If aging in place is your goal, then you need to examine your circumstances with a long view in mind. For instance, how will your home function as you age? What accommodations can you offer for the people who will care for you? How will you pay for needed care? All these factors need to be weighed, says the Record Online in the article “Start planning now so you can ‘age in place.’”
Many homes will need to be remodeled for aging in place, and those changes may be big or small. Typical changes include installing ramps and adding a bathroom and bedroom on the first floor. Smaller changes include installing properly anchored grab bars in the shower, improving lighting, and changing floor coverings to avoid problems with walkers, wheelchairs, or unsteady seniors.
Choosing a caregiver and paying for care are intertwined issues. Many adult children become caregivers for aging parents, and for the most part, they are unpaid. Family caregivers suffer enormous losses, including lost work, career advancement, income, and savings. Stress and neglect of their own health and family is a common byproduct.
You’ll want to speak with an estate planning eldercare attorney about how or if the parent may compensate the child for their caregiving. If the payment is deemed to be a gift, it will cause a penalty period, when Medicaid won’t pay for care. A caregiver agreement drafted by an elder law estate planning attorney will allow the parents to pay without a penalty period. The child will need to report this income on their tax returns.
The best way to plan ahead for aging in place is with the purchase of a long-term care insurance policy. If you qualify for a policy and can afford to pay for it, it is a good way to protect assets and income from going towards caregiver costs. You can also relieve the family caregiver from duties or pay them for caregiving out of the insurance proceeds.
Without long-term care insurance, the next option is to apply for community Medicaid to pay for care in the home, if available in your state, or possibly a benefit called “Aid and Attendance” for certain qualifying veterans or their spouses.
Another option is a spousal refusal, which may allow the couple to keep more assets and income. When an applicant has too much income, a pooled income trust may be used to shelter income from going towards the cost of care. This is a complicated process that requires working with an estate planning attorney to ensure that it is set up correctly.
Self-paying for home care is another option, but it is expensive. The average cost of home health care in some areas is $25 per hour, or $600, for a full day. When you get to these costs, they are the same as an expensive nursing home.
Planning in advance with careful analysis of the different choices will give the individual and the family the best picture of what may come with aging in place. A better decision can be made once all the information is clearly assessed.
Reference: Record Online (Aug. 31, 2019) “Start planning now so you can ‘age in place’”