My $0.02 worth...
My in-laws are starting to need extra assistance, and even though we're not closely involved (due to the fact they live 10 hours away), we'd like to make sure they're making the right choices.
First, financially they are doing ok, but are not super wealthy. My FIL has dementia and he is going to need to go to a nursing home very soon (or some type of assisted living). They recently sold their house (in a different state) to move to their current location - an apartment. The house was fully paid for. They hate their current location. My MIL believes that they need to buy another house soon and put the money into that, in order to qualify for extra assistance. Is this how it really works?
I know they are getting some advice from some senior-type organizations
, but want to make sure they're asking the right questions. To me, it appears that you need to be very poor or very wealthy to ensure you get proper care as you get older. Any truth to this? Any help out there from anyone that's gone through something like this would be appreciated. For one thing, I'd like to know what we need to get prepared for as we get older.
Individual situations (and underlying finances, as well as state laws) of course vary. The one broad but consistent observation I will offer here is that the expressed logic of buying another house to "qualify for extra assistance" may very well be badly flawed and completely unfounded. More specifically, any and all owned real estate is an asset
which could (and surely would) be attached (via lien) in a Medicaid eligibility situation once other more liquid assets are spent down.
Assisted living might very well be a better choice and a much more appropriate option than buying another home for their particular situation and available funds.
People may try to "shield" assets to facilitate access to assistance, but ultimately are subjected to a competent "5 year lookback". In essence, any and all assets discovered (and yes, all would
be discovered) to have "disappeared" or to have been "transferred into another name" will still be regarded and treated as if still on hand, available and in possession. There is no allowable or achievable "hiding" of assets in that 5 year "lookback" time frame. That "lookback" period was once 3 years, but was changed to 5 years during the George "W" Bush administration (no political commentary intended; I'm merely providing a time frame / point of reference).
People sometimes use the terms "nursing home" and "assisted living" interchangeably, but often inappropriately. Assisted living facilities generally require a certain level of functionality and independence for residency, as well as sufficient liquid financial assets to meet hefty monthly residency payments. If level of functionality and independence declines beyond a certain point, resident(s) may (depending on the facility) not be able to remain there at all, now requiring the more extensive services provided in a nursing home. Some (not all) assisted living facilities (and some nursing homes) have very separate "memory care" (Alzheimers / dementia) sections on site. Many (not sure if all) nursing homes (un
like assisted living facilities, which AFAIK are mostly "private pay") may have beds available for Medicaid eligibility.
Nursing home quality range and / or costs are just all over the map.
This is a complicated and difficult matter for you and your loved ones to tackle. Been there, done that --- some of the most stressful days of my life to date, by far.
Btw, some so-called "senior advice" entities are actually little more than commission based marketing and referral entities. I could name one in particular I came to particularly dislike, but won't --- I'm not looking for a lawsuit. Suffice it to say that some other family member, not
just the elders themselves, should / must get directly and personally involved to help identify and separate objective, legitimately senior-helpful entities from commission-motivated (...ahem) "seniors advisors".
My advice would be to have the in-laws at least have an initial (likely free) consultation with an elder law attorney
in the state of the elders' residency, preferably with
other family members present for clarifications and clear retention of important information and details. At the very least, said consultation will hopefully address and clear up any existing misconceptions or incorrect assumptions. Elder law attorneys deal with these (sometimes complicated) matters routinely --- and exclusively.
I feel for you and wish you luck. It's not an easy road upon which to travel, but it's a part of life. In something of a role reversal, the former child sometimes must become the responsible parent to parent(s). Be grateful that the folks are still here for you to reciprocate and actively show love and gratitude in a meaningful way.