FINANCIAL AND LEGAL ISSUES

People work a lifetime, expecting to reap the benefits of their labor upon retirement. But soaring health care costs and the lack of a national long-term health care insurance program have impoverished millions of older people. Though the average person knows little about government benefits and entitlements programs, when long-term health care needs arise, one quickly discovers that Medicare will cover only a portion of the costs of much of the health care services required.

The state Medicaid program is intended to meet the long-term care needs of people whose income and resources are insufficient. Long-distance caregivers are advised to familiarize themselves with the eligibility requirements and to take the necessary steps early on to secure these benefits for eligible loved ones. In some areas of the state, it can take up to a nine months to process an application for Medicaid benefits. While benefits will be paid retroactively to the date of application if the application ultimately is approved, in many instances family members will have to cover expenses in the interim. This can pose a true financial hardship.

If your loved one hasn't already done so, you should contact an attorney who specializes in elder law about preparing a ''living will" stating the care recipient's wishes about care in case of a life-threatening illness or injury. The attorney will likely suggest that other legal documents be executed, such as a durable power of attorney and the declaration of a health care surrogate, so that in the event of future incapacity, bills can be timely paid and decisions can be made on the care recipient's behalf without having to suffer the indignities of guardianship proceedings. Additional information pertaining to legal issues appears in Chapter 2.