Financial issues in elderly care varied, complex
| • | Special report: The Graying of Hawai'i |
By Deborah Adamson
Advertiser Staff Writer
As Hawai'i's elderly population grows, more families are having to cope with the financial impact of caring for older relatives. Advertiser readers were asked to submit questions to our panel of experts:
Q: Is there any possible way for Boomer children to afford nursing home care for their parents without having to sell the home and property of the parents? We are currently in this situation.
— H. Yamada
A: Look into long-term care insurance for your parents, but it might be costly. They also could draw down on any cash value life insurance policies or apply for a reverse mortgage — a special loan where a portion of the home equity is converted into cash.
Another strategy is to include the use of less expensive care, if it's medically possible. Instead of full-time nursing home care, which costs between $6,000 and $7,000 a month, perhaps the senior can be placed in an adult daycare center on weekdays at a cost of $1,000 and up a month, and a family member can watch over him or her at night. Hire a nurse occasionally for about $25 an hour.
The last resort is Medicaid, which pays for long-term nursing home care. But seniors must be impoverished to qualify. To apply, call 587-3521.
— Cullen Hayashida, co-host of Kupuna Connections, an 'Olelo program for seniors and caregivers
Q: We have a general will drawn in another state. Is it valid in Hawai'i? Also, in some states, you can select beneficiaries for property and most investments, which allows assets to be transferred automatically upon the death of the owner without going through probate. Any such thing in Hawai'i?
— M. Ell
A: If your will was properly executed and prepared in the other state, then Hawai'i will recognize it. As for the transfer of assets to beneficiaries without going through probate, it won't be automatic unless assets are in a revocable living trust. The exceptions are life insurance products, which includes annuities; retirement accounts and some mutual funds that allow transfers to beneficiaries without going through probate.
— Mel Hertz, chairman of the Financial Planning Association of Hawai'i
Q: If an elderly widowed person over 65 applies for Medicaid and is within asset limits but has his home in an irrevocable trust, is a lien still placed on the home? Will the property need to be removed from the trust? What actions are taken with the lien and when is the lien enforced?
— Laverne Tsukamoto
A: Medicaid cannot place a lien on a property within a trust, so the asset must be taken out of the trust. Once a lien is placed, Medicaid will try to recoup its expenses when the home is sold or ownership is transferred — if the senior is still living.
If the senior has passed away, Medicaid will not enforce a lien if there is a surviving spouse, a child under 21 or a child over 21 but blind or disabled, a sibling who owns part of the house and has lived there at least one year before the senior moved into the nursing home or a non-dependent child who has lived in the home for at least two years before the senior entering the nursing home and who provided care.
If the house is bequeathed to the family and the family wishes to keep the home, it must pay Medicaid back. However, low-income families and those with family farms may be exempt from having to pay Medicaid back. For more details, call 586-5390.
— Eligibility section, Hawai'i's Med-QUEST Division
Q: My folks live on the Big Island and my dad just turned 80 and my mom is blind. My question is, how do I apply for support for the caregiving of family members? I live in California and would like to help my folks out.
— Jack Perry
A: There isn't much financial help available to caregivers at present. Some aid is available through the Chore Services program of the state Department of Human Services' Social Services division, but it's limited and there's a waiting list. Your parents would have to apply for the program and choose to pay you to perform chores for them. But pay is the state minimum wage up to 20 hours a week. For information, call 933-8820 for East Hawai'i and 327-6280 for West Hawai'i.
— Hawai'i Department of Human Services, Social Services div.
Q: My mother lives on Kaua'i with my brother. They have a nice home and until recently she has been able to stay alone during the day. Unfortunately, she broke her hip about a month ago and was in Wilcox Hospital for one week, then moved to Garden Isle Health Care facility for rehabilitation. She is being released but is still not able to walk. This presents a problem for my brother during the day. He has work. Is there any assistance that we could look into that would be available during the day until she fully recovers and is able to get around?
— Susan Moss
A: Look into Kupuna Care, which provides subsidized home services to seniors. Your mom must be at least 60 years of age and need help with at least two of these daily activities: eating, dressing, bathing, using the toilet, transferring from one place to another, mobility, preparing meals, shopping, managing money, using the phone, doing housework, using public transportation and taking medications. For information, call 523-4545.
— Cullen Hayashida, co-host of Kupuna Connections
Q: We take care of my widowed 88-year-old mother and the financial issues around long-term care insurance concern me. I'm 55 years old and unable to work any longer because of the painful effects of rheumatoid arthritis. In order to protect my husband's and my assets, we applied for long-term care insurance. Although my husband qualified, I was turned down by a number of private insurers. Would you be able to refer me to an appropriate agency or person for help, advice or resources regarding my particular circumstances?
— Mrs. L. Freitas-Asato
A: Contact SagePlus, a state program that provides health insurance information, counseling and referrals to people 60 or older, their families and caregivers. Trained volunteer counselors provide free consultations and presentations. For information, call 586-7299.
Also, contact the state Insurance Division at 586-2790 and ask to see a list of long-term care insurers registered and licensed to do business in the state. You might want to widen your search since some insurers are willing to insure sicker customers, but they'll charge higher premiums.
— Cullen Hayashida, co-host of Kupuna Connections
