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.

[Kelt]

Originally Posted by easygoingfemme

Kelt, hoping you get results from the tissue sample very quickly and that the results are not worrisome...

It's good news, the cancer has not returned. The infection is a weird one and quite large, but we are treating it aggressively with antibiotics (which I hate but are sometimes what you have to do..), topical steroids, and probiotics that will continue for three weeks after the antibiotics so that we can help her system rebuild when this is hopefully past. Thank you for keeping in touch on this .

Originally Posted by Kelt

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.

I wanted to come back in on this since I came across something new to me and I learn everyday how much all of this costs.

I was looking at a "Long term healthcare cost calculator" on the Lincoln Financial site since mom has an annuity there and I am sort of looking at whether or not I should do a long term policy or annuity for myself. It was interesting that instead of using the $200-$300k figures for 5 years used by financial planners, their tool uses $91,250k per year with anticipated inflation of 2.9% per year. That is just the default starting point, the calculator has sliders to change the basic variables to test different scenarios. I'm sure other companies have similar tools. Granted this is a type of company that sells large and complicated insurance products it would be in their interest to use higher numbers to sell bigger plans.

However, it seems like maybe they are closer to the truth, and maybe under still, to what I'm seeing with my friends and myself dealing with this.

Food for thought...

[Kelt]

Pretty sure mom has "Sundowners" I'm learning about it.

She had her second middle-of-the-night stroll last night after being the only one who heard a fire alarm, same as last time. At least this time she grabbed her purse and didn't get locked out.

She also cancelled her driver to the dentist today because her primary nurse called her this morning to say he would take her. He's in El Salvador this week.

I spoke with her back-up nurse who has lots of dementia experience and told her I thought mom was having "auditory hallucinations" and a couple of other things. She said she thought it was this sundowners condition. In reading through some of the symptoms, I'm glad she's only having the more benign ones for now.

[easygoingfemme]

Originally Posted by Kelt

Pretty sure mom has "Sundowners" I'm learning about it.

She had her second middle-of-the-night stroll last night after being the only one who heard a fire alarm, same as last time. At least this time she grabbed her purse and didn't get locked out.

She also cancelled her driver to the dentist today because her primary nurse called her this morning to say he would take her. He's in El Salvador this week.

I spoke with her back-up nurse who has lots of dementia experience and told her I thought mom was having "auditory hallucinations" and a couple of other things. She said she thought it was this sundowners condition. In reading through some of the symptoms, I'm glad she's only having the more benign ones for now.

My grandmother had sundowners syndrome and it was really rough as time went on. She "ran away" a lot at night and imagined a lot of horrible things were happening in her house and out in the world. Once she was in assisted living she had a security alarm on her wrist to alert staff if she tried to break out at night. I do know that, when it was first developing, we found she improved when she started getting injections of vitamin B12. The summer months also help as it really is impacted by darkness. Winters get rough with sundowners. I'm sorry this is being added to her care needs.

[Martina]

My mom has 24/7 HHA's and long-term insurance which covers about a fifth of the cost. The rest comes from savings. I have lung issues and arthritis. I cook and do the finances and arrange everything, take her to treatment, and so on. It really takes two to take care of her, and as I am an only child, the second person is someone we have to pay. If she goes into a facility, long term insurance will pay more, and with her income, I imagine she would be fine. It's not likely though. If she goes downhill (god forbid), it probably won't be long because she has a kind of cancer that when it grows, it grows fast. It's glioblastoma. What Beau Biden had.

She just got out of the hospital. Stroke, they think, but they are not sure. At least it wasn't tumor growth.

[MsTinkerbelly]

For the years we cared for my mother it was the worst stress I can ever remember going through, and I had help!

My spouse stepped up and changed her life to work from home...she was there doing all the bathing and wiping during the day while I went out to work, and I had the nights including all trips to dialysis. I had to take a lot of time off work to take her to doctor appointments, but fortunately in California my employer had to let me!

While we had a lot to handle, I really felt blessed to have had that time with mom. I will always be grateful that I had such a wonderful love to help get us through it.

My thoughts go out to all of you struggling to find ways to care for your loved ones.

[Martina]

I am so so sick of unsolicited advice especially from "friends" of my mom's who have not offered or given any help. (Silent scream)