NYC “Community Medicaid” vs Out of Pocket?

I live in NYC and I’m POA FOR MY 104 year old uncle.

First of all, I’m so thankful to have found a community where people are so helpful. I have a question about Medicaid. I am helping my 104 year old uncle make a decision about Medicaid. Currently he is paying out-of-pocket for two aides whom he really likes to give him a stable warm 24/7 home care environment. I suspect he will run out of funds in about a year and a half to two years.

Here is my question:

1, Some people have said that I should create a trust (so his remaining funds can go to charities he’s chosen as beneficiaries after death,)  enroll him in community Medicaid now and begin getting some financial relief with the aides Medicaid would supply. They also say, with the amount he’d save he could probably afford to pay out of pocket for at least one of his trusted aides.

2, Other people say ‘why not just spend down all of his funds and keep the two out of pocket aides he likes, and in a year and a half – god willing, if he’s still well- he’ll have to join Community Medicaid anyway.

My own worries are these:

I am afraid of the instability of many different aides coming in shifts; he likes stability and the same faces.

I’m worried about patching together and managing the services and aides because I am two hours away from him.

Im worried that Medicaid will not give him 24/7 aid- which he needs.  (Can’t bathe, toilet, eat,, without help).

I’m worried the Trust doesn’t buy me that much time anyway!

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