Advising Aging Parents Facing Financial and Health Crises

schenbew

Recycles dryer sheets
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My parents have had a tough year, with both of them battling cancer. As their health has deteriorated, my brothers and sister recently became aware that their financial health is in even worse condition than their physical health. Unbeknownst to the children, they privately made a series of catastrophic financial decisions when confronted with a declining market (2008-2009) and large, uncovered medical bills in the past few years.

I'm hoping the members of this forum can assist me in finding and refining options so we, the children, can advise them on their financial issues, and allow them to focus their energy on their health issues. I don't have all of their financial details, but I am hopeful the major portions sketched out below are enough to generate some useful feedback to help us develop options and questions to ask.

Background:

1. Both parents are in their late 70s. DF just learned his Stage I lung cancer has progressed to Stage IV, and was given a 6-12 month life expectancy. He is living at home with DM, who has been battling heart disease, breast cancer, and several other chronic metabolic diseases, for a few years. DS lives, along with DS’s daughter, with them and help out a great deal.

2. They are both collecting SS and are on Medicare. DF believes they collectively receive less than $2,000/month, and is checking on this for me (he confirms they took SS at 62, so this amount seems about right).

3. They have $12K in jointly held credit card debt and no financial assets above 3 figures. This is mostly medical debt DF paid a couple of years ago, which I have advised him to NOT do anymore.

4. DF took out a joint reverse mortgage on their home several years ago of the lump sum type. DF believes the payoff amount is "about $140-150K" today with the accumulated interest.

5. DF has a Medicare supplement plan provided through his previous employer that costs him approx. $200/month and basically picks up the all the costs Medicare doesn’t for covered procedures; that’s the good news. The bad news is that the policy ends when he passes – no way to transfer it to DM, who has approx. $20K of medical debt due to previous procedures Medicare didn’t cover.

I’ve done some research for my parents, and I believe the following appear to be their main options:

1. Declare bankruptcy.

2. Investigate Medicaid eligibility. I'm certain their net worth is well into negative 6 figure territory, and with their only income from SS and below the generic Medicare threshold, I think they would qualify. I understand each state has their own Medicaid requirements, and thankfully they live in a state that has expanded Medicaid. This will be particularly important for DM once DF passes, since her income will drop and Medicare supplement policy will go away.

3. Reverse mortgage. DF and DM would like to sell the house to DS, and continue live with DS post sale. This would allow them to escape having to pay taxes, upkeep, utilities, etc. When I looked into the impact of DS “buying” the house from DF and DM, sites like elderlaw.com noted this could (maybe...) endanger their Medicaid eligibility and that an attorney specializing in elder law should be consulted before taking any action.

My plan:

1. Schedule an appointment with their local county Senior Corps to discuss their situation and options, with a focus on Medicaid eligibility.

2. Schedule a session with an elder law attorney to investigate legal options, focusing on how to sell their house with the reverse mortgage.

3. Strongly encourage them to put together a monthly budget (before and after DF’s passing) and a net worth statement.

4. Investigate/apply for Medicaid and or other state programs that could assist with their current and future medical bills.

Am I missing something? Any other options? Questions I should ask DF and DM to help further develop their options?

I appreciate any insights or lessons learned from others who’ve faced similar situations. The reverse mortgage in particular is like a black box to me since I have no experience with them, and welcome insights on how to approach this issue.
 
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Seeing a social worker and elder attorney seems like a great first step. I'm not an expert on the subject but I've dug into this a little because I have a relative or two who may end up in the same financial situation. This probably depends on the area, but some of the programs available for seniors and low income households in our area are amazing. The senior centers have almost free door to door bus service and free meals, activities and some services. One has a senior match service for roommates for low cost housing. One community even has free Uber for seniors. Some have low cost produce. The library has many free online course, ebooks, audio books, and free event passes. There are government and utility programs for reduced rates for Internet service, phones and energy bills. For groceries there's food stamp and food banks (plus the free lunches at the seniors center and discount produce). There are programs for subsidized housing.


I'm not sure what your local area / state would have in terms of programs, but with their SS income, Medicaid, food stamps or food bank assistance, and possibly other programs like subsidized housing, reduced energy bills, senior transportation, maybe free lunches your parents might be able to live not a glamorous life but might be able to have all their basic needs met.
 
I'm not an expert, but any assets given away would create the lookback period, and would eliminate Medicaid eligibility. If the DS buys the house, it would have to be done at market value, but I'm not familiar with the exact rules. I think this is a really bad idea, for a number of reasons, mostly related to DS's financial and personal investment and liability (he would take on some of his parents' costs).

Without knowing the house's equity (after Reverse Mortgage and any primary mortgage), it's hard to evaluate the situation.
 
Very sorry to hear about your parents' troubles, health and financial. You have a good plan outlined to start with some experts before you make any decisions. I think getting a firm handle on their assets (or lack thereof) and expenses is also critical to making a plan. Good luck and keep us posted.
 
How do you get that their net worth is negative six-figures? From the OP they have $12k of credit card debt, some medical debt ($20k?) but on the other hand they presumably have some positive home equity.

How much is the house worth?

Before you see professionals I think you need to nail down the facts better. How much they receive in SS and how much is his and how much is hers since if he passes first then she will get his higher benefit. How much they have in debt and who they owe and the nature of that debt. What they house is worth? (tax appraisal value and Zillow, etc as a general indication). What they owe under the reverse mortgage and what the payoff would be. How much the property taxes, utilities, etc are for the house?
 
I have been through a similar situation.
Have you considered their DS covering taxes and utilities for rent while staying there and your parents could will the house to him on their death?
I agree that selling the house to him at this point will cause potential big problems.
Check with the local Agency for Aging on any possible senior help with taxes and utilities that may be available if they are not already receiving it.
If they have no assets then bankruptcy may not be necessary. Your state laws will determine, but house, car and income from SS may be free from collections. Check with your state laws, but a call to the credit card company informing them of them not being able to pay may result in write off. It will ruin their credit score, but that shouldn't matter at this point.
Medical debt can be negotiated, and a small monthly payment is usually enough to get them satisfied.
Consider your local consumer finance counseling for information on your local laws and perhaps some options available.
This is a lot to tackle, but take it one step at a time.
 
Sorry this is happening to your family.

Are both your parents mentally capable and willing to make hard decisions about their finances? If the answer is no, just stop and do nothing, because you don't really have the power to do anything.

The cost in money and in family relationships when you try to force issues like this is enormous. You mention brothers and a sister, which means there are at least four of you plus whatever spouses are around. The odds that you will agree about what to do and how to do it are stacked against you. Say they draft you to "take care" of this you'll be the one that takes all the fallout and there will be fallout.

I take the DS living in house to be your sister and niece. Which hugely complicates things as far as selling the house and settling up. Your sister and her DD should be grown woman who can advocate for themselves, are they living there for free, are they paying any bills at all, because your parents can't afford this setup. If I'm wrong and the DS is your son and GD even more reason for you to stay out of it.

So what should happen? Well sorry to say nature will probably take its course with your DF and that is sad , yet if Mom is left alone all decisions can then be made on what is best for Mom and Mom alone which simplifies things in the end.

If your parents are willing to actively tackle this, make an appointment and take them to the senior counselor. If they are willing to talk to a lawyer help them find one and make an appointment but you really can't do these things for them.

Make sure they have food and utilities in their home although this should be part of the duty of the relative living with them and just be ready to help when asked. It's going to be rough with all these things going on at once but just take one day at a time and do your best.

If you feel you just have to do the things on your list, make the eldercare attorney last because the more info you have when you talk to the lawyer the less it will cost you. and of course your parents have no money for an attorney.
 
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I absolutely agree you should consult with an elder law attorney before any financial steps of any kind are taken. A few comments though:

1. Who is going to pay off the current reverse mortgage? That company will want to be paid off.

2. Leaving aside the Medicaid issues (which absolutely require getting good legal advice), is buying this house in DS's best interest particularly if DS has to get less equity because of the need to pay off the current reverse mortgage?

3. Look at DM's budget and what it will be like after DF passes. Many times a spouse can't really afford to continue living in a home after the other spouse passes. Even if it can work for a time it often can't work long term. Also will she be able to maintain the house? Yes, DS and her daughter are perhaps available but often when a spouse passes there is a need to hire out some of the work that the deceased spouse was doing. That can add greatly to living expenses.

DM will need to carefully consider if remaining in that house is the best long term decision. Again, getting feedback from others such as an elder law attorney may help in making the decisions.
 
I would meet with an elder care attorney first. Explain the situation and your plan and take the steps that the attorney advises you to take. The attorney’s plan may be different than yours.

Make sure that you find a highly rated attorney who specializes in elder care issues.

We just went through the same thing with MIL. DW researched and found an excellent elder care attorney. She created a plan and some documents. We executed the documents and plan. All went well and we anticipate smooth sailing.
 
I would meet with an elder care attorney first. Explain the situation and your plan and take the steps that the attorney advises you to take. The attorney’s plan may be different than yours.

+1 on seeing the attorney first.

You may have options that you didn't know you had. That was the case for us and that alone made seeing the attorney worthwhile.
 
An eldercare attorney is doing LOADS of good for my parents as I type this. They are not cheap, but the benefits are significant. So +1 on that suggestion.
 
There is not enough information to determine whether to declare bankruptcy. What is the value of the house?

I'm sorry for the unfortunate situation.
 
Making Some Progress....

Thanks for all your replies; very helpful. To address some of the comments made and issues raised:

1. I reached out to the govt Senior Services office where my parents live. They were very helpful and made me aware of many great options the state and county offer, very similar to those daylatedollarshort described. If DF & DM qualify, it will be of tremendous assistance to them. I spoke to DF about this option, told him about the options available, but that they all remained just good ideas and possibilities until he calls the office, does a phone screening (no in person visits during Coronavirus times!), requests the forms and COMPLETES and returns them with the required documentation. DF and DM are not suffering any loss of mental faculties that my brothers, sister or I can detect, so we cant do it for them.

We understand and are sensitive to the fact that they are dealing with the unexpected gut punch of having their financial security and independence yanked away from them and now need to rely on others for help. Trying to be sensitive to this, but solving their problems requires action on their part, as ivinsfan pointed out. We will continue to prod DF and DM to take action, but I sense a certain amount of resignation when talking to them about financial issues.

2. I am in the process of looking for an elder law attorney in their area. I live out of state, but plan to travel there in a couple of weeks, where I will coordinate the attorney office visit with DF and DM. Fingers are crossed the attorney will be able to offer options we aren't aware of at this point.

3. Reverse mortgage and debt. As pb4uski noted, my debt math was off a bit since I was fearful there were some other outstanding personal loans or that they were underwater on their house & reverse mortgage. I've been reassured there is no other debt than what I initially described, and after doing some quick Zillow work the rough market value of the house (approx $165K), minus the reverse mortgage (DF isnt exactly sure what the payoff amount is - another issue to be resolved when I travel home soon...) and typical real estate sale transaction costs are about equal. This bodes well for Medicaid eligibility, since any monetary windfall from selling the house could endanger this benefit.

4. Budgeting. DF and DM are only aware in approximate and vague numbers what their monthly income and costs are; very different than my ability to quote my budget to 2 decimal point accuracy from memory. When I travel up in a couple of weeks, working up a budget with them is going to be a top priority after the attorney visit. Doing so, as everyone on this forum knows, will allow them to prioritize their expenses and make informed decisions on what to cut, add or change. It will also give the children something concrete to use to supplement with assistance as required. I dont have a problem helping, but I am not of fan of throwing money at problems (the symptoms) and ignoring the root cause(s). To give DF some peace of mind, we also plan to work out a budget for when DM after DF passes, as Katsmeow noted, to determine if she can continue to live in their house or needs to pursue other options sooner rather than later.

5. Bankruptcy. Appears less likely now since the debt isnt that high, but I'm curious to hear the attorney's thoughts on this.

6. Neither parent is a vet, so VA assistance options aren't on the table.

Again, thanks for your thoughts and comments. I'll make additional posts as the situation develops.
 
OP a really tough spot for everyone. I know a lot of posters have recommended an eldercare attorney and have said they are expensive. Based on your added details your parents do not have money to pay the lawyer and are basically destitute so no assets really of any kind. IMO money would be better used to help them with daily living then an eldercare attorney, they don't need one.

In your shoes I'd help them drill down to any income based aid available and nail down that budget. Also try to figure out the exact terms of the reverse mortgage as pertains to your Mom continuing to live in that home. Selling the home leaves your Mother with absolutely nothing in reserves which is frightening for everyone.

As for sister and the house she'll have to pay market value anyway so that's a non issue. The eldercare lawyer isn't going to have a magic bullet for them, because there isn't one.

From your own admission the financial problems started over 10 years so there is a ton of denial going on here. Couple that with the overwhelming feelings of a terminal illness and it's going to rough. All the best to you and your family.
 
Thanks for all your replies; very helpful. To address some of the comments made and issues raised:

1. I reached out to the govt Senior Services office where my parents live. They were very helpful and made me aware of many great options the state and county offer, very similar to those daylatedollarshort described. If DF & DM qualify, it will be of tremendous assistance to them. I spoke to DF about this option, told him about the options available, but that they all remained just good ideas and possibilities until he calls the office, does a phone screening (no in person visits during Coronavirus times!), requests the forms and COMPLETES and returns them with the required documentation. DF and DM are not suffering any loss of mental faculties that my brothers, sister or I can detect, so we cant do it for them.


That is good news on the government services. Actually one of the options is to get power of attorney for finances, but the elder attorney may be able to advise on that. I don't know if your parents are there yet, but we had to do that for one of our parents. Another relative who lived closer helped fill out all the social services forms. Your parents might have to sign the forms but you or a sibling could help fill them out and gather documentation. You might also be able to set up a time for the social services phone screening, gather documents and be present during the call for support. You could also work with them on a budget. If they resist you could start a sample budget based on what you know just to get the ball rolling, and show how much extra they will have for discretionary spending, or at least stop getting into debt, if they can get aid from all the social services and community support programs they qualify for. Good luck.
 
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That is good news on the government services. Actually one of the options is to get power of attorney for finances but the elder attorney may be able to advise on that. I don't know if your parents are there yet, but we had to do that for one of our parents. Another relative who lived closer helped fill out all the social services forms. Your parents might have to sign the forms but you or a sibling could help fill them out and gather documentation. You might also be able to set up a time for the phone screening, gather documents and be present during the call for support. Good luck.

+1
 
... 3. Reverse mortgage and debt. As pb4uski noted, my debt math was off a bit since I was fearful there were some other outstanding personal loans or that they were underwater on their house & reverse mortgage. I've been reassured there is no other debt than what I initially described, and after doing some quick Zillow work the rough market value of the house (approx $165K), minus the reverse mortgage (DF isnt exactly sure what the payoff amount is - another issue to be resolved when I travel home soon...) and typical real estate sale transaction costs are about equal. ...

I'm not very familiar with reverse mortgages, but does that mean that they can live in house without a house payment as long as they live but once the second of them die that the reverse mortgage company gets the house... and DS could then buy it from them if he wished to? So DS could pay the lesser of the fair value of the house or the outstanding loan balance?

If so, it's like having a paid off house in that you don't have to make monthly mortgage loan payments but with no home equity since the value of the home approximates the reverse mortgage balance and selling costs.
 
I'm not very familiar with reverse mortgages, but does that mean that they can live in house without a house payment as long as they live but once the second of them die that the reverse mortgage company gets the house... and DS could then buy it from them if he wished to? So DS could pay the lesser of the fair value of the house or the outstanding loan balance?

If so, it's like having a paid off house in that you don't have to make monthly mortgage loan payments but with no home equity since the value of the home approximates the reverse mortgage balance and selling costs.

Living in the house also includes the costs for utilities, upkeep, taxes, HOA fees, etc. Reverse mortgages are generally not a good deal. If they were, ex-movie stars and sports heros wouldn't be promoting them on TV.
 
^^^^ WADR, pretty useless post.

Where in the world did I say or suggest that it was a good idea? I was just trying to ascertain the facts of the situation.

And wouldn't it be obvious that the homeowner would still be responsible for utilities, upkeep, taxes, HOA fee, etc.?
 
You did not say it was a good idea, nor did aja8888 suggest that you did. I read aja8888's comment as just general good advice, being addressed to OP.

I'm interested because a relative, who just paid off the house with life insurance from spouse's death, is now considering a reverse mortgage due to unexpected expenses. To the extent that it is my business, which it isn't except for caring about the person, I would like to caution this relative (who is also disabled and probably can't stay in the house many more years) about doing the RM now, since it may limit their options later on. It is amazing how many people don't think about expenses above and beyond the mortgage payment.

Living in the house also includes the costs for utilities, upkeep, taxes, HOA fees, etc. Reverse mortgages are generally not a good deal. If they were, ex-movie stars and sports heros wouldn't be promoting them on TV.

^^^^ WADR, pretty useless post.

Where in the world did I say or suggest that it was a good idea? I was just trying to ascertain the facts of the situation.

And wouldn't it be obvious that the homeowner would still be responsible for utilities, upkeep, taxes, HOA fee, etc.?
 
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^^^^ WADR, pretty useless post.

Where in the world did I say or suggest that it was a good idea? I was just trying to ascertain the facts of the situation.

And wouldn't it be obvious that the homeowner would still be responsible for utilities, upkeep, taxes, HOA fee, etc.?

Take it easy on me :blush:, I'm trying to be helpful and add some details about reverse mortgages. Buyer beware on these vehicles is all I wanted to imply.
 
^^^^ WADR, pretty useless post.

Where in the world did I say or suggest that it was a good idea? I was just trying to ascertain the facts of the situation.

And wouldn't it be obvious that the homeowner would still be responsible for utilities, upkeep, taxes, HOA fee, etc.?

That will be the budget they need to work on. Those bills will probably still be cheaper then moving from the home and renting. The OP never said if the other two adults living in the house DS and D are paying anything at all to the monthly recurring bills. They need to figure out some basics before dumping a bunch of money they don't have on an eldercare lawyer.

A reserve mortgage with no other assets kind of ties you to the house you live in until you die. If Mom ends up needing more care they will have to dump the house and put her on Medicaid.
 
You did not say it was a good idea, nor did aja8888 suggest that you did. I read aja8888's comment as just general good advice, being addressed to OP.

I'm interested because a relative, who just paid off the house with life insurance from spouse's death, is now considering a reverse mortgage due to unexpected expenses. To the extent that it is my business, which it isn't except for caring about the person, I would like to caution this relative (who is also disabled and probably can't stay in the house many more years) about doing the RM now, since it may limit their options later on. It is amazing how many people don't think about expenses above and beyond the mortgage payment.

These things are a little more simple when it's just one person. Do you know about a possible RM because they asked you an opinion? I find people I know with large financial problems only tell you part of the whole story when they ask me for an "opinion" so I generally don't have an opinion to give them.
 
and typical real estate sale transaction costs are about equal. This bodes well for Medicaid eligibility, since any monetary windfall from selling the house could endanger this benefit.

You might consider a different outlook regarding Medicaid eligibility. If your parents wound up with a positive balance on the house proceeds after selling, it would likely not endanger a future Medicaid benefit. It would only delay it. That's likely a good thing.

During the period before they spend down to Medicaid eligibility levels they could include in spending needed repairs on the house and car, some basic necessities (clothes, medical durable equipment not covered by Medicare), Medicare supplemental policies, pay off existing medical debt, prepay final death expenses, etc. Your elder attorney will advise you on what spending is allowable during the so-called "spend down" period.

My MIL had about 1.5 years of (frugal) expenses after selling her condo and paying off the reverse mortgage. We were able to accomplish a lot for her during that period. Then she went on Medicaid.

As others have mentioned, get professional advise on this. But do stop wishing for them to be broke now as there are likely benefits to delaying becoming indigent, even if that result is inevitable.
 
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