Comprehensive Guide to Medicaid and Long-Term Care Planning
Planning for long-term care and Medicaid eligibility can feel overwhelming, especially for families facing illness, advanced age, or disability. This guide explains the steps Louisville residents can take to protect assets, ensure access to necessary care, and pursue Medicaid benefits when appropriate. We explain common pathways, timelines, and the practical choices families must consider. Our goal is to help readers understand the options available in Tennessee so they can make informed decisions about care, finances, and legal protections while preserving dignity and family resources over the long term.
Long-term care planning involves more than arranging medical support; it requires thoughtful coordination of finances, housing, legal documents, and benefits. For many families, Medicaid becomes a vital funding source for nursing home care and certain home-based services. Understanding when and how to pursue Medicaid, and what planning approaches are permitted under Tennessee law, helps prevent unnecessary depletion of assets. This section offers a practical overview of the timelines, eligibility factors, and commonly used planning techniques to guide families through difficult decisions about care and protection.
Why Medicaid and Long-Term Care Planning Matters for Louisville Families
Early planning for long-term care and Medicaid eligibility can reduce stress and protect family resources during a medical crisis. When care needs arise, families who prepared in advance often secure more stable living arrangements and avoid hurried financial choices. Proper planning can help preserve assets for a spouse or heirs while accessing benefits that cover care costs. It also establishes legal documents such as powers of attorney and healthcare directives, which allow trusted family members to manage finances and medical decisions when an individual is unable to do so on their own.
About Jay Johnson Law Firm and Our Approach to Elder Law
Jay Johnson Law Firm serves Hendersonville and surrounding Tennessee communities with focused attention on estate planning, probate, and elder law matters including Medicaid and long-term care planning. Our team assists clients in assessing eligibility, preparing applications, and structuring plans that align with state rules and family goals. We emphasize clear communication, practical options, and step-by-step guidance designed to reduce uncertainty for families navigating care transitions. Clients receive individualized attention to ensure their financial and personal wishes are respected throughout the planning process.
Understanding Medicaid and Long-Term Care Planning in Tennessee
Medicaid and long-term care planning in Tennessee centers on aligning resources and eligibility rules so that qualified individuals can receive needed care without exhausting their savings entirely. The service includes evaluating income, assets, and available benefits, and advising on permissible planning measures to help clients meet the program’s requirements. Counselors also look at housing implications, spousal protection rules, and transfer look-back periods. Clear planning helps families navigate complex paperwork, avoid application delays, and understand how different living arrangements affect eligibility for benefits and care services.
Effective planning also involves preparing advance directives and legal authority for decision-making, such as durable powers of attorney for finances and healthcare. These documents ensure trusted people can act when an individual can no longer manage affairs. In many cases, we coordinate with financial advisors and care managers to design a plan that balances short-term needs with long-term goals. Understanding options for community-based care versus institutional care, and how those choices interact with Medicaid rules, helps families obtain appropriate support while managing costs and protecting heirs where possible.
What Medicaid Planning Entails and How It Works
Medicaid planning includes the legal and financial steps taken to help an eligible individual qualify for Medicaid coverage for long-term care services. It involves a detailed review of income, assets, and transfer history under Tennessee law, and the preparation of documentation required for an application. Planning strategies may involve allowable spending, asset protection techniques that comply with state regulations, and timing considerations to address look-back periods. Professionals also guide families through appeals and denials, helping correct application issues and advocating for fair evaluation of eligibility.
Key Elements and Typical Processes in a Long-Term Care Plan
A comprehensive long-term care plan typically includes an assessment of care needs, a benefits eligibility review, and preparation of necessary legal documents. The process begins with a financial inventory, followed by recommendations for asset management and benefit applications. Practical steps include submitting Medicaid forms, arranging for medical documentation, and implementing spending or protection measures that comply with the law. Coordination with family members and care providers is essential to align physical care plans with financial timelines and to ensure a smooth transition when services begin.
Key Terms and Glossary for Medicaid and Long-Term Care
Understanding frequently used terms can make planning easier. This glossary explains common phrases related to Medicaid and long-term care, including eligibility timelines, asset treatment, and legal roles. By clarifying language like look-back period, deemed income, and community spouse resource allowances, families can navigate documents and conversations with greater confidence. Clear definitions reduce misunderstandings and help clients follow advice that fits within Tennessee’s regulatory framework while protecting family interests and ensuring access to appropriate services.
Look-Back Period
The look-back period refers to the timeframe Tennessee Medicaid reviews prior asset transfers to determine whether transfers were made to qualify for benefits. If a disqualifying transfer is found during this period, a penalty period may apply before eligibility begins. It is important to understand what transfers are considered and how they are calculated. Planning must account for this timeframe so families can make informed choices, avoid unintended delays in benefits, and structure arrangements that meet both legal requirements and practical caregiving needs.
Community Spouse Resource Allowance
The community spouse resource allowance protects a portion of assets for the spouse who remains living in the community when the other spouse seeks Medicaid-covered long-term care. This provision helps the community spouse maintain financial stability and cover living expenses. The allowance amount is determined according to state rules and income considerations. Proper planning ensures that the community spouse retains adequate resources to avoid undue hardship while the institutionalized spouse receives the necessary care funded by Medicaid.
Preadmission Screening and Care Planning
Preadmission screening and care planning involve evaluating an individual’s medical and functional needs before they are admitted to a facility or begin receiving certain long-term care services. The process documents care requirements and helps determine appropriate support levels. This documentation is often necessary for Medicaid applications and helps ensure that the care setting aligns with the person’s needs. Early coordination of medical records and assessments aids timely processing of benefit applications and placement decisions that support quality care.
Durable Power of Attorney and Healthcare Directives
Durable powers of attorney and healthcare directives allow trusted individuals to make financial and medical decisions when someone cannot act for themselves. These documents are foundational in long-term care planning because they provide a legal mechanism for continuity of decision-making. They can prevent guardianship proceedings and enable quick responses in emergencies. Drafting clear and legally valid documents tailored to Tennessee requirements helps families ensure that decisions are made according to the person’s preferences and that authorized individuals can carry out necessary tasks efficiently.
Comparing Limited Approaches and Comprehensive Planning
When considering Medicaid and long-term care planning, families can choose limited, transaction-focused steps or a more comprehensive plan that addresses multiple aspects of care and finances. Limited approaches may handle a single issue such as completing an application or preparing a power of attorney, while comprehensive planning integrates asset protection, benefits timing, and future care contingencies. Evaluating the trade-offs involves looking at immediate needs, long-term goals, family dynamics, and how different options affect eligibility and quality of life for the person receiving care.
When a Limited Approach May Be Appropriate:
Addressing Immediate Administrative Needs
A limited approach can be appropriate when the primary requirement is completing an urgent Medicaid application or executing essential documents to enable immediate decision-making. For families who simply need help navigating forms, gathering medical records, or establishing a power of attorney quickly, targeted assistance reduces delays and ensures compliance with procedural requirements. This narrow focus is often suitable when long-term resources are sufficient, and the family’s priority is ensuring immediate access to care rather than restructuring finances or assets for extended protection.
Handling Single-Event Financial Decisions
A targeted plan may suffice when a single financial action, such as arranging payment for a short-term care need or resolving a specific estate matter, resolves the immediate concern without the need for broader restructuring. This approach reduces time and expense when the family’s objectives are narrow and clearly defined. It still requires careful documentation to avoid future eligibility issues, and it can be combined later with additional planning if circumstances change or if the family decides broader protections are necessary.
Why a Comprehensive Long-Term Care Plan Often Provides Greater Protection:
Protecting Family Resources and Access to Care
Comprehensive planning often better protects both access to care and family finances over time by addressing multiple interconnected issues. Families that anticipate ongoing or escalating care needs benefit from a coordinated strategy that considers long-term Medicaid eligibility, spousal protections, housing transitions, and succession planning. A broader plan helps reduce the risk of unintended consequences from isolated transactions and creates a cohesive roadmap for decision-making, funding care needs, and preserving resources for remaining family members or heirs while complying with state rules.
Coordinating Medical, Financial, and Legal Decisions
When care needs are complex or likely to change over time, comprehensive planning coordinates legal documents, financial arrangements, and healthcare decisions to ensure consistency and continuity. This coordination can prevent gaps in coverage, clarify responsibilities among family members, and help anticipate future transitions between home care and facility-based care. Building a plan that includes powers of attorney, beneficiary designations, and benefit timing creates a unified approach to protect the person receiving care and provide clarity for those who must act on their behalf.
Benefits of Taking a Comprehensive Planning Approach
A comprehensive approach to Medicaid and long-term care planning can reduce confusion during crises and improve outcomes for families by aligning care choices with financial and legal tools. It typically includes documentation to authorize decision-makers, a plan for benefit applications, and asset management strategies that follow Tennessee rules. By planning ahead, families can often avoid rushed decisions, ensure continuity of care, and preserve the person’s preferences and dignity. Long-term coordination also helps to minimize disputes and provides a clear path for handling future care transitions.
Comprehensive planning also assists with intergenerational continuity by documenting wishes and establishing mechanisms for orderly transfer of financial responsibilities. It clarifies who will handle finances, who will make healthcare decisions, and how assets will be managed or preserved during a period of long-term care. This predictability benefits the person receiving care and relieves family members from making ad hoc decisions under stress. The result is an organized framework supporting both short-term needs and long-term family goals.
Improved Eligibility Outcomes and Timely Access to Services
Comprehensive planning tends to produce smoother Medicaid applications and better coordination with providers, which can result in more timely access to services. Careful documentation of medical need, proper completion of financial disclosures, and awareness of timing rules reduce application errors and administrative delays. Families benefit from a proactive process that anticipates requirements and organizes evidence and accounts in a way that supports eligibility determinations, allowing the person to access appropriate long-term care without unnecessary interruptions.
Greater Financial Predictability and Family Peace of Mind
By addressing both immediate care needs and future contingencies, comprehensive planning increases financial predictability and offers families reassurance about next steps. Establishing clear directives and documented plans reduces uncertainty about who will make decisions and how costs will be managed. This clarity helps family members focus on caregiving rather than administrative confusion, and it supports better communication across generations about expectations, responsibilities, and the distribution of remaining resources when appropriate.
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Practical Tips for Medicaid and Long-Term Care Planning
Start planning early and gather records
Starting planning early gives families time to organize financial records, medical documentation, and legal papers before care becomes an emergency. Early preparation makes it easier to track income, assets, and any past transfers that could affect Medicaid eligibility. Collecting physician notes and care assessments in advance speeds the application process. Open conversations with family about goals and preferences ensure decisions reflect the person’s wishes. Early planning also allows for thoughtful choices that comply with Tennessee rules while preserving options for future care transitions.
Document decision-making authority
Coordinate with care professionals
Work with medical providers, care managers, and financial advisors to develop a cohesive plan that addresses both care needs and benefit eligibility. Early coordination helps ensure assessments reflect true medical need and that paperwork is completed accurately. Communication among care professionals and family members supports timely placement and access to services. Coordinated planning also facilitates appropriate timing of benefit applications and any permissible financial arrangements, leading to better outcomes for care and family stability over time.
Reasons to Consider Medicaid and Long-Term Care Planning
Families should consider planning when there is a risk of needing extended care because advanced planning protects financial resources and ensures access to appropriate services when care is required. Planning helps identify potential pathways to Medicaid eligibility and addresses the legal steps needed to authorize decision-making. It also offers a framework for discussing care preferences, housing transitions, and how costs will be managed. By taking action sooner rather than later, families can reduce the likelihood of rushed choices and make decisions that align with personal values and legal requirements.
Another reason to pursue planning is to reduce family strain during health crises by clarifying roles, responsibilities, and financial arrangements ahead of time. Preparing documents that name decision-makers and outline financial arrangements prevents disputes and ensures that care proceeds without administrative roadblocks. Planning is also important when a spouse remains in the community and needs protection from financial hardship. Thoughtful planning balances access to benefits with fair treatment of surviving family members and preserves the person’s dignity throughout the care journey.
Common Situations That Lead Families to Seek Medicaid Planning
Families often seek Medicaid and long-term care planning after a hospitalization that signals the need for extended assistance, when a diagnosis indicates progressive care needs, or when a loved one moves to a nursing facility. Other triggers include sudden depletion of savings due to medical bills, changes in marital or living arrangements, and uncertainty about who will make financial and medical decisions. In each case, planning helps stabilize the situation by clarifying benefits options and putting legal authority and documentation in place.
Hospitalization or sudden health decline
A sudden hospitalization or decline in health often accelerates the need for long-term care planning because decisions about post-acute care and funding must be made quickly. Families in this situation benefit from immediate help organizing medical records, documenting care needs, and initiating Medicaid applications if appropriate. Preparing powers of attorney and healthcare directives is also important to allow trusted people to manage affairs. Rapid but careful planning helps avoid hasty financial moves that could complicate future benefit eligibility or family relationships.
Admission to a nursing facility
Admission to a nursing facility is a common trigger for families to seek Medicaid planning because facility care can be expensive and eligibility rules are complex. Planning in this context focuses on determining resource limits, documenting medical necessity, and implementing permitted strategies that preserve assets for a spouse or heirs when possible. Timely submission of applications and proper documentation are essential to avoid gaps in coverage and to ensure the resident receives appropriate care without unnecessary financial depletion.
Anticipated long-term support needs
When a chronic condition or progressive illness suggests increasing support needs over time, families should begin planning before care becomes urgent. Anticipatory planning allows for more options, including arranging home-based services, coordinating benefits, and structuring finances in a compliant manner. Early steps help protect against disruptive financial consequences and provide a roadmap for transitioning between levels of care. This foresight also gives family members time to discuss preferences and responsibilities calmly rather than under duress.
Local Medicaid and Long-Term Care Planning Help for Louisville Residents
Jay Johnson Law Firm offers guidance to Louisville residents navigating Medicaid and long-term care decisions in Tennessee. We help families evaluate eligibility, prepare necessary documentation, and implement planning measures that follow state law. Our team focuses on practical solutions tailored to each household’s financial and personal circumstances, assisting with powers of attorney, benefit applications, and coordination with care providers. We aim to make the process less stressful by providing clear information and step-by-step support when families need it most.
Why Choose Jay Johnson Law Firm for Long-Term Care and Medicaid Planning
Jay Johnson Law Firm brings focused attention to estate planning, probate, and elder-care funding issues for Tennessee families. We offer personalized consultations to review finances, care needs, and legal documents and then recommend practical, legally compliant approaches to address those needs. Our process emphasizes clear communication and timely action to help families apply for benefits, protect resources where possible, and create decision-making tools that reflect personal values and priorities.
We work with clients to gather necessary documentation, navigate application procedures, and coordinate with healthcare providers and care managers to present a complete picture of need. Our goal is to reduce administrative obstacles and help families implement plans that support access to appropriate services. We provide honest assessments of likely outcomes and alternatives so clients can choose the path that best fits their situation and long-term objectives.
Throughout the process, we prioritize clarity and responsiveness, ensuring family members understand next steps and timelines. We assist with guardianship avoidance strategies through proper powers of attorney and advance directives, and we guide families through appeals and corrective actions if applications are delayed or denied. This approach helps clients focus on care while legal and financial issues are handled in an organized and legally sound manner.
Contact Jay Johnson Law Firm to Begin Planning Today
How We Handle Medicaid and Long-Term Care Planning
Our process starts with a comprehensive intake to understand the client’s medical condition, financial picture, and family dynamics. We then outline possible planning options, prepare required legal documents, and coordinate benefit applications. Communication is ongoing during the application process to address requests for additional information and to advocate for timely determinations. We also provide follow-up support to adjust plans as care needs or financial circumstances change, ensuring continuity and compliance with Tennessee regulations.
Step One: Initial Assessment and Document Collection
The first step is a thorough assessment of assets, income, medical records, and prior financial transfers to determine potential Medicaid eligibility and planning needs. We gather documentation such as bank statements, insurance information, and physician notes to create a clear picture of the situation. This assessment identifies immediate actions, timing considerations, and any documents that must be prepared to support an application. Understanding the full context early enables more accurate recommendations and avoids surprises during the application.
Financial Inventory and Resource Review
During the financial inventory, we catalog assets, income sources, and recent transfers to understand how resources are treated under Tennessee Medicaid rules. This review helps identify what is counted, what may be protected for a community spouse, and what actions are permissible without triggering penalties. The goal is to establish a baseline for eligibility and identify practical steps that align with legal constraints. Clear documentation of resources supports accurate and timely application completion.
Medical Documentation and Care Needs Assessment
Collecting medical records and care assessments is essential to demonstrate the level of care needed and to support eligibility determinations. We help obtain physician statements, functional assessments, and treatment records that detail the condition and daily assistance required. These records are critical to establishing medical necessity for long-term care services and ensuring applications reflect the true scope of need. Strong documentation reduces back-and-forth requests and accelerates the decision-making process.
Step Two: Plan Implementation and Application Preparation
After assessment, we implement the chosen planning steps and prepare the Medicaid application with supporting documentation. This phase may include drafting powers of attorney and healthcare directives, coordinating with financial managers, and completing forms accurately. We guide clients through permissible spending or transfers when applicable and inform them of timing considerations like look-back periods. Properly compiling the application package reduces the risk of denials and helps ensure a smoother review by state agencies.
Drafting and Executing Legal Documents
We prepare legally valid powers of attorney, healthcare directives, and other documents needed to authorize trusted individuals to manage finances and medical decisions. Proper execution of these documents avoids guardianship proceedings and ensures continuity in decision-making. We explain how each document functions, who should be appointed, and how to update them if circumstances change. These documents are important not only for Medicaid applications but also for ongoing management of care and finances.
Completing and Filing the Medicaid Application
We compile financial records, medical documentation, and declarations needed to file a complete Medicaid application on behalf of the applicant when appropriate. Accurate completion and timely submission are important to minimize delays. We monitor the application, respond to information requests, and assist with appeals or corrections if issues arise. This hands-on support helps families focus on caregiving while administrative tasks proceed in the background with attention to detail and compliance.
Step Three: Ongoing Monitoring and Plan Adjustment
After initial approval or during the application review, ongoing monitoring and adjustments may be necessary to address changes in medical condition, income, or household composition. We review benefit notices, advise on reporting requirements, and update documents or strategies as life circumstances change. Regular check-ins help prevent unintentional breaches of program rules and allow the family to adapt plans for evolving care needs, ensuring continued access to services and protection of family resources where permitted under law.
Responding to Agency Requests and Appeals
If the Medicaid agency requests additional information or issues a denial, we assist in preparing responses and pursuing appeals where appropriate. Prompt and accurate replies often resolve requests without escalation, but some cases require additional advocacy to correct errors or clarify documentation. We guide clients through the appeals process, assembling evidence and legal arguments to support eligibility. Effective handling of agency interactions reduces delays and improves the chances of a favorable decision.
Adjusting the Plan as Needs Evolve
As care needs and financial circumstances change, we recommend adjustments to the long-term care plan to maintain eligibility and protect family interests. This may include revising legal documents, updating financial arrangements, or modifying living arrangements to align with care requirements. Ongoing review ensures that planning remains consistent with current rules and the client’s wishes, providing stability for both the person receiving care and their family members throughout the course of long-term support.
Frequently Asked Questions About Medicaid and Long-Term Care Planning
What is Medicaid planning and why is it important?
Medicaid planning involves organizing assets, income information, and legal tools to help an eligible individual obtain Medicaid coverage for long-term care services. The process includes reviewing financial accounts, documenting medical necessity, and preparing the required application materials while following Tennessee rules. It is important because it helps families access funding for nursing home care or certain home-based services without unintentionally depleting resources that a community spouse or heirs may need.Effective planning also establishes decision-making authority through instruments like durable powers of attorney and healthcare directives. These documents allow trusted persons to manage finances and medical decisions, which simplifies the application process and reduces the likelihood of guardianship proceedings. Together, these steps provide structure and clarity during a stressful time and help families make choices that balance care needs with financial realities.
How does the look-back period affect planning?
The look-back period is the timeframe Tennessee Medicaid reviews past asset transfers to determine whether transfers were made to qualify for benefits. If transfers during this period are found to be disqualifying, a penalty period may delay eligibility. Understanding which transfers are counted and how the penalty is calculated is central to planning, since certain actions can trigger delays in benefit eligibility if not handled properly.Because the look-back period affects timing, it is important to document the purpose of transfers and consult with knowledgeable advisors to ensure transactions comply with program rules. Planning that considers the look-back window can help families time actions appropriately, use permitted expenditures, and minimize interruptions in access to necessary care services.
What documents do I need to apply for Medicaid long-term care?
A Medicaid application for long-term care typically requires proof of identity, income statements, bank and investment account statements, documentation of property ownership, and medical records that demonstrate the need for care. Additional items may include recent financial transactions, insurance policies, and legal documents such as powers of attorney or trust instruments. Gathering these documents early reduces delays and supports a complete application.Medical documentation from treating physicians and care assessments is especially important to establish the level of care required. Having physicians prepare clear statements about functional limitations and ongoing needs helps the agency evaluate eligibility more efficiently. Organizing records and maintaining clear copies streamlines the filing and review process.
Can a spouse remain in the community while the other receives Medicaid?
Yes. Tennessee provides protections for the spouse who remains living in the community when the other spouse requires institutional care. These protections can include allowances for a portion of the couple’s resources and income to ensure the community spouse can maintain a reasonable standard of living. Identifying community spouse resource allowances and income rules is an important part of planning to protect the spouse at home.Proper documentation and application of spousal protections are essential to prevent undue hardship. Planning strategies should evaluate the household’s combined resources, potential allowances, and how benefits can be structured to support both individuals. Clear guidance helps families understand their options and secure appropriate benefits without unnecessary financial strain.
How long does the Medicaid application process take in Tennessee?
Processing times for Medicaid long-term care applications vary depending on the completeness of the submission, the need for additional documentation, and agency workload. A thoroughly prepared application with clear medical records typically moves more quickly than one with missing or inconsistent information. Timely responses to information requests from the agency also reduce delays in decision-making.Because timelines can be unpredictable, families should prepare for administrative delays by organizing documentation and following up proactively. Assistance in compiling a complete application and responding to agency inquiries helps minimize processing time and increases the likelihood of a timely determination of benefits.
What happens if my Medicaid application is denied?
If a Medicaid application is denied, the applicant or representative can request a review or file an appeal according to Tennessee procedures. Denials often arise from incomplete information, documentation issues, or disputes about medical necessity or resource calculations. Identifying the reason for denial is the first step in preparing an effective response or appeal.Appeals involve submitting additional evidence, clarifying records, and explaining the circumstances of contested transfers or income calculations. Prompt action and well-organized documentation improve the chances of overturning a denial. Support during an appeal helps families present the strongest possible case and address administrative errors or misunderstandings.
Can assets be protected for heirs during Medicaid planning?
Some planning techniques allow families to protect certain assets for heirs, but these must comply with Tennessee Medicaid rules and the look-back period. Legitimate strategies may include proper use of allowable transfers, trusts that meet state requirements, and structuring beneficiary designations. Each option must be evaluated for legal compliance and potential impact on eligibility timing.Because improper transfers can trigger penalty periods, careful documentation and timing are essential. A considered plan balances the desire to preserve assets for heirs with the need to secure benefits for the person requiring care. Professional guidance helps identify permissible approaches and avoid actions that would jeopardize eligibility.
Do I need a power of attorney for Medicaid planning?
A durable power of attorney is a foundational document for Medicaid planning because it authorizes a trusted person to manage financial affairs when someone cannot do so. Without it, families may face court proceedings to obtain authority, which can be time-consuming and costly. Having this authority in place ensures transactions and applications can proceed smoothly when needed.Healthcare directives work alongside financial powers to document medical preferences and appoint decision-makers for treatment choices. Together, these documents prevent delays and confusion, support coordinated care, and provide clear legal authority for those acting on behalf of the person who needs assistance.
How does home-based care differ from nursing facility coverage under Medicaid?
Home-based care and nursing facility coverage differ in the types of services covered and the eligibility pathways for Medicaid. Home-based services may be available through community-based programs that allow a person to receive care at home, while nursing facility coverage typically addresses more intensive institutional care needs. Each pathway has distinct income and asset criteria as well as program-specific requirements that affect planning.Assessing the level of care needed and the available program options helps families determine the most appropriate setting. Care coordination and documentation of medical necessity are important for both home-based and facility care, and careful planning can maximize the likelihood of securing services that fit the person’s needs and preferences.
When should I start planning for long-term care and Medicaid?
It is best to begin planning as soon as there is a realistic possibility of needing extended care, such as after a diagnosis indicating progressive decline or following a hospitalization that suggests long-term support may be necessary. Early planning provides more options and time to prepare documentation, evaluate resources, and implement permissible measures without creating unintended eligibility issues.Starting early also allows families to put legal documents in place and to discuss preferences calmly rather than under time pressure. Thoughtful early action can reduce future expenses, prevent avoidable transfers, and ensure that the person’s care and financial affairs are managed according to their wishes.