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A Supportive Podcast for those Dealing with a loved one with Memory Loss

Getting Medicaid to Pay Without Groing Broke First

Getting Medicaid to Pay Without Groing Broke First

00:00:02 – 00:05:03

Welcome to fading memories, a podcast with advice, wisdom and hope from caregivers who have lived the experience and survived to tell the tale. Think of us as your caregiver, best friend. As you know, my mom suffered from Alzheimer’s, and cognitive impairment affected my grandmother and great grandmother. It seems to run in my family, but I’ve learned my brain health doesn’t have to follow the same fate as those who came before me. I am doing what I can to improve the health of my brain, including eating a better diet and exercising. However, I learned recently that when it comes to nutrition, most of us are still living with undernourished brains. And I know I need something to fill those nutritional gaps. This led me to neuro reserve and their product relevant. Relevant is a nutritional supplement that restores the vital nutrients for a healthy, aging brain. Relevant includes 17 of the most important nutrients that specifically target long-term brain health. These nutrients come from the Mediterranean and mined diets which studies have discovered can reduce our risk of Alzheimer’s by over 50%. You can use my code FM 15 for 15% off of your order. This code is good for subscriptions, which will apply to all future orders, as well as individual orders. Go to neuro reserve dot com to purchase. The link is in the show notes, and you can also find it on my website. Neuro reserves mission is to help our brain span Matt our lifespan. How many of you have had caregiving, thrust upon them suddenly, and one of your first and biggest concerns is how are you going to pay for the care your loved one needs? It’s no surprise that our healthcare system offers very little in terms of long-term care. What is available is, in general, extremely expensive. It seems that unless you are poor or very well off, your options for long-term care are few and far between. However, there are options available if you know where to look and know early enough to put the right plans in action. And that’s what we’re discussing today. How to get Medicaid to pay for care without going broke first. Welcome back listeners. We are having an excellent conversation today, joining me on the podcast is Jason neufeld, and I hope I got that right. You did? Oh yeah, I’m really terrible with names and I didn’t have him pronounce it before I unpaused. So running a risk, he is an attorney and elder law attorney in the great state of Florida, and we are discussing how to get Medicaid to pay for all the things we need to pay without draining your bank account first. Is that a correct assessment? Yeah, I think that’s right. Thank you, Jennifer, for sure. Thank you very much for having me. It’s really nice to be here and yeah, Medicaid, it’s all about the principle is, you know, if you are ultra wealthy, you can well afford to pay for everything that you need. If you’re impoverished, you may already qualify for Medicaid that will pay for healthcare, long-term care, home healthcare, nursing home care, all these things that are very, very expensive. And as everybody in the middle who’s getting the short end of the stick, right? So Medicaid claims all about working with people who don’t yet qualify and then we have our legal and ethical ways of protecting what they have, so they qualify for these benefits, so they don’t have to impoverish themselves first. Not only do we get the short end of the stick, I think they smack us around with it. Yeah, yeah. Right. Thankfully, my parents, home was paid for. And my dad had a good retirement and he had investments. So we rented out my mom’s home and let’s see. So between the rental income, her social security and an infusion from their financial planner into her into the trust bank account. She had plenty of money. Great. Yeah. When you can, when you can live off of your investments and it’s a different source of income, that is, of course, the best. If you can do that, it’s always better to do that if you can avoid having to do all these craziness to qualify for Medicaid. Certainly I say cash is always better than anything. There’s no restrictions on it. You know, everyone takes it, right? Certainly, that’s terrific. It’s really nice position to be in. And I didn’t have to try to deal with that system. Gratitudes for that one. There you go. Thanks, mom, thanks, dad. Appreciate it. Yeah. Definitely. And, you know, I don’t know how familiar you are with the prop 13 where they basically took a sledgehammer to a tiny tax problem back in the 70s.

00:05:04 – 00:10:02

That’s just not done good things for our state, but basically a paid for home, under prop 13 taxes. You know, we paid the Gardner, the homeowners, this insurance, and one other thing. The property taxes. Right. She had plenty of money. That’s great. She would have had plenty of money for a very long time. So yes, it was very grateful that my dad was very frugal and hoarded at all. But that worked out in the end. It did? Yeah. So where should people start if they are in the middle and they don’t have a house they can rent out? Yeah. Like we did. Right, yeah, I mean, so it depends on where they are in life. So if they’re young like you and, you know, they have some time before they are going to need these long-term care services. I also tell people I go it’s good to talk to a trusted financial planner who can help you look into long-term care insurance because similarly long-term care insurance is just as good as cash. Just as good as having cash. The problem with it is most people when they look into it, they see how incredibly expensive it is. So that’s not an option for everybody. And in addition, once you are of a certain age, or you have certain ailments, you just won’t qualify no matter how much money you have. They’re just going to go, we’re not going to underwrite you because you are of a certain age or because you have these conditions. And so, you know, these insurance companies, that’s what they’re all about. We don’t want to avoid paying out whenever possible. So usually my clients come to me when they are in their late 60s, 70s, 80s or even later. And most typically, it’s because there has been a deterioration in their health. Sometimes upsetting like right after a heart attack or a stroke, sometimes it’s more gradual, like with dementia, right? You don’t start. It’s not one day you’re lucid in the next day you’re out of it. It’s a slow progression. And they realize they can’t for whatever reason they can’t do for themselves anymore independently. They need help typically in one of three scenarios. It’s paying for care at home. It’s going to an assisted living facility where, you know, you’re in like your own apartment, but you’re near all the services or that highest level of care is nursing home or skilled nursing facility care. And when they quickly realize is that those things are very expensive. And Medicare what we all get when we turn 65 and we’ve paid into the system, which you get regardless of what you have. Has a very limited long-term care benefit. People go, I have the best Medicare plan ever. So I’m all set. No thank you, Jason. I don’t need you. And I go, well, you know, take a closer look at that plan because 0% of them cover more than a hundred days in a nursing home. Or we’ll cover any bit of an assisted living facility. That’s non medical, or they won’t cover home healthcare to help you cook and clean and go to the bathroom and get dressed and shower and all these sorts of things. Medicaid death. So they’ll come to me and they’ll have typically they may or may not own their house. And on top of that, they’ll have between 50 and say $750,000. And they’ve done a calculation they go, even with, you know, let’s say they have a quarter $1 million. Well, if you’re in a nursing home that costs 11,000 hours a month, that goes real quick. That’s not that sounds like a lot of money, but it winds up not being that much when you have all these long-term care expenses. So they come to me when they have that realization. And then we go through with them there’s more than one way to skin the cat. We have different, you know, they all have pros and cons, which is why having the cash to begin with is great. Having long-term care insurance will be with this great. But when people come to me, we’re going to be able to protect probably about 70 to 80% of their assets, which is great, because they think they’re going to lose everything, but we’re going to protect most of what they have through different strategies and then we will legally and ethically qualify them for Medicaid to kick in and pay for some or all of their long-term care needs. That’s excellent. Yeah. Because you know, as we’ve read, most likely, in the news, the top 1% have a lot of income protecting I don’t want to say loopholes, but strategies. Legal. Yeah. And, you know, the majority of this country does not. So it’s nice to hear. Hear about a few. Go ahead. What’s interesting? What’s interesting is I get this as a negative as to what I do. People go, what do you mean, you take someone who has quarter $1 million and you’re hiding it? Isn’t that stealing from the government? Isn’t that, you know, that’s not patriotic. That’s un American. And I go, well, let’s think about it this way. If you were in the 1% and you had $10 million in your bank account.

00:10:03 – 00:15:00

What you would do is you would go to a tax planning attorney and you would say, I would like to pay as little in taxes as possible. I want to do it legally. I don’t want to do anything that’s going to, you know, get me in trouble with the IRS, but what can I do to pay as little at little as possible? As I tell people, I’m doing the same thing except I’m doing it for working class middle class upper middle class folks who have much more to lose, right? When I save my clients a couple 50 or a hundred or a couple $100,000, I would argue it is significantly greater impact on their quality of life than when the tax that’s going to save the guy with $10 million a couple million, right? So I feel very proud about what I do. And again, I don’t hide anything from anyone. I tell the government exactly what it is that I’m doing with my clients income and assets and why still understate and federal law, they have to grant my clients access to these benefits. My dad would have loved you. His theory with he with the IRS was everything is deductible right up into the audit. We have we had a family business together his poodle, both of them, ’cause over the years, there were two different ones. Came with him, and he wrote off the grooming, which familiar with poodles is not cheap. They got fussy hair to deal with. And I think he wrote off the vet and the food, like the whole, all the expenses for the dog. He wrote them off. Because the dog was a mascot of the business. Okay. I’m like now, if I tried that with my golden retrievers, who I referred to as spokes dogs. Offline, I told Jason about my CPA attorney person. And he wouldn’t do it. He’s a little more conservative. And it’s fine. I’ll pay for my own dogs. But that was big outs theory. Yeah. I don’t have them just for a tax write off. That’s funny. Although, you know, now that my daughter’s nearly 30, I’m like, could we have had that child tax credit when I was younger? And she was, you know, a kid, and but it’s okay. That’s right. Moving moving on. You do. You’re doing it. I could be doing a lot worse right now. My husband’s in real estate. Okay, oh, he must be doing great. Yeah, he’s a lot busier than he’d like to be, but, you know, it’s one of those things where it’s like, gotta make hay while the sun shines. Then do it. Absolutely. I did tell Jason I live in a suburb of San Francisco that grows corn and cherries. Amongst other things, but that’s our two top corners. Very nice. There we go. You can tell I’m not a farmer. To find the word crop. So where would somebody let’s say our situation was my dad ended up in the hospital and after bouncing my mom around for three weeks. He was in the hospital for 32 days. You don’t bounce somebody with Alzheimer’s. Advanced Alzheimer’s around like that for three weeks and not suffer. All of us were suffering from. That’s right. Having to do that. So we am in the hospitals like they are basically a 110% done with my dad. There’s nothing more we can do. We’re releasing them. Like, no, you’re not. I didn’t know this was happening and I don’t have anything in place. I literally had to find home health aides overnight. Yep. Not the best scenario. And I do stressful. Yeah, let’s not fight. Well, you have to make a very important decision on the fly. Not how it’s how most of us end up doing it, but not the way I recommend. That’s true. So the in home healthcare was $28 an hour when it was the two of them, which, you know, simple math was over $700 a day. And then after he died, we move my mom into memory care. So thankfully, my husband was smart enough to talk to my parents financial planner and let him know what was going on. Yep. And because everybody knew everybody. He helped facilitate getting bills paid and all that because my sister and I and our families could not afford $700 a day for more than a few days. So where would we have started knowing? I mean, he came home on hospice, so you know what was happening. Right. Yeah, a lot of people start with their financial planner. I get a lot of referrals from different financial planners. Hopefully they know. I say my biggest problem as an elder law attorney who focuses on Medicaid planning is that a lot of people don’t know that what I do exist. That’s why I love doing shows like yours. I’m trying to really get the word out that even if you’re not in Florida, there’s for example, anywhere in the United States, you can go to what’s called the national academy of elder law attorneys website that’s nae ELA the acronym dot org and you can click on find an attorney. You just literally put on your zip code and give you a list of attorney that I say there’s no.

00:15:00 – 00:20:02

There aren’t any elder law turners worth their salt who are not a part of the national academy of elder law. So that would be a great first place to start. I get oftentimes, it’s the financial planner knows that Medicaid planning exists and they’re great. Because a lot of people, the natural reaction is, you go to your financial plan you go, do you know what? How am I going to afford this ? And some of them who are less educated are going to go, well, we’re going to put you into a conservative investment, and then we’re going to stretch it out as long as we can. And we’ll get you through another couple of months or a couple of years. Those who are in the know hopefully have a relationship with an elder law attorney that they trust and we go, okay, we need to do more than just stretch out your current investments. We need to do some real asset protection. That’s really what it is that I do. It’s asset protection just for middle class folks. So those are two great places. The financial adviser, or if they don’t know, you know, if they’re not telling you that they know what elder law is or what Medicaid planning is, you go to the national academy of elder law attorneys and you find someone who’s experienced in doing Medicaid planning. That’s really what the key words does not many people have heard of that. They know a state planning. They heard of elder law, but Medicaid planning is really the key term that your listeners are going to want to look out for. That’s also really good to know. And write that down, so I don’t forget. Since I don’t need to use it, and it’s. Okay, I did write it down right? ’cause B in California, like I said, it’s not called Medicaid around here. Right, that a cat, that’s right, I guess, Medicare, planning attorney. Yeah, and we work with, it’s a smaller percentage, but we do have people who, and it’s typically it’s for folks really like you who have seen a relative go through this experience and knows how expensive it is. People who if they have the wherewithal and they want to think about these things, they go to an elder law attorney well before they need these services. Because we have some asset protection strategies that we can use only if we have 5 years in advance to plan, which is great. We have most of my clients don’t have 5 years. They need it tomorrow or next month. So yesterday. Exactly, or a whole suite of other services that we use. But the folks who have the wherewithal to New York gosh, I saw my mom and dad went through and I don’t want to go through that or put my kids through that. We’ll go see an elder law attorney sooner and say, listen, what can we do to protect my stuff now? Because I know dementia runs in my family. I know Parkinson’s runs in my family. What are we going to do to make sure that my long-term care needs are taken care of? And I tell people, you know, I do some general state planning as well, right? The wills, the trust, the powers of return, and it’s how people, you know, if all the fancy, revocable, irrevocable, special needs trust, and advanced plan that I do, there’s no more important document than I can provide one of my clients and a well drafted durable power of attorney because if you wait until your loved one has lost their ability to make decisions for themselves. Now, instead of them getting their spouse or child or trusted loved one, the ability to help them make decisions, now we’re going to court, which is a lot more expensive and more time consuming in California think it’s conservatorship in Florida. That’s called guardianship where we’re going to a guardianship judge and we’re saying listen misses Smith did not plan in advance. We need to start making decisions for her, but she can’t do it anymore. So we’re getting a judge involved, which is unfortunate because if you just came one to an attorney sooner, you could have bypassed that. The other issue that I want people to look out for is people want to be Pennywise and pound foolish by downloading these three power of attorney forms off the Internet. And what always happens with that is those forms are going to be good for certain issues and they will not work with others. For example, the free forms that see over the Internet are usually fine for things like banking, right? They’ll give you the ability to go access bank accounts and that’s important. So you’d have to help your level and pay bills and that’s useful. But when it comes time for more advanced Medicaid planning, they’re always lacking. And so people go, Jason, don’t worry, I got this power over 24. I did a years ago when I look at it and it’s fine in Florida. There’s like the same three free forms. I see over and over again. So I just have to glance at and I go, nope, that’s not going to work for what we need to do because it just doesn’t give you the ability. It’s not specific enough with what we do. And you can’t do general. You can’t just say, I give Jennifer the ability to do everything for me, so help me God, and that’s the end of it. You can’t do that. I have to be very specific. And if it’s not in there, you can’t do it. And certain states have specific laws like Florida, where if even if it’s there in black and white, if it’s not initial properly, you can’t do it.

00:20:03 – 00:25:07

So there are all people think that they’re being crafty by downloading this free form. And I don’t need to pay a lawyer money to do that. And I go, well, you know, you’re really if you’re a gambler, you know, I get it, but this doesn’t seem like the type of thing you want to gamble with. Well, I’m going to refer my Friends to the Neela dot org because they are in their early 60s, looking at retirement, ones retiring this year, one’s retiring next year, and they’ve looked into long-term care insurance, and at their age, and there’s minor health issues, nothing significant. Yeah. That they would have to pay $50,000 buy in. For each of them. So they have decided to quote unquote self insure. Right. So anyone they’ve got they’ve had good jobs, all the years they’ve got. They’ve got good assets as far as I know. I don’t open their bank statements or anything but they’ve done fine. They’ve got three kids. To one is married one is engaged. And the youngest one is, you know, 25 and starting his life. So, you know, they’ve got family to consider. Yeah. But this sounds like they have the time. Hopefully, the 5 year window to plan ahead. So that maybe they can take care help. Take care of themselves without burdening their children and their well they have one grandchild. I’m assuming more will happen. Right. And I’ll give you, I’ll give your listeners another long-term care insurance tip, which is and we looked into these traditional long-term care policies. My wife and I looked into it. And we’re both thank God and excellent health, my wife’s a lawyer, I’m a lawyer. We’re doing all right. And I want to look at these traditional policies. I go, who is paying these premiums? This is ridiculous. It’s crazy. And we say, we’re not doing that. But what we did do is you can buy life insurance with a long-term care rider. And that is a much more affordable and still very useful way to plan for to get long-term care insurance when you look at these traditional policies which are ridiculously priced. You can get this life insurance. So what I like about it is we have this life insurance, and I have kids and I go, someone’s gonna use this policy. It’s either gonna be me because I need the long-term care or my wife or kids if I happen to go before any long-term care. So I like it no matter what happens. Someone’s benefiting from this insurance. It seems like a nice a nice sense of security for my family. So, you know, it’s good to ask about, hey, if we can’t afford a long-term care and straight up, let’s look at these life insurance policies with these long-term care riders. You know, our insurance agent is a friend and I do not know of those plans. There you go. So I will have to I will have to go harass them. And pet their golden retriever. They have their golden goes to their office. So, okay, so we’re at the my dad’s on hospice. In home, caregivers at 700 plus dollars a day because this was four years ago. And we know we’re going to put mom into memory care. But perhaps they didn’t have the investments which paid about 25% of her expenses. So now we’re having to figure out where this 25% is coming from. Yeah. And we’re like, ugh. Right. So your talk, hopefully, then you’re talking to an elder law attorney and they’re gonna go through with you the different ways. Again, everything I tell people we do a consultation because there’s more than one way to do it. And there’s none of them are a magic wand. That’s not like I just have this great trust that I just throw all your money into that has no negative repercussions. Everything has a drawback to it. So we’re typically not doing one strategy we’re putting together a collection of strategies to balance out depending on my client’s circumstances and what’s best for them and their families. It’s a little bit different for everybody. Don’t lose hope because there is a way to do it. And it’s all, you know, it’s all with an eye towards putting more money in my client’s pocket. Give them access to resources that wouldn’t have had access to otherwise. So whether it’s completely stopping the financial bleeding or whether it’s at least slowing it down significantly, it’s all a benefit. So it’s like my joke is it’s a very easy sale because I tell people, you know, everyone will explain to them what it is that I can do, I get checks and hugs because they’re like, they think they’re gonna lose everything or nearly everything, and I go, no, no, we’re gonna be able to save most of this stuff and here’s how we’re gonna do what nears the timeline and they’re just so happy. So it’s a really nice it’s a really fulfilling area of law I gotta tell you it’s a really nice to be able to help a lot of families this way. We’re very grateful for people like you. So do you have like some generalities you can tell people which directions you might look at for them, obviously this is not blanket advice for everybody because you just said it was you have to assess it.

00:25:07 – 00:30:01

Everybody’s different. It’s hard to give a specific example for a few reasons like so for example in Florida. Some of the strategies that we use here won’t work in California because Medicaid this is actually good for people to know. Medicaid, it’s a state and federal partnership, but it doesn’t transfer. So if you have Medicaid in California, if you move to Florida, you don’t automatically get medicated in Florida. You have to reapply and there are different standards. So you may not qualify for Medicaid in the one statement, but not qualify in another. And similar so I tell people, you know, so for your listeners purposes, if they have a relative in Florida or they’re thinking about moving to Florida, hopefully they’ll call me or someone like me in Florida. But if in any other state, they got to deal with someone in that state because I don’t know the particularities of California law. I really don’t. I’m only licensed to practice in Florida, so that’s what I focus on. So they really, I’m hesitant to even get into some of our strategy because people may go, oh, that’s a great idea, but it may be inapplicable, not applicable to wherever they are. But really, it is going to be so worth their while to go pay for an hour of a lawyer’s time to sit down, go through their specific circumstances to get a plan for what they can do. What I do is I charge a consultation fee, but if they hire me, it’s a credit toward whatever they hire me to do. So I’m just trying to get tire kickers to get rid of that. But everybody walks out of one of my consultations significantly more educated than when they walked in. And even if they don’t hire me because they don’t need me or because, you know, they’re maybe to move into another state. They’re always very thankful that they now understand what is a very confusing process. Definitely, I have learned more about Medicaid slash mostly Medicaid, ’cause I haven’t talked to an elder law attorney for the show. That’s based in California. I have talked to them for my own use. We did our financial trust and all that good stuff last summer. Good for you. Just so people know it really isn’t that big a deal. And we have one daughter and we do have a family history of dementia. And my daughter has a chronic illness. It’s not life threatening or anything, but, you know, so when the attorney said, oh, you want everything to go to your daughter. Okay, great. What happens if she goes first? Right. And I looked at him and I went, well, that’s just an awful question. What a good one. Let me think on that one. Those fiance, but they’re not, you know, they’re not married and my husband and I are just old enough to be a little old school and it was like, huh, did we give it all to him or like, what? Yeah, that’s really important because that’s where Medicaid planning and estate planning really intersect. We deal with people who have special needs children. Or maybe they’re not special needs now. Maybe God forbid son or daughter gets into a car accident and becomes disabled. And now they need to qualify for these benefits. So we never want to be in a situation where mom and dad’s assets are now mom and dad pass away. So our daughter’s getting an inheritance and we don’t want it to jeopardize their access to benefits. So part of a state plan is is not only dealing with it. So I families with special needs children who know that they need to protect them from this sort of thing. But it’s even useful because we build it into our trust packages where I say state planning is a lot overpacked for a vacation. We put a lot of stuff in there that you may not need. But if you do need it, you’re so glad that it’s there, right? So we put stuff like that in there that basically says that God forbid your daughter would have become disabled in the future, then this your trust is going to protect her. And similarly, what if she gets divorced? Maybe you don’t want her husband having access to half of your stuff, right? Maybe you want to make sure that we keep it in the trust. So it’s for her use and if they get divorced, he can’t touch it. It’s not part of their marital assets, right? Normally he’d get 50% of her stuff. Not if it’s properly in a properly drafted trust that your attorney has done. So these are all things that we’re thinking. Again, you’re right. We all think that the circle of life is going to be parents die before their children. That’s how it normally happens. That’s how we hope it happens, but it doesn’t always work out that way. So the trusts are providing for these multiple contingencies. What if it doesn’t work out the way we plan, we can build in there what’s supposed to happen? What your intention is to happen? Which is now I got to ask my husband double check a question that you brought up, which is fine. You know, and that’s all good and the gentleman is in our rotary club. So, you know, it’s a good relationship. But you know, like you were saying the circle of life. My dad passed away four years before his mom. So, you know, and that was tough on her.

00:30:02 – 00:35:00

He was the oldest son. And she recently passed and, you know, it’s kind of interesting because my dad’s parents did have quite a bit of money. They didn’t. When they first got married, but my grandfather was real good at making it and keeping it. Nice. And I got a lot of interesting stories about how he kept it, but that’s okay. That’s for a different podcast probably. Let’s just say his poor upbringing never left him and I’m kind of the same way. I’m very frugal, but, you know, I enjoy. I enjoy life, so I’m not suffering from my frugality. But they gifted money to my dad and his two brothers, regularly. So that when my grandmother passed away, I was like, oh, I see she gave away most of the money before she died. Okay, that’s cool. Yeah. And, you know, that’s fine. You know, I’ve never been one of those people that expected an inheritance. Right. Not my money, so whatever I got, I got 5 bucks. Great. If I didn’t shine, it wasn’t my money to begin with. So it was really interesting to kind of after the fact see what their machinations were ’cause I know, ’cause my dad gifted my daughter money. She ended up in college for 5 years. Which was typical of where she went, but nobody, nobody bothered to tell us that the federal student loans only covered four years. So that was kind of an abrupt slap in the face right at the beginning of the 5th years like wait a minute. Hopefully that gift made a little bit of a difference. Oh, it did. It paid for the whole year. Oh, excellent. And it was perfectly. Yeah, that was the exact amount of money you could gift somebody for the year. Them encouraging any taxes. Right. So it was really interesting to see that financial planning, how it played out in the long run. Excellent. But what else should people, okay? So we’re going to the NE LA dot org which is going to be in the show notes. Yep. What else should people be? If you’re taking care of a loved one, is there things that we should be considering doing for them and then we’re going to after you answer that question will go on to what we should be doing for ourselves. So yeah, I mean, what people should be doing for their loved one is you know, part of talking to an elder law attorney is learning about resources. There’s lots of resources out there and just so hard to find them. So I also advocate getting involved in the disease supported organization, the Alzheimer’s association, the Parkinson’s association, everyone has their support group and find a support group because a I think it’s important not to suffer in silence because there is a problem of caregivers pre deceasing the ones that they are taking care of because the stress is all on them and they have the weight on their shoulders. So finding a caregiver support group is great, because it’s not only are you going to feel better for the catharsis. But you’re going to hear from other people how they have found access to different resources. So that is absolutely essential. Also, when they are elder law trainer, we’ll talk about this. But when you access Medicaid, you’re not just accessing the long-term care, they have other resources. They provide to you, like in Florida, Medicaid will pay for home adaptability and safety equipment to be installed in the house. Making the bathroom safer or non slippery and the grab bars and the wheelchair lifts and all these sorts of things, which is really, really important. It will also provide respite care for the caregiver, right? They need a break every once in a while. So sometimes you’re taking your loved one, you’re bringing them to a facility for just a couple days, so you can go recharge and take a little vacation and just be if you don’t take care of yourself, you can’t take care of your loved one. It’s gonna negatively impact everything about it. So keeping the holistic process in mind, I think is I think is incredibly important. So yeah, there’s that. Well I can echo the get into a support group. My dad passed away march of 2017. We put mom in the memory care the same month. That was a fun month. And I went to the hospice grief support and it was like, well, this is great for this one part of my life. Right. But I got this other bigger part. I don’t know how to deal with my mother and this is way worse than I was. Yeah. You know, I mean, I saw them all the time, but it was without my dad as a buffer. Dealing with her was ten times worse than it had been with him. And so I like normal people these days, Googled for a support group, found the Alzheimer’s association, support group, and as you guys can tell from my background, I am an advocate, and I’ve done the walk. Yeah. But the first support group I attended the first meeting I attended, I felt better about what was going on in my life.

00:35:00 – 00:40:02

And then the second month, I was able to help somebody else. So it was like, immediately, you know, you’re just sort of brought into the group. I still go, although it’s been virtual and my mom’s been gone over a year, so I’ve missed the last two because I’ve been doing other things on Thursday nights. But, you know, I don’t need them as much, but I still kinda go, ’cause they still kind of want to see me. So there’s definitely a benefit. It’s not like a boo hoo hoo fast or an OPD. They help you, you help them, it really is a very nice thing to do. It’s very important. Before we were online, we had matings with some like 30 people. It was pretty cool. Yeah. Like one night I came home, my husband said, oh, how’d it go? And I’m like, well, I was like 32 people and he’s like, well, that’s good. I’m like, yeah, I’m one respect, but not so good in another respect. Right. So yeah, definitely. So we’re talking to an elder law tourney. We’re getting in a support group. Finding out resources through whatever association is attached to whatever we’re dealing with. Okay, so we got them covered. Now what should those of us gen xers, some of the older millennials that are taking care of family? What should we be looking at so that we can break this crazy cycle that is not healthy for anybody? Yeah, I think everyone needs a everyone needs to talk to whether it’s an elder law attorney or an estate planning attorney. Everyone needs their own estate plan. We just never know what’s going to happen to us. And so the idea is if we can avoid things like guardianship court and make sure that you are, people don’t like to think about this stuff because it of course brings up our own mortality. And they also think that signing things like a power of attorney or healthcare story and a healthcare proxy designation is giving up control over themselves. And I always tell people, you’re not, it’s an incredibly empowering experience. Where you choose who gets to help you. Because if you don’t, the judge chooses who gets to help you. So there’s certainly is the potential for abuse. You don’t just give out the power of attorney Willy nilly, you want it to be with someone who you do indeed trust. And if you don’t trust, by the way, there’s nothing inherently bad about guardianship or conservatorship. Some people, it makes sense. They go, I want a judge overseeing what somebody is doing. And that makes sense for some people, right? But for most people, I’d rather my son, my daughter, my spouse, be the one who helps me if I need help for myself. So there’s that. And then again, no one knows what tomorrow brings and just to have a plan in place is gives you peace of mind. It gives your family peace of mind, I like to encourage people to think about prepaying for not necessarily the younger millennials, but once you’re 60 and over prepay for your funeral and burial arrangements, someone’s going to have to bear that expense at some point in time. So you might as well get it taken care of one last thing for your loved ones to worry about. And then you’re talking to your financial advisers, get that long-term care insurance. Cash is always going to be key. Long-term care insurance, even if it’s part of a life insurance rider, is better than Medicaid. I’m a Medicaid planning attorney and I’m readily and that that we don’t know what Medicaid is going to be like in 20 years from now or 30 years from now. So it’s a plan your financial future, so you can maintain control over all your decisions and not have to engage in Medicaid planning always better and more likely that you’ll be able to do it if you plan in advance or bury your head in the sand. It has never served anybody. And if we haven’t learned after last year, 2020, you know. One day we were, you know, my rotary club is meeting in person and then the next week the governor is saying that’s it. The 7 counties from San Francisco Bay Area are closed. That’s right. That was that was a marked 16th and our first rotary club online was March 23rd. You know, I mean, it was just like all of a sudden, life, it just did a one 80 on all of us. And my daughter does background checks, and the courthouse that she worked out of. It’s she’s an independent contractor type person. Closed in March of 2020. This is June of 2021. It is still closed. We reopened next week. Don’t know what that means for that particular courthouse. She was basically quote unquote off work for 5 months, and then the courthouse in Oakland opened, which is the main one. I guess it’s the main courthouse in that county. And so, you know, here we are still, you know, what is a 16 months later? I don’t know when she’s going back to her original courthouse. If she’s going back, you know, and that’s not a big deal in the scheme of life, but it just, you know, I try to talk to people, you know, my dad planned. I’m a planner. Last year was hell ’cause you couldn’t plan anything, but that’s okay. I survived. But we’ve talked about, you know, it’s just my husband and I and our daughter and almost son in law.

00:40:03 – 00:45:01

And we’ve talked about, what do we want to do? You know, do we want to be buried? Do we want to be cremated? We want to be turned into a tree. We want to be turned into a gemstone. There’s like a whole bunch of crazy options these days. Right, that’s true. And once you’ve talked about it, you know, when these new forms of burial or whatever you want to call them come up, you can just joke about them. Like, you still want to be a tree? Okay, good. You’re a tree. You know, it’s no big deal. You know, but my family’s a little weird, but, you know, and it’s the same thing we talked to that we did our estate planning and there were some challenging questions. What if you do if Jennifer comes down with Alzheimer’s because my mom had it? My maternal grandmother had vascular dementia and my maternal great grandmother had some form of dementia. She died before I was born. Not even sure they distinguished back in those days it makes me sound really old, but whatever. You know, and it’s like, once you get through these tough questions, it’s like yeah. Oh, okay, well now I have an answer and moving on. Now it’s no big deal. It’s really, you know, when he asked us, well, what happens if your daughter goes first? It was like, yuck, and it did. We had to think about it for a while, not that we don’t trust the son in law, but, you know, it’s like, well, what if they do get married and then they get divorced and then you start going through all the what ifs and then you sort of decide it’s been in the family for like 9 years, like what the hell? You know who else is gonna have our money? Right. If it’s not them. So you know, you just you just end up making it just because part of your DNA I guess is like maybe. It’s really very fair. You know, I know my paternal grandma grandmother who just passed away recently. Her husband, my grandfather, he planned everything. I mean, if they had the burial site, everything. And they tried to talk to her about it and she’s like, I don’t want to hear it. Don’t want to talk about it. And it didn’t serve her. Trust me. I’m sure he discussed it with the sons. So it wasn’t like that conversation got lost, but yeah, we don’t really want to talk about what happens after we die, but you know what? You’ll be dead, you won’t care. See, I told you my family’s weird. That’s funny. That’s how we are. It’s a valid philosophy. And yeah, it’s a lot of people just don’t want to think about this and they’re going to not going to happen to me and I don’t want to think about dying or becoming incapacitated. And maybe they’ll be fine and maybe they won’t, but it’s not a state planning is not such a burden some expensive process that it should prevent anyone from doing it. And by the way, if you don’t have a will or you don’t or you only rely on a will, you’re still going to court, your kids are going to court. So if you don’t do it for yourself, you do it for your kids. Save them the time, the money of having to hire an attorney in Florida. It is legally required if you’re going to the probate process to hire an attorney to do it. You’re not even allowed to try to do it yourself. I guess who wrote the laws? My colleague wrote it. But that’s what, but if you had said you use a revocable trust instead of relying on the will, now you get to avoid probate altogether. You don’t have to hire the attorney to do it. And yet, getting a trust is a little bit more expensive than just getting a will, but it’s, again, don’t be Pennywise and pound foolish is worth it in the end. It’s a good investment in the end and talk to it. I want to encourage people to talk with estate planning attorney, if they’re younger, talk to an elder law attorney. If they’re worried about these long-term care expenses, because these are real issues that affect many, many Americans. And as we get, listen, our healthcare system, well, I guess this is arguable. But it trends getting better. People are living longer. But guess what? As we’re living longer, and now we have more of an opportunity to need assistance with our long-term care, because we’re not getting older and fitter, we’re getting older and just lasting longer. That’s true. Yeah, right? I mean, these are real issues that are affecting millions and millions of people. So I hope I hope you’re listeners have taken something away from this conversation. Well, if I didn’t know that you could do Medicaid planning. I did know I have talked in the past to like a, I don’t think they’re attorneys. They were like a Medicaid planning service. Oh, don’t you? I didn’t get this, but I didn’t get the same information I got from you. So it’s like, okay, more information is good. There are, I’m glad you brought that up because there are a lot of these non attorney services who say they can help you with Medicaid planning. And what happens is they’re, well, I can’t speak for all of them, but they tend to be one trick ponies, meaning they have they have like an annuity that they’re going to try to sell you, and that’s all they’re going to do. So everything they see is they’re going to ask you to buy annuities because there’s a way to structure annuities so that they don’t count against you for Medicaid purposes.

00:45:03 – 00:48:43

And I go, you’re just doing yourself into service. And sometimes these firms are venturing into the unlicensed practice of law because they’re then they’re giving you legal advice when they shouldn’t be. So I hope that if you’re thinking about Medicaid, go see a Medicaid lawyer. It’s just you’re going to get the best advice by someone who’s been trained who is the license to do this stuff as opposed to, you know, the one the guy who’s just trying to sell you their one product. That makes sense, but like I was starting to say, if I’ve learned something beneficial, especially the life insurance with the long-term care writer, then I’m sure everybody listening has gotten some tidbit that they should take advantage of. If not, at least you’ve helped me and I’m gonna help my Friends. I’m glad it’s so serving. If we could touch one person, I’m good with it. There’s so much bad information about there with Medicaid planning. Again, that’s my goal is to try to get good information. I wrote a book about it, just because again, it’s not, you know, I have this book that goes for $10 on Amazon. It’s not a money maker. It’s I’m just trying to get good information out there. And what’s the title of the book? Yeah, it’s how to get Medicaid to pay for some or all of your long-term care expenses a little bit of a mouthful without having to wait 5 years without having to sell your house and without having to go broke first. And that’s on Amazon. I’m happy that I can send you a link to that. And if you like. Tell me the link and I will throw it in the show notes, so other people can read good information because definitely have to counter the bad stuff that’s out there on the Internet or the well intentioned but not good stuff. I write a lot of articles, I post a lot of videos on my website, which is elder needs law dot com and I try to again just my effort to try to get good information out there and educate people. We all had to become like media companies too. I know. It’s so true. Yeah, I mean, it’s really, it really is, I mean, I like it. I mean, there’s a lot of competition for it, but I like the idea of a lot of lawyers take the philosophy of pay me money and I will solve your problem. And my philosophy, I’m going to educate you, I’m going to put out what I could put out a lot of free information out there. And if you want my help, I’m happy to provide it if you’re figuring it out on your own, then God bless you. And then I’m fine with that too. Okay, so that was elder needs law dot com. All righty, I want to make sure I wrote that down right. Well, thank you very much. This has been very informative. Thank you. You guys have a terrific weekend and I appreciate all the advice. Thanks so much, and thanks for having me. I hope this knowledge puts a bright smile on your face because I know the struggle most of us go through with finances, pain for care, it’s a whole learning curve that we all have to take. And if you’re like me and this information comes too late to be of benefit, it’s not too late because you can educate other people around you, and that is the whole point of bringing you this information and these conversations. Make sure you share this with everybody that you know because even if you’re not caregiving at some point, you may need it, or you may be providing it, and this is the kind of information that all of us need to know as we go forward and aging well. I want to thank you guys for tuning in once again. Make sure you’re following me on social media . Please leave a review on Apple podcasts, so new people can find us and as always, I will be in your ears again next Tuesday.