How to Legally Protect a Loved One with Dementia

How to Legally Protect a Loved One with Dementia

by | Mar 21, 2023 | Blog, Caregivers, Elder Law, Long-Term Care, Nursing Home

When a loved one is diagnosed with dementia, you can make the news of a devastating diagnosis a little easier for them by taking steps to make sure certain several legal documents are put into place as soon as possible. An elder law attorney can help you put a plan into place to support you and your loved one every step of the way, including establishing a durable power of attorney, a living will, a medical power of attorney, and an estate plan. These legal documents for caregivers will give you peace of mind that you are fulfilling the wishes of your loved one as they navigate their diagnosis and disease.

Durable Power of Attorney

A durable power of attorney allows you to make financial decisions for your loved one when they are no longer able to advocate for themselves. Working with an elder law attorney and your loved one to establish yourself as an agent will allow you to make financial decisions, sell property, handle any financial accounts like IRAs or savings, and pay bills. Establishing power of attorney is an especially crucial step to take following a dementia diagnosis. If you fail to do so and need to take over financial responsibilities for your loved one down the road, you will have to pursue a guardianship or conservatorship through the court system, leading to expensive legal fees and unnecessary hearings.

Estate Plan

In addition to establishing power of attorney to make sure their financial responsibilities are handled, your loved one may want to establish an estate plan for their assets and investments at the time of their dementia diagnosis. Your loved one and an elder law attorney can discuss any specific plans or intentions they have for their assets to make sure their investments and income are protected. An important legal document for caregivers, an estate plan provides you with a clear directive of your loved one’s wishes and them with a sense of control over their assets.

Living Will or Advanced Health Care Directive

Eventually your loved one will reach a point where they are no longer able to make health care decisions for themselves. Before that happens, you and your loved one should have a discussion about potential medical issues that might arise and what choices they would like to make for treatment. Legal documents for caregivers like a living will are legally binding and make it easier for you and them to feel confident that their wishes will be respected during more advanced stages of their disease. The living will should also include the name of the person who will become your loved one’s medical power of attorney. An elder law attorney can help you draft this document and make certain that your loved one’s voice is heard.

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, or download our free guide: Caring for Aging Parents: The ABCs of Long-Term Care Planning by filling in the brief form below.



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Should I be Thinking About Medicaid Asset Protection Planning?

Should I be Thinking About Medicaid Asset Protection Planning?

by | Sep 7, 2022 | Elder Law, Medicaid Qualification

Medicaid is a federal program administered by the states that helps individuals who meet certain asset criteria pay for long-term care costs. Because Medicaid is a means-tested program, certain financial conditions must be met to qualify, which means that it is important to plan ahead. Unfortunately, people often wait until it is too late and a sudden illness, disability, or other crises occurs before planning for long-term care. Medicaid crisis planning is a strategy that can help you qualify for Medicaid, without experiencing financial ruin.

Long-term care is expensive, and these costs only continue to increase. The average life span of adults is also increasing, which translates to more years of care at increasingly higher rates. Without a plan in place, these costs could be financially devastating. In fact, without proper planning, your life savings could be wiped out within months of needing long-term care.

Due to Medicaid’s strict eligibility requirements, many individuals fail to meet the income and asset requirements, but still cannot afford the cost of healthcare on their own. Medicaid planning is a way to assess an individual’s situation and devise a strategy to help qualify for Medicaid if it becomes necessary.

Two popular strategies employed to meet these financial qualifications are:

  • Spend Down
  • Medicaid Asset Protection Trust

The spend down strategy is a way to reduce countable assets by carefully spending excess funds on things like medical expenses, home improvements, prepaid funerals, etc. To prevent applicants from simply giving away their money or resources to qualify for Medicaid, the federal government implemented the “look-back period.” Each state’s Medicaid program uses slightly different eligibility rules, but most states examine all of a senior’s financial transactions dating back five years from the date of their application. If a transaction is found to be in violation, the applicant will be assessed a penalty.

When it comes to the length of the penalty period, there really is no limit.  It is based on the amount of money given away during the last 5 years.  Unfortunately, if a senior has gifted their assets during the look-back period and requires nursing home level care, this will have to be paid out of pocket until the penalty period runs out and they become eligible for coverage.

The other problem with the spend down strategy is that your assets are depleted.  As an individual, you can only have $2,000 in countable assets!  A more favorable strategy to spending all of your assets is to implement a Medicaid Asset Protection Trust (MAPT).  A MAPT is exactly as it sounds – a trust designed to protect assets from being counted for Medicaid eligibility. When planned properly, an MAPT protects the home, other properties, and investments.  When designed properly and in advance, the assets in the trust will go to your heirs instead of having to spent on nursing home care.

The trust must be irrevocable for exemption from Medicaid’s asset limit. This means that the trust cannot be cancelled or changed. Once the assets are transferred into the trust, they no longer belong to the individual, nor can that individual regain ownership of the assets. If the assets are in a revocable trust, Medicaid considers the assets to still be owned by the Medicaid applicant. This is because they still have control over the assets held in the trust.  As a result assets in revocable trust do not provide the necessary asset protection from long term care costs.

Planning well in advance of the need for long-term care is the best course of action when considering a Medicaid Asset Protection Trust.  Transfers of assets to MAPTs do not result in immediate Medicaid qualification as they are subject to the 5 year look back as well.  The advantage is that if the assets have been in the MAPT for 5 years, they are not counted by Medicaid.  Therefore, the sooner you do the planning and get the MAPT set up, the more likely your nest egg will be protected if you need long term nursing home care down the road.

At Miller Estate and Elder Law we have extensive experience advising clients on Medicaid planning. Contact us today so that we can help you qualify for Medicaid, while also protecting your assets and your loved ones.

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What is a Medicaid Crisis and What Are Your Options?

What is a Medicaid Crisis and What Are Your Options?

by | Aug 20, 2022 | Asset Protection, Elder Law, Long-Term Care, Medicaid Planning

Imagine that your parent or another aging loved one suddenly finds themselves in need of nursing home care. If they haven’t already planned for the potential cost of long-term nursing care, they could find themselves in an incredibly compromised and vulnerable position. Because of the strict income and asset limitations that dictate who is eligible for Medicaid, your parents (or even you) may end up blowing through your life savings in order to pay for the cost of long-term care.

It is well known that Medicaid has a 5-year lookback period, so those who find themselves in immediate need of long-term care often assume there is nothing they can do to get qualified.

Fortunately, that is a myth. With the help of a qualified elder law attorney, Medicaid Crisis Planning could help you or your loved ones preserve some of their assets while becoming eligible for Medicaid.

What is Medicaid Crisis Planning?

About 70 percent of American seniors will need some type of long-term care planning, many of whom will find themselves in nursing homes. Because of the high nursing home costs—the median annual cost of a private room in a nursing home is over $100,000—it is important to meet with an elder law attorney to work out a detailed plan to prepare for this situation long in advance.

If, however, you find your loved one facing an unexpected health emergency that will likely require nursing home care, you do have options. For people who have assets significantly higher than the Medicaid threshold, the best of these options is Medicaid Crisis Planning. Medicaid Crisis Planning is a way to avoid spending down your entire life savings when faced with an immediate or near-immediate health situation.

How Does Medicaid Crisis Planning Work?

With Medicaid Crisis Planning, the person facing a nursing home visit gifts a large part of their assets—sometimes up to 50 percent—to a Medicaid Asset Protection Trust, or in some cases directly to a child or another loved one. The rest of the person’s assets are then converted to an income stream through a Medicaid Compliant Annuity (or in some states a promissory note) After these transfers are completed, the patient applies for Medicaid to cover the nursing home cost.

In most cases, the application will be approved subject to a penalty period.  That penalty period is based on the amount of the gift they have made to their child or other loved one (and any other transfers for less than fair market value that have been made in the past 5 years). During this period of ineligibility, (penalty period) the person will privately pay for nursing home care using their monthly income, as well as the funds produced by the annuity or payments from the promissory note or annuity. Once the ineligibility period has expired, Medicaid will start paying the monthly nursing home bill.

While the applicant will need to use some of their life savings initially, in the long-run, they will be able to salvage some of what they’ve worked a lifetime to accrue.

Long-Term Care Planning

With proper long-term care planning, you and your loved ones can be protected from having to spend down your entire life savings when faced with an unexpected nursing home admission—without the need for Medicaid Crisis Planning. An elder law attorney will help you protect your assets and guide you through which financial moves to make (or NOT make) as you age. For example, it may be advised that you set up a Medicaid Asset Protection Trust or purchase assets that are exempt from Medicaid.  This can prevent you from incurring a penalty, should you need to apply for nursing home Medicaid in the future.

The sooner you start planning for the cost of long-term nursing care, the better.  As it goes, an ounce of prevention is worth a pound of cure.

Whether you are interested in long-term care planning or find yourself in need of Medicaid Crisis Planning, it is important that you work with an experienced estate and elder law attorney. Elder law matters are as complicated as they are essential, so choosing the right professional can make all the difference.

At Miller Estate and Elder Law, we have many years of experience with long-term care planning and Medicaid Crisis Planning. Call (256) 251-2137 to speak with a member of our legal team today or contact us using the brief form below.


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Providing Care After an Alzheimer’s Diagnosis: Caring for Aging Parents

Providing Care After an Alzheimer’s Diagnosis: Caring for Aging Parents

by | Jul 26, 2022 | Aging Parents, Elder Law, Long-Term Care

When a parent or another loved one receives an Alzheimer’s diagnosis, the news lands like a devastating blow. Knowing that you will soon watch someone you love lose their memory and struggle with daily tasks is emotionally wrenching. In addition, your loved one will eventually need intensive dementia care, which can put heavy strains on a family—both psychologically and financially.

Although it’s unlikely that you will be able to provide all the care necessary for a parent diagnosed with dementia, many children do take on a large share of the burden of looking after their parents. For most people, caring for aging parents or loved ones who have received an Alzheimer’s diagnosis is a whole new experience, and one that is very overwhelming. Knowing a few basics about dementia care can help ease the burden.

Everyday Care for Those Diagnosed with Dementia

Because people with Alzheimer’s will start to experience changes in memory and their ability to think clearly, they will need help performing many everyday tasks. The inability to perform what used to be simple tasks can prove quite frustrating, and understandably so. Here are some ways you can help support a loved one who is struggling with dementia:

  • Establish a routine. For people with Alzheimer’s, doing the same thing at the same time every day can help them stay focused on and involved in their own lives. Furthermore, certain tasks need to be performed at a time when the patient is most alert, so it’s important to schedule these at that specific time each day.
  • Help your loved one write down tasks and reminders. Writing down the things they need to do and remember will encourage them to take responsibility for their life, and will also help keep their mind sharp.
  • Allow the person to do as much as possible by themselves. Although Alzheimer’s patients will need more and more help as their disease progresses, it’s important to allow them as much independence and autonomy as possible.
  • Provide choices. Providing the person with simple choices, like the choice between two shirts to wear, can help them feel empowered and stay focused.
  • Reduce distractions. Make sure the environment your loved one lives in is free from distractions, particularly during mealtime or conversations. Otherwise, they may get confused.

Safety Considerations for People Diagnosed with Alzheimer’s

As well as helping the person with their daily tasks, providing them with a safe environment is an important part of dementia care. Here are a few things you can do to prevent them from getting injured:

  • Lock away potentially dangerous objects, such as cleaners, medicines, matches, or knives.
  • Remove anything that the person could trip over, such as extensions cords or small rugs. Also, install handrails or grab bars to help the person maintain their balance.
  • Keep the thermostat on a lower setting so that the person won’t accidentally burn themselves.
  • Insert safety plugs into unused electrical outlets.

Legal Concerns

In addition to providing care for a loved one diagnosed with dementia, there are also important legal considerations that come with looking after their affairs. At the first word of an Alzheimer’s diagnosis, you should contact an elder law attorney to ensure the proper legal documents are in place so you can focus on providing care, and not a lengthy and costly legal process. Drafting documents while your loved one is still coherent is essential, though there are limited options for those whose loved ones have already lost significant cognitive function.

At Miller Estate and Elder Law, we have many years of experience helping people whose loved ones have received an Alzheimer’s diagnosis. Use the brief form below to download a copy of our free guide: Caring for Aging Parents or call (256) 251-2137 to speak with a member of our legal team today!



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What is a Trust…and Do I Need One?

What is a Trust…and Do I Need One?

by | Apr 13, 2022 | Avoiding Probate, Elder Law, Estate Planning, trust

Most people know that a will is an important piece of the estate planning puzzle, but there are many misconceptions about trusts. Most people believe that trusts are reserved for the very wealthy. While it’s true that not everyone needs a trust, it is hardly limited to those with multi-million dollar estates. Depending on your estate planning goals, assets, and wishes, a trust may be a very viable option for you—even if your estate is modest.

But, what is a trust…and how do you know if you need one?

What is a trust?

A trust is a legal contract that ensures the proper distribution of assets to the trustor’s beneficiaries. Assets can be distributed in the exact manner you wish them to be. The individual creating the trust—called a ‘trustor’ or ‘grantor’—places title to his or her assets into the ownership of the trust. The process of transferring assets to the trust is called ‘trust funding,’ and is an essential part of successful trust creation. The trustor will also name a person to manage and administer the assets held in the trust, called a ‘trustee.’ A well-organized and regularly maintained trust has the potential to save your loved ones from certain headaches, like probate court, and can offer tax benefits for inheritances, as well as more privacy and control over your assets.

General Guidelines

Generally speaking, trusts may be a viable option for you if you have a net worth of $100,000 or more, a considerable portfolio of real estate and other tangible assets, or detailed instructions for how you’d like your assets to be distributed to your beneficiaries when you pass away. It’s important to note that these recommendations are not set in stone, as each circumstance is highly unique, and even those who don’t meet these guidelines may still benefit from drafting a trust.

Types of Trusts

To further answer the question “what is a trust,” and determine whether a trust will fit your unique needs, it’s important to understand the different types of trusts that exist, and what makes them different. The most common types of trusts include:

  • Revocable (aka ‘Living’) Trust: This flexible trust allows you to cancel, maintain, and make amendments to the trust while you’re still alive. A revocable trust isn’t subject to probate, but doesn’t always protect assets from creditors, as the trustor still legally owns the assets that have been transferred to the trust.
  • Irrevocable Trust: Contrary to a revocable trust, irrevocable trusts are not able to be revoked or amended without the consent of all beneficiaries named in the trust. While this certainly limits the flexibility of the trust, it better protects the trustor from creditors and lawsuits. Additionally, an irrevocable trust can help minimize estate tax liabilities.
  • Testamentary Trust: Also referred to as a ‘will trust’ this type of trust is generated from a last will and testament, becoming effective (and irrevocable) after the trustor passes away. Testamentary trusts ensure that assets are distributed to beneficiaries at a designated time—known as the ‘trust expiration,’—which is prompted by a triggering event, such as the beneficiary turning a certain age. Because this trust is part of a will, it must go through probate before the trust can be created.
  • Charitable Trust: This type of irrevocable trust allows you to leave behind a legacy of giving. Charitable trusts are often established to reduce estate and gift tax liabilities. A charitable remainder trust (CRT) carries the added benefit of providing a source of income to you or your beneficiaries during the trust term. At the time of your passing, all remaining assets will then be distributed to the designated charity.
  • Special Needs Trust: Parents and guardians of children and adults with a disability can use this type of trust to protect a beneficiary’s eligibility for needs-based government programs, like SSI and Medicaid. This allows trustors the ability to provide financially for these beneficiaries when they are no longer around to physically care for them.

While creating a trust isn’t for everyone, it is a valuable part of an estate plan for many, providing an additional layer of protection for your legacy, and the future security of your loved ones. The flexibility, problem-solving, and variety that a trust provides makes it an attractive option for those seeking a well-rounded estate plan.

Educating yourself on trusts is only the first step. When it is time to create your trust, working with an experienced estate planning attorney will ensure that your trust is established and funded properly. Contact usvia the brief form below to get started today, or learn more about protecting your assets by signing up for Miller Estate and Elder Law’s FREE estate planning workshop.



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My Spouse Needs to go to the Nursing Home…Now What?

My Spouse Needs to go to the Nursing Home…Now What?

by | Mar 6, 2022 | Asset Protection, Elder Care Planning, Elder Law, Long-Term Care, Nursing Home

You’ve been married to your spouse for decades. Lately, you’ve noticed that they are losing the ability to look after themselves. You realize that they may soon need nursing home care. You know this requires a lot of planning. Are you prepared?

When a spouse needs nursing home care, most people find that they are ill-prepared for the expenses associated with it. Paying out-of-pocket is expensive. After all, you’ve worked a lifetime to purchase your home and build your nest egg you should be able to pass those down to your children and grandchildren…not lose them to the nursing home. Your other options are to apply for Medicaid, or use long-term care insurance. Sadly, long-term care insurance is often overlooked until it’s too late to get it, leaving Medicaid as the only option. However, Medicaid eligibility can be tricky, and most people wonder how their assets might be impacted.

What Happens to My Income?

If your spouse has to go to a nursing home, all of their income will go to the nursing home.  You can keep all of your income but in many cases that is not going to be enough.  Without proper long-term care planning and a loss of your spouse’s income, your life savings could be drained in a matter of months if you have to pay out-of-pocket. Becoming eligible for Medicaid is challenging, with inhibitive income and asset limitations that may leave your spouse unqualified to receive these benefits. As the spouse who is not going to apply for Medicaid (also known as a “community spouse”), your income will not be factored in to eligibility. However, your spouse’s monthly income (which cannot exceed ~$2,523 per month ) will be used to determine Medicaid eligibility, and to pay for care, if approved. This leaves you at home with just one income to cover all of your expenses.

What About My Other Assets?

The other consideration when determining Medicaid eligibility is the assets that are owned by you and your spouse, regardless of whose name they are held in. The Medicaid applicant cannot own assets valued over $2,000 to qualify, not including your primary home or car. You, as the community spouse, can keep half of your assets, up to a maximum of $137,400.

You might also wonder which assets are included—and which are excluded—in the Medicaid application process. Typically, liquid assets, like bank accounts, insurance policies valued over $1,500, stocks and bonds, mutual funds, and second homes and cars, are considered countable assets. It should be noted that your home and one car are not included. This is because the community spouse would continue to reside in and otherwise utilize these assets. Additional assets that are exempt from Medicaid include personal effects, burial plots, and life insurance policies valued under $1,500.

So, What Are My Options?

If your spouse needs nursing home care now, and you are faced with either having to pay out-of-pocket or qualify for Medicaid, you still have some options. You may be tempted to spend down or transfer your assets, but Medicaid will look back 5-years from your application date to ensure you did not give away money to become eligible. Medicaid qualification is a confusing area of law, so it is best to plan with an elder care attorney who can take the guesswork out of applying for Medicaid and help you to avoid common mistakes that may cause penalties and delays in approval.

If you expect your spouse will need nursing care in the not-so-distant future, it’s best to start planning immediately. This is also a good time to consult with an elder law attorney about best practices for maximizing retention of assets and nursing home care provisions for your spouse. Your elder law attorney may suggest actions like:

  • Paying down existing bills: Medical bills, car loans, credit cards, etc.
  • Home improvements: Repairing plumbing and heating systems, fixing the landscaping, purchasing household goods and furnishings, and making structural modifications.
  • Funeral trusts: Purchase a pre paid funeral plan which in not countable and while takes care of an inevitable expense.

At this point, you’ve probably determined that paying for long-term nursing home care can be complicated at best, with so many variances and challenges depending on your unique circumstances. Proper planning should be implemented sooner rather than later to prevent costly and stressful consequences. Miller Estate and Elder Law can help you strategize in order to yield optimum benefits for you, your spouse, and—ultimately—your entire family.

Watch our FREE webinar to learn more about Medicaid eligibility and how to get your spouse qualified for the care they need, without sacrificing your life savings.

https://millerestateandelderlaw.com/medicaid-qualification-webinar

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