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I'd certainly pay off the misc debt and medical bills right away. For the mortgage, I'd calculate out what your 'total cost' of refinancing is going to be. Evaluate what the best possible re-fi deal you can get is and at what point do you recoupe the money (closing costs, points, etc.) for refinancing with the new, lower payment. Call me morbid, but if your break even point is out six or seven years (as it often is with refinancing), and your mom is 85, it's not worth it to refinance. She'll most likely be in a nursing home (or worse) before you get your money back. If that's the case, you'd be better off to take that money and put it in to an annuity or some other sort of retirement vehicle and use it as income for your mom (which would also effectively drop her house payment). However, if she's 55, that's a whole different ball game.


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