Senior Finances: The Transition to Medicaid, with Daphne Davis
Daphne Davis at Pinnacle Senior Placements talks about how to plan ahead when a senior loved one only has a few years worth of assets. There will be compromises, depending on estate values. When you know when and what drives them, you can be prepared for compromises. That comes from working with someone who knows how to project costs outward while honoring today.
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*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 provided by pinnacles senior placements LLC and answers for elders radio. Welcome back everyone. We are back here with Daphne Davis from pinnacles senior placements on answers for elders radio and we are now talking about in our last segment. Daphne, we’ve kind of been through number one, the emotional process that it is to end, but I think there’s this emotional current that goes through everything, obviously, and I’m glad we started out and then we talked about really basically the costs of, you know, what long term care really costs and reallys to realize just how expensive living in care, but also what happens if Marm or dad stay at home with a son or daughter? What is the cost, not only to them but, most importantly, to you as a family member, and what does that mean? So in this last segment we’re going to talk a little bit about how to plan ahead for eventual realizing that maybe Marm or dad only has two or three years left of assets. How do we, you know, what do we do with that? I’m guess, guess. How do we plan and maintain quality of life? That’s the big question, because it’s going to mean that we have to really know what our high as values are and where we’re willing to compromise. HMM, because there will be compromise and that compromise varies, I’m sorry to say, based on what your estate is, sure and so, and that compromise can come sooner or later. But when you know what your highest values are and what really drives your decisionmaking processes, the compromises are not as painful. When you know when those compromises may happen or what drives a compromise, you can be prepared for it and not have that cold water splashed in your face that comes with working with somebody. I’m sorry to be a broken record, but comes to working with someone who knows how to project out and still on or today. Right. So let’s talk about someone who, as a story, is an assisted living. They’ve chosen to leave their home. Mom and dad went together. They said, I don’t want to clean the gutters and I don’t want to go outside in the rain to get my mail, and so they’re an assistant living in. Generally health is okay, but there’s some disease processes that are going on. Something might have some parkinsons, somebody might have some indicators of dementia, but they’re doing great and they’re a great support for each other. Somebody passes away and now we have one person in assisted living and their right arm is probably gone, because they’ve been supporting each other for a fifty, sixty years right, and through the processes of life some behaviors or shortcomings or challenges were covered up right, and now we see new things that are needing more attention. Very, very common it is. It happens all all the time. So now you’re having to increase the amount of care for the person who the surviving spouse. Remember that this the second spouse didn’t have to pay those in large numbers that I was talking about. A second person who lives in the same apartment has a second person fee of somewhere between five hundred to a thousand dollars a month. So that’s taken away. So now we can apply that to care for the remaining spouse and trying to replace that right arm. And it happens so often. But now we might be moving into Gosh, you know, mom’s pretty healthy, she just needs a little more support. And have we even thought about. What if something happens to mom? What if she has a stroke, very common, more common than we realize. What if something happens with her cognition? You know, we know mom’s a little forgetful or she’s got some short term memory loss and and now that you know dad is gone or seeing a little more forgetfulness or her safety judgment doesn’t seem to be as clear. Should we be worried about that? Not Worried, but certainly aware. Now we need to look at is this community that they’re staying in that’s meeting their needs physically and emotionally? Will they be able to support our parents on a financial level? If my mom now runs out of some money, you know, she outlives her money that’s left, because they’ve been there for three or four years at the assisted living can they convert to Medicaid? Most often assisted living buildings do not convert to medicate. There are very, very few and you know, unfortunately I don’t know a percentage, but it is very low. I mean I don’t even think like one per cent are partners. But we and that’s what one thing that we’re blessed about. So I am going to memory again. For them, absolutely, and especially for member care. Yeah, Yep, a lot for the memory care for them. There are a few communities that do have strong Medicaid licenses and they have a business model, HM, that they have factored in and want to service medicate from the very beginning, or close to the beginning, but it’s few and far between. In the story that we’re talking about an assistant living, more than not, mom will not be able to stay right financially. Not even talking about Health Requi fronments, I’m just financially. So how do you plan for that? When should you make a move? Should you make a move? Generally? Yeah, generally, if I were to say a broadbrush, I would say yes, make a move. Yeah, because we don’t have a crystal ball. No, what we do know is that if you are hit with having funding drop and there’s no medicaid, you’re going to wigh. You have to move and now you have no money right to move and it’s much more difficult. Well, the Medicaid options are so limited, both in assisted living and an adult family homes. Adult family homes are going to be the most flexible financially. Let me say that again. They’re the most flexible financially. They don’t have a corporate entity that says this is our rule, hardened fast. The adult family home can it’s privately held. They can have kind of a gray area and be able to look at each situation individually. So let’s say mom has I’m going to use she has two hundredzero dollars left. Okay, two Hundredzero, wow, that’s a lot of money. Not If you figure minimally, and this is such a Con Servant of number, if you figure five thousand dollars a month for her care, that’s Sixtyzero a year. That’s three years left right of her care and that doesn’t even count. You know anything that MOM does outside clothing? You know food? That’s not paying or co pay for her medications, right, that doesn’t even pay for her you know insureance? No, you know anything? No, it doesn’t. So that’s the time to be starting to look at do I need to make another change, because she still can have quality care. And remember, I used a very conservative five thousand dollar number for her care per month. That’s Sixtyzero a year. When you’re looking for another community, the general rule right now is two to three years of private pay, and I’m going to talk about adult family homes. In an adult family home before they will accept Medicaid payment. So the thing that in times are a change in folks and we don’t get to vote on it. But the thing that we need to be aware of is I want quality care, I need to be able to convert to Medicaid, but I don’t want to compromise where my mom lives physically close to me. I don’t want to have to drive, you know, thirty minutes to go see my mom. I still want to be five to fifteen minut it’s away from my mom. All of those things are an important piece so that you can have options. With two HUNDREDZERO dollars, you still have options. If there is something going on in terms of her health, more than not you can bet that it will progress downwardly and her care costs will go up. We’ve talked about the three legged stool of having the medications, hydration and nutrition in balance right. And sometimes when you’ve lost in our story, if you’ve lost a spouse or there’s a disease process progressing, one of those things start waning a little bit right. And my personal feeling is the higher the the acuity of care the more intimate that care should be, so that people don’t have to use up their physical energy to remembering basics of life. Did I drink enough water? Right? Did I take my medication? I know I ate, but was it protein or was it sugar? You know, makes a difference. And and you know, I’m sure too, just that whole process is there’s depression. Is is common, yes, and depression can escalate symptoms of depressive of dementia, and it can also, you know, get you off balance, like you were talking about. You can create UTI’s and different types of things like that. So there’s a lot of factors and taking care of yourself that can, you know, bring forward symptoms that normally for your kidneys and livers, you know, flushing out the toxins in your body. I mean, our body is a machine, HMM, and we need to keep it at optimum. So so actually sounds to me like, and this is just thinking out loud, if mom or dad all of a sudden there’s a loss of a spouse, no matter what the situation is, that’s really a good time to call you, no matter what the asset factor is or anything like that. If there’s a spouse that’s lost. There’s going to be differences in in ask. AREN INCOME COMING IN? Correct? Yes, absolutely, and it’s also probably a really good time to sit down with you and then you have great resources to bring it. Let’s talk about that loss of income. I mean that means a pension. Yeah, is potentially gone. Yeah, the social security is gone. HMM. There might have been a life insurance policy this this population of people generally don’t have that life insurance policy because they have other mechanism. Right, but those that income stream is gone. You know in our story that we’re doing today. But there are other things that can change. So I guess what I want you all to hear is please, don’t be the ostrich and not look at the finances and factor out two to three years. It’s that’s kind of the goal that we want to look at now. There are exceptions to that role. Please don’t take that to the bank and say, Oh Gosh, we’re in trouble, because there are options for the six month conversion, the one year conversion, the converting right now today. Right, I have options for you. You just need to know where there are. You know, and does it fit your highest values? Right. I just can’t stress that enough. So, Daphne, I hope that our listeners today have gotten so much value from what you’ve had to say. I know I sure have. And you know, no matter what you think out there to our listeners, you know you might not think it’s now the right time to contact Daphne. I would air on the side to contact Daphne number one. Her services are free to you. There is no obligation, there is no anything. All you’d need to do is pick up the phone. And how do they reach you? Eight hundred and fifty five, seven thirty four, one thousand five hundred. Awesome. So thank you so much for sharing this hour with us. This is a wonderful program and I’m just thrilled to always have me on the shop and well, thanks for inviting me. The preceding podcast was provided by pinnacles senior placements LLC and answers for elders radio. To contact pinnacles senior placements, go to Pinnacle Senior Placementscom.
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Originally published July 21, 2019