Role of Elder Care Attorney

Kibbee

I am wondering about the role of a CELA in my situation.  

A little background:  DH's diagnosis of Major Neurocognitive Disorder stems from surgery and treatment for brain cancer over 20 years ago.  Post surgery / chemo & radiation he was left with compromised executive function which meant he could no longer work in his field (Master degreed professional).  He tried other less taxing jobs but continued to experience difficulty and ended up out of the work force for good in 2008.  There were no disability benefits available through his work, and the "suits" at Social Security deemed him not disabled so he has never had disability of any kind.  Because of this I've been working with a financial planner for many years, to build some security for our futures.  I have all of the paperwork in place there to manage our investments, including his retirement accounts.  I've also been the one to initiate and manage his SSN payments, and had no problems doing that.

I've also worked with an attorney in 2018 to set up a Revocable Trust.  All investments and our house are in the Trust.  My sisters are the Trustee & backup if anything should happen to me, and they are aware of my wishes for DH's care.  The Trust also includes DPOA for property, and DPOA for Health Care.  The DPOA for Health Care was officially activated by two physicians in 2021, after he completed testing with a neuro-psych and received his updated diagnosis.  The Trust also includes a Will, Probate Avoidance Agreement, Authorization for Disclosure of Health Information, Authorization for Final Disposition, instructions for Disposition of Personal Effects.  We also have End Of Life Directives on file with our health care providers.

We have no Long Term Care Insurance, as no company would sell a policy due to DH's health history and pre-existing conditions.  If DH needs LTC, we would have funds to pay for it for a number of years.  At some point he would hopefully qualify for Medicaid help.  Would a CELA's role be to help me navigate the Medicaid situation?  I want to make sure I understand the process, and that I am not doing anything now and in the time leading up to Medicaid that would put us at risk of not qualifying.  Since I know this question will come up, we are residents of Wisconsin.  Thank you.

JoseyWales

YES!!!  

I have no idea about Wisconsin, but I can tell you that I contacted one about 5 years before I needed to apply for Medicaid. It helped me organize my finances somewhat and know what to expect a bit. Put my mind at ease on other issues.

Ed1937

Kibbee, I would suggest that you see a certified elder law attorney, instead of a regular elder law attorney, if possible. When they are certified, they are required to have ongoing education, so they are the best bet for you to get the most protection you can. After the first meeting, you should have a good idea of what they can protect for you.

Rescue mom

Our financial planning sounds like yours. But about Medicaid planning…I recall reading that some here did it themselves, but everybody I know IRL (in real life) and via several support groups, got a certified elder law attorney to help with Medicaid.

Several tried it themselves, had problems and big delays, then went to the lawyer. Everyone said the lawyer helped them enormously, and knew numerous “tricks of the trade” to make things better, easier and faster.

And everybody was amazed at how much of what they heard via grapevine, family, whoever, about Medicaid, was simply not true, or outdated (rules change often), or from another state with different regs.

One warning, for what it’s worth: Most had bad experiences with those lawyers who often offer a free lunch or grocery gift cards, etc., to hear a “presentation” about Medicaid qualifying. Such offers are widespread in my FL retirement area, maybe not so much elsewhere. Some may be legit, but there’s been a lot of issues and warnings with them around here.

Beachfan

Something outside the box to consider is the facility in which you desire placement. DH is in a Memory Care Facility (MCF) in Pennsylvania.  They do nothing but Alz/dementia.  Staff are highly trained, costs are all inclusive, residents can age in place and behaviors, wandering, etc. are managed.  In PA, MCF’s do not accept Medicaid.  Presently, costs are just under 6K/ month, paid out of pocket.

Kibbee

Josey Wales, Ed1937, Rescue Mom and Beachfan - Thank you for taking the time to respond, and for all of your good advice and feedback.

I'm meeting with my Will & Trust attorney next week to sign off on an updated version of our Trust.  I will ask her for a recommendation of a CELA within her law firm.  She works at a large and reputable firm that came highly recommended, and I have had a good experience with them thus far.

We are a number of years out from needing placement, so I think the timing is good to begin working with a CELA and getting the information I need to have all of my ducks in a row.

Regarding facilities for placement - there are three within 10 miles of my home (one within walking distance) that offer multiple levels of care, from AL, to Memory Care and Skilled Nursing, so age in place is possible.  I think DH would need either MC or maybe SN if MC cannot deal with his mobility issues.  My top two picks have been around for years, and have excellent reputations.  (Although it comes at a price$$!)  The third opened about 7 years ago, and has had some turnover issues within their leadership team.  Hmmm.  

Much to look into and think about - and your insights and tales of firsthand experiences with CELAs is very helpful.  Thank you.

Crushed

What did your lawyer say about the social security disability application ?

  

wspceo1

Yes an elder care cela certified lawyer would help.  FYI Medicaid will consider a revocable trust to be joint assets that they can grab.  The reason is that since it is revocable it can be used to pay for your lo's long term care. Only an irrevocable trust since it only used in the case of death and therefore is not touchable and considered part of your existing assets.  It is worth checking on this and avoid a financial surprise when you least want it.