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My mom is 96 with Alzheimer's/dementia and wishes to live out her days in her own home. Medicaid Waiver would only approve her for 31 hours of home care. When I called the Agency on Aging they basically said she was approved for 31 hours but they didn't have any caregivers or agencies available, I would either have to care for her myself or she would have to go to a Nursing Home. They won't pay for a live-in caregiver. I ended up having to call every home care agency I could find in the book and finally found one who could provide a few hours per week but couldn't cover all 31 hours.


At this point I have to screw up my life, move into my mom's place, look after her 24 hours per day 7 days a week but only get paid for the 24 or so hours the home care agency doesn't work. Should they ever have an opening to provide all 31 hours, I would get nothing.


We know my mom's care will soon be beyond my ability, then the only choice will be a Nursing Home. What would have happened if my mom had lost her ability to walk one day and I wasn't here?


A note on the house. Some have asked about it and what I know is the tax value is $22,000. No idea what the fair market value might be, but I would be expecting a low ball offer unless updates are made. What her lawyer told me: The life estate was created in 2008 transferring ownership to me at that time but allowing my mom to keep her house as long as she was alive. The law was changed in 2017 to no longer allow a life estate to shield the house from Medicaid Recovery, but since the Life Estate was created before the new rule went into effect, we would be fine. The only problem would be if my mom goes into a nursing home now, Medicaid would expect me to pay fair market value for rent to my mom but since I don't have a job and no income to pay the rent, I would have to move out and be homeless as long as she is alive. For me it's a place to live until I find something else.

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You are under no obligation to accommodate your mother's unrealistic wish to die in her home. This is because she could not have known that the trade-off was to wreck your life to make it happen. As a mother myself, I'd never ask this of any of my sons. She had good intentions by creating the Life Estate.

You need to solve the issue with the house. If I were in your shoes I would invest in a 1-hr consult with an actual elder law attorney to find out if you can make the decision to sell the home without her input because she has dementia/ALZ. Does she have a medical diagnosis of dementia? Or is this just your opinion based on observation? Surely there is a provision in the Life Estate doc for this issue. But I don't know and neither does anyone answering your post. I would not rely on anonymous strangers to give you a crowd-sourced answer to a very important legal question that could impact you and your mom's financial future. I wish you all the best!
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AlvaDeer Feb 2021
To me the OP does have somewhat more "ob ligation" than I usually assign to children of elders. This woman GAVE her a home, and now that home is no longer the Mom's asset. She already gave it away and has only a life estate. She could have done a reverse mortgage that allowed her more time in her home, but chose to give it to the OP instead.
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You would not have to move out if you got a job. You may qualify now to be a caregiver but 8 hour shift, and there is a huge need to do this work. Looks like you did shield the home from recovery and have done all your homework on medicaid in your area. I had no idea that it varies so radically state by State until Stacy told me that MI allows for 24/7 in home care; something I cannot even imagine a state affording to do for elders.
I think you have paced it out well for us, and short of being the 24/7 caregiver it does look like the option is a nursing home for your Mom. As to whether her mobility would increase of decrease thereby it is difficult to know, but over time it will decrease as the trajectory is downhill over all.
Tough decision and I am sorry; I think you have done your best to protect you both.
You can find out fair market value on your home (and essentially it is your home) by have real estate agent visits to assess value. Some people do not like updated and would rather do that on their own; while a new kitchen increases value in mind of realty companies, I would not want someone else's black marble wonder in all truth, and we bought our place precisely because it hadn't been messed with.
Wishing you good luck.
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Please see my answer here:

https://www.agingcare.com/questions/would-it-be-possible-for-me-to-take-a-job-if-the-agency-on-aging-says-my-mom-cant-be-left-alone-465076.htm?orderby=recent&page=1�

Do you know the $15,000 home value/asset rule? Go to 2 appraisers to get the home valued at less than $15k. My eye hurt too much to research but do you have siblings?

EDIT: Anyway, my states ombudsman office helped quite a bit. They cannot represent you or her because she is not in a home. For me, they pulled statutes, highlighted what was needed and gave me my non lawyer arguement in email. Contact them.
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Your mother is lucky she's getting 31-35 hours a week of homecare that is Medicaid paid. They will not pay for live-in help to keep someone at home. Why should they? Medicaid is supposed to be to pay for people who are impoverished and can't afford care for themselves. It's not there to protect assets for adult children.
They will not pay for live-in help.
Here's your choices.
Take the number of caregiving hours Medicaid will allow. Then you care for your mom the rest of the time if you want to protect the asset of her house. You can also bring in some additional help that will be paid out of pocket that the state doesn't have to know about. Check out an online caregiver finding site , and look for someone. You can negotiate the price with the caregiver directly. I worked a case a few years back where we needed 24-hour weekend help. A good caregiver was found who worked Friday to Monday morning for $325. That's pretty decent.
Your other choice is Medicaid will pay for your mom to go into a nursing home and they take her home.
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Stacy0122 Feb 2021
Not true, depending on the state.

OP does not need to pay out of pocket. It is Medicaids responsibility to ensure services are in place, not OP.
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