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I am concerned because this individual has no wife or children to assist in later years if care is needed. Long-term care insurance is vital, as this person is middle class and does not have sufficient wealth to pay for care himself. What can my friend do going forward?

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Swimmer - just as an aside, having a spouse or kids doesn't mean that they will be there to "assist in later years". People get divorced,or widowed; kids have their own lives to live often far from the parent. It's the reality of aging in America, we really all need to plan ahead.
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There will be some sort of insurance available but the premiums and limitations to the policy for someone with PD will significant so it might not be worth it. I'd suggest that they go to see a financial advisor about setting some long term goals. Meet with 2 or 3 different ones to find one that understands the situation and that they can work with. What they might want to consider is doing investments to support a special needs trust.

Special needs trusts can be really good for those that know there will be a debilitation coming up as it plans for the future and is exempt from Medicaid. A good stockbroker is going to know an attorney who can do the trust. I have a cousin who had polio in the 1950's and then now has the affects of secondary polio which many seem to get when they hit their later years. His parents set up a special needs trust years ago for him and since it's a trust it's a separate legal entity or legal being and has no affect on his going on Medicaid or Medicare for his health care needs and expenses. The trust paid for his car to be redone for him to drive (which Medicaid would never pay for) and for extra caregivers above what Medicaid pays. What you might do is help him find a PD support group and talk about with the members to see if any of them have a financial advisor they have worked with so you don't have to go down the PD learning path......Good luck and it's wonderful that you can be a friend to him.
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Fortunately, there are safety net programs in the US that will make sure your friend is taken care of. One way would be for the state or a facility to apply for guardianship and apply for Medicaid on his behalf when his money runs out. Many elderly people are in the same position. I am glad that there is a safety net to catch them.
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