There's a lot of wisdom in these forums and so I thought I'd ask a question that is weighing on my mind. My 92 year old Father in Law is currently independent, living in a 55+ community, where he's been for 25 years. He lost his wife of 66 years in 2022 after doing an excellent job as her primary caregiver for nearly 3 years after she had a series of strokes. It was only after she was unable to transfer at all (final 6 months), that the last hospital/rehab stays ended up in a nursing home until the end. It was a pretty awful ending.
We are a mid-50s, childless (by choice) couple and my husband is the only remaining child. There's another family member (ex of another sibling), who is still in the mix, but has a lot on his plate and not likely to be of any major assistance in the future. He'd spend time visiting, but there wouldn't be any serious caregiving help.
My father in law is down to his final 100K, plus his house (roughly worth 400K). He's currently completely independent...drives, cooks, golfs, keeps up with doc appointments, etc. But he's slowing down, and we know what's coming....and I know all of this can turn on a dime.
We've had no discussions regarding his future care with him. My husband is sort of avoiding it, as is his father. His father occasionally says things like..."well, at least I'll be leaving you the house", which leads me to believe that he sees himself "aging in place" in his home, which I don't know will be possible. And we don't need the inheritance. I always saw the house as a resource for his care needs if necessary....and we're getting there.
My husband and I have worked our whole marriage...nearly 30 years, to save and invest so that we could retire early and for the first decade or so, be international nomads, settling down somewhere down the road....sooner if one of us has any condition that would necessitate that. Currently we're both healthy, but we know that age comes at you fast...and that mid-60s/early 70s is quite different than mid-50s.
Now that we're within a year of that coveted freedom in retirement, I fear that (being brutally honest), we're going to end up "stuck" here, caring for our father. I can envision a slow decline where he needs increasing levels of assistance when he's no longer able to drive. If we hire help, it will be very expensive and as I've stated, his nest egg is quite low. I believe that it's quite possible that he could live another decade. We don't even want to live in the state anymore, let alone end up as caregivers.
Sorry, this is rambling, just wondering if any of you have a thoughts on how to even broach this subject with him. We don't want to depress him, but we also want to at least be honest in telling him that we don't intend on becoming primary caregivers...at a minimum. We wouldn't even get into our dream of being international nomads, because that dream would have to be shelved if he's still with us. We'd likely remain in the same state, and travel as much as possible, when possible.
Thanks for any thoughts.
You can have this meeting with whatever "visual aids" necessary to graphically show his resources and worst-case scenarios regarding care needs and his financial resources. Also include the sale of his house as part of those resources. The printouts are so that he has something to look at and consider after this conversation, and to prove you had the conversation, should he conveniently forget.
In my own case with my stepFIL who was a jerk and also broke and in debt, who was trying to assume us into his caregiving and (hilariously) without giving anyone PoA to do so... I bluntly told him what would happen if he didn't at least give me or someone PoA: he would become a ward of the county and then his court-appointed guardian would put him in a Medicaid facility (he had Parkinsons) and he would have no control and neither would we. So, I informed him and he chose. He refused to give us PoA. He became a ward of the county and I only visited him once to drop off some clothes. It was awful but he chose it.
At the very least your FIL has to figure out a local PoA if you'll be traveling.
Then he needs to know the money part: how much he has left, what it would pay for.
Then, what will it look like if something happens to him while you're not there and he still hasn't prepared for this moment. And then what will it look like if there is a rational plan in place than everyone agrees on.
Then you let him decide. Give him a deadline. Remind him right before the deadline. After that if he doesn't take any initiative, throw up you hands and say "oh well!" and then live out your retirement dream.
Also...ask him if he took care of his parents or inlaws? I always break out this reality for my Mom when she complains about anything between us (no, her 2 older sisters did that for their Mom -- she only visited her once a year).
Interesting you mention his in-laws. His own parents died before he was forty, and so no care necessary for them. His father in law was cared for by his mother in law until he died. When mother in law (my husband's grandmother) had a medical event at age 89, they moved her down to their county from her apartment and she was placed in a nursing home where she lived for 2.5 years until she passed. They did visit regularly, but they had recently retired themselves....and while they did have an extra bedroom, they did not move her in with them. And so, that's certainly something that I'd bring up if necessary.
The reality is....in this country, we are working seemingly harder than ever to keep people alive longer and longer....without much thought at all of who will care for them as they age. And again, brutally honest here....we do not want to be primary caregivers for our father. We've never said we did, never volunteered for it, and never made any such promises. I know we'd resent that very quickly and feel trapped in a life that we don't want.
The backup PoA is an excellent idea that we hadn't thought of. The "ex" of my husband's sibling would take on that role, for decision making purposes.
It amazes me that families don't talk of any of this. Here's a gentleman, lucky AND unusual in being independent at 92 after caring for his wife. And with all family surrounding him lovingly.
He's already made a LIFETIME of decisions. Why would this be new?
In my family it's been different.
My parents ALWAYS spoke with me about plans they had to prevent me ever being responsible for them.
I have done the same with my daughter. I spent my career as an RN and saw the result of what happens when no one talks.
The need to knows?
A) documents, where they are and what they say
B) plans for care of self when I cannot do it MYself
C) Where everything is
D) Who is POA, who is POD on accounts/where they are. Where all deeds and etc are. How much money is there. My instructions are called "The Death Book " and collaged with Day of the Dead stuff. Daughter has a copy. It is updated
E) End of life wishes and what they would be/ advance directives
Here you are clearly marvelously articulatete and intelligent; Yet no one brings any of this up. WHILE THEY STILL CAN.
So....gather your courage. And then it's "Dad, we need to have a sit-down talk".
And then it's "WHAT ARE YOUR PLANS?".
100,000 will keep your Dad in his home for a short period of time. Perhaps with 24/7 needs, about a year. A reverse mortgage might do it for longer. My partner's mom had marvelous luck with that. So you discuss options:
Is it to be a medicaid nursing home when no one wants the home as inheritance, nor needs it? I hope not. Clawback will take it anyway.
Is it sell the home and get a good ALF? When the time comes.
Is it time to say "Dad, we don't NEED your home. But what we DO need is reassurance that you will have care and we will have a retirement of travel, our own lives, and etc. You are doing well, and we hope that lasts to the end, but what are your wishes and instructions for us if it does not?
Now, Dad might get lucky. My own Dad sat down in his easy chair, turned on Monica Lewinsky as guest on Larry King Live, and died in seconds with a smile on his face. Shocked my mom, but an easy way to go at 92. (yup. his age). He's already told me about how ready he was, how tired. How much he longed for the long nap. I have already spoken with my daughter about how ready I am. About how much I do NOT fear death but DO fear torment, pain, debility. We TALK.
My bro? Not so lucky as my Dad. Car crash at 84 and diagnosis of probable Lewy's.
But WE HAD TALKED and we knew what to do. I got the POA and Trustee of Trust, he got the good ALF place. We worked together. We TALKED together. He told me he hoped he could beat Lewy's by dying. Got sepsis and DID JUST THAT. And there were no regrets, nothing to say "Oh, I wish I knew.....oh, if only I had asked.......oh, what would he want me to do now......." because I knew all along.
If you leave this to the phone call (and you are correct. It will come. Mine was "Are you aware we have your brother here at Desert Regional?" I wasn't) then that will be very sad.
You need to talk. Make it clear that it's time to make plans for the "what if". Dad will be RELIEVED to know options, to show you where everything is, not to have to wonder. He's already making comments. He's ready.
So it is this month. It is now. It is a phone call "Dad, we would like to have you over to dinner, and we would like to have a talk about what sort of plans and thoughts you have for the future.
Good luck.
Update us if you will?
I will tell you, that it's not like we're uncommunicative with my in-laws. Our pattern when MIL was alive and well was to visit with them about once every 4-6 weeks for dinner and a visit. Talk once a week on the phone. My FIL would tell you that he's "close" to his son, but I know that's never really been the case. They love each other, they're family, but with very different interests...etc.
But, we've also been good to them. My husband has had access to FIL's online activity for years so whenever an issue pops up with the computer...etc, he can help them. We've navigated through scams, etc and honestly, FIL is really still with it in that department. Ten years ago when my husband's sibling died we were around them a lot more than usual and I sniffed out that money seemed to be "tight"....and I was right. At that time we bought them a new car and began sending them $500 a month for "extras" that they needed. And then we all kind of went back to our usual pattern of visits...etc. Fast forward 9.5 years later, MIL's health is in serious decline and on the advice of doctors and social worker, we begin the "medicaid spend down" in anticipation that MIL could end up in a SNF for 2-3 years, as her own Mother was. Long story short, we found out at that time....that my in-laws had not spend one cent of the money we sent them....they saved it, and so it went to the nursing home, for a new roof and a new car for FIL. MIL died before we could complete the spend down, so it was all moot....at the end of all of that, he was left with 120K and the house.
Now we have access to his bank accounts, CC accounts...and monitor everything. We no longer send money monthly (he'll just save it), but we make sure his needs are met (and they are).
We do have the PoA for him, but now realize we need a back-up. We have the medical directive. We have the will and know what he wants for his funeral (that is prepaid).
We have a big 3 week trip to South Africa planned for September and so that's a good place to kick off the conversation. That we need another PoA, but that will just be the kickoff. You all have made me realize we need to put all cards on the table.
Part of our reluctance is that he loves where he lives. He still has his one best friend there. He's still on the golf team, bowling league and bocci league...etc. His current burn rate, as things are (knowing they could slip overnight) is only 10-11K per year, plus his SS. He's a depression baby...so very frugal.
But I am seeing some things slip.....and I know the decline can be very steep at his age. Thank you very much for the advice. The fact that he's mentally competent is a huge advantage as it is his decision ultimately. We'd likely try to steer him towards AL, because I can see it being very difficult to manage logistically, even if we remain nearby.
I would take him on tours of assisted living places and have him choose which places he would go when the time comes. Tell him that having a plan in place is much better than waiting until an emergency where he ends up in the hospital and then has to be placed without him having picked out 2-3 places , and then ultimately going to the one that has a bed available.
He also needs to have his paperwork , POA in order etc .
If/when he ends up in a facility and you are traveling , you could always order and have things delivered to him that he may need , ( new clothing , shoes , toiletries , books , whatever he wants ).
Other people have been POA without being close by to their relative in care. And if you wanted , you could hire someone to check on him , or hire a geriatric care manager .
Good Luck . I hope your FIL is cooperative Your husband needs to be a big boy and be proactive in setting boundaries with his father and stop avoiding this.
I agree that my husband needs to face this. I think, quite honestly, we're both hoping for a miracle and that he'd remain independent until he passed....suddenly. But I know that's a pipe dream. I'm going to have to be the one to facilitate this conversation.
www.genworth.com/aging-and-you/finances/cost-of-care
The Talk is one of many things no one wants to do but, once everything's lined up, all are so glad they had it.
Best wishes and happy travels
You can have all the information and options ready to talk about, but doing it this way respects the fact that he is currently independent and in charge of his own life.
However, after reading many of the responses here, I also feel like we now need to be very clear about "next steps" for my FIL, even if those "steps" aren't necessary in next year or more. I think we owe it to him (and ourselves) to be very clear that we won't be his primary care givers. And also that his nest egg isn't going to support him for very long in his home with private care.
I hate that we even need to have this conversation with him, but we honestly don't know what he's thinking....just guessing at this point. But as others have said, this is his life. And he needs to know the whole picture so that he can process this information and then we can best guide him as we go forward.
We could have another decade to go, and so we just want him to understand that we aren't going to be living a "retirement" like he and his wife did, in a 55+ community with a very local existence.....where we'd be available even in the first phases of him needing assistance.
There can be some changes made now before he may need care. Like him selling his home and moving somewhere less expensive. This would free up a lot of funds should he need them. Then if the time comes (and at 92 years it may not) where he needs caregivers, hire them.
I did this line of work for 25 years. If the time comes when he needs live-in caregivers, privately hire two people who split the week. Or they work one week on, one week off. You always need more than one person and never let a someone's home become a caregiver's official residence. That leaves the door open to all kinds of problems.
Your FIL will have money so there will be the option of hiring privately if needs be. You can always negotiate the price with independent, private caregivers. Or you can do as Waytomisery suggests and take him to see a few AL facilities. Get his name on some waiting lists. He'll have half a million dollars along with whatever his monthly income is and any other sources like investments, etc... at his disposal and he's 92 years old. He could get into any AL facility he wants.
You need to make things plain with your FIL that he's not moving in with you, nor will you and your husband ever move in with him to be his caregivers. That's not happening and he needs to be told this now.
Because 80% of his net worth is wrapped up in the house, I think we'd deplete his funds very quickly in the event that he needs in-home care. Even if we go the private route, and tap the mortgage, I think we could be in trouble in 2-3 years. And honestly, that's just a guess. I have absolutely no idea what a private caregiver costs for 24 hour care. But I'm guessing....it ain't cheap.
One thing I forgot to mention is that he does have a small LTC policy....covers just $80 a day, for a period of about 30 months. It's not much, but could slow down burn rate if he eventually ends up in a SNF.
What I don't know a lot about, and need to learn...is about the Assisted Living to SNF continuum of care facilities. I know that many have a "buy in", and then a monthly rate, but I don't know what happens if my FIL were to deplete his nest egg (meaning house and all)....before needing care at a SNF. Or, if he did need care in a SNF, do they accept medicaid patients if we're at that point in the game.
It truly seems that the people "in the middle" like my FIL almost have it the toughest. If you have no money at all...there are options, or tons of money....tons of options. In the middle, it's a real conundrum in how to manage it from a resources standpoint.
FIL needs a facility with a continuum of care so that he can go from independent living to assisted living to memory care or SNF as his needs require. If he's lived in his over-55 community for 25 years, he quite likely will know lots of people who are doing the exact same thing. They can even keep their old dominoes groups, and he can meet his longtime friends for lunch. Private caregivers are readily available as is transportation. He could keep his same doctors.
Do your research and find several suitable places near him. The ones near me are nice and offer numerous kinds of rooms, apartments and plans. You may have many choices. Visit them and take him with you. He may be delighted at the idea, or at least not angry.
Now we have my 86 year old brother in law who lives in a 55+ community in South Jersey. I keep telling my husband he needs a plan for when his brother can no longer live on his own. Other than his brother making a will and assigning POA to my husband they have not discussed any 'what ifs". As my husband says..."we don't talk about that kind of stuff". My husband is 75 (I'm 57) and we live 2 hours away so not like we can pop in and do check ins with him. BIL is in decent health, not great but not bad. And he does not have the resources your father has. My husband did help a bit with my father, but he really has no idea how bad and stressful it can really get. And he has the issue of distance to deal with. Not to mention he is up there in age too.
I urge you to force the hard conversation. Check out where he lives and see if they have different levels of assistance. If he is in South jersey there are a lot of places to choose from.
I think Fawnby is correct....in us helping to help him to tour places, give input...etc, if he decides to go this route.
Make sure toast up from if they have Medicaid beds and how many. Never consider a facility that doesn't have continuity of care and accepts Medicaid. That is the deal breaker.
Also, you may need to have The Talk with him more than once. Give him a little time to accept it and come to peace with reality that we don't control when or how we exit, so we need to control as much as we can and that only happens with a well-thoughtout plan.
You are just going to have to spend down his money until the big event happens and then you will make decisions based on that.
Does anyone have POA?
There are so many things that might or might not happen between now and then. I feel you though about having a loose plan B in the back of your head
I think I've gone from thinking that having a "loose plan B" in the back of my mind....to having a much firmer game plan. Ultimately though, it's not for me to decide. It's his life, and we can assist/guide the best we can. And also be honest with him about our plans and what his expectations should be where we're concerned.