For many aging seniors who are starting to need extra help, moving in with your children is not a viable or desired option. Unfortunately, sometimes parents and children do not want to think about the inevitable and do not talk about what plans the parents have or have not made. Whether your parents are in good health, on the brink of needing additional care or need immediate assistance, it is never too early to start or act on planning discussions. And if they need immediate care, take heart, there are still options available to them.
If your parents' finances are in good condition, the planning process is important to focus on protecting their assets and setting funds aside for their long-term care. Long-term care insurance can help provide resources for obtaining care both at home or in a care facility. However, LTC insurance can be quite expensive and gets more so as you age. Getting advice is critical, and lawyers who specialize in elder care laws can provide valuable guidance, even if used just for a consultation. For a fee, they can help set up trusts to protect assets, and some offices provide medicaid application assistance as well.
If your parents have limited resources, there are still options available to them. Many county offices have an Office/Department of the Aging that provides information regarding a variety of services in their areas, like home health care agencies, meal programs and senior centers. Many home health care agencies can provide both skilled nursing or aides who can assist with daily living activities, like getting dressed, preparing meals, etc. If your parent only needs a little assistance a few times a week, home health care agencies are a good option. Many locations provide transportation to senior centers that can also help provide activities like exercise or other social events.
If your parent needs more round-the-clock care, there are assisted living facilities and nursing home facilities. Assisted living facilities allow for more independence, typically in apartment-style surroundings where support staff is readily available if help is needed. Some facilities have both assisted living and nursing home wings so that as conditions progress, residents can be moved between facilities and remain close to more self-sufficient spouses. These facilities are usually private pay and require that your parents have the resources to pay for rent.
When your parent doesn't have those resources, you can look at facilities that accept Medicaid patients. Medicaid is used for long-term care, after Medicare has been exhausted. Medicaid applications can take months to be approved, so you want to start the process as soon as you think it may be needed. The application does not have to be approved prior to your parent moving in, as nursing home facilities will accept "Medicaid pending" patients, but the application should be in progress.
Medicaid laws vary from state to state, so you should look for assistance in understanding your state's requirements, either from an elder law attorney or from the state social services department. All will require that your parents funds, except those protected by a trust, or allowed by the state, for example, to support the spouse, be exhausted. Look back periods exist, e.g. in New York, five years, in which the state will review any financial statements to see if funds were transferred, that may be asked to be returned. Once again these rules and exceptions vary based upon state so you want to check them out way in advance if possible.
Tremendous amounts of information exist to help seniors if you know where to look for it. Even if your parents seem to be in perfect health, it's never too early to have a serious discussion about what they would like to have happen, and positioning them to better be able to achieve that. The earlier you start, the more likely you will be able to accommodate their wishes. But even if you need to act quickly, make sure you stay calm and explore your different options, as well as the different providers that exist within each option. These will be some of the most important decisions you can help your parent make, and you don't want to rush through them or feel pressured to make just any choice. Knowing your options will put you in a much better position to help take care of the people who have always taken care of you.
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