An Example of When an Elder Law Attorney And/or Care Manager Would Be Right for You

We recently had this scenario come up with one of our prospects.

A senior was in rehab recovering from a stroke. She was preparing for discharge. Based upon her condition at discharge, it appeared she would either need to live at an assisted living facility (ALF) or go home with in-home care.  Where can/should she go?

• If she goes home, she will need a caregiver 24/7 for at least a few weeks and may need 8 hours a day or more ongoing, all of which will be out of her pocket. Health insurance does not cover in-home care.
• If she goes to an ALF, it will cost her $4,000-$5,000 a month based on her current condition.
• Funds are limited. With in-home care or ALF care she may have 4-5 months of cash.
• She owns a house valued at $150,000 with no mortgage.
• Her family is out of town. She has no one else local to assist her.
• They are discussing getting her qualified for Medicaid. To qualify:
  • her cash assets other than her residence and a car need to be below $2,000.
  • her income needs to be below $2,313 a month.
• Her income meets the criteria. As noted above her non-real estate assets could fall in line within a few months but she still has the house to consider.
• What should the family do?
  • They need to consider hiring an Aging Life Care Professional (ALCP) to help coordinate her care. This is costly, but she does not have a local person to assist her and she cannot do these things herself. An ALCP could help her decide which route to go. If moving to an ALF, they could help her pick out the right community for her, hire someone to sell her house and/or move her, line up her doctor appointments, etc. If she decides to stay at home, the ALCP could help her determine her service requirements, pick her caregiver/home care company, oversee service quality, etc.
  • The family needs to hire an elder care attorney to assist with the Medicaid application and the house versus trying to do this all on their own.
  • Why?
    • If she moves into an ALF and doesn’t live in the house, it won’t be exempt for Medicaid and her assets will be too high to qualify, so she’ll run out of money in a few months.
    • If she sells the house without sheltering the proceeds, she won’t qualify for Medicaid (though she should net enough cash to live about 24 months at an ALF).
    • She could go home and use a reverse mortgage to fund about 15 months of in- home care, but if the funds are not sheltered, she will not qualify for Medicaid.
    • These are just a few examples of what could happen.

Hiring professionals that work with these challenges every day may cost a few dollars, but it is well worth it in the long run. Between her house and her limited savings, she has enough funds to hire professionals that will maximize her benefits and help her live in the place she loves for the longest time possible.