<p>Is the elder without nursing home care? Does one gift recipient return the gift via payment for skilled nursing while another opts out? I could see this getting pretty complicated on the ground. If there is no way to pay for several months of nursing home care and a family rallies to provide home care, is the “meter” on for Medicaid, so that as soon as all is “paid up”, the elder is eligible for nursing home payment or must the elder actually be in a skilled facility paying out of pocket? Perhaps others who faced this directly have more information- this just some of what I would want to understand better if I were in this situation. Clearly, every family is different which also impacts how it would play out.</p>
<p>Caring for aging parents really stresses relationships in families. It is very sad and must break hearts of parents; the last thing a vulnerable, frail, and likely financially strapped parent needs is to have the adult kids in discord. I have seen this in a lot of previously happy and functional families. Hugs to everyone managing unpleasant family dynamics on top of tough health situations with parents.</p>
<p>Yes, often the “gifted” kiddo no longer has the funds gifted by the frail parent, having spent it on education, “costs of living,” or whatever. The “responsible” kids who have been shouldering the bulk of the caregiving are having to do everything and also deal with getting parent qualified for Medicaid. There is resentment when the resources don’t stretch far enough and when there is the gap because of the gifts given by the parent. I have seen and heard it by my friends and loved ones. It is very awkward and heartbreaking–resentment is a frequent emotion by caregiver and formerly gifted.</p>
<p>Don’t get me wrong, I love my siblings, and I am happy to help out one of them in need. I can understand Medicaid’s rules against people hiding money. I’m sure there are a lot of wealthy people out there that do that. But it would be a shame for mom to be without care because she helped out one of her children in a time of need. It’s hard to say no to a sibling who is in need, and I’m worried I’m going to have to do that at this point because of the impending Medicaid scenario.</p>
<p>As for the only child comment, my son is an only child, and he thanks God every day he is. Irregardless of only or multiple child, one child does always carry the weight of the care for the elder, and it continues on into the estate settling. My husband is dealing with his father’s estate all alone, and his brother has no interest in the sharing the financial responsibility of settling the estate, and will just wait until the spoils are ready to be divided and take his share after my husband has deducted what he’s paid out of his own pocket to settle the debts.</p>
<p>These scenarios speak to how advantageous it is to understand these decisions from the outset and try to develop a family understanding about how to proceed. It is so hard to do this when parents may not be thinking ahead. A long time ago, when my parents did their legal/financial planning for these later years, I spent a lot of effort trying to understand the implications of gifting. As some major health issues had already begun to surface, we took gifting off the table as their resources were limited enough to begin with and we thought we could face this “look back” issue. It meant that eventually, they were truly “spent down”, but it was a smooth process and care was never in jeopardy. </p>
<p>Seeing what our elders have experienced has been most illuminating for my husband and I. While no one can undo history, the information might be helpful as we look ahead to facing these years within our family. Recognizing that laws may change, keeping up with the estate planning, saving and paying attention to how our children are navigating their adult lives will all be worthwhile. </p>
<p>And on the one child tends to take all the responsibility front, that would be true for me. Interestingly enough, most of my closest friends are also the designated family “driver”.</p>
<p>I always hated being an only child growing up because my parents’ attention, both positive and negative, was always on me. Now,I wish I had someone to share the burden with. I have a hard time even going on vacation because there’s nobody else to deal with things that come up, and my mother has a knack for getting sick whenever I have plans to be away for even a long weekend. Leaving the country is absolutely impossible.</p>
<p>My sibling example is with my DH and his siblings. Although his parents lived closer to one of his siblings, they all shared the burden of cooking meals, grocery shopping, doctor’s appts, decision-making, and, ultimately, cleaning out my FIL’s apartment after his death and settling his estate. They must have been the exception. I know this isn’t how it is in alot of families.</p>
<p>Funny, everyone is available to share the fun and good times, but they all disappear when the true work begins. They also tend to surface when there may be an inheritance involved. Shellfell, your DH and family was very fortunate to be able to share the good and tough times, that’s what family should be all about. Right now, we are “spending down” my mother’s retirement account before we will be forced to apply to Medicaid. She has a 24 hour aide that has become a member of our family over the past 2 1/2 years. My mom is loved, catered to and taken care of in every sense by this wonderful angel. I dread the thought of placing her in a skilled nursing facility when the money is just about spent. We were advised to place her as private pay when we have about 6 mos. worth of money available. The process for Medicaid approval can take a few months and by law, the facility cannot “put her out”. This way, we can place her in the facility that we feel can best fulfill her needs.</p>
<p>Like travelnut said, gifting was not an option when my father passed away, leaving my wheelchair bound mother with no source of income. Problem is, when you have a large sum of money come in, those in need start asking for help. And, unfortunately, you just have some greedy people who want to do something they otherwise couldn’t afford to do, and why not ask Mom for some help. As a mother, Mom is not going to say no. You’d be surprised how much those little helps can add up. Of course, the sibling that controls the checkbook is the bad guy when he/she says no, and that sibling is also the one who never takes a dime. Not only because it’s morally reprehensible to them to take money from a wheelchair bound widow, but ethically, as the person controlling the money, they feel morally obligated not to participate in such behavior. So, while the siblings get to take nice vacations and buy nice cars and send their kids to expensive colleges, the responsible sibling lives within their means, and eventually, probably, winds up bearing the cost for the elder’s care when the money does, in fact, run out.</p>
<p>I can see how this is very difficult and how hard it is to deal with. It is very tough on relationships for everyone. Right now, mainly I & my sister of all 7 of us sibs are the ones who are first to be called by my folks if they need anything. Since both she & I have flexible schedules, it has been working pretty well & I am grateful.</p>
<p>One sib has been whining about no retirement funds but I stressed that each of us makes choices and it is not up to my folks to help out folks who have made poor choices. I pointed out to mom that they have 7 figures of equity in their home if they are in such dire financial straits and hopefully they will stop trying to get my folks to “help” them, but who knows?</p>
<p>I am hoping my folks will never try to spend down for Medicaid, but who knows what the future will bring? Dad is still working every day because he loves it, so I think their assets will last them quite a while, even though dad will likely live another 20 years, if he follows his uncle’s footsteps.</p>
<p>Montegut- Ouch. I guess almost everything in life comes down to character. It is hard to be the one setting the limits. I also find that often in a family, some fail to see their parent/s as elderly, frail, terminal, losing ground (financially and health-wise), while others are only too aware of the handwriting on the wall. The degree of denial tends to correlate with the degree of neediness and self-absorption. YMMV. If you spend all your adult years viewing your parents as there for all of your needs, at any time, without limits, the rubber can really hit the road if the parents can no longer say yes. </p>
<p>HIMom- hope your efforts to fortify your folks pay off. I also value what I have been able to do for my parents as they face/d this phase because it was a chance to do right by them that has also has stretched me and deepened my understanding.</p>
<p>I really feel for people who navigate not only frail elders and a complex system, but also unhelpful or demanding siblings. While I don’t have any help from my siblings, I also have no demands or interference. They have missed a lot.</p>
<p>Yea, our folks helped fund college and any grad school for all 7 of us. We all have good educations, 6 of us have married and all of us live in nice homes. NONE of us have any special needs or NEED of my parents assets and we strongly feel the folks should spend it as THEY choose, preferably on themselves. </p>
<p>Whenever we are asked to help dad with his computers or other tech, we buy him the best that Costco sells because he deserves it and can well afford to have what is best for him. H is happy to give free tech support and the sibs have stopped whining about why dad only gets the best. </p>
<p>They always call us first and we will defer to a sib that we mention who has more expertise (for example, one of my sibs has an iPhone like dad, so when they call us about dad’s iPhone, we have them call brother & he comes over to help–we also call that same brother when they have a TV issue, since we rarely watch TV & only have the most basic cable while brother has many, many TVs throughout his house & the most expensive cable package). We’re fine being the “go to” kid and so far we’re all pretty harmonious.</p>
<p>It has been really awful at different times, but we have managed to move my father into assisted living, renovate his condo, get rid of all but his essential stuff, and sell his condo–all in four months!</p>
<p>Montegut: so sorry you’re dealing with that difficult family dynamic.</p>
<p>One of the bright sides of being an only child is that there’s no siblings to squabble with!</p>
<p>Turns out mom does have an aaa. 3.2 cm. Had a private chat with her doctor and we are all on the same page. A pleasant surprise: I brought up my concerns about her homemade security measure (that I was worried would be an issue in the case of an emergency) and she immediately said I was right & removed it. Wow. Saying I was right AND complying? Huge. </p>
<p>She has her cardiologist visit this week so we’ll flesh out the implications of the aaa. My takeaway from what I’ve heard so far is that it could be years before that is an imminent danger.</p>
<p>Question: have any of you ever had to deal with “tough” skin? Mom has bloodwork at least 1x/month and while her veins can often be troublesome, the various nurses at her hematologist usually can work their magic. Twice this month the nurses have had a hard time, to the point where my mom’s skin bent the needle. They couldn’t do her transfusion last week after 3 of the very experienced nurses tried all their tricks. She’s going back Tuesday and they’ve told her to push water, but it just seemed odd.</p>
<p>Tonight at 11:00, my dad passed away. He was one stubborn old Irishman right until his last breathe. He had been doing pretty well and I am so glad I saw him twice this week. Once on an unseasonably warm day, I left work and took him for a walk in his wheelchair and on Thursday, I had lunch with him. This morning I got a call that he was vomiting and they were worried about aspiration and so they ordered chest xrays. Two hours later they were calling an ambulance. Everything seemed to be shutting down. And so tonight as I sat next to him and held his hand and said the rosary aloud (I, the Presbyterian - go figure), he passed away. </p>
<p>In the last year we were at the hospital at least four times, and each time it seemed he might die. He was so ornery, he always bounced back so it is hard to believe that he won’t be back tomorrow giving me a hard time and wondering who stole his colostomy bags. </p>
<p>Love to all of you as you care for your parents.</p>
<p>Best to you, WNP2! It’s always tough to lose loved ones, even though sometimes they can be VERY trying. Glad you were able to spend so much time with him in his final days and were even holding his hand as he died. I’m sure that was very comforting.</p>
<p>Having our parents age is very challenging, but I am cherishing all the time we’re allowed with ours.</p>