I’m willing to bet that…

Right now you are feeling a bit of worry about your spouse, parent, or loved one.

If you see potential dementia symptoms, then you have very important steps to take in order to avoid money being a big issue what it comes to your loved one receiving the best possible care.

Your loved one’s care is important for his or her comfort, and your sanity (a burned out caregiver does not help someone with dementia).

The purpose of this article is, to first, help you figure out where you loved one is in his or her stage of dementia.  Next, to give you two paths you should consider in order to protect assets from a nursing home spend down.

This article is based on my personal experience as an elder law attorney helping 100s of families in the Jacksonville area with aging loved ones who require long-term care because of dementia.

Determine Your Loved One’s Stage of Dementia According to his or her Symptoms (Step 1)

Dementia is a term for a collection of signs and symptoms that result from brain disease or trauma.

A loss of brain function results in the ability to communicate, think (memory or process actions), express feelings, and perform motor skills such as walking, eating, dressing, or bathing.

Sometimes the disease acts quickly and sometimes is a slow decline.

The type of dementia and the affected parts of the brain determine the speed of decline.  For example:

 

• Alzheimer’s disease unfolds gradually and mainly affects memory and reasoning ability.

 

• Vascular dementia is usually a result from a stroke, mini-stroke, or TIAs. Thus, symptoms can emerge suddenly or gradually depending on the severity of the stroke.

 

• Lewy Body Dementia is like a combination of Alzheimer’s and Parkinson disease.  Lewy body dementia could first appear like a movement disorder or may include hallucinations, sleep issues, or other behavior issues.

 

• Parkinson’s Disease Dementia may start as a physical issue then memory could be affected 5 years or later.

 

There has been some experiences I’ve seen where someone’s dementia has totally accelerated after a surgery.

In the most common pattern of mental decline not caused by a stroke or prolonged through Parkinson, Medical professionals have developed several models to classify the stages, but here is a simplified 3 stage model that is commonly used:

 

• Stage 1 – Mild/Early.  Others are first aware of memory lapses, but your loved one may be good at covering it up.  Here, your loved one may have issues writing or driving (beyond their normal standards).  Also, your loved one’s moods and personality swings may be unusual for them to act.  This stage could last from 2 to 4 years.

 

At stage 1, your legal planning options are probably going to be the best.  You will be ahead of the game.

 

• Stage 2 – Moderate/Middle.  At this point, your loved one has can’t hide memory lapses.  You loved one repeats him or herself.  Personal hygiene and care may be declining.  Mobility and coordination is off.  Hobbies and social interaction may be declining.  I have seen from the caregivers I have worked with say that this stage lasts between 2 to 10 years.

 

Here, you are probably thinking about assisted living or moderated in-home care for your loved one.  Thus, you can receive immediate benefits from planning now.

At stages 1 and 2, someone can be at the home with minimal care as long as there are no other medical problems going on.

Further, at stages 1 and 2, you need to get your loved one’s power of attorney in place using a qualified elder law attorney experienced in helping families with dementia and long-term care concerns.

You can order my book on hiring the right attorney for this type of issue; it also explains why you should avoid online durable power of attorneys and wills AT ALL COSTS.

 

• Stage 3 – Severe/Late.  Dementia is obvious to everyone… even people first meeting your loved one.  Behavior may be very inappropriate or different.  He or she is a greater fall risk.  Eating could be a problem. Supervision is required around the clock.  This later stage can last 1 to 3 years.

 

Nursing care is imminent (or your loved one is in a nursing home now) in stage 3 and you should take action now.  If your power of attorney is no good, you may be looking at court guardianship that starts at $7,000.

Nursing home care is equally imminent if your loved one showing dementia symptoms also has other medical issues.

Take Action if Your Loved One’s Dementia Symptoms will Require Long-Term Care (Step 2)

When I say long-term care assistance is required…

I mean that you are at the point where your loved needs help with activities of daily living.

Or you are constantly on “alert” or “alarms” because of behavior issues such as:

• Combativeness
• Wandering
• Inconsistent sleep patterns

Activities of daily are needs that your loved one can no longer perform unsupervised or without prompting:

• Bathing
• Dressing
• Eating
• Transferring from bed to chair, and visa versa
• Financial or medication management
• and so forth.

If you are worried about the costs to provide for these needs (or having to involve others in the first place), then you are not alone in your worries. This affects all caregivers.  It leads many to feelings of guilt.

If your loved one is a veteran, or has survived a veteran, then VA benefits are available to assist with adult day care through the VA hospital social worker.

If you need more money to provide your loved one with the best care possible, then the VA offers up to $2,100 in tax-free benefits that can go towards paying for care in-home or care at an assisted living community.

You can receive more information about these VA benefits, including qualification requirements, by [ddpp extraclass=” trigger=’onclick’ popup_to_show=’770′ ]clicking here[/ddpp].

Also, you can seek assistance from Medicaid.

No, Medicaid is not just food stamps or something to be ashamed of.  Medicaid helps cover the nursing home that charges $8,000 a month. Most, if not all, nursing homes in Jacksonville accept Medicaid as a form of payment. It is illegal to provide “lesser” care because Medicaid is helping with the bill.

Yes, $8,000 a month is the average monthly bill at nursing homes in Jacksonville… even at the “bad” ones.  Some non-profits such as All Saints or Taylor Care charge less, but you’re still looking at $7,300 or so at those places.

 

The nursing home Medicaid benefits help prevent the spend down of personal savings. You can even qualify in many cases, even if you have been told your income is too high or your assets are too high.

 

 

 

Other common nursing home spend down myths that can be avoided are:

• You don’t lose your home
• You don’t have to get a divorce
• You don’t have to wait 5 years
• You don’t have to pay everything you have to the nursing home

Unfortunately, your options when you do not have 5 years are not always 100% perfect.  But your legal and financial options are certainly better than giving all your money to a nursing home.

You can learn more about how to prevent the nursing home spend down by clicking here.

If you are not quite there, then you need to, at least, get a durable power of attorney executed.  An elder law attorney should be the one who prepares this important legal instrument.

How to Beat the 5 Year Lookback and Prevent Nursing Home Spend Down (if Your Loved One is in Earlier Stages)

If you think your loved one is stable, but showing very early signs of dementia, then you can still take early action to protect assets.

In fact, I am going to explain the best way to protect assets from nursing home spend down if you cannot afford and qualify for long-term care insurance.

There is a type of asset protection trust you can create now.

You can set up this trust today and then, after 5 years, the assets held by the trust are off the table when it comes to paying for a nursing home.

After 5 years…

• The nursing home cannot touch this money in the trust

• The State of Florida cannot touch this money in the trust

Families with dementia use this type of trust if the dementia symptoms are caught early.  The trust is also used when someone’s dementia may require nursing care in 5 years, but his or her liquid assets are between $400,000 – $800,000.

This trust is a little tricky to explain in this article, but you can learn more about it by download my free report on this asset protection trust.

Conclusion

You need to make sure an elder law attorney experienced in public benefits law (veterans benefits and Medicaid) drafts the durable power of attorney.

If you think your loved one needs nursing home care in less than 5 years, you can learn more about how to prevent the nursing home spend down by clicking here.

If you think your loved would need care in more than 5 years, then you should consider the use of an asset protection trust, which you can learn more about in this free report.