Helping Aging Parents Plan for the Future

Parent Q&A

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  • I'm looking for recommendations for attorneys that specializes in elder law regarding how to qualify for Medi-Cal.  We have a parent with dementia and trying to figure out to how to pay for memory care for the long haul.

    i am an estate planning attorney in Berkeley, but do not handle the complex issue you need, planning to qualify for a MediCare nursing home. It is a complex subject in which careful planning is required since the Medicare rules and look-back requirements must be met. Greg Wilcox, in Berkeley, is a specialist in this area. i have referred clients to him who are satisfied. 

    I used Chris Packard, http://www.packardadvisoryservices.com/. He's a consultant who helps you navigate medi-cal. IMO, much more practical than an attorney -- we tried them first, but the ones we called couldn't give a cost estimate and I got the sense that they'd prefer elder issues that have a higher billable-hours potential :) Chris isn't the only consultant I've worked with -- but these dedicated medicaid consultants are, well, focused on getting the elder qualified for medicaid. Good luck!

  • I am venturing into new territory, and need some wise advice and guidance.

    My father-in-law, age 71-ish, is starting to slip a bit.  Nothing too bad, but to me the signs are there - he gets rattled easily, loses things constantly, and generally has more trouble navigating the frustrations of daily living.  Not surprising, given his age.  He currently lives alone, on a sailboat.  He has no assets at all, aside from an older car and his (older, not valuable) sailboat.  He still practices law, but his main source of income is social security.

    For now, everything is ok, but looking down the road he will not be able to live on a sailboat forever.  At some point he will need some other kind of housing, as well as possibly more services (medical care, food stamps, whatever he can qualify for).  

    I assume that any kind of senior housing has long wait lists, so the time to get started is now.  But what do I do, and where do I go?  I have no idea where to start, to find out what his options might be.  

    His boat is in Alameda, but I believe his mail is delivered to Berkeley.  I don't even know where he would be considered a resident (I assume that matters?).  Most of his friends and social network are in Berkeley, so ideally I would get him on some waiting lists there.

    Our resources to help him are very limited, our finances are already stretched thin.  Living with us would be a very big challenge - we are already a family of 4 living in 900 square feet (and my FIL can be somewhat difficult to deal with).  If it comes down to it, of course we will take him in, but it might well destroy our marriage.  I would prefer to avoid that. 

    Those of you who have been down this path, what steps should I take now?  What agencies do I contact, what information to I need to provide them with?

    Thanks for your help!

    Welcome to the world of caring for an elderly loved one! Although you read is still pretty independent be sure to keep an eye out that he is still paying his bills and taxes (or dock fees), and taking any medications correctly; those things are the first to get away from a declining elder. Some important points to know as you begin this journey: neither the local, state nor federal government is going to subsidize your father's care, you will have to pay for it. Medicare pays for a limited time (up to 60 days) if he is admitted to a nursing facility for something serious like recovering from major surgery, pneumonia or complications of diabetes. Likewise they might provide limited services for someone at home who is unable to carry out the tasks of daily living without assistance (open wound or diabetes care, can't dress, feed or bathe themselves). If you do end up paying for help, hiring a part time, in-home helper is still the cheapest way to go. However, you will spend a lot of time looking for such a helper and overseeing their employment. I set up a debit account for my mom's occasional helpers so they have access to money (but not all the bank accounts!) for groceries, etc. Agencies may cost a little more and offer a little more convenience, and they probably weed out undesirables at the outset, but I have found that ultimately they are no more reliable than the individuals I have found on my own. Taking care of your elderly father isn't a one shot deal; you  don't hire someone to help and then be done with it. His needs will increase, caregivers come and go, etc. It becomes a part of your daily tasks to attend to. Good luck to you! Here are some local resources that might help you get started:

    http://www.eldercareresourcesbayarea.com

    http://www.eastbaysmartsenior.com/?cat=62

    http://www.aplaceformom.com/senior-living

    http://www.aplaceformom.com/senior-care-resources/articles/elder-care-costs

    http://theelderhub.com

    http://www.elderstogether.com/find-ideal-assisted-living.html

    http://www.seniorseasons.com

    I work for the City of Berkeley's MoW program and have delivered to Redwood Gardens on Derby off Sports  Lane, very near UC campus. Check it out, it might be affordable for you. Lovely area.

    Take him in Now. Put him to work around the house. Make him help the kids with the homework. Sell the boat and the old car and make him contribute the SS $ towards the mortgage/rent and the bills. Otherwise you will feel guilty as heck when he loses the boat and car and ends up on your doorstep in even worse shape. My2Cents

    Look on Alameda County website for senior affordable housing. U will find a list of HUD subsidized senior housing. Look for open wait lists get applications and apply right away. You will have to wait perhaps a year or more. 

    Hi there,

    I'm sorry for your family that you need to navigate such a tricky, frustrating, and often deeply sad circumstance 

    I would suggest getting in touch with the UCSF Memory and Aging Care Center (http://memory.ucsf.edu/patientcare/mac), where they could do a comprehensive assessment of your father in law. Oftentimes, diagnoses are limited at best when done by primary care physicians. With limited information, it can be trickier to treat the situation/person and find suitable caregiving based on the older adult's needs. UCSF is also likely to provide many resources to help your family come to terms with such a change and provide referrals for things like boarding care.

    Good luck!

    Genoa

Archived Q&A and Reviews


Questions


Husband's absent mother has now returned - must we support her?

Dec 2011

I'm hoping someone has good advice out there. My mother-in-law moved out of state when my husband was a toddler. She was pretty much absent in his life except for a couple weeks here and there until a few years ago when she moved back to the Bay Area. She sees us every couple months and is trying to re-establish contact, mostly now that he has children of his own. That, and the fact that she is in her 70s without a partner to care for her in her later years, are two of the reasons she moved back. I do not care for her at all, and he is pretty indifferent toward her. She was not part of his life for such a long time and is frankly such a bland person and emotionally closed that it is hard to be around her. Financially she receives a small social security payment each month along with a 401k that is running out. She rents her house and makes car payments, but otherwise she doesn't have a lot of extra expenses. My husband and I have been getting into arguments about financially supporting her as she gets into her older age. I am inclined not to do it as we are completely strapped financially taking care of our kids and living in the Bay Area. He thinks we're legally obligated but I disagree. Can someone shed some light on how this works if she doesn't have enough money to live on but we don't want to have to support her? Obviously I don't want her to be out on the street or anything, but I feel angry about having to support someone who was completely unavailable for my husband from early childhood on. Not loving my MIL


You are not legally obligated. But why let this create conflict with you and your husband? You should both sit down with her and have a serious conversation - maybe she has financial expectations of you, maybe she doesn't. Get the full story, share your position with her, and the communication should help you feel better, or at least more like you're on the same team as your husband. Wish My Husband Would Do This


I don't think there is a legal obligation, but as someone who is now caring for an elderly parent who wasn't there for me in some ways (not as much so as your MIL, however) I can tell you that guilt is a really, really heavy burden and one it is very hard to free yourself from. Your husband may have a lot of trouble not helping his mother even though his rational side says he doesn't owe her anything. Please have some compassion for how hard this is for him. (I do have a lot of sympathy for you, too!) Personally, I'd suggest talking to a family therapist about how to handle this. Good luck.


I am not an attorney and do not know with certainty but I am fairly sure that people are not legally obligated to provide for their biological parents. As far as morally obligated, she is not the one who raised your husband so I don't think he is morally obligated either. You should not support her financially in any way but why not allow her to spend a little time with your family since she is probably lonely? anon


You are NOT legally obligated to help your MIL in any way. I believe that Medicare will pay for her to be in a nursing home if she can no longer pay her rent. You can contact Area Agency on Aging (www.aging.ca.gov) for some guidance, if you want to help your MIL with those sort of practicial issues...but you don't have to do so! anon


Wow, what a generous and caring husband you have - who is willing to sacrifice to take better care of his mother than she took care of him. You should be proud.

I had a friend with a somewhat similar situation - not financial support, but husband kept trying to maintain a relationship with his mother, who was, objectively speaking, just a horrible person. My friend kept trying to point out to her husband all of his mother's bad qualities (of which there were many). The more she pointed them out, the more he defended her, and eventually they divorced. Loyalty to one's parents, no matter how bad they are, is a powerful human emotion (and I think a good one). I recognize that money is tight for most of us, but I think you need to start with the perspective that your husband's desire to help his mother financially is legitimate and even good, and accept that part of your family budget is going to help support her. If you're having a hard time doing that, I'd suggest working on changing your attitude instead of your husband's mind. I think your husband is right on this one


Long-term plan for elderly counterculture inlaws

March 2010

My partner's parents were prototypical 60's hippies who never reentered the mainstream after they left. While they have passed along great core values to him (their only child), they have managed to make it to their 60's without savings, jobs, or any plans for their long-term care. They are not married and have no social networks to rely on so my husband and I are now brainstorming how to prepare for their old age which they both show signs of entering and for which we seem exclusively responsible.

His father is an artist who earns about $30k a year in cash. This money is always gone as quickly as it comes in. His mother is an aspiring artist who used to work in medical reception but has not been able to find a job in nearly 4 years, possibly due to age discrimination and possibly in part to an under-medicated thyroid condition. (I know, it's bad.) Mom has just filed for food stamps and job skills training but dad has really no plan in place and aside from being eligible for VA benefits (!) is apparently eating only what he is growing in his garden... admirable but problematic for obvious reasons.

The hardest part for us is that we're slowly saving to buy a house and build a life for us and our small children. It's difficult to think about that savings and *not* help dad who needs money for food but our future and our children are what my partner and I had prioritized in our planning before. I'd like your suggestions for several things to get us started on what is a really difficult task financially but more importantly, emotionally. Has anyone been in a similar situation with their parents? How do you get a plan in place to help them save, find the right social services to contact, support groups, agencies, or senior consultants? How do you talk to your parents about these tough topics without offending them? (Last time he tried, mom said ''just wheel me out into the forest when the time comes...'' ) In addition, I'd love suggestions on a counselor or support group to help us deal with the anger he's feeling towards his parents for refusing to deal with this situation. A little too much to handle


why not look for a home that has an inlaws unit (or ability to easily add one) and keep your inlaws in it. 60 is pretty young still and they can help with babysittin. The Fathers VA can help contribute to mortgage and food. Theres still alot of foreclosures on the market so you might be able to find one to fit your whole family at a decent price anon


It's interesting to see that you are facing some of the same problems my siblings and I face, though my parents are definitely not what you would call ''counter-culture.'' They just don't like to save, plan, or think about the difficulties of old age or (dare one even say it) death. I love their youthful, free-wheeling ways, but sometimes I worry, too. I think my Dad would be deeply offended if he thought I was sitting around imagining how he might become a burden to his kids in old age -- he would definitely come up with the ''push me into the forest'' line (though in his case, it would be a ''crick'' instead of a forest). It is a delicate balancing act: letting elders have their autonomy and dignity in the later stages of life, and giving them the support we feel they need (or feeling guilty about not being able to give the support). But I do think that you might be leaning too much toward the latter side -- feeling that you are responsible and that their situation will leave you feeling either guilty or impoverished, depending on how you act. Give the responsibility back to them. Without saying ''I wash my hands of you, then,'' let them know that you are concerned and loving, but you won't be able to come up with the cash for crises. If they then prefer not to plan with you, you have to let them be, but absolve yourself also. And you can think a little about what you would be able to do (take one or both of them in, help them locate services) in order to assuage your conscience. But they might say no! And that's something their dignity might demand. loving daughter of free-wheeling folks


Oh yes, I have been there. I know exactly what you are up against! And my mother said almost those exact same words to me. But I didn't let her ''go into the woods to die'', of course, I took her into my home and got her signed up with Social Security, Medicare, Charlotte Maxwell Clinic and a number of other great social services which are available to low-income people in crisis. Help is out there, when you need it. And its hard to know what kind of help, medical and otherwise you will need, until that time comes.

I understand that you are trying to plan ahead - a foreign concept to your in- laws - and maybe you will encounter some considerable resistance, at least as long as they are healthy and have some options. That's ok. You will need some good financial advice, which I don't have. But rest assured, your savings is not in jeopardy. Their choices, and limitations, will impact you, but mostly on the emotional level. You are right: resentment is the biggest obstacle, and now is a good time to sort it out so that your whole family can have a loving and respectful relationship with his parents, whatever their situation. Protect the relationship and you will be very glad you did, in the end.

I would be happy to talk with you directly if you like, since my recent experience is so very similar. I suspect there are a lot of us beginning to encounter these problems, offspring of the original hippies, now ''sandwich generation'' with young kids of our own.


My mom reached her mid-60's with no job and no retirement - she had been a teacher for years, but she cashed out her retirement fund in her late 40's and then had only my deceased dad's tiny social security widow's benefit to live on when she finally got to the point where she could no longer find work. I was sending her money every month to cover utilities. But the story has a happy ending. I found Section 8 senior housing for her here in Berkeley - there was a wait of several years during which she lived with my sister in the South, and then she came here and has been very happy in her apartment building in Berkeley. She pays only 25% or her SSA check for rent, and can get by on the balance. She is now in her 80's. She has Medi-Cal, sees a wonderful doctor at the Over-60 Clinic in Berkeley, and has an in-home helper paid for by Medi-Cal so she can live independently. California actually does a very good job supporting its poor seniors. I recommend that you start to get together some information about this for your in-laws, so you are prepared when the time comes.


Need to make plans for mother's eventual incapacity

Dec 2007

My elderly mother-in-law recently had a scary round of falls and mental confusion. Though she seems to be recovering, my husband and I are now aware that we need to make plans for her eventual incapacity -- hopefully that will be years down the line, but it could be next week if she has another bad fall. We'd like to have a plan in place before we're in crisis mode. She has virtually no assets so will be relying on Medicare/cal for her eventual care. How do we start planning? Who do we need to talk to? Lawyers? Social Workers? Elder care specialists? Her insurance is through Kaiser right now, do they have resources of this sort? Hoping for the best, planning for the worst


What you've had is a warning, especially in terms of the mental confusion. I urge you to see an estate planning attorney sooner rather than later; if you wait, and her mental acuity declines too far, it will be too late for simple things like a durable power of attorney (to let you deal with her finances) or a will. An estate plan includes these documents and more. If you get it all set up before you need it, you won't have to worry about it when the time comes (even if it is far in the future, as we'd all hope).

It might also be a good idea to start checking into the medical resources available to her. If you're going to need a longterm care facility at some point, for instance, you don't want to be searching for a good place at the same time as you're trying to deal with a crisis. As with the legal/financial aspects, it helps to have a plan in place. Kathleen


you might want to check out a book called 'moving mom and Dad' by Donna Robbins. She has a website at ultimatemoves.net which also details the various services she provides to families dealing with these kinds of issues. Donna was very helpful with my mom. Good luck. paula


Hi there...good for you for wanting to plan for her incapacity sooner than later. I am/was a geriatric SW for a long time (now a SAHM) and encourage you to contact the SW dept at Kaiser to talk w/a SW there about completion of a Durable Power of Attorney(DPAHC), DNR etc. Since she doesn't have many assets (or none at all), this will make it much easier and you may not have to contact a lawyer to create a will/trust, etc. The SW dept at Kaiser can give you community referrals for low cost lawyers as needed. Whoever the primary agent/decision maker will be for her should also discuss her wishes w/her primary MD (if she has one) and what she wants her code status to be in the event of an irreversible situation. I have seen time and time again a bad fall being the end of any kind of independence. Good luck....anon anon


It's very important to have a plan in place before it's needed, and most of the nice nursing homes have a waiting list. Would she like to try an assisted-living facility for now? They have resources to help plan an eventual transfer to a full-care facility later, if needed. Been there