A Beacon in the Dark: How Care Management Trusts Guide Your Healthcare Decisions

As you age, you may face the challenge of maintaining your independence and dignity while receiving adequate care. You may also want to stay at home and avoid going to a nursing home unless absolutely necessary. If you are looking for a way to address your personal care needs and preferences, you may want to consider creating or updating a care management trust.
Need for Personal Care Instructions
Personal care refers to the services and support that you may need in case of illness, injury, disability, or aging. These services may include medical care, nursing care, home health care, assisted living, hospice care, personal assistance, and other related needs.
Personal care can be expensive, complex, and difficult to navigate. It can also have a significant impact on your autonomy, dignity, and quality of life. Therefore, it is important to plan ahead and create a legal framework that can address your personal care needs in a way that reflects your wishes, values, and interests.
One of the tools that can help you with this goal is a care management trust. A care management trust is a type of trust that is created specifically to manage and finance your personal care needs. Unlike a typical trust, which is mainly focused on the distribution of assets after death, a care management trust is designed to provide ongoing support and guidance for you during your lifetime.
What is a Care Management Trust?
A care management trust is a legal arrangement that allows you to transfer some of your assets into a trust that is managed by a trustee. The trustee can use the trust assets to pay for your personal care expenses, as well as any other expenses that you authorize. You can change or cancel the trust at any time, as long as you are mentally competent.
A care management trust can be tailored to your specific needs and preferences. You can decide what type of care you want, where and how often you want it, and how much you want to spend. You can also specify who can visit you, who can make medical decisions for you, and how your assets should be managed. You can change or update your instructions as your situation changes.
What Instructions Can You Include in a Care Management Trust?
A care management trust can include a variety of instructions that can help you achieve your personal care goals. Some of the instructions that you can include are:
  • The criteria for determining your incapacity or need for care, such as including family members and a doctor’s certification.
  • The scope and limitations of the trustee’s authority and discretion, such as the acceptable levels of care, expenditures for remodels, care for pets, or support of others.
  • The standards and preferences for in-home care, such as credentials, agencies, or employing family members.
  • The activities and hobbies that you wish to pursue or maintain, such as reading, gardening, traveling, or volunteering, and the resources and support that you need to do so.
  • The values and beliefs that you wish to respect or honor, such as your religious, cultural, or ethical convictions, and the arrangements and accommodations that you need to do so.
  • The people that you wish to involve or exclude in your care, such as your family members, friends, neighbors, or professionals, and the roles and responsibilities that they have.
These are just some examples of the instructions that you can include in your care management trust. You can be as specific or as general as you wish, but you should make sure that your instructions are clear, consistent, and realistic. You should also review and update your instructions periodically, especially when there are significant changes in your health, finances, or personal situation.
Converting a Revocable Living Trust to a Care Management Trust
A revocable living trust is a common estate planning tool that can help you avoid probate and control the distribution of your assets after your death. However, it may not provide enough guidance for your personal care needs during your lifetime, especially if you become incapacitated. You may want to convert it to a care management trust by adding more details and flexibility for your care instructions and addressing potential conflicts of interest.
To convert your revocable living trust to a care management trust, you will need to amend and restate your trust document and update your funding documents, such as your deeds, titles, or beneficiary designations, to reflect the name and the terms of your new trust.
Adding a Care Management Trust to Your Planning
A care management trust can be a valuable tool to plan for and manage your personal care needs. It can provide you with more options and flexibility, while also respecting your values and goals. It can also provide you with security and confidence, knowing that you have someone reliable and qualified to take care of you and your estate. If you are interested in creating or updating a care management trust, or if you have any questions about this or other estate planning options, we can help you create a plan that addresses your care planning needs, protects your interests, and preserves your legacy.