Life Care Plan: What is it?

Many adult children and their spouses are faced with how to care for very elderly parents. They have also been dedicating all their spare time and more to give help to the parents at home and have learned that giving care full time is not an easy job. The time commitment alone is wearing. Another lesson learned is that it is a big learning curve, which is true. It not only involves the physical, but the financial and legal aspects as well.

The physical part is what kind of care is needed and how much. Is it simply helping with household and personal tasks due to mobility, or cognitive issues? Or is it help with bathing, dressing, feeding, and more? If the parent is fully on board with getting help, that is a big plus. But if the parent is resistant to accepting help, that can be a serious problem. And that often happens, because it is not easy for anyone to admit to themselves that they cannot do certain things safely or properly. It is a sign they are losing their independence and no one likes that. So the child caregiver has to learn how to suggest, encourage and motivate that parent, to limit certain activities, such as using a stove, or going up and down stairs, or bathing without supervision due to risk of a fall.

After decades of assisting families to get care, we know that paying for that care is the huge issue. Will parents have enough money to stay in their home, and if needed, pay for care? Families are “up against the wall” in figuring out how they are ever going to solve the care issues, including handling finances and qualifying for Medicaid, or VA benefits, or Connecticut state programs to help pay for care. A life care plan addresses what kind of care you need, where you will get it, and how to pay for it. We help you by guiding you on what to do, how to do it, and how to pay for it.

That is why what we call a life care plan can be a tremendous help to the family. An experienced elder care coordinator who knows the physical problems of aging, and the solutions, can guide the family in making the home safe and livable for a parent, and getting appropriate outside aid so the children do not burn out with the physical and psychological strain. A life care plan is a comprehensive plan to get the care the parent needs to stay at home, if physically possible, and qualify those elderly parents for the programs that can pay for the care they need. If homecare is not feasible, then finding an assisted living facility or as a last resort, a nursing home may be the best option.

A Medicaid or VA paralegal or elder care coordinator can assist in getting care paid for by a government program, while the family uses the parents’ money to pay normal living expenses. In most husband and wife situations, all assets can be saved for the healthy spouse. Even for a single person, there are often options to save assets while getting care paid for by a government program. In some cases the child can get paid by Medicaid for giving personal care.

The third aspect of a life care plan is to have all the documents in place, so that the family has the ability to handle the assets, apply for programs, and preserve as much of the life’s savings as possible. That involves a power of attorney with special powers that allow the family to take full advantage of all the laws that protect assets. An example is to have a power of attorney with language that permits a 401k to be transferred to the healthy spouse, without paying income taxes, and then qualifying the sick spouse for Medicaid to pay for care. That means significant savings that the couple needs to live on. And in cases where one spouse needs care, and the family’s savings are put in the healthy spouse’s name, that healthy spouse needs a special will with a trust inside it that will protect the assets if the “healthy” spouse dies before the one needing care. A dramatic example is a case where a spouse needing long term care was in a nursing home and the family had several hundred thousand dollars. The other spouse was also in the nursing home, but with terminal cancer. All the money was put in the name of the terminally ill spouse with cancer and when that spouse died a few months later, all of the money was saved by the special will with a trust inside it. Only 1/3 of the income that money earned had to be paid for care, and the surviving spouse went on Medicaid for several years before passing away.

In every life care plan, there needs to be an experienced elder care coordinator to solve care problems that will arise, a Medicaid or VA paralegal who knows how to process the application, and an elder law attorney to advise the family on the options available. That way the family can get the appropriate care needed, preserve as many assets as allowed under the laws, and keep mom or dad in the best living situation possible. A life care plan is a huge help in keeping mom or dad safe and the family satisfied that everything possible has been done to care for dad or mom in the best living situation possible.

Attorney Stephen O. Allaire is Of Counsel and Attorney Halley C. Allaire is principal in the law firm of Allaire Elder Law, members of the National Academy of Elder Law Attorneys, Inc., with offices at 271 Farmington Avenue, Bristol, (860) 259-1500, or on the web at www.allaireelderlaw.com. If you have a question, send a written note to either attorney at Allaire Elder Law, LLC, 271 Farmington Avenue, Bristol, CT 06010, and they may use your question in a future column.