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Medicaid Estate Planning

Perceptions of Morality and Necessity

^a Braceland Center for Mental Health and Aging, Institute of Living, Hartford Hospital's Mental Health Network, Hartford, CT, and Department of Medicine, University of Connecticut Health Center, Farmington

Correspondence: Leslie Curry, PhD, MPH, Director, Braceland Center for Mental Health and Aging, 400 Washington Street, Hartford, CT 06106. E-mail: lcurry{at}harthosp.org.

Laurence G. Branch, PhD

Purpose: Although several studies have examined the magnitude and prevalence of Medicaid estate planning (MEP), little is known about factors that influence individual behaviors in this area. Normative data regarding public perceptions of and motivations for MEP are nonexistent. This study explored views about MEP among community-dwelling older adults and family caregivers. Design and methods: Eighteen focus groups were completed (N = 155), with a stratified homogeneous sample to ensure representation from individuals of varying race/ethnicity, experience with nursing home and home care services, and socioeconomic status. Analyses of transcripts were completed with NUD*IST 4.0 software. Results: Disincentives for MEP included losing control of one's assets, Medicaid stigma, and perceived immorality of MEP. Incentives for MEP included preservation of one's estate and protection of a spouse. Finally, variability in accessibility to and awareness of MEP was described. Implications: This exploratory study identifies motivations for individual behaviors and describes evolving social norms regarding MEP; implications for policy and research are discussed.

Key Words: Long-term care financing • Nursing homes • Social norms

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