LIFE CARE PLANNING
Since the beginning of 2006, we have taken a different approach in our office regarding care of our clients. We have added to our staff Marie Leiker, RN/BSN, as a Geriatric Care Manager, who now oversees the care of our clients enrolled in Life Care Plans. Life Care Plans offer a holistic approach to coordinate family, health and legal issues for our clients. The following is a version of an article I recently wrote for the Kansas Senior Times.
For this month’s article, let’s ignore the laws and politics that affect the elderly. My heart breaks when I am dealing with a client who has saved all of his or her money, no matter how little or how much, and ignored legal, health, family and personal care matters. So many times we deal with clients or their loved ones jumping straight from their home right into a nursing home. That sudden jump could have been prevented with appropriate planning.
Kansas people are tough. Many have been through rough times. We go through life making do with what we have, saving for our families or for that rainy day. We are independent — we do not need others. We rely on ourselves — or our families — no matter what.
While this may be a trait that is sometimes admirable, sometimes it is a trait that is destructive – financially, physically and emotionally. Not only is it destructive to the elderly person, it is just as destructive to the family and the others trying to give care.
Statistically, it has been established that the older you are when you go into a nursing home, the shorter your stay will be. The shorter your stay, the less money you will spend on nursing home care; thus, the less of an impact nursing home care costs impact your spouse and family.
Let’s take a simple analogy: If you have a leaky sink, you will save money up front by not getting it fixed. By not getting it fixed right away, you can use that money for something else, right?
But, by not fixing the leak early on, the simple leak begins damaging other parts of your home: first the cabinet, then the floor, then the subfloor, and then even the very structure of the home. Your problem has gone from a $50 fix to perhaps a permanent, nonrepairable problem.
So it is with our lives as we grow older. We need to take care of ourselves when problems arise; more than at any other time, we need to take preventative measures. We need to be willing to intervene and not just accept chronic health issues as “part of getting older.”
When people first come to see me, many want to talk about Medicaid planning, or end-of-life planning. I want them to focus on PLANNING FOR LIVING! And, even better yet, LIVING WITH A PLAN!
Legal and health care decisions need to be integrated; they need to work together and compliment each other. Each needs to be able to respond to changes in the other.
Let’s look at some specifics: A power of attorney for healthcare can be vastly different for people with one type of illness versus people with another type of illness. A living will may need to be adjusted as one grows older or develops different or other chronic illnesses. Wills and trusts may need to be established or modified if Medicaid is a possibility. Long term planning may be called for with the early onset of certain chronic illnesses. Long term care insurance can be used as a planning tool, allowing preservation of assets for your family and allowing you to engage in long term estate planning. With certain chronic illnesses, minor modifications to one’s home may ensure more safety and thus increase the ability to stay in one’s own home. Utilizing and coordinating various free services helps many chronically ill people stay in their home for longer periods of time. The list goes on and on.
A nursing home with associated expenses will cost $3,500 to $4,500 a month (in our area). What if you took the equivalent of one or two months of nursing home care costs and spent it on planning for and addressing your care? If that delayed your need for nursing home care for six months, the savings would be $19,000 to $23,000.
But what if the nursing home is delayed for a year or more? Look at the savings for yourself, your family, and even perhaps Medicaid. By taking care of yourself now, you will live more healthy and independently for a longer period of time.
When people come in to see us about Medicaid or estate planning, and they are faced with a chronic illness, we try to refocus them on setting up a PLAN FOR LIVING. We have a geriatric care manager that assesses the potential client’s status, and based on that assessment, we then start making a coordinated plan that addresses their legal and healthcare issues – then we tie them all together. We also address the various resources that are available to the person who is chronically ill, as well as resources available to their care givers.
We do not stop there. After a “plan” is in place, we continue to work with the client and their families, both through our legal work and through our care coordinator. The “plan” may need, and most likely will need, to be changed over time. That may be because of the changing laws, changing family situations or changing health needs, or a combination of all of those. Changing the plan is appropriate.
YOU NEED TO BE ABLE TO FIND, GET AND PAY FOR GOOD CARE FOR THE REST OF YOUR LIFE. THE GOAL IS TO ALLOW YOU TO STAY SAFELY AT HOME OR IN THE LEAST RESTRICTIVE ENVIRONMENT AS LONG AS POSSIBLE AND TO HELP YOUR FAMILY AND PROTECT YOUR ASSETS. My experience is that is what we really want and need.
When faced with a chronic illness for yourself (or a loved one), make your priorities in the following order: (1) Promote your good health, safety and wellbeing at all times; (2) address asset management issues; (3) make good decisions for yourself relating to your healthcare and long term care needs; (4) protect your assets in case you need nursing home care; (5) protect assets for the benefit of your family; (6) restructure your assets to make estate administration easier after your death; and (7) avoid probate and other costly proceedings after your death.
I encourage you to seek assistance on setting up your PLAN FOR LIVING.