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She needs to be paid, full stop. Not only because all of her household costs will increase but also because her quality of life will deteriorate.

As his needs progress, her life will be consumed. The caregivers will have days and nights off, but she won't. Weekends away, if she can have them at all, will be canceled or cut short. No spontaneous day trips and no taking the day to hang out with friends; anything she does will require having the phone ringer turned all the way up in case of an inevitable fall.

She will lose all privacy. Not only will her dad live there but also a steady stream of caregivers, VNA nurses, physical therapists and occupational therapists will be marching through her house. No time for hobbies or time to visit with her own children/grandchildren. No private time to spend with her spouse. There will be no such thing as a moment to herself.

If he goes into the hospital, it will tie her up for that total time plus two or three days after while all of the f/u appointments are made, cancelled appointments rescheduled, new medications are filled, and new VNA RNs and therapy are lined up. Plus making all of the calls/texts to family members to keep them informed of every time they cough, sneeze or have a BM.

If every person who took in an elderly family member were reimbursed for their expenses and paid minimum wage for the actual number of hours they worked and were on call, the nations economy would be thriving.

Hell yeah, she should be paid and well.
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She should receive compensation. We give up a lot to care for our loved ones. No one really knows what it is like until they have walked in our shoes.

My mom had a stroke (short term memory loss) and moved in with me five years ago. She sold her property at a discount to my brother (totally their business and between them), she gifted my sister what she wanted her to have (totally their business and between them), and I am the beneficiary on her insurance policy (totally our business and between us). I let my mom pay the difference in what my utility and grocery bills were before she moved in and what my bills are now (she pays $30 per month electric, $20 per month gas, $180 on groceries.....) because she said that it is not right for her not to contribute something. I let her contribute because that's what she wants to do. Our elders still need to feel relevant too. I cook and she likes to do the dishes. She can do her own laundry and enjoys it. I assist with her bath and make sure that she gets to all of her medical appointments (I complete all of the paperwork and keep up with her medications.) ensuring that she gets proper treatment. I do all of the shopping and run the household. This list is not all encompassing, but those of you who are caregivers get the picture. At times it feels like you are raising another child, but then you realize that it's the person who raised you. I love her with all my heart! I do find that I need to stay up after she goes to bed because I need time to decompress and just be alone. Not much privacy here now. The hardest part for me has been her trying to tell me what to do ALL THE TIME!!! 😂 I'm nearly 60! She does go to visit with my siblings all along in order to give us both a break.

The bottom line for me is that I know that our situation is not perfect, but we all communicate and make it work for our moms' sake. Your sister is going to be giving up a large part of her life. She deserves compensation and her siblings' support. Each sibling should put themself in her shoes.
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Allwalls Apr 2021
Great information! Thank you. We have asked Dad what he wants but it changes depending on how lonely he is feeling, etc. At times, he says he's coming home for good. Then he'll say he's just coming home for a "visit" for the summer. If he starts insisting on going back to Florida as it gets closer, we may consider assisted living there but that creates another whole set of issues since no family lives in FL.
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A few comments sound like some think you and the others are trying to get "free" care for him, but based on all that I have read, my take is that you and the siblings think your sister is going to be in over her head. Certainly she is welcome to give it a try, but have a backup plan ready. You are aware of how much it impacted you, but either she doesn't acknowledge that or thinks she can do better. Even the least difficult elder can be a monkey wrench when living with us full time. But, before embarking on this, your dad should be asked.

You've written:

"She wants him to live with her..."
"He says he's too old to decide where to live."

But, although he says that, has anyone directly asked his opinion about living with her? He should have a say in this too. 

You also indicated that "...he chose to come home.", so he CAN make some decisions. Assumption is he is living with you now? Has he any inkling that a move might be in his future? Has he voiced any opinions, if he is aware of your sister's plan?

If he's on board and she wishes to give this a whirl, then some kind of legal agreement about payments needs to be done. In addition, your sister needs to know the legal and financial implications involved in being paid, either for rent or care-giving. From what you've written, care-giving would be done by hiring others, and this should be paid from dad's income/assets. Under the table, big NO-NO! Payments need to be documented and saved, for tax and potential Medicaid assistance. Hiring people for "cash" begs problems. Are they claiming the income? Are they licensed and insured? Sister may scoff at this, but if/when this becomes a problem, it will impact more than just those "cash" people!

As for compensation, personally I would only want enough to cover the increase in my own costs. The house is mine, so I wouldn't ask my mother to pay for it. Utils and grocery will increase, so if she can estimate 3-6 months of current expenses, that can determine how much of an increase there is with him living there. If she has to transport him to appts, etc, that could be added to a monthly estimate, but unless he's really ill with many appts, that should be a minimal impact. If the laundry involves many more loads, some compensation for time to do this. Cooking, unless he requires a special diet, doesn't really impact us - just a little more food, already in the grocery cost increase.

Is it a mistake? There's no way to tell unless she tries this. Not all elders become cranky, difficult or need excessive care, at least not in the first few years. My mother was still living on her own into her early 90s. Dementia impacts were mainly driving, cooking and managing bills. Your dad is about the age mom was when we finally moved her to MC. I tried hiring aides, but she thwarted that in less than 2 months (1h/d only, with plans to increase if/when her needs increased.) She was still mostly self-reliant for several years after that - fully mobile, able to bathe and dress, feed herself, etc.

If your dad is still very healthy and able, this journey could last many years. Is she aware of that? Of course his needs will increase with time and age, but just having him in her home for MANY years can become tedious, esp if he becomes more needy or difficult.

JoAnn29 said:
"But if she is being paid then so should the other sister be paid. What she does in time consuming."

I would agree with JoAnn29's comment, but that is up to the sister who is doing the work. If it isn't complicated and she's happy doing it, so be it. I am now kicking myself that I didn't take compensation, but my tasks were much more complicated. If it were just managing her bills, no big deal. I was more concerned about ensuring there were enough funds to continue paying for her and the MC.

Have a backup plan for when sister discovers this isn't a cake walk. Squash the idea about hiring people for "cash", as that won't end well. Get a legal payment "agreement" done with EC atty.
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Adding to my comment, but addressing issues not part of the original question:

You mention his house being sold and a condo in FL. IF the assets from the house sale haven't been put safely aside, I would highly recommend setting up an irrevocable trust. Although I didn't realize it until later, one of the primary reasons the atty had us do this was to "protect" the assets for inheritance. That was NOT part of my plan, so I did not do as he suggested, which was to feed the funds needed for mom and MC through my account, not hers. That would impact MY income, but more importantly is that I feel if she has funds for her care, that should be used for her care. Despite HIS plan, the funds were well managed and even outlasted her. IF she had needed to go to a NH, I would have used her funds, so WE could choose the place, not Medicaid.

Condo in FL should be sold too, unless you and siblings could use it as a vacation place. I had to deal with mom's condo after we moved her to MC. THAT sucked down almost 2 years of my life, not counting the time I had to help when we took the car away! Clearing, cleaning and getting repairs done, paid for with her funds, but also paid for with my time! It was about 1.5 hrs away, but that pales in comparison to travel between MI and FL!!!

For sister managing dad's finances - if she's using his SS funds, she should become Rep Payee through SS. It wasn't hard to do, mom didn't go with me to the appt and the yearly accounting isn't bad (can be done online through your own SS account.) While it's easy to manage someone's primary account, including SS funds, legally we are required to do this. That's up to your sister. If SS ever questions it, she might have some fun explaining! Likelihood is low, but it still exists.

Sister who wants to take dad in, with compensation: she also needs to know that if this compensation increases her income enough, it will impact what she pays for Medicare. I found this out when we sold mom's condo. It was a Life Estate (something I would NOT recommend unless the person has a known condition and fairly certain time line, plus they can live in the place until or close to TOD. Her "share" wasn't that much, but it WAS enough to push her over the limit (about 88k), so Medicare jacked up her cost. In her case, it would revert back the next year as it was a one time hit, but if sister's income hits/exceeds that amount yearly while caring for him, she needs to know about this as well.

Another thought - while many think hiring help to keep an elder out of AL is less expensive, they need to do the math! I don't know the going rate for aides where you live, but using $20/hr daytime rates (the rate goes up for nights, overnights, weekends, holidays) and 8 hr/day, the monthly expense would be almost $4900.

Both my brothers were clueless about the cost of care. After we toured the first place, they both said "Gee, for that kind of money, I'll take her in!" They had NO clue what "taking her in" would entail. I knew better. There's no way I could physically care for her and also my place would not be a good fit. YB was still working, but presumably he could stop and do the care. OB isn't local, so he'd be on his own. My initial response was if you want to do this, fine, but you NEED to understand ALL the implications! Neither followed through, thankfully. Neither would have been a good choice.

On the flip side of math, mom's MC place was just over 8k. Yes, it is a lot, but divide by 30 days and then by 24 hrs, it's less than $12/hr. There are many costs associated with a facility that have to be covered, so she isn't "getting" 8k in care. Insurance, taxes, food, maintenance, staff for care, preparing food, cleaning, admin, etc. all add up!

She was well cared for, clean and fed, relatively happy. I would not change anything (except banish dementia!)
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Your sister should be paid if there are funds to do so.  If this is such a walk in the park, why aren't one of the other siblings taking dad in?  Your sisters life will change.  If he has dementia, he needs help and he needs watched.  He isn't just a border...he will also need companionship. She will more than likely be cooking, cleaning and doing his laundry, making his dr's appointments and taking him there.  When he can no longer bathe himself of manage toileting, you all will need to hire someone to come in and assist with that.  She isn't going to be able to just leave him and take a day trip...her life will change.  As his dementia worsens, she won't even be able to go to the grocery without having him watched. 

I can only assume none of the other siblings have been the caregiver of someone with dementia or this question wouldn't be asked.  Not only should she be paid, but when dad passes, if there is still money left, she should get her fair share when it is equally split among the siblings.

If you and your siblings don't like the idea of sis getting compensated for changing her life and taking dad on, then send him to assisted living.
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The bottom line is there will be another mouth to feed, not to mention prescription administration and custodial duties. If you had to hire someone for these services, it would not be free.
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Your dad’s dementia will not stay as-is. Would you and your other siblings be willing to alternate care? So if you there are 4 of you, you would each have him for 3 months of the year? If your answer is “no,” gladly pay your sister! He can pay her himself from his Social Security. Think of it as rent and food if you must, but it is much, much more. I would be thrilled .
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Allwalls Apr 2021
Thank you for responding. Having him live with others wouldn't work. For one thing, they all live in different states and I've been told moving someone with dementia isn't good for them.
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