As you or a loved one ages, a time may come when long-term care is needed, either at home, in an assisted living facility, or within a nursing home.
The legal and financial aspects surrounding long-term care can be overwhelming to manage.
An elder law attorney has specialized knowledge to help protect your rights, property, and well-being while accessing and paying for care.
Understanding Long-Term Care
Long-term care refers to a variety of supportive personal and health services for seniors or disabled individuals needing hands-on assistance, supervision, or medical care for extended periods.
This type of care aims to help people live as independently and safely as possible when they can no longer perform basic daily activities on their own.
You may require long-term care services if needing help with:
- Personal hygiene – bathing, dressing, grooming
- Mobility – getting in and out of bed, walking, climbing stairs
- Eating – assistance eating meals and drinking fluids
- Toileting – getting to the bathroom, incontinence care
- Cognition – memory loss, disorientation, dementia behaviors
- Health monitoring – diabetes, blood pressure, wound care
- Housekeeping – laundry, cleaning, cooking meals
- Transportation – to medical appointments, errands, social functions
Long-term care can be provided at different levels depending on need:
- At home from family caregivers, home health aides, nurses
- Adult daycare and senior centers for socializing and activities
- Assisted living communities with some healthcare support
- Skilled nursing facilities for round-the-clock medical oversight
Deciding whether long-term care is necessary and choosing the right setting requires planning well in advance when possible. An elder law attorney can navigate the complex legal and financial landscape.
Key Ways an Elder Law Attorney Can Help
A lawyer specializing in elder care law has the expertise to assist seniors and families on many fronts including:
1. Advising on Medicaid eligibility
Medicaid is the primary payer of long-term care services, covering some costs for those meeting state eligibility thresholds for income and assets. Determining one’s eligibility status and taking steps to meet guidelines can be extremely complicated.
An attorney familiar with Medicaid regulations can offer guidance on qualifying even when financial criteria seem challenging to meet. Proper advanced planning is crucial.
2. Assistance planning asset transfers
In some cases, seniors may need to transfer or convert countable assets, which could be subject to Medicaid look-back periods and potential penalties if not done carefully. An attorney can help plan appropriate transfers and conversions to maximize eligibility.
3. Handling applications and appeals
Attorneys are familiar with documentation requirements and processes for Medicaid and Veterans Affairs applications. They can also file appeals if benefits are denied. This can improve chances of successful enrollment.
4. Guidance on reducing home equity
Medicaid has limits on how much home equity you can shield. An attorney has strategies to potentially reduce your home’s equity value to meet Medicaid thresholds through special kinds of reverse mortgages, installment sales contracts, or life estates.
5. Setting up special needs trusts
These trusts allow seniors to provide funds for disabled beneficiaries without affecting their Medicaid eligibility. Attorneys can establish and administer special needs trusts.
6. Creating Medicaid Asset Protection Trusts (MAPT)
MAPTs shelter assets so they are not counted against Medicaid limits. The assets can then pass to heirs after Medicaid stops paying for long-term care. Attorneys establish specific language and protocols.
7. Assistance with guardianship and conservatorship
If there are questions about an elder’s ability to make financial or care decisions, the attorney can petition for legal guardianship and represent the senior at hearings.
8. Reviewing contracts
Attorneys can review admission and resident care agreements for assisted living or nursing homes to ensure favorable terms, reasonable rates, and protections if problems arise.
9. Providing referrals to geriatric care managers
These professionals can offer hands-on assistance researching care facilities, arranging home care services, and providing ongoing case management. Attorneys often have partnerships with geriatric managers.
10. Mediating family disputes
Attorneys can step in to mediate any disagreements among family members regarding aspects of long-term care planning and financing.
11. Preventing elder abuse
Cognitively impaired seniors in facilities are at risk for financial exploitation. Attorneys can watch for signs of abuse and pursue legal remedies.
12. Clarifying healthcare surrogate roles
An attorney can ensure documents clearly establish who can act as a healthcare agent or proxy to make care decisions if a senior becomes incapacitated.
Ongoing legal guidance maximizes financial resources reserved for heirs, prevents complications in obtaining benefits, and helps choose optimal care arrangements.
Professional Assessment of Care Options
Beyond the financial and legal dimensions, an elder law attorney can provide seasoned perspective regarding different long-term care placements:
1. At-home care
An attorney can outline pros and cons of hiring home health aides versus relying on family caregivers. They can also explain tax credits like the Dependent Care Credit which provides financial relief.
2. Assisted living communities
Attorneys have insight into what assisted living contracts entail. Some retain room deposits if care needs necessitate moving to a nursing home. An attorney can negotiate terms.
3. Skilled nursing facilities
Attorneys can interpret terms around discharge for hospitalization, Medicare coverage, and resident rights. This protects against being compelled to leave if more acute care is needed.
4. Adult day services
An attorney explains when these services might address care needs, typical costs and hours, and transportation logistics.
5. Specialized memory care
Attorneys grasp enhanced staffing, activities programming, security protocols, and environmental design of memory care units, including potential additional fees.
6. Multi-level senior living campuses
Some communities offer the full continuum – independent living, assisted living, memory care, and nursing home care – in one location. Attorneys advise the benefits.
Armed with expertise around senior housing and long-term care, an attorney serves as a knowledgeable, impartial advisor examining all aspects of a situation to recommend suitable care strategies.
The labyrinth of financial, legal, and care decisions surrounding long-term services can leave families feeling overwhelmed and uncertain where to turn. An elder law attorney eases these stresses.
Their specialized legal background combined with expertise in senior care resources helps protect assets and benefits, weigh placement options thoughtfully, and advocate forcefully for your best interests.
If you or your loved ones may have long-term care needs on the horizon, consult an attorney who can start planning discussions early when possible and remain involved implementing strategies over time. With proper guidance, you can move forward confidently.