<p>Dharma, GTAlum makes a VERY important point in#3387. You have to expect that the care she needs will increase as time goes by, perhaps drastically increase, either permanently or intermittently.</p>
<p>You said your mom is coming home soon. Have you contacted any ALs to see if they have immediate openings? </p>
<p>ETA:
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<p>Dharma, I’m quoting Fang for emphasis. It’s really true, every word. Let her words roll around in your head for awhile. </p>
<p>arabrab, that’s an excellent link. It sounds like Dharmawheel’s mom’s caregivers will be subject to wage and hour laws. Under the new regulations, if a home health caregiver is required to wake up at night in case the client wakes, they have to be paid for their sleeping time. If the caregiver is allowed an eight hour sleep shift-- that is, if the caregiver is not required to get up in the middle of the night, no matter what the client does-- then the caregiver doesn’t have to be paid for the night, but if the caregiver is expected to respond to any emergency that might come up, they must be paid.</p>
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<p>So a worker who works at 24 hour shift must be paid for 24 hours. They must be paid overtime wages.</p>
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<p>Please don’t believe this. Your mother is volatile,erratic, and demanding, and if I read between the lines, particularly with you. Very few and no one should allow this to invade their family life. Perhaps feeling guilty is why you are working so hard to dance to her tune? </p>
<p>I want to offer up an experience of my husband and sister. His mom is the one who brings in every needy person. During the ages of 10 - 16 she took in her aunt, because the others were fed up with her. She essentially abandoned her own children to care for this nasty, ungrateful woman, and 40 years later there is still a lot of resentment from my husband and her sister over being marginalized like that. </p>
<p>Fast forward to our children. Mother in law then turned all her focus on her own parents care and essentially missed out again on my children. Never attended a game, a play, to receive awards, etc. Now she wonders why my college age son doesn’t call her from school. Every visit when we invited her started with - well, if I can change this doctors appointment, and get someone to drive them here or there, find someone to make them dinner, and as long as they aren’t sick or need me, then yes, I’ll come. Chances were she wouldn’t come.</p>
<p>Be very mindful your children are your primary responsibility right now. Not to make you feel guilty, I know it takes effort to set things up. But perhaps set limits and remind yourself to be present in your own children’s lives.</p>
<p>Lots of good info here, and great link, arabrab and oldmom.</p>
<p>Dharma, don’t know what state you are in, but in around 2011 NYS changed their rules. It was pretty complicated and at the time only one of the 2 caregivers we had for my dad was paid through a third party agency. The Paperwork, taxes, etc was unwieldy, especially with being out of state. We were in the process of having her transitioned to be an agency employee when my dad passed away.</p>
<p>Here’s an article from the NYT speaking to what arabrab posted above, with the upcoming federal regulation changes:</p>
<p><a href=“U.S. to Include Home Care Aides in Wage and Overtime Law - The New York Times”>http://www.nytimes.com/2013/09/18/business/us-to-include-home-care-workers-in-wage-and-overtime-law.html</a></p>
<p>Dharma,
you are a wonderful child. You have a right to set limits. You cant take care of others if you don’t take care of yourself first.</p>
<p>Thank you contributors. Researching IL. Things do not look good. Nicest place nearest says “prices start at $4,950 a month.” Next nearest “prices start at $4,100 a month.” Then Googled Assisted Nursing that Accepts Medicaide.</p>
<p>This is from a NYState govt. website: It essentially says, if I interpret correctly, that Assisted Living Facilities–where you pay down your income–provide far superior care than when you pay down and switch over to Assisted Living Program (medicaid). Many pages about abuses to and investigations of care to patients of ALP./ This would be the scenario if my mother sold her house, went into ALF,switched over to ALP.</p>
<p>Only official licensed ALPs accept Medicaid and SSI to pay the fees. Most Assisted Living Facilities, on the other hand, solely accept private payment for their residential services. In such facilities, however, it is possible to apply for regular community Medicaid and to receive Medicaid personal care services, which are provided independently, having nothing to do with the ALF facility.</p>
<p>State law enacted in 2004 to require licensure for “ALF” facilities does NOT apply to ALPs. This has been criticized by the Long Term Care Community Coalition because protections for ALFs do not apply to ALPs – all the more necessary as the state expands the growth of ALPs - see below. See Long Term Care Community Coalition, Vulnerable and Unprotected: The Status of Elderly & Disabled Assisted Living Residents in New York State (Spring 2010) posted on <a href=“Assisted Living Resources - How To Choose Assisted Living”>Assisted Living Resources - How To Choose Assisted Living;
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<p>Mother sounded very chipper on the phone last night and nagged me about when she is going home. I reminded her that her “care meeting” in on Wednesday and could not be before then. Judging from the rest and care she’s had, and feeling better, I have an intuition that she will refuse ALL these options, insist on living alone again and relying on the services she is eligible for under Medicare, and the cycle of decline / ER / hospital etc. will just continue. That is what I expect.</p>
<p>And though I will review AL with her (which seems out of the picture because of cost, anyway), I know she would never agree to sell her house and move, and would express this very angrily accuse me of in effect “dumping her” as she did yrs ago with her remark, “If you put me there you will have a suicide on your hands.”</p>
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Please don’t let her manipulate you. Respond with “I hope you would not make that choice” or something like that</p>
<p>From the article: Live-in domestic service workers who reside in the employer’s home and are employed by an individual, family or household are exempt from overtime pay, although they must be paid at least the federal minimum wage for all hours worked.</p>
<p>I worked the numbers. I think that if we have Polish ladies and monitor their time carefully, we would comply. I also noticed that the new law begins Jan 2015, but from the quotation above, I think we would be okay. Thanks for the link to the NYT article. It was very useful. And thank you for the caring remark.</p>
<p>Oh, reading backward, what Cardinal Fang wrote yesterday means it looks like I’m wrong about the overtime thing, etc. The lawyer will know on Monday. I told my mother last night to be in her room at her phone on Mon between 3 and 4 so the lawyer can talk to her herself, which would be a big help. Also I expect the psychiatrist will agree to be a big help.</p>
<p>Dharmawheel, my extreme sympathy and empathy. My relationship with my dad had its own history over the years, I was called suddenly to manage the care of him and my stepmother when one of my brothers who had been doing it for four years, walked away. For the first 2 years, whenever I walked into their house, I felt like I was going to be electrocuted, or something–it was like in the movies about nuclear attacks when the alarms boomed in the background, with a neon message flashing: DANGER! DANGER! But I did what I had to do: not very well or efficiently but I couldn’t leave them alone. They lived an hour from me and I usually went there twice a week. My dad learned not to ask me to stay for dinner because I never did. I survived with the excuse that I had to get back to make dinner for my kid, who was in high school by then.</p>
<p>Then came Hurricane Sandy. Their area of Long Island lost power for 2 weeks. He refused to look for a motel or shelter and stayed with my stepmother who was getting pretty addled by Alzheimer’s by then. After 2 days of living with a Coleman lantern and stove in the cold, he consented for them to come to stay in my apartment. In order to accomplish this, I had to ask my daughter to find a friend to stay with–our place is small with one bathroom and no privacy for her bedroom. It was absolutely the hardest thing I ever did.</p>
<p>When the power came back and I took them home, sanitized my house (my stepmother, ugh!), and my daughter came back and the subways started running again and school started, I was still completely stressed out. I could not relax. So I asked a bunch of my friends if anyone could recommend a therapist. I had known for a while that it would be a good thing to have therapy but I hesitated because it seemed that it would take a long time to explain myself, for the therapy to help, and what if I didn’t click with the therapist (which had happened before)? But a friend recommended someone and within a few months of very hard work, the ingrained alarms started to abate. On the first day, the therapist told me that issues with parents can almost always be resolved, but it is so much better to do it when they are still alive. And I can certainly attest to that. When he died in April it was very hard but I can’t imagine how it would have been without therapy. Worth.every.penny.</p>
<p>Best of luck. Stop googling for now and talk to the lawyer on Monday.</p>
<p>This is just my own pov, not really aimed at dharma. As kids, we are taught to be good, to do right, heed our parents wishes, not cause problems, etc. In many cases, it’s natural that when they’re older and frailer, we want to return the care and support they gave us, however we can. Same as tending to our own kids, as best we can. It feels right. </p>
<p>With long time problem parents, when it’s all wildly out of balance, all about what they want, their pleas, insistence and threats, we have to carefully navigate between the (inner) child and our status as adults (and spouses and parents.) If something doesn’t make sense, causes us to go through gyrations, manipulates our good intentions, whatever, etc, we have to try to see it for what it is. And sometimes say No. Saying No can be done kindly.</p>
<p>One of the signs of imbalance is sometimes how happy we are when they are finally up or chipper, agree to think about thinking about some possibility or compromise, when we get that rare word of appreciation, etc. Or, when we find ourselves afraid of their reactions, coming up with whatever words we think will appease them, to keep from getting whacked by them. </p>
<p>I totally know what oldmom means. </p>
<p>Dharmawheel, all this discussion shouldn’t make you lose sight of the fact that your mother has the $60K, and for the short term, her staying in her house with aides might be the best choice. She’ll be happy to return home, and for the short term she can stay in her house with the aides. For the short term, you don’t have to worry about the overtime regs, because they don’t take effect for six months.</p>
<p>With elderly people, health changes happen. Six months from now, her health situation might be very different, and living at home might be out of the question anyway. It makes sense to research a reverse mortgage, but you don’t have to get one this second. (BTW, Mr. Fang looked up the exact percentage she’d be entitled to borrow, at her age, with interest rates the way they are now. She’d be entitled to borrow 65% of the value of her house.)</p>
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<p>On your spreadsheet of the cost of keeping your mom home, be sure to add food, utilities, taxes, cleaning supplies, transportation…all that are included in the price of the AL. </p>
<p>I do agree with CardinalFang, short term you can see how far the 60K goes. </p>
<p>From experience, $60K will last about a year. Not sure of her monthly income, with interest, may last a little longer. You might try contacting social services. After she spends down her liquid assets, she may be eligible for home health care assistance through an agency that is authorized from the State of NY. If you have caregivers at that time that you like, sometimes the agencies will hire them and assign them to your mom. Good luck on Monday.</p>
<p>ECmotherx2, are you saying that 24/7 in-home care will cost $60K per year? </p>
<p>^ at least. And remember that social services or medicare homemaker help is a hour or two at a time. Same for personal assistance. That’s in one of the documents. </p>
<p>Advice from attorney will be valuable. </p>
<p>Also the problem is going to be, if you move mom home, it will be very difficulty to get her out of there. The difference in money between house sold and house with reverse mortgage is huge - maybe a year or more of care. If she is at AL at $4100/mo, SS covering $2000, she is not drawing down as greatly with her assets. All the expenses with home ownership, taxes, maintenance, utilities etc are gone when the house is sold.</p>
<p>Get over the emotional hurdle of trying to please complaining mother if you have the power to get her into some kind of reasonable cost facility that will do well for her ST and long term.</p>
<p>You absolutely have to have the boundaries to do the right thing for yourself, your family, and for mother to be in safe care.</p>
<p>As others have said, her health will continue to decline. Better to get into the more choice facility which hopefully her assets can hold out for her remaining years, than totally drain assets and then get into a medicaid nursing home.</p>
<p>The cost of 24/7 is going to be about 60 K/yr. $150/day times 7 is $1,050 a week. 52 weeks. And add to that the payroll service and workman’s comp. I haven’t looked into the price of payroll service, but I read that a yr of workman’s comp insurance from Allstate is only $47/yr.</p>
<p>And yes, you lose a whole yr of paid care money if you chose RM over IL.</p>
<p>Old mom, your story is extraordinary. The part about Hurricane Sandy is horrific. Luckily I have a husband who is a good listener and cheerleader, and a good friend who is a social worker who works with elderly who listens sympthetically and offers good concrete advice. </p>
<p>But logged on now to report the most remarkable afternoon. Every evening mom adds her list of “things to bring” so I got the stuff and went to the vet to get a copy of the dog’s vaccintion records so I could bring her to the NS. Helps me to have the dog and makes staff/inmates happy. Very surprisingly (how did he know me?) A Director stopped me as I entered and said, Just to let you know your mother asked to speak to the NS Psychiatrist, and they did. Weird. How did he know who I was, and what about professional/client privacy? But this might have bearing on the story that follows.</p>
<p>Found mother emerging from bathroom looking frail and weak. Clearly she cannot live alone. The dog went wild to see her which was nice. She laughed and said, You know, I don’t think I’m going to live very long. Then she asked me how things were going… I told her I was researching "care options"and that new laws were in place to ;protect caregivers,and as we had agreed,we would do everything right and legally. I told her straightforwardly that whatever route we take would be expensive, and she surprised me by saying “Anything done well is going to be expensive.” And I told her about my research into RM, how she would get much more value if she sold the house and moved to AL, and said a RM rep would come to the house for a free consultion. I told her I was looking into AL, but I know she would be very adverse,I mean, downright refuse, to go that route. </p>
<p>She wants to go home and wants the caregivers. She asked me,how long will my money last? Six years? I said nothing, and paused for a long long time. She asked how long? I replied (sorry to admit, I padded my answer to talk about “experts”, I have consulted numerous business people, bankers, accountants,and other professionals,and their estimation is three years. Long silence. Then she asked, and then what? I said, you will be 91, you are frail and have several health issues. You are likely to be even more frail and to have even more health issue… I think you will need full-time nursing assistance. She replied, which means a nursing home. I said , yes. She said, I don’t think I will live for three more years. But yes, I understand. Good thing we had the happy dog to pet and play with.</p>
<p>So the conversation I expected to take place after I saw the lawyer and/or went to the caregiver’s meeting on Wednesday came up today. She initiated it. I am wondering if the psychiatrist who talked to her asked her to discuss her vision of the future etc. And certainly she is feeling bad because she mentioned death twice.</p>
<p>So my anxiety about “confronting her” and the disaster that might ensue is abated. Now I am wondering, what if we get the RM and in six months she needs skilled nursing staff in a NH, or dies? I know the lawyer can explain this on Mon, or the RM rep when we talk on Tues.</p>
<p>Oldmom, I can’t believe you had to make a two-hr round trip to your father’s home twice a wk. My parents bought a house two doors down from me about 15 years ago when it went on the market. Didn’t like it, but recognized the benefit for when they entered old age. I know very well the feeling of a nuclear explosion type of reaction when entering my mother’s house. </p>
<p>Dharmawheel, if she dies, the house is sold and the money is used to pay off the money owed on the reverse mortgage. What’s left is her estate.</p>
<p>If she lives for only a short time, the cost of the reverse mortgage is a very large price to pay for the use of her equity in the house for such a short time.</p>
<p>If she lives for too many years, she runs the risk of outliving her money.</p>