This week’s blog continues the discussion of an aging adult who wants to stay in his or her home. The introductory installment (on February 11, 2016) discussed the emotional turmoil that can face the adult children in deciding whether to accede to the aging parent’s wishes to stay home. The February 18, 2016 installment discussed home modifications that may make it easier for an aging adult to stay home. The February 25, 2016 installment discussed medication management. The March 3, 2016 installment discussed hiring someone to help with activities of daily living. The March 10, 2016 installment discussed whether aging in place is an appropriate choice for someone suffering cognitive issues. The March 17, 2016 installment discussed services that can make it easier for an aging adult to stay home. The March 24, 2016 installment discussed the aging parent moving into an adult child’s home. Today’s installment will discuss an adult child moving into the home with his or her aging parent.
Many of the issues discussed in the last installment about the aging parent moving into the home of the adult child must be considered before an adult child moves into the home of an aging parent. Moving in with an aging parent requires the cooperation of the child’s spouse (if there is one) and the child’s children (i.e., the aging parent’s grandchildren) if any. The physical layout of the aging parent’s house might be very important to the parent’s ability to stay home. Of course, living in the parent’s home (grandparent’s home as far as the children are concerned) needs to fit into the lifestyle of the adult child’s family.
There is one big difference when the adult child moves into the aging parent’s house. The aging parent might be able to give the house to the child without creating a problem with Medicaid (if the aging parent later needs Medicaid to help pay for long term care.) There are some specific conditions that must be met, however, for a transfer of the house to be okay with Medicaid.
The short version of this rule is that Medicaid will reward the adult child that helps keep the aging parent out of a nursing home for two years.
So, to qualify for a transfer of the house to the adult child:
(1) the aging parent would need to move into a nursing home if not for the adult child’s help at home,
(2) the aging parent must have a level of care assessment indicating that the parent needs an “intermediate level of care” (usually meaning that the person needs help with two “activities of daily living” such as bathing, toileting, dressing, grooming, getting out of bed or a chair, walking around, or eating,)
(3) the doctor issues a letter stating that the aging parent would need to be in a nursing home if not for the child’s presence in the home,
(4) the child must live in the parent’s house for two years, and
(5) the parent must not move into a nursing home for at least two years.
(Note: This is only a Medicaid rule. It does not avoid possible IRS taxation of gifts. It also does not make the parent’s mortgage go away.)
Sounds easy, right? Maybe, maybe not!
The aging parent needs to get good care. The incentive of a home transferred from Mom or Dad should NOT create an incentive for failing to get the care that Mom or Dad actually need. Failure to take proper care of Mom or Dad should create a great deal of guilt. If extreme, it should prompt a visit from Adult Protective Services.
An adult child (with our without family in tow) moving into the aging parent’s home can sometimes help the parent age in place. The home and the child’s involvement need to be appropriate for the aging adult’s care. If everything falls into place (and that’s often a matter of luck,) the family may be able to protect the house from the parent’s long term care costs.