Life Care Planning: The Best Protection for Elders and Their Families

Elizabeth D. Johnson
Legal Assistant

There’s a reason we call it "The Best Protection for Elders and Their Families."

Life Care Planning will help you make the best decisions to protect yourself later on. It can help you achieve your goals and reduce stress for yourself and for your family.

The primary goal of a Life Care Plan is to assist the senior and their family in being able to make legal, financial, and medical decisions without government or court intervention (such as a guardianship, which can be very costly), prolong the senior’s stay at home, protect their quality of life, and preserve their assets.

Over the next 25 years, it is estimated that the number of American households that are caring for an older relative will double. That means that care giving for elderly relatives will become as common as childcare. Care giving in this capacity can be costly, both for the senior citizen and for his family members. Most people want to stay at home (or with an adult child) rather than entering a nursing home. However, most people also don’t want to be a burden on their children, or their children live far away or are too busy with their own lives to provide care for their parents. 

Additionally, many people don’t have children or don’t trust their own family members to provide good care to them or make wise decisions on their behalf.  A Life Care Plan can address all of these issues and concerns.

It’s never too early to start thinking about all of this. One must be prepared for a future where you may not be in control so that your best interests and wishes are carried out properly. So often, clients come to us only when there is a crisis, at which point there are far fewer options available.  By planning early, you can establish your overall priorities and make a plan that meets your goals and adapts to you as your medical or financial situation changes.

You may ask why a law firm would be at the center of the Life Care Plan. So much of the aging process intersects with the law (estate planning, long-term care planning, probate and trust administration, etc.). Instead of stepping in when there is a crisis, a Life Care Plan allows the law firm to be part of the aging process from the start, to maximize the legal options available to the aging client when needed.

So, what is included in a Life Care Plan? First, you would meet with an attorney to discuss your unique goals, conduct a thorough analysis of your financial situation, and determine eligibility for government benefits. Then there would be a medical assessment and on-site evaluation of your current living arrangements with an elder care coordinator (ECC) who has a background in health care and social work. Finally, the attorney and elder care coordinator would work together to develop your Life Care Plan: a written assessment of your current situation and plan for implementing your goals.

The elder care coordinator will work as liaison between you, your family, and all facets of aging: financial, legal, medical, and senior resources. Your elder care coordinator will put you in contact with various senior resources to enhance quality of life, such as resources to help you age in your own home, or, eventually, find facility care that meets your needs. The average person going through the aging process for the first time likely does not know about these various resources and programs in the area, but the ECC already has this knowledge from helping many other clients age gracefully.  If you do eventually need facility care, the ECC can visit you in a facility unannounced to see how you are really being treated. The ECC will know what to look for and can identify subtle problems that your family members might not recognize.  Because the law firm is at the center of your Plan, an attorney can step in and advocate on your behalf to a long-term care facility as soon as the ECC notices a problem.

A Life Care Plan also includes a comprehensive review of your current estate planning documents, if you have them, and creating new estate planning documents for you if you do not have anything in place. Your attorney will also discuss how you plan to pay for care. Do you have long term care insurance, Medicaid, or will you be paying out of pocket? If you or your spouse is a veteran, you would want to look into veteran’s benefits. Your Life Care Plan will also provide safeguarding against financial abuse. Financial abuse and exploitation is more common than people may realize, so your attorney will go over options on how to protect yourself and your assets.

Finally, your Life Care Plan will be an ongoing relationship that adapts to your needs. We will be aware of your family dynamic and will be on the lookout for suspicious or unusual behavior. When sudden changes occur (health issues, death in the family, etc.), your ECC will not have to play catch-up, but can instead step in to solve problems as soon as they appear. We will already be very familiar with your finances and medical situation so that we can step in and help immediately.

In conclusion, proper planning for your aging can be expensive and there are many individual components to consider. A Life Care Plan combines all of these individual components into a single, cohesive plan. Providing input now lets you take control of where and how you age and takes stress off of loved ones. A Life Care Plan is a gift to yourself and your family and an investment in your future.

If you would like to learn more or schedule an appointment, please give us a call.

Medicare vs. Medicaid

Barbara K. Armstrong
Paralegal

I am often asked what the difference between Medicare and Medicaid actually is. So, I decided to do a little summary on the differences that I hope you will find helpful in the event that you, a relative, or a friend has questions. 

MEDICARE:

Medicare is a federal health insurance program for individuals 65 or older, under 65 with certain disabilities, or any age if they have End Stage Renal Disease or ALS. The federal government provides coverage and it is paid for from payroll tax.  The coverage depends on the type of plan you choose and may include the following:

• Care and services received as an inpatient in a hospital or skilled nursing facility (Part A)
• Doctor visits, care and services received as an outpatient, and some prevent care (Part B)
• Prescription drugs (Part D)

Medicare Advantage plans (Part C) combine A and B coverage, and often will include drug coverage (Part D) as well. Medicare costs depends on the coverage that is chosen.   The costs may include premiums, deductibles, co-pays and coinsurance. Upon reaching the age of 65 years, many people are enrolled in Part A automatically.   To be sure of your eligibility, you should contact your local Social Security office.

MEDICAID:

Medicaid is a joint federal and state program that helps pay health care costs for people and families who have limited income and resources.  There are different programs that are designed for specific populations. Although Medicaid is a joint program, it is governed by the state you reside in.  Each state creates its own Medicaid programs, which have to follow federal guidelines. Mandatory benefits include, in part:

• Care and services received in a hospital or skilled nursing facility
• Care and services received in a federally qualified health care center, rural health clinics of freestanding birth centers (licensed or recognized by the individual state)
• Doctor, nurse midwife, and certified pediatric and family nurse practitioner services

Medicaid costs depends on income and the rules of your state. Costs may include premiums, deductibles, co-pays and coinsurance. Certain groups are exempt from most out-of-pocket costs. Eligibility for Medicaid depends upon the state that you live in. If you think that you may qualify, you should call your State Medical Assistance (Medicaid) office to inquire.