Estate Planning and MassHealth Management for Parents with Dementia
Few diagnoses are more devastating than dementia. With 10 million new cases each year, this syndrome touches many families. When your parent is diagnosed with dementia, many things are out of your control. Managing your parent’s healthcare, home management and estate planning needs is a concrete way to help.
How Do I Arrange for Care?
Here in Massachusetts, one of the first things you’ll want to do when your parent is diagnosed with dementia is to find out whether they’re already receiving MassHealth coverage. MassHealth (Medicaid) may pay for long-term care services for a member with dementia. Whether your parent needs to move to a 24-hour facility or needs support to help them stay in the home, securing MassHealth coverage is the first step.
MassHealth coverage is for Massachusetts residents who are either at least 65, or who need long-term care. Your parent probably doesn’t yet have this coverage if they’re younger than 65 or have been relatively healthy up until now. In any case, starting the MassHealth application process with the guidance of a knowledgeable attorney is generally a good decision after your parent is diagnosed.
Helping a parent become MassHealth eligible can be confusing under the best circumstances. The process will be even more complicated if your parent is unable to do all the work of gathering the necessary financial and personal documents. MassHealth has strict financial requirements for eligibility. The last five years of your parent’s financial history will be examined to see whether they’ve given away assets in a way that disqualifies them from receiving coverage.
How Can I Help My Parent with Estate Planning?
Because dementia is degenerative, there’s a sense of urgency around estate planning for someone who is newly diagnosed. Ideally, your parent will already have detailed plans in place. But as you know all too well by now, things don’t always work out ideally.
Start the estate planning process right away if your parent hasn’t yet made these decisions. As long as they still have the legal capacity to understand and sign documents, they may be able to make their final wishes known.
A living will is one of the documents you’ll probably want to make sure your parent signs. Also called an advance directive, a living will is essentially a written record of a person’s wishes concerning their end-of-life care. When the time comes, your parent may not have the capacity to make decisions about things like whether to receive life-prolonging intervention and what kind of comfort measures should be used in their final days. A living will provides a guide map to help the person’s family and medical staff make the right decisions.
Your parent’s attorney may also help establish a revocable or irrevocable trust, a durable power of attorney, a will and/or healthcare proxy. Exactly what estate planning tools will best support your family depends on a number of factors, including whether the parent with dementia is married and what type of assets they own.
What Should I Do With the House?
Again, your parent’s specific circumstances will affect what you can and should do with any property they own. If your parents plan to become MassHealth eligible, managing their home is an important step in the process. In some circumstances, MassHealth places a lien on a member’s home so that if the house is sold, MassHealth recoups its costs from the profits. But that’s not an inevitability.
It could be that your parent will be able to stay at home indefinitely, with some support from in-home health workers. If they enter a long-term care facility, their spouse or children may be able to stay in the home without MassHealth placing a lien. In this case, it’s important to think ahead about how the remaining family members will pay for home repairs and maintenance. The MassHealth member is allowed to keep very limited assets.
While a diagnosis of dementia can take an emotional toll on a family, there are proactive steps adult children can take to help see their parents wishes fulfilled. Whether your parent needs assistance with estate planning, or you have questions about the MassHealth application process, we’re here to help. Contact us today to discuss your parents’ needs.