ELDER LAW CONTINUED
ELDER LAW CONTINUED
My mom is ready to consider various types of
housing options for seniors. How can an attorney
An attorney who is a veteran in elder law can guide
you through the potpourri of housing options –which
come in all sizes, settings, and shapes - on the
market for seniors and the ones that are best suited
for your mother. Briefly, housing options generally
fall into three categories, based on level of services
and/or care provided:
(1 ) Independent Living Retirement Communities:
These complexes are for seniors who are able to live
on their own, but want the convenience of a
comprehensive service package. Meals,
housekeeping, activities, transportation and security
are provided to active older adults.
(2) "Assisted Living" Facilities: In addition to the
services mentioned above, these facilities provide
personal care assistance to residents. This means
that, in addition to housekeeping services, residents
receive assistance in managing their medications
and a helping hand with bathing, grooming and
dressing. Settings can range from three or more
older people in a homelike setting, to dozens of
residents in an institutional environment.
(3) Nursing homes: Nursing homes offer continuous
round-the clock nursing care as well as other
support services in a single setting. Nursing homes
are certified to provide different levels of nursing
and medical services, from custodial to skilled
nursing (services that can only be administered by a
Other options are continuing care retirement
communities (also called Life Care Communities),
group homes, share housing, adult foster care, home
and community care, and elder cottage housing
(commonly known as ECHO housing).
Will Medicare pay for a stay at a nursing home?
The only type of "nursing home" care Medicare helps
pay for is skilled nursing facility care. Medicare does
not pay for custodial care when this is the only kind
of care your mother or father need. Custodial care is
primarily for the purpose of helping your mother or
father with daily living or meeting personal needs
such as walking, dressing and eating, etc. His or her
condition must require daily skilled nursing or skilled
rehabilitation services which can only be provided in
a skilled nursing facility. The skilled care she receives
must be based on a doctor's orders.
Medicare Part A can help pay for certain inpatient
care in a Medicare certified skilled nursing facility
following a hospital stay of at least three days in a
row, not counting the day of discharge.
Custodial care in a nursing home may be covered by
Medicaid if the individual meets the specific state
income and resource requirements for Medicaid
What if I do not want to go to a nursing home?
You cannot be committed to an institution against
your will (except temporarily in an emergency) unless
a court authorizes the commitment after a hearing. At
the hearing, the court must determine that you are
mentally ill and either unable to care for yourself or a
danger to yourself or others. You have the right to
be represented by an attorney at the hearing. If you
cannot afford an attorney, the court must appoint
one. If you sign a document waiving your rights to a
hearing and to an attorney, you can apply to the court
at any time to have those rights reinstated.
Do children have to pay for parents in nursing
No. Children have no legal obligation to pay for their
What about Medicare and Medicaid?
The number one issue facing older Americans is
health considerations. Since most of us do not have
a personal, on-site, physician, we work with the
federal Social Security and Medicare systems.
Whether you are entitled to benefits depends on if
your circumstances and if you satisfy the system's
In the Medicare program, people who are receiving
full retirement benefits, those who have attained age
65 with reduced benefits and those who qualify for
social security disability benefits are eligible for
Do not confuse Medicare with Medicaid, which is the
health insurance system, run by the state, for those
people with low income and limited assets.
A very brief word about SOCIAL SECURITY-
Your Social Security benefits - paid by a tax on you
and matched by your employer - supplements other
income you have through pension plans, savings,
investments, etc. Social security benefits are based
upon your earning averaged over your working
lifetime. A formula is used to determine the amount of
your benefit - as a rule of thumb, about 42% of your
earnings is replaced by social security benefits. See
our section on Social Security Law for further details.
How does Supplemental Security Income fit into this
Supplemental Security Income - typically referred to
as "SSI" - provides payments to people with low
incomes and few assets. To qualify, you must:
(1) be living in the United States (or the Northern
(2) be a citizen of the United States or be legally
living in the United States
(3) be age 65 or older, or blind, or disabled.
The base income level to be eligible for SSI depends
on whether or not you work and where you live
(some states have higher SSI rates and higher
income limits than the national standard). The basic
asset test is $2,000 for an individual or $3,000 for a
married couple - although not all property owned is
included - the primary residence and many personal
belongings are exempt.
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