Who should pay for one family member to act as caregiver to parents?

[Midpack]

Quote:

Originally Posted by pb4uski That's a good idea. If they have some friends/acquaintances in assisted living nearby, then they should arrange to visit and get their experience. Everyone I have ever talked to who lives in assisted living loves it. IMO there isn't much to dislike about cooking and cleaning up after it being taken care of for you so all you need to worry about is keeping your living quarters tidy. Personally, I would sign up for it in a NY minute.

I need to follow up on this. They've told us "all their friends died long ago" and we accepted that, but it may not be entirely true.

Unfortunately DW's Mom had to be forced into assisted living (after an event and hospitalization, her doctor would not release Mom to return to independent living at her home), and later to a nursing home. She hated every minute of it. And my parents know it (my fault).

But when I get the chance I am going to try to work in a discussion, tours, with 'just in case you ever need it' as the premise.

[2B]

Quote:

Originally Posted by Midpack But when I get the chance I am going to try to work in a discussion, tours, with 'just in case you ever need it' as the premise.

Be sure to show them all the pigs flying around the flag pole out front.

[chris2008]

Quote:

Originally Posted by braumeister What worked for us is that my mom knew several people in the same age group who had moved to retirement communities, some with assisted living options. I took her to visit a couple of them, and I could see her beginning to soften her attitude a bit. Others have posted similar stories here, so I know mine is hardly unique.

I have a similar one:
My mom has lost vision of one eye last December and the other one and her hearing is bad, too.
So we gave her one week at a nice assisted living place close to our home for free as a test and gift. The staff there did their best to make it a nice experience for her.
Anyhow, she tried to return home and make it on her own again till summer.
But then she gave up and decided to move into her small apartment.
She felt at home right from the beginning. Now, after 4 months, she is as happy as a clam.

The test week really was the key.

[Mulligan]

Quote:

Originally Posted by Midpack I need to follow up on this. They've told us "all their friends died long ago" and we accepted that, but it may not be entirely true. Unfortunately DW's Mom had to be forced into assisted living (after an event and hospitalization, her doctor would not release Mom to return to independent living at her home), and later to a nursing home. She hated every minute of it. And my parents know it (my fault). But when I get the chance I am going to try to work in a discussion, tours, with 'just in case you ever need it' as the premise.

I held off posting from an earlier comment waiting to see your response and you provided exactly what I was thinking in relation to "the friends are all gone". That opportunity may have passed 20 years ago. Certainly worth a shot, but I know you are not going to put too much stock in it bearing fruit. They clearly have a plan and a thought out one at that. I sure hope I remember all this as I can see myself as staying out of the home at all cost, also. Hopefully I will be smart enough to use a method that doesn't burden anyone.


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[anethum]

Midpack, I would urge your sister to exercise extreme caution before she upends her life by quitting her job and moving. Sooner or later, your parents will either no longer need help, or they will need help your sister will be unable to provide. More likely sooner rather than later.

My parents are 94 and 93 years old, have always been independent, and are still living in their house. They both expressed to me their desire to remain in their house as long as possible. One difference in my situation is that I live just 10 minutes away. Both of my parents were in great shape until my dad turned 90. Since then, he had a series of mini-strokes resulting in increasing physical and mental deterioration. He has vascular senility and virtually no energy.

I deal with most of the house issues now and there are constantly issues that come up. My dad was very handy and used to do all of this. My mom still does all of the cooking and cleaning. She's a superb cook and I think it gives her purpose. Unfortunately, my dad, who always loved her cooking, eats very little now.

My mom still drives but only in a very small radius to nearby grocery stores and drugstores. Anything further away, I drive her.

6 months ago my dad had a more serious stroke and now he's incontinent and largely immobile, though there's no paralysis. He also no longer has interest in anything and sleeps much of the time, but he's not in pain nor unhappy. Since that stroke, he needs 24/7 home care. My mom doesn't like having someone in the house all the time but she recognizes that the only practical alternative would be a nursing home for my dad. He's getting much better care at home, but it is not cheap. There's a registered nurse during the day for 12 hours, and a nursing assistant for 12 nighttime hours. There have been a few brief occasions (including yesterday) when I had to take care of my dad. I've changed his diaper, shaved him, and moved his mostly dead weight from hospital bed to chair and back. I could not do it on a daily basis. The main daytime nurse is superb and we are very fortunate to have him.

This home health care costs more than $16K/month. My parents have a generous COLA'd pension, though not as generous as your parents' pensions. I have POA and have handled their finances and taxes for several years. Until 6 months ago, money was added to their savings. Now it's flowing the other way. Fortunately, they can afford this expensive home care for several years, if necessary. My biggest concern is if something happens to my mom. In 2013, she was incapacitated twice for about 3 weeks each time, and I had to do much more until she recovered.

It would certainly have been easier for me if they had moved to an apartment or a senior facility. One friend of theirs did that and urged them to join her. They visited her place while my dad was still fairly healthy. Although they liked it, they didn't like it enough to consider moving there.

My task this week is to calculate how much beyond the RMD we can take out of my dad's IRA and still have them not owe any taxes due to their huge medical deductions this year.

I was very fortunate in the parent lottery. We're all trying to do the best we can in the circumstances that exist now.

[pb4uski]

Quote:

Originally Posted by anethum ....It would certainly have been easier for me if they had moved to an apartment or a senior facility. One friend of theirs did that and urged them to join her. They visited her place while my dad was still fairly healthy. Although they liked it, they didn't like it enough to consider moving there. ...

First, great post. Second, would your parents consider a senior facility (assisted living or whatever) now?

[2B]

Quote:

Originally Posted by anethum My task this week is to calculate how much beyond the RMD we can take out of my dad's IRA and still have them not owe any taxes due to their huge medical deductions this year.

If you are paying $16,000/month you have a medical tax deduction of 172,800 if you are pulling the whole $192,000 out of an IRA. You can deduct anything over 10% of income. What I don't know is how this may be impacted by the AMT.

You can try plugging some cases into whatever tax software you can get your hands on. The 2013 version is just as good as any since we have no clue what tax changes will be made or not made in the next few weeks. This may also be a time to get a professional opinion if it's not crystal clear to you.

I used my in-laws' nursing/assisted living expenses to effectively eliminate any income tax liability for several years. It also allowed me to completely drain their IRA. I didn't bother rolling their small IRA over into a Roth because the amount was under $10K. I didn't think it would be worth dealing with this small amount as an inherited Roth.

[anethum]

pb4uski, I broached the subject with my mom a few weeks ago. She wants to stay in the house.

2B, the home healthcare didn't begin until June of this year, so it looks like the medical deduction will be about half of that amount. In addition to their pension and Social Security, there are both capital gains distributions as well as LTCG from their mutual funds I've had to sell previously this year in order to pay the nursing bills. When my dad was of sound mind, he invested their savings fairly wisely, 45%/55% stocks/bonds in mutual funds. I only wish he hadn't put it in so many funds!

[2B]

Quote:

Originally Posted by anethum pb4uski, I broached the subject with my mom a few weeks ago. She wants to stay in the house. 2B, the home healthcare didn't begin until June of this year, so it looks like the medical deduction will be about half of that amount. In addition to their pension and Social Security, there are both capital gains distributions as well as LTCG from their mutual funds I've had to sell previously this year in order to pay the nursing bills. When my dad was of sound mind, he invested their savings fairly wisely, 45%/55% stocks/bonds in mutual funds. I only wish he hadn't put it in so many funds!

Does she understand the spending? You can afford it for several years so where does this leave your mother then?

My SIL was lobbying for home health care for my in-laws so they didn't have to go to an "old folks home." My MIL was in such poor shape that we would have had expenses similar to yours plus she would have had to be transported by ambulance for weekly doctor appointments. My in-laws. Other than their house they had enough assets for about a year. Even if we did a reverse mortgage on their house, my FIL would have outlived his money.

My FIL was very social and was in a lot of clubs/groups. He had multiple small accounts with firms all over the place. He had two small variable annuities. They were not LBYM types so my FIL/MIL appeared rich but they weren't. They both grew up in the Depression so that's not the guarantee of being frugal some people seem to think it is.

[anethum]

Quote:

Originally Posted by 2B Does she understand the spending? You can afford it for several years so where does this leave your mother then?

I think you're really asking whether I understand their spending. I do. My mom doesn't need to worry about their finances and I have explained to her why.

[Sue J]

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Originally Posted by 2B You can deduct anything over 10% of income. What I don't know is how this may be impacted by the AMT.

If either of them are 65 the exclusion is 7.5% of income.

[Walt34]

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Originally Posted by Midpack I need to follow up on this. They've told us "all their friends died long ago" and we accepted that, but it may not be entirely true.

It might be your best shot at convincing them. People their age, even if your parents don't know them, may have a great deal of credibility on the subject.

Also, if they soften a bit on the topic, many of the places will let them stay a night or two there for a minimal fee - $50-$70 - to see how they like it "for if the time comes". That may give them a chance to talk to other residents about what they like about living there.

Like the others I also think you sister's offer of uprooting herself and taking care of them will end badly, no matter the good intentions. But alas, she's not asking us.

[Midpack]

Well the hoopla is over (for now?) and Dad and sister "accept" that we're not planning to subsidize sister, and they've clearly shared their disappointment in me. Glad to learn that I am a bad son and brother, makes the holidays special. It ended, as I expected, when Mom learned what was going on and put the kibosh on the whole deal as she did in March. Dad still insists that sister will have to move near them, just not now...and sister is certain she can help them come what may.

Thanks again for the perspective you all offered, it was very helpful, even if it doesn't seem so just yet.

[Brat]

Perhaps at some point your sister would consider spending her vacation visiting your parents so that she could assess their needs and her ability to care for them. Two weeks would be ideal if she can arrange that.

Sister could also look for employment in your parent's community and if she can find something suitable move nearby. Again, that would provide her prospective on your parents' needs and her capacity to help them.

[easysurfer]

Family dynamics can be pretty crazy. What's obvious, fair and right for one member may not be at all for another.

[robnplunder]

Quote:

Originally Posted by Brat Perhaps at some point your sister would consider spending her vacation visiting your parents so that she could assess their needs and her ability to care for them. Two weeks would be ideal if she can arrange that. Sister could also look for employment in your parent's community and if she can find something suitable move nearby. Again, that would provide her prospective on your parents' needs and her capacity to help them.

Good idea. Taking care of adults can be a tough job. It wears on the best of us.

[daylatedollarshort]

Quote:

Originally Posted by Midpack Glad to learn that I am a bad son and brother, makes the holidays special.

You might be a bad son and brother but you are pretty witty. I got a good laugh out of that, mainly because we are going through a financially illogical parental guilt trip request here as well, though at least for now ours is on a smaller scale.

[ivinsfan]

Quote:

Originally Posted by Midpack It is an acceptable outcome indeed. However sister is relying in part on inheritance, and has told me same. So while she agrees I should not be asked to pay, a secondary motivation for her to move and help care for parents would be to reduce their out-of-pocket costs to preserve their $ estate (her inheritance).

Why is your sister now expressing disappointment that you do not want to pay her to care for your parents? Is she telling you one thing and your parents another? That is going to make the situation more difficult for everyone.

[daylatedollarshort]

Quote:

Originally Posted by Midpack Well the hoopla is over (for now?) and Dad and sister "accept" that we're not planning to subsidize sister, and they've clearly shared their disappointment in me. Glad to learn that I am a bad son and brother, makes the holidays special. It ended, as I expected, when Mom learned what was going on and put the kibosh on the whole deal as she did in March. Dad still insists that sister will have to move near them, just not now...and sister is certain she can help them come what may. Thanks again for the perspective you all offered, it was very helpful, even if it doesn't seem so just yet.

I think an elder law attorney could be made to be the bad guy. I just don't see how it would make any financial sense to spend down your assets at your age to care for them when your parents are financially well off and in their nineties. They are the ones who should be in spend down mode.

[2B]

Quote:

Originally Posted by Brat Perhaps at some point your sister would consider spending her vacation visiting your parents so that she could assess their needs and her ability to care for them. Two weeks would be ideal if she can arrange that. Sister could also look for employment in your parent's community and if she can find something suitable move nearby. Again, that would provide her prospective on your parents' needs and her capacity to help them.

My SIL was adamant that DW and I should do whatever it takes to let my FIL stay in his home. She flew in for a week (all she had available) and spent the week totally taking care of her father. At the end of the week, she announced that that was all it would take and we could now take over. Gee, who would have thought that immersing ourselves 24-7 for an indifinite period of time would be a problem? This was when he was in the early stage. The neurologist recommended we not try to do it if he had the assets. That didn't mean anything to loving, caring SIL. She was happy to have us do whatever it took so she could feel good about the situation.

I offered to put him on a plane so she could take care of the situation. That wouldn't work for her. She wouldn't have the time available.

I agree that Midpack shouldn't have to conform to his parents' or sister's view of what he/she should do. Personally, I think the whole thing is a ploy by the father to make it as difficult as possible to make anything happen. I also think that having the sister living somewhere other than the parents' house is a waste. If she gets a job in the area, she would be only marginally available.

The parents don't want help. They don't want to leave their home to make things safer/better for them. Sister "close by but not there" won't make anything better or safer. It will take a "train wreck" before anything happens.