The title of this article lists items that are in almost everyone’s house and from the time we learn to safely use them at age three or four, we don’t give them a thought. They are just part of our daily lives. But as we get up in age, those three items can become more dangerous to us than when we were toddlers. Most toddlers experience falls in their learning to safely use stairs, tubs, and rugs, and bruises and pain dissipate over hours or days and there is seldom long-term impairment. But when someone is 80, instead of 8, a broken bone, or dislocated joint, or concussion may not heal very well, or may incapacitate an otherwise self-reliant elder person to the point where they cannot stay at home. It’s our experience in aiding families get care for their loved ones that the single biggest reason for needing long term care, starts with a fall. Let’s be realistic, bones, muscle cells and that old brain just do not recover as fast, and sometimes not at all from the dreaded fall.

The five year rule is based on a federal law that is intended to prevent a long term care applicant for Medicaid, (Title 19), or a spouse, from giving away assets in order to qualify for payment for that care. It does not matter whether the sick spouse or the healthy spouse gives away the assets. It will create a period of time, called the penalty period, during which the state will not pay for the care. It is important to know that the penalty period does not begin until one of the spouses is in a nursing home, or has reduced their countable assets to the eligibility amount and is otherwise functionally eligible. The sick spouse is limited to $1600, and as of January 1, 2024, the healthy spouse can keep up to $154,140 of countable assets. The state doesn’t simply rely on what the applicant reports in the application. A caseworker will check the land records to see if a deed has been filed to transfer title. They will also see a social security number, check if the applicant and spouse have any bank or investment accounts, life insurance policies or annuities that have existed during that five year look back period. The Medicaid caseworker can look at any and all transactions to see if assets were given away. If there is a deposit in an account, the caseworker will ask where that came from if the source is not clear.

Everyone in Connecticut knows the old saying that autumn leaves must fall and indeed that is what we are experiencing right now. A staff member at Allaire Elder Law came up with the bright idea of comparing the changes of color on leaves to the changes in life as we age. When we are young and full of energy, we are like those green leaves of summer. But as the decades go by and people move into their 60’s, 70’s, 80’s or older, that aging body starts to lose some muscle mass, coordination, and increases muscle and other pains to let us know we are not young anymore. That’s natural, and fine as it goes, until physical or mental declines reach the point where the activities of daily living (ADLs) become difficult to do. Those are bathing, dressing, feeding and toileting yourself, and transferring into or out of a bed or a chair. Risks to safety awareness can also arise. When one or more of those activities of daily living (ADLs) start to decline, it is the body’s sign that the autumn of life has arrived. Fortunately for us humans, that is usually a multiyear process, and we need to modify our daily activities to account for the physical and mental decline.

At some point in every adult’s life, whether birthdays or health problems or family changes such as birth of a child or parents needing care makes us think about what happens to our assets and our families’ well-being when those changes occur. Here are some thoughts derived from years of experience.

When a parent suffers a stroke or other acute illness, the family is suddenly faced with difficult and costly decisions about where to get care and how to pay for it. There is also another matter of great concern, and that is who is legally liable to pay for very expensive long term care, either at home or in a nursing home.

Sooner or later every generation faces the minor or major issues, involving safety, care, and living arrangements as parents age. Physical ability, mental acuity and increasing dependency on help from others are the issues that have to be addressed. Let’s look at a typical aging couple and in this example assume the husband is developing a degree of dementia and decline in motor skills.