There are some studies that show that ketones either endogenous or exogenous can not only slow but reverse late stage mental issues. Get on pubmed and dig around.
Printable View
There are some studies that show that ketones either endogenous or exogenous can not only slow but reverse late stage mental issues. Get on pubmed and dig around.
Sorry you are going through this. My mother's battle with Alzheimer's just ended this past summer. It sucks, and will only get worse, but at least it gives you time.Quote:
Originally Posted by Tbonewannabe
One piece of advice i can give is to not forget to think of your Dad through this as well. Often the caregiver will drive themselves into an early grave by spending so much effort on the spouse. Do what you can to ease his burden. Also explore your options for part time home care to give him regular breaks.
Talk to an attorney who specializes in estate planning next week. Don’t wait. When my Dad passed away he left instructions for us to buy a long term care insurance policy for my mom. He had started researching it but ran out of time. It was expensive and wasn’t something we would have done without his wishes but when the time came it was a relief to know she had it. She only lived about 16 months in assisted living but it was a major relief knowing that financially she was taken care of. I know it’s too late for your mother but it might be something to consider for your father.
Assuming there is no LTC insurance, consult an estate planning attorney immediately. There is correct and incorrect information in this thread.
Don't start transferring assets until you consult an estate planning attorney. It can get complicated quickly, medicaid has a 5 year look back period, so you may have to wait until 5 years after transferring assets before medicaid eligibility, if that is necessary.
Nothing they can do if everything is sold. We sold everything we couldn't hide. And we used an attorney in Hattiesburg to get it handled. It worked. Not only that, but the nursing home had to refund us money in the end for not handling things appropriately.Quote:
Originally Posted by Homedawg
We filed a lawsuit at one place where a crack head work beat him up. Got money there too.
It's as shitastic as life gets. I don't wish it for anyone. Hope I kill over before then.
As soon as something is amiss with them, make the move to avoid issues people are mentioning.
A will or trust won't work with Medicaid, because it will have to be prorated after the time of death, and It will just start that 5 year look back period that Homedawg mentioned. Been through all of this with a lawyer and and an expert consultant on Medicaid.Quote:
Originally Posted by Saltydog
I'm sorry you are going through this, and I wish ya'll the best. My Dad passed away in an assisted living facility this past March and my Mom has been in a nursing home since April of 2020. The nursing home has been costing at least $7000 a month (the price fluctuates on what the government tells them to charge a month) and the government has not paid anything on her stay. Homedawg is 100% correct on Medicaid. Medicaid has a five year look back period. So if you are deeded the property during that time from your Mom or Dad, it is not protected from Medicaid. Any Medicaid approval has to be after that 5 year look back period has ended before you can use Medicaid and still keep the property. Other assets such as CD's, Stocks, Mutual Funds etc. can not be transferred during that 5 year look back period, and it doesn't even matter if your name is on any accounts. I was deeded the farm property and the home, and the five year look back period will be over the later part of April this year. I have been told by an Attorney and a consultant that is considered an expert on Medicaid, and knows the ins and outs, on what you can do or not do, that the land will be safe after that date. If I had been willed the land it would not have been, because when the will is prorated that just starts the five year Medicaid look back period. My suggestion would be to talk with an attorney or somebody like I have that knows the ends and out on what you can do and not do concerning Medicaid coverage. Like an attorney friend told me, you work basically all of your life and try to save up some money , and then health issues come into play and the government wants you to spend pretty much everything you have before Medicaid is an option. It sux but that's the way the government works.
At the age, of 95, my mother had a stroke, leaving her completely disabled. Sixteen years prior, I had sold my home, moved and changed jobs to look after her, her home, and 3 acres of land.
Even though the doctor told me I had no choice, I knew this time I could not physically do it, and the nursing home was our only option. The hospital assigned the nursing home here, in NW MS, which fortunately was, and still is, the best run one in the area. Very few can afford to pay out of pocket, and long term care does not usually cover it all. She, nor I, could afford to cover the costs. Our only option was through Medicaid.
Thankfully, I already had legal power of attorney, had been handling all her finances for years. Plus, 7 years prior she had her attorney draw up a Will, with a Property Quit Claim Deed included, so that when she drew her last breath all property would automatically go into my name. Because I was not a spouse, or dependent, if the quit claim had been done in under 6 years the state could have legally claimed her property, and I would have been without a home right then and there.
Every state?s laws are different. If I remember correctly, in MS, if a person is admitted under Medicaid, and their spouse is still living, in the residence, then the spouse is allowed to stay there as long as they are able, or die while living there. Then, the state claims the estate.
If need be, you can try either contacting their Regional Medicaid office to see if they will mail you the state requirements, or Google MS Medicaid to possibly find it.
The other option would be to seek advice from an in-state elder law attorney.
Once an Alzheimers patient is past the early stages, I do not agree with trying to keep them in the home. I know this from observing my Mom trying to care for my Dad, with Alzheimers, before his passing. It was devastatingly difficult mentally and physically on her. My closest friend now has her husband, with Alzheimers, in a memory care home. He became too dangerous for her to look after alone.
But, even if they are docile, unless you have been close to that situation, you have no clue how exhausting, in every possible way, it is. Two couples, who were close to me, dealt with Alzheimers. In both cases, it was the husband looking after the wife, and both of the husbands died well before their wives. That is very common.
No one can understand, unless they have had some hands-on experience with Alzheimers patients for extended periods of time. Try to imagine continual sleep deprivation because many roam throughout the night, often finding ways to get out. And, of course, you can never let them out of sight day or night, or leave car keys, knives, or scissors accessible. You might find a stove eye turned on high, maybe with a dry pot or one with food left on it. Or, a ironing board with a hot iron left on & laying flat on the board. My father once found his truck keys that Mom thought were well hidden. All of us, as well as local authorities, wound up searching for him for hours. We were fortunate that he was located before he hurt himself, or worse someone else. Just answering the same questions for hours on end can try the patience of a saint. Years ago I knew of a family down on the coast looking after a relative, with Alzheimers, in their home. As I understood it, he was very docile and amiable. They said one Saturday, some of the family were in their den talking, when the relative said he was going to the kitchen for a glass of water. They thought nothing of it because it was something he had still been able to do for himself. Shortly after they heard him coughing and gagging. He had gone in a cabinet, found a random bottle of liquid, poured a glass and drank it. It was bleach. He died. They were devastated.
That makes my point. It is virtually impossible to watch someone every minute, 24 hours a day, every day of the year. You cannot anticipate their every move or thought. You cannot have patience all of the time. Or, it will kill you trying.
Glad it worked out for you.Quote:
Originally Posted by Cooterpoot
One more thing, does your mother have a living will? My mother did, and paraphrasing here, but hers stated her wishes which were should there be no chance, for quality of life, she wanted no lifesaving measures administered whatsoever. Following her stroke, she instructed me to put it immediately on file with the nursing home. The attending doctor said that was one of the most important documents for them to have on file regarding their patients.
I do not know the cognizance, of your mother, but if she does not have one, and can understand the concept, I would advise completing one asap.
Find a competent lawyer.
Some of the advice being given on here was not legal 20y ago. The 1st adviser we sought gave some of it.
The Elder lawyers(Huntsville AL) and 2nd financial adviser we saw said it was not legal.
Find a doctor that cares about your mom being comfortable. Full stop.
Docs had my dad on Warfarin.
Found a good doc that took him off that and put him on 1/2 baby aspirin a day.
If they don't already have one, get a living will and DNR. It can help in some situations.
Even so, DNRs meant nothing in our ER. The ER will try and save them.
A hospitalist finally took over and put dad on Hospice.
People who have never been through it can think this callous. They do not understand.
Find some way to relieve stress each day.
Pray, meditate, exercise....
Find a way for your dad to get away for at least an hour or so at times.
Be extra nice and patient with family and care givers.
There is no reason to make an already horrendously stressful situation worse.
Wish we'd always done this.
Depending on the progression, learn to enjoy talking about things that happened long ago.
Often they can remember those. Talking about them seemed to calm dad.
Visit care facilities between 9 and 11. Notice how the residents are being cared for.
If your mom has any monthly income, miraculously care facilities often charge almost all of that.
Almost like there's a correlation there. It may not be as bleak as your dad believes.
Hope this helps.
They can't "take your property". They charge you for providing assisted living. It's pretty simple when you're single. You pay for care as long as you can, and if you ever don't have enough money to pay, Medicaid will pay. The "lookback" rules people are referencing are to make sure people needing assisted living don't give away their property to push the costs for their care onto taxpayers before they run out of money. That is all straightforward enough and eminently fair.Quote:
Originally Posted by beerfarley
It gets complicated when you are married, as if you don't plan well, you can easily have a couple that saved diligently and have enough assets to live an upper middle class life in retirement, but don't have enough to cover $100k a year for one spouse while also maintaining the primary home and living expenses of the independent spouse. In those situations, one spouse needing assisted living can result in both spouses ending up with essentially nothing beyond a homestead and some pretty modest exempt income. I don't think you should really be forced to scramble more than one half the nest egg to care for a spouse, but that's an almost impossible standard to enforce.
Hard disagree on it being fair. If the costs weren't ridiculous, maybe. And pushing the cost onto the taxpayer? Give me a break. This is the most un-empathetic post I've seen on here which is saying. You clearly have not had to personally deal with the hell that is having a loved one get sick in the United States. If you aren't upper class (read as: 1M+ income annually, so maybe 1 or 2 people on this board) then you're choices are: help keep them comfortable and piss all their money / assets away, let them die quick and not comfortably to help the rest of the family, or do what others have suggested.Quote:
Originally Posted by Johnson85
I want you to think how stupid it sounds to say that getting permanently disabled and saddled with severe medical bills at 40 after having worked two jobs a vast majority of your adult life (and not 'fake jobs' either, one was school teacher which is a whole other issue) which causes your family to file bankruptcy and be left next to destitute, to say that THAT is eminently fair. Really think about it. And if your two brain cells can't realize how stupid it is., then **** off and post less.
Lord knows I rarely agree with J85, but to be fair he was only referring to a single person. It makes some sense, if you are concerned like J85 is about any person anywhere 'undeservedly' getting something for free from the govt. The other school of thought, once minimal but quickly growing in this country, is to stop means testing everything and just give benefits to everyone equally. The rich already paid for it with their taxes, stop obsessing over them getting a public benefit. Conservatives are generally against this because they want govt services to be seen as welfare for the poor, so as to make them unpopular and thus drive support for lower taxes for the rich.Quote:
Originally Posted by Tater
Medicaid doesn't necessary take your property after your death to settle the bill. I'm assuming they would have to file some type of legal claim against your estate, a Medicaid Supervisor once told me many times they don't even bother, but you never know. That's why is important to consult an attorney who is knowledge in this area.
A former neighbor investigated nursing home abuse for the State AG, he had some sad and terrible stories. Obviously you want to keep a loved one out of a nursing home as long as possible, but many will end up there at some point. If a loved one does end up in one, it is important to check on him/her as much as possible, which can be very challenging if you have children at home or live far away.
I've instructed my kids to just let me out in the woods if it ever comes to me needing to be put in on.
Our healthcare costs are ridiculous. That's what happens when you artificially limit supply while subsidizing demand. I wish we wouldn't be so stupid with it, but the way to fix that is to stop pushing stupid policy, not to try to subsidize it more. Medicaid is means tested welfare. It's not supposed to help people preserve assets or pass on assets to family. It's supposed to make sure they are not left on the street when they don't have money.Quote:
Originally Posted by Tater
I actually have had to deal with it with a grandparent. Had my grandfather's health declined quickly instead of slowly, he could have passed on a high six figure inheritance to his children. Instead, he pretty much exhausted his savings on end of life care. I think in general all his children are happy they had more time with him. I've never heard any of them complain that taxpayers didn't pick up the bill so that they could get an inheritance. I've certainly never thought that. Somebody has to pay for end of life care. I wish we didn't make it unnecessarily expensive without improving the quality (most nursing homes that will take medicaid are not where you want to be), but provided we're going to make it expensive, it seems pretty reasonable and empathetic to say people pay for it if they can, and taxpayers pay for it if they can't. It doesn't seem empathetic to me to want other people to pay more taxes so I could inherit more money. Lots of people don't get inheritances. And I suspect that on average, people with parents who could have left them a good sized inheritance except for end of life care probably still start off with a leg up on average, even without the inheritance.Quote:
Originally Posted by Tater
Well, disability at 40 is a little different from what we were talking about, but when somebody becomes disabled and has to rely on the government for care and support, what is the "fair" amount of support they should get? If you provide them the median income, then is that "fair" to the people that are working and making less than the median? If you provide them the income they were making before disability, is that "fair"? Certainly hard work goes a long way, but inherited traits matter a lot too. Is it fair that getting lucky in inherited traits but unlucky in health gets you better income than somebody that is unlucky in inherited traits but lucky in health? What about the person that is lucky in inherited traits but gets unlucky in health before establishing an earnings history? Those don't seem like questions with obvious answers to me, even if you have more than two brain cells. And that's ignoring the incentive problems when you make government aid too generous. Disability pay is not particularly generous right now, and we still have tons of people that pursue fraudulent disability claims so that they can not work and/or work for cash. That's not going to get better or easier to address if disability pay gets more generous.Quote:
Originally Posted by Tater
ETA: And again, I don't think somebody should be made worse off by being married to somebody that needs end of life care. They shouldn't have to give up more than half their nest egg. But while that's an easy enough concept, I don't know how easy it is to put into practice.
Without getting political about it - a major issue is that Medicare and Medicaid are not being used as intended. They were meant as insurer/provider of last resort - so their programs are built around that approach. You HAVE to be indigent qualify. Our political leadership - unable function from any perspective - has allowed the insurance/medical industrial complex to turn Medicaid and Medicare into the defacto providers for everyone over 65 without changing the structures of the program. Think about how broken our system really must be if for the majority of citizens in the country the only option for elder care is give away all of your assets and declaring yourself indigent. And as you can see from multiple posts on this thread - that is the typical experience.Quote:
Originally Posted by BoomBoom
We, as a country, have to do better than this.
Well it does seem like that, the government swoops in when people are the most vulnerable.
The other side of the coin is this, if the government gave zero assistance, what would be the financial outcome of an elderly person going into an assistant living facility with mental cognitive issues? Would the surviving spouse be responsible for the money? Yes they would, until they were bankrupt. Would they then kick the patient out on the street if they couldn't pay, yes they would.
The issue here is simple. One large group of individuals in this country, cannot stand a person getting a benefit for something when they do not meet the needs test for that benefit. We demand as a society that in order to receive government assistance, you cannot exceed some arbitrary benchmarks. This is why there are monetary limits to welfare, basically forcing people not to earn too much money or else they lose benefits. Keeping them on the edge of poverty, because it takes too long to earn a living wage when you start from nothing. The solution here is to offer a time based welfare system. IF you qualify for welfare and get a job to help your family and you exceed the threshold for that benefit, maybe you should be given a couple more years to truly get on your feet before the benefit expires. The flip side of that is that people actively manage their production to make sure they don't lose that benefit and they stay on the system longer.
When it comes to twilight of life issues like this, what would half the country agree is the correct path? Give money to someone that has money to pay for these services, or not? Imagine you have 500k saved for retirement and your wife, age 65, is suffering mental decline. That 500k will be consumed in a matter of 50 months, easily. Not even considering the spouse that is still on the outside trying to survive.
Yep. Means testing is a major issue with all welfare systems, but dammit if a large portion of our country just cannot stand someone getting something for free when it isn't them or their family. youtube channel 2 cents just had a video on means testing and the welfare system keeping people poor. Almost impossible to break out of the cycle, because at a certain limit that isn't a comfortable living, a person losses so much assistance it is prohibitive for them to grow.Quote:
Originally Posted by BoomBoom
Was Medicare ever intended to be an insurer of last resort? They penalize you for not enrolling and to my knowledge, other than getting a more generous subsidy the lower your income, it's not really means tested. Everybody gets it and gets a very subsidized rate, and the amount of the subsidy. I thought it was designed from the beginning, to basically be like Social Security and provide welfare that is not means tested but instead structured to be "progressive".Quote:
Originally Posted by BrunswickDawg
That's not the only option. That is a way for people to game the system so they don't have to pay for elder care. I don't doubt that we unnecessarily inflate the cost of assisted living, but I come across people that are pissed because their parents had to spend their $100k nest egg down at the start of their 4 year nursing home stay. However inflated it is, I don't think it's reasonable to think that a $100k nest egg plus social security is going to be able to pay for several years of nursing home care without spending down that $100k.Quote:
Originally Posted by BrunswickDawg
That's fine, but people have to be realistic about what it's going to do to people's quality of life over the course of their life if we're going to make assisted living available without requiring people to exhaust their assets first. If you're going to have people work for 40 years and collect enough taxes from them to pay for any needed assisted living without them having to spend down their assets first, that's going to be a significant amount of taxes. There's a reason so few people by long term care insurance. It's really expensive. Certainly we could stop inflating the cost of medical care, but I don't think assisted living is ever going to be cheap as long as we are dependent on people to provide the care. Monitoring and assisting nursing home residents is labor intensive and will presumably continue to get more expensive due to Baumol's cost disease.Quote:
Originally Posted by BrunswickDawg
Was Medicare ever intended to be an insurer of last resort? They penalize you for not enrolling and to my knowledge, other than getting a more generous subsdiy the lower your income, it's not really means tested. Everybody gets it and gets a very subsidized rate, and the amount of the subsidy. I thought it was designed basically like Social Security, to be more or less welfare that is not means tested?