Alton Nichols and Betty Hall, Photo by David Lassman

Recently, the child of one of my clients told me about a wedding her parents had attended. The wedding was that of a giddy-in-love senior citizen couple. The groom was 82, the bride 87; both living at the same long-term care facility. The bride was heard to gush, “I wanted to marry a younger man this time.”

Love and marriage is wonderful (as is obvious from the photo of Alton Nichols and Betty Hall, pictured above) but for senior citizens it raises very different issues than it does for the young and newly married. One obvious issue is the fact that most seniors already have adult children, and many of those adult children are quite vocal in their concern about their mother or father becoming involved in a new love life. Before mom or dad get married, many children want to make sure that their inheritance is protected.  To that end, many seniors use wills or trusts which direct that assets go to “my kids and grand-kids,” or create pre-marriage-property-settlement agreements (pre-nuptial contracts) which require that the pending bride or groom give up any interest in their new spouse’s assets.

Despite these attempts to safeguard assets for the original families, there is another hidden danger to the family wealth whenever a senior chooses to wed. A trust or pre-nuptial agreement does not protect the assets of one spouse from being drained to pay for an ill spouse’s medical costs, including long-term care costs. The “Common Law of England” required long ago that husbands and wives be legally responsible to pay for each others’ necessaries, and our own government adopted that requirement. Included in those “necessaries” are food, housing, and yes: healthcare. This includes the cost of care when someone is diagnosed with Alzheimer’s, Parkinson’s or any other long-term illness.

To protect themselves from this hidden drain on a lifetime of earnings, healthy vigorous seniors who are considering getting “hitched” must consider the wisdom of purchasing long-term care insurance and perhaps engaging an elder law attorney to assist them with longevity planning. All this must take place before your marriage, so that you have some idea of what your real risks are. Elder law attorneys have many creative legal solutions that go beyond the traditional estate planner’s basic will and trust, which merely deal with the distribution of your assets at the time of your death, avoidance of probate, and minimization of estate taxes.

If you are over 65 and considering saying “I do,” please recognize that you are also promising to pay for your new spouse’s future long-term care medical expenses. “In sickness and in health” is a standard line in most wedding vows, and the state of Illinoise takes that vow and makes it law. In the Chigaco metropolitan area the monthly cost for assisted living expenses ranges from a low of $2,500/month to about $6,000/month, and the cost for skilled nursing home care ranges from $5,500 to $10,000/month, or more.

With these numbers in mind, it’s good to remember that when you say “I do” what you’re really saying is “I’ll pay.”

A sweet 82 year old gentleman shuffled into my office the other day. I have known him for over 35 years, so I could not help but notice that he is now bent over with scoliosis and arthritis of the spine, and his breathing is quite labored. Salt of the earth, he is; He and his wife have a simple home, and are frugally living on what they perceive to be a “comfortable” retirement. Like many seniors, their combined pension/Social Security income is approximately $2,200 a month.

This man is in my office because his wife, age 81, is declining—she has arthritis in her back, shoulders, and hands, and is currently in the rehab center of a local nursing home recuperating from a fall at home that resulted in compression fractures of her vertebrae. She is also having problems with her short-term memory. Yet when I ask him how he is doing, he tells me, “I’m okay. We’ve been handling things at home. But I am a little worried that I may not be strong enough to help my wife when she gets released from the hospital.”

The ideal solution for this all-too-common situation would be for the couple to hire some in-home nursing care on a long-term basis, or perhaps a move to a long term care facility. However, when I suggest this to clients the reaction is often fear, or resistance at the very least. They aren’t ready to take that step yet; they don’t know what it entails, and are afraid they will lose their independence. Many of them also feel they can’t afford the cost of long term care, and are determined not to resort to Medicaid. In fact, when I mention Medicaid to the client whose story is featured in this post, his reaction is strong: “I don’t want to use Medicaid. I am afraid of Medicaid.”

My client doesn’t understand yet that Medicaid is his only governmental assistance option in the event that his wife must go into an assisted living facility or nursing home. He also doesn’t yet realize that assisted living of some kind is all but inevitable. This confusion could be avoided if the subject is approached before a crisis hits, but broaching the topic is not easy. Often it is one of the children or grandchildren who have to bring it up.

In this case, as with many others, the earlier the subject is brought up, the better. If you aren’t sure how to begin looking into long term care, there are a few websites that can get you started, including Long Term Care Living, and this guide from the AARP website.

The law surrounding elder care issues can be confusing to those who don’t deal with it every day, especially the laws concerning Medicaid, which are murky and convoluted. Our role here at Law Elder Law is to help seniors understand their options for assisted living and Medicaid, and help them plan for a future in which they can be comfortable—both physically and financially.