April 29, 2014

Your Advocacy Connection – We Do Exist

By Kathy Nitz
GolderCare Solutions

Recently, my co-worker, Kathy Nitz and I facilitated a workshop about who is going to pay the nursing home and how to avoid costly mistakes before it’s too late. Kathy and I have presented many educational forums over the years, but this one was a bit different. First, we presented on subject
matter that we are extremely passionate about. Second, the folks who participated in this workshop were not only looking for information to help their parents, but also for information to help them make decisions for themselves should they need long term care in the future. From their response, it is clear that our community is thirsty for accurate information to make well informed decisions for themselves, as well as for their aging parents. Being the youngest of six children and watching my own mother’s health deteriorate, eventually ending up in a nursing facility, I find myself not only the facilitator but also a participant in this process. It gives me a new perspective. It also motivates me to share what people need to know in preparation for a potential cathartic medical event that could land them, or their loved one in long term care.

Aging is complex. We may have care needs that can impact whether we remain in our home versus going to a
higher level of care, such as a nursing facility or assisted living. Finding the right combination of care at home or elsewhere is not an easy process, yet any planning that we do starts with care. Quality of life is at the nexus of how we navigate our options. What folks don’t realize is that our quest to secure the right combination of services and/or transitioning to a new environment where care can be provided can be just as stressful for the family as it is for the one who is making the life change.

One of the biggest frustrations for folks who find themselves in this situation is getting conflicting, often wrong, information from various sources regarding what you “can do” and “can’t do” and still be eligible to access public assistance {Medicaid} to help pay for care in a nursing home. Often this information is provided by folks you trust, professionals who truly know “their stuff.” They very likely do know the rules about their particular area of expertise. What they may not understand is how their particular field interacts with Medicaid. We refer to this as “silos of information.”

One common example of this is the IRS rules related to gifting. Your tax professional may tell you that you are allowed to gift a maximum amount each year without penalty. This would be true for tax purposes, but not for purposes of Medicaid and long term care. Taxes and Medicaid are completely different rule systems put in place for entirely different reasons.

Another example, we also often hear folks say, “The bank just told me to put my name on my mom’s account,” to assist with their mom’s banking needs. This may solve one problem, only to create another issue dealing with Medicaid if they need long term care in future.

There are multiple benefits available through the Veteran’s Administration. One of those benefits is a pension benefit called Aid & Attendance [VA A&A]. Rules and eligibility requirements for this pension are very different from the rules/eligibility for Medicaid. What one may do to gain eligibility for VA A&A is very different than gaining eligibility for Medicaid.

Although I could go on and on with examples, I will close with a couple final points. Following our workshop, we have had multiple attendees come to our office to meet with us. Many of these folks have been following well intended erroneous advice for years paying in long term care. It has been their stories that prompted me to write this article on this particular subject. In the absence of comprehensive professional direction, they have been left to figure out all the different rule systems on their own. The most common response we hear is “I wish that I would have talked to you sooner…we didn’t know you existed”. Be sure to get the facts from a source who understands all the different “silos of information” before you make application for any assistance. I strongly recommend folks entering long term care get the facts about assistance long before financial assistance is actually needed.

Filed Under: Family, Finance, Retirement