Introduction to Elder Law for Caregivers

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Article written by Don L. Rosenberg, Attorney and Counselor
The Center for Elder Law
Troy, Michigan
An ElderCare Matters Partner

Caregiving for someone with Alzheimer’s, a related dementia, or a physical illness is one of the most difficult jobs in the world. In addition to making sure that your loved one is safe and their daily needs are met, you are also faced with the fact that there are many financial and legal issues that must be addressed.  As if that were not enough, you also are trying provide the best quality of care at the least cost to the family.   Caregiving is expensive and stressful.  Hopefully, this article can provide some insight to the wisdom of consulting an elder law attorney as soon as one can.  An elder law attorney can provide the navigation one needs when confronted with the various complex laws to ensure the greatest quality of care at the least cost. 

Elder law is not just for senior citizens who are no longer independent or who are about to enter a nursing home. Elder law is for anyone who is middle aged and beyond — and sometimes even younger.  One may say Elder Law is for anyone who wants to be old one day.

There are now more than 5 million people in the United States living with Alzheimer’s and is now the 6th leading cause of death.  This is a 10% increase from 5 years ago, and clearly supports the long forecasted dementia epidemic.  One in eight persons age 65 and over have Alzheimer’s disease and nearly half of all persons over the age of 85 have Alzheimer’s.  Every 68 seconds someone develops Alzheimer’s disease; by mid-century someone will develop Alzheimer’s every 33 seconds. (Alzheimer’s Association Report, 2012 Alzheimer’s Disease Facts and Figures) In addition to the dementia epidemic there are the many millions of people that are afflicted with illness that also need care.  The fact is that for many, one day you are living a normal life and the next minute you are a caregiver.  

You are not alone. There are over 50 million caregivers in this county.  Studies show that 12 million people in this country need long term care. Twenty-one percent of American adults provide free caregiving for loved ones.   Fifty-nine percent of these caregivers either work outside the home, or have worked outside the home, while providing care. It has been estimated that the value of free services given by caregivers is in excess of $320 billion a year.  Additionally, as a result of caregivers, businesses are also effected by the caregiving epidemic.  Specifically, over 60% of caregivers work and dedicate on average 18 hours per week to provide care.  Family caregivers account for 73% of early departures and late arrivals in the workplace.  Caregiving by an employee costs the average employer $2,100 per employee or for all employers as much as $33 billion annually.  (Met Life Caregiving Cost Study Productivity Losses to USBusiness July 2006 and Caregiving in the U.S. by National Alliance for Caregiving in Collaboration w. AARP, 2005.) These services are provided by family members without regard to cost because of the love and respect they have for their loved ones. (Alzheimer’s Association Report, 2010 Alzheimer’s Disease Facts and Figures) 

These statistics only represent the economic cost of caregiving.  It does not even address the emotional and physical toll on caregivers.  The fact is that 70% of all caregivers over the age of 70 die first. (Alzheimer’s Association Report, 2010 Alzheimer’s Disease Facts and Figures)  People generally do not think about the health of the caregiver or plan for the unthinkable – the caregiver having health problems or passing away before their loved one with dementia.  It is for this reason that one must approach each situation from the worst case scenario.  The only way one can prudently plan is to plan for the worst and hope for the best.  The time to look down the road and make major decisions regarding your health and the health of your loved ones is now. 

It is important to understand the difference between an elder law attorney and an estate planning attorney. Estate planning attorneys are typically concerned with what happens to your estate upon your death and deal with disability when a person is no longer able to participate in their own decisions.  On the other hand elder law attorneys in addition to having estate planning expertise also can ensure that your affairs can be managed in the event of your disability, or even if you are competent and not disable to allow someone to become involved in your medical and financial affairs to the extent that you would want them to, as well as once you pass away.

Specifically, an experienced elder law attorney also has an special expertise in Medicaid, Veterans and Special Needs Planning and will address the following tough questions like: 

     Who will make my medical decisions when I am no longer able to make them? 

     If I am unable to care for myself, how can I achieve the greatest quality of care without bankrupting me or my family? 

     Who will be able to talk to my doctors and the hospital when I require guidance even though I am able to make my own medical decisions? 

     Who will make my end of life decisions? 

     What happens if I get sick, and is there a way I can stay in my home or in some least restrictive setting other than a nursing home and receive financial assistance. 

     What happens if I get sick and cannot stay in my home anymore, and how am I going to pay for this care? 

It should be obvious that for caregivers of loved ones with Alzheimer’s and related dementia or any health issue that information regarding Medicaid and estate planning is a necessity.

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