Tuesday, October 25, 2011

Spending Down to Medicaid--Prepaying Funeral Costs

Your aging parent has more care needs than dinero. He or she is on the road to Medicaid. As the dollars shrink, mostly to cover eldercare, you can do some things to provide for your parent's future.

Welcome to the world of the Medicaid spend-down. Each state sets its own rules for Medicaid eligibility and how people can spend their limited funds before they reach the asset limit--usually $2000.

My favorite spend-down strategy is prepaying funeral costs, probably because my family's experience ended happily.

The story went like this: Daddy and Mother's tiny retirement nest egg of $60,000 dwindled rapidly soon after they both moved to a Wisconsin nursing home. My sister Carol landed on a great idea. Having power of attorney, she set aside in a specific account, earmarked funds to pay all their funeral costs, including preparation of the body, minister's and soloist's fees, and other expenses related to the service.

In addition, the plan included monies for plots, burial stones, and even enough for a dinner for family and friends. Funds were set aside for our family's out-of-state flights, hotel costs, and car rentals, too. When the time came for the funerals, we adult children didn't worry about money.

What a blessing not to be stressed about finances! And later, after all the accounting, there was money left over--not much, but some.

It was a good way to spend down money before they converted to Medicaid funding.

Wednesday, October 19, 2011

Losing Your Marbles? A New Way of Looking at Eldercare

Juggling generations is dicey. The needs of an eighty-year-old aging parent for peace and quiet run counter to a two-year-old grandson's penchant toward screaming. And it's up to us Boomers to keep it all together.

Try as we might, life often unravels before our eyes. We start losing our marbles. For me, it happened on the eve of my parents' fiftieth anniversary surprise celebration. When I met them a week earlier at the airport, they were hunched in wheelchairs, exhausted from their five-hour-flight. What a shocker! Daddy's Parkinson's had progressed so much since I'd seen them last. Mother, also frail, looked like she could tip over.

During their two-week visit, we crammed in two graduations--one high school and one college--plus a wedding and the surprise 50th anniversary celebration. But what I remember most was the continual feeling of being split in a hundred pieces. Teenage sons crying, "We're out of milk, AGAIN." Mother and Daddy shuffling here and there, accidents waiting to happen. Like little birds, they chirped out their needs: Fleet enemas, dry cleaning, clean underwear. And of course, there were the needs of our daughter, the bride.

One day I remembered the "marbles" presentation. Years earlier at a conference for senior care professionals, a motivational speaker underscored the importance of positive words. To help him remember to say kind things to his spouse, his coworkers, his family, he placed 10 marbles in his left pocket at the beginning of the day. With every sincere compliment he would transfer a marble to his right pocket. His goal was to give 10 compliments a day.

During my parents' visit I didn't actually buy marbles to transfer from pocket to pocket. But the idea of intentionally complimenting folks in all the generations helped me cope. I started "seeing" the good, rather than just the sea of need. One day I caught my Dad, a retired minister, explaining a New Testament passage to our 18-year-old son. "Grandpa can really help you understand the Bible, can't he?" I said.

When Grandpa voiced his fears of tripping as he walked down the aisle at Shari's wedding, I assured him, "Tim is strong. He loves you. He'll make sure you're OK."

No, the marbles idea didn't take all the stress away, but it did give me a better handle on things. Just thinking of the marbles put a smile on my face.

If you think you're losing your marbles, you might be right. But try transferring them, from pocket to pocket, as you say kind things about the generations. The situation won't always get better. But you probably will. Take it from soneone who knows.

Monday, October 10, 2011

Your Aging Parent Refuses to Spend Money on Eldercare

A penny saved is a penny earned. All her life your aging parent has lived by Ben Franklin's words. But now, she needs assisted living or in-home care. The cost scares her to death.

Eighty-three-year-old Lois felt that way. Over the years she'd collected diagnoses like barnacles: diabetes, congestive heart failure, and more. She needed medication management, plus help with showers, dressing and other daily activities. As we talked, she fixated on the expense.

"It's SO expensive. It's SO expensive," she repeated.

"You can afford it," her son said, citing numerous investments. Lois wasn't convinced. So what to do?

Perhaps your parent's story is similar. Before you point out the "facts," try drawing her out with an open ended question. Something like: "I know you're really concerned about spending so much money. What troubles you most about that?"

You might be surprised at what you hear. Having grown up in the Depression, she may feel a sense of failure at spending money on herself, even though needed, instead of providing a larger nest egg for the kids. I've heard other elders say, "I've always given a substantial amount of money to the church. If I go to assisted living, I won't have as much to give." Still others are paranoid they'll run out of money. They've never spent more than their monthly income.

Whatever they say, listen before speaking your peace. And try to affirm their concerns. Then you can calmly point out how what the monthly fees will cover and how life will be better should they get care. Another tactic: Let them know that you'd like to move to assisted living or hire home care so YOU don't worry. The idea of sacrificing for you and your family members may make sense.

I often use this phrase:

"Remember during your lifetime you always saved for a rainy day?" "Well, right now it's beginning to drizzle." Or "It's pouring!"

Have you used other words to help convince your parent to get care? Tell me about it.
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