My husband and I are 74 years old. My 80-year-old brother has advanced Lewy Body Disease with dementia and lives some 700 miles away. He was diagnosed a year and a half ago, at which time I abruptly assumed responsibility for his care. Using POAs for finance and healthcare and working with a wonderful local geriatric care manager (at my own ongoing expense), my brother moved to an equally wonderful Adult Family Home with memory care. I worked with a realtor and my brother’s friend/neighbor/tenant to sell his rental properties. All of this was done from my home, thanks to the Internet. For 9 months my husband and I paid my brother’s expenses ($274,000). Since the sale, I can now pay his bills online from his checking account and can reimburse us for ½ of those expenses. We will absorb the rest because I overpaid the contractor (hired on a time and materials basis, which I know better than to do) for refurbishing the properties before selling them. I also have an 84-year-old sibling who does not/will not contribute. My husband and I are on our own.
My brother now has assets that I anticipate will support him for another 2 years or more, at which time we will apply for Medicaid for him. I have 2 concerns:
1) What is my obligation, financially, if he does not qualify for Medicaid for some reason? I have engaged an elder law attorney in my brother’s city, at my own ongoing expense, to advise us on a continuing basis, and she will execute a promissory note to justify our reimbursement. I have all of the documentation necessary to support the loan when applying for Medicaid. But, assuming that Medicaid survives the current administration in Washington, D.C., there will be additional expenses. The state might cover some of those expenses, other than a private room, but I can’t guess what other expenses I might feel compelled to pick up. I understand that I would not be legally required to support my brother and our care manager assured us that the state would not have him living on the street, but I feel uneasy making long-term plans for my husband and myself if I can’t predict future financial obligations. Am I justified in declining to contribute financially after my brother has depleted his own assets?
2) Even more pressing is the damage already done to our own life style. We have neglected our own needs for more than 3 years while attention was directed to attending to my brother’s needs. More pressing than deferred house maintenance and no time for exercise is the damage done to our health. My husband has a number of health conditions that contribute to weakness and low energy, so he lacks the stamina to resist the anger, resentment, despair and depression that result from being burdened with the unchosen sacrifice of having our lives “hijacked” by a person whom he despises and has opted not to see for 40 years. My husband now envisions the retirement savings from 1 income (his) being drained. I confess to finally feeling considerable resentment myself, now that I have moved past the crisis-management stage of caregiving. My brother is a narcissist who was incorrigibly financially irresponsible, repeatedly “borrowed” heavily from his vulnerable elderly mother, never married, somehow drained an inheritance, frequented a casino, mortgaged his properties heavily, and didn’t save for retirement. Now he is tenderly cared for by a staff whom he condescends to them (they are “uneducated”) and resents them because they speak a foreign language among themselves. I would attribute this behavior to symptoms of LBD, which is characterized by paranoia and delusions, but this type of arrogant behavior was typical even before his dementia.
What now? This isn’t fair. The cost to us is immeasurable, indescribable. I finally see that I rescued my brother at the expense of my husband’s emotional and psychological health, which was shaky even before I assumed responsibility for him.
Given your own situation, I think there is none at all
Me personally, I would have put it all in a lawyers hands and allow him to take his fees from the proceeds of selling the properties. Medicaid would have excepted that more so then her trying to reimburse herself. The lawyer could have set him up in an AL and eventually applied for Medicaid. She would have done her duty without any out of pocket. I don't think we are suppose to take care of someone else at the expense of our families suffering. Really surprised her DH didn't put his foot down before now.
Sorry, when you marry your responsibility is to your husband. This brother is a taker. Doubt he would do the same for her.
I agree that she should not go into financial danger to keep him in such an expensive facility!.. I do believe that they may need some more financial agility & planning. There are much more affordable options & public benefits to be had!!... And her brother did have some resources & earned some Medicare options. But, the fact is that few people have the "perfect plan" when there is a family medical emergency, or an unexpected long-term disability...You have to keep researching, planning, & adjusting, I believe!.. However, I do think it's great that she has been a caring family member! Besides, there are many things that are infinitely more important & rewarding than "Money," to include Life, Love, your Faith & conscience, & your Family! ;)
Family IS vitally important; and when it's all said & done, you will be on the "high ground" & at Peace, just feeling great about what you did, especially as your circle of family & friends may get smaller & smaller in your elder years...
And in many cases, spouses come & go, but your Siblings will always be there.... Of course, your spouse cannot ever appreciate your deep bond (since birth) with a brother, who very well may have been a much more agreeable & adorable person before he became so ill. You certainly have memories & they weren't all bad. But, Love & Family should extend beyond "personality or lifestyle differences," so I commend you for taking on such a challenging project.
Now you can streamline this process, turn to Medicaid, and look for a more affordable set of options for his future. I think $274.000 per year is very high for a skilled nursing facility. Sometimes if you shop around & consider other nearby (or not so nearby) towns, you can find a better deal with equivalent or superior standards.
We thought we were stuck with an $11K per month bill for my father in a nice facility when his health suddenly declined, along with $20K regular charges in related medical expenses. (believe me, the entire long-term care situation will be difficult for anyone regarding ANY relative!! We do have an obligation to our father & he is caring to all. But, that did not make the planning any less troublesome or stressful!!)...
As it turned out, we were able to get discounts & referrals with the specialists' help, plus substantial Medicare coverage of extraordinary expenses. The family even sought grant aid. And then we found back-up options-- such as distant VA facilities (free & many received 5 stars). Plus, we shopped around in the immediate area & finally found a fantastic small home care home in a close neighborhood that offered 24/7 full-time registered nurses, delicious home-cooked meals, visiting therapists, and it was only $3K a month--wow!!...
My father does not yet qualify for Medicaid either, but we have financial limits.
Keep looking for a BETTER DEAL!!....& utilize Medicaid/Medicare, as needed!!...
Again, I commend you (& your husband should be glad that you are so faithful & compassionate, as demonstrated with your brother!!)...Hopefully, your husband will benefit from your good, generous heart in his future, too, & your kindness continues to sustain his health & your marriage even now!!.. On some level, I'm sure that he admires what you have done, even if it is a bother along the way. Just keep up the search for other options, reduce any financial burden, & change your outlook, so you feel the true benefits of resolving this situation in a commendable way!!..When your brother is finally settled in an affordable, quality situation, you will be so glad & at Peace throughout your life!!..Take care! :)
Scripture tells us we become 1 when we marry, so you can't use that she is doing the right thing as a justification.
Your attitude is a large part of why spouses go, who wants to be treated like a dispensable money machine by anyone, little alone someone that stood before God and promised to forsake all others for you.
Keep this formost in mind and it will help you make decisions that seem to be tougher for you than the community here.
Also, keep in mind that he is now on borrowed time, and you and your hubby will most likely be here after he has moved on.
Some of these same questions may be asked about you with your kids, etc. They will most likely be less difficult for them if you have some resources left for them to work with.
You seem to have stepped up when needed. Be proud of that! But a reassessment seems to be in order for your wellbeing and know that it is more important at this stage than continuously taking one for the team until there is none left.
Remember both of you are at the age that makes it very difficult to make up any money that you lost taking care of your brother. Pay yourselves back than figure out what can and are will to do.
The best of luck!
Keep very fastidious records and Assume your brother will qualify for Medicaid when the time comes. Get on with YOUR life.
Well, yes, of course, you are justified; more than that, given that these funds have been paid over to the detriment, as you now see it, of your husband's welfare, I'd say you're obliged, wouldn't you? Surely, this isn't really a question.
I wonder if the difficult emotions you're feeling, such as some resentment, stress, anxieties about the future, perhaps fear of falling short morally, are feeding into each other. If you can untangle them a bit it might be helpful.
If I can single out one, it would be how you feel about what your brother's care has already cost you. Immeasurable, indescribable cost, to the detriment of your husband's wellbeing, on behalf of a person from whom you were estranged and whom your husband actively despised. I don't think you would be quite human if you weren't angry, at least somewhat. But, who with? Just your brother, or yourself as well, for being taken for this prolonged ride?
Well, everything that you have already given is done and gone. The support in his time of need was your gift to him; and whether or not he deserved the help and is duly grateful (you may laugh hollowly if you wish) it was generously given and is gone all the same. No use regretting. But if you now say that enough is enough, why would that *not* be okay?
You need to get over protecting your brother from his choices and be a wife. It actually makes me mad for your husband, you sound as though his feelings have little to do with your actions, you know how he feels and you are not stopping yourself and you feel like you both can't have a future because your brother might need your money. What? That is insane, read what you yourself wrote about your brother, you are willing to sacrifice your husband for this person? He made choices that have led his life here, he pays the consequences for those choices, that is life.
If you give him all your money and you or your husband becomes ill and need long term care who is going to give you all their money?
You can't expect people to give up their stability because you made bad choices. Your brother can't expect you to do that. If he is pressing you, stop seeing him or talking so often.
Please take care of your marriage, divorce at your age is hard, especially when you have no money.
Adding- you have NO moral/ethical responsibility towards him, but I will tell you that when it comes to the stresses and weariness and unfairness and sorrow attached to caregiving, whether you dearly love your dependents or are angry and irritated by your responsibilities makes little difference.
We are caregivers to two of the dearest human beings on earth, but we are also exhausted and sometimes ill because of the time commitments, scheduling issues, worry, decision making etc. connected to their care.
Fortunately for us in our case, we do receive bundles and bunches of love and appreciation for what we do, and for that we are endlessly grateful.
Once you apply for medicaid and he is excepted there is no reason you should have to spend any money on him. He will have Medicare as his primary and medicaid as secondary so you can drop any secondary insurance he carries. He can use the drs. at the facility. So no need to take him out of the facility. Foot doctor will come there as well as Dentist and Eye doctor all paid by Medicare and Medicaid. You can have the facility become his payee for SS and any pension. Laundry can be done there too. If you want, all u have to do is visit. He is no longer responsible for bills. The spend down amt can only be used for him personally. He will receive a Personal Needs Acct (PNA) where a sm portion of his SS about $50, will be put aside for any personal things he may need. Like clothing, shoes, socks, books, candy, etc.
There is no financial expense to you. You r not responsible for brother. You can use his assets for the lawyer. Which I would now even if it means putting him in NH. Personally, I would have paid myself back as much as I could and put him on Medicaid. Why should you and husband suffer for a man who did this to himself. I don't blame ur other sibling. Why should he spend money he may need for himself in the future.
Get all of your money back if possible, he can go on Medicaid sooner than later. Keep records of expenses for the repairs to sell his properties and get a promissory note for the entire amount, just because some unethical contractor over charged doesn't make it your baby. It is truly unfortunate that you ever spent any money improving the properties, almost never recoup when it is a forced sale.
He has made made his choices, welcome to the consequences brother.
Why would you ever subject your life to this person? You have no obligation to him whatsoever. You do have an obligation to your husband, so start paying brothers business out of his money, a NELA certified elder law attorney can file the Medicaid application.
You need to stop the financial bleeding, now. Seeing an attorney with all these facts (I admit I got lost along the way!) and taking on as little as you possibly can for his care would be enough!
You shouldn't fear for your own independence at the sake of a freeloading family member. Your "obligation" was zero and is less than zero now. You did all you did out of a sense of familial closeness that you admit you don't even feel.
I hope you can be made whole and live a wonderful retirement with your DH.
You ARE NOT legally responsible for your brother, Never were, aren't now.
Please get some legal help and try to start healing from this. ( WE ALL have narcissists in our families--trust me, you are not alone in THAT!!)
Best of luck to you. You certainly deserve some time for yourselves.