Parents caring for the parent support thread (Part 1)

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<p>Greetings friends and fellow-care caregivers. Above is the thread about my 87 year old mother’s recent decline and dramas and my questions. I mistakenly posted it in the wrong place (not here). So I have pasted it above. </p>

<p>My mother is in her second nursing home stay and her “caregivers meeting” is scheduled for a wk from today, so obviously I have a week to rest. As I describe in my posts, she will ,through a licensed NYC agency, have two Eastern European women ttake turns living with her 24/7 because she is now so weakened, needs someone to “hover” while she walks,needs someone to cook…needs 24/7.</p>

<p>We hired two exceptional women (described in the post) but unfortunately one immediately got a 7day a wk job and forfeited ours. The agency gentleman assures me he can easily find another woman. The woman who is doing 4 days will do 7 until we find a second woman, but it does seem that the agency man performs miracles in finding qualified, experienced women fast.</p>

<p>First, the 4 day woman is an American citizen (she is divorced, has a MA in Poland but says at her age and with good but limited English can’t find another type of work BTW, she had the MA in a folder with scores of other qualififation documents including a licensed caregiver certificate). I typed out lists of rules, duties, regulations,requirements, and she was pleasant about everything. I insist that the women pay taxes and she says she has for 20 years and takes care of it all herself. Should I follow this in any way, require to be shown tax returns, on what periodic basis, or what? With the agency, we agreed on $170 a day…$150 “net” $20 “taxes and other deductions.” Thank God, she has health insurance and is an American citizen .She showed me her health cards. She pays social security. Do I need to monitor/oversee her social security payments? She has a car and will relieve me of constant shopping/ MD appts etc. As mentioned in my post above, my mother is Polish-American and will profit by this gregarious woman’s company and “chat in Polish” which my mother loves… Her references (about 5) looked truly authentic and several noted her excellent cooking, which would greatly delight my mother. My mother and the caregiver talked about music, books, art, and much more, and the caregiver’s charity (held hands, eye contact, etc) seemed totally authentic and genuine. </p>

<p>Do I need to involve a lawyer and what am I missing? I will considerately and thoughtfully take any advice on this, so please don’t hesitate to contribute - I will pay attention. I know very little outside my “liberal arts” field and respect the savants on CC. </p>

<p>And (probably due to my anxiety over this) I’ve skirted around my main question: my mother has 60K in savings and a house worth about $250,000- $300,000 - needs a bank/realtor assessment). There is no question she can live with me, and she is incredibly sharp and intelligent and certainly cannot live in a nursing home, which wouldn’t be cheaper, anyway. BTW, my MIL spent down her savings at at age 94 in in a nearby NH with dementia.On Medicaid. So, obviously money is the immense and,in the real world, the main issue. Question: Should I leave the 60K alone and immediately get started on a reverse mortgage arrangement? What is the best way to pay? I know the sad drawbacks of reverse mortgages, but what is the alternative? Should i start spending the 60K which I may have to do during the weeks it takes for a reverse mortgage to be approved? How best to pick a bank and what questions to ask? As with seemingly all agencies( I contacted 7 )the agency takes 2 wks of salary for its involvement, then steps out of the picture…unless needed for emergencies, whatever that means… Essentially, the relationship quickly becomes solely between the caregiver and the client.(The man did say that if the “fit” was not good after 3 wks, he would provide a replacement for no charge.) I told the women there would be no cash, only checks, and checks made out to their name, not “Cash.” Finally, despite her fraility (her ailments are rapid heartbeat under RX management, high bloodpressure under RX management, occasionally diarrhea under control when she eats only what is on her list of approved foods, severe and, sadly, painful arthritis, scoliosis which has her totally bent over and makes walking difficult–cane and baby steps and walker and helper necessary, ocular degeneration I think it’s called (losing eyesight), deafness because she hates wearing her hearing aids), a lifetime of manic-depression under RX management (fun times!) ,her main organs are all excellent and she is likely to live a long time. So what I am leading up to asking, what happens when the money runs out.?..when and how and how do I assess the timing of putting the house on the market while it is under reverse mortgage? I know these questions could wait for later and may turn out to be unnecessary, but it would ease my mind to have a “long term picture/plan.” (I am the sole caregiver; my sister in Reno is, sadly, in chronic bad health, unable to travel, practically unable to work…)</p>

<p>Thank you, kind readers, and interested friends!</p>

<p>Why not ask your mom about whether she’s interested in selling her house? Since she has $60K in cash, that will help provide for living expenses while the home is on the market, but I don’t understand what you hope to gain by a reverse mortgage instead of an outright sale of her home. If she sells it, she will get $250K exempted from capital gains (provided she lived there as her primary residence for 3 of the past 5 years). It will give her more options and I see now reason for enriching a reverse mortgage middleman and dealing with all of those hassles. The home is likely in better condition now than it will be with several years of no one occupying it. </p>

<p>Alternatively, you could hire a property manager and rent out the place while you and your mom figure out when she wants to sell it (but it is easier to sell if no one is living there–looks more spacious without furniture and don’t have to work around tenant schedules, etc). The net income from the rental should help offset her expenses.</p>

<p>Dharmawheel - I agree with HImom, the most economically sensible plan is to sell her house and rent or buy a smaller dwelling. An apartment would be easier for her to manage. Is assisted living an option? For my MIL and FIL with mobility problems, the AL staff helped obtain an electric wheelchair to help with the mobility issues so that they didn’t need spotting 24/7. All meals were provided. They just needed to be able to transfer to the electric chair and go downstairs. </p>

<p>Thank you, and I should have explained. I live two doors down the block from my mother and visit frequently with my three daughters. She is extremely attached to the house (beautiful, central AC, steps from public park with lake) and it is very expensive to live here even if she relocated to a condo/rental, which she would never consider. I assume you are suggesting she move? As a step to save/accrue caregiver costs? Am I missing some great benefit, because I assume she would have to rent or buy somewhere else and close to me) and nowhere can she live as cheaply as she does now. Of course, she owns the house outright and to my amazement manages to live on SS because from my viewpoint she seems to spend a lot food from catalolgues, gadgets and clothes and slippers from catalogues, that sort of thing). </p>

<p>After my father died eight yrs ago i took her to stay overnight at a very nice upscale Independent living facility… Now she would need assisted). She would have had companionship at meals, entertainment, frequent outings, etc. When I picked her up the next morning,she said to me “If you put me there, you would have a suicide on your hands.” Nice choice of words, mom. (And she did try it once, see first thread if you’re interested.) But thanks for your reply and fill me in if I’m missing something, I do appreciate it.</p>

<p>Thanks GT alum, your message came while I was typing. There is nowhere cheaper for her to move and she wouldn’t budge, as I explain. A nice feature of her house is that her bedroom and all needed features are downstairs, and the caregiver will have a private upstairs, large bedroom and private bath. I can’t imagine squeezing her and a caregiver into an apt. It will be a very nice job for the caregivers who, judging from their references, had much worse jobs previously, poor women. Thank you for contributing.</p>

<p>No Dharmawheel, you are not missing anything, I was indeed suggesting selling the house so that you would have more money for your mother’s care. For my in-laws, selling the house and using the money for assisted living was the best way to get them the care they needed. Every way we did the math, selling the house would bring in more money than a reverse mortgage, especially considering maintenance and taxes. Plus, with no crystal ball, your mom’s years of living in the house, even with a caregiver may be very limited which further diminishes the value of a reverse mortgage. My understanding is that a reverse mortgage is only a wise decision for those who can plan to be in their house for many years. </p>

<p>But I’m no financial expert, only someone who has lived through the care of in-laws and living through the care of my parents. Fortunately, they were willing to relocate to good facilities that can meet their individual needs. </p>

<p>It seems like a financial consultant could help.</p>

<p>As far as the women paying taxes - you should send them 1099 forms. </p>

<p>But my concern reading your post is not taxes, it is workers’ comp insurance. Are you covered? Are the women covered? Does the agency provide this? </p>

<p>OK, I’m sorry I misunderstood and didn’t know your mom plans to remain in her home while living on funds from the reverse mortgage. Sorry she didn’t like the place you took her for an overnight. Did she say what she didn’t like about it? Is it the idea in general, setting or that particular one? Different places can have very distinct characters and some are more attractive and inviting than others.</p>

<p>Agree that it might be worthwhile consulting with a fee-only financial planner to figure out what assets she has that might work to help pay for her caregiver. It might also be useful to speak with a medical social worker and have a needs assessment to figure out what exactly she NEEDS at this point so that those can be addressed. It’s great that your home is so near hers, so you can drop in and keep in close touch as desired.</p>

<p>Dharmawheel, you say that your mother is currently in her second stay at a nursing home. She’s 87. If/when she returns to her house, she’ll need 24/7 care.</p>

<p>Judging by my experience and the reports of other people on this thread, you should not expect your mother to be healthy enough to live at home for a long time. At some point pretty soon, she’s going to need more care than can be provided at home, unless she could afford to hire 24/7 skilled nursing, which is dubious.</p>

<p>I suggest making a spreadsheet, and seeing how long her $60K will last at the current expenditure level. Then make a reasoned estimate about whether she would be likely to be able to continue in her house after that time. It’s not unlikely that the end of the $60K will roughly coincide with the end of her ability to live in her house, and she/you could sell the house at that time.</p>

<p>Agree with the above post #3308–in any case, it might be worthwhile having a realtor take a look at the home and suggest anything that needs to be done to make it more salable that is cost effective that might be done now or soon so when the time comes it is ready to market.</p>

<p>The facility was sublime, and it was simply her personality and extreme attachment to her home that made her dislike it so much. </p>

<p>About workman’s comp. Yes, this is the kind of thing I need to understand. The woman who will stay 4 days/wk has full medical insurance. Does this satisfy our responsibility for workman’s comp? I sure hope so. I just sent an email to the agency to urge him to find us a second woman with her own health care and wrote that without it, we would reluctantly have to ask her to sign us a waiver to not hold us responsible in the unfortunate event of an accident or injury. But this strikes me as feeble and amateurish and not really what “workman’s comp” is about. I sure hope individual healthcare is sufficient. I can certainly follow up with the agent about workman’s comp,but judging from dealings so far, the agency just seems to be the “go between”. I did ask him for guidance for how to be sure the women pay their taxes,social security,etc. </p>

<p>Thank you Cardinal Fang for your supportive words. Certainly, the 60K will not last long,and my mother is a plucky, determined fighter. I foresee her outlasting her 60K,hence the reverse mortgage is my only idea…if she lives after that runs out, it will be the future she dreads, a nursing home on Medicaid, like my MIL.</p>

<p>Worker’s comp is TOTALLY DIFFERENT from worker’s comp. The latter covers penalties if she is injured on the job, including damages, lost wages and other things. Waivers are not good enough. Our bookkeeper helped us get our worker’s comp policy for our non-profit. It is based on the wages and risk rating of the job. It is protection for you as the employer–they can’t sue you if they are entitled to worker’s comp, the latter is their only recourse.</p>

<p>Your department of labor may be helpful to you in figuring out who you can get to write a worker’s comp policy for you for these types of employees. You could also ask the Department of Health, Office on Aging, as I’m sure they’ve run into this issue as well.</p>

<p>If they are employees rather than independent contractors, YOU are supposed to be doing the withholding as well as paying their worker’s comp. If they are independent contractors, you can get them to sign a waiver and indemnification agreement.</p>

<p>Here are links as to whether they are employee vs independent contractor:
<a href=“http://www.erginc.com/pdfs/independent_contractors_20_questions.pdf”>http://www.erginc.com/pdfs/independent_contractors_20_questions.pdf&lt;/a&gt;
<a href=“Topic No. 762, Independent Contractor vs. Employee | Internal Revenue Service”>http://www.irs.gov/taxtopics/tc762.html&lt;/a&gt;&lt;/p&gt;

<p>Our small nonprofit just made everyone employees except for those who contract themselves out to do similar work and just do our little tasks as a very small part of their business (like our webmaster). We have worker’s comp for those on payroll, even if it is only once a year they work for us.</p>

<p>What happens if she gets the reverse mortgage, and a year later she needs to move to an assisted care facility </p>

<p>What HIMom said - workers’ comp is not covered by individual health insurance. These women will be lifting your mother, may trip and fall down the stairs, may get carpal tunnel, any host of injuries that would fall under workers’ comp. I wouldn’t have anyone working in my home who was not covered. If the agency doesn’t provide it, you should find another agency that does.</p>

<p>But if there is an agency involved, aren’t you paying them and they are making the proper employer deductions? Or is this just some sort of matchmaker? </p>

<p>I have heard state laws vary re: reverse mortgages. And some possible complexities the families didn’t anticipate. Try googling laws or issues for your state. That’s one where I’d speak with an estate attorney or one versed in this sort of transaction. </p>

<p>In my state, if you are in AL and your money runs out, certain tiers of providers are obliged to take the Medicaid payment. But, depending, not obliged to keep her in the exact same facility, if, eg, there is demand for those rooms and the AL owners have another location that makes better business sense to them. Again, need to check state laws. This may be where the state/city elder resources folks can help. ?</p>

<p>edited</p>

<p>All this is very helpful,and although daunting, this is what I need to hear. From skimming the article, the women will be employees and will need workman’s comp. Tomorrow I will start by calling my county’s dept of the office of the aging and the dept of labor and learn. I just wrote a long email to the agency rep asking for feedbback and help on tax and workmancomp concerns and asking what his other clients do and how they do it. But PhotoOp, all the agencies I called worked this way–as middlemen–so I can try to redelve into the internet and find “another agency” but I think they all (?) work this way. After I hear back from the agency rep and do my phone calls tomorrow, I may need to call/see/pay for my lawyer to step in; one of his specialties is elder care law, luckily. </p>

<p>When I hired care for my elderly aunt I used an agency that provided all that. They billed me and they paid the nurses. This was a long time ago though. But even if its more expensive, that’s what I would be looking for - a full service agency, not a go-between. If these women become your “employees” you will be responsible not only for workmens’ comp but also payroll taxes, social security deductions, etc. That just seems like too much to ask a consumer to take care of.</p>

<p>Looking forward, our posts crossed. What does ymmv mean? Regretfully, given how far I’ve gone, I may have to look for an agency with more involvement, if I can find one, and it will cost more. The reverse mortgage consideration seems to be serious enough to discuss with a lawyer, and not just go to a bank. </p>

<p>Cardinal Fang, I just imagined selling the house while in the midst of a reverse mortgage that was no longer warranted. Does anyone know?</p>

<p>When we hired care for my SisIL, we used an agency that we paid who paid for everything out of the amount we paid. Some folks are matchmakers while others are services. The out of pocket in the short run may be less if you pay checks directly to the service provider, but the agencies who charge more MAY BE covering the overhead, including worker’s comp–check to be SURE. We NEVER hire anyone that isn’t covered by worker’s comp–for our protection and that of the workers. </p>

<p>YMMV means your mileage may vary.</p>

<p>In general, once the person with the reverse mortgage leaves the premises, everything become due; not sure you will have the option to sell if it’s under a reverse mortgage or how that works; realtors may be able to advise you or the reverse mortgage lenders. One thing that may be considered is a sale and leaseback–sell the property to you or someone else and then lease or rent it back to mom for as long as she needs/wants to remain there safely. Someone who wants to buy as an investment may find it very attractive to have a built-in tenant.</p>

<p>The discharge people at the hospitals and medical social workers may know of agencies who handle everything and bill you for what you need to pay. That may be the cleanest way to go, to be sure the paperwork is done properly and there is proper insurance and withholding.</p>

<p>If you’re thinking of Medicaid, be aware that there is often a look back period, where they scrutinize finances going back for several years to be sure there aren’t assets that should be available toward the indigent’s care. Elder attorneys are more versed in the nuances, which change.</p>

<p>The example tale I had heard was about clauses related to selling the house back to the family and, I think, how those costs are calculated. Dharma, sometimes you can get the details/legalese from a lender, then read the fine print. But I’d use an attorney to bless the potential arrangement and educate me, beyond what I would learn from google.</p>