Most people do not think seriously about long-term care until they are already in the middle of a crisis. A parent’s health declines faster than expected. A diagnosis comes earlier than anyone anticipated. The options that would have been available with advance planning are no longer on the table. Long-term care planning is one of those areas where the earlier you start, the more tools you have available and the better the outcomes tend to be.
At Mandelbaum Barrett PC, the firm’s elder law attorneys work with families and individuals on proactive long-term care and estate planning throughout New Jersey and New York. November’s designation as National Long-Term Care Awareness Month is a prompt worth taking seriously, particularly for anyone who has not yet started this conversation.
What Is Long-Term Care and Who Needs It?
Long-term care refers to a range of services designed to meet personal, custodial, and medical needs over an extended period. This includes home health aides, assisted living, memory care, and skilled nursing facility care. Long-term care is not primarily about treating specific medical conditions; it is about the ongoing support that people need when they can no longer fully manage activities of daily living on their own.
According to the Administration for Community Living, roughly 70 percent of people who reach age 65 will need some form of long-term care during their lifetime. Yet many families proceed without a plan, assuming that Medicare will cover what is needed or that family members will step in when the time comes.
The Financial Reality of Long-Term Care in New Jersey
Medicare does not pay for custodial or long-term care in most circumstances. It covers skilled nursing care for a limited period following a qualifying hospitalization, but it does not cover ongoing support over months or years of declining health. The cost of long-term care in New Jersey is significant. A private room in a skilled nursing facility can exceed $150,000 per year, and home care costs have risen substantially.
Families who have not planned may find themselves spending down assets rapidly before qualifying for Medicaid, which does cover long-term care for those who meet the eligibility criteria. Medicaid has strict income and asset limits, and the five-year look-back rules create serious complications for families who begin planning too late. Assets transferred within five years of applying for Medicaid may trigger a period of ineligibility for benefits.
Medicaid Planning and Proactive Strategy
Medicaid planning is not about hiding assets. It is about legally structuring assets over time in a way that protects a surviving spouse, provides for other family needs, and preserves eligibility for benefits that exist to serve exactly this population. The tools available include irrevocable trusts designed to shelter assets from Medicaid’s asset calculations, gifting strategies implemented well before the five-year look-back window begins, and spousal protection provisions that allow a community spouse to retain a meaningful share of the couple’s assets.
These strategies require time to work. A family that begins Medicaid planning five or more years before a potential nursing home admission has significantly more flexibility than one that starts six months before. The difference in outcomes can be substantial in terms of assets preserved and options retained for both the person who needs care and the family members around them.
Planning Tools That Go Beyond Finances
Long-term care planning also encompasses the legal documents that ensure someone has authority to make decisions on your behalf if you cannot make them yourself. A durable power of attorney allows a trusted person to manage finances when you are unable to. A healthcare proxy and advance directive address medical decision-making and end-of-life care preferences. Without these documents, families may need to seek court-appointed guardianship, which is a more expensive and time-consuming process than preparing documents in advance while you have capacity to do so.
Contact Mandelbaum Barrett PC for Long-Term Care Planning
National Long-Term Care Awareness Month is an opportunity to take action rather than simply acknowledge the risk. The attorneys at Mandelbaum Barrett PC work with individuals and families throughout New Jersey and New York on Medicaid planning, irrevocable trusts, powers of attorney, and comprehensive elder law plans designed to protect both the individual and those who care for them.
To discuss your situation with a member of our team, contact Mandelbaum Barrett PC today. Our elder law attorneys are ready to help you build a plan that protects what you have worked to build.