Making long-term care decisions should occur when you are in your 60s or 70s, if not sooner. Dementia begins in the 60‘s and the chances of its onset double every five years afterwards.
Considerations
First, determine whether a person’s living situation is appropriate. For example, review whether doorways are sufficiently wide for a wheelchair.
Next, address whether the person should stop driving and needs alternative transportation. A plan should also cover the estate planning and elder law issues of making of health care and financial decisions.
Hospice and palliative care should be considered. A person should move into a hospice facility when they exhibit signs of a diminished quality of life including severe difficulties communicating and being unable to feed or groom themselves or interact with others.
Palliative care, in addition to providing comfort, also treats side effects and improves quality of life. It should be obtained earlier.
Plans
The plan should include specific documents. First, prepare an authorization to assign a surrogate if the family notices change in their relative.
Consider an ethical will that contains the reason behind what the family is doing. It should exceed basic issues and explain quality-of-life issues and who will deal with various caregiving aspects.
A personal service contract covers who will manage certain services and how these will be paid. It designates who will be the primary caregiver and their compensation and set aside funds from the estate to pay for these services. Contracts may help achieve earlier Medicaid qualification but can be expensive.
Finances
Financial planning should also begin as soon as possible because Medicaid has a five-year lookback period. It cannot be delayed once a person is diagnosed with dementia. Long-term care insurance is very costly but provides for better care if you can afford it.
Put your financial house in order. Bills should be paid timely and household expenses and repairs should be resolved as quickly as possible.
People should simplify their investments by having one broker and reduce their accounts. This improves knowledge about your financial status and transferring funds to a surrogate when necessary.
Investment proceeds should be set aside for payment of two to five years of long-term care. Many facilities do not admit a resident unless they have proof of resources which is usually two years of payments. Care usually costs $100,000 per year.
Attorneys can assist with planning options. They can also prepare the documents needed to help assure your wishes are followed.