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What Does Long-Term Care Actually Cost?

What Does Long-Term Care Actually Cost?

by | Jan 23, 2023 | Blog, Caregivers, Long-Term Care, Nursing Home

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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bill@millerestateandelderlaw.com

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

by | Jan 15, 2023 | Blog, Caregivers, Long-Term Care, Nursing Home

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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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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Medicaid Income Limits: Will Medicaid Take My Home?

Medicaid Income Limits: Will Medicaid Take My Home?

by | Mar 17, 2022 | Asset Protection, Long-Term Care, Medicaid

Many people worry about what will happen if their spouse needs to go to the nursing home. Will Medicaid take the home where so many of their memories were made? What about their car? Investment accounts? Their life savings? While it’s true that Medicaid income and asset limits are strict, with proper planning and an understanding of Medicaid eligibility requirements, most couples can avoid losing their hard-earned assets to the nursing home.

In Alabama, the average cost of nursing home care is $6,459/month—and this number is expected to increase to $11,648 by the year 2038. Medicaid will pay the cost of long-term care for those who meet income and asset eligibility requirements. If you are married, in order to qualify for Medicaid, the individual who needs nursing home care cannot have monthly income in excess of $2,523, and cannot own assets valuing more than $2,000. The spouse who doesn’t need nursing home care—known as the “community spouse”—can keep one half of their assets, valuing no more than $137,400.

Fortunately, for married couples, Medicaid does not include the marital home towards the asset limit. The community spouse can continue to live there. However, if they eventually need long-term nursing care, Medicaid will put a lien on the house for the amount of money they pay for your care, and your children may not be able to inherit the home.

That being said, you have worked a lifetime to accumulate your wealth and assets, and passing them down to your children and grandchildren is important. There are some strategies that can help you comply with Medicaid income limits, without making costly mistakes that could disqualify you:

1. Asset Protection Trusts. These trusts, when drafted and funded properly, transfer the ownership of assets from you to the trust. This means they are protected from Medicaid, and other creditors and predators. However, keep in mind that Medicaid will look back 5-years from the date of application—any assets transferred during that period can incur penalties.

2. Income Trusts. Qualified or Pooled Income Trusts can hold income in excess of the $2,323/month limit imposed by Medicaid.

3. Medicaid Compliant Annuities or Promissory Notes. This can be helpful to offset the cost of nursing home care if a penalty period is inflicted. While planning ahead is obviously a better choice, if you find yourself in a crisis where nursing home care becomes necessary on short notice, this strategy can save you and your heirs money.

4. Spend Down Assets in Compliance with the Look-Back Period. The following purchases and investments will not violate the 60-month look-back period:

a. Pay off accrued debt
b. Purchase medical devices, like wheelchairs, dentures, eyeglasses and hearing aids, etc.
c. Home modifications and renovations
d. Vehicle repairs
e. Create a formal life care agreement with the help of an attorney
f. Pre-pay for your funeral

To qualify for Medicaid, it’s imperative that you avoid certain mistakes—and some of them are not so obvious. Working with a qualified elder law attorney who understands Medicaid income limits and eligibility requirements, as well as how to structure a trust to protect your assets while increasing your chances of qualifying for Medicaid, is so important.

Attorney Bill Miller of Miller Estate and Elder Law is an experienced elder law attorney, with offices in Birmingham and Anniston, AL. Gain access to his free 20-minute webinar about Medicaid qualification by following the link below, or contact us via the website today.

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

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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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