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Case Study: Long-Term Care Planning

By Harry S. Margolis

When we teach classes on long-term care planning we often use hypothetical clients to illustrate the application of legal planning techniques to actual situations. Here’s one such case study:

Tim and Joyce come to see you to discuss their mother, Sandra, who is 84 years old and beginning to show signs of dementia. They are planning for their mother to move to an assisted living facility near where Joyce lives so that it will be easier for Joyce to help out as needed and they won’t be as worried about Sandra living alone. Sandra is reluctant but willing to make this move.

In addition to asking you to review Sandra’s existing estate plan, Tim and Joyce are wondering if it’s possible to get some assistance paying for her assisted living care or, ultimately, for nursing home care if that ever becomes necessary.

Sandra’s assets can be summarized as follows:

House (fair market value)                                   $400,000

Savings & investments                                        $250,000

IRA                                                                         $150,000

Credit shelter trust left by Sandra’s husband     $300,000

Her income is $2,000 a month from Social Security and a small pension.

You are the lawyer. For long-term care planning purposes, what steps do you advise the family take with respect to:

  1. The house?
  2. Sandra’s savings and investments?
  3. Her IRA?
  4. The husband’s trust?

Would your advice change if,

  1. Sandra needed immediate nursing home care?
  2. Joyce and Tim had a brother with developmental disabilities living in a group home?
  3. Sandra had long-term care insurance covering up to $200 a day of care for three years?


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