Attorney advises seniors on assisted living and options for home care

When it comes to elderly care, attorney Arthur Bergeron finds that many people are unclear about the difference between assisted living facilities and nursing homes. With that in mind, he focused on assisted living in the first session of a two-part legal clinic, “Living where you want with the care you need,” hosted by the Tisbury Council on Aging at the town’s Senior Center on Monday night.

In most basic terms, an assisted living facility differs from a nursing home in that it does not offer skilled nursing services 24 hours a day, Mr. Bergeron said. The three assisted living facilities on Martha’s Vineyard certified by the state’s Department of Elder Services include the Henrietta Brewer House in Vineyard Haven, Long Hill Assisted Living for the Elderly in Edgartown, and an assisted living wing at Windemere Nursing and Rehabilitation Center at Martha’s Vineyard Hospital.

In addition to housing, assisted living facilities provide seniors with independent living while providing support services such as housekeeping, all or most meals, a monitoring device such as Life Line, and activities, Mr. Bergeron explained.

“Typically when you go in, you sign an individualized service plan, so the services you’re getting vary,” he said. “And the costs vary along with the service plan.”

Mr. Bergeron cautioned seniors to be cautious and read plans carefully, because some facilities charge a separate fee for every service.

Assisted living is a transition step between living in one’s own home and going to a nursing home, Mr. Bergeron noted. He said typically about 50 percent of people who start in assisted living end up in a nursing home.

“But what that really means is that 50 percent don’t,” he pointed out. “Fifty percent of the folks end up being able to live the rest of their lives independently, in an assisted living facility. Which is not as good as being at home, but not bad.”

A matter of cost

For most seniors, the biggest issue is cost, given that it may cost anywhere from $3,000 to $6,000 a month, Mr. Bergeron said. For many seniors, there is a gap between the cost of assisted living and their income. Unfortunately, MassHealth does not cover assisted living. It only covers facilities that are certified as having 24-hour a day nursing home care.

As a result, more than 80 percent of people that are taking advantage of assisted living facilities are wartime veterans and their spouses, who qualify for a monthly Veterans Administration (VA) basic pension with aid and attendance, Mr. Bergeron said.

He invited Patty Servaes, a consultant with Elder Resource Benefits Consulting (ERBC) in Sudbury, to give an overview of the pension and to talk about eligibility guidelines, including medical requirements and income and asset limits.

Ms. Servaes is a VA accredited agent but does not work for the VA. She said although the tax-free aid and attendance pension has been around since the 1950s, she finds that many veterans are unaware of it.

To qualify, veterans and/or their spouses must require the assistance of another person with activities of daily living. The non-service connected benefit is not limited to veterans injured in service. The benefit is available to veterans who served at least one day during a period of war, at least 90 days in total, and were other than dishonorably discharged.

Ms. Servaes said given that the benefit was created as a means-based program to help keep wartime veterans and their spouses off welfare, the pension level is very low.

For example, a surviving spouse may receive up to $1,113 a month, which includes $416 for aid and attendance.

“So the basic pension, let’s just round it and say it’s about $700, in order to get it, your monthly income would have to be below $700,” Ms. Servaes said.

Once applicants meet the disability criteria for aid and assistance, the actual amount of the original award is determined by their monthly financial means test.

While MassHealth does not consider assisted living expenses reimbursible, the VA does, Ms. Servaes said. And, the pension with aid and assistance also can be applied to private pay nursing home costs. She advised seniors who think they might qualify to call her at 508-270-7556 or Dukes County Director of Veterans Services Jo Ann Murphy at 508-693-6887.

There may be a fee involved for Ms. Servaes’s services beyond an initial consultation.

Mr. Bergeron, an attorney in the Mirick O’Connell law firm in Worcester, has practiced law in Massachusetts for more than 30 years. Elder law, estate planning, probate and trust administration, and land use matters are his focus.

Mr. Bergeron frequently provides educational programs on elder law topics to Councils on Aging, which he began offering on Martha’s Vineyard in 2009. Many of his presentations are now available for viewing online at www.youtube.com/elderlawfrankandmary.

Part Two

Mr. Bergeron will present the second installment of the legal clinic, “Staying Home No Matter What,” at 5:30-6:30 pm on Monday, October 28, at the Tisbury Senior Center at 34 Pine Tree Road. His presentation will focus on home care programs that can keep seniors safe and sound while living in their own homes. To register call 508-696-4205. Refreshments will be provided.