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

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

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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What to Look for During Holiday Visits to Aging Parents

What to Look for During Holiday Visits to Aging Parents

The holidays are often called the most wonderful time of the year, especially for aging parents. For many families who live far apart, they are also a time when adult children and grandchildren travel to visit aging parents. Even if you are in regular contact by phone and email, it can be tough to recognize signs of aging that require further attention until you are with your loved ones in person. Do you know what to look for during holiday visits to aging parents?

Let us talk about some of the signs that it may be time to look into getting your aging parent some day to day assistance, or to begin exploring options for long-term care.

The first thing to look for in your aging parents is forgetfulness. Forgetfulness is often one of the first signs to watch for. It is normal for memory to change over time. If your parents, however, are forgetting routine and long-term information, such as their street address or how to get to the grocery store, this could be a sign of the onset of Alzheimer’s or another form of dementia.

Decrease in socialization can also be a red flag in aging parents. If your normally active, social parent is spending a lot less time out of the house, this may be cause for concern, especially if he or she is now living alone after being widowed and is not getting social interaction without a spouse in the house. You can help by looking into local activities at a senior center, house of worship, or the library.

Driving issues are also things to watch for. Unfortunately, your parents probably taught you to drive, and you may be the person who has to take away their keys. If vision and spatial issues become too much and impair their ability to drive safely, it is probably time to sit down and talk to your parents about alternatives.

Additionally, be mindful of cleanliness. If your parents’ home has unexpected piles of junk mail and newspapers suddenly stacking up in the corners, it may be time to talk about getting them some help to organize and discard.  If there is a true cleanliness issue, however, with food not being disposed of properly or mold accumulation, it can also be a sign of dementia.

Our office remains committed to serving the elderly and their loved ones. For legal help and support concerning elder law issues, please reach out to us to schedule an appointment.

Can Filial Responsibility Laws Leave You On The Hook For Your Parents Nursing Home Bill?

Can Filial Responsibility Laws Leave You On The Hook For Your Parents Nursing Home Bill?

While parents today may be generally informed that they could be liable for the debts of their children, they rarely consider whether they may actually find themselves on the hook for the debts of their parents. Did you know that over half of the United States have filial responsibility statutes on the books? This may come as a surprise to many people.

A filial responsibility law provides that an adult child has the responsibility to support his or her adult parent. The statutes vary between states. Arkansas requires only payment for mental health services and Connecticut only applies if the parent is under sixty-five. Meanwhile, a court in Pennsylvania entered a judgment of $93,000.00 against an adult son for his mother’s nursing home bill.  

The positive news may be that, in most instances, these statutes are old laws that have not been repealed and are rarely enforced. Until they are removed from the books, however, the risk may be out there that these laws may be used as a collection tactic, as the gentleman in Pennsylvania discovered, much to his chagrin. Once one long-term care facility successfully utilizes the filial responsibility laws to collect from an adult child, it may only be a matter of time, until others follow suit.

The key takeaway here is to take a proactive, rather than a reactive, approach to filial responsibility laws. Having conversations with your parents regarding their finances, as well as, plans to cover the cost of a nursing home before the need arises, can be very important. If they have a long-term care policy, get a copy. It may also be prudent to be designated as their durable power of attorney to manage their finances should they become unexpectedly incapacitated. 

An estate planning attorney can explain the filial responsibility laws in your state to you and your parents.  In addition, the attorney can discuss options to safeguard against liability under these laws, such as Medicaid eligibility, long-term care insurance, life-insurance policies with long-term-care benefits or even the possibility of a reverse mortgage on your parent’s home. For more questions on this topic and related matters, please reach out to our office to schedule an appointment. 

Key Considerations When Your Spouse May Need Nursing Home Care

Key Considerations When Your Spouse May Need Nursing Home Care

For many of us, the time will come when we have no choice but to seek extra attention and care for our spouse. Is it time to consider moving your spouse to a nursing home? This can be a difficult decision as there are many things that you want to protect your spouse from, including abuse and general mistreatment. Even though you may not have a choice but to place him or her in a nursing home, that does not mean that it has to be a horrible experience for either you or your spouse. 

First and foremost, you want to ensure that the home you have selected is Medicaid/Medicare approved as this will help you make the best choice financially. Here are a few other things you can add to your checklist to help you make the best decision for your spouse as well as your peace of mind. 

1. Ask if residents can have their personal belongings, including furniture, in their rooms. You may also want to find out whether your spouse will have storage space, such as an appropriately sized closet and drawers in the room.

2. Verify amenities provided by the nursing home. Will your spouse have computer and internet access in his or her bedroom? Will there be a television? Will there be a window to provide natural light? Access to these types of comforts can help ease the transition into the nursing home.

3. Inquire about what type of activities the home offers and if the facility helps residents who may not be mobile. Find out if the nursing home has outdoor areas for your spouse to use. You may also want to ask if your spouse will be able to choose what time to get up, go to sleep, or bathe.

4. Look into the support provided for residents with advanced health care needs. For many of us who are struggling with this decision, our spouses may not be in very good health. For example, a common disease that impacts many Older Americans is dementia. If this is the case with your spouse, you may need to know if the nursing home has specific policies and procedures related to the care of residents with dementia. If the facility does, what types of non-medication based approaches do they employ when trying the first attempt to respond to behavioral symptoms for residents living with dementia? What percentage of residents have dementia and are currently being prescribed antipsychotic medication? This can help you to understand the type of residents that your spouse will be surrounded by as well as the home’s workload.

These are just a few tips to help guide you in making a difficult decision and help you to do what is best for your spouse. These kinds of major life changes often come with complicated legal issues. Miller Estate and Elder Law can provide you with guidance to help you make informed decisions on long-term care planning and nursing home issues. Get in touch with our office today to schedule a meeting.