To find financial assistance for aging-in-place improvements, you will need to consult with your local government or nonprofit agencies to see if they offer any grants or interest rate discounts. Your bank may also offer some options, but be sure to do your research first.
Here are some of the most common ways that people find financial assistance for aging-in-place improvements:
Consult your local government or nonprofit agencies – You can contact a nearby public health department about the availability of grants and tax credits that can help offset costs. You can also look into a variety of tax deductions that may be available for improving accessibility in your home, such as the wheelchair ramp tax deduction. Nonprofit organizations such as Habitat for Humanity and AARP Foundation offer interest rate discounts as well as other assistance.
As people grow older, they may need to make adaptations to their home in order to age-in-place.
There are a few different ways that people can find financial assistance for these types of improvements. A family member, friend or neighbor may be willing to lend a hand and help with the renovations. There are also organizations that will donate the materials needed for the project in return for labor on behalf of the person SonderCare making the improvements.
There are also government-sponsored programs that offer financial assistance in order to ensure that older adults can stay in their homes as they age. This type of program is often called an "Aging-In-Place" program and it will usually provide funding for minor changes like grab bars or ramps, but not major structural renovations like wheelchair access or widening doorways.
It is possible to download application forms from each state’s Medicaid agency. In fact, it would be a good idea for many seniors and family caregivers to go ahead and get a copy of these forms, if only to see what kind of information the agency requires to process an application. But a serious question remains: Should you plan and apply for Medicaid by yourself or seek professional assistance?
The truth is that Medicaid planning is not a do-it-yourself project, and applying for Medicaid long-term care is seldom, if ever, easy. Most people understand the questions on a Medicaid application and how to answer them. However, applicants may not understand the impact of these questions or what the state is really trying to find out by asking them.
Benefits of Hiring an Elder Law Attorney for Medicaid Application
Elder law attorneys specialize in helping older adults with long-term care planning, estate planning and government benefits. Those with experience in Medicaid planning understand each state’s rules and regulations and help families by identifying comprehensive strategies to legally obtain and maintain eligibility for public benefits.
Avoiding Medicaid Penalties
Medicaid planning is very complex, and most people are not familiar with the various exceptions and exemptions to the gifting rules. For example, most Medicaid applications will ask if an applicant has made any gifts or other asset transfers for less than fair market value within the last 60 months (or 30 months in California). The purpose of this question is to find out whether the applicant is subject to a Medicaid penalty for having made any disqualifying transfers. If they did, the penalty would prevent the applicant from receiving Medicaid benefits for a certain number of months. This is calculated by dividing the total value of the transferred assets by the average nursing home cost in the applicant’s state (these numbers are updated and published each year).
In some cases, there are exceptions that can help applicants avoid a Medicaid penalty period. In other situations, applicants who have made disqualifying transfers during the look-back period may be better off delaying their Medicaid application. Most people aren’t familiar enough with the ins and outs of Medicaid eligibility rules to successfully avoid these pitfalls on their initial or even subsequent attempts to qualify.
For seniors who anticipate needing to apply for long-term care Medicaid within the next few years, devising a foolproof Medicaid planning strategy is the best way to ensure an application is approved. Timing is a very important part of the planning process. A Medicaid lawyer will take all aspects of a senior’s personal and financial situation into consideration to determine when they should apply and whether additional steps must be taken to avoid disqualification for benefits.
Protecting the Community Spouse
The financial Medicaid eligibility rules for married couples are different from those for unmarried applicants. An elder law attorney can devise a plan for a married couple to spend down their assets to qualify for long-term care Medicaid but still retain enough resources for the healthy spouse to remain in their home and cover their costs of living.
Navigating the Medicaid Spend-Down Process
It may also be possible for an applicant to reorganize their assets and income in ways that help them continue living in the community for as long as possible but also ensure they will qualify for long-term care Medicaid when they need it. Applicants can retain ownership of certain types and amounts of assets while still maintaining their eligibility for benefits.
In some instances, a personal care agreement is a great way for a senior to compensate their family caregiver(s) while legally spending down to meet Medicaid asset and income limits. The ways in which bank accounts and even real estate are titled can help or hurt an applicant’s Medicaid eligibility as well. Attorneys are well-versed in these and many other legal, medical and financial factors that determine if and when a senior’s application is approved.
Read: How Joint Bank Accounts Affect Medicaid Eligibility
Deciding When to Apply for Medicaid
Finally, applying too early or too late can cost a senior and their family many Click here for info thousands of dollars. It’s best to begin thinking about the application process at least five years before a senior anticipates needing long-term care. This will allow for asset preservation prior to the look-back period. Of course, an elder’s health and care needs can change a great deal in that timeframe, especially if they have a chronic medical condition like dementia or Parkinson’s disease. It may be wise for some families to look into Medicaid planning even earlier to ensure they’re prepared when the need for long-term care arises.
Applying too early may result in a penalty and a longer period of ineligibility than normal. Sometimes waiting until an applicant is sure they’re eligible is the best (and most affordable) course of action. On the other hand, filing an application too late means that an elder and their family would miss out on months of long-term care Medicaid coverage while awaiting a determination. Finding the right time to apply can be very tricky and is different for each person. Failing to time things correctly can be a costly mistake.
Sidney Katz, MD, first formulated an index of basic activities that are necessary for a senior to live independently in 1963. The Katz Index of Activities of Daily Living is still used by healthcare professionals to assess functional abilities and evaluate long-term care needs in older adults.
The use of indexes to measure daily functioning is important in the overall assessment of a senior's wellbeing because appropriate levels of assistance with ADLs can improve an elder’s independence, health outcomes and quality of life. An official assessment of the ability to complete the six activities of daily living (ADLs) contributes to the determination of a senior’s eligibility for both supportive services and financial assistance such as Medicaid long-term care, VA benefits, and the payment of long-term care insurance claims.
What Are the Six Activities of Daily Living (ADLs)?
Activities of daily living fall into six categories of basic skills needed to properly care for oneself. Due to varying levels of physical and/or cognitive decline, a senior may be able to complete ADLs safely and independently in some categories but not have the skills necessary to complete others. Levels of assistance also vary; seniors may need help ranging from prompting or supervision to total support in order to ensure these basic physical needs are met.
When evaluating daily functioning, evaluators will assess these 6 basic areas of functioning:
Eating
Is the individual able to move food and drink successfully from the table to their mouth?
Bathing and Personal Hygiene
Is the individual able to get in and out of the shower or bath without assistance? Are they able to wash their face, body and hair? Are they able to groom themselves, maintain oral hygiene and care for their nails?
Dressing
Is the individual able to choose appropriate clothing? Are they able to put on and take off these items, including fastening and unfastening them properly.
Continence
Can the individual maintain control over their bladder and bowel function?
Toileting
Is the individual able to transfer on and off the toilet, clean themselves, and resecure their clothing?
Walking and Transferring
Is the individual able to walk independently? Are they able to move to and from a chair and bed without the assistance of another person? Note that the use of assistive devices or mobility aids such as canes or walkers is an acceptable source of support in walking and transferring independently.
Creating a Care Plan based on ADLs
The amount of assistance a senior requires to complete each of these ADLs is used to determine the level of care they require and create a personalized plan for support, called a care plan. For this reason, most state and federal assistance programs, home care companies, adult day care programs and senior housing facilities require an ADL assessment as the starting point for establishing a person’s suitability or eligibility for services and/or coverage.
When navigating elder care options, benefits and supportive services, ADL assistance can be referred to as personal, companion or custodial care. This non-medical or “unskilled” care is commonly provided by family caregivers, personal companions and home health aides in a senior’s own home, in many adult day care settings, and in assisted living communities. Of course, assistance with ADLs is also provided in long-term care settings that offer higher levels of skilled care, such as memory care units and nursing homes.
If you are noticing a change in functional abilities that is impacting your loved one’s ability to live independently, use our ADL Worksheet as a tool to determine how much assistance they require.
Printable: ADL Assessment Checklist
A professional assessment is often the gateway to eligibility for additional services. Functional assessments that identify ADL difficulties can be made by physicians, nurses, case managers, and occupational therapists. Furthermore, long-term care insurance companies typically employ assessors to make eligibility determinations for policyholders who wish to begin using their long-term care benefits. One of the best resources for beginning the formal assessment and care planning process is your local Area Agency on Aging. AAAs can let you know where to have a needs assessment performed and, in some cases, may actually be able to conduct assessments themselves.
For more information regarding the importance of this measure and the role of activities of daily living (ADLs) in planning for a senior's long term care, explore our articles, assessments and Q&A from other caregivers in the Caregiver Forum.
