Moving stepfather into long term care facility. Need advice.

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MrMojoRisin
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Moving stepfather into long term care facility. Need advice.

Post by MrMojoRisin » Thu Jul 13, 2017 7:24 pm

Not sure if I am writing this for therapeutical reasons or whatever but here goes.
My mother remarried late in life to a gentleman that had led a very successful career in the insurance industry but was pretty much wiped out when AIG went [out of business --admin LadyGeek]. He is 87 and she is 83.
He and my mother put their estates into separate trusts when they married. Bob (nom de guerre) lived in a nice motor coach and had come back to Mom’s home town as his estranged son lived there.
I am named as POA him after my mother and jointly with a niece of his. His son was passed over for various reasons. The niece and I are fine with each other and she lives out of state. We communicate frequently.
Here is the situation.
Bob has been diagnosed with Alzheimer’s dementia. He has no short term memory and is pretty frail physically. His home health care provider has strongly recommended that he be placed in a long term care facility for his safety and that of my mother’s.
I’m a bit resentful that this man that had no real support network has now placed my mother and myself in the position of having to arrange his LTC.
When they first married I knew this might happen and so toured several LTC facilities in the area and selected one and they put money down to be on the list.
I am now tasked with getting his financial affairs in order so that it pretty much runs on auto pilot.
Here are his resources:
Social Security and a small pension
An annual fixed annuity that he can tap for about 20K this month and cash out entirely next year at this time to the tune of 117K minus what he might take out this month. This is a taxable account. (that is current value, the annuity is a blend of equity and bond indices, I am suggesting he place it in a guaranteed 2.8% account to protect his assets, at 87 he can’t take much of a market correction or whatever)
He owns a motor coach and has put his son on as co-owner.
Cash on hand is negligible. He was overdrawn on his checking account so Mom covered that.
The one bright spot is he has a long term care policy that has a lifetime limit of 181K…
His current expenses are:
He pays on three life insurance policies, one that is spelled out in a divorce decree that benefits his ex-wife that he was married to for a short time, one that benefits his son and one his granddaughter.
He pays for two or three time shares.
There are some minor miscellaneous expenses as well.

What I want to do is set things up for him on auto pilot. He has not the capacity to consider tax consequences and the like. Mom really does not need to be burdened with this as she is in failing health both mentally and physically. I do not want to be guardian to this man but want to do right by him.

His only heir, his son, has done nothing but take advantage of him whenever the possibility presented itself. Just last month he was given a credit card so he could get some prescriptions filled. Normally I do this but I wanted his son to take some responsibility and I was tied up. Anyway, the son take the credit card and uses it like his personal piggy bank for the three weeks he has it and charges about 600 bucks for B.S. We never did get all the prescriptions filled that the nurse gave him.

Anyway….short story long…..this is my game plan at the moment but I really would like some collective wisdom.

I will set up a trust account at a local Bank and Trust that will receive his SS and pension and any other funds he can collect. One of those deposits will be the sale of the motor coach. I am going to offer the son the chance to buy out his father’s half of the coach after we get it appraised by a couple of RV dealers. If son refuses to play ball I will tell him to either come up with half the price or sale it outright and split the proceeds. If he refuses I will inform him I will report him to DHS for elder abuse in the matter of the credit card.
They will pay the retirement center x amount a month with the LTC paying the balance. I plan on spending about 75% of his monthly income towards the retirement center and the rest to be paid by his LTC policy. The 25% not accounted for will be for medical costs and the like.
I want it to run on auto pilot and then will resign my position as trustee or whatever. May even turn it over to his son with some safeguards in place to prevent him from fleecing his dad.

Anyway, what suggestion or ideas can anyone offer?

Gnirk
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Re: Moving stepfather into long term care facility. Need advice.

Post by Gnirk » Thu Jul 13, 2017 7:59 pm

it's no fun being the person responsible for overseeing his care and finances, but it sounds like you are the one most capable, and he and your mom are fortunate to have you. I've been the financial and medical DPOA for my mom, who had Alzheimer's, so I know what it's like to be the responsible one.
However, I do have one question: Is the long term care facility a memory care facility? There can be great differences between the abilities of different facilities to care for a person with Alzheimer's, and the ideal would be a memory care facility that offered different levels of memory care.

BTW, there really are no safeguards that I know of if you turn the responsibilities over to his son, who has a history of fleecing his dad. It will be giving the fox the key to the henhouse.The son should not have any access to anything of his father's, or your mother's.

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KlingKlang
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Re: Moving stepfather into long term care facility. Need advice.

Post by KlingKlang » Thu Jul 13, 2017 8:22 pm

Sorry about this situation.

Would it be useful to consult with an elder law attorney to discuss how best to use the remaining assets, prepare for when/if the assets are exhausted, prepare for a successor trustee/guardian, and keep the son from getting anything?

I agree with Gnirk that there is no way that the son should be given responsibility for anything. He sounds like the type of person that would pry the fillings out of his father's teeth.

trueblueky
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Re: Moving stepfather into long term care facility. Need advice.

Post by trueblueky » Thu Jul 13, 2017 8:36 pm

So sorry. We had similar situation.

What does his LTC insurance pay per day? How long will that last at the facility? Around here, memory care would be around $7,000/month, but that varies widely. How much of the difference does SS/pension cover?

In our experience, when someone is in LTC permanently, they don't have many other needs except any uninsured medical. Expenses that can be trimmed, should be, in my opinion, so that the money stretches as long as he does. Medicaid can eventually pay when everything else is drained, but not necessarily for the quality you'd want.

The life insurance policies are likely very expensive at his age. How soon can you sell the time shares?

Again, so sorry. Glad someone competent, caring and a little detached is in charge.

MrMojoRisin
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Re: Moving stepfather into long term care facility. Need advice.

Post by MrMojoRisin » Thu Jul 13, 2017 9:12 pm

Gnirk wrote: However, I do have one question: Is the long term care facility a memory care facility? There can be great differences between the abilities of different facilities to care for a person with Alzheimer's, and the ideal would be a memory care facility that offered different levels of memory care.
Yes, it is a memory care. It actually has three levels, Independent, Assisted and Memory Care. The memory care unit has individual apts with a small sitting area, dining area and bedroom. Large bathroom. There is access to an outdoor garden where clients raise vegetables and flowers and can go out there unescorted.

Thank you for your kind words...

Sorry about the admin edit, it's a common phrase in my area and I used it without thought....

MrMojoRisin
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Re: Moving stepfather into long term care facility. Need advice.

Post by MrMojoRisin » Thu Jul 13, 2017 9:17 pm

What does his LTC insurance pay per day? $124.00 per day after 100 day exclusion
How long will that last at the facility? Hopefully with SS, Pension and LTC he can make it about 4 years or so
Around here, memory care would be around $7,000/month, but that varies widely. How much of the difference does SS/pension cover? SS and Pension total about 3K per month. Memory care will run 55-6K per month.

In our experience, when someone is in LTC permanently, they don't have many other needs except any uninsured medical. Expenses that can be trimmed, should be, in my opinion, so that the money stretches as long as he does. Medicaid can eventually pay when everything else is drained, but not necessarily for the quality you'd want.

The life insurance policies are likely very expensive at his age. How soon can you sell the time shares? Not sure, I need to find out who they are with and how to sale them. Mom just wants to stop payment but I'm afraid that will just get him sued.

Again, so sorry. Glad someone competent, caring and a little detached is in charge.Thank you for the kind words

NotWhoYouThink
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Re: Moving stepfather into long term care facility. Need advice.

Post by NotWhoYouThink » Thu Jul 13, 2017 9:22 pm

You are taking on a difficult and stressful task, and I commend you for it. There is always a need for someone to step up, and it's not always a fair process to assign that responsibility.

First, triage is your friend -
- ignore the problems too small to matter
- ignore the problems too big to solve
- focus your efforts where they can do some good.

Get educated on what it takes to activate the LTC benefit from his policy - there will be some specific needs - cognitive and physical - which will have to be properly documented to activate the insurance. Work with the facility and his medical providers to get this done. There will be social workers at the facility that know how to do this, they do it every day for a living. Work with them as needed to get the documentation in place if it isn't already.

I don't know why you think you need a trust account at a bank. Why do you need to set up a trust? Are you trying to protect it from his son? His son does not have POA, your mom does. Don't waste effort on things that aren't needed.

Do you have the physical title for the RV, so you are sure both names are on it? Look up your state's laws on selling vehicles with more than one name on the title. Can either party sell it? Use google. If you can't wade through it pay a lawyer. And what's the hurry? You say that with his LTC policy, then only 75% of his income will be needed to pay for care, with the other 25% going to what? What's the current need for the sales proceeds from the RV?

Get over the credit card abuse. $600, really? Yes, it was wrong, but it is small beans in this story. Your contempt for his son oozes from your posts. He probably likes you as well as you like him, so why start fights? (If you really want to pursue this, I think the appropriate method is to report to the credit card company that the charges were fraudulent. They will probably require you to file a police report to demonstrate the fraudulent nature of the charges. And probably nothing will happen.)

Don't issue ultimatums to the son that you don't have the means or will to follow through on. You don't have to like him, but forget any thoughts of changing his nature.

Consider using some of the money from the annuity to hire a senior care manager. Google that term and your city to find some. They aren't cheap, but if your mother is frail, his son is unreliable, and you are unwilling to devote significant time to his care than someone needs to. He isn't broke yet, let his money go toward paying for someone to manage his care.
Last edited by NotWhoYouThink on Thu Jul 13, 2017 9:30 pm, edited 1 time in total.

tibbitts
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Re: Moving stepfather into long term care facility. Need advice.

Post by tibbitts » Thu Jul 13, 2017 9:27 pm

I’m a bit resentful that this man that had no real support network has now placed my mother and myself in the position of having to arrange his LTC.
What were his alternatives? You saw the results of expecting anything out of the son. It seems like he tried to divide things between you and the niece, but of the two it seems you two (because of your mother) are the closer relatives. I think the issue you're having is more with your mother for marrying him in the first place, and I get that. It sounds like he might have had money wrapped up in AIG beyond what he had to (options, etc.) at that stage of his (former?) career... but he wouldn't be the first person to do that. Even now you have people, especially in some industries like tech, that are probably still doing that.

Zott
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Re: Moving stepfather into long term care facility. Need advice.

Post by Zott » Thu Jul 13, 2017 9:54 pm

As far as the life insurance policies go, I assume the one for his ex-wife can't be changed, but perhaps he can be convinced to change the beneficiary on the other two, if he decides to keep them, to his wife. Under the circumstances, it seems that she would need the proceeds more than the son and granddaughter who, from your post, don't seem to be contributing anything.

There was a recent discussion here about websites that help people dispose of unwanted time-shares---expect to get little for them. I agree that a "trust" is unneeded and would create administrative complications.

You mention a 2.8% "guaranteed account". What would that be, the rate is significantly higher than what I've seen recently?

Good luck.

CULater
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Re: Moving stepfather into long term care facility. Need advice.

Post by CULater » Fri Jul 14, 2017 7:49 am

Having had to care for my elderly mother (now 100) with dementia I'm not entirely sure you can ever put things on "autopilot". Caring for folks in this situation is a moving target. At some point it seems likely you will have to move your elder into a nursing home because the facility you are in now will not be Medicaid-eligible, only private pay. You need to plan for the possibility of Medicaid assistance down the road. You should consult an elder law attorney to help with your planning in this regard. One strategy that might be available to you in your state (not all states allow it) is the "half a loaf" strategy. You can google this on the internet to learn more. Basically, it is a strategy that allows you to qualify for Medicaid while avoiding impoverishment as a precondition. Throw this term at your elder law attorney and if they don't know what you're talking about, then find another elder law attorney.
May you have the hindsight to know where you've been, The foresight to know where you're going, And the insight to know when you've gone too far. ~ Irish Blessing

FBN2014
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Re: Moving stepfather into long term care facility. Need advice.

Post by FBN2014 » Fri Jul 14, 2017 8:21 am

Run don't walk to an elder care attorney who knows the Medicaid rules in and out. Also if he is a veteran he may be eligible for the VA aid and attendance program which can provide almost $2,000/month. You can pay for the attorney from his funds and you should be compensated for your time because navigating the LTC road will take a lot of your time initially. I speak from experience.

MrMojoRisin
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Re: Moving stepfather into long term care facility. Need advice.

Post by MrMojoRisin » Fri Jul 14, 2017 8:22 am

NotWhoYouThink wrote:You are taking on a difficult and stressful task, and I commend you for it. There is always a need for someone to step up, and it's not always a fair process to assign that responsibility.Thank you.

First, triage is your friend -
- ignore the problems too small to matter
- ignore the problems too big to solve
- focus your efforts where they can do some good.I'm going to frame this along with the poem "Desiderata" and hang on my wall.

Get educated on what it takes to activate the LTC benefit from his policy - there will be some specific needs - cognitive and physical - which will have to be properly documented to activate the insurance. Work with the facility and his medical providers to get this done. There will be social workers at the facility that know how to do this, they do it every day for a living. Work with them as needed to get the documentation in place if it isn't already. Have contacted the LTC company, they are sending out forms.

I don't know why you think you need a trust account at a bank. Why do you need to set up a trust? Are you trying to protect it from his son? His son does not have POA, your mom does. Don't waste effort on things that aren't needed. Trust may be the wrong term. Stepfather already has a revocable living trust established and I am a trustee of it. Gives me very broad powers. However I do no want to be saddled with this and would prefer to turn the day to day operation over to a company that can run the books and take care of tax issues and such. Wife and I plan on extensive RV travel in the near future. Our RV, not step fathers. Mom physical and mental health are in decline as well so niece and I will be running things. I want to get it set up to take care of him and then ride off into the sunset.

Do you have the physical title for the RV, so you are sure both names are on it?[b]I have not seen it, have been told son and father are both listed.In our state if the title says "and" both must sign it over. If the title says "and/or" or "or" then only one needs to sign. I don't care who winds up with it, but I want stepfather to have half of the proceeds from it.[/b] Look up your state's laws on selling vehicles with more than one name on the title. Can either party sell it? Use google. If you can't wade through it pay a lawyer. And what's the hurry? [b]I want this over and done with and each year of age on the RV is one more years depreciation. Also I suspect that once son knows it is going to be sold he will trash it.[/b] You say that with his LTC policy, then only 75% of his income will be needed to pay for care, with the other 25% going to what? Costs such as insurance deductables. What's the current need for the sales proceeds from the RV? [b]I want to put as much money into his account as I can so when I ROIS I know I have done all I can for him.[/b]

Get over the credit card abuse. $600, really? Yes, it was wrong, but it is small beans in this story. Your contempt for his son oozes from your posts. He probably likes you as well as you like him, so why start fights? (If you really want to pursue this, I think the appropriate method is to report to the credit card company that the charges were fraudulent. They will probably require you to file a police report to demonstrate the fraudulent nature of the charges. And probably nothing will happen.)Good point, I've never cared for him since he trashed my lake cabin.

Don't issue ultimatums to the son that you don't have the means or will to follow through on. You don't have to like him, but forget any thoughts of changing his nature. Good advice........

Consider using some of the money from the annuity to hire a senior care manager. Google that term and your city to find some. They aren't cheap, but if your mother is frail, his son is unreliable, and you are unwilling to devote significant time to his care than someone needs to. He isn't broke yet, let his money go toward paying for someone to manage his care. Now that's a new term I was unaware of.......thanks!!

MrMojoRisin
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Re: Moving stepfather into long term care facility. Need advice.

Post by MrMojoRisin » Fri Jul 14, 2017 8:33 am

FBN2014 wrote:Run don't walk to an elder care attorney who knows the Medicaid rules in and out. Also if he is a veteran he may be eligible for the VA aid and attendance program which can provide almost $2,000/month. You can pay for the attorney from his funds and you should be compensated for your time because navigating the LTC road will take a lot of your time initially. I speak from experience.
Per your advice I have contacted one and will contact another one to get an idea of costs. VA will not get involved until his net worth is less than 80K and that includes my mothers assets.

FBN2014
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Re: Moving stepfather into long term care facility. Need advice.

Post by FBN2014 » Fri Jul 14, 2017 8:41 am

MrMojoRisin wrote:
FBN2014 wrote:Run don't walk to an elder care attorney who knows the Medicaid rules in and out. Also if he is a veteran he may be eligible for the VA aid and attendance program which can provide almost $2,000/month. You can pay for the attorney from his funds and you should be compensated for your time because navigating the LTC road will take a lot of your time initially. I speak from experience.
Per your advice I have contacted one and will contact another one to get an idea of costs. VA will not get involved until his net worth is less than 80K and that includes my mothers assets.
Right now VA doesn't have a look back period for transferring assets although that may be changing since it has been considered by VA in the past. A sharp attorney will be able to strategize the best way to go and still protect your mom.

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djpeteski
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Re: Moving stepfather into long term care facility. Need advice.

Post by djpeteski » Fri Jul 14, 2017 8:57 am

MrMojoRisin wrote:
I will set up a trust account at a local Bank and Trust that will receive his SS and pension and any other funds he can collect. One of those deposits will be the sale of the motor coach. I am going to offer the son the chance to buy out his father’s half of the coach after we get it appraised by a couple of RV dealers. If son refuses to play ball I will tell him to either come up with half the price or sale it outright and split the proceeds. If he refuses I will inform him I will report him to DHS for elder abuse in the matter of the credit card.
They will pay the retirement center x amount a month with the LTC paying the balance. I plan on spending about 75% of his monthly income towards the retirement center and the rest to be paid by his LTC policy. The 25% not accounted for will be for medical costs and the like.
I want it to run on auto pilot and then will resign my position as trustee or whatever. May even turn it over to his son with some safeguards in place to prevent him from fleecing his dad.

Anyway, what suggestion or ideas can anyone offer?
I think your plan is really good. One further thing: liquidate or don't pay for the timeshares. These are notoriously difficult to get rid of, so you may just want to stop paying the maintenance fee. He could be turned over to collections for this, however, does that really matter at this point?

One way to get rid of them is to ask the timeshare company to take them back or have them sell yours. This might work if they are actively selling the timeshares. For example lets say a salesman gets a 1K commission for selling a week out of their inventory, you could offer them 5K for selling yours.

If a relative is using them, then offer them to take them over, whatever. He won't be using them and certainly can't afford them.

Keep in mind that providing this much thought and attention you are doing a service to another human being that is unable to help you. This is giving and I respect you for doing so.

MrMojoRisin
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Re: Moving stepfather into long term care facility. Need advice.

Post by MrMojoRisin » Sun Jul 16, 2017 6:47 pm

Well the best laid plans of mice and men.....

Mom called me today and said no way she is putting her husband into a long term facility, she can take care of him just fine, thank you.

This is the second time Mom has stopped action on her husbands behalf. On the POA forms she is listed first with myself and his niece being jointly next in line.

I've reached my limit and told her fine, run with it.

I know that the home care charge nurse had made mention of getting the state involved if things were not to move Bob into a proper care facility. Since Mom is his POA and his spouse I guess she can cross that bridge when she gets to it.

IF and only IF, I get involved again it will be only after she has formally submitted the papers surrendering her POA position.

I have always said you have the right to go to the great beyond in the hand basket of your own choosing, you just don't have the right to take anyone with you.

SleepKing
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Re: Moving stepfather into long term care facility. Need advice.

Post by SleepKing » Sun Jul 16, 2017 7:12 pm

MrMojoRisin wrote:Mom called me today and said no way she is putting her husband into a long term facility, she can take care of him just fine, thank you.

This is the second time Mom has stopped action on her husbands behalf. On the POA forms she is listed first with myself and his niece being jointly next in line.

I've reached my limit and told her fine, run with it.

I know that the home care charge nurse had made mention of getting the state involved if things were not to move Bob into a proper care facility. Since Mom is his POA and his spouse I guess she can cross that bridge when she gets to it.

IF and only IF, I get involved again it will be only after she has formally submitted the papers surrendering her POA position.

I have always said you have the right to go to the great beyond in the hand basket of your own choosing, you just don't have the right to take anyone with you.

Excellent decision. I have experienced similar personally, and have watched from afar almost exact situation with extended family. Everyone loves 'dumping' onto the responsible and capable party, but usually drags their feet or ignores advice or refuse to come to consensus. Responsible party reaches breaking point and says 'good luck'. Other parties unable to handle situation and back come begging for help....the next step is up to you...

You seem like a good, caring, honest person.
Know your limits.
Don't get walked over.
Realize you have other priorities in life and the opportunity cost is tremendous with minimal compensation.
Help as able.

Good luck,
Sleepy

FBN2014
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Re: Moving stepfather into long term care facility. Need advice.

Post by FBN2014 » Tue Jul 18, 2017 8:03 am

MrMojoRisin wrote:Well the best laid plans of mice and men.....

Mom called me today and said no way she is putting her husband into a long term facility, she can take care of him just fine, thank you.

This is the second time Mom has stopped action on her husbands behalf. On the POA forms she is listed first with myself and his niece being jointly next in line.

I've reached my limit and told her fine, run with it.

I know that the home care charge nurse had made mention of getting the state involved if things were not to move Bob into a proper care facility. Since Mom is his POA and his spouse I guess she can cross that bridge when she gets to it.

IF and only IF, I get involved again it will be only after she has formally submitted the papers surrendering her POA position.

I have always said you have the right to go to the great beyond in the hand basket of your own choosing, you just don't have the right to take anyone with you.
No surprise here. I've seen this scenario or play out many times with my own family. I was once told by a doctor that making bad decisions does not mean a person is incompetent. These family dramas all end badly with resources being wasted, relationships being damaged, and the elderly person not getting good care in a safe environment.

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