Planning for Long-Term Care

Elderly man and daughter

One of the hardest things about getting older is seeing your parents and other loved ones become more frail and unable to care for themselves. When that happens, long-term care may be the best option for their safety and well-being.

When you think of long-term care, you may envision a nursing home. But what long-term care really means is extensive care, and that can take place in many settings, of which a nursing home is only one. Some people do well in an assisted living setting, where they receive housing, support services such as cleaning, and help with activities of daily living (ADLs) such as bathing and dressing. Still others are able to receive care at home on a long-term basis, with a team of family members and professionals to provide personal care, medication management, health monitoring, transportation, and other services.

But one thing that all types of long-term care have in common is that they are costly. And the need for care is likely to affect you, or someone you care about. The sooner you begin planning for that possibility, the better—and the greater your options.

Who Needs Long-Term Care?

Attorney Danielle Mayoras recently discussed long-term care planning with Rachelle Graham of CBS News Detroit. As she pointed out, statistics show that 70% of people who reach the age of 65 will need long-term care at some point. How long is long-term? For nursing home residents, the National Care Council reports that the average stay is 835 days—well over two years.

And while the great majority of people in nursing homes are indeed older, that doesn’t mean that the rest of us can put off planning for care. Anyone can find themselves needing extensive care due to early-onset Alzheimer’s, a stroke, or an injury. The bottom line is that it’s never too soon to start planning for the need for long-term care.

What Does Long-Term Care Cost?

Unsurprisingly, the cost of long-term care depends on the type of care and the geographic region in which it’s provided. The unifying factor is that there are no bargains to be had—and when it comes to the health and safety of a loved one, you no doubt feel that quality is more important than savings, anyway.

In any case, prepare for sticker shock: Danielle Mayoras observes, “Right now, the average cost of a nursing home in Michigan is $130,000 per year. And that’s the average! A lot of facilities are going to be much more.”

Because the level of care in assisted living is lower than that of a nursing home, the cost is somewhat lower, too: the national median cost of assisted living in 2023 was $59,940 per year. But due to the individual nature of in-home care, expenses may be higher than that of assisted living—perhaps $65,000-$70,000 per year or more.

Options to Pay for Long-Term Care

If you have an aging parent, the numbers above probably caught your attention. Many people don’t have enough in savings to pay for the care they might need, at least for very long. But even if you don’t have a parent who needs care, you should start thinking now about the possibility that someday, you might.

Fortunately, there are options beyond self-insuring (saving up to pay for your own care). One of these is long-term care insurance, which is just what it sounds like: coverage to pay for your care in the event that you ever need long-term care. Long-term care insurance can be expensive, especially if you have a history of health issues, but the younger you are when you purchase it, the lower the premiums are likely to be. Many people buy long-term care insurance in their 50s, before they need care but after many of the expenses of raising a young family are behind them. There are even hybrid policies available that pay a life insurance benefit if the policyholder never needed long-term care.

What if you can’t afford long-term care insurance, or can’t qualify for it? Medicaid (not Medicare) will pay for long-term care in many cases. However, there are asset and income limits, forcing many people to “spend down” their assets before they are able to qualify for assistance. What’s more, there are rules in place to keep you from transferring property to loved ones in order to become eligible for Medicaid. The program has a five year “look back” period to determine if an applicant made any transfers for less than fair market value during that time—like putting their house in their child’s name.

Luckily, attorneys at our law firm specialize in Medicaid planning, which can help provide your loved one the greatest quality of care at the least cost to your family. This is a very complicated area of the law so it is critical to work with an attorney that specializes in this area. The need to spend down assets becomes especially complicated if one spouse in a married couple needs to go into a nursing home while the other remains in the community. An experienced elder law attorney can help navigate this and other complicated issues, and dispel common myths about the planning process.

Help is Available for Long-Term Care Planning

Whether you are in a crisis situation where a loved one needs care now, or you are planning ahead for your own possible needs, it’s wise to assemble a team to help make sure you can get, and pay for, the best possible care, while preserving as many of your assets as possible.

In an immediate or crisis planning situation, Danielle Mayoras states, “The first person on the team, the “quarterback,” is the elder law attorney. That person is someone who really needs to concentrate in this area and not dabble in it, because it is a very complicated area of the law.” Filling out the team is the care manager, the person who assesses care for the senior, making sure they are in a good facility and getting the type of care they need. Also important is the financial advisor or CPA who offers insight into financial issues involved in care.

If you need help putting a loved one’s care in place, or simply want to relieve your children of the need to do crisis planning for you, Barron, Rosenberg, Mayoras & Mayoras can help. We invite you to set up a free consultation by calling (248) 213-9514 in Michigan or (941) 222-2199 in Florida to connect with our skilled and knowledgeable elder law team. You can also use our simple online contact form.