Over the last several decades, the lifespan of the average American has increased significantly. This is undoubtedly a good thing. However, the aging population has brought with it a whole host of new concerns, including the need for a wider array of elder care options. According to the Georgetown University Public Policy Institute, approximately 70 percent of Americans over the age of 65 will require long-term care at some point. This doesn’t mean that everyone will end up spending their golden years in a nursing home, though. In fact, only about 5 percent of senior citizens live in a nursing home for five years or more. Most other seniors will utilize a mix of short-term residential stays and at-home care.

If you are planning elder care for yourself or a loved one, take time to review your options before making long-term decisions. Let's face it - no one wants to end up in a nursing home, right? So as we age, we need to consider the effects of our health and mental status on where we receive long-term care. Some of the more popular alternatives to nursing home care include the following:

  • Home care services: These services are well-suited to people who do not need intensive medical care, but who do require help with chores, meals or other household needs. In some cases, seniors might hire an aide to come in several days a week. These services are typically privately paid by the senior - no government services (i.e., Medicaid) will pay for this type of care at home.
  • Adult day care: This is a great option for seniors who can live at home with support, but are bored, or for caregivers who need to take a break. Seniors can visit adult day centers to share meals and activities with similarly-situated individuals. Medicaid generally does not pay for day care but some PACE programs (Such as the Suncoast PACE) in Florida pay for day care situations.
  • Assisted Living: A great option for those needing some assistance and who may need supervision, medication management or greater socialization.  Assisted living facilities in Pinellas County generally run about $3,000 to $7,000 per month depending upon the level of care care and other issues.

As helpful as long-term care may be, it is also very expensive. Medicare only covers a small portion of the care that seniors need. Medicare does not pay for long-term care at all, for instance. For that reason, it is important to start planning for long-term elder care well before it is needed. You don’t want to be caught by surprise and without a plan.  In preparing for your possible long-term care, there are generally three paths you should consider:

  1. Gifting assets before the 5-year Medicaid look-back period. If you want to do this, you will likely want to consider an irrevocable asset protection trust.  
  2. Incapacity planning, i.e., good estate planning, including powers of attorney, healthcare surrogates and living wills. If you do not want to give your assets away to your children before you need a nursing home (like most people) then you should prepare for your long-term care with good estate planning.  Good estate and incapacity planning documents can allow your heirs to protect your assets if you give them the powers to do so.
  3. Purchasing long-term care insurance for those able to afford it and before you get older - i.e., in your 50's and 60s.

If you or a loved one need long-term care in Florida, Medicaid can be helpful in a variety of situations. Importantly, a good elder law attorney can help decide what long-term care programs may assist you and can help you plan to access these programs if your assets are above the limit. Our law firm, for instance, can help with Medicaid spend-down planning, in the right situation.

If you want to learn more about incapacity or asset protection planning, wills, trusts, long-term care insurance and more, please feel free to attend one of our free virtual webinars, or watch a recorded past seminar.

If you want to learn more:

D. Rep DeLoach III
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Estate Planning and Board Certified Elder Law Attorney
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