July 2023

Elder Law Update. News and Important Information For Seniors and Their Families.

Whether you’re choosing someone to help yourself or someone to assist a family member, it can feel overwhelming and confusing to choose the right caregiver. This is a highly personal decision and one you want to have confidence in moving forward, so here are some of the most important things to keep in mind as you scout out possible caregivers.


How to Know It’s Time for a Caregiver


Perhaps a spouse or other family member was picking up these additional responsibilities over the last several months or years, but there are also signs that someone needs more consistent, additional, or advanced help in the home.


Here are signs that an independent loved one is unable to care for themselves any further, or that a temporary caregiver like a family member needs help:

  • A current caregiver is suffering from their own health issues, is overwhelmed, or no longer has the time required to assist.
  • The person needing care is experiencing loneliness or depression.
  • The person needing care shows a lack of personal hygiene, sudden weight loss, or indications of malnutrition.
  • There are unpaid bills, stacks of mail, or important paperwork ignored throughout the home.
  • The home has numerous fall hazards that required help navigating, such as deeply pitched stairways or step-in bathtubs.
  • The person needing care is unable to perform daily tasks like cleaning.
  • The person needing care has no food, inappropriate food, or spoiled food in the home.

How to Decide What Kind of Caretaker You Need


Once you make the decision that further help is needed, it is extremely important to dedicate some time towards researching and communicating with potential caregivers.


There is an array of possible solutions to your problem, such as engaging a friend or family member you already know or hiring someone from a private company. Having a clear understanding of what help is needed will help you pinpoint the specific services and time commitment required.


Here are some of the most common professionals providing care services and what they do:

  • Home health aides check vital signs and manage activities of daily living (such as dressing, bathing, and using the bathroom. HHAs must have 75 hours of training and may hold licenses from the state.
  • Personal care aides do not hold licenses and can serve as companions and helpers doing things like picking up medications or offering rides to appointments.
  • Skilled nursing providers (LPNs) provide and direct medical care that a nonmedical or home health aide cannot, such as administering IVs. They may also be trained in speech, occupation, or physical therapy.
  • Certified nursing assistants or licensed nursing assistants take vital signs, monitor infections, clean catheters, assist with walking, and change dressings. Any medical tasks are performed under the direction of a nurse practitioner or registered nurse. CNAs can also help with personal care. Nursing assistants must complete at least 75 hours of training.
  • Registered nurses hold an associate’s degree or nursing diploma and have passed a National Council Licensure Exam. They can advise family members, operate medical equipment, administer medications, and provide direct care. As such, they typically cost more than all other aides.


How to Find a Caregiver


You may want to start your search by letting other trusted friends and family know what you need. you never know who may be able to recommend you to a registry, agency, or person providing those services. You can also communicate with local healthcare agencies and nonprofits or churches who may have referrals to these services.

Make sure to schedule an initial meeting with the person who will provide care since this individual will be so closely involved in your personal life or the life of the person requiring assistance.


Did you know that 70% of people in the U.S. will need long term care at some point in their lives? The cost for these stays and medical care varies widely based on where you live. The Genworth Cost of Care Calculator can give you an idea of what it costs in your region. Most people are surprised to learn that the average monthly median cost for a semi-private room in a nursing home is $7,908. It goes up to over $9,000 nationally for a private room. Since Medicare doesn’t cover the costs of these stays and care, you need to look elsewhere.


Don’t have long term care insurance or the private funds to pay for a stay in a nursing home or assisted living facility? You’re not alone. Many people need additional support in the form of Medicaid but may not realize all that’s involved in getting this help.


Understanding Medicaid’s Resource Limits


When someone applies to receive Medicaid benefits, such as in a nursing home, on the assisted living location or their own home, there is a resource limit. A person cannot have assets that are greater than the limit in order to receive Medicaid benefits.


The lookback period refers to the program’s right to investigate financial transactions made by people in the time leading up to their Medicaid application.


One of the primary purposes of the look back period is meant to prevent people from gifting their assets or selling them for less than fair market value in order to meet the asset limits. The Medicaid agency will review any asset transfers made by someone applying for these benefits within the look back period, including gifts or transfers made to an applicant’s spouse.


Penalty Periods


Penalty periods of ineligibility for Medicaid may apply. This look back period begins on the date of a person’s Medicaid application for long term care, and the typical look back period is five years or 60 months.


Any financial transaction made in this five-year period is subject to review. In order to plan ahead for the possibility of needing support from the Medicaid program, it is best to work with an experienced estate planning lawyer.


For example, if it is found that someone made transfers of $50,000 in funds during the years in the lookback period, and the average cost of patient care in that state is $5,000 a month, the patient is ineligible for benefits for 10 months.


Allowable Transfers


A lawyer can discuss strategies you can use to legally qualify for Medicaid that do not lead to any period of ineligibility. Advanced planning is crucial for making sure you have considered all possible avenues and have taken the appropriate steps to protect your interests.


Here are some options for allowable transfers:

  • Taking advantage of your state’s Community Spouse Resource Allowance.
  • Transferring assets to disabled children under 21 for their care.
  • Paying off joint or personal debts.
  • Making gifts of your home’s ownership interest to siblings who own a portion of your home and have lived there at least 12 months.
  • Gifting your home to primary caregiver adult children who have lived with you for you two years before your Medicaid application.

Discuss other strategies with a lawyer to put yourself in the best possible position to avoid the Medicaid lookback period.