A Most Difficult Talk: End of Life Planning

By Diana Palmieri

Discussing your aging and burial plans with loved ones is not an easy task. I am hoping that this article will help some of you at least open the door a crack, whether it be with a spouse or parent. The last thing we want is our family fussing and arguing over nursing homes and burials.

To help you begin this most important discussion with your loved ones, there is a great Web site called “Aging with Dignity” (www.agingwithdignity.org). It has a great tool called “Five Wishes,” which discusses what you want in the event you become incapacitated. It addresses important points such as who you want to care for you, what medications you want or don’t want, how comfortable you want to be, and so on. This document will replace certain legal documents you have in place, so please read it very carefully and consult an attorney with questions. Five Wishes currently meets legal requirements in 42 states, and it will ship documents world wide. For those of you outside the United States, check with a legal advisor to see if these documents might fit in to your end of life planning and care.

Long-term care insurance is another facet of end of life planning that tends to be ignored.  According to the Medicare Web site, by the year 2020, 12 million older Americans will need long term health care. There seems to be a misconception that Medicare will handle the costs of long term care. Medicare will only pay for skilled nursing or home health care that is medically necessary and requires certain conditions. Long term health care will pay for custodial care, which are your activities of daily living (called ADLs). These ADLs are walking (called transferring), bathing, toileting, dressing, continence, and eating. Visit http://www.medicare.gov/LongTermCare/Static/Home.asp for more information.

Medicaid planning is also something to be discussed sooner, rather than later, with your parents.  Medicaid benefits can pay for nursing home care, but many are unaware of the difficulty in getting these benefits. To qualify for Medicaid assistance, you cannot have more than a certain dollar amount in what’s called “countable assets.” This can be income from social security, retirement savings, and income from pensions. In the event too much money is received, you either pay out of pocket or spend down your assets until you actually qualify for the benefit. Under federal and state law, there is a look back period of five years to determine if assets have been moved from your parent’s name in order to qualify for Medicaid. Visit http://www.cms.gov, Centers for Medicare and Medicaid for more information. Also find out about Veterans Benefits. If your parent served in the military, he or she is entitled to certain federal benefits. There is a big misconception that veterans had to be injured during their service. This is not true. Go to the Department of Veterans Affairs Web site http://www.vba.va.gov/VBA for more information.

Particularly touchy, emotional, and expensive are the subjects of burial costs and funeral planning. I have been in the middle of folks arguing over burial vs. cremation. Do you honestly want family arguing over what to do with you? I think not. Many funeral homes and crematories will allow you to plan and pay for your burial costs and get everything set up now. Funeral homes and crematories are in business to make money, and they know there are profits to be made from grief-stricken families. Shop around and read the fine print. Did you know there are burial insurance policies you can take out specific to end of life expenses? These policies are considered “simplified issue,” which means a short application and no medical exam. Contact your insurance agent for more information and details about these policies.

 In any family, talking about death and end of life planning is likely to stir up emotions and acknowledgment that we are not going to live forever. Life expectancies are longer, so our loved ones could be around longer. This is not an excuse to put this important planning off. Elder care attorneys who specialize in this field can help you, as this planning can be complex. The end of everyone’s life is unknown, but we can prepare and have piece of mind knowing these important plans are in place.

The information in this article is not intended to be legal advice. You are encouraged to seek  legal advice from an independent professional advisory.

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Diana Palmieri is dually registered with Vanderbilt Securities LLC and H Beck Inc., which are unaffiliated. Securities offered through Vanderbilt Securities LLC, member SIPC/FINRA/MSRB. 




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