Douglas S. Holden
3 Steps to Take Regarding Aging Parents
As my parents age, what should I do? Step One: It is critical that you determine if your parents have estate documents. If they do, make sure that their estate documents are up-to-date. By estate documents, I mean a Last Will and Testament, Living Will (this is the “Pull the Plug” document), Health Care Durable Power of Attorney, and General Durable Financial Power of Attorney. When I say up-to-date, I mean within the last 5 years.
Note that not all estate documents are created equal. When I first started practicing law, to make a living, I pretty much “specialized in whatever came in the door.” Yes, that is a bit cute and even funny, but I can tell you from personal experience that my documents were not the best, most comprehensive documents. When I began to narrow down my interests, the documents became better. Not until I began teaching law school, and also began to concentrate on estate planning, did these documents begin to take shape. Not until I wrote some curriculum on elder law and began to seek advanced training, did everything take shape. I review documents all of the time and I tell some clients that their documents are good, adequate, or not so good. I tell them that laws and times have changed. And I explain where and why I would do things differently. On the other hand, you should go through this process as well. How old are your documents? What circumstances have changed in your life that might merit revisions or new documents? Often, if you go through this process, your parents will as well.
Step Two: Assuming you complete step one, next is the Medicaid question: “Who will take care of you when you can’t take care of yourself?" First, couples are, relatively the same age. Perhaps within five years. This age difference might allow one spouse to take care of the other for a little while, but it does not resolve the issue that the well spouse can only take care of the ill spouse for a short period of time.
I have seen many couples do this fairly well, but it comes at a steep sacrifice – the well spouse will see health deterioration rather quickly. Caregiving is a tough, tough business. In addition, except for dementia, males spouses deteriorate at a quicker rate than the female spouse. That being the case, that generally leaves the 120-pound female spouse trying to lug around the 190-pound male spouse. If the tables are turned, the male spouse may be able to physically care for the female, but that is not always the case. Let's face it. At age 70+, physical labor becomes harder and harder. Some couples tell me that their kids will take care of them. I have seen this work well for a while, but not too often is this solution something that will last longer than a few years. So what are the alternatives? There is, of course, Long-term Care Insurance, retirement living, assisted living, nursing home care, and in-home help for each level of care. In 2018, the average private-pay retirement living costs around $5,000 per month. Assisted living costs around $6,500.00 per month. Nursing home around $8,500. Do the math. How long will your parents be able to afford private pay before the funds run out? Medicaid is the next part of the answer. Our government has provided us with this safety net for long-term care called Medicaid. The problem, in order to qualify, one cannot exceed $2,000.00 in assets – resources- and can have income no greater than $2,250.00 per month (2018 amounts). So, if you are a person of modest means – let's say $300,000.00 in assets and $2,500.00 per month income, You do not qualify. Of course, there are exceptions and exemptions, but you can see the issue. Elder law attorneys know how to preserve assets yet still get clients to become eligible for Medicaid.
Step Three: Don’t panic. However, pretending all of this stuff in Part One and Part Two of this series will just go away, is not the answer. Get the facts. Make educated choices. Some people come into my office with wide, bloodshot eyes and tears running down their faces.
Remember, there are things that can be done, but first, pull out your documents, if you have them. Read them. Study them. Ask for help. As my father used to say, “A word to the wise…” So here is a word to the wise. What do you say to those who get all their “education” from Internet sites? Or T, radio, newspapers, their neighbor’s daughter’s, boyfriend’s uncle’s best friend? Look... I’m all for self-help, but know your source, look at references. A financial advisor may really be funny on the TV or radio -- so if you want “funny,” go for it.
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