Phase 3 Planning - Reflections of Winter

Phase 3 Planning – Medicaid for Nursing Home Residents

As a Family Caregiver, you have done as much as you can for as long as possible. Now what? It’s time to be honest with both yourself and your family; you have started feeling the adverse effects of Caregiver Burnout (more on that later). Before you find yourself needing a personal caregiver, let’s talk Phase 3 Planning.

Phase 3 Planning is the answer to what happens when care is no longer working at home. At this point, your family has spent a lot of time, money and effort to help Mom realize her dream of staying at home. However, despite your best efforts, her care needs have reached the point where more is demanded. For a number of reasons, you have reached the point where a Nursing Home decision needs to be considered. These reasons include:


At this stage, Mom may now need much more time than the family can personally provide. 


Care at home is expensive.  It could be that to stay at home would require hiring outside caregivers 24/7.  At the rate of $20+ per hour, neither Mom nor the family can afford it. We often see situations where all of Mom’s money is spent in an effort to keep her at home.  Now she’s out of Money and the kids have to work, so the only option is Nursing Home Care. For more on paying for care, head over to our blog, “This Health Care Stuff Costs Money!

Increased Need for Skilled Nursing Care

Sometimes a person just needs full time skilled Nursing Care that can only be provided in a Skilled Nursing Facility (SNF).

Family Caregiver Burnout

Unfortunately, this is another common occurrence.  The family tried way too hard for way too long to provide care for their Loved One that taxed them to the limit.  Two of the biggest causes of Burnout I have seen are:

Prolonged Free Time Infringement

The family member had little outside assistance and was spending ALL of their “free” time helping Mom.  A few “Free Time Infringement” examples are: spending time that they would have spent doing things like sleeping, exercising or tending to their own personal care needs; spending time with their family; spending vacation days on vacation rather than caring for their Loved One

Regularly Performing Overwhelming Tasks

Regularly Doing Tasks that are way out of a family member’s skill level, physical ability or comfort zone. Examples are giving injections or doing even more complicated procedures on or for Loved One; regularly lifting more than they should and suffering back injury; regularly doing things that they never could have imagined, like Daughter helping Dad take a shower or Son helping Mom on and off the toilet.  They did it because it had to be done and there was no other option.

As you can see from the short list above, there are several reasons that a Family may come to a decision that it’s time we consider Nursing Home Care for Mom or Dad.  There is no right or wrong here – it’s been my experience that families do the best they can with the skills and resources that they have available to them.

As an interesting side note, Cindy and I attended a Conference yesterday where a very skilled medical practitioner was commenting on the increase she had witnessed  in amount, level and sophistication of home care provided by family members for their Loved Ones in the last few years. She mentioned that a lot of the care and many of the procedures that  had been administered by medical professionals in years past, were now being performed, out of necessity, by family members. From what I have seen, this trend will only increase. Even more demands will be placed on families in the future.

Phase 3 Planning: Nursing Home & Medicaid Planning

If you have made the Nursing Home decision for Mom, it’s important to take certain actions so as to help her get the assistance that she needs without suffering a “Gap in Coverage”.   Gaps result in potentially long periods of time where Mom has to pay out of pocket for care received. With proper planning, these gaps can often be reduced or eliminated entirely.

Getting a Loved One qualified for Medicaid assistance without jeopardizing their home or requiring spend down of monetary assets is not a simple project.  Failure to plan properly can substantially delay Mom or Dad’s receipt of Medicaid assistance to help pay monthly Nursing Home care.

Proper planning can often reduce the total amount of money required to be spent before receiving Medicaid assistance.  This is particularly important where there is a “well” spouse that needs the money or income to help pay for this monthly expense at home.

To assist with this project, it’s critical to seek the assistance of an Elder Law Attorney who regularly does Medicaid application work.   It’s also important to gather certain information prior to meeting with the attorney. Each state will have different requirements, but to get you started, click below to download your Phase 3 Checklist, completely free.  

Next Step

Hopefully you have read the previous 2 blogs in this short series and downloaded the respective free checklists. If not Click here for Phase 1 and here for Phase 2 Checklist links to read those articles and download these checklists.  

Best wishes to you as you do your Phase 3 Nursing Home Medicaid Planning.  If you are in Arkansas and need assistance with this, just give us a call or email us at  If you live in another state, it’s very important that you contact an Elder Law or Estate Planning attorney in your area for assistance.  

We want to be friends!

Ok. That might come off a little fast, but you can trust us. We want to help! We fully understand the stress and turmoil that you are facing as Family Caregiver – including personal experiences with burnout.

In our time as caregivers, we have amassed a wealth of knowledge that we desire to pass on. We understand the emotions involved while making necessary preplanning and caregiving decisions. Likewise, we have met many professional caregivers (like Alzheimer’s Caregiver Phil Smith), as well as other family members who were thrust as Family Caregiver. All caregivers have shared the same advice – Join a community! There is nothing more cleansing for our situation than knowing that we are not alone!

We have since created Caregiver Connection. Caregiver Connection is a newsletter that we write personally and send to fellow Caregivers. It is full of tips, tricks, direction and even professional advice. If you would like to sign up, click the button below.

Please Invite Someone to Our Newsletter

Being an Adult Kid who is helping mom as she is declining can be a scary, frustrating and lonely place lacking stability. You feel like you are solely responsible for solving Mom’s problems while managing yours. Some occasional input and a community you can trust would help, especially when facing burnout! This is a way that all of us can be working together as caregivers!

Many others that you may personally know are having to figure it all out by themselves. Most of them have no community. Please take a minute and do them a favor. Copy this link ~> <~ and send it to them in an email or private message. They can click on it and subscribe to our newsletter for free.

Then they can enjoy weekly tips and encouragement. They no longer have to feel so alone in their family caregiver journey. They will appreciate the favor! Thank you for thinking of them!

Thank You for being a Caregiver for Your Loved One – you are making a huge difference in their life!

About the Author

Doug & his wife Cindy have not only helped hundreds of families with their estate planning and elder law needs over the years, but have personal experience as caregivers and advocates for their Loved Ones as well.

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