Long Distance Elder Care: Are my hands tied?
January 16, 2012 7:15 AM Subscribe
Long distance elderly care dilemma: Advice on moving my 85-year old aunt to assisted living from a rehab center and out of her dilapidated house in rural upstate New York.
My 85- year old spinster aunt lives alone in a rural community in upstate NY. She is currently in a rehab facility where she was sent after a hospital stay that resulted from a visit to her doctor's office. She had gone for a regular checkup and the doctor discovered she had some significant lung and heart aliments that required immediate hospitalization. At the hospital, it was determined she was "deconditioned" and needed to build up some strength as well as receive on-going care. Hence, admisssion to a rehab center.
She refuses to sign a health care proxy, despite the entreaties of her new doctor, the facility social worker and myself. She also will not sign a power of attorney so I can manage her affairs (I am the only relative she has). Despite all this, she is mentally clear as a bell and despite some short term memory loss, quite competent.
On a visit last weekend, I saw that it is clear from her condition that she will never go to her home again and that assisted living is her next destination. I did stop by her house which is on a dead end street in a depressed area and which is basically falling apart.
My question: How do you liquidate a house and its contents if you have no legal standing? Are there agents or brokers who can do this for her? Given her condition--can't walk nor travel by herself--how does she get home to take stuff she wants? [She has nothing with her except the clothes she had when went to the doctor three weeks ago]. I don't have a key and I live 500 miles away.
My 85- year old spinster aunt lives alone in a rural community in upstate NY. She is currently in a rehab facility where she was sent after a hospital stay that resulted from a visit to her doctor's office. She had gone for a regular checkup and the doctor discovered she had some significant lung and heart aliments that required immediate hospitalization. At the hospital, it was determined she was "deconditioned" and needed to build up some strength as well as receive on-going care. Hence, admisssion to a rehab center.
She refuses to sign a health care proxy, despite the entreaties of her new doctor, the facility social worker and myself. She also will not sign a power of attorney so I can manage her affairs (I am the only relative she has). Despite all this, she is mentally clear as a bell and despite some short term memory loss, quite competent.
On a visit last weekend, I saw that it is clear from her condition that she will never go to her home again and that assisted living is her next destination. I did stop by her house which is on a dead end street in a depressed area and which is basically falling apart.
My question: How do you liquidate a house and its contents if you have no legal standing? Are there agents or brokers who can do this for her? Given her condition--can't walk nor travel by herself--how does she get home to take stuff she wants? [She has nothing with her except the clothes she had when went to the doctor three weeks ago]. I don't have a key and I live 500 miles away.
Does she want to go to assisted living? Does she have friends and neighbors who care about her? Does she belong to a church or other such group? Have her doctors said she cannot go home? Could she go home with some assistance provided on a daily basis?
There is probably some organization in her town that could help you sort things out, a Council for the Aging, public Senior Citizens' Center. There might also be a local non-profit organization that does repairs on seniors' homes.
If you tell us what town this is maybe we can help find some good local resources.
Seconding what Thorzdad said about legal issues.
posted by mareli at 7:55 AM on January 16, 2012
There is probably some organization in her town that could help you sort things out, a Council for the Aging, public Senior Citizens' Center. There might also be a local non-profit organization that does repairs on seniors' homes.
If you tell us what town this is maybe we can help find some good local resources.
Seconding what Thorzdad said about legal issues.
posted by mareli at 7:55 AM on January 16, 2012
Oh and dilapidated means different things to different people, I don't know you so don't really know what the term means to you..
posted by mareli at 7:57 AM on January 16, 2012
posted by mareli at 7:57 AM on January 16, 2012
Response by poster: In response to Mareli: Excellent questions. To clarify.
She does see the value of assisted living. She most likely will elect to go
Friends and neighbors that care. Just people who look in to see if she is ok.
Church-goer for sure. That's a great idea to follow-up.
Her doctor said she can't really care for herself at home. Perhaps some assistance.
Sullivan County, New York
Dilapidated: holes in windows, rotting window sills, overgrown with trees, unpainted in years, steps deteriorated.
Hope this adds clarity.
posted by captainmickey at 8:08 AM on January 16, 2012
She does see the value of assisted living. She most likely will elect to go
Friends and neighbors that care. Just people who look in to see if she is ok.
Church-goer for sure. That's a great idea to follow-up.
Her doctor said she can't really care for herself at home. Perhaps some assistance.
Sullivan County, New York
Dilapidated: holes in windows, rotting window sills, overgrown with trees, unpainted in years, steps deteriorated.
Hope this adds clarity.
posted by captainmickey at 8:08 AM on January 16, 2012
FWIW assisted living can cost up to $3,000 per month. (more 'round here). Does she have the cash or long term care insurance? She may have to sell the house or get a reverse mortgage. Then there's Medicare. If they are paying for any or all of this, there are certain rules regarding property.
THE FIRST RULE IS never say she will not be returning to her home. This is a bell ringer for Medicare. In many cases If there is the chance that she will return to her home they have limited access to its worth.
As far as the original question her doctor is the best way to try and communicate to her that you are only trying to help. In my mother's case her Dr. was the only voice of authority she would trust.
posted by Gungho at 8:37 AM on January 16, 2012
THE FIRST RULE IS never say she will not be returning to her home. This is a bell ringer for Medicare. In many cases If there is the chance that she will return to her home they have limited access to its worth.
As far as the original question her doctor is the best way to try and communicate to her that you are only trying to help. In my mother's case her Dr. was the only voice of authority she would trust.
posted by Gungho at 8:37 AM on January 16, 2012
Do you know anything about her financial state? Can she even afford assisted living? If not has she already begun the process to file a medicaid claim? Most asst. living places will not take you unless you have the money to cover a couple of months or already have your medicaid qualification letter in hand. She will end up stuck in the nursing home (they cannot discharge her if she cannot care for herself) even though she doesn't need that level of care if she doesn't have her financial ducks in a row for assisted living.
posted by TestamentToGrace at 8:43 AM on January 16, 2012
posted by TestamentToGrace at 8:43 AM on January 16, 2012
Here's a link that might be helpful.
The house does sound unsafe!
I hope it all gets worked out.
posted by mareli at 8:43 AM on January 16, 2012
The house does sound unsafe!
I hope it all gets worked out.
posted by mareli at 8:43 AM on January 16, 2012
If you want to liquidate her house, you are going to have to be appointed her guardian by a judge. Of course, if you live 500 miles away, that's probably not such a good idea. Perhaps you can seek out someone from her church who might be willing to be appointed guardian so that there's someone on the ground who you trust to make the best decisions for her. You could seek co-guardianship.
It sounds like your fierce, independent aunt who is still sharp deserves some straight talk about the state of her house if it is that bad. A "you deserve better" talk is your logical next step. She may not see the shoddiness of her home but you can be damn sure that telling her that if she falls over those broken steps and breaks a hip, or gets pneumonia from the drafty windows, she will be in rehab for a long, long time, possibly the rest of her life. She deserves to live in a place that is kept safe for her to live as independently as she can. Rehab sucks, but the state of her home is going to send her right back there, soon. She deserves to live somewhere that will keep her out of rehab and the hospital as much as possible so she can enjoy her life.
There are things called "living estate sales" that are basically just like estate sales and often run by the same companies. The only difference is that the owner is alive. You may be able to find one that is willing to liquidate the house and put everything up for sale except a few special things that will move with your aunt into an assisted living home. These companies are frequently used to raise immediate capital to fund the first few months at a retirement home or nursing home. Seek referrals, especially through the rehab center, local nursing homes, and funeral homes. They will steer you clear from the scams.
The fastest way to ensure that she will not return home to a house with holes in windows and disintegrating steps is to contact her local building authority to have the home condemned. If you choose to go that route, be ready the next day to have the contents liquidated.
posted by juniperesque at 8:48 AM on January 16, 2012
It sounds like your fierce, independent aunt who is still sharp deserves some straight talk about the state of her house if it is that bad. A "you deserve better" talk is your logical next step. She may not see the shoddiness of her home but you can be damn sure that telling her that if she falls over those broken steps and breaks a hip, or gets pneumonia from the drafty windows, she will be in rehab for a long, long time, possibly the rest of her life. She deserves to live in a place that is kept safe for her to live as independently as she can. Rehab sucks, but the state of her home is going to send her right back there, soon. She deserves to live somewhere that will keep her out of rehab and the hospital as much as possible so she can enjoy her life.
There are things called "living estate sales" that are basically just like estate sales and often run by the same companies. The only difference is that the owner is alive. You may be able to find one that is willing to liquidate the house and put everything up for sale except a few special things that will move with your aunt into an assisted living home. These companies are frequently used to raise immediate capital to fund the first few months at a retirement home or nursing home. Seek referrals, especially through the rehab center, local nursing homes, and funeral homes. They will steer you clear from the scams.
The fastest way to ensure that she will not return home to a house with holes in windows and disintegrating steps is to contact her local building authority to have the home condemned. If you choose to go that route, be ready the next day to have the contents liquidated.
posted by juniperesque at 8:48 AM on January 16, 2012
As you are probably realizing, elder care is a real mess that seems to require many disparate items falling into-place in just the right order, at just the right time. You would do well to get as much solid information on your aunt's finances and then consult with an elder-care attorney, to figure-out the right approach to her long-term care.
It's a freaking nightmare of mazes.
posted by Thorzdad at 9:10 AM on January 16, 2012
It's a freaking nightmare of mazes.
posted by Thorzdad at 9:10 AM on January 16, 2012
What an awful situation! As Thorzdad says, eldercare is a real mess. Even if the legal documents are in place it's a mess - and if the elder is in denial AND is still mentally capable, it's a true nightmare. I've been there with my mom and friends have been their with THEIR elderly relatives.
You say she's a churchgoer - try contacting her pastor or priest for some help. Clergy are trained and experienced in caring for their congregations in all sorts of ways and sometimes can help when no-one else can.
Most long-term help is going to depend upon her finances, whether she is willing to sell her house, whether anyone else can act upon her behalf, etc. but you can at least try to get the ball rolling and work with what you have.
Here are some links for you:
Senior Law resources
New York State Office for the Aging
If she insists upon returning home, Lotsa Helping Hands is a great website for coordinating care among caregiving friends, family, neighbors and congregations. It's not professional caregiving, but as a stopgap, might help to rally friends and neighbors (you say she has those) to step in and at least see to it that she gets meals, hopefully some home repairs, and is not lying unconscious on the floor with no-one knowing.
For home care, here is a link to the Home Care Association of New York State.
posted by Rosie M. Banks at 9:22 AM on January 16, 2012
You say she's a churchgoer - try contacting her pastor or priest for some help. Clergy are trained and experienced in caring for their congregations in all sorts of ways and sometimes can help when no-one else can.
Most long-term help is going to depend upon her finances, whether she is willing to sell her house, whether anyone else can act upon her behalf, etc. but you can at least try to get the ball rolling and work with what you have.
Here are some links for you:
Senior Law resources
New York State Office for the Aging
If she insists upon returning home, Lotsa Helping Hands is a great website for coordinating care among caregiving friends, family, neighbors and congregations. It's not professional caregiving, but as a stopgap, might help to rally friends and neighbors (you say she has those) to step in and at least see to it that she gets meals, hopefully some home repairs, and is not lying unconscious on the floor with no-one knowing.
For home care, here is a link to the Home Care Association of New York State.
posted by Rosie M. Banks at 9:22 AM on January 16, 2012
You are not your aunt's POA. You can give suggestions to her, but get her permission before you do ANYTHING other than just calling her and visiting her. That includes looking into her finances, contacting people on her behalf, etc. If she says No, you don't do it.
If you want to speak with a REPUTABLE elder care attorney and pay the fee, though, just to get yourself prepared, that is your business and your right. I don't see how you can become the guardian of a mentally competent person, but IANANYSL.
I guarantee you, she will resent any attempt on your behalf to do anything that looks like running her life, particularly in the way of finances or disposing of her home. That could really backfire on you, and her, as she gets more frail and needs more help. Right now, if she wants to let the damn house rot, it is HER business until she asks you for help.
I'm glad to hear that she is going to assisted living. Again, if you are not her POA, she'll have to sign the forms and figure out the finances herself with the help of the facility staff. Do not let yourself get put on the hook for anything ("responsible party," "guarantor") without an attorney-prepared POA in hand. This sounds really harsh but she is choosing this road. I hope for her sake she will change her mind.
posted by Currer Belfry at 10:28 AM on January 16, 2012
If you want to speak with a REPUTABLE elder care attorney and pay the fee, though, just to get yourself prepared, that is your business and your right. I don't see how you can become the guardian of a mentally competent person, but IANANYSL.
I guarantee you, she will resent any attempt on your behalf to do anything that looks like running her life, particularly in the way of finances or disposing of her home. That could really backfire on you, and her, as she gets more frail and needs more help. Right now, if she wants to let the damn house rot, it is HER business until she asks you for help.
I'm glad to hear that she is going to assisted living. Again, if you are not her POA, she'll have to sign the forms and figure out the finances herself with the help of the facility staff. Do not let yourself get put on the hook for anything ("responsible party," "guarantor") without an attorney-prepared POA in hand. This sounds really harsh but she is choosing this road. I hope for her sake she will change her mind.
posted by Currer Belfry at 10:28 AM on January 16, 2012
Response by poster: Thank you all for this invaluable advice and forwarding of resources. I think I see the next steps for me. And you're right, this is not easy.
posted by captainmickey at 12:35 PM on January 16, 2012
posted by captainmickey at 12:35 PM on January 16, 2012
If she really doesn't want to leave her house, how about looking into the cost of fixing it up and hiring home health care aides to come in every day? Quite honestly, unless the house is much worse than you're describing, that's probably going to be the cheapest option by a long shot. Assisted living is beyond expensive and if she has no money, there really are so very few decent assisted living homes out there that you may just be SOL anyway. Anyway, I would look into getting the house fixed and either finding a live in companion / caregiver or at least aides who can stop by every day - this is more or less what we have done with my 83 year old aunt and it's working out very well. She's much happier and more comfortable in her own home and the cost is really substantially cheaper than assisted living would be.
posted by mygothlaundry at 2:32 PM on January 16, 2012
posted by mygothlaundry at 2:32 PM on January 16, 2012
A couple more ideas that might help if she does return home:
She can sign up for Meals on Wheels which will deliver hot, nutritious meals to her and provide someone to check in on her every day. My grandma LOVED her regular Meals on Wheels delivery guy and he enjoyed chatting with her (we teased Grandma that she had a boyfriend).
Rebuilding Together, formerly known as "Christmas in April," is a public service program that fixes up low income seniors' houses. It may be that your aunt would be a candidate and they could help her get her home in better shape.
posted by Rosie M. Banks at 3:45 PM on January 16, 2012
She can sign up for Meals on Wheels which will deliver hot, nutritious meals to her and provide someone to check in on her every day. My grandma LOVED her regular Meals on Wheels delivery guy and he enjoyed chatting with her (we teased Grandma that she had a boyfriend).
Rebuilding Together, formerly known as "Christmas in April," is a public service program that fixes up low income seniors' houses. It may be that your aunt would be a candidate and they could help her get her home in better shape.
posted by Rosie M. Banks at 3:45 PM on January 16, 2012
How do you liquidate a house and its contents if you have no legal standing? Are there agents or brokers who can do this for her?
To the first question, you don't. If she is compos mentis, it's her decision. To the second question, though, the answer is yes, there are lots of people who can do this for her. Real estate agents for the house, and auctioneers for its contents, to be specific. When she is ready to relinquish her house and possessions, those professionals can take care of it. So you could remind her of that and help put her in touch with agents and auctioneers (whom you might happen to have vetted).
posted by bricoleur at 10:04 PM on January 16, 2012
To the first question, you don't. If she is compos mentis, it's her decision. To the second question, though, the answer is yes, there are lots of people who can do this for her. Real estate agents for the house, and auctioneers for its contents, to be specific. When she is ready to relinquish her house and possessions, those professionals can take care of it. So you could remind her of that and help put her in touch with agents and auctioneers (whom you might happen to have vetted).
posted by bricoleur at 10:04 PM on January 16, 2012
You've already received a lot of great advice. I'd just like to offer one more resource, who may be helpful either now or in the future: Janice Wallace, an eldercare coach. I know Janice and have consulted with her myself, although my issues were nowhere near as complicated as yours. She's a good, and knowledgeable, person.
She has a website called Caring for Caregivers.
posted by jeri at 1:00 AM on January 17, 2012
She has a website called Caring for Caregivers.
posted by jeri at 1:00 AM on January 17, 2012
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You can't. I believe they call that grand theft.
You need to get a judge to award you guardianship over your aunt. This, though, will require a lawyer and a lot of documentation/testimony from doctors and other professionals involved in your aunt's case.
posted by Thorzdad at 7:51 AM on January 16, 2012 [1 favorite]