Helping declining relative out-of-state

[ProfessorArtNerd]

Ugh here we go again. My dad’s sister had a hemorrhagic stroke and is in the hospital. My sister and I are next of kin. There’s no one else. Her ex husband is worse off than she is (he had Alzheimer’s). We live in Philadelphia, and she lives in Florida. We haven’t seen her in years (she didn’t come to either my dad’s funeral in December or their sister’s funeral in January of last year). She asked my sister and me to be her medical decision makers and she mayyyy have a loving will. She started all these things in January of 2023, after their sister died, but I never signed anything. But we are next of kin, as I said.

She’s going to need assisted living or skilled nursing probably forever. I had to pick a place from a list, so I just looked at the reviews. I have no idea what I’m doing and it’s not like I can just fly down and sort things out. I feel awful about that, but my kids are about to start school, I need another kidney stone blasting procedure and my own job is about to start back up.

I can’t imagine trying to do what we did with our other aunts house- it was months of cleaning out and getting rid of stuff, and she only lived a little more than an hour away. How do you do this?

I’m so overwhelmed

Does anyone have any help or suggestions for how to help a declining relative from out of town?

[wildrice]

You haven't seen her in years - do you have a relationship with her? If you really don't, I don't think you do anything honestly. Or do what you have bandwidth for, but don't go too far out of your way. It doesn't sound like she's put a lot of effort into you, so it's ok to give her back what she has provided.

I am a long way from this point myself, but I can't really imagine burdening my sister's kids with caring for us when we get old. We made our own choice to not have children and it's not up to them to have to step in to do what kids would do, when they already have parents of their own to worry about. I don't really know what we're going to do (lol) but I do know it won't be their problem!

Note: I don't think children are OBLIGATED anyway but certainly there is more reason to hope they would help out under these circumstances. 

[mrsukyankee]

Same as wildrice. At most, I'd talk to my aunt about money for a service to come in and sell what they can and get rid of what they can't - they exist. That's my plan for when my H and I can no longer take care of ourselves (well, I'm hoping we get rid of tons of stuff and are minimalists beforehand).

[k3am]

When we cleaned out my mom’s house, I was posting a ton of stuff on the local BNG. The admin was also a real estate agent - she said her team of ladies could have the house cleaned out and ready to list in 5 days - with their fees coming out of her commission - as long as we weren’t particular with the stuff… and I assume they also kept proceeds of anything they managed to sell, but honestly knew my sister would never go for it, so didn’t ask may questions. We were picky with the stuff though, but the idea was tempting, especially as we entered month 3 of cleaning out the house and me flying down on weekends…

If you feel you must do something/want to help, use aunt’s estate/assets to wrap up things for her from long distance and only put in what minimal bandwidth you can let go.

[ssmjlm]

Florida is really good at this stuff because of the senior population.

I would check with the hospital social worker handling her case and then get with the facility she's being moved to.

When my grandparents moved into a place, the facility had different tiers of help, one of which was basically full service move out, get rid of everything in the house. It was pricey, but sometimes it's worth outsourcing.

[mofongo]

You don’t have to do anything! You are her legal next of kin by blood relation, that doesn’t hold you to anything. It’s ok to say you just can’t. That is a BIG ask for someone that you’re not super close with, and live so far from!

[ProfessorArtNerd]

Aug 21, 2024 13:44:26 GMT -5 mrsukyankee said:

Same as wildrice. At most, I'd talk to my aunt about money for a service to come in and sell what they can and get rid of what they can't - they exist. That's my plan for when my H and I can no longer take care of ourselves (well, I'm hoping we get rid of tons of stuff and are minimalists beforehand).

She thinks she’s in a hotel in Tokyo. Last week it was France. She keeps trying to order wine from “room service”. She’s not up to making any decisions, unfortunately.

I’d love to use a service, and I’m like 99% sure my sister and I are her beneficiaries. My other aunt was the sentimental one- I know aunt M has a couple of my paintings from undergrad, but I don’t know how much else she has that would be of interest to me or my sister. Honestly I don’t want my sophomore year paintings either 🤣

[waverly]

How will the long term care be paid for? I would just focus on that. As far as cleaning out the house and selling it, I suppose that could all be remote with hiring a company to do an estate sale and a realtor, but I don't know that you have to jump to cleaning the house out right now. It could potentially happen at any time as long as she doesn't need the funds to pay for the LTC.

[heygrey]

Just reiterating that it is okay to do the bare minimum including doing nothing at all. It doesn't sound like you have a relationship outside of being blood relatives so matching energy and all that. She didn't invest in you when she was well, she doesn't get to drain you in her time of need.

[SusanBAnthony]

I think you ideally fly down for a weekend to take important papers and anything else you want to save out of her house, and then you hire a service to empty it out and sell it. And you use her money to pay for your trip down and for the service.

But if she doesn't have you set up to be able to use her money, you do nothing.

[thebreakfastclub]

I believe you've done the best you could choosing a place and vetting with reviews.

My husband's elderly aunt downsized out of a 5 bedroom house using an estate sale company. They did the work of clearing out and selling possessions and took a cut of the profits. Nobody needs to clean out the place.

I would match energy with what you reasonably can provide here. You can't and shouldn't shoulder a burden that nobody else is jumping up to help you with.

[ProfessorArtNerd]

Is there a way to find out if I’m able to control her finances? I don’t even know what I’m looking for. I can’t really swing too much on my own

[livinitup]

I think SusanBAnthony makes the best point when she asked if your aunt set you up with access to her funds to fly down and even make any arrangements on her behalf? Any legal documents that say you are allowed to do anything with her possessions or property? Without funds or docs., at the very minimum, you don’t fly in and you don’t really do anything but answer questions from a list of options on a phone call.

I don’t really know what happens to bills, bank accounts, and homes when a person is discharged to long term care. I suppose with a rental, the rent payments stop being paid and the landlord secures an eviction at their own expense and effort. With home ownership, I’ve heard stories but have no idea how the state “takes the house” to pay for the LTC.

Basically, in sudden situations without any planning, children check the mail for bank accounts and bills and make calls based on what’s in the mail.

ProfessorArtNerd Do you know anything about her accounts or bills or what she owns? Starting from zero seems like an impossible lift. You certainly don’t have to clean out her house. I don’t even know if you have a clear legal right to do so. ‘There isn’t anyone else and we are next of kin’ doesn’t really have legal power to do anything with someone’s accounts or possessions who is still living. Sadly.

[stemmie]

Are you and/or sister designated as her POA? If so, you need to read that document and figure out whether it is springing (needs to be activated by medical expert) or durable (survives her incapacitation)?

What kind of money is available for her care? Does she have a LTC policy? That may dictate decisions. If there's no POA, you may need to seek guardianship. Be aware professional guardianship is a big thing in FL and can be sketchy AF-- they move on elders and pay a salary from the person's assets and place them in some random nursing home. On the other hand, hospital delirium is real; she might clear a bit once out of the hospital.

If you and/or your sister are POAs or wish to assume guardianship, I would try to arrange to move her to a facility in Philadelphia given her lack of support in Florida. When dad was diagnosed with dementia and too incapacitated to advocate for mom when needed, I moved them back to where I live. FWIW, I managed the sale of both their homes-- including the one in FL. If she is in an area where retirees and 55+ communities are a thing, you might be able to sell the place turn-key. When I sold mom's place in central FL (so not fancy ocean front resort area), I listed with an agent who managed almost everything for me. I came down for about 4 days and filled a PODS unit with personal items-- some high end MCM furniture, clothing, papers, etc and arranged to ship a car north. Everything else conveyed with the house-- easy peasy.

[ProfessorArtNerd]

Aug 21, 2024 17:38:01 GMT -5 stemmie said:

Are you and/or sister designated as her POA? If so, you need to read that document and figure out whether it is springing (needs to be activated by medical expert) or durable (survives her incapacitation)?

What kind of money is available for her care? Does she have a LTC policy? That may dictate decisions. If there's no POA, you may need to seek guardianship. Be aware professional guardianship is a big thing in FL and can be sketchy AF-- they move on elders and pay a salary from the person's assets and place them in some random nursing home. On the other hand, hospital delirium is real; she might clear a bit once out of the hospital.

If you and/or your sister are POAs or wish to assume guardianship, I would try to arrange to move her to a facility in Philadelphia given her lack of support in Florida. When dad was diagnosed with dementia and too incapacitated to advocate for mom when needed, I moved them back to where I live. FWIW, I managed the sale of both their homes-- including the one in FL. If she is in an area where retirees and 55+ communities are a thing, you might be able to sell the place turn-key. When I sold mom's place in central FL (so not fancy ocean front resort area), I listed with an agent who managed almost everything for me. I came down for about 4 days and filled a PODS unit with personal items-- some high end MCM furniture, clothing, papers, etc and arranged to ship a car north. Everything else conveyed with the house-- easy peasy.

I’m almost certain she’s in a 55+ condo. That’s a good thing!

[ProfessorArtNerd]

stemmie thank you so much for helping me remember that’s she’s in a 55+ community! When my other aunt was sick, her 55+ was helpful. Okay whew thanks again, I have a
Place to start

[rosiebear]

You have such a kind heart. Ditto everyone who says to do the minimum and let social services do their stuff. This is not on you.

[stemmie]

ProfessorArtNerd,

I'm curious, was your other aunt in a 55+ age-restricted community (developers given tax advantages in exchange for not burdening local schools) or was it a CCRC (Continuing Care Retirement Community)? My parents have lived in 3 different age-restricted communities and none of them offered much in the way of support services; the apartment one had a scheduled van service that ran to local shopping centers 3x a week but the houses had even less. I'm asking because my own mom seems to be having a cognitive shift of sorts, and I may be revisiting dementia-caregiving and I really don't know if I have it in me to do this a second time.

The other piece is that, with this not being your first rodeo, you'll find senior support programming different than what you experienced in NJ and PA. Our CELA, who does only elder and special needs law, advised mom to move out of FL as the state funded safety nets like residential Medicaid (for memory care/SNFs) is badly funded with wait lists and mediocre offerings compared to either PA or NJ. (FWIW, NJ is more generous with community spouse allowances and offers memory care funding compared to PA which only does Medicaid funded SNFs) The CELA also had concerns about predatory guardianship in FL being a real risk; ironically my parents bought their home in FL from the estate of a women who'd been declared incompetent and assigned a professional guardian who sold the house/contents to fund a bed in a SNF.

[ProfessorArtNerd]

Aug 22, 2024 5:30:50 GMT -5 stemmie said:

ProfessorArtNerd ,

I'm curious, was your other aunt in a 55+ age-restricted community (developers given tax advantages in exchange for not burdening local schools) or was it a CCRC (Continuing Care Retirement Community)? My parents have lived in 3 different age-restricted communities and none of them offered much in the way of support services; the apartment one had a scheduled van service that ran to local shopping centers 3x a week but the houses had even less. I'm asking because my own mom seems to be having a cognitive shift of sorts, and I may be revisiting dementia-caregiving and I really don't know if I have it in me to do this a second time.

The other piece is that, with this not being your first rodeo, you'll find senior support programming different than what you experienced in NJ and PA. Our CELA, who does only elder and special needs law, advised mom to move out of FL as the state funded safety nets like residential Medicaid (for memory care/SNFs) is badly funded with wait lists and mediocre offerings compared to either PA or NJ. (FWIW, NJ is more generous with community spouse allowances and offers memory care funding compared to PA which only does Medicaid funded SNFs) The CELA also had concerns about predatory guardianship in FL being a real risk; ironically my parents bought their home in FL from the estate of a women who'd been declared incompetent and assigned a professional guardian who sold the house/contents to fund a bed in a SNF.

The other aunt was in an age- restricted community.  I should say that the HOA only really helped us by way of ensuring she was up to date on dues, putting us in contact with helpful neighbors and working with our realtor to sell the place when she passed.  She actually died before she moved into a nursing home.  As did my dad- we were on the way to discuss long term care at the place where he was rehabbing and he'd died.  I kind of hope for a peaceful passing like he had for my aunt. 

[rubytue]

Just to second looking into her community. If she is in a CCRC, they should have lots of help available, including long term care. It may be something an older person with no close relatives would look toward. (E.g,, we hit that point, we will be looking toward one because of the lack of any close younger relations).