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Trying to talk my elderly parents into seeing an elder lawyer.

Posted: Tue Sep 10, 2019 11:45 am
by rai
So my unsophisticated parents 79 mother and 87 father. They are very modest living and don’t have much invested mostly live on SS and both have pensions. I don’t know the specifics but paid off house as well. No long term care insurance but may have some life insurance.

Anyway I told mom she should see an elder lawyer to get them squared away on any protections or trusts that may be applicable. I hear Medicare will pay for various services provided you are bankrupt or similar. Neither parent needs nursing home or in-home care yet.

Anyway both are not informed about anything regarding trusts and my mom has antidotal story of someone she knows who was put into something (trust? IDK) but the end result was she then placed in a ‘bad’ nursing home. I don’t know the full details. But imo if my folks ever had to pay for NH facilities they’re modest income wouldn’t go far at all.

So could anyone tell me the benefits and reasons why an elder lawyer would be needed and what services they provide so I can let my parents know. I’m not going to force them to do anything but just like to give some constructive advice.

Thanks

Re: Trying to talk my elderly parents into seeing an elder lawyer.

Posted: Tue Sep 10, 2019 12:08 pm
by Silk McCue
First I would recommend that you click on the link below and get an education on New Hampshire Medicaid. You can use the web to get a base education on this topic with just a small amount of effort.

Your parents don’t appear to have many assets and you did not mention any sizable IRAs, taxable accounts or other large assets. If that is the case then a Medicaid compliant trust isn’t going to do anything for you.

So basically just Social Security and pension, I’m not certain that there’s much planning that necessarily going to be put into place until the time that one actually needed the services and then an elder law attorney might be of assistance to structure income to qualify if their income was too much (that would use a Miller Trust but should not be done in advance) The house will not be at risk so long as either of them are alive.

There would be a five year look back for any trust created at this point.

https://www.dhhs.nh.gov/dfa/medical/adults.htm

Google “medicaid planning in new hampshire”

Cheers

Re: Trying to talk my elderly parents into seeing an elder lawyer.

Posted: Tue Sep 10, 2019 12:23 pm
by dbr
Right on above. The main complication is the house. It might be worth talking to someone about the strategy when one owns a home.

It is absolutely a good idea to investigate the options for care in a facility if one or both of the parents can no longer stay at home or even for care at home. A particular concern is getting support while allowing the other parent to stay in the house.

There may be an eldercare counselor available in your area that does not require going so far as an attorney. I think you need information more than legal action right now.

Re: Trying to talk my elderly parents into seeing an elder lawyer.

Posted: Tue Sep 10, 2019 12:52 pm
by Jack FFR1846
If you think that one or both of them will need to go into an assisted living facility, it's not too soon to go look at them. You can even do this on your own, and much can be done on the phone. We had a relative placed in a municipally run facility that's very good. Some very basic questions for them to answer:

Is there a waiting list and if so, how long is it? (if there's a 20 year wait, you can certainly cross them off)

What are the income limits? There could be both minimums and maximums. In our relative's case, her income was pennies from being over the limit because of an annuity. Keeping under got her a subsidized placement. Although the unsubsidized cost was all of 10% more.

Is there a private full pay period and what happens after that? In the facility we found (and others), there is a period of 2-5 years of full pay. In our relative's case, the sale of her house has taken care of this. There is no spouse. Once spent down, the facility handles medicaid plus her pension and annuity. No social security in her case as she worked for the state. If/when she has to step up to full nursing home, that's part of the deal.

From your description, I would think that any thoughts of a trust to move assets to the next generation would be detrimental to them as they might then be unable to full pay at a facility that they would want to go to. As you might expect, moving into an assisted facility without money coming in to pay for the facility is going to mean a "less good" facility. I don't think you want that. We did have to do a lot of talking with our relative who had always planned to leave her house to my wife and her sister. Part of the talks involved convincing her that neither my wife or her sister had any interest in her house (both own their own house and honestly, the place was an unsafe dump of a house that I called "bulldozer ready").

Re: Trying to talk my elderly parents into seeing an elder lawyer.

Posted: Tue Sep 10, 2019 1:57 pm
by dbr
If putting things in a trust means trying to transfer assets to heirs and then depend on public assistance for nursing care, then it could indeed be that one would end up in a "bad" nursing home instead of a better one a person might have been able to pay for.

As suggested, it is not too soon to investigate the available resources and proceed with one's eyes open.

Re: Trying to talk my elderly parents into seeing an elder lawyer.

Posted: Tue Sep 10, 2019 2:13 pm
by increment
I believe that typically trusts, etc., of this type are specifically intended to prevent people from being able to spend their money on their own care. That is how people get the taxpayers to contribute.

If your parents don't have other estate-planning documents, particularly power of attorney for property, power of attorney for medical matters, and advanced medical directive, then that alone is a very good reason for them to consult someone like an elder lawyer. (Your state may have different names for those documents. If needed, having them prepared in advance is very useful because in a crisis it is very, very annoying to have extra dealings with financial and medical bureaucracies.) Questions about trusts, etc., can be addressed during that consultation.

By the way, did "NH" above mean "nursing home" or"New Hampshire"?

Re: Trying to talk my elderly parents into seeing an elder lawyer.

Posted: Tue Sep 10, 2019 2:27 pm
by Silk McCue
increment wrote: Tue Sep 10, 2019 2:13 pm ...

By the way, did "NH" above mean "nursing home" or"New Hampshire"?
Great question. I clearly thought the OP meant New Hampshire when I posted above. NH is the abbreviation for a state and not a nursing home. I am now rather certain they meant nursing home. I won’t modify my post as Google will quickly find the appropriate website for their state. OP needs to educate themself first before they can help their parents. Board Certified Elder Law Attorneys aren’t cheap.

Cheers

Re: Trying to talk my elderly parents into seeing an elder lawyer.

Posted: Tue Sep 10, 2019 2:37 pm
by dbr
For example, as a part of the information, see here: https://www.payingforseniorcare.com/med ... dence.html

There is much more to investigate.

Re: Trying to talk my elderly parents into seeing an elder lawyer.

Posted: Tue Sep 10, 2019 2:43 pm
by rai
Silk McCue wrote: Tue Sep 10, 2019 2:27 pm
increment wrote: Tue Sep 10, 2019 2:13 pm ...

By the way, did "NH" above mean "nursing home" or"New Hampshire"?
Great question. I clearly thought the OP meant New Hampshire when I posted above. NH is the abbreviation for a state and not a nursing home. I am now rather certain they meant nursing home. I won’t modify my post as Google will quickly find the appropriate website for their state. OP needs to educate themself first before they can help their parents. Board Certified Elder Law Attorneys aren’t cheap.

Cheers
I meant to say Nursing Home. :oops:

Re: Trying to talk my elderly parents into seeing an elder lawyer.

Posted: Tue Sep 10, 2019 6:54 pm
by Stinky
rai wrote: Tue Sep 10, 2019 11:45 am So my unsophisticated parents 79 mother and 87 father. They are very modest living and don’t have much invested mostly live on SS and both have pensions. .....

So could anyone tell me the benefits and reasons why an elder lawyer would be needed and what services they provide so I can let my parents know. I’m not going to force them to do anything but just like to give some constructive advice.
Do your parents have the basic documents - will, POA, advance directive? I certainly hope so, but your posts have been silent on that (I think).

Re: Trying to talk my elderly parents into seeing an elder lawyer.

Posted: Tue Sep 10, 2019 8:55 pm
by bankle
Stinky wrote: Tue Sep 10, 2019 6:54 pm
rai wrote: Tue Sep 10, 2019 11:45 am So my unsophisticated parents 79 mother and 87 father. They are very modest living and don’t have much invested mostly live on SS and both have pensions. .....

So could anyone tell me the benefits and reasons why an elder lawyer would be needed and what services they provide so I can let my parents know. I’m not going to force them to do anything but just like to give some constructive advice.
Do your parents have the basic documents - will, POA, advance directive? I certainly hope so, but your posts have been silent on that (I think).
Agree wholeheartedly that these documents are very important to have in place.

Re: Trying to talk my elderly parents into seeing an elder lawyer.

Posted: Tue Sep 10, 2019 9:35 pm
by TexasPE
rai wrote: Tue Sep 10, 2019 11:45 am
Anyway I told mom she should see an elder lawyer to get them squared away on any protections or trusts that may be applicable. I hear Medicare will pay for various services provided you are bankrupt or similar.
I advise consulting an Eldercare attorney. Medicaid (not Medicare) has some look-back rules for finances, allows some exemptions from basis (different in different states), etc. A competent Eldercare attorney can set you straight.

Re: Trying to talk my elderly parents into seeing an elder lawyer.

Posted: Tue Sep 10, 2019 9:49 pm
by cheese_breath
TexasPE wrote: Tue Sep 10, 2019 9:35 pm
rai wrote: Tue Sep 10, 2019 11:45 am
Anyway I told mom she should see an elder lawyer to get them squared away on any protections or trusts that may be applicable. I hear Medicare will pay for various services provided you are bankrupt or similar.
I advise consulting an Eldercare attorney. Medicaid (not Medicare) has some look-back rules for finances, allows some exemptions from basis (different in different states), etc. A competent Eldercare attorney can set you straight.
And have him/her educate you on Medicaid beds. Medicaid won't pay anything unless the patient is in a Medicaid bed. It's possible the person who ended up in the bad nursing home was there because there weren't any Medicaid beds available in the better ones.

Re: Trying to talk my elderly parents into seeing an elder lawyer.

Posted: Tue Sep 10, 2019 11:18 pm
by smectym
Since, as OP concedes, neither parent is currently ready for assisted living or a nursing home, goading and herding them into a flurry of “planning for the next stage” is premature. Leave them in peace

Re: Trying to talk my elderly parents into seeing an elder lawyer.

Posted: Wed Sep 11, 2019 1:10 am
by BarbBrooklyn
Just for starts, get yourself a clear understanding about the difference between Medicare and Medicaid.

Going to a site like AgingCare.com will provide you with lots of articles about options for eldercare.

Find out if Assisted Living is covered by Medicaid in their state.

The need for an eldercare attorney is crucial if ONE parent needs facility care and the other remains at home. The "community spouse" generally benefits from having a specialized attorney advise on how assets get split so that the community spouse does not become impoverished.

Medicare does not pay for long term care. It WILL pay for rehabilitation services in a facility after a patient is admitted ( not under observation, but admitted) for 3 midnights. Payment is in full for up to 20 daysIF the patient is making progress; for days 21 through 100, there is a copayment of ~ $160 per day. Check if your parents have a Medicare supplement that will pick up this copay. At their age, it would be a good idea for them to have that supplementary coverage.

Re: Trying to talk my elderly parents into seeing an elder lawyer.

Posted: Wed Sep 11, 2019 7:20 am
by cheese_breath
smectym wrote: Tue Sep 10, 2019 11:18 pm Since, as OP concedes, neither parent is currently ready for assisted living or a nursing home, goading and herding them into a flurry of “planning for the next stage” is premature. Leave them in peace
It's not a matter of goading and herding, it's a matter of becoming prepared in advance rather than frantic rushing if/when it happens. We weren't adequately prepared when DW had her stroke, and it sure would have been easier if we had been.

Re: Trying to talk my elderly parents into seeing an elder lawyer.

Posted: Thu Sep 12, 2019 1:43 pm
by FIREchief
smectym wrote: Tue Sep 10, 2019 11:18 pm Since, as OP concedes, neither parent is currently ready for assisted living or a nursing home, goading and herding them into a flurry of “planning for the next stage” is premature. Leave them in peace
An estate attorney once told me that the optimal time for a person to establish MPOA, DPOA, Living Will, HIPPA release, etc. is on their eighteenth birthday. I think there is much truth in that.

Re: Trying to talk my elderly parents into seeing an elder lawyer.

Posted: Thu Sep 12, 2019 2:00 pm
by NotWhoYouThink
The comment above that you should educate yourself on Medicaid is appropriate. It sounds like your parents don't have significant assets, so they may not need a trust but they probably need to know what their situation would be if one of them needed nursing home care but the other was healthy enough to stay in the home. You can look up the Medicaid rules in your state. look for the rules for the "community spouse", the one that is not in need of nursing home care.

edited to add:
for myself, I would rather keep the house as an asset and use the proceeds from the house to pay for better long term care for myself and my spouse than put the house in trust and leave the nursing home choice to the state.