There is no question that long term care for the elderly is expensive. Similarly, there is no question that as the population ages, the cost of long term care will continue to increase if for no reason other than the basic economic propositon that increased demand pushes prices higher when the supply doesn’t increase proportionally.  With boomers turning 65 at the rate of 10,000 a day there is practically no way for supply to keep up with demand.


It’s also true that everyone doesn’t have the financial resources to obtain Cadillic levels of long term care for their elderly family members. That doesn’t mean that you should throw in the towel and take whatever care is available for your elderly parent, sibling or spouse.

Long term care planning, whoever your are, whereever your are, whatever the physical or medical condition of your elderly loved one, and whatever your financial circumstances, can help ensure that your elderly loved one receives the best care available for their own needs. Long term care planning includes ensuring that you receive all of the financial benefits that you may be entitled to receive, such as Medicaid benefits or VA Pension Benefits (Aid and Attendance).

So, where do you start?

Where you start will depend on whether you are in a “crisis” mode or if you are doing “advance” planning.

“Crisis” Planning

A “crisis” mode does not mean there is a medical crisis.  It means that there is an immediate need to take some kind of action regarding the long term care of the elderly adult.  Often it is caused by a fall, stroke, or other incapacitating event that causes an immediate need for nursing home care.  The first step for this type of planning usually involves finding an appropriate skilled nursing facility to provide rehabilitation or residenctial care for the stricken elderly person. The second step usually is to find a way to pay for the long term care without depleting all of the eldedly person’s financial resources, or to find a way to pay for the long term care when financial resources are limited.

Often, when this kind of planning is required, there have been no advance directives put in place, and it sometimes is necessary to have a court supervised guardianship established so that someone has the legal authority to act on behalf of the elderly person. The expensive, time-consuming, and invasive guardianship usually can be avoided if advance directives are in place before the “crisis” arises.

Advance directives include: (1) a durable power of attorney for financial matters; (2) a designation of health care surrogate to provide for medical decisions when you are unable to communicate with your medical care providers, and (3) a living will.

Advance directives should be prepared, ahem, in advance of the need for those documents. If the elderly person no longer has “legal capacity” to sign such documents, the court-supervised guardianship may be the only option available to provide the legal authority necessary for a family member or loved one to make decisions on behalf of the now incapacitated elderly person.

Advance Planning

If you are not in a crisis mode, and are preparing for the inevitable need for long term care in advance, your first step should be to work with an
elder law attorney who can help you design and implement a long term care plan that works for you and your family, based on your financial circumstances and medical condition. 

An experienced long term care attorney can help you prepare for your long term care needs by providing the advance directives discussed above, as well as assist in restructuring your assets so that your long term care needs financially do not impoverish your spouse, and help you preserve the assets you have accumulated during your lifetime are not exhausted by the costs of your long term care.

Legal Options

Your long term care attorney may use trusts, the re-titling of assets, a long term care spend down plan, or other options to ensure that your assets and financial resources are protected from the rising costs of long term care, and yet ensure that you receive the best long term care available for your circumstances.

The most effective planning can be accomplished before the planning is needed, so don’t wait until you’re in crisis mode if you want the best planning available for you and your family.

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