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So the question is, "Is 100% of your benefit larger than her benefit at age 70 if she waits?" If your benefit is larger, then she should take it early.


Worth checking. Have to factor in the lost income due too waiting.

CNC
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Apply for Medicaid.
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Medicare is the first place they went. They don't qualify. The whole Medicare game has changed in CT. Their house is worth 50,000 too much. But even if they sell it Medicare back dates 6 years on sale of assets.
Bruce
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Ment Medicade back dates assets.
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Medicaid has “spend down” guidelines for people who have assets.

My advice: find a Medicaid accepting nursing home that is acceptable to your parents and then talk to the staff about how to qualify. They will guide you through it.

https://ctlawhelp.org/files/pamphlets/benefits_work/spenddow...

https://www.senior-planning.com/connecticut-medicaid-title-1...

http://www.ct.gov/dds/lib/dds/factsheets/medicaid_title_19_f...

https://ctlawhelp.org/files/pamphlets/elderly/your_home_t19....
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Also, suggest you speak to an elder law attorney.
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Bruce,

Sorry your family is going through that. So not fun.

I would suggest taking this thread over to this board and staying there for support. Lots of good people there who have been through what you will go through, having lots of advice to give.

http://boards.fool.com/taking-care-of-parents-116503.aspx?mi...

Both in their mid 90's. Father sharp mentally with no life threatening illness mother has quickly deteriorating dimensia.

In the mean time, some terminology to chew on. You are looking for an assisted living facility with a memory care unit. Nursing homes are for those who are physically incapacitated and usually just for a short time frame. FIL may not join his wife since he is not ill, particularly if she already does not remember who he is. It is rather traumatic for a woman to wake up to someone she does not know lying next to her in bed. It is a brutal disease. And there needs to be an exit strategy if he does join her, since a memory care unit is inappropriate for him. Because he is competent, if MIL's dementia is not too bad they may be allowed to go to regular assisted living as a couple, but that is not a long term approach. She will get worse.

A professional in your state is probably the best way to go as things are different state by state. Look up Senior Advocates in your state. I don't have the skills to help with that but Sheila on the Taking Care of Parents board may give you some good tips.

Remember to breathe. Rough seas ahead.

IP
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My DW's great-aunt sold their family home and went through the
Medicaid route. The local nursing home helped them get through the
paperwork - but this was years back and regulations change w.r.t.
home values and such. We had family go through church nursing
facilities - those worked by transferring property as I recall.
Neither situation was pleasant and put a major strain on the
families. All the children helped out as they could at the time
and FIL in particular spent every evening visiting until the
dear lady passed - over some 4 or 5 years.
Dementia is an odd disease - state - environment. Comes and goes
at times and periods of lucidity frequently cause more anguish than
the periods when the mind drifts away. FIL always had difficulty dealing
with times when she thought he was his father. Possibly due to his
father also having a period of uncertainty before he passed. That turned out
to be a cancer related issue.

Howie52
Will keep you in our prayers
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Medicare is the first place they went. They don't qualify. The whole Medicare game has changed in CT. Their house is worth 50,000 too much. But even if they sell it Medicare back dates 6 years on sale of assets.
Bruce

If, as you say they don't qualify, then the cost will be borne by them, their house and /or the family.
Medicare and medicaid are not games.

The last time I checked in my area, Nursing home care for Alzheimer patients ran about $9K to $14K per month (Thats $108K to $168K per year) per person depending upon needs, with about a 2% to 3% inflation increase per year.. Plus there are waiting lists. Non-refundable community fee. Security deposit and monthly rent up front in advance.

If their home is one floor or with a bedroom and bath facilities on the ground floor it might make sense to start with some home nursing care. If there is some sort of council of aging group in your area they might have a group or care givers to help prepare meals-clean the home do shopping etc Then you come to the bathing and other personal needs. Even these people cost about $15 to $25 an hour. Plus can family members pitch in and help with time and/or money?

I hope this helps
b&w
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Don't forget to look into HUD housing. I'm aware of retirement communities here that will put people in an efficiency apartment for HUD rates. HUD does not consider assets they say, but they pay a percentage of income for room and board. So you can live there on Social Security checks--no matter how small.

The one I know about is primarily independent living, but additional services are available for those who need it up to the assisted living level. Not sure about dementia patients.
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If their home is one floor or with a bedroom and bath facilities on the ground floor it might make sense to start with some home nursing care.

Years ago, I know of people who did this by hiring a live-in helper. She moved into one of their extra rooms and was there to help when needed. I'm not sure if they do this anymore, but apparently people are available for this kind of live-in care.
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The one I know about is primarily independent living, but additional services are available for those who need it up to the assisted living level. Not sure about dementia patients.

Dementia patients aren't put in independent living facilities. Advanced dementia patients require 24 hour nursing care in locked facilities. Tough getting the skilled staff at night so usually they are short staffed. I've talked to nurses (and aids) that have worked 2 8 hour shifts in a row then 1 8 hour off and then 1 8 hour on (That's 24 out of 32 hours on duty caring for people that can't help themselves) due to the shortage.

It's not cheap. And the states don't have the money to cover the 62% of these patients that they are currently paying for. That's why there is a shortage of facilities.

b&w
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Years ago, I know of people who did this by hiring a live-in helper. She moved into one of their extra rooms and was there to help when needed. I'm not sure if they do this anymore, but apparently people are available for this kind of live-in care.

When the patient deteriorates to where they can't take care of themselves but don't know they can't--That's when the safety issue comes in ---And you will be creative and you will spend money to protect your love one. A lot of money to protect your loved one. The States are broke. The Fed ain't doing much better. WHO IS LEFT TO PAY, IF NOT YOU?

Everyone here is talking about the thousands and thousands of dollars they are tucking away in IRA's in Roths In 401Ks. And nobody wants to pay the bill when a loved one is sick.

b&w
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Everyone here is talking about the thousands and thousands of dollars they are tucking away in IRA's in Roths In 401Ks. And nobody wants to pay the bill when a loved one is sick.

Let me offer you a different example. Dad, after a 10 hour surgery, went into a manic phase that lasted about 9 months. It can be a side effect of anesthesia that does not get made much of until you are faced with it. All of the sudden this formerly frugal man was like Opus in front of the late night TV infomercials. There was nothing he would not buy and buy in bulk. We had to follow up behind him returning things, getting him out of contracts on homes and RVs, neither of which he had the strength to operate or maintain. We went to his family doctor and were told the bar of competency was so low that we would never get Dad declared incompetent. It was also at this time that he invested a considerable amount of money with his "friends," the young annuity sales man who would take him and stroke debilitated Mom out for a couples dinner along with his wife. Now I loved my parents, but in no way was a young couple looking to hang out with them for anything other than parting them from their money.

Try as we could, we could not protect him from himself. But in the state I lived there were laws that required the kids to pick up their parents' debt and the nursing homes were starting to come after the kids. Fillial Responsibility Act, or something like that. So you couldn't keep someone from frittering away their hard earned savings, but you could be saddled with the bill. Disconcerting to say the least.

In Dad's case what goes up must come down and his multi-month mania crashed to depression before he could spend all their savings. They had enough to finish up with but hundreds of thousands were wasted. Even cancelled his long term health care insurance after decades of premiums because he didn't want to pay it anymore. Cancelling at the time when it was most likely to be needed was not the best move, and indeed, it could have come in handy.

Lesson learned? Accumulation may be phase 1 but included in the strategy needs to be a way to protect yourself from yourself as you age. Perhaps for another thread.

IP,
preferring not to go too far down that memory lane
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Everyone here is talking about the thousands and thousands of dollars they are tucking away in IRA's in Roths In 401Ks. And nobody wants to pay the bill when a loved one is sick.

Just who is going to pay for YOUR care when you've spent all your money on others' care?
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IP writes,

Lesson learned? Accumulation may be phase 1 but included in the strategy needs to be a way to protect yourself from yourself as you age. Perhaps for another thread.

</snip>


Thus my preference for delaying Social Security to age 70. As Rayvt likes to point out, at the wealth level of many folks on this board, it doesn't matter whether you take it early or late since you don't need the money. But delaying SS until age 70 (and getting a 75% increase in the monthly payout vs. taking it at 62) is cheap insurance against the risk that any cognitive infirmities of old age causes your fortune to dwindle.

intercst
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Everyone here is talking about the thousands and thousands of dollars they are tucking away in IRA's in Roths In 401Ks. And nobody wants to pay the bill when a loved one is sick.

There can be a difference between a loved one and a relative.
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Thus my preference for delaying Social Security to age 70. As Rayvt likes to point out, at the wealth level of many folks on this board, it doesn't matter whether you take it early or late since you don't need the money. But delaying SS until age 70 (and getting a 75% increase in the monthly payout vs. taking it at 62) is cheap insurance against the risk that any cognitive infirmities of old age causes your fortune to dwindle.

intercst


I wonder about your thoughts on my wife. She is 62 and I have advised her to start SS now, as she will get my rate when I croak (I am some years older, and also have more earned income.) She wants to wait.

CNC
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CountNoCount writes,

I wonder about your thoughts on my wife. She is 62 and I have advised her to start SS now, as she will get my rate when I croak (I am some years older, and also have more earned income.) She wants to wait.

</snip>


If she waited until age 70, would her benefit be larger than 1/2 of yours after your passing? And if so, by how much? If half of yours is larger in any event, then it's a no-brainer for her to take SS at 62.

intercst
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If she waited until age 70, would her benefit be larger than 1/2 of yours after your passing? And if so, by how much? If half of yours is larger in any event, then it's a no-brainer for her to take SS at 62.

intercst


It is my belief that once I croak she will get 100% of my dole. (and forfeit her own.)

CNC
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It is my belief that once I croak she will get 100% of my dole. (and forfeit her own.)

Right!

So the question is, "Is 100% of your benefit larger than her benefit at age 70 if she waits?" If your benefit is larger, then she should take it early.

Have you tried that SS maximizing software from Larry Kotlikoff?

https://maximizemysocialsecurity.com/

intercst
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So the question is, "Is 100% of your benefit larger than her benefit at age 70 if she waits?" If your benefit is larger, then she should take it early.


Worth checking. Have to factor in the lost income due too waiting.

CNC
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I wonder about your thoughts on my wife. She is 62 and I have advised her to start SS now, as she will get my rate when I croak (I am some years older, and also have more earned income.) She wants to wait.

The math is: For each $333/mo of additional benenfit starting at age 66, it costs you $1000/mo for 4 years (62 to 66) or $48,000.

The mistake people make in making this decision is to see the extra $333/mo and ignore that $48,000 cost. Well, yeah, everything looks great if you ingore what you paid for it.

From 66 to 78 ($48,000/$333 = 144 months = 12 years) you are just getting your own money back.



...when I croak (I am some years older, and also have more earned income.)

Right. When you die she takes over *your* benefit and hers goes away. If that happens before she turns 78, then her deferral is a net loss.

[I] also have more earned income.

It gets complicated. Quite often she is better off by taking the spousal benefit (half of yours) instead of her own. When she files, SSA will automatically figure this out and will give her whichever one is the most money.
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But delaying SS until age 70 (and getting a 75% increase in the monthly payout vs. taking it at 62) is cheap insurance against the risk that any cognitive infirmities of old age causes your fortune to dwindle.

I'm not sure that this gives you the "cognitive infirmity" protection that people talk about.

For an age 66 FRA of $2667 (which is much higher than the average), the age 62 & 70 benefits are $2,000/mo and $3,520/mo.

It seems to me that the scenario where you had such a high income that your FRA benefit was $2667, *and* where an extra $1520 a month was a substantial boost in your old-age lifestyle----is unlikely.

If you lost all your own retirement money and that's all you have, then are there quality nursing homes that won't take $2000 but will be happy with $3520? If a quality nursing home costs $6000+, then neither amount will do you any good. I understand that there are places that will keep you in after you run out of money, in exchange for whatever your SS check is. In that case, the one who gets the benefit of the higher SS check is them not you.

----------
The way I kinda think about this stuff is like this. I buy a lot of books used from thriftbooks.com, etc. and use coupons for groceries and restaurants. But if thriftbooks went away and we never got coupons----it would not change my lifestyle. I'd be buying the same books -- just new -- and buying the same groceries and going to the same restaurants.

The extra money is nice, but has negligible difference to my lifestyle.
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Worth checking. Have to factor in the lost income due too waiting.

There are lots of places that have information. Here is my spreadsheet: https://www.dropbox.com/s/gebanzrbr3g33qf/My%20SS%20breakeve...
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It seems to me that the scenario where you had such a high income that your FRA benefit was $2667, *and* where an extra $1520 a month was a substantial boost in your old-age lifestyle----is unlikely.

Having a higher guaranteed monthly income does not guarantee that you will be able to sustain your old lifestyle if you throw away all your money, but it does make it more difficult to give away the whole store. It goes to my comment about how do we protect ourselves from ourselves in old age and verges away from the paying for nursing home title of the thread.

It is difficult to plan for possible future mental instability.

IP,
with a strong family history of Alzheimers
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Having a higher guaranteed monthly income does not guarantee that you will be able to sustain your old lifestyle if you throw away all your money, but it does make it more difficult to give away the whole store

Yes, indeed. But my point still stands---that when your total income is just your SS benefit, there's not a whole lot of difference between $2000/mo and $3520/mo. Neither is enough to pay for decent nursing home care. Maybe just a better class of refrigerator box under the freeway overpass.

(Heh, there was a story some 25-30 years ago in the Chicago loop. There was this homeless guy who set up housekeeping in the machinery space of one of the moving bridges. The only way for him to get enough clearance to get in or out was when the bridge was raised. Eventually a cop noticed him going in, and they pulled him out.)



how do we protect ourselves from ourselves in old age

Indeed. We went through this with one of our parents. There is a short period of time where you realize that you are going bonkers and the time you can't function. Of course, if you are lucky you have trusted[*] adult children to manage you. Sad thing we saw, one of the ladies we conversed with at the extended care facility told us "I am the only one left. Husband, sons, daughters....all gone. Only just me now."

We discussed this with the doctor and I mentioned a potential plan to accumulate a large supply of sleeping pills. The doctor, of course, didn't say anything verbally, just gave a slight nod and changed the subject.

Since we don't have any handy highway bridge abutments near us (assuming I was still competent enought to get the car started), my Plan C (if Plan A and Plan B don't work) is to scatter loaded handguns around the house with attached signs "Insert here and pull trigger."


------
[*] Our local paper every once in a while runs a series of some elderly person who got scammed by what they thought was a trusted relative or caretaker. Most egregious case was where *they* sued *her* when she finally threw them out of her house.
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But my point still stands---that when your total income is just your SS benefit, there's not a whole lot of difference between $2000/mo and $3520/mo. Neither is enough to pay for decent nursing home care.

SS's not meant to be an end all be all cure, rather one of the enhanced tools in your box. We are also maxing out the value of our pensions by delaying them and feel as though the 4% 30 year fixed mortgage we got last year on the purchase of our city home is like buying an annuity with an inflation hedge. By the time we are looking at assisted living/nursing homes we should have two paid off homes that we can sell or reverse mortgage, or rent at a good profit, even after management fees. And by delaying pensions, SS, we have some tax advantaged opportunities for Roth conversions that will hopefully net us more money in the long run. While none of this precludes our giving away all our funds in a fit of insanity, it at least provides us with more wiggle room if we give some of it away. There is no magic bullet, at least not one I have thought of.

We discussed this with the doctor and I mentioned a potential plan to accumulate a large supply of sleeping pills. The doctor, of course, didn't say anything verbally, just gave a slight nod and changed the subject.

I've thought of similar exit strategies but the problem is that you have to put these into operation when you are mentally present. Having witnessed multiple family members descend into Alzheimers it is remarkable the paranoid cunning and deception that evolves as the person in question devolves. The last 10 years with Dad were a nightmare and I have zero desire to foist that on to our kids should I start to devolve that way.

We are young enough to have time to figure that out and I need to look into some sort of trust. Don't know what other path to pursue. At least I recognize the potential problem and am not ignoring it.

IP
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As the original poster to this thread I would like to thank everyone who responded with their ideas and compassion.
Bruce
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Of course, if you are lucky you have trusted[*] adult children to manage you.

Living in a (mostly assisted living) retirement community, I've seen a number of good and bad examples of how adult children (and trusted caregivers) treat the elderly.

The vast majority of those moving out of here to live with (or near to) one of their children has not worked out. There are a few good examples of children managing the money, but in those cases the children already have their own money. They're more or less just monitoring the automatic payments of things like credit cards, rent, etc.

However, our worst elder care situation here is a memory wing. No nursing home situations.

We had one situation here where the resident/caregiver had an almost mother/daughter relationship. The resident thought the world of the caregiver, and vice versa. Both were very nice people. However, it turned out the caregiver had been embezzling money over the years. About $10K total. A little here and there. It was discovered by the son when he was going over her credit card bills and found some suspicious retail charges while the mother had been confined to rehabilitation. They would never have been noticed otherwise.
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