Have you considered that one of the most common side effects of aging parents seems to be an inevitable change in family dynamics? After being taken care of by your parents your entire childhood, followed by enjoying a beautiful co-existence with them as adults, it may now be time to take care of your parents. This can be a daunting task, but one thing may be certain in all of this. Planning for long-term care will likely make everything go smoother. With the holidays and family time approaching, it may be a good time to begin the conversation of long-term care planning. When talking to your parents about long-term care over the holidays, try to use these 5 tips:
Remember this is likely as challenging for them, as it is for you. As people age, there can often be a lot of fear surrounding the loss of control and independence. There may also be feelings of embarrassment with their children they always cared for now caring for them. Since you will likely have spent time thinking and preparing for the conversation, extend your parents the same courtesy by not ambushing them. Consider calling or sending an e-mail a few days before your visit, letting them know you would like to talk about their long-term care plan.
This is about their wishes too. While you may have your own ideas about what is best for your parents, allowing them to participate in the decision making process also allows them to retain their dignity.
Provide information. Your parents may want to do long-term care planning, but have found the entire process overwhelming. If you have done some research on wills, long-term care insurance, life insurance, and Medicaid planning, you may be in a good position to help them understand some of the basics.
Offer to assist. Instead of just providing information and leaving your parents to do the rest, offer to see the long-term care process through with them. For example, you can assist them in locating an elder law attorney and attend the appointments with them.
Consider another messenger. You know the old saying about lashing out at the ones you love the most. If the talk does not go as planned, consider having a more neutral party, such as their physician, broach the topic, and then, you can step in to assist.
While discussing long-term care planning with your parents can feel uncomfortable, you can take comfort in knowing they can relax in their golden years, once they have a secure plan for long-term care. For assistance establishing a long-term care plan, please reach out to our office to schedule an appointment.
‘Tis the season to give and receive, but did you know that this can have significant consequences if you need to apply for Medicaid in the next three to five years? Can gifts impact Medicaid eligibility? Yes, this can have impacts for both the giver and receiver.
Regarding the gift giver, it should be noted that the IRS allows a tax-free annual gift of fifteen thousand dollars per person with an unlimited amount of donees. In other words, a wealthy donor could gift away over a million tax free dollars per year by gifting a hundred different people the maximum fifteen thousand dollars.
It can be vital, however, to understand these are tax laws and Medicaid takes a different stance on gifting in terms of Medicaid eligibility. When a person’s assets are reviewed for Medicaid eligibility, this includes a “Look-Back” period of thirty to sixty months, depending upon the state. If it is discovered that the Medicaid applicant has gifted money in order to be eligible for Medicaid, the penalty is Medicaid ineligibility. The length of time of ineligibility is determined by the amount of the gift and the average cost of a private pay nursing home in the area.
A person deemed ineligible for Medicaid due to gift giving has some options. It is possible for the gifter to collect the gift back, or reimbursement, in order to “un-do” the penalty. Even if possession of the money makes them ineligible for Medicaid, they can spend it down by temporarily paying for long-term care or making a home modification related to their disability until they reach eligibility status. There may also be a possibility of an undue hardship waiver, if Medicaid ineligibility will cause the person to go without medical care, food or shelter.
There may also be important impacts on the gift receiver. All states have an asset limit to be Medicaid eligible and it is not very high. In fact, many states have limits falling in the range of fifteen hundred to two thousand dollars. Even a small gift can push a Medicaid recipient over the eligibility limit. Any gift received must be spent within a month in order to avoid affecting Medicaid eligibility. A Medicaid recipient has options if they receive a gift. They can pay off debt, purchase a funeral trust or a Medicaid eligible annuity. If money is received before applying for Medicaid, the money can also be spent down in a similar fashion.
If you will be giving or receiving money or other assets this holiday season and anticipate this may impact your Medicaid eligibility or someone else’s, contact our office to discuss your options.
At any given time, the majority of elder caregiving is performed by family members. Often, though, the elder’s health declines to the point that paid outside care services can be required for him or her. Whether due to an illness, like Alzheimer’s Disease, a debilitating injury or simply old age, the demands of elder health care can exceed even the most dedicated family caregiver’s capacity to give.
Shifting to paid care can be emotionally difficult, even when it is obvious that it is in an elder loved one’s best interest. A healthy transition can induce feelings of failure and guilt, especially if a senior loved one values his or her independence and resists.
Statements like, “I don’t need any help,” or, “I don’t want a stranger in my house,” can be crushing when you are trying to help. Just like a parent looks after the best interests of a young child, an adult child may need to look after the best interests of his or her elder parent.
Let us share a few suggestions for you to consider when launching into a paid caregiver dynamic:
Reassure an elder loved one that hiring help does not mean that you are going to abandon him or her.
Be present for initial meetings between the caregiver and an aging loved one to help establish rapport.
Show outside caregivers how to do things in ways that are familiar and pleasing to the senior adult to help them feel comfortable.
Tell an elder loved one that working with a care provider is something they can do to take part in his or her own care.
Include an elder loved one in the caregiver process by asking him or her to try it out for a week, and then listen to feedback.
When selecting caregivers, try to find a personality or cultural match to create a sense of common ground, although cultural differences also make for interesting combinations.
Once the relationship is established always check-in to keep an eye on things.
Above all, an elder loved one’s quality of life, and therefore, quality of care, is the most important objective in any caregiver relationship, whether family or paid. Feelings of guilt can be overcome in taking steps to achieve this important objective. We work with families each day to solve challenges just like the one described here. Let us know how we can help you and your loved ones today.