
Discussing Long Term Care with Aging Family Members
Discussing Long Term Care with Aging Family Members
With an estimated 70% of Americans needing long-term care after age 65, planning for long-term care is an integral part of an estate plan. It’s better to talk about long-term care and make a plan before the family is confronted with an emergency situation. Advance planning means that you’ll have more options to secure proper care, protect family wealth, and ensure that the community or surviving spouse will not become impoverished.
Start With a Calm Discussion About the Future.
Aging parents may be reluctant to discuss the possibility of needing long-term care, so it must be addressed thoughtfully. I know because I now am one. It can be hard for the dominant decision maker to give up the helm. Ironically, giving up some control now can actually give you more, not less, control if you lose capacity, because you get to select the person or people you trust most, instead of leaving it to fate, or worse, a judge who doesn’t know you or the family.
If one or both parents have chronic illnesses, they may be more receptive to the discussion. If the discussion is kept short and pleasant, you’ll be more likely to have follow-up conversations, which will be needed.
Financial Concerns for Long-Term Care
Most people’s first concern about long-term care, in-home or facility, concerns its impact on their finances. While costs vary from region to region, long-term care costs are expensive. Living full-time in a skilled nursing facility can easily cost $100,000 a year. Home health care is less costly. However, there are limits to the level of care that can be provided at home, and staffing shortages often make home health care complex.
Do You Have Long-Term Care Insurance?
Find out if your parents bought long-term care insurance and ask to see a copy of the policy. If you don’t understand it, ask a professional for help. There are waiting periods for most policies before coverage begins. If they are not in good health or are too old, premiums for a new policy may be prohibitive.
Are They Eligible for Medicaid?
If the family anticipates relying on Medicaid to cover the cost of long-term care, a Medicaid Asset Protection Trust (MAPT) should be discussed. Trying to simplify qualifying for Medicaid by transferring assets to children, including the family residence, creates many unexpected problems. Medicaid has a five-year look-back period. Any transferred assets will be uncovered, resulting in coverage being denied. A MAPT protects assets from being counted for Medicaid eligibility. However, this trust must be created and assets transferred five years before applying for benefits.
Long-Term Care in a Continuing Care Community
Moving from the family home to a continuing care residence is another solution. These communities offer different levels of care, which change as the individual or couple’s needs change. Finding the right one requires considerable due diligence. The financial health of the organization, whether or not there is a doctor on premises, what local hospitals are affiliated with the community, whether or not the apartment will be guaranteed to be sold and money returned to the family upon the passing of the individual or surviving spouse, etc., are all questions to be asked.
Plan for the Legal Aspects of Aging
If your aging parents have an estate plan, when was it last reviewed? They should address this (if they don’t have one) as soon as possible. Their estate plan should include several documents addressing incapacity. These include a Power of Attorney, so a designated person can manage financial and business affairs. A Medical Power of Attorney is also needed if the parent cannot express their wishes for medical care. A Living Will is a separate document containing their wishes for treatments they do and do not want to be used to keep them alive.
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In fact, one of the reasons you took the time to do your estate planning was to help guide you through exactly this situation. We gave you a binder with important sections to fill out so this grieving period can be just that. You planned ahead. You organized your information. You created a roadmap for your loved ones and for yourself.












But here’s the good news: you don’t have to do it alone. At our law firm, we offer free consultations to representatives when one of our clients passes away. Preparing you ahead of time for what this role actually involves can make the difference between a smooth administration and one that has you pulling your hair out.
Also, probate is a court-supervised process of transferring title and satisfying the taxing authorities, including the court and IRS, and dealing with creditors. You will be working with the Register of Wills in the county where the decedent had lived, and will be filing documents with the local Orphans’ Court. If you are not experienced with that process and its procedures, we can help streamline it, as we have handled thousands of such cases.
We’ve helped hundreds of families through this process, and here’s what we know: those who prepare are calmer, more confident, and less likely to be ambushed by surprises. Meeting with counsel early—before you’ve opened accounts, transferred assets, or distributed grandma’s collection of porcelain frogs to the cousins—saves headaches later.
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