My 90 year old aunt lives at home and her son is her full time caregiver. Her husband died a year ago, so if she requires long term care, her husband is not alive to reap the benefits of spending down their money. How does she spend down her assets to qualify for Medicaid? We filed for Medicaid for him as he required long term care in a nursing home for the last 5 mos of his life. My aunt benefited from the spend down of their assets, as that was the rule. How does the spend down work when a spouse is not at home to have the money spent on their needs? Can her credit card bill be payed off?