Elder Law and Estate Planning

A Texas family caregiver needs four core documents: a durable power of attorney, a medical power of attorney, a HIPAA release, and a directive to physicians. Without these, a caregiver cannot legally manage finances, speak with doctors, or make medical decisions for a loved one.

The best time to sign these documents is before a health crisis, while your loved one still has legal capacity. If capacity is already lost, guardianship may be the only remaining option, and it is slower, more public, and more expensive. Christina Lesher helps Houston families put these documents in place quickly and correctly.

Texas families pay for long-term care through five main sources: private savings, long-term care insurance, Medicaid, VA benefits for qualifying veterans, and family support. 

Medicaid is the largest payer of nursing home care in Texas, and eligibility depends on strict income and asset limits.

Many families assume they earn too much or own too much to qualify. 

In reality, an elder law attorney can often restructure income and assets legally so a loved one qualifies without spending everything first. 

Planning early preserves more options and more of the estate.

Medicare does not pay for long-term nursing home care. It covers up to 100 days of skilled rehabilitation after a hospital stay, and coverage often ends sooner. 

Medicaid pays for ongoing nursing home care and certain in-home care for Texans who meet income, asset, and medical need requirements.

This is the single most common point of confusion we see. Families expect Medicare to cover a nursing home stay and learn at the worst possible moment that it will not. Understanding this difference early gives your family time to plan.

A Miller Trust, formally called a Qualified Income Trust, is a legal tool that lets a Texan qualify for Medicaid long-term care when their monthly income is above the Medicaid income cap. Income flows through the trust so the applicant meets the eligibility limit.

In 2026, many Texas seniors fall into the gap where they earn too much for Medicaid and far too little to pay privately for care. 

A Miller Trust closes that gap. Setting one up requires precise drafting and consistent monthly funding, which our office handles for families across the Houston area.

The STAR+PLUS Home and Community Based Services Waiver is a Texas Medicaid program that pays for care at home or in assisted living instead of a nursing home. It helps seniors who need nursing-level care remain in their community.

Waiver slots are limited and there is often an interest list, so timing matters. An elder law attorney can help you understand eligibility, get on the list early, and coordinate the waiver with the rest of your loved one's plan.

A caregiver should talk to an elder law attorney at the first sign that a loved one may need help managing health care, finances, or daily life. 

Early planning protects legal authority, preserves assets, and prevents a crisis from forcing rushed decisions.

Common triggers include a new dementia diagnosis, a fall or hospitalization, a move toward assisted living, or confusion about paying for care. 

If any of these sound familiar, the right time to call is now, while the most options are still open.