When Seniors Need Care: How Knowing Your Options Can Make All the Difference

As our population continues to age, providing for and affording long term care has become a significant concern. Most seniors would prefer to remain in their homes, however, being able to do so safely and without the assistance of their adult children, friends or neighbors can be quite challenging.

When Seniors Need Care: How Knowing Your Options Can Make All the Difference

By Laura Burns

It is often the families that will seek legal advice once they have reached a difficult moment or breaking point – for example, if an elderly parent or relative has fallen, has become seriously ill, or if the care needed has surpassed the ability of the caretakers.

Very often, families are surprised by the options and the resources available to assist them with the care of a loved one. Many adult children would prefer to care for their elderly family members themselves. However, due to the demands of their careers, their own family needs and the lack of resources (time, money or expertise, etc.), they are unable to provide the caliber of care needed.

There are a variety of services available to seniors who are in need of assistance – whether that need is simply to have help running errands and keeping their home neat, or needing assistance of an aide who can help them with their daily personal care needs. If private payment is an option, many families come to rely upon Companion Companies, who provide placement of a Companion for the family’s loved one. The Companion can offer an array of services to assist with the care of a loved one, including transportation to doctors appointments, grocery shopping, medication reminders, meal preparation, light housekeeping, and even a watchful eye if a loved one is suffering from Alzheimer’s, a Dementia condition or other chronic illnesses.

If the need for care includes assistance with bathing, getting dressed, and other personal hygiene activities, a certified nursing assistant may be appropriate and can provide the support the elderly person needs throughout the day. There are many companies throughout Long Island that offer these services, and private payment, long-term care insurance coverage, or coverage through Medicaid can help pay for these services. Unfortunately for our seniors, Medicare, which is the primary insurance provider for those over the age of 65, does not provide coverage for long-term care services.

New York State’s Medicaid program can be confusing and it is common for program benefits to be misunderstood. Many families are surprised to learn that they can qualify for Medicaid home care without exhausting their financial resources. The Medicaid program in New York State is a means-tested program - meaning you must qualify financially. For in home care, there is no look-back period regarding eligibility, and therefore, qualifying for Medicaid home care services is a real possibility for many families. This can often be a life-saver, especially those who cannot afford long-term private payment for services. The Medicaid home care eligibility requirements should not however, be confused with nursing home coverage through Medicaid, which is where the five (5) year look back period applies.

When considering your options, it is advisable to seek assistance from an attorney who practices in the field of elder law. Generally, it takes approximately three to four months to get Medicaid coverage in place, and therefore approval upon the first submission of the application is essential. In addition and although there is no look back period with respect to home care, many families find that they must transfer or make changes to financial accounts, or transfer real estate to ensure that Medicaid will not seek to file a lien against the property. In certain situations, Medicaid may also seek to recover from an applicant’s estate upon their passing. The transfer of financial accounts or real property will have significant legal and tax consequences, and the assistance of an attorney can help protect families and guide them through the process.

Lastly, many families are surprised to learn that there are an array of options with respect to Assisted Living facilities, both concerning the amenities available, as well as the monthly cost (there are also limited Assisted Living facilities that accept Medicaid as partial payment). Assisted Living facilities allow seniors to enjoy the benefits of being independent, while providing the support they need for daily living. When trying to evaluate the options available to assist a loved one, this possibility is often overlooked, or considered akin to a nursing home, which is not the case.

Whether your family member requires daily assistance or you are simply concerned about being prepared for the future, knowing all of your options and what you are legally entitled to can make all the difference. As the old saying goes, knowledge is power.

*** This article should not be construed to offer legal advice and is written solely for the purpose of providing information.

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