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My aunt who has health issues promised to leave her home to a couple in the family if they moved in and take care of her. They have not moved in and it has been over 15 months. My aunt is supposed to have someone there 24/7. Another person in the couples family is living in the house with my aunt, but sleeps during the day and is only with my aunt in the evening. If one of the couple does not come during the day, no one is there to ensure she takes her medicine, prepare her food, check her sugar. Many times when she has called us or we her, she says that she is hungry and we take her food. She has been left alone all night and a day with no way to order food because her phone died and she did not call anyone. She was left alone and fell outside. She had to sit there for 2 hours in the heat until they came home. She cannot prepare her own food because of mobility issues. Is there a way to have a document drawn up listing the minimal expected care required to honor the agreement? She will not agree to back out of what she promised even though they have not followed through. When someone suggest that if the couple is not there during the day that the other family member living in the home should be
awake?

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Your aunt is being neglected. These people are only looking out for themselves.

You’re dreaming if you think that this couple will take good care of your aunt. A contract won’t make any difference to them.

Why are you interested in drawing up a contract to reward these people with a house?

Your aunt should rely on professionals for her care. She can sell her home to pay for care in a facility.

If this couple wants her home they can buy it from her instead of trying to take advantage of a vulnerable woman in need of care.
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Jada824 Dec 2023
NHWM,
Very well said. She is not safe at home
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Your aunt needs to be in 24/7 care where professionals look after her. I like the idea of taking her to visit a few. Where I live, there are many very nice ones as well as smaller care homes. Many provide gardens where the residents can grow flowers, visits from dogs and cats (and even a miniature horse!), outings to shops and restaurants, visits from dance groups in the area, etc. Why anyone would prefer to stay in their cluttered old homes with lackadaisical relatives, no trained professionals and no services is beyond me.

Get aunt to think about the possibilities of better things.
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elisny Dec 2023
Respectfully, there is no such thing as 2/47 care. The closest would be a well run & compassionate adult care home. But there are no guarantees, for sure.

Again, in a conventional ALF or NH, you could be screaming for help for a long time before someone responded. And if you couldn't yell or press a working call button, good luck. I spent years (on average 8 hours/day) in a "high end" ALF/MC/NH. Outside of it not smelling horrible and having a fairly stable staff, it was a prime example of "institutional neglect" and the more care you needed, the less you got (relative to your needs).

24/7? How is it, I was the one to discover an ALF resident lying on her floor. Not a staff member in sight, or even on that floor. BTW: The resident's neck was broken.

24/7 care? My mother was unable to press the call button or initiate any communication -- and per Federal NH guidelines she should have been checked on "frequently," which was suggested as every 30 minutes. When I asked the Administrator, during a Care Conference, if they could check on my mother hourly, the Administrator said "no" - every two hours like everyone else. Of course, even every two hours was bogus.

24/7 care? Until I discovered and raised it with the Nursing Director, my mother was routinely not "changed" for 8 hours. Even after they improved it, they reverted to every 5 hours during the mornings (approx 6AM - 11 AM).

24/7 care? Even after a nurse had been assigned to my mother dozens of time, if not over a hundred, the nurse testified under oath that she was not aware of my mother having any sensory impairments. My mother was legally blind.

I could go on and on and on . . .

Good luck. IMO: People who promote conventional NHs and ALFs deserve them. Arrggh.
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These people are not taking care of your aunt now . Even if she had a document drawn up , who would enforce that these people do the caregiving? This is a bad idea .

Your aunt should sell her house and go in assisted living so she doesn't starve . Call APS , report a vulnerable elder .
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I would see an attorney for this question.

This, to me is extremely POOR decision making.
Let us presume I fall ill.
Let us say I am paralyzed neck down, no family, but wish to stay in my home.

Let us say I find someone who will say "I will take care of you and keep you in your home if you only leave your home to me".
A) This would require legal work and a contract.
B) The caregiver could care for me for 15 years only to have me change my mind, and change the will as to whom the house is left.
C) The caregiver can decide "Wow, this is too hard" or can get ill or can die.
D) And the caregiver is not getting paid?

How many ways here can you spell d-i-s-a-s-t-e-r. because this sounds like a train coming at me down the tracks.

None of this should be considered without all parties consulting an elder law attorney, who, I can only believe, will start to sketch trains.
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If your aunt needs 24/7 care then she should not be at home. She needs to go into a facility. Your own post proves that home care doesn't work.

She should sell the house and apply the funds to pay for the facility. Your aunt can draft a will to give any money left over to whoever she wishes.

Stop doing things the hard way.
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elisny Dec 2023
In my opinion, and based on what I have witnessed myself, your assertion is inaccurate. I have known of numerous very limited elders, including people with dementia, who have been healthfully, compassionately, and successfully cared for in their homes.

It is a misconception that a typical facility would provide 24/7 care. They don't. They may be staffed 24/7, but they do not provide care or even observation 24/7. You'll be lucky to be engaged with or observed even once every 2 or 3 hours.

In a facility you will have little to no control over the care. In a facility you will be forced to operate on their schedule and as they wish. It will probably smell and for sure, if it is a nursing home or memory facility, will be very noisy. Your loved one will most likely be bored out of their minds. And good luck with the food and food choices. Good luck with the price staying stable (there is nothing to prevent the jacking up of the cost.) And, of course, residents lose much of their sense of independence.

IF you actually love your relatives and can arrange for them to stay at home, that is the better option for almost all of them. Another viable option - better than a "facility" -- is an adult home or a "green house" (https://thegreenhouseproject.org/), a house where there are 2-8 residents, with care providers there 24/7.

I would rather die in my home than be placed in a conventional long-term-care facility.
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Promising to leave a home to someone in exchange for care is a bad idea. There is no guarantee the house will be left unencumbered after all the final care bills are paid, the LO may decline to the extent that they need 24-7 care beyond the capabilities of the caregivers and will need a NH or additional help. The cost of the additional care can approach or exceed the value of the house. Wills can be changed at any time and the caregiver could be left holding the bag. The caregiver will be working without earning Social Security credit, pay or any other benefits. Or, as in this case, the caregivers may not perform as promised.
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Your aunt is calling
the shots. In reality she should sell her house and move into AL, so she has 24/7 care.

A verbal promise means nothing, is it in writing?

It appears that she is not thinking clearly common with someone who has dementia.

You can call APS and have a home health care check.
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Contracts for a person's care are in reality, enforced only after damage has been done.

My suggestion is to put your aunt in assisted living and make a her house a rental or sell it. It sounds like she doesn't have reliable or trustworthy people around her.
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What does aunt say about this, apart from not being willing to change the ‘will agreement’? Is she satisfied with the standard of care, food etc? If she is, there is not much you can do at present. Are her care needs increasing? What does she think about the level of care she will need in future?

It might be worth taking aunt on a couple of AL guided tours, so that she can see what the sale of her house would make her eligible for, (tours usually include a nice lunch). It might also help to let her know that if she reaches the stage of needing NH care and needs Medicaid, the lien for care costs will take precedence over a will. She can’t guarantee that this ‘agreement’ will every work to pass the house, as well as not working to provide the care she expected.
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Does anyone know if this is just a promise or a binding agreement to leave the house to them in her will? They may not be helping because they know she has not changed her will.
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notgoodenough Dec 2023
Or this couple never agreed to this "deal".

Or they spoke with THEIR attorney who warned them as to what a ***terrible*** idea this is.

I would never, ever, EVER agree to this exchange of a house for caregiving. Especially elder care. Even ***IF*** you could provide 24/7care to this person, to what ends? You give up your livelihood, and source of income? For a house that, in the end, you might not be able to afford, because you have no outside source of income and therefore can't keep up with the property taxes, insurance, maintenance, upkeep, and all the myriad costs that go hand-in-hand with home ownership?

And what happens if/when aunt needs more care than can be safely given in her home? Then what? When the house has to invariably be sold to fund Aunt's care, will they THEN be compensated for the care they've already given? Or will it be "sorry, you're SOL, because we can't reimburse you because then it will look like ***gifting*** and if Auntie outlives her funds and needs Medicaid...".

Compensation for caregiving should be given in the form of cash. We do not live in a barter society.

OP, the best thing you can do for your aunt, at this point in time, is to tell her that this couple, for whatever their reasoning, clearly has no intention or desire to take care of her in her home, that Aunt should rescind this offer of "house in exchange for care" and figure out what her next REASONABLE course of action should be.
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