Elder Law Estate Planning Legal Topics

There’s No Place Like Home

For many seniors, staying in their own home — as opposed to a nursing home or similar facility — is a priority.  Indeed, according to a Sun News article, surveys show that “aging in place is the overwhelming preference of Americans over 50.” But it can be a major challenge to find ways for seniors to continue living at home as their need for care increases. There are things that attorneys can do to help make the desire to stay at home a reality.

To carry on their activities of daily living at home, seniors need many different types of services. Depending on their physical and mental condition, they may need medical services, therapy, personal care (such as assistance with dressing and bathing), homemaker chores (such as cooking and house cleaning), and transportation.

Here are some ways that you can help pave the way for a senior to continue to live at home comfortably:

  • Legal planning. You can provide legal planning so that the senior’s desires on residential placement can be implemented, even when that person can no longer articulate those desires effectively. Planning involves incorporating the senior’s wish to stay at home, if applicable, in durable powers of attorney for property, health care directives, and trusts. It may also involve advocating a position for the person or his or her family in conservatorship proceedings in which the decision on residential placement may ultimately be made by a court or a court-appointed conservator.
  • Obtaining resources. You can also help the senior and his or her family obtain government benefits or help in using available financial resources most effectively to pay for care at home. There are government programs, such as In-Home Supportive Services (IHSS); Medi-Cal Home and Community Based Waivers; Medi-Cal coverage for Adult Day Health Care Centers (ADHCs), and a variety of community services (e.g., home-delivered meals, case management, care registries) funded by the Older Americans Act (42 USC §§3001-3057).  Financial resources include those intended to pay for long-term care, such as long-term care insurance policies and income tax benefits, and those not originally intended to pay for long-term care, such as home equity loans, life insurance, and IRAs.
  • Planning for in-home help. Even if financial resources are available, issues may arise when the senior requires care at home, such as liability, employee benefits, insurance, and elder abuse. All of these issues should be considered and addressed as part of the plan for the senior to stay at home.

The state budget crisis will likely result in a reduction or termination of some federally and state-funded services that help seniors planning to stay at home, so you need to stay on top of these developments and be prepared to advise your clients accordingly.

Planning, coordinating, and paying for care at home often requires creative solutions culled from many disciplines and sources. Here’s an opportunity to use all of your skills and creative abilities in the aid of seniors.

For more on what counsel can do to help a senior continue to live at home, including a discussion of government benefits, turn to CEB’s California Elder Law Resources, Benefits, and Planning: An Advocate’s Guide, chap 6.

© The Regents of the University of California, 2012. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited.

2 replies on “There’s No Place Like Home”

Concerning the IHSS program, media reports have it that the California legislature slashed its funding considerably in last year’s budget. From what I read, the cuts are being implemented by requiring proof a greater level of financial or medical need before the state assigns an IHSS worker to the applicant.

Has anyone out there had experience with the new, meaner IHSS budget?

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