On Elder Care & Filial Repsonsibility

A comfortably well-off Christian conservative relative recently described over dinner an intention to “legally” move all of his assets into his childrens’ names. He and hs wife would then collect Medicaid through their last months on earth. In this way they would not be a “burden to the children.”

I was mystified as to how he justified this on moral grounds, considering his devout Christian beliefs, and politically, since he rails against these social programs at the least provocation. So I read with interest Jane Grosses piece in the NYTimes New Old Age blog, Adult Children, Aging Parents and the Law:

[I]t fascinated me to learn that in 30 states, (PDF of 30-state list) adult children are legally responsible, at least on paper, to pay for necessities like food, clothing, shelter and medical attention for indigent parents. These statutes, known as filial responsibility laws, are modeled on the Elizabethan Poor Laws of 1601, which made blood relatives the primary source of support for family members, the elderly included. Public assistance was available only as a last resort.

Civil or criminal cases seeking assistance or reimbursment from adult children “all but stopped” with the New Deal and Social Security. Medicaid, in 1965, ended it for good. But Medicaid is now in trouble:

The staggering cost of long-term care and the explosion in the number of people who will need it has prompted a second look at filial responsibility laws as a way to deal with the impending crisis. The National Center for Policy Analysis, a conservative policy group, identified contributions from adult children as one solution to increasing expenditures and insufficient revenues in a 2005 issue brief. A few law journal articles followed, most recently one earlier this year in The Elder Law Journal.

The more temperate arguments about holding adult children responsible take into account the competing demands on their savings, if they have any, including college tuition and impending retirement. Also, most proponents of enforcing filial responsibility laws would exempt those who were abandoned in childhood and see to it that one sibling doesn’t get stuck while the others skip town.

Among the most thought provoking ideas in the journal articles are these from Allison E. Ross, in “Taking Care of Our Caretakers: Using Filial Responsibility Laws to Support the Elderly Beyond the Government’s Assistance.’’ Would enforcing these laws encourage families to plan for the costs associated with the end of life, as they do for the costs at the beginning? Would the transfer of assets from parent to child as an inheritance protection plan stop if the children would then have to spend that money on their parents? And would the quality of life for the institutionalized elderly improve if adult children supplemented rather than replaced the government’s support? That’s what most of us do informally anyhow.

Times’ commenters roared their disapproval, prompting an update from Jane:

It was not my intent to suggest that filial responsibility laws were fair, wise or likely, in this day and age, to ever be enforced again. I simply was interested, personally and intellectually, in exploring whether such laws existed now or ever had and, if so, whether there was any movement, however limited or far-fetched, to revisit the question under current conditions vis a vis Medicaid.

Valuing a calm quiet dinner table at Thanksgiving, I can only wonder what my relative might think.