Checklist When Visiting Assisted Living Facilities

When visiting an assisted living for you or your loved one, ask the right questions to find a safe, affordable community with quality care.

When you are trying to find an assisted living community for yourself or a loved one, you need to do your homework to find at least three candidates that meet all the needs of the future resident. After you have narrowed your search down to those facilities, you should visit each one with the person who will be living there. Know what you want to look for before you visit the first center, so you will get all the information you need from every facility.

It is easy to get overwhelmed in the process of finding the right assisted living community. To help you in this quest, use this checklist when visiting assisted living facilities.

  1. First impressions count. Pay close attention to your initial thoughts and feelings about the assisted living center as you approach and enter. Your instincts often pick up on “micro-symptoms” that can indicate a problem, even before you notice the issue itself.
  2. Try to see down the road. Visualize yourself or your loved one actually living at the assisted living community. Ask yourself if you would be happy there. Pay attention to whether you feel comfortable or anxious. Evaluate whether the staff and other residents are friendly and inviting.  Does this facility have skilled nursing on site?  If the resident’s health worsens, would they have to move?
  3. Use your Nose. When you walk through the building, pay attention to the smells. You should not be able to detect any unpleasant odors. Strong “cover-up” scents are also a potential warning that the place likely has cleanliness issues.
  4. Look for dirt, dust, and grime in the obvious locations and places, like the baseboards and windows. Cleanliness counts in an assisted living facility.
  5. The staff in action. Watch the staff when they are interacting with the residents. Look at the body language of both the staff and residents.  Is the staff courteous and warm?  Are the residents resentful or fearful? Keep looking until you find an assisted living facility where both the residents and the staff are happy, warm and friendly.
  6. The proof is in the pudding. Good food is one of the highlights for many people who reside in assisted living. Visit during mealtime and arrange to eat a meal there. Find out if the meals are both nutritious and tasty. Get a copy of the monthly menus to check for variety. Find out the center’s policy, when a resident cannot come to the dining room.
  7. Explore the both outdoor areas and the indoor facilities. Make sure that your loved one would be safe when enjoying some fresh air outside.
  8. The current residents. You can find out valuable information from the people who already live at the center. Without making them feel uncomfortable, notice whether the residents are well-groomed and wearing clean clothes. Sit and visit with some residents. Let them know you are considering this community for yourself or a loved one. Ask for their advice. Find out if they have to wait a long time for personal care or other services. If so, the facility is likely under-staffed.
  9. Check the price.  Assisted living isn’t cheap, but don’t let price drive the decision.  If you go to the cheapest place, you can expect to get a matching level of care.  Instead, consider the price and then consider how you’ll pay for assisted living.  Medicaid isn’t always available for assisted living, but may be if health worsens and your loved one is in a nursing home.  Perhaps the Veterans Administration offers a benefit you can use, or perhaps you have long-term care insurance.  See our Elder Law page for a longer overview.  https://galligan-law.com/practice-areas/elder-law/ 

In the end, this is an important decision and you should do your homework to find the right assisted living for your or your loved one.

References:

A Place for Mom. “Tips for Touring Assisted Living Communities.” (accessed August 7, 2019) https://www.aplaceformom.com/planning-and-advice/articles/tips-for-touring-assisted-living

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Why an Attorney Should Help with a Medicaid Application

Seniors should consider medicaid asset protection planning as part of their estate plan.
Hiring an attorney to prepare a Medicaid application may save money in the long run and get your loved one the care they need.

Elder law attorneys can be very helpful when it is time to complete a Medicaid application, and they can save money in the long run, ensuring that you (or a loved one) get the best care. Instead of waiting to see how wrong the process can get, says The Middletown Press, it’s best to “Use a lawyer for Medicaid planning” right from the start. Here’s why.

Conflict of interests. When a nursing home refers a family to people for preparing the Medicaid application or offers to complete it themselves, very often the person has dual loyalties: to the nursing home who refers them the work (or signs their checks), and to the family who will pay them a fee for help with applying for benefits. Whose interests comes first?

Everyone wants the Medicaid application to be successful, but let’s be realistic. It’s in the nursing home’s best interest that the resident pays privately for as long as possible, before going on Medicaid. It’s in the resident or family member’s best interest to protect the family’s assets for care for the resident’s spouse or family.

An attorney has a duty of loyalty only to his client. He also has an ethical and professional responsibility to put her client’s needs ahead of her own.

Saving money is possible. Nursing homes in some areas cost as much as $15,000 a month, in Texas they tend to be cheaper, but still in the several thousands.  While every market and every law practice is different, it would be unusual for legal fees to cost more than a month in the facility. With an experienced attorney’s help, you might save more than her fee in long-term care and related costs.

Further, attorneys can find ways to complete a Medicaid application and successfully obtain benefits without simply spending all of your assets before applying.  Many times nursing home staff will offer to do the Medicaid application after the assets are nearly entirely spent.  A quality elder law attorney will find ways to complete and file a successful Medicaid application while protecting your legacy.

The benefit of experience. It’s all well and good to read through pages of online information (Google, Esq.), but nothing beats the years of experience that an attorney who practices in this area can bring provide.  Any professional in any field develops knowledge of the ins and outs of an area and applying for Medicaid is no different. Without experience, it’s hard to know how it all works.  See Mary’s blog for more detail about how an attorney helps with this process.  https://galligan-law.com/when-you-need-an-elder-law-attorney/

Peace of mind from a reliable, reputable source. Consulting with an experienced attorney about a Medicaid application will help you avoid years of wondering, if there was more you could have done to help yourself or your loved one.

There are multiple opportunities for nursing home residents to preserve assets for themselves and spouses, children and grandchildren, particularly when a family member has long term care needs. However, here’s a key fact: if you wait for the last minute, there will be far less options than if you begin planning long before there’s a need for a Medicaid application.

Reference: The Middletown Press (July 29, 2019) “Use a lawyer for Medicaid planning”

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Estate Planning When Faced with a Serious Illness

More young and middle-aged workers find themselves in the role of family caregiver.
Everyone needs estate planning documents, but a serious illness makes that need more urgent. 

More than 130 million Americans are living with chronic illness. Forbes’ recent article, “Estate Planning Musts When You Or A Or A Loved One Has A Chronic Illness,” says that if you (or a loved one) are living with a chronic illness, you’ll likely need the same estate planning documents most people should have.

The article discusses these key estate planning documents, along with some suggestions that might help you customize them to your unique challenges because of chronic illness. These documents need to be tailored to your specific needs, so you should consult your estate planning and elder law attorney about what works best for you.  It’s also best to put your estate planning documents in place soon after your diagnosis, so that you can return your focus to your health, family and well-being.

HIPAA Release. The Health Insurance Portability and Accountability Act of 1996 governs the requirements for maintaining the confidentiality of protected or personal health information (PHI). A HIPAA Release lets someone you trust access your protected health information.  This is an important estate planning document because it provides your decision makers with information about your condition so they can best serve your needs.

Living Will. This is a statement of your health care wishes and can address end of life decisions, as well as many other matters. If you’re living with a chronic illness, there are special considerations you might want to make in having a living will prepared. For example, you might explain your specific disease while continuing to address other health issues.  You can address the disease you have, at what stage and with what anticipated disease course, and how if at all these matters should be reflected. It is also critically important to discuss these wishes with your loved ones before the issue arises so they understand what you want.

Medical Power of Attorney. This is sometimes known as a medical proxy. It is an estate planning document in which you designate a trusted person to make medical decisions for you if you’re unable to do so. You can give guidance to your medical agent about your preferences, goals and concerns in your medical care.

Financial Power of Attorney. This estate planning document lets you designate a trusted person to handle your legal, tax, and financial matters if you can’t or if it becomes difficult to do so. There are some unique considerations for those living with chronic illnesses to consider. One is the amount of control that should be given up now or at what stage. Another key issue in a power of attorney is if you should sign a special power that restricts the agent’s authority to certain specified items or sign a general power that provides broad and almost unlimited powers to the agent.  It is especially importantly that your power of attorney include authority to handle Medicaid and other long term care benefits if you are facing a serious illness.

Appointment for the Disposition of Remains.  This is a basic estate planning document by which you choose a person to execute your burial wishes and let them know what those wishes are.

Declaration of Guardians.  This is an estate planning document in which you name a person to serve as a court appointed guardian should you need one.  If you have the other documents in place you’ll likely never need this, but it is important to have as a safety net naming someone you trust to be guardian instead of a court appointed agency or lawyer if the need ever arises.

Will and Revocable Trust. Finally, Wills and  Revocable Trusts are estate planning documents which control the flow of assets at your passing.  You should speak with your attorney about which is right for you, but if you or a family member has a chronic illness, using a revocable trust may be a good way to provide for succession of your financial management.  A revocable trust allows the successor trustee to act quickly to manage the finances if you cannot do so yourself and under the guidelines you create.  This way, the trustee can pay for the care you need.

Everyone should have these estate planning documents as part of a well-crafted legacy plan, but if you or a loved one is facing a serious or chronic illness, you may be facing additional challenges that make this planning more critical.

Reference: Forbes (July 5, 2019) “Estate Planning Musts When You Or A Or A Loved One Has A Chronic Illness”

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