Most of us hope to be able to live out the final years of our lives in our own homes. While the desire to remain in your home is certainly understandable, it is also important to plan for the very real possibility that you will one day need the type of care only available at a nursing home facility. If you do find yourself faced with the need for around the clock care, having a plan in place means you will be prepared for the high cost of that care. and your loved ones will know which facilities you prefer. Researching facilities now also ensures that you receive the best care available if you ever do need the type of care offered at a nursing home. To help get you started, the estate planning attorneys at The Mendel Law Firm, L.P answer some me frequently asked questions about nursing home planning. If you have additional questions or concerns, please feel free to contact our office to schedule a consultation.
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In the United States, we are fortunate to benefit from advances in science, technology and medicine that have dramatically increased our average life expectancy over the last century. Nevertheless, your odds of being disabled in at least two activities of daily living or of being cognitively impaired is 68 percent for people age 65 and older. Of those who do become disabled or cognitively impaired, about 40 percent will need nursing home care. By age 85, you will stand a 75 percent chance of needing some type of long-term care services before the end of your life. Nursing home planning ensures that your wishes will be honored if you need to be placed in a nursing home and that you can afford the cost of that care without putting your assets at risk.
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The U.S. Senate Special Committee on Aging explained the difference as follows: “It [long-term care] differs from other types of health care in that the goal of long-term care is not to cure an illness, but to allow an individual to attain and maintain an optimal level of functioning….Long-term care encompasses a wide array of medical, social, personal, and supportive and specialized housing services needed by individuals who have lost some capacity for self-care because of a chronic illness or disabling condition.”
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As of 2018, the average nationwide cost of a year in LTC was $100,000. Texans are fortunate in that the average cost for that same year in Texas was about $80,000. While residents of Texas may pay less for nursing home care, with an average length of stay of three years, it is easy to see how the cost of nursing home care can deplete a retirement nest egg if you have to pay for them out of pocket.
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Although you may depend heavily on Medicare to cover health care expenses as a senior, Medicare only covers long-term care following a hospital admission, and even then only for a short period of time. Most private health insurance policies also exclude nursing home expenses, meaning you may very well be forced to pay out of pocket if you fail to plan ahead.
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For seniors who need assistance with the daily tasks of living or who require less extensive medical care, there are alternatives to nursing home care, including home health care, adult day health care, and assisted living facilities. In addition, Medicaid waiver programs in most states will pay for in-home and community care that is aimed at keeping seniors in their own homes.
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Doing your homework when searching for a nursing home is crucial to ensuring that the care you, or a loved one, receive is the best possible care. There are a number of websites that can be used to help you find nursing home care in your area and even compare the quality of care offered at the facilities. Two excellent federal resources are Medicare.gov (the federal government’s official site for Medicare) and Eldercare Locator which is a public service of the U.S. Administration on aging. The Texas Health and Human Services also publishes a list of licensed nursing home facilities.
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Medicaid is a healthcare program that is primarily funded by the U.S. federal government; however, it is administered by the individual states. Consequently, the eligibility guidelines and benefits offered can vary somewhat from one state to the next. There are different eligibility categories within Medicaid, however, every state has at least one category under which seniors can potentially qualify for benefits.
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Unless you have the resources to cover the cost of nursing home care out of pocket for an indefinite period of time, you will likely find yourself turning to Medicaid for help. Currently, over half of all seniors in nursing home facilities rely on Medicaid to help cover the high cost of care. Medicaid will help with your nursing home expenses if you are eligible for benefits. To be eligible, you must meet the very low “countable resources” limits that can put your retirement nest egg at risk if you failed to plan ahead. Medicaid planning ensures that your assets are protected and that you do qualify for benefits if you need them down the road.
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The reality is that nursing home abuse is a very real problem in the United States. One study found that more than 40 percent of nursing home residents have reported abuse, and more than 90 percent report that they or another resident of the facility have been neglected. Research from 2010 indicates that up to half of all nursing home attendants have admitted abusing or neglecting elderly patients.
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The most important thing you can do to prevent becoming a victim of abuse is to plan ahead. Do your “homework” now so you know which facility has the best reputation and which facilities have been repeatedly fined for violations or even accused of abusing a resident. Visit facilities in your area now, while you have the opportunity. Reduce your wishes and references to writing within the nursing home planning component of your estate plan. Although it may be a difficult conversation to have, sit down with an adult child and have an open discussion about elder abuse. In the event that you develop dementia or are otherwise unable to express yourself, in the future it is imperative that someone you trust knows what to look for and how to respond if abuse is suspected.
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