What are the Alternatives to a Nursing Home?
If you are physically or mentally incapacitated, severely disabled, suffer from Alzheimer’s disease or dementia, or require 24-hour custodial care, a nursing home or long-term care facility may be the best option. However, if you are able to function independently, but need assistance with shopping, cooking, cleaning, laundry, and transportation, there are several senior housing options and senior assistance services you can use in most areas to avoid a nursing home.
If you live in a rural area and want to live independently in your senior years by utilizing senior assistance services, you may need to relocate to a more urban area. It is usually more difficult to obtain the services required to live independently in a rural area, unless you have a strong support system of family and friends.
The alternatives to living in a long term care facility include:
Using a combination of in home care and community care, including assistance from family and friends; adult day care; Meals on Wheels; in home nursing care and homemaker services from home health agencies; and senior assistance services for cleaning and shopping.
Assisted living facilities, board and care homes, and continuing care retirement communities.
What Happens to My Property and My Estate If I Have to Go Into a Nursing Home?
If Medicaid pays for any services for you on or after your 55th birthday, including nursing home care, medical services, in-home care or community-based services, Medicaid has the right to recover from your estate after your death all amounts it paid on your behalf. This is referred to as estate recovery. When you accept benefits from Medicaid, a debt is created that must be paid by your estate after your death. Medicaid’s recovery against your estate will be delayed if at the time of your death you have a surviving spouse or a surviving child who is either under age 21, disabled or blind.
Medicaid also has the right to place a lien on your property. If your spouse, a sibling, unmarried child under age 21, or a child who is disabled or blind lives in your home, Medicaid may not be able to place a lien on your home in some circumstances, due to certain exemptions available under Medicaid. Medicaid can also place a lien on and take recovery action against your personal property, cash, annuities, other real estate, and certain other types of property.
If you are concerned about preserving assets in your estate to ensure your spouse will have a home and adequate financial support, you may need to engage in Medicaid planning, especially if you do not have a good long-term care insurance policy. Also, if you want to leave an inheritance for your children, grandchildren, or other heirs, or want to leave a charitable gift in your will to a particular charity, there are two important steps you should take:
Find out whether you qualify to purchase long-term care insurance to pay for nursing home care and related types of long-term care if you should need it; and
Meet with an estate planning attorney who has experience in Medicaid planning to find out how to plan your estate so your assets are protected in the event you need nursing home care.
