Advice for long term memory care

My girlfriend’s father was diagnosed with Alzheimers 2 years ago and he’s practically in end stage. Literally the only person he remembers in his life is his wife who is the primary caregiver. It’s getting to be too much for his wife and they need to start thinking about memory care, perhaps residential. He is a veteran but they have too many assets to get help from the VA, yet they aren’t rich.

Is a long term insurance policy a possibility or is it to late for that? Is there a way to put all the assets in a trust or some other way to shield them so they can qualify for VA benefits?

So sorry to hear about that. My dad died from dementia last year and got it at 61 back in 2013

She probably needs to see an elder law attorney to see what can be done in her situation. That said, getting into a good home can be few and far between as unfortunately 95% of the beds are occupied by females and thus it’s really difficult to get a double occupancy bed for a male. Hopefully you’ll be able to get guidance on when VA help is available and finding a decent facility for your girl friends father

It’s about what the spouse can keep and what the husband must spend before he qualifies for assistance. My dad was in 3 homes in the 6 years


I just want to mention that nursing homes and assistant living facilities are very different. Most assistant living facilities don’t accept Medicaid while most nursing homes do. However, since Medicaid pays a fraction of what a private pay pays for a nursing home, it is much easier to get a bed at a good nursing home if you can afford to pay for it in the beginning.

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You are correct Bridge

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It’s probably too late for LTC insurance.

Depending on your state, Medicaid may pay for a skilled nursing facility. The Alzheimer’s Association may be able to guide you. There’s also a website called aplaceformom that might help.

If they’re looking at memory care at an assisted living place instead of skilled nursing, that is harder, unless they already have LTC insurance or are wealthy. Those places run between $6,000 and $11,000 per month.

Another thing to consider would be if there is an adult day care place where they live. Some are connected to assisted living centers. It doesn’t solve the whole problem, but can be a place for him to be in the daytime so the wife can do other things, or just have a respite. A place like that gave me a year and a half at home with my wife. Otherwise, I’d have probably had to have her placed earlier or quit my job.

Our system is ridiculously convoluted and insufficient.

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I would also second the recommendation of an elder law attorney, one who specializes in Medicare and Medicaid. If they haven’t consulted before now, it’s likely too late to get a POA, but the attorney can go over options.

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Thanks for the advice, a POA isn’t necessary because the mother is in great health. It’s just becoming overwhelming for her.

Every person over the age of 18 should have a POA, designating who can make medical and financial decisions if they are unable.

That said, you can only get one if you’re of sound mind, which he likely no longer is. If he were to argue about anything, it would have to involve a conservator ship, which is more complicated and expensive.

I remember overwhelming. And exhausting. Good luck.

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I assumed the spouse has authority if you are incapacited.

Often,yes. But, there could be kids who would disagree. And with dementia, the tricky part is she can’t override his wishes as long as he’s coherent, not even with a POA.

One scenario described to me was when the adult day care called an ambulance because one of the participants broke an arm. They refused to get in and the emergency techs couldn’t force him.

It can get really messy. Luckily, I didn’t have much problem. We got a POA established early on and when it was time for my wife to be placed, she didn’t have much vocabulary left.

Too late for the dad to get a POA but the mother should. My girlfriend is an only child so that helps a bit I guess.

Mcarley, how much did Adult day care cost for you and did you get help from medicaid in California?

My girlfriend seems to think there is a way to shield assets so they can qualify for VA assistance. They already have the assets in a trust but doing anything further sounds shady or illegal. Bear in mind that these people aren’t oil barons, we’re talking about 2m or so but the daughter actually doesn’t know the number.

If they got $2mil they should be fine. That is what savings is for. Find a good place with good care and use some of that $2mil.

I can only imagine working and saving only to get dementia and the kids want to dump me in some shit hole nursing home on taxpayers dime to preserve my wealth for thier future inheritance.

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If you’re inferring that’s what is happening here, you can fuck off. I don’t know the actual number, $10,000 a month can be an enormous number and chew through assets. My girlfriend is actually preparing to help financially even though she may not have to.

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If I remember right (anyone feel free to correct me), when I was in the military a POA was required due to possible deployment.

I am going to tell my kids to do that, and go spend my money on liquor and whores!!


I agree with this part of the post. The problem is the wife also has to live off the $2M as it’s not only the husband so it’s not $10k a month, it might be $13 to 15k. If the husband spends more than 5 years in nursing care, it could impoverish the wife. My dads assets lasted 4.5 years before he was impoverished

Yes this is what savings and investments are for - to be spent - not to be given as an inheritance. That said, there is a look back period. I don’t know if there’s anyway to shield $$$ eventually once you reach a certain # of years of nursing care

It’s not always about assets. When my FIL, a WW2 vet, needed to be institutionalized, we could not get him into a VA facility because there were simply no vacancies and the wait list was long. We had to place him in a nursing home.

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Sorry if you interpreted it this way as it was not intended to imply that you were doing this.

I don’t know the limits of everything but there are lookbacks to prevent someone from gifting all their wealth and shifting to taxpayer dime. This happened to a family member in my wife’s family some time ago but it was only $50K. The state demanded the $50K back before they would pay for care. The daughter already blew the money. Advance family planning with trusts is a way to potentially shield this kind of wealth. I’m no expert in the field but I certainly need to plan ahead.

It is reasons like this why I think about getting a untraceable bitcoin wallet. The point of bitcoin is to keep government eyes out of your finances.

That’s a huge problem and why they have so many restrictions