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Boomers have more ways than they might realize to pay for elderly parents' care

Posted: Friday, October 10, 2003

Joan Coleman calls it her nightmare. When her 74-year-old mother fell ill, Coleman assisted her in the hospital and also had to get her stroke-afflicted 75-year-old stepfather and 95-year-old grandmother into a nursing home.

That put Coleman in the difficult position many baby boomers face suddenly thrust into helping parents pay for expensive nursing care that threatens to drain savings accumulated over a lifetime.

In Coleman's case, the nursing home for her grandmother and stepmother was sucking $3,000 a month from their savings. Coleman's mother suggested selling the family home to pay for it.

Coleman instead sought help from an elder-care consulting firm that arranged for the nursing home to be covered by California's Medicaid program. For her relatives to qualify, Coleman sold their house and liquidated their savings accounts, but she was allowed to keep the proceeds to buy another home as an asset for the family.

''I knew that there had to be a way for them to get help, but my mother had been looking into everything,''' said Coleman, now 54. ''I had no clue.''

Many boomers the 76 million Americans born between 1946 and 1964 have planned for their own retirement and for the nursing care they might someday need. It's a wise move, considering the steadily increasing life expectancy rates boomers have seen in their lifetimes.

But boomers' parents are from an era of lower expectations and an age before long-term care insurance and other mechanisms arose to cover the rising cost of professional nursing care. A bed in a facility for the elderly can exceed $50,000 a year.

Many senior citizens are not eligible to have Medicare or Medicaid programs pick up the tab, but they also don't want to see everything they've saved evaporate as they pay for a nursing home in their final years. And so they often need adult children to help them figure out how to finance the care.

''There's a huge information gap, and people truly don't know where to turn,'' said Valerie VanBooven, a long-term-care consultant in St. Louis. ''The challenge for adult children of aging parents is to find out where they can get that kind of information. I probably get 100 e-mails a day.''

Dennis Conte of Los Angeles sought advice from the same firm that helped Coleman, Nursing Home Services LLC, when his mother-in-law needed to enter a $2,800-per-month facility. The firm arranged for her to be covered by California's Medi-Cal, leaving enough in the family accounts for Conte's father-in-law to live on and for his own nursing care a few years later.

''It would have been a problem for us to pay for my father-in-law and mother-in-law both,'' Conte said. ''We would have somehow done it, but it would have been a tremendous burden. I had children going to college you know how that is.''

Some states determine Medicaid eligibility by setting a limit on how much income a single senior or a senior couple can have; others measure their assets. So the kinds of tactics that made Coleman's and Conte's relatives eligible, like shifting savings, transferring assets or selling a home, are not always practical or possible.

And those practices also have critics, who say they amount to an unfair grab of precious government funds.

Among the other advice boomers might get from elder-law attorneys and financial planners:

Adult children who pay for more than half of their elderly parents' care can claim the parent as a dependent and get tax deductions.

Flexible spending accounts let adult children pay for some of their parents' care with pretax money.

Sometimes lawyers can arrange ''personal care contracts'' that transfer assets to family members who assist an elderly person even after he enters a nursing home.

A revocable family trust can keep property out of probate when an elderly person dies. That is important because some states put liens on property during the probate process to recover Medicaid funds spent on an elderly person's care. An adult child also might need what's called a durable power of attorney to administer a parent's assets.

It might make sense to transfer an aging parents' assets into annuities that pay them a steady annual income. However, William J. Browning, president of the National Academy of Elder Law Attorneys, cautions that annuities generally carry penalties if they need to be withdrawn say, to pay for nursing care in the first seven years.

Long-term care insurance is generally aimed at people who are many years from needing professional assistance. But some insurers will write long-term care policies for reasonably healthy people in their 70s and 80s though it gets quite expensive by then. Some insurance companies also offer policies that will give heirs back the premiums paid by elderly people who died before they needed professional care.

Ultimately, VanBooven said, ''everybody can do something.''

On the Net:

National Academy of Elder Law Attorneys: www.naela.org

VanBooven's site: www.theltcexpert.com



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