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How to help loved ones with mental disabilities

While mental illnesses take an obvious emotional toll, they can hurt families financially as well. If someone you love is affected by a mental illness, consider these tips for getting a handle on the situation. By Laura T. Coffey.

It can happen to anyone, from any walk of life, when you least expect it. A child can be diagnosed with autism. An aging parent can be diagnosed with Alzheimer’s disease. A middle-aged spouse can be diagnosed with any number of incapacitating mental disorders.

While such illnesses take an obvious emotional toll, they can hurt families financially as well.

The rigors of lining up the right kind of care can be draining, and planning for the future can become much more complicated than it otherwise might have been.

If someone you love is affected by a mental illness, consider these tips for getting a handle on the situation.

1. Assess decision-making abilities. Does your family member need help making major – or even extremely basic – financial decisions? Be sensitive to just how much help your relative actually needs right now, or is likely to need over time. Allow the person to be as independent as possible for as long as possible.

2. Line up supervision at the right time. When serious decision-making help is needed, consult with a lawyer to determine whether someone trustworthy should be given durable powers of attorney, trustee status or guardianship over your loved one. While different in scope, each of these approaches allows someone else to handle your relative’s affairs.

3. Find the right kind of legal help. You can find lawyers who specialize in issues affecting the disabled through the National Academy of Elder Law Attorneys.

4. Determine eligibility for government help. If the illness is so debilitating that your loved one can’t earn enough money to live on, he or she may qualify for Medicaid or Supplemental Security Income (SSI). Basic rules for eligibility can be found through the Social Security Administration and through your state’s department of health, human services, social services, or children and families. (The department names vary from state to state.)

5. “Spend down” wisely. In most cases, your aging relatives would have to impoverish themselves in order to qualify for Medicaid. Be sure to help them pay off bills and debts first before they apply. Such obligations are not factored into the government’s formula for determining eligibility.

6. Understand the system. Your loved ones would stand a much better chance of getting into a nursing home or assisted living facility they – and you – prefer if they go in as private-pay patients as opposed to Medicaid patients. You can help them apply for Medicaid after they’ve lived there for several months or more.

7. Look into Special Needs Trusts. You can use such trusts, also known as Supplemental Needs Trusts, to set aside money for specific needs for relatives who qualify for Medicaid or SSI without disqualifying them from receiving those benefits. Have a lawyer draft such a trust for you.

8. Plan ahead. To get a handle on how much money you might need over time to cover a family member’s expenses, use Merrill Lynch’s Special Needs Calculator.

9. Tap into local support. You can find contact information for local experts through the National Alliance on Mental Illness (1-800-950-6264). The national Eldercare Locator (1-800-677-1116) can connect you with your local Area Agency on Aging office if you’re lining up care for an aging relative.

10. Make sure your child’s care is covered. If you die before doing any advance planning for your disabled child, the courts could appoint a guardian without direction from you. Your child also may not be equipped to handle money inherited from you. The book “Planning for the Future: Providing a Meaningful Life for a Child with a Disability After Your Death” contains helpful advice in this arena.