Mother in law out of money for co-pays

[Brett_Cameron]

I would pay it

 

[easysurfer]

My brother's ex's mother passed away from cancer of the esophagus several years ago. At that time, her and her husband had a good amount of savings built up with their lifetime of hard work. The insurance didn't cover all her expenses, so he had to dip into their savings to pay the rest. Then about a year later, he died of lung cancer. Once again, not all was covered so he had to drain a good portion out of his own savings. I'm sure when they were building up their savings, the plan wasn't to drain the savings away on hospital bills.

The cost is only a part of the equation. Another part is family dynamics (for example, does the mom have other children who also can help out? Or does it somehow only fall on the one daughter?).

 

[kombat]

BigE and H2ODude make sobering points. The reality is, nobody lives forever. We all have to leave, one way or another. It's pretty clear that OP's MIL is leaving via lung cancer. Whether it's this year or next year is academic. It's not like she's going to make a miraculous recovery and live another meaningful, fulfilling 20 years.

Is it worth RCHT sacrificing a year of his own family's future retirement, to buy his MIL 2-3 more months of being bedridden and coughing up phlegm?

Nun suggested that there should be no limit to what we should spend on our loved ones. The question here is, should OP spend $5k to buy a few more months? But nun's math doesn't permit any limits on either side of the equation. Nun seems to be suggesting that $5k for 6 months is equally as valid as spending $100,000 for 1 month. Would you drain your 401(k) of $500,000 to buy a week? Sell your house for another day? As I said, they're going to die eventually anyway - isn't it selfish of them to expect you to sacrifice so much of your own life, so they can eke out a few more sunrises of their own?

 

[sheehs1]

BigE brings up something I was hesitant to bring up. The whole thread seems to be about the cost. I'm wondering about the benefit? After my mother was diagnosed with lung cancer, had 1/3 of lung removed (very invasive) she still ended up with metastasis being diagnosed 2 weeks later. Passed ~5 months later. Saw same thing with FIL; multiple myeloma and tens or hundreds of thousands spent last month or two. I know there are no guarantees in treatments, but before I'd commit a substantial portion of family assets to it I'd want to know likely benefit. I suppose many will ask "how can you put a price on treating a loved one?" But not doing so is why health care is so beyond control now in my opinion. If healthcare is ever to be controlled it will have to rationed to some degree.

Same with my Dad. In hindsite, I am sure he would not have decided to have the surgery to remove part of his lung. His quality of life was never the same and he didn't last more than a year afterwards.
That said, it is difficult to know what decisions we would make given the same situation. It would certainly be less of a conumdrum if it was MIL's decision. Has anyone in the family or the family as a whole sat down with her to go over the alternatives, the expectations for her quality of life, the prognosis and lastly, the cost?

 

[kombat]

I'm sure when they were building up their savings, the plan wasn't to drain the savings away on hospital bills.

But hasn't study after study shown that unexpected medical expenses are exactly what ends up consuming vast portions of peoples' retirement savings?

Shouldn't people have known this and planned for a big chunk of their nestegg to go towards fighting illnesses in their old age, rather than holding up their hands and crying, "How could I have known?"

 

[easysurfer]

It is a tough choice to make. Many on this board have been in the position of being asked to help out those who are not quite as forward thinking as we would like, myself included.

Yes there are limited resources but you have to live with the results of the decision.

Think about how your choice will affect the rest of your life, and your relationship with your wife. It has to be a choice you both can live with.

Yes. I agree it's a very tough choice that both spouses have to live with the results. Hopefully, it's one that both really have agreed upon.

 

[easysurfer]

But hasn't study after study shown that unexpected medical expenses are exactly what ends up consuming vast portions of peoples' retirement savings?

Shouldn't people have known this and planned for a big chunk of their nestegg to go towards fighting illnesses in their old age, rather than holding up their hands and crying, "How could I have known?"

I think a lot of people think, "That's what good health insurance is for. To cover major medical illnesses" instead of my life savings is pegged to cover medical expenses in my golden years. Then when they realize, they aren't fully covered 100% it isn't a matter of crying but of shock.

 

[Purron]

I would pay it

+1

 

[Midpack]

I would pay it

+1

+2. I wasn't direct in my earlier post, but I'd pay it too. This isn't about the MIL's behavior, what matters is DW - period. I'd pay, AND have a long discussion with DW about any future support so there's no misunderstanding between MIL, DW and self again. Might avoid issues if there's a "next time" as seems to be implied...

Like others here, I am paying for ongoing in home services for my MIL, though not as expensive (yet). I do it without any discussion for DW's peace of mind...easy call.

 

[Jay_Gatsby]

I think a lot of people think, "That's what good health insurance is for. To cover major medical illnesses" instead of my life savings is pegged to cover medical expenses in my golden years. Then when they realize, they aren't fully covered 100% it isn't a matter of crying but of shock.

Healthy living is as important as having healthy savings to pay for medical care in one's old age. Hopefully, the former will mitigate or delay the need for the latter.

My paternal grandfather lived until he was 100 and 1/2 years old. His "secret", if you want to call it that, was remaining active, eating small meals, and adopting a mental outlook on life that minimized his stress. My maternal grandmother lived until she was almost 97 and did the exact same thing. Their respective spouses, unfortunately, did not do so and both passed away several years earlier (though still in their late-80s).

In regards to the OP's question, I would minimize everything discretionary in his MIL's life that costs money, perhaps going as far as assuming responsibility for her financial affairs. No more cigarettes, cable TV, cell phone, etc... Only then would I pay the co-pays for medical care (directly to the doctor's offices).

 

[H2ODude]

Just another add onto my earlier comment, and it may have no similarity to OP's MIL's diagnosis. I just remembered how after they discovered the metastasis with my mother (they didn't look before the surgery IIRC) my father was incensed that she was put through such surgery for no purpose. I spent a good bit of time talking him out of finding a lawyer to sue.

What's my point? I'm fairly cynical when it comes to these massive amounts of healthcare thrown at folks for whom there really is no cure. In the end both my parents left here from our home with hospice. I'm sure more healthcare could have been thrown at her cancer and his emphysema at great expense (like with FIL; bought him maybe a month before hospice and the exit).

Contrast that with our son who was diagnosed with retinablastoma (cancer of retina) at 14 months. I was ready to sell house, go anywhere, to cure it. As they were preparing to remove eye, discovered, nope, it's not cancer (Coates Disease). So as a family member I'm ready to pay any price to cure someone with hopefully a good long term outcome. Drag out pain and suffering just to defeat death for a few more months? No. And I hope that the same philosophy is applied to me. If our assets can cure me of something, great. Evaporate to keep me in some twilight misery for a few months, no. Save the money for the heirs.

 

[Midpack]

Just another add onto my earlier comment, and it may have no similarity to OP's MIL's diagnosis. I just remembered how after they discovered the metastasis with my mother (they didn't look before the surgery IIRC) my father was incensed that she was put through such surgery for no purpose. I spent a good bit of time talking him out of finding a lawyer to sue.

What's my point? I'm fairly cynical when it comes to these massive amounts of healthcare thrown at folks for whom there really is no cure. In the end both my parents left here from our home with hospice. I'm sure more healthcare could have been thrown at her cancer and his emphysema at great expense (like with FIL; bought him maybe a month before hospice and the exit).

A little off topic, but I don't disagree about excessive healthcare at the end. I hope I follow through and forcefully decline when it's my turn, on my own behalf. Too often the decision seems to be left to doctors and family members, when IMO the patient should speak up and stop it (yes, I realize sometimes they are not able, but certainly they often are able).

My father has 'no heroic measures' in his will, and he's been very clear with all of us that he wants those instructions followed, no exception.

 

[Jay_Gatsby]

A little off topic, but I don't disagree about excessive healthcare at the end. I hope I follow through and forcefully decline when it's my turn, on my own behalf. Too often the decision seems to be left to doctors and family members, when IMO the patient should speak up and stop it (yes, I realize sometimes they are not able, but certainly they often are able).

My father has 'no heroic measures' in his will, and he's been very clear with all of us that he wants those instructions followed, no exception.

Unfortunately, most people don't think about such things until after they're diagnosed. Even then, they're resistant to the idea of limiting medical care because that would be tantamount to admitting defeat.

My father, who died of cancer, had a DNR (do not resuscitate) order in his medical file. He did, however, fight until his very last few days for any kind of reasonable treatment (he was a 40+ year doctor) that would buy him more time with his family (not for himself, but for us to delay the grief of losing him).

 

[Animorph]

I'd be happy to pay $5k, I expect my MIL could very well need it too, but that's not a whole lot for me. It sounds like it is a significant amount for the OP. Scale it up to $250k and I'm right there with the OP, debating the value of that cost, particularly towards the end of life and for someone I'm not particularly motivated to help, and the impact that it would have on my family.

 

[travelover]

A little off topic, but I don't disagree about excessive healthcare at the end. I hope I follow through and forcefully decline when it's my turn, on my own behalf. Too often the decision seems to be left to doctors and family members, when IMO the patient should speak up and stop it (yes, I realize sometimes they are not able, but certainly they often are able).................

Been there. FIL had made it clear that he did not want heroic measures, yet when it came to crunch time, his daughter from his first marriage insisted that he couldn't have really meant it when he wrote it. Turned into a rather nasty tug of war between MIL, the daughter and the hospital.

I'd be happy to pay $5k, I expect my MIL could very well need it too, but that's not a whole lot for me. It sounds like it is a significant amount for the OP. Scale it up to $250k and I'm right there with the OP, debating the value of that cost, particularly towards the end of life and for someone I'm not particularly motivated to help, and the impact that it would have on my family.

I guess all I can say is that if you upset your DW, it could cost you half of everything. Been there and done that , too.

 

[Katsmeow]

I would not draw a line at any amount of money. You are in a terrible situation and I wish you had access to a better solution through your healthcare provider/insurer. If your MIL cannot afford to pay for her own care will Medicaid help? I'd look into that option, but be prepared to help your MIL out if necessary.

Really? What if it would cost a million dollars to treat the MIL and it was all the money you had? What if it had only a 1% chance of curing her? What if had a 0% chance of curing her but would lengthen her life by a week?

I think that if the amount in question is a few thousand dollars I would pay it, but there is a point where if helping someone else was going to materially affect my own future I just might not be able to take that on. And I don't see that it would be my fault that I wouldn't bankrupt myself (and this has nothing to do with whether MIL has been frugal or not frugal).

 

[MichaelB]

We each have the privilege of selecting our own course of treatment but not the right to choose for another, unless specifically designated to do so. When facing that moment the confusion and stress is immense.

Health care professionals make every effort to assist but are still limited by their inability to chart the progress and outcome of every person’s illness. I would much rather pay for treatment that is unsuccessful than deny the opportunity for a positive result.

 

[easysurfer]

I think either way, it's a tough call, to keep on fighting at all costs or to set a limit as to how much one is able to give. It's more that just a matter of monetary cost but a very personal value judgement.

I remember the final day of my brother's life. Luckily, he was still alert and aware enough to communicate. His son (only child), pretty much said to him, "it looks like we aren't able to save you, do you wish for us to keep fighting, if you do than we will." At that time, my brother said, "The pain is too great, let me go." With that said, the decision to keep fighting or not is so much clearer. IMO, otherwise, the monetary costs is only a part of the equation. The other is the emotional impact on and dynamics of the entire family.

 

[FIREd]

I would much rather pay for treatment that is unsuccessful than deny the opportunity for a positive result.

I agree. I would pay it, personally.

 

[bubba]

When my dad was diagnosed with lung cancer, it was determined inoperable due to other lung/breathing issues; he couldn't survive on one lung. He started with treatment (I thought the deductible for one chemo session was $5K, but surely I'm wrong), but decided to discontinue treatment after a short while. Essentially, the radiation destroyed his quality of life for the 14 months he lived after diagnosis and he regretted starting treatment in the first place. (How would you know without trying, though?) I would have spent everything we had (and husband would have agreed) if it would cure him, but we all knew from the beginning that the hope was slim-to-none.

For us, we've signed health directives and our only child has been told exactly what we want. I sincerely hope that when I'm facing it, I will be strong enough to know when to stop and accept reality.

To the OP, do what you and your spouse can live with. My suggestion would be don't disregard the amount of resentment your spouse might hold against you if you don't approach this with the proper degree of thoughtfulness and respect toward MIL.

 

[ChadR]

This discussion is drifting into the topic that had great discussion in this thread:
http://www.early-retirement.org/forums/f38/why-doctors-die-differently-60257.html

The articles in the first and second post are great discussions on the extremely tough topic of quality of life vs quantity of life when dealing with terminal or very likely terminal illnesses.

On topic of this post I would have an extremely hard time providing any financial aid to a family member who still has some means of covering a part or the whole cost. It isn't clear to me in the first post what additional steps the MIL has taken to liquidate assets or source government financial aid, etc.

My FIL is currently funding his brother's medical costs in his fight against cancer. In the mean time his family has maintained their normal standard of living and haven't sacrificed much financially. The brother's family was even intending to go on a two month vacation overseas while leaving their father behind. I find it despicable that they would think to even leave their terminally ill father at a time like this and that they would abuse the financial aid they are receiving from the family to take an extremely lavish and expensive vacation. I also, think my FIL is partly to blame for enabling this kind of reprehensible behavior.

 

[haha]

I guess all I can say is that if you upset your DW, it could cost you half of everything. Been there and done that, too.

And 1/2 is likely a better than average result.

Ha

 

[NW-Bound]

We each have the privilege of selecting our own course of treatment but not the right to choose for another...

YES!

On the other hand, what right do I have to demand that other people make sacrifices for me, so that I can pursue every treatment, no matter what costs, no matter how slim the chances are? How do I value the extension of my fleeting moment in this world over other people's needs?

Could the cost of my nebulous treatment be better used to save the lives of several youngsters, who could then have a long healthy life, and who can then work to support society, to pay SS and Medicare taxes so that my younger surviving family members can also get some benefits?

I have been thinking that it would be nice if I were sufficiently rich to take care of all my future medical bills, so that, in the case I want to live as long as it is possible, no matter what quality of life, I would not face the burden of guilt that my extra week in this world would cost so much.

These are not easy questions to answer.

I sincerely hope that when I'm facing it, I will be strong enough to know when to stop and accept reality...

Yes, yes, and yes!!!

 

[rodi]

We each have the privilege of selecting our own course of treatment but not the right to choose for another, unless specifically designated to do so. When facing that moment the confusion and stress is immense.

Agreed.

This was brought home for me when I had both my father and brother dying simultaneously, in different states. When my dad was first dx'd with multiple myeloma he made sure his medical directive was up to date and that my sister and I and his "domestic partner" (my step mom) were fully aware of his wishes. No extreme methods. Unfortunately, his health took a left turn and sniffles turned into septic pneumonia in less than 24 hours. He was intubated and in a coma 2 days after we'd had a nice family party. But when the organs started failing we knew what his wishes were. We declined the surgery to install shunts for dialysis, etc... He passed quickly and on his own terms.

My brother's wishes were the exact opposite. He wanted EVERY method, no matter how extreme, to be used even though "cure" was off the table. He did not do well with chemo... and the cancer kept growing. He was referred to a specialist in Denver who was willing to do surgery on his inoperable tumor. That started the 7 surgeries in the last 3 weeks of his life. I'm sure the costs were through the roof. (But covered since we'd kept up his COBRA payments.) His quality of life was awful. Those last weeks were in and out of surgery and the ICU... Intubated, on heavy pain meds but still in pain, having his hands tied down so he wouldn't extubate himself. But he was insistent, and had made clear in his medical directive, that ALL measures should be taken. It was hard for my sister and I to watch, and reiterate, his choices... but they were his choices.

It comes down to the individuals choice. Not those around them.

 

[Finance Dave]

I'm with 73ss. This isn't about your mother in laws poor choices. Nor is it about your wife being a stay at home mother. You are both in this as a team, and need to approach it that way. Start talking now to find the balance between helping your wife do what she feels she needs to do as a caring daughter and what you need to feel financially secure.

I suggest you find an amount you are both comfortable with, and let your wife give it to her mother as she sees fit.

Good luck.

I agree with this one. And use it as a learning....talk to other inlaws BEFORE something like this happens, and set the rules and limits in advance.