Procedure for Setting Up VA Fiduciary Account for Mom's Benefits

"It Really Was Quite Easy and Painless. "

Hello All,

Today we finally had the meeting with the rep from the VA to set up the Fiduciary Account for mom's Aid and Attendance Benefits. As promised I will tell you all how it went and what I found out about the process. 

The meeting was very informal. We met at the Adult Family Home where mom is now living. The rep needed to meet with my sister who was to become the fiduciary and my mom, in order to assess her abilities to handle her own money. I went along to see how the process worked and just in case there where any questions about her application since I was the one who filed the initial forms.

The rep was very nice. She asked my mom the usual questions when checking for dementia; Do you know what year it is? Do you know who is president? Do you know where you are? Have you been in the hospital in the past year? Mom was able to answer some of the questions but with further conversation and my mom's own admittance, it was obvious that she needed help and could not manage her money on her own. 

The rep then gathered required information. She needed copies of my mother's financial  statements, bank accounts and any other sources of funds. She needed verification of my mother's current monthly income - social security and any other sources besides the VA benefits. A list of her current medical expenses was also needed - medicare supplement premiums, and lists of medications and cost of care at the Adult Family Home. Then she asked for two references from my sister who would testify to my sisters trustworthiness. She also asked for my sisters approximate yearly income.

After gathering all the information she went over the process for setting up the account. My sister will receive a letter of approval from the VA after they complete a background and credit check on her.  She then needs to take the letter along with a direct deposit form which the rep gave her to the bank and have them set up the account. The account will be in my mother's name with my sister's name listed as fiduciary. She said any bank can be used. Once the account is set up the back payment that is owed to my mother will be deposited into the account and her regular monthly payments will start going into that account.  

Here are a few rules about how the account is to be handled:

•  My sister will have to write checks from this account directly to the Adult Family Home, she cannot transfer the money into mom's other account and write one check, she will have to write two checks every month.
• There is never to be any commingling of funds with any of my sisters own money. The money is to be used only to pay for mom's  care ( already knew that ).
• My sister must keep records of all expenses in case they were to ever audit the account. Not hard since it's money in money out kind of situation.
• We are to notify the VA if mom moves or goes on medicaid anytime in the future. 

Other than that it was pretty straight forward. The meeting lasted about 30 minutes and she wanted to see my mother's room before she left. We were glad to get this piece of the puzzle in place so that from here on out things should be straight forward. 

By the way, if someone has ever filed for bankruptcy they cannot be a fiduciary for another under the VA rules. 

Hope this helps you if you are facing this procedure in the future. It really was quite easy and painless. We are very grateful to have these benefits for mom as they allow us to have her in a nice quiet place with some wonderful people looking after her. Without the VA we would have had to apply for medicaid and then the uncertainty of where she would end up would have been an issue. We will have to apply for medicaid in the future if she out lives what she has left but at least this buys us some time (about 4 years) to see what our options are without having to make a hasty decision we may regret. 

If you are in a situation like ours, I suggest that you take the time to research medicaid facilities, as I will be doing, over the course of the next several months. Find out what facilities take medicaid and if there is a waiting list. I find being proactive makes things easier and less stressful for all. 

Until Next Time
Take Care All,
Ruth Anne

Meeting with VA for Fudiciary Account Posponed a Week

Happy Saturday to all,

Our meeting with the VA rep to set up mom's fiduciary account was suppose to be yesterday. The rep called in sick so now the meeting is set for next Friday 2/19/2016. I was disappointed as I hoped to have information to share with you on how the process works, but this extra week with give you more time to send in your questions about VA Aid and Attendance Benefits. You can use the link at bottom of article or you can email me at ruthann@palcaregivers.com.

Hope to hear from some more of you as this is a great chance to get you questions answered by a expert, the rep, not me.....


Until Next Time
Take Care
Ruth Anne

94 Year old Abused By Caregiver. How to Hire the Right Caregiver

Hi everyone,

Hope you are doing well today. Monday I posted about how the weather here in Michigan was so mild this winter, I spoke to soon.....Now it's snowed and by the weekend it's going to only be 9 yes I said 9 so winter is not done yet. 

My post today about how to hire the right caregiver for your loved one was prompted by something I saw on TV Tuesday . Just as I was leaving the Adult Foster Home where my client lives I caught a glimpse of the show Right This Minute. The show was airing a clip about  a caregiver who was caught on camera abusing her 94 year old dementia client.  It is quite disturbing. I will provide you a link however I must warn you watching it is hard and very unpleasant. 

Because this is not a random case unfortunately, it got me thinking about how do you go about finding the right caregiver. Although we try to care for our loved ones ourselves, that is often just not possible for us to do on our own, so we turn to outside help to accomplish the job. Wanting only the best for our loved ones we should use caution when hiring someone to come into our home. We all know we should do background checks and check references but here are a few things you may not think to do.

Meeting With VA For Fiduciary Account This Week

Hello Everyone, 

Well the Super Bowl is over tomorrow is Fat Tuesday and the weather is still not that bad here in Michigan. All this means we are marching ever forward toward spring...hooray !

This week we finally will be meeting with the person from the VA to set up the fiduciary account for my mother's Aid and Attendance Benefits. Now mind you she has been getting monthly benefits since June of last year so that tells you how far behind the VA is in getting stuff done. 

For those of you who are working with the VA setting up a fiduciary account may be in your future too. Just what is a fiduciary and why do we need to go through this process? I will try and explain to the best of my knowledge.

When we applied for mom's benefits she was, because of her dementia, deemed unable to manage her finances by the VA. We already knew this as she no longer could remember to even ask about her finances which was quite a change for her. All her life she was sharp as a tack when it came to money. She worked hard and saved her money wisely. She knew where her money was and when things came due etc... Because of her failing eyesight myself or my sister have been helping her with her bills for years but she always knew exactly what was what. Then about a year and a half ago she just stopped showing interest in it. By this time she was living at my sisters and my sister was a signer on her accounts so I guess mom knew in her mind everything was taken care of. 

Should Parents Pay Their Children For Care?

Do you have loved ones you are caring for? How about grand children? If you are here reading this blog, chances are you are a caregiver.

It's been a few days since I have posted and I am sorry for the delay. I have been caught up in my caregiving duties as well as enjoying time with my precious 16 month old grand daughter, she is such a delight and a welcome refreshment to help make it through the tough times!

Do you visit and post in the online forums such as caring.com or agingcare.com? I have also been doing a lot of reading and posting on these forums lately and find there are so many wonderful people out there doing what we do, caring for a loved one with all that entails and just trying to put one foot in front of the other on the journey we travel.

One subject that has been coming up quite a bit in the forums lately is the debate on whether or not it is proper to ask your parents to pay you to act as their caregiver, provide housing and the like. And the opinions run the gamut. So I thought I would share some of my thoughts as well as how the government feels about the subject.

Consider: What type of care are you providing? What have you had to give up to provide this care? And how do your parents feel about the services you provide?

Many of you have given up so much to care for your parents and do so willingly, out of love. When your parents need intense care or supervision as my mom now needs, you may have moved them into your home in order to provide that care. Many of you have also had to give up outside employment to stay home 24/7. 

Some feel that no matter what you have to give up, you should never charge your parents for care, after all they raised you and provided for you for many years. If that is your opinion and you have the financial resources to do so that is fine and I applaud you for your devotion and love. Some however do not have the financial resources to not work. So when their parents need care they have a few options. They can hire a caregiver, put their parent in an assisted living or nursing home or they can work for their parents and provide the needed care. If given the options most parents would likely prefer to have their own family caring for them for as long as that is possible.

Consider what it would cost to put a parent in an assisted living facility. If they need anything other than basic assistance such as meals and general supervision the costs can be $5 to $6 thousand dollars a month. If they need to go to a nursing home the costs can skyrocket to $8 thousand and above. If you were to hire an in home caregiver the cost would be anywhere from $20 to $30 dollars an hour depending on how much care is need and what area of the country you live in. These costs can eat up even a healthy retirement account in no time. 

If you are the one providing the care, you may as many people feel, it is only reasonable that you get paid. How much is something you and your parent can work out, which in my experience is very reasonable and so much less than what they would have to pay for outside care. No one should take advantage of their parents and charge them outrageous amounts of money just because they feel they can, this is a form of elder abuse. However no one should question a reasonable amount. 

Caring for a parent who is aging is a very tough sometimes full time job. If you have siblings who do not participate in the care they may question you getting paid. In that case you need to make them understand just how much you have given up and how much you do for mom or dad or both. If they are worried about their inheritance, remind them of how fast that will disappear if mom goes to a nursing home.

And the government too feels it reasonable for a family member to be paid for services. Many do not know that Veterans Benefits can be used to pay family members. In most states a medicaid waiver can be uses to pay family caregivers. The government is beginning to realize something that has been obvious for years, and that is, that keeping the elderly at home with family is much more cost effective. They are finally starting to get it. 

So if you are caring for mom or dad, grandma or grandpa and you need to be paid, in this person's opinion that is fine. You are working hard, maybe harder than you ever have before. You are also making a better life for your family member, because they are being cared for by someone they know and love. You are doing a good thing. Don't feel guilty!

One important note for paid family caregivers - please have a caregiver contract in place. This is especially important if you are using government benefits to pay your wages. Also this will protect you if in the future your loved one has to go on medicaid and the money to pay you was used during the 5 year look back period.  (The Deficit Reduction Act of 2005 expanded the look back period from 3 years to 5 years.  Almost every state has adopted this or is in the process of adopting this rule).  If you do not have a contract the government may look at those payments as gifts and require them to be paid back. The contract will save you in that case. Another good reason to have a care contract in place is if there are any disputes between family members regarding inheritance, we all know how nasty greedy relatives can be. For information on how to structure a care agreement you may want to check out this link click here . 

Dear Ruth Anne, Here's what I think...

I hope this information helps those of you who are wrestling with this subject. And I would love your feedback. How do you feel about it? What side do you come down on? Please share your thoughts. 

Until Next Time
Take Care
Ruth Anne






 

Facing The Tough Decision To Place Mom In An Assisted Living

As my readers know I am not only a professional caregiver, I am also, along with my sister caring for my 91 yr old mother. Now we are at a crossroads in her care.

The task of caring for her at home is becoming just to much for my sister and I. And so we are searching for the next place to plant our foot on this journey of family cargiving. This is the toughest step we have had to take so far, but for the sake of all of us it is a step I feel we must take. Even if the road is a bit rocky and our footing is a bit unsure we must trudge ever forward.

Today we looked at a facility that is classified as an adult foster home in Michigan. It is the largest of its type, as classified in the state, being a 20 bed facility. In Michigan there are 3 types of adult foster homes licensed by the state, which are also called homes for the aged. They are 6 resident, 7-10resident and 11-20 resident.

The facility was nice with private rooms with private bath, staff seemed nice and she can bring some of her own furniture. And best of all it is close to all of her family and friends and so visiting will be easier. The only draw back is she only has enough money to stay there for 2 yrs which means if she runs out of funds and has to go on Medicaid we will have to move her again in 2 years. 

Monday I will reach out to the Area Agency on Aging ( most every county in the U.S. has one) to see what advise they can offer as we make some very tough and sometimes scary decisions.

My mom is a wonderful person and a great parent, grandparent and great grandparent and we want see to it that she is as happy as possible during her final years. And that is why these decisions are so hard to make.  I will share with all of you the progress we make as we take these next very tenuous steps. The time has come, the time no child looks forward to, when we have to make decisions for our parents that they may not at first like, hopefully mom will understand and know it is for the best. At least I pray she does.

Until next time

Take care my friends and share the story of your journey on this road with us. The old saying goes there is strength in numbers, and we all need strength on this journey.

Ruth Anne

This always reminds me of a verse in scripture which says:

"Very truly I tell you, when you were younger you dressed yourself and went where you wanted; but when you are old you will stretch out your hands, and someone else will dress you and lead you where you do not want to go." -John 21:18, New International Version 

It is a big responsibility.

Will

Helping Our Alzhemier Clients: Do They Experience Hallucinations ?

Today is a rainy cold day and I am off work, so I don't have to be at mom's today. So I thought I would share with you and interesting bit of information I have just learned about Alzheimer's clients.

Most mornings I will listen to NPR (National Public Radio). This week there was a piece on about Alzheimer patients and hallucinations. The report tracked a patient with Early-onset Alzheimer's disease, who is using a tape recorder to journal his experiences as he travels this very scary and unfamiliar road. A road which many of us may one day travel ourselves.

The report was titled - Seeing What Isn't There: Inside Alzheimer's Hallucinations.

Salvador Dali: Persistence Of Memory

What I find interesting as a caregiver is how this piece of information may in some ways help us understand our clients better. One case in point I can think of is showers. If you have the responsibility of showering a client with Alzheimer's you know it can be a very trying experience for both you and your client. My clients physician once told me that they don't see the shower for what it really is, and may perceive it as a threat of some kind. He had a patient who thought he was being asked to get into a boat and he thought the boat was sinking. That of course made him very fearful. Could it be that he was hallucinating at the time? Well maybe so.

There are other times when our clients behavior may seem odd to us, however if they are seeing things that are not there it would explain a  lot about their actions. This is just one more bit of information that we can have in our data banks to help us deal with the day to day issues that we face when caring for an Alzheimer's patient, whether it be a client or family member.

"Up to 50 percent of people who have Alzheimer's disease experience hallucinations, delusions or psychotic symptoms, recent research suggests." - National Public Radio

On a similar note my mother has severe macular degeneration, and it is common for patients with this disorder to see strange things also. I will share some insight on that with you tomorrow. And also I will have some links to information on just what it is they see, because believe it or not, when they tell about their visions - or draw them if they able there is a common thread...... so unusual you wont believe it.

Until tomorrow Take Care

Ruth Anne

Today Is Another Family Caregiver Day

This morning I don my family PAL hat, as opposed to my professional PAL hat.

 

Monday is one of my days to care for mom. So up at 5:30 a.m. to be to sisters by 8:00. Mom needs to go for blood tests today and can't eat, so we're going to get an early start... well so I thought.

Mom is getting very slow these days so I need to be super patient which isn't always easy. Most of us are so used to doing things fast - just donning our clothes and jumping in the car. Not so when you are a person of 91 years. An hour to dress an then 15 minutes to load into car before we can go. But that is just the way it is, we must move at their speed, we cannot hurry the family member we care for.

After blood tests mom wants to go to lunch. I can't say no, she doesn't get out much and lunch out means so much to her, and its worth the effort. I then spend the rest of the day with her at my sisters house while my sister is at work. I know how stressful this is becoming for my sister and I try to do as much as I can to lighten the load. Tomorrow I have my client I care for but must spend some time looking into a place for mom. Will update you on the search process and how it all progresses.

Until then Take Care

Ruth Anne

Caring for Mom and Dad

Dear Friends,

Did you see the recent PBS show entitled: Caring For Mom & Dad ?

 

Until now my blog posts have been about being a professional caregiver. However today I want to switch gears a bit and talk about being a PAL caregiver for a family member. You see I have done both. If you have read my posts you know  I have worked for other families caring for their loved ones, however I have never posted about caring for a family member as I have done for many many years. I can tell you from experience that they are in so many ways very different

My father passed away in 2001 suddenly, leaving my mother, who has severe macular degeneration, to live alone. My siblings and I did not feel that it was safe for her to live alone as she was about 45 minutes away from both my sister and I  and could not drive or care for other needs on her own. She was 77 at the time. Without hesitation we decided to have mom move in with us and she lived with my husband and I for 9 1/2 years. She has now been living with my sister for the last 4 1/2 years and is now 91.

The stress of having someone else in your household is heavy. The decisions you have to make for a family member such as a mom or dad are complicated and not always easy.