Planning for Nursing Home Care

Jamie McNie of Germantown found herself several years ago in a stressful situation -- responsible for the finances and health of an ailing parent. At first she helped feed and clothe her mother. As her mother's forgetfulness progressed, McNie grew concerned she would have to make decisions that were beyond her expertise.

"I knew I needed an elder care lawyer," said McNie, who sought out Elizabeth Forgotson Goldberg. "She told me I was not going to get anything done if my mother didn't have a will, a durable power of attorney and a health care power of attorney."

With these documents, a family member or caregiver can handle a person's money and make health-related choices should that person become incapacitated. Without them, a family is limited in assisting an ailing parent or a spouse who needs help.

Reginald McNeil knows that all too well. His mother suffered a massive stroke and spent a year in a nursing home unable to sign a power of attorney. During that time, her son sought to have Medicaid pay for her nursing home care, but she never qualified. After she died, proceeds from the sale of her home were used to pay her nursing home bills. "I just didn't know" about planning for long-term care, McNeil says.

Congress this month passed a bill that seeks to prevent well-off families from qualifying unfairly for Medicaid nursing home benefits. The same law could make it more important for lower- and middle-income Americans to seek professional advice about long-term care.

Certain financial transactions are acceptable under Medicaid nursing home eligibility rules, whereas others can put Medicaid coverage out of reach for weeks, even years. Experts say detailed financial records are crucial for people seeking to be declared eligible for Medicaid assistance.

Some experts suggest that people explore long-term-care insurance. Such coverage is not for those already in crisis, and it has limitations. For example, people with chronic health problems may not be able to get it, and policies can be costly.

The new law encourages seniors to consider a reverse mortgage or to tap equity in a home to pay for long-term care. But older homeowners may find these products of limited value, since they generally require the borrower to live in the house.

If you or a loved one is in crisis, experts advise getting legal and financial counseling. Here are some sources of information:

· http://www.naela.org/public/index.htm The National Academy of Elder Law Attorneys offers suggestions for finding a lawyer experienced with issues surrounding long-term care.