Long story short ....I typed a long post with every detail...but it disappeared when I tried to log in. My dad has Parkinson's and Dementia. Since Dec it has quickly progressed. My brother walked away after the firts of 5 hospitalizations. Said he couldn't handle it mentally or physically. He blocked our numbers and we haven't spoke to him since. He said he didn't want any part of it or anything from our dad if he passed. I am unable to work during the week bc I have to take care of my dad (although he is in the hospital at the moment) along with handling his finances, making sure his home is checked weekly, filing for VA benefits (bc he is a veteran). I feel like if I compensate myself that I would be taking his $$$ and I don't want to do that.... I have turned down two jobs this month alone, bc being a POA is a full time job in itself. Other than one cousin that my dad grew up with, we (my husband and I) have no one else to help us. We are at a crossroad now.....and had to make the decision on seeking assisted living. The dementia has progressed so much...the last admittance at the hospital, my dad thought I was his wife and that we were in a lawyers office & I was filing for a divorce. :( At the moment, my daddy knows me as his daughter again, but than can quickly change. I met with our family lawyer and she said I needed to compensate myself....but there again, I feel it's my job as his daughter to do and that I'd be wrong for paying myself to do this. But......I could really use the help as I'm only able to work on the weekends bc my husband works full time and can not help me with the things I have to do for my daddy. Can anyone give me some advice on this??
As Caregiver, you are providing care that may continue to save your father from a nursing home admission. But without a written agreement, you may be setting yourself up for unnecessary self-doubt and criticism.
A Caregiver Contract recognizes and rewards the time and effort that you give to care, and it helps to prevent arguments and misunderstandings among other family members who can't or won't help.
And without a written agreement, the elder who pays you for care could be disqualified from Medicaid coverage if he does need nursing home care in the future. Medicaid could consider payments to family members to be "disqualifying transfers."
If you talk with your family lawyer or an Elder Law Attorney in your state, the Attorney can prepare a Caregiver Contract that is compliant with Medicaid regulations in your state, to document the compensation and services in a format that Medicaid can understand and accept. If you are authorized in the Power of Attorney document to sign the Contract on your father's behalf, the Contract can be an effective way to manage details, so you can focus your energy on his needs and minimize the impact on your physical health and financial well being. Your are performing a valuable service, well worth the compensation.
Grace + Peace,
Bob- Age 80.
I can see 2 issues here 1) is it OK to be compensated and 2) will compensation affect future medicaid application
Some get compensation. Where I am (Alberta, Canada), compensation has to be specified in the document, but I have read here that in some states compensation is allowed without it being specified. I personally have no problem with that if the parent can afford it, as caring for a parent and their business is a lot of work.
However - I gather your father is past the point where he could sign a contract compensating you as caregiver.
So, you have to make sure that you are not jeopardizing any possible future application for Medicaid for your dad that could see any money taken by you as "gifting". You need to check with a lawyer experienced in elder law and Medicaid regulations to make sure that aspect is covered.
To me, your dad & you really do not have any time to do anything "creative" with his $. Things are going to need to get turned into income to pay for a facility. Should you as his dpoa compensate yourself its a breach of your fiduciary duty & if dad should need to apply for medicaid before 2022 will place a transfer penalty against dad. The only way to "pay" you would be IF you are providing caregiving to him as a job and this is done by a drawn up by an atty, personal services contract in which dad pays you and all is fully reportable and taxable income. If your family lawyer is clueless on Medicaid compliance and regulations, you need to find a new NAELA atty to handle all dads legal from here on out.
Dads right now in a hospital and then moving into AL, right? Then the facilities are providing all care. Too late imo for caregiving contract.
At this point, to me, the first hard decision will be determine what level of care he needs to go into AND second hard decision, how long he can private pay for care from his existing assets. You mentioned AL & Memory care. I'd try to speak with social worker to find out what level of care he is likely to be discharged to needing and if that level of facility takes Medicaid for your state. If not, then it's all private pay. Dads VA aid & attendance will provide some funds towards this but all the rest is private pay.
If its looking like dad could do either memory care or a NH, it may be best to go into a NH as he won't have to move again(!!) 6 - 9 months from now.
Most families just do whatever time & costs needed without any compensation.
Third hard decision will be his home. Dad can continue to own his home but it may not be at all feasible for him to pay for care AND cover house costs. If you already find your time for oversight on the property isn't feasible, the house needs to be sold. If house is to go on market, dad may want to pay in advance for house costs (utilities, taxes, insurance, yard). If DOM (days on market) is 4 mos for your area, maybe prepay 6 mos as there's likely a few weeks needed to get house market ready. If house needs cleaning or clearing, dad pays for this although you as dpoa can write the checks from his account. Otherwise you or other family will pay those costs. If you reimburse yourself at closing, it will likely be considered gifting should dad apply for Medicaid.
VA A&A will provide income to the vet for in home caregivers or if they are in a facility.
But what seems to happen with vets, is that between their income & A&A, they still can't cover the cost of the facility. So going on Medicaid is better as all costs will be covered.
Now once on Medicaid, 2 things happen for vets...... Their A&A stops but get a $100 VA personal needs allowance & their monthly income then must be paid to the facility as the required copay or SOC (share of cost) but they get a Medicaid personal needs allowance (from $ 35 - $115 depends on your state, for my mom in TX was $60). Other than his 2 allowances, Dad will have no $. Someone in the family will need to pay all on his house if he wants to continue to own it (allowed as an exempt asset for medicaid).
It's all a lot of decisions to be made to with PLUS the day to day medical with your dad. It's easy to become overwhelmed & burn out. Try to clearly speak with discharge & SW as to what level dad needs and go look for ones that meet his needs. Often family put the elder at AL as its 1/2 the price of a NH thinking they can private pay till death but get a 30 day notice to move them 3 - 4 months later as the reality is they need a NH. Or AL has add-on's as they cannot do their ADLs so the costs spiral up. Hopefully between his savings, pension & house sale he will have 200-400k so likely enough $$$ to private pay for a few years of care. But if not, he's going to apply for Medicaid & you want to do things now that pose NO problems later.
((((((caring))))) - igloo is our unofficial resident expert on these things so you can trust what she says. I totally agree about finding a lawyer who specializes in these matters, and about selling the house to provide for dad's future care. Dad's disease is progressing so he has increasing needs for care and it is expensive.
"Really the social worker & discharge planner at the hospital dad is at can be of immense help in getting through all. "
Sounds like a good place to start! Let us know how you make out!
You need to look at this with your heart and HEAD. 'Put on your life jacket first." How are you affecting your retirement and your future social security by not working? And, frankly, sounds like you need to force some balance into your life. Dad is cared for, help is available. Seek it.
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