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Just wondering if everyone else is finding out that you need to be either super rich or dirt poor to find some type of help for their parents?
I've been looking after my mom and dad for a few months now - the former caretaker dropped this in my lap just before I lost my job and now I'm with my parents and hours away from my wife.
My dad worked hard all his life, getting a GED and promotions in a shipyard to move from pipefitter to management and moving up in the Army Reserves for more than a decade to get a good medical insurance plan upon retirement.
It seems that the middle class really don't have that much support when it comes to either getting in-home care or a place in a facility.
Am I the only one who sees it like this?

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It's always been that way, really. My father was a poor immigrant who came to the USA as a child, no education, had to work his butt off and quit school at 12 years old to help support the large family.

His 2 year war-time Army career provided him with Veterans Aid & Attendance benefits for he & my mom, thank God, so together with their SSI, I was able to place them in Assisted Living back in 2014 after he fell and broke a hip. He also had 2 stocks (believe it or not) that we cashed out that provided enough $$ to continue my mother's ongoing care after his death in 2015. One stock was from the department store she'd worked at as a clerk for about 6 years back in the 80s! They had profit sharing back then and it really paid off.

When those funds run out, the Aid & Attendance survivor benefits won't be enough (together with her SSI) to pay for her Memory Care, so I'll have to apply for Medicaid to fund her long term care in Assisted Living.

I don't think the VA pays benefits for the Army Reserves, but you should definitely check into it. You can also contact an elder care attorney for advice about Medicaid, and selling your folks' home (if they own one) and how to go about preparing for the 5 year look back. The consultation is normally free.

Finally, look into their Medicare plan to see what services are offered. Also check into the 'good medical insurance plan' your dad has that you've mentioned. If they have a house, it may be a good idea to sell it and downsize to finance in-home help for their old age. You shouldn't be the primary care giver if you're living away from your own wife & family! Check out all the resources available.

Wishing you the best of luck moving forward.
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I think you're thinking about it the wrong way. Basically you need to realize that everyone has to pay for their own care-until they have nothing left to pay. Its just that the rich can afford fancy exclusive assisted living facilities or round the clock personal in home care if they desired. For the very well off, this could go on indefinitely. For many others, they can afford something like this for a certain period of time, but not indefinitely. For the middle class, they may be able to afford this for a lesser amount of time, but it is still something that may be accessible for a period longer than what the poor can afford. For the poor, they can't afford this at all. The poor are stuck with shared rooms in a nursing home. The poor never had any other option.
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Contact the VA they may have several options.
A call to Veterans Assistance Commission might yield better and faster results.
If he actively served he may get more but it is worth checking out. Might even want to check to see if he qualifies for any union benefits.
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Your right. Like said what has to be done is every cent they have saved or invested needs to go towards their care. Some middle class people fall where their monthly income is too much for Medicaid and other services. Yes, there are trusts like the Miller trust where the overage goes into the trust, but then when the person dies, the trust reverts back to Medicaid.

AL cost at the least 5k a month. You get 3500 a month from SS and pension and that is all u have. Not enough to pay for an AL but too much to receive Medicaid, if like my state the income cap is a little more than $2300. Your between a rock and a hard place.

Your parents will not meet the criteria for help until their assets are spent down to 2k which is the average cap for Medicaid in most states. Thats why there are lots of people carrying for parents that are really stuck.
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mstrbill Jan 2021
Joann, there seems to be a misperception (not just you, but many others) that Medicaid is not accessible to some because they make too much monthly. That is simply not true. If one needs a SNF, and coverage paid by Medicaid it is accessible even if the monthly income is over the limit. Different states have different ways to go about it, but you can always qualify if needed.
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There are some resources for veterans to help pay for home care and for other options, if your dad is a veteran. My mom cancelled her LTC 2 1/2 years ago, my brother let it happen, I tried to get it reinstated, unsuccessfully. She wanted to remain in her home, so that is what I helped her do, but I am tired and trying to access help/respite for her now. If your dad has medical problems and is in his home, his primary care md or other provider can order home health for both dementia and whatever medical problem, if you are in an area that has access to home health services. Also, companion (non-medical care) may be of help, some only take private pay, LTC but some do work with veterans through a special program. I am having to go the private pay route to get started with my mom, although her pcp did order home health for her recently, but has not begun since her medicare plan was changed for 2021. Hope you will find some assistance.
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My father grew up almost exactly like yours and my mother saved by denying herself and him their whole married life together.

The 5 1/2 WONDERFUL YEARS she spent in residential care cost almost the entire million dollars she’d saved in the 40 years they were married, and what was left over paid for her burial.

I didn’t begrudge her a cent of it, but if SHE had known the situation would go as it did, she would have wanted her grandchildren to have her estate for themselves.

She was ENORMOUSLY generous to her family, but as stingy as Scrooge for herself.

She’s still after many years, terribly missed.
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We were fortunate that my mom served in the Army and we get VA benefits.  Between that and siblings helping me, I get by.
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What "in home care" do you see the dirt poor getting that you have no access to? Because your Dad is now in a position to "spend down", that is to say using his benefits he earned and saved toward his care. When those benefits are GONE he will be dirt poor, and he will be getting the "care" you feel the dirt poor are getting.
I am so sorry. I understand the point you are trying to make, but I assure you that the dirt poor are not getting a whole lot out there.
My brother was a waiter all his life. Yet he saved enough that he had enough money to take care of himself in good style until his death. To afford a really good ALF, and his good insurance supplemental, and to do as he wished. He was a saver for his entire life. Someone dirt poor would not have got that placement, but rather been put in a nursing home that accepts medicaid. And sad it is to say, there is a huge difference.
I am middle class. I have worked hard all my life at a profession I worked hard to get into. I have taken great joy in making an excellent salary and in paying my taxes to the government for "greater good" (while of course wanting always to argue how it is/should be spent; that's called normal). I will be unlikely to outlive the money I have managed to save throughout a lifetime of much loved hard work and great care in management. I consider myself very lucky, and the day will never come when I envy the poor. As to the very wealthy who give nothing back? Tis to shrug about them; I always wonder how much they need before they feel safe and can "give back." Some do. Some don't. Greed will always be with us.
I don't spent lots of time resenting anyone, but certainly I never for a second, even when I was young and struggled so hard that hunt's tomato sauce over noodles was what I ate in order to pay the 18.00 a week rent, envied the dirt poor. In fact, I didn't envy the rich either. As long as I could cough up that rental and keep working toward the life I wanted to live, it was ALL good. I feel very lucky in that.
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mstrbill Jan 2021
Great perspective and post
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Our situation is different. We're on the poor side with no savings, retirement, pension, etc. BUT my son with early onset Alzheimer's is only getting caregivers because he is developmentally disabled. It is our home or a horrible nursing home for a 41 year old. We HAVE to have in in my home as long as possible. The alternative is dreadful and he would have no quality of life. Caregivers in our area would be about $18 an hour. He needs 24/7 care with awake staff at night. If he was "only" disabled, he would not likely get caregivers but only nurses that would come into the home. That would be awful for there is no quality of life because they would not do things with him and there would be no activities, exercises for his OT and SLP therapy, and no outings ever. And nurses here only work weekdays, with no evening or weekend shifts.

I think maybe you are still "new" to the caregiver needs and will find over time that there are not many resources or support services unless your family has a substantial amount of money for long term care. So "middle class" and "dirt poor" are both in the same boat. There is a massive shortage of caregivers in the US and it is getting worse because of the pandemic.
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It is true. Ideally you'd like to be able to pay for private care but at almost $20. hour, it's nearly impossible. In NY to qualify for Medicaid home care you must have very low income and assets. Any property, retirement accounts will be attached at the end of the recipients lifetime. Every situation is different but I strongly suggest you see a highly regarded elder care lawyer who can explain what options are available in your case. It's certainly worth the consultation fee, if any.
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You are not alone. I had to sell my mother’s house to pay for memory care for her because I cannot care for her at home with 2 teenage kids and a demanding job with travel. Her place is 6,500 per month and in a few years there will be no money. Her place is very good but they don’t accept Medicaid so if I keep her there I will have to put a second mortgage on my house and retirement will not be an option. No one tells you this. Medicaid facilities where I live are pretty terrible. I don’t know how people without a house to sell do it. I really agree with your observations and I am sorry you are going through this too.
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I agree with your observations. It may not be right or fair but finding what the real options is an essential step.

You've chosen to help: will you now help support them to move into this next stage of their lives? Help them to choose from their real world options?

Or will you keep on as their 24/7 solution, acting as a buffer, leaving you own home & wife indefinately?

(Sorry to sound harsh. I have parents who refuse to plan for their own future with apparently sky high expectations I will just fix everything).
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