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Given that Medicaid has a five-year rule for transfer of assets, the first step is to consult with an elder care or RE attorney about whether or if the real property can be liened in whole or in part for payback and what, if anything, you can do to shield yourselves from that possibility.
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Yes, you have it right. The cost of living, and even caring for people who will live to almost 100 years of age will not be supported well or easily in a system that now has most of the money in the hands of the 1%; and those earning low wages will not be able to save for their own care. This will get worse, not better.
You say "we own his home". Hopefully you bought it for fair market value, but if he still had a loan on that home, the profits from it will last only a very short time.
Medicaid WILL pay for his care in a nursing home. But you may not be well satisfied with that nursing home and it certainly will not be on a par with a good ASL place.
So here you are. The choices are as you say. A nursing home and medicaid. Or move in with you and be cared for by you. Your parent is 95 so that would last at most 5 years in normal circumstances. Some are looking at this with parents in their early 70s so they are looking at two decades of caregiving. There are no other choices now, at this point, when it has come to this. And given that in our nation some are paying Federal Student Loans they were lured into when they are on Social Security, I can't see things getting better.
I suspect your family may not want to give up their own lives in the care of an elder. So you are down to Medicaid and the kind of care it pays for in a Nursing home. This varies widely across our country.
And I am left with the helpless words we who answer anything on Forum are often left with. I wish you the best of luck. I caution you against using your own money, as you are going to need every single penny you can save for your own time in this position.
I am so sorry. But you got it all, and you got it right. And like so many things, there is no "fix-it" and there is no answer.
I caution you against "moving in there" as well. Often the people we see do this, sacrificing years of their lives in care, end up homeless, jobless, without job history and penniless as well as ending mentally unstable from attempting 24/7 care. You can read their stories all over the Forum.
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jolobo Dec 2020
Thank you. We bought the home more than 5 years ago, so it's not an issue.
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If you do not call APS they can claim neglect.

Right now it is self neglect but, as time passes and he needs more help than he is getting and you know this, that is when it becomes a situation for you and your siblings.

Call now so that he is on their radar and you have proof that you have been trying to help him with the situation. They also know about and can implement services that the public can not. They can also force issues that you can not. Call APS today. He is a vulnerable senior that needs help.

You dealt with Medicaid for your mom, what do you know about your dads finances that you are worried about? You can see a certified elder law attorney to get advice on fixing whatever you are concerned about or find that it is nothing to worry about.

Best of luck finding the best solution for your dad.
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jolobo Dec 2020
Yes, his finances need explaining and back-up documents. It's kind of a nightmare to get together as I saw when I did this for my mom several years ago. There may be substantial penalties as well.
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The answer is a Nursing Home paid by Medicaid. You do not have to move in, in fact I would advise against it. You can contact APS, they will check on him and monitor his status, and when he is unable to be alone anymore, and meets SNF requirements, that's where he will go.
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jolobo Dec 2020
But what if after that Medicaid has some problem with his finances? And I end up having to pay for the time he spent in the NH?
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I and all my siblings have POA. Actually, the trouble will be that he will refuse to go to a nursing home. He has said many times he will not go. And he throws fits if he doesn't like something suggested about his life. Big fat disturbing and sometimes violent fits where things get thrown at you. Don't get me wrong, our relationship has never been better than it is now. But I stay away from certain topics and always agree with him to keep the peace. And since mentally he is in fine shape, I don't see how I can accomplish this unless he is in a more advanced state of decline. And when that happens, there is at least 3 months waiting for the green light from Medicaid. I know from doing this for my mother. 3 months, if you are lucky. And I would have to take care of him during that time. I am not putting him in a nursing home prior to that green light because what if there is some problem and Medicaid refuses him and then we would have to pay for those months and then take him home. I have thought about reporting him to the DMV, but he hasn't had an accident and it is his only independent option. But I know you're probably right about that. Although, I think soon he will not be able to hoist himself into it. The truck he drives belongs to my sister's business, they bought it for him, so I have no right to do anything with it. And she won't do anything about it. She is not pro-active at all. Given all these caveats, I see the writing on the wall.
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mstrbill Dec 2020
Let him be, call APS to check on him.
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Sadly, your father’s condition will worsen and he most likely will need increasing amounts of help including with bathing and bathroom needs. It’s rare to reach his age and maintain all those skills, not his fault. When a person can’t live on their own and care for their needs, it’s on them to figure out what to do next, or if not competent, it’s on their POA. It’s not on you to change your life and move to accommodate him. Looks like his choices are limited by location and income, and a nursing home with Medicaid paying for it may be what’s coming. I’m sorry you’re faced with this, but please don’t move and put yourself in a position you already know isn’t good
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rovana Dec 2020
This is a good point to consider: the elder has to make the accommodations, not the caregiver. Just simple fairness.
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I don't believe that you should be moving in with him, into a house that is in "horrible shape, very neglected and ugly inside". He shouldn't be living in those conditions either. It sounds like he is probably ready to be put into a nursing home, since he can't afford an assisted living facility, and you know that Medicaid will help cover that. Sometimes the decisions we have to make aren't easy, but they should always be made with the best interest of the involved parties in mind. And in your case, the nursing home makes the most sense. That way you will know he is safe, and taken care of, instead of worrying about him out in the boonies, in a house that's falling down around him, with no cell service and no medic alert service either. It's really a no brainer.
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First, are you his durable PoA? If not and he is of sound mind, this needs to get in place right away. This can be done by downloading the forms for his state off Legalzoom.com or Rocketlawyer.com. You will need 1 copy for him, 1 for each PoA so that everyone has a notarized original. You may need to have witnesses when notarized. Banks and hospitals have notarys. So do UPS Stores. Or you may need to find a mobile notary in his area. Digital notary services are becoming a thing as well.

If you already have DPoA, great! If not and he refuses to take this step then you will need to enlighten him to the reality called Ward of the County or guardianship. Please do not move in with him. This gives the false impression that he is still "independent" and able. He is not. You may want to consult with a reputable faith-based facility near you (if you will be managing his affairs going forward). Faith-based facilities are more flexible and understanding. They may allow him in to LTC and therefore he may qualify for Medicaid. They did this for my MIL. In my state the look-back is 5 years. My advice is to resist moving in with him. If you need to call APS then so be it, it will get him placed sooner. Also, please go into his state's DMV and anonymously report him as a dangerous driver so that he doesn't hurt others (this happened in my own family -- my uncle went through a red light and it killed his own wife and dog and injured the other party). Remove his car physically if that's what it takes. I wish you much success and peace in your heart as you move through this transitional time with him.
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NavyVet90 Dec 2020
Wow. That is so sad and frightening. I think the DMV reporting might vary state to state. True story: My father had always been a terrible driver, reckless, speeding tickets, had his license revoked twice when younger, numerous accidents and fender benders. Never his fault of course (yea right.) No one would ride with him. It only got worse as he got older and more inattentive. In Florida, we had sent in the report to the DMV (he was in his 90's by then.) We heard nothing for months. One day I met his PC doctor who came to the Independent Living apartment do to a checkup. My father had smoked non filter cigarettes for 65 years, had half the right lung removed at age 80 and was supposed to be on oxygen but was too vain to be seen dragging the tank around. Doctor told him straight up his lungs were shot. Dad had the nerve to tell the doc that it wasn't from smoking, his lobe was removed because it was revenge by someone he knew in NY who told the surgeon he was a sex offender! (Yes, he was also paranoid delusional and a sociopath. Whenever he felt slighted or didn't get his way, that's the story he told to anyone who would listen.) Afterwards, I pulled the doc aside and he filled out the same form, signed it and mailed it to the DMV. Lo and behold, my father finally got a letter from the state capital that he had to go get tested or surrender his license. I took him to the DMV personally and he surrendered the license. We finally got his keys away from him and sold the car. Lost count of how many vehicles he totaled in his life time. I could fill a book with the insanity that was my father!
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