Alternatives To Nursing Home Care

Many seniors choose to stay in their homes, apartments or assisted living facility despite significant care needs.  This can, however, present considerable challenges to adult children who are trying to balance their own family responsibilities with coordinating care for a parent, as well as for a spouse who may be faced with being a primary caregiver around the clock for an indefinite period of time.

Unfortunately, many elders have an ongoing need for assistance in order to remain safe in their home.  Such a need for assistance can be the beginning of a difficult and frustrating journey for both the elder and their family.  Families try valiantly to meet all the care needs their loved one  may have but often they realize they can’t do everything, or caregivers may become burnt out and resentful.

Fortunately, there are a number of options for services available to families in such a situation.   These services include homemaking, laundry, food shopping, and meal preparation as well as personal care, safety checks, and meals-on-wheels.  These services can be coordinated to ensure the elder can maximize their chances of remaining safe in the community and hopefully avoid the need for placement in a long-term care facility.

A comprehensive analysis by an Elder Law Attorney is a valuable step in the process of creating a successful plan of care for a loved one in need.  Such an analysis can reveal more options for finding affordable care in the community while planning for the possibility that long-term placement in a facility may be needed.  Some individuals can qualify for Community Medicaid Benefits and then be eligible for expanded home services through their ASAP or other Medicaid subsidized home care programs such as PACE (Program for All Inclusive Care for the Elderly).

There are significant differences in eligibility for each Medicaid program, so the analysis should be done by professionals with experience in working with both Community and Long-Term Care Medicaid.   Please call our office for more detailed information on community based programs or to schedule a no-cost initial consultation.

Financial Planning For Families With Special Needs

ESSENTIAL STEPS TO ACCOMPLISH YOUR GOAL

  • Start Early and Get Help –  Lack of planning may have disastrous consequences.  Planning for special needs families often involves several  financial, legal and benefits-related strategies.  Assembling a team of qualified professionals to advise you will take time.  A financial advisor, estate planning attorney, benefits coordinator, trustee/trust company, family physician/registered nurse, and of course family members may all need to be involved in the ultimate plan.
  • Establish a Special Needs Trust – If you’re receiving government sponsored benefits, a gift or inheritance may cause a disqualification of those benefits.  A frequently asked question  is how to provide for a family member with special needs without jeopardizing those government benefits.  Parents may purchase life insurance to be paid out to a special needs trust.  They may also designate the special needs trust as a beneficiary in a will, trust or retirement account.  The funds designated to the special needs trust at death may be used to supplement the special needs family member without jeopardizing their benefits.
  • Draft a Letter of Intent – How can you be assured that proper care will be given to your child? You’ve established a special needs trust  to provide financial assistance when you’re gone, but have you named  a person that will assume the role of guardian or caregiver?  Do they know the name and address of your child’s physician?  Do they know their therapies, procedure and medication schedule?  Do they know their faith and where they attend religious services?  Answers to these and many other questions should be discussed and memorialized to ensure the best possible care for your child.
  • Consider Life Insurance – Someone, most likely a family member, will have to step in to act as a guardian and raise your child.  In all likelihood, that family member will have to pay for some of the services the parents had provided when able.  If the estate was not large enough, life insurance can provide the needed funds to help defray the cost of care.
  • Review Often – Many changes will occur during the course of your life.  Reviewing your plan annually will ensure everything is up to date to give you the peace of mind your family is taken care of.

Social Security Reports No Increase In Benefits for 2010

Normally, seniors receiving social security benefits see a 2-3% increase in their benefits each year.  For the first time in decades, there may not be a cost-of-living adjustment.  For some, social security checks may be lower when factoring in Medicare Part B premiums.  Most, however, are protected by a provision that ensures Medicare premiums don’t increase more than any increase in Social Security benefits. FULL ARTICLE.

Veterans Aid and Attendance Benefit

LITTLE KNOWN PROGRAM CAN PROVIDE HELP FOR VETERANS

One often unclaimed, but very valuable program available to veterans is the VA aid and attendance benefit.  This program was created to help veterans, veterans and spouses or surviving spouses by providing financial assistance to help defray the costs and expenses with assisted living or at home care.  Generally, it is a benefit for those that need assistance with at least one of the activities of daily living .  The program provides a tax-free monetary benefit to those that qualify.  The eligibility guidelines include:

  • Wartime veteran or surviving spouse
  • Served at least 90 days of continuous active duty service during eligible dates*
  • Honorable Discharge or equivalent
  • In need of assistance with care

This benefit often goes unclaimed because some veterans are not aware of its existence, do not think that they are eligible, or may be discouraged by the complex and burdensome application process.  Because of the strict guidelines and lengthy eligibility process, those eligible should seek guidance from a professional familiar with process and accredited in the area of veterans benefits.

*WWII – Dec. 7, 1941-Dec. 31, 1946    Korea – June 27, 1950-Jan. 31, 1955    Vietnam – Aug. 5, 1964-May 7, 1975                Gulf War – Aug. 2, 1990-TBD

What Is Elder Law?

Elder law is an area of law that encompasses any legal issue facing the elderly.  It is often associated with estate planning but can involve much broader social, economic and health related difficulties facing aging Americans. Some of the concerns that become more important to us as we grow older and may require more careful planning include:

  • estate planning
  • planning for a long term medical care requirement including Medicaid planning
  • planning for incapacitation with the use of durable powers of attorney and health care proxies
  • issues requiring guardianships and conservatorships
  • elder abuse and other issues involving nursing homes or skilled nursing facilities
  • SSI, SSDI and other government benefit programs
  • special needs trusts

As the elderly population grows each year, so will the issues facing these individuals requiring a comprehensive estate plan that addresses long term care needs.  Often times, planning  must take into account strategies involving financial planning, estate planning, and other asset protection techniques.  Other times ancillary issues involving home health care, skilled nursing facilities, long term care insurance and disability benefits must be addressed.  Elder law attorneys, geriatric or nurse case managers, financial planners and professional well versed in benefits planning are often involved to ensure all needs are met.  Advanced planning can help to minimize the problems and stress associated with these issues.

Use Care When Planning For Special Needs Children

Being a parent comes with great joy but significant responsibility.  It is no different for parents of children with special needs. In some situations, careful planning can be critical to address a family’s financial needs.  Parents must not only plan to care for their children during their lives, but they must also take steps to ensure they have a plan in place if their child is not able to support or care for themselves when they are gone.  When is the right time to plan?  It is never too early to begin to plan for your child’s care.  As housing and work options may be limited when persons with disabilities reach the age of majority, financial planning must be addressed to ensure there are assets available to cover the long term costs to care for your child. 

COMMON MISTAKES

  • If your child is receiving government benefits, naming your child as a direct beneficiary may disqualify them for needed benefits
  • Disinheriting your child, or directing your special needs child’s inheritance to another family member with the understanding the money will be used to care for your child should be considered with exreme caution.  A lawsuit, divorce, or bankruptcy would subject the assets earmarked for the care of your child to great risk
  • Failing to name a dedicated trustee that will be involved in the life of the child. Naming a trustee to merely distribute the assets, and have no other involvement in the child’s life, may not be the best option

One effective planning tool is the use of a special needs trust.  A special needs trust holds assets earmarked for the costs of caring for your special needs child and distribute those assets for the benefit of your child without jeopardizing eligibility for government benefits.  A comprehensive and often reviewed estate plan will ensure that your special needs child is cared for when you are no longer able to.