Adult Illness, Alzheimer's and Dementia, estate planning, Financial Planning

Shirley’s Tale: A Widow with Dementia

By Rick Law, Senior Advocate at the Estate Planning Center at Law Elder Law – Across from the Aurora Premium Outlet Mall, right near the Farnsworth exit off the I-88 tollway in Aurora, IL. Shirley was an aged widow who eventually developed dementia. She was in her 80’s at the time of receiving a diagnosis of Alzheimer’s-type dementia.  A women of moderate middle-class means, she was like the majority of seniors.  In other words, she essentially had middle-class income and corresponding net worth.  She didn’t have sufficient income or assets to provide private-pay, luxury nursing home care for the full period of time that they had dementia. Most seniors in the United States do not have sufficient resources to pay for even one full year of private pay at either an assisted-living facility or a skilled-care nursing home. Since dementia is a progressively debilitating condition, many of those affected will need multiple years of ever-more-expensive care. Once one’s personal resources have been exhausted, each state has a nursing home Medicaid benefit program, which may become the sole resource to pay for skilled nursing home care for those affected by Alzheimer’s disease. Although nursing home Medicaid benefit eligibility varies from state to state, an institutionalized person occupying a Medicaid-funded bed is essentially asset-less and income-less. Let’s explore the impact upon dignity and quality-of-care life differences that can be achieved when an appropriate special-needs trust is used to supplement the very limited nursing home Medicaid resources available to a person with Alzheimer’s. At one time, Shirley and her husband, Curly, had enjoyed a life of health and prosperity. Like most men, Curly’s health began to deteriorate several years before Shirley had any significant aging-related health issues. And as is quite common, Shirley provided most of the care for her husband for many years. During the time of his decline in health they spent a substantial amount of their marital assets on Curly’s ever-increasing health-care needs. Eventually, Curly had to be moved out of the home and had to be institutionalized in a skilled nursing home setting. By the time he died, Shirley was substantially impoverished—so she was unable to continue to afford their marital home or to remain in the neighborhood that they had enjoyed for many years. She was forced to move to a small apartment where she lived frugally on one Social Security check of $1,200 per month. Her assets were $120,000 in total, which represented the proceeds from the sale of their home. A few years later, Shirley developed dementia of the Alzheimer’s type. After she became unsafe in a normal environment, she needed to live in a skilled nursing care setting. In her state of residence, one does not qualify for nursing home Medicaid until all assets above $2,000 have been “spent down” on health care. In addition, once a person has qualified for nursing home Medicaid benefits, all of the income is assigned to the care facility in which they reside. The only exception is that the institutionalized person may keep $1 per day, which is referred to as the “personal needs allowance.” Near the end of Shirley’s life, she was out of money and out of options. With only $30 per month for her personal-needs allowance and less than $2,000 in assets, she was bereft of any resources beyond the state nursing home Medicaid benefits. If she needed dental care, new dentures, hearing aids, modified mobility devices, specialized therapies, foot care, or other such services, the likelihood of the state meeting her needs was remote. Shirley powerlessly lived out her final days warehoused in a nursing home Medicaid bed. Too many families needlessly lose everything they have.  Don’t let that be you.  If you need help paying the overwhelming cost of long term care, give our office a call at 800-310-3100.  Your first consultation is absolutely free.  We’ll let you know what steps you need to take, right now, to protect yourself and your family.  Call now, because when you’re out of money, you’re out of options! Sincerely, Rick L. Law, Attorney, Estate Planner for Retirees. Rick was named the #1 Illinois elder law estate planning attorney by Leading Lawyer Magazine. He has been quoted in the Wall Street Journal, AARP Magazine,, and numerous newspapers and articles. Rick is the lead attorney for Law Elder Law, LLP, focusing in Estate Planning, Guardianship, and Nursing Home Solutions. His goal is to give retirees an informed edge when it comes to dealing with an uncertain future.  Get flexible retirement strategies that work during good times and bad, plus information on how you can save your home and assets from being used to pay for long term care.  Call 800-310-3100 for your free consultation now!