The time has come for LTC. Any advice?

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The time has come for LTC. Any advice?

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Hi, it's me again. I wrote back in November of last year to ask about helping my parents with this ordeal. My dad is now in the hospital and will have his other lower leg amputated. Long term care is inevitable at this point. If you remember, she met with an elder law office who was going to charge $14,000 for "life care planning", which included the medicaid application, a will, and putting my mom's house in a Family Asset Protection Trust, so that when he passes away, the nursing home cannot take her home (after she passes away). So many of you told me to forget that deal, no way would anyone pay $14,000 for that. That is for a year, then if she wanted to keep them on after that (for herself I guess), it would be $3,900 for years 2-5. Just for a recap, they live in TN, would have to spend down roughly $110,000, and sell one vehicle. Their house is paid off and would bring about $175,000 if sold. My mother would definitely want to sell as it is too much for her to take care of. She is a pretty healthy 75yr. old, expected to live many more years. They have no stocks, no insurance policy's, nothing extra. Just checking, savings and SS. My Mom should be able to keep part of his SS to bring her's up to what the community spouse is allowed per month. She only receives something in the $800 range. She honestly can't make it without his. So that's where we're at. I think the only other Elder Law office anywhere close is in Nashville, which is 2 1/2 hours from Greeneville. I don't think that is feasible for her. She is worried that he might not qualify for TennCare (Tennessee's Medicaid). I think a double amputee, diabetic with heart disease, and stage 4 kidney disease would qualify, especially after the spend down. I'm trying to convince her not to use this Elder Law office in Johnson City that charges $14,000 (even though that fee can come out of the spend down). Okay, now what say you?

Care Decisions Elder Law Long Term Care

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Please speak with Medicaid. Look at the application, talk with social security administration before you spend 14k.

There are rules about assets that mom can keep. I have read that she could have 120k and that means that she would not have to split the house with dad 50/50. She will also be allowed part of his ss to make it every month.

You have to do something about finding out if you should depend on someone that would gouge people in this situation. Get on the internet and make some phone calls.

Not trying to be rude but you are talking about paying 8% of their assets to do a form, that's insanity. You aren't dealing with very much money to justify paying 8%. The reality is that you and mom are the ones that will be gathering all of the required information anyway, so why not put some effort in now to know if that is your only choice. I bet you find filling out the form is the easy part, gathering everything to fill it out is the daunting bit and that will be on you guys to do. The attorney will just send a list of what you have to provide.

Have you pursued anything regarding this since you posted in November.

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No, nothing further, other than I did purchase a Medicaid book that Igloo572 recommended. My mother sort of just froze back in November. It was all so overwhelming to her. The thought of losing 1/2 of their money after years of always being careful and saving, she just sort of decided she would keep him at home as long as possible. It has been a long 4 months too. She kept wondering well what if she paid that $14,000 and then he dies soon after, and here she did that "spend down". She never got started on anything in the house either. She has a lot of work to do and hire done if she wants to get it sold. You know how it is when you are facing something so big, that's it's easier to just put your head down and face it all some other day. So once again here we are, and she is scared, sad, worried, feeling like she won't make it through this. I will gladly sit down and fill out the application with her. I can call SS, and talk to the Social Worker at the hospital tomorrow. But she still wants to get her house in a trust, so they can't take it after he is gone and she is gone. Bless her heart she wants us kids to have something when they're gone. The attorney said she could still sell it while in this trust, she just can't buy something for less money, or Medicaid will want their share. She needs to get into something more comfortable with no stairs, no laundry in the basement, no 2 acres to take care of. She needs to get dad's name off the house I guess, and the vehicle as well. To make it all worse, she had been telling him for months, if he loses this 2nd leg, he will not be able to live at home. Well I talked to him before the surgery and he said the only hard part will be "getting in the house when he goes home from the hospital". Ugh. He had forgotten that he always has to go to rehab from the hospital, and he's forgotten that he won't be going home this time. (cue the tears).

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Carrie, I have not seen your other posts..or if I have I do not recall them and the answer to the question I have is not in your profile.
Is your dad a Veteran? If so it is possible that you could get quite a bit of help from the VA depending on where and when he served. (contact a Veterans Assistance Commission office there service is FREE)
Is there a Senior Center in your town that has a Social Worker that you can talk to they might have some ideas for you as well.
the other advice is an Elder Care Attorney is the type of attorney that you need to talk to. Someone that does this type of law daily not someone that does all sorts of law and a bit of Elder Law once in a while.

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No, Dad is not a veteran. Yes, there is a Senior Center in town. I will have mom ask if there is a social worker.
This attorney is in the office with the one who is certified in Elder Care Law. That's why we chose them. We asked if they could just draw up a trust for the house and prepare the Medicaid application only, to which they said yes but would still charge the same.

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If it were me in your (or your Mom's) shoes, I would pay the attorney. But that's just me. I don't trust my own ability to do it myself and be sure I did everything right, and the money is going to have to be spent for care anyway before LTC Medicaid kicks in. Plus Mom has SS to deal with in obtaining part of Dad's assets. I would just spend the money and hire the attorney to advocate and take care of things the right way. Most others disagreed with me back in Nov and will disagree now, but I just think its too complicated to do (and energy consuming) that it would be worth it to have a professional do it given the amount of money at stake.

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Thank you mstrbill.

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Do you know what facility your dad will be moving to next? When my mother went to a nursing home and Medicaid became inevitable after a time, the business manager there walked us through the process, she was very knowledgeable and familiar with it, and there was no charge. The hospital social worker could also be of help, depending on the quality there. It would be great if the house could be sold quickly and mom relocated before Medicaid comes into play. When my mom was on Medicaid my dad had to sell one car. Other than that he kept the house, his retirement and SS, and their checking and savings. He did do a short time of private pay prior to Medicaid. I wish you the best as you walk through this

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Thank you. Yes, he always goes to the in-patient rehab side of the facility that they use in Johnson City, TN. My mom is worried because insurance always sends him home after two weeks, ready or not. She did not know she could appeal that decision. Last time he was sent home even though the therapy staff felt he needed more time, and he could not even walk! They helped get him in my mom's truck and when she got home, she had to call the ambulance people to come help get him into the house and into his bed. They have steps at every entry, the least amount being up a steep sidewalk, then 7 steps. So we need to know, what is the process to let the NH know that he cannot return home? Isn't it her decision to make? She could not even get him out if there was a fire. He quite possibly will be released from the hospital to rehab on Monday. I will definitely get a hold of the Social Worker. Mom just met her this evening at the hospital. I am trying to do what I can from here in Indiana, but I will head to my Mom's in two weeks.

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You really need to speak to Medicaid. Mom would be the Community Spouse. Assets will be split, your Dads being spent down. Mom will not be made impoverished. But each state is different as is each situation so call your local Medicaid office.

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Okay thank you very much, will do.

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The time has come for LTC. Any advice?

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