Three families came this past week to discuss the problems and stress of giving care to a spouse with some degree of dementia. In each case the caregiving spouse, all of whom happened to be wives, talked about and exhibited signs of the toll it was taking on them. They were not getting sleep, were anxious for their spouse and themselves, and felt overwhelmed by the unrelenting demands. They were incredibly devoted to their husband’s care, but reluctantly came to the realization that their own health was suffering, and that if they themselves became sick, that was bad for both spouses. What could they do?

After a person suffers a medical crisis, such as a fall, or a stroke or heart attack, and after hospital treatment ends, rehabilitation services are often required to get the person back to the best possible level of functioning. What services are needed, where to get them, and who pays are the critical concerns that all families have. 

Life changes occur for people of all ages, and for those in the senior population the choice of living options can become very important. Stairs could be more difficult to use, or an extra bedroom might be needed for a caretaker, or the bathroom may be impractical or downright dangerous for a person with poor balance. Here are some thoughts on the choices for living options.

Everyone wants to pass on some of their hard earned estate to their heirs. There are important things to consider when those assets are passed on. If the children are minors, or even young adults, they either cannot handle money, or may not have the experience and judgement to handle a sudden inheritance. A twenty year old may think a flashy new car is needed. Married children could be faced with divorce or health problems for themselves or their spouse. How can you protect your heirs who due to age, inexperience or family situations may not be able to hold onto their inheritance?

Rumors, fears, and casual conversations about Medicaid often lead to false and erroneous beliefs that deter a family from seeking help paying for home care, or nursing home care. One common belief is “the state will take everything”. In fact the state does not take anything. What it does do is make people spend their assets in accordance with the Medicaid rules until they are eligible. For example, a person living at home could pay off a mortgage, could buy furniture or a lift chair, could do prepaid funerals and could make improvements to their home. These are only a few examples of what the rules allow for a spenddown.

If you are taking a long road trip to a place you have never been, you probably are going to look at a road map to help make decisions on the route to choose. But nowadays, the GPS on phones or cars has provided a new method of guidance from start to finish. If you then deviate from the route, it recalculates and tells you a new route or routes to follow.