Answer:  If you are a professional who helps families plan for or deal with ANY of their elder care matters, then you owe it to yourself to be listed on America's #1 online source for "Elder Care Experts"….

ElderCareMatters.com

ElderCareMatters.com is where you will find more than 2,000 competent, caring elder care experts located across America, including:

• Elder Law Attorneys
• Estate Planning Advisors
• Financial Planners
• Investment Advisors
• Geriatric Care Managers
• Insurance Professionals
• Life Care Planners
• Professional Organizers
• Reverse Mortgage Lenders
• Senior Move Managers
• Senior Real Estate Professionals
•  Tax Advisors
• Aging in Place Professionals
• Daily Money Managers
• And other elder care experts with long and successful careers working with seniors and their families

This is also where you will find some of America's best:

• Assisted Living Communities
• Alzheimer's / Memory Care Communities
• Continuing Care Retirement Communities
• Home Care Agencies

Together, we provide families across America with:

• Unparalleled professional expertise
• Up-to-date elder care information & answers to your elder care questions
• Competent, caring assistance with a wide range of elder care services

So if you are a competent, caring elder care professional who helps families with ANY of their elder care matters, then request today an Application for Membership in the national ElderCare Matters Alliance and get listed on ElderCareMatters.com - America's #1 source for "Elder Care Experts" plus information and answers about a wide range of elder care matters.

Phillip G. Sanders, MBA, MSHA, CPA
Founder & CEO
ElderCare Matters, LLC
ElderCareMatters.com

Answer:  What a great idea!  Yes, we can make this happen.

In fact, I am pleased to announce that starting Monday, October 3rd, ElderCareMatters.com will "Feature" every week one of our 80 different elder care services.  For example, during one week we may showcase Elder Law or Geriatric Care Management or perhaps Elder Abuse Litigation Services.  And during this week, families are encouraged to send us their questions about this specific elder care service.  Then every day we will post an answer to one of your questions in the Question of the Day section of  ElderCareMatters.com, an answer provided by one of our Elder Care Experts who practices in this specific elder care service area.  Additionally, we will post during this week one or several original articles about this service, written by members of the national ElderCare Matters Alliance who practice in this specific service area.

And, yes, ElderCareMatters.com would be pleased to provide a link each week to ALL of our elder care experts, by state, who provide this "Featured" Elder Care Service. 

Thank you again for this great idea.

Phillip G. Sanders, MBA, MSHA, CPA
Founder & CEO, ElderCareMatters.com
1-877-379-4500

Answer:  It is my pleasure to provide you with the following list of the 87 different elder care services that are currently provided by the members of the national ElderCare Matters Alliance on ElderCareMatters.com:

1. Accounting Services
2. Adult Day Care
3. Advance Medical Directives
4. Aging in Place Services
5. Alzheimer's / Memory Care Communities
6. Annuities
7. Arbitration
8. Asset Protection Planning
9. Assisted Living Communities
10. Assisted Living Referral Services
11. Bankruptcy
12. Bill Paying
13. Budgeting
14. Caregiving Education
15. Companion Care
16. Conservatorship
17. Consumer Law
18. Continuing Care Retirement Communities
19. Cremation Services
20. Crisis Intervention
21. Daily Money Management
22. Dementia Care
23. Disability Income Insurance
24. Disability Planning
25. Elder Abuse Litigation Services
26. Elder Law
27. ElderCare Planning
28. Estate Administration
29. Estate Liquidation
30. Estate Planning
31. Family Law
32. Financial Planning
33. Funeral Services
34. Geriatric Care Management
35. Guardianship
36. Health Insurance
37. Hoarding Clean Up and Coaching Services
38. Home Care
39. Home Downsizing Services
40. Home Health Care
41. Home Modifications
42. Hospice Care
43. Independent Living Communities
44. Investment Services
45. Life Care Planning
46. Life Insurance
47. Litigation
48. Long Term Care Insurance
49. Long Term Care Planning
50. Medicaid Planning
51. Medical Services
52. Medical Alert Systems
53. Medical Claims Processing
54. Medical Equipment & Supplies
55. Medical Malpractice Litigation
56. Medicare Consulting
57. Medicare Supplemental Insurance
58. Medication Management Services
59. Moving Services
60. Nursing Homes
61. Personal Finance
62. Powers of Attorney
63. Probate
64. Professional Organizing
65. Public / Non-Profit Resources
66. Real Estate Services
67. Rehabilitation Services
68. Residential Psychiatric Care
69. Respite Care
70. Retirement Planning
71. Reverse Mortgages
72. Securities Arbitration & Litigation Services
73. Senior Housing
74. Senior Move Management
75. Senior Move Planning
76. Senior Relocation Services
77. Social Security Disability Services
78. Special Needs Planning
79. Tax Law
80. Tax Planning
81. Tax Preparation
82. Transportation Services
83. Trustee / Fiduciary Services
84. Trusts
85. VA Benefits
86. Wills
87. Wound Care

The goal of ElderCareMatters.com is to provide families across America with the help they need to plan for and deal with their elder care matters.  Let us know if there are other elder care services that you would like to have us list on ElderCareMatters.com – America's #1 source for Elder Care Experts plus information & answers about a wide range of elder care matters.

Phillip G. Sanders, MBA, MSHA, CPA
Founder & CEO, ElderCare Matters, LLC
ElderCareMatters.com
1-877-379-4500

Answer:  Thank you for your kind comments.  This is exactly what we at ElderCareMatters.com are trying to accomplish, i.e., to become a trusted resource to ALL families across America regarding elder care matters. 

We continually strive to make it easier for families such as yours to locate ElderCareMatters.com via ALL the major internet search engines, and we will continue to improve our search engines rankings for key words related to elder care matters.

In addition to our improved internet ranking, ElderCareMatters.com now has more than 1,600 professional members who provide 72 different elder care / senior care services to help families across America plan for and deal with their elder care matters. 

The # of professionals listed on ElderCareMatters.com is increasing daily; however, there are still many professionals across America who are not yet listed on this national elder care matters resource. 

If you know of elder care providers near YOU who are not yet on our list, encourage them to join the national ElderCare Matters Alliance and to be listed on ElderCareMatters.com - America's #1 source for Elder Care Experts plus information and answers about a wide range of elder care matters.

Thank you for your support of Elder Care Matters and for your help in increasing the # of professionals listed on ElderCareMatters.com - a resource to help families across America plan for and deal with their elder care matters.

Phillip G. Sanders, MBA, MSHA, CPA
Founder of ElderCareMatters.com
1-877-379-4500

Answer:  ElderCareMatters.com is an elder care resource to help families across America plan for and deal with their elder care matters.  With this goal in mind, we will continue to add more elder care-related services to ElderCareMatters.com in order to make this online elder care resource invaluable for families looking for help in planning for and/or dealing with their elder care matters.

Below are the 72 different elder care services currently listed on ElderCareMatters.com (with more services soon to be added): 

1. Adult Day Care
2. Advance Medical Directives
3. Aging in Place Services
4. Alzheimer's / Memory Care Communities
5. Annuities
6. Arbitration
7. Asset Protection Planning
8. Assisted Living Communities
9. Assisted Living Referral Services
10. Bankruptcy
11. Caregiving Education
12. Consumer Law
13. Continuing Care Retirement Communities
14. Crisis Intervention
15. Daily Money Management / Bill Paying
16. Dementia Care
17. Disability Income Insurance
18. Elder Abuse Litigation Services
19. Elder Law
20. ElderCare Planning / Long-Term Care Planning
21. Estate Administration
22. Estate Liquidation
23. Estate Planning
24. Financial Planning
25. Funeral Services
26. Geriatric Care Management
27. Guardianship / Conservatorship
28. Health Insurance
29. Hoarding Clean Up and Coaching Services
30. Home Care
31. Home Downsizing Services
32. Home Health Care
33. Home Modifications
34. Hospice Care
35. Independent Living Communities
36. Investment Services
37. Life Care Planning
38. Life Insurance
39. Litigation
40. Long-Term Care Insurance
41. Medicaid / Disability Planning
42. Medical / Healthcare
43. Medical Alert Systems
44. Medical Claims Processing
45. Medical Equipment & Supplies
46. Medicare Consulting
47. Medicare Supplemental Insurance
48. Medication Management Services
49. Moving / Relocation Services
50. Personal Finance / Accounting / Tax Preparation
51. Powers of Attorney
52. Probate
53. Professional Organizing
54. Public / Non-Profit Resources
55. Real Estate Services
56. Rehabilitation Services
57. Residential Psychiatric Care
58. Respite Care
59. Retirement Planning
60. Reverse Mortgages
61. Securities Arbitration & Litigation Services
62. Senior Move Management
63. Senior Move Planning
64. Social Security Disability Services
65. Special Needs Planning
66. Tax Law
67. Tax Planning
68. Transportation Services
69. Trustee / Fiduciary Services
70. Trusts
71. VA Benefits
72. Wills

If you need help with your family's elder care matters, you can count on ElderCareMatters.com to provide you with the experts, information & answers you need to plan for and deal with your elder care matters.

Phillip G. Sanders, MBA, MSHA, CPA
Founder & CEO of ElderCareMatters.com
1-877-379-4500

Answer:  Almost 1,600 professionals across America who help families plan for and/or deal with the issues of aging are now members of the national ElderCare Matters Alliance and listed on  ElderCareMatters.com - America's #1 source for Elder Care Experts plus information and answers about a wide range of elder care matters.

Listed on ElderCareMatters.com are professionals who provide a total of 69 different elder care services (and this # will continue to grow), including:

• Adult Day Care
• Aging in Place Services
• Assisted Living
• Daily Money Management / Bill Paying
• Elder Law
• Estate Planning
• Financial Planning
• Geriatric Care
• Home Care
• Life Care Planning
• Medical Equipment & Supplies
• Real Estate Services
• Senior Move Management
• Special Needs Planning
• VA Benefits
• Wills

The # of professionals listed on ElderCareMatters.com is increasing daily; however, there are still many professionals across America who are not yet listed on this national elder care matters resource. 

If you know of elder care providers near YOU who are not yet on our list, encourage them to join the national ElderCare Matters Alliance and to be listed on ElderCareMatters.com - America's #1 source for Elder Care Experts plus information and answers about a wide range of elder care matters.

Thank you for your support of Elder Care Matters and for your help in increasing the # of professionals listed on ElderCareMatters.com - a resource to help families across America plan for and deal with their elder care matters.

Phillip G. Sanders, MBA, MSHA, CPA
Founder of ElderCareMatters.com
1-877-379-4500

Answer:  Our commitment at ElderCare Matters is to provide families across America with elder care resources (Experts, Information & Answers) to help them plan for and deal with their elder care matters.  To this end, we have no set # of experts that we will showcase on ElderCareMatters.com but rather we are inviting ALL competent, caring elder care professionals across America to become a part of this phenonmenal elder care resource.

ElderCare Matters is where you will find 1,579 Elder Care Experts near YOU (and this # is growing daily) who have years of experience in helping families with elder care matters, including:

• Elder Law Attorneys
• Estate Planning Advisors
• Financial & Investment Advisors
• Geriatric Care Managers
• Insurance Professionals
• Reverse Mortgage Lenders
• Senior Move Managers
• Tax Advisors
• Daily Money Managers
• Other elder experts with long and successful careers working with seniors and their families

This is also where you will find some of America's best:

• Assisted Living Communities
• Alzheimer's / Memory Care Communities
• Continuing Care Retirement Communities
• Home Care Agencies

So if you help families plan for and/or deal with elder care matters and you are a competent, caring elder care professional, then you should be listed on ElderCareMatters.com – America's #1 source for Elder Care Experts plus information and answers about a wide range of elder care matters.

To request an Application for Membership to the national ElderCare Matters Alliance, send an email directly to: info@ElderCareMatters.com

Phillip G. Sanders, MBA, MSHA, CPA
Founder & CEO of ElderCare Matters
ElderCareMatters.com
1-877-379-4500

Answer:  The more resources (Experts, Information & Answers) families have available to help them with their elder care matters, the better decisions they will be able to make when planning for and dealing with these important elder care matters.

In fact, this Labor Day weekend, my family and I are dealing with Elder Care Matters with my in-laws because my Mother-in-Law has Alzheimer's Disease with a myriad of other health issues and my Father-in-Law finally made the decision early Sunday morning to admit her to a Skilled Nursing Facility.

My family and I found the help we needed (including finding the Elder Law Attorney whom my Father-in-Law hired from a small South Georgia town) through my contacts with the national ElderCare Matters Alliance, a national network of 1,576 Elder Care Experts who have "teamed up" on ElderCareMatters.com to provide families, such as ours, with the resources that they need to be able to make educated decisions about Elder Care Matters.

The purpose of ElderCareMatters.com is to provide ALL families across America with easy online access to ALL competent, caring Elder Care Experts in America, plus useful, up-to-date Elder Care Information, and answers to their Elder Care Questions.

Although ElderCareMatters.com currently has 1,576 professional members available to help families with their elder care matters, this is not enough. 

So in order to encourage ALL Elder Care Professionals across America to become a part of this online resource, we have decided that we will now offer 3 different Membership options, including a FREE Basic Membership option.

Now, there should be no excuse (including financially) why ALL competent, caring Elder Care Professionals across America should not be listed on  ElderCareMatters.com - America's #1 online source for Elder Care Experts plus information & answers about a wide range of elder care matters. 

To request an Application for any of our 3 different levels of Professional Membership (Basic, Premium or Lifetime) to the national ElderCare Matters Alliance, send an email directly to: info@ElderCareMatters.com.

Phillip G. Sanders, MBA, MSHA, CPA
Founder, ElderCareMatters.com
1-877-379-4500

Phillip G. Sanders, MBA, MSHA, CPA
Founder of ElderCareMatters.com
1-877-379-4500

This week's Featured Elder Care Expert on ElderCareMatters.com is Phillip G. Sanders, MBA, MSHA, CPA, Founder of  ElderCareMatters.com, America's #1 online source for Elder Care Experts plus information & answers about a wide range of elder care matters.

Every day this week (M-F), Mr. Sanders will answer one of your questions about this online elder care resource that helps families across America plan for and deal with their issues of aging.

One selected question along with Mr. Sanders' answer will be posted on the Featured  Elder Care Question of the Day section of ElderCareMatters.com.

So if you would like to ask the Founder of ElderCareMatters.com a question, just send a short email (a few sentences please) to: Questions@ElderCareMatters.com.

And remember to bookmark ElderCareMatters.com and check back often to see if your question is our Elder Care Question of the Day.

Answer:   Yes, there are planning steps you can take now.  First, check with your local agencies, such as the Area Council on Aging to find out what eldercare services are available in your area. You may find that there are adult day care centers that cost nothing or are very reasonably priced. Next, determine out what the cost of eldercare is in your community. These providers will include home health care agencies, nursing homes, and assisted living facilities. Prices vary, so survey the market carefully.

Involve your children and inform them of your wishes in the event you need custodial eldercare services, and write down your wishes. Name one of your children or friends that you trust as your eldercare coordinator. As an aside, it is always a good idea to consult with an attorney and have a durable power of attorney drafted, as well as a living will.

If you have assets available for possible eldercare expenses, you should designate those as being for that purpose. If you have existing life insurance or annuity policies, it may be possible to leverage those products by re-positioning them into products that can provide enhanced eldercare dollars in the event that you need them. Check with your financial advisor.

To find  competent, caring elder care professionals across America who are located near You and can help you with your elder care matters, go to: www.ElderCareMatters.com - A FREE online resource to find elder care experts plus elder care information & answers to your elder care questions.

Gregory D. Roberts, CFP, CLU, ChFC, CLTC, EA
Life Solutions
Aiken, South Carolina  29803
803-617-9805
Member of the national ElderCare Matters Alliance, South Carolina chapter 

Answer:   As far as the Veterans Administration is concerned, the home your father owns is considered his home whether or not he is currently living there and will not impact his eligibility for benefits.  One thing you and your family should be careful of, however, is renting the home.  If you rent the home and its classification switches from residential property to rental property, it may be considered an asset and cost your father his veteran’s benefits.

To find  competent, caring elder care professionals across America who are located near You and can help you with your elder care matters, go to: www.ElderCareMatters.com - A FREE online resource to find elder care experts plus elder care information & answers to your elder care questions.

Dennis B. Sullivan, Esq., LLM, CPA
Estate Planning & Asset Protection Law Center of Dennis Sullivan & Assoc.
Wellesley, Massachusetts  02482
781-237-2815
Member of the national ElderCare Matters Alliance, Massachusetts chapter 

Answer:  You should contact the local authorities immediately, report the theft, and ensure they understand that you’re fearful for your safety. In addition, I would terminate the services of your current caregiver and contact a local licensed home health agency.

To find  competent, caring elder care professionals across America who are located near You and can help you with your elder care matters, go to: www.ElderCareMatters.com - A FREE online resource to find elder care experts plus elder care information & answers to your elder care questions.

Bart Delsing, Owner & Chief Operating Officer
FirstLantic Healthcare, Inc.
Delray Beach, Florida  33445
561-243-7979
Member of the national ElderCare Matters Alliance, Florida chapter 

Answer:   This is a great question. Choosing the home health agency that is best-suited for your needs is essential, but the most important selection is the caregiver. Selecting a caregiver that understands the specific needs and dynamics of an Alzheimer’s patient is critical and will determine the success of a strong relationship between your parents. Here are the questions I suggest you ask: 

1. Is the home health agency licensed? If so, request a copy of their license. This will insure that the agency is operating under the regulations of the state.
2. How long has the agency been in business? It is best to choose a well-established agency. They generally  offer more experienced, trained caregivers.
3. Are the caregivers licensed, insured and supervised? You want an agency that has professional, general liability and workers compensation coverage. If the caregivers are going to drive your parents, you should inquire about non-owned auto insurance. If caregivers are transporting patients and utilizing their own vehicle, this is a must. If they’re going to use your parents’ auto, call your parents’ insurance carrier and inquire about adding them to coverage. Moreover, if driving is required, ask the agency if they run a DMV check on the caregiver.
4. Does the agency do an Assessment Visit? If so, is this done by a Registered Nurse and is there a cost ? This is another significant step in the process for a number of reasons. You might feel that your mother needs four hours per day, but after assessing her, the opinion of the licensed professional might be considerably different. A clinically trained expert can determine if other services are needed, e.g. physical therapy. In addition, a better understanding of the home surroundings will ensure a safer environment for your parents.
5. How often is the caregiver supervised and by whom? Look for a RN supervision answer here. If not, that’s a concern.
6. What type of background screening is required of the caregiver? You should focus on a criminal background, abuse registry and reference checks. For me, the criminal background and reference checks are the most important.
7. Can I/we interview the caregiver(s)? If so, is there a charge? Either way take advantage of it.
8. If we’re not satisfied with the current caregiver, what’s the agency policy on providing a replacement?
9. Does the agency have a minimum amount of hours that are required? Although this varies agency by agency, most require a four hour minimum.
10. What are the rates?
    1. Hourly
    2. Daily: This is typically a live-in case where the caregiver is present in the home for 24 hours per day. This practice varies agency by agency based on the availability of live-in caregivers.
    3. How often do they bill and are you required to pay in advance? If they request advanced payment, it is typically for two weeks.  See if you can pay this on a credit card. The credit card will offer some safeguard to you if you’re not happy with the agency and want to make a change. 

Another aspect of selection is whether or not your parents have Long Term Care insurance (LTC). If they do have coverage, here are some questions. 

1. What LTC carriers do they accept?
2. Do they accept Assignment of Benefits (AOB)? If so, this allows the agency to bill the LTC carrier directly.
3. Does the policy have an Elimination Period? If so, how long? If the policy does, which most do, you’re required to pay for services within the Elimination Policy. An Elimination Policy can range from 30 to as many as 120 days. 

I hope that I’ve given you a starting point for discussions with prospective home health agencies. I would shop  a minimum of three agencies and dig as much as possible.

To find  competent, caring elder care professionals across America who are located near You and can help you with your elder care matters, go to: www.ElderCareMatters.com - A FREE online resource to find elder care experts plus elder care information & answers to your elder care questions.

Bart Delsing, Owner & Chief Operating Officer
FirstLantic Healthcare, Inc.
Delray Beach, Florida  33445
561-243-7979
Member of the national ElderCare Matters Alliance, Florida chapter 

Answer:  Meeting the needs of your loved one from hundreds of miles away is no easy task. Increasingly, as the population ages, many families are finding themselves in similar situations. Professional geriatric care management specializes in the challenges associated with long distance care giving. This service is designed to ensure peace-of-mind when it is neither feasible nor realistic to be hands-on and act as a locally-based caregiver.  A professionally trained care manager specializes in caring for the aged, injured and disabled, and acts as a consultant and advocate for your loved one, ensuring the integrity of care you demand.  

For instance, at FirstLantic Healthcare, we conduct a thorough assessment of the client’s needs, evaluate his or her ability to function independently, review his or her physical, emotional, and social well-being, as well as financial viability and medical condition. We develop and discuss a plan of care, arrange for the appropriate services, and fully implement the plan, which can be as extensive or as minimal as the situation warrants. Services include:

-          Client advocacy

-          Comprehensive evaluations and assessments

-          Special needs trust and disability management

-          Crisis intervention

-          Supportive counseling

-          Medication management

-          Budget preparation

-          Attendance at appointments

-          Coordinating care and community services

-          Residential placement assistance

-          Guardianship monitoring and/or avoidance

-          Legal support through complementary documentations

Care managers are nurses or social workers, specialists that understand the intricacies of the healthcare system.  If and when you make the decision to hire a professional management company, be sure they deliver the right combination of service, professionalism and kindness. It makes all the difference in providing you a sense of security and alleviating the anxiety and concerns of taking care of your loved one in the best possible manner.

To find  competent, caring elder care professionals across America who are located near You and can help you with your elder care matters, go to: www.ElderCareMatters.com - A FREE online resource to find elder care experts plus elder care information & answers to your elder care questions.

Bart Delsing, Owner & Chief Operating Officer
FirstLantic Healthcare, Inc.
Delray Beach, Florida  33445
561-243-7979
Member of the national ElderCare Matters Alliance, Florida chapter 

Answer:  Ask the experts of the national ElderCare Matters Alliance, 1,500 of America's top elder care experts with years of experience in helping families plan for and deal with their elder care matters. 

Every day one of our elder care experts will answer your family's important questions about elder care matters – from legal, financial, housing, healthcare, etc.

If you would like to ask one of our Elder Care Experts a question about his/her areas of expertise, just send a short email (a few sentences only please) to: questions@ElderCareMatters.com.

Every day we will post one of your questions along with an answer provided by our Featured Elder Care Expert of the Week on the homepage of www.ElderCareMatters.com (which is currently visited by thousands of families each week).  Yours may be one of the questions posted.  Of course, we'll keep your question anonymous and generic so that every family may benefit.  Not to worry.

So bookmark www.ElderCareMatters.com and visit us daily as questions about a wide range of elder care matters are answered FREE of CHARGE by some of America’s top elder care professionals with years of experience helping families plan for and deal with the issues of aging.

Phillip G. Sanders, MBA, MSHA, CPA
Founder, ElderCare Matters
1-877-379-4500
www.ElderCareMatters.com

Answer:  Medication Therapy Management (MTM) is a process that reviews and evaluates how each senior is responding to their unique group of medications—prescription, non-prescriptions, over the counter and natural medications, supplements, vitamins, minerals…any item that is in use to improve health.  It also evaluates food intake, how the medications are taken or used.   

Families, caregivers and other loved ones also share their insights about how the senior is responding to the “medications”, as many of them are with the senior at various time of the day.  An action plan is developed to address these issues or concerns.  There are many things that the senior and/or their family can do to improve the benefits of the “medications” in use and to minimize the side effects or other problems.  Prescribers are also contacted for changes in medications orders, provided with information about the use of multiple medications and changes made in medication dosage, and frequency of dose. 

Having one person organize such reviews and provide information to other members of the healthcare team can be very successful in avoiding the “close calls” that cause seniors end up in the emergency room, admitted to the hospital or even subsequently moved to the nursing facility. 

Medication Therapy Management may also be known by another name…Comprehensive Medication Review (CMR) which is defined as a systematic process of collecting patient-specific information, assessing medication therapies to identify medication-related problems, developing a prioritized list of medication-related problems, and creating a plan to resolve them with the patient, caregiver and/or prescriber. A CMR is an interactive person-to-person consultation conducted between the patient and/or caregiver and the pharmacist and is designed to improve patients’ knowledge of their prescription, over-the-counter (OTC) medications, herbal therapies and dietary supplements, identify and address problems or concerns that patients may have, and empower patients to self-manage their medications and their health condition(s).  

I hope this helps…

To find other competent, caring elder care professionals across America who are located near You and can help you with your elder care matters, go to: www.ElderCareMatters.com - A FREE online resource to find elder care experts plus elder care information & answers to your elder care questions.

Lynn Harrelson, R.Ph., FASCP, Senior Care Pharmacist
8302 Cheshire Way
Louisville, Kentucky  40222
502-425-8642
Member of the national ElderCare Matters Alliance, Kentucky chapter 

William "Bill" Brown, Attorney at Law
2999 E. Dublin-Granville Road
Suite 217
Columbus, Ohio  43231
614-890-9099
Member of the national ElderCare Matters Alliance, Ohio chapter

This week's Featured Elder Care Expert is William "Bill" Brown, Attorney at Law, Member of the Ohio chapter of the national ElderCare Matters Alliance (a network of  almost 1,500 elder care experts).  Attorney Brown has practiced in the areas of probate, elder law, trusts and estate planning for over 50 years, and is the author of "Trusts" and "Estate Planning a Practical Guide".

Every day this week (M-F), Mr. Brown will answer one of your questions about his areas of expertise , and this selected question along with Mr. Brown's answer will be posted on the Featured Elder Care Question of the Day section of ElderCareMatters.com.

So if you would like to ask Attorney Brown a question about one of your elder care matters, just send a short email (a few sentences only please) to: questions@ElderCareMatters. com.  

And remember to bookmark ElderCareMatters.com and check back often to see if your question is our Featured Elder Care Question of the Day.

Answer:  This is a tough and not uncommon situation.  Your parents may be “in denial” about their situation or they may be perfectly aware but fatalistic – that is, “we can’t do anything about our situation so we might as well live our lives and the kids will take care of us when the time comes.”  Of course, they may truly not understand the consequences.  You don’t mention whether this is new behavior or if your parents have always lived beyond their means.  Reading between the lines, I’m guessing that this is more “business as usual” than not since your parents don’t own their home, have a “small” retirement account despite your father’s profession, and seem to be carrying a credit card balance.  If that’s the case, the situation is especially tricky, because their “system” has worked for them up to now and they may simply assume that will continue.  If, on the other hand, this is new behavior, it may be an indication of cognitive decline and the best place to start may be to take each of them for a thorough medical check-up. 

One way to begin to address this is for you and your sister to sit down with your parents and have a discussion about where and how they would like to age and the resources they have available to them to facilitate that plan so that the two of you can be sure that you know their wishes and can try to follow them.  After having that general discussion, I’d suggest that your transition the discussion into allowing the two of you to document what they have and where it is “just in case something happens to them suddenly” and you have to step in to their shoes.  As a part of this process, you should eventually be able to identify their income, expenses, assets and liabilities.  The next step would be to forecast a couple of scenarios and show them what will happen if……  In other words, if nothing changes, they will run out of money in X years.  Or, if one of them needs care, they will run out of money in Y years.  Perhaps you can then use this as a starting point for discussion of some changes they can make in their spending habits.  I call this process developing a family transition plan.   I have an outline of all of the items that should be included in this “family transition plan” and if you email me using the contact information provided I will be happy to provide it to you.  In general, the more dispassionate and non-judgmental you can be, the better the discussion will go.  I find when I’m working with families like yours that working through “the math” is often the best way to change behavior. 

To find competent elder care professionals who are located near You and can help you with this type of elder care matter, go to: www.ElderCareMatters.com - A FREE online resource to find elder care experts plus elder care information & answers to your elder care questions.

Sheri Samotin, President
LifeBridge Solutions, LLC
Naples, Florida  34108
239-325-1880
Member of the ElderCare Matters Alliance, Florida chapter

Answer:  It depends what you mean by “respite care.”  If you mean this in the most general way, that is, finding an alternative source of supervision and assistance for your loved one while you are at work, then you can certainly do that on a regular scheduled basis.  You might arrange for a caregiver to come in to your home, or you might find an adult day center in your area.   Many adult day centers will provide transportation between the client’s home and the center, and they typically provide one or more meals each day.  In both of these cases, the client or family will need to pay for these services as they are not covered by Medicare.  If the client has long term care insurance, these services are typically covered expenses under the terms or the policy.  Some adult day centers offer a sliding scale payment structure or are subsidized by local or state governments.   In some states, clients who are covered by Medicaid are also eligible for services in the community on a regularly scheduled basis as part of a “diversion” or “waiver” program where the goal is to keep these individuals out of nursing homes which are generally more costly.  However, since Medicaid is a state run program, you need to become familiar with what is available in your state.

To find competent elder care professionals who are located near You and can help you with this type of elder care matter, go to: www.ElderCareMatters.com - A FREE online resource to find elder care experts plus elder care information & answers to your elder care questions.

Sheri Samotin, President
LifeBridge Solutions, LLC
Naples, Florida  34108
239-325-1880
Member of the ElderCare Matters Alliance, Florida chapter

Answer:  This type of question comes up frequently and the answer depends upon the details of the Power of Attorney document that your mother signed back when she had capacity.  Each state has its own standards with regard to the construction of durable power of attorney rights, but even within that variation, it depends upon what the lawyer who drafted the agreement did or did not include.  If your family was my client, I would advise your brother that it is always best for the person who is serving as POA to be as transparent as possible in performing his duties, but in the end of the day, it is up to that person (the POA) to manage your mother’s affairs in accordance with the POA document and his best judgment.  While you can’t “force” your brother (the POA) to include you and your sibling in decision-making regarding your mother’s affairs, you can request that he does so.  Perhaps you can suggest that the three of you hold a family meeting (either in person or by phone) to discuss things.  If you are concerned that the POA will refuse or that the conversation might quickly become unpleasant, you might want to suggest that the POA engage an objective third party to facilitate the meeting.  This person’s fees would be paid for either from your mother’s funds or equally by the three of you.  The third party could be the attorney who drafted the original agreement, another attorney, a family transition coach, or any other neutral party with skill and experience in such situations.

To find competent elder care professionals who are located near You and can help you with this type of elder care matter, go to: www.ElderCareMatters.com - A FREE online source to find elder care experts plus information & answers about a wide range of elder care matters.

Sheri Samotin, President
LifeBridge Solutions, LLC
Naples, Florida  34108
239-325-1880
Member of the ElderCare Matters Alliance, Florida chapter

Answer:  The truth is that acknowledging that you need help with the business of life is really, really hard for most seniors.  If they come to the point where they need your help, they are confronted with their own limitations.  And those limitations won’t “get better” in most cases.  Deep down, your mom and dad know that this is the beginning of the end of their independence as they have come to know it. 

Here are some tips on how to take charge without taking over.

1. If possible, do the tasks alongside your mom and dad rather than doing it for them.  While this approach might take longer than doing it yourself, you allow them to retain some self-esteem by letting them take the lead.
2. Let your mom and dad tell you what aspects of a particular activity they needs your help with, and if possible, try to limit your assistance to just those things, at least for now.  Of course, if your mom and dad don’t have a realistic picture of what they can do for themselves, you will need to gently find a way to help them see your perspective.
3. Be respectful, and ask permission before you just jump in.  For example, when you take your parents to a doctor’s appointment, don’t just assume that they want you to come into the examining room with them.  Instead, ask them if they’d like you to be there the whole time, or if perhaps you can just be called in toward the end of the visit to make sure that YOUR questions are answered.
4. Set up invisible safety nets.  For example, if you come every Sunday and set up your mom’s medications in a weekly medication management system, you can have some expectation that she will take the correct medications at the right time.  But it wouldn’t hurt to also have a way of checking that once or twice during the week.  This might take the form of a medication management visit by a home care company or trusted friend or relative or perhaps daily medication reminder phone calls from you.
5. Make a distinction between safety and everything else.  When your mom or dad’s safety is on the line, you might just have to take charge by taking over.  On the other hand, if you’d just prefer that something be done a certain way or at a certain time, there might be an opportunity to loosen the grip a bit.

Sometimes, no matter how you approach the situation, you’ll find yourself in a confrontation with your mom or dad over how to best care for them.  At these times, you and your parent might find it helpful to talk with an objective third party such as a family transition coach who can shed new light on the situation.  Your job as your parent’s caregiver is to keep them safe, comfortable, and happy.  As long as you keep that in perspective you should have no trouble taking charge without taking over.

To locate competent elder care professionals who are located near You and can help you with this type of elder care matter, go to: www.ElderCareMatters.com - A FREE online source to find elder care experts plus information & answers about a wide range of elder care matters.

Sheri Samotin, President
LifeBridge Solutions, LLC
Naples, Florida  34108
239-325-1880
Member of the ElderCare Matters Alliance, Florida chapter

Answer:  This will depend on laws of the state in which your mother resides.  However,  a doctor's report will be needed to show that your mother is incapable of managing her own affairs.

To locate competent elder care professionals who are located near You and can help you with this type of elder care matter, go to: www.ElderCareMatters.com - A FREE online source to find elder care experts plus information & answers about a wide range of elder care matters.

John E. Settle, Jr., Esq.
John E. Settle, Jr., Attorney at Law 
Bossier City, Louisiana  71111
318-742-5513
Member of the ElderCare Matters Alliance, Louisiana chapter

Answer:  I would NOT risk losing Medicaid over this car. I suggest buying the car for a nominal price.

To locate competent elder care professionals who are located near You and can help you with this type of elder care matter, go to: www.ElderCareMatters.com - A FREE online source to find elder care experts plus information & answers about a wide range of elder care matters.

John E. Settle, Jr., Esq.
John E. Settle, Jr., Attorney at Law 
Bossier City, Louisiana  71111
318-742-5513
Member of the ElderCare Matters Alliance, Louisiana chapter

John E. Settle, Jr., Attorney at Law

John E. Settle, Jr., Esq.
1915 Citizens Bank Drive    
Bossier City, LA 71111
Telephone: 318-742-5513
e-mail:   Send E-Mail
website: http://www.SettleLawFirm.com

This week's Featured Elder Care Expert is John E. Settle, Jr., Attorney at Law, Member of the Louisiana chapter of the national ElderCare Matters Alliance (a network of 1,450+ elder care experts) and Founder of the Law Office of John E. Settle, Jr., a law firm in Bossier City, Louisiana, a firm that specializes in Elder Law, Estate Planning, Elder Abuse Litigation and closely related practice areas. 

Every day this week (M-F), Mr. Settle will answer one of your questions about his areas of expertise (Elder Law, Estate Planning, Elder Abuse, Probate, etc), and this selected question along with Mr. Settle 's answer will be posted on the Featured Elder Care Question of the Day section of ElderCareMatters.com.

So if you would like to ask Mr. Settle a question about one of your elder care matters, just send a short email (a few sentences only please) to: questions@ElderCareMatters. com.  And remember to bookmark ElderCareMatters.com and check back often to see if your question is our Featured Elder Care Question of the Day.

Question:  I recently relocated my elderly mom from New York to Virginia. She is living in an assisted living facility by me. She still has her home in NY where two apartment rents help to pay for her assisted living room rent, prescriptions, incontinence care, etc. The rest of her care fees come out of her savings. Is her assisted living rent deductible on her tax return?

Answer:  Although I am not a CPA, my understanding is that the IRS may allow her to deduct the cost of assisted living rent as a medical expense if your mother needs assistance due to a chronic illness.  IRS publication 502 defines chronically ill as being unable to perform 2 or more activities of daily living without substantial assistance or if the person needs substantial supervision due to a cognitive impairment.  From what you described, it appears as though she would be able to deduct her assisted living costs as a medical expense. However, her total medical expenses must exceed 7.5% of her adjusted gross income in order to be deductable. 

I would recommend that you keep all receipts from the assisted living community, as well as receipts for all other medical expenses that your mother incurs during the year.  Then talk with your tax preparer to make sure that you take advantage of all the available deductions.

To locate competent elder care professionals who are located near You and can help you with this type of elder care matter, go to: www.ElderCareMatters.com - A FREE online source to find elder care experts plus information & answers about a wide range of elder care matters.

Angela N. Manz, Attorney at Law
The Law Firm of Angela N. Manz
Virginia Beach, VA  23452
757-271-6275
Member of the ElderCare Matters Alliance, Virginia chapter

Answer:  Generally, a POA or Health Care Proxy does not necessarily need to be redone simply because your mother moved to another state.  However, I recommend that you have them reviewed by an elder law attorney who practices in Georgia to make sure that they comply with Georgia law and to make sure that they have all of the necessary powers needed to make decisions for your mother.  For instance, if Georgia law requires that the health care proxy be notarized and New York does not, then you may need a new one prepared or it won’t be accepted.  Or if your mother’s POA does not have certain powers which may be necessary for asset protection planning, then you may want to have a new one prepared. If the attorney in Georgia does recommend that your mother sign new documents, he or she should also tell you the specific reasons why that recommendation was made. 

To locate competent elder law attorneys who are located near You and can help you with this type of elder care matter, go to: www.ElderCareMatters.com - A FREE online source to find elder care experts plus information & answers about a wide range of elder care matters.

Angela N. Manz, Attorney at Law
The Law Firm of Angela N. Manz
Virginia Beach, VA  23452
757-271-6275
Member of the ElderCare Matters Alliance, Virginia chapter

Answer:  I just met with a son and his mother to review the change she has experienced with the ability to care for herself. It was a great meeting in that his mother expressed to me where her concerns were and the son expressed his concerns. Together we came up with a plan to help with meals, assistance with her bath, some brain fitness activities and a weekly jaunt to the local pool! She wants to stay at home as long as possible and needs more support to stay safe. 

What you are experiencing with your mother is at the heart of what Professional Geriatric Care Managers do. We evaluate the status of the elder, listen to their needs and coordinate a plan of care for them with the support and understanding of the family. 

A good first step would be to call a Geriatric Care Manager for an initial evaluation of your mother ideally with her support and approval.

To locate competent geriatric care managers who are located near YOU and can help you with these types of elder care matters, go to: www.ElderCareMatters.com - A FREE online source to find elder care experts plus information & answers about a wide range of elder care matters.

Amy Cameron O'Rourke, MPH, CMC
The Cameron Group
Orlando, Florida  32803
1-888-896-2010
Member of the ElderCare Matters Alliance, Florida chapter

Answer:  We educate, evaluate, navigate, advocate–

We are very good at preventing complicated crisis that can create an unnecessary decline in function for the elder. So many older adults want to stay in their home and with various levels of support this is achievable. In fact, many older adults do well with “Assisted Living at Home”-which is what the Care Manager creates with the family and the elder as part of the team. 

If the finances do not allow the elder to remain at home with health care, the Care Manager can help select a community for the elder and teach the family how to secure the best and most appropriate services within the facility. We can also file for appropriate benefits that will assist in paying for that care. 

We teach families how to “navigate” the health care system—It is widely believed that the health care system is fragmented-hospital care, nursing home care, assisted living care, home care—so many systems to understand and effectively navigate. We help select facilities and then help the family work within the system for the benefit of their loved one. An important component is what services are covered by Medicare and what services become the responsibility of the parent. 

Some families can’t agree on what to do for their parent. Care Managers provide an objective view and help the families come to an agreement on a plan of care. 

Some families simply don’t know what to do and need advice, guidance and direction throughout this stage of their parent’s life. 

It’s hard to put this into words, but there is frequently a level of anxiety that is present in a child with an aging parent. There are so many unknowns, and uncertainty in helping the parent.  We are able to help lower anxiety by providing helpful information and resources that make this a meaningful time for both the child and the parent. 

There is more—Let me list other services Care Managers offer: 

• Accompany on Dr. appointments providing the physician a written summary of the status of the elder;
• Help ensure compliance with Drs. Orders (Changes in medication, labs needed etc.);
• Communicate with family members after a Drs. Appointment;
• Make appropriate Drs. Appointments-streamline appts for the elder;
• Securing services at home when requested or desired-physician care, lab, x-ray, podiatry-;
• Prevent hospitalizations-frequent hospitalizations can often be caused by poor nutrition, hydration, non compliance with medications, falls—all preventable situations;
• Communicate with families at a distance as to how things are going with parent;
• Conduct family meetings via conference calls;
• Twenty four hour emergency support-if something happens to a parent, we meet at the hospital and advocate for the elder in the hospital;
• If a move to a facility is needed-can help select a facility appropriate to the elders’ budget, location and personality;
• Help the elder stay at home and stay independent as long as possible with the coordination and supervision of companion or home health aide staff;
• Secure benefits to pay for care;
• Understanding Medicare, Medicare HMO’s, Medicare D, Long Term Care Insurance, and discovering other little known benefits that help pay for care. 

I hope this isn’t overwhelming, but I believe we provide such a valuable supportive service to the elder and their families it is difficult to stop with one line or two.

Hourly fees range from $85.00 – $250. per hour depending on the area of the country. Assessment fees range from $450.00-$1,200.

Amy Cameron O'Rourke, MPH, CMC
The Cameron Group
Orlando, Florida  32803
1-888-896-2010
Member of the ElderCare Matters Alliance, Florida chapter

Answer:  How fortunate for your friend that she had you to provide care for her when she needed it. I have seen many situations like this and I find them so sad. I am not an attorney, so please know that my advice to you comes from experience only and not a license to help with legal issues. My general advice to you is to seek an attorney who would be willing to communicate with the family for you. I work with attorneys certified in elder law and would start there. If this is the wrong area of law, these attorneys can point you in the right direction. 

If there was anything in writing from her to you, this would help your cause. If there were any witnesses to your conversations or to your working relationships, this would also help you. If she is aware and alert, you might consider having another conversation with her. If she has any friends that knew the two of you maybe one of them would advocate for you. 

I hope this helps, good luck and many blessings to you for reaching out to help an elder.

Amy Cameron O'Rourke, MPH, CMC
The Cameron Group
Orlando, Florida  32803
1-888-896-2010
Member of the ElderCare Matters Alliance, Florida chapter

Answer:  No, the ability to stay in Assisted Living in Florida has not been abolished. If an elder wants to die in their home (Assisted Living is classified as home) they have the right to stay in Assisted Living. As her need for care increases (i.e. she becomes dependent or “bed bound”) she can remain in Assisted Living; however, she must pay privately for the extra care she needs. 

Assisted Living facilities are licensed to provide assistance with care. When an elder needs total care Assisted Living facilities are required to discharge the elder to a more appropriate setting, usually a nursing home; the only exception to this rule is when the elder is on hospice. When an elder is on hospice and needs total care they are allowed to stay in the facility but must pay extra for the care needed. Assisted Living facilities are not licensed or staffed to provide total care.

I hope this answers your question!

Amy Cameron O'Rourke, MPH, CMC
The Cameron Group
Orlando, Florida  32803
1-888-896-2010
Member of the ElderCare Matters Alliance, Florida chapter

Answer:  Keeping an elder out of the hospital while dealing with their multiple pathologies and can be challenging. Elders are frequently admitted to the hospital for the following preventable reason:  falls, undiagnosed infection, dehydration, and non-compliance with medicine. 

Once an elder is hospitalized, a rapid decline in health can occur. The old adage, “an ounce of prevention is worth a pound of cure” is so true in the too-often occurring syndrome of frequent hospitalization and rehabilitation stays for an elder. With careful monitoring of fluid and food intake, daily exercise and a closely supervised medication regime, hospitalizations can be prevented. 

These interventions can be implemented daily or every other day, depending on the elder’s need, by family members, professional staff, or a combination of both.  Adult children of an elder might say “My Mom or Dad won’t accept help.”  This is a natural response for a frail elder faced with losing some independence. We would advise bringing in an objective third party (professional care manager) to assist in these discussions and the implementation of care to achieve the desired outcome which, for most elders, is to stay at home and out of the hospital for their remaining days.

To locate competent geriatric care managers who are located near YOU and can help you with these types of elder care matters, go to: www.ElderCareMatters.com - A FREE online source to find elder care experts plus information & answers about a wide range of elder care matters.

Amy Cameron O'Rourke, MPH, CMC
The Cameron Group
Orlando, Florida  32803
1-888-896-2010
Member of the ElderCare Matters Alliance, Florida chapter

Answer:  I guess you are at least aware. Now you need to develop a plan and take action. Your retirement lifestyle is dependent primarily on two things…your required spending and your monthly income or cash flow.  

Look at your current spending patterns and spend a little effort projecting those patterns into your retirement years. Then list what retirement income you will have.  

Obviously, if the spending is far greater than the income, you have serious work to do. If that is the case, don’t wait until retirement to “fix” the shortfall, start today. Work on lowering your “fixed” monthly costs and save more to increase your retirement cash flow. If you are not comfortable doing this on your own, you may need the help of an accountant or a Certified Financial Planner in your area. But, do take action or you will likely follow your parent’s pattern.

To locate experts in your state who can help you with these elder care matters, go to: www.ElderCareMatters.com - America's online source for elder care experts plus information & answers about a wide range of elder care matters.

Philip C. Benedict, CFP
Benedict Financial Advisors, Inc.
Atlanta, Georgia  30328
770-671-8228
Member of the national ElderCare Matters Alliance, Georgia chapter

Answer:  Whether giving away assets is a good strategy for your parents will depend on a number of factors including their age, health, how they feel about giving up control over their assets, and how they feel about having less flexibility regarding where care can be provided.  

Oftentimes assets are given directly to a child with the thought that the child will use the funds for the parents later when the need arises.  But a true and complete gift does not come with strings, once given to the child there is no legal obligation on the part of the child to help mom and dad later.  What if the child does have good intentions to help mom and dad, but divorces, is sued, is influenced by a spouse, or is just not good with money?  Mom and dad’s hard earned assets may be taken away forever. 

Giving assets away can be tricky.  If after giving assets away mom or dad needs care prematurely i.e., within 5 years of the gift, a penalty period or period of ineligibility for Medicaid will result.  This period will not begin to run until mom or dad applies for Medicaid. 

You don’t indicate your parents age or health status, but purchasing a long-term care insurance policy to cover a period of 5 years could be a good investment.  There are policies available that include a return of premium feature, meaning that if the policy is not used the premiums are given back.  There are also life insurance policies that have long-term care riders.  With this type of policy if long-term care is needed the policy is tapped and if not it continues as a regular life policy paying a benefit on death. 

It will be worthwhile to consult with an elder care attorney to learn about all the options for long-term care planning available.  The guidance of a professional will save the family time, money and stress in the long run.

To locate experts in your state who can help you with these elder care matters, go to: www.ElderCareMatters.com - America's online source for elder care experts plus information & answers about a wide range of elder care matters.

Heather R. Chubb, Life Transitions Lawyer
The Chubb Law Firm
Gold River, California  95670
916-635-6800
Member of the national ElderCare Matters Alliance, California chapter

Answer:  The VA’s Aid & Attendance (A&A) benefit is available to war-time veterans who need assistance with activities of daily living, such as bathing, feeding, dressing, or protection from the hazards of the daily environment.  The assistance can be provided in the veteran’s own home, in a board and care home (also referred to as a group home or RCFE (Retirement Care Facility for the Elderly)) or in an assisted living facility.  This pension provides a married veteran $1,949/month, single veteran $1,644/month, or veteran’s surviving spouse $1,056/month tax-free income to help pay for care. 

In addition to being a wartime veteran and needing assistance there are also income and asset limitations to qualifying for the program. 

The claims process can be very frustrating if you have not been trained and do not understand the law.  You may be denied outright or your claim may take many more months to complete because of information requests and exchanges between you and the VA.  I strongly recommend that you use the services of a VA accredited individual or organization, which includes state and county veterans service agencies. 

The VA recognizes three groups to assist veterans in the preparation, presentation and filing of claims.  VA accredited attorneys, accredited Veterans Service Officers (VSO) and claims agents.  You can find a list of these groups by city and state at the VA’s Office of General Counsel’s Accreditation website.  It is against the law to charge for services to help prepare and file the claim. 

Whomever you seek out for advice should understand not only the VA laws and rules, but also those for Medicaid (Medi-Cal in CA) and tax laws.  These programs are very different and what may be acceptable under one program may have adverse consequences under the other programs.  The right professional will help you develop the most appropriate planning to meet your specific needs.

To locate experts in your state who can help you with these elder care matters, go to: www.ElderCareMatters.com - America's online source for elder care experts plus information & answers about a wide range of elder care matters.

Heather R. Chubb, Life Transitions Lawyer
The Chubb Law Firm
Gold River, California  95670
916-635-6800
Member of the national ElderCare Matters Alliance, California chapter

Answer:  First, let me say that it is nice to see a family discussing planning in advance of the need for long-term skilled nursing care.  By planning now a greater variety of options are available to meet your goals.  I am going to presume that you are concerned about preserving assets if your parents need to rely on Medicaid to pay the nursing home bills.  The Medicaid rules vary somewhat for each state, but as a general principal to get the most preservation you will need to plan at least 5 years in advance of the need for care. 

Any planning that is done must consider not only the rules for Medicaid eligibility but also the recovery (or payback) rules.  For example, the home is an exempt asset for eligibility purposes and it could remain in your parents’ name, but upon the death of the remaining spouse the state will want to be paid back for the care it provided to the ill spouse, which could result in the forced sale of the home. 

Asset preservation will fall into 2 categories – converting assets from non-exempt to exempt and getting assets out of your parents’ names, i.e., giving them away.  Some examples of conversions include using funds to make repairs or improvements to the home, buying mom and dad a new car, purchasing a Medicaid compliant annuity or entering into a personal care contract. 

Because giving assets away means a loss of control over the asset, your parents need to be part of the plan.  If they are “young” healthy elderly they may not be ready to give up control.  Flexibility in the plan will be important as will giving assets away in the right way.  

Oftentimes assets are given directly to a child with the thought that the child will use the funds for the parents later when the need arises.  But what if the child divorces, is sued or is just not good with money?  Mom and dad’s hard earned assets may be taken away forever.  Included in the definition of “giving away” is adding a child’s name to the house deed or bank accounts.  Therefore giving assets away in the right way is critical.  Special irrevocable trusts work nicely to provide the protections your parents need.  

A final word of warning when giving assets away, if mom or dad needs care prematurely i.e., within 5 years of the gift, a penalty period or period of ineligibility for Medicaid will result.  This period will not begin to run until mom or dad applies for Medicaid. 

When it comes to Medicaid and asset protection planning timing and knowledge are everything and it is not a do-it-yourself project.  An elder law attorney in your state will be able to guide and educate your parents about the Medicaid rules applicable in your state and which preservation techniques will suit them best.

To locate experts in your state who can help you with these elder care matters, go to: www.ElderCareMatters.com - America's online source for elder care experts plus information & answers about a wide range of elder care matters.

Heather R. Chubb, Life Transitions Lawyer
The Chubb Law Firm
Gold River, California  95670
916-635-6800
Member of the national ElderCare Matters Alliance, California chapter

Answer:  The truth is that, the Medicaid department is not authorized to send anyone over to actually take possession of the house.  However, after the death of the second parent the state wants to be paid back and may seek “recovery” from assets owned by the survivor at the time of the survivor’s death.  However, the state may only be paid back up to the amount that they actually paid out, but this still may result in the forced sale of your parents’ home. 

However, in your case there is an exception to the recovery rules because your parents have a disabled child.  When there is a surviving disabled child a recovery claim is prohibited by federal and state laws.  The surviving disabled child will need to provide documentation of disability or blindness, such as a Social Security or SSI award letter and a birth certificate showing they are the child of the deceased. If the surviving child does not have documentation of disability from the Social Security Administration, he/she can still file for a disability determination with the Medicaid department.  It is important to note that the surviving child does not have to live in the home (or even in the State, for that matter) in order for recovery to be barred. 

Signing over the home now may sound like a good idea, but it carries some big risks.  First, when your parents sign over the house they lose control and that can mean that the kids can kick them out at anytime.  In addition, if a child’s marriage ends in divorce or the child is sued the house can be taken away.  Finally, if your parents sign over the house and then need Medicaid within 5 years of the transfer a penalty and ineligibility for Medicaid for a period of time will result with the ineligibility period starting at the time they apply for Medicaid. 

As you can see Medicaid planning is filled with traps for the unwary.  I encourage you to seek the advice of a qualified elder law attorney in your state who will help guide you through the process.

To locate experts in your state who can help you with these elder care matters, go to: www.ElderCareMatters.com - America's online source for elder care experts plus information & answers about a wide range of elder care matters.

Heather R. Chubb, Life Transitions Lawyer
The Chubb Law Firm
Gold River, California  95670
916-635-6800
Member of the national ElderCare Matters Alliance, California chapter

Answer:  I’m pleased to hear that your mother’s doctor is being proactive and discussing the importance of an Advance Directive with her.  If your mom’s health continues to be good you may not need to do anything except keep in communication with her and stay on top of her medical needs.  It may be valuable to both you and your mother if you accompany her to her doctor’s appointments in order that you can develop a deeper understanding of your mom’s medical conditions and needs.

An Advance Healthcare Directive (AHCD) is a legal document in which the creator, in this case your mom, hand selects a trusted person to make medical decisions for her and speak for her if she is incapacitated or otherwise unable to speak for herself.  These decisions cover a wide variety of actions from making doctor’s appointments to making end of life decisions (i.e., “pulling the plug”).

However, just having this document is not enough and all AHCDs are not created equal.  It is essential that as the decision-maker (aka “agent” in legal terms) you understand your rights under this document, as well as your mom’s rights and healthcare wishes.  Most of those rights are described right in the document so you and your mom need to really read and understand it, so that you understand the importance of leaving instructions and information to carry out your wishes should something happen to you.

Because it is impossible to include instructions for every situation within the AHCD, you need to have discussions with your mom about her healthcare wishes.  And, this is not a one-time discussion.  Over the last few decades advances in medical technology have created an environment where people can be kept “alive” much longer.  But there is a big difference between being “alive” and having a quality life.  Discuss with your mom what quality of life means to her.

To locate experts in your state who can help you with these elder care matters, go to: www.ElderCareMatters.com - America's online source for elder care experts plus information & answers about a wide range of elder care matters.

Heather R. Chubb, Life Transitions Lawyer
The Chubb Law Firm
Gold River, California  95670
916-635-6800
Member of the national ElderCare Matters Alliance, California chapter

Heather R. Chubb, Life Transitions Lawyer
The Chubb Law Firm
Gold River, California  95670
916-635-6800

Ms. Chubb is this week's Featured Elder Care Expert on www.ElderCareMatters.com, and will be answering your questions about Elder Care Matters.

Heather R. Chubb is a Life Transitions Lawyer in the Sacramento area dedicated to helping individuals and families make the best possible legal decisions for themselves and those they love. She uses her passion to educate her clients and make navigating the legal world easy, understandable and comfortable.

While each of her clients has different needs and objectives; they all have the common goal of protecting those they love, keeping control for as long as possible, making the most of assets they worked hard to acquire, and making things as easy as possible for their loved ones. She is particularly attuned to the needs of the “sandwich generation” balancing the demands of children, home, work and caring for elderly parents.

Whether developing a foundational estate plan, special needs plan, long-term care plan (including Medi-Cal and VA benefits), or advanced plan, or administering a plan upon death or incapacity, the focus is the individual client and their needs and goals.

Heather is a member of the State Bar of California Trusts and Estates section, WealthCounsel, the National Academy of Elder Law Attorneys (NAELA), and the national ElderCare Matters Alliance, California chapter.

Answer:  Elder financial abuse is any practice or conduct that misuses, takes or conceals a vulnerable elder’s funds, property or assets. Elder financial abuse includes any type of investment fraud that uses misrepresentation, deception, trickery, false pretence, or dishonest act to the financial detriment of a senior.

A fiduciary duty is an affirmation obligation imposed on one person to act in the best interest of another person.  Whether or not a fiduciary duty is owed to an elderly client depends on the law of the state where the senior resides. In some states like Georgia, stockbrokers owe fiduciary obligations to their clients but insurance agents and bank officials normally do not. Nonetheless, this does not give an insurance agent or bank official a license to defraud a senior out of his or her money or property and the agent or official can still be sued by the senior for fraud.

Let me know if I can be of further assistance to you.

J. Michael Bishop, JD
Smiley Bishop & Porter, LLP
Atlanta, GA  30338
770-829-3850
Member of the national ElderCare Matters Alliance

Answer:  The practice you are referring to is commonly known in the securities industry as “unauthorized trading.” It violates securities laws and securities industry rules. Unauthorized trading occurs when a broker makes trades in a customer’s account without having any authority, either in writing or orally, to do so. Unless a client gives a formal written grant of "discretion" (like a limited power of attorney) to her broker, a stockbroker is not entitled to trade in the client's account without obtaining prior approval for the specific trade.

In your Aunt’s circumstance, if she has given you a financial power of attorney to act on her behalf, you should immediately notify the brokerage firm’s manager in writing that no new transactions should be executed in the account because of her condition.  Even in the absence of a financial power of attorney, you should notify the manager in writing that your Aunt is suffering from Alzheimer’s.  Either way, this will put the brokerage firm on notice it has potential liability and the broker’s conduct will be more closely scrutinized.

If the transactions in your Aunt’s account have not been authorized, she has a right to recover losses she has sustained on the unauthorized purchases and I would suggest you contact a securities lawyer to advise you further. If the broker’s manager wants to meet with you to discuss your Aunt’s account, keep in mind this is akin to the insurance adjuster trying to get a statement from a car accident victim before the victim can talk with a lawyer. If the broker has engaged in authorized trading someone knowledgeable should do a complete account review to be sure nothing else improper has transpired in the account.

Let me know if I can be of further assistance to you.

J. Michael Bishop, JD
Smiley Bishop & Porter, LLP
Atlanta, GA  30338
770-829-3850
Member of the national ElderCare Matters Alliance

Answer:  A Ponzi scheme is a phony investment plan where investors are promised high rates of returns on their investment but no real legitimate business operations exist to generate profits or earnings. Instead, early investors are paid from funds put into the scheme by later investors. When the promoter of the scheme can no longer attract new investor money to pay early investors (or he has stolen investor funds to fund his own lifestyle) the scheme collapses.

Ponzi schemes derive their name from criminal financier Charles Ponzi who is credited with creating this fraud back in the 1920s.  Charles Ponzi duped thousands of investors through a postage stamp speculation scheme. Ponzi promised to pay investors a 50% return on their investments within 90 days. Ponzi had no legitimate business or investment opportunity in place to generate earnings and used incoming funds from new investors to pay off earlier investors.  

Some warning signs associated with Ponzi schemes are:

•  Promises of unrealistically high returns with little risk.
• Claims by the promoter that the investment opportunity is extremely complex and usually only available to large overseas institutional investors like foreign banks and insurance companies.
• Requirement by the promoter that investors not discuss the investment with third parties and keep all aspects of the investment confidential.
• Representations by the promoter that investor funds are never at risk and are always held in an escrow account.
• Lack of transparency/refusal of the promoter to disclose to investors the location of investor funds or how the funds have been invested.
• Opportunity to reinvest promised payments at increasingly higher rates of return.
• Inability to pay investors requested withdrawals or refusal to allow investors to cash out their investments.

Let me know if I can be of further assistance to you.

J. Michael Bishop, JD
Smiley Bishop & Porter, LLP
Atlanta, GA  30338
770-829-3850
Member of the national ElderCare Matters Alliance

Answer:  A securities brokerage firm and its brokers have a duty to only recommend investments which are suitable for a customer in light of the customer’s objectives and individual circumstances. This is known as the “suitability doctrine.” Specifically, the Financial Industry Regulatory Authority (“FINRA”) rules state:

"In recommending to a customer the purchase, sale or exchange of any security, a member shall have reasonable grounds for believing that the recommendation is suitable for such customer upon the basis of the facts, if any, disclosed by such customer as to his other security holdings and as to his financial situation and needs."

Where a senior’s life situation dictates a conservative investment approach and a broker recommends high risk investments not designed to preserve the senior’s financial resources, the senior can have a suitability claim against the broker and his or her employer for damages. 

It’s likely your mother signed an arbitration agreement when she opened her brokerage account  and gave up her right to file her case in court.  Therefore, your mother needs to file an arbitration claim to recover her money. Nearly all arbitrations are conducted by arbitrators appointed by FINRA. 

Let me know if I can be of further assistance to you.

J. Michael Bishop, JD
Smiley Bishop & Porter, LLP
Atlanta, GA  30338
770-829-3850
Member of the national ElderCare Matters Alliance

Answer:  Here are some telltale signs of Financial Elder Abuse:

• Unusual or unexplained expenditures by the senior.
• Large cash withdrawals from the senior's bank account
• Numerous checks being written to a person or company that you do not know
• Wires or asset transfers out of the elder's bank or investment accounts that the senior cannot explain or doesn't want to talk about
• Numerous unexplained credit card charges
• Monthly account balances in the senior's bank or brokerage accounts that have suddenly declined dramatically
• The senior living without certain basic necessities even though he/she should have the money to afford them
• The senior recently lending money to someone you don't know
• Large amounts of money in the senior's investment account suddenly being invested in one product like a deferred variable annuity

From a practical perspective, there are a few simple things you can do to help your mother avoid Financial Elder Abuse:

• Have your mother's bank and brokerage firm send you duplicate copies of her monthly account statements.
• Also, most banks allow their account holders to set up daily email alerts.  Ask your mother to let you set up an email alert that sends you the daily balances on her bank accounts.

Let me know if I can be of further assistance to you.

J. Michael Bishop, JD
Smiley Bishop & Porter, LLP
Atlanta, GA  30338
770-829-3850
Member of the national ElderCare Matters Alliance

Answer:  It depends of the type of financial advisor handling your parents’ money. If the advisor is a stockbroker, it’s likely your parents signed an arbitration agreement when they opened their account. This means they agreed in advance to file their case against the stockbroker and his employer in an arbitration forum and gave up their right to file their case in court.  Normally, the Financial Industry Regulatory Authority (“FINRA”) is the arbitration forum where your parents’ case would have to be filed.  Arbitration has both advantages and disadvantages but is less costly than filing an action in court and will likely get faster results. The arbitrators selected to hear the case can award your parents compensatory damages, punitive damages and attorneys’ fees– just like a jury can in court. For an overview of the FINRA arbitration process, click on this link: http://www.sbpllplaw.com/2011/04/an-outline-of-the-finra-arbitration-process-for-customer-broker-disputes/

If the advisor is not a stockbroker and your parents did not sign an arbitration agreement, they can file their case against the advisor and his employer in court. Whether they file their case in federal or state court depends on a number of factors including:

a) where your parents live
b) where the advisor lives
c) where the advisor’s employer maintains its principal place of business
d) how much money your parents lost, and
e) the legal causes of action asserted in the complaint.

Let me know if I can be of further assistance to you.

J. Michael Bishop, JD
Smiley Bishop & Porter, LLP
Atlanta, GA  30338
770-829-3850
Member of the national ElderCare Matters Alliance

Answer:  FINRA’s Central Registration Depository (CRD) system contains registration and background information on stockbrokers. Certain information from this system can be accessed through FINRA’s BrokerCheck website at: www.finra.org/Investors/ToolsCalculators/BrokerCheck/.  

The BrokerCheck report which can be obtained through the website discloses complaints other clients have made against the broker, arbitration cases and lawsuits where the broker has been found liable and shows cases that are currently pending against him. The report also reflects disciplinary actions brought by securities regulators where the broker was sanctioned. Let me know if I can be of further assistance to you.

J. Michael Bishop, JD
Smiley Bishop & Porter, LLP
Atlanta, GA  30338
770-829-3850
Member of the national ElderCare Matters Alliance

J. Michael Bishop, JD
Partner in the Law Firm of Smiley Bishop & Porter, LLP
Atlanta, GA  30338
770-829-3850
www.sbpllplaw.com

Member of the national ElderCare Matters Alliance, Georgia chapter

I am an Atlanta native and partner in the law firm Smiley Bishop & Porter LLP. I received my law degree from Mercer University law school in 1984. For the last 26 years, my firm and I have dedicated our law practice to representing investors whose trust has been abused by dishonest financial advisors, stock brokers, investment advisors and financial planners. We have been fortunate during this time to have successfully represented numerous seniors who have been victimized by unscrupulous investment companies and their employees.  

Our firm prides itself on being keenly aware of the unique factors associated with representing seniors. Personally, I have served on the Board of the Elder Law section of the Atlanta Bar Association, am a member of the National Academy of Elder Law Attorneys and a Charter Member of the ElderCare Matters Alliance.  I am also a member of the Public Investors Bar Association. 

My law firm is based in Atlanta, Georgia but our practice is national in scope. We have represented investors in numerous venues throughout the Southeast and across the United States. We have successfully represented clients with claims against virtually every major Wall Street firm, including: Bank of America/Merrill Lynch, UBS/PaineWebber, Morgan Stanley/Dean Witter, Wells Fargo Securities/Wachovia Securities, Prudential Securities, Citigroup/Smith Barney, Shearson/Lehman Brothers, Bear Stearns, Credit Suisse, Ameriprise Financial, Morgan Keegan, and LPL Financial, as well as numerous others.

Answer:  Your husband should qualify for Medicaid given his age and disabilities. You didn’t mention his or your monthly income or your family resources. However, assuming his monthly income is less than $2,022.00, assuming his resources are less than $2,500.00, and further assuming your family resources are less than $109,560.00, then your husband should qualify for Medicaid benefits. Allow me to add that your current situation as a “burned out” primary care giver is common. It would appear essential to your continued good health that your husband transition into a long term skilled care facility in the near future. I recommend that you contact an Elder Law attorney to assist your family with the asset planning and Medicaid planning that will be required for your husband to successfully qualify for Medicaid, while at the same time protecting your family assets. Also, please visit the Center for Medicare and Medicaid Services website at www.cms.gov for further information and helpful resources. Thank you for your inquiry, and best of luck!

To locate experts in your state who can help you with these elder care matters, go to: www.ElderCareMatters.com - America's online source for elder care experts plus information & answers about a wide range of elder care matters.

Dennis Duncan, Attorney at Law
The Law Offices of Dennis L. Duncan, P.C.
Macon, Georgia  31210
478-254-4232
Member of the national ElderCare Matters Alliance, Georgia chapter

Answer:  You will need to file a Petition for Guardianship and Conservatorship with the Probate Court in the county of residence for your mother in Illinois. I practice Probate Law in Georgia, and every state may handle the petition process a little differently. Please check with the website www.ProbateIllinois.com. There you can enter the county of residence for your mother and proceed directly to that county’s Probate Court website for more specific information regarding the petition process. You will need to contact a Probate Law attorney in Illinois, who is familiar with the court of jurisdiction. If the process in Illinois is like the process in Georgia, then procedurally this is what you can anticipate: A lengthy Petition for Guardianship and Conservatorship must be completed, which will include among other things, your mother’s financial records, medical examination reports/physician affidavit, and contact information for all living relatives. The relatives are notified by copy of the petition, and they are given time to object by filing a caveat if they so choose. If a caveat is filed, a period of discovery is allowed by the court before setting a court date. Mediation may be mandated by the court or the parties may elect to resolve any differences thereby. If no resolution can be reached, a bench trial takes place, and the Probate judge decides the outcome. If there is no opposition to the petition, a less formal in chambers hearing is held by the Probate judge, and the Guardianship and Conservatorship is granted by the court to the petitioner. I hope this information proves helpful, and I wish you the best of luck!

To locate experts in your state who can help you with these elder care matters, go to: www.ElderCareMatters.com/statechapters.htm

Dennis Duncan, Attorney at Law
The Law Offices of Dennis L. Duncan, P.C.
Macon, Georgia  31210
478-254-4232
Member of the national ElderCare Matters Alliance, Georgia chapter

Answer:  The process is usually initiated with an in-depth consultation, which can be accomplished in person or telephonically. Prior to the consultation, I provide the client with a financial questionnaire to be completed on behalf of the Applicant/Recipient of benefits. Customarily, the goal of my Elder Care Planning clients consists in shielding family assets, while at the same time assisting a family member’s transition into a long term skilled care facility. Once I have gathered all of the family, medical and financial history needed to formulate a plan of action, I provide the client with a comprehensive Elder Law Opinion Letter for a set fee. Once they have had an opportunity to review and consider same, we have another consultation. If the client wishes to proceed with the plan of action, they provide me with a retainer. The requisite actions necessary to perfect the plan are then implemented. I hope you find this explanation helpful. Thank you for your inquiry and best of luck!

To locate experts in your state who can help you with these elder care matters, go to: www.ElderCareMatters.com/statechapters.htm

Dennis Duncan, Attorney at Law
The Law Offices of Dennis L. Duncan, P.C.
Macon, Georgia  31210
478-254-4232
Member of the national ElderCare Matters Alliance, Georgia chapter

Answer:  Most of the larger insurance companies offer Long Term Care Insurance, including Northwestern Mutual, MassMutual, State Farm, John Hancock, Genworth, MetLife, Mutual of Omaha, and AARP. The federal government also offers Long Term Care Insurance to its employees. Unfortunately, none of these policies is inexpensive. I recommend that you speak with a qualified insurance agent to determine what alternate types of policies are available and to comparison shop for the best price.

To locate long term care insurance experts in your state who can help you with these elder care matters, go to: www.ElderCareMatters.com/statechapters.htm

Dennis Duncan, Attorney at Law
The Law Offices of Dennis L. Duncan, P.C.
Macon, Georgia  31210
478-254-4232
Member of the national ElderCare Matters Alliance, Georgia chapter