Thoughts on Independence from an Elder Law Attorney

Independence Day has come and gone, but this time of year always reminds me of why I focus on estate planning and elder law: these areas of practice allow me to help my clients live at home independently for as long as possible.  Let’s take a brief look at some of the planning options available.

Cash and Sweat Equity
For most people, the support necessary to remain at home with care comes, either primarily or in part, from two sources.  The first is your own savings to hire private home health aides, make modifications to the home for easier mobility, etc.  The second source is the human component – time committed by your family, neighbors, and community. 

One’s own savings and network rarely provide all the necessary care.  For that reason, we look to other sources, and we combine those with your savings and your people.  Only then are we able to slow the depletion of your assets (and protect your family and friends from “burn out”).

MassHealth and Elder Services
Most people know that MassHealth covers the cost of nursing home care for eligible residents of Massachusetts, but MassHealth (often in tandem with your local Elder Services agency) also offers assistance for home care and assisted living through a variety of programs.  For example, the Personal Care Attendant Program will pay for a specified number of hours of personal care services each month.  Meanwhile, the Home Care Program provides in-home support services for older adults, people with disabilities, and people with dementia.

Another way to obtain financial assistance for home care is through MassHealth Waiver Programs.  To be eligible for these services you must meet certain income and asset requirements, which proper planning can help you accomplish.  You must also show that without waiver services you would be forced to move to a nursing home.  The most robust waiver program is called the Frail Elder Waiver, which can provide a wide array of vital services.  PACE, technically not a waiver program, also has income and asset requirements and provides a host of coordinated services, including assisted living.

Veterans Administration
The VA provides several services for veterans wishing to remain at home, such as home health aides, visiting medical staff to the homebound, and day programs.  And available to both the veteran and the spouse or widow is Aid & Attendance, which is a cash supplement that you can use for medical expenses, such as home care and assisted living.

Reverse Mortgage
A reverse mortgage allows homeowners to borrow money against the value of their home.  Reverse mortgages are designed for elders and are only available to people 62 years of age or older.  The loan can take several forms, including monthly payments, a line of credit, a lump sum, or a combination of all three.

Long-Term Care Insurance
As the name implies, one can purchase a long-term care insurance policy in advance to help pay for long-term care in the future.  However, if you wait too long to apply for coverage, or until you have developed medical problems, you may not be able to qualify for a policy.


My role is to help you map out a plan to pay for care in order to stay at home for as long as possible.  I can help you make a plan for “what if” in the future, or, if you are in need of care immediately, we can develop a “need it right now” plan.

As always, I am here to help you remain independent and reside in your own home for as long as possible.  Please reach out so we can create a plan. 

Until next time, take care….

Alexis