Today’s Q&A on ElderCareMatters.com is about whether elders should gift to their adult children

Question:  I am 75 years old and have a modest amount of savings, a home without a mortgage and a small retirement pension plus my monthly social security check.  I am in relatively good health, and quite candidly hope to live for another 10-15 years.  I have one child who is in her 50s but can’t seem to keep a job or a marriage.  She is again without a job and is now divorced for the 3rd time.  My question is whether I should start gifting her my money and perhaps gift her my home as well in anticipation of my needing nursing home care in the future.  What would you recommend I do from a financial planning perspective, factoring in the fact that elder care cost so much in California?”

Answer:  It is great to hear that you are in good health, but your finances may not be as healthy as you are.

The good news is that your estate is under the current $5 million limit, so there are no estate tax issues.

The bad news is that, based on your information, you have very limited liquidity, and liquidity is the secret of financial survival.  In my opinion, you need to have $1 million in liquidity, that is cash, stocks, or a pension plan, so that you are financially secure during retirement.

Also, there is a real concern about Medicare.  Will it be around in 10 years and will it pay the lion’s share of your medical expenses in the future, and if not, will you be able to afford these medical expenses?

Another concern that you should have is that California is bankrupt.  What affect will this have on its ability to provide California residents with Medi-Cal benefits?

If you have not done so already, I would suggest that you do the following:

  1. Meet with a financial planner to develop a financial “road map”.
  2. Meet with an attorney to have the following legal documents prepared:  Power of Attorney for Health, Power of Attorney for Finances, and a Living Trust (which can help your estate avoid the high cost of Probate)

Finally, regarding your daughter.  I would suggest that at 50 years of age that she assume responsibility for herself–that she find a job, and perhaps start thinking about taking care of you and your elder care needs.

Hope this helps.

Orlando J. Antonini, CPA/PFS, CFP, QFP, RIA, NCG
Antonini CPAs LLP
San Francisco, California
Member of the national ElderCare Matters Alliance, California chapter


Today’s Q&A on ElderCareMatters.com is about decision making and Powers of Attorney

Question:  If you have the Power of Attorney for a person what sort of paperwork do you need to keep, and are you authorized to make decisions re: the care of that person in an assisted living facility or nursing home if the person is still in his/her right mind?

Answer:  Once the durable Power of Attorney for health care or finance is in place, the designated person who holds the Power of Attorney should keep as much documentation about the person as possible, including a list of their medications, physician’s report including diagnosis, allergies, etc., advanced healthcare directive, POLST (physician’s orders for life sustaining treatment), DNR (do not resuscitate) , family history, medical history, copy of the Will, bank information, mortuary information, etc. The Power of Attorney is authorized to make decisions re: the care of that person in an assisted living facility or nursing home even if the person is still in his/her right mind.

My answer to your question is based on my many years of being a long term care Administrator.  If you need more specific information about these legal documents, I would suggest you contact an Elder Care Attorney in California, which can be found on ElderCareMatters.com.

Daniela Berindei, Administrator
Elite Elder Care
El Dorado Hills, California
916-267-1346
Member of the national ElderCare Matters Alliance, California chapter


Today’s Q&A on ElderCareMatters.com is about Medicaid-Funded Home Care

Question:  I am caring for my mother in my home in California.  It is a full time job.  Will the state provide any kind of assistance to pay for this elder care?

Answer:  The state of California offers a program called In-Home Supportive Services (IHSS), which is paid for by Medicaid funds (MediCal, in California).  The program, administered by each county, does provide a certain number of home care hours, based upon an assessment by a county social worker.   

The care may be provided by a family member, who is paid by IHSS, if the recipient qualifies for MediCal and the caregiver is acceptable to IHSS.   

There is a Website with links to each of the counties’ offices: http://www.cdss.ca.gov/agedblinddisabled/pg1785.htm 

If your mother does not qualify for MediCal, you can talk to a reputable employer-based home care agency about the possibility of working for that company.  The care will not be free to your mother, of course, and you would have to pass the agency’s background screening, but you would be legally employed.

Bert Cave, President
Support For Home
Sacramento, California
916-482-8484
Member of the national ElderCare Matters Alliance, California chapter


Today’s Q&A on ElderCareMatters.com is about Daily Money Management

Question:  I’ve been hearing a lot lately about a new service called “Daily Money Management” that may help my mother.  Would you please let me know what this new elder care service is, including the benefits of using a Daily Money Manager, and what the cost of this service will be.  Thank you.

Answer:  Daily Money Managers help people handle their daily finances and, depending on their individual practice, a variety of other administrative tasks.

There are 2 different daily money management programs at Diablo Valley Foundation for The Aging: AARP Volunteer Money Management Program and Fee for Service Money Management Program.

The AARP Volunteer Money Manager Program offers money management service to help low-income older and/or disabled adults who have difficulty budgeting, paying routine bills, and keeping track of financial matters. An AARP Money Manager can also help deal with some debt problems, help obtain credit report/score. Organizations like Diablo Valley Foundation (DVFA) supervises volunteers and monitors all accounts. AARP recruits volunteers for the program and provides general guidelines. 

Within AARP Volunteer Money Management Program, there are 2 programs: Representative Payee and Bill Pay. 

When someone becomes the Representative Payee, he or she will set up a new bank account which is accessible only to the Representative Payee. A volunteer is assigned who will visit the client, work out a budget, and pay the bills. Clients must be 60 years old and older, and have a qualifying annual income limit of $35,298 for a single person and $49, 947 for the couple, assets under $35,000 (excluding home and car). AARP requires a medical verification of client’s inability to manage his/her own finances. 

A monthly fee for Representative Payee Program may be charged depending on income and other expenditures 

If someone becomes Bill Payer, all of the above applies, except the client retains control over his/her accounts, and medical verification is not required. 

A monthly fee for Bill Payer Program may be charged on case-by-case basis. 

A Fee for Service Money Manager will research all financial documents to determine the clients’ financial position and assets, sets up a Quicken or other financial software program that will track assets, expenses, and income. The Fee for Service Money Manager also writes client’s checks upon receipt of bills, reconciles all accounts monthly to statements, and sends reports to family when requested. 

FFS Money Manager also reviews all accounts to analyze net worth, transfers funds when necessary, makes deposits/withdrawals from clients’ accounts, and prepares information for annual tax preparation. 

Basic FFS Money Management fee is around $50/hr plus mileage to client’s residence.

Robert Kain, Executive Director
Diablo Valley Foundation for the Aging
Walnut Creek, California  94595
Member of the national ElderCare Matters Alliance, California chapter


Today’s Featured Elder Care Expert on ElderCareMatters.com is Kathy Bate, California Aging in Place Specialist

Question:  “I am seeking information about Aging in Place.  What is it, what are the advantages of Aging in Place vs Institutional Care, and what is the difference in cost?”

Answer:  Aging in Place means that residents don’t need to move from their homes in order to accommodate their changing needs. When surveyed, over 85% of the older population say that they would prefer to stay in their homes rather than relocate to assisted living or nursing homes if possible. Major life changes in our Senior years such as moving away from friends and neighbors is very stressful and disorienting. Staying in one’s home is a lot less expensive than being institutionalized and can contribute to longer, happier lives. In California, it can cost up to $100,000 per year to live in Assisted Living. For less than that amount, modifications can be made for safety and ease allowing Seniors to stay at home for perhaps 10-20 years.Children of Seniors  can show great care and compassion for Mom and Dad by spending a little in advance to make their homes safe and accessible through minor modifications.

Is it better to spend $80,000 – $100,000 per year (15 x $100,000 = $1,500,000) at Assisted Living or spend $80,000 x 1 = $80,000 and live at home for another 15 years? 

As an Aging in Place Specialist (CAPS certification by the National Association of Home Builders), we are able to recommend and offer attractive design solutions that create a safe and comfortable environment for individuals who want to age in place…but are not experiencing health issues that require constant medical care, or have progressive or other conditions that require home modifications/equipment, or are dealing with an abrupt or traumatic health-related change. 

At that time “Adaptable” and “Accessible” Design may become necessary. Then a team of experts including patients P.T.and O.T. offer their recommendations to guide your interior designer and contractor to make more extensive modifications including special medical equipment. Depending on the progression and longevity, these major modifications may or may not be the best solution. 

I encourage all my clients who want to stay in their homes to plan ahead now when remodeling their home. Well-designed kitchens and baths, wider hallways and door openings, and open floor plans that offer “Universal Design” elements can provide multi-generational access and even increase the value and saleability of ones home. Aging in Place Design really is valuable for anyone at any age – we are all aging every day.

Kathy Bate, ASID, CID, CAPS
Designs for Independent Living
The national ElderCare Matters Alliance, California chapter
ElderCareMatters.com

 


Next Week’s Featured Elder Care Experts on ElderCareMatters.com

Next week’s Featured Elder Care Experts on ElderCareMatters.com will be the members of the California chapter of the national ElderCare Matters Alliance.

All next week, the members of the California chapter of the national ElderCare Matters Alliance (who are some of America’s top Elder Care Experts) will answer your questions about a wide range of elder care matters (from legal, financial, caregiving, housing, etc.), and their answers to your questions will appear on ElderCareMatters.com.

So if you have questions about elder care matters, send us an email at Questions@ElderCareMatters.com, and one or several of our Elder Care Experts from the California chapter of the national ElderCare Matters Alliance will answer them on the homepage of ElderCareMatters.com.  (Please include your name and email address)

Thank you for your interest in Elder Care Matters.

Phillip G. Sanders, MBA, MSHA, CPA
Founder & Chief Executive Officer
ElderCare Matters, LLC
ElderCareMatters.com


Today’s Q&A on ElderCareMatters.com is about a new website, ElderCareWebsites.com

Question:  “In my opinion, the more Elder Care Resources there are available to help families with their elder care matters the better decisions they will be able to make about this most important issue. My quesion is whether ElderCare Matters (since you are already an established company) would consider financially sponsoring another website, one that would be an alphabetical directory of some of America’s top elder care websites so that families across America could also refer to this resource for additional help with their elder care matters?”

Answer:  What a great idea!  It is our pleasure to be able to financially sponsor another elder care resource for families across America to use to make better elder care decisions.

In fact, several weeks ago we launched www.ElderCareWebsites.com, a FREE, secure online elder care resource that includes many of America’s top elder care websites.  This is where families can find an alphabetical listing of company websites that have information about a wide range of elder care / senior care services, including Elder Law, Estate Planning, Financial Planning, Daily Money Management, Geriatric Care Management, Home Care, Long Term Care Insurance, Senior Housing, etc.

Feel free to bookmark this online listing of elder care websites, and don’t forget to check back often for additional websites that soon will be listed on www.ElderCareWebsites.com, an elder care resource that includes many of America’s top elder care websites.

Phillip G. Sanders, MBA, MSHA, CPA
Founder & CEO, ElderCare Matters, LLC
The national ElderCare Matters Alliance

www.ElderCareMatters.com

 


Question of the Day on ElderCareMatters: "Why is it important for me to have a Power of Attorney?"

Answer:  We all can expect to age and none of us are immune to health crises that may leave us incapable of properly handling personal financial matters. You want to make certain that someone you have complete trust in (known as your agent) will manage your affairs if you are unable to do so. The Power of Attorney (POA)  is a way to do this.
 

A POA is an extremely powerful document that your agent can use for a variety of Medicaid, estate and long term care planning needs, both foreseen and unforeseen.  Once you choose your agent – someone you have full, total and complete trust in – your POA authorizes that agent to act on your behalf to perform such functions as drawing checks on your bank accounts for specific purposes, append signatures to routine correspondence, act as a signatory to real estate closings and buy and sell financial securities. 

  

After your possible incapacity, your agent will be empowered to sign your name and is obligated to act in your best financial interest at all times and in accordance with your wishes.

 

Paul T. Czepiga, Esq., CELA
Czepiga Daly Dillman, LLC
Newington, Vernon, Wethersfield, CT
860-597-7995
www.CtSeniorLaw.com
Charter Member of the national ElderCare Matters Alliance, Connecticut chapter
 


Today’s Q&A on ElderCareMatters.com is about Geriatric Care Management

Question: “My elderly parents live in Oklahoma and I live in Texas. I want them to move into an assisted living facility or to an elder adult community, but they want to stay in their own home. I have heard of Geriatric Care Managers, but I don’t really know how my parents would benefit from their services. Can you provide insight into how these elder care experts could perhaps help my parents stay in their home and help me not worry about them?”

Answer: Perhaps you’ve noticed memory loss, a decline in what your loved one is able to physically do or increased medical issues. This can be frightening, whether you live out-of-state, or nearby. Sometimes we think that having them move into some type of assisted living situation is the best or only solution, but that isn’t always the case. You and your parents can benefit greatly from the services of a geriatric care manager who can help you sort through appropriate options while considering your parents’ and family’s values. A geriatric care manager (Care Manager) is a health care professional who strives to offer objective information and alternatives to support the well-being, safety and independence of your loved one.

Care Managers help elders and their families by:

  • Providing a comprehensive assessment to determine if living at home is a safe option. If not, care managers can offer professional, objective opinions to assist families as they sort through the decision process for elder care residential options;
  • Arranging and managing in-home services to assist with health, home and personal needs;
  • Providing short and long-term support to families engaged in local or long-distance care giving;
  • Coordinating health care appointments and necessary medical follow-up;
  • Preventing unnecessary or repetitive medical care;
  • Helping to navigate complex medical systems, diseases and insurance issues;
  • Assisting primary caregivers in the home, across town or at a distance, in coping with emotional stress caused by elder care;
  • Offering education and support to manage the disease process (Alzheimer’s, Cancer, etc.);
  • Giving caregivers the information necessary to make early informed decisions about health care needs before an acute situation arises;
  • Supplying an extra pair of eyes and hands to help with the care of a loved one.

Gina Fisher, LCSW
Executive Director of Clinical Operations
University of Oklahoma College of Nursing – Life Stage Solutions
Member of the national ElderCare Matters Alliance, Oklahoma chapter

 


Today’s Q&A on ElderCareMatters.com is about VA Benefits for assisted living

Question:  My 87 year old mother is in declining health and needs to move to assisted living.  I’m worried about the cost because she’s on a fixed income.  My father served during World War II.  Is she eligible for any kind of Veteran’s benefit?

Answer:  The surviving spouse of a veteran who served at least 90 days of consecutive active duty service, at least one day of which was during wartime, may qualify for a non-service connected pension from the Veterans Administration.  The surviving spouse must have been married to the veteran for at least one year (or have had children by the veteran if married less than one year) and been living with the veteran throughout the marriage and at the time of the veteran’s death. 

If your mother has limited assets, and if the cost of assisted living, combined with her other out-of-pocket medical expenses, will exceed or come close to her total annual gross income, she should be eligible for a widow’s pension.

Debra A. Robinson, Esq.
Robinson & Miller, P.C.
Alpharetta, Georgia  30005
770-817-4999
Member of the national ElderCare Matters Alliance, Georgia chapter


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