Pamela - I guess I have a different perspective. If I am at the end of life, divesting assets is the least of my concerns. Appropriate care is.

In most states, if one spouse needs care, the other need not divest all assets - they are entitled to keep the home where they reside, a car, a certain amount of cash, and income to cover their needs. The rest goes to care for the spouse.

For the last surviving spouse, the home will either be sold or or a lien "attached" to cover care. Then when it is sold, the state is repaid.

We worked hard all our life to build a retirement nest egg and pay for our home in case of needing care, since 3 of our 4 parents did in the end. Both my Mom and Mother-in-law ran out of their savings just a few months before they died and we were grateful for Medicaid covering the deficit. People seem to treat Medicaid as an entitlement, like Social Security and Medicare, when in reality it is paid by our state and federal governments and is a form of welfare - actually meant for when we run out of our own funds.