Coming out From the Rock: Everybody Needs Somebody Sometimes

Help. We all need it to get through our day-to-day routines.

Someone turning 65 today has almost a 70% chance of needing some type of long term care services and supports in their remaining years (LongTermCare.gov). Those are some pretty good odds.

What kind of support a person needs and receives has a major impact on their quality of life. It can determine where they live, affect their health, and more.

It is important to think about what that support might look like so that you can have everything lined up when your LO needs it.

Here are some questions to ask when it comes to preparing for the help your LO needs.

How does my loved one want to be supported when their needs change? 

Ask straight up what they want. Most people have a pretty good idea of what a good life would look like for them.

I’m pretty sure your family members first answer isn’t going to be “moving into a nursing home.” So I wouldn’t use that as a jumping off point.

Who does my LO want to make their decisions about their care if they’re no longer able to do so?

Everyone (aging or not) should have a document called a Durable Power of Attorney. This document outlines who a person trusts to make their decisions about their affairs, like finances, living situation, health care.

Get on the same page about this and get it in writing. This document is prepared by a lawyer, so it means you will have to fork over some cash to get it done. It will be worth it for you in the long run. 

When you have the document finalized, make tons of copies of it – you will be handing them out left and right at the bank, the hospital, the doctor’s office, and anywhere else you have to act as that person’s official rep. 

Who will provide their care when they need it?

There is no one size fits all solution when it comes to caring for a loved one, no matter the situation. Most people use a combination of different types of supports in a variety of settings.

Family and friends

What are our family dynamics like? What capacity does our family have to care for them?

Families are the core unit of society and the primary source of support for most people who are aging or have a disability.

Obviously, families come in all shapes and sizes. Depending on the size and resources of your family, you may be able to meet your loved ones needs without relying solely on community services and government supports.

All hands on deck! If you have a large family, with lots of siblings, cousins, you’re probably in good shape. Everyone can pitch in a little so the burden of care doesn’t fall on one person.

You may find that leveraging family and friends as a support might not work for you. Some people don’t feel comfortable getting up close and personal with their family members. Getting older often means needing more help. It’s vulnerable. It’s sometimes embarrassing. Sometimes it’s easier or more comforting to have a ‘professional’ coming in to do things like dressing, toileting, and bathing.

Others have limited social capital. They might be elder orphans, which means they don’t have siblings or offspring. Or they may be estranged from their family members. 

The good news is, either way, there are supports for families who are caring for seniors…. which leads me to the next question:

Are we aware of options and resources for people who need help to age in place and live independently if we decide we need some help?

You may find out that you need more information before you can really have this conversation and make decisions. That’s okay. There are piles and piles of information out there about options for senior living and services.

The best way to find out what’s available to your aging loved one is to get in touch with your local Area Agency on Aging. You can find it at eldercare.gov

What assets does my loved one have to pay for care in their home or in a residential setting if they need it? 

These assets can include:

• Retirement and pensions 
• Investments, stocks, and bonds
• Rental properties
• Savings

Another asset some people have is a Private Long Term Care insurance policy. Most LTC insurance plans have a *HCBS (Home & Community Based Services)* benefit, which will allow you to pay for care in their home. These insurance plans are accepted by home health providers to pay for any professional caregivers they may need to come in and assist them. 

(We talked more about assets in the last post of the series: All About the Moolah.)

Would my loved one qualify for Medicaid (not Medicare)?

Remember, Medicare does not pay for in-home care. However, Medicaid is a publicly funded program based on financial need that does cover long term care in in nursing homes, and long-term care services provided at home, such as visiting nurses and assistance with personal care. You can learn about what Medicaid covers here: https://longtermcare.acl.gov/medicare-medicaid-more/medicaid/index.html

In some states, your loved one can ‘hire you’ as a paid caregiver through Medicaid’s self-directed long-term services and supports (LTSS) waiver programs. Learn more about that here: https://www.aarp.org/caregiving/financial-legal/info-2017/you-can-get-paid-as-a-family-caregiver.html

The caveat to Medicaid is, you have to financially qualify for Medicaid. So this normally means a person has already forked over all of their assets for their care and are in dire straights, or they never had the means to get the care they needed to begin with. When you are on Medicaid, you’re not allowed to have assets like life insurance policies, checking and savings accounts, stocks and bonds, certificates of deposit, real estate other than your primary residence, or a car. (Because if you had all those things, then you wouldn’t need the government’s help, right? Let the eye rolling commence.)

The other thing to know about Medicaid, is any assets are counted between a married couple. In most states, a couple is not allowed to have more than $3,000 in assets. It is vital to know about asset limits and eligibility criteria when considering Medicaid as a support.

In the next post in the series, we’re going to look at questions related to where a person will live as they get older. A lot of people think that old people ‘go live in nursing homes.’ There is often more to just getting dropped off at a skilled nursing facilities. It is normally the last resort or a decision made in response to a crisis. I will guide you through some questions to discuss how to make home sweet home possible for your LO as they get older.

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