Elderly man speaking with elder law attorney about his long-term care needs

Know Your Options: The Spectrum of Long-Term Care

by with No Comment Elder Law

Elderly man speaking with elder law attorney about his long-term care needs

You’ve no doubt heard about assisted living and nursing home care, but there are many other long-term care options available. An article by U.S. News & World Report provides an introduction to the types of care now available. You can read the full article here.

Adult Day Care

Adult day care offers relief to family caregivers and a safe, social environment for older adults. It is suitable for people with mild cognitive impairment, Alzheimer’s disease, or other forms of dementia; people who could benefit from speech, music, occupational, or physical therapy; and elders who crave activities and interaction with peers. Adult day care centers for people with dementia occasionally offer nighttime hours in recognition of the fact that some seniors are more active at night.

Aging in Place

The concept behind aging in place is to live independently in your own home and community as you grow older. Home modifications such as widening doorways to accommodate wheelchairs and installing grab bars in bathrooms make aging in place possible. Even people with chronic medical conditions can remain at home longer with the help of home health care aides.

In-Home Health Aide

As the name implies, home health aides provide services in an elder’s own home. For example, certified nursing assistants or patient care assistants under a registered nurse’s direction can provide health-related services such as checking vital signs, changing bandages, and assisting with medications or medical equipment. In addition, home health aides or elder companions can assist with personal chores such as meal preparation, light housekeeping, grocery shopping, transportation, and bathing. You can find in-home health aides through a home-care agency.

Continuing Care Retirement Community (CCRC)

Continuing care retirement communities offer a “tiered” or “one-stop” approach to meeting the needs of aging adults by providing a wide range of care options at a single location. The spectrum of care starts with independent living in single-family condominiums or apartments for relatively healthy adults. As a senior’s daily needs change, he or she can transition to on-site assisted living or nursing home facilities. This convenience comes at a price, however. CCRCs are expensive and often include substantial upfront entrance fees and monthly charges. Upon enrolling in a CCRC, residents typically select from extended (all-inclusive), modified, or fee-for-service contracts.

Elder Co-Housing

Co-housing is a community-focused arrangement that combines private homes with shared gathering spaces. Co-housing communities for those over 55 years of age may be particularly attractive for seniors who want to live among peers who share common interests and hobbies. As of this writing, co-housing options are rather limited. You can learn more about this option by visiting the Cohousing Association of the United States website.

Next time we’ll look at foster care, post-acute care, assisted living, and nursing home care.

home aging

Aging in Place vs. Nursing Home Care: Important Factors to Make the Right Choice

by with No Comment Elder Law

home aging

A growing portion of the older population wants to stay in their homes as long as possible. This is known as “aging in place” and has several benefits when it is appropriate for the individual. However, there are some other care concerns to consider when deciding whether someone is at the point of needing additional help.

COMFORT AND FAMILIARITY

Most people want to remain in their homes because of the comfort, familiarity, and memories within it. Moving into assisted living or a nursing home is a big change for anyone, but especially for a senior who feels the loss of their independence during this transition. Remember that, when it is safe for them to stay there, someone’s home can support their overall mental and physical health.

If staying in the same place is important to your loved one, look for ways to ease your mind while also protecting their independence. Is there a neighbor or friend who can check on them each week? Can you drop in every other weekend to make sure things are going well?

SAFETY CONCERNS

Many adult children or other loved ones start thinking about these issues because they’re concerned over safety. Triggering events prompting a conversation about additional care needs include a loved one beginning to show signs of dementia or suffering one or more physical incidents like a fall in their home.

YOUR TIME AND PROXIMITY

As a family member, it’s natural to want to do everything you can to care for a loved one. Caregiving, however, can be very difficult and time consuming. It can be even more challenging if you don’t live nearby. If your time and that of other family members can no longer support a loved one, a nursing home or assisted living may be the answer.

FINANCES

Whether or not your loved one owns their home is the first consideration. Ongoing mortgage payments are just part of the puzzle. It can be hard for people to part with their home, but maintenance concerns and costs can be problematic. Evaluate the age of appliances and yard maintenance required, too. At some point a home might be more trouble than it’s worth to the occupant.

MEDICAL SUPPORT NEEDED

If a loved one only needs help with light housekeeping or meal preparation, they may not need to move to another location, especially a nursing home. Local organizations or a part-time hire could help with these needs while allowing your loved one to stay in their home.

However, if they have more advanced medical needs or challenges with multiple activities of daily living, in-home care from a medical professional could bridge the gap. For more advanced situations, a nursing home might be appropriate.

There are other care options along the spectrum in between care services provided by family and a nursing home. Part-time help from someone local such as a nurse, in-home care providers, assisted living, and adult day care are just a few. For someone who needs extra support but does not require the support of a formal nursing home, these options are well worth exploring.

Contact a New York Elder Law Attorney

An experienced elder law attorney can help you to assess your unique needs and goals. Contact Amoruso & Amoruso, LLP for a personal meeting.

Filial Responsibility: Are Children Responsible for Their Parents’ Long-Term Care?

by Elder Law

Filial Responsibility Laws, also known as Filial Support Laws, are relatively unknown. More than half of US states (including Puerto Rico) could hold adult children financially responsible for their parents’ long-term care. If your parents live in one of the following states, you could be held legally responsible for their healthcare: Alaska, Arkansas, California, Connecticut, Delaware, Georgia, Indiana, Kentucky, Louisiana, Massachusetts, Mississippi, Montana, Nevada, New Jersey, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Puerto Rico, Rhode Island, South Dakota, Tennessee, Utah, Vermont, Virginia, and West Virginia.

At one point, 45 US states had statutes that left adult children responsible for their parents’ nursing home care. After Medicaid was established in 1965, many states repealed these laws. The filial law system was adopted from England’s “Poor Laws”, a set of social measures meant to support low income citizens that could not afford care. Medicaid and Social Security helped to reduce the need for these laws.

While filial laws are rarely enforced, the rising cost of healthcare and longer life expectancies increase the likelihood of elderly individuals outliving their savings, which could rekindle these laws’ implementation. If your parents live in a state with filial responsibility laws and they start to accumulate healthcare bills they cannot afford, the provider may be within their rights to sue you for payment, and win. Some states can even extend criminal penalties to children who deny covering care. For example, according to North Carolina law, refusal to support your parents could result in a Class 2 misdemeanor that could earn you up to 120 days in jail.

If a parent becomes eligible for Medicaid, then the government will pay for nursing home care in most cases, and these laws become irrelevant. The Medicaid Estate Recovery Program (MERP) will sometimes try to recover the cost through the recipient’s estate after death. However, Medicaid does not require that adult children contribute directly to their parents’ care. In cases where the child and parent share assets, such as joint bank accounts or jointly owned real estate, the state may take action against these assets when trying to recover long-term care costs.

The best way to avoid issues with these laws is to get involved with your parents’ financial planning to ensure they have a plan to pay for long-term care themselves. An estate planning and elder law attorney can help create a plan to protect your parents’ assets while alleviating you of your filial responsibility. It is also important for families to consult with an attorney when applying for Medicaid or when beginning to plan Medicaid strategies, such as changing asset ownership or spending down assets.