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Planning: People in a Pickle


In two of our recent columns https://keystoneelderlaw.com/long-term-care-planning-7-tools-for-success-part-1-of-2/, attorney Kelly Appleyard presented a case study which outlined planning tools that help families navigate some of the challenges of aging. Unfortunately, we hear from many real people who failed to plan, planned incorrectly or incompletely, or planned to fail by not doing anything at all. (Names in this article have been changed to protect privacy.)

Can you imagine being in Martha’s position?  She called because her husband, Brian, fell at home, was hospitalized, and is now receiving rehabilitation in a nursing home.  The physician is recommending that Brian remain in the nursing home because Brian has significant limitations and caring for him would be a challenge, especially since Martha has experienced some physical issues herself.

Martha is in agreement with this recommendation, however she is facing several dilemmas. Throughout their marriage, Brian took care of all of their finances.  Martha wanted to share in this responsibility, but Brian always told her not to worry about it. As a result, Martha has little knowledge about their ability to pay for nursing home care.

Martha also lacks the authority to access some of the finances she is aware of, or even to request additional information about accounts that are only in Brian’s name. Brian’s “I will handle it” approach prevented them from establishing estate planning documents which would give Martha the ability to act for him in case of a debilitating illness or other life-changing circumstance. His current willingness and capacity to provide this authority to Martha is questionable.

Martha and Brian have children who may face risk because of their parents’ situation. As it stands now, if Martha cannot pay the nursing home bill, Pennsylvania’s filial support law would allow the nursing home to sue one or more of the children for Brian’s care costs. Even if Martha was knowledgeable about their finances and could apply for public benefits to help pay for his care, Brian’s eligibility for benefits would be delayed due to their previous purchase of a house for one of their children who is experiencing financial difficulties.

What types of decisions have you and your loved ones made, or avoided making, about planning for the years ahead? Decisions are a part of daily life. From little things like what to eat for breakfast to major life events such as career choices, all of our choices impact our lives in some way. These impacts can be major or minor, desirable or undesirable, pleasant or uncomfortable, or somewhere in between these ranges.

Some decisions are made quickly without much thought, while others require careful consideration of options and potential outcomes. Decisions made with inaccurate or incomplete information, with disregard for potential consequences, or which are avoided altogether can result in situations that most people would not welcome.

Consider these additional situations we have encountered:

  • Mother had previously appointed two of her children to act as co-agents on her power of attorney. Mother developed symptoms of dementia and one child stepped in to assist mother. The other agent didn’t agree with his actions and the family ended up in court.
  • A business owner was ready to retire and agreed to sell his business to a friend.  A sales contract was signed with an attorney and the friend was making payments to the owner. Time passed and the original owner died.  His heirs are trying to settle his estate, but the sales transaction for the business was never completed and it is unclear how much the friend has paid and how much he still owes. Multiple attorneys are now involved.
  • Father has guardianship for his adult son who has a disability. Father promised son that he could always live in their home. Father is now in a nursing home and they both need help to manage their affairs.  Father also made no financial or practical arrangements to help fulfill the promise he made to his son.
  • A family wanted to be smart about planning ahead to preserve the family farm and visited an attorney who helped them establish a revocable trust. Although the trust may have provided some benefits, years later they discovered it offered no protection from the costs of long-term care.

If you are thinking “This will never happen to me,” think again. Differences of opinion occur even in the most loving families. An individual who is turning 65 today has an almost 70 percent chance of requiring some type of long-term care services. Thirty-five percent of all older adults will utilize nursing home care for either a short-term stay or longer residence. One hundred percent of us will encounter death and may want or need the assistance of others along the way.

Careful planning does not always prevent messy life events, but it can help reduce the chaos and pressure. Which path will you follow?

You can choose to do nothing and leave life to chance. Or you can choose to exert some control over who can assist you with decisions, what plans are in place for your affairs while you are living, what’s left at the end and how it will be distributed, and the amount of work and stress you and your loved ones will experience throughout the journey. Failing to plan is a bad dill.  

Karen Kaslow, RN, BSN