My parents own a home in one state, but they are currently staying with my sibling in another state about 3 hours from their house. Dad is still working, and since he can no longer drive, my sibling has been taking him to work, which is about a 1-hour commute each way in good traffic. My sibling is a teacher and will be going back to work soon, so this setup is not sustainable.
Mom has mild cognitive impairment, and her doctor has said she should not be home alone during the day right now while we figure out what’s going on. Dad is still working but has short-term memory concerns. They can still do basic daily care — bathing, dressing, toileting, eating, and getting around the house — so we’re not sure what level of help we actually need.
We are planning to contact county/senior resources and start POA paperwork. We may also need to help them sell their house and relocate closer to family, but the logistics feel overwhelming.
For those who have been through this: who should we call first — Area Agency on Aging, elder law attorney, doctor/social worker, Medicaid waiver office, geriatric care manager, or someone else?
Are there any realistic low-cost/no-cost options for daytime supervision, transportation, reminders, respite, or adult day programs when someone only has Medicare?
Thanks
Mom probably cannot assign POA now with her Dementia. Dad may be able for his. He may not be able to work any longer. When it comes to care, they will need to pay for that. Medicaid does have a program but you can't have any assets but the home you live in.
You can start with Office of Aging to see what resourses are available in the County they will reside in. Social Services can help you with Medicaid. If you sell their home, it has to be at Market Value, cars too. No big gifts can be made. Medicaid has a 5 yr lookback.
An Elder Law attorney can also advice on how to use their assets properly in case of the future need for Medicaid, and on how the rules work for one spouse to stay at home while the other goes into care, if that proves to be the case.
Medicaid in particular is state based, so you'll need to take into account where they'll be living if they need to decide. Also POAs are based on state laws. That doesn't mean that one written in one state won't be accepted in another, but it might cause complications.
Whoever has POA needs to use the financial decisions based on the parent's best interests. If the parents are going to continue living with a child, there should be a written contract with that child about the parents' financial contributions to the household. This needs to be fair to the child, and in writing to prevent "gifting" conflicts during the Medicaid look-back period. This is something the Elder Law attorney can prepare. So again, might be contingent on which state the parents are living in.
Check for the services listed in your last paragraph with the local aging care office. The one where I live is extremely unhelpful, so you may need to rely on google and word-of-mouth for the complete availability. Meals on Wheels is a national program but locality-based, so that is something you can also look into.
Yes, it surely does feel overwhelming. I hope you and your siblings can work cooperatively together. In particular please remember that no one should be pressured to move in with the parents, or to move the parents in with them. If someone does FREELY volunteer to do that, all arrangements need to be fair to them, and there should not be an expectation that such a decision is permanent.
Also, don't count on your dad's employment continuing. If he has declined to not being able to drive, his performance at work may be declining too, and he may be told to retire. I wonder if there's any way to ascertain how his employment is going without being intrusive. Does he get performance reviews or anything? Things may be fine, but just be aware that they may not be.
Let us know how things go.
You have gotten good advice so far. It sounds to me like mom at least could benefit from assisted living but it is likely not affordable, at least not without selling the house.
Elder care lawyer can explain a lot of this, including whether mom can grant POA. Geriatric care manager can advise on available options and costs for same— adult daycare, aide services, continuum of care places, spend down for Medicaid etc.
You are asking all the right questions.
Just bear in mind they are both almost surely going to go downhill. Memory issues, cognitive issues, physical issues all generally get worse over time. So plan for 2-5 years from now at least as much as for tomorrow insofar as you can. No one knows how quickly they will progress or what is next.
Are either of you in touch with Dad’s boss or coworkers? My dad was working up to a year before he was diagnosed with dementia and really having problems on the job. Forced retirement after an illustrious career. Good luck!
Thanks for the advice about a geriatric case manager. I will look into that.
What kind of job does your Dad have that it's worth driving him 2 hrs per day?
How old is he?
More information would be helpful.
What other kind of info do you need?
Thanks everyone!
As for mom, there are a veritable multitude of different dementias. I'm with my husband at his memory care facility to help him almost every day. You cannot imagine the variety of dementias the residents have! Ask mom's doctor if she should be taking Aricept or Memantine. If her dementia is Alzheimers, these drugs could slow down its progression.
Good luck as you walk this difficult path with your parents.