A crux regarding elder care

[Ewe Mama]

Some of you may have read my posts regarding my father's diagnosis of prostate cancer. The other elephant in the room is that my parents are in the process of declaring bankruptcy. My father wouldn't go to the doctor when his initial symptoms appeared because they have so little money and he felt he couldn't afford to go. They are living on social security.

 

My parents have borrowed money from every member of the family just to cover their prescription fees some months. Other than asking for money, my parents never discuss their finances with me.

 

Both parents were in poor health to begin with and this is going to make it 10x worse. They live out of state and do receive some assistance. Would they have to live in my state for a certain amount of time before they would qualify for assistance here if we were to find a way to move them?

 

We have 3.5 acres of land and could possibly build some housing for them. The lot right next door is available, as well, so that would be a possibility. The thing is, Ram Man's cancer wiped out our savings. We don't want to overextend ourselves, but my parents are going to need help.

 

I need some help thinking this through. Who would I talk with to figure out if this is even feasible?

 

Another wrinkle is that my mother has hoarder tendencies and convincing her to downsize to a very modest sized home would be very difficult for her, an a bit insulting, too, in her mind.

 

There is now way we could move them into our house.

 

Please help, as I have no idea where to even begin.

[TammyS]

I would talk to an elder care social worker in your area.  Dealing with parents in a different area will not be new to them.

 

As for your mother, personally, I wouldn't even touch whether she's insulted or not.  I would just make the offer to move her into another place near you, and then let them make the decision about whether or not to take you up on it. 

 

BTW, I have seen "housing pods" for elders that can be delivered and set up on your property, rather than building something onsite.  I'm not sure if buy them or lease them, but it might be worth looking into.

[PinkyandtheBrains.]

 

 

A good elder care social worker will be able to help you find resources. The one I talked to in my area was able to provide lists of information and sources of help.

 

The one here was very helpful, there are quite a number of options for low income situations but they are hard to find if you don't know where to look.

[OhanaBee]

I second the idea to talk to a social worker about this.

 

We just had this happen with a great aunt who lives away from all the rest of our family.  She, too, is a hoarder and we were astonished at the amount of STUFF we had to wade through in her apartment and 5 [FIVE!!] storage units.  In the end, we're hoping we got out any and all of the family stuff.  Then we just had to walk away from it.  We can't pay the fees and she couldn't keep up with the rent.

 

A social worker in her area helped us find a care-home for her.  It took some doing, and it's not really what any of us wanted, but none of us have the ability right now to take her in, even if she had been willing to travel across the country [doubtful].  We tried to take her feelings into account, while at the same time being realistic about what was possible. Many times, those two things clashed greatly and we had to chose the most realistic solution.

 

(((Hugs))) to you.....I know this isn't easy.

[TechWife]

In regards to their prescriptions - have them apply for "Extra Help" paying for Medicare Part D premiums. This will reduce the heir premium payments and reduce their prescription copays. The amount they will have to pay depends on their income. Just by way of example, my parents' monthly premium is under $30 and the most they pay out of pocket for a prescription is $7.40, and that's for brand name.

 

Here's some information for you:

https://www.medicare.gov/your-medicare-costs/help-paying-costs/save-on-drug-costs/save-on-drug-costs.html

 

 

I'll try to remember to post more tomorrow - right now I'm on my iPad and typing is difficult.

 

ETA: If either of your parents are veterans that served during wartime, they can get the Veterans Aid & Attendance Improved Pension. They do not have to be drawing a pension from the service in order to get this benefit. Follow the links on this page for qualifying service dates and info on how to apply. My father's paperwork went through very quickly. We use the money to pay. Home health aid two days a week.

 

http://www.veteranaid.org

 

Also, see what VA benefits are available in your area. The VA provides my fathers hearing aids, he can use a VA hospital and he could get low cost prescriptions there were he to use their doctors. This is all available to him even though he does not have any service related disabilities or injury.

Edited May 18, 2016 by TechWife

[Amy in NH]

I admit I don't know enough about this topic, and I'm afraid I am going to have to learn quickly in the coming years, but if they are struggling enough to be constantly borrowing and declare bankruptcy won't they qualify for Medicaid?

[Guest]

I admit I don't know enough about this topic, and I'm afraid I am going to have to learn quickly in the coming years, but if they are struggling enough to be constantly borrowing and declare bankruptcy won't they qualify for Medicaid?

This. Sounds like they would, but the regs seem to vary by state. My MIL had to help her parents in IA and the rules were different than here in TX.

 

I would also call your city zoning board and ask about putting additional housing on your property. We have a couple of people in our area who tried to do that and the city won't permit it.

[TechWife]

I admit I don't know enough about this topic, and I'm afraid I am going to have to learn quickly in the coming years, but if they are struggling enough to be constantly borrowing and declare bankruptcy won't they qualify for Medicaid?

The short answer is: it depends! Medicaid varies state by state.

[TammyS]

This. Sounds like they would, but the regs seem to vary by state. My MIL had to help her parents in IA and the rules were different than here in TX.

 

I would also call your city zoning board and ask about putting additional housing on your property. We have a couple of people in our area who tried to do that and the city won't permit it.

 

She said she had 3.5 acres, I doubt she's in the city.  But you do make a good point about zoning and various options (attached, non attached, permanent, non perm, etc).  It does, unfortunately, get complicated.

[Guest]

She said she had 3.5 acres, I doubt she's in the city.  But you do make a good point about zoning and various options (attached, non attached, permanent, non perm, etc).  It does, unfortunately, get complicated.

 

Complicated indeed!! I'm on more acreage than that, and some of my "neighbors" have two or three times our acreage, and we are all within the city limits. As the city has grown the mentality has changed with zoning regulations, and the rural mindset is disappearing which is sad. 

[G5052]

Call your Area Agency on Aging and also the one where they live to get an idea of what resources are available.

 

I've done this over and over with relatives and have yet to have one move close to me. It always ends up being long-distance which is really, really hard. I'm flying out this summer to visit my aunt and uncle whom I'm concerned about. They actually have a guesthouse where a caregiver could live and the resources to do that, but I'd still be handling some things long distance.

 

We have some land, but if I had to do a quick move, I'd probably buy or rent a travel trailer or elder pod to get them with me right away while I figured things out. We have electrical out to a corner of our property, so that would work.

 

Also my experience is that these crises can quickly get worse. Just a warning to be prepared.

[zoobie]

Definitely contact an elder care social worker. It's possible they aren't maximizing options for prescription coverage. Part D, shopping around, getting rebates from manufacturer, etc. can be very overwhelming. It's possible they qualify for Medicaid.

 

There are other options for cutting living expenses. Senior housing. Utility companies often offer price breaks that aren't advertised. I called and got my grandmother's phone to $10/mo just by asking what low income options were available. That was back when $10/mo was cheap for it prior to VOiPs, etc. Now you might be able to cut it more.

 

Make sure their taxes are done correctly with medical costs included. They may be paying when they shouldn't or not receiving EICs they could. They might qualify for food stamps.

 

An elder care attorney can help look at this too, especially if they will be looking at Medicaid to cover health care costs. You want to make sure their assets are exhausted properly.

Edited May 18, 2016 by zoobie

[Retired]

sadly I live in a state with the highestt percentage of medicaid recipients.  I know the in-outs for this state. 

 

I thought I would throw this out there if your dad was in the military even non war he can get his meds trough the VA system much cheaper than medicare subs.    We use medicare for my parerns primary medical stuff.  My dad gets Health Spring (medicare plus insurance free) and we pay 350 a month for moms BCBS insurance.   My parents still could not afford to live on there own without me doing the blue cross and the VA medications. They do not own a home but rent.

 

My parents were nver responsible with money.  I've been walking tight- rope taking care of them and still saving for my own retirement and keeping finacially safe.

 

Good Luck!   I feel for you.   I have had my parents live with us a few times but our lifestyles don't mesh.  We have property and at one time were going to build them something but realized that they do not respect boundaries enough for that to work.

 

 

 

 

 

[Ewe Mama]

In regards to their prescriptions - have them apply for "Extra Help" paying for Medicare Part D premiums. This will reduce the heir premium payments and reduce their prescription copays. The amount they will have to pay depends on their income. Just by way of example, my parents' monthly premium is under $30 and the most they pay out of pocket for a prescription is $7.40, and that's for brand name.

 

Here's some information for you:

https://www.medicare.gov/your-medicare-costs/help-paying-costs/save-on-drug-costs/save-on-drug-costs.html

 

 

I'll try to remember to post more tomorrow - right now I'm on my iPad and typing is difficult.

 

ETA: If either of your parents are veterans that served during wartime, they can get the Veterans Aid & Attendance Improved Pension. They do not have to be drawing a pension from the service in order to get this benefit. Follow the links on this page for qualifying service dates and info on how to apply. My father's paperwork went through very quickly. We use the money to pay. Home health aid two days a week.

 

http://www.veteranaid.org

 

Also, see what VA benefits are available in your area. The VA provides my fathers hearing aids, he can use a VA hospital and he could get low cost prescriptions there were he to use their doctors. This is all available to him even though he does not have any service related disabilities or injury.

They have just a smidge over the disqualifying limit. My mother hasn't been able to take some of her meds for months because they can't afford it all. My dad now has 12 prescriptions and I have no idea how many my mom has, but it has to be close to that number.

 

Unfortunately, neither has served in the military, so that closes a lot of doors.

 

Thank you for the ideas, though!

Edited May 19, 2016 by Ewe Mama

[Ewe Mama]

Are they considering selling the current home and moving into low income senior housing? Or is the home going to be seized for back taxes?

I have no idea what is going to happen to the house. I don't think they know, either.

[Ewe Mama]

I'm going to have to talk to the zoning committee this week/next week. They keep bizarre hours. I know we own three parcels of land, so technically, we could sell it to someone else who could then build on on it, so why couldn't we develop it ourselves?

 

There is a rental house right next to the small vacant lot beside us that would be perfect for my folks. I wish we had snapped it up when it went on the market last year, but someone else beat us to it.

[Ewe Mama]

I'm even reading up on tiny houses and earth bag houses, trying to find affordable options.

[FaithManor]

Wow Ewe Mama, we are in the same boat. My dad is dying of cancer AND my parents are losing everything too.

 

For the sake of your family, I would not move someone with hoarding tendencies into my home. Sorry to say, but that tendency may intensify like hoarding on steroids when her husband dies as new trauma can make it a lot worse. It could be very bad for your own children.

 

Medicaid varies from state to state, and so it is entirely possible that they could qualify if they moved there, but might not as well. You should have a county liason person with the Agency on Aging for your state. This person should know the ins and outs of your state laws. You need to get a hold of this person in your parents' county as well. Chances are, in the middle of all of this, it is a bad time to move. It is sad, but our bureaucracies are so red tape laden that elder care and end of life decisions that may involve moving and what not need to be made well in advance of them being necessary. Chances are they need to stay put, though you might get lucky and be in a state that has no residency requirements and what not, and can actually get paperwork processed in a timely manner. Sadly this is not the case around here, and it can take 6-8 months of insanity to finally get signed up for Medicare/Medicaid. 

 

I would after talking frankly with the Agency on Aging representative for their area also call his medical practitioners and the hospitals he uses. While they can't disclose medical information to you unless he has already signed and filed the paperwork with them to make you his medical proxy, you can explain to them the financial picture. Chances are your parents, by borrowing a lot of money, have presented themselves to medical personnel and accounting departments as people who can handle their co pays, deductibles, and prescriptions. If informed, it may very well be that there are charitable institutions, donations to the hospitals, and free meds through a variety of programs. My dad is currently getting his anti-depressants for free through a deal his psychiatrist has with a charitable group. I finally convinced my mom to call Beaumont hospital and explain their situation. Their portion of dad's medical bills right now that is not covered by Medicare is over $10,000.00, and they have an annual deductible of $4500.00. Since they are losing everything, they only have their social security which is a combined total of $1800.00. Once Beaumont was aware, they dropped mom and dad's monthly payment on his bills to $75.00 a month, and told mom that when dad dies she won't have to pay anymore because the balance will be covered by a large, charitable group, and that the hospital can also afford to write off some of it. So they pay this little bit until he dies, and then that is it. They also told her that if they can't afford his prescriptions anymore, that when the time comes, they have donated money that will help with that. They'll have to drive to Beaumont to get prescriptions filled, but the gas and time will be worth it.

 

Once he goes on hospice, there will be a LOT more help for them. Still, there should be something out there to help with meds, weekly housekeeping, even transportation at least that is if their county isn't nearly bankrupt like ours is.

 

Given how much money you have already contributed and that you are still raising a family, I think that building something for your folks is probably less viable a choice than looking into senior housing in their area. There should be some decent, subsidized, low income senior complex in the county. We have four in our county alone, and we are a rural, backward, half bankrupt county. They need to get on a waiting list now. Even if you still think there might be some way to move them near you, since it is an unknown, they need to get on those lists asap. If an opening appears, they can always turn it down. But often there is a wait time so better to "hedge your bets" so to speak.

 

 

[umsami]

We were looking for quick temporary (or possibly permanent) housing and found these pre-built log homes made by the Amish.  They're pretty much good to go, except for pouring a foundation (or putting in a basement) and hooking it up to sewer/water.  Look a bit nicer than a single-wide, too.  They seem to be all over, so I would google for a place near you.  http://www.amishcabincompany.com/

 

 

I also bookmarked this site of kit houses and such.  http://www.motherearthnews.com/green-homes/natural-building/kit-homes-zm0z12djzmat.aspx

[Carol in Cal.]

I was going to mention senior housing, too.  Around  here, seniors are charged a fixed percent of their income, so when their income drops their rent does as well.

[StephanieZ]

I'd suggest familiarizing yourself (very well) with their finances, their bankruptcy strategy, their Social Security situation, and available helps. If I were you, I'd want to sit in with the bankruptcy attorney ASAP. I'd want to strategize whether it makes sense to complete the bankruptcy now, or wait until the medical bills are finished. 

 

Any debts they have to family members are going to need to be forgiven, for sure, IMHO.

 

Assuming your mom is getting a SS check as well as your Dad, and assuming his is higher . . . When your dad passes away, your mom will likely be eligible for EITHER her current SS check amount or 100% if your Dad's Soc Sec check amount. In most cases, Dad's full amount would be higher. So, if they complete a bankruptcy and wipe the slate clean, then she may be in better shape after the bankruptcy. 

 

Once someone declares bankruptcy, they can't do it again for quite a few years (7? 10?), so your mom will need to be very responsible about finances after the bankruptcy finalizes, as she's going to be stuck with new debts for quite a while.

 

I'd be very cautious about lending/spending money and/or co-signing or singing for anything. Talk to a lawyer if at all possible. If you need to help them financially, be cautious and strategic, so they don't just "lose" your help via the bankruptcy process.

 

(((hugs)))