My brother and I used my Mom’s financial assets (about $300k) to provide good quality care for her at a private-pay memory-care facility. Our commitment was to use everything she had for her needs, and we felt blessed to be able to do so.
Sounds like she would be spending everything she had anyway. Except she would be giving it to the government or a crappy nursing home giving her substandard care. This way, at least, she would getting the best possible care for that money.
Our family is doing the same with “our inheritance” My parents sold their house, went into assisted living private pay for three years when health started to decline. Great quality of life during the spend-down period. My dad suddenly died and now my mom is in their memory care section. The staff all knew my parents and mom is getting excellent care under Medicaid plus cost share from social security.
As an only child, I knew that I would be responsible my parents’ care. I know this seems odd, but when I was young and first employed I purchased a life insurance policy for myself and named my parents as beneficiaries. Although it wasn’t a high value policy-the value did increase each year-the premiums were inexpensive because of my age. My thought was that if I died before my parents, they would have something to provide for their care if I wasn’t there. I’m now 74 years old and my parents have died, but it always gave me comfort to know that I did that for them.
Great job! Unfortunately, today's youth do not often have that sentiment. And with one or two kid families becoming the norm, that will more heavily burden the system with elderly who have no family that can or will care for them. I wish we were all like you.
Thank you. This was totally informative to me and justified what I’ve been thinking. I have a pretty large 401k and very generous RMD. Small pension and great Social Security. I do not want to even consider a nursing home and think I will be perfectly capable of paying for in home care if it becomes necessary. Now I’m very comfortable with that goal.
Actually, very wealthy or very poor. The system is structured to make sure that if you worked hard and saved, they will make you poor before paying. And even then they will do their best to recover the money they spent on you. If you can save enough to afford your own care you are best off. Everyone else is screwed. The poor are already qualified so they get a minimum level of care releasing the children from the burden. By poor I mean renters with low income and no assets. I am allowed two thousand dollars of assets for everything including bank accounts. If I had a home it would be exempt for qualifying, but then they would put a lien on it for all expenses paid in my name so they would get paid before anything went into my estate. What a joke, I have no estate. My long term care plan is a long walk off a short pier as I cannot swim. If I enter a nursing home they would take my social security check and give me fifty dollars a month for personal items. That would be everything I am allowed to have.
7 years ago both my children said no way about going to a nursing home. My daughter passed away and my son married a girl "WHO" NO DOUBT in my mind!, I'm going to a nursing home. Which is what I've always told my kids. I'm just saying, no matter what kid's tell you now, thing's happen😔 and then other things change if spouses change. Please think about that.
The odds are 96 to 4 that you will not go to a nursing home long term, more than 3 years. See if you can pay down any mortgage, so you can do a reverse mortgage for those possible 3 years! Then tell daughter in law she and your son can A. Help you with care in your home B. Help you with care in their home Or C. Not help and you will find your care with your house and leave everything extra to a pet charity! lol She may think differently, depending on the equity in your home!
Many who demean Medicaid as immoral or mooching have never had to face a 5 or 8 or 10k monthly bill out of their own pocket for a parent’s nursing care after the parent has exhausted his or her resources.
I think that a lot of people might not be demeaning the Medicaid program itself as "immoral or mooching". They think that Medicaid was designed to help the poorest of the poor. I know a woman who had a paid for, very expensive house in one of the nicest areas in town. She also had a paid for beach house. She said that she and her husband were giving away their money as fast as they legally could to their also rich children, so that the woman and her husband could get on Medicaid when they needed LTC. Should taxpayers really be subsidizing already rich people who just want to make their own children and grandchildren richer?
@@joanschilleci7564 First, asset giveaways such as you describe can disqualify Medicaid applicants if done within 5 years of application. Second, if the woman you "know" does all her giveaways more than 5 years before applying, she is gambling on living long enough for her nefarious scheme to pay off and will have to live on seriously reduced assets in the meantime. Third, she will likely also have her LTC choices reduced to a shared room at place that takes Medicaid, which rules out the sort of accommodations she sounds accustomed to. Fourth, when she dies the govt can put a lien on the houses to recover costs if they go through probate. And five, only a principal residence can be shielded from Medicaid asset counts, and only up to certain amounts of equity, which rules out beach houses and might even rule out your friend's high-end, paid-for main house. Point being: Yes, somebody somewhere will game any system you set up. If more controls are needed and make sense, put them in place. But don't use "I know someone" anecdotes to malign a program whose recipients are about 1000 times more likely to be legitimately poor than they are to be rich moochers with beach houses. If you're really interested in the topic here's some actual information: www.medicaidplanningassistance.org/can-medicaid-take-my-home/
As with my family, we didn't want to put our mom in a nursing home but her dementia got so bad that we could not properly take care of her ourselves. Fortunately we found a wonderful Methodist care facility in Chelsea Michigan where she had very good care. Her aides were truly loving and kind. She ran out of her own money there but they let her keep her private room on Medicaid anyway until she passed.
@@angelarecker7973 Yes, people with Alzheimer’s wander, and it’s not safe. It’s important for family to get their sleep so they can manage things and be a support for the person in need of care. Exhausted people are cranky and mean.
They are run no different, and of course the staff are kind. But is the care truly getting done and done right, under my licensure, no, no it is not. And management could care less if my CNA’s disappear or sit outside gossiping for two hours or don’t do their rounds and change & turn people every two hours. These folks are hitting up up the morning and left until after dinner when finally they will be put back to bed and changed. Trust that. And nowadays my help, I’m an RN, are agency staff, new staff each day claiming they didn’t know this or that. Honestly it’s impossible job to do.
@chilloften I hate lazy coworkers and lazy nurses (not you). You are in charge as the nurse. We are all part of the care team. Give report at the beginning of shift discuss break times and let them know if you can't find them on the unit you will page them overhead. No one wants to be paged overhead and the managing office hearing someone's name constantly gets irritating so they will be reprimanded. Also, if they have friends in the facility, the work will get done because they don't want their friend to get in trouble. If you expect neglect, anonymously report it and go from there 😉
How outrageous. Since nursing homes cost so much per month, you would expect that the level of care would be top notch. However, to hear that the care is extremely sub-par is a travesty, and people shoud be outraged. Where is Congress on this? This is where we need strict regulations on nursing homes. I've heard that we do, but are they enforced? Apparently not, so what a travesty. So we need more strict regulations and severe penalties for nursing homes that are actually enforced for those facilities that don't comply. What a shame for seniors in the final years of their lives. We can do better as a nation.
You would not believe the type of folk I’ve been forced to work with in these places. And most come from agencies these days. They run the place and the smear campaign against anyone wanting the care done that I’m signing for.
Sure . Now that's OUR turn, we call it a travesty that nursing home care is sub par. This is not news people 20 years ago, the rules for Medicaid and the sub-par care was nearly identical to today's standards. My grandmother endured a "good" nursing home for her last years of life. The care was sub-par and we couldn't afford "better". She died in less than 2 years due to being "interred" - she was in emotional, mental and physical hell the entire time. Today my mother is at the door of decision - i.e. stay home or go to a nursing home. My stepfather is doing everything he can to provide her care at home so she doesn't have to experience the same end of life "care" as her mother did in the "good" nursing home. He cannot afford 24/7 in home nursing care - which we have seen is also another form of sub-par or simply unreliable care that is entirely dependent on the provider's skill, temperament and personality.
The sad news is that healthy people in their 80s and 90s who can't take care of themselves spend many years in nursing facilities. My mother-in-law lived for 8 years after going to a facility, and my 92-year-old mother was told by her doctor that she'll probably live to be 100. Medicaid needs to require more quality care from these facilities.
Your family is out of the ordinary. Statistically only 4% spend more than 3 years in a nursing home. Maybe they go in very sick, or maybe poor care or depression speeds it along? :(
We had to suddenly place my mother in a nursing home after a 2nd fall & due to her Alzheimer’s she became unable to walk. We had done no planning. Hired an attorney to help with the spend down and found a wonderful Medicaid memory care center. They are out there!! ❤
They are not in North Carolina! My husband suffered a severe traumatic brain injury 2007 and I cared for him at home until 2014 when I needed cancer surgery. After much effort I did find ONE Medicaid facility with a memory care unit that agreed to take hime temporarily until I recovered - and I still had to pay a portion out of pocket because of our small home and my work income . They refused to admit him to the memory care wing because he was agitated and upset the other residents - plus the unit was full. The nursing home promised a lot but did not deliver. It smelled, his sheets were not changed, and residents sat in the hallways in wheelchairs during the day. He died 2016 in another nursing home (equally bad), after he broke his hip. From 2007 until his death, I received an inside look and many Medicaid nursing homes, and they are hell holes. No human being should ever live in one.
@@macpduff2119 I agree. We really needed Congress to set up another program that everyone can pay into, and take over all those robber-owned nursing homes, make them not-for -profit. Strict standards of care, staffing, safety, and cleanliness. My mother lived for seven years in nursing homes with dementia. Luckily, we were able to transfer her from Georgia (don't get me started) to one close to my sister in Virginia, where she got great care on Medicaid at a not-for-profit facility. Before we could get her on Medicaid we had to pay $60,000 out of pocket, for horrible care in Georgia. He's giving all this advice for people with million dollar estates. Give me a break.
@@itguru2037 my comment was more about how I was able to spend every single day with my dad for 7 years once he was no longer physically able to care for himself. We traveled the country, vacationed, and shared quality time together. I could never put him in a home. He deserved better and he got better. I’d do it all over again. At 92 he was still a roller coaster lover. No, moving into my home wasn’t about protecting assets, it was about maintaining his quality of life and allowing me to be with him.
Damn! We just fired a high priced firm specializing in Trust planning. We were very uncomfortable with them because it felt like a factory line approach to planning. We actually got a sizable refund which made me suspicious. This video alone could have save me all that trouble. They pushed hard for an irrevocable trust, (10 times more expensive than other trusts and yearly Maintanence fees for life!) . They weren't answering our questions at all and were angry we kept asking. We have a small but successful family company and income sources and Roth IRA's that mean our income would have remained low six figures (minimally) for life and this alone would have rendered us ineligible for medicaid type coverage of a lengthy assisted living stay AND we would have incurred six-figure(!) tax liabilities because of our Roth IRAs while losing the ability to pass those on tax free to the kids! Thank You Paul. You have confirmed all my suspicions in 11 minutes and have a new subscriber.
Thank you for this.. I knew in my heart there is no way I could let my mother live that way when she had saved the money for much better care. At 87 yrs old an a former nurse.. she would be tortured with that kind of care. She's staying with me for as long as she wants.
That gives her peace! My mom and I had a pact she would stay in her house until the money ran out then reverse mortgage, then if that wasn’t enough, come to me. She didn’t want to leave New England for SCal! But she would if she had to, in the end. She passed before her money was gone at 87, stayed in her home with wonderful CNA ladies. And she was only out of her home 1 week at the end of life. RIP mom. :(
Years ago, we purchased the home for my parents, and they rent from us. It's in our name, and we take care of the insurance/taxes/upkeep and we charge them monthly rent.
As an estate planning attorney who does not do Medicaid planning but gets asked the question often, I think this video is fantastic! The best explanation I've heard. Thank you!
Except he needs to clarify better who he WOULD advise to get non revocable trust, and that such a trust also skips probate. So there is more than one reason for such a trust!!! Probate eats into the costs of your estate, with lawyers, courts and other costs taking a big bite and being all in your business. Handling my mom’s probate, ongoing due to lost trust / investment docs from 1995, has been so costly and so painful. Just repeating over and over again, to strangers on the phone, “ mom mom passed and I am executor and need to…” everything from cable and tel, to banks and home fire insurance… a million times. :(
I was in a rehab (nursing home) for a month from an accident- The people who work there were kind and helpful, professional, the facility clean and didn't stink... I was fortunate that it is only about a mile from my house and my wife and kids visited often. But... probably ALL nursing homes suck. It's not home, and it's not pleasant to have to ring the nurse to help with using the commode, and other built-in indignities. . I hope to never experience that again.
I wish this was your first video. I just finished setting up a irrevocable trust for my mom after following your previous videos and now I'm second guessing myself.
We paid close to 7K totally for my Dad’s nursing home a month. He was in a double room. The guy who was in with him was on Medicaid and received the same care as my Dad did. It took all my Dad’s money for the last 14 months of his life.
You overpaid for a double room. His room mate was lucky. My mother paid for herself and got good care. My Aunt went on medicaid and was transferred to a double room. A nightmare for her to be with a patient who played the TV loud 24 hours a day and we couldn't get it changed.
@@Essays4College Most nursing homes take both private pay and state pay. It wasn’t a state nursing home but a private nursing home that also took both.
@@Essays4College I don’t know. My parents had it for 2 years. It was $700 a month for both. They were in their early 80s I think. When I moved to their property, they canceled it. I know some people have it but I do not.
Paul: This video really hit home for me. I've struggled with what my husband and I should be doing with our estate. I thought our goal was to protect our assets from the nursing home, but we just need to hang on to our assets and plan for the "best" home nursing care that we can afford. I've seen what COVID has done in our local nursing homes and I will not let that happen to my husband or to me...Thanks for opening my eyes to what I already knew.
My mother was in a 'Medicaid' nursing home for over 5 years. I would visit weekly and just destroy my heart watching her be neglected. Medicaid required a double room, all 3 roommates she had were abusive, the place smelled, only broken English spoken and food sucked. During the Covid PLANdemic she was moved to a hospice room on 1st floor so us kids could still visit with full surgical gowns which made my mom think the world outside was coming to a end. Then our Governor found out they were allowing us in and threatened to shut them down. My mom passed weeks later all by herself wondering what happened to her family. Looking back now that most of that overaction was for nothing but a power grab, I get mad at government overreaching, and makes me want to plan for my own future better.
@@HighCountryRambler What happened in the nursing homes was disgusting. I do not agree that the government overacted. People in nursing homes were dying in droves, and they thought they were abandoned. They couldn’t hear their loved ones on the phone, or see them on FaceTime. I believe staff were infecting them. It was not right for you to be going in. Some places had visiting outside, or put residents near first-floor windows and family could be outside. I am very sorry for your loss, and your mom’s and your family’s emotional distress.
@@HighCountryRambler I'm so sorry for your mother! Of course your heart is broken 💔💔💔. Nevertheless, I'm troubled you believe it was a plandemic. I'm no fan of his, but once Pres. Trump finally did get moving, I believe he tried. He could have told us about it earlier, but he could not help what happened in China.
I appreciate that you included the moral aspect. It seems that so many today will sell their soul for a few dollars. Significant decisions such as estate/Medicare planning should be made thoughtfully and include all aspects such as financial, legal, moral and practical. I think you did a great job of covering the landscape in this regard. It seems too many lawyers simply want to sell you their services and not really evaluate what makes sense for each couple or individual given their unique circumstances.
Is it moral and right that people work 45 years or more, and in last decade of life have to sell the family home and pay all benefits for awful care in a nursing home? And we also fund both Social Security and Medicare through taxes! Give me a break. The gov allows this to offset the unfairness, and if allowed that is great! But really only 4% end up in a care facility for longer than 3 years! I think family should be able to help parents stay in home, encourage “inheritance” spend down to do so! And protect the family home so 45+ years of work can leave something to next generation. A trust how ever can skip probate, so that is also a good reason, it is $1200 to $1500 now, that could say inheriting kids, tens of thousands of dollars.
I have an 86 year old sister who has been in and out of the hospital for at least a couple of months now. She has several serious health problems such as congestive heart failure, Stage 4 kidney disease and uncontrolled diabetes. Her husband was recently diagnosed as having dementia so he’s not much help in taking care of her. Her 2 daughters are determined that she will never go to a nursing home. So in the meantime when she is out of the hospital she is sometimes staying at the one nieces home who works full time. The other niece takes care of her two grandchildren who are both babies and a third one on the way. I sometimes fill in to stay with my sister as she needs someone with her 24/7. This has been going on for a couple of months. They also need someone to take her to one of her many doctor visits and I fill in there also. I don’t know how much longer they can keep this up. My sister can feed herself and can move around some with a walker but she is very unstable and needs all her meals prepared and at least someone to help with her bathing. She is not on Medicaid. She has a Medicare Advantage Plan and I believe another supplemental insurance plan. I think she would probably be better off in a skilled nursing facility or someone to be with her 8 to 9 hours a day which is what one daughter is trying to arrange for her. I think it is very easy for her family to say they don’t want her in a nursing home but it’s a very big burden on everyone right now.
Medicare does not pay for long-term care. It pays for a limited number of days after you are released from a hospital. After that, good luck. The "advice" in this video is only for people with very large estates. If you are middle class, they will make you spend down your assets out of pocket, until you have nothing, then you are eligible for Medicaid.
I am sure if you offer to pay the 7 to 15k a month it will cost at a nursing home the family will give your opinion the proper weight. Also remember most homes are chronically understaffed and filled with near minimum wage rotating workers. Instead of changes as needed based on bowel movements many locations check in at a set timeframe that easily extends hours based on staffing and workloads. Bed sores and infections often follow. So be prepared to be blamed on the poor service you chose when only paying 7-12k a month for services. If you pay around 13-20k a month you will find more care givers per patient, your mileage will vary on how nice the caregivers actually treat your loved one.
Also forgot…. The home will do a means test on the application. Your loved one’s estate must contain enough assets to pay for their projected lifetime. If no many high end homes will not accept the application.
Spend or move out of your name then hand over any pension or doc security monthly, and sell family home if not in an irrevocable trust! I am getting trust anyway to avoid probate for my kids!
I recently spoke with a nurse practitioner, whose grandmother had a wonderful experience for 18 months in hospice. You may want to look into that because you don’t have to take the person to doctor appointments. The nurse that comes to the home communicates with the doctor about what the person needs. This is something we’re thinking about
saddest incidents from two personal friends and one family member , after going into a nursing home, even “quality” care , personal clothing and other items were stolen with no concern from administrator. Wrote name on new clothing but still not there on next visit. One friend asked me to check used clothing stores,her items were high quality clothing. So sad treatment like this. great info on this today thank you
@@genxx2724 so sorry it happened to her;shouldn’t be.Just heard from another person who now has a locker at foot of his bed. He alone has access. Thought it’s a great idea.
@@lmr691 Clothes are taken to be laundered and never make it back. My mom bought her loose-fitting floral dresses in pretty colors with snaps down the front, and cardigans to match. Her name was on everything. Writing it in inch-high letters in the dresses made no difference. She was in her late eighties, not ambulatory, and couldn’t see well. She was in no condition to get out of bed and access a foot locker. She was a nursing home patient. They’re helpless.
@@genxx2724 Yes, it is so sad and very frustrating for you. My mother-in-law’s new clothes were marked as you did but it didn’t matter. Her clothes weren’t always hers and new items always disappeared. I just don’t know how our loved ones can be protected.
Here in California I was told by my aunt's social worker that if we decide to go with the Medicaid route be prepared for a 3 year waiting list so plan accordingly.
One of your best videos! Great honest points Paul thank you. Dying with close to zero is gaining traction. Yes, talk is cheap when kids say they will take care of you. Don't count on it.
So true! Children will say they will take care of you no matter what. They just don't realize that when their parents get to the point where they need that level of care, they may not be physically able to take care of them. My mom didn't want to go into a nursing home and we kept her out as long as we possibly could. However, her level of care is now so high there is no possible way either my sister or I can take care of her. We both have our own health problems and the nursing home is the best place for Mom because of that.
With the exorbitant cost of health care these days in this country, I would never want to burden my children with that. It is our responsibility to make sure that doesn’t happen. I don’t feel it is fair to expect our children to financially provide care, unless money is of no issue. For any parent to expect or even feel entitled to that, is selfish.
Unless we give them our money now when they need for grad school etc, and are leaving them a very valuable home! I don’t expect to live in their home, but I expect help in staying in mine with care as long as possible. Even if I spend down the equity in the house and all my cash! Families help each other!
I always felt I would NEVER put my parents in a nursing home. Unfortunately because of health issues, I may end up in a nursing home, so I'm not sure I could do anything for them. Which really sucks because most of my adult life I spent my life taking care of elderly and sick (dying) people. Now at 54 years old I'm in a wheelchair myself.
Aside from the recovery period after a stroke. Mom stayed with me. I hired caregivers for the nine hours needed to continue working. Her SS and pension paid for the care giver, she had poor medical coverage, I covered housing and food, everything required of a parent to care for a child. I was lucky to spend time with her but my back will never recover. She passed at home after 8 years. Those years with her proved to be the best investment I ever made. I worked until retirement and now survive on my SS and 401K plan. Slow death for me will be a dismal undertaking. Trust would be no more than a cash-out for a family that doesn't even seem like mine. I have never seen a nursing home that provides the care or love a family could, but they have a well oiled machine for circling the wagons. Siblings, nieces, nephews and grandchildren are complete zeros.
Number ten is that every dime Medicaid spends on their care will be put as a lien on the exempt home so you pay it in the end anyway unless the parents are renters. So many miss that asset when they are planning because they are told it is exempt. It is called Expense Recovery.
@@Jen-ur4ut Yes, some states have made recovery nearly impossible or totally impossible, but the states that allow it are relentless. They won't kick a surviving spouse out but when they die, the rest of the family is out and they take it. I've seen a few adult children evicted and homeless due to this action here in Missouri.
@@Jen-ur4utmy grandmother lived in FL and my dad and aunt fought over whether to sell her house to pay for better care or protect it and use Medicaid so they could inherit it. I think my dad won the battle (protect the house) but it seemed wrong to me.
All if your points are valid. As a single person with no children, my estate will go to several relatives. I long ago decided I would not relinquish control of my assets as I have never seen that work very well. So, I don't know how I will achieve it, but I do know that the resources I have worked a lifetime for, I want to be a benefit to someone else and not for keeping a broken body breathing. If I can't function, then I want it ended because I don't want to be a burden to myself or anyone else. This "keep the lights on" by any means available is part of a sick society and I hope to have the ability to use a bullet if that is my only option. ...just trying to be realistic.
While I agree with you, that's not the issue that Mr. Rabalais is talking about. He's not talking about keeping someone alive in a hospital at all costs, he's talking about nursing home care and how to protect one's estate from getting entirely consumed by the enormous cost of it, and whether the actions that one has to take in order to gain that protection are worth the downsides.
I agree completely. I am not rich, but I have strived to save money so that retirement won't be a terrible burden. And when I go, I would like to leave something for my children. My hope is to create some generational wealth or at least some additional assets to help them going forward. I'll figure it out so that I leave something behind.
My biggest complaint is when a single parent (that has dementia/Alzheimer's) is placed in a nursing home and the medical proxy DOES NOT let the nursing home know that there is LIVING family. My mother lived in Massachusetts and I live in Georgia. When she was placed in the nursing home I tried to contact nursing home to ask a variety of questions. They refused to speak with me, stating that there were NO LIVING FAMILY listed in her initial paper work. That the medical proxy said there was none. Yet when she passed away in October; who did they want to claim her and pay for cremation and burial?
I am single, 73, fairly healthy, but losing my vision and will prolly need nursing home care in a few years....your advice has been very straightforward and easy to absorb......thanks very much.......do you take out of state clients?
Medicare should have a built in coverage or a separate option to buy Long-term care insurance, at least it should cover a year. The problem is one can get severely ill for a year or two and wind up spending all their assets on LTC, after they recover they have zero $ in the bank, and out of a job too, its like going bankrupt. And this can happen to anyone at any age, not just seniors. So, Medicare and all health insurance plans should have by default one year of LTC, only a small percentage will windup using it, so the cost should be minimal as everyone pays.
Yeah and they also need to pay for dental and vision, but that will never happen even if the health of your mouth and teeth are just as important as your overall health.
You're a good guy. Your video is making me re-think doing an Irrevocable Trust as we were advised to do for my mom, and just doing a Revocable Trust for her. I want to do what's best for her. She worked hard for her money and deserves the best care from me and aides. You give good, sound, conscientious, ethical advice. Your clients are lucky to have you and your knowledge.
I'm so thankful for all your videos, and this one was most important to me and made me see things I did not consider before. You are a very generous man, and attorney, that is giving us little people so much great free advise. Thx again.
I’m glad I found out aboutMedicate planning. Ideally don’t like nursing homes They control you and your power and dignity.I hope to live with my Family. I’m late than ever .I will talk to estate attorney as soon as possible.thankyou😮 E 😮
Thank you for this information. It definitely confirms that I made the right decision for my mother to NOT put her farm property interests into a trust. It's been less than 5 years and she is able to be in one of the top nursing homes in the area. This home does take Medicaid, but is primarily a private pay facility. It has only been a few days, but I can already see she is getting so much better care where she is at than my father-in-law who is at a primarily Medicaid facility. I also have the philosophy that retirement planning is done for you to use for living including any care you need. An individual does not plan for retirement so that their children can have an inheritance. As far as COVID, the facility where she is at had very few cases and/or deaths. Where my father-in-law is at had one of the biggest outbreaks in the area. Mom did not get it, but my father-in-law did. It really does make a difference when the facility is primarily a Medicaid facility vs. a primarily private pay facility.
@@SandfordSmythe Yes, they do as does the home my mom is in. It’s just that primarily private pay facilities typically provide a higher quality of care even if they accept Medicaid.
@Cathy Berry Are you trying to drag Biden into this? This existed for decades. Medicaid [ not Medicare] is mostly a state thing. The feds will require certain basic mandated programs for the states. How they are set up in states is a local decision. One factor is the amount Medicaid will pay for nursing home providers. It is very minimal and many nursing home can do better with private pay. Paying for nursing home placements is a very expensive proposition, and many states would have their citizens complaining about taxes. This was considered for earlier versions of Obamacare, but it was rejected as being too expensive.
Appreciate this video confirming thoughts I have had since my wife is disabled and on SSDI. We're in our 40s and we hear a lot about this Medicaid planning. It hasn't made sense to me since I make a lot of money, and we even have long-term care insurance if we need it (which we bought in our 30s, so cheaper), so I wondered about Medicaid nursing homes. This video confirmed that Medicaid planning is not for us. I also have wondered morally about Medicaid paying, since we have resources. While my wife does have Medicaid, it's only a secondary insurance to my primary, so it rarely pays anything (though it drops the negotiated rate so we rarely have coinsurance), making me feel better.
One of the few countries who prey on the most vulnerable senior citizens who have worked hard their entire lives only to have the state Medicaid take everything they, or their children, away. Absolutely criminal that this society condones, encourages, exploitation of seniors.
@@niftynimbus5808 yep. The rest of the world is wrong! Long live capitalism! Feed the rich, tax the poor, till there are no more poor. So what if we’re excluded from the club, stay on that treadmill! Listen to George Carlin. He was right. The owners want poorly educated, barely literate workers, hard working people who know one thing for sure: the system is designed to keep them where they belong, down…with a big red, white and blue dick shoved up their asses.
Very good info, few know or think this way. I have to save this video. Single people are always at a major disadvantage when it comes to taxes, benefits, long term care,etc.
Single people subsidize everyone else, while using nothing but the some of the country’s physical infrastructure: roads, sewers, etc. When we need something, we’re on our own. We need help when we are ill, recovering from surgery, and when we’re elderly. We get told to go pound sand, and oh, by the way, keep paying taxes to provide for others while you’re at it.
Incomplete info!!! There are other reasons to do an irrevocable trust, but many here are just saying ok good I don’t need this! Find the lawyers and courts will take a good chunk of your estate and your kids will have the hell of probate. This video gives the idea you don’t need a trust for this one reason. But should warn there are other reasons you may want one anyway!
This video is God sent. I was diagnosed with CMML leukemia 4 months ago and have been struggling with what to do. My response below explains my experiences with State funded nursing homes before my husband died 2016. I have a small home and I think the best way to leave my children any inheritance is to either live at home until my end or take money from selling my home and build a room onto my daughter's house. It's only recently that families started thinking that State funded facilities should care for their sick family members. My elders lived at home - sometimes with help from family members if needed, - until their final couple hospital admittances.
That is best, but with the changes in society over the last seventy years or so, smaller families, geographically far flung, children may not be able to provide in home care. Then what?
Here in central California one (good place) here locally is approx. $2750 a month plus a one-time charge of $500 for accounting. That price is for a shared room. I think the rate goes up $50 a year. That doesnt include extras like in house hair salon etc. I have been taking care of her for 11 years in her home and she is pretty much thriving. No major health issues (except for Alzheimers). She is going to be 88 on Dec. 3, 2021 and she has had Alzheimers for 11 years. I think shes gonna break records. She gets the best food and coffee at home. If I didnt take care of her, her house would be gone.
I would not be surprised if you learned that $2750 is grossly understated. I'm in Illinois, one of the least expensive places to live in the US, and a good nursing home in my area is between $8000-11,000 a month. $2750 would be the Medicaid payment and I would rather my mom die than put her in one of those homes.
@@vegetabohls9124She isnt on medicaid. And I thought $2750 was ridiculous! 🤯 Are you guys talking about the cost of "skilled nursing" because yes that is like triple the cost of assisted living.
Our mom (I'm one of 4) lost $$$$$ on get rich quick schemes. She thought we'd pay for a deluxe nursing home. Since she had verbally or physically abused all of us no one wanted her near them. I put her near me, and used her remaining funds to care for her. I'd visit, until she'd start screaming at me, then I'd leave. Tina, Al's wife
I am sorry that your mother was an awful person. I am glad that you were decent to her at the end, although it was a tough row to hoe, and your took the brunt of it for your sibs. I hope that they appreciate you, I do.
Your story is very familiar. My sister quit her job in order to take our mother in. Unfortunately, after a couple years, my mother grew demanding and difficult to be around. Early, one morning she decided to take her car and leave while everyone was asleep and drove cross-country and returned to where her house was. Then she talked my brother into taking her in by downplaying how much help she really needed. Once she moved in with him, he quickly realized what a big mistake he made. With his work schedule it became unsafe for her to live with him and we ultimately had to move her to a nursing home. Unfortunately, some parents just can't (or won't) live under their children's roof and their best option really is a nursing home.
This confirms what I have been thinking. Between pension, social security, investment income, and RMDs I should be able to self finance. It would work out best if I stay out until 75 though, thus no smoking or drinking and plenty of exercise.
My god! I’m SO glad I ran across this video! I kept wondering why everyone was telling my wife and I to protect our assets now so we wouldn’t have a Nursing Home get it all. But who the heck wants to go into a Medicaid-funded nursing home? We.re fortunate enough to have enough savings & assets that, with our SS and small pension, SHOULD help us to self-fund ourselves in an Assisted Living or Private Pay facility for a number of years. And retain full control of our estate. What a burden of worry you have lifted from us today with this video! Thank you!!!
My mother dreaded going into a nursing home when she was d Iischarged from the hospital to the nursing home. She was inconsolable. Now, when she was able to leave the nursing home for her house home, she fought it! She told her doctor she still felt weak, etc. He gave her an extra week, and then made her go home. The next time she needed to go into the nursing home, she looked forward to it so much, and was welcomed back by her "friends." I know that's not the experience we all hear about, but it was hers, so I realize there are good nursing homes.
A big variable is the person's attitude and ability to fit in with others, adapt to life in an institutional environment, accept help and friendship and make the best of things. Some people can do those things and others can't. Reviewing and reflecting on their past experiences will give a reasonable indication of how they will do in decent nursing home.
Ask a local lawyer if there are any other reasons to get an irrevocable trust. You may or may not want one, but you should have more info before deciding.
This is great info. Thank you for making this video. I’m glad that the title was not rhetorical. You gave excellent reasons that helped me to be educated and make an informed decision.
This is VERY well done. We keep having friends and family tell us we should do the trust thing. After watching this, I’m going to leave our assets as is.
Honest information. Thank you - I was on the verge of transferring property into an irrevocable trust until I found out my income would disqualify me from receiving Medicaid assistance. Your video reinforced my research and saved me over $5,000 legal fee. I now believe if I need to go into a nursing home, then I will use my assets to help pay for a well researched, close to perfect home. (Does anyone believe there is a 5 year/5 star nursing home?). If there is please reply.
@nitah congratulations! for your decision to live through your final days enjoying the fruit of your labor. I recently learned if you leave assets to your children, means you did not calculate well for your life expenses. Enjoy ❤
You are right,about,government run nursing homes,,my Brother and Sister,were in one,for over eight years,and both have passed,,,,,,,mainly because of inadequate,,Care.
I am divorced, 70, and have twin daughters. I have $2.6 million in savings and $53K annual social security. I have been hearing for years that I need some scheme to protect my money from nursing homes. I have always thought that this is ridiculous. I easily have enough money to pay for top notch care. I did not buy long term care insurance because I feel I have enough money to self insure. It seems criminal to hide your money so that other tax payers cover my care. Glad to see one video that actually encourages people not to scheme and hide their money.
All of the reasons for and against are too mind numbing to consider correctly. I think what would really help would be to structure a series of interview question formatted as a flowchart that would help decision making, making sure no circumstances are left out and the decision is appropriate for any given scenario.
I took care of my Mom for 10 years. She wasn’t remembering to take her pills. And had what the doctor thought the beginnings of Alzheimer’s. Turns out she did. I promised her she would pass in her own home. I kept my promise. My sibling, who retired and moved to The Villages in Florida soon after he called me out of the blue and said “go live with Mom, you are disabled and do nothing all day or I’ll put her in a nursing home!” He never visited her. I moved in with Mom at his request(he had Mom change her will leaving him and his wife as POA and executors of her will which she told me she told me in her own words, I know I made a mistake but wanted him to stop nagging and screaming at me”. He had closed all of her grandchildren’s ITF accounts and deposited money into Moms checking account before she passed. And put her home up for sale 3 days after I buried my Mom. Not only did he now have to pay estate tax on that ITF money, he held back giving it to children until after he took me to court to have me evicted after 2 months. I had had a stroke a week after Mom passed. Took almost a year, but I recuperated almost fully. I thought I could trust my daughter who I took in along with my baby grandson when she separated from her husband in 2016, I put her name on my home to avoid estate tax, but finding out more and more not so…she now wants me out, states she owns half this house…Trust no one. Sad in Pennsylvania
Horrible. Neglectful care and not removing soiled linen. Please consider editing and using a more appropriate word. Everyone in this comment section is polite.
Where I am, it costs $35 per hour or 15k per month for one private care staff. My dad has dementia and may live 5 years. My mom can't deal with him and staff at home. It's too much of a disruption. So we are getting him qualified for medicaid. We will pay the penalty and minimize losses to assets for my mom.
We have had family in a nursing home, a supposedly wonderful board-and-care house, home with caregivers, and in a sub-acute facility. After seeing all of this, wealthy family members built a house with an ADU that has a walk-in shower, joist in the ceiling so a hoist can be installed for lifting a person into the bathtub, kitchenette with microwave, refrigerator, and freezer, and laundry room. It’s on the first floor, on the opposite end of the house from the master bedroom, which is upstairs. That way one of them can be cared for without disrupting the other, if and when the need arises. Linen that gets soiled in the middle of the night can even be washed immediately without causing a disturbance.
Another idea: as a City solo retiree, live in a “full-service” high rise building, a short car or cab ride from your doctors, and use their gym, common garden or outdoor space, and repair, upkeep services. Roam an urban neighborhood. Enough with suburbs. With long term care insurance, caretakers visit you post injury (heaven fore-fend).
We don't live near a city with those kind of places. My dad passed 2 months ago and our issues with nursing home care are thankfully over until my mom needs them in the mean time we are trying to figure out how to renovate her home to accommodate.
Timely as 91 y/o mother is currently living with family for past year but haven't ruled out assisted living/nursing home in future if declines. One issue as you mentioned irrevocable trust that I found out the hard was as deceased step-father's living trust converted to irrevocable for her benefit a new tax ID is created with the conversion to irrevocable, as would happen if creating a new irrevocable trust when living. The problems is, when calculating taxes, there is no standard deduction, making all income immediately taxable. While that Trust was flattened relatively quickly, she has her own living trust which, as a former stockbroker, I manage on an LPOA basis (not TTEE). Not concerned about her outliving the trust...despite family history of females reaching 100, as setting up a portfolio for 8 to 10% return should cover costs without drawdown of assets. An example, managing her IRA with a 9.?% RMD, grew the account last year by 20% with utility index stock managed portfolio that more than covered the RMD.
Atty. Rabale makes some good points. I'm feeling like I should protect some of my assets though, say $5,000, only because if I were to end up in a nursing home and exhaust my assets all I'd get of my income for any personal expenses is. I doubt I'd have much need for "spending money" at that point t but if I wanted something like an iPad or an iPhone I wouldn't want to do without and I'd never ask anyone else to get it for me.
Leave a life insurance policy for your family if you want. Have long term policy for yourself. Use your savings, 401KS, Roth IRA, Bonds, S.S., Retirement, etc... for living. If you don't want to pass on your home, you can do a reverse mortgage, but fully investigate the terms. If you get in a bind you can sell the life insurance policy too.
Reverse mortgages are another scam. You'll get maybe 65% of the equity you have in the home. Some of that money must be used to maintain the home and pay insurance and taxes. If you go into the Medicare program, you'll have to account for all those assets (except life insurance) as to when transferred or sold within the past 60 months and what you did with the proceeds. The gov't motto: "We've got what it takes to take what you've got."
Reason #1 for not doing medicare planning was my folks situation. Dad died suddenly at home. No need. Mom never wanted to go and REFUSED and was horrible once there making nursing home care short term.
Very valuable info. i did not know that IRAs cannot be transferred without paying all taxes. Very professional, he could be selling Medicare trusts but is objective!
Partially helpful. Part two should be OTHER reasons you may want an Irrevocable Trust. There are at least a few. Protect the house against lawsuits. Skip probate at your desk. Put in law an agreement between spouses that one persons house goes to their children as agreed. Any others??? Just wondering before tons of people cancel Trust appointments. :)
My mother's (at home) hospice doctor told me everyone wants to be at home. They don't want to be in assisted/skilled nursing. She is 88, has been at home for 12 years with Alzheimers and no longer needs a hospice doctor. She is doing too well. 🤭
Awesome advice down the line… Advantage Medicare plans now even have many services that allow seniors to have quality services to their home… while maintaining control of their assets. I’ve listened to several of your videos.. this one and writing a holographic will were so helpful….You are a blessing.. I live in Southfield, Michigan.. 69 yes old..
You better read about how the Medicare HMO plans are using software that applies “average” need for medical treatment for various conditions and uses these metrics to deny treatment.
This is an awesome video. Thank you. I was actually ready to start the process of getting my elderly mother to put her home into an irrevocable trust - I now will not do that. I am going to help her put the home into a revocable trust - just to save on the probate expense someday when she does pass.
Great, until… someone walks by your mother’s home, trips on a tree’s roots that the city planted there in the public sidewalk. That person goes flying and lands on their head on cement walkway, right outside you mom’s door. You happen to be visiting your mom watches , you call 911 and you both watch as an ambulance takes them away, unresponsive. A week later mom get a lawsuit. Her , personally as the homeowner responsible for sidewalk upkeep. They want $250k for traumatic brain injury that is life changing injury. But.. the city should be sued, not mom! Ah, check this out. Most cities long ago had closed door sessions and moved responsibility to homeowners and cities indemnified themselves! Mom can be sued and the house lined and sold at her death! Because a revocable trust will not protect the house against lawsuits. No, I am not a lawyer… I know someone sued this wsy but for a lot less as less injured. His lawyer said pay as fast as you can before they ask for higher damages!!! So please, think about other reasons you may want an irrevocable trust, then decide. If you live in a corner, homeowner responsible for both sidewalks! Fyi
But here is the problem with us kids/grandkids who do not want our elders in a care facility (and I use that word "care" tongue in cheek 🙄) - I was one of those people who said I would NEVER want them to end up in a facility - BUT--- My Grandfather had Alzheimer's and he only had one child, my Mom, and one grandchild, me. At a certain point, people with Alzheimer's need to be watched every minute. Just like a two year old you wouldn't leave alone in the house to even run to the store for milk, same thing. And that stage can go on for years (and only gets worse, not better like with two year olds). Well when it got to that point, and my Mom and I worked, and we couldn't afford a 24/7 nurse, aide, or babysitter... then you are screwed. ---- So to all of the people saying "never" out there, you cannot say that. You HAVE TO plan. Even if a family member doesn't work and is willing to live with the elder, at a certain point with a person with Alzheimer's, you aren't PHYSICALLY able. My Mom and I are women and we couldn't have carried my Grandfather to the bath for a shower, or picked him up when he fell, or the onslaught of a ton of other physical tasks (and mental) that go on every minute with a patient with Alzheimer's. I promise you... 99% of people cannot do that. I could write a book on this and as a nurse myself I try to educate families, but many don't listen and live in denial. Unless you have money enough for 24/7 care in the home, AND you can 100% guarantee your elder will not develop dementia related Alzheimer's disease (which you cannot guarantee that!) - then you MUST plan. Listen to this man, watch his videos and have the hard conversations with your elders and other family and get a rock solid plan in place. Then if and when the sh** hits the fan, at least financially and logistically, you'll know how to proceed and a lot of stress will be mitigated. The emotional part isn't something you can prepare for, but the rest of it is. Do it.
I would die before going into a nursing home and let them take everything I own. My grandparents are in their late 60's and they told me never trust a nursing home and I believe them.
My great-grandma was in nursing homes when I was a teenager. As a result of this trauma, I have lived my life being careful with money and investing for retirement.
If you want to die, it won't cost you a cent. All you need to do is stop eating for a month. I've seen several nursing home residents do this to themselves as they simply gave up the will to live.
Medicare and SSI are meant to be used for an individuals final care should they need it. Why should I pay for someone else’s care ( through my taxes) when they have the assets to pay for their own. I’m all in for charity but not for making someone else , or their children rich.
I agree. That's how it should work. Unfortunately, any time a government, company, individual, etc. offers cash, benefits, paid time off, etc. people will find ways to game the system.
I am so glad I watched several of your videos as it really helped me in my decision making as far as which kind of trust I will get for estate planning purposes. Thank you!
My brother and I used my Mom’s financial assets (about $300k) to provide good quality care for her at a private-pay memory-care facility. Our commitment was to use everything she had for her needs, and we felt blessed to be able to do so.
Your mom raised you well!
Amen!
How long did the money last?
Sounds like she would be spending everything she had anyway. Except she would be giving it to the government or a crappy nursing home giving her substandard care. This way, at least, she would getting the best possible care for that money.
Our family is doing the same with “our inheritance” My parents sold their house, went into assisted living private pay for three years when health started to decline. Great quality of life during the spend-down period. My dad suddenly died and now my mom is in their memory care section. The staff all knew my parents and mom is getting excellent care under Medicaid plus cost share from social security.
As an only child, I knew that I would be responsible my parents’ care. I know this seems odd, but when I was young and first employed I purchased a life insurance policy for myself and named my parents as beneficiaries. Although it wasn’t a high value policy-the value did increase each year-the premiums were inexpensive because of my age. My thought was that if I died before my parents, they would have something to provide for their care if I wasn’t there. I’m now 74 years old and my parents have died, but it always gave me comfort to know that I did that for them.
That is thoughtful of you.
Great job! Unfortunately, today's youth do not often have that sentiment. And with one or two kid families becoming the norm, that will more heavily burden the system with elderly who have no family that can or will care for them. I wish we were all like you.
Good points!!! Thanks again
We’re you able to cash out your policy after your parents died or did you have term insurance?
Thank you. This was totally informative to me and justified what I’ve been thinking. I have a pretty large 401k and very generous RMD. Small pension and great Social Security. I do not want to even consider a nursing home and think I will be perfectly capable of paying for in home care if it becomes necessary. Now I’m very comfortable with that goal.
So the bottom line is always the same: you’re screwed unless you are wealthy.
Actually, very wealthy or very poor. The system is structured to make sure that if you worked hard and saved, they will make you poor before paying. And even then they will do their best to recover the money they spent on you. If you can save enough to afford your own care you are best off. Everyone else is screwed. The poor are already qualified so they get a minimum level of care releasing the children from the burden. By poor I mean renters with low income and no assets. I am allowed two thousand dollars of assets for everything including bank accounts. If I had a home it would be exempt for qualifying, but then they would put a lien on it for all expenses paid in my name so they would get paid before anything went into my estate. What a joke, I have no estate. My long term care plan is a long walk off a short pier as I cannot swim. If I enter a nursing home they would take my social security check and give me fifty dollars a month for personal items. That would be everything I am allowed to have.
@@markpashia7067 😩
Right, if you are house poor, get irrevocable trust and pay that money, … but if rich don’t bother?
Actually, the opposite. You get screwed if you’re wealthy. If you’re not you get a free ride.
We're screwed no matter what we do.
7 years ago both my children said no way about going to a nursing home. My daughter passed away and my son married a girl "WHO" NO DOUBT in my mind!, I'm going to a nursing home. Which is what I've always told my kids. I'm just saying, no matter what kid's tell you now, thing's happen😔 and then other things change if spouses change. Please think about that.
The odds are 96 to 4 that you will not go to a nursing home long term, more than 3 years. See if you can pay down any mortgage, so you can do a reverse mortgage for those possible 3 years! Then tell daughter in law she and your son can
A. Help you with care in your home
B. Help you with care in their home
Or
C. Not help and you will find your care with your house and leave everything extra to a pet charity! lol
She may think differently, depending on the equity in your home!
Many who demean Medicaid as immoral or mooching have never had to face a 5 or 8 or 10k monthly bill out of their own pocket for a parent’s nursing care after the parent has exhausted his or her resources.
I think that a lot of people might not be demeaning the Medicaid program itself as "immoral or mooching". They think that Medicaid was designed to help the poorest of the poor. I know a woman who had a paid for, very expensive house in one of the nicest areas in town. She also had a paid for beach house. She said that she and her husband were giving away their money as fast as they legally could to their also rich children, so that the woman and her husband could get on Medicaid when they needed LTC. Should taxpayers really be subsidizing already rich people who just want to make their own children and grandchildren richer?
@@joanschilleci7564 First, asset giveaways such as you describe can disqualify Medicaid applicants if done within 5 years of application. Second, if the woman you "know" does all her giveaways more than 5 years before applying, she is gambling on living long enough for her nefarious scheme to pay off and will have to live on seriously reduced assets in the meantime. Third, she will likely also have her LTC choices reduced to a shared room at place that takes Medicaid, which rules out the sort of accommodations she sounds accustomed to. Fourth, when she dies the govt can put a lien on the houses to recover costs if they go through probate. And five, only a principal residence can be shielded from Medicaid asset counts, and only up to certain amounts of equity, which rules out beach houses and might even rule out your friend's high-end, paid-for main house. Point being: Yes, somebody somewhere will game any system you set up. If more controls are needed and make sense, put them in place. But don't use "I know someone" anecdotes to malign a program whose recipients are about 1000 times more likely to be legitimately poor than they are to be rich moochers with beach houses. If you're really interested in the topic here's some actual information: www.medicaidplanningassistance.org/can-medicaid-take-my-home/
They are referring to parents transferring their assets to children, then claiming poverty and getting Medicaid.
What is nuts is you could almost hire a private nurse for $10k a month.
why would you be responsible for your parents nursing home bill??
As with my family, we didn't want to put our mom in a nursing home but her dementia got so bad that we could not properly take care of her ourselves. Fortunately we found a wonderful Methodist care facility in Chelsea Michigan where she had very good care. Her aides were truly loving and kind. She ran out of her own money there but they let her keep her private room on Medicaid anyway until she passed.
If I may ask, what facility is this in Chelsea? Thank you.
Sometimes it is so hard on the family especially with dementia, that a nursing home is the only answer for sanity sake.
@@angelarecker7973 Yes, people with Alzheimer’s wander, and it’s not safe. It’s important for family to get their sleep so they can manage things and be a support for the person in need of care. Exhausted people are cranky and mean.
They are run no different, and of course the staff are kind. But is the care truly getting done and done right, under my licensure, no, no it is not. And management could care less if my CNA’s disappear or sit outside gossiping for two hours or don’t do their rounds and change & turn people every two hours. These folks are hitting up up the morning and left until after dinner when finally they will be put back to bed and changed. Trust that. And nowadays my help, I’m an RN, are agency staff, new staff each day claiming they didn’t know this or that.
Honestly it’s impossible job to do.
@chilloften I hate lazy coworkers and lazy nurses (not you). You are in charge as the nurse. We are all part of the care team. Give report at the beginning of shift discuss break times and let them know if you can't find them on the unit you will page them overhead. No one wants to be paged overhead and the managing office hearing someone's name constantly gets irritating so they will be reprimanded. Also, if they have friends in the facility, the work will get done because they don't want their friend to get in trouble. If you expect neglect, anonymously report it and go from there 😉
How outrageous. Since nursing homes cost so much per month, you would expect that the level of care would be top notch. However, to hear that the care is extremely sub-par is a travesty, and people shoud be outraged. Where is Congress on this? This is where we need strict regulations on nursing homes. I've heard that we do, but are they enforced? Apparently not, so what a travesty. So we need more strict regulations and severe penalties for nursing homes that are actually enforced for those facilities that don't comply. What a shame for seniors in the final years of their lives. We can do better as a nation.
Most people have no idea what a strong lobby the nursing home industry has.
How can we do better?
Anyone can say we can do better - but How?
You would not believe the type of folk I’ve been forced to work with in these places. And most come from agencies these days. They run the place and the smear campaign against anyone wanting the care done that I’m signing for.
Completely agree.
Sure . Now that's OUR turn, we call it a travesty that nursing home care is sub par. This is not news people
20 years ago, the rules for Medicaid and the sub-par care was nearly identical to today's standards.
My grandmother endured a "good" nursing home for her last years of life. The care was sub-par and we couldn't afford "better". She died in less than 2 years due to being "interred" - she was in emotional, mental and physical hell the entire time.
Today my mother is at the door of decision - i.e. stay home or go to a nursing home. My stepfather is doing everything he can to provide her care at home so she doesn't have to experience the same end of life "care" as her mother did in the "good" nursing home. He cannot afford 24/7 in home nursing care - which we have seen is also another form of sub-par or simply unreliable care that is entirely dependent on the provider's skill, temperament and personality.
The sad news is that healthy people in their 80s and 90s who can't take care of themselves spend many years in nursing facilities. My mother-in-law lived for 8 years after going to a facility, and my 92-year-old mother was told by her doctor that she'll probably live to be 100. Medicaid needs to require more quality care from these facilities.
Medicaid needs to them more.
Your family is out of the ordinary. Statistically only 4% spend more than 3 years in a nursing home. Maybe they go in very sick, or maybe poor care or depression speeds it along? :(
Ive learned more from you watching this than from our attorney. Thank-you sir!
As a (non-elderly client) attorney who is often asked about such techniques, I believe that your presentation is the best one I have ever heard.
We had to suddenly place my mother in a nursing home after a 2nd fall & due to her Alzheimer’s she became unable to walk. We had done no planning. Hired an attorney to help with the spend down and found a wonderful Medicaid memory care center. They are out there!! ❤
They are not in North Carolina! My husband suffered a severe traumatic brain injury 2007 and I cared for him at home until 2014 when I needed cancer surgery. After much effort I did find ONE Medicaid facility with a memory care unit that agreed to take hime temporarily until I recovered - and I still had to pay a portion out of pocket because of our small home and my work income . They refused to admit him to the memory care wing because he was agitated and upset the other residents - plus the unit was full. The nursing home promised a lot but did not deliver. It smelled, his sheets were not changed, and residents sat in the hallways in wheelchairs during the day. He died 2016 in another nursing home (equally bad), after he broke his hip. From 2007 until his death, I received an inside look and many Medicaid nursing homes, and they are hell holes. No human being should ever live in one.
@@macpduff2119 I agree. We really needed Congress to set up another program that everyone can pay into, and take over all those robber-owned nursing homes, make them not-for -profit. Strict standards of care, staffing, safety, and cleanliness. My mother lived for seven years in nursing homes with dementia. Luckily, we were able to transfer her from Georgia (don't get me started) to one close to my sister in Virginia, where she got great care on Medicaid at a not-for-profit facility. Before we could get her on Medicaid we had to pay $60,000 out of pocket, for horrible care in Georgia. He's giving all this advice for people with million dollar estates. Give me a break.
@@macpduff2119 I am so sorry for your loss.
I moved my father into my home for the last 7 years of his life. Best decision ever.
For who? You or him?
In Florida your home is protected. Ever hear of Lady Bird?
@@itguru2037 my comment was more about how I was able to spend every single day with my dad for 7 years once he was no longer physically able to care for himself. We traveled the country, vacationed, and shared quality time together. I could never put him in a home. He deserved better and he got better. I’d do it all over again. At 92 he was still a roller coaster lover.
No, moving into my home wasn’t about protecting assets, it was about maintaining his quality of life and allowing me to be with him.
Damn! We just fired a high priced firm specializing in Trust planning. We were very uncomfortable with them because it felt like a factory line approach to planning. We actually got a sizable refund which made me suspicious. This video alone could have save me all that trouble. They pushed hard for an irrevocable trust, (10 times more expensive than other trusts and yearly Maintanence fees for life!) . They weren't answering our questions at all and were angry we kept asking. We have a small but successful family company and income sources and Roth IRA's that mean our income would have remained low six figures (minimally) for life and this alone would have rendered us ineligible for medicaid type coverage of a lengthy assisted living stay AND we would have incurred six-figure(!) tax liabilities because of our Roth IRAs while losing the ability to pass those on tax free to the kids! Thank You Paul. You have confirmed all my suspicions in 11 minutes and have a new subscriber.
Thank you for this.. I knew in my heart there is no way I could let my mother live that way when she had saved the money for much better care. At 87 yrs old an a former nurse.. she would be tortured with that kind of care. She's staying with me for as long as she wants.
That gives her peace! My mom and I had a pact she would stay in her house until the money ran out then reverse mortgage, then if that wasn’t enough, come to me. She didn’t want to leave New England for SCal! But she would if she had to, in the end. She passed before her money was gone at 87, stayed in her home with wonderful CNA ladies. And she was only out of her home 1 week at the end of life. RIP mom. :(
Years ago, we purchased the home for my parents, and they rent from us. It's in our name, and we take care of the insurance/taxes/upkeep and we charge them monthly rent.
As an estate planning attorney who does not do Medicaid planning but gets asked the question often, I think this video is fantastic! The best explanation I've heard. Thank you!
Except he needs to clarify better who he WOULD advise to get non revocable trust, and that such a trust also skips probate. So there is more than one reason for such a trust!!! Probate eats into the costs of your estate, with lawyers, courts and other costs taking a big bite and being all in your business. Handling my mom’s probate, ongoing due to lost trust / investment docs from 1995, has been so costly and so painful. Just repeating over and over again, to strangers on the phone, “ mom mom passed and I am executor and need to…” everything from cable and tel, to banks and home fire insurance… a million times. :(
I was in a rehab (nursing home) for a month from an accident- The people who work there were kind and helpful, professional, the facility clean and didn't stink... I was fortunate that it is only about a mile from my house and my wife and kids visited often.
But... probably ALL nursing homes suck. It's not home, and it's not pleasant to have to ring the nurse to help with using the commode, and other built-in indignities.
. I hope to never experience that again.
Many facilities, even private ones, are short staffed, and it can take ages until someone comes to help you to the bathroom, or change a diaper.
I wish this was your first video. I just finished setting up a irrevocable trust for my mom after following your previous videos and now I'm second guessing myself.
I am so glad I saw this I was all set to change to a irrevocable trust, but have decided otherwise after seeing this
We paid close to 7K totally for my Dad’s nursing home a month. He was in a double room. The guy who was in with him was on Medicaid and received the same care as my Dad did. It took all my Dad’s money for the last 14 months of his life.
You overpaid for a double room.
His room mate was lucky.
My mother paid for herself and got good care.
My Aunt went on medicaid and was transferred to a double room. A nightmare for her to be with a patient who played the TV loud 24 hours a day and we couldn't get it changed.
If you could pay $7,000 per month why was he in a Medicaid-patient facility?
@@Essays4College Most nursing homes take both private pay and state pay. It wasn’t a state nursing home but a private nursing home that also took both.
@@PATSYBSWEET So what's all the hubbub about having this private care and long-term care insurance then?
@@Essays4College I don’t know. My parents had it for 2 years. It was $700 a month for both. They were in their early 80s I think. When I moved to their property, they canceled it. I know some people have it but I do not.
Paul: This video really hit home for me. I've struggled with what my husband and I should be doing with our estate. I thought our goal was to protect our assets from the nursing home, but we just need to hang on to our assets and plan for the "best" home nursing care that we can afford. I've seen what COVID has done in our local nursing homes and I will not let that happen to my husband or to me...Thanks for opening my eyes to what I already knew.
My mother was in a 'Medicaid' nursing home for over 5 years. I would visit weekly and just destroy my heart watching her be neglected. Medicaid required a double room, all 3 roommates she had were abusive, the place smelled, only broken English spoken and food sucked. During the Covid PLANdemic she was moved to a hospice room on 1st floor so us kids could still visit with full surgical gowns which made my mom think the world outside was coming to a end.
Then our Governor found out they were allowing us in and threatened to shut them down. My mom passed weeks later all by herself wondering what happened to her family.
Looking back now that most of that overaction was for nothing but a power grab, I get mad at government overreaching, and makes me want to plan for my own future better.
@@HighCountryRambler What happened in the nursing homes was disgusting. I do not agree that the government overacted. People in nursing homes were dying in droves, and they thought they were abandoned. They couldn’t hear their loved ones on the phone, or see them on FaceTime. I believe staff were infecting them. It was not right for you to be going in. Some places had visiting outside, or put residents near first-floor windows and family could be outside. I am very sorry for your loss, and your mom’s and your family’s emotional distress.
Very helpful video. Thank you.
@@genxx2724pp hot fried Chicken on 189th😊
@@HighCountryRambler I'm so sorry for your mother! Of course your heart is broken 💔💔💔. Nevertheless, I'm troubled you believe it was a plandemic. I'm no fan of his, but once Pres. Trump finally did get moving, I believe he tried. He could have told us about it earlier, but he could not help what happened in China.
I appreciate that you included the moral aspect. It seems that so many today will sell their soul for a few dollars. Significant decisions such as estate/Medicare planning should be made thoughtfully and include all aspects such as financial, legal, moral and practical. I think you did a great job of covering the landscape in this regard. It seems too many lawyers simply want to sell you their services and not really evaluate what makes sense for each couple or individual given their unique circumstances.
Is it moral and right that people work 45 years or more, and in last decade of life have to sell the family home and pay all benefits for awful care in a nursing home? And we also fund both Social Security and Medicare through taxes! Give me a break. The gov allows this to offset the unfairness, and if allowed that is great!
But really only 4% end up in a care facility for longer than 3 years! I think family should be able to help parents stay in home, encourage “inheritance” spend down to do so! And protect the family home so 45+ years of work can leave something to next generation.
A trust how ever can skip probate, so that is also a good reason, it is $1200 to $1500 now, that could say inheriting kids, tens of thousands of dollars.
I have an 86 year old sister who has been in and out of the hospital for at least a couple of months now. She has several serious health problems such as congestive heart failure, Stage 4 kidney disease and uncontrolled diabetes. Her husband was recently diagnosed as having dementia so he’s not much help in taking care of her. Her 2 daughters are determined that she will never go to a nursing home. So in the meantime when she is out of the hospital she is sometimes staying at the one nieces home who works full time. The other niece takes care of her two grandchildren who are both babies and a third one on the way. I sometimes fill in to stay with my sister as she needs someone with her 24/7. This has been going on for a couple of months. They also need someone to take her to one of her many doctor visits and I fill in there also. I don’t know how much longer they can keep this up. My sister can feed herself and can move around some with a walker but she is very unstable and needs all her meals prepared and at least someone to help with her bathing. She is not on Medicaid. She has a Medicare Advantage Plan and I believe another supplemental insurance plan. I think she would probably be better off in a skilled nursing facility or someone to be with her 8 to 9 hours a day which is what one daughter is trying to arrange for her. I think it is very easy for her family to say they don’t want her in a nursing home but it’s a very big burden on everyone right now.
Medicare does not pay for long-term care. It pays for a limited number of days after you are released from a hospital. After that, good luck. The "advice" in this video is only for people with very large estates. If you are middle class, they will make you spend down your assets out of pocket, until you have nothing, then you are eligible for Medicaid.
I am sure if you offer to pay the 7 to 15k a month it will cost at a nursing home the family will give your opinion the proper weight. Also remember most homes are chronically understaffed and filled with near minimum wage rotating workers. Instead of changes as needed based on bowel movements many locations check in at a set timeframe that easily extends hours based on staffing and workloads. Bed sores and infections often follow. So be prepared to be blamed on the poor service you chose when only paying 7-12k a month for services. If you pay around 13-20k a month you will find more care givers per patient, your mileage will vary on how nice the caregivers actually treat your loved one.
Also forgot…. The home will do a means test on the application. Your loved one’s estate must contain enough assets to pay for their projected lifetime. If no many high end homes will not accept the application.
Spend or move out of your name then hand over any pension or doc security monthly, and sell family home if not in an irrevocable trust! I am getting trust anyway to avoid probate for my kids!
I recently spoke with a nurse practitioner, whose grandmother had a wonderful experience for 18 months in hospice. You may want to look into that because you don’t have to take the person to doctor appointments. The nurse that comes to the home communicates with the doctor about what the person needs. This is something we’re thinking about
saddest incidents from two personal friends and one family member , after going into a nursing home, even “quality” care , personal clothing and other items were stolen with no concern from administrator. Wrote name on new clothing but still not there on next visit. One friend asked me to check used clothing stores,her items were high quality clothing. So sad treatment like this. great info on this today thank you
That happened with my great-grandma back in the late 1970s - early ‘80s.
@@genxx2724 so sorry it happened to her;shouldn’t be.Just heard from another person who now has a locker at foot of his bed. He alone has access. Thought it’s a great idea.
@@lmr691 Clothes are taken to be laundered and never make it back. My mom bought her loose-fitting floral dresses in pretty colors with snaps down the front, and cardigans to match. Her name was on everything. Writing it in inch-high letters in the dresses made no difference. She was in her late eighties, not ambulatory, and couldn’t see well. She was in no condition to get out of bed and access a foot locker. She was a nursing home patient. They’re helpless.
@@genxx2724 Yes, it is so sad and very frustrating for you. My mother-in-law’s new clothes were marked as you did but it didn’t matter. Her clothes weren’t always hers and new items always disappeared. I just don’t know how our loved ones can be protected.
@@genxx2724hy don’t you take care your mom at home ? And stop to complain
Here in California I was told by my aunt's social worker that if we decide to go with the Medicaid route be prepared for a 3 year waiting list so plan accordingly.
One of your best videos! Great honest points Paul thank you. Dying with close to zero is gaining traction. Yes, talk is cheap when kids say they will take care of you. Don't count on it.
Myself or my wife would be in greater trouble if either of our kids were in charge of us, never going to happen...
Thanks H B
@@Stormin_Norman Yes indeed gotta know your children.
So true! Children will say they will take care of you no matter what. They just don't realize that when their parents get to the point where they need that level of care, they may not be physically able to take care of them. My mom didn't want to go into a nursing home and we kept her out as long as we possibly could. However, her level of care is now so high there is no possible way either my sister or I can take care of her. We both have our own health problems and the nursing home is the best place for Mom because of that.
@@Stormin_Norman I definitely hear ya Norm!!!
With the exorbitant cost of health care these days in this country, I would never want to burden my children with that. It is our responsibility to make sure that doesn’t happen. I don’t feel it is fair to expect our children to financially provide care, unless money is of no issue. For any parent to expect or even feel entitled to that, is selfish.
Unless we give them our money now when they need for grad school etc, and are leaving them a very valuable home! I don’t expect to live in their home, but I expect help in staying in mine with care as long as possible. Even if I spend down the equity in the house and all my cash!
Families help each other!
I always felt I would NEVER put my parents in a nursing home. Unfortunately because of health issues, I may end up in a nursing home, so I'm not sure I could do anything for them. Which really sucks because most of my adult life I spent my life taking care of elderly and sick (dying) people. Now at 54 years old I'm in a wheelchair myself.
@@0annonymous I've been thru pt but it didn't help. The nerves are dead in my left leg, so no amount of exercise is going to help that.
@@reneebrown2968 I’m terribly sorry. May I ask the cause? Best regards.
I’m not in a wheelchair but I have bad arthritis in my spine which gives me limited mobility. I feel for you.😢
I'm so sorry, me too but verbally abused as well. Life is hard I know, I have a VERY bad back too, part of it IS being a caregiver from the age of 8.
Aside from the recovery period after a stroke. Mom stayed with me. I hired caregivers for the nine hours needed to continue working. Her SS and pension paid for the care giver, she had poor medical coverage, I covered housing and food, everything required of a parent to care for a child. I was lucky to spend time with her but my back will never recover. She passed at home after 8 years. Those years with her proved to be the best investment I ever made. I worked until retirement and now survive on my SS and 401K plan. Slow death for me will be a dismal undertaking. Trust would be no more than a cash-out for a family that doesn't even seem like mine. I have never seen a nursing home that provides the care or love a family could, but they have a well oiled machine for circling the wagons. Siblings, nieces, nephews and grandchildren are complete zeros.
Number ten is that every dime Medicaid spends on their care will be put as a lien on the exempt home so you pay it in the end anyway unless the parents are renters. So many miss that asset when they are planning because they are told it is exempt. It is called Expense Recovery.
Lady Bird Deed takes care of that. Not all states allow it but FL does.
@@Jen-ur4ut Yes, some states have made recovery nearly impossible or totally impossible, but the states that allow it are relentless. They won't kick a surviving spouse out but when they die, the rest of the family is out and they take it. I've seen a few adult children evicted and homeless due to this action here in Missouri.
@@Jen-ur4utmy grandmother lived in FL and my dad and aunt fought over whether to sell her house to pay for better care or protect it and use Medicaid so they could inherit it. I think my dad won the battle (protect the house) but it seemed wrong to me.
All if your points are valid. As a single person with no children, my estate will go to several relatives. I long ago decided I would not relinquish control of my assets as I have never seen that work very well. So, I don't know how I will achieve it, but I do know that the resources I have worked a lifetime for, I want to be a benefit to someone else and not for keeping a broken body breathing. If I can't function, then I want it ended because I don't want to be a burden to myself or anyone else. This "keep the lights on" by any means available is part of a sick society and I hope to have the ability to use a bullet if that is my only option. ...just trying to be realistic.
While I agree with you, that's not the issue that Mr. Rabalais is talking about. He's not talking about keeping someone alive in a hospital at all costs, he's talking about nursing home care and how to protect one's estate from getting entirely consumed by the enormous cost of it, and whether the actions that one has to take in order to gain that protection are worth the downsides.
Not legal
I agree completely. I am not rich, but I have strived to save money so that retirement won't be a terrible burden. And when I go, I would like to leave something for my children. My hope is to create some generational wealth or at least some additional assets to help them going forward. I'll figure it out so that I leave something behind.
@@marciasloan534so….there is assisted suicide in my state and at least one other.
My biggest complaint is when a single parent (that has dementia/Alzheimer's) is placed in a nursing home and the medical proxy DOES NOT let the nursing home know that there is LIVING family.
My mother lived in Massachusetts and I live in Georgia. When she was placed in the nursing home I tried to contact nursing home to ask a variety of questions. They refused to speak with me, stating that there were NO LIVING FAMILY listed in her initial paper work. That the medical proxy said there was none. Yet when she passed away in October; who did they want to claim her and pay for cremation and burial?
Now, this is bizarre, dont you have her name on your birth certificate? So wrong not to let you 2 be with her when she was still around...
That is evil! Regardless, non-relatives can visit.
I am single, 73, fairly healthy, but losing my vision and will prolly need nursing home care in a few years....your advice has been very straightforward and easy to absorb......thanks very much.......do you take out of state clients?
You are so absolutely right Sr! This is coming from a retired nurse!
Medicare should have a built in coverage or a separate option to buy Long-term care insurance, at least it should cover a year. The problem is one can get severely ill for a year or two and wind up spending all their assets on LTC, after they recover they have zero $ in the bank, and out of a job too, its like going bankrupt. And this can happen to anyone at any age, not just seniors. So, Medicare and all health insurance plans should have by default one year of LTC, only a small percentage will windup using it, so the cost should be minimal as everyone pays.
I think NJ has something like that where you spend down to a certain point then you apply for the state medicaid plan.
Yeah and they also need to pay for dental and vision, but that will never happen even if the health of your mouth and teeth are just as important as your overall health.
Who would be willing to pay for this?
dream on...till we stay out of wars that last 20 years. i vote Donald Trump
You're a good guy. Your video is making me re-think doing an Irrevocable Trust as we were advised to do for my mom, and just doing a Revocable Trust for her. I want to do what's best for her. She worked hard for her money and deserves the best care from me and aides.
You give good, sound, conscientious, ethical advice. Your clients are lucky to have you and your knowledge.
I'm so thankful for all your videos, and this one was most important to me and made me see things I did not consider before. You are a very generous man, and attorney, that is giving us little people so much great free advise. Thx again.
I hope they have Kevorkian Home Kits available at Walmart in the near future. Nursing homes are a life sentence with no chance of parole.
Ever hear of a 9MM? No need to buy a kit from Walmart
Go to the Howard Johnsons Ethical Suicide Parlors. They're the ones with the purple roofs.
I’m glad I found out aboutMedicate planning. Ideally don’t like nursing homes
They control you and your power and dignity.I hope to live with my
Family. I’m late than ever .I will talk to estate attorney as soon as possible.thankyou😮
E
😮
A bottle of Tylenol, pull the plug on a boat, play chicken with a train, Tarzan dive off a tall cliff... Come on people, add some suggestions.
They do, it's called a .45 caliber round, around 95 cents.
Thank you for this information. It definitely confirms that I made the right decision for my mother to NOT put her farm property interests into a trust. It's been less than 5 years and she is able to be in one of the top nursing homes in the area. This home does take Medicaid, but is primarily a private pay facility. It has only been a few days, but I can already see she is getting so much better care where she is at than my father-in-law who is at a primarily Medicaid facility. I also have the philosophy that retirement planning is done for you to use for living including any care you need. An individual does not plan for retirement so that their children can have an inheritance. As far as COVID, the facility where she is at had very few cases and/or deaths. Where my father-in-law is at had one of the biggest outbreaks in the area. Mom did not get it, but my father-in-law did. It really does make a difference when the facility is primarily a Medicaid facility vs. a primarily private pay facility.
Some of these homes are willing to offer a Medicaid bed when it will later be needed.
That is good to know. That makes sense!
@@SandfordSmythe Yes. I have heard that as well.
@@SandfordSmythe Yes, they do as does the home my mom is in. It’s just that primarily private pay facilities typically provide a higher quality of care even if they accept Medicaid.
@Cathy Berry Are you trying to drag Biden into this? This existed for decades. Medicaid [ not Medicare] is mostly a state thing. The feds will require certain basic mandated programs for the states. How they are set up in states is a local decision. One factor is the amount Medicaid will pay for nursing home providers. It is very minimal and many nursing home can do better with private pay. Paying for nursing home placements is a very expensive proposition, and many states would have their citizens complaining about taxes. This was considered for earlier versions of Obamacare, but it was rejected as being too expensive.
Appreciate this video confirming thoughts I have had since my wife is disabled and on SSDI. We're in our 40s and we hear a lot about this Medicaid planning. It hasn't made sense to me since I make a lot of money, and we even have long-term care insurance if we need it (which we bought in our 30s, so cheaper), so I wondered about Medicaid nursing homes. This video confirmed that Medicaid planning is not for us. I also have wondered morally about Medicaid paying, since we have resources. While my wife does have Medicaid, it's only a secondary insurance to my primary, so it rarely pays anything (though it drops the negotiated rate so we rarely have coinsurance), making me feel better.
One of the few countries who prey on the most vulnerable senior citizens who have worked hard their entire lives only to have the state Medicaid take everything they, or their children, away. Absolutely criminal that this society condones, encourages, exploitation of seniors.
Rather than preying every day with 50% tax rates like socialist countries. Hooray for the NIH says no one in UK
@@niftynimbus5808 yep. The rest of the world is wrong! Long live capitalism! Feed the rich, tax the poor, till there are no more poor. So what if we’re excluded from the club, stay on that treadmill! Listen to George Carlin. He was right. The owners want poorly educated, barely literate workers, hard working people who know one thing for sure: the system is designed to keep them where they belong, down…with a big red, white and blue dick shoved up their asses.
My folks didnt plan so when my mother get dementia the home in NJ cost her $20,000 a month and she lived for 3 years
These private pay facilities are $5k-15k per month .
Both my parents died at home never went into the nursing home and my dad was 95! My mom is 87!
From my current perspective, this was the best and most important video you made. Thank you!
Thanks Glen. Just trying to keep it real!
Many thanks for being clear, concise, and to the point as so many videos are not. Great job.
Very good info, few know or think this way. I have to save this video.
Single people are always at a major disadvantage when it comes to taxes, benefits, long term care,etc.
Single people subsidize everyone else, while using nothing but the some of the country’s physical infrastructure: roads, sewers, etc. When we need something, we’re on our own. We need help when we are ill, recovering from surgery, and when we’re elderly. We get told to go pound sand, and oh, by the way, keep paying taxes to provide for others while you’re at it.
Incomplete info!!!
There are other reasons to do an irrevocable trust, but many here are just saying ok good I don’t need this! Find the lawyers and courts will take a good chunk of your estate and your kids will have the hell of probate.
This video gives the idea you don’t need a trust for this one reason. But should warn there are other reasons you may want one anyway!
This video is God sent. I was diagnosed with CMML leukemia 4 months ago and have been struggling with what to do. My response below explains my experiences with State funded nursing homes before my husband died 2016. I have a small home and I think the best way to leave my children any inheritance is to either live at home until my end or take money from selling my home and build a room onto my daughter's house. It's only recently that families started thinking that State funded facilities should care for their sick family members. My elders lived at home - sometimes with help from family members if needed, - until their final couple hospital admittances.
That is best, but with the changes in society over the last seventy years or so, smaller families, geographically far flung, children may not be able to provide in home care. Then what?
Here in central California one (good place) here locally is approx. $2750 a month plus a one-time charge of $500 for accounting. That price is for a shared room. I think the rate goes up $50 a year. That doesnt include extras like in house hair salon etc.
I have been taking care of her for 11 years in her home and she is pretty much thriving. No major health issues (except for Alzheimers). She is going to be 88 on Dec. 3, 2021 and she has had Alzheimers for 11 years. I think shes gonna break records. She gets the best food and coffee at home. If I didnt take care of her, her house would be gone.
I would not be surprised if you learned that $2750 is grossly understated. I'm in Illinois, one of the least expensive places to live in the US, and a good nursing home in my area is between $8000-11,000 a month. $2750 would be the Medicaid payment and I would rather my mom die than put her in one of those homes.
Are you getting paid as a caregiver?
It's terrible to pay that kind of money for a shared room. Small rooms, ok.....shared, no way.
@@vegetabohls9124She isnt on medicaid. And I thought $2750 was ridiculous! 🤯 Are you guys talking about the cost of "skilled nursing" because yes that is like triple the cost of assisted living.
@@jojo-pq5lo No. I am her daughter.
Thank you for video. All you hear is moving g assents but your last point said it all. Totally took that moving assets out of our thoughts now. Thanks
Our mom (I'm one of 4) lost $$$$$ on get rich quick schemes. She thought we'd pay for a deluxe nursing home. Since she had verbally or physically abused all
of us no one wanted her near them. I put her near me, and used her remaining funds to care for her. I'd visit, until she'd start screaming at me, then I'd leave.
Tina, Al's wife
It’ a sad experience. I experienced something similar w my mum.
I am sorry that your mother was an awful person. I am glad that you were decent to her at the end, although it was a tough row to hoe, and your took the brunt of it for your sibs. I hope that they appreciate you, I do.
Your story is very familiar. My sister quit her job in order to take our mother in. Unfortunately, after a couple years, my mother grew demanding and difficult to be around. Early, one morning she decided to take her car and leave while everyone was asleep and drove cross-country and returned to where her house was. Then she talked my brother into taking her in by downplaying how much help she really needed. Once she moved in with him, he quickly realized what a big mistake he made. With his work schedule it became unsafe for her to live with him and we ultimately had to move her to a nursing home. Unfortunately, some parents just can't (or won't) live under their children's roof and their best option really is a nursing home.
This is one of your best videos from my perspective and needs.
This confirms what I have been thinking. Between pension, social security, investment income, and RMDs I should be able to self finance. It would work out best if I stay out until 75 though, thus no smoking or drinking and plenty of exercise.
I’m almost 77 and this is the best review I have seen! Thank you for finding my algorithm; I am a new fan!!
My god! I’m SO glad I ran across this video! I kept wondering why everyone was telling my wife and I to protect our assets now so we wouldn’t have a Nursing Home get it all. But who the heck wants to go into a Medicaid-funded nursing home? We.re fortunate enough to have enough savings & assets that, with our SS and small pension, SHOULD help us to self-fund ourselves in an Assisted Living or Private Pay facility for a number of years. And retain full control of our estate. What a burden of worry you have lifted from us today with this video! Thank you!!!
My mother dreaded going into a nursing home when she was d Iischarged from the hospital to the nursing home. She was inconsolable. Now, when she was able to leave the nursing home for her house home, she fought it! She told her doctor she still felt weak, etc. He gave her an extra week, and then made her go home. The next time she needed to go into the nursing home, she looked forward to it so much, and was welcomed back by her "friends." I know that's not the experience we all hear about, but it was hers, so I realize there are good nursing homes.
A big variable is the person's attitude and ability to fit in with others, adapt to life in an institutional environment, accept help and friendship and make the best of things. Some people can do those things and others can't. Reviewing and reflecting on their past experiences will give a reasonable indication of how they will do in decent nursing home.
Fantastic ideas. I am torturing myself about Nursing Home for me and my husband, but this video makes sense. I should not worry about it. Thank you!
Ask a local lawyer if there are any other reasons to get an irrevocable trust. You may or may not want one, but you should have more info before deciding.
This is great info. Thank you for making this video. I’m glad that the title was not rhetorical. You gave excellent reasons that helped me to be educated and make an informed decision.
Partially informed! Speck to a 20 mins free local attorney as the OTHER reasons you may, or may not want an irrevocable trust.
This is VERY well done. We keep having friends and family tell us we should do the trust thing. After watching this, I’m going to leave our assets as is.
Some trusts are different than medicaid motovated trusts
we put our home in an irrevocable trust to our son since the home would be his anyway. I didn't want him to lose what would be his.
This just may be your best video with some great points made. Thanks!!
Thanks. Just trying to keep it real.
The government believes that since you came into this world with nothing you should leave in the same condition.
Your video is actually an excellent answer to many questions I have had for years. One of a kind expert you are!
Honest information. Thank you - I was on the verge of transferring property into an irrevocable trust until I found out my income would disqualify me from receiving Medicaid assistance. Your video reinforced my research and saved me over $5,000 legal fee. I now believe if I need to go into a nursing home, then I will use my assets to help pay for a well researched, close to perfect home. (Does anyone believe there is a 5 year/5 star nursing home?). If there is please reply.
@nitah congratulations! for your decision to live through your final days enjoying the fruit of your labor. I recently learned if you leave assets to your children, means you did not calculate well for your life expenses. Enjoy ❤
You are right,about,government run nursing homes,,my Brother and Sister,were in one,for over eight years,and both have passed,,,,,,,mainly because of inadequate,,Care.
Thank you so much for this information! This is enormously helpful to me as a widow making all the financial decisions on my own.
Glad it was helpful!
Thanks. We all need to know this. - TAV ♥️🇺🇸🌎👍
I am divorced, 70, and have twin daughters. I have $2.6 million in savings and $53K annual social security. I have been hearing for years that I need some scheme to protect my money from nursing homes. I have always thought that this is ridiculous. I easily have enough money to pay for top notch care. I did not buy long term care insurance because I feel I have enough money to self insure. It seems criminal to hide your money so that other tax payers cover my care. Glad to see one video that actually encourages people not to scheme and hide their money.
All of the reasons for and against are too mind numbing to consider correctly. I think what would really help would be to structure a series of interview question formatted as a flowchart that would help decision making, making sure no circumstances are left out and the decision is appropriate for any given scenario.
Watch again and take notes.
Nursing home care in the northeast is north of 13-14 thousand a month.
@@danskdna8550 my apologies, it’s per month, not year. Once I read that back I knew something wasn’t right
Thank you. Excellent advice. I just lived this scenerio
We need more Hospice care
I know take care of your parents and don’t put them in a nursing home.. they took care of us for 18 years.. we owe them 18 years.
I took care of my Mom for 10 years. She wasn’t remembering to take her pills. And had what the doctor thought the beginnings of Alzheimer’s. Turns out she did. I promised her she would pass in her own home. I kept my promise. My sibling, who retired and moved to The Villages in Florida soon after he called me out of the blue and said “go live with Mom, you are disabled and do nothing all day or I’ll put her in a nursing home!” He never visited her. I moved in with Mom at his request(he had Mom change her will leaving him and his wife as POA and executors of her will which she told me she told me in her own words, I know I made a mistake but wanted him to stop nagging and screaming at me”. He had closed all of her grandchildren’s ITF accounts and deposited money into Moms checking account before she passed. And put her home up for sale 3 days after I buried my Mom. Not only did he now have to pay estate tax on that ITF money, he held back giving it to children until after he took me to court to have me evicted after 2 months. I had had a stroke a week after Mom passed. Took almost a year, but I recuperated almost fully. I thought I could trust my daughter who I took in along with my baby grandson when she separated from her husband in 2016, I put her name on my home to avoid estate tax, but finding out more and more not so…she now wants me out, states she owns half this house…Trust no one. Sad in Pennsylvania
I learned so much from this video. You are doing a real public service by posting. Thanks.
Protected half our mothers assets just prior to going in , with “ the half a loaf “ technique.
Thank you for this! Very informative!!
My parents saved their money to pay for their care. Why should we expect the government to pay for their care?
Many never had the money
I was in sales and I called on healthcare facilities. Out of 25 nursing homes I called on only one did not smell of piss.
Horrible. Neglectful care and not removing soiled linen. Please consider editing and using a more appropriate word. Everyone in this comment section is polite.
@@genxx2724 Piss off.
I appreciate your comment, as I have no experience with nursing homes. Thanks.
Where I am, it costs $35 per hour or 15k per month for one private care staff. My dad has dementia and may live 5 years. My mom can't deal with him and staff at home. It's too much of a disruption. So we are getting him qualified for medicaid. We will pay the penalty and minimize losses to assets for my mom.
We have had family in a nursing home, a supposedly wonderful board-and-care house, home with caregivers, and in a sub-acute facility. After seeing all of this, wealthy family members built a house with an ADU that has a walk-in shower, joist in the ceiling so a hoist can be installed for lifting a person into the bathtub, kitchenette with microwave, refrigerator, and freezer, and laundry room. It’s on the first floor, on the opposite end of the house from the master bedroom, which is upstairs. That way one of them can be cared for without disrupting the other, if and when the need arises. Linen that gets soiled in the middle of the night can even be washed immediately without causing a disturbance.
Another idea: as a City solo retiree, live in a “full-service” high rise building, a short car or cab ride from your doctors, and use their gym, common garden or outdoor space, and repair, upkeep services. Roam an urban neighborhood. Enough with suburbs. With long term care insurance, caretakers visit you post injury (heaven fore-fend).
We don't live near a city with those kind of places. My dad passed 2 months ago and our issues with nursing home care are thankfully over until my mom needs them in the mean time we are trying to figure out how to renovate her home to accommodate.
It costs the patient $35 an hour and the caregiver is lucky if she/he gets $15 an hour for caring for the patient.
Really excellent advice! Practical and realistic. Thanks.
Timely as 91 y/o mother is currently living with family for past year but haven't ruled out assisted living/nursing home in future if declines. One issue as you mentioned irrevocable trust that I found out the hard was as deceased step-father's living trust converted to irrevocable for her benefit a new tax ID is created with the conversion to irrevocable, as would happen if creating a new irrevocable trust when living. The problems is, when calculating taxes, there is no standard deduction, making all income immediately taxable. While that Trust was flattened relatively quickly, she has her own living trust which, as a former stockbroker, I manage on an LPOA basis (not TTEE). Not concerned about her outliving the trust...despite family history of females reaching 100, as setting up a portfolio for 8 to 10% return should cover costs without drawdown of assets. An example, managing her IRA with a 9.?% RMD, grew the account last year by 20% with utility index stock managed portfolio that more than covered the RMD.
Atty. Rabale makes some good points. I'm feeling like I should protect some of my assets though, say $5,000, only because if I were to end up in a nursing home and exhaust my assets all I'd get of my income for any personal expenses is. I doubt I'd have much need for "spending money" at that point t but if I wanted something like an iPad or an iPhone I wouldn't want to do without and I'd never ask anyone else to get it for me.
Leave a life insurance policy for your family if you want. Have long term policy for yourself. Use your savings, 401KS, Roth IRA, Bonds, S.S., Retirement, etc... for living. If you don't want to pass on your home, you can do a reverse mortgage, but fully investigate the terms. If you get in a bind you can sell the life insurance policy too.
Reverse mortgages are another scam. You'll get maybe 65% of the equity you have in the home. Some of that money must be used to maintain the home and pay insurance and taxes. If you go into the Medicare program, you'll have to account for all those assets (except life insurance) as to when transferred or sold within the past 60 months and what you did with the proceeds. The gov't motto: "We've got what it takes to take what you've got."
Reason #1 for not doing medicare planning was my folks situation. Dad died suddenly at home. No need. Mom never wanted to go and REFUSED and was horrible once there making nursing home care short term.
Very valuable info. i did not know that IRAs cannot be transferred without paying all taxes. Very professional, he could be selling Medicare trusts but is objective!
Litigation (non-estate) attorney here. This was super helpful! I've been wondering about Medicaid planning and didn't really know much about it.
Glad it was helpful!
Partially helpful. Part two should be OTHER reasons you may want an Irrevocable Trust.
There are at least a few.
Protect the house against lawsuits. Skip probate at your desk. Put in law an agreement between spouses that one persons house goes to their children as agreed. Any others??? Just wondering before tons of people cancel Trust appointments. :)
@@robinsmith8846 an irrev. trust protects the house? how please? in Florida?
Thank you for this amazing video. You totally answered my questions about medicaid planning for nursing homes.
Glad it was helpful!
So another words, we are screwed to try and protect our assets and still be able to use them. I guess the final word is, Dont Get OLD!!!!!!!!!
thank you for saying out loud what I have been thinking. A high net worth individual should just pay if the need arises.
My mother's (at home) hospice doctor told me everyone wants to be at home. They don't want to be in assisted/skilled nursing. She is 88, has been at home for 12 years with Alzheimers and no longer needs a hospice doctor. She is doing too well. 🤭
Thank you for the well balanced, thoughtful information.
#10 - You have spent a significant number of years investing in long-term care insurance and you are financially able to continue doing so.
I know ... right? I can't believe he didn't mention this one. You seem to be the only one who mentioned this
This information was VERY helpful! Thanks!
Awesome advice down the line… Advantage Medicare plans now even have many services that allow seniors to have quality services to their home… while maintaining control of their assets.
I’ve listened to several of your videos.. this one and writing a holographic will were so helpful….You are a blessing.. I live in Southfield, Michigan.. 69 yes old..
You better read about how the Medicare HMO plans are using software that applies “average” need for medical treatment for various conditions and uses these metrics to deny treatment.
This is an awesome video. Thank you. I was actually ready to start the process of getting my elderly mother to put her home into an irrevocable trust - I now will not do that. I am going to help her put the home into a revocable trust - just to save on the probate expense someday when she does pass.
Great, until… someone walks by your mother’s home, trips on a tree’s roots that the city planted there in the public sidewalk. That person goes flying and lands on their head on cement walkway, right outside you mom’s door. You happen to be visiting your mom watches , you call 911 and you both watch as an ambulance takes them away, unresponsive.
A week later mom get a lawsuit. Her , personally as the homeowner responsible for sidewalk upkeep.
They want $250k for traumatic brain injury that is life changing injury.
But.. the city should be sued, not mom! Ah, check this out. Most cities long ago had closed door sessions and moved responsibility to homeowners and cities indemnified themselves! Mom can be sued and the house lined and sold at her death! Because a revocable trust will not protect the house against lawsuits.
No, I am not a lawyer… I know someone sued this wsy but for a lot less as less injured. His lawyer said pay as fast as you can before they ask for higher damages!!!
So please, think about other reasons you may want an irrevocable trust, then decide.
If you live in a corner, homeowner responsible for both sidewalks!
Fyi
Great, honest video. Paul, you answered some of my questions from watching other of your videos.
But here is the problem with us kids/grandkids who do not want our elders in a care facility (and I use that word "care" tongue in cheek 🙄) - I was one of those people who said I would NEVER want them to end up in a facility - BUT--- My Grandfather had Alzheimer's and he only had one child, my Mom, and one grandchild, me. At a certain point, people with Alzheimer's need to be watched every minute. Just like a two year old you wouldn't leave alone in the house to even run to the store for milk, same thing. And that stage can go on for years (and only gets worse, not better like with two year olds). Well when it got to that point, and my Mom and I worked, and we couldn't afford a 24/7 nurse, aide, or babysitter... then you are screwed.
---- So to all of the people saying "never" out there, you cannot say that. You HAVE TO plan. Even if a family member doesn't work and is willing to live with the elder, at a certain point with a person with Alzheimer's, you aren't PHYSICALLY able. My Mom and I are women and we couldn't have carried my Grandfather to the bath for a shower, or picked him up when he fell, or the onslaught of a ton of other physical tasks (and mental) that go on every minute with a patient with Alzheimer's. I promise you... 99% of people cannot do that. I could write a book on this and as a nurse myself I try to educate families, but many don't listen and live in denial. Unless you have money enough for 24/7 care in the home, AND you can 100% guarantee your elder will not develop dementia related Alzheimer's disease (which you cannot guarantee that!) - then you MUST plan. Listen to this man, watch his videos and have the hard conversations with your elders and other family and get a rock solid plan in place. Then if and when the sh** hits the fan, at least financially and logistically, you'll know how to proceed and a lot of stress will be mitigated. The emotional part isn't something you can prepare for, but the rest of it is. Do it.
There are always vultures waiting and looking for any opportunity to rob you of everything you've got.
I would die before going into a nursing home and let them take everything I own. My grandparents are in their late 60's and they told me never trust a nursing home and I believe them.
I checking out. some type of drug or something. Fuck that.
My great-grandma was in nursing homes when I was a teenager. As a result of this trauma, I have lived my life being careful with money and investing for retirement.
Agree!
If you want to die, it won't cost you a cent. All you need to do is stop eating for a month. I've seen several nursing home residents do this to themselves as they simply gave up the will to live.
Medicare and SSI are meant to be used for an individuals final care should they need it. Why should I pay for someone else’s care ( through my taxes) when they have the assets to pay for their own. I’m all in for charity but not for making someone else , or their children rich.
I agree. That's how it should work. Unfortunately, any time a government, company, individual, etc. offers cash, benefits, paid time off, etc. people will find ways to game the system.
Great Paul! Good to see other side of the coin. ThankU!
Thanks Bill!
I am so glad I watched several of your videos as it really helped me in my decision making as far as which kind of trust I will get for estate planning purposes. Thank you!
Best of luck!