Most Significant Issues in the Long-Term Care by Kurt R. Bachman

What is one of the most significant issues that must be addressed in the long-term care, asset preservation, and estate planning process?

The process of planning with a client for long-term care, asset preservation, and estate planning has revealed many regularly recurring elder law issues that are common among many clients. First, and foremost, is the need to assess the long-term caregiving needs of the client and to plan for the same. Doing so usually involves consideration of implementing Caregiver Agreements to compensate family members who will assist with basic Activities of Daily Living (A.D.L.) in an effort to extend the client’s ability to live at home. In addition, Expense Sharing Agreements can be utilized if the client must move into a family members’ home to receive the required care to perform A.D.L.’s. At some point, a Medicaid Waiver may be considered to obtain paid outside care assistance in the home. This type of care requires a home assessment and financial planning. It is generally a viable option when the client is unable to perform A.D.L.’s, the family is unable to provide full-time assistance in the home, and the client and family desire to avoid institutionalized care. Another benefit of a Medicaid Waiver is if full institutionalized care becomes necessary, Medicaid eligibility is automatic upon transfer to a qualified Medicaid facility.