Why You MUST Plan for End-of-Life Care NOW
The High Cost of Denial: How Families Suffer When You Don’t Plan Ahead
Most people don’t want to talk about death. And that’s exactly why so many families fall apart when it comes.
Death is not predictable. You may have time to prepare—or you may not. A stroke, a cancer diagnosis, or a fall can change everything overnight. Yet too many families wait until a crisis hits to have essential conversations and make critical decisions.
The consequences are devastating: unnecessary suffering, wasted money, family conflict, and medical care that doesn't reflect the person's true wishes.
In Dying With Love by Genera - a guidebook for navigating end-of-life care with compassion and clarity, we learn that love is not just what you feel—it's what you do. Planning ahead is an act of love.
This article is your wake-up call. We’ll explain why Medicaid’s 5-year lookback rule could destroy your family’s finances, why Medicare won’t save you, and how three real families suffered tragic and costly consequences by failing to plan.
1. The 5-Year Medicaid Lookback Rule: What It Is and Why It Matters
Medicaid is the largest payer of long-term care in the United States, but it’s not something you can rely on at the last minute.
Medicaid’s 5-year lookback period is a federal rule that examines all financial transactions made by a Medicaid applicant in the 60 months prior to applying for coverage. If the applicant gave away assets or sold them for less than market value during that time—say, to a family member—the government may impose a penalty period during which Medicaid won’t cover care at all.
This means if you wait until a diagnosis to start planning, it’s likely too late to fully protect your assets or qualify for benefits.
Families can lose tens or hundreds of thousands of dollars paying out-of-pocket for care that Medicaid would have covered—if only the person had planned ahead.
✔️ Planning Tip:
Establish a Medicaid Asset Protection Trust (MAPT) at least five years before care is needed. This allows you to shelter assets from the lookback period and ensure Medicaid eligibility when the time comes. Genera’s Caring for Aging Parents course covers your options here.
2. Medicare Will Not Cover Long-Term Care—Here’s the Reality
Many assume Medicare will cover nursing home or in-home care. It doesn’t.
Medicare only covers short-term skilled nursing care, up to 100 days, and only after a hospital stay of at least 3 consecutive days.
It does not cover custodial care—help with bathing, dressing, eating, or long-term supervision—unless skilled care is also required.
This misconception causes countless families to delay planning, only to discover Medicare stops paying just when care becomes most necessary and expensive.
3. Most People Die Without a Plan—And It Costs Everyone
According to a 2024 study by Caring.com:
Only 32% of Americans have a will.
Among parents with children under 18, only 27% have any estate plan at all.
Without a Living Will, Power of Attorney, and end-of-life care instructions:
Family members argue over decisions
Health providers deliver aggressive care by default, even if it’s unwanted
Families overspend on care and legal fees
Loved ones are left second-guessing what the patient would have wanted
4. Real-Life Examples: What Happens When Families Don’t Plan
Case 1: A Father’s Wishes Ignored
James, age 81, had a stroke and was unconscious. His adult children disagreed on whether to continue aggressive treatment. He had no advance directive, and the hospital proceeded with full resuscitation efforts.
He spent 12 weeks on life support, accumulating over $180,000 in unreimbursed costs. After his death, the siblings never spoke again.
Case 2: The Family Home Lost to Medicaid Recovery
Gloria, a widow, moved into a nursing home after a fall. She assumed Medicare would cover it—but it didn’t. Her family applied for Medicaid, but four years earlier, she had deeded her home to her son.
This triggered a two-year penalty period. The family had to pay $150,000 out of pocket and eventually sold the house to cover costs. The home Gloria hoped to pass down was lost.
Case 3: No Guardian for the Children
Brian and Melissa, in their 40s, died in a car crash, leaving two children behind. They had no will, no guardian appointed, and no life insurance.
A custody battle ensued between both sides of the family. The children were placed in foster care temporarily, and family relations were permanently damaged.
5. Planning Is Love in Action: What Dying with Love Teaches Us
The book Dying With Love by Genera outlines how proactive conversations and planning aren’t just legal or medical necessities—they are emotional and relational lifelines.
When you plan:
Your wishes are known and honored
Your family avoids chaos and resentment
Medical decisions reflect your values
You reduce financial burden on loved ones
You protect generational wealth
“Don’t leave behind confusion and conflict. Leave behind clarity and love.” – Dying With Love
6. Start the Conversation: What You Need to Do Now
Here’s what every adult—young or old—should do today:
Have the Conversation
Talk to your loved ones about your wishes for care, life support, funeral arrangements, and legacy.
Create Legal Documents
Use Genera's Legacy Planning Courses to complete:
Living Will
Power of Attorney (Medical & Financial)
Last Will and Testament
Guardianship designations (if you have kids)
Care preferences for home, hospice, or facility care
Plan for Medicaid Early
Don’t wait until a crisis. Work with professionals or follow Genera's Financial Legacy Planning section in the Caring for Aging Parents course to establish asset protection years in advance.
Prepare Financially
Set aside funds, consider long-term care insurance, and understand what Medicare and Medicaid will—and won’t—cover.
7. Final Thoughts: Don’t Let Your Family Pay the Price of Your Silence
End-of-life planning isn’t about fear. It’s about freedom.
It’s about making sure the people you love aren’t left scrambling. It’s about ensuring your voice is heard, even when you can’t speak. It’s about dying with dignity—and helping your family live with peace.
The cost of inaction is too high.
Start today with Genera’s Dying With Love and step-by-step planning courses. Because waiting until it’s too late is the worst decision of all.
Explore the Dying With Love Book
Get the guide that’s helping families make compassionate, confident decisions:
Read the book now →
Take the Genera Legacy Planning Courses
Avoid Medicaid mistakes. Get your documents in order. Protect your family.
Start your plan today →
