For When You Need to Make the Tough Decision....

For When You Need to Make the Tough Decision: Planning for Long-Term Care

Article by Hazel Bridges

While Americans are living longer, are more active than older generations, and are staying more productive and employable well past the standard retirement age of 65, they still have the common concerns that other older generations had, namely, “What will happen if I can no longer take care of myself, or take care of my loved one?”

To be sure, many older Americans want to age in place, according to a study published by AARP, which means they want to stay in the homes they own for as long as they can. And according to Jane Bennett Clark writing for Kiplinger, almost 90 percent of people over 65 want to live in their homes for as long as possible. And by taking care of yourself (which includes eating a healthy diet and doing safe exercises that will keep your body strong), you could live in your current home for many years to come.

Of course, there are always the inevitable events that change those plans: the fall that breaks a hip, the heart problems that develop, the onset of Alzheimer’s or other memory problems, cancer, and even just the basic inability to move around inside the house. Even though senior citizens find Medicare and Medicaid invaluable, they provide little help when a senior needs to move into an assisted living facility or a nursing home.

At this point, you might feel well and strong enough that you’re dreaming of hosting your great-granddaughter’s wedding rehearsal dinner in your home (even though she hasn’t been born yet). But if things don’t go as you dream, it’s always good to have a plan in case you, your spouse, or both need to move into a skilled-care facility.

Here are three steps to take.

Determine Your Net Worth

Your net worth is simply a calculation of the dollar amount of what you owe subtracted from what you own, and that includes your house, money in savings and retirement plans -- in short, your assets minus your liabilities. Your biggest asset, though, will be your house. Chances are you’ve already paid off your mortgage (or are close to paying it off). Still, you must determine its value. Dave Ramsey suggests three steps to finding the value, the last of which involves speaking to a real estate agent. An agent always uses fresh information and knows which neighborhoods have houses with prices trending upward and downward. Another option is to do some research online. The value of your house is essential to know in case you need to sell it to pay for a long-term stay in a nursing or assisted living facility for one or both of you.

Speak with a Professional About Medicaid Issues

Medicaid, which is administered by your state, pays for long-term care once your own assets are extinguished. You should speak to an attorney who specializes in Medicaid in order to clarify “gifting” issues. According to Mark Eghrari of Forbes, “gifting” secures your assets so you cannot be forced to use them to pay for long-term care. An attorney can also help you with other planning issues as well. You probably won’t need to work with a Medicaid specialist unless it becomes necessary to do so.

Have a ‘Trigger’ Plan

If your overall plan is to age in place, you should determine when it will be time to consider moving into a skilled care facility. It’s an extremely emotional decision. The easiest decision to make might be “if one has to go, then we both go.” But if one of you needs highly specialized care, that decision might not be the best one. U.S. News & World Report suggests first using community resources to help at first until the care becomes overwhelming. That’s when you should visit potential facilities and start the decision process.

Just because you’re growing older doesn’t mean your life trajectory has to follow what others have done before. Entering skilled care is not inevitable, but like many other aspects of being a senior citizen, you can plan for it in case it happens.

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