Monday, May 21, 2012 The Decision to Exercise Spousal Refusal Can Be Painful, But Often Necessary
Couples who are still married, even into their 70s or 80s are the lucky ones. They’ve made it through the hard times, the ups and downs of life, and still have their companion at their side. But even the most devoted of spouses is sometimes finds it necessary to exercise “Spousal Refusal” to pay the long-term care bills of their spouse when he or she has lost the ability to perform the activities of daily living. This may sound cruel and selfish, but as this article in the Huffington Post points out, exercising Spousal Refusal can sometimes be the only way to save the healthy spouse’s small nest egg for his or her own later years.
Spousal Refusal isn’t about turning away from a spouse in their time of need; in fact, many of the elderly individuals who exercise this option do so only after a long and painful decision-making process, and they do it not out of selfishness but out of necessity. “Those who need help beyond [the first 100 days of nursing or rehab care covered by Medicaid] are facing costs in excess of $100,000 per year in many areas of the U.S. It is not uncommon for someone to lose their house and all of their savings because they had to go into a nursing home.”
As the article points out, couples who choose to pay for a spouse’s long-term care costs won’t be left completely out in the cold. “Anti-spousal impoverishment laws were enacted on the federal level in the late 1980s. In 2012, the well spouse (or community spouse) is permitted to retain up to $113,640 in assets while his or her spouse is covered under the Medicaid program.” Unfortunately, in this day and age, $113,640 doesn’t go a long way, especially if the healthy spouse lives for another decade or so.
The decision to exercise Spousal Refusal is not an easy decision to make. Married couples must weigh the costs and benefits—not only financial costs and benefits, but emotional and ethical as well. No couple should have to go through this alone. The advice of a trusted elder attorney, or an estate or financial planner can help.
Friday, May 18, 2012 Talking to Your Parents About Retirement
Most people consider financial matters a private affair, and only talk about it with their spouse or their financial advisor; but when it comes to retirement and long-term care Americans just can’t afford to be silent any longer. According to a recent article in the Wall Street Journal, “Nearly two in five adult children financially support parents 65 or older... and 86% of millennials expect to care for an aging parent or other elderly person in the future.” This means that while we may not want to talk about finances with our parents or children, chances are we’re going to have to, and the sooner the better.
Some parents won’t initially be comfortable talking about finances with their children, and many children will feel uncomfortable asking; but just because you have a conversation about finances doesn’t mean it has to be invasive. The article suggests starting off by asking your parents any questions you may have about getting your own retirement savings in order. “Ask your parents for advice on your own 401(k) or health-insurance plans and then ask them how they've handled their own. Then share any financial wisdom you have with them.”
Another way to start off the conversation is to simply ask your parents if they have any retirement or estate planning documents, and where you should look to find them if and when the time comes. This can be an opener to asking if there’s anything in their plan that they would like you to be aware of. “These [documents] typically include a will; a living will, which spells out what life-sustaining care a person wants; a financial power of attorney, which authorizes someone to undertake certain financial activities on behalf of a parent; life-insurance policies; information on bank, brokerage other financial accounts; and contact information for any lawyer, trustee or financial adviser.”
As more and more adult children find themselves helping their parents financially during retirement, it becomes more important than ever for those adult children to be involved in (or at least aware of) their parents retirement planning process. If you worry that your parents may need financial help in their golden years, it’s better to broach the subject sooner than later.
Monday, May 14, 2012 The Pros and Cons of Long-Term Care Insurance
Do you have long-term care insurance? SHOULD you have long-term care insurance? These are questions that currently plague many forty-, fifty-, and sixty-somethings, as well as some precocious thirty-somethings. We’ve been hearing and reading more and more about long-term care insurance in recent years, but we still don’t seem to have any kind of firm consensus about whether it’s a good investment—whether it’s a necessary investment—or not.
This recent article from CBS online, entitled Why Long-Term Care Insurance Is Important, argues that “LTCI is a tool that can help preserve and protect financial assets, provide flexibility to choose the type of care, offer the ability to choose where care is received, help to ensure high-quality care, and provide financial and emotional support for the family.” This article helps readers not only understand why LTCI might be important, but what are the important questions to ask when considering whether and which long-term care insurance might benefit you and your family.
Of course, not everyone thinks long-term care insurance is necessary. Another article, this one from the Wall Street Journal, provides both sides of the argument. The pro-LTCI writer argues that “For those who buy and keep their policy it is a no-regret proposition. No one who has paid premiums and receives their benefits from the policy regrets having paid those premiums.” You pay a small regular sum over the course of a few decades, and when the time comes you are saved from bankrupting your family by paying as much as $250 a day, often for months or more.
The opposition writer against long-term care insurance argues that the likelihood that you’ll need to use the insurance policy is exaggerated. “It may be more useful to learn that 67% to 70% of seniors who do go into a nursing home are discharged within 90 days, and that after two years, less than 6% of those admitted will still be there.” This is important information to have, but $250/day for even 30-60 days can quickly wipe out a significant portion of a retiree’s savings.
Whatever you choose, make sure you account for your decision in your retirement and estate plans. Talk about the decisions with your estate planner, your financial advisor, and especially with your children. Long-term care expenses can be significant, and it’s always best to be as prepared as you can possibly be.
Monday, April 23, 2012 Compassion is Key When Talking to Aging Parents
Being a caregiver is one of the most difficult (and rewarding) jobs on the planet; but sometimes when it comes to strong-willed aging parents, getting them to admit they might need a caregiver is more difficult than the caregiving itself. Take the story of David Solie, published recently in the Los Angeles Times; “David Solie thought he was being a good son and a competent manager. But his strong-willed mother was having none of it.”
According to the article, Mr. Solie (who “had cared for hundreds of elderly patients as a physician's assistant” ) and his mother did not speak for almost three years after he tried to convince her that she “should move someplace easier to navigate -- an assisted living complex, perhaps.” Mr. Solie also expressed that his mother “should relinquish her role as chief caregiver to Roger [Solie’s brother], who could be placed in a group home.”
These kinds of suggestions are often very difficult for independent and strong-minded seniors to hear, and with good reason; after having taken care of themselves, their children, and in some cases taken care of their own parents as well, in their time—it’s not easy to have someone come along and say they can’t do it anymore.
The key, says Mr. Solie, is to recognize and respect a parent’s psychological needs as well as their physical limitations. Once they were on speaking terms again, Mr. Solie started “asking his mom questions about her life and listening intently to her stories. Acknowledging to his mother that there were no longer easy ways to reconcile her safety and her desire to stay put, he asked what would work for her. Then mother and son struck compromises that built a network of support around her and Roger in their home.”
The process of transitioning elderly parents from independent lifestyles they may not be able to handle anymore will be made much easier if you begin the process by asking and listening, instead of simply telling. If the ultimate goal is to increase ease and avoid frustration, shouldn’t that be the goal of each conversation along the way as well?
Monday, April 16, 2012 A “New Wave” of Lawsuits May Force Children to Pay for Elderly Parents’ Nursing Costs
Many of our clients and readers are caregivers of elderly parents; they have chosen to take responsibility for their parents—whether it be physical responsibility, financial, or other. But what if instead of making that choice, you had responsibility for your aging parents thrust upon you? This is exactly the issue addressed in this recent article from Elder Law Answers.
“John Pittas' mother entered a nursing home for rehabilitation following a car crash. She later left the nursing home and moved to Greece, and a large portion of her bill at the nursing home went unpaid. Mr. Pittas' mother applied to Medicaid to cover her care, but that application is still pending. Meanwhile, the nursing home sued Mr. Pittas for nearly $93,000 under the state's filial responsibility law, which requires a child to provide support for an indigent parent. The trial court ruled in favor of the nursing home.”
The article points out that many states still have filial responsibility laws on the books, but that those laws are rarely enforced. This ruling by the Pennsylvania Supreme Court does not bode well for Baby-Boomers, many of whom are finding themselves caught between caring for elderly parents and for grown children who have not yet left the nest.
Perhaps one of the most disturbing things about this case is that the nursing home was given so much leeway. The Pennsylvania Supreme Court found that “the law does not require [the nursing home] to consider other sources of income or to wait until Mrs. Pittas’s Medicaid claim is resolved.” This would seem to condone (if not encourage) a litigious mind-set among nursing homes. As if this weren’t bad enough, the court “also said that the nursing home had every right to choose which family members to pursue for the money owed.” If you are one of many siblings you could find yourself involved in a lawsuit merely because you live the closest, are the wealthiest, or called mom more often than your brothers or sisters.
The best way to ensure that your family doesn’t find itself embroiled in a similar lawsuit is to ensure that you (or your elderly parents) have a plan in place to pay for long-term care. Contact our office to explore your options.
Monday, March 19, 2012 The High Emotional—And Financial—Cost of Alzheimer’s Disease
Alzheimer’s is a disease that affects everybody it touches—husbands, wives, children and grandchildren—they all bear witness to their loved one’s slow demise.
Sadly, emotional stress is not the only stress that accompanies Alzheimer’s disease; those loved ones serving as caretakers may carry a huge amount of financial stress as well. The cost of caring for an Alzheimer’s patient can run anywhere from $64 a day to $77,380 a year, and because Alzheimer’s disease can be such a long-lasting disease (a person can suffer from Alzheimer’s for up to 20 years) the costs of care can end up being astronomical. It’s obvious that people can’t do it alone.
Long-term care insurance can be very helpful in paying for the costs of care necessary for a loved one suffering from Alzheimer’s… if your loved one has thought ahead and purchased the policy before they or their spouse began suffering from symptoms of Alzheimer’s. Some people may not have thought ahead and hope that government programs will be able to help with the high cost of care. Medicaid [Medi-Cal in California] can be helpful (Medicare doesn’t cover the cost of long-term care)… if you fall in the right category and know how to navigate the complex system.
Unfortunately, learning how to navigate the system is not something you can do in an hour or two. Because your experience will depend on a number of unique factors we can’t give you an easy set of instructions to follow. The best advice we can give is to say that right now, the best way to navigate the Medicaid/Medi-Cal system is to find someone who knows the system to assist you. Most estate planning and elder law attorneys help their clients with these issues on a regular basis. If you want to ensure that you and your loved ones will be cared for no matter what the future may bring, don’t be afraid to ask your attorney for help.
Wednesday, March 14, 2012 Advice for Executors: How to Manage Final Medical Expenses
Most people die in a hospital; sometimes after a long and slow decline, sometimes after a quick and unexpected tragedy. If you are an executor of the deceased’s estate this is significant because it means that there are usually final medical bills to be paid. What most executors do not know is that these final medical bills are not necessarily just like all the other final expenses, especially when it comes to filing a final tax return for the estate; this article from SmartMoney.com explains why.
“…When a person incurs medical expenses and dies before they are paid, the executor of the decedent’s estate can elect to treat those medical expenses as if they were paid when incurred – as long as the estate pays the expenses within one year after the date of death. In other words, this election allows those expenses to be deducted on the decedent’s final Form 1040, even though they were not paid by the date of death.”
Many executors may not think of this because medical expenses can only be deducted if they exceed a certain percentage of the deceased’s adjusted gross income (7.5% to be exact); but health care being what it is, final medical expenses can quite often reach this point.
This sounds easy, but be careful if the deceased’s estate exceeds the $3.5 million estate tax exemption—you may want to look into other options. The article suggests that in this case it might be beneficial to “forgo the election and count the unpaid medical expenses as liabilities on the estate tax return.”
As the executor of an estate you may have more options than you are aware of when it comes to taxes, probate, and achieving the best results for the beneficiaries. If you are unsure about any of these—or other—issues, please contact our office, we can help advise you on all angles of the trustee or probate process.
Monday, March 12, 2012 Estate Plan Forgery: How to Tell and What to Do
The question of will forgery or undue influence of a testator is not a common question, but one that does come up periodically in an estate planner’s office. The movies have given people certain expectations when it comes to a death in the family and probating a will: a book-lined office, the entire family assembled for a formal reading of the will, shocked and angry reactions as a loved one’s fortune goes to an unknown and unlikely character...
This Hollywood portrayal may be generally off base, but the basic premise is based on the very real feelings that come with the death of a loved one: helplessness, confusion, familial bonds, and sometimes even betrayal. A will doesn’t have to be forged for there to be strong feelings of anger or suspicion when the contents end up being different than the family was led to expect. And while forged or secret wills may not be as common as the movies would have us believe, they aren’t completely unheard of either.
So what should you do if you suspect that the will of a loved one has been forged or tampered with? First of all, don’t try to deal with the situation alone. Dealing with the death of a loved one is stressful and emotional, and everyone—including you—is likely to be quicker than usual to react without thinking. Instead, seek the advice of a trusted third party (an estate or probate lawyer is ideal,) someone who can help you distance yourself and look at the situation objectively.
Will forgeries are very rare, but incidents of testators (especially elderly testators) being unduly influenced by a selfishly motivated caregiver or family member are much more common. If you suspect foul play was involved in the creation of a loved one’s will, make an appointment with an estate or probate specialist. We can help you work through your suspicions in a safe environment and explore your options should you feel the need to take action.
Friday, March 09, 2012 Providing Care for Divorced or Remarried Parents
Divorce is difficult on a family no matter what the circumstances. Even when a divorce is best for all involved, there is always an amount of stress and emotional trauma involved. In fact, it has recently become apparent that the effects of divorce—stress, family upheaval, and tighter finances—can last years into the future. Our firm works frequently to help divorced or remarrying couples update their estate plans to protect their new blended families, and we often see how the effects divorce can continue to have even as much as 20 or 30 years down the road—not just on the couple but on their grown children now acting as caregivers.
Adult children of aging parents often find themselves caring not only for mom and dad but also for stepmom, stepdad and sometimes even another stepparent from yet a third (and current) marriage. Dividing time (and often finances) between so many parents with new and special needs can quickly take its toll, as can the family politics that come with adult siblings, half siblings, and step siblings.
With all of this complexity and intermingling family ties, it is more important than ever to have conversations about estate planning and long-term care with parents and siblings before mom and dad (and stepmom and stepdad) get to an age where they need in-home or around the clock nursing care. A good estate plan can eliminate much potential fighting and confusion by clearly defining who will be making financial decisions and who should be making health care decisions when mom or dad become incapacitated. A caregiver agreement can provide financial assistance to the one sibling who inevitably ends up shouldering most of the care giving burden.
If you are a part of a blended family don’t wait for time to take its toll; talk to your parents and siblings now about any challenges the future may bring—and how to meet those challenges together.
Wednesday, March 07, 2012 Elderly Daycare Can Help Prevent Caregiver Burnout
Many of our clients provide care for elderly loved ones; some even providing constant, around the clock care. Care giving is a demanding, overwhelming, and often grossly underappreciated job. In addition to giving up their own time and interests, caregivers have to watch someone they love slowly regress and lose the ability to do even the most basic of tasks. Often, the senior being cared for eventually loses their ability to even recognize the people around them… including the person giving constant loving care. For all of these reasons, it’s very common for caregivers to experience depression and fatigue… caregiver burnout.
Depression and burnout does not have to be the plight of all caregivers, especially if you know the symptoms and how to combat them. The good news is that there are many preventative strategies which are readily available… the hard part for caregivers is valuing their own time and mental health enough to take advantage of them.
One of the best ways to avoid caregiver burnout is by making time for yourself periodically. Adult day service centers provide personal care, social activities, therapy and meals during the day while caregivers need to be away at work or even taking a much-needed break. If you have a parent who can no longer care for themselves during the day, adult day services might be a good solution for everybody involved.
There is a saying that hardships shared are halved, and joys shared are doubled; this is as true of care giving as it is for anything else. Many caregivers are reluctant to ask for help, but sharing the burden could save you from caregiver burnout. Don’t be afraid to reach out.
Wednesday, February 29, 2012 How to Prevent Family Fighting Over Mom’s Will or Trust
Most people believe that creating an estate plan is a private and personal business; something you do alone or with your spouse, between you and your attorney, with your children, grandchildren, or other beneficiaries kept on a strictly need-to-know basis. In an ideal world this would be true: parents and their adult children would always get along, and when those parents passed away their children would quietly and respectfully follow their wishes regarding the distribution of their estate.
Unfortunately, we don’t always live in an ideal world, and inheritance and estate planning can often cause tension between parents and children—sometimes before the parents have even reached retirement age! This does not have to be your family’s fate, however. Even if you suspect your children won’t like what you’ve put in your will or trust it may be possible to keep the peace and prevent family fights from breaking out—both in the here and now, and after your death.
Some people choose to simply keep their wishes secreted away in a safety deposit box when they know their family members will disapprove of the contents, and then let everyone fight it out on their own after the grantor has passed away; but this only puts off the bad feelings and can often cause lasting rifts among siblings at a time when they most need the love and support of family. Furthermore, this strategy of secrecy doesn’t address what happens if you become incapacitated and need one of your trustees or agents (in all likelihood one of your children) to take over your affairs.
A better option than secrecy is to invite your children to join you in a meeting with your estate planning attorney. This gives you an opportunity to share your plans in the presence of a knowledgeable professional who is on your side; it also gives your children the chance to ask questions and get clear and immediate answers. More often than not tension about mom and dad’s estate plan stems from a lack of understanding, or a worry that mom or dad have been taken advantage of. Having a family meeting with your attorney can be reassuring, educational, and put everyone one the same page moving into the future.
Thursday, February 23, 2012 Have You Seen This Person?
If you are a Caucasian woman, aged 35 or older, possibly married, very likely working full or part-time—then there is a good chance that you are also (or will soon be) serving as a caregiver for an aging parent or relative. At least this is what a recent report released by the National Alliance for Caregiving, AARP, and MetLife indicates.
The entire report, entitled “Caregiving in the U.S., A Focused Look at Those Caring for Someone Aged 50 or Older” is 73 pages long, but you needn’t read the entire thing to get an insider’s peek at the state of caregiving today. And the report isn’t limited to caring for an aging relative; it includes statistics on those caring for special needs children, as well as family members of any age.
Some of the more interesting statistics listed in the report are:
* 40% of Caregivers are aged 50-64.
* 63% of those receiving care are over the age of 75.
* 67% of Caregivers are women.
* 76% of Caregivers are Caucasian.
* 89% are caring for a relative (36% of the time it is the caregiver’s mother.)
* Over half of caregivers are employed while caregiving; and...
* Caregivers provide an average of 19 hours of caregiving per week (in addition to their regular employment.)
It is worthwhile to note that according to this study most of these caregivers are unpaid for the care they give, which makes sense if they are caring for a family member and are doing it voluntarily—but a full 43% said that they felt they did not have a choice to take on the role.
Our office can’t prevent you from one day needing a caregiver (or one day having to serve as a caregiver) but we can help you plan for when that day may come. Thinking and planning ahead can keep you—and your loved ones—from ending up in a situation where you feel you have no choice.
Monday, February 20, 2012 Dementia and Alzheimer’s: Is It Too Late For Mom Or Dad To Execute Legal Documents?
The question of competence has become a very big issue in the estate planning/elder law world over the past few years. As the population ages, and awareness of Alzheimer’s and dementia diagnoses grow, more and more adult children are questioning the ability of their elderly parents to make legal and financial decisions. Some children are unhappy with the choices their parents make; but most are simply concerned, and want to ensure their parents are not working in confusion against their own best interests, or being taken advantage of by others.
Estate planning attorneys must assess the competency of every client before they sign any documentation, and most attorneys can confidently make this assessment based on observation, experience, and instinct during the course of interaction; but every once in a while a situation arises that is not so clear, or a family member will express concern about the principal’s ability to understand and sign legal documents.
If you are worried about the competency of your loved one here are a few things to consider:
* Does he have the ability to articulate the reasoning behind a decision?
* Is his state of mind fairly stable, or do his moods and opinions change frequently and without cause?
* Does he appreciate the consequences of any given decision?
* Does he understand when a decision is irreversible?
* Does he recognize the substantive fairness of a transaction?
* Is his current decision-making consistent with his previous lifetime commitments?
In order to determine whether or not a person is competent to sign a will or trust, however, an assessment should be much more focused:
* Does the principal have a clear knowledge of his assets?
* Does he have a full knowledge of the persons to whom the estate is being left?
* Is he able to reasonably formulate and express a plan for the disposition of the estate?
The unfortunate truth about elderly illness is that competency in a person afflicted with the beginnings of Alzheimer’s or dementia can often change from day to day or even hour to hour. If there will be any question at all about the competency of the principal the safest thing to do is to express your concerns to your attorney, and have mental examination performed by a doctor. Of course the very best way to ensure mental competence is to create your estate plan early, before age or dementia becomes a factor.
Wednesday, February 08, 2012 Will Medicare Provide for You in Your Golden Years?
Many retirees (or soon-to-be-retirees) have been living and saving under the assumption that Medicare would pay for a bulk of their medical costs during retirement, but a recent article in the Wall Street Journal reveals that counting on Medicare may not be the safest bet anymore. According to the article, one of the most important facts that retirees need to understand about Medicare is that “Medicare pays for very little long-term care, and you’ll still need significant savings to cover the rest of your medical expenses.”
This statement may come as a shock to those who fall in the soon-to-be-retired category simply because they likely haven’t had to give much thought to post-retirement medical costs yet; but they may be in for a rude awakening when the time comes to rely on Medicare. “Two-thirds of those on Medicare also said they pay the same, or more, for healthcare now than when they were working. They have been unpleasantly surprised by the cost of Medicare Part B premiums, what you pay for doctor and outpatient coverage, with 44% paying more than they had expected.”
Fortunately, our readers can become aware of this need to be more proactive about their own healthcare, and can start planning now. How you should plan will depend greatly on your age, your current rate of saving, and many other factors. Please contact our office (or your own trusted attorney or financial planner) today.
Monday, February 06, 2012 A Difficult Decision: Choosing a Nursing Home for Yourself or Your Loved One
If and when the time comes to choose a nursing home—either for yourself or for a loved one—how will you know how to choose the right one? A person’s living situation often has a lot to do with how happy they are, so it is important to choose carefully and wisely. When you do begin the process of choosing a nursing home, you don’t have to go into it blind. Here are a few things to consider and questions to ask when you start your search:
A Matter of Money - Nursing care is an expensive prospect, so one of your first considerations when looking for a nursing home will be how much it will cost and how you (or your loved one) will pay for it. Fortunately, it is likely that the entire cost will not have to come out of your personal finances. The Medicare.gov website offers an overview of different strategies to pay for quality nursing care. Your elder law attorney can help you navigate these—and other—options.
For-Profit vs. Non-Profit – Not all nursing homes are created equal, and according to this recent article the choice between a for-profit or non-profit home can be one you’ll want to consider carefully.
Evaluate Staff and Policies – Taking the time you need to evaluate the staff and the policies of the homes on your list will quite possibly be the most important part of your decision-making process. This article from the “Our Parents” website provides a comprehensive list of questions to ask yourself, the nursing home staff, the residents, and more before you make your decision.
Location, Location, Location – Finally, we all know that location is everything, and this is true of nursing homes as well. Issues of location ranging from how close the home is to family and friends, to what kind of view can be seen from the windows can all be of the utmost importance.
Choosing a nursing home may well be one of the most difficult decisions you will ever make, so it’s best to go into it prepared. Don’t be afraid to get in touch with the professionals who can help you make the best possible decision for yourself and your loved ones.
Wednesday, January 18, 2012 As Elder Population Grows, So Does Need for Awareness of Elder Abuse
Elder abuse is a disturbing (and often underreported) issue that will eventually impact all of us—if not on a personal level then most likely by touching the life of someone we know and love. Elder abuse is something that is difficult for most people to consider, not only because the idea is such a disturbing one, but also because it is so insidious.
Elder abuse can be either physical or financial; it can happen to seniors suffering from Alzheimer’s or dementia as well as seniors who still have all their mental faculties; and the perpetrators can be strangers, nursing staff, or even family members. Once you begin to learn about it, it seems that the opportunity for elder abuse can be lurking around every corner.
This recent and disturbing article from PBS Frontline brings to light some of the ways that the medical community itself has managed to overlook or ignore elder abuse whose evidence is right under their noses. “Autopsies of seniors have become increasingly rare even as the population age 65 or older has grown. Between 1972 and 2007, a government analysis found, the share of U.S. autopsies performed on seniors dropped from 37 percent to 17 percent.” What this means is that “coroner and medical examiner offices, which are responsible for probing sudden and unusual fatalities... — hampered by chronic underfunding, a shortage of trained doctors and a lack of national standards — have sometimes helped to send innocent people to prison and allowed killers to walk free.” This may be especially true in cases of elder abuse. It’s clear that something needs to be done.
USA Today reports that not everyone has their heads in the sand. "There is a genuine recognition by those who are concerned by the abuse of elders that there need to be appropriate safe houses for them to get them out of immediate harm's way... Nationally, we've been aware of the need for elder abuse shelters, but they've been slow in coming into fruition." Furthermore, public figures (such as Mickey Rooney) coming forward with their own stories and experiences has helped raise awareness of elder abuse.
For more information about elder abuse and what you can do to prevent it, you can go to the National Center on Elder Abuse website, or contact our office.
Friday, January 06, 2012 A Woman’s Work Is Never Done
Do you know who will take care of you when you are unable to take care of yourself? Studies show that most caregivers for aging seniors are likely to be women, and most likely to be your daughter or daughter-in-law. What this means is that unless parents have a plan for their future long term care, the financial burden of caring for these aging parents will fall to daughters and their families.
Serving as a caregiver for elderly parents includes more than just driving to doctor appointments or helping with the shopping, it often includes paying for food and medical costs, as well as taking time away from careers to care for family members. In fact, it’s not unusual for female caregivers to experience a significant loss of income over a lifetime in reduced salary and retirement benefits.
Many seniors think that they will have government programs such as Medicare and Medicaid to fall back on, but these programs don’t always provide as much as expected or hoped. Relying on government programs can leave your children or family members footing just as much of the bill as they would without the programs. Instead, seniors may want to consider investing in long-term-care insurance, which can provide more flexible and comprehensive coverage than government programs, and save seniors and their families much time and money.
If you are a daughter of aging parents, now is the time to talk to your parents about the future. Studies show that you are the one who is likely to shoulder the responsibility of caring for parents as they age. Doing so will affect your family, your career, your finances, and even your health.
The subject of aging and elder care is a difficult one, but not one to be left to the last minute. Talk to your family about your wishes and plans for the future, then bring your estate planning attorney into the discussion. Once you have an idea of your wishes, an expert can help you feel better about your options, and put you on the right path for keeping your family healthy, happy, and financially secure in the years to come.
Wednesday, December 14, 2011 Who Will Be Making Your Difficult Healthcare Decisions?
A recent article in the LA Times reminds us of just how important it is to have some kind of living will or advanced healthcare directive, and that it is absolutely necessary to talk about these things with your loved ones. If you have not done these things it is your loved ones who will be left to make the painful and terrible decisions about your medical treatment and possibly even the heart-wrenching DNR determination.
The author writes of his father—chronically ill, stroke survivor, suffering from mild but advancing dementia—who is currently staying in a nursing home, “where they've put him on a diet of pureed foods and thickened liquids, but he often refuses to eat, demanding to be taken home and fed the home cooking he's always loved. It's hard to tell him that may never happen, and that his options are increasingly grim. If my dad can't eat, a feeding tube will be his only choice. Other than giving up the fight.”
The family is now struggling to decide if a feeding tube is the right course of action, what their father would (or does) want, and how involved he should be in the decision considering his current state of mental health. “We worry... that with mild but advancing dementia, my father won't be able to fully comprehend the implications of being fed through a tube implanted in his gut. And if he declines it, is he competent to make that decision?” These are the heart-breaking decisions that can leave loved ones asking themselves for years after, “Did we do the right thing?”
We often shy away from talking about these issues with our family members and loved ones. We think that they are too sad, too depressing, or too far into the future to worry about yet. The only thing that can make these decisions even the tiniest bit easier, however, is knowing for certain what your loved one would want; and the only way to know for certain is to talk about your feelings with your family, and to put your wishes in writing with a living will or healthcare directive. Our office can help you do this.
More often than not the best that can be hoped for in a situation like the one discussed above is that some measure of peace is attained. We wish this for the author of the article and his family, and we wish this for any of our readers involved in similarly difficult and painful circumstances.
Monday, December 05, 2011 Nursing Home Etiquette to Remember During Holiday Visits
Nursing homes during the holiday season tend to see a little more activity than they do during the rest of the year, whether because of families coming to visit loved ones, or local groups or individuals bringing holiday cheer to residents who may not have family living nearby. Taking time to visit with nursing home residents during this time of year can be an immensely rewarding experience for all involved, especially if new or infrequent visitors keep a few simple rules of etiquette in mind:
1. Call the nursing home staff ahead of time to schedule your visit. This not only ensures that you won’t be interrupting any previously scheduled mealtimes or activities, it also gives the residents something to look forward to (and prepare for, if necessary.)
2. Be aware of what to expect. Some will have physical disabilities such as trouble with their hearing, eyesight, or ability to move freely. Some residents may have Alzheimer’s or dementia and may have trouble remembering people or conversations. If you aren’t sure how to respond in certain situations you can ask a member of the nursing staff for advice.
3. Knock before you enter a room. The residents’ rooms are their homes and should be treated as their personal and private space. It is polite to ask permission before entering a room or before handling personal objects on display, but residents will likely welcome queries or questions about photos or personal objects, and this is an excellent way to get a conversation started.
4. Be a good listener. Elderly residents have a lot of history and experience to share, and providing a friendly and attentive ear will be gratifying not only to your elderly friend or relative, but will likely be a fascinating experience for you as well.
5. Be aware of your host’s energy level. Nursing home residents can often tire quickly and 20-30 minutes may be a tiring visit for them. (On the other hand, if you and your host are in the middle of a conversation or game there is no need to rush through to stick to an arbitrary schedule.)
6. Bring photos, cards, or board games with you. Conversation will not always flow easily and freely, and having a back-up plan such as a deck of cards can dispel awkward silences. You may also consider offering to write or read letters for residents who may have trouble with these activities.
7. Don’t promise to visit again unless you truly intend to follow through and can even put it on your calendar right then and there. Nursing home residents may not get many visitors, breaking an appointment can be a heavy disappointment for your friend or relative.
Monday, November 28, 2011 A Mother’s Thoughts on the Struggle Between Adult Children and Their Aging Parents
Salon.com recently published a touching and illuminating article about Baby Boomers and their aging parents—about the transition from being the cared for child to the caregiving adult, and how Boomers are dealing with this new development. This is not the first article to be written on the subject, but this one is unique because it is written by one of the parents.
Author Lillian Rubin writes that she can see the growing worry in the eyes of her 63 year old daughter, “who wants me — her 87-year-old mother — to be in touch when I leave town, even if only for a few days or a week, who calls when she’s traveling though she never did before, whose anxiety announces itself over the phone lines when we haven’t talked for a while: ‘Are you OK?’ I tell her I’m fine, ask her to stop worrying. ‘It’s my turn to worry,’ she replies.”
Even when their parents still have the ability to care for themselves, Boomers can’t help but worry about what might be coming down the road, and when the shoe might drop. This worry can have the effect of putting adult children on edge, and making their parents feel smothered. Rubin writes movingly—and fairly—about the struggle on both sides of the divide. “Parents commonly resist their children’s attempts to intervene, but they are often in denial about the depth of their decline and can’t or won’t see what’s plain to others: They need help. If children back off from the conflict, their parents can fall through the cracks. If they don’t, parents are often resentful and difficult.”
Rubin admits that she has no easy answers, that every family will need to search for their own solution, but our firm knows that finding a solution is easier if you don’t have to do it alone. Having a solid estate plan is not going to solve all the problems between parents and their children, but having a good Advance Healthcare Directive and Financial Power of Attorney can certainly make both parent and child feel a little more secure. Furthermore, opening the lines of discussion for these two documents can clear the way for other important discussions down the road.
Monday, November 21, 2011 What To Do When You Discover That Mom or Dad Is Not Okay
In this day and age many families are spread across the country, with these winter holidays being their only chance to see each other during the year. This means that many adults are planning a trip this holiday season to visit aging parents they haven’t seen in months—or possibly haven’t seen in over a year! But what many people don’t anticipate is how much can change over a year, or even during a few short months. It is not unusual for adult children to find that their aging parents are not doing as well as they thought.
If a visit to your aging parents this holiday season brings up worries or concerns for you, or if you aren’t sure what to do or where to start, we have a few tips and suggestions that might help. Of course, every family will be different, but these suggestions can get you started down the road to ensuring your parents have the help and care they need.
1. First and foremost, talk to your parents.—some elderly people may be in denial about how much they need help, but many recognize when they begin losing the ability to care for themselves, and appreciate the opportunity to express their concerns and look for assistance.
2. Talk to your siblings—if you’ve noticed mom or dad aren’t doing so well, your siblings have probably noticed something too. Talking about the situation together may help you get a clearer picture of exactly what’s needed, and you may be able to plan the next steps together.
3. A recent article on the New York Times New Old Age Blog recommends contacting a geriatric care manager—this is someone who can work with you and your siblings together, someone “who can assess the situation, come up with a plan and supervise its execution.”
4. As also mentioned on the New Old Age Blog, sometimes the best thing to do is not to come in during the holidays and make snap decisions or sweeping changes, sometimes the best thing you can do is to make small, slow changes. The article points out that “engaging a bill-paying service or a chore service, a transportation program, a few hours a week of a home helper to handle laundry and shopping” can often make a huge difference.
5. Ask your parents if they have some kind of estate plan, or at the very least encourage them to have an advance healthcare directive or living will. If they do not have any kind of powers of attorney, try to help them find an estate planner or elder attorney they can trust and feel comfortable with, who can ensure they have the legal protections they need.
Friday, November 11, 2011 NOW is the Time to Think About Long-Term Care
As Baby Boomers begin to retire and to think about life after retirement, many find that one of their primary concerns is that of long-term care. Some news sources seem to think that paying for long-term care is going to be a number one issue in the coming years, not only for elderly individuals and their families, but for our society as a whole.
“The cost of long-term-care itself is not trivial. Nursing homes cost on average $87,235 annually... One year in an assisted-living facility is now $41,724. Adult day services are $70 per day, and home health aides cost $21 per hour... How can the country deliver and finance long-term-care for its rapidly aging population?”
It is comforting to know that AARP takes a somewhat less dramatic view of the issue. While they do agree that most seniors will at some point face the need for long-term care—“even if you're in good health today, there's a good chance that you'll eventually need some type of long-term care, at least for awhile”— they urge people to take a pragmatic approach... and to start planning as early as possible. “The cost goes up with age, but it's still affordable for many people over age 65. Once you hit the mid-70s, though, the cost of a good long-term care policy becomes very expensive, and it may be difficult to qualify for [it].”
An elder law or estate planning attorney is another resource for seniors and their families who are trying to plan ahead for the possibility of paying for long-term care. We specialize in helping you sort through your options, get your financial ducks in a row (right now and years down the line), and apply for government benefits, if necessary.
Don’t let the need for long-term care catch you by surprise. Contact our office to start planning now.
Friday, October 21, 2011 Senior Citizens to Receive a Raise
There is good news today for senior citizens! According to this article in CNN Money, “Social Security recipients will receive a cost of living adjustment of 3.6% starting in January.” This will be the first “raise” recipients have seen in three years, and most welcome the increase. “Many seniors have felt squeezed since banks are paying virtually no interest on savings accounts and stock market declines has eroded their retirement accounts.”
Unfortunately, many seniors may not see a useful increase in their social security income thanks to a hike in Medicare premiums expected to be announced next month. “For the past two years when Social Security benefits stayed the same, many seniors were shielded from the increase in Medicare premiums because of a "hold harmless" provision that protects more than 70% of beneficiaries... However, high-income beneficiaries and new enrollees did see their benefits reduced because they are not covered under the provision.”
Even with the expected increase to Medicare premiums, most seniors are simply glad to see evidence that The-Powers-That-Be recognize the rising cost of living. While most recipients of Social Security do have an alternate form of income, with their SS benefits representing “about 41% of the elderly's income”; there are some who “rely on the monthly checks for 90% of their income.”
For more complete information about the coming changes in Social Security please read the full article. For help understanding how this change may fit in with your other benefits, or may affect your estate planning, please contact our office.
Wednesday, October 05, 2011 Facing the Challenges of Caregiving as a Family
As senior issues and caregiver concerns get more media attention, more and more families are making the question of who becomes mom or dad’s primary caregiver a family decision. Although one sibling may still take on the role of “primary caregiver,” families are making the conscious decision to try to share caregiving responsibilities more equally. This is definitely a step in the right direction, but as this article from the Family Caregiver Alliance points out, there are still likely to be challenges.
Choosing a Primary Caregiver. The primary caregiver often ends up being the sibling who lives closest to mom or dad; it may start with a ride to the doctor here and there, but before you know it one sibling is shouldering almost all the responsibilities. Discussing the role of primary caregiver as a family can make everyone feel more involved and result in more support for mom or dad. The local sibling may still choose to care for parents’ daily needs, but out of town siblings may choose to take mom or dad on annual vacations or provide financial support.
Making Financial Decisions. Hopefully your parents have made arrangements for their long-term care expenses; but if not, you and your siblings may feel honor-bound to take care of the expenses yourselves. While the most logical route may seem to be an equal division of expenses between siblings, this may not be feasible or fair for every family. Siblings should take the time (and perhaps consult with an advisor) to discuss the various medical and care expenses, payment options, and financial strategies.
Living Arrangements and Long Term Care. Facing the reality that mom can no longer care for herself is a painful revelation for any family; making the decision to move a parent to a nursing home or long term care facility can be fraught with feelings of anger, guilt, or even denial, and siblings may be tempted to lash out at each other during this emotional time. Consulting with a Geriatric Care Manager or another trusted advisor at this time can help the entire family understand the situation, manage expectations, and keep emotions in check.
Making decisions as a committee can be difficult, especially when some members of the “committee” live far away, but when everyone is involved in the decision-making process then everyone is more likely to support a final outcome. Getting together with your sibling on a regular basis—even if it’s only by phone—to discuss the care of elderly parents can not only keep everyone on the same page and minimize disagreements, it can also provide a rare opportunity to grow closer as a family. Friday, September 09, 2011 How Does Your State Rank on the Long-Term Care Scorecard?
One of the primary concerns of the aging population is long-term care. As the life expectancy of Americans goes up so does the expectation that they will someday need some form of long-term care. You may not know whether that care will happen in a hospital, a nursing home, or in your own home, but you can be sure that it will be expensive.
How expensive will long term care be? It turns out the answer to this question depends a great deal on where you live. The AARP, The Commonwealth Fund, and The SCAN Foundation recently released a report which they call “The Long Term Scorecard,” which compares states and ranks them according to categories. The website Web MD has an article explaining how to use the scorecard and what it means.
The article in Web MD states that “Long-term care is unaffordable for middle income families, according to [The Long Term Scorecard report.] Even in states where nursing home care is most affordable, such care averages 171% of an older person's household income. The national average is 241%.”
Some states, however, have been making the issue of long-term care a priority, and have been wrestling with questions such as how to make it more affordable to residents and how to provide support to family caregivers. According to the article in Web MD, they’ve broken down the information in “The Scorecard” to help readers understand which states provide the best support (either financial, social, emotional or legal) for the elderly and their caregivers.
The article “ranks states' performance according to four categories: 1. Affordability and access, 2. Patient choice of both provider and setting, 3. Quality of life and care, and 4. Support for family caregivers.” The states ranked highest overall were Minnesota, Washington, Oregon, Hawaii and Wisconsin; while the lowest ranking states turned out to be Mississippi, Alabama, West Virginia, Oklahoma and Indiana. (For more information on how the states were ranked and what each ranking means please read the article here.)
Perhaps the most important lesson to take from all this is that no matter where you live, or what your health is like right now, it is very likely that you will need some kind of long-term care in the future, and that that care will be expensive. Burying your head in the sand or choosing to “think about it when the time comes” will only make things worse for you and for your family. Call our office and let us help you prepare now for whatever the future may bring. Friday, August 26, 2011 Are You Hurting Your Own Chances At Retirement?
According to
a
recent article in the Wall Street Journal, many Baby Boomers are no longer
worried about when they will be able
to retire, but if they will be able to
retire at all. In many cases the reason for this worry stems not so much
from any kind of selfish inability to save, but from a tendency to be too generous.
In addition
to a growing trend (hinted at in the WSJ article above) of Baby Boomers tapping
their own retirement funds to help pay for the care of their elderly parents, this
article in USA Today warns of the all-too-common danger of Boomers shorting
their own retirements to pay for their children’s college educations.
“People are
willing to go to extreme measures because they value a college education so
highly... Among parents who are planning for their children's college, 24% say
that they tap their retirement accounts. And that doesn't reflect people who reduce
or halt retirement contributions [to make tuition payments.]”
One thing
that both of these articles agree on is that when it comes to saving money,
Boomers need to put their own needs first. While the immediate financial needs
of an elderly parent or college-bound child may feel more pressing, it’s a very bad idea to short your own
retirement account (and your future) to cover their costs. If you have an
elderly parent in need, before you dip into your own savings contact a good
elder law attorney who can help you review your (and your parent’s) options,
and help navigate the VA Benefits or Medicaid system if applicable.
As far as
college tuition goes, by neglecting your own retirement to pay for your
children’s college education you may simply be perpetuating a dangerous cycle,
putting your children in the position of having to pay for your expenses when your savings runs out in the future. Financial
advisors, college admissions counselors, and the school’s financial services
center may be able to help you explore your options for paying for tuition. Monday, August 15, 2011 New York Becomes 29th State to Pass Alert System for Vulnerable Adults Legislation
Last month
saw some good news for seniors and their families in the state of New York. State
Governor Andrew Cuomo announced on his
website that he “signed a law to create a statewide alert system for
missing vulnerable adults, similar to the nationwide Amber Alert program, which
will help authorities locate cognitively impaired persons who go missing.” By
signing this law Governor Cuomo added New York to the growing list of states with
similar programs in place to help find and protect seniors with Alzheimer’s who
may wander away from their homes in confusion.
The first state-wide
public notification system for vulnerable adults, sometimes called “Silver Alert”
programs, was passed in Oklahoma in 2006. Since then 28 states have joined
Oklahoma in passing Silver Alert legislation (or something similar) and five
states have some kind of vulnerable adult alert legislation pending.
According to
Governor Cuomo’s announcement, New York’s new Amber Alert for Seniors program “provides
for the rapid public dissemination of information regarding adults with
dementia, Alzheimer's, or other cognitive impairments who go missing. Under the
new law, the same Amber Alert mechanisms used to find missing children will be
activated for missing vulnerable adults, including the printing and
distribution of photographs and posters, a toll-free twenty-four hour hotline,
a curriculum for training law enforcement personnel, and assistance for
returning missing vulnerable adults who are located out of state.”
New York’s
program—and the similar programs in all participating states—are a comfort to the
families of seniors afflicted with Alzheimer’s or dementia. Too often we read
news stories about seniors who have wandered away from their homes and are not
found until it’s too late. If you worry that your elderly relative may be at
risk for wandering, check the laws of your state to find out which programs are
available to you and how to enroll (if necessary).
If your
state does NOT have a program in place you may want to consider enrolling your
elderly loved one in the MedicAlert® + Alzheimer's Association Safe Return®
program. To learn more about this nation-wide emergency response service click
here. Wednesday, August 03, 2011 Addressing the Growing Financial Concerns of Baby Boomers
The “golden years” are supposed to be a time to retire and relax after a life of working hard for yourself and your family, but according to a recent story on NPR, Baby Boomers have some big financial concerns about the future, many of which involve how they will pay for health care in their golden years.
“The struggling economy, a longer life expectancy, ever-increasing health care costs and challenges facing Social Security are putting added pressure on the boomers, those born between 1946 and 1964.”
An Associated Press LifeGoesStrong.org poll questioned almost 1,500 adults, over 1,000 of whom were Baby Boomers, and found that while ALL Boomers had some concerns about financial comfort and survival as they aged, the younger Boomers in particular (those born in the ‘60s) had the strongest—and the most all-encompassing—concerns.
This discrepancy in fear makes sense when you consider that “Many older boomers still have a defined benefit pension plan, probably some decent retiree medical insurance and Social Security,” whereas “the youngest boomers... face more uncertainty about their pensions, their Social Security, their housing and their medical care.”
The NPR article does not offer any easy fixes or instant comforts to these financial concerns—indeed there are no easy fixes—but it does offer a few suggestions to help Boomers ease their minds about those things that worry them the most:
-
Push retirement back as long as you can to put off drawing on your savings until absolutely necessary.
-
Start investing in long term care insurance, and do so as early as possible. “Costs for long-term care insurance can range from $1,000 to $8,000 a year, depending on age, health conditions, policy term and other factors.” As you get older the cost goes up—sometimes very steeply.
-
Don’t neglect your estate planning. According to the poll, “Forty-percent of the boomers polled said they had a legal will to spell out how their possessions should be distributed after death,” and even fewer had health care directives, proxies, or living wills. A health care directive “allows people to document their wishes concerning medical treatment, and the proxy is a medical power of attorney that allows for the appointment of a trusted person to make medical decisions in case an individual is unable to do so.”
Our office can help you address any concerns you might have about your own (or a loved one’s) golden years. Don’t hesitate to contact us. Wednesday, August 03, 2011 Addressing the Growing Financial Concerns of Baby Boomers
The “golden years” are supposed to be a time to retire and relax after a life of working hard for yourself and your family, but according to a recent story on NPR, Baby Boomers have some big financial concerns about the future, many of which involve how they will pay for health care in their golden years.
“The struggling economy, a longer life expectancy, ever-increasing health care costs and challenges facing Social Security are putting added pressure on the boomers, those born between 1946 and 1964.”
An Associated Press LifeGoesStrong.org poll questioned almost 1,500 adults, over 1,000 of whom were Baby Boomers, and found that while ALL Boomers had some concerns about financial comfort and survival as they aged, the younger Boomers in particular (those born in the ‘60s) had the strongest—and the most all-encompassing—concerns.
This discrepancy in fear makes sense when you consider that “Many older boomers still have a defined benefit pension plan, probably some decent retiree medical insurance and Social Security,” whereas “the youngest boomers... face more uncertainty about their pensions, their Social Security, their housing and their medical care.”
The NPR article does not offer any easy fixes or instant comforts to these financial concerns—indeed there are no easy fixes—but it does offer a few suggestions to help Boomers ease their minds about those things that worry them the most:
-
Push retirement back as long as you can to put off drawing on your savings until absolutely necessary.
-
Start investing in long term care insurance, and do so as early as possible. “Costs for long-term care insurance can range from $1,000 to $8,000 a year, depending on age, health conditions, policy term and other factors.” As you get older the cost goes up—sometimes very steeply.
-
Don’t neglect your estate planning. According to the poll, “Forty-percent of the boomers polled said they had a legal will to spell out how their possessions should be distributed after death,” and even fewer had health care directives, proxies, or living wills. A health care directive “allows people to document their wishes concerning medical treatment, and the proxy is a medical power of attorney that allows for the appointment of a trusted person to make medical decisions in case an individual is unable to do so.”
Our office can help you address any concerns you might have about your own (or a loved one’s) golden years. Don’t hesitate to contact us. Friday, July 22, 2011 War Veterans May Be Unaware They Qualify For VA Aid and Attendance Benefits
One of the services Elder Law and Estate Planning attorneys often provide is helping clients navigate the application procedures and bureaucratic systems for the various state and federal medical insurance programs; and one thing that remains a surprise throughout the years is how many people forget about the VA Aid and Attendance Program for war veterans.
According to the Department of Veterans Affairs website, VA Aid and Attendance is “a benefit paid to wartime veterans [or their spouses] who have limited or no income, and who are age 65 or older, or, if under 65, who are permanently and totally disabled.” Unfortunately, too many veterans and their spouses are unaware that they qualify for this benefit, or even worse, have never been informed that the program exists.
An informative article in the Washington Postquotes the VA’s deputy undersecretary for disability assistance as saying that he believes they are only reaching “about one in four eligible veterans.” Part of the reason for this is that “there are a lot of veterans where it’s been 40 years or more since they’ve been on active duty. It just doesn’t occur to them there may be a benefit from the VA.”
If you are a war veteran over the age of 65 it is very likely that you and/or your spouse qualify for Aid and Attendance Benefits. Eligibility requirements include:
· You served at least 90 days of active military service 1 day of which was during a war time period. (If you entered active duty after September 7, 1980, generally you must have served at least 24 months, or the full period for which called or ordered to active duty.)
· You were discharged from service under conditions other than dishonorable.
· Your countable family income is below a yearly limit set by law (The yearly limit on income is set by Congress.)
· You must need help with at least one activity of daily living: dressing, eating, walking, bathing, adjusting prosthetic devices or using the toilet. Those who are blind, living in nursing homes or require in-home care may also be eligible.
For many veterans and their families the financial assistance they receive from their VA Aid and Attendance benefits can be an incredible help. Unfortunately, the application process required to receive the benefits can be daunting. “It’s not a simple process. A&A applicants must mail the forms, copies of service records, marriage certificates, proof of insurance and medical records to the regional VA office. If a third party is making the application, an additional form, 21-22-a or 21-0845, must be completed.”
This is why many veterans ask a knowledgeable Elder Law or Estate Planning attorney to help with the application process. The right attorney can help you find and fill out the correct forms, gather the necessary records and materials, and keep track of progress throughout the entire process. If you think you may be eligible for VA Aid & Attendance Benefits please don’t hesitate to contact our office. Wednesday, July 20, 2011 How Should A Caregiving Relative Be Compensated?
It is common knowledge in our society of aging Baby Boomers that many adult children end up taking months or even years off from their lives and careers to provide care for their elderly parents. Most children do this out of love and a sense of duty, but even in the closest of parent-child relationships there may be an unspoken expectation that appreciation for the caregiving child’s time and effort may be reflected in the parent’s will or trust. After all, professional caregivers demand a salary, is it too much to expect that a relative serving as caregiver should be compensated as well?
Take as an example the case of Anthony Olivo, who this article in Forbes describes as “a tax lawyer who ended up providing nearly full-time care for his mother and father.” Anthony “worked in law firms from 1976 to 1988 and then opened his own practice. Yet by 1994, given all the time he was devoting to his parents and their health problems, he found it hard to maintain his practice. He lived with his parents and gave them round-the-clock care from 1994 through 2003, during which he earned no significant income from his law practice.”
Now Mr. Olivo is asking that the U.S. Tax Court deduct $1.24 million from the estate of his parents for fees it paid to Anthony while he was serving as caregiver. Mr. Olivo is not challenging his parents’ wishes, he is not asking for more of the estate than his parents bequeathed to him; rather, he is asking that a “salary” for caregiving be deducted from the taxable portion of his inheritance.
Unfortunately, in the absence of a legal agreement, the tax court is unable to rule in Mr. Olivo’s favor: “The court was careful to note that Anthony rendered extraordinary care and that his efforts were commendable. However, the court ruled that his mother’s estate did not establish that Anthony was entitled to that pay. There were no written agreements and scant evidence the family agreed to pay him.” Furthermore, “There was no contract and no firm evidence of how much Anthony’s services were worth.”
We sympathize with Mr. Olivo, and hope that our firm can help save our clients from ending up in a similar situation. Simply leaving the caregiving relative “a little extra” in a will or trust is not enough, we cannot stress enough the importance of a legal caregiver agreement if a family member is providing caregiver services—especially if that family member is giving up time from his or her own career to do so. Wednesday, July 06, 2011 Do Not Go Gentle Into That Good Night
“Do not go gentle into that good night,
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.”
-Dylan Thomas, Do Not Go Gentle Into That Good Night
The Dylan Thomas poem from which the above lines are taken fairly accurately expresses the American view of death. Even after a long and satisfying life we tend to think of death as something to be fought against with all of the tools at our disposal. We struggle to keep parents, grandparents, or patients alive for just one more week, one more day.
But the new film Consider the Conversation suggests that a natural death after a long life may not be a single event to struggle against, but rather a process to be faced with as much grace and comfort as possible. Created by Mike Bernhagen, a business development specialist turned hospice advocate after watching the slow physical and cognitive decline of his elderly mother; and Terry Kaldhusdal, a teacher and filmmaker; the documentary is a labor of love.
“Consider the Conversation does not seek to hand down answers. Rather, it provides something far more important - the questions all of us need to contemplate. That being said, the producers have three goals for this film: 1) to change the current American attitude from one that predominantly views end-of-life as a failed medical event to one that sees it as a normal process rich in opportunity for human development, 2) to inspire dialogue between patient and doctor, husband and wife, parent and child, minister and parishioner, and 3) to encourage medical professionals, healthcare organizations and clergy to take the lead in counseling others.”
The film brings up issues that every adult child should be talking about with their elderly parent, and that every elderly patient should be having with their doctor. These are also issues that you should be discussing with your estate planner as you create your Living Will or Advance Healthcare Directive.
The film Consider the Conversation is being shown on public television stations around the country. Check the website for an updated screening schedule, or to purchase the DVD. Wednesday, June 29, 2011 Veteran Journalist Shares Her Personal Experiences Entering the Medicare System
Trudy Lieberman has had plenty of experience with Medicare—of course up until now most of it was from the outside looking in. As a journalist for more than 40 years specializing in insurance, health care, health care financing and long-term care, one would think that when the time came this year for her to enter the Medicare system herself she’d be an old pro. Unfortunately, as Ms. Lieberman discovered—and shared with the readers of her exceptional five part article series in Time Magazine’s Moneyland—entering the Medicare system as a patient can be confusing for even the most knowledgeable of inside reporters.
While her experience as a reporter may not have made signing up for Medicare any easier for Ms. Lieberman, her willingness to share her entrance into Medicare with readers may make the process easier for the rest of us. Here are just a few of the issues Lieberman has written about thus far:
Sorting through Medicare information and choosing a plan: “Brochures and ‘lead cards’ for Medicare Advantage plans and Medigap policies began flooding my mailbox in January. This stuff can be a real burden, but some of it’s worthwhile – some even important – so you can’t just throw it all away...Hopefully, my sorting system (partly informed by decades of reporting on Medicare, partly by common sense) will make the task easier for you.
Choosing a Medigap Plan to fill in the gaps of Medicare coverage: “It quickly became clear that the push to give consumers more choices and more information has actually made the job of picking a Medigap plan much harder. I ended up having to check out multiple websites, brochures, handouts and make several toll-free calls for assistance.”
Finding a plan to cover the cost of prescription drugs: “I decided to ask my pharmacy about the retail cost of the drugs I currently take. I’ve always had great drug coverage, so it was shocking to learn that my prescriptions would cost $3,131 a year if I had to pay out-of-pocket. (Of course, from interviewing seniors over the years, I know some folks actually pay four or five times that amount.)”
We know how confusing and time consuming dealing with Medicare can be, so it’s helpful to know that many elder law attorneys specialize in helping seniors with this very process—we can help you too. Wednesday, May 04, 2011 What to Do When Mom Can No Longer Manage Her Own Money
One of the most difficult aspects of caring for an elderly parent (or helping an aging parent who lives far away) is keeping one step ahead when that parent begins to lose the ability to manage his or her own finances. Many seniors can be very resistant to discussing what they feel is an extremely private and sensitive topic. Furthermore, according to this article in AgingCare.com, “for many elders, being able to take care of their own finances is an important symbol of independence and self-worth,” and one that they are not likely to relinquish easily.
Unfortunately, an elderly parent’s ability to manage their own money may cease before they are willing to ask for help. In these cases, it may be up to their children and loved ones to step in and help as best they can. What follows is a list of some non-invasive, non-offensive steps adult children and caregivers can take to help aging parents manage their finances.
· Ask for a list of important people and information you might need in case of emergency. This list would include contact information for an attorney, financial advisor, primary care physician, and insurance agent.
· Ask where your parent keeps important documents and how an executor or advisor could access those documents upon your parent’s death or incapacity.
· If your parent is willing, discuss their estate plan with them, including who they have chosen as their agent or executor, and what you can do if something happens.
· Ask your parent to make a list of monthly bills, expenses and account numbers. Although your parent may not want to hand over this information right away, the list should be stored with other important estate planning documents so that it can be accessed in case of emergency.
· As you keep track of your own financial deadlines (tax filing deadlines and the like) set up reminders for your parent as well.
· Ask that your parent list you as an “emergency contact” with their utility services, this means that you would be informed if your parent’s service is in danger of being terminated.
· And finally, talk to your parent as often as you can. Keeping open lines of communication is the very best way to stay informed about the abilities and well-being of your aging parent. Friday, April 22, 2011 New Criteria for Alzheimer’s Can Lead to Early Diagnosis, Better Treatment and Planning
Alzheimer’s Disease is a devastating illness which affects families all over the country; from the adult child who fears that her father’s recent forgetfulness might be a harbinger of something more sinister, to the elderly gentleman who wonders how he will possible pay for the care his beloved wife requires.
Over the years, the treatment received by Alzheimer’s patients has depended in part on how the disease is diagnosed; and according to this article from a New York Times blog, “new criteria [for diagnosis], unveiled on Tuesday by the National Institute on Aging and the Alzheimer’s Association, will have consequences for family caregivers. Informed by research showing that changes in the brain may be under way a decade before any symptoms appear, the guidelines are likely to lead to increasingly early diagnoses.”
One of the most significant results of these new criteria is the establishment of three distinct stages of Alzheimer’s disease:
Pre-Clinical Dementia, wherein “There’s some biological or structural brain evidence that the Alzheimer’s process is under way, but the person’s not disabled and the family doesn’t notice any problem.”
Mild Cognitive Impairment, in which “someone has problems that don’t cause disability, but they’re evident enough that the patient and a family member or another observer agree, ‘Yes, it’s noticeable.’”
And finally, actual Dementia, which includes the signs and symptoms we all already associate with Alzheimer’s disease.
One of the most practical implications of these new criteria will be the early diagnosis—and thus the earlier treatment—of Alzheimer’s. The article mentions that these treatments are not yet curative, but there are medications that can help with the symptoms, and there is some evidence that “if you optimize the treatments for other diseases that make Alzheimer’s worse, like diabetes and heart disease, that increases the likelihood that Alzheimer’s will not accelerate.”
Perhaps of the most significance to elder law attorneys is the fact that early diagnosis can allow families to make the legal arrangements they need before the disease progresses to the point where it is too late. If the disease can be diagnosed in the Pre-Clinical stage, or even the stage of Mild Cognitive Impairment, the person receiving the diagnosis may have the time to consult with an attorney and put their affairs in order, helping to ensure that they—and their family—are provided for in the years ahead. Wednesday, April 06, 2011 The Benefits (And Risks) of a Multi-Generational Household
Throughout history, the multi-generational household has always had its place in our society. At times the multi-generational family has been common and plentiful, at other times rare and seen only on the fringes of society. In the past few years, for reasons of both economy and practicality, the percentage of Americans living in multi-generational households has been steadily rising. In fact, a recent article in the Wall Street Journal states that “In 2008, a record 49 million Americans, or 16.1% of the population, lived in households with at least two adult generations or a grandparent plus one other generation, according to the nonprofit Pew Research Center in Washington. That is up 17% from 2000.”
Although multi-generational living had fallen out of fashion in the decades prior to this, there are a number of reasons why inviting elderly parents to live with you can benefit the entire family. “By living together, families say they are better able to meet one another's needs for child and elder care. Moreover, money saved on rent can help finance a graduate degree, a job search or a down payment on a house, or offset the costs of long-term care.”
But setting up housekeeping with your parents (or your kids) isn’t as simple as merely moving furniture, often there are financial—or even legal—details to be worked out. Here are some of the things you should discuss before you build the “in-law extension” in your home:
Will the situation be permanent or temporary?Whether your kids are moving back in until they find that dream job, or your parents are coming to live with you until they find the right retirement community, it’s important to discuss these goals and practical steps that will be taken to reach them. “Those who prefer a temporary arrangement should work out an exit strategy—for example, by estimating how long it will take a person experiencing financial problems to regain his or her footing.”
Will the “new tenants” pay rent, or make any other contribution to household expenses?If so, it is absolutely imperative to work out a rental agreement before hand. Also, the “landlord” will need to ascertain whether the rent they collect should be reported to the IRS as income. “Some landlords simply aim to cover the extra expenses they incur. In that case, they owe no taxes on the payments they receive.”
If two generations are looking to purchase a new property together, there are completely different details to be considered.“When generations join forces to purchase or modify a property, each should retain an advisor to review the tax and estate-planning consequences and protect their investment in the event the union dissolves.” Additionally, “joint ownership can pose problems for those who may need to rely on Medicaid to cover future nursing-home costs.” It is a good idea to consult with an elder law attorney before signing any contracts. Wednesday, March 30, 2011 A Caregiver Agreement Provides Benefits for All
A recent article in the VOA News.com recently brought to our attention the fact that while many adult children are serving as caretakers for their aging parents, very few may be receiving monetary reimbursement for their time or trouble. Our firm is not surprised by this at all. Many children and grandchildren feel that helping their aging relative is a privilege, or perhaps a responsibility, and not something that they would ever dream of taking money for. What these families don’t realize is that creating a caretaking agreement between relatives is something that benefits both the caretaker and the elderly relative.
The reaction of David Fowler, the subject of the article mentioned above, when his brother suggested David get paid for caring for their mother, reflects the views of many adult children who have elderly parents to care for. "At first [I was] kind of uncomfortable with what he was talking about because… I don’t want to make a profit off of my mother," said David. "That’s just not in our way of thinking."
But a financial arrangement between a caretaker and elderly relative can actually be “a way to protect the older person. There may come a time when they have to go into a nursing home, have very little money left, and should qualify for Medicaid, the government’s medical assistance program for poor Americans.”
The catch is that this financial arrangement must be an official one. Any money given to a caretaker outside of the legal caretaker agreement could be construed as simply a gift. "The monies you paid to the family caregiver absent an agreement in writing will be deemed to have been gifted by you to the family caregiver... causing a period of delay wherein which you will not qualify for the Medicaid benefit." A caretaker agreement could easily prevent this disqualification or delay.
Although you may feel that you would gladly care for your mother or father for free, consider the benefits of a caregiver agreement and talk to your attorney about whether a contract of this kind could be useful to your family. Wednesday, March 09, 2011 A Way to Help Parents and Grandparents in Financial Need
Estate planning is often about how people can pass wealth on to their children or grandchildren, but what if a child wants to give financial gifts to a parent or grandparent? This article from Bloomberg discusses just that: how GRATs Let Children Pass Millions to Mom or Granny Free of U.S. Gift Taxes.
As the elderly population of the U.S. increases, and as the effects of the economic downturn hit, more and more adult children find that their parents or grandparents are not doing as well financially as they had hoped. Many need help paying for medical expenses, home care expenses, mortgage or rent payments, etc. Adult children would like to be able to help, and a properly executed GRAT can be the perfect vehicle for wealthy children to give financial aid to their parents or grandparents without taking away from their lifetime gift-tax exemptions.
“With a GRAT, a child sets up a trust with a term of at least two years and funds the trust with stock or other investments. The trust pays the principal plus interest back to the child over its term as if it were an annuity, based on an interest rate set by the Internal Revenue Service. Any appreciation of the underlying investments above this ‘hurdle’ rate passes on to the GRAT’s beneficiary, in this case the parents, without being considered a gift for tax purposes.”
However, this opportunity may not be around forever. The Obama administration has recommended imposing a 10 year minimum term on GRATs, an act which would make the GRAT strategy significantly less useful for many families. Adult children who would like to use a GRAT to pass wealth up to their parents or grandparents should consult with a financial or estate planning advisor sooner rather than later.
If you do miss out on the GRAT window, however, there are other options for helping elderly relatives, including paying medical expenses for the loved one (so long as payments are made to the service provider directly, rather than to the relative.) Contact our office for other options and more information about helping elderly parents and grandparents. Friday, February 11, 2011 Long-Term Care; Be Prepared in an Area of Uncertain Options
It’s flu season again, and the strain going around this year has been a difficult one, mainly because of how long it keeps its victims out of commission. So the article we recently found on Time.com about Long-Term Careseems particularly timely and relevant, if only because this year’s flu could be seen as an omen of what’s to come as Baby Boomers age into their golden years.
According to the article, “A huge wave of baby boomers may need long-term care in their golden years — and yet fewer than half have taken steps to prepare for it... two-thirds of Americans believe it's important to plan for long-term care, but only 44% have taken steps to protect themselves.” Part of the reason for this lack of preparedness is that Baby Boomers underestimate the likelihood that they’ll need long-term care, or they overestimate the likelihood that their children or families will be able (or willing) to provide that care.
But there’s another reason why Baby Boomers are statistically unprepared for the crisis of old age; to put it simply, there aren’t any clear avenues to solid and reliable financial preparedness. “While it's clear that not enough people are thinking about preparing for their long-term-care needs, it's not at all clear what, if any, the best solutions are.”
Some think that extra savings in the bank will cover the cost of long-term care; others believe that government programs such as Medicaid or Medicare will take care of them. Unfortunately, both of these beliefs are mistaken. “The average cost of a nursing home ranges from $85,000 to $120,000 a year, while hiring an aide to spend six hours a day on average in the home starts around $40,000 a year... Medicare, meanwhile, only covers up to 100 days of long-term care and often involves co-payments. Medicaid will cover long-term nursing-home care but only after the person has drained his or her savings account.”
The only other obvious solution is long-term care insurance; but even with long-term care insurance, nothing is clear cut, and too many people have found themselves paying into a policy and ending up with no return on their investment. This isn’t to say that long-term care insurance shouldn’t be an option, only that it’s one to be well-researched. Long-term care insurance is still one of the best options out there, but “There have been horror stories of people paying premiums on long-term-care insurance policies for years, only to find the benefits won't cover their needs 20 or 30 years down the road when health care and long-term-care costs are significantly higher.”
The best advice we can give is to do your research and ask for the help of an advisor with experience in elder law, elder care, and senior financial planning. Whatever you do, don’t throw the baby out with the bathwater—we may have no clear and easy answers yet, but that’s no excuse to remain completely unprepared. Wednesday, January 26, 2011 Knowledge and Communication is Key to Avoiding Family Fights
Do your adult children know which of them will be your power of attorney if something happens to you? Most people don’t want to think about Alzheimer’s, dementia, or getting old; and those who have thought about it often choose to keep their wishes secret, their documents held under lock and key until the time comes when they are needed. But according to a recent article in Reuters, one of the most critical steps a parent can take toward preventing sibling fights is to state early and openly which adult child is their choice for power of attorney.
“In order to avoid conflict, parents [should] sit down with their children and spell out who has been appointed and why... It’s something that really has to be thought out in advance, hopefully before a crisis has arisen and while the parent is still able to express their goals.”
Open communication can go a long way toward smoothing relationships between family members, but if that by itself isn’t enough to keep the fights to a minimum, the advice of a trusted advisor can often dispel suspicions that may be brewing just beneath the surface. But don’t wait until arguments have already exploded, the best course of action is to consult with your advisor before intervention is necessary. Asking your advisor to sit down with yourself and your family members gives each child a chance to ask questions and voice their concerns; it also gives them a chance to hear from your own lips what you’re planning and why you’re planning it. Wednesday, January 19, 2011 Making Plans for Aging at Home
There used to be very few options for seniors who began to have trouble living on their own. In many cases the only options available were to move in with family or move into a nursing home. Now, however, that doesn’t have to be the case. With new advancements in technology, the help of family and local aging services, and with some planning and forethought, many seniors will be able to live at home and on their own for many years. Here are a few things to consider right now if you want to age at home in the future:
Support System-Do you have family or friends nearby who can check on you regularly and help when home maintenance issues crop up? Having someone close to you who can provide you with transportation is helpful as well, although many cities have public transportation services that may be an option.
Home Renovations- Is your home senior or handicap friendly? Are doorways and hallways wide enough to accommodate a wheelchair? Could you easily add ramps or lifts in place of stairs, if necessary? Do your kitchen and bathrooms facilitate easy maneuverability with as little reaching or bending over as possible?
Security or Medical Alert System-Having a security or medical alert system in place can provide immeasurable comfort to an elderly homeowner and his or her family. The technology for this is improving by leaps and bounds, and there are a number of different options available.
In-Home Care Services- The length of time you can remain in your home can be greatly increased if you have the financial means for (and access to) quality in-home care services. Someone to do basic cleaning and cooking, and help with daily activities, can prolong your time spent at home... but you have to plan for it.
Getting older shouldn’t mean you have to give up your home, your friends and neighbors, or your independence. For more information about what you may need to stay in your home as you age check out the website for the National Aging In Place Council. Friday, December 10, 2010 Adult Children and Elderly Parents: Caring for Each Other
The idea of adult children caring for aging parents or grandparents is not a new one. In fact, with the aging Baby-Boomer population, adult children giving up free time or extra hours at work to care for relatives is a growing trend. But recently families have begun creating “caregiver compensation agreements,” something which can end up benefiting both parties in a number of ways.
According to a recent article in the Wall Street Journal, “the high unemployment rate, the rising cost of nursing-home care, an aging population, and a 2006 change in Medicaid law that makes it harder for people who wish to qualify to give away assets” are all contributing factors to the growing trend of these compensation agreements among family members.
How can it help you?
If you’re a caregiver the benefits of a caregiver compensation agreement are fairly self explanatory. “Some 37% of caregivers surveyed by the NAC in 2007 said they had quit a job or reduced their hours to accommodate their responsibilities,” some kind of compensation seems only fair. And if you feel uncomfortable taking “wages” from your parents, there are other ways to arrange for compensation. “Attorneys say many families pay an hourly wage. As an estate-planning tactic, others opt for annual gifts or a lump-sum payment designed to cover services over an extended period. Some arrange for the caregiver to receive a larger inheritance.” It will all depend on what works best for your family.
If you’re the one receiving the care, compensation agreements can benefit you as well. Paying a family caregiver can help you deplete your savings and qualify for Medicaid, it can also help you reduce your taxable estate, as well as give a gift of sorts to younger family members who may be in need. Remember that Medicaid rules vary from state to state, so enlist the help of your attorney before signing any contracts.
However you may decide to structure your compensation agreement, disclosure can be of the utmost importance. Make other family members aware of the agreement up front to avoid suspicion or hurt feelings later on. Wednesday, December 08, 2010 Talking to Siblings About Caring for Mom and Dad
Many modern families have members living all over the country—and all over the world. Which means that the holiday season provides one of the only times to all get together in person, celebrate, catch up... and talk about caregiving strategies for aging parents. Unfortunately, this kind of conversation can be a difficult one, especially if not all siblings agree about mom or dad’s needs, or if one sibling feels that he or she shoulders an unfair amount of responsibility. In spite of the difficulty, having the conversation can be of the utmost importance.
In this article in Time Magazine author Francine Russo describes the consequences that can follow when lines of communication break down. “It wasn't until my mom's funeral, watching my dad and sister cling to each other and weep, that I got a hint of their long ordeal — and how badly I'd screwed up.”
Russo makes the point in her article that much of the tension and disagreement among siblings can come from inaccurate or conflicting information. “Friction often stems from parents giving their children different information about how they're doing. Mom may put on a good show for the out-of-towner, who then discounts what the local sibling says.” This is all the more reason for siblings to communicate with each other, not just through mom or dad.
If you aren’t sure how to get the conversation started, Paula Spencer, senior editor for Caring.com wrote this article for Third Age which gives some helpful strategies on how to ease into the difficult topic of caring for aging parents this holiday season. Monday, November 29, 2010 Estate Planning Through the Ages
Can you remember what you were doing in your early 20s? Can you imagine what kind of life you’ll be living in your 70s or 80s? We experience incredible changes as the decades roll by—not just to ourselves, but in the world at large. With our lives changing so much, our estate planning documents and strategies should hardly remain static. Here is a guide to how your estate plan may or may not evolve through the decades.
In Your 20s:You’re young, just finishing school and starting in your career, unlikely to be married yet... the last thing you’re thinking about is estate planning! At this time of life, who gets your “stuff” may not be as important as who will make your decisions. Choosing your financial and healthcare agents and creating your power of attorney and healthcare directive are the important things to do at this time.
In Your 30s:Marriage, children, home ownership—most of these things happen in your 30s, and your estate plan should reflect that. Now is the time to choose guardians for your young children, decide with your spouse how your joint property will be distributed, and get serious about life insurance.
In Your 40s:This is when your strategy may switch from simple direction of inheritance to more serious asset protection. You’ve worked hard and saved, and you’ll want to think about the best way to maximize your assets with trusts and tax planning.
In Your 50s:As your children start to become independent you may have more freedom with your income. Some people choose to create charitable trusts, some prefer to invest for retirement, and still others decide it’s time to take a risk and start over with a second career. Your estate planner can advise and help with all of these.
In Your 60s:Ah retirement! Making the big change from work to retirement means making changes to your estate plan as well. If you’ve been keeping up with your planning through the decades all that is required now will be some basic maintenance; changes to account for marriages of your children, the birth of grandchildren, and your own relocation to someplace warm and sunny. But beyond the basic maintenance, you may want to start doing some simple Medicaid and long-term care planning—just in case.
In your 70s and Beyond: Health is the key word now. Our life-spans are getting longer, but so are our illnesses, you need to be ready. Tighten up your estate plan, invest in long-term care insurance, and although it may sound morbid, talk to your doctors and family about your end-of-life decisions.
The life alterations that come over a span of decades are difficult enough; you don’t want to have to find a new lawyer every time your circumstances change. Our firm makes it our business to keep up with you at every stage. Wednesday, November 03, 2010 Facing the Future with Long Term Care
November 2010 is Long Term Care Awareness Month, which means it’s the perfect time to talk about your thoughts, concerns, and plans for your own long term care. According to this article by Ken Dychtwald, PhD, “average life expectancy is now at 78 and rising. And, if you're already 55 or more, life expectancy has soared to around 84.” Furthermore, “Two-thirds of people over age 65 will need some kind of long term care.” This means that it can never be too early to start planning for your future.
Dychtwald points out in his article that “Uninsured medical expenses are the top financial worry among men and women age 55 and over. People... worry most about these expenses' unpredictability and potential for high costs.” People know that their health is likely to decline slowly as they age, and people know that they will need care—possibly a lot of it—that the cost of this care is rising steadily, and that they will need a way to pay for it. In spite of this, “many Americans are confused about what long term care actually is, and they're surprised to learn that Medicare and/or traditional health insurance do not cover most long term care needs.”
Life expectancy is rising, and the nature of “old age” is changing quickly. We live longer, but we don’t necessarily live better; and what we’re headed for is an entire generation of people who are unprepared for the rigors and expense of “the new” old-age. Luckily, this doesn’t have to be the case.
The article above suggests that “There are three core topics in family conversations about long term care: (1) what care options are most preferred (e.g. if you needed some help, would you prefer to be cared for at home, in an assisted living facility or in a nursing home?); (2) potential roles and responsibilities of different family members' (and possibly, help from a professional care coordinator, aid or nurse), should it ever be necessary to manage care; and (3) how to pay for any required long term care (with your or a family members' savings, through Medicaid or with a long term care insurance policy?).”
We urge our readers to talk about these issues with their loved ones. The conversations may be uncomfortable at first; but fear of the future—lack of preparation for the future—is far worse. Discuss long term care with your loved ones and your trusted advisors. Be ready for whatever the future may bring. Monday, November 01, 2010 The Quiet Devastation of Alzheimer’s Disease
According to a recent report put out by the Alzheimer’s Association, 5.3 million people have Alzheimer’s disease. Chances are that you or someone you know has been touched by this illness. In spite of these overwhelming statistics, Alzheimer’s continues to be a disease that sneaks up on individuals and their families, quietly tearing apart lives with uncertainty and confusion. Estate planners and elder law attorneys sometimes see this heartbreaking confusion in our own offices when elderly clients or their families come to us, concerned that a loved one no longer has the capacity to sign or make decisions about legal documents.
A new article in the New York Times discusses the slow and sometimes invisible development of Alzheimer’s disease, and some of the earliest warning signs that your loved one may be suffering. “New research shows that one of the first signs of impending dementia is an inability to understand money and credit, contracts and agreements.” This comes as particularly bad news to families who put off their estate planning year after year, each time telling themselves “We’ll do this next year for certain.”
By the time families come into our office with their suspicions about their aging loved one it may be too late for us to help. “Lawyers have guidelines, published in 2005, that include warning signs of diminished capacity, like memory loss and problems communicating and doing calculations. The guidelines instruct lawyers to look at the legal requirements for capacity in specific situations, like making a gift. But many questions remain.”
Plans created after the suspicion of Alzheimer’s or dementia has set in can be fraught with doubt, and often cause conflict among family members. We have seen the rifts and heartbreak the illness causes in even the strongest of families. We urge you to take care of important legal and estate planning issues early, before questions of competence can cast the shadow of doubt over your wishes. Friday, October 29, 2010 Just Say No? Medical Marijuana in Nursing Homes
The legalization of marijuana is on the ballot in California this November, but California isn’t the only part of the country where marijuana is making news. The use of marijuana for medical purposes is being debated around the nation—especially as concerns elderly patients in nursing homes which receive federal funding through Medicare or Medicaid.
This article on the New York Times’ New Old Age Blog reports on this issue, and just how concerned and confused nursing home facility administrators are about what their options are and how to proceed. “Any patient using medical marijuana breaks federal law. Marijuana is listed as a Schedule 1 drug, which means the federal government considers it to have no medicinal value. Despite this, physicians in 14 states and the District of Columbia are allowed to recommend it. . . Many facility administrators wonder how they can comply with federal law and preserve their reimbursements and at the same time permit residents to medicate with marijuana.”
Federal funding isn’t the only conflict attached to the medical marijuana issue. Nursing homes in New Mexico (a state where marijuana was legalized for medicinal purposes in 2007) report that “the lack of dosing direction has caused problems. . . Pills in nursing homes are in what they call vacuum packs: you have to pop a pill out one at a time. They don’t do that with marijuana. It’s an amount of marijuana in a small plastic bag, so there is no way to track if someone took one or two pinches.”
Another issue to consider is the stigma attached to marijuana use, and complaints from other patients or residents.
Medical marijuana is generally prescribed to seniors to help them deal with chronic pain. Oregon’s long-term care ombudsman, Mary Jaeger, asks in the article above “Wouldn’t any one of us, in our own homes, feel that we have the right to live our lives by our own values and choices, to preserve our own dignity and, frankly, to live pain-free?” Will seniors moving to federally supported nursing homes have to find other ways to deal with chronic pain? And more importantly... will they be willing to do so? Wednesday, October 20, 2010 Plan Ahead to Avoid Financial Pitfalls in 2011
A recent article in U.S. News and World Report points out that although “the Great Recession may technically be over... Consumers [still] don't want to spend and are still slowly digging their way out of the mountain of mortgage and personal debt that helped fuel the downturn.” Among those groups who are still struggling the most are seniors and retirees, many of whom took a devastating hit to their retirement investments and savings, and are still struggling to recover.
Unfortunately, according to the article, 2011 may bring with it some new financial concerns for seniors. Some of the “major money issues” seniors will have to think about in the coming year include a zero cost of living adjustment from the Social Security Administration, changes to certain Medicare policies, a rise in income and capital gains tax rates, and the return of the estate tax, among others.
Although the article itself offers no particular solutions to these financial concerns—it merely gives a warning of what’s to come—there are steps you can take to avoid some of the worst financial pitfalls. Because each individual situation will be different there is a danger to blindly following (or offering) standard advice across the board. However, with consultation and careful planning there are a number of strategies estate planners can recommend that may help your family protect your assets now, and when the estate tax returns. Forewarned is forearmed, and taking the time to consult with your estate or financial advisor and plan ahead may be the best action you can take. Wednesday, September 29, 2010 What “The Cost of Aging” Means Today
“The cost of aging” used to mean failing eyesight, bodily aches and pains, and maybe the loss of your teeth; but nowadays “the cost of aging” can mean the loss of your happy marriage!
With growing numbers of senior citizens being diagnosed with debilitating elderly illnesses, and with the cost of nursing care on the rise, more and more couples are finding that they simply can’t afford to pay for the numerous visits to the doctor, endless medical treatments, and rising cost of prescription medicines. Many seniors hope that Medicaid will help, but before you can get assistance from Medicaid you will have to spend down your own assets to almost nothing—this includes spending down any savings or retirement assets you may have.
If you are the spouse of someone diagnosed with an illness such as Alzheimer’s or dementia you can really get the short end of the stick. As this editorial in the New York Times points out, you can put all of your financial resources toward your spouse’s care, only to find that at the end of it all you “face a bleak retirement with neither [your spouse] nor your savings.” Some seniors are discovering a dismaying truth: that if they want to keep some kind of nest-egg for themselves, one of their only options is divorce and the separation of finances that comes with it.
This isn’t the first time the subject of divorce for financial reasons has come up. MSNBC dealt with the issue earlier this year with this segment on “Today”. But there is some good news amongst all this gloom and doom—poverty or divorce don’t have to be your only choices. If you start planning early, you can be prepared should something like this happen to you and your spouse. Long-term care insurance is one good preventative measure, or ask your estate planning attorney about other asset protection strategies you can employ.
Aging is hard enough without having to end a happy marriage (and feel like you’re abandoning a beloved spouse) to ensure your own financial future. Please call our office to find out what your options are. Monday, September 20, 2010 Help for Alzheimer’s Patients AND Their Caregivers
Shakespeare said that old age is a return to childhood; without teeth, without voice... and in the case of Alzheimer’s patients, without memories. But if the elderly have to endure the drawbacks of childhood, shouldn’t they get some of the benefits too?
The Family Caregiver Alliance must have thought so too, because a few times a year they sponsor a weekend sleepover in Alamo California called Camps for Caring. The program provides campers with an experience “of shared meals and stories, of activities creative and expressive, of exercise in the outdoors and of new friends and memories made over the weekend.” But the significance of the experience can go far beyond that.
According to a recent story about Camps for Caring on NPR, although “campers typically don't remember details of the retreat... the experience significantly lifts their mood.” In fact, “Post-camp surveys of family caregivers indicate that the ‘good feeling’ lingers, and it even can improve daily functioning.”
Beyond being a beneficial experience for the elderly attendees, Camps for Caring provides a much-needed break for overworked caregivers, who often attend to their elderly loved one around the clock, and can quickly find themselves dangerously close to the burnout breaking point.
Out of state residents may find it difficult to take advantage of the Camps for Caring program, but that doesn’t mean that caregivers or their elderly charges must leave themselves at the mercy of the effects of Alzheimer’s. In addition to information about Camps for Caring itself, the NPR article includes some tips from experts that can make dealing with Alzheimer’s easier on everyone. Or you can go to the Family Caregiver Alliance’s Family Care Navigator to find organizations and resources in your area. Friday, September 03, 2010 How to Help Your Elderly Parents When You Live Far Away
We write a lot on this blog about the concerns that caregiver children have for their elderly parents, but that’s only one side of the story. Many families also have an adult child living far from home, and though the concerns of the long-distance child may be different from the one who lives down the street, they’re no less important. Here are some of the more common concerns we hear about in our office, and some suggestions for addressing them:
I worry that when I talk to my parents on the phone I’m not getting the whole truth about their health or situation. This is one of the most common concerns of long-distance children. The best thing to do is be up front with your parents. Tell them that you want—and need—to know the truth, even if they think it will worry you. If you still don’t think they’re being completely honest, enlist the help of a sibling or nearby friend or neighbor who can be your eyes and ears. You can also ask your parents to sign a waiver with their doctor giving him or her permission to share their medical details with you.
I’m afraid that my mom is losing the ability to manage her money and could end up broke. Seniors are the most common victims of financial fraud, and it’s hard to keep tabs on mom or dad if you live far away. The best way to prevent financial fraud is to talk about money with your parents early and often. It may go against the grain, but discuss your own finances with them if it will help them open up about theirs. Visit as often as you can and watch their mail for letters from promotion companies or shady looking “charities”; and put your parent's phone number on the National Do Not Call registry (1.888.382.1222 or www.donotcall.gov)
I feel guilty that my sister (who lives in the same town as my parents) is shouldering the bulk of the burden. The sibling who lives closest does often end up being the physical caretaker of elderly parents, but that doesn’t mean those who live far away can’t help. The most common contribution from long-distance children is financial support—and that’s no small thing! Offer to pay for a housekeeper, in-home care assistant, taxi service, etc. And don’t forget to talk to your sister about what she needs. Helping your caregiver sibling is another way of helping your parents.
I love my parents; I want to do more to help than just give them money. A common complaint of seniors is loneliness and fear of being forgotten. One way to help your parent and help calm your own fears is to simply keep in touch. Make a point of calling your parent on a weekly or bi-weekly basis. Send frequent cards or e-mails. Plan a family vacation that your elderly parent can be a part of. You can help your parents with your expertise as well; try to be involved in “the big stuff” such as meetings with estate planners, financial planners, nursing staff, or geriatric care managers. And most importantly, work regular trips to visit your mom or dad into the budget. There’s really no substitute for face-to-face communication.
I think that my siblings close to mom and dad are making the wrong decisions for them, or are pressuring them to make decisions they don’t really want to make. Undue influence is a serious accusation, and if you truly think your siblings may be threatening or manipulating your parent you should seek the help of a professional. Before you take irreversible action you need to have a private conversation with your parent; ask if they are being coerced and try to determine if fear is a factor. If you still think your parent is being manipulated against their will contact an elder law attorney immediately.
I don’t want to miss out on what could be my last moments with my parent. There’s just no way around it, your parents won’t be here forever, and nobody wants to feel that there were things left unsaid. If you truly worry that your parent is facing his or her last days the best advice we can give is to go visit if at all possible, and make your visit matter. Look through old photos, talk about your memories, and say the things that need to be said. If you can’t visit in person make phone calls or send letters. Don’t save your best sentiments for the eulogy—tell your parents how important they are to you today. Friday, August 27, 2010 Caregiver Compensation Agreements Benefit Elders AND Caregivers
Caring for an aging relative is hard work. Many of the people who serve as caregivers admit that they often feel as if they have two jobs—their day job, and the part-to-full-time job of caregiver. If you consider that in our fast-paced society time is money, then most of these caregivers are not only giving up their time, but also their potential income. Caregivers need to know that it doesn’t have to be this way; caregivers can be compensated according to mutually agreed upon terms of a Caregiver Agreement, or Personal-Care Contract.
Elder law attorneys have known about Caregiver Agreements for a long time, but a recent article in the Wall Street Journal will hopefully raise caregiver awareness of this useful contract; especially, as the article mentions, given the “still-fragile” state of the economy. A Caregiver (or Employment) Agreement “should document a caregiver's responsibilities and hours and set a rate of pay that's in line with local practices. Both the caregiver and care recipient should sign the contract and disclose it to the rest of the family.”
An agreement of this sort can be useful not only for the care-giver and the cared-for; it also comes in handy if you think you may need to rely on Medicaid to cover nursing home costs sometime in the near future.
“Before Medicaid will pick up the tab for nursing-home costs, it requires applicants to recoup certain payments made to relatives over the previous five years -- and use the money to pay the nursing home... But if payments to relatives are made under the terms of a written employment agreement, often called a personal-care contract, the law allows it.”
But remember, “to pass muster with Medicaid, it's important to have such a contract in place before the services are rendered."
This is why it is extremely important to talk to an attorney who is well-versed in elder law and Caregiver Agreements before any contracts are signed or money changes hands. Wednesday, August 11, 2010 Will Long-Term Care Living Arrangements Prevent You from Leaving an Inheritance?
In our last post we wrote about what matters most when choosing a long-term care living situation, suggesting that it’s not always the place that matters most, but the mind-set of the elderly person who will be living there, and how involved that person is in the decision-making process. However, this does not mean that the quality of each living place doesn’t matter at all. In fact, according to the Wall Street Journal great care should still be taken when selecting a long-term care living situation... especially if you’re considering a Continuing Care Retirement Community (CCRC).
If you are considering a CCRC for yourself or an elderly loved one, you may want to read this article in the WSJ, which mentions that although more and more older Americans are drawn to the benefits offered by a Continuing Care Retirement Community, those benefits “often come at a steep price and ‘considerable risk.’"
The article goes on to mention that “So-called CCRCs—which typically offer fine dining, health clubs and on-site long-term care—have grown in popularity along with the aging of the population, particularly among the upper-middle class and affluent,” but that “the economic downturn is making it tougher for potential new residents to sell their existing homes and fill openings in new and expanded communities, which are generally regulated by state governments. As a result, low occupancy levels are challenging the industry's financial models.”
We mention this because many of our clients are at a time in their lives when they or their elderly parents are looking into long-term care living situations, and we see how difficult it is to sort through all the choices and find a place that fits. Not only is quality of life an important factor (maybe the most important factor), but for many people the cost of the place they choose may mean the difference between leaving their children an inheritance and dying penniless.
We urge any of our readers who are in the market for long-term care living arrangements to look carefully at all their options; ask questions, do the research, and don’t be afraid to ask for help or a second opinion. Monday, August 09, 2010 What Matters Most When Choosing a Long-Term Care Living Situation?
Elderly people and their families can spend months—sometimes years—looking for the perfect long-term care living arrangement. Most families try to avoid the nursing home option to the very end, believing that assisted living or small residential care homes provide a better quality of life. But is this fact or fiction?
Paula Span in her article on the NY Times New Old Age Blog suggests that “what variety of facility an older person lives in may matter less than we’ve assumed. And that the characteristics adult children look for when they begin the search aren’t necessarily what makes a difference to the people who move in.”
Span’s suggestion is based on (among other things) a recent study published in The Journal of Applied Gerontology, which found that among 150 Connecticut residents living in various long-term care situations (assisted living, nursing homes, residential care homes), the type of living situation itself made little difference in the resident’s emotional well-being. Rather, happiness and contentment was more a matter of “the characteristics of the specific environment they’re in, combined with their own personal characteristics — how healthy they feel they are, their age and marital status.”
Logically enough, a resident of a long-term care facility of any kind is more likely to report satisfaction and comfort if they had a hand in choosing their living situation, if they were part of the decision making process. In fact, it is the process itself—researching options, visiting facilities, considering current and future social and physical needs and how they will be met—that is the beginning of acclimatization.
Whatever your choice, you’ll want to know that you have options for paying for your long-term care living situation. Medicare.gov has published a chart summarizing and comparing the various options for long-term care financing. Or please feel free to contact our office for more information. Monday, August 02, 2010 The Next Step In Elderly Home Care
Many adult children of an aging parent get to a point in their parent’s care where they feel they have only two options: move their parent in with them so that they (or their spouse) can provide around-the-clock care, or move their parent into a nursing home. Reaching this point can be a very emotional time for both parent and child; with the parent feeling anger and frustration at the loss of independence, and the child feeling that they have somehow failed their parent.
Improving technology may never be able to remove the need for this decision entirely, but it may be able to postpone it a little. A recent article in the New York Times describes some new technologies that help adult children monitor their aging parent right inside the home, therefore removing the need (or at least delaying the need) for physical around-the-clock supervision.
One of the new technologies mentioned in the article (called GrandCare) “allows families to place movement sensors throughout a house. Information — about when doors were opened, what time a person got into and out of bed, whether there’s been any movement in a room for a certain time period — is sent out via e-mail, text message or voice mail.” It is this kind of in-home monitoring that may allow seniors to remain in their homes longer.
Some seniors have reservations about these new technologies, however, something that they consider to be an invasion of privacy. Nancy Schlossberg is quoted in the article as comparing these new technologies to nanny-cams, “Big Brother is watching you — there’s something about it that’s very offensive.” Some seniors may agree with her, but if it comes down to a choice between technological monitoring or moving to a nursing home they may find that “Big Brother” is the lesser of two evils. Wednesday, July 21, 2010 Falling Through the Cracks
Our country may be facing a simultaneous growth and recession... unfortunately, according to journalist John Leland, the two seem to be at odds. What we are referring to is the growth of the elderly population and the recession of funds available to help this aging community pay for the care they need.
The economic downturn of the past few years has hit the elderly with a double-whammy. Many of them lost close to all of their savings when the stock market bottomed out, and now budget cuts to state-funded home-care services threaten to force many of them out of their homes and into hospitals or nursing facilities.
“’I’m not getting a cost-of-living adjustment, and now I’m not getting food,’ said Joyce Plennert, 83, who is on a waiting list for Meals on Wheels in Palatine, Ill. ‘Now I’m worried my home services will be cut. Without that, I’d be in a nursing home, if I could find one with room.’”
According to the above-mentioned NY Times article, a number of states have already made cuts to home-care services, including Alabama, Arizona, California, Colorado, Florida, Kansas, Mississippi, Missouri, Nevada, New Jersey, New York and Texas. “The situation is grim, and it’s safe to say that present trends are expected to continue,”
These budget cuts impact more than just senior citizens—they affect the professional caregivers and home aides who lose their jobs when state programs are cancelled, as well as the families of the elderly. When these seniors lose their ability to live at home it’s their families who will have to pick up the slack either by contributing to the costs of care or more often by become the caregiver themselves.
If you or a loved one is facing a loss of benefits due to budget cuts don’t be afraid to explore your options. Geriatric care managers can help families through confusing times, and other advisors such as elder lawyers, estate planners, financial planners and others can offer invaluable advice when creating your plan for the future. Monday, July 12, 2010 How to Tell If Your Loved One Needs In-Home Care (And What to Do About It)
It’s not always easy to know—or to admit—that a loved one is unable to fully care for themselves anymore. The signs develop gradually, and aren’t always easy to pick up on if you see your loved one on a daily or weekly basis. Often it’s the son or daughter who has moved away and comes home for a visit who notices (what is to them) the “sudden decline” in mom or dad’s ability to perform the most basic of tasks.
If you suspect (but aren’t sure) that your loved one may need in-home care, there are a few signs you can look for to help you decide. The “Right at Home” website has an article listing ten signs that home care could benefit your loved one, and Responsive Home Health has a 3 page questionnaire to help you determine whether or not mom or dad is still just fine at home alone. The signs you’ll want to look for include:
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Inability to prepare own meals
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Frequent falls
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Inability to keep up with basic hygiene such as bathing and brushing teeth
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Depression
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Sudden isolation
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And more...
Once you know for certain that your loved one needs in-home care you’ll have to face the sometimes daunting task of finding (and figuring out how to pay for) the right service. A recent article in the Wall Street Journal provides some excellent information on how to find the right kind and level of care for your loved one. For example: does your parent need just a little bit of help with cooking and housekeeping, or is more comprehensive care (such as daily help with bathing, grooming, mobility and medication) necessary? The level of care your loved one needs, as well as what financial resources you have available, will help narrow down your choice of agency or aide.
Always remember, you don’t have to go through any of this alone. There are a number of dedicated professionals who can help you along the way—including our office. Don’t hesitate to contact us with any questions you may have. We’re here to help you. Friday, July 09, 2010 Is Medicare Headed for a Crisis?
If you are among the wave of Baby Boomers about to begin enrolling in Medicare you may be in for some tough times. Recent stories in Financial-Planning.com and USA Today report that the number of doctors refusing new Medicare patients is reaching a record high—and it’s not expected to improve anytime soon, especially since last month “Congress failed to stop an automatic 21% cut in payments that doctors already regard as too low.” Doctors simply feel they cannot afford to treat Medicare patients anymore.
Here are some of the distressing details you’ll find in the USA Today article:
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The American Academy of Family Physicians says 13% of respondents didn't participate in Medicare last year, up from 8% in 2008 and 6% in 2004.
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The American Osteopathic Association says 15% of its members don't participate in Medicare and 19% don't accept new Medicare patients. If the cut is not reversed, it says, the numbers will double.
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The American Medical Association says 17% of more than 9,000 doctors surveyed restrict the number of Medicare patients in their practice. Among primary care physicians, the rate is 31%.
What this means for seniors is that although you may be able to qualify for Medicare you may not necessarily be able to count on it. But you can take action to ensure that a crisis for Medicare doesn’t mean a crisis for you. Your financial advisor or estate planner can help you determine what options you have regarding long-term care, asset protection, and even using alternate strategies in conjunction with Medicare.
The days of being able to count on the government to take care of you in your old age may be coming to an end. It’s time to make your own luck and plan for your own future. Our office can help. Wednesday, June 30, 2010 Should A Bank Help You Care for Your Elderly Parents?
The influential Baby Boomer generation is aging, which means more and more of them are taking on the responsibility of caring for their elderly parents, and the Boomers are beginning to face up to the fact that they will need caregiving themselves in the not-so-distant future.
Large banks are not immune to this trend—and the potential to increase their client base by offering financial elder-care services. The question is, how effective can a bank be at helping you care for your elderly relatives?
According to this article in the Wall Street Journal banks can be helpful with certain financial issues such as helping to “sort out medical bills, hire in-home care or even manage the sale of a home.” Some of the larger banks are even beginning to offer more in-depth services such as “estate planning and setting up powers of attorney... crisis management (triggered, say, by a broken hip or a car accident); health and home assessments; Medicare-coverage selection and claims management; and evaluating retirement communities and long-term-care facilities.”
All of this sounds great, but before you get too excited our firm would like to caution you to be as careful about hiring a bank to do your estate or elder care planning as you would be with any other attorney or professional advisor. After all, as the WSJ article says, “banks and trust companies aren't doing this solely out of the goodness of their hearts. Providing extra services targeted at the elderly and their family caregivers can bump up the asset-management fees that clients pay each year. . . [or] persuade a few clients to move assets to an institution to meet its minimum deposit requirements.”
So we urge you, before you jump into anything—whether it be with a bank, an attorney, a CPA or other important advisor—do the research and ask all the questions you need to ask in order to find out whether this advisor truly knows their stuff; knows the ins and outs of the law and the care-giving industry; and most important of all, make sure the person or institution you hire will be working for you, will be your advocate and your ally during difficult and confusing times. Wednesday, June 23, 2010 Can You Really Afford Long-Term Care Insurance?
The American Association for Long-Term Care Insurance recently released a report on the costs of long-term care insurance, and the results were surprising. Most people mistakenly believe that long-term care insurance is going to be expensive and difficult; but in fact, according to the report, “over one-fourth [of buyers under the age of 61] paid less than $999-per-year.” And in fact, “fewer than one in 10 (9.3%) pay $3,500 or more.”
This is great news! This means that long-term care insurance could cost you less than $100 per month! The trick is that you have to think about it early. “Age at the time of application plays an important role in determining the cost for long-term care insurance the Association study reports. While 41.5 percent of buyers under age 61 pay between $500 and $1,499-per-year, only 20.8 percent of buyers who are ages 61-to-75 pay within this range.”
This is not to imply that if you’re over the age of 75 you’re out of luck. You’re not likely to get the same great rates as someone in their 50’s, but you still may not have to pay an arm and a leg for long-term care insurance. According to the report, of applicants aged 76 and older only 28.2% end up paying an annual premium of $4,000 a year or higher. Actually, almost half of applicants in this age range still end up paying less than $2,500 a year. This may not be the attractive $500/year you could have gotten in your 50’s, but it also isn’t the thousands of dollars a month most people seem to be afraid long-term care insurance is going to cost them. In fact, it’s only a little over $200/month.
If you’ve been thinking about long-term care insurance, don’t wait any longer. This is one situation where time is not on your side; the quicker you act the better it will be. Wednesday, June 09, 2010 World Elder Abuse Awareness Day is June 15
As we age we become vulnerable. We begin to doubt our memories, our bodies are not as reliable as they used to be, and technological advances outstrip our abilities to keep up with them. With this vulnerability comes the opportunity for abuse.
Unfortunately, elder abuse is becoming more and more common, both physically and financially. Seniors are a growing class of individuals with money in savings or retirement, and there is no shortage of scam artists looking to take advantage of them financially. The truly sad fact is that most financial elder abuse is committed by someone close to the victim, a person in whom they have placed their trust. In such cases, the abuse may not be pre-meditated, but that in no way makes the abuse acceptable.
The good news is that there are ways to guard against elder abuse; and one of the best ways to guard against it is to be aware of it. June 15th is World Elder Abuse Awareness Day, and we urge our readers to participate and find out how they can learn more about this issue.
To learn more about the warning signs and risk factors, and what you can do to help prevent elder abuse, click here. If you think that someone you know may be the victim of elder abuse, either physically or financially, you can help. The National Center on Elder Abuse has a help hotline, as well as a list of warning signs, and community outreach opportunities. Wednesday, June 02, 2010 How to Find the Perfect Senior Living Arrangement
When it comes to living arrangements, senior citizens have far more options available to them today than they ever have in the past: independent retirement communities, assisted independent communities, at-home assisted living, at-home nursing care, live-in nursing homes... the list can go on and on. Having all these options available is almost certain to make it easier to eventually find the right living arrangement, but it doesn’t necessarily mean the search itself will be easier. In fact, having so many options and facilities to consider can often make the search that much more confusing.
The search for the right living arrangement—either for yourself or for an aging family member—can be much easier if you know ahead of time the right questions to ask and the important things to look for. This article in U.S. News and World Report shares 9 things to look for in your search for an assisted living facility, including:
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Making sure the facility is licensed
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Ensuring the facility’s financial stability
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Getting referrals
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Making visits to assess the facility’s staff
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Asking what current residents have to say
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Considering whether it can meet not only your current but also your future needs
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Asking about payment options (including Medicaid)
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And more
Having so many different options these days means we can hope that finding the right senior living arrangement is a much more personal—and pleasurable—task than it has been in the past. Some of the best retirement communities or nursing homes have long waiting lists, so starting your search early will improve your chances of finding the place that’s right for you. But be careful, nursing home and assisted living contracts can contain surprises and should be carefully considered; or better yet, have an attorney look at the contract for you.
With the many choices now available there’s no reason not to have exactly the senior living situation you want and need. Monday, May 17, 2010 Stuck In The Middle: Caring For Aging Relatives
“Too rich for most government-funded social programs and not rich enough to pay for full-time, long-term care services.”
Does this sound familiar? It is exactly the kind of financial situation most elderly find themselves in today, and one which requires many adult children who are still raising their own kids to also care for their parents. That is the situation in which Michelle Singletary, Washington Post staff writer, finds herself in today. In her W.P. article Prepare now for a future that might include caring for your elderly family, she describes the feelings of frustration, admiration, and obligation that come with caring for her elderly father-in-law.
Singletary writes movingly about the realities of caring for an aging relative, but what she seems most determined to convey is that it is never too early to start thinking about what your own parents’ future holds. “If you have even an inkling that you may become the caregiver for an aging parent or relative, start planning for it now. Ask questions about the person's finances. Collect information from community and nonprofit organizations. Get your own finances in order because you'll probably have to pitch in financially.”
Part of planning for your aging parent or relative is thinking about Medicaid, Long-Term Care Insurance, and the best way to save and protect your assets. Call our firm and let us help you—and help your aging parents. Monday, April 26, 2010 A “Graying Trend” In Caregiving
What will you be doing when you’re 73? If you think you will have earned the right to have someone take care of you, think again; you may end up serving as a caregiver for someone else. A recent article in the New York Times describes a new trend in caregiving: the elderly are being cared for increasingly by the elderly. According to the article, “Professional caregivers — almost all of them women — are one of the fastest-growing segments of the American work force, and also one of the grayest.”
As odd as it may sound, the arrangement of 55-75 year olds caring for 85-100 year olds often works out beautifully. Older caregivers may not be able to do much heavy lifting, but what they are able to do is connect with their charges. Many older caregivers have already spent months or years caring for their parents or spouse, so they have an understanding of the fear, frustration and stress the families are going through. In addition, because older caregivers often share similar culture and experiences, the relationship can end up turning into a friendship, as with the case of Grace Jackson and Mary-Lou O’Neill:
“Grace Jackson, who is 101, said she never wanted a helper at home and resented Mary-Lou O’Neill, 73, when she arrived four years ago at Ms. Jackson’s daughters’ insistence. But as their relationship has grown, ‘It’s developed into a friendship,’ Ms. Jackson said, adding that friends who had younger aides were often offended by their manners or language.”
The down side to this “graying trend” in caregiving is that most of these elderly women—in spite of how they excel and make the best of their situation—become caregivers because they have to, they can’t afford to retire completely, even at the age of 70 or 75. The time to think about your own future is now. Talk to your advisors about planning for your own retirement; because although you may have everything it takes to be a wonderful caregiver in your senior years, the fact is that you may not want to. Monday, April 19, 2010 Help For Caregivers: 10 Steps Toward Taking Care of Yourself
The number of people serving as caregivers has exploded in recent years, and according to PR Newswire the number of caregivers now tops 65 million people (29% of the population of the US.) This includes people providing care for elderly adults, special needs children, young adults with disabilities, and more. These caregivers are people who offer their time, energy and financial support to ensure that their loved one—parent, child, sibling, grandparent—lives a life of joy and comfort. It is admirable and often selfless work... and it can take its toll on the caregiver.
Many caregivers are working so hard to take care of everyone around them that they forget to take care of themselves. Their health will often suffer, their financial security goes untended, and their own social interactions fall by the wayside. All of this can quickly lead to one thing: Caregiver Burnout.
Although we don’t hear much about it, Caregiver Burnout is a very real phenomenon. Described as similar to Post Traumatic Stress Syndrome, Cargiver Burnout can cause depression, withdrawal from society, self-neglect, erratic behavior, and at its worst—suicidal tendencies.
But there are ways to combat the onset of Caregiver Burnout. HelpGuide.org provides an entire section on how to recognize and prevent Caregiver Burnout, including tips for family caregivers and a list of some of the warning signs of Caregiver burnout. And that’s not all, this article in PR Newswire offers 10 steps caregivers can take to ensure they take care of themselves financially.
If you are the caregiver in your family it is essential that you (and your fellow family members) recognize the difficulty of the work you do. Be aware of your limits, respect them, and don’t be afraid to put yourself first. Caring for yourself isn’t the selfish thing to do; it’s the smart thing to do. Thursday, April 08, 2010 Will You Be Able To Afford Old Age?
Are you ready for the financial implications that come with growing older? As the average American lifespan grows longer the cost of aging becomes more and more prohibitive.
A recent segment on NBC’s The Today Show is takes a close look at long-term care and the price individuals and couples are required to pay as age related illnesses make it more and more difficult for senior citizens to live at home without care.
The show tells the story of “Roberta” and her husband, a couple married for 44 years, who felt there was no choice but to divorce after Roberta’s husband was diagnosed with dementia and the subsequent nursing home bills quickly depleted their assets. After paying no less than $75,000 in care costs, Roberta was advised by her attorney that one of the only ways to conserve her remaining assets for her own support would be to divorce her husband, allowing him to qualify for Medicaid coverage.
With growing numbers of senior citizens being diagnosed with debilitating elderly illnesses, and the cost of nursing care on the rise, more and more couples are finding that without some kind of long term care insurance they simply can’t afford the cost of aging. Medicaid can help, but as the story of Roberta and her husband shows, Medicaid doesn’t come without its own price.
Plan ahead for your own old age by talking to your advisors about Medicaid and your options for long-term care insurance. Friday, March 19, 2010 How to Choose the Right Nursing Home
A recent article in the New York Times calls choosing a nursing home for your loved one “one of the hardest [decisions] you will ever make;” and yet it is a decision that almost all of us will have to think about eventually (whether for a grandparent, parent, spouse, or for ourselves.) It is a decision that is made infinitely more difficult if you are forced to make it under pressure.
But choosing a nursing home doesn’t have to be the difficult and unpleasant decision we think it will be, not if you know what to look for, and have the time to really review all your options. Walecia Konrad, author of the article mentioned above, breaks the process down into four steps, and gives valuable advice on how to approach each individual step:
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Doing the research
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Visiting the homes
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Asking the right questions
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Consulting the experts
The home you eventually choose will be a very personal decision based on a number of factors; location, the preferences of your loved one and your family, health, and of course finances; but having all the right information—and confidence in your ability to evaluate that information—is a key part of making this very personal and very emotional decision. Monday, March 15, 2010 Protecting Your Parents, Protecting Yourself
Do you need long-term care insurance? You may think you’re too young to think about that quite yet, but what about your parents? If you’re reading this blog it’s likely that your parents are at an age where they soon may need some sort of care, whether that will be in-home care, nursing care, or even need to stay in a nursing facility; if your parents haven’t planned ahead for this eventuality, the burden for their care—either financial or physical or both—may fall on you.
It is for this very reason that a new trend in long-term care insurance seems to be emerging. According to this article by Stacy Schultz, there is an upswing in the purchase of long-term care insurance by the Boomer Generation—except the insurance isn’t for the Boomers themselves, it’s for their parents. “Many of them have just had a relative go through being in a nursing home, and they see the devastation and the stress it causes,” quotes the article. “They’re concerned about mom and dad, and if their parents don’t have a lot of means they want to buy insurance for them.”
If you are considering buying long-term care insurance, either for yourself or your parents, you have a number of options, especially compared to even just a few years ago. Forbes.com recently published an article outlining the improvements in long-term insurance, and what your options are if you’re buying it today.
Take an hour or two this month to talk to your parents (or your kids) and advisors about what the coming years have in store. You may not need long-term care insurance, but you will certainly need a plan, and it’s never a bad idea to know your options, especially when it comes to protecting your future. In the lives of many Boomers, protecting their own future also means protecting their parents’ futures. Friday, February 05, 2010 The Family That Plans Together Saves Together
According to the New York Times, “an estimated 38 million Americans provide care to an aging relative.” With numbers like this you would think this would be a frequent topic of conversation within families, but this is rarely the case. Unfortunately, because we tend to avoid the uncomfortable subject of our parents aging, most families are unprepared when mom or dad begins to need help (either physical or financial). But denial can’t stop the inevitable from happening; it only means that you and your siblings will be unprepared when the time does come to care for mom or dad.
What this article in the New York Times stresses is the importance of planning as a family. Parents may think that by keeping their troubles to themselves they’re saving their children stress and heartache, but evidence shows that sons and daughters do end up shouldering part of the burden—financially, physically and emotionally. It stands to reason that if they’re going to share responsibility, these responsible children should have some part in the planning process as well.
The Times article offers some suggestions on how to discuss the issue of aging with your parents and your siblings, and how to prepare for the future together, including how to:
Open the conversation with your parents and siblings
Assess financial conditions and options—including Medicare
Learn about care options and their costs
Don’t wait to have this conversation. As financial gerontologist Rosanne Roge is quoted as saying, “The most important thing is to recognize that it's likely that elders who live a long time are going to need some help... and you have to pay for it some of the time.” The best time to prepare is now.
Wednesday, February 03, 2010 The Question of Competence
One of the things estate planning attorneys have to deal with in their line of work (most often with elderly clients) is the question of whether or not a client is competent to sign their legal documents. Every principal (or person executing the documents) must be competent, and most attorneys—most people—can make this assessment based on observation, experience and instinct during the course of interaction; but every once in a while a situation arises that is not so clear, or a family member will express concern about the principal’s ability to understand and sign legal documents.
How can you tell if a person is competent? In her book Senior Moments author Jacqueline D. Byrd quotes law professor Peter Margulies’ six factors to determine capacity:
- Ability to articulate reasoning behind a decision
- Variability of the client’s state of mind
- Appreciation of the consequences of a decision
- Irreversibility of a decision
- Substantive fairness of a transaction
- Consistency with lifetime commitments
Byrd goes on to say that for the purposes of determining whether or not a person is competent to sign a will or trust, however, the requirements may be slightly different; more focused on whether or not the principal has a clear knowledge of his or her assets, has a full knowledge of the persons to whom the estate is being left, and is able to reasonably formulate and express a plan for the disposition of the estate.
The unfortunate truth about elderly illness is that competency in a person afflicted with the beginnings of Alzheimer’s or Dementia can often change from day to day or even hour to hour. If there will be any question at all about the competency of the principal the safest thing to do is to have mental examination performed by a doctor, and even perhaps include a video will. Of course the very best way to ensure mental competence is to create your estate plan early, before age or dementia becomes a factor.
Thursday, January 21, 2010 Where Can Seniors Find “Home Sweet Home”?
Where you live is a defining aspect of your character throughout your life. Your “hometown” often plays a large part in the formation of your character; as adults we decorate our homes to reflect our interests, hobbies and loves; and the neighborhoods in which we choose to raise our children (city, farm, suburb) tell us a lot about our underlying values and where we feel safe and secure.
The idea that where you live is an important part of who you are doesn’t diminish as you get older—in fact, the longer you’ve lived in a place the more it seems to become a part of who you are, and vice-versa—so it’s no wonder that seniors are as choosy about where they live as any of the rest of us. What follows are some of the options for senior living arrangements. What you and your loved one will choose will depend on health, finances, community support, and of course—your family.
Most seniors would prefer to stay in the home they’ve known and loved. A senior or retirement community may look perfectly nice to a son or daughter; but mom or dad may see the retirement community as a first step toward losing their independence and being forgotten. Many senior citizens can stay in their homes for quite some time so long as they have the support of family and community and perhaps the help of an in-home caregiver.
Another option for housing is a senior or retirement community. These are often independent communities which provide age-segregated living opportunities for seniors who are still active. They usually provide social activities, regular transportation around town, and some personal care or nursing services. These communities can be the perfect solution for a still active senior who is unable to drive anymore, but be very cautious when choosing a community; with no regulation or governing body the non-social services they provide can be suspect.
A nursing home is the most drastic option for senior living, and is usually reserved for chronically ill people who need medical care and regulation in addition to help with the most basic of daily tasks. The decision to use a nursing home is a difficult and emotional one, and should not be put off to the last minute. Not only because nursing homes are expensive, and require as much advance financial planning as possible, but also because finding the right nursing facility for your loved one can take time.
Whatever housing option you are looking for, don’t be afraid to ask for professional help or advice. A Geriatric Care Manager, Elder Care Support Services, or an Estate Planning or Elder Law Attorney can help your family make and implement this tough decision.
Wednesday, January 06, 2010 Who Cares About Medicare?
One of the main concerns of anybody who is retired or nearing retirement is how to pay for medical expenses. Research shows that a healthy 65 year old couple can expect to pay somewhere around $305,000 in out of pocket medical expenses during the course of their retirement—and that’s a healthy couple! With expenses like this staring them in the face, it’s no wonder senior citizens are concerned about Medicare.
For those who don’t know, Medicare is a government administered insurance program providing health insurance coverage to people aged 65 and older, or to disabled persons who meet certain qualifications. The Medicare program has many parts which variably cover hospital insurance, medical insurance, and more recently, some prescription drug costs. The Medicare program has proven to be a valuable resource for senior citizens since it was signed into law in 1965, but the program is far from perfect or comprehensive. This, plus recent developments with the health care reform bill have many people asking questions about the future of health care insurance for retirees.
To help answer these growing concerns about health care costs and the Medicare program, Time Magazine has published a special article about how to navigate the Medicare maze. One of the most valuable portions of this article is “When—and How—to Enroll in Medicare”, but the article discusses other important issues such as:
- Medicare’s Part A, B, D and More
- How Medigap Policies Can Help
- When to Buy Long-Term-Care Insurance
Still, the best way to assure that you are getting the right medical coverage for yourself or your spouse during your retirement is to talk to a professional. Federal and State sponsored health insurance programs offer necessary help and coverage—but they can be fraught with confusing procedures and enrollment difficulties. Your estate planning or elder law attorney will be able to help you with the process. Don’t wait until it’s too late.
Wednesday, December 16, 2009 Talking About Elder Care
Do you know who will take care of you when you are too elderly to take care of yourself? According to the statistics your caregiver is likely to be a woman, and most likely to be your daughter or daughter-in-law. What this means is that unless you have a plan for your future long term care, the financial burden of caring for you will fall to her and her family.
“Financial burden” refers not just to the expense of paying for food and medical costs, but to loss of income incurred over years of care-giving. “Women take time away from their careers to care for family members,” writes George I. Connolly, “and… lose an average of $659,130 over a lifetime in reduced salary and retirement benefits.”
Many people think that government programs will pick up what they can’t pay for themselves, but relying on government programs can leave your family footing just as much of the bill as they would without them. You may want to consider other alternatives as well, such as investing in long-term-care insurance. If you aren’t sure about your options, or how to start planning for the future, call our office for help.
If you are a daughter of aging parents, now is the time to talk to your parents about the future. Studies show that you are the one who is likely to shoulder the responsibility of caring for them as they age. Doing so will affect your family, your career, your finances, and even your health.
The subject of aging and elder care is a difficult one, but not one to be left to the last minute. Talk to your family about your wishes and plans for the future, then bring your estate planning attorney into the discussion. Once you have an idea of your wishes, an expert can help you feel better about your options, and put you on the right path for keeping your family healthy, happy, and financially secure in the years to come.
Wednesday, December 09, 2009 Portrait of A Caregiver
If you are a Caucasian woman, aged 35 or older, possibly married, definitely working at least part-time—then there is a good chance that you are now or will soon be serving as a caregiver for an aging parent or relative; at least, this is according to the new report released by the National Alliance for Caregiving, AARP, and MetLife.
The entire report, entitled “Caregiving in the U.S., A Focused Look at Those Caring for Someone Aged 50 or Older” is 73 pages long, but you needn’t read the entire thing to get an insider’s peek at the state of caregiving today. And the report isn’t limited to caring for an aging relative; it includes statistics on those caring for special needs children, as well as family members of any age.
Some of the more interesting statistics listed in the report are:
- 40% of Caregivers are aged 50-64.
- 63% of those receiving care are over the age of 75.
- 67% of Caregivers are women.
- 76% of Caregivers are Caucasian.
- 89% are caring for a relative (36% of the time it is the caregiver’s mother.)
- Over half of caregivers are employed while caregiving; and...
- Caregivers provide an average of 19 hours of caregiving per week (in addition to their regular employment.)
It is worthwhile to note that according to this study most of these caregivers are unpaid for the care they give, which makes sense if they are caring for a family member and are doing it voluntarily—but a full 43% said that they felt they did not have a choice to take on the role.
Our office can’t prevent you from one day needing a caregiver (or one day having to serve as a caregiver) but we can help you plan for when that day may come. Thinking and planning ahead can keep you—and your loved ones—from ending up in a situation where you feel you have no choice.
Monday, November 09, 2009 Don’t Take That IRA Withdrawal Yet! New Options for Seniors in 2009
If you are a senior 70 ½ or older who owns an IRA we have good news for you. Last year Congress approved legislation that waives the minimum withdrawal requirement for seniors in 2009.
This leaves seniors with more options than usual regarding their IRAs. You can still choose to take the withdrawal, of course; but deferring the withdrawal has the double benefit of allowing your investment to continue to grow within your IRA and lowering your taxable income for 2009.
If you were unaware of this legislation and you’ve already taken your withdrawal for 2009 you’re still in luck—the IRS is allowing seniors who have already taken the withdrawal to change their minds and roll their money back into a retirement account.
Of course, all of this good news doesn’t come without restrictions and exceptions, the first of which is that the deadline for the rollover is November 30th, or 60 days after you receive your withdrawal, whichever is later. Sandra Block explains all of the rules and restrictions—and goes into further detail regarding the benefits to seniors—in her article in USA Today.
The bottom line is that seniors with IRAs have more options this year than usual. You’ll want to explore those options with a trusted advisor and take advantage in whatever way you can.
Wednesday, November 04, 2009 The “Second Victims” of Alzheimer’s Disease
The “first victim” is the person who is actually diagnosed with Alzheimer’s disease; the person who finds their memory failing, their personality changing, their past and present fading into a sea of frightening and confusing fragments of recognition. But Alzheimer’s disease affects more than just its victims, it touches the lives of their families and friends as well… especially their spouses.
These are the “second victims”; the spouses and caregivers who find their own lives fading away as well as they sacrifice and struggle to do right by a person with whom they have spent many loving years, who recognizes them—and whom they recognize—with less and less frequency. These “second victims” can suffer from depression and health problems as well, often with tragic results. This article in the Wall Street Journal states that, “A 2006 study published in the New England Journal of Medicine found that spouses of people with dementia and psychiatric diseases were more likely to die themselves within a year of the afflicted spouse's death, compared with similar cases involving colon cancer, fractures or heart problems.”
The WSJ article details the diminished existence of “second victims”, and exposes the controversy around how some of them are choosing to protect their mental health and find companionship again. Although this is at heart a very personal issue, it touches on some legal issues as well:
How can you prepare financially for the full-time nursing care a late stage Alzheimer’s victim often needs? How does government assistance fit into the equation?
How can you ensure that you or your spouse have a loving and trustworthy conservator caring for you when you are unable to understand and make your own medical and financial decisions?
Is there a way to ensure that the wealth and assets you accumulated during your life together will pass to your children and grandchildren if your spouse chooses to one day remarry?
If someone you love is dealing with Alzheimer’s disease please don’t hesitate to let us help by taking the legal questions off your plate. Alzheimer’s disease creates enough loss and confusion without the added uncertainty that comes with these legal issues; and when you’re living day by day, every little bit helps.
Monday, October 19, 2009 The IRS Provides One More Reason to Consider Long-Term Care Insurance
In the estate planning business we help people plan for the future, not only for their children and heirs but for themselves as well; which is why we are pleased to share the news that it just got a little bit easier to plan for your own financial future, because according to this article on Emax Health the IRS has just approved higher tax deductions for long-term care insurance.
Advancements in health care and our standard of living mean that Americans are living longer than ever before, but that doesn’t mean they’re living better in their old age. Very few of us get to be healthy and hearty until our dying days; rather, most aging Americans will experience a slow decline in their mental and physical health, and require some kind of nursing care, either at home or in a nursing facility. Unfortunately, the cost of that care is prohibitively expensive, and once a patient’s own financial resources have been exhausted the burden then falls on their family, or they end up relying on government benefits.
Long-term care insurance is one way of planning ahead to pay for the nursing care that most of us will almost assuredly need. The higher tax deductions approved by the IRS offer one more reason to consider long-term care insurance: by planning for your future you can save on your taxes right now. But do your research and consult with a professional before you jump in, because the deductions are available only on “qualified” policies, and there are limits to how large a premium can be deducted depending on the age of the taxpayer at the end of the year.
Wednesday, October 14, 2009 Alzheimer’s Disease Can Take Your Memory AND Your Financial Security
Alzheimer’s disease affects as many as 5.3 million people in the United States; which means it affects as many as 5.3 million families, because Alzheimer’s is a disease that affects everybody it touches—husbands, wives, children and grandchildren—they all bear witness to their loved one’s slow demise.
Sadly, emotional stress is not the only stress that accompanies Alzheimer’s disease; those loved ones serving as caretakers may carry a huge amount of financial stress as well. According to this article by Denise Bonilla the cost of caring for an Alzheimer’s patient can run anywhere from $64 a day to $77,380 a year, and because Alzheimer’s disease can be such a long-lasting disease (a person can suffer from Alzheimer’s for up to 20 years) the costs of care can end up being astronomical. It’s obvious that people can’t do it alone.
Some of the options to help Alzheimer’s patients pay for medical expenses are long-term care insurance or Medicaid (Medicare doesn’t cover the cost of long-term care). Long-term care insurance can be very helpful… if you’ve thought ahead and purchased the policy before you or your spouse began suffering from symptoms of Alzheimer’s. As for the government programs, those also can be helpful… if you fall in the right category and know how to navigate the complex system.
Unfortunately, learning how to navigate the system is not something you can do in an hour or two. Because your experience will depend on a number of unique factors we can’t give you an easy set of instructions to follow. The best advice we can give is to say that right now, the best way to navigate the Medicaid/Medi-Cal system is to find someone who knows the system to assist you. Most estate planning and elder law attorneys help their clients with these issues on a regular basis. If you want to ensure that you and your loved ones will be cared for no matter what the future may bring, don’t be afraid to ask your attorney for help.
Friday, October 09, 2009 Guilty Verdict for Brooke Astor’s Son Brings Elder Abuse Issues to the Forefront
The recent verdict by a New York jury finding Anthony Marshall guilty of stealing from his aging mother Brooke Astor while she suffered from Alzheimer’s disease is a hopeful one for elder abuse experts. Elder abuse is an issue that is all too common in our society, but one that rarely gets much attention. And it isn’t only the very wealthy who fall victim to elder abuse. According to the National Center on Elder Abuse “between 1 and 2 million Americans age 65 or older have been injured, exploited, or otherwise mistreated by someone on whom they depended for care or protection.”
Financial abuse of elders in particular goes under-reported in our culture, mainly because it leaves no visible scars to tip off friends and family. It is disheartening to discover that in most cases of financial exploitation of elders the perpetrator is a family member, often the victim’s own son or daughter.
When mom or dad begins to show signs of dementia or Alzheimer’s disease, the child who lives closest is often the one who ends up serving as caretaker—both physically and financially; but that may not be the child best suited to the purpose, and it may not be the child mom or dad would have chosen had they been able. One way to prevent this from happening is to make your own decisions about who your physical and financial caretakers will be by executing a nomination of conservator, health care directive, and durable power of attorney. These three simple documents can allow you to choose the best person to care for you when you are unable to care for yourself.
Don’t let someone you know become a victim of elder abuse. If you suspect a situation of elder abuse please call your local elder abuse hotline for help. If you want to do everything you can to prevent getting into a situation of financial elder abuse yourself, call our office.
Monday, September 28, 2009 Geriatric Care Managers Provide Help for Families and Caregivers
Caring for elderly relatives is always a team effort. Sometimes the team consists of the entire family, sometimes the team is a man and wife, and sometimes the team consists solely of the elderly person and their primary caregiver; but no matter how you look at it, elder care is a complex, difficult, and expensive job, and one made 10 times easier if you have a knowledgeable and trustworthy expert on your team.
There are many knowledgeable elder care experts out there: doctors, lawyers, social workers; but few of them can straddle ALL of the elder care issues (medical, legal, residential, financial) to help you look at the big picture. A geriatric care manager is someone who can do just that—look at any given situation from all angles and advise your elder care team on the big picture. This article in the New York Times describes geriatric care managers as assessors, counselors, mediators… and sometimes someone to play “bad cop” in a tough situation.
Of course, because most insurance companies won’t yet pay for the services of a geriatric care manager, hiring one is going to be an extra expense; but it is the business of a GCM to know the ins and outs of the elder care system, and the money they save your family by helping you research experts and options, and avoiding bad situations can more than make up for the expense.
A geriatric care manager cannot replace a doctor or a lawyer on your elder care team, but they can help all of the team players work together effectively toward a common goal: ensuring that your loved one is well taken care of in the best situation possible.
Monday, September 21, 2009 What To Do When Your Kids Don’t Like Your Will
In an ideal world elderly parents and their adult children always get along, and when those parents pass away their children quietly and respectfully follow their wishes regarding the distribution of their estate. Unfortunately, we don’t always live in an ideal world, and inheritance and estate planning can often cause tension between parents and children before the parents have even reached retirement age!
What are your options when you know your kids won’t like what you’ve put in your will or trust? Many people choose to simply keep their wishes secreted away in a safety deposit box until they’ve passed away and then let everyone fight it out on their own; but this only puts off the bad feelings and can often cause lasting rifts among siblings. This strategy of secrecy also doesn’t address what happens if you become incapacitated and need one of your trustees or agents (in all likelihood one of your children) to take over your affairs.
A better option than secrecy is to invite your children to your final meeting with your estate planning attorney. This gives you an opportunity to share your plans in the presence of a knowledgeable professional who is on your side; it also gives your kids the chance to ask questions and get clear and immediate answers. More often than not tension about mom and dad’s estate plan stems from a lack of understanding, or a worry that mom or dad have been taken advantage of. Having a family meeting with your attorney can be reassuring, educational, and put everyone one the same page moving into the future.
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