If you are physically or mentally incapacitated, severely disabled, suffer from Alzheimerís disease or dementia, or require 24 hour custodial care, a nursing home or long term care facility may be the best option. However, if you are able to function independently, but need assistance with shopping, cooking, cleaning, laundry, and transportation, there are several senior housing options and senior assistance services you can use in most areas to avoid a nursing home.If you live in a rural area and want to live independently in your senior years by utilizing senior assistance services, you may need to relocate to a more urban area. It is usually more difficult to obtain the services required to live independently in a rural area, unless you have a strong support system of family and friends.
The alternatives to living in a long term care facility include:
Using a combination of in home care and community care, including assistance from family and friends; adult day care; meal delivery programs; in home nursing care and homemaker services from home health agencies; and senior assistance services for cleaning and shopping.
Assisted living facilities, board and care homes, and continuing care retirement communities.
Nursing Home Bills May Affect Your Heirs
If you are evaluating your options for long term care, you may also want to consider how nursing home costs may impact your spouse, children, and other heirs. If your family is not in a position to cover the costs of long term care, you may want to meet with an attorney to discuss Medicaid planning, long term care insurance or other options to prevent your heirs from having to pay these expenses. For an overview of how your children can be impacted by your long term care, read our article on
Parents Nursing Home Bills.If your spouse, partner or child is not prepared to pay your long term care expenses, it is important for them to be informed about how to handle your admission to a nursing home facility, as well as any bills or demands for payment they may receive. Since you may be incapacitated or unable to assist them with these issues when the time comes, it is a good idea to discuss nursing home costs with your family in advance.
What Happens to My Property and My Estate If I Have to Go Into a Nursing Home?
If Medicaid pays for any services for you on or after your 55th birthday, including nursing home care, medical services, in-home care or community-based services, Medicaid has the right to recover from your estate after your death all amounts it paid on your behalf. This is referred to as Medicaid estate recovery. When you accept benefits from Medicaid, a debt is created that must be paid by your estate after your death. Medicaidís recovery against your estate will be delayed if at the time of your death you have a surviving spouse or a surviving child who is either under age 21, disabled or blind.
Medicaid also has the right to place a lien on your property. If your spouse, a sibling, unmarried child under age 21, or a child who is disabled or blind lives in your home, Medicaid may not be able to place a lien on your home in some circumstances, due to certain exemptions available under Medicaid. Medicaid can also place a lien on and take recovery action against your personal property, cash, annuities, other real estate, and certain other types of property.If you are concerned about preserving assets in your estate to ensure your spouse will have a home and adequate financial support, you may need to engage in Medicaid planning, especially if you do not have a good long-term care insurance policy. Also, if you want to leave an inheritance for your children, grandchildren, or other heirs, or want to leave a charitable gift in your will to a particular charity, there are two important steps you should take:
Find out whether you qualify to purchase long-term care insurance to pay for nursing home care and related types of long-term care if you should need it; and
Meet with an estate planning attorney who has experience in Medicaid planning to find out how to plan your estate so your assets are protected in the event you need nursing home care. An attorney may be able to help you set up a trust or use other estate planning methods to achieve the best possible outcome when planning for long term care.
Most people are not sure if they will need long term care insurance and many people cannot afford it. Before purchasing a policy, be sure to evaluate many different long term care insurance options with the help of a licensed professional such as a financial planner.Also, if you plan to pay for nursing home bills using benefits such as
Medicare, Medicaid or other benefit programs, make sure you are reviewing information applicable to 2017 and thereafter, since most benefit programs change frequently.
You May Be Unable to Afford a Nursing Home
Unless you have taken steps to plan for the cost of nursing home care through estate planning, long term care insurance or Medicaid planning, you may be unable to pay the cost of nursing home care. When one of my family members had to stay in a nursing home for over a year, I was surprised to learn how much it cost. Although the nursing home was not in a major U.S. city, the annual cost was in the range of 150,000 dollars. The annual cost of nursing home care varies dramatically depending on where you live. Estimates of annual long term care costs in cities throughout the U.S. are published regularly by many large insurance companies. For example, estimates of annual nursing home costs circulated by long term care insurance companies in 2017 range from a low of approximately $62,000 dollars per year in some very low cost areas to a high of over $160,000 per year in some of the highest cost areas. This is one of the main reasons so many people are going without other necessities so they can pay large annual premiums on long term care policies hoping to avoid being a burden on their children. For more detailed information on the cost of long term care, contact continuing care communities in your area for estimated pricing on independent living, assisted living, and nursing home facilities. Many people require nursing home care for much longer than one year, so even those who have accumulated a substantial retirement savings may find that funds set aside for their spouse's retirement and an inheritance for their children is quickly wiped out. Funeral and burial costs can also deplete the assets in your estate. See
can I afford a funeral.