Long-Term Care Planning and Timing Move to Assisted Living

A recent JAMA Internal Medicine study titled “The Natural History of Disability and Caregiving Before and After Long-Term Care Entry” examined the health and caregiving needs of assisted-living residents. Study results highlighted the median move-in age, the average level of care needed and likely long-term needs. This article expands on the research results to highlight how your assisted-living move-in impacts elder law in your estate planning and the strategies to consider.

How Does Timing Your Move to Assisted Living Influence Long-Term Care Planning?

The study indicates that the mean age for moving into assisted living is 85, and they are less likely to be severely disabled compared to those entering nursing homes. The research identified a critical period of one to two years during which the care needs of assisted living residents could escalate to levels seen in nursing home settings. This progression underscores the importance of upfront discussions and planning regarding long-term care strategies.

Despite relatively good initial health, over half of the new residents had dementia, highlighting the need for comprehensive planning to protect financial and personal well-being in the event of cognitive decline.

Legal Strategies for Assisted Living Planning

As the average entry age into assisted living is around 85, it is crucial to prepare for possible increases in care needs, including issues related to dementia or cognitive decline. Legal and financial strategies to consider with your elder law attorney include:

Living Trust: Living trusts are a three-party agreement between the creator, trustee and beneficiary. With well-written terms and instructions, these trusts can protect your assets and funds.
Irrevocable Trust: Irrevocable trusts transfer asset ownership to the trust and can help lower your estate’s value.
Powers of Attorney (POA): Durable POAs give legal authority to a trusted person to oversee financial and healthcare matters when you are incapacitated.
Advance Care Directives: These directives specify your preferences for medical care, including decisions about treatments and care facilities.

Elder law attorneys are vital in navigating the legal complexities associated with transitions to assisted living. They help draft critical documents like living wills and powers of attorney and ensure that your rights are protected throughout the process.

Conclusion

Deciding to move into an assisted living facility is a significant life choice that impacts quality of life and health care in later years. Consulting with elder law professionals helps families devise flexible plans that accommodate changing care needs, ensuring that legal and financial protections are in place for residents as they transition into and within senior living communities.

Key Takeaways:

Optimal Timing for Assisted Living: The average age for moving into assisted living is 85, with prior home care averaging 18 hours per week.
Evolving Care Needs: Health and independence levels can approach those of nursing home residents within one to two years, indicating possible changes in care needs.
Personalized Decision Making: The decision to move into assisted living varies greatly and should be based on individual health, care requirements and personal preferences.
Role of Early Long-Term Care Planning: Elder law attorneys are crucial for helping seniors with early long-term care planning that protects individual rights and assets before a move to assisted living is necessary.

Reference: JAMA Internal Medicine (Nov 6, 2023) “The Natural History of Disability and Caregiving Before and After Long-Term Care Entry”

Caring for a Loved One from a Distance

Trying to coordinate care from a distance becomes a challenge for many, especially since as many as 80% of caregivers are working. Add COVID-19 into the mix, and the situation becomes even more difficult, reports the article “When your parent is far away and you are trying to care for them” from the Pittsburgh Post-Gazette.

The starting point is to have the person you are caring for give you legal authorization to act on their behalf with a Power of Attorney for financial affairs and a Health Care Directive that gives you authority to receive health information under HIPAA (Health Insurance Portability and Accountability Act). It is HIPAA that addresses the use, disclosure and protection of sensitive patient information.

Next, have a conversation about their finances. Find out where all of their important documents are, including insurance policies (long-term care, health, life, auto, home), Social Security and Medicare cards. You’ll want to know where their tax documents are, which will provide you with information on retirement accounts, bank accounts and investments.

Gather up family documents, including birth, death, and marriage certificates. Make sure your loved one has completed their estate planning, including a last will and testament.

Put all of this information into a binder, so you have access to it easily.

Because you are far from your loved one, you may want to set up a care plan. What kind of care do they have in place right now, and what do you anticipate they may need in the near future? There should also be a contingency plan for emergencies, which seem to occur when they are least expected.

Find a geriatric care manager or a social worker who can do a needs assessment and help coordinate services, including shopping for groceries, medication administration and help with basic activities of daily living, including bathing, toileting, getting in and out of bed, eating and dressing.

If possible, develop a list of neighbors, friends or fellow worshippers who might create a local support system. If you are not able to visit with any degree of frequency, find a way to see your loved ones on a regular basis through video calls. It is impossible to accurately assess a person’s well-being, without being able to see them. In the past, dramatic changes weren’t revealed until family members made a trip. Today, you’ll be able to see your loved one using technology.

You may need to purchase a smartphone or a tablet, but it will be worth the investment. A medical alert system will provide further peace of mind for all concerned. Regular conference calls with caregivers and your loved one will keep everyone in touch.

Caring from a distance is difficult, but a well-thought out plan and preparing for all situations will make your loved one safer.

Reference: Pittsburgh Post-Gazette (Sep. 28, 2020) “When your parent is far away and you are trying to care for them”

Estate Planning Blog Articles

Estate & Business Planning Law Firm Serving the Providence & Cranston, RI Areas

Long-Term Care Planning and Timing Move to Assisted Living

How Does Timing Your Move to Assisted Living Influence Long-Term Care Planning?

Legal Strategies for Assisted Living Planning

Conclusion

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