Where and how can your elder family member receive the most comprehensive care? I work closely with family members, hospital discharge planners, social workers and geriatric care managers to help with residential placement decisions needed for the care of your elder family member. The right placement may be an assisted living facility, nursing home, or in the comfort of the elder’s home. In those cases where the elder’s level of care is too great for home or assisted living placement and a skilled nursing facility is required, the family must concern themselves with a very basic question – “How can we pay for this?”
Asset Protection Planning
When faced with a nursing home placement, I help develop a financial plan that provides for the elder’s care needs in skilled nursing facilities. That plan not only addresses how the elder can afford the cost of the nursing home but also what strategies can be developed to preserve as much of their accumulated wealth as possible.
In most cases, where the elder’s income is insufficient to cover the cost of long term care the family is required to turn to the Medicaid program for assistance. I work with the family to gain safe passage though the many federal and state regulations that cover the Medicaid program, taking that responsibility off their already heavily burdened shoulders.
I advise the clients as to what assets can be exempted and rendered unavailable for their long term care costs and how they can further protect many of their assets while at the same time qualifying for assistance from State and Federal programs.
Protecting the Spouse
When I work with adult children of a disabled parent they often express concern for the parent who will remain at home. “How will Mom be able to afford to live at home if Dad is in the nursing home”? I familiarize the family with the “spousal impoverishment” rules that assure the healthy spouse receives what the government deems a “reasonable” amount of resources and income from the combined resources of the parents. Since the healthy spouse may have a different opinion as to what is “reasonable” I help develop plans that increase that amount so that the healthy spouse will realize a greater share, thus giving her comfort knowing that her spouse will be well cared for and she will be able to remain at home and afford to do so.
Protecting the Home
For most people, protecting the home is of paramount importance especially as it is often the highest value asset they own. I take steps not only to remove the home’s value when determining an elder’s eligibility for Medicaid assistance, but also develop a plan to keep the property protected once Medicaid assistance has been approved.
Estate Planning Documents
As part of any asset protection plan, I provide whatever documentation the elder and his spouse might need to address their present circumstances, including a completely new and updated estate plan for the healthy spouse if the sick elder is married. This includes financial powers of attorney, health care directives and Living Wills, Trusts, Last Wills and Testament and new property deeds where required.
The elder requiring long term care is often without the legal capacity to make planning decisions on his own. When that happens I review the elder’s existing estate planning documents to see if appropriate powers were given to an attorney-in-fact. In those cases where the documentation does not exist or is insufficient for asset protection then a guardianship proceeding in probate court is required. I guide the family through that process and file appropriate petitions to obtain judicial approval of whatever asset plan has been developed so the elder can obtain Medicaid approval.