What is “Aging in Place”? Today’s Q&A on ElderCareMatters.com

Question:  What is “Aging in Place”?

Answer:   An AARP survey found that 85% of all Americans over the age of 65 would prefer to stay in their own homes and communities as they age, and that most seniors would prefer to receive their elder care assistance in their home rather than have to move to an institutional setting like a nursing home.  This “stay at home” approach is known as “Aging in Place”.

If you need help with this or other elder care / senior care matters, you can find thousands of Elder Care Professionals from across America on ElderCareMatters.com – America’s National Directory of Elder Care / Senior Care Resources for Families.

You can also find Elder Law Attorneys on ElderLawAttorneys.us and Estate Planning Attorneys on EstatePlanningAttorneys.us – 2 additional websites sponsored exclusively by the national ElderCare Matters Alliance.

bdailey What is Aging in Place?  Todays Q&A on ElderCareMatters.com
Bob Dailey
Visiting Angels East Valley
Mesa, Arizona
An ElderCare Matters Partner

Why is it important to use an Attorney when applying for Medicaid Benefits?

Question:  Why is it important to use an Attorney when applying for Medicaid Benefits?

Answer:  Applying for Medicaid benefits can be a daunting process. The Deficit Reduction Act of 2005 increased the look-back period for nursing home applications from three years to five years (36 months to 60 months). This means that five years of financial documentation must be provided to the Medicaid agency in order for the application to be complete.

Unfortunately, the Medicaid application process is not one that can be easily researched online. Due to specific rules and regulations, as well as the lack of uniformity amongst counties, it is a matter of knowledge and experience in the area that allows for successful navigation of the system.

While there are certain cases that can be handled without the assistance of an attorney, it is important for an applicant and his or her family to obtain competent legal advice if they are interested in protecting assets, or if the applicant has made gifts within the five years prior to applying for Medicaid.

Unlike other areas of the law, specific instructions and procedures are difficult to find in writing. For example, in New York City a “transmittal” form is required, while Nassau County asks for a “pick-up letter”. If the documents specific to the applicant’s county of residence are not provided, the application can be refused or denied, which can potentially affect the applicant’s eligibility date. Counties also differ in the turn-around time allowed for additional information requests and in the ability to grant extensions to obtain missing documentation.

Furthermore, an elder law firm can devise and implement a comprehensive Medicaid and estate plan that often saves clients thousands of dollars. Creative legal techniques may be used to preserve assets even at the 11th hour in most cases.

We have had clients come to our office who had either been unaware of the existence of elder law attorneys or who did not want to pay for fees associated with using an attorney. Unfortunately, many of these clients have had Medicaid applications that had either been denied or had been approved for a period and then subsequently denied when Medicaid reviewed the case and discovered an issue at a later date.

For example, it is not uncommon for a family to come into our office after receiving guidance on how to protect assets with a ‘gift/loan plan.’ A gift/loan plan is a technique that can save approximately half of the applicant’s assets even if advanced planning was not done. Unfortunately, it is all too likely that such a plan will not be implemented correctly, and that rules will be misapplied by a non-attorney who is not familiar with all the planning techniques available to him or her. As such, it is beneficial to obtain the advice of an experienced elder law attorney who can implement the right plan, explain all the rules, and weigh the costs and benefits of the best Medicaid plan under the circumstances, including gift, estate, and capital gains tax implications. Each case must be assessed and tailored to the individual’s specific needs, rather than applying the cookie cutter approach often employed by non-professionals.

If you need help with this or other elder care / senior care legal matters, you can find thousands of Elder Law Professionals from across America on ElderCareMatters.com – America’s National Directory of Elder Care / Senior Care Resources for Families.

You can also find Elder Law Attorneys on ElderLawAttorneys.us and Estate Planning Attorneys on EstatePlanningAttorneys.us – 2 additional websites sponsored exclusively by the national ElderCare Matters Alliance.

rfatoullah Why is it important to use an Attorney when applying for Medicaid Benefits?
Ronald A. Fatoullah, Esq., CELA
Ronald Fatoullah & Associates
Great Neck, New York
An ElderCare Matters Partner

America’s Caregivers Can Find Help with a Wide Range of Elder Care Matters on One Website

Question:  Our family is now dealing with elder care issues for both sets of parents, and we desperately need help with a host of elder care matters, including Elder Law, Geriatric Care Management, Home Care, Medication Management, and Financial Management. When will ElderCareMatters.com include ALL Elder Care Professionals in our State so that we can simply search this one Elder Care website to find ALL the help we need with our family’s Elder Care Matters? This would truly simplify our LIVES.

Answer:   ElderCareMatters.com was founded more than a decade ago with one objective in mind: To provide families across America with a Single Internet Source to help them plan for and deal with their Elder Care Matters. We now offer families easy access to thousands of Elder Care Professionals across America on ElderCareMatters.com, and we are continually striving to include ALL competent Elder Care Professionals across America on ElderCareMatters.com – America’s National Directory of Elder Care / Senior Care Resources for Families.

Thank you for your support of ElderCareMatters.com.

psanders1 Americas Caregivers Can Find Help with a Wide Range of Elder Care Matters on One WebsitePhillip G. Sanders, MBA, MSHA, CPA
Founder & CEO of ElderCare Matters, LLC
ElderCareMatters.com

Will Medicare pay for any of my mother’s nursing home costs?

Question:  Will Medicare pay for any of my mother’s nursing home costs?

Answer:  Medicare has provisions that if you are in the hospital and you are transferred out of the hospital directly to a nursing home facility to receive rehabilitation for whatever medical condition you have that Medicare will pay for the nursing home care up to a limited number of days as long as you are making progress under Medicare rules. So it is possible for Medicare to pay for part of your mother’s nursing home care when she leaves the hospital and needs rehabilitation.

If you need help with this or other elder care / senior care matters, you can find thousands of Elder Care Professionals from across America on ElderCareMatters.com – America’s National Directory of Elder Care / Senior Care Resources for Families.

You can also find Elder Law Attorneys on ElderLawAttorneys.us and Estate Planning Attorneys on EstatePlanningAttorneys.us – 2 additional websites sponsored exclusively by the national ElderCare Matters Alliance.

whesch Will Medicare pay for any of my mother’s nursing home costs?
William E. Hesch, Esq., CPA, PFS
William E. Hesch Law Firm, LLC
Cincinnati, Ohio
An ElderCare Matters Partner

Most Common Types of Senior Scams

Question:  Would you please provide us with some information about the most common frauds / scams that are being performed on seniors?

Answer:  There are a variety of scams that people perpetrate on seniors. Most are geared towards draining them financially or to secure their information for identity theft. Below are some of the most common types of Senior Scams:

  • Medicare and Healthcare Scams: Also known as a Medicare discount-drug card scam, these people will call, email, or even go door to door selling fraudulent discount Medicare drug cards. It is important to note that any situation like this is always a scam – legitimate prescription drug benefit companies are not allowed to make unsolicited sales pitches.
  • Free Contests and Magazine Subscriptions: This type of scam is one of the oldest in the book. Almost always done by mail, and now sometimes through email, a scammer will claim that the senior has won a free contest or can have a free subscription to a magazine if they provide enough personal information to verify that it is them.
  • Grandparent/Grandchild Scam: This type of scam is done over the phone or through an email. A scammer will pretend to be the senior’s grandchild, asking for money. Usually the “grandchild” is in some dire or embarrassing situation and asks the grandparent not to tell the grandchild’s parents. This prevents the grandparent from checking on the situation first before sending the money.
  • Charity Email: This scam tends to be more prevalent during the holidays. Scam artists send out emails soliciting contributions, usually using the name of a legitimate charity, with a link to send money. Seniors will give out their bank account information and other personal information through the link.

How to Prevent Senior Scams

The best way to help prevent someone from scamming your elderly loved one is to have a conversation with them about the risks and warning signs of fraud. For seniors that are less capable of making sound decisions, it is up to family members to be more vigilant in their watch for scams.

Sadly, seniors in the early stages of dementia or Alzheimer’s are more likely to become the target of fraud. It is difficult because the senior still believes that they are capable of making financial decisions even though they may no longer be able to do so on their own. An easy way to protect your loved one from scams is to add an adult child to the senior’s bank accounts to help look for suspicious withdrawals or payments.

If there is a concern that your elderly loved one has been taken advantage of in a scam, the first thing you should do is call a credit reporting agency and put a freeze on any compromised accounts. Adding a lock to the mailbox and taking the senior’s name off of subscription lists can also decrease the chances of a scam.

If you need help with this or other elder care / senior care legal matters, you can find thousands of Elder Care Professionals from across America on ElderCareMatters.com – America’s National Directory of Elder Care / Senior Care Resources for Families.

You can also find Elder Law Attorneys on ElderLawAttorneys.us and Estate Planning Attorneys on EstatePlanningAttorneys.us – 2 additional websites sponsored exclusively by the national ElderCare Matters Alliance.

mettinger Most Common Types of Senior Scams
Michael Ettinger, Esq.
Ettinger Law Firm
Albany, New York
An ElderCare Matters Partner

New York Elder Law Attorney Answers Today’s Question on ElderCareMatters.com about Power of Attorney

Question:  Would you please provide us with some information about Powers of Attorney?

Answer:  

  1. What is a Power of Attorney?

A Power of Attorney is a document in which you can appoint an agent to make financial transactions on your behalf if you are not present to make these transactions.

  1. What is the difference between a Power of Attorney and an Executor?

A Power of Attorney is in effect only during your lifetime. An Executor takes over the management of your estate upon your death. You name the Executor in your Will.

  1. What is a durable Power of Attorney?

A durable Power of Attorney states that the Power will be in force even if you become subsequently become disabled.

  1. How do I appoint an agent?

The Power of Attorney form is a form that must be signed before a Notary Public.

  1. What powers can I give to my agent in the Power of Attorney?

The form lists the areas of authority that you delegate. These include real estate transactions, banking transactions and insurance transactions, to name a few. However, the Power of Attorney does not in itself authorize the agent to make unlimited gifts.

  1. How can I authorize my agent to make gifts?

A Power of Attorney can be personalized to indicate the authority to make gifts and the limits, if any, on this authority.

  1. My bank has its own Power of Attorney Form. Do I need it?

A general Power of Attorney must be honored by banks. However, they sometimes are reluctant to honor them, so if you can sign the bank form, it is often easier for the agent to make transactions later on.

  1. Whom should I appoint as my agent?

You should appoint only someone whom you trust explicitly. You may also appoint two people acting together as an additional safeguard.

  1. If any accounts and house are all jointly held, do I need a Power of Attorney?

The joint accounts should be able to be accessed without the Power, but for real estate, a Power of Attorney will be needed.

10. Can I appoint my agent so that he or she has authority only if I become incapacitated?

The Power of Attorney is not valid for an agent appointed until he or she has signed the Power of Attorney before a Notary Public. You may execute the Power of Attorney but not have your agent sign until you are incapacitated.

If you need help with this or other elder care / senior care legal matters, you can find thousands of Elder Care Professionals from across America on ElderCareMatters.com – America’s National Directory of Elder Care / Senior Care Resources for Families.

You can also find Elder Law Attorneys on ElderLawAttorneys.us and Estate Planning Attorneys on EstatePlanningAttorneys.us – 2 additional websites sponsored exclusively by the national ElderCare Matters Alliance.

jrobert New York Elder Law Attorney Answers Todays Question on ElderCareMatters.com about Power of Attorney
Joan Lensky Robert, Esq.
Kassoff, Robert & Lerner, LLP
Rockville Centre, New York
An ElderCare Matters Partner

Difference between Mild Cognitive Impairment (MCI) and Dementia

Question:  What is the difference between “Mild Cognitive Impairment” (MCI) and Dementia?

Answer:   The distinction between mild cognitive impairment and dementia can get a bit blurry. In California, Residential Care for the Elderly (RCFE) facilities can accept people with varying degrees of memory loss. Once a person is diagnosed with dementia, there are additional licensing requirements a facility in California must meet.

The definitions that follow are from the Community Care Licensing regulations:

Mild cognitive impairment” (MCI) refers to people whose cognitive abilities are in a “conditional state” between normal aging and dementia. Normal age-related memory changes can include:

  • forgetting a person’s name
  • location of an object

Individuals with MCI have difficulty with short-term memory loss. MCI is a state in which at least one cognitive function, usually short-term memory, is impaired to an extent that is greater than would be anticipated in the normal aging process. MCI is characterized by short term memory problems, but no other symptoms of dementia (e.g., problems with language, judgment, changes in personality or behavior) that affect a person’s daily functioning. Individuals with MCI may experience some difficulty with intellectually demanding activities, but lack the degree of cognitive and functional impairment required to meet diagnostic criteria for dementia.

Dementia” means the loss of intellectual function sufficient to interfere with an individual’s ability to perform activities of daily living or to carry out social or occupational activities, such as:

  • thinking
  • remembering
  • reasoning
  • exercising judgment
  • making decisions
  • other cognitive functions

Dementia is not a disease itself, but rather a group of symptoms that may accompany certain conditions or diseases, including Alzheimer’s Disease. Symptoms may include changes in personality, mood, and/or behavior. Dementia is irreversible when caused by disease or injury, but may be reversible when caused by depression, drugs, alcohol, or hormone/vitamin imbalances.

Someone meeting with Mr. Sweetbriar might wonder why his family is so concerned about his memory. He is alert and focused and answers your questions with reasonable clarity. However, his family describes his difficulty remembering his grandchildren’s names, dialing wrong numbers, and losing his sunglasses twice in the last month.   The key to providing care for Mr. Sweetbriar is in the diagnosis from his physician. His doctor has diagnosed mild cognitive impairment.

There are a considerable number of additional requirements for a RCFE to be approved to provide care and supervision to people with dementia. A person with dementia will be considered “non-ambulatory” (even if he/she walked into the doctor’s office unassisted) because he or she would need assistance in leaving the facility in an emergency. The local fire authority must approve the beds for non-ambulatory residents.   There are some common sense requirements for safety – to address behaviors such as wandering, aggressive behavior and ingestion of toxic materials. All staff are required to receive training when they begin work on specific issues for people with dementia, as well as eight continuing education hours on dementia each year.

It is wise to ask if a facility is approved to care for people with dementia (it was referred to in the past as having a “dementia waiver.”) These homes are approved by Community Care Licensing for dementia services, if they can show adherence to the licensing requirements.

If you need help with this or other elder care / senior care matters, you can find thousands of Elder Care Professionals from across America on ElderCareMatters.com – America’s National Directory of Elder Care / Senior Care Resources for Families.

You can also find Elder Law Attorneys on ElderLawAttorneys.us and Estate Planning Attorneys on EstatePlanningAttorneys.us – 2 additional websites sponsored exclusively by the national ElderCare Matters Alliance.

rmayer Difference between Mild Cognitive Impairment (MCI) and Dementia
Rhonda Krantz Mayer
Community Training Connection, Inc.
Chatsworth, California
An ElderCare Matters Partner

Pennsylvania Elder Law Attorney Answers Today’s Question about Using Trusts to Plan for Long Term Care

Question:  Why would one use a Trust to help plan for long term care?

Answer:  Planning for long-term care involves the consideration of many factors. There are a number of reasons that trusts can be used as part of an individual’s long-term care plan. Sometimes an individual may place assets inside of a revocable living trust. If the individual becomes incapacitated, the trustee will have the ability to manage the trust assets immediately, and those assets can be used for the care of the individual. Revocable trusts are more commonly used as part of planning for an individual’s death to deal with issues such as probate (or multi-state probate), or privacy.

Irrevocable trusts are more commonly used in planning for an individual’s long-term care. If an individual does not have a long-term case insurance policy, they are self-insured for any long-term care needs they may have. That means it is up to the individual to pay for all of the costs associated with long-term care. Medicaid is the federally-funded, state-implemented program which pays the costs of long-term care for individuals who qualify. To qualify for Medicaid, an individual must generally have a very limited amount of assets in his or her name.

Irrevocable trusts can be used, either alone or in conjunction with other planning strategies, to reduce the amount of assets in an individual’s name for Medicaid purposes. By transferring assets into an irrevocable trust, that individual may qualify for Medicaid sooner; and at 5 years after the time of the transfer into the irrevocable trust, those assets are protected from having to be spent on long-term care. The Medicaid rules are very complex, and implementing a planning strategy using trusts should only be done with a qualified elder law attorney to avoid any potential planning failures or pitfalls.

If you need help with this or other elder care / senior care legal matters, you can find thousands of Elder Care Professionals from across America on ElderCareMatters.com – America’s National Directory of Elder Care / Senior Care Resources for Families.

You can also find Elder Law Attorneys on ElderLawAttorneys.us and Estate Planning Attorneys on EstatePlanningAttorneys.us – 2 additional websites sponsored exclusively by the national ElderCare Matters Alliance.

jruggiero Pennsylvania Elder Law Attorney Answers Todays Question about Using Trusts to Plan for Long Term Care
James J. Ruggiero, Jr., Esq.
Ruggiero Law Offices, LLC
Paoli, Pennsylvania
An ElderCare Matters Partner

Senior Move Manager Answers Today’s Question on ElderCareMatters.com about Downsizing

Question:  We are about to move Mom from her home in which I was raised to an Assisted Living facility. What are some of the things we should consider during this “downsizing” process?

Answer:  The first step in downsizing is to choose the furniture going to the assisted living community. Use the floor plan from the community to decide what fits. You will need to visit the apartment that is being rented, measure the walls, locate the light switches, the cable TV outlet, the air registers, and the windows and mark these items on the floor plan. Once that’s done you can measure the furniture that you’d like to take and make sure it safely fits in the apartment. You do not want to make the space seem any smaller than it is.

Think about purchasing smaller couches that are firm and easy to get up from, a flat screen TV to hang on the wall, a bistro kitchen set with chairs that have arms and a new bed.

Once you’ve chosen the larger items to take to the new apartment choose the items you love such as family photos, decoratives, heirlooms, etc. Whatever is left can be given to the family (if they want them), sold through an estate sale or donated. This seems like an easy process but it can be a very emotional situation and the older adult may need some time to part with their personal items. Moving out before cleaning out the house is usually easier than trying to distribute items while living there. If mom isn’t ready to part with everything yet, is a little confused on what she wants to take, is worried the new assisted living community isn’t for her or has other concerns this is a good solution. The house and the contents are still there but a timeline needs to be set to get the items out of the house and the house on the market for sale. If it’s not possible to afford assisted living without selling the house and its contents then you might need to hire a third party, such as a Senior Move Manager, to assist with the whole process. This person will help sort, distribute items no longer wanted/needed and help move your mom.

If you need help with this or other elder care / senior care matters, you can find thousands of Elder Care Professionals from across America on ElderCareMatters.com – America’s National Directory of Elder Care / Senior Care Resources for Families.

You can also find Elder Law Attorneys on ElderLawAttorneys.us and Estate Planning Attorneys on EstatePlanningAttorneys.us – 2 additional websites sponsored exclusively by the national ElderCare Matters Alliance.

jprell Senior Move Manager Answers Todays Question on ElderCareMatters.com about Downsizing
Jennifer Prell, Senior Move Manager
Paxem, Inc.
Cary, Illinois
An ElderCare Matters Partner

Elder Law Attorney Answers Today’s Question On ElderCareMatters.com About Applying For Medicaid Benefits

Question:   How would we go about applying for Medicaid benefits?

Answer:  Medicaid benefits are going to be different in every state.  The first thing you need to determine is what benefits you seek.  For instance, in Pennsylvania, if you are seeking benefits for home and community based services, you will start with the local area agency on aging.  If you are seeking benefits for nursing services provided in a nursing home, you would file the application at the County Assistance Office.  In any event, you can get this information from your local Area Agency on Aging or an experienced Elder Law attorney.

If you need help with this or other elder care / senior care legal matters, you can find thousands of Elder Care Professionals from across America on ElderCareMatters.com – America’s National Directory of Elder Care / Senior Care Resources for Families.

You can also find Elder Law Attorneys on ElderLawAttorneys.us and Estate Planning Attorneys on EstatePlanningAttorneys.us – 2 additional websites sponsored exclusively by the national ElderCare Matters Alliance.

rslutsky Elder Law Attorney Answers Todays Question On ElderCareMatters.com About Applying For Medicaid Benefits
Robert M. Slutsky, Esq.
Robert Slutsky Associates
Plymouth Meeting, Pennsylvania
An ElderCare Matters Partner