"Qualifying your mother for Medicaid will be a challenge," continued the lawyer, "as long as she owns her house.

"Unmarried Medicaid recipients can only have countable assets worth $2,500. 'Countable assets' for an unmarried Medicaid recipient include everything except a prepaid funeral and burial plan, personal property and, in certain circumstances, a car to travel to medical appointments.

"If your mother could move back home, then we could use a 'reverse mortgage' to help fund the cost of home care. A reverse mortgage allows seniors to access the equity in their homes, without having to make payments. The amount drawn from the home equity, plus deferred closing costs and accumulated interest, has to be repaid when the homeowner dies or moves out of the home.

"Otherwise, we'll have to sell the home, and I don't see that as a winner for you, Joe. You still need to live in your mother's home, right?"

Joe nodded mournfully. "I really wouldn't have anyplace to go," he said. "Since I lost my job and my wife left last year, the only reason I've been able to stay afloat is being able to live in Mom's place. I can afford the utilities and taxes and insurance, but I couldn't afford to buy or rent a place of my own right now. I'm looking for work, but middle-aged men have a hard time of it in this job market."

Sue, ever the practical daughter, demurred. "I don't see how Mom can come home. She's been in the nursing home for 2 years now. How would we replace the care she's been receiving?"

"It'd be tough," agreed the lawyer. "Someone would have to be responsible for your mother's care, and for coordinating the aides. But now, unlike when your mother fell in 2009, Joe is living in the home, so there's someone there to care for your mother.

"You'd have to make arrangements to bring her home, like making sure doorways were wide enough and that there were no stairs she'd have to go up and down. You'd have to get a hospital bed. You'd have to make sure that the kids wouldn't be a problem. And you'd probably have to hire aides to stay with your mother when you couldn't be there. The cost of caring for your mother at home might be as high as the cost of the nursing home."

"It has to be lower," objected Joe. "How could having her live at home be more than the seven grand we're paying a month at the nursing home?"

"Remember," the lawyer said, "that you don't just have to pay the cost of aides and medical supplies. You'll have to pay property taxes, homeowner's insurance, costs of home upkeep and maintenance, food and utilities costs. These can make the cost of staying at home higher than the cost of assisted living in a facility."

"I'm paying those now," Joe said, "and I don't see why I can't pay them after Mom moves home. So the aides are the only cost, and that can't be higher than the nursing home costs."

"Maybe not," agreed the lawyer, "but be sure to count all the costs before you make your decision."

"I think we should just sell the place," asserted Sue, "and put the cash in the bank to pay for care. That's tough for Joe, but best for Mom."

"It might be the simplest solution," concurred the lawyer, "but it might not be best for your mother or for the family as a whole. Y'all need to talk things over. If you need a referral to a qualified real estate or lending professional, I can help with that, but first you need to decide on a course of action. I'm here to help, but the decision is yours."