Dad is 88, in a wheelchair & needs 24/7 care. He recently had a stroke & suffers from dementia. He is a happy & sweet man. We have to dress him, change diapers, bathe him. We take him to all medical appts & coordinate all healthcare care including medication. He receives 3+ delicious home cooked meals a day. We do his laundry & change his bed linens. It takes both of us to get dad in & out of the car. We are also in charge of selling his assets. I have POA. We don't want to overcharge but want to be fairly compensated. Dad can afford the $3000 a month
Sure enough, once mother was home, I found the tabs in place and unmolested. I'd still like to shove the dam' thing up her nostril.
Do you think there might have been an element of too many cooks (with too few cooking skills) involved in all this?
You can probably take some swabs yourself and bag them up, if that's easier than hauling the whole thing in?
I see you are already working out what is and is not worth the battle, and I congratulate you - I wish I'd got there as fast.
Well, I'm glad you've got him out of there anyway. How's he doing in rehab?
Take deep breaths. Remember that at least *some* of the deterioration in your father's condition, inevitably, will be attributable to advancing age and naturally declining health. So although there are many questions to be answered and explanations given, don't fire both barrels before you've got more clarity.
Best wishes to you, and to your Dad for a good recovery - please let us know how you get on.
Kickbacks or personal recommendation? If I knew a care home to be a good one because they'd looked after my MIL nicely, I would certainly recommend it to others. Whereas what you're implying, if one follows your train of thought to the end, is that your brother, your father's aide and this lawyer were bribed by the AFH to accept substandard care for your father.
Is that what you really believe happened?
I understand and sympathise with the rage one feels when family members appear to be responsible for failures in care. My goodness, I do. But where are you all at now, and what do you want to happen next?
How much care can cost... At the roughest calculation, four years ago acceptable residential care for a not especially demanding elder ranged from £750 to £1200+ per week. x 52 = £39,000 - £62,400 = $48,300 - $88,100 at today's exchange rates. But that's not including medical care, of course.
Have you asked your brother to account for your father's spending over the full six year period?
Where is your Dad now?
Bless you for caring for your father...
Someday you will understand it is a blessing.
Take care.
To think that staff is actually going through responses to make sure that your needs as readers are met is, I think, quite remarkable! What a great act of service!
So let me see if I may be of help to you and others in similar circumstances. There are two primary issues to be considered here: 1. income and other tax liabilities possibly accruing to the parent and adult children and, 2. qualifying for public benefits.
Let’s take the last one first because if you are interested in making sure that all of Dad’s expenditures or transfers are in line with meeting the financial requirements to qualify for Medicaid or Veteran benefits (non-service connected pension) – either now or in the future – there are certain do’s and don’ts. For instance, you will want to carefully document all transactions and you will not want any uncompensated gifts coming from
Dad to the adult children within five years of application for Medicaid.
If, however, you are not interested in, or can never foresee Dad receiving public benefits of any sort including Medicaid, then the ideas below are of no value to you and Dad can just gift all of his assets to you with no tax consequences at all (except for potential Unified Estate and Gift Tax consequences if total lifetime gifts exceed $1 million in 2013 – presuming the “Bush tax cuts” expire).
In the case where public benefits would be helpful now, or may be needed in the future, you have several options that will work with varying efficacy from a practical and taxation standpoint. (By the way, all of the strategies below can be used either by themselves or in conjunction with one another).
1. Charging Room and Board – It is perfectly legitimate to expect any adult to contribute to household expenses and to pay for their own health, maintenance, and welfare. Expenses paid by Dad, whoever they are paid to for these purposes, will not have a negative impact with respect to public benefit eligibility from a “gifting” standpoint as all transfers from him, to you, will, hopefully, be for the fair market value of goods and services being provided. There are income taxation implications which you can read about here; IRS “Renting to Relatives” regulations.
2. Charging for Care Giving Services – Here too, there is nothing “wrong” with being compensated for the personal care giving and other services (advocacy, management of financial and other personal affairs, etc.) you are rendering. For public benefit eligibility purposes it is important that the details of the arrangement be established by contract. This “Personal Services Contract” will establish a term, the rate of pay, the services to be rendered, and other provisions that will, in fact, allow a lump sum amount to be transferred from Dad to you in full advance satisfaction of the contract – a legitimate and legal transfer from a Medicaid eligibility standpoint. Again, though, there is a tax issue in that because this is an employment contract, income taxes and other employment based taxes will apply causing appreciable diminution of funds with little in the form of “deductions” available to offset the liability.
3. Purchasing a Life Estate – When an parent moves into an adult child’s home and has assets that would disqualify them from public benefit eligibility, or if the adult child would like to avoid the income tax consequences resulting from numbers 1 and 2 above, it may make sense for the parent to purchase a “Life Estate” in the home of the child.
The purchase of a Life Estate is as its name implies - the purchaser is buying the right to live in the property for the rest of their life with all the rights thereto. At the purchaser’s demise, all rights revert back to the “remainderman” (the adult child who sold the Life Estate to the purchaser).
The maximum amount that will be considered fair compensation as a purchase price will be the fair market value of the home minus the “remainder interest” as determined by using tables provided in your State’s Medicaid manual. Here is an example using Florida’s tables: If the home has a fair market value of $300,000 and the purchaser age is 88, $92,577 can be transferred to the adult children to purchase a Life Estate. (If the parent were younger, say age 77, a transfer of up to $141,147 would be permitted).
The purchase of a Life Estate by the parent would effectively reduce his/her assets without creating a Medicaid eligibility penalty and without creating (in most cases) a taxable event. If the purchase of the Life Estate were not enough to bring the parent’s assets to a low enough level for eligibility, either or both 1 and 2 above could be used.
Caveat: The parent must live in the children's home for at least one year for the transfer to not be deemed a gift.
4. The Supplemental Needs Trust (SNT) – Another option available in many states is participation in an SNT. This is an irrevocable trust, in fact the only irrevocable trust other than an Irrevocable Funeral Trust, that the parent can transfer assets to and become immediately eligible for Medicaid provided all other requirements are met. Unlike other trusts, a new trust document is not drawn and a lawyer is not required as the parent is simply joining an existing trust previously established by a 501(c)3 organization specifically to benefit Medicaid beneficiaries. Assets transferred to the trust may be used for virtually anything required for the health, maintenance and welfare of the grantor (parent) including paying for room and board and/or the support services of an adult child. The caveat here is: a) the cost of trust administration and, b) any funds remaining in the trust at the demise of the parent must first be used to pay back the State Medicaid program for the cost of Medicaid services rendered. Any residual thereafter may be distributed to heirs.
A lot to consider, I know, but I hope this helps. Good luck and God Bless
As I said, you must have a lot of family support/income. If so, consider yourself to be very lucky.
It is all well-and-good to name the caregiver as beneficiary, but if the parent's health gets to the point where a care center is necessary, or significant in-home professional care is needed and Medicaid must be applied for, swish, there goes the life insurance. If there are assets to pay for care, they should be used to pay for care while the care is being given, in my opinion. A beneficiary status or an inheritance are pie-in-the-sky and cannot be counted on.
Often a caregiver must give up a job to perform the caregiving role. This means no benefits, no SS credit is building up, no pension dollars being put aside, as well as lack of income. The caregiver may have children to educate and certainly has an old age to plan for. A loving parent would not expect this kind of sacrifice IF the parent could afford to pay for his or her own care, in my opinion.
You should not "charge" your parent for care. You should certainly do all the chores that you mentioned out of the goodness and love that you have for him. He, in turn, will or should reward you kindly by naming you as the beneficiary of his life insurance policy. What comes around, goes around....or is it, what goes around comes around? This is not a "foreign" concept.
To call the practice of having parents who can afford to pay for their care, paying for the care, American, shows a very shallow understanding of the width and breadth of the American cultures. Typical of people who have no idea of the immensity of this country or the diversity of our cultures and regions.
You use the term "most" in regards to your own culture- not a very specific percentage is it? That could mean 51%, not very impressive. What stats do you have that suggest our country's percentages are less than your country's?
American bashing, such an old foreign game.
Most of the answers were helpful and kind to the member who posted the question. However, some of you came across as judgmental and just thoughtless. This is the one place many of us come to for comfort. Honesty is different from unkindness. Please be kind even when you disagree with someone. Rebecca