Life Care Planning
We believe that planning for most seniors and persons with disabilities involves much more than traditional estate planning. By focusing on “planning for living,” rather than simply estate planning (“planning for death”), we help our clients and their families protect their assets and their choices while making sure that they will continue to be well cared for even when they are in poor health. Whenever appropriate we work with geriatric care managers. Geriatric care managers are experts in assessing health problems of older people and in devising and monitoring appropriate care plans for them. Our life care planning services include both counseling and advising on or preparing agreements to facilitate these goals, including:
Personal Care and Life Care Agreements
Most seniors want to remain at home as long as they possibly can. Extra help to remain in the home can be very expensive—remaining at home can easily cost $10,000/month for around the clock caregivers, not even counting the other ongoing costs of living at home, and few people can afford this expense for very long. Sometimes a child has been a caregiver, but the personal and financial toll on the caregiver child can be enormous. In the past, parents have sometimes made gifts to a caregiver child to partially compensate the child for her services, but these payments can disqualify the parent who later needs Medicaid assistance in a nursing home, particularly since passage of the Deficit Reduction Act on February 8, 2006. Payments by a parent to a caregiver child are treated as gifts under Medicaid regulations unless there is a contemporaneous written agreement by the parent to pay the child for such services. These agreements, usually called “care agreements,” must specifically identify the services the child (or other caregiver) is agreeing to provide. The agreement must specify compensation that is reasonable, usually based upon the hourly cost of equivalent care by a third-party caregiver or company. To protect the parent, there should be some way to enforce the child’s performance of the agreement, particularly if the parent is agreeing to compensate the child in advance for lifetime care (sometimes called a “life care agreement”). Medicaid authorities normally presume life care agreements include an undertaking by the child caregiver to pay for nursing home care, and if that is not the parties’ intention, the life care agreement must specifically exclude any obligation to pay for nursing home care.
Long Term Care Insurance Counseling
Long term care insurance, if purchaser can afford the premiums, can provide security for seniors by paying all or part of the cost of assisted living charges, in home care, or nursing home care. Not all long term care insurance policies have the same provisions, and some insurance carriers are stronger and more reliable than others. There is little uniformity in state regulation of the policy provisions or the companies, and we can help you make the decision whether to purchase or retain particular long term care insurance policies.
Alternative Housing Options
Seniors and others with disabilities have a broad range of housing options, including remaining at home, independent living apartments, assisted living facilities, nursing homes, and life care communities (which include a continuous spectrum of housing that allows the resident to progress from independent living to assisted living, and nursing home care). Each option has its own advantages and disadvantages, and there are numerous choices for consumers for each of those housing options. It is usually helpful for geriatric care manager to evaluate the care requirements for a senior with health issues. We can advise you of which options might be the right choices for you based upon your care needs and your budget.