Caregivers and Stress

[Kelt]

Originally Posted by DapperButch

Yes, Sir, I am! Why do you think mumsie has long term care insurance!

The first order of business for me after Dad died was to find mom a good financial advisor. He said that my mother was in that sweet spot place financially where based on her age (and other health data), she should have enough money to live through the rest of her life, including assisted living needs. The other option was long term care insurance. I voted for long term health care insurance, my sister agreed, and mom rolled with it. I do believe I did due diligence in choosing the policy and had enough information to be convinced it wouldn't "go away" or something when she finally needed to access it. It is also very low criteria of medical assistance needed, in order to get it activated.

She put down a HUGE amount of money to buy it in one block. At that time, doing monthly payments meant that if you didn't use it (i.e. died before you needed to access it), your heirs lose it. With buying the the policy outright, and if it wasn't used, your heirs got more than half back. I heard that this changed at some point since we bought mom's policy; heirs will get some money back even if owners of the policies paid monthly for it.

Anyway, the data shows that people die on average between 2-3 years after moving into assisted living. The policy that my mother bought will cover her for 6 years for an assisted living apartment costing slightly more than twice the amount of the average cost of an assisted living facility per month around here. I believe the data indicated that services in her home - even 24 hour coverage- would last about that long, too. I dunno. Then, of course, if she needs more, she still (hopefully) will ahve enough money to cover her until the end. She only spends what she makes per year, pretty much. I DO think it will be ok. Otherwise, I think that my rich sister should cover her costs! lol

Did you look into/encourage your mother to buy long term care insurance after your father's death (I think I asked you once if they had any and you said no?). If not, why not?

I have heard that the price for long term care has gone of astronomically since my mother bought her policy 6 years ago. It had already gone up a great deal at the time she purchased; supposedly when these type of policies came out insurance companies set the cost of those policies too low and were scrambling to get on top of it.

I didn't know really anything about long term care before I looked into it, but having worked with the severely mentally ill in the past, I knew a lot about medical care, including the fact that they had to have NOTHING in order to get into long term care facilities. That is what started my hunt.

Do you recommend parents selling their houses to their kids early on so that this asset could not be touched? I am just thinking about how it is problematic if a person sells/gives money to their heirs less than 5 years before prior to their "spin down". At that was my understanding 10 years ago. Or something like that.

Lol, of course you've got it handled financially, I wasn't questioning that. I just want to make sure you're ready for the sudden course changes that can happen. My mom is very well off, I figured I could just staff her up at home with lawn guy, housekeeper, cook etc. Who knew a damn head gasket on the Buick could start a cascade of events that would lead to me moving her thirty days later??! It has actually turned out very well and she thanks me at least weekly for getting her into a place where she can make friends and feel safe. (Those little pull cords make her feel much better, and me too)

I'm really glad you got your mom one of the policies that pays a set amount to be used at will rather than just covering specific events, it should save you a ton of headaches. The 6 years should be plenty, just don't start it until you need to.

My mother doesn't have long term insurance per se, we just pay as we go. A number of years ago my father hit a point where he considered them to be self insured and he was right. She has SS+pension+2 large untouched annuities and a trust fund so we're good to go so that she can have the best of whatever she wants. I just manage the managers at this point (that sounds so easy now after a year of tearing my hair out to set it all up). It used to be that folks with assets would set it up so that the kids could be "evil" and strip them of assets through legal maneuvering and then just show up with "gifts". This was how my folks were set up for years but the IRS wised up about 15-20 years ago, the 5 year look back is now carefully scrutinized as I understand it.

On the house, I would ask an Estate attorney. She could gift it now but of course any amount over $14k would have gift tax applied, if there are any trusts involved it could be held inside of that to be protected from liability and just regarded as part of her portfolio. Unless the title changes names prior to her death there will be possible estate taxes involved if she leaves over X amount. Over my pay grade, you should look into it. The annual "tax free gift" of $14k per year is a great tool for folks it could apply to. My best bud's mother has been in a facility for years and is about to run out of money and get switched to Medicaid. His sister has been doing this for years; have their mother "gift" the money which was set aside in an account for if she should run out in the sisters name. You do have to have faith in the account holder to not just hijack the money though. Now when they need it they can use it for the extras not otherwise covered. I think this might be a way around the look back as well, check with someone qualified.

Right now I am mid-estate plan for myself and it looks like I will put my house into a trust, it makes life much easier for whoever gets it. When I knew I would have to sell my folks house I just cleaned out the possessions and handed the keys to the trust officer. They are required by law to get fair market value and do all the messing about with RE agents and such. I was so overwhelmed at that point I would have sold it for $10 just to be done with it, so the trust set up really helped.

On a side note: I posted some time ago an article about the cost involved in "the last five years" of the three primary ways people go, cancer, heart or dementia/AZ and the ranges given were $200-$300k for the five years. As I look at my mothers actual expenses now with fairly low needs I think those numbers are wrong, it must discount housing or something because she's about $50k per year after taxes now ($250k for 5yr) and it will only go up from there. The place where I have her is within a couple hundred bucks a month of the other places so it isn't much out of line with "average" independent living + six hours a week of personal care. By contrast, when my father was dying that last month when he was under hospice the SNF charged $10k for the one month room and board and that didn't include supplies or medical. I guess that's just to say the numbers used by planners might not pass the reality test.

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I know some of this doesn't look like what most would consider "caregiver stress" since it isn't the daily feeding, clothing, driving around part of it. I've done a share of that too, spoonfeeding my father who hated me and brushing his teeth when staff didn't show at the SNF, setting up my mother who didn't call me for 26 years because she was too timid to cross my father etc.. I think stress comes in different forms and everyone gets a unique set of challenges. I talk about having to do this all myself, but on the other hand I don't have to work around siblings that might have different ideas or other relatives trying to micromanage.

I really hope other folks will come by and give their take on what they are dealing with. Anyone who cares about anyone else be it partner, parent, or child is exactly one nasty accident or disease away from suddenly becoming a "caregiver" in some capacity.