I was hoping to hear some stories of how you have convinced your parent(s) to move to assisted living when you can't pick up the cost.
Long story short, we moved my parents in with us 4 years ago to a larger house we purchased to accommodate everyone (them, hubby and I, and 3 kids) and things have gotten steadily worse. They had given us money to make the house more accessible- 2 ramps, entry modifications, we added a bathroom on their level they could access, etc. My husband did all the work himself to save cash but they were still expensive modifications. Mom clearly hates living with us and has become very unpleasant, dad has Parkinson's. Recently she has fallen 3 times in the past 10 months, breaking a hip, a knee, and cracking a pelvis. We no longer feel it is safe for them to live here as we work full time and still have responsibility with children at home that take us out in the evenings. However, when we bring up assisted living she throws the money at issue at us. Claims they can't afford to move because they have given us 'all their money.' (They haven't, the repairs were a decent amount of the modest amount they had but they do have some reserves left and are getting SSI). We have offered to help with the cost of assisted living but can't pick up the whole monthly bill and I am angry because we used the money they 'gave us' for repairs and upgrades they needed and have never once asked them to share the very sizable cost of the mortgage for the larger home, the utilities, food or anything.
How do we convince them to leave????
Financially, you said your parents have lived with you for 4 years and ONLY PAID for modifications that THEY required in a home YOU paid for. You are also paying for THEIR food and utilities I believe you wrote. If they were in assisted living already at an average $4,500 a month per person, that would be $108,000 per year for 2 people. With those figures the modifications they paid for have long since been "paid back" by your caring for them over the past 4 years. The ramps they needed as a modification are not going a selling point to the home later on.
If your parents are getting even $1000 SSI per month, and not helping with their own living expenses, they also could have saved an additional $96,000 already over the past 4 years. Did the modifications even cost that much?
Your mom needs assessment to evaluate why she keeps falling (to keep her safe), and also for why she's becoming "unpleasant" because there could be a developing depression and/or dementia. Your dad has Parkinsons which is progressive and will likely need more help going forward also.
A social worker, or your area agency on aging may be able to help with getting your parents to move to a place that is more suitable for their now changing needs. Even if they don't like the sound of it, it sounds like they need this to keep them safe. It's difficult to find a good facility that will also accept Medicaid for when their assets run out. We've found the best one's can have a waiting list of a year or more for places close enough to where we live.
Good luck with everything!
Consider that if your parents are getting even $1000 SSI each per month each for the past 4 years, they could easily have saved an additional $96,000. This may already be more than enough to recoup the modification money your mom is so angry about. You didn't say how much they gave for modifications to the home, so this is only an estimate.
If they wanted to stay in their own home and pay a caregiver to help them for only 8 hours a day at $21 per hour 7 days a week that would be $61,300 per year. This amount doesn't include their own food or utilities for which they would be paying also. Now that they need to have someone around all the time due to safety reasons, it would be even more expensive.
Either a paid caregiver while you are out working or finding a good facility that will accept Medicaid when their money runs out appear to be the only options that would work long term. Waiting lists can be a year or longer we've found. Your area agency on aging, a social worker, or elder care attorney will be the best sources for help making future decisions.
Try and find a place that has transitional care....maybe they can start in assisted living, but make sure there is skilled nursing care available so that the next move is as easy as possible. Many times one spouse requires more care than the other and it's helpful if both facilities are on the same grounds or connected so that they can see each other daily.