The second most difficult talk to have with parents, after the first which is giving up driving, is the talk about money. It is a difficult and often times embarrassing topic between a child and a parent who is losing the ability to handle finances and may be vulnerable to fraud. Here are some thoughts.

Many people know that Medicare will pay for rehabilitation services in a nursing home if the patient has had a three day inpatient admission to a hospital. A physician must order the care in a nursing home and it must be related to the condition that resulted in the hospital services. Practically speaking, the care must only be available on an inpatient basis. The person must need to receive seven days a week of nursing home care, or skilled therapy five days a week or some combination seven days a week. This is the normal rehabilitation families know about.

Here is a story of the human spirit. A 96 year old WWII veteran has been living in an assisted living facility in New Jersey for over 4 years. One by one the old time friends have passed on and the nearest child lives over 3 hours away. The new friends she has made over the years provide needed companionship, and one or more family members would visit about every two weeks. Then Covid-19 hit.

Friends naturally want to help their friends and their thoughts and advice give comfort in life. Faced with medical or legal problems, however, nonprofessional advice may be incorrect, and could result in serious unintended consequences. The following is an illustration of how well intended, but wrong advice could affect a family’s ability to stay at home, get homecare paid by the Connecticut Home Care Program for Elders, and preserve an inheritance for children and grandchildren.

Assume a friend is talking with a couple that wants to do estate planning to minimize inheritance taxes, capital gains taxes, avoid probate, and pass on those hard-earned life savings to their children. The friend says the way to do that and to avoid probate is to put assets into a revocable trust. They decide to consult with an elder law attorney who evaluates their particular financial situation and based on that situation, the attorney recommends an irrevocable trust to accomplish all their purposes.

These three words represent critical questions on what kind of care a person with dementia or physical disability will need, where that care will be given, and who is going to pay for it.

COVID-19 has created an opportunity to reinvent how we think about long-term care.  Dr. James Wright, medical director of several Richmond, VA area nursing homes, has been on the frontlines of the COVID-19 pandemic.  Based upon his personal experience over the past several months, Dr. Wright will discuss why long-term care needs to change and how we can better care for our seniors going forward..