Elder Law

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:

• Inability to prepare own meals
• Frequent falls
• Inability to keep up with basic hygiene such as bathing and brushing teeth
• Depression
• Sudden isolation
• 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:

• 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.
• 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.
• 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 15^th 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:

• Making sure the facility is licensed
• Ensuring the facility’s financial stability
• Getting referrals
• Making visits to assess the facility’s staff
• Asking what current residents have to say
• Considering whether it can meet not only your current but also your future needs
• Asking about payment options (including Medicaid)
• 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:

1. Doing the research
2. Visiting the homes
3. Asking the right questions
4. 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:

1. Ability to articulate reasoning behind a decision
2. Variability of the client’s state of mind
3. Appreciation of the consequences of a decision
4. Irreversibility of a decision
5. Substantive fairness of a transaction
6. 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 30^th, 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.