Discussing Long Term Care
With an estimated 70% of Americans needing some personal care assistance after age 65, planning for long-term care should be an integral part of everyone’s estate plan. It’s better to talk about long-term care and make a plan before you’re confronted with an emergency situation. Advance planning means that you’ll have more options to secure proper care, protect family wealth, and ensure that loved ones don’t become impoverished by the high cost of care.
Start With a Calm Discussion About the Future.
Most adults are reluctant to discuss the possibility of needing long-term care, so it must be addressed thoughtfully. 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.
It may help to start with a discussion of your own plans. By being open and transparent with your wishes for care, your parents or other loved ones may be more willing to discuss their own plans.
Financial Concerns for Long-Term Care
Most people’s first concern about long-term care, whether in-home or in assisted living, memory care, or a nursing home, concerns its impact on their finances. Long-term care costs are expensive.
According to Genworth Financial, the average cost of in-home care in 2024 in the Dallas area is $5,200 per month (40 hours per week). Assisted Living in the Dallas area costs an average of $5,241 per month, but does increase as care needs change over time. Specialized Memory Care communities are even more costly. Nursing home care in Dallas costs an average of $5,688 for a shared room and $7,178 for a private room. These costs do not include medications, medical appointments and procedures, or hospitalization.
Long-Term Care Insurance
Find out if your parents bought long-term care insurance and ask to see a copy of the policy. Policies vary, but a typical plan will have a 90-day “elimination period” (number of days you need to be receiving care or residing the the care community) before eligibility is triggered. The plan will then usually have a per-day benefit for a certain number of days. Other plans have a maximum benefit amount. If you don’t understand the plan, ask a professional for help. As a person ages, and/or their health deteriorates, the cost of premiums for a new policy rise, becoming prohibitive.
Medicaid
If the family anticipates needing Medicaid to cover the cost of nursing home care, it is best to plan ahead. In Texas, Medicaid very rarely covers Assisted Living Care. Nursing Home Medicaid qualification is complicated, and it’s best to work with an experienced Certified Elder Law Attorney to ensure approval the first time you apply. Medicaid has a five-year look-back period for asset transfers. Any transferred assets will be discovered, and could result in penalties, and coverage being denied.
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. There are just a couple of continuing care communinties in the Dallas area. It may be helpful to work with a Placement & Referral Agent to locate the right community.
Plan for the Legal Aspects of Aging
If your aging parents have an estate plan, when was it last reviewed? We often meet with clients who haven’t updated their will since their children were minors. Estate Planning Documents should be reviewed and updated every few years or whenever there has been a significant change (births, deaths, divorces, moves, etc.)
An estate plan should include several documents addressing incapacity. These include a Durable Financial Power of Attorney, so a designated person can manage financial and business affairs. A Power of Attorney for Healthcare is also needed if the person cannot express their wishes for medical care. A Living Will is a separate document containing written wishes for treatments.
Long term care decisions are complicated and often require professional guidance. It may be helpful to hire an Aging Life Care Manager who can complete an evaluation and help you navigate the
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