trust money wouldn't be used for your parents' housing and medical.
While it's a good idea to apply for Medicaid even before the nursing home is needed, Medicaid now "looks back" 5 years so and examines what has been transferred to other people's names. Do NOT transfer the house or put your name on a joint bank account with them. If you need to be able to pay their bills, instead get a financial Power of attorney. I would also consult an elderlaw attorney regarding this trust issue especially in light of your siblings' wanting to get hold of it.
I believe that Trudas is right regarding the SS money going to the other spouse if they were to qualify as "impoverished".
Medicaid doesn't pay for much home health care, but they pay for certain things.
There are certain assisted living facilities who will accept a person or persons who are able to pay for 2-3 years (whatever they stipulate) and then will accept Medicaid after that (these are becoming few and far between but you might want to look into that).
There are many, many baby boomer generation families who are going to be held responsible for caring for their parents. I recently spoke with a governor who said "don't count on the government to help you with caregiving - there is not money. Both of my grandparents died in our living room and families are going to be expected to care for their elders." ouch

Best wishes as you search out your options and congratulations for being proactive rather than waiting for an emergency situation.

Shelley Webb

If the one family member goes into a nursing home the other would apply for spousal impoverishment. Then they end up receiving the others' SS (i think) along with there and most of the time are able to stay at home by themselves. The Aging and Disability Resource center in your area should be able to help you with this.

Low income housing for the elderly, food stamps, assistance for utilities, medi- cal for meds & dr visits. Make sure no assets are in their name for @ least 1yr before applying for medi-cal.

First off, I am sorry this is so long. But I have two comments for you!
It took me quite a while to get over not getting any help from my siblings. How funny your and mine are about the same. Sis "tries" to live way above her means. She fools alot of people but not me. Shes a car sales person. So she gets to drive a brand new vehicle. Fooling everyone. She rents her home(pretends like she owns it), Her house looks like something out of a magazine when you walk inside on main floor. But don't go upstairs or into the basement she is a hoarder and its disgusting. My brother, well he is very inmature. He soaked what he could out of mom and has moved on. So I know how frustrating it can be. I used to beg, cry, plead and bribe them to help. But was always giving an excuse. Don't get me wrong some days I still get angry. But I have accepted it the best I could. I am here for mom and thats all that matters. I am the one who makes sure she is bathed, feed and taken care of. I am the one who stays up during the night to sit by her bed, I am the one that mom still knows and is told "I love you". Over the last 2 1/2yrs I have gained so many memories, some good and some bad, some funny and some sad. But those are MY memories of the time spent with mom. That my siblings have lost out on. Because of me, mom has been able to remain in her home. I have stood up to my siblings and lost my relationship with them because I love and respect my mother. I have set aside my needs and wants because I am doing the right thing. Yeah, it might sound like bragging to some. But, this is how I moved past the resentment I have towards siblings. How I turned the negatives into positives. I was never one to pat myself on the back. But when you show selflessness to take on the responsiblitity to take care of a loved one YOU DESERVE A PAT ON THE BACK!

Both of your parents should be able to qualify for medicaid. Medicaid will pay for NH and home health if needed and if they are able to qualify for Home Hospice that will help too with nurses and additional aides coming into the home. So if it is financial more feasible to keep both of them at home and use medicaid for home health care. Remember medicaid goes back 5 years to review income. Another thing I can't remember if you said the own or rent. If they own. then Medicaid will attach a lien to the property to gain back some money after they pass away. If they do own there is a program(in PA) thats reimburses some property taxes paid. Most utility companies have programs for low income that reduces the bill. Your parents because of income can get energy assistance that will help with heating there home(rent or own). They can get food stamps and there heath insurance paid for thru your state welfare system. They can get meals delivered to the home. On medicaid all medicines should be $0 copay or a small amount. Also there is home weatherization programs(waiting list may apply) but the program will replace heater, insultation, windows etc. My mom who doesn't qualify for medicaid recently got additional insultation in attic, new seals around doors and a new fridge through the Electric company. Contact your area on aging or go to there website they will tell you what programs your parents my qualify for. There are alot of programs out there to help with elderly to remain in there home. You might find more or less programs available in your state. I am sure it varies. But don't be afraid to ask for help the worst thing is to be turned down. These programs are there for a reason.

If there is a spouse in the community and the other in a NH, Medicaid will not count the house as an asset. Nor the car and the communal spouse may be allowed to keep, I believe up to 90% of the NH's spouses income/social security. I would strongly recommend that you talk to the folks at a the Medicaid office or there are filling services out there that can help.

I understand. completely. I have a brother... sorta. I won't go into the issues here, but it has taken me years to get to the point I'm at about him. My mom divorced my dad when I was seven, remarried when I was about ten, and then divorced again when I was eighteen. she's alone now, in more ways than one, and I am her only connection with the world outside of her NH.

Many caretakers are in a similar position to your parents. they have cared for the medically needy spouse or relative until their own money is gone, and then the NH steps in and the caretaker is left with no money, and no way to get by without the help of the medically needy person's small income.

This is the situation: medicaid will help the person in the NH only after all said person's money is gone. If the house is in that person's name, the house must be sold before medicaid will kick in. So, the spouse living in that house? Dunno. But my bets are on the house still needs to be sold, and the spouse or caregiver must find a new place to live.

The world is not a kind place to the financially challenged. There is what you've termed 'welfare', in the form of food stamps, which pays for very little food, only enough to keep you alive if all you eat are carbohydrates. Not hugely healthy. (Which is why we have so many obese poor people, but that's another subject.)

So, what to do with the spouse after the partner goes to an NH? No one can take him/her in, so it has to be up to the spouse's income to live. First, I'd need to know the condition of the spouse. Is he capable of dealing with his own finances? If so, it isn't even up to you to decide what to do. If the spouse is a mentally capable person with his own income, you have very little to say.

However, if the spouse has issues that need medical attention, himself, then you may want to consider assisted living for both of them now, while they can both participate in the decision as to where, what, when. Remember, you aren't actually alone. They are still there, with their own ideas on what to do and how to do it. You may not agree, but then, until you have POA, you have very little to do except offer your opinion.

So don't stress. Ignore the siblings, and live your own life according to your own idea of what is right and good. They will do the same for their lives. It only hurts you to carry around all this anger weight. Doesn't seem to be hurting them. So lose the anger, and focus on the good things in your own life. Positive self talk helps. It may sound a lot like talking to yourself, but it does help in the long run.

IE: my brother just called and wants all ma's things shipped to him. Do I get angry? No. I laugh, and tell him he can come visit Ma and ask her to give him her things. If she okays it, then I will hand them to him. I can use the space in my basement. He tries to argue with me. calls me names, selfish bitch among them. I say: Goodbye, dear brother. I hope you remain in good health and are happy. -- then I hang up the phone, take a look at my grandkids' shining faces as they say 'Yuv you Gamma Yisa!' and I know it doesn't matter what my stupid little brother thinks. He's a fool who will reap what he sows. I do not send the stuff, nor do I even ask Ma about it. It is a non-subject now, since he won't visit Ma, or even call her. He only wants her money and expensive things because he failed to provide them for himself.

Your siblings are to be pitied. They may get nice things, money, all of that, but they will not understand how good it feels to be an unselfish, caring person. Live your own life, and let them go to hell in their own manner.

sorry this is so long, and really doesn't have many answers. I sorta vented. lol Good luck with the issues, and remember to find something to focus on that has absolutely nothing to do with parents or siblings. Sometimes, that can put things into perspective. Most of all, remember to laugh once a day. It doesn't solve anything, but it sure does feel good. :D

Lisa

In CA some of the AL's and SNF's will allow the spouse of a patient to live in the same room at a reduced cost. At one of the private facilities in my area, they charge a set fee for the patient & $500 extra for the spouse. It is worth checking into.

I wanted to share what I wrote back to JaneB so you can all get the picture. Because I know I'm on my own planning my paretns financial future, I have to start asking these questions. Jane suggested to turn my attitude in something postiive. Boy, would I like to!! I just can't.

JaneB -Your comments to me were very helpful and I wasn't offended in the least! Thank you. My sister wants their money or what she calls "her share" of a trust that is yet to be broken. She can't get it until they both pass and that is making her crazy. Although she gets thousands of dollars a month in alimony. She takes in 3 times the amount of money both parents receive combined in social security. She doesn't work or live in reality as she took her settlment bought a house she can't afford to run and a mercedes. Blah, blah, blah...the brother is just lazy. What is out of sight is clearly out of his mind so he'd rather not participate. My parents continue to jusify their selfishness but I can't do it all anymore. I'm a wreck and I blame my loser siblings for that. They haven't called me or writen in over a year. Ok, enough of that. The bottom line, I can't get past this; how much I resent them for bailing on me. Thus, my screen name. You are right in everything you say about turning it into a positive. I'm just not there yet. I want to be, but I'm not.

xo
Thanks again.-SS

Sometimes you need to check with a lawyer. In Texas most will consult with you for free the first time. (your state may vary)

Oh, man. Now I see what you are asking. I would start here: does that spouse understand the situation enough to be able to have an opinion? There must be others in a similar situation who might be looking for roommates, as long as they can care for themselves. Maybe he/she could take in another who is in the same boat? I wish I had a better answer. What's horrifying is that, even if you saved and saved for retirement, this can still happen.

One last thought: Write your future self a letter, and remind yourself what you know to be true: taking in this parent will harm your family. You may find yourself in a crunch and not remember.

And some unsolicited advice...see the bigger picture here, in terms of your siblings. I have no idea why they won't help but, in their minds, they have good reasons. Find a better name for yourself, one that identifies you with something good about you, or positive in your life, or even just your name or nickname. It may be that you see other options in this situation, if you can look at it through a lens which is less fraught and murky than your siblings' selfishness. You can't change them, so try to identify with and as something better. I hope you aren't offended...it wasn't meant to offend or to add to your burden.

My dad recently passed away so my mother's income was increased slightly with a widow's pension from the railroad. However, I made sure to get them both on Medicaid back in March. Through other programs through the Area Agency on Aging which your state may have, she is provided food every day and we get a caregiver for six hours a day allowing me to work. She will be going into a group home soon and medicaid will help pay for that. Look into group homes if she is still coherent and functioning. Otherwise a nursing home will be her only option. I have seven siblings...none help with my folks. I'm in debt $50k but my siblings don't care. Good luck!

There are ALF's that will admit them. You will have to do some research for your area.

Medicaide will help pay for a nursing home when your parents have assets of $2000 or less. You will have to spend down all of their assets to qualify. If your dad is a veteran, your mom is eligable for a Widow's Pension if he passes away first. It takes 6-12 months to get it, but it pays up to $1500 a month for housebound care or nursing home costs.

Thank you all for checking in. It is not the money for the nursing home parent. I get that. Yes, he or she will go on Medicaid. But the other spouse, also called the community spouse, that is still living independently while his/her spouse in the nursing home. For that person still living independently, now has no money because the nursing took most AND SS doesn't cover they monthly living expenses. What does that spouse do if no one will take them in?

That should have been Home hospice, not Some hospice, that's what I get for not proof reading before submit.

I have no intelligent response, I am sorry to say, mom is 94 and lives with me, we have some hospice, but when the day comes when she is no longer with me I am not sure how I will be able to survive without her contribution to household expenses - everything I do I examine to decide whether I will be able to do without it in the future, cable tv, newspapers or magazines, much simpler food, etc.. Good luck to the both or all of us.

By all means apply for Medicaid. If either was a Vet talk to the VA. They might be able to help. Good luck

Do your research on facilities that take Medicaid patients... Not all do. That way, you will know your options ahead of time there, too.