Do You Want To Go To The Nursing Home? Must You?
Do The Right Thing, Without Breaking The Bank
Who Wants Institutional Care?
Why Don’t You Move In With The Kids?
Why Don’t The Kids Move In With You?
Whom do you know who is impatiently champing at the bit to get into institutional long-term care? Which of your friends or fellow church members are eager to dump the familiar surroundings of home, cottage, farm to live with strangers? Oh boy! Middle-class America’s highest ambition: “When I get old, I want to move out of my house to live in a tiny apartment with a hot plate and no privacy!” If you do know someone like that, please introduce me. I’ve never met anyone like that myself… Over the last 32 years of this elder law stuff, met thousands of folks who feel differently, though.
Is it crazy to think that, as we get older, we are less able to care for ourselves and our surroundings? Why do you want to be pushing the lawn mower around at 87? Or shoveling snow? What’s the answer?
Traditionally, for many families, one solution has been living together. Three generations, one roof. Mary Rose O’Connor, my widowed Irish grandmother, lived with us for many years. 1700 square feet (including the attic) with 3 grown-ups and 8 kids sharing a single bathtub and one toilet. Not always easy, but it was all we knew… it had to work. How could that succeed today, with everyone’s expectations so different?
Is it surprising that different families come up with unique variations on this theme? Life-long bachelor who never left home now provides care for mom who spent the last 30 years bringing clean laundry, meat loaf and Hot Pockets™ to the basement. Single working woman moves back to care for dad. Grandma moves in with her married kid. And the kid’s kids. And their dog. Folks sell home/farm/cottage, build “in-law” apartment at the favorite kid’s home.
Are these arrangements ideal? Do they always work? Imagine June and Ward Cleaver, now in their 80’s, moving in with Wally or the Beaver… Wouldn’t that be great! Leave It To Beaver Revisited: Life Lessons for a New Generation. Wonderful! Now imagine Eddie Haskell’s mom moving in with him… The Edge of Night, indeed.
Do you think preservation of the family home/farm/ cottage figures into these discussions? Do we keep it? Sell it? Use it? Don’t we all know that the homestead is “protected” if nursing home care is required? We have all heard that bit of misinformation, right? And what if you sell the family property outright? Might as well hand over the cash to the long-term care facility, I guess…
Besides, who will actually provide care? Mom and dad want to live on their own. They do not really want the kids to move in. Given their druthers, the kids do not want mom or dad to move in, either. Aren’t we having this conversation because we can see clearly now that there is a significant need? And, to be brutally honest, we saw this coming years ago and have avoided the conversation until now… Denial ain’t just a river in Egypt.
Doesn’t it all boil down to: How do parents and children work together to provide necessary care? How do parents and children cooperate with one another to preserve the family home/cottage/farm? As Baby Boomers gracefully glide (kicking and screaming) into their twilight years, should their accumulated wealth go to long-term care facilities or be maintained within the family?
As rampant, uncontrolled inflation rips through and makes a mockery of your children’s middle-class America’s hopes and dreams, should you stand idly by? Can you?
As long-term care costs of $6000, $12,000, $25,000 per month deflate your parents’ life-savings, destroying their security and introducing them to nursing home poverty, should you stand idly by? Can you?
Are you opposed to finding mutually beneficial solutions to these riddles? Is it impossible to believe that we can thread this needle? It is crazy to think that you have come to the right place to get workable solutions? Would you like several more rhetorical questions?
Long-Term Care: Just The Facts, Ma’am
Can we agree on 7 basic, long-term care fundamentals?
1. Long-term care is crazy expensive.
2. 70% of folks will need an average of 3 years of skilled long-term care.
3. Long-term care makes middle-class America broke.
4. When middle-class Americans go broke, Medicaid pays for long-term care.
5. Your taxes already paid for your long-term care through Medicaid.
6. Just as with Social Security and Medicare, you should not have to go broke to get some pay back on the tax dollars you paid in.
7. Despite what “they” say, your homestead is at risk. The Child Caregiver Exception
Is it possible to save the homestead for caregiving children? Here’s what the Bridges Eligibility Manual 405, pp 10-11 (1-1-2022) says:
It is not divestment to transfer a homestead to the client’s:
* * *
• Child age 21 or over who:
Lived in the homestead for at least two years immediately before the client’s admission to LTC or waiver approval (BEM 106), and
Provided care that would otherwise have required LTC or waiver services (BEM 106), as documented by a physician’s (M.D. or D.O.) statement.
In other words, Medicaid has no problem with you giving the house to your kid who lived with and cared for you for twenty-four (24) months. Providing skilled care type services. Provided you have a doctor’s letter. Who knew? (We did!) And now you do too.
Easy Case: Kid Cares For Parent At Parent’s Home
1. Dad with dementia.
2. One hundred and ten pound Mom cares for two hundred and fifteen pound Dad. Dementia increasing. Mom no longer spring chicken.
3. Concerned Kid moves home to help. Kid changes drivers license, voter registration, tax address. Kid provides care that would otherwise have required long-term care or waiver services.
4. Dad stays out of nursing home. Doctor documents.
5. Two years and one month later. Dementia worse than ever. Dad must get residential nursing home care. Other requirements met.
6. Mom deeds homestead to Concerned Kid.
7. Medicaid says, “OK! No penalty.”
Hard Case: Parent Sells Home, Moves In With Kid
Fact: When one spouse cares for the other, the caregiver spouse dies first 40-50% of the time.
1. Dad with dementia.
2. Caregiver Mom dies first.
3. Dad moves in with Concerned Kid and family at their house.
4. Dad sells homestead. Has much cash.
5. Dad buys a full or partial interest in Concerned Kid’s home with Dad’s home sale cash. This full or partial interest is now Dad’s homestead.
6. Kid provides care that would otherwise have required long-term care or waiver services.
7. Dad stays out of nursing home. Doctor documents.
8. Two years and one month later. Dementia worse than ever. Dad must get residential nursing home care. Other requirements met.
9. Using appropriate Financial Power of Attorney with necessary provisions, Dad deeds Kid’s house back to Kid.
10. Medicaid says, “OK! No penalty.”
Can You Really Do That? Is That Legal?
Faithful readers know that The Elder Law Reporter does not write the rules, we merely read them. And report the results to you. Not making stuff up. Whose fault is it that nobody told you about these things? Sure, the blame game is pretty popular with some folks. We think it is better to light one candle than curse the darkness. Let’s take it from here without the coulda, shoulda, woulda, shall we?
This “Child Caregiver Exception” has been used by many families over the last 30 years. Preserving homes, farms, cottages, cabins. Legal? As the day is long. Approved repeatedly over the decades by the Michigan Department of Health and Human Services. Because it is the law. Of course, applications must documented to a fare-thee-well. Hundreds of pages of audit-proof financial records. So, yes, you can really do that. If you do it correctly.
Why Would Medicaid Let You Get Away With Such Piracy?
Is it piracy when the State lets you keep some of what you have earned? Is it ridiculous for you to get a bit of return on your tax dollars? Do you deserve nursing home poverty?
Of course, the State answers, “Yes, yes, a thousand times yes!” to these questions. So why do they allow the Child Caregiver Exception? Somebody once said, “Follow the money.” Let’s consider. If Concerned Kids are caring for Mom and Dad at home, then Medicaid is not paying for Mom and Dad to be in a long-term care facility. Who is saving money now?
Everybody wins. The State avoids years of paying for nursing home care. Mom and Dad get to stay home. Kids get to inherit the family home, farm, cottage. And family bonds are strengthened. Gee, how’d that happen? LifePlanning™ that’s how.
Is Now A Bad Time For A Real Solution?
Do you have all the answers? Maybe you do not see any problems at all. Is it possible that you do not believe in the passage of time or its effects on you?
Peace of mind and financial security are waiting for everyone who practices LifePlanning™. You know that peace only begins with financial security. Are legal documents the most important? Is avoiding probate the best you can do for yourself or your loved ones? Is family about inheritance? Or are these things only significant to support the foundation of your family?
Do you think finding the best care is easy? Do you want to get lost in the overwhelming flood of claims and promises? Or would you like straight answers?
Well, here you are. Now you know. No excuses. Get the information, insight, inspiration. It is your turn. Ignore the message? Invite poverty? Or get the freely offered information. To make wise decisions. For you. For your loved ones.
The LifePlan™ Workshop has been the first step on the path to security and peace for thousands of families. Why not your family?