People often think about speaking with an Elder Law attorney when an older person faces the high cost of nursing home care. Many times people wait even longer…after they have paid most of their nest-egg on care and realize that in a few short months they will have nothing. While we do help families in these situations, we are able to do so much more if instead they call us when the initial diagnosis of a serious chronic illness is made or when the elder reaches the landmark age of eighty.
When people come at this earlier stage, we work with the family to first understand the aging or disease process that they are facing and develop a plan to allow care to be provided in the optimal setting. With the assistance of our nurse advocate, we consider the disease trajectory and the probable progression of symptoms. Many of our clients express the desire to stay in their homes. With proper planning, this is often possible. The home must be safe and adequate care must be provided in the early stages. Sometimes this means bringing in some amount of care in the home before it may be abundantly evident to the family that such care is required. Having some assistance can prevent some of the negative events (such as falls) that would necessitate a greater level of care (and cost) that may not be able to be provided at home.
Obviously any type of extra care can be expensive. That is why we attempt to identify alternate payment sources that can augment the resources of the family. These alternative payment sources include long term care insurance, VA benefits (for war-time Veterans or their widowed spouses) and Medicaid.
We also analyze the income sources available against the needs for monthly income. Particularly when one of a married couple requires institutional care, the well spouse must have adequate income to maintain his or her accustomed standard of living. If the majority of the sick spouse’s income is required to pay for care, the well spouse may not only face the enormous loss of no longer living with their life-long mate, the well spouse may also face financial ruin. A court can divert a greater share of the sick spouse’s income to the community spouse. This legal action can make a huge difference to a well spouse.
Families should not wait until they have achieved complete “spend down” to seek help. At that point, many options for preserving functioning and resources are lost.