Michigan Estate Planning Blog

Planning for Late-In-Life Care

Planning for the health and proper care of an aging parent is no easy undertaking. That is a given. As a parent moves toward healthcare and assisted living there are myriad questions and issues to consider. These run the gamut from financial to medical and, yes, the emotional. By way of a primer, consider reading (and sharing) a recent Forbes article titled “The Basics: Assisted Living For Your Parent.” Some of the most important issues in planning for late- or end-of-life care include understanding the various kinds of facilities and treatments available. There is, for example, a decided difference between nursing home care and an assisted living situation. Even within assisted living communities there are many different kinds of facilities, from the large to the small and the homey to the clinical. In the end, you must know what to look for and what is appropriate for the elderly loved one in need of care. The key, if possible, is to include your loved in the evaluation process. Ensure that they are included in the discussions and options. Otherwise, expect resistance to change because the transition to care away from home is by nature very disruptive on many levels. Once you know the kind of care needed and your loved one is on board, then comes the question of how to pay for it and how to understand Medicaid, Medicare, and the programs that can help fill the gaps. Needless to say, this can be a complex process. Be sure to read and share the original article to help you and your loved one make a transition that is right for their circumstances.

Reference: Forbes (March 13, 2014) “The Basics: Assisted Living For Your Parent”

For more information, see www.jerryreiflawyer.com

Old Age Costs Rising

Are you planning for your old age or perhaps the old age of a loved one? If yes, then you know that such planning is all about getting a handle on healthcare. Unfortunately, the most recent study from MetLife indicates that the costs for long-term care and assisted living are rising at an even faster rate than in previous years despite the weak economy. According to the MetLife study: • The national average daily rate for a private room in a nursing home rose 4.4% from $229 in 2010 to $239 in 2011. • The national average monthly base rate in an assisted living community rose 5.6% from $3,293 in 2010 to $3,477 in 2011. • The national average daily rate for adult day services rose 4.5% from $67 in 2010 to $70 in 2011. • The national average hourly rates for home health aides ($21) and homemakers ($19) were unchanged from 2010. Businessweek offers some coverage of the development, along with the words of the director of the MetLife Mature Market Institute, Sandra Timmermann. According to Timmermann, “The state of the economy, combined with rising health-care and energy costs, are having a significant impact on long-term care rates.” Indeed, even though MetLife is the largest life insurer in the U.S., it also has discontinued its long-term care insurance policies for these very reasons. Likewise, the CLASS Act (the first public-option long-term care insurance) recently shut down. In the end, this is rather grim news for those planning for their old age or an elder loved one.

Reference:  Businessweek (October 26, 2011) “Long-Term Care Costs Rise at Faster Pace, Metlife Says”

Old Age Costs Rising

Are you planning for your old age or perhaps the old age of a loved one? If yes, then you know that such planning is all about getting a handle on healthcare. Unfortunately, the most recent study from MetLife indicates that the costs for long-term care and assisted living are rising at an even faster rate than in previous years despite the weak economy. According to the MetLife study: • The national average daily rate for a private room in a nursing home rose 4.4% from $229 in 2010 to $239 in 2011. • The national average monthly base rate in an assisted living community rose 5.6% from $3,293 in 2010 to $3,477 in 2011. • The national average daily rate for adult day services rose 4.5% from $67 in 2010 to $70 in 2011. • The national average hourly rates for home health aides ($21) and homemakers ($19) were unchanged from 2010. Businessweek offers some coverage of the development, along with the words of the director of the MetLife Mature Market Institute, Sandra Timmermann. According to Timmermann, “The state of the economy, combined with rising health-care and energy costs, are having a significant impact on long-term care rates.” Indeed, even though MetLife is the largest life insurer in the U.S., it also has discontinued its long-term care insurance policies for these very reasons. Likewise, the CLASS Act (the first public-option long-term care insurance) recently shut down. In the end, this is rather grim news for those planning for their old age or an elder loved one.

Reference:  Businessweek (October 26, 2011) “Long-Term Care Costs Rise at Faster Pace, Metlife Says”

ELDER LAW

Choosing the right nursing home for a loved one is no easy choice. There are simply so many factors involved, not least of which is cost, and there is always the ultimate concern that your loved one receive the proper care. Still, there are ways of determining the good from the bad. Reuters collected advice from several experts in a recent article and specifically pointed out the controversy surrounding the difference between for-profit and non-profit facilities. The article dwells on the legal battles of a former Florida state-appointed consumer advocate, Brian Lee, and the controversy there, but the central kernel is a suspicion of for-profit nursing homes. Last month the U.S. Government Accountability Office published a study indicating that for-profits had more frequent and serious deficiencies than non-profits. Indeed, it is not the first such study to come to that conclusion (see here and here, amongst many others.). Unfortunately, these decisions are seldom simple. For-profit nursing homes make up more than two-thirds of all nursing homes. So, most of us will probably be using a for-profit facility – but forewarned is fore-armed, so be sure to do your research. Experts indicate that a good starting point is the Medicare website and the ratings there, but you will also want to visit the facility to do your own fact-finding. Indeed, many say that you should visit at various times, the evening especially, and to do so unannounced to see what things are really like. Cleanliness, accessibility, and a pleasant environment are all important, but what is more important is to be sure that the residents themselves are happy and aware. It’s often not enough to simply trust a hospital discharge practitioner since they might not know best. Patience and persistence are key.

Reference: Reuters (August 23, 2011) “For-profit or not: what to consider when choosing a nursing home”

ELDER LAW

After four years or so the housing market is still idling at terribly low levels, but even if we’re all feeling it, it’s our nation’s seniors that seem to be uniquely hurt. The problem has been growing over those years, and I’ve written about it here, but the Kaiser Health News recently put out an article taking stock of the situation and new reactions from assisted-living and nursing home facilities. With housing prices and market demand so low, seniors simply can’t get up and enter into a facility, even if they need it. For many seniors, the plan had always been to use the equity in their home as the investment to keep them afloat in retirement but the value in those homes simply dropped in 2008. Even if you can forget how much the house was worth in 2007, before the crash, it’s simply not easy to sell a house these days and they tend to just sit on the market for years, or fetch too little money to make the sale possible. It’s causing seniors to wait that much longer before they can enter into a facility, and that’s time on top of however long it took them to finally make the decision to give up the home in the first place. It isn’t good for finances, and it is especially bad for health. The facilities themselves aren’t happy with the trend and some are working to help ease the transition. In certain facilities across the parts of the country that were hit hardest by the housing bubble the occupancy rate has dropped as much as 10%, with nursing homes and continuing care facilities hit the hardest and assisted-living only slightly better. In response, some of those facilities have begun incentive programs from simple real estate education classes to more fluid contracts that allow the entrance costs of the facility (usually something like the cost of a home itself) to be paid whenever the house is sold. One management company, Brookdale Senior Living, has even begun offering to buy seniors’ houses at pre-determined prices if they do not sell within a set amount of time on the market. For you or a loved one it means that there are a number of possibilities to plan for. Those that can’t quite get out of their homes might consider bringing the care to them through in-home care services or perhaps living with loved ones. Still, if a facility is necessary then there may be options out there, depending on the facility and your part of the country, and it might be possible to work with the administration; chances are you’re not the only one with the problem and they may offer a solution.

Reference:  Kaiser Health News (August 21, 2011) “Housing Bust Derails Some Seniors’ Assisted-Living Care”