Before 2008, H and I enjoyed (!) meeting with financial advisors.
Obviously no longer the case as I am doing it alone and the finances were not what they were. With ALF pending at least at some time I am trying to figure out what is what. I get the sense that the posters on this forum have varying financial situations.
So, I wonder, who do you trust? Do you have a money manager, a CPA, a broker, an estate lawyer, do you do it on your own aka what Suze Orman advises, such as transacting your own etf deals?
As for me, I get conflicting information. I went to two elder care attorneys, (ot here, but anyway...) and could not have received two more conflicting opinions.
Medicaid seems like the eternal mystery. Trusts and annuties also. As many opinions as there are practitioners.
How are you, or how have you found your way with this?
(BTW, we thought, with a projected retirement date for H, that we had it all figured out. The mortgage would be paid, one pension would start and the other could be delayed, etc. Had projected income and % for investments. Never guessed that income would stop at age 52.)
This whole process can be a mystery and a challenge. I have found that while recommendations from friends usually work, it is not always the case. The local ALZ office may be some help and they may have an attorny on their board. In addition, there is a national clearing house for eldercare attorneys that will have names in your area. This will be key if you choose to pursue Medicaid.
Not knowing your situation, I offer some suggestions: -I'd begin w/an attorney. Preferably one experienced in elder care. If you have not already completed all the necessary Powers of Attorney..general, health care, end of life, etc., and updated your wills I would begin there. You will need these frequently going forward. -The firm may have financial planning resources or can recommend one to review your assets and financial position and give recommendations. I would not suggest, given todays financial enviornment, doing it yourself. - Depending on the firm, they may also have staff, usually licensed social workers familiar w/the states regs. for qualifying for Medicaid if you choose to look into this option. They can tell very quickly if you can be eligible for assistance. States vary but some have an income ceiling as a start..income based on individual, joint or may have no ceiling. If it appears you can qualify, these people will be invaluable in helping you do what is necessary to become qualified (asset reduction management, changing from joint ownership to you only,etc,) file the application and work with the county or state social services office to move the application along and be that office's contact for any questions. - Costs will vary. Depending on what needs to be done...in my case everything..the cost may be between $5-8K. In fact, because I ended up choosing MN for her care after completing the legal documents for NC , I needed to do it twice. All in all, money well spent.
I hope this helps some. The journey is a long one but it will help to be prepared for whatever lies ahead.
The attorney we have used for 25 years did our power of attorneys and such, and now I have found an elder care attorney who seems really knowledgeable about Medicaid planning in my state.
For financial management, I have ended up by accident with it spread out. One manager does my 403b--retirement savings from my salary (equivalent to a 401k, similar to an IRA). Another does the investment account with my inherited funds. I have a third account I manage myself with some other inherited funds. The advisor who does retirement savings cares about us personally but what he knows is the issues for people in the situation where all they have is what they earned. The one who does my inherited funds is used to working with people with serious wealth, which I do not have. I fall somewhere in between and I feel no one really gets my situation. I have had some interest in all this myself for a long time, which is an advantage. But before the downturn I had invested quite aggressively, which means now my main goal is to not have to sell stocks/mutual funds before the stock market recovers more.
From what I have learned, I now think there is a strong argument to be made that the best way to invest in stocks (money you won't need for 10 years and can take some risks with) is to invest in index funds through a company like Fidelity or Vanguard--managed mutual funds charge higher fees and they don't consistently beat the stock market indexes. A stockbroker picking individual stocks is also unlikely to beat the indexes consistently, but that can have tax advantages. However, those aren't the issues most of us face now. The tough question now is how to get more income than banks pay, and I don't think there is a good answer.
If you need to have someone manage investments and savings so you don't have to worry about it, I recommend finding someone who will care personally. Do you know someone from church or a community service club, or an old friend of your spouse's? Only people who are seriously wealthy have much chance of finding an investment advisor who is smarter than average and might make them more money. The rest of us should focus on finding someone who will care and will understand our situation and make recommendations based on that understanding, not based on what will make them more money.
I fully understand why people without the means needs the governments help to meet the financial crisis this disease brings. I do not understand why people who have the means, and did not purchase long term care insusrance should be allowed to use loop holes in the law to beat the system. Yes I have long term care insusrance and I did not buy enough, but I am willing to pay my fair share.
The answer is: I don't really trust anyone. In order to plan how I would manage investments, I read many (6 or 7 or so?) books on retirements strategies, focusing on a particular theory exemplified in "The Coffeehouse Investor."
Then, I took what I'd learned from books and synthesized the parts that made the most sense to me into an Index Fund based approach, using funds available through one of the major low-cost, no-load firms.
And I track it, and try to re-assess/rebalance a couple of times a year or so, as recommended.
I am not so naive as to imagine I can do this better than a professional, but I think, for me, it came to a decision to make my own mistakes, but based on a book-based education.
moorsb, that little comment helped me, about the "without the means"
I have been struggling so about getting State Medical, (FOR ME), as I have not had a doctor visit in 15 years, just cannot afford it.
We do qualify, honestly I wish I could afford to buy my own insurance. Trying..to get over the guilt of applying for this, and not to feel like a "welfare" case. HELLO!!!!!! a little voice tells me.....YOU ARE FULL TIME CAREGIVING AT HOME>>>THINK WHAT IT WILL COST THE STATE IF YOU COULD NOT DO THAT!
Coco, I agree with moorsb regarding if do have the means, then you should be using them & not trying to find all kinds of loop holes, for Government assistance. Medicaid, is suppose to be a health care program for people with low income & limited resources, like yourself. Please do not feel guilty. I hope everything works out for you.
I have a good friend who is a finanial planer and manages about 1/2 of my IRA holdings. I enjoy picking individual stocks so I manage the rest. My husbands IRA is 80% cash but the other 20% mimicks what our friend picks for my account. I agree with Pam it helps to have someone who knows you and can be trusted.
Moorsb- I completely agree with you on loopholes for those who have the means to pay for care. I also have long term care insurance on my husband that in end stage will cover about 50-80%. Even if I did not have this policy I would not consider seeking advice from an elder care attoney with my present finiancial situationn. For me it would be hard to justify having a six figure income, income producing assets, and a large amount of money in my husbands IRA. On the other hand I know several spousal caregivers who are strugling to make ends meet- I'm glad they are able to get help from Medicaid.
We hired an Elder Attorney just out of the phone book and we were very pleased with the knowledge this person had and how quickly everything was put it its proper place.
As far as gov. assistance goes I have mixed feelings on the matter. Of course if money is no object AT ALL then it is really doubtful a person would qualify for gov. assistance. At the present time, my dh and I have little to no financial concernes and for that I am grateful. However, with my hd being only 64 and having to pay $4,000 to $6,000 per month for care totally out of our resources as well as maintaining sufficient income for me to live on, money could become a real problem in a hurry.
Also, money has to be saved for when I might be in the same position as my dh. or who knows we both might need it at the same time. The money that the gov. waste daily makes me be concerned less and less about applying for whatever is available because we both paid into this all our life.
We do not have LTC insurance. I recall my bro-in-law suggesting it back when Jeff had early signs. Of course, once Dx happened, it would have been too late anyway. That I didn't look into it is my own fault and problem. I COULD afford to place. The question is...what about if the legacy of my grandmother (AD in her 80s) and my father (Parkinson's in his 70s) catches up with me? If I am unsuccessful at carrying out my "out to sea" exit plan, I will need the $ to save my children from any fate worse than checking me into an ALF. It is for that reason that I'm very iffy about the likelihood of doing anything but keeping Jeff here for the long haul.
While it took a large chunk of our disposable income my husband I chose to invest in LTC. We could have spent the money on more enjoyable things. Sometimes it comes down to a choice.
If the law is broken, then it needs to be fixed. We do not need a cottage industry that guides people thru the loopholes. Bluedaze I totally agree, we could have taken the money spent to purchase Long Term Care and used it on other things that would have brought pleasure, We are not wealthy but we can manage. I just wish that the Country would fix the loopholes and make health care more affordable.
I have LTC but, you can spend a lot of money on a ALF before the LTC kicks in. At least my policy doesn't kick in unless I meet several points...like not able to walk to bathroom, feed myself...etc. My dh doesn't have a LTC policy but as bad as he is he still wouldn't qualify to be able to use it. I have had my policy for at least 18 years. and I also have paid into medicare/medicaid for 13 years. So I think if I need either one or both of them I will not feel quilty.
Yes, em-LTC insurance. The first 100 days of my husband's stay was on me. After that the dementia ALR was totally covered. I hope the time never comes-but if it does I will be covered to stay in my own home with care. I still cringe when I make my insurance premium payments. At least once you are on the service you no longer pay premiums.
My insurance has the same requirement 90 day of care paid out of pocket then the policy kicks in. I gave them a lump sum and in return my wife and I are both covered for life. Most policies only give you 48 months of coverage. I also found out that you can buy life insurance with early death benefits. If you have a disease and a doctor says you have 2 yrs or less then the policy would pay the full death benefit, this is on term life insurace policy that I have. It is a lot cheaper than Long Term Care and all the hoops you have to jump thru to get paid.
We didn't get long term care insurance before my husband was diagnosed. I was 52 and he was 62 and we hadn't started thinking very seriously about retiring (I didn't realize he should be but had lost the ability to handle that kind of planning). The thought had crossed my mind 15 years earlier, but back in the late 1980s early 1990s I saw a lot of reporting about how the long term care insurance industry did not have its act together. And we were busy with kids--my husband was diagnosed when the younger one was a freshman in high school.
I am trying to shelter some money, in three circumstances. (1) I don't want to spend _my_ retirement savings on my husband's care--I'm going to need it. I did get LTC insurance on myself when my husband was diagnosed; the women in my family tend to die of Alzheimers at age 95. (2) I inherited some money from my grandmother and greatgrandmother that I would like to pass on to my kids, not spend on my husband's care. When we married, we signed a pre-nuptial agreement to protect that money as mine and for our kids, not joint property with my husband, but Medicaid doesn't recognize that agreement and would require me to spend it on his care. (3) I want my mother to change her will, in case she dies before my husband, so that the money I would inherit from her will go to our kids. If I inherited it, I would be required to spend it on my husband's care.
It was a first marriage for both of us, but I was 32 and my husband was 42 when we married. We always managed our investments separately (thank heavens, he made some bad mistakes). Everything that is his will go for his care--we chose to have him receive a higher pension that pays only until he dies and we put all of his retirement savings into an annuity that pays only until he dies and then nothing is left. In my particular situation (I have higher lifetime earnings than he does and we didn't see marriage as a financial merger), it seems to me entirely fair that everything that is his should be spent on his care but not fair that I should have to spend my retirement savings or family legacy. Unfortunately, the way the law is written, I have to exploit loopholes to achieve that.
pamsc you are so right. Family money should stay in the family. What bugs me is people who lived above their means without a care in the world, no plans at all. All of a sudden they want someone else to pay.
I totally agree that family money should stay in the family. That is why I had my father-in-law remove my husband's name from his cd & replace with our sons names. However, the savings we had went to his care.
For me, the most difficult thing to deal with was that the income stopped at 52 (H's age). He had to be licensed and have continuing ceu's. Until the troubles, there was no reason to think that he would not work until at least his 60's. Not for me, for for himself, being able to work at a profession he mostly liked, to be able to contribute to the community and do pro bono work.
All gone now.
As soon as he heard about LTC insurance he applied; too bad, the markers were already there.
I think if I had hindsight about that we would not have pursued dx while in his 40's; the ramifications have been so severe.
Family money is often protected in a trust and I'm sure I'm not telling anyone here anything they don't already know. Why Medicaid considers this available is a mystery to me.
My father wants what he has trusted to me to be available to me. (He does not especially like H, but I don't think that even matters, really).
Until reading some comments here, I did not really know elder care lawyers are specifically for medicaid. I consulted two because each had differing views on future planning. Additionally, they reviewed poa, living will, and other documents.
I have to go back to my father. Now in his late 70's his major concerns are his golf game and his dividends. Okay, I say that with some sarcasm, but, he worked hard for what he achieved and he did that for his wife and his daughter.
My circumstances are soemwhat similar to pamsc-I have an inhertance that my parents worked very hard to create for their 2 daughters. The money and property has never been comingled with any of DH's assets, and were to be available to me and my sister should we need them. Medicaid does consider them as available assets for DH's care when/if we need to apply for Medicaid.
DH & I worked hard, planned to continue working and saved before we allowed ourselves any "luxuries". DH does have LTC but it has a lifetime cap. I do not qualify for LTC due to a debilitating, long term illness. Knowing this, I saved aggressively to make sure we could afford in home care for me when the time came. Now that DH was dx'd at 58 (now almost 62) and has required in-home care because I am unable to assist with all the ADLs, he is using his LTC ins and will most likely begin to use his IRA assets when the LTC maxs out. I am not opposed to using his funds for his care, however, since I will need care, I am opposed to having to use the money I saved because I couldn't qualify for LTC ins on his care. It means everything I had separately will be used up before I need them. This is not right.
Elder care attorneys are not only for Medicaid planning-they can assist you and your spouse with the legal documents which will be needed in order to have the authority to make financial, legal, health decisions on behalf of your spouse. Many also know Medicaid laws and can advise how to shelter assets so that your spouse will be eligible for Mediacid and you won't lose what you've saved.
My DH and I don't have LTC insurance but have worked hard, saved, have some extra real estate we could sell and I also have some money passed down to me by a family member. We plan and hope to pay our own way for nursing home or in home care. It would be nice if there's some left for our children but I think the best gift we can give our children is being able to take care of ourselves in old age. The big problem is not knowing how long or how much it will take, especially with Alzheimer's. When I hear of someone having this disease and living 20 or 25 years, I cringe. We sure don't have that kind of financial security.
Time and money. How much and for how long? Of course, if you tell me H will need AL, or even home care, which is not my, or his N's preference, those are the questions.
A friend had a spouse dx with a cancer. Told it would be six months to one year. Friend said, the best place possible, which was done. It ended up being eight months. I can do eight months! I can't do five years, or fifteen or 20.
I am in my early 50's. If, as mentioned upthread, all the money is depleted what will I live on and for how long? What if I live to be in my 80's? How is it that money my father worked hard for all goes to H's care? Why can't it be safeguarded for my care?
I truly do not get it. Father works hard, leaves funds to daughter, H uses it all, daughter is left with nothing.
To reverse it, if this happened to me instead of H I would not expect what his father left to him to be exhausted for my care because I think that would not be fair to H or his parents.
Having no children, the closest I have is a dear niece who I want to name in my will/trust. But those funds could go to her husband. I have nothing against her husband, but I hardly know him and would want my funds to go to her. I guess as Medicaid is set up, if he needs it first, it goes to him and she gets nothing.
Truly I do not get it. As the eldercare lawyer explained it to me, I could stay in this house, which I don't want or need, and would be penalized if I left it. One car, okay. and then $109,000 to do what, last the rest of my life?
Going back to what pam and LFL have said, I can understand why the state, so to speak, should be able to use his money, but mine? I read a NYT article from some time ago and it said that lawyers in NY and othe NE states are advising spouses to just say no. How to go about that I have no idea.
And then the government is spending bazillions on other concerns. It is not exactly that those of us who are CG's have nothing else to worry about, now you need to take our resources too?
What does "just say no" mean-refuse to spend your money on spouse? The govt will come after what you have-aggressively to recapture what it spent on your spouses care. Just say no means divorce? In a community property state you still have to divide assets (although there MIGHT be an opportunity to protect inherited property/money) and the court will appoint a lawyer to ensure your spouse's interests are represented.
As I said in a previous thread, our attorney said you'll get the house and be allowed up to $109,000. Unfortunately you won't be able to afford to live in the house.
this 'just say no' is valid in only 3 states . new york, connecticut and florida i think. i checked this out some time ago but it wasnt in my state. you say no to spending your own money on spousal care, and yes they will come after you but it is supposed to be only for the 'medicaide' rates and not the private pay reimbursement amount. if you live in one of these states, you should ask a good elder care attorney about your options. i am sure there are plenty of lawfirms out there handling these issues. divvi
i found some info on this post above. it may be of interest to those living in any of these 3 states. this gives a general idea how it works. of course you'd add attorney fees:( divvi
Back to the original question--I think you need multiple advisors: CPA--tax advice Elderlaw Attorney--Medicaid and estate planning Financial advisor--investment advice
After dx, I interviewed 3 financial advisors, and their advice was all over the map. One suggested we put all $$$ in the stock market (wouldn't that have been lovely)??? I ended up sticking with the woman DH had already been using, she has a good heart as well as head on her shoulders. You need someone who will give you the appropriate advice for a couple dealing with a terminal, expensive illness. Sadly, not all advisors seem to take that into account--some are more interested in their own commissions.
I don't live in any of those states and just read about "just say no" in the NYT and thought I would pass it on to LFL.
I have never had good luck with a CPA; think they view my portfolio as not really worth it. I joke "turbotax" is my CPA.
I like my current financial advisior, quite a bit, and plan to stick with him at least for now. What he may lack in experience seems to be redeemed by his interest, and it seems genuine to me.
Also of importance, his advice seems congruent with my lawyer says. I depend on her the most, as she specializes in estate planning as well as elder care law. What kind of threw me was that I went to a specialist's specialist in elder care law and she and my lawyer have very differing opinions. Not really on medicaid as it seems that door is closed, but on general future planning. I can't afford a third opinion.
I totally agree on the heart factor. It is more than exhausting to dredge up this stuff over and over and at least for me I have to intuit some level of caring.
(MarilyninMD- I am far more interested in equities than is the advisior- I love picking stocks and he kind of just shakes his head and points to all these graphs on my portfolio and talks about bonds and mutual funds.)
Well, Abby, if you have nerves of steel then go for it with the stock market!!!! I have retired friends who were ready to jump off a bridge when the market tanked (and coincidentally, are the parents of the financial advisor who wanted to put all our assets in the stock market). They are older than we, but are pretty healthy and not dealing with anything like AD, just had to make lifestyle changes until things recovered. CPA is for tax advice and prep, not really investment advice. I probably could use Turbotax too and save some $$$, but DH was a CPA and this way I get it off my plate. Check out annuities; that's what we did and it seems to be working well. Combo of investing in stock market/life insurance/income source; downside is that they are complicated.
Oh, marilyninMD, so far I have managed to listen to the experts almost all of the time but sometimes I just want to pick a stock and follow it. I have had some good luck, and some terrible luck.
Both my advisor and lawyer are in favor of annuities for me. But, at my age I am not able to buy into many of them. If I have this right, they advise "immediate irrevocable" at no more than 25% of the portfolio. As they say, the caution for me is to not have anything roll over into what would be considered joint income in this community property state. Also, they have said that many annuities can't be purchased until age 55, some 60 and some 65.
Neither advise me to handle it alone and I am looking, just looking at Fidelity and Vanguard.
I, too, have heard of those who just took out what they had left in 2008 and put it under the mattress.
I just like to have something to think about other than H's dementia, the state of this house, and the condition of the property. Those I have to look at everyday while the financials are something I can look at on the internet and it "takes me away", at least a little bit!
Abby--I'm not a stock follower (DH was), but I've heard of people who just pick a stock and follow it without actually buying. I was 56 when I bought my annuity, age didn't factor in.
I get it about having something to think about other than dementia--we all need that!
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