Elder Transitions Planning

The Dilemma

One of the most confusing and stressful times for Michigan seniors and their families is when they must transition from complete independence to some level of dependence, whether it be the need for in-home care, or the need to reside in a senior living community, assisted living facility or a nursing home.

In many instances, seniors are reluctant to seek the assistance that they require for fear that their family will place them in a nursing home. As a result, the senior struggles in isolation, which often causes his or her condition to deteriorate faster, resulting in the need for rehabilitation in a hospital or nursing home.

This transitional period presents a variety of medical, financial, and legal dilemmas. Because seniors and their families lack the experience to properly deal with many of these problems, a certain “paralysis by analysis” results. The confusion typically relates to determining what level of care the senior requires, how to obtain the needed care, how much the care will cost, and how the senior will pay for such care without losing everything rapidly.

The care giving burden sometimes falls upon the senior’s children, who may have children of their own and may still be employed. Often times, the child’s first exposure to dealing with his or her parents’ affairs is an urgent call-to-action over some traumatic event involving one of his or her parents (e.g. a hospitalization after a fall), and the child typically lacks the information and legal authority needed to act.

In Michigan, assisted living level care costs on average $3,250 per month and nursing home level care costs on average $8,084 per month. Not surprisingly, one of the biggest concerns the elderly have is how they or their spouse will pay for such costs without losing everything. Many seniors are under the mistaken belief that there are no options to help pay for these costs, and that they must lose everything before they can receive any such assistance.

The Solution

In response to these situations, Estate Planning & Elder Law Services has developed the Elder Transitions Plan™. While each plan is tailored to the specific needs of the client, the Elder Transitions Plan™ typically includes a “Care Plan,” an “Estate Plan Assessment,” and an “Asset Preservation Plan.”

Without knowing what the level of care is required, the senior and his or her family are just “spinning their wheels” trying to figure out a course of action. As part of the Elder Transitions Plan™, a “Care Plan” is often conducted by a geriatric case manager. Our firm has a network of qualified geriatric case managers who can assist families with this part of the process.

The Care Plan developed by the geriatric case manager should provide:

• A comprehensive “In-Home Care Plan,” as well as the coordination of the requisite medical and personal care services, that allows the senior to remain safely at home, for as long as possible.
• Assistance with locating and coordinating alternative living arrangements, as well as review of all related residency and care service agreements
• Recommendations for other helpful elder service providers, such as senior moving managers, senior transportation, etc.

However, even the best plans will fail if someone does not have legal authority to implement them. Therefore, as part of the Elder Transitions Plan™, an “Estate Plan Assessment” is performed to identify any deficiencies in the senior’s estate plan and to recommend any needed documents or amendments to existing documents, including powers of attorney, wills, living trusts, and other specialized estate planning documents. If the senior is unable to execute any needed legal documents, our firm will recommend the probate proceeding needed to obtain the required legal authority to act on behalf of the senior. Our attorneys are also available to assist with any necessary probate proceedings.

The last major element of the Elder Transitions Plan™ relates to the development of a plan to pay for the senior’s care costs, while preserving some or all of the senior’s assets for the senior, and his or her spouse and heirs. Although the options available to help pay for care are dependent upon a number of factors, the primary factor is the level of care the senior requires (i.e.in-home care, assisted living level care, or nursing home level care).

The Elder Transitions Plan™ outlines the resources available to help pay for such costs and the steps that must be taken to obtain those resources, including:

• Advice on how to improve Medicare Part D (prescription) and Medigap coverage
• Maximizing Medicare’s skilled care and other benefits
• Assistance with pursuing coverage under a long term care insurance policy
• Advice regarding financial products and techniques to “private pay” for care costs, slow the loss of the senior’s resources, and minimize tax liability in the process
• Advice on how to become eligible for federal and state assistance programs, such as Medicaid and Veterans Benefits

Many seniors are interested in exploring Medicaid and VA programs. Which of these programs to pursue, and when, is primarily dependent upon the level of care the senior requires. The eligibility rules for these programs are dramatically different. Actions taken to qualify for one program can adversely affect the senior’s opportunity to qualify for benefits under another program. All too often, seniors and their families are advised to take certain action to qualify for one program that results in irreversible disqualification from another program that they may need in the future.

The Elder Transitions Plan™ takes into account these differing program eligibility rules. It identifies which programs the senior may benefit from immediately, based upon their present level of care (e.g. in-home or assisted living level care), and which programs they may need to pursue in the future, should they require a higher level of care (e.g. nursing home level care). A multi-stage “Action Plan” outlines the steps necessary to qualify for benefits under each program and how to transition from one program to the other, without being disqualified from any one program. Our firm then assists with the execution of those steps.

Many of our clients find great peace of mind by doing this planning when problems are “on the horizon,” rather than operating in “emergency mode” when something traumatic happens. However, for those already in “emergency mode,” the Elder Transitions Plan™ provides immediate solutions to their problems and a welcomed relief from the associated stress.

Consult with Us About Your Elder Transitions Plan™

Our elder law team is available to consult with seniors and their families about Elder Transitions Planning™ and how it can bring peace of mind and protection to you and the ones you love. Complete our online information form or call 888-663-7407.

With offices in Northville and Brighton, we work with seniors and their families throughout Southeast Michigan, including Livingston, Washtenaw, Oakland and Wayne Counties.

Elder Transitions Planning™

Estate Planning & Elder Law Services, P.C. (“EPEL”) does not provide medical services, nor does it recommend treatment. Consequently, any medical services are provided by independent healthcare practitioners, who are not employees or agents of EPEL. EPEL provides legal, financial, and elder-related informational services through our employees and contracted service providers. Therefore, various services through our program may be provided by independently contracted partners. All of our services are offered in a manner that fully respects and protects the privacy of our clients and the confidentiality of their medical information and is compliant with all regulatory requirements.