John is seventy-eight years old and married to Pam, who is seventy-seven years old. John is 6 feet 2 inches tall and probably pushing two hundred pounds. The couple has one son who is thirty-nine years old and lives in Montana, a long distance from John and Pam in Marietta, Georgia.
John was diagnosed with Parkinson’s disease about three years ago. He has been able to manage with help from Pam until the past six months when he has become more unstable and has fallen on several occasions. Pam is very healthy, but when he falls, she doesn’t have the strength to help him get up. The first time, he lay on the floor for several hours thinking he would be able to gather his strength and get up by himself. When that didn’t work, Pam went across the street and asked a young man to come to their rescue. The neighbor and Pam were able to get John off the floor. Luckily, John hadn’t broken any bones, but he was fairly bruised.
The next time John fell, he knew they were going to need help. Pam again approached the neighbor for assistance. The neighbor was very willing to help the older couple. However, John was humiliated. He had always been a strong man. He had worked in construction throughout his life. Now, he felt weak and scared. He didn’t say anything to Pam because he was ashamed and didn’t want to worry her.
Pam was scared too, but she didn’t want to let John know. She was worried he was going to break a hip or something and she wouldn’t be able to help him. What if the neighbor wasn’t home the next time he fell?
John’s next tumble happened when Pam wasn’t home. Fortunately, he had his cell phone in his pocket. He called 911. Emergency medical services arrived within a few minutes in an ambulance with sirens blaring, capturing the attention of the entire neighborhood. Paramedics were able to quickly get John up, and he wasn’t seriously hurt. Initially, he had planned to keep this a secret from Pam, but the sirens ruined that idea.
As John became more unstable and experienced more falls, he became scared to take a shower. The tub was slippery and wet. He didn’t want to fall and have to receive assistance when he was naked. The limitations of Parkinson’s had seriously impacted his life. He resisted leaving home because there were five stairs he would have to maneuver to get out of the house.
He didn’t go to Friday breakfast with his buddies anymore. He stopped attending church. He and Pam hadn’t been out to dinner in months. He had become isolated. John had expected some progression of the disease, but not to be so limited already. He had thought he would have years before this would happen. John started thinking about what his options were.
He knew that Ron, an older gentleman in his Bible study, had an aide from a company come into his house to help him. Ron told John that he paid $25 per hour for that service. John quickly decided his falls were too inconsistent to pay someone to be there every day.
In Marietta, there were several assisted living communities. When Pam was at the store one day, John called several of them to learn about the services they offered and the prices they charged. John was shocked to learn a one-bedroom apartment at one assisted living facility would cost $5000 per month for both of them. He got out his calculator to crunch some numbers and determine exactly where they were financial. He became even more depressed.
During their fifty-two years of marriage, John had always been able to provide for his family. They were not wealthy, but they were always comfortable. In the past when they needed more money, he would take on some additional jobs. Now, that wasn’t an option. They were on a fixed income. He called Ron for advice. Ron recommended he talk to an elder law attorney and offered to drive him to an appointment.
John came into my office looking for help. He had difficulty walking into the office and he appeared hopeless. During our conversation, I learned that he had Parkinson’s disease and about the resulting limitations he was experiencing. John wanted a financially sound plan before he talked to his wife, but when he looked at their finances, he couldn’t find anything they could afford.
John and I reviewed his finances. He and Pam were receiving $5000 per month with their Social Security checks and his pension. They had $10,000 in a savings account, $85,000 in an individual retirement account, and $30,000 in an investment account, bringing their total assets to $125,000.
While seeking solutions, I asked John if he was a veteran. He was! He had served in the Army in Vietnam. I optimistically thought of the VA Aid and Attendance pension. If he met the three-factor eligibility requirements, this could really help them. After I thanked him for his service, he validated his dates of service as having been during the designated wartime, and that he had an honorable discharge. The first factor was achieved.
John had told me about his falls and his inability to shower by himself. The second factor of the criteria is for the applicant to require assistance with two activi- ties of daily living and have predictable unreimbursed medical expenses. While John did require assistance with showering and mobility, he was not currently paying for any care. Therefore, at this point in time he did not meet the second factor.
The third and most complex factor of the requirement is based on the couple’s net worth. Based on total assets of $125,000, they would meet the third factor on the surface. However, adding in their combined income of $5,000 per month would make them ineligible. Putting that aside, there was another problem. If John and Pam move into assisted living, they would most likely sell their house. I had to inquire about whether they had any equity in their house, or if they were renting.
They were renting, but the question reminded John of a lot they had bought with the intention of building their retirement home on it one day. The lot was worth $5,000. This increased their net worth to $130,000, or $906 over the maximum allowable by the VA.
A Plan for Qualifying
I had to help this man who was now in tears. Together, John and I developed a plan. John really liked the assisted living facility called Happy Acres, which cost $5000 per month for both him and Pam and required an additional $1000 deposit. Once John paid the deposit, their assets would be down below the maximum amount, so they could meet the third factor of the eligibility requirements. That still meant we had to figure out how to qualify for the second factor, recurring medical expense. Once they moved into Happy Acres, they would be paying $5000 per month for assisted living, which the VA considers an allowable medical expense. There wasn’t any reimbursement John was going to receive, and it was a monthly charge, so the cost met the predictability requirement.
Now, remember net worth for the VA includes annual income and assets. Since the couple had $5000 in monthly income and they were going to pay $5000 each month for care at the assisted living facility, their income for the VA calculation would be zero.
Meeting all three factors, John and Pam would qualify for the VA Aid and Attendance benefit and receive $2,266 per month. This equates to over $27,000 per year in tax-free money. With this benefit and their income, they should not need to use any of their assets at this time. Happy Acres employees will help get John up if he falls and assist him with showers. Plus, as his disease progresses, additional assistance is available for him as he needs it.
When John told Pam of the idea, she was relieved to know they could afford a safe place and that she didn’t have to care for John alone. This gave her such peace of mind to know others would be available to help her and John. It was an extra bonus when Pam discovered the assisted living included all of their meals and cleaning their apartment.
John and Pam moved into Happy Acres within the next couple of months. Without the VA Aid and Attendance benefit, they would have spent all of their income just to live at the assisted living facility. Doing so would have required them to use their savings for all of their other living expenses. At that rate, their savings would not have lasted very long. With the additional money from the benefit every month and the additional services at Happy Acres, John and Pam have made new friends and are enjoying their best life.
At Nelson Elder Care Law we helped more than 2,000 families to protect their life savings and pay for care as they age while maintaining their independence and dignity. The firm has been recognized as #42 on the Law Firm 500 and by the local Chamber of Commerce for customer excellence. We can be reached at (678) 250-9355.
If you haven’t read already, you can read our preview article Improving The Quality Of Life For Wartime Veterans.