Need advice on strategy for MIL

[DanP]

Hi folks, have been benefiting from this forum selfishly for my own ER (which I think I've kind of achieved, but consulting some hours a week so...)

BUT we are in our early 50's and the pressing topic of my MIL is hitting us, I'm very ignorant on this topic so need the group advise. Her situation:

* Lives about 3 hours away from us, 15 min away from her other daughter (both DW and other daughter are great and caring).

* MIL is a single woman, ~80 (because we cant ascertain her age, as odd as that sounds, onward). Hard working lady in her life, spends almost nothing.

* Basic SS maybe 20k/yr. No other income. Savings (in her checking account!) ~100k. House, no mortgage, worth maybe 200k.

* Her health - well that is the concern. Lucidity is a day-by-day situation, and not improving.

That is the picture. When we pick her up to visit she is happy and we talk about sell the house and enjoy your assets to be near grandkids by getting an assisted place nearby. She is excited and her assets would buy her some good years at nearby places.

But then in other not-so-lucid moments she feels that she would die if she left her home, despite how miserable and alone she is there. Her neighborhood friends have all died so its not that. Frankly the area is not getting any better either.

SO - sorry for the long post but had to set it up. The question now becomes:

a) Accept the fact that emotionally she can't move from her home, so make it the best there until she is forced into a medical home

b) She uses her assets to willingly move into a place that offers increasing assistance, lots of those around here

AND the real question is: we would love B, give her the best moments possible, use up her money doing that!

But if its A, should we maybe start encouraging some gradual cash/college gifts to the grandchildren, which she stresses about so much?

In my head the order should be: manage her money for her best remaining life, failing that fund grandchildren.

Ok, I realize this is by now a long rambling post and maybe in the wrong sub-forum. If so Mod please move to the appropriate area.

 

[bingybear]

With my DMIL when she was frustrating on dealing with her house we asked her if she ever considered moving to a place where she wouldn't have to deal with that. She jumped on it. DW and DMIL checked out place and she picked one. She's been there 1.5 years and still seem really happy with the choice.

Don't get me wrong... it can be difficult to leave their home.

I'm not sure I would encourage gifting if she may need the money going forward for her care. If you do go with gifting, remember the 5 year look back for medicaid and nursing homes.

 

[Ginny]

a) then b). I had to deal with this in my family and with many clients. No one should push (discuss, yes) the person to move if they do not want to do so. However, if they fall twice, do not pay their bills, leave the stove on, wander away or get lost driving, then it is seriously time to change something. Enlisting an atorrney or doctor's help if possible is a good idea. "No you cannot live in your house alone anymore." Gifting of her money should not be done due to medicare rules and the fact that she may need it. If she has more than $5.5 million, gifting might be a good idea to avoid the estate tax.

 

[KCGeezer]

Has MIL given power of attorney and medical poa to either of the sisters? Does MIL know she's slipping? My DS and I had a very similar situation with DM. Mom had already agreed to DS setting up most everything for the month to month spending via auto pay so we might have had a leg up on you because that.

She remembered/knew she had made the decision to put us in charge for 'when the time comes' when she was fully independent. We framed it as "well if you trusted us when you made that decision, and you trust us now, believe us, this is going to be best for you".

Was not an easy talk and took quite a bit to help her through meeting with realtors, deciding on an independent facility, garage sale and the move. Almost went sideways a couple of times. We talked up how the house could be a home for some other lucky person and focused on what she wanted to keep for her new digs.

That was 3 years ago. Took about a month for her to integrate into the culture and make friends. 3-4 months later and asking about/pining for her house became a fairly rare occurrence.

Unfortunately, she's continued to slip mentally and physically. When she worries about running out of money we just say 'you're covered until you're a hundred, after that we're going to have a bake sale'. When she wants to gift one of us kids (there's 6 of us) we help her write checks and then we all tear them up. Grandkids and greats take a little more finesse.

If it helps, there's a bunch of people that have or are in your situation. Hopefully you can help her see it as a new phase of life and live to tell about it.

 

[Katsmeow]

My mother is 93 and is insistent about staying in her home. In our case, we have invited her to live with us. She has no other children and we are almost 4 hours away. But, she is mentally competent and can make that choice. We make sure she knows she has the option but then leave it to her.

It sounds like at this point, she wants to do A. If she is mentally competent then I think that is that.

As far as gifting people if she chooses A -- I'm not sure why you want to encourage that. Shouldn't she be keeping her funds for her own good. It might be different if she had a lot more assets but with only 100k in cash she may need that over the years including for things like house repair.

And if there is every a possibility of Medicaid (not Medicare as was suggested by someone) then having given away assets could be a problem with the look back period. If that is too be considered you should consult with a competent elder care attorney.

 

[pb4uski]

I often wonder why these assisted living places don't have programs where prospective residents can stay a few days to get a good idea of what they would be getting into, what the environment is like, talk with other residents, etc.

That would seem to be a non-threatening way for people like your MIL to get over the physcological hurdle of a big life change.

 

[Texas Proud]

Moving is tramatic with someone of diminished capacity....

My mom now cannot even stand to stay at a hotel for one night... she will start to ask when we are going home...

We have hired someone to stop by 3 days a week and take her to water aerobics and stores... we are thinking about going 5 days at some point in time...

Yes, mom is very lonely, but she is unwilling to go to a place that would have company..... and I KNOW she would be better off... but some of my sisters know of parents who passed quickly after they were 'forced' to move...

 

[Mr._Graybeard]

Some areas are fortunate enough to have adult day care centers (an unfortunate name, I know) for seniors with memory impairment or some other special need. The provide a social outlet as well as some assistance with daily living during daytime hours. Clients return to their homes in the evening. Something like that could serve as a transition to life in an assisted setting.

 

[audreyh1]

I often wonder why these assisted living places don't have programs where prospective residents can stay a few days to get a good idea of what they would be getting into, what the environment is like, talk with other residents, etc.

That would seem to be a non-threatening way for people like your MIL to get over the physcological hurdle of a big life change.

Well, I think some of them do. And there is something called respite, where someone can stay temporarily to give a home care giver a break.

 

[audreyh1]

Moving is tramatic with someone of diminished capacity....

My mom now cannot even stand to stay at a hotel for one night... she will start to ask when we are going home...

We have hired someone to stop by 3 days a week and take her to water aerobics and stores... we are thinking about going 5 days at some point in time...

Yes, mom is very lonely, but she is unwilling to go to a place that would have company..... and I KNOW she would be better off... but some of my sisters know of parents who passed quickly after they were 'forced' to move...

Loneliness is a huge issue for seniors isolated at home. I think even folks who are used to being on their own need company when they become very elderly.

 

[chris2008]

For my mom (then 85) a test week in an assisted living place 10 min from us worked (almost) like magic.
Up to then she lived 2 hours from us and I am the only child.
We gave this test week to her for christmas "so that you know it and can better take a decision when time comes".
Once there she realised how much easier she could have it.
On the way back to her house she already discussed where to put which piece of furniture. BUT... once back home it took 5 months of back and forth to actually sign a contract and she moved after 3 more months. We did not clear her house and put it on the market for 3 more months so that she could ask us several times to bring certain items she was missing. This list became shorter and shorter.
However, we refused to take her back to the old home for visits once she had moved out "as it is no longer the place you know and will just make you sad". She could have gone easily by train if she really wanted but did not.
Now that the house has sold and is remodelled she has been in the neighborhood several times and is good with it.
She was and still is happy in her new environment, 3 years later.
Her only regret is that she did not move earlier.
What I learned:
If possible, do a test run like a week in a guest appartment.
Take your time, decision taking and moving is not happening on a weekend.
If possible go for appartments with a seperate bedroom. The jump from house to one-room-only often feels like depletion.
Good luck to DW, SIL and MIL!

 

[jazz4cash]

Oh my. Having a bit of a reaction from just seeing MIL in the title. When I was working we didn't have TSP reports but we did have an MIL (Monthly Information Letter). It's great to be ER'd!

Agree with PB4 and Audrey. I see lots of places have adult daycare and some offer the service as an extension of their assisted living residences. Some offer drop in service or guests may go for a day or two/week to get some social interaction. Some of the churches around here have senior services too. Just by coincidence I attended a memorial service at a senior residence facility that I have driven past 500 times and ever knew it wasn't an upscale gated subdivision. Heck I got in there,looked around and I could see myself in that setting at some point.

 

[braumeister]

Has MIL given power of attorney and medical poa to either of the sisters? Does MIL know she's slipping?

This is critical. Do it sooner rather than later.

I often wonder why these assisted living places don't have programs where prospective residents can stay a few days to get a good idea of what they would be getting into, what the environment is like, talk with other residents, etc.

Many do, and it's a great convincer.

For my mom (then 85) a test week in an assisted living place 10 min from us worked (almost) like magic.
...
Once there she realised how much easier she could have it.

This worked extremely well for my mom as well.

 

[Golden sunsets]

DanP; I've just been through this with DM. She is nearly 93 and just moved from her home which she had shared with my DF for 67 years to an independent living facility near me. The facility also has an assisted living section, which she may need. It also accepts Medicaid IF a resident runs out of money. Dad passed away in 2010 and she did pretty well until about 2 years ago. I live 40 minutes away and visited as often as I could but that still was usually not more than once a week. When we would discuss where she would like to live when staying home was no longer feasible, she agreed that a facility near me made sense but in her mind that was always a long way off. We started noticing memory issues about a year ago. I took over her finances and am her POA. I also became vary concerned about her driving about a year ago and convinced her to never drive out of town and not drive at night. I knew though that her driving days were numbered. I began to notice that her executive skills were slipping as well. And in the past year she has lost perhaps 5 close friends.

In April of this year DH and I felt we needed to transition her to a facility near us. We first enlisted the aid of her DR, who spearheaded the discussion with her. DH and I visited 6 communities. We chose the three that we felt made most sense and visited with her. We steered her toward one in particular which she was comfortable with. Cost was one of the considerations and the fact that they accept Medicaid if a resident runs out of money. The move itself went smoothly. I used a room planner software program to envision furniture placement in her new digs. We packed over the course of about three weeks. I placed colored masking tape on all objects. Some pieces were to go to her new apt. Other pieces went to our basement. Some pieces remained for staging. We moved her in one day and had the movers place the furniture per my room plan. Her apt looked terrific by the end of the day of her move.

We then turned our focus to her home. We hired a dump guy to empty out everything that we had not taken except the staging furniture. We hired a cleaning service to make it shine. We hired painters to spruce up rooms that needed attention. We had the carpets cleaned and placed the house on the market within 2 weeks of her move.

The move was very emotional for Mom. She really misses not having a car. She fretted about the cost of her new living quarters and mentioned walking home to her old home one night. (Not a good thing for me to hear). Then the house sold. She did attend the closing, which we felt would give her closure. Since the closing she seems more at peace. I see her three to four times a week and take her to all of her DR appointments although the facility will take her if I am away. She has settled into a routine with activities and her apt is a bright sunny place with all of the things she is familiar with. Dining is a major focus of her day where she can socialize in the Dining Room and I don't have to worry about her nutrition. She receives the newspaper from her old home town daily so that she still feels connected to the city she lived in for 92 years. She is generally a very optimistic person so that helps. But this has been very emotional. I'm an only child so I had 100% of the responsibility for decisions. My DH has been a great support. What is that song about the child becoming parent of one's parent. I feel like that has happened to me.

I don't think I could have made this happen any sooner. I think you are facing this conundrum now. But I feel that if we allowed her to stay in her home any longer it would not have been a safe environment for her. That is perhaps the key to your decision. For Mom, the time was right, though she didn't fully appreciate it. It did take about 5 months for this process to unfold.

Regarding finances you mention that her NW is about $300,000 once the house is sold and SS is $20,000. With those numbers I would think that she will be invading principal right away even if she starts with lower cost independent living. These facilities are expensive. DM can afford the price tag of her current situation without selling investments, but if and when she moves to assisted living the price tag goes up to about $90,000 per year. At that level she would have maybe 5 - 7 years of runway. She would be unlikely to live that long but I sleep well at night knowing that the facility does take Medicaid.

This is tough stuff but we do what we must to protect our loved ones. Sorry for the long post.


Sent from my iPad using Early Retirement Forum

 

[DanP]

Thanks for the replies, lots of good insights!

She gave daughters control of her account, but yes time for me to make this right and deal with the proper POAs. She knows she is slipping and trusts us so obtaining them should not be a problem, I just need to make it happen.

The idea of her staying at a nearby assisted living place during one of her visits has a lot of merit, and she will feel in control.

 

[Mdlerth]

Don't wait - take the test drive

I second the suggestion to get MIL to sample some AL options. And do it sooner than later. If MIL waits until there is no choice, her alternatives will be worse.

Without doubt it's a hard decision for some seniors to leave their house. My own parents, despite having agreed during lucid intervals that they could no longer manage by themselves, pitched a gigantic fit when it came to pulling the trigger on moving out. It didn't matter whether the move would b to a spacious, comfortable AL complex or into the home of one of their 5 kids (none of whom lives closer than 4 hours away).

They clung desperately to the house, in "when you pry my cold dead fingers from it" fashion. It was doubly frustrating, because they had never even liked that house, despite having lived there for almost a decade. But as long as they were in it, they could maintain the illusion of independence. Moving out of it meant acknowledging their diminished capacity, which they were unwilling to do.

Their stubbornness ultimately cost them. In the house on their own, they wouldn't take their meds or eat properly so they crumbled at an accelerated rate. Their physical and mental condition deteriorated so far that the state determined they were a hazard to themselves. DM and DF ended up in a municipal nursing home which is both more expensive and less luxurious than the AL options they might have exercised when they were still healthy enough to be admitted. Now they have no other options; they're too fragile to ever leave.

 

[OldShooter]

I'll reinforce the need to get her paperwork in order: Will, health care POA, general POA if you can get it. Get her in front of an elder law attorney absolutely ASAP and with him/her ascertain whether she is competent enough to sign. If not, figure out a strategy. If she dies intestate, your state will determine how the estate (the house ) is divided. Maybe that's acceptable. If she's incompetent, I don't think the house can be sold without a court order. The attorney will know.

Do this tomorrow, not next week or next month. Her competence is headed only one way.

 

[PatrickA5]

Running into the same issues with my dad. He's 96 and lives alone. He can still get around, but is going downhill. He is anti-social and has stated that he would never live in a nursing home or assisted living. Never. So, my brother and I are doing everything we can to figure out ways for him to stay at home.

Just yesterday, we were trying out a new home delivery service from his favorite grocery store via online shopping. I thought it was wonderful. He complained about everything about it - but mainly the cost. I told him that they have to pay someone to pick up the food and deliver it so it's going to cost more. He didn't care. Cost too much. Same thing with the house cleaner - he's fired about 4 already (last time because they were 15 minutes late). He complains that he can't do the laundry, but won't allow us to find someone to come in and help him out.

It's a major struggle and stress on all of us. Not sure what the answer is.

 

[Sunset]

....

As far as gifting people if she chooses A -- I'm not sure why you want to encourage that. Shouldn't she be keeping her funds for her own good. It might be different if she had a lot more assets but with only 100k in cash she may need that over the years including for things like house repair.

And if there is every a possibility of Medicaid (not Medicare as was suggested by someone) then having given away assets could be a problem with the look back period. If that is too be considered you should consult with a competent elder care attorney.

+1
The assets are small, and she will need the money to move into and live in a supported living housing, without the money OP will be very restricted/refused acceptance at many places.

It would be helpful to at least earn 1.25% interest on the money via an online bank savings account.

 

[Walt34]

I second the suggestion to get MIL to sample some AL options. And do it sooner than later. If MIL waits until there is no choice, her alternatives will be worse.

I second what he said!

We saw it happen ~5 years ago with FIL, and it did not end well. He was terrified of nursing homes because he had to put his father in one but that was in the 1960's when they gave you a room, a TV, and you waited to die. We showed him several, he agreed they seemed nice, but refused to move to independent living until a medical issue forced him to move to a nursing home. Fortunately for him (and us) it was a well-regarded place that had just opened a new building and that cleared out the normal five-year waiting list.

The thing is, he probably would have lived longer (was diabetic but didn't/couldn't care for it well) because the staff would have been on top of the care and diet. He was also very social and was lonely alone in the house, especially after he couldn't drive anymore. No one in the family has any doubt that he would have been much happier and healthier in the AL place.

Do see an elder law attorney about the POA, will, and what the plans are when the inevitable happens. One of the things I'm very grateful that my mother did was make funeral arrangements ahead of time. About the only thing we (me and two sisters) had to decide was what kind of flowers to buy.

With FIL, the POA was worth every nickle the attorney charged. Without it, DW wouldn't even have been able to do a change of address at the post office without a court order, let alone sell the house and car, dispose of furniture, etc.

Re gifting her money, be careful about that because of the Medicaid five-year lookback, and talk to the elder law attorney first before even thinking about it.