Did you know that twelve percent of Texans are over the age of 65?
While longevity is a wonderful byproduct of our modern society, the downside is that age often arrives at a cost. Declining health often means that seniors require daily support; from meal preparation to hygiene and medical nursing care. These necessities quickly become expensive. In the state of Texas, there are options for seniors in need of care, as well as financial resources and options the family may need to consider.
Sometimes, an elderly family member may need someone to shop, cook meals, and do some light house cleaning chores. If cooking has become an issue, there is a Texas outpost of the national Meals on Wheels organization, providing food to seniors for little or no cost.
If you are comfortable having an outsider visit an elderly family member in their home, there are many in-home care services available from agencies and franchises, as well as from individuals. Several national resources are also available, such as Care.com and visitingangels.com, but there are local and county options as well. Costs can vary widely and payment is either by the hour or a day-rate. There are also local and state agencies that provide some limited financial and services support. Details on those programs are available on the Texas Health and Human Services (HHS) website. If the senior owns his/her home but is running low on cash, looking into a reverse mortgage may provide the needed cash for services while allowing them to remain in the home.
Assisted Living and Nursing Home Care
The inability to cook meals or travel to the store, a pharmacy, or a doctor without assistance is relatively easy to remedy with piecemeal service options, from ride-share and UBER to delivery services. However, if your elderly family member has a deteriorating medical condition, such as Alzheimer’s, dementia, or physical impairment such as onset Parkinson’s, or blindness, being alone may no longer be an option. If a live-in caregiver is not an option, he/she may not be able to remain in their home. If this situation develops, it may be time to investigate an assisted-living or nursing home alternative.
If the individual is still relatively ambulatory and possesses strong cognitive powers, moving to an assisted living situation can be an ideal solution. Assisted living facilities offer both single and shared living quarters and provide meals and activities that are ideal for someone who would benefit from social interaction. They are expensive, unfortunately. In Texas, costs for assisted living facilities range from $4,000, to as much as $10,000, a month or more. Of course, amenities vary widely as well.
Facilities are licensed. There is also a nonprofit organization, Assistedliving.org that may be a useful guide to the cost, location, and quality of Texas providers. Again, they may range in cost from high $3,000 to $10,000/month. Most assisted living facilities offer step-up care options or can refer you to comparable facilities when your senior needs nursing care, or memory care support.
Costs associated with a nursing or assisted living facility vary. However, the senior’s assets, including a home (unless alternative asset planning has been undertaken years in advance), will be drawn down to pay the monthly costs. There are often entry fees or deposits of thousands of dollars that may or may not be drawn upon for monthly expenses. While room and board, including meals, may be part of the monthly cost, other incidentals, such as hair salon services, cable, and turn-down services, may cost extra.
Finally, if a senior has spent down their assets and requires nursing home care, it is never too early to visit Medicaid options. Medicaid is both a Federal and State-run program. There are nursing facilities in the state that accept Medicaid-eligible seniors, but space is often limited. There are many asset limitations for Medicaid and the paperwork could take weeks, perhaps months to complete.
Of course, financial planning today often includes consideration for older parents and relatives that may need assistance—both physically and financially—beyond their means. Talking to your accountant and estate planner is a good first step in discovering what options and resources will be needed in advance of when your senior needs a helping hand.
Please do not hesitate to reach out to Insogna CPA for more information or a discussion on this matter.