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My husband requires long term care after suffering a massive stroke 5 months ago. Medicare has cut us off which was expected. My poor husband cannot make rational financial decisions and we do have to pay for nursing care. He complained to one of his brothers which created a cascade of suspicion and doubt that I'm trying to "take his money". He suffers from delirium associated with stroke and is easily rattled. They choose to believe he's mentally acute and can make his own decisions. I've arranged for our elder care attorney to meet with us at the current facility to try and explain things to my husband. He told me he'd rather stay as he is than pursue any further care to save money. But he's not thinking rationally. Has anyone else been through this with a family member? If so, how did you handle it?

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This is 100% none of your brother-in-law’s business. If he continues to question you, I would have the lawyer send him a cease and desist letter.
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Reply to Southernwaver
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You need to talk to this lawyer about splitting assets. Your husbands split would go to his care and when almost gone, you apply for Medicaid. Once he is on Medicaid you become the Community Spouse. You remain in the home, have one car and get enough or all of your monthly income to live on. You are entitled to assets from the marriage. As POA you do not have to answer to his brothers. Asvhis wife, you do not have to answer to his brothers.
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Reply to JoAnn29
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Husband's brother? It's nice he cares about his brother's wellbeing. But it would be nicer to show he cares with more respect.

Otherwise it could appear that this BIL is a 'know-it-all' who thinks HE knows better that everyone..

I've met them before..
The Mr/Ms Big Heads who know better. Know better than any Doctor about diseases or medications. Sometimes make their own diagnosis too.
Know better than nurses when & how to care for the patient.
Know better that a person is *all there* based on a short phone call.
Know better that if a person WANTS to stay in their home this means they CAN - despite the care burden being too high for the spouse/household members.

A big trumpet.
Puffed up with their own air & noise..
But not taking the time to read the music & understand what the band is doing.

Is this man a caring brother? One you can talk honestly with & explain?

Or an ignorant trumpet?
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Reply to Beatty
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1) You say that your husband “told me he'd rather stay as he is than pursue any further care to save money. But he's not thinking rationally”. If he needs nursing care, not PT or curative care, it’s difficult to ‘save money’. However it can be rational to turn down PT or curative care which is not likely to mean a major improvement, even if you would prefer him to try. Can you explain the difference to him and to his brothers?

2) DH may have complained about the cost of the nursing care, because we all know that the cost of care can be quite staggering. That’s not the same as suggesting that you are “trying to take his money". You aren’t getting his money, if it’s going to a care facility. It’s a good idea to have the details to make the finances quite clear. For example, you might open a new bank account for payments for his care, so that all 'his' transactions are in one place. That makes it easier to keep the accounts and receipts straight. Then you transfer money from your joint account (or from his account if you have already split your finances) to top up his ‘care’ account, and your joint account shows normal household and personal expenses..

3) Posters with difficult family members are justified in taking the line that ‘it’s none of their business’, but in many cases it makes sense to explain and avoid doubts, suspicion and bad feeling. Can you encourage the brothers to spend enough time with him to understand that he is no longer “mentally acute and can make his own decisions”? Phone calls are not enough. Perhaps find a summary of the simple tests that are given, and suggest that they go through them with him to check it out for themselves, if they don’t believe you. If necessary, explain ‘showtiming’ to them – that many people can get things together for a short time to seem quite OK, but it’s a big strain for them. If they are there longer, the ‘showtime’ will collapse.

4) PLEASE follow the advice to ‘split your finances’. This will impoverish you permanently if you don’t.

Yours sincerely, Margaret
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Reply to MargaretMcKen
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TouchMatters Aug 23, 2024
thank you. I, too, am concerned with this woman's / the wife's finances and not finding herself destitute.
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I read this again, and wondered whether DH and the brothers think that without the ‘extras’ (like PT), you could and should care for him at home for free. If that might be what’s going on, even if they are not saying it, you need to think about it and come up with your answers.
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Reply to MargaretMcKen
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How are you taking his money?
It is your money as well and you are going to pay for his care.
You cannot help it if people like BIL are in denial about his brother’s needs.
You don’t have to explain yourself.
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Reply to Evamar
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You are going to need a diagnosis from the doctors involved (hopefully one a neuro doc) that your husband is incompetent in managing his affairs.
Look for our will and see if there is a "springing POA" in it that designates you to manage things as POA for hubby.
You should see an elder law attorney. With need for long term care a division of finances may be necessary so that you don't spend his half of your assets and your OWN. If you need the help of a fiduciary they can help you find one. If you need temporary guardianship they can assign that.

As to the opinions of other family members tell them to stay out of your affairs as you manage this illness for your husband.
Do get help. I am so very sorry.
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Reply to AlvaDeer
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TouchMatters Aug 23, 2024
Thank you. I'd suggest the same as you are. What I am unclear on is if the husband here has the mental capacity to 'talk to an attorney'. As you say, an MD diagnosis is needed. Gena
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I have not dealt with this type issue, but I have been dealing with others not understanding the full depth of my husband's dementia... even our sons. I began texting quotes, details of incidents and videos of my husband that I was witnessing to show our sons the progression of his dementia. I hesitated doing this for a long time because it felt like I was putting their father down and often they brushed it off but over time they have accepted it more. Before doing this, it was simply that I knew he was progressing but couldn't pull a specific example out of my head to share when trying to explain my concerns. It also is handy to have that info in hand at his doctor's visits. No one can fully understand what is happening until they personally witness it.

I have found that both Parkinson's and Dementia have a wide spectrum that any given period of time in the day a person can appear very normal and that period seems to happen when family is around! However, it seems that the period of time he is at his worst is when strangers are around and I feel embarrassed for him because I know that is not truly my husband either. I am sure I am exaggerating but In his case I do not call it showtimers because I see all levels even when we are alone, it is simply a fact of the disease progressions.
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Reply to KPWCSC
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Do you currently have POA? Do not give it up if you do.

Sorry to hear that outside family is contributing to your stress. You and your husband only need to be concerned with the advice of the elder care attorney. It seems as if you have had one for a while so that is one step in the right direction.

Your BIL can butt out because it is your money as much as your husbands. You need to protect your future as well as your husbands immediate care. I know it is better said than done but turn a deaf ear on any outside comments from those that do not have any right to an opinion or judgement. It may get overwhelming with the amount of work that needs to be completed. Take things one step at a time and make sure your POA, living will and any medical directives are updated also. You also need to take care of yourself as well as your husband.
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Reply to AMZebbC
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While it is of course true that it’s none of your BIL’s business it’s also true that your husband obviously trusts him or can be influenced by him and that the two of you being on the same page will make things far easier for everyone that being at odds. To that end I would suggest a family meeting with your husbands care team (including a doctor) and including your BIL and any other family members needing to understand the situation. Let the medical professionals explain his issues and needs to everyone and answer questions. Then if given options you can include your BIL and husband of course in the discussions knowing you are the decision maker so don’t be swayed from what you know is best for DH and for you. Hopefully after hearing from the care team your BIL will help keep your husband on board with your care decision rather than at odds with it. Having the attorney come in to talk about what you do have set up and what you should set up now financially is a great idea. Again your attorney who he knows is making the recommendations and explanations will remove you from the fore front for your husband. In these meetings be his advocate, as you obviously are but not the main deliverer of news he doesn’t want to hear.

This is a very difficult time, adjustment for both you and your DH, accepting limitations is not easy and “rising to the occasion” is very common, we all do it (we call it show-timing with dementia patient's) so it takes family who aren’t around day in and day out to see the times their LO isn’t “rising” a much longer time to grasp the changes and of course denial is a powerful thing. It’s not fair to add that burden on the main caregiver (you) but it’s one of the things we really have no choice in, I looked at it as a privilege that Mom didn’t mask her decline with me the way she did with her siblings and my youngest brother who weren’t around as much but called regularly. She didn’t want them visiting either because it was so exhausting for her to hold it together and be the person she wanted to be for them. Frustrating and unfair as it is try to give your BIL a little more rope, he doesn’t grasp the situation the way you do, he isn’t the one caring for his brother and his brother is probably able to maintain the appearance of capability with him so he is able to believe that his brother is more capable than he is. Bring him into the fold, if you will and let the doctors explain the situation and options to him. If that isn’t helpful ask him to come stay and care for his brother (visiting daily as I assume you are doing) so you can go visit (insert family or whatever). Maybe that will help him experience the reality of the situation.
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Reply to Lymie61
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Ask doctor to evaluate your husband for mental capacity. If he is not mentally competent, ask doctor to note this in his chart and write a letter stating his is no longer mentally competent. Use this document to do any business in your spouse's name. I hope you have a POA written up by a lawyer. If not, every state that I know of considers the spouse to the the one to make decisions in these cases.
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Reply to Taarna
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Simple if his brothers really care they they can contribute $$$
90% of the question here have to do with parents. Spouses are an entire different story. The system is stacked against you. The system wants all your money but in the end you need to survive as well. You can spend a lifetime saving for the future and a sick spouse wipe everything out. Personally I tried to care for my wife at home as long as possible. I gave up my business so I could care for her. It was a substantial financial drain but it could have been worse. True caring families can ease the financial burden.
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Reply to Sample
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swmckeown76 Aug 31, 2024
Not necessarily true of a spouse's money. In the state where my late husband and I live (or rather he lived before he died and I still live), Medicaid-compliant annuities are legal. As long as the spouse obtains Medicaid-compliant annuities before the person requiring Medicaid starts on it, Medicaid cannot touch that money. An elderlaw/estate planning attorney can help with purchasing them. And a spouse can keep ~$130K of joint assets (the amount increases a little each year) and Medicaid cannot touch that. either. If they own a home or condo, the spouse can also remain there. It's only after s/he dies that Medicaid can go after it. Laws do vary by state, of course, so that's why you need to research your state's laws and/or consult an elderlaw/estate planning attorney.
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