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Dad is 88, in a wheelchair & needs 24/7 care. He recently had a stroke & suffers from dementia. He is a happy & sweet man. We have to dress him, change diapers, bathe him. We take him to all medical appts & coordinate all healthcare care including medication. He receives 3+ delicious home cooked meals a day. We do his laundry & change his bed linens. It takes both of us to get dad in & out of the car. We are also in charge of selling his assets. I have POA. We don't want to overcharge but want to be fairly compensated. Dad can afford the $3000 a month

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Nothing like as dangerous, Lisa, but among many run-ins my SIL accused me of not telling me that mother's hearing aids were broken. I asked if she'd removed the tab over the new batteries. She retorted angrily "the hearing aids are BROKEN."

Sure enough, once mother was home, I found the tabs in place and unmolested. I'd still like to shove the dam' thing up her nostril.

Do you think there might have been an element of too many cooks (with too few cooking skills) involved in all this?

You can probably take some swabs yourself and bag them up, if that's easier than hauling the whole thing in?
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Just took dad's cpap in to be evaluated as I was pretty sure my brother hadn't been maintaining it properly. Mask hasn't been changed in over 2 years. Filter dirty/black, not sure when it was changed last, there was black mold on the soft rubber part of the reservoir, and when I went to check the filter in the "So Clean" cleaner to see if there was a date on it to say when it needed to be changed, I discovered the blue plastic film that says, "please remove before use" was still on it. So all the time they've been using the CPAP and supposedly cleaning it daily, the cleaner has been useless as the filter isn't filtering anything. No wonder dad got bronchitis. I am going to take it to doctor and see if they can (or think they should) do a culture. I am wondering if he's got black mold in his lungs. If that's not neglectful care (or abusive) I don't know what is.
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Happy to send Prayers for Bill :) He's had one answered, anyway - he's a lucky man that you've been able to juggle your priorities round and create enough time to intervene.

I see you are already working out what is and is not worth the battle, and I congratulate you - I wish I'd got there as fast.
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Thank you for your responses. I appreciate the objective advice. I will keep you posted.
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As far as why I reported to Dad's lawyer, I was still hopeful she had some professionalism and actually cared about my dad. Understand that if I had contacted another lawyer in California, it would have set up an adversarial relationship and I would have been cut out of the loop completely. (I did consult one here when they set all this up, but laws are different state to state and he couldn't do much but advise). Also, my dad was never declared incompetent -- the POAs were durable and took effect immediately after signing, not upon his inability to act on his own behalf. So it was all legal, for the most part. I can certainly challenge the way he spent the money, as the IRS will have something to say about that. But legal battles are costly and time consuming and I had a job here, and not time to fight that fight. As it is, I have taken family medical leave, and have my summer off. Kids all graduated now. I have another four months before going back to work to devote to dad and see if I can untangle this mess. It's been a little bit of hell on earth. If you are the praying type, please keep my dad in your prayers. His name is Bill. He deserves some health and happiness after all he's been through.
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Sorry - cross-posting.

Well, I'm glad you've got him out of there anyway. How's he doing in rehab?

Take deep breaths. Remember that at least *some* of the deterioration in your father's condition, inevitably, will be attributable to advancing age and naturally declining health. So although there are many questions to be answered and explanations given, don't fire both barrels before you've got more clarity.

Best wishes to you, and to your Dad for a good recovery - please let us know how you get on.
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Dad is in rehab now. I'm leaving in about an hour to visit, hoping he makes a full recovery. Very dicey as he has congestive heart failure, peripheral neuropathy and many other chronic diagnoses that make recovery a challenge. What kind of person yells and screams at his elderly father in a wheelchair? Spends hundreds of thousands of dollars and feels entitled and no remorse? It is hard to fathom. Dad still doesn't understand what has happened here. I'm not sure he ever will or should, as it would break his heart. He thinks my brother is a great guy who took great care of him. He knew brother was angry when he decided to move (as brother yelled at him several times when discussing it--Dad even called his lawyer to tell her he was afraid of brother. She just said, "I can't control whether your son gets angry with you or not." I hope we're not too late to have my dad have some decent quality of life and be able to see his friends and family again. He was so isolated for so long. My brother has no friends or sense of community -- just his now ex-wife, girlfriend (who was wife's best friend and lived with them for five years) and his kids. It's hard to comprehend what he's done to our father.
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Lisa, if you already suspected that your father's lawyer was unduly influenced by your brother why on earth did you choose her to report the abuse to?

Kickbacks or personal recommendation? If I knew a care home to be a good one because they'd looked after my MIL nicely, I would certainly recommend it to others. Whereas what you're implying, if one follows your train of thought to the end, is that your brother, your father's aide and this lawyer were bribed by the AFH to accept substandard care for your father.

Is that what you really believe happened?

I understand and sympathise with the rage one feels when family members appear to be responsible for failures in care. My goodness, I do. But where are you all at now, and what do you want to happen next?
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I do have access to accounts now. I may file a 1099 on my dad's behalf, as the $6300 per month brother was given in form of a check each month should have been counted as income. If he wrote all of that off as "expenses for dad's care" he should have to account for it.
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I could have reported my brother to adult protective services, but being so far away, he would have prevented contact with my dad, and an investigation would have been traumatic for dad. Dad's lawyer had nurse who visited 4 times a year to check on his care. All visits were pre-arranged, not drop in, and dad has mild dementia, so never complained about anything. He believed all the lies my brother fed him about how great his care was, despite sitting in a chair in front of tv all day, sometimes in house by himself. As soon as I saw the conditions in the board and care, my husband and I started renovating our home here and hiring people to care for dad to get him back here. I flew back and forth three times in a month and a half, got friends and family to call dad, etc. to help His health declined quickly and he is now in rehab after being in hospital for a week with bronchitis, uti and congestive heart failure symptoms that went untreated for several weeks before we were able to move him. It has been horrific. Be careful who you trust. Do not assume lawyers are trustworthy, or family members are trustworthy. If it looks like a rat and smells like a rat, it's probably a rat. Get everything in writing, involve neutral third parties -- several-- in consulting. Oh ... and try not to have a raging narcissist with no conscience for a brother.
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What about the house that brother built? Whose asset is that now?

How much care can cost... At the roughest calculation, four years ago acceptable residential care for a not especially demanding elder ranged from £750 to £1200+ per week. x 52 = £39,000 - £62,400 = $48,300 - $88,100 at today's exchange rates. But that's not including medical care, of course.

Have you asked your brother to account for your father's spending over the full six year period?

Where is your Dad now?
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As I said, there is much more to the story. I witnessed abuse, reported it to "dad's lawyer" (hired by my brother) who did nothing about it. I showed her the financial statements, she said she "didn't want to get in the middle of family business." By the way, this lawyer is the one who set up POA, will, and all the accounts, got the VA stipend, and charged dad $10,000 to do so, in addition to $1500 per year for "end of life planning." So she made $15,000 off dad in four years. (PS -- you can qualify and apply for VA stipend on line for free. And the adult foster care/"Board and Care" facility brother chose for dad once he was done with him was the same one lawyer put her mother in law in several years ago, and the same one dad's in home health care nurse put her mom in. There are only 6 residents at a time, and I find this highly coincidental and hinting of kickbacks from the Board and Care owner.) I should probably also mention there were five other people living with my dad full time, two part time, while Dad was living with brother. Only one had a full time job (my brother) until brother lost his job and was out of work for 6 months. So it's pretty clear dad was paying the bills for all, who had no problem with this.
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Just tried to post twice and got booted out of system, likely because post as too long. Short version? My brother saw an opportunity 6 years ago and ran with it. Took dad into his house, in exchange for $50,000 to build a new home and monthly "care costs." He moved Dad in and paid family members to "care for" dad, until it became too difficult at home. Dad's needs originally were not that great -- could dress himself, bathe himself, etc. at first. Now, needs 24 hour care. Brother took all his money, took his dignity, took him away from his friends and family he'd known here for 40 years, isolated him, took over all control of everything. Dad arrived with $150,000 in savings and a monthly income of $6300, which increased to $7500 after he qualified for VA stipend about 8 months after moving in with brother. $6300 x 8 months = $50,400. $7500 x 45 months = $337,500. That's a total of $537,900 over just under 5 years. Dad now has just over $20,000 in his revocable trust and $35,000 in his irrevocable trust, with about $5,000 left his "care account" -- the bogus account brother set up to divest money so dad could qualify for VA stipend so he "had it later when he needed it." This means my brother spent $477,900 (roughly) of dad's money over the past 5 years supposedly on his care. How much do you suppose an 83-87 year old man actually "costs" to care for per month? $477,900 divided by 53 months is $9,016 per month that my brother spent of my dad's money to provide poor care, neglect, emotional and financial abuse, and which ended with brother putting dad in a horrible adult foster care when his needs became too great.
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Absolutely YES! And yes, it should be all in writing. Simple contract will point out all you will be responsible for while caring for your father. But it will also help if you can find visiting physician too see your dad at home. One trip to doctor's office might bring a lot of problems considering that your father will be in contact with few sick people who might carry cold/flu virus/bacteria.
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I want to congratulate you on your good care of your dad. You have received some good advice from others on here. Now to figure out the best from all the options. I think it wise to take the above to your family lawyer/tax person to help You decide. I do not know if you have siblings...it is best that you all agree and sign...for everybody's sake. One thing I would urge you tho to do is explore the idea of getting a wheelchair van. I noted it took both of you to get In the car. A used unit is economical.Look they Ebay to get ideas on values.
Bless you for caring for your father...
Someday you will understand it is a blessing.
Take care.
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It looks like the link to the IRS website I had in number 1 above did not post. To find the information try a Google search for "IRS “Renting to Relatives” regulations" and the IRS page should come right up.
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The staff here at AgingCare.com asked me to comment as they felt that your question has not been properly addressed.

To think that staff is actually going through responses to make sure that your needs as readers are met is, I think, quite remarkable! What a great act of service!

So let me see if I may be of help to you and others in similar circumstances. There are two primary issues to be considered here: 1. income and other tax liabilities possibly accruing to the parent and adult children and, 2. qualifying for public benefits.

Let’s take the last one first because if you are interested in making sure that all of Dad’s expenditures or transfers are in line with meeting the financial requirements to qualify for Medicaid or Veteran benefits (non-service connected pension) – either now or in the future – there are certain do’s and don’ts. For instance, you will want to carefully document all transactions and you will not want any uncompensated gifts coming from
Dad to the adult children within five years of application for Medicaid.

If, however, you are not interested in, or can never foresee Dad receiving public benefits of any sort including Medicaid, then the ideas below are of no value to you and Dad can just gift all of his assets to you with no tax consequences at all (except for potential Unified Estate and Gift Tax consequences if total lifetime gifts exceed $1 million in 2013 – presuming the “Bush tax cuts” expire).

In the case where public benefits would be helpful now, or may be needed in the future, you have several options that will work with varying efficacy from a practical and taxation standpoint. (By the way, all of the strategies below can be used either by themselves or in conjunction with one another).

1. Charging Room and Board – It is perfectly legitimate to expect any adult to contribute to household expenses and to pay for their own health, maintenance, and welfare. Expenses paid by Dad, whoever they are paid to for these purposes, will not have a negative impact with respect to public benefit eligibility from a “gifting” standpoint as all transfers from him, to you, will, hopefully, be for the fair market value of goods and services being provided. There are income taxation implications which you can read about here; IRS “Renting to Relatives” regulations.

2. Charging for Care Giving Services – Here too, there is nothing “wrong” with being compensated for the personal care giving and other services (advocacy, management of financial and other personal affairs, etc.) you are rendering. For public benefit eligibility purposes it is important that the details of the arrangement be established by contract. This “Personal Services Contract” will establish a term, the rate of pay, the services to be rendered, and other provisions that will, in fact, allow a lump sum amount to be transferred from Dad to you in full advance satisfaction of the contract – a legitimate and legal transfer from a Medicaid eligibility standpoint. Again, though, there is a tax issue in that because this is an employment contract, income taxes and other employment based taxes will apply causing appreciable diminution of funds with little in the form of “deductions” available to offset the liability.

3. Purchasing a Life Estate – When an parent moves into an adult child’s home and has assets that would disqualify them from public benefit eligibility, or if the adult child would like to avoid the income tax consequences resulting from numbers 1 and 2 above, it may make sense for the parent to purchase a “Life Estate” in the home of the child.

The purchase of a Life Estate is as its name implies - the purchaser is buying the right to live in the property for the rest of their life with all the rights thereto. At the purchaser’s demise, all rights revert back to the “remainderman” (the adult child who sold the Life Estate to the purchaser).

The maximum amount that will be considered fair compensation as a purchase price will be the fair market value of the home minus the “remainder interest” as determined by using tables provided in your State’s Medicaid manual. Here is an example using Florida’s tables: If the home has a fair market value of $300,000 and the purchaser age is 88, $92,577 can be transferred to the adult children to purchase a Life Estate. (If the parent were younger, say age 77, a transfer of up to $141,147 would be permitted).

The purchase of a Life Estate by the parent would effectively reduce his/her assets without creating a Medicaid eligibility penalty and without creating (in most cases) a taxable event. If the purchase of the Life Estate were not enough to bring the parent’s assets to a low enough level for eligibility, either or both 1 and 2 above could be used.
Caveat: The parent must live in the children's home for at least one year for the transfer to not be deemed a gift.

4. The Supplemental Needs Trust (SNT) – Another option available in many states is participation in an SNT. This is an irrevocable trust, in fact the only irrevocable trust other than an Irrevocable Funeral Trust, that the parent can transfer assets to and become immediately eligible for Medicaid provided all other requirements are met. Unlike other trusts, a new trust document is not drawn and a lawyer is not required as the parent is simply joining an existing trust previously established by a 501(c)3 organization specifically to benefit Medicaid beneficiaries. Assets transferred to the trust may be used for virtually anything required for the health, maintenance and welfare of the grantor (parent) including paying for room and board and/or the support services of an adult child. The caveat here is: a) the cost of trust administration and, b) any funds remaining in the trust at the demise of the parent must first be used to pay back the State Medicaid program for the cost of Medicaid services rendered. Any residual thereafter may be distributed to heirs.

A lot to consider, I know, but I hope this helps. Good luck and God Bless
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Blueberry, I think you are right that you don't understand American culture. For one thing you are making judgments based on too little data. I have lived in my community for more than twenty years. I absolutely do not know which of my neighbors get flowers or dinner from their children for Mother's Day, nor do I know what they do for their own mothers on that day. I did not know that about my neighbors in the previous community I lived in. Heck, I don't even know what my siblings do for our mother on that day, unless we all go in on a large gift or I happen to see a bouquet from one of them when I visit Ma. And yet you claim you know what people in this country did for their mothers on Mother's Day. Excuse me, but I am highly skeptical. No holiday in this country has higher flower sales than Mother's day. Obviously very large numbers of Americans send flowers on that holiday. For many restaurants Mother's Day is the busiest day of the year. (I don't like crowded restaurants and my kids know I prefer to go out on different days). And you claim to know who pays for these meals? Piffle! Are you basing your entire impression of American culture regarding parents on one or two people you happen to know about? No wonder you don't understand American culture. And that is too bad, since you are living in America.
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Blueberry, How does a person work at a paying job if they are caring for someone at home full-time meaning they have to be there for the person all night and all day, everyday? What if they can't afford to pay anyone else to look after their loved one so they can go to an outside job?

As I said, you must have a lot of family support/income. If so, consider yourself to be very lucky.
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anybody should at least give a card and flowers to their mother at Mother's day. If you don't have money to pay restaurant. You can cook dinner to your mother at home. if you don't have money to buy anything. Go to find a job. Do Not find a ton of excuse for yourself.
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Blueberry, It's kind of hard to buy dinner, flowers and pay mom's bills without any income. Sounds like you must have a lot of family support/income. Just curious, how do you know some people just gave a card and didn't buy flowers or pay for their mother's dinner? I know a lot of people and wouldn't have a clue who paid the restaurant bill on Mother's Day.
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OneHatedDL, i mean "most" is 80-95% people in my country to take care of their own parent without pay. No children ask to be born in this world. i looked around where i am living (Massachusetts) no people take care of their parents (except 2 Italian background families). I knew and saw people only give a card to their mothers at Mother's day without flower and mothers paid dinner at mother's day. that's definitely unaccept in my culture, you can grab any people on street to ask this question in my country. The answer will be same like my answer. Every country has different culture i can respect that, but my background i can't accept to charge my own parent. Actually, I take care of my mom, i paid her bills and make sure she is all set and happy.
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I'm sorry, Jeanne, I did not consider other siblings./ You are correct.
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N1K2R3, is it fair for one child to assume all of the financial burden of caring for a parent, when there are 4 in the family? And then the other 3 expect equal shares of the inheritance? Pay-as-you-go to the child who is doing the caregiving is a way of equalizing the inheritance. The child who does the caregiving gets paid for it, and then all children divide whatever is left (if anything) as an inheritance.

It is all well-and-good to name the caregiver as beneficiary, but if the parent's health gets to the point where a care center is necessary, or significant in-home professional care is needed and Medicaid must be applied for, swish, there goes the life insurance. If there are assets to pay for care, they should be used to pay for care while the care is being given, in my opinion. A beneficiary status or an inheritance are pie-in-the-sky and cannot be counted on.

Often a caregiver must give up a job to perform the caregiving role. This means no benefits, no SS credit is building up, no pension dollars being put aside, as well as lack of income. The caregiver may have children to educate and certainly has an old age to plan for. A loving parent would not expect this kind of sacrifice IF the parent could afford to pay for his or her own care, in my opinion.
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I suppose that I'm "judgmental and thoughtless". I'm in agreement with Blueberry: " Did your parents charge you when you were little?"
You should not "charge" your parent for care. You should certainly do all the chores that you mentioned out of the goodness and love that you have for him. He, in turn, will or should reward you kindly by naming you as the beneficiary of his life insurance policy. What comes around, goes around....or is it, what goes around comes around? This is not a "foreign" concept.
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Do children in your country ask to be born? Children don't in the USA, which is why they are the responsibility of the parents.

To call the practice of having parents who can afford to pay for their care, paying for the care, American, shows a very shallow understanding of the width and breadth of the American cultures. Typical of people who have no idea of the immensity of this country or the diversity of our cultures and regions.

You use the term "most" in regards to your own culture- not a very specific percentage is it? That could mean 51%, not very impressive. What stats do you have that suggest our country's percentages are less than your country's?

American bashing, such an old foreign game.
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Did your parent charge you when you little and need them take care of you? I won't do it. Maybe it's culture. In my country, most people won't charge their own parents. They will do everything to take care of them. Some of them pay money to support their parents live. It's why sometime I don't understand American's culture.
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You should be getting $4200. My husband was in a home for one mo. $7000.00. Higher in other places. They are getting off cheap.
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When a parent does not have much money and becomes ill they can apply for medicaide their families except for spouses are not responsible for their medicial bills unless they have given them large gifts of money within 5 years of appling for medicaide then they would most likely have to give that money back before medicaide would be received-an Elder Lawyer would be able to give advice this is not being judgemental. A spouse of a person getting medicaide is usually left with very little money to live on that is very true.
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When my father became ill two years ago, my husband and I had 21,000 dollars in savings to help with our retirement pensions. We have a child in college that we wanted to use the money for, also. We used all of our savings during my father's illness. No matter how much we want to ignore the issue of money, it is a concern that must be dealt with when someone becomes a caregiver.

Most of the answers were helpful and kind to the member who posted the question. However, some of you came across as judgmental and just thoughtless. This is the one place many of us come to for comfort. Honesty is different from unkindness. Please be kind even when you disagree with someone. Rebecca
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