Probably one of the best things about being an estate planning and elder law lawyer is that I get to work with and help seniors. I am often dealing with the adult children of elderly parents as they are suddenly dealing with a crisis with Mom or Dad or a slow evolving process of needing to help them out as they age.
There are two main issues for us to discuss if you are helping an elderly parent. The first issue we need to discuss is whether Mom and/or Dad have their estate planning in place and updated. Do they have a will? Is there a trust? Have their assets been transferred into the trust? Is there a recent power of attorney allowing you to make decisions for them (if they want you to do that)? The cutoff for completing estate planning is competence. Once a person loses competence, we lose a lot of ability to proactively complete estate planning for them.
There are alternatives. Without a power of attorney, we’ll have to file a petition for guardianship to have the court appoint you as the legal representative.
We usually see outdated or incomplete estate planning with older clients and that’s why it’s especially important that we tackle this issue first. Because going forward, those documents have to be done before it’s too late.
The second issue is whether Mom or Dad should stay at home, can move to an independent living facility (the next best thing to being at home), should go to assisted living or must go into skilled nursing. This largely is going to hinge on their medical condition and whether Mom or Dad wants to move. If they are going to a facility the question then becomes how are they going to pay for that? It is one of the unfortunate quirks in our healthcare system that physical ailments (such as heart problems / strokes) are paid for nearly in full by Medicare, regardless of age, but diseases such as Alzheimer’s and other forms of dementia are not covered when they require more extensive and prolonged care for their patient.
Depending on the type of facility, there are a few different ways to pay for long term care. The first is private pay. Next and best is long term care insurance. Then there are government programs such as VA Aid and Attendance and Medicaid.
VA Aid and Attendance is available to veterans and surviving spouses of veterans who have served one day in a war time period, had 90 days of active duty and were discharged honorably, are in need of the “aid and attendance” of another person with the activities of daily living and have limited assets and income.
Medicaid is a federal program administered through the states and is much more stringent in the amount of assets an individual can have (in Missouri, less than $1000.00).
No matter what the circumstances, you will need a competent estate planning and elder law attorney to guide you through the process. Estate planning and elder law has a lot of moving parts and they are constantly changing.