Dear Quentin,
My father, 75, is essentially destitute and in failing health. He is in a rehabilitation facility after a hospital stay, must rely on oxygen and is not fully mobile. He worked his whole life but spent his money skiing with friends or buying expensive things. Our mother left him after 25 years. Thankfully, she is doing fine, but he continued living however he wanted for the past 15 years. Finally, his lifestyle and choices caught up with him.
We want him to have peace in his golden years, but I am exhausted from jumping through hoops for a man who never did anything to help his family — or himself. One of my sisters and I are coordinating his care. He has less than $20,000 to his name and no income besides Social Security, yet he will need full-time care. He had been living with my sister, but that is no longer tenable given his condition, and my apartment is far too small.
Because he has virtually no money or assets, we don’t know what his options are — or what our legal obligations might be. While he is our father, he has been emotionally abusive and manipulative, even going so far as to lie to the hospital about his smoking and drinking habits. He has never accepted responsibility for his situation or his health, nor has he apologized for his behavior. In his view, everything is someone else’s fault.
The Son
Related: My dad left when I was 9, reconnected with me in my 50s and now needs money. What do I owe him?
You can email The Moneyist with any financial and ethical questions at qfottrell@. The Moneyist regrets he cannot reply to questions individually.
Dear Son,
Your letter doesn’t include a question — and that’s OK.
However, there is a moral conundrum hovering over your letter: “What do I owe him?” You owe your father what you feel able to give him. It may mean drawing up a plan of action with your siblings. From what you say, he will pull as many strings as he can to get you to offer or agree to help. Sometimes, it’s easier to say “no” to a request than to resist someone pulling at your heartstrings to acquiesce to their wishes. So be firm.
You do owe yourself something during this process. You owe yourself the grace to step away, if that’s what you need to do. You owe yourself the power of living in your truth, free from the emotional manipulations of others. Your resistance can include maintaining your silence or speaking plainly, if kindly. It may be that you tell your father that he needs to explore Medicaid as an option, because he has run out of money and luck.
The road ahead will be easier if you can either process or shelve your emotions — you can love his humanity and dislike the man — and keep your feelings separate from the logistical task ahead, which is making sure that he’s got a roof over his head and the required care to see him through his remaining months or years. Let go of the grief and resentment and longing that you had for your father, for now at least, and get the job done.
Filial-responsibility laws do exist in more than half of states.
Filial-responsibility laws do exist in more than half of U.S. states, but they are unevenly enforced. Brennan & Rogers, a Maine-based law firm, says those laws obligate adult children to provide necessities such as food, clothing, housing and medical care for their parents who can’t afford to take care of themselves. “Generally, most states with such laws do not require children to provide care if they lack the ability to pay,” it says.
“States also vary in the factors they consider when determining whether an adult child can pay,” the law firm adds. “Children may not be legally obligated to support their parents if the parents abandoned them or did not support them. Regarding long-term care, most low-income parents qualify for Medicaid. This makes it unnecessary for a nursing home to pursue the resident’s children for payment.”
From what you say, you do not wish to walk away. He is your father and, as challenging as he has been during your lifetime, you don’t wish him pain or discomfort. You and your siblings also have clear and healthy boundaries — none of you are willing or able to provide him with housing. That’s fair enough. You have a right to a secure and peaceful life. What he will require is help with lots of and lots of paperwork.
Here’s a to-do list for you and your siblings: Speak with the rehab facility’s social worker as soon as possible. Consult a local elder-law attorney for advice about whether filial-responsibility laws apply in your state. Agree with your siblings on a plan of action, which may include not getting pulled into any drama and remaining firm on the subject of housing — that is, getting your father the nursing-home care he needs.
Navigating Medicaid
Hickman Lowder, an Ohio estate-planning and elder-law firm, offers a checklist of documents for successfully navigating Medicaid. “This can include W-2 forms, tax returns, pay stubs and documentation of any government assistance,” such as Social Security or unemployment benefits, as well as “account statements, life insurance information, receipts for major purchases,” and a record of any large gifts the person applying for Medicaid has made to others
Medicaid is a needs-based program, with strict financial requirements, so leave no stone unturned. Gather proof of residency, citizenship documents like a birth certificate and passport, and documentation related to any dependents, the law firm says. You’ll need to document any other insurance coverage your father has, such as Medicare or prescription coverage, including how much he pays in premiums.
“Double-check your documents for accuracy and completeness,” it adds. “This can help ensure there are no missing pages and all information is clear and legible. Make copies of everything you submit to the Medicaid agency and keep them for your records. The agency processing your application may misplace, misfile, or otherwise incorrectly deny your application for failing to provide documents.”
Medicaid is a needs-based program with strict rules.
If your father has no housing and no income or means of support, his immediate problem is the $20,000 in his bank account. Medicaid rules vary by state, but he will need to spend down that $20,000 in order to qualify for Medicaid. The asset limit in most states is around $2,000 (or $3,000 for a married couple). He will also need a doctor to recommend that he stay in a nursing home.
To avoid the five-year lookback rule, he will need to use that $20,000 for qualifying expenses. That could include outstanding medical bills from the past six years, in-home care or safety upgrades like wheelchair access, modifying a bathroom or adding a stair lift to a home. He could also prepay funeral and burial expenses or pay off a credit card. He may sell assets for less than their fair-market value within 60 months of applying.
Talk to his social worker about the next steps. Once approved for long-term care through Medicaid, most of his Social Security income will go to the nursing home. Medicaid then pays the remainder. In most cases, you will not and should not be asked to pay. A family member or attorney may also wish to hold power of attorney for him — both medical and financial. Without legal authority, coordinating care could become difficult.
As a child, you no doubt needed and wanted a father who was loving, kind and present. Maybe your other siblings feel the same way, but psychologists will tell you that every child is part of a “different” family and has different experiences within the same family. Take care of yourself, too. You owe yourself the truth: You can do so much for your father and no more. You get to choose how involved you become.
Draw a line in the linoleum — and make sure he doesn’t cross it.
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