The neighbors in the town where I grew up had a child with severe Downs Syndrome. The child lived at a state school during the week and came home to the parent's home on weekends. Upon the parent's death, the child would live at the state school full time. As they were not well off, they agreed to give everything to the state upon their death in return for the state care of their child. They were not happy about it. They felt the state should have taken care of their child for free.
As a consequence, they never upgraded their home. They never maintained anything beyond absolute necessity. The contents was kept to a minimum. They kept no bank accounts or investments of any kind.
They died within three weeks of each other. As soon as the second spouse was deemed too ill to return to the home, the relatives swooped in and took everything that wasn't nailed down and some of which was. The house was in such a deteriorated state, that I doubt the state got much for it as that particular neighborhood ran down as well.
The expenses for that child over the years and until she dies at that state school had to be astronomical. The state didn't get anywhere near recompense. I suspect many DUmmies will do as my old neighbors did... live in squalor simply to avoid letting the state get a dime of their money. Yes, they were Democrats.