ASSISTED LIVING FOR MOM, PART 4, What About The Money?

Vivian @ Pixabay

The Future

I know. Talking about Mom’s future can be uncomfortable, especially when the topic is money. So, if you haven’t already, take a few minutes to read the first parts of my series (below) about the conversations you should have. Part 1: With yourself, Part 2: With siblings, Part 3: With the Place. 

I’m neither a lawyer nor a therapist, but maybe I can help you navigate the financial fear factor. I’ve dealt with it myself in several ways; with my mother, my mother-in-law and my recently deceased wife. Your story will differ from mine, but I’ll bet they have a lot in common. And whenever I say "Mom," the same applies to Dad.

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To be brutally honest, you’ll need to quickly acquire a graduate degree in senior financing. You’ll get my two cents worth in here, plus I'll include links to sites I think best explain things. This is a good place to start. It has an excellent explanation of Medicare and Medicaid.

Medicaid allows for the movement of certain qualifying assets. See more about that down below.

From Part 1, Context: attend a local caregiver group, even if you don’t live near your mother. The ones I attended always had members with real-life advice on money issues. They were a gold mine of information for how and who to deal with about assisted living. This is especially true with local groups. They can help you see the light at the end of the tunnel.

Mom's Records

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Medicaid, the VA, and many other government programs are "means-tested." This means: they’ll want to know your mom’s assets and monthly income. Does she have that information? Who does?

Can she prove she was born in the US? What’s the value of her house? Her car? Is Mom or Dad remaining in the house? Start thinking about how to help her collect her financial records, and I mean everything. 

Power of Attorney (POA) for Financial Affairs

Has she given you a POA? The arrangements for my wife and her mother would have been impossible without one. Talk to an eldercare attorney if you can. Convince Mom to sign one for you or you’ll get nowhere. Does she have dementia? If so, read this.

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Giving access to one's money is scary. Mom may want her financial POA to kick in only when “I can’t do my bills by myself anymore.”  

Here’s a downside to that: if she becomes incapacitated, usually one or two doctors have to state, in writing, that she is. Arranging that isn't always easy, and it can happen right when important financial issues are staring you in the face. 

A POA that activates upon signing is easier for everybody. Trust is key here. Put this on the top of the list of things to talk to Mom about, if you haven’t already. If she has dementia, this site has some good information about that. 

Safe Deposit Boxes (SDB)

Klarinette71 @ Pixabay

Does she keep her most important documents in a safe deposit box? Your first surprise may be at the bank when they refuse to accept your POA unless it specifically gives you access to her SDB. Have Mom specify in her POA that it does. This is important if you’re using your own blank forms from the Internet. Our eldercare attorney was worth every penny.

Reverse Mortgages (RM)

Be super careful here. RMs can't be used for most mobile homes. Most manufactured homes qualify. If you plan to ask Medicaid for help to pay Mom’s nursing home costs (almost 60% of NH revenue come from Medicaid), the proceeds from the RM will probably be counted as part of her assets. Look here for a certified advisor. Click on "CRMP Only."

Discuss the options for renting her home, too. Remember, RMs come with interest, which accumulates. I think this site is the best way to weigh Mom's RM options.

Dennis Larsen @ Pixabay

VA Benefits and VSOs

The VA offers Aid & Attendance and other benefits certain veterans or their survivors can use in nursing homes. Mom must first apply for and be receiving a VA pension to get “A&A”. It's explained here:

VA regulations can be confusing. Service organizations, like the VFW, DAV, and others offer free help and you need not be a member. Go here to read more: Click on: Find a new Representative and apply via mail or fax. When the page resets, choose: Recognized Veterans Service Organization (VSO) and enter your state to begin.

VA staff are fine, but Veterans Service Officers will speak to you like members, and they can also help you with the paperwork. If Mom or Dad has a service-connected disability, they might also be eligible for free nursing home care. Find out here:

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PACE

Sometimes called Life Programs, PACE can help seniors continue to live at home, instead of having to live in a Medicaid nursing home or in assisted living. Here's a site that explains it:

Here's a PACE test for eligibility: which also tells you if Mom lives in one of the 31 states that have that program. 

Home Health for the Housebound

If financials prevent or the family wants Mom to remain at home and she becomes housebound, she may be eligible for medical care at home. Here's an explanation:.

A doctor must prescribe Home Health: Before she passed away, my wife could do very little without my help. She could, with difficulty, get in our car for me to drive her everywhere. They disallowed her because I helped her NOT be homebound. When she could no longer get in the car, and her appointments were with doctors, they allowed it.

Important: When the time comes, Hospice and Home Health provide separate types of care, but Medicare will not pay for both. See if your city or town has a volunteer hospice program that will add your loved one to their patient list.

Transferring Assets to Qualify for Medicaid:

Medicaid does not intend to bankrupt the stay-at-home ("community") spouse when the other spouse is moving into a Medicaid facility. This explains how Medicaid examines a person's assets: Each state is different. It bears repeating: find a good eldercare attorney. As you explore each facility, ask these questions, too: "Do you offer Medicaid beds? Do you require a period of "self-pay" from Mom before you'll accept Medicaid?"

Edu Carvalho @ Pexels

Congratulations on reading this. Your mom will thank you. It is complicated but doing it right will help both of you sleep better at night. Remember why you're doing this. She was there for you.

Any errors are mine alone, for which I apologize. Stay tuned...

Ron