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??
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!
Grace + Peace,
Bob- Age 80.
This thread has some of the best advice I've seen. I had a similar problem. I asked my accountant and my lawyer friend (but I had to pay them) My mother moved in with us at her request and we (mostly my wife) cared for her for 25 months/24/7 before we just had to find a facility, which was the best I'd seen and the same or cheaper than those lesser places...sorry...digress. Being paid for poa work does several things and each has an effect on the other. The prudent thing to do is check with all who are capable of helping to figure it out...that's the professionals who deal with this sort of thing. Even the public sector help will be good. Follow the law to your advantage. Working with the governmental agencies if you're doing this 24/7 will be just like doing two jobs. You won't find it easy to record everything they require AND get the caregiving done too.
Oh, if you didn't log in or if you're unsure, copy what you wrote before you post the answer. That will save it in case you need to paste it after log in.
In THIS case, you can never compensate yourself for your caretaking. However, what I have done is to create a healthcare company, subcontract other caretaking companies to be caregivers as well as hiring myself to be a caregiver for my father. Now, my time has value - but it is treated as income - so I do have a job after all.
So, Caring, if your concern about being paid for POS duties is just a moral quandary, rest your mind. If Dad provided in the POS document that you were to be paid, that's what he wanted done with his money. If the attorney is recommending it, unless you mistrust her legal advice, you should get paid. If you think your attorney is mistaken, you need to see another attorney who specializes in elder and estate planning.
It's not morally wrong to be compensated for your time. You can put the money away in savings in case you need to spend on your dad later if you want.
Read to him whatever. And pay yourself at least $12.00 per hr and pay Social Security and taxes on income. Job title: home care provider, ask atty for further suggestions. I was my uncle's legal gu a rdian but guardianships are expensive. Are there elder law attys in your city?
This has been a learning experience. When my husband's visually handicapped sister recently decided to change her POA from my husband to one of our adult children, I suggested that she include compensation in the new document. Likewise, my husband and I have included compensation in our own POA documents which name each other first, and then one of our children. I feel that it is a matter of fairness, especially if one child is doing far more than the others and giving up their free time or other employment to fill the POA role. Having one child do all the work with no compensation is bound to cause resentment. Just make sure it is set up correctly so that it doesn't cause tax or Medicaid issues in the future.
You must take care of yourself, or you will burn out, and be no help to anyone. Create less stress, and bring in more Love. These are precious times....
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.
"Put on your life jacket first" is excellent, wise advice.
And you got it right with your log-in name. Care taking elderly parents IS NOT EASY. Learning how to balance using our head AND our heart is a very important life-lesson for every aspect of living.
They can be a godsend for families dealing with complicated elder issues. Their skills run the gamut and they've seen it all before.
I understand your circumstances well. My husband took 24/7 care of his mother who had Alzheimer's for six years (I with him for 3 years). Before we met I took care of my first husband from the day after our wedding for 23 years, total care for 20 years (he had MS and was quadriplegic, on a feeding tube and could not eat or speak for 15 years).
When I met my current husband I knew I was going into another long term care giving experience from day one. Unfortunately Mom only lived 3 more years after we married. She was also 24/7 and as God would have it in his providence, she needed two people shortly after we came together. My husband was her POA, and his brother could care less about helping with mother. My husband was alone to care for both his parents until they died at home.
It is a hard decision to make to keep one's parent at home and make the sacrifices needed to see them safely to the end, with some quality of life. As POA, we lived our lives as we needed in order to keep Mom home with us, and we also spoke to a lawyer who stated, it is life, you do what you must and keep good records. He gave us specific advise to our personal situation I can't go into here.
As someone earlier mentioned how getting assistance and caregiving are two jobs, that is no exaggeration at all! I have 29 years experience with 24/7 at home care. The 23 years with David I had to apply for every program out there (all the ones mentioned) and had to keep daily detailed records of care while doing it in order to keep him home with me. It was the hardest thing I have ever had to do, being a caregiver wife, but it was the best decision of my life!
Now, when L and I got married I knew taking care of my new Mother In Law would be a big job and very different from MS, but also similar in some ways. The difference here was her son gave up his livelihood (an artist) to take care of both parents while living with them, he did everything to give them a high quality life until death. Again, the best decision he could have ever made. In spite of having POA, he gave of all he had as well to do this important calling. We didn't apply for any programs for Mom, we lived off what we had, what she had, kept good records, talked to lawyers and social workers, etc.....
The bottom line is this....where do you want your Daddy to be, with you, happy until the end? Count the cost to you. Could you sacrifice time, energy and personal life for a while and feel good about that? At the end of his life, will you be glad you put him in a facility or kept him home? I know full well the consequences of them both, Mom needed to be in a facility for rehab, but it was for a short time (months) and very costly, not just financially either.
Listen to your lawyer, get advise from everyone out there in the field and take notes, record conversations if the other party is willing, so you can refer back to what was said for comprehension. Do whatever you have to figure out what is the best thing to do to help your Daddy get to the end with the best quality of life, and in the end, I promise you, you will be glad you took care of him 24/7 for years untold if need be because you will know you honored him and that is worth more than all the money in the world.
The one thing I would advise you to do is make sure you and your husband get regular respite. The lawyer told us it is the one cost no one frowns upon. I sure hope it goes well with you, your husband, and your Daddy. You will be blessed in the care giving and I pray it will go well with you each moment you do....
This money covers my gas, wear & tear on car, insurance, the need to get a cell phone, stationary, stamps etc plus I had to hire a cleaning lady [2 times a month] to free up my time as my husband ended up doing everything [not fair & he has his own health issue as do I ] so I figure about 1/2 is used up with these issues - I get enough to have a bit of spending money for a light lunch a few times a month [often on way to or from visiting her] which helps lift my spirits too which as time goes on can be quite important
This is not taking money from your dad's care but actually paying to make your time freer to do that care - you give your love freely but you still need to pay for gas for the car, food etc -
This is not enriching yourself but making sure you are not impauversing yourself either - take that money if you want & put it for savings your own old age - I bet your dad would really approve of that idea
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.