living will vs. healthcare proxy

This question often arises where an individual requires some assistance with her activities of daily living but can largely function on her own. These are almost always homecare cases and can be tricky from a planning perspective.

We utilize the professional knowledge of geriatric care managers, nurses or social workers to assess the functional limitations of our clients. We do this at the outset of every homecare case. Relying on the advice of these professionals allows us to work closely with our clients to make a more informed decision.

Generally, we want the cost and effort involved in preparing a Medicaid application to outweigh the cost of privately paying for care at home. Usually, where an individual requires more than 6 hours of care, a Medicaid application should be explored. Of course, there are other eligibility factors to consider as well.

In some cases, we might recommend applying for Medicaid even where an individual requires only a few hours of care. In a recent case, our professional assessment suggested that while care needs were minimal, our client would need additional care on a steady, increasing basis over the next six months and beyond. Since a community Medicaid application takes a few months to be approved, we elected to be proactive at an early stage and file the application. In this case, the family was also privately paying for aides which over time, exceeded the cost of a Medicaid application. Without the benefit of a professional assessment, the family may have deferred this decision resulting in significant private funds being spent on care.

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