What Does Long-Term Care Actually Cost?

What Does Long-Term Care Actually Cost?

Elderly man walking with walker and nurse assistance

Although no one likes to think about it, as your loved ones get older, there’s a good chance that they will need more intensive medical care. Whether that means having a home health aide look in on them a few times a week or moving them into a nursing home full-time, it can be a difficult and emotionally wrenching situation to care for a family member who can no longer take care of themselves.

In addition to the emotional demands, long-term care is extremely expensive, and can drain your loved one’s savings account…fast! That’s why it’s essential to plan ahead and work with an estate planning or elder law attorney who can help protect you or your loved ones from running through their savings. This helpful guide will take you through the basics of long-term care planning, specifically when it comes to caring for your aging parents. Below are some answers to common questions about the cost of long-term care.

How Much Does Long-Term Care Cost?

Long-term care takes many different forms, but it can generally be divided into two categories: in-home care, where trained professionals care for your loved one in their own home, and residential care, where they leave their home and live in an assisted living facility or nursing home.

Whichever form of care is right for your loved one, the costs can be challenging. For in-home care, the average hourly rate in Alabama is $20/hour, but it can easily range upwards of $30, depending on your location and the level of care provided. For assisted living, the average cost in Alabama is about $3,500 per month, although this rate may be higher in more expensive areas, such as Birmingham or Florence.

The most expensive option is a nursing home residency. Costs vary considerably, but one recent study puts the average yearly cost for a semi-private room in Alabama at $80,000 a year, and the price for a fully private room at $84,000. Needless to say, these costs can stretch the budget of the average household more than just a little bit.

Planning for Long-Term Care Expenses

Although these numbers can be head-spinning, there are resources available to help you meet them. Medicare benefits can serve as a valuable bridge for when your loved one first requires more intensive medical assistance, but are not a long-term solution. Medicare benefits only cover 80 percent of costs, and only cover 100 days of care. In addition, they typically only cover skilled nursing care, and limited home care.

Medicaid benefits, though, cover most of the additional long-term care costs that Medicare cannot. Medicaid is need-based, but there are ways to qualify…no matter what your financial situation. With proper legal planning and the correct organization of your assets, you will be able to protect your savings and pay for whatever assistance your loved ones may need.

The Importance of an Elder Care and Estate Planning Attorney

Navigating the costs of long-term care can be a complicated and challenging experience, which is why it’s so important to plan ahead. The need for long-term care can arise suddenly, and if you haven’t properly prepared for this possibility, you may find yourself scrambling for help. Meeting with an experienced elder care and estate planning attorney can help you plan for whatever may happen to you and your family, and help you rest easy knowing your family’s assets are safe.

At Miller Estate & Elder Law, we have many years of experience helping people care for their loved ones—while protecting their hard-earned savings. Contact us today and start putting your family first.

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Preventing Falls in Nursing Homes: How to Ensure the Safety of Your Loved Ones

Preventing Falls in Nursing Homes: How to Ensure the Safety of Your Loved Ones

Elderly man walking with walker and nurse assistance

As an elder law and Medicaid planning attorney, I help a lot of families protect their assets from the cost of long-term care. However, I also care deeply that your loved ones are in good hands after they transition into a nursing home facility. If a loved one is going into a nursing home—or if they already reside in a long-term care facility—it’s important to be aware of the fall prevention practices that are in place.

As your loved ones age, their risk of falling increases tremendously. Each year, millions of seniors suffer falls at home, in public places, or in long-term care facilities. According to the CDC, approximately one out of four seniors fall each year, and falling once doubles the chance of falling again. Falls are frequently fatal, but even non-fatal falls lead to serious injury about 10-20% of the time. This can be anything from broken bones to serious head trauma.

The repercussions from these types of falls are much greater than the physical injuries alone. Falling can result in a functional decline, reduced quality of life, and fear of falling again, which can lead to feelings of depression, helplessness, low self-esteem, and social isolation. 

When visiting your loved one in the nursing home, check to ensure the facility has addressed the following risks: 

Environmental Risks – Environmental factors can be a huge contributor when it comes to falls. Things to look for include loose carpeting, slick or glossy floors, poorly arranged furniture, and dim lighting. Along with this, residents should be encouraged to wear rubber-soled athletic shoes or lace-up or strap-on shoes that fit snugly, rather than just socks or slippers. 

Health Risks – Each resident should be assessed by the nursing home staff to identify any health issues that may make an individual more prone to falls, such as fainting, low blood pressure or certain medications. The health history should also explore if there are any past incidents of falling and if there are any mobility issues.

Exercise – The nursing home should offer a daily exercise program and promote an overall active lifestyle for their residents to improve balance, strength, and gait, and therefore help reduce the risk of falls. Oftentimes residents are assigned wheelchairs though they have little need, and the reliance on the wheelchair eventually erodes their endurance, strength and balance through neglect. 

Staffing – Staff members should be provided educational programs that teach them how to provide the level of care and attention that residents need. They should be able to recognize when a resident is at risk of falling, and there should be proper procedures in place in case a fall does occur. The facility should also be adequately staffed especially during high traffic times such as meals. 

When a loved one transitions to a nursing home, you want the absolute best for them in terms of their wellbeing—and we want to ensure their wellbeing, also.

If your loved one is not prepared for the potential cost of long-term nursing care, and you are beginning to notice a decline in their physical and/or mental health, it’s important that you take certain legal steps…and fast.

Download the Free Guide and e-Book Now!

Start by downloading our free guide: Caring for Aging Loved Ones. In this guide, you’ll learn which questions you should be asking, how to have “the talk” with your aging loved ones, the 6 steps to take before (or during) a crisis, and which mistakes to avoid while preparing to qualify for Medicaid.


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The Difference Between a Power of Attorney, Guardianship and Conservatorship

The Difference Between a Power of Attorney, Guardianship and Conservatorship

A power of attorney (POA) and a guardianship/conservatorship are different types of legal arrangements, each of which dictates who will care for you and your estate if you become incapacitated. Although each of these arrangements has their place, having a durable power of attorney in place is generally a more proactive way to plan for the “what ifs” of the future. If you need to be able to make decisions on behalf of your incapacitated spouse or aging loved ones, having power of attorney is much easier than going through the burdensome process of establishing a guardianship or conservatorship. Filing for guardianship/conservatorship is not only more expensive, but it’s also more time-consuming, and…a judge may decide not to grant you these roles at all!

What is a Durable Power of Attorney?

A durable power of attorney (POA) is a legal document in which you name a person who will act on your behalf if you become incapacitated or are otherwise incapable of looking after your finances. The agent that you appoint will typically have the power to handle most of your financial matters, including opening and closing bank accounts, signing checks or contracts, and buying and selling real estate. There are several different types of power of attorney documents, but a “durable” power of attorney is one that is specifically designed to remain valid in the event of incapacitation or mental incompetency. A durable POA must be signed while you or your loved one is still of sound mind and body.

What are Guardianships and Conservatorships?

A guardianship is a court proceeding in which someone is given legal control over another person’s personal situation. The individual who assumes guardianship has the right to make decisions involving the other person’s healthcare, whether to put them in assisted living, or otherwise where they should live, etc.

A conservatorship goes hand-in-hand with a guardianship. It is a court proceeding, but rather than being granted the power to make personal decisions, this arrangement grants another person legal control over financial matters: paying bills, cashing checks, accessing bank accounts, etc.

If you were to become incapacitated or otherwise incapable of making financial decisions—and you do not have a durable power of attorney in place—then the court will assign you a guardian and/or conservator. This person—or, in some circumstances, these people—will typically be given the power to make legal, financial, and health decisions on your behalf, and may or may not require court approval to enact these decisions. Before the court approves a guardianship or conservatorship, it requires the testimony of a physician who has personally examined the ward and found that they are indeed incapacitated.

What are the Differences Between a Power of Attorney and a Guardianship/Conservatorship?

There are several major differences between a durable power of attorney and a guardianship/conservatorship, but the most significant is that in the former, you get to choose your agent, while in the latter, the court decides who will be entrusted with the decision-making on your behalf.  Although the court also assigns an attorney to represent the incapacitated individual and ensure that the guardian and/or conservator is acting properly, you can never be sure that this agent will truly be operating in your behalf. The thought of not being able to choose your own agent should give anyone pause.

Another difference between the two arrangements is that a guardianship/conservatorship is much more expensive and burdensome to acquire. A power of attorney is easily and affordably arranged, while a guardianship/conservatorship is a far more intensive process involving at least one doctor and at least two lawyers, all of whom need to be paid.

Don’t Hesitate

The bottom line is that, by ensuring you have a durable power of attorney in place, you can save not only time and money, but your dignity as well. No one likes to think about what will happen if they should become incapacitated, but it’s impossible to predict the future and it’s far better to prepare for any possibility now. Whether for yourself or for an aging loved one, making sure a power of attorney is in place well before the onset of a cognitive disorder is crucial to the security of your estate.

At Miller Estate & Elder Law, we have many years of experience helping our clients establish durable powers of attorney, and navigating difficult medical and financial situations. Contact us today and ensure that you or your aging loved one has a say in their own future.


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Having Tough Conversations About Estate Planning… Without Ruining the Holidays

Having Tough Conversations About Estate Planning… Without Ruining the Holidays

woman and man with grey hair smile and look at each other doing yoga

Estate planning conversations are usually tough and probably not top-of-mind as families gather for the holidays. Discussing death and finances are often two of the most uncomfortable topics for families to talk about. Not talking about them, however, can lead to severe—and sometimes devastating—consequences.

While it might be difficult to broach the subject, the holiday season actually provides a great opportunity to talk to your family. Everyone is gathered in once place, opening the door to have important, distraction-free, in-person conversations. Many families take this time to share stories from the past, and celebrate what is to come, but these gatherings also provide the perfect canvas for heartfelt, emotional discussions.

Regardless of age, many adults delay the estate planning process, as it can be uncomfortable to contemplate one’s own mortality. Due to the delicate nature of the topic, conversations should also be approached delicately, and with the utmost respect for privacy and comfort zones. There are many ways to segue into estate planning conversations during the holidays. Here are a few ideas to point you in the right direction.

  • Start by having smaller conversations with other family members about their estate plans before going straight to mom and dad. This will allow you to test out the topic and determine how to best bring it up in a bigger group discussion.
  • Wait for a good time to bring up your own experience with estate planning, or—better yet—ask the group for advice. This will open the door for a collective discussion about what documents your family has already put in place, and what still needs to be done. Do some research ahead of time, so you know what estate planning tools your parents should have in place. This will help direct the conversation, if you find that your parents do not have a comprehensive plan in place.

The goal of these discussions is not to pry or try to obtain information about your inheritance. It is to ensure that your parents have their estate plans in order, so that you and your loved ones aren’t left to contend with a probate nightmare after they pass. If you discover that they are ahead of the game, make them promise that they will revisit it every once in a while to make sure it stays up to date with their situation and currents wishes.

If nothing has been done, suggest helping them research an estate planning attorney to start the process. Having a plan in place will provide peace of mind that your parents are protected, and that your future won’t include a time-consuming, costly, and emotional probate battle. This is one of the best gifts your parents could give you this holiday season.

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5 Signs Your Parents May Soon Need More Healthcare Support

5 Signs Your Parents May Soon Need More Healthcare Support

woman and man with grey hair smile and look at each other doing yoga

The holidays are a time for warm family gatherings and togetherness, but if your parents are beginning to age, it can also be a chance to check up on how they are faring. Being tuned in to the health of your aging loved ones is important. Taking note of any early warning signs that they may need additional healthcare support is crucial to getting them the care they need, when they need it.

Below is a list of some of the most common signs that your aging loved ones may soon need more care:

  1. Difficulty with Standing or Mobility. As people age, their balance and strength diminish. If you notice a parent leaning over or looking wobbly, they may need additional help. In addition, if your loved one is leaving the house less often, they may have mobility issues that need to be addressed.
  2. Confusion or Forgetfulness. Did your mom forget what she was saying mid-sentence? Did your dad continually repeat himself? Forgetfulness or confusion can be a sign of cognitive decline and may indicate that your parent needs more healthcare support.
  3. Decline in Personal Hygiene or Housekeeping. If you notice that a parent’s grooming has begun to suffer, it’s possible that they may need additional help with daily tasks, such as brushing their teeth or bathing. If you visit their home and notice more clutter than usual, this may also be a sign that they can no longer take care of themselves sufficiently.
  4. Difficulty Keeping Appointments or Paying Bills. Missing appointments or leaving bills unpaid is a key sign that your parent may be experiencing cognitive decline. Look around for unopened mail and listen to any phone calls that your parents receive from bill collectors attempting to collect payment, or healthcare providers attempting to reschedule missed appointments.
  5. Loss of Interest in Favorite Activities. If your parent is no longer enjoying the activities or interests that used to get them excited, it can be a significant indicator that something has changed. Whether due to mobility issues or cognitive changes, isolation is a major sign that your parent(s) need more healthcare support.

Caring for an aging parent is difficult at best, and heart wrenching at worst. If you notice any of the above warning signs, don’t ignore them. Even if you still sense that your aging loved one will be able to maintain their independence for a few more years, now is the time to make sure you get the appropriate legal documents in place to ensure your ability to care for them when the time comes. It’s also a good time to start planning for the cost of long-term care—remember, Medicaid has a 5-year lookback period, so preparing to qualify for this program should start as early as possible!

At Miller Estate & Elder Law we have many years of experience helping people with all aspects of caring for their loved ones. We’ve developed a helpful guide, Caring for Aging Parents, which includes important information about preparing for and providing the care your aging loved ones may soon need. Complete the brief form below to gain access to this free resource.

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Estate Planning for Blended Families

Estate Planning for Blended Families

woman and man with grey hair smile and look at each other doing yoga

Congratulations on finding true love—again! Getting remarried opens the door to so many new and wonderful opportunities. Never mind the tax benefits—you have another chance to build a life with a perfect-for-you partner! And, if you or your new spouse have children—or if you plan to have more children together—you can look forward to growing and merging your families! Of course, every major life milestone requires you update your estate plan, and estate planning for blended families presents its own unique challenges.

When it comes to getting remarried, many people are inclined to keep their estate plans simple, and leave their assets to their spouse. However, when children are involved, this isn’t so straightforward. For example, if you lost your ex-spouse to death, you may not want your new spouse to inherit the assets that once belonged to your previous spouse. Or, if you are remarried but co-parenting with your ex, you may want some of your assets distributed to them, so they can use those assets to continue raising your children.

There are countless considerations, but here are the top mistakes we see in estate planning for blended families.

  1. Failing to update your will (or draft a new trust). This is the first (and most obvious) step after getting remarried. You wouldn’t want your ex-spouse to inherit your home, car, or other assets, right? However, it’s not always as simple as leaving everything to your new spouse, especially when children are involved. How can you be sure that your new spouse will honor your wishes for your children to inherit your assets after they die? Do they have children from a previous marriage? Do you want their children to inherit any of your assets? These are questions to consider, but the complexity of the matter makes trusts for second marriages a highly viable estate planning tool. Trusts for second marriages will ensure your assets pass down to your new spouse, your children, their children, and any other loved ones exactly as you intend.
  2. Not updating your beneficiary designations. Updating your will may be obvious, but many people forget about the beneficiary designations listed on their bank accounts, insurance policies, and retirement accounts. We can’t tell you how many times we’ve surprised a client by telling them that their ex-spouse is still listed as the beneficiary on their 401(k) account, and they had no idea. Accounts that use beneficiary designations will not pass through probate, so whoever is named beneficiary will receive those assets immediately after your death—there is no court proceeding to argue or contest this decision.
  3. Treating all heirs equally. There are countless considerations when it comes to deciding how to distribute your assets between your spouse, children, and loved ones. There is no rule that says you need to treat all heirs equally, and this is especially the case in estate planning for blended families. For example, if you owned your house before your new spouse moved in, you may want the home (or the proceeds from selling the home) to go to your children rather than your spouse. Another example, you may distribute a greater percentage of your assets to your biological children, and leave less for your step-children. Finally, if any of your heirs have addiction issues, gambling issues, or are otherwise irresponsible, you may want to look into trusts for second marriages, as a trust will give you more control over the circumstances under which your assets are distributed. When leaving unequal inheritances, it’s recommended that you communicate with your heirs about your decisions, so there are no hard feelings or resentments after you pass away.
  4. Not working with an estate planning attorney. When it comes to estate planning for blended families, there is so much to consider. What we’ve discussed here is only brushing the surface. A qualified estate planning attorney will guide you through the process of updating your estate plan—or drafting an estate plan to begin with—ensuring that all of the “what ifs” are addressed, and that every decision has a contingency.

No one wants to pass away and leave their family either with a giant mess to clean up, or hard feelings about who received which of your assets. Updating your estate plan when you get remarried is an important step to ensure you leave a legacy of love, and not of anger and confusion.

Miller Estate & Elder Law can help you plan for the many uncertainties of the future. We offer comprehensive estate planning and elder law services, and can guide you through the process of protecting yourself, your family, and your assets. Contact us today!

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