We all wish we could stay healthy forever. A degenerative diagnosis can be life-changing. But it doesn't have to come with a total loss of control. Find out how estate planning for long-term care for chronic and terminal conditions can help provide certainty and peace of mind when the time comes to move to a supportive arrangement.
In this blog post I will discuss how you can plan for long-term care for chronic and terminal conditions in your future. I will explain how patients and families facing degenerative or chronic conditions can take steps now to put finances and decision-making authority in place so they will be protected as their condition advances.
How do you want to spend your final days? If you are diagnosed with a degenerative, chronic, or terminal condition, it can raise questions about quality of life, treatment regimens, and other major medical decisions. If you don't take a proactive approach to planning your end-of-life care, these decisions could be taken out of your hands. A court-appointed guardian could end up being the one deciding where you spend your days, and what treatment you receive. You can take control of your care by doing estate planning ahead of time.
Who will make decisions for you when you can't make them yourself? Without advanced estate planning, a probate court judge can assign end-of-life decision-making to anyone who petitions for guardianship. While the courts generally prefer to appoint family members, your guardian could end up being a facility manager where you are living, or even a lawyer.
You can take control of your end-of-life decisions by creating a patient advocate designation (also called a durable power of attorney for medical purposes) while you are still healthy. This document dictates who you want making decisions for your treatment and care when you are no longer able to do it yourself. It can also limit those decisions or describe who should be consulted (including doctors or family members) before big decisions are made.
Just because you designate who will make your end-of-life decisions doesn't mean you don't want to control what those decisions are. This is where health care directives (sometimes called a living will) come into play. This is a document that describes what you want to happen in your final days. It can include whether you want life-saving treatment, how aggressive of treatment should be used, and whether your patient advocate should consider experimental treatment or alternative health methodologies.
Your health care directives work best when created well in advance, and when they are paired with thoughtful conversations about your choices with your designated patient advocate. Unless your medical providers and close family know that your living will exists, your wishes may be ignored when they are needed most.
The who and the what of planning for chronic and terminal conditions are important, but your careful planning could fall apart if there is not money to fund your care. Medicaid is available to older adults and many with chronic illnesses. But if Medicaid and Social Security is all you have, you may not be able to live the lifestyle you expect in your final days.
Proactive financial planning is crucial to executing your long-term care plan. Medicaid is only available to those who qualify. If you have too much income, or too many assets, you may not be eligible. You can plan to shift resources into trusts or to family members, but you have to do it ahead of time. When you apply for Medicaid, it includes a look back period for asset transfers. If you haven't taken proactive steps, your last minute gifts and transfers could still be counted as assets on your Medicaid application, or could result in a disqualification period.
Instead of relying on Medicaid, you can use estate planning, including a living trust, to provide for your living and medical needs during a chronic or terminal illness. A well-funded trust can accommodate for your needs whether you see your condition coming, or if a sudden catastrophic event leaves you unable to care for yourself.
Planning for long-term care for your chronic or terminal condition includes being certain you have your finances in order. But it is also about ensuring you stay in control of your life. If you receive a life-changing diagnosis, you should meet with an estate planning attorney right away, so that you can proactively plan for your needs and your preferences at the end of life.
Rebecca J. Braun, J.D., is an estate planning and elder law attorney for Mobile Legal Services, PLLC, in Southeast Michigan. She can help with estate planning and trust administration. She will travel to clients, free of charge, in Monroe, Oakland, Washtenaw, Wayne, and Southern Macomb Counties. Contact us for an initial assessment.