Elder Law, Medicaid

“We’re Okay, We don’t need any help”

A sweet 82 year old gentleman shuffled into my office the other day. I have known him for over 35 years, so I could not help but notice that he is now bent over with scoliosis and arthritis of the spine, and his breathing is quite labored. Salt of the earth, he is; He and his wife have a simple home, and are frugally living on what they perceive to be a “comfortable” retirement. Like many seniors, their combined pension/Social Security income is approximately $2,200 a month. This man is in my office because his wife, age 81, is declining—she has arthritis in her back, shoulders, and hands, and is currently in the rehab center of a local nursing home recuperating from a fall at home that resulted in compression fractures of her vertebrae. She is also having problems with her short-term memory. Yet when I ask him how he is doing, he tells me, “I’m okay. We’ve been handling things at home. But I am a little worried that I may not be strong enough to help my wife when she gets released from the hospital.” The ideal solution for this all-too-common situation would be for the couple to hire some in-home nursing care on a long-term basis, or perhaps a move to a long term care facility. However, when I suggest this to clients the reaction is often fear, or resistance at the very least. They aren’t ready to take that step yet; they don’t know what it entails, and are afraid they will lose their independence. Many of them also feel they can’t afford the cost of long term care, and are determined not to resort to Medicaid. In fact, when I mention Medicaid to the client whose story is featured in this post, his reaction is strong: “I don’t want to use Medicaid. I am afraid of Medicaid.” My client doesn’t understand yet that Medicaid is his only governmental assistance option in the event that his wife must go into an assisted living facility or nursing home. He also doesn’t yet realize that assisted living of some kind is all but inevitable. This confusion could be avoided if the subject is approached before a crisis hits, but broaching the topic is not easy. Often it is one of the children or grandchildren who have to bring it up. In this case, as with many others, the earlier the subject is brought up, the better. If you aren’t sure how to begin looking into long term care, there are a few websites that can get you started, including Long Term Care Living, and this guide from the AARP website. The law surrounding elder care issues can be confusing to those who don’t deal with it every day, especially the laws concerning Medicaid, which are murky and convoluted. Our role here at Law Elder Law is to help seniors understand their options for assisted living and Medicaid, and help them plan for a future in which they can be comfortable—both physically and financially.