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You need to sell her home and use those proceeds to pay for her memory care, and when those funds run out you apply for Medicaid for her, and they will continue to pay if your mom is still alive at that point.
I don't think you realize just how difficult it is to care for someone with dementia 24/7. Right now she has lots of people caring for her, and if she were to come live with you, it will be only you providing that same 24/7 care and you will have no life what so ever.
So no you should not buy any house using your moms money under the guise that it's because you want to now care for her. Medicaid will definitely frown at that, and penalize her if and when she would need them in the future.
Someone in the family reported it, and she went to jail for 5 years.
Be VERY careful. Consult an attorney.
This is a legal Fiduciary responsibility that is held to highest standards under the law. You have a right to get expert advice about something you are doing for your mother as her POA. So do see an elder law attorney so that you more fully understand your roles as POA and its powers and limitations.
Depending on where you live, and you find you need to hire 3-shifts of caregivers, it could cost you $20,000 per month, yes per month. That's the amount my Dad paid when he need around the clock caregivers a few years back. That will bite into your Mom's savings a heck of a lot faster than her $6,700 cost in Memory Care.
Do not touch Mom's money to purchase a house. There is always a chance that your Mom may need to go back to a nursing facility, later under Medicaid. And Medicaid may consider whatever $$ you use to buy a house as "gifting". That means Mom will have to come up with the money to pay the facility as Medicaid will not kick in until the gifted amount is reimbursed. See how complex this can be.
As for selling the house, purchasing another and moving your mom in to care for her 7x24 - I did this with my dad (not the sell and buy part, but everything else), and did ok while he was doing ok. But then he had a BIG health event, and even though I had 8 hours of respite care a week (1 4-hour respite care worker shift twice a week), I only got 4 hours of sleep per night. It was unsustainable. I am smart, capable, and aware - and at the end of that timeframe (8 months), I could hardly put a sentence together.
I really advise against taking care of your mom on your own - no matter how capable you are. My dad ultimately needed to be closer to medical services and facilities, so we found a wonderful AL where we visited him 3-5 times a week. And staff to care for him - there were at least 4 ppl per shift who replaced the 1 of me.
It has taken me well over 2 years to regroup after this. While I am grateful I got to help my dad, it was diminishing returns for him, and for myself. As I stated above, I was losing the ability to function well and putting my own health at risk, and Dad wasn’t getting the quality of care he needed.
2. Second, depending on what state your mom would be living in at the time that she needs to obtain Medicaid, your mother may well be rendered ineligible for Medicaid for up to 5 years by virtue of any gift(s) of money or real estate. California Medicaid does NOT penalize any such gifts made on or after 1/1/2024. But I do not know any other state that does not penalize such gifts.
3. Further, you could possibly be held liable for financial elder abuse for such gifts in civil court and/or in criminal court, even though you are her financial agent doing what you think is in her best interest.
4. It is very important to see the value of keeping her care in a high quality professional care facility catering to people with dementia. Caring for a person with dementia at home becomes increasingly demanding as her symptoms progress. It becomes an exhausting full-time job that will turn into a 24/7 job. Few family members have the professional skills to handle that care proficiently. And few humans regardless of their professional skills can handle any 24/7 job. Most of my clients who did that full-time care for a family member at home could not go on after a certain point, and they ended up way over their heads and compromising or ruining their own health. Their loved one also received poorer quality care by the loving caregiving family member(s) than the ill family member would have received at a quality facility. For example, in one case, it became impossible for the wife AND the son to keep their loved one clean because the loved one refused basic hygiene to be provided by the caregiving family members, but once the loved one went to a facility, their skilled caregivers were able to work with him to keep him clean.
5. There are so many risks involved in your proposed plan for dealing with your mom’s home. It would be best to contact me up with a long term plan of care under the guidance of an experienced elder law attorney to evaluate your mother’s DPOA and any trust, the options, future Medicaid eligibility, the sale of your mom’s home, capital gains tax consequences, the best way to achieve your goals. You can pay the attorney out of your mother’s funds as her agent.
6. What might be the best thing that only you can give your mom is to visit her on a daily basis in a high quality facility to watch over her care and to give her lots of love. If the facility knows you are coming every day, the caregivers will make sure that your mom is up, fed, cleaned, and dressed. You can and should read her chart, get to know her caregivers, ask them questions, find out how she is doing, and give her lots of daily love, even if and when she no longer recognizes you.
7. So I would say, try to decide where you want to live, and move your mom to a quality facility close to you. And use her money and any sale proceeds to be able to afford quality professional care for her so that you can oversee her care and remain the big provider of unconditional love that only you can give. Best of luck to you. Your heart is in the right place.
To ensure enough FUNDS for Mom's care in MC? Or get Mom OUT of MC?
Mom isn't living in her old home, it's just racking up bills. So makes sense to sell.
Or, could it be rented out for income? (Maybe you don't want the hassle of tennents, maintence etc?)
"buy another home with safe setting.."
IF this is within the legalities of your POA + IF your sister is in agreement + IF your Mom wanted to leave her current home (probably has a social network built in) + IF Mom's care needs are doable at home + IF care agencies have plentiful staff in the chosen new home area..
That's 5 big IFs to equal a maybe..
Legal + sister + Mom + able + aides = a chance at a workable plan. But will it be a SUSTAINABLE plan? For how long?
Maybe explain more about Mom's care level needs.
What I imagine is this..
.. Imagine selling her home, buying a new one, setting up a team of aides & services then a short time later realising it is all too hard. Then having to place Mom back in a MC & sell her home AGAIN. Only this time you will need housing too 🫨
Why not do a TRIAL first. Really ensure you KNOW what the care needs are. Eg take Mom home for a weekend & then have a good think.
If your POA was legally done by a lawyer in the state of Florida, it is legal in every state. You should still consult a lawyer in the state of Maryland though just for peace of mind.
You do know that if you become her caregiver, you can pay yourself out of her funds. You can also get paid (out of her money) for your POA services.
If you want to buy a property with her money in Maryland with the purpose of moving her in and taking care of her, do it. If your sister is agreeable to this plan and there's no other family who will give you a hard time on it, then go ahead and do it. You were not appointed POA by the court so you will not have to answer to them. Since your mother's memory care bill is still being paid in cash, she's not on Medicaid. So you won't owe the state or the memory care facility any explanations where the money is being spent.
If there's no one to contest this plan, don't worry about it. Go ahead and do it. Just don't involve social workers or nurses or anyone affiliated to any kind of care facility or social services in the state your mother is in. They will fight you tooth and nail to keep her in the memory care and in turn keep her money flowing in that direction.
A word of advice though. If your mother has been in memory care for two years already she needs round-the-clock care. Do you have a careplan in place for moving her into a private residence? Please for her sake as well as your own, don't assume that you can take care of her 24/7 because you can't. I was a caregiver for 25 years and am telling you from experience. A family member may have the best of intentions and God bless them for it, but they burn out fast and then there's a Situation.
There will have to be reliable homecare in place. There will also have to be a plan in place should you need to place her again. This happens too. Families take a LO out of care and they end up having to put them back in.
Make all these plans first before you even consider moving her. There also has to be a plan in place if something happens (God forbid) to you. Your mother will still need care 24/7-365. You and your sister have some serious planning to do.
Most people who take on home care of a parent with memory issues will end up needing treatment for clinical depression. Less than half will seek help. Both of you will suffer in that situation. Please be truly honest with yourself about your ability to put their health and welfare first every single day. It’s beyond exhausting and sad. A good memory care facility is worth every penny.
And please advise your friends and family to establish a living trust long before they hit 70. It needs to be in place approximately 5-6 years before they enter care to protect their wealth.
However, some advice…
First, consider TN for excellent memory care facilities at more affordable rates. The Autumn Care Karns near Knoxville is beautiful and staffed by the kindest and most professional of people. The rooms are very nice and the region is friendly and gorgeous. Flights to Knoxville are very affordable from the east coast of a 7.5 hr drive from Maryland.
Conversely, you want to be absolutely sure your siblings and any other surviving members of the family are in board(in writing) with your plan to buy a home for her care. It could be seen as an abuse for your benefit if challenged by relatives. Further, I sincerely doubt you will be saving any money on her care given my own experience. You will need to provide around the clock care for her between yourself and home health aides. It’s a lot more expensive than the initial conversations with home health care companies would lead you to believe. Beyond that you will have transportation costs to regular medical appointments and hospital stays when they inevitably fall or get ill.
You aren’t protecting her wealth/inheritance with buying another home as it will be considered her wealth when she needs to move back into memory care/hospice at some point. Memory decline is RAPID and scary. You don’t want to be doing that on your own long term.
Her assets will be used up in her care and then medicare will pickup the tab at the end. Without a trust in place dating before your became POA, I don’t think you have many options. If she had a will signed by a notary before the POA that assigned specific value disbursements to you and your family, you may be able to send those amounts to yourself and sister(get clearance with a lawyer and possibly courts first). That will allow you to set that money aside to help provide for her when her money runs out.
It’s going to be expensive for you too when her money runs out. That’s the sad reality of caring for a parent. I wish you well and hope her memory doesn’t get worse and she stays healthy for many years in comfort. That hasn’t been the case for my own family or the others I have observed but you never know.
Good luck and make sure to protect your own health, physical and mental.
FWIW each State administers all of its various Medicaid programs uniquely but under overall Federal Guidelines. So realistically there needs to be a decision made as to exactly what State works best - both medically and financially- for her to have as her legal permanent residence that makes sense for how their LTC Medicaid program runs,
best support system for her and for you as the living with her caregiver,
the costs of living for the State. And since there is a house involved what options are out there for each State in regards to recovery. Like if I’m not mistaken both FL and MI allows for “Lady Bird Deeds”, if so, that allows you to think about the house way differently as no Estate Recovery if done correctly.
BUT
There could be another way to approach this, where is the house, FL? Or MI? Why is there not the consideration to have her move back into the existing still in her name home? Unless her old house is a hovel, going back into an existing home with furnishings, utilities set up & on, property insurance established (especially important if in FL), etc is way waaaaaay less time, energy and $. If her old house is in FL, just the thought of having to deal with clearing out and getting a house market ready in a State that will be totally under hurricane watch (Hello Helene!) this Thursday and already has a property insurance crisis happening would be super stressful.
Why not do this?…. Like she stays in her current MC while you do whatever to make her old place safe and secure for her to living in it and for you as well AND using her $ to do this as it’s all for a home that is 100% in her name. Then once that’s done you move her out of her MC and you are living there full time to caregive and have a room done to allow for InHome care providers to have a room to stay in when you mom gets to the point that she needs 24/7 oversight. She uses her income and her savings to pay all property costs and she could do a Caregiver Agreement with you to pay you a smallish sum. Everything drawn up by elder law atty, no DIY. You have no other job for at least 2 years and should her care get beyond what you and paid InHome can do, then after 2+ yrs only then she moves into a NH/SNF
Also overlooked in the articles on “assets can be gifted in CA” is that CA does means testing & fairly rigorous medically “at need” assessment for eligibility. CA still has an “income limit” and income is means tested. CA goes with 138% of poverty rate and for an individual this is about $20,783 a year / $1,676 MONTHLY INCOME MAXIMUM for eligibility. Huge # of folks make from their SSA retirement income alone well over $1676. Lots make SSA FRA max $3,822 or SSA max of $4873. Even age 62 max of $2710 too much $. Over $1676 = over resourced & ineligible for MediCal to cover SNF costs. So $1,680 a mo, you’re ineligible. That elder in CA unless they were an extraordinarily low wage worker their entire life will have to use their income, their savings and their house sale $ to private pay for care as they will be over resourced due to the means test approach CA does. Maybe they can get whatever CA version of what a Miller Trust is done, but they better have family who will pay for atty fees on all this. That “assets not counted” situation is complicated. There is no chance of LTC Medicaid eligibility in CA without a means tested resource assessment being done. CA does the PARIS match as well. Data gathering wise CA is very sophisticated; stuff surfaces.
For elders and POA & families in CA, they have to be careful….. yeah they can give that 2M house away but if they have any type of decent SSA income they are ineligible. Then what?
On the medically “at need” eligibility, CA has almost all entries to a NH that participate in MediCal come in via a post hospitalization discharge or PACE referral. Other states tend to be more in the 70% range. To me, that shift in Medicare rehab paid coverage to qualified (IRF) facilities for Day 1-Day 60 once the $1632 Part A is met & 61-90 @ $408 per day met, is the driver behind this as it costs the State so much less from its Medicaid budget. Plus easy peasy review by State caseworker into CMS database to ensure truly needing skilled care.
We did make sure that the facilities had medicaid certification before placing them on private pay basis, which was a very short time for both.
Your mom is blessed to have you guys advocating for and watching out for her, they truly are the most important things we can do when a loved one is placed in a facility.