When talking to an elder law attorney, what questions should you ask about spend downs, and what questions you should be prepared to answer? If you have the power of attorney for a senior loved one, how do you start the conversation with the family about their assets, and how do you best navigate this with them? Elder law attorney Jim Koewler joins Suzanne Newman to answer these questions.
Many people have false assumptions about Medicaid. The biggest question is how much care is needed. Most people don’t think they want assisted living, but also don’t realize the family burdens this creates to provide them with 24/7 care forever. This is an unrealistic expectation, because the quantity of care eventually exceeds caregiver ability, and the person receiving care then struggles when they aren’t getting the support they need.
Start the conversation with, “I want to try to keep you home, but what happens when I don’t think I can any more?” That is a difficult question to ask, but it has to be asked.
What next? Unless the caregiver is an RN with long-term care experience, explain that you’re not an expert with the type of care they may eventually need, so seek out a geriatric care manager. Go to https://www.aginglifecare.org and search for one near you. Tell your family that you need to gain some expertise on what your loved one is likely to need down the road. Make a care plan with professional input.
Find out what’s expected of you: what kind of care your loved one wants. Make sure you have power of attorney, so medical personnel can talk to you about their care. Your caregiver should have general power of attorney for you — if they’re caring for you, empower them to pay for your care.
Even if care isn’t needed yet, notification of power of attorney should be given to banks and investment houses so legal departments have time to look over the legal documents. Don’t put this off until an emergency arises, as you don’t have to have to wait for legal reviews in order to get funds.
For spend downs, you have to ask about, and know about your loved one’s assets.
Jim Koewler addresses later-life financial and legal issues. Talk to an elder law attorney to guide you in your state with your situation. Learn more at Answers for Elders or at Jim’s website.
View Episode Transcript
*The following is the output of transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors.
The following podcast is by Mr Jim Koewlere, elder law and special needs attorney, helping and protecting those who need long term care. And Welcome back to everyone to answers for Alder’s Radio Network. And we are here with wonderful Jim Taylor and we have been talking about spend down. How do you qualify for long term care benefits? Now you need care, maybe you have a spouse that needs help and you earn a situation where you’re having to try to figure it all out and Jim, we have gone through a lot of different scenarios. But I am going to now step into the seat and say, you know, I get calls probably more about this topic than anybody else because people don’t understand the whole principles of Medicaid. Number One, there’s a lot of misnomers, Jim, about that. People think that they can still get all of their inheritance like say, well, Mom, dad are giving me all their you know x number of cash because this is what’s in their will, or I’m getting the house when they die or anything like that. Those things change obviously with Medicaid. If you know, if those things come into the picture, that’s a whole other topic we can talk about later, but I get a lot of questions about I don’t even know how to approach to topic with my parents on what kind of financial assets they do, when, when care needs to happen and what my role is. Maybe I’m dead the designated power of attorney. That I know this, I need to know the answers to this question of what their desires are and how do I best help navigate this with them. So, Jim can can I just kind of start with you with that kind of scenario and, course, can you begin to share with me how do we start? Okay, the big question is what kind of care? How much care? What is the proper setting for your lovedown who needs care? The vast, vast, vast majority of people, I can’t say all of them, because my great aunt actually chose you on a nursing homely, even thought you was healthy. But the vast, vast, vast durty people never want to move into nursing home. Never one. We do assisted living, okay, but and they don’t realize, or maybe they do and just don’t care, that they are asking their family to take care of them, no matter how much care they need, no matter the family, not having training, not having a day off, not having a second chip, not having a quipment. Okay, so that is many times an unreasonable expectation. That is the different, probably the most difficult piece of the conversation to have. Mom, you want me to promise to keep you home. I may not be able to do that and if not, I’m not. If I try to keep you home or my home or your home or whatever, even though you probably would get better care somewhere else, it hurts your health and hurts my health, and when my health gets hurt by this, your health is going to be hurt even more just because I can no longer do it. When a family caregiver, caregiver gets to you into their rope, there’s no place else for them to go, then the caregiver struggles and the person receiving care is going to struggle more simply because they’re not getting the support that they have been getting. Answer that not getting the support they need. Correct family caregiving, the unpaid family caregiver is, in my view, the most difficult job in the world. So you have to start the conversation with yeah, mom, I want to try to keep you home, but what happens when I don’t think I can anymore right, and that is a difficult thing to say. Is a difficult question to ask. It’s a difficult question to ask of yourself if you’re the caregiver. Yeah, but it has to be asked. So what? What next? Okay, now my suggestion is to bring into the conversation. I’m not an expert on what you need. Now, maybe you you know, maybe the feeling Brimer is an ur end with long term care experience. Okay, then fine, then that’s who needs to look. Okay, but you don’t have experience and what someone needs. I suggest you seek out a jarretic care manager. I’m using nurses, by the way. Not many elder the attorneys anywhere in the country at what we call care coordinators. I have three, two our ends at an LPN with a lot of experience. I’m the only one in Ohio as far as I know, using nurses. You don’t have to use an Odo laws outlaw attorneys. Care coordinators as a whole organization of jetter carey managers. They now call themselves aging life care professionals. So go to aging life care dot org and there’s a search function there for someone near you. So if you I urge you to have enter into the conversation and say mom, Dad, sisters and brothers. I think we need some expertise on just what is mom likely to meet? I’m he’s going to pick on long but if mom likely to need yeah, even if it’s just for a couple of hours, to do an assessment and help you come up with the care plan right, rather than just fly by the Sei your pants the whole time. That would be my first suggestion. You know’s haven’t talked about outlaw. Turney to all here other than some at the t use care coordinators. Okay, right, I’ll put my nurse against anybody in the country, by the way, and those of you who use other nurses we put might be against. Need to this. See what we’re doing here, okay, but get some professional ed advice and the professional input on what is likely to come in the future on care, and it’s not just what you see now. Well, SAR on the road. Okay, that would be the first step. Yeah, and then after that we go and I funny, and what you think you want. Let’s talk about but the first step wants likely to be coming, and that’s from someone who’s seen the Kearney well, and I think the main thing starts with you need to find out who the designated power of attorney will be and and if who that person is, and then I believe it’s a responsibility of that person to have those conversations. Before you even say yes, I’ll be your power of attorney, I need to know what you expected me, what your expectations are of you, know what kind of care you want. Because here’s the thing that I think a lot of things people think okay, and it certainly was a case in my mother’s situation. She appointed my former sister in law who, basically because she was up in Antichortis, where my mom’s all of her her bank accounts were up there, right, but then she had to be relocated down here to where I was in Lynnwood and Selsnahamash County, which is about an hour drive away, right. And so what happened is is I was down here trying to take care of her, right, but I had all the responsibility and no authority and which to do so. That did not work for us because wherever I would go with her, whether it was a senior living community that she lived in, they legally couldn’t talk to me about my mom, and yet here’s this person an hour away that had really no, no same level of emotional attachment to these issues because she’s so far removed. So what? And she’s an inlaw. Yeah, and she’s an in law. Yo, the but the bottom line was I remember having a really difficult conversation with my mom, but I said, mom, you know, I know why you chose this person to do this. I get it and it’s not working, because this is what’s going on, and it’s like, here’s the thing. For me to continue in the role I’m in, I need to have the ability to care for you. If you don’t want that to happen, then you’re going to have to we’re going to have to figure something else out. Because that was a scenario that mom finally realize, wow, that’s this isn’t working, and so she then we did go to win attorney, elder law attorney, because that was really important, and one of the things that we really shocked this person is that she had that she got a notice in the state of Washington which was called a revocation of however, turney, which meets she says, what did I do wrong? It’s like you didn’t do anything wrong, you just weren’t logistically, you know, available to which is a perfectly valid reason. So those are some conversations that you need to have upfront with your your loved ones, of who is, you know, who’s really carrying the ball here. You know, are you going to give it to this person? That is just because my son is a financial planner, but he lives five hundred miles away. That doesn’t necessarily mean your son is the right individual to be that person. And those are the conversations that we’ve had before. Obviously, when you say how to choose people to represent you. But again, this comes into a situation that families are trying to face and everybody is different. There’s not a single scenario that is cookie cutter. They’re really you’re not. We’re all individuals, and I think that’s one of the things, Jim, that you’ve been able to really help us with now in these conversations hot what are some ways, what kind of questions, you know, should we know about? Like how do we approach that question of, you know, how much money do we have to work with? You know kind of things. I guess that’s my question. Yeah, and that’s it. That that can be a touchy subject. Some parents, some families, are wide open about money. This is what I got, this is where it is, you know. Here’s all the statements, just so you know. Here’s the account number. Most are not most or not some are, you know, somewhere in the middle. They you know, the family knows some but not everything, but some are just completely closed. My kids don’t need to know what I’ve got. NOPE, until I’m dead. And that’s what we find a lot. And I’m going to blame the state planning attorneys there. Okay, a state planning attorneys. People are right wheels for a living. are very good at thinking about what happens when you die. Hmmm, they suck at thinking about what happens when you need long term care. Interesting. Yeah, okay, which is why we have so many bad powers of attorney out there and why really all on you and I spent so much time talking about who I to be the on the power returne. Who ought to be the agent, just referencing back folks, one most likely be your caregiver. Should be your agent on everything. Yeah, so that he or she, usually she, has the ability to take care of you and make decisions about your hair and the ability to pay for them. So health care power returney or proxy or whatever it’s called in your state. Yeah, and the General Dura will power returney. So they believe spend money, okay, and power. You’re likely caregiver. And just like you’ve seen, you know, with if some if brother is the financial whiz and has the general power returney with it, might live just down the street but isn’t the one doing care every day. He did understand how difficult it is and doesn’t see what it means to be getting to the end of the caregiver’s role. Is so difficult, and I guess that’s the thing that I wanted to end this topic with, is that, you know, this is a really complex situation, but it’s something that really whoever is involved in you know, as I act as your agent, as you need care, there’s going to likely be a time when somebody needs to step in and be your advocate, and that’s why involving that individual upfront, of knowing what they have to face and where you know what the situation is down the line, I think is very valuable and certainly important to touch and two big points on preparing in advance for this. Not even huge points, okay, but very important points. No, as you mentioned, no one who’s going to be the omnipower of attorney should be ambushed. They should know and they should agree to do something. Okay, exactly second once a power of attorney is signed and ready to go, even if no one needs care yet, that needs to be given to the banks and investment houses, any place that is likely to need it. You real estate, didn’t care until you’re actually doing real estate, turned action, but you’d the bank is going to take time to look at it. Yeah, you want to. You don’t want to them to be sending this to the law department while you’re trying to forgot, how mom’s going to get care. No, so you want to take that in early to both the all the investment houses, including Iras at this point. Okay, all the forum case, all you Iras, whatever, and where they have their investments and where they have their bank. Right, right. Give them time to look at it before the stuff hits the fan. Jim, this has been such a valuable conversation. Thank you so much for today and we are so thrilled to be able to deliver this information out to our listeners. I know it’s very important and on a lot of people’s minds right now, so thanks for being with us. Thanks, Suzanne, and I would like to thank each and every one of you for listening this week on the answers for elders radio network, and we are always here to answer your questions and also check us out, check Jim out on the answers for Alder’s podcast network. We’re on Google, apple, spotify and more. So looking forward to all of you having a great week and until then, be good to each other. State of Ohio residents, you have a friend to help you navigate long term care while protecting your assets. You can reach Jim at wwwing Seniorscom or just email him at j Koewler afe. That’s J Kayler AFE at protecting Seniorscom.
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Founder and CEO of Answers for Elders, Inc., Suzanne Newman proclaims often, “Caring for my mom was the hardest thing I ever have done, but it was also my greatest privilege.” Following a career of over 25 years in sales, media, and marketing management, Suzanne Newman found herself on a 6-year journey caring for her mother. Her trials and tribulations as a family caregiver inspired an impassioned life mission outside of the corporate world to revolutionize the journey that so many other American families also find themselves on. In 2009, she became the founder and CEO of Answers for Elders, Inc., subsequently hosting hundreds of radio segments and podcasts, as well as authoring her first book. Suzanne and Answers for Elders, Inc. have spent 14 years, and counting, committed to helping families and seniors along their caregiving journeys by providing education, resources, and support. Each week on the Answers for Elders podcast, Suzanne is joined by vetted professional experts in over 65 categories including Health & Wellness, Life Changes, Living Options, Money, Law, and more. Suzanne lives in Edmonds, Washington with her husband, Keith, and their two doodle dogs, Whidbey and Skagit.
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