Utah Estate Planning Attorney: Long-Term Care and Estate Planning

ESTATE PLANNING ESSENTIALS

It usually starts with a phone call.

“My dad had a fall. He’s okay, but we’re looking into care options.” Or, “Mom’s memory is slipping. We’re not sure what the next few years are going to look like.”

Or sometimes it’s more direct: “How do we protect the house if we need to get her on Medicaid next month?”

These are crisis calls. They come after something has already happened. But by then, your choices are narrower. The stress is higher. The tools that would’ve made a big difference a year ago might now be off the table.

That’s why long-term care shouldn’t be an afterthought—it should be a core part of your estate plan. A Utah estate planning attorney can help you prepare for this while you still have time and options.

Because estate planning isn’t just about what happens when you die. It’s also about what happens if you live a long time and need help along the way. And the odds are, you will.

You Probably Will Need Long-Term Care—At Least for a While

Nearly 70% of adults over age 65 will need some form of long-term care during their lifetime. And 1 in 5 will need care for five years or more.

These aren’t just numbers—they represent real people, real families, real futures. Odds are, someone you love will end up needing long-term care. And there’s a good chance you will too.

The worst part? Most people aren’t remotely prepared for it. They assume it won’t happen to them. Or if it does, they’ll cross that bridge when they come to it. But that bridge shows up faster than you think—and without a plan, it’s easy to find yourself scrambling to catch up.

And here’s what makes it especially tricky: long-term care usually doesn’t start as a dramatic event. More often, it begins with something that feels manageable. Until it isn’t.

Maybe you need help getting in and out of the shower. Maybe your spouse forgets where they put the mail or whether they already took their medication. Maybe you’re doing just fine now, but you know the time is coming when stairs will feel like mountains.

Long-term care is a broad category. It includes things like:

• In-home caregivers

• Assisted living

• Memory care

• Adult day programs
  

And yes, nursing homes too.

But regardless of what kind of care it is, it can get very expensive. And too often, people assume it won’t affect them - or that if it does, they’ll deal with it later.

Estate Planning Without Long-Term Care Is Like a House Without a Roof

You can have a beautifully written will. You might have a revocable trust that’s fully funded, beneficiaries listed, all the right signatures in place. But if your plan doesn’t address what happens if you need long-term care—and how to pay for it—you’re leaving a major gap.

Because here’s what happens if you don’t plan:

• Your family scrambles to figure out who’s in charge.

• They start paying for care out-of-pocket—sometimes with their own money.

• You burn through your estate just trying to stay afloat.

• And eventually, the estate plan you built with so much care has nothing left to give.

This isn’t theoretical. I’ve seen it happen more times than I can count. And every time, someone says, “We just didn’t think it would get this bad, this fast.”

The Cost of Long-Term Care Isn’t a Side Issue—It Is the Issue

A private room in a nursing home can easily run $10,000 per month or more.. Assisted living? You’re easily looking at $4,000–$7,000 per month, depending on the level of care. Even part-time in-home help costs thousands per month if you need consistent coverage.

So let's say you need to spend some time at a nursing home, which typically costs around $7,000 a month—sometimes more depending on location and level of care. That’s not top-tier luxury care. That’s just what it costs these days for a facility that provides a secure environment, round-the-clock support, and staff trained to handle skilled nursing needs.

Now imagine your spouse develops dementa. He or she needs memory care at this rate for two years. That’s:

$7,000 × 12 months × 2 years = $168,000.

Later on, you might need care yourself. Let’s say you spend three years in a skilled nursing facility at $10,000 per month—not uncommon if you need more intensive care or end-of-life support. That’s:

$10,000 × 12 months × 3 years = $360,000.

Together, that’s over half a million dollars in long-term care costs between two people—$528,000, to be exact.

About as much as the average mortgage these days. - the total value of your house.

It takes most people 30 years to pay that off.

And here’s what most people don’t realize. If Medicaid pays out for your care, the state will recover those costs from your estate after you pass away. That could mean your home, your land, or your remaining savings—whatever’s left.

That's right. Medicaid is one of the largest creditors of an average estate in probate.

So even if you can’t afford to pay those costs upfront, and you get help from the government to pay for care, it still ends up coming out of your legacy unless you plan ahead to protect it, often through tools like a Medicaid asset protection trust.

This is why this kind of planning is incorporated with your estate. If there's anything that can be done about it, it's in the planning stage.

And here’s the part that surprises people: Medicare doesn’t cover it. At least not the kind of long-term care we’re talking about. It may cover short rehab stays after a hospitalization, but not ongoing help with bathing, dressing, eating, or managing medications.

So how do people pay for this?

There are three options. And a good Utah trusts and wills attorney will be able to help you through these options.

Incorporating Costs of Long-term Care with an Estate Planning Attorney

1. Private Pay (Use Your Own Money)

This is the simplest solution—but it can also be the most draining, especially for people with average estates. If you’re paying out-of-pocket, you’ll need to rely on savings, retirement accounts, or income from investments. If this is your plan, your estate plan needs to account for the cash flow needs of your long-term care costs over time.

That's the benchmark we use: Can you reasonably afford to pay for the worst-case scenario without exhausting the estate?

A good Utah estate planning attorney will ask: Are your assets liquid? Will your spouse still have enough if you need care for 3–5 years? Is your home vulnerable if you run out of cash?

This is also where we may bring in a financial advisor to stress test the plan—what happens to your estate if one spouse needs $8,000/month in care for several years?

2. Insurance

Long-term care insurance can be a valuable part of the toolkit—but it has to be set up early, while you’re still healthy enough to qualify. And it’s not just about standalone LTC policies anymore. Many families are turning to hybrid products—life insurance or annuities with long-term care riders. These can be structured to pay out for care if needed, and still leave something behind if not.

A good estate plan will take these policies into account and coordinate them with the trust, the power of attorney, and the overall distribution plan. If you have a policy and no one knows it exists—or no one can access it in time—it won’t do you much good.

3. Medicaid (with Proper Planning)

Medicaid is the only public program that pays for long-term care, but qualifying isn’t automatic. In most states, including Utah and Arizona, you need to meet strict asset and income limits, and there’s a 5-year lookback on any gifts or transfers you may have made. Those transfers will trigger a penalty that will delay the time when eligibility benefits can start, even after you've already exhausted the assets you have.

This is where estate planning and long-term care planning really start to merge. Because if you plan early enough, there are ways to protect your assets while still setting yourself up for Medicaid eligibility. This might include:

• Transferring your home into a properly designed trust

• Shifting assets out of your name early enough to avoid the lookback

• Structuring gifts or transfers to avoid penalties

• Using special types of irrevocable trusts like Medicaid asset protection trusts.

But timing matters. These strategies only work if they’re put in place well before care is needed. A lawyer for trust and will planning can help you elevate your options and make the right moves before it's too late.

And that brings us to a major point most people overlook.

Powers of Attorney and Health Care Directives Are Not Enough

Yes, you need a power of attorney. Yes, you need a health care directive. These are essential tools in any estate plan, and they become critical during a long-term care crisis.

But let’s be clear: they are only part of the plan.

A power of attorney doesn’t make money appear. It doesn’t protect assets. It doesn’t qualify you for Medicaid or solve the financial side of care. What it does do is give your trusted agent the authority to act on your behalf. That becomes especially important if you’re trying to qualify for Medicaid quickly and need to move assets or apply for benefits.

But if you’re planning in advance—before the crisis—then you can use other tools to actually shape the financial picture in a proactive way. That’s what gives you options later.

Working with a Utah estate planning attorney early makes it easier to integrate those tools into your plan while you still have capacity.

Why Timing (and Mental Capacity) Matter

This is where things can get tricky. If you wait too long to set up a long-term care plan—especially if cognitive decline has already started—you might not be able to sign legal documents anymore.

That’s because estate planning requires mental competency.

If a parent or spouse is already struggling with memory loss or confusion, they may not be legally capable of creating or amending a trust, signing a new power of attorney, or shifting assets for Medicaid planning. At that point, we’re limited to emergency strategies—and those are almost always more expensive and less protective.

This is a hard topic. No one likes to think about decline. But the kindest, wisest thing you can do for yourself and your family is plan while you’re still able to do so.

What an Estate Plan with Long-Term Care Actually Looks Like

A complete plan doesn’t just ask, “What happens when I die?” It also asks, “What happens if I need help living?”

Here’s what that looks like in real life:

• A trust that protects the home from Medicaid recovery (like a Medicaid asset protection trust)

• Powers of attorney that explicitly allow long-term care and Medicaid planning

• A review of retirement assets, to understand what can be used (or not)

• Insurance policies coordinated with the trust and beneficiary designations

• Conversations with family—so everyone understands the plan

• Contingencies in place for care, not just death

It’s not always dramatic. Most of the time, the result is simple: when care is needed, no one panics. The money’s there. The tools are in place. The family knows what to do.

And that’s exactly the kind of peace a good estate plan should deliver.

Final Thoughts: Plan for Independence, Not Just Inheritance

There’s a quiet truth that runs underneath all of this: long-term care planning is about freedom. Freedom to get the care you want, where you want it. Freedom to avoid burdening your spouse or children. Freedom to protect what you’ve worked hard to build.

Estate planning isn’t just about dividing things after you’re gone. It’s about protecting your ability to live with dignity - no matter what the future holds.

If you're ready to start building a plan that takes care of you in life and your loved ones after, let’s talk.