As I totally expected, FIL ended up back in ER last night. What a mess. I'm really not sure what SIL (or even FIL) expected to happen and of course no plan for MIL's care.......again. SIL and her DH were babysitting their new granddaughter when FIL had to be taken in. So, she got a neighbor of theirs to come over and stay with MIL, while her DH stayed home with their grandbaby. After a couple/few hours, of course the neighbor was ready to be done, but SIL said the dr. told her she needed to stay at the hospital with FIL, so she didn't know what to do. Well...call your daughter up, tell her it's an emergency, and she's going to have to come pick up her baby! Geez.
FIL earlier this week had filled out DNR paperwork. He now has congestive heart failure as well as C-diff, so rather than put him in intensive care at the hospital it was decided to send him back home and get hospice set up. So SIL took him back home (this is around 11pm), but hospice isn't coming until Monday. So, she leaves them by themselves and goes back home! omg. I guess someone is coming today to do an assessment for nursing home care on both of them. SIL said it's a requirement by the state or something to have this assessment done.
She seems more concerned with the money aspect of it all. She actually messaged this morning to ask if I could look up and see if nursing home care is tax deductible. DH says "that's what she is worried about?!!". Then DH talked with his dad this morning. He commented something similar about the money for the care and no inheritance to the kids. DH was like we don't and never have expected an inheritance, you are supposed to use your money for your and mom's care.
I started to say to DH that I am just not getting why they are all so concerned with using their savings and income for their care and started to compare to my grandma and how we worked it with her. Well, he started to spout out some "they are poor, your grandma didn't have a house payment, etc". I said first off, they have way more money than my grandma ever did. They have some savings, they have a pension and both get social security. They also have a house that is paid off, other than they do have a $20k line of credit loan (this per SIL). The house is probably worth $200k. My grandmas little mobile home was worth $12,000. They do not have to sell their house in order to qualify for medicaid, after their savings run out. Once they die, medicaid may go after some of the proceeds from the sale of the house, but they do not have to sell it to have their care paid for by medicaid (at least this is what I am reading, as they have less than $520,000 in home equity). So, this all doesn't have to be this big issue they are making it to be.
Go into assisted/nursing care. Use their savings and regular monthly income to pay for it. Once the savings runs out, they can go on medicaid. Their monthly income will still go towards the cost of care and medicaid will pick up the rest. SIL can either then get the house sold or she can wait and do it after they pass. I'm just not understanding why they are all not wanting to use their money for the care they obviously need. They are both at the stage in life where that is what they need and don't have a choice. That is what their money has to be used for. Plain and simple. It's not like they need to keep their savings for some other reason or use.
SIL is complaining (and rightly so) that she doesn't have enough time to deal with all this and work her job, take this much time off all the time, etc. Well, then she's going to have to get serious and just tell them this is what is happening. They are going into nursing care and that is that.
On another parent issue, my mom had an MRI done yesterday of her brain. Probably a good thing as apparently she told DD (dd happened to call her yesterday afternoon after she got off work) she didn't realize she was having an MRI done at this appointment! She also mentioned to DD that the medicine she takes for her excessive sweating..Paxil......can cause memory problems, so the doctor might reduce her dosage. DD didn't know what the medication was, but she was pretty sure Grandma was confused about what she is taking it for. I told DD, no, that medication is for anxiety and she has been taking it for years. She said grandma seemed kind of flustered and confused by it all and I said, I'm sure it was a tiring overwhelming day and when she has that, she gets so she doesn't remember stuff very well.
I decided to wait and call her this morning, after she got some rest. She seemed pretty good. She did say she sure didn't remember them telling her she was going to have an MRI. I then asked about her medication the dr. wants to change dosage...(to see if she was still thinking this was medication for her sweating)...all's she said was "it's paroxetine (paxil) but I don't even remember anymore why I take it or why I started taking it". I told her its for anxiety and she said "oh, I must have started taking it when your dad got sick, well, I probably don't need it anymore".
I was just doing some online reading that medications like Paxil are thought to be associated with a two fold increase in cognitive impairment. So, I hope the doctor looks at this seriously and works on getting her off of it. She said something about the doctor said waiting until summer to do it. It has always frustrated me that a medication that was supposed to be a temporary fix, while she was going through stress, turned into a permanent thing. I know that is what caused her big weight gain (a good 50 pounds on a petite 5'4" frame) and the sweating she suffers from. I'm sure it probably isn't helping her memory/brain function either.
Oh that is a nightmare situation and I suppose the distance between you doesn't help. I feel for you all!
ReplyDeletethe distance sure makes it hard and kind of helpless feeling. DH just tries to call his parents almost every day
DeleteI went through the process of finding an assisted living facility for my Dad last year. There are referral services such as "A Place for Mom" that will help you find a place at no charge to you. I had someone set up tour appointments and drive me to the facilities for tours. One thing to keep in mind about assisted living/nursing homes is that not all places take Medicaid when the resident runs out of funds, so you need to ask them specifically about that.
ReplyDeleteIt's a lot of work to find a place, evaluate the contract, figure out the finances, move the parent, deal with the parent's house, etc., so I definitely feel for your SIL having to do this while she is still working. And if the parent/parents are not being cooperative, that makes it even harder!
I will tell SIL about the referral services. I know she said she went and looked at a couple of places yesterday. Thanks for the info!
DeleteDefinitely find out if they can transition to a Medicaid bed when their money runs out. Some places make you pay privately for two years. Also make sure they can qualify for Medicaid since neither one will be living in the house. The rule about not selling the house is so that the one remaining at home is not left homeless. I agree with Julie that it is quite a bit of work to get them settled. If the house is not sold then you will have to leave it vacant or rent it. Good luck to all of you.
ReplyDeleteI honestly do not think either of them probably even has 2 years left to live, especially FIL now. I know SIL had contacted an elderly attorney in the past to get set up on their finances and how to spend down, etc. What I just read about the house is if they do not have more than $520k-ish (I can't remember exact figure) in equity in their home, they do not have to sell it (if they are both in nursing home) to qualify for medicaid, but medicaid may come back for funds after the house is sold. They do not have to count the equity in the home as an asset to qualify for medicaid, once their money runs out and their income is low enough.
DeleteKaren, you are correct. Most places, SIL is finding out, want 2 years of private pay. So, they will need to sell their house quickly so they have the funds from that to private pay.
DeleteIf they have not made and paid for their funeral arrangements that should be done as that money can be sheltered when applying for Medicaid.
ReplyDeletethat's a good point. I will check with SIL to see if this part has been done. Thank you for the suggestion!
DeleteThat is a lot on your families plate. Is there an Area center on Aging? They might be able to help sort options.
ReplyDeleteI'll have to check on that. See what info I can get to SIL on referral agencies, etc.
DeleteI agree with all of the above comments. At this point, your in-laws need to be where they can be cared for. Not a fun situation (trust me, I know since I'm dealing with it right now with my own dad) but there comes a time when enough is enough. Your SIL can't keep going on like this either.
ReplyDeleteNo, she surely can't. Maybe if she, DH, and the other brother all tell them this is how it has to be, it would help her resolve to stick to what she wants/needs to do with them at this point.
DeleteMaybe your husband could spend a week or two helping your SIL find a place and get all the paperwork started. They are more likely to cooperate if he is there. Sometimes it takes a village to effect the needed changes.
ReplyDeleteunfortunately having to also host my Dh for a week or more would probably put his sis over the edge LOL. We live 7 hours drive away and DH would have to either stay in a hotel, at sis's or at his parents. He knows not how to cook himself a meal (except cereal) so she'd be now having to take care of him too, haha. Hopefully he and his other brother can do some phone call ganging up and convincing. Plus, DH has his hands completely full with our house build.
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