The Future and Security of your Son or Daughter

What Will Happen After I'm Gone?

Imagine for a moment that tomorrow evening, on your way home from a party, you and your spouse pass away in a car accident. Have you ever wondered what will happen to your child* with a disability after you are gone? Who will watch your child or who would be the guardian or trustee? Stop wondering. Through a very special planning process you can ensure that all these concerns are taken care of.

Estate and Financial Planning for a person with a disability is like no other type of planning-it is special. Imagine a process that will assure that your child with a disability will always have a friend, advocate and protector of their legal rights and insure that your child's governmental benefits are never altered, diminished or destroyed as well as ensure that they will have a meaningful life after you are gone. This is what Special Needs Planning can accomplish.

Why a Will is NOT Enough

If you were to die with only a Will in place or no planning at all for your disabled child, any estate left to your child is, in reality, a gift to the government! Your child will lose his or her benefits and medical coverage while spending down your well-intentioned inheritance. It is a gift to the government instead of your child. Unfortunately this knowledge has led most parents to intentionally disinherit their child with a disability.

The Perfect Solution: The Special Needs Trust

There is an alternative to the harsh realities of a Will-it is the Special Needs Trust (SNT). The Special Needs Trust is the ONLY reliable method to make sure your inheritance and gifts benefit your child with a disability. The point of the SNT is to keep the assets in a form that will be available for your child but will not disqualify him or her from benefits for which he or she might be eligible

A properly drafted Special Needs Estate and Financial Plan will specify that the money is not to replace the benefits, but is to supplement them and ensure that funding is available to meet your goals. The SNT may be used for extra medical care, personal items such as TV's, radios, computers, vacations, companionship, advocates or any other item or service to enhance your child's self-esteem or situation-anything but food, clothing and shelter.

While government agencies recognize SNTs, they have imposed very strict rules upon them. This is why it is vital that you consult an experienced attorney-not just one who does general estate planning, but one who is knowledgeable in SNTs and current benefit law! One wrong word or phrase can make the difference between an inheritance that benefits your child and one that causes your child to lose the many services, assistance and benefits available.

The Letter of Guidance

Almost as important as the SNT is the Letter of Guidance. The Letter of Guidance helps pave your child's transition by giving future caregivers the information about your child they so vitally need. A Letter of Guidance is based on the premise that no one knows your child better than you do. It is a document that describes your child's history, current status and what your wishes, hopes and dreams are for him or her.

The Letter of Guidance addresses the following areas:

• Family History
• Medical History
• Housing
• Education
• Religion
• Rights & Values
• Leisure & Recreation
• Likes & Dislikes
• Day Programs//Work
• Daily Routine
• Daily Living Skills

When Should I Plan?

The answer is simple. Start Now. Start Today. Procrastination is easy-when your health is good, the future looks bright and there are hundreds of other pressing tasks to be done. Yet none of us can predict the future. What will happen to your child if something happens to you? Plan NOW and say to yourself, "I know I've done all I can for my child's future-something that was extremely important to do. Now I am relieved and that is very exciting!"

Special Needs Planning – With Special Needs Estate and Financial Planning you can Provide a Meaningful Life for your Loved One with a Disability After you are Gone.

• Provides Lifetime Supervision and Care
• Maintains Government Benefits
• Provides Supplemental and Special Needs Benefits
• Avoids Family Conflict

One Parent’s thoughts about Planning:

One parent shared their experience about how they felt about planning as follows:   It has been in the back of my mind for years, soon after I found my son had this lifelong disability.  What would the future hold for him when I wasn’t there anymore to be his advocate, friend and supporter?  It was both a big and little worry.  Big, because it gave me a whole in my gut whenever the question crept in.  And little in the sense that I tried not to think about it.  I’d think I’ll worry about that tomorrow, next week, when he’s older, when I’m older.

Of course, I’ve done things to prepare for that future he’s going to have without me, things like teaching him how to wash clothes and shop.  But should I write a will?  Make an estate plan?  No, for years, I dodged that one totally.  But you know, it’s funny.  Now that we’re finished up our estate and only need to periodically review our plans, I feel like an enormous burden has been lifted up from me.  The big, black, scary, shadow is gone.  Well, not totally gone, I suppose.  I still worry about Sam, what will happen to him in his life.  I guess every parent does that.  But now I don’t worry the same way.  I have done all I can do for that part of his future, something that was extremely important to do, and I am very relieved.  Now I feel like we can deal fully with the present day and see to see the other things that need to be done to prepare for our child as an adult.  And that is very exciting.

Don L. Rosenberg, Attorney and Counselor
The Center for Elder Law
Troy, Michigan  48098
Premium Member of the national ElderCare Matters Alliance, Michigan chapter

An Adult Day Care Perspective on Health Care

All of you reading this, no doubt, have had some sort of dealing with day care. However, most people only have an experience with a traditional child daycare.  While not a new concept, adult day care has quietly gone unnoticed.  Few know what adult day care is, what occurs at an adult day care center, or even where one is in any particular community.  Few insurance companies have adult day care centers listed as providers in their policies, yet the adult day care center industry could save insurance companies and taxpayers a great deal of money.  Now, the Affordable Healthcare Act (AHA) hits hospitals with readmission penalties for chronic patient readmissions.   As such, alternatives are necessary.  Adult day care centers bridge the gap between an elder living at home or with family and assisted living.  Adult day centers are here to help.

The driving force to change this industry is financial.  This is relevant to the post acute setting.  According to The Washington Post, “The federal government and health policy experts consider frequent readmissions a sign of the shortcomings of the nation’s health-care system, with more than one in five Medicare patients returning to the hospital within a month of discharge” (Rau, 2012).  Some readmissions are just unlucky, but in many cases they are preventable with the proper care setting.  Medication errors and injuries due to illness or the side effects of medication are often causes for these readmissions.  These specific problems, among others, reside within the realm of an adult day care center.  The federal government, through the AHA, is now aggressively penalizing hospitals for frequent readmissions within thirty days of discharge.  This begs the question, “What do we do with our patients at discharge?”  According to data provided by the Genworth Cost of Care Survey in 2012, the median daily cost of care for an individual in adult day care is approximately $2,010 per month.  This seems very reasonable compared to home health ($4,560 a month per an 8 hour day), an assisted living facility ($3,300 per month), or a semi private room at a skilled nursing facility ($6,000 per month) (Genworth Financial, Inc., 2012).  From a financial perspective alone, the day care industry is set to provide a much-needed effective lower cost option in the post acute setting.

According to the National Adult Day Services Association, there are approximately four thousand six hundred adult day care facilities nation-wide (National Adult Day Services Association, 2010).  Many of these facilities are not licensed because they fall below the pre-determined number of patients regulated by the state.  Tennessee, for instance, requires a license if ten or more are in a day care center (Tennessee Department of Human Services, 2000).  To obtain and retain licensure, these facilities must meet the minimum guidelines set forth by each state.  Again, in Tennessee, there are requirements regarding the amount of education a director must possess, minimum staffing standards, space requirements, and a multitude of other life safety standards in order to keep their citizens safe.   Only licensed day care facilities can serve Medicaid, Veteran Affairs (VA) and those insured by long-term care policies.  The caretakers in a licensed facility assist clients with the activities of daily life, help with medication management, aid in physical and mental activity, provide social interaction, and monitor safety concerns during the course of a day.   The adult day care center is a viable alternative for those families that are fortunate enough to possess a support structure during evenings and weekends.  For others, it would reduce the necessity of expenditures of exorbitant amounts of money on private duty in-home caregivers.  In all instances, it allows people to spend time where they want to be, at home.

Not all adult day care facilities are the same.  Some operate very similarly to the day care where a working parent might take his or her children.  Others operate under a medical model.  There are day care centers that employ registered nurses, therapists, counselors, doctors, and dieticians.  These facilities have access to all of the medical benefits that one could receive in an assisted living facility or skilled nursing facility, at superior care ratios to either, and some even operate directly within an assisted living or skilled nursing facility.  However, many are stand-alone facilities, owned and operated locally by friends, families, and neighbors.

The digital age is closing all the space that exists between our borders.  It allows us to streamline medical records and charting.  It provides our patients with a wealth of information about each of our services.  We are now able to seamlessly move up and down the spectrum of care.  The inclusion of day care gives caretakers a cost effective option among all the other more expensive alternatives.  Patients may be admitted to the hospital, then discharged to a skilled nursing facility, and subsequently admitted to an adult day care—all of these steps completed to ensure that each person is fully equipped to return to the life that he or she would like to live.   

We hear working adults say, we are a “sandwich generation.”   We find ourselves not only having to care for our children, but we are caring for our parents as well.  This is a combination of economics and timing.   We are experiencing burnout and our loved ones are suffering.  Our generation has grown up and has worked with computers and the internet for most or all of our working lives, and we are nevertheless a busy and efficient bunch.  However, we are all looking for answers to this dilemma.  Without the health industry recognizing the role of adult day care, these families are looking at massive financial and social obstacles when searching for necessary health care for these most important people in their lives.

J. Michael Leebron, Director
Spectrum of Care Adult Day Center
Murfreesboro, Tennessee
Premium Member of the national ElderCare Matters Alliance, Tennessee chapter

Trust Basics

by Scott A. Makuakane, Esq., CFP
Counselor at Law, Est8Planning Counsel LLLC
Honolulu, Hawaii  96813
State Coordinator of the national ElderCare Matters Alliance, Hawaii chapter

A trust is the legal relationship that is created when a person transfers “stuff” to a trustee with the understanding that the trustee will manage it for the benefit of one or more beneficiaries.  We use the term “stuff” to mean any kind of property you can own.  It includes both real property—such as land and buildings—and personal property—such as bank accounts, stocks and bonds, and personal effects.  The person who transfers the stuff to the trustee is called a trustmaker.  This person is also known as a settlor, grantor, or trustor.  Usually, the trustmaker is also the trustee (or perhaps co-trustee) and the initial beneficiary of the trust.  It is not uncommon for husbands and wives to create two separate trusts and to be the co-trustees of both of their trusts during their joint lifetimes, and then, after the death of one spouse, to have the survivor serve either as sole trustee or co-trustee with one or more other individuals or a trust company. 

A trust is controlled by a document called the trust agreement (sometimes called the trust instrument).  The trust agreement sets out the rules about how the trust will be run.  We often refer to a client’s set of estate planning documents as their “rule book,” and the trust agreement is the part of the rule book that controls the trust. 

If the trust agreement says that the trustmaker can revoke it or change it, the trust is what we call a revocable trust.  If the trust agreement does not allow the trustmaker to change or revoke it, we have what is called an irrevocable trust.  Irrevocable trusts are used in many estate plans.  They allow trustmakers to make gifts but keep the recipients from having complete control over the gifted assets.  Irrevocable trusts play an important part in many estate plans.  They can help provide tax savings, creditor protection, and expert management of assets. 

A living trust is one that you create and fund (transfer stuff into) during your lifetime.  It can be revocable or irrevocable, depending on how much control you want to maintain over the trust and its assets.  A revocable trust gives you complete control, whereas an irrevocable trust gives you limited or no control.  A testamentary trust is one that goes into effect and is funded following your death because it is governed by your last will and testament. 

You remain in control of your trust assets as long as your trust is revocable.  The trustee is bound by the trust agreement.  You have final say over what the trust agreement says, and failure to abide by the trust agreement can make the trustee personally liable to the beneficiaries, including yourself.  This means that if the trustee messes up, that person may have to pay for the mess out of his or her own pocket.  Most often, the trustmaker of a revocable living trust is the initial trustee.  In that situation, the trustmaker does not have to worry about anyone questioning his or her management of the trust.  In fact, potential beneficiaries have a vested interest in not doing anything that might cause the trustmaker to revoke the trust or change the trust agreement in order to exclude a troublemaker.  This is a simple demonstration of the “golden rule” of estate planning: 

      The One who hath the Gold maketh the Rules

 If your kids are good kids, they won’t stick their noses into what you do with your trust.  If they are bad kids, hopefully they are smart kids and will at least act like good kids as long as you’re alive because they won’t want to be disinherited.  If you do not have any children—or don’t have any that you like—don’t assume that revocable living trusts are not a good idea for you.  There are many good reasons for creating trusts, and some of them may apply to your situation.  One reason that many people create revocable living trusts is so that their stuff will not go through probate after they are gone, or through conservatorship if they become incapacitated. 

Once assets are transferred to the trustee, the trustmaker no longer holds legal title to them—even if the trustmaker and the trustee are the same person.  Thus, if the trustmaker dies or becomes incapacitated, the trust continues, and the successor trustee (who is named in the trust agreement) takes over administering the trust.  

Trusts are often the building blocks of effective estate plans.  They provide simplicity, flexibility, and predictability in dealing with your assets.  The also give you the peace of mind of knowing that you have arranged your affairs to ensure that your wishes will be carried out, and that future transitions (such as your incapacity or death) will be much easier on your loved ones.

 ARE YOU HAVING A BAD HEIR DAY? 

By James J. Ruggiero Jr. Esq., AEP®
Ruggiero Law Offices LLC 

As Benjamin Franklin once said, “You may delay, but time may not.” No truer are these words than in the case of estate planning. The average person allows 10-to-15 years to elapse before revising his or her estate plan. Life’s ups and downs, and the impending estate tax law changes, present the opportunity to protect your legacy. 

Unless Congress acts before the end of the year, in 2013, the estate tax rates in effect prior to the Bush tax cuts enacted in the early part of the last decade return. Although in 2012, the maximum rate was 35 percent on taxable estates in excess of $5,120,000, in 2013, the top marginal rate will be 55 percent, and the exemption rate will decrease to $1 million. For example, if your estate were worth $1.5 million, in 2012, you would not have paid federal estate tax; whereas, in 2013, you will pay federal estate tax because of the decreased exemption. With the potential impact of this in mind, don’t let the heir day of your loved one turn out to be a bad heir day, which most of us run the risk of doing by failing to implement an estate plan in the upcoming year.           

By way of example, in 2006, 46 percent of the general public had a will; however, in 2007, that percentage dropped to 37.  But actually, estate planning is about more than having a will.  Four basic documents encompass a good estate plan:  a Last Will and Testament, a General Durable Power of Attorney, a Healthcare Power of Attorney, and a Living Will. 

Each of us needs an updated Living Will 

The recent celebrity case involving Gary Coleman provides a clear example of the ills that can occur without an updated estate plan. In 2006, Coleman created a healthcare directive that gave his then-wife power to make medical decisions if he became incapacitated. It apparently included a statement to prolong his life for as long as possible. After divorcing and failing to revise his healthcare directive, Coleman suffered a head injury and was admitted to the hospital, diagnosed with a brain hemorrhage.  Coleman’s ex-wife decided to take Coleman off life support only one day after he was admitted.  

In some states, divorce fails to nullify a healthcare directive.  If you have been through a divorce, it is wise to review your estate documents to ensure they continue to reflect your wishes.  

Form your own dynasty 

Although problems can arise due to neglecting to update healthcare directives, preserving wealth is perhaps the greatest concern. Too often, we underestimate the size of our estate, not realizing the problems this can cause after we have gone.  Trusts provide a viable option for ensuring that your heirs do not pay excessive estate taxes upon your death.  Different types of trusts are available to meet your needs and the needs of your loved ones.  

A dynasty trust is one way wealth preservation can be achieved.  Despite its name, the term has nothing to do with aristocracy.  With a dynasty trust, you transfer the assets of a business, real estate, or other income-producing property to the trust. Depending on the exact terms, the income accumulates or is paid out on behalf of the trust’s beneficiaries: children, grandchildren, or even remote descendants. Assuming the assets remain in the dynasty trust, they will not be included in a beneficiary’s estate when he or she dies.  Thus, the asset values can continue to compound over several generations without any erosion due to estate taxes.  Further, because the beneficiaries do not own the assets, there is protection against loss from creditors or divorce proceedings. Wealth is preserved and remains in the hands of family–with little or no tax consequences. 

Create a “heir” style that works for you 

When is a good time to update your estate plan?  While it is always good to maintain a current estate plan, significant life events mandate a revision.  If you’ve recently started a business, you may need to update your estate plan.  Crucial aspects, such as business succession planning, guarantee that the wealth you’ve worked so hard to build is passed on to those you love or designate. Additionally, our changing economy can result in loss of a job or early retirement, both invoking the need for a review.  Similarly, a spouse that is re-entering the work force or changing from full- to part-time status, necessitates re-evaluating your assets.  

Changes in family may dictate a change in your estate plan. If a son or daughter should marry someone you would prefer not to include as an heir, inevitably, you would want to take a second look at your estate planning. You would find it important to avoid the risk that your wealth could end up in the hands of a former son- or daughter-in-law. 

Indeed, even if you like your in-laws, other life events can trigger an update to your estate plan.  Have you recently moved into Pennsylvania? Or, are you planning a move to another state?  If so, it is good advice to learn about the laws of your new locale to make sure that your plans are protected. Even marriages, births, and other happy events in our lives should awaken the notion that our estate plans need to be re-examined. 

Perhaps you have a domestic partner who you would wish to one day become your heir. Pennsylvania does not recognize same sex or common law marriages. Thus, in this Commonwealth, a same sex or opposite sex non-related individual inheriting from you will be taxed at a rate of 15 percent. Don’t let him or her experience a bad heir day. Trusts and other estate planning, such as beneficiary designations on financial accounts, can play an important role in preserving the assets of your domestic partnership. 

Most of us put estate planning on the back burner. It’s easier to choose to wait for tomorrow. By contrast, we go to the barber or beauty salon on a regular basis because we defy being caught having a bad hair day! Applying mousse, gel and spray guarantees we will have a good hair day.  Similar protection in the form of a good estate plan can be applied so that a bad heir day is likewise avoided.  

Have your estate plan updated today, and do wonders for your heir!

Scott A. Makuakane, Esq., CFP
Est8Planning Counsel LLLC
Honolulu, Hawaii
808-587-8227
Member of the national ElderCare Matters Alliance, Hawaii chapter

The national press has picked up several reports in the Honolulu Star-Advertiser about the plight of Karen Okada.  Karen is a 95-year-old woman who signed a “Death with Dignity Declaration” and a “Durable Power of Attorney for Health Care Instructions” back in 1998.  Both documents purport to control “in all circumstances.” 

The Queen’s Medical Center, where Karen was hospitalized for pneumonia, determined that Karen was essentially brain dead, or, in any event, had “permanently” lost the ability to participate in medical treatment decisions, and that the provisions of her Death with Dignity Declaration required that her feeding tube be withdrawn.

On the other hand, Karen’s health-care agent, in consultation with doctors who are not associated with Queen’s, disagreed with the conclusions reached by the Queen’s physicians.  What the agent knew, and the Queen’s physicians discounted, was that just before she was hospitalized at Queen’s, Karen was conscious and able to interact meaningfully with her family and caregivers.  During the time she was at Queen’s, on the other hand, Karen was for the most part unresponsive when doctors examined her, but her family reported that she smiled at least twice at her adult grandchildren and nodded to her grandson in response to his question of whether she was able to breathe freely.

The policy of Queen’s was to give precedence to an advance health-care directive over a durable power of attorney in all events, and without inquiring into why a person may have signed apparently contradictory documents.  Accordingly, Queen’s took the unusual step of suing Karen’s health-care agent in order to get a court order forcing him to direct Karen’s physicians to remove her feeding tube.

Of course, no one would want to be part of this kind of drama.  So what can you do to make your wishes clearly known so there will be no questions about how to carry them out?

1. If you do not have an advance-health care directive in place, get one.  Make sure your loved ones—including your children over the age of 18—have advance health-care directives too.
2. Learn all you can about the options that can be written into your advance health-care directive.  These are not “one size fits all” documents.  Your wishes may differ greatly from those of your friends and family members, and the document you sign should express your particular desires.
3. If you have an advance health-care directive that is more than 5 years old, there is a good chance that it will not accomplish what you think it will.  Review it right away with your legal counsel.  Make any appropriate changes and updates.
4. If you want to give a trusted family member or friend the power to make health-care decisions for you, make sure the power of attorney meshes well with any other instructions you may want to provide.
5. Be sure to give your health-care providers your permission to give your medical information to your family members or other trusted decision makers.  Federal and State privacy laws can restrict your doctor from talking with your health-care agent unless you specifically grant that permission.
6. Review your advance health-care directive periodically to make sure it accurately states your current wishes.  Once per year is not too often.
7. Make sure you have a mechanism in place for giving you access to your advance health-care directive, no matter when or where an emergency might occur.  Not all health problems happen in the home, and if you have a crisis situation while you are travelling, you will need a way to make your health-care documents accessible to your caregivers.
8. Talk with your family about your wishes BEFORE a crisis arises.  Make sure everybody is on the same page.  If your chosen decision makers indicate hesitation about carrying out your wishes, think about naming someone who will.  Your assurance to your loved ones of how seriously you intend your instructions to be taken will give them the courage to carry them out. 

Knowledge is power.  The more you know about advance health-care directives, and the sooner you act on that knowledge, the more likely it will be that your wishes will be carried out.

In case you were curious about what happened to Karen, her family was successful in gaining her release from Queen’s and placing her in a care home.  Since then, Karen has gained 20 pounds and has regained her ability to interact meaningfully with her family.

Heather R. Chubb, Esq.
The Chubb Law Firm
Fair Oaks, California
916-241-9661
Member of the national ElderCare Matters Alliance, California chapter

Keeping Our Seniors Safe From Scams

Our seniors are a charitable bunch, but sometimes that can get them into trouble.  And the scammers out there know it.  The scammers know that our seniors are often isolated and being a friendly bunch are willing to talk to a friendly voice.  They also know the mail is the highlight of the day for many seniors.  Seniors are also inclined to provide information via surveys.  And everyone likes to think they could win it big with the lottery or sweepstakes.

Take my father in law.  He has always been charitably minded, but when the stack of donations threatened to topple off the kitchen counter we knew there was a problem.  This is a smart man who had a very successful career in sales, but now he was exhibiting signs of short-term memory loss and reduced executive function.  We learned soon thereafter that he did indeed have all the hallmarks of Alzheimer’s disease.

The charitable snowball was a wake up call for my family. It was really scary when we started digging into things.  At one point, we made a list of all the “charities” he donated to and it topped 100.  Fortunately, it wasn’t big amounts, $15 – $30 at a pop, but that added up quickly to hundreds of dollars a month.  Not surprisingly, in researching these “charities” we determined that some of them were not  non-profit 501(c)s and many of them used the majority of the money they received not for their charitable purposes, but rather for administration and obtaining more donations.

We found the following resources to be very helpful in wading through this mess.

Check out the credentials of a potential charitable organization before you make a donation.  Charity Navigator – www.charitynavigator.org - is a great site to gather information.

You can also confirm charitable status of an organization through the IRS web site- www.irs.gov/app/pub-78/– remember that some organizations (like churches) may not be listed, so ask the organization for more information if you’re not sure.

Charity Watch (formerly American Institute of Philanthropy)  www.charitywatch.org rates many organizations and provides copies of their annual reports.  This is where you can find information about how they are using the funds, especially the amount spent on administration i.e., fundraising.

The Better Business Bureau Wise Giving Alliance—www.bbb.org/us/charity/ - publishes the Wise Giving Guide three times a year.  The Guide summarizes the results of the Alliance’s latest national charity evaluations and features a cover story, usually with giving tips, on charity accountability issues or other topics of interest to donors.

The more difficult item that we also dealt with was surveys.  My father-in-law received surveys from all sorts of groups, many with often polar opposite political slants, and he felt compelled to fill them out and return them, sometimes with a donation.  This only served to get his name on more lists and create more mail.

Finally, and most dangerously, there were the “sweepstakes” and “lottery” winner letters.  Hundreds of them.  You know the ones . . . “you may be a winner”. . .  just send in $$ to pay for the tax, insurance, or handling.  In some instances what you are actually doing in returning the response form and fee is agreeing to allow the company to take a monthly amount out of your checking account or credit card to keep you informed of upcoming lotteries, etc.  In other instances they use the information to hound you for more money and will even arrange to come to your house to pick up the insurance and handling fee.

We saw this first hand as well.  We’re sure it started with sending in a response and check, but it ended with a series of increasingly harassing phone calls and his consent to allow someone to come to the house to pick up the insurance fee.  Fortunately we were able to head off the in-person visit and the wiping out of his bank account, but just barely.  It gave us a terrific scare.  No sooner had we closed his bank account and opened a new one, the very next day he received a call from some outfit requesting his bank account number to set up an account to prevent identity theft of his internet accounts!  Sadly, and in this case fortunately, his short-term memory allowed him to give out the old bank account number and no further damage was done.

Three key things to remember when it comes to lotteries or sweepstakes:

No legitimate lottery or sweepstakes will ask you to pay the taxes in advance of receiving your winnings.

If you don’t remember entering, it’s likely a scam.

If it sounds too good to be true, it probably is.

If you have a senior in your life you can do them a world of good by just checking in and taking a look at the mail.  If something seems out of order it may be time for a tough conversation and someone to provide a little more oversight.  Communication with compassion is the key since no one wants to think they can no longer be independent.  But that conversation may lead in interesting directions.  I have a number of clients that were grateful when their loved one offered to help with the everyday financial management such as bill paying.

Here are some ways to prepare for and start tough conversations:

If charitable contributions are getting out of control checking out the charities using the above resources can be a great starting point.

The Federal Trade Commission, among other helpful information for consumers, has a terrific Consumer Alert regarding scams.  You can find it here http://www.ftc.gov/bcp/edu/pubs/consumer/alerts/alt099.shtm

If you have never heard of the “Lottery” organization and/or never entered a drawing this is a big clue that it is a scam.

Read the fine print to see what you are really paying for with the lottery.  No legitimate lottery will make you pay insurance, shipping, or handling, and taxes are not paid up front.

It’s a jungle out there and we all need to do our homework and be safe when it comes to our hard earned money.

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

Don’t Overlook Veterans Benefits for Long Term Care  

Veterans or widow(er)s of veterans may be entitled to a non-service connected  monthly pension to offset long term health care costs such as home health care, assisted living or nursing homes.  Many veterans are unaware of this benefit or assume they don’t qualify because they didn’t retire from the military. 

Who Qualifies? 

The main requirements for a pension for a veteran or widow(er) are:                                

• the veteran served at least 90 days of consecutive active duty         service, one day of which was during a war-time period;
• the veteran’s discharge was not dishonorable;
• the claimant’s income and assets are under certain limits; and
• the claimant has a permanent and total disability. 

Assets

There is no specified limit on the amount of assets, but the VA will look at whether a claimant has sufficient means to pay for health care, taking into account the annual health care costs, and the claimant’s life expectancy.  Assets that will not be counted in the analysis are the home, car and personal belongings. 

Income

 The claimant’s annual medical expenses should exceed or be close to the amount of annual income.  Medical expenses include health insurance premiums, prescription costs, caregivers, home health aides and the cost of an assisted living facility or nursing home.  If the claimant is a married veteran, the medical expenses of both the veteran and the spouse will be counted. 

Disability

 To meet the disability requirement, the claimant’s doctor must confirm that the claimant is housebound and in need of assistance from another individual.  The disability does not have to be service related.  People aged 65 or older are presumed to be disabled and are not required to be rated as disabled under the VA schedule. 

Benefits

 There are three types of tax free pensions available, each with different eligibility requirements and each paying different amounts.  The maximum non-service connected pension is called Aid and Attendance, and is available to a veteran or widow(er) who is either blind, living in a nursing home, or in need of assistance to  manage the activities of daily living. 

2012 Maximum Pension Rates for Aid and Attendance

Single Veteran         $1,703 per month
Married Veteran       $2,019 per month
Widowed Spouse     $1,094 per month

A veteran who qualifies for a non-service connected pension can also apply for benefits through the VA health care system, such as prescriptions, medical equipment, glasses, hearing aids and incontinence supplies. 

In these difficult economic times, an extra $1,094 to $2,019 a month in tax free income is not something to ignore.  If you are a veteran or widow(er) who might qualify, or if you have a family member who might qualify, now is the time to get started gathering the necessary information and filing a claim.  It can take six months or longer for a claim to be processed, but once a claim is approved, payments will be retroactive to the month after the claim was filed.

Harry Felsenthal, Certified Aging in Place Specialist
Licensed Contractor, State of Florida
Call Harry Enterprises, Inc.
Lutz, Florida  33549
813-505-3329
www.CallHarryEnterprises.com
Member of the national ElderCare Matters Alliance, Florida chapter

Aging in Place Means Aging in Your Home

This ultimately applies to everyone on the planet, as we are all aging and will eventually need changes to our home to make life easier and safer.  The best plan for making Aging in Place modifications to your home is, do a little at a time.  Many areas of your home may need adjustments, but if you focus on one area at a time you will be better able to devise a plan for your long-term goal of staying in your home. 

Although we all age, Aging in Place doesn't mean the same thing to everyone.  For some, making adjustments to their home is planning for the future.  For some, making adjustments to their home is a more immediate need.  If you are limited physically in some way due to a birth defect, illness, or injury, the Aging in Place home modifications can be a more urgent matter.  However, this still is an individual need for each persons' individual situation. 

Making a list of priorities is a great place to start.  Your Aging in Place professional can inspect your home, and help you decide what areas of your home should be addressed first.  From there, you will experience a more comfortable lifestyle and ultimately a safer environment.  Each step you take to make your home work better for you will alieviate stress, and give you peace of mind.  If wheelchair access is your primary issue, then building ramps will give you the freedom of entering and exiting your home, or wider doorways can allow you to move throughout your home without assistance.  Adding shower rails, seats, or easy-access stalls can add much needed safety, while alterations to light switches or your kitchen design could just make life more fulfilling.  How wonderful would it feel to get that independence back? 

After you can perform simple tasks around the home by yourself, you will be able to easily prioritize other areas of the home to help your home once again be a sanctuary of peace and safety.  Your high quality of life is the most important goal to achieve, and your Aging in Place specialist will get you there.

Scott Makuakane, Attorney at Law, CFP
Founding Partner, Est8Planning Counsel LLLC
Honolulu, Hawaii  96813
808-587-8227
www.est8planning.com
Member of the national ElderCare Matters Alliance, Hawaii chapter, State Coordinator

The Perils of Joint Tenancy

One day Dad and Mom hear about this great idea called “joint tenancy” and put their sons Moe, Larry, and Curly on title to their house.  Joint tenancy appeals to Mom and Dad because it provides a way for title to the house to pass more or less automatically to the next generation without the headaches of probate.  It’s cheap.  It’s easy.  What’s the worst that could happen?

All goes well for about 20 years, but then one day Moe announces, “My wife is leaving me and she says she is going to take me for everything I’ve got, including my 20% of your house.  She can’t touch that, can she?”  Not to be outdone, Larry chimes in with, “Remember that car crash I was in three years ago after my insurance had lapsed?  Well, the people in the other car got a judgment against me and their lawyer is asking questions about what I own.  I don’t have to tell them that I own a fifth of your house, do I?”

To make a long story short, if Dad and Mom are not able to buy off Moe’s ex-wife and Larry’s judgment creditors, then their house could get sold out from under them.  They would get 40% of the net proceeds, but that probably would not be enough to replace their home with a comparable place to live.  A “cheap” and “easy” estate planning strategy ends up being neither.  If Dad and Mom had invested a little money in having a comprehensive estate plan prepared, they could have held on to their house during their lifetimes and given Moe and Larry their shares of the house in trusts that would protect the house from the boys’ ex-spouses and creditors.

Even if Dad and Mom were to dodge the bullet with Moe’s ex-wife and Larry’s creditors, another way joint tenancy could bite them in the behind is by losing the opportunity to provide some adult supervision for Curly’s share of the inheritance.  If Curly is characterized by bad judgment, bad habits, and hanging out with bad people, Dad and Mom would be foolish to give Curly anything.  What they might want to do instead is have Curly’s share of the house held in trust for Curly’s benefit.  Dad and Mom could place a range of restrictions on when distributions could be made to Curly, from proving to the trustee that he is gainfully employed, to passing a drug test.

While joint tenancy is not necessarily to be avoided at all times and at all costs, it is very important to understand its ramifications.  He (or she) who puts other people on title to assets for probate avoidance/estate planning purposes may be making a huge mistake.  Joint tenancy costs very little at the front end, but it exposes your back end to some very unpleasant possibilities.

Ronald Zack, Esq.
Ronald Zack, PLC
Tucson, Arizona  85701
520-331-3232
www.TucsonEstatePlanning.com
Member of the national ElderCare Matters Alliance, Arizona chapter

Last Will and Testament (Yours and the one the state has for you)

Without a will, or some other form of estate planning, your property will pass by intestate succession.  In other words, if you don’t have a will, the state has one for you.  The problem is that the state may not do things the way you would have done them yourself.  Also, any property not provided for in your will or through other planning, will follow the state’s intestate succession laws, so even if you have a will, the state may decide where some of your property goes.

Here is what Arizona has planned:

1.         If you are married, all of your separate property and your half of the community property will pass to your spouse, as long as you have no children (or no descendants – grandchildren, great grandchildren, etc.). If all of your children are also the children of the surviving spouse – the kids you’ve had together – then all of your separate property and your share of community property still passes to your spouse.  The idea is that the kids will eventually get it.  (A.R.S. 14-2102 (1)).

2.         If you have children who are not also the children of your spouse, your spouse will get half of your separate property and none of your half of community property. (A.R.S. 14-2102 (2)).

3.         If there is no surviving spouse (or any property that does not pass to the surviving spouse under number 2, above), property flows, in this order, to:

            a.         Your descendants – children, children’s children, etc., through the generations.

            b.         If no descendants, your parents.

            c.         If no descendant or parent, to the descendants of your parents (your siblings, nieces  and nephews, etc.)

            d.         If no descendant, parent or descendant of a parent, then grandparents or descendants of grandparents (your uncles, aunts and their kids, etc.).

                        (A.R.S. 14-2103)

4.         Then to the state. (A.R.S. 14-2105).

            It is very rare that property would pass to the state – usually, there is somebody among parents or grandparents and their descendants – all your siblings, nieces, nephews, cousins, etc.  Still, your property is likely to pass to people you hardly know, don’t know, or even worse, people you were not particularly fond of.  The law also defines how shares are to be distributed and requires that relatives of half blood (step-relatives) inherit the same as if they were whole blood relatives. (A.R.S. 14-2107).

            Some people say they are not concerned with distribution because they do not have much money, property or other material assets.  Keep in mind that this situation can change after death.  The younger you are, the more likely the death will be accidental.  If so, there may be someone else liable, in an automobile accident for example, and such liability could result in a large payment to your estate.  There are cases of medical malpractice or product liability that cause serious illness or death and result in large awards to estates of deceased people.  In that event, your will or the state’s will control distribution.

            Another problem with not having a will involves minor children.  In a will, a parent can appoint a guardian of an unmarried minor.  If both parents are dead, or one is dead and the other incapacitated, the appointment will become effective upon filing the named guardian’s acceptance with the court.  A minor over the age of 13 can object to the appointment of the guardian. (A.R.S. 14-5202 and 14-5203).

            Without a will naming a guardian, it is possible that Child Protective Services would become involved, or that relatives and friends could become involved in a contested guardianship proceeding in court. 

            It is important to note that the naming of a guardian in a will is only effective if both parents are dead or one is dead and the other incapacitated.  This raises additional issues for single parents and divorced parents of minor children.  It is not unusual that the custodial parent feels the surviving parent is not an appropriate person to gain custody.  In such a situation, it is important to seek legal counsel to try to avoid that result. 

            Wills can be simple or complex.  It is possible to build trusts into wills (testamentary trusts), to do tax planning and to provide for distributions to be made over time.  Even a simple will, however, can be fraught with perils.  For example, courts will follow the statutes very carefully as to how a will must be drafted and executed.  If formalities are not followed, the court is unlikely to consider a will valid, especially if someone contests it.  Formalities include things like how the will is signed and witnessed.  Issues such as the capacity of the person making the will or undue influence by others may arise.  And Arizona law contains some exceptions, exemptions and allowances that cannot be avoided by writing a will.  This is not a do-it-yourself project.  Your estate plan deals with everything you own and everyone you care about.  It makes sense to do it right to make sure you get the result you expect.  An attorney, knowledgeable of Arizona statutes, should be consulted to make sure that what you want can and will happen after your death.

Paul T. Czepiga, Esq., CELA
Czepiga Daly Dillman, LLC
Newington, CT  06111
860-594-7995
www.CtSeniorLaw.com
Member of the national ElderCare Matters Alliance, Connecticut chapter

THE ‘POWER’ IN A POWER OF ATTORNEY

Lawyers are continually asked by clients whether they need a Power of Attorney.  There is no universal answer to this question, as everyone’s financial situation and relationship with others is different.  A meaningful response requires that the client understand what a Power of Attorney (commonly referred to as a “POA”) is and what it can and cannot do. 

In general, we recommend that our clients execute Powers of Attorney, but only after discussion of several considerations, outlined below.  The utility of a POA can be best described by the old saying, “Never has so little done so much for so many.”  We will explore the benefits of a POA later in this article, but we will begin with a basic understanding of what a POA is. 

Definition 

A POA creates an agency relationship between the person who signs the POA, known as the principal, and the person who is appointed as POA, known as the agent.  Only the principal is required to sign the POA.  The agent has authority under the POA only for so long as the principal is alive or at any time before the principal revokes the POA. 

A POA can allow the agent to perform an unlimited number and range of functions on behalf of the principal.  A POA can also limit the functions an agent can perform. 

A POA should be durable – meaning that the principal intends to allow his agent to (continue to) act on his behalf in the event of the principal’s incapacity.  A POA is durable if it contains language that expressly states that the POA will remain in effect regardless of the principal’s subsequent incapacity.  Without such a statement, the POA lapses if the principal later becomes incapacitated – something almost always not intended when drafting POA’s for estate planning purposes. 

Springing Power of Attorney 

Once a durable POA is signed by the principal, the agent is allowed to act on the principal’s behalf – the agent can perform any of the functions allowed under the POA immediately.  However, some people want to execute a POA so that in the event of their incapacity at some point in the future, someone will be able to pay bills, write checks, etc. on their behalf.  As a result of changes in Connecticut law made in 1993, a principal can execute a Springing Power of Attorney.  A Springing Power of Attorney can grant the same authority that a (non-Springing) Power of attorney allows, but does not go into effect until some later triggering event. 

For instance, Mrs. Smith may be perfectly capable of managing her own affairs now, but may be concerned that as she ages her abilities may decline.  She may want to ensure that someone she trusts will be able to help her out in the future should she need it.  With a Springing POA, Mrs. Smith can name someone as her agent, but her agent will not have authority to act on her behalf (access bank accounts, etc.) until some point in the future when Mrs. Smith is no longer capable of managing her affairs on her own. 

A Springing POA will only marginally protect Mrs. Smith, though.  Under Connecticut law, the agent, before he can act under the Springing POA, must sign an affidavit in front of two witnesses and a notary attesting to the facts that (1) Mrs. Smith named him as agent in a POA, (2) his authority does not take effect until Mrs. Smith becomes incapable of managing her affairs, and (3) this contingency has occurred.  The agent does not need to produce independent medical evidence that Mrs. Smith is really incapable of managing her affairs (unless Mrs. Smith required it as a condition to the agent’s authority). 

Choosing an Agent 

This scenario leads to a discussion on choosing an appropriate agent.  Whether a person should grant a POA to another depends entirely on whether the person has full, total, and complete trust in another person.  If there is no one in whom a person has such trust, then she should not execute a POA – Springing or otherwise. 

Using our example above, if Mrs. Smith required her agent to sign an affidavit and attach a certification by a Connecticut-licensed physician attesting to her incapacity, she clearly does not have full, total, and complete trust in her agent.  We have found in our practice that roughly 60% of our clients use the Springing POA and the rest opt for a non-Springing POA. 

Limitations and Other Express Powers  

In financial planning and Medicaid planning contexts, it is best to give a POA that conveys the broadest possible authority, limited only by the principal’s concerns.  Connecticut’s statutory POA and Springing POA forms convey thirteen separate powers, including “all other matters.”  Although this sounds fairly inclusive, it is not. 

The most harmful limitation is that the Connecticut statutory forms do not expressly give an agent the ability to make gifts of the principal’s assets.  One’s incapacity does not lessen the need to reduce the gross taxable estate for estate tax reduction purposes or to remove assets out of one’s name for Medicaid eligibility purposes.  Without an express gift-making provision, it will be very difficult to transfer the principal’s assets to her beneficiaries even though this is what the principal would have wanted.  Even so, gift-making provisions should not be automatically included in all POA’s without first considering the need and ramifications of such a power.  If gift-making is to be included, then the principal should also address to whom and to what extent gifts may be made.  To her spouse only?  Unlimited gifts?  To children?  Must gifts to children be of equal value?   

Other powers that we expressly add to our POA forms after discussion with our clients include dealing with the State of Connecticut, the I.R.S. and D.R.S. on all tax matters (income and gift, including gift splitting, sales and use tax), accessing safe deposit boxes, changing domicile, creating/funding/requesting distributions from trusts, and changing beneficiary designations on life insurance, annuities and retirement plans.  Although some of these powers are arguably included in the statutory form, it is wise to explicitly express them in the POA for enforceability purpose. 

Acceptability of a Power of Attorney by Third Parties 

You may take all the appropriate steps to execute your POA, but your agent may encounter difficulty trying to use the POA at some point in the future.  Although the POA you sign is effective until you revoke it ands o long as you are alive, some financial institutions and banks have internal policies whereby employees are instructed to only honor POA’s that are dated recently (in some cases, within six months).  Some companies may request that the principal sign a statement that the POA has not been revoked – but what if the principal is now incapable of signing such a statement?  These internal policies will frustrate your agent’s ability to act on your behalf. 

Your advisor can add language to the POA stating that unless the third party (bank, life insurance company, etc.) has actual notice of revocation, they may rely on the agent’s authority.  Your advisor can also include hold harmless or indemnification language to assuage the third party’s concerns.  Whatever the method, your advisor should add whatever language possible to make the POA acceptable to the outside world. 

An alternative or additional protection to a POA is creating a living or revocable trust.  A living trust typically names the principal (client) as trustee and also names at least one successor trustee.  The successor trustee will step in to manage the trust if the original trustee becomes incapable or passes away.  If the principal transfers or re-titles his assets into the trust, then if he should become incapable, his successor trustee would be able to manage the assets – including paying bills, writing checks, etc.  Financial institutions seem to be more accepting of a successor trustee’s authority than the authority of what they deem to be an out-dated POA.  

In summary, a POA is a powerful and useful tool for a variety of estate planning needs, both foreseen and unforeseen.  Once you sufficiently identify your estate planning or Medicaid planning needs, you should execute a POA as soon as possible to ensure a seamless transition in the management of your finances from you to your agent if you should become incapable of managing your own affairs.

Dagmar M. Pollex, Esq.
Law Offices of Dagmar M. Pollex, P.C.
Braintree, Massachusetts  02184
781-535-6490
www.PollexEstatePlanning.com
Member of the national ElderCare Matters Alliance, Massachusetts chapter

Planning for Your Adult Children With Special Needs Can Also Protect Your Assets From Nursing Home Costs

Parents and grandparents of an adult disabled child often ask what’s the best way to make provisions for that member of the family who will not be able to be self-sufficient. Parents generally try to consider the future non-financial needs of the child after the parents are gone.  With whom or where will the child live?  What housing options or assistance are available?  What activities does the child enjoy? Next, there is a need to estimate the future financial needs of the child, taking into account projected government assistance. 

When the parents of disabled children think about a financial and estate plan, they plan for their own future, as well as the child’s.  Parents with disabled children understand the need to protect their own savings from risks during their lives.  Nursing home costs pose a threat to every estate. 

Luckily, the Medicaid rules offer important special protections for parents of disabled children by allowing gifts to be made to supplemental needs trusts for the benefit of adult children with disabilities. These gifts do not create a disqualification or penalty period for the parents if they will need nursing home care for themselves in the future. 

Another important question is this. How will the parents’ estate be allocated to reach the goals they have for themselves and their child?  They may consider leaving a larger share for the disabled child who has greater need than the other children. 

However, this is generally not a good option if government benefits may be needed, since most government assistance requires the recipient to have very low income, very low assets, or both. An outright bequest to the child or a trust which gives the child too much ownership over the money will disqualify the child from government assistance until the child spends down the trust assets. 

As part of their overall estate planning, parents of special needs children can have a portion (or all) of their estate stay in a trust for the benefit of their disabled child after they die. 

The assets will be managed by a Trustee chosen by the parents. In some situations, a brother or sister of the child with special needs is a good choice. Other times, it would be better to name a professional trustee with experience in managing special needs trusts and providing services to the beneficiary. 

The trust should be drafted so as to not disqualify the child from government assistance.  This kind of a trust is called a supplemental or special needs trust.  The parents can include guidance or legally binding directives about how the money is to be used for the child. 

Even small amounts in a special needs trust can make a huge difference in the quality of life of a disabled child.  For example, while the child’s basic needs could be met with government assistance, the trust could be used to provide “extras” like a television, a trip to visit relatives or tickets for relatives to visit the child, a special van, or computer with voice-recognition technology.

Russell Hodges, Esq., Managing Partner
Hodges Law Firm, LLC
Atlanta, Georgia  30040
www.RHodgesLaw.com
Member of the national ElderCare Matters Alliance, Georgia chapter

Personal Care Contract Payment to Family Members: ANOTHER MEANS OF ASSET PROTECTION

Can I help preserve my assets by paying a family member for my care?

James J. Ruggiero, Jr., Esq., AEP
Ruggiero Law Offices
Paoli, Pennsylvania  19301
610-889-0288
www.PaoliLaw.com

"ARE YOU HAVING A BAD HEIR DAY?"

As Benjamin Franklin once said, “You may delay, but time may not.” No truer are these words than in the case of estate planning. The average person allows 10-to-15 years to elapse before revising his or her estate plan. Life’s ups and downs, and the impending estate tax law changes, present the opportunity to protect your legacy. 

Beginning in 2011, the tax rates in effect prior to 2010 return in force. Although in 2009, the rate was a flat 45 percent on taxable estates in excess of $3.5 million, in 2011, the top marginal rate will be 55 percent, and the exemption rate will decrease to $1 million. For example, if your estate were worth $1.5 million, in 2009, you would not have paid federal estate tax; whereas, in 2011, you will pay federal estate tax because of the decreased exemption. With the potential impact of this in mind, don’t let the heir day of your loved one turn out to be a bad heir day.           

How could that happen, you ask? Well, in 2006, 46 percent of the general public had a will; however, in 2007, that percentage dropped to 37. 

Actually, estate planning is about more than having a will.  Four basic documents encompass a good estate plan:  a Last Will and Testament, a General Durable Power of Attorney, a Healthcare Power of Attorney, and a Living Will. 

Each of us needs an updated Living Will 

The recent celebrity case involving Gary Coleman provides a clear example of the ills that can occur without an updated estate plan. In 2006, Coleman created a healthcare directive that gave his then-wife power to make medical decisions if he became incapacitated. It apparently included a statement to prolong his life for as long as possible. After divorcing and failing to revise his healthcare directive, Coleman suffered a head injury and was admitted to the hospital, diagnosed with a brain hemorrhage.  Coleman’s ex-wife decided to take Coleman off life support only one day after he was admitted. 

In some states, divorce fails to nullify a healthcare directive.  If you have been through a divorce, it is wise to review your estate documents to ensure they continue to reflect your wishes.  

Form your own dynasty 

Although problems can arise due to neglecting to update healthcare directives, preserving wealth is perhaps the greatest concern. Too often, we underestimate the size of our estate, not realizing the problems this can cause after we have gone.  Trusts provide a viable option for ensuring that your heirs do not pay excessive estate taxes upon your death.  Different types of trusts are available to meet your needs and the needs of your loved ones. 

A dynasty trust is one way wealth preservation can be achieved.  Despite its name, the term has nothing to do with aristocracy.  With a dynasty trust, you transfer the assets of a business, real estate, or other income-producing property to the trust. Depending on the exact terms, the income accumulates or is paid out on behalf of the trust’s beneficiaries: children, grandchildren, or even remote descendants. Assuming the assets remain in the dynasty trust, they will not be included in a beneficiary’s estate when he or she dies.  Thus, the asset values can continue to compound over several generations without any erosion due to estate taxes.  Further, because the beneficiaries do not own the assets, there is protection against loss from creditors or divorce proceedings. Wealth is preserved and remains in the hands of family–with little or no tax consequences. 

Create a “heir” style that works for you 

When is a good time to update your estate plan?  While it is always good to maintain a current estate plan, significant life events mandate a revision.  If you’ve recently started a business, you may need to update your estate plan.  Crucial aspects, such as business succession planning, guarantee that the wealth you’ve worked so hard to build is passed on to those you love or designate. Additionally, our changing economy can result in loss of a job or early retirement, both invoking the need for a review.  Similarly, a spouse that is re-entering the work force or changing from full- to part-time status, necessitates re-evaluating your assets. 

Changes in family may dictate a change in your estate plan. If a son or daughter should marry someone you would prefer not to include as an heir, inevitably, you would want to take a second look at your estate planning. You would find it important to avoid the risk that your wealth could end up in the hands of a former son- or daughter-in-law. 

Indeed, even if you like your in-laws, other life events can trigger an update to your estate plan.  Have you recently moved into Pennsylvania? Or, are you planning a move to another state?  If so, it is good advice to learn about the laws of your new locale to make sure that your plans are protected. Even marriages, births, and other happy events in our lives should awaken the notion that our estate plans need to be re-examined. 

Perhaps you have a domestic partner who you would wish to one day become your heir. Pennsylvania does not recognize same sex or common law marriages. Thus, in this Commonwealth, a same sex or opposite sex non-related individual inheriting from you will be taxed at a rate of 15 percent. Don’t let him or her experience a bad heir day. Trusts and other estate planning, such as beneficiary designations on financial accounts, can play an important role in preserving the assets of your domestic partnership. 

Most of us put estate planning on the back burner. It’s easier to choose to wait for tomorrow. By contrast, we go to the barber or beauty salon on a regular basis because we defy being caught having a bad hair day! Applying mousse, gel and spray guarantees we will have a good hair day.  Similar protection in the form of a good estate plan can be applied so that a bad heir day is likewise avoided.  

Have your estate plan updated today, and do wonders for your heir!

Michael A. Jensen, Attorney at Law
JENSEN LAW FIRM, PLLC
P.O. Box 571708
Salt Lake City, Utah  84107
801-519-9040
www.UtahAttorney.com

If You Don't Have a Will, What Happens to Your Estate? 

I often get asked: “What happens if I don’t have a Will?”

Depending on the size of your estate and the number of your children or other heirs, you may not need a will. I generally recommend a will, since most of the time it makes sense to have one.

But, if you don’t have a will or if you procrastinate and put off preparing or signing a will, there is still hope that your estate passes to your heirs as you intend.

If you die without a valid will, you are said to have died intestate. Since the majority of persons die without a will (it is estimated that only 25% of the population has a will), laws have been developed to deal with these situations. They are known as intestate laws.

Most states have enacted the Uniform Probate Code. Utah is one of those states. If you die without a valid will, there is a predetermined method for the distribution of your estate. Title 75 of the Utah Code contains the Uniform Probate Code.

Chapter 2 of Title 75 contains the code for Intestate Succession and Wills; Part 1 of Chapter 2 deals with Intestate Succession.  This Part sets forth the rules on how your estate would be distributed if you die having no valid will.

In the preceding two paragraphs, I used the word “valid” to qualify a will. That is, not all wills are valid. Simply because you have a will, it may not conform to the formalities required by law. If your will is not valid, then it is as though you had no will at all. In that case, your estate follows the rules in Part 1, entitled Intestate Succession, and which states at its beginning: 

“Any part of a decedent's estate not effectively disposed of by will passes by intestate succession to the decedent's heirs as provided in this title, . . .” 

In the limited space allowed for this article, I am not able to fully treat the issue of how your estate would be distributed under intestate succession. However, I will attempt to provide a few highlights. 

If you rely on the Probate Code for the distribution of your estate, you should first obtain a copy of it and study it carefully. The Probate Code is amended from time to time, and your understanding of it must be updated when changes are enacted. 

First, if your spouse survives you and you have no children from any other spouse, other than the one that survives you, your entire estate goes to your surviving spouse. 

Second, if you have children from a previous spouse, then your surviving spouse receives the first $50,000 of your estate plus ½ of your remaining estate. Your children then share equally in that part of your estate not passing to your surviving spouse. 

However, the rules on distribution become a bit more complicated if two or more of your children fail to survive you.  Distribution is made on the basis of "per capita at each generation.” What this means is that your grandchildren will be treated equally. 

An example may help. Suppose that your spouse predeceases you. That is, she dies before you. Further suppose that you have four children, two of whom predecease you.  Prior to their death, however, suppose that one of them had three children and the other had five children, representing eight grandchildren. 

In this example, ½ of your estate would go to the two surviving children and ½ would go to the eight children of the predeceased children. Under the new “per capita” concept, all eight of your grandchildren would be treated equally. Under the old rule, replaced in 1998 and called “per stirpes,” your eight grandchildren would not have been treated equally. 

If you don’t have a Will, you have no control over who takes charge of your estate.  In contrast, if you have a Will, you can nominate the person you want to act as your Personal Representative and administer your estate. 

Does this sound confusing? Well, it may seem so, but it generally works the way mostpeople would want their estate to be distributed. The better approach in planning your estate, however, is to rely on solid legal advice by contacting an Elder Law Attorney.

Gregory D. Roberts, CFP, CLU, ChFC, CLTC, EA
Life Solutions
Aiken, South Carolina  39803
803-617-9805

Member of the South Carolina chapter, national ElderCare Matters Alliance

Asset-Based Solutions for Long Term Care Coverage are Gaining Favor 

I recently came across some very enlightening statistics: The odds of a person in the U.S. being involved in a serious automobile accident are only 3 in 900 or 0.33%. The odds of having a residential fire in your home are 7 in 900, or 0.77%. The odds of ever being admitted to a critical care unit are 21 in 900, or 2.3%. Virtually every working American has insurance coverage to protect against these catastrophic occurrences, but only 5% of Americans has actually purchased long-term care insurance. What are the odds that we would ever need some sort of long-term care benefits? Would you believe that 70% of Americans who are currently age 65 or older will need some sort of custodial medical care before they exit this globe?

The question then becomes why only 5%, when the need is so apparent? In my view, there are two reasons. The first is the cost of long term care coverage. For example, a married couple, both age 55 in good health, would together pay about $2500 annually to provide enough policy benefits to cover home health/long term-care expenses in Aiken and in the CSRA. That required premium may be deductible as a medical expense, depending on the magnitude of other medical expenses you have in a given calendar year, since only those medical expenses in excess of 7.5% of your adjusted gross income are deductible.

If you have self-employed income that is greater than your long term care premium, the good news is that the entire premium is generally deductible for you.

The other reason why so few persons have actually purchased long-term care coverage is that if you don’t use it, you lose it. In other words, there are typically no refund options in older policies. Current long-term care policies do offer a return of premium option, but for an additional cost, which may make the overall cost prohibitive.

As a result of these two factors, most Americans have chosen to self-insure their future long- term care expenses. Actually, that approach is not that bad an idea, if you and your spouse have sufficient assets set aside to pay for future home health/long term care expenses. How much should you set aside? Well, the average stay in a facility or the average length of time one would require in-home care is about 3 years. In Aiken that length of care would cost in the neighborhood of $125,000-$150,000 in current dollars. But what if you or your spouse were to contract Alzheimer’s or dementia? Then, the period of confinement could be as long as 7-10 years, at $45,000 to $50,000 per year.

An interesting product solution is now available as an alternative for those who wish to self-insure against the costs of long-term care. That solution is an asset-based one, and it operates like this example: for a 65 year old female, who is able to reposition $100,000 of her assets, she could purchase a single premium life insurance policy that would provide her heirs a death benefit of $166,000. But this policy has two other great features: while she is alive, should she ever require home health care or long term care benefits, the policy would provide up to $500,000 for those expenses, provided that she could not perform at least 2 of 6 specified activities of daily living, such as bathing, toileting, dressing, eating and others. And the best part is that if this lady were ever to change her mind, this product provides an unconditional money back guarantee at any time. Sounds too good to be true, right?

Perhaps, but in order to qualify, this person must be relatively healthy; she must have the assets to re-position; and finally, she must actually purchase this policy. Believe it or not, there are several highly rated life insurance companies who offer products such as the one I am describing.

Check with your financial advisor and find out if he or she is acquainted with this dynamite method for providing long term care benefits.

Dennis B. Sullivan, Esq., CPA, LLM
Estate Planning & Asset Protection Law Center of Dennis Sullivan & Associates
888 Worcester Street, Suite 260
Wellesley, MA  02482
781-237-2815
Member of the national ElderCare Matters Alliance

6 Mistakes Your Trustee Can Make That Can Spoil Your Trust

One may feel honored to be appointed as a trustee, but there are several legal duties and responsibilities the job carries with it.  There are several ways a trustee can ruin a trust and destroy a beneficiary’s inheritance.  This article will discuss some of the most common errors we see. 

Error #1: Not Properly Accounting for Trust Records 

Most states, including Massachusetts, require trustees to provide regular accountings to the trust beneficiaries; current, future, and potential future beneficiaries.  These accountings must contain detailed records of all income received by the trust as well as all distributions the trust makes.  While this task may seem simple, if the trustee mucks this up, even once, they leave themselves open to a potential law suit by beneficiaries, which they will be forced to pay for out of their own pockets.  

To avoid this potential pitfall the trustee should consider hiring a professional CPA and/or attorney with experience in the field of trust administration.  The trust records will likely be sufficient and the trustee, by hiring a professional, limits their personal liability for errors.  

Error # 2: Failing to Diversify Investments 

Many trustees decide not to reinvest trust assets, such as stock, that have served the trust well and earned a lot of money over the years.  In cases where the trust holds stock in a company owned or run by the dearly departed the decision to reinvest assets can be even more difficult.

It is the duty of the trustee however to make sure that the trust’s assets are diversified and invested in such a way as to create income for the trust. 

Investment management is the most litigated area of trust administration.  The process can be long and difficult and lead to significant trust assets being spent on legal fees rather than being paid to beneficiaries.  Following the Prudent Investor Standards set forth by the Center for Fiduciary Studies will help aid trustees in meeting their fiduciary investing responsibilities. 

Error #3:  Making Biased Distributions 

Trustees owe a fiduciary duty to current beneficiaries as well as remaindermen (future beneficiaries).  Many times, the interests of the current and future beneficiaries are not the same.  Current beneficiaries may want to see the trustee invest in high yield securities while the future beneficiaries would like to see a safer investment with a lower yield.  How does the trustee balance the interests of both parties?  A a trustee, especially if they are a family member, may, knowingly or unknowingly make distributions in favor one beneficiary over the others.  It can be especially difficult for a family member trustee to set aside their biases, but the trustee owes the same duty to all beneficiaries.  

Error #4: Expecting a Pay Day 

Some trustees believe that their role as trustee will lead to a quick payday.  This is generally not the case however.  It can take a lot of time and effort for the trustee to be paid because the process gives all beneficiaries the opportunity to voice their complaints about the job the trustee has done. 

To avoid long arduous litigation, it is advisable that the trustee set up a schedule of fees, signed off on by all the beneficiaries. 

Error 5: Having a False Sense of Security 

The role of trustee carries with it unlimited liability.  Anything that the trustee does improperly, whether it be on purpose or by accident or by simply not knowing their responsibilities, can lead to the trustee being sued and forced to pay damages out of their own pocket.  The trustee can be liable not only for money lost due to their actions but also money that could have been earned had they acted correctly. 

Many assume that because the beneficiaries are family members they will be insulated from being sued.  The reality is however, that, many family member trustees end up in court.  A trustee should never assume they will not be held liable for their actions simply because the beneficiaries are family.  

Error 6:  Not Knowing When to Go to Court 

Trusts are often used to avoid the necessity of having to go to court to distribute an estate.  There are situations when a trip to court can save the trustee a lot of trouble.  If the trust documents are ambiguous and one course of action will benefit one group of people and another course of action will benefit another group of people, the trustee should not make a decision, because they are likely to end up in court explaining their decision.  The trustee should file appropriate documents with the court and let a judge decide how to proceed.  

Selecting a trustee who is experienced and financially savvy is important when considering who you should appoint. 

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

The Top Five Things to Consider When Choosing
Your Home Healthcare Provider 

When faced with choosing a home healthcare provider, more often than not, it is a topic you have not discussed with your family and loved ones prior to the need for one. While one’s initial instinct might be to choose the first name that appears when you Google “home healthcare,” like all other good decisions, it is best to do your homework. All home healthcare companies are certainly not alike.

Home healthcare is typically skilled nursing and therapy services and often includes the need for other non-medical services that address functional needs of everyday living such as meals and grooming. This personalized care eases the anxiety and stress associated with most forms of healthcare and allows a maximum amount of freedom for the individual.

Given how critical it is to feel safe, confident and comfortable in your decision, look for these important factors prior to choosing.

Is the agency licensed and accredited? 

Home healthcare providers that are licensed need to be so with at least one of the following accreditation organizations: Accreditation Commission for Health Care (ACHC), Community Health Accreditation Program (CHAP) or Joint Commission on the Accreditation of Healthcare (JCAHO). For hourly and live-in care, the agency must have a registered license in home health care with the State of Florida. Keep in mind that prior to July 1, 2010 not all home healthcare agencies were required to be accredited, but FirstLantic Healthcare chose to be accredited at the highest level with ACHC. 

How long has the company been in business? 

Well-established providers generally have higher staff retention rates than upstart companies and thus offer more experienced, trained caregivers. New home healthcare companies are popping up everywhere, everyday so it is highly important to make sure they have the proper accreditations and procedures in place. 

Do they offer the types of services required? 

Whether it is professional nursing or supportive services, a comprehensive home healthcare provider will deliver a wide variety of services, ranging from professional nursing to physical, occupational, respiratory, and speech therapies. They also may provide hourly and live-in home care services either at your home, assisted living facility, nursing home or even at the hospital. In addition, some home healthcare agencies, such as FirstLantic Healthcare, offer professional care management whereby care managers work privately and individually with each client and their families or loved ones to create a short or long term plan of care that meets the unique needs of each client. An individual may receive a single type of care or a combination of services, depending on the complexity of his or her needs. 

What do others have to say about the company? 

If a home healthcare provider has been around awhile, you should have no problem researching their reputation through the Better Business Bureau, local healthcare providers, and from friends and family. Check out their website for testimonials and/or call the agency to see if they offer a referral contact. It is important to hear that the company is reliable, and that the services they offer are delivered with professional, compassionate care that you deserve and demand. 

Do they offer quality caregivers? 

Proper screening of caregivers is critical to ensuring your safety. Make sure they have the appropriate, and most up-to-date, certifications and licenses for the particular care you require. There is no substitution for a professional, dedicated, and compassionate caregiver.

Once you have done your homework, you can feel confident moving forward on choosing the provider that aptly suits your needs and offers the most complete and personalized care for you or your loved one.

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

Risky Medications 

Everyone who cares for todays’ seniors will eventually deal with the problems created by the medications that the seniors use. Some seniors have other watchful eyes on the medication they use. The general public is generally unaware that since Medicare was initiated in the mid-sixties that pharmacists have been federally mandated to review the medications of all Medicare patients residing in nursing homes or long term care facilities (LTCFs) across the country. Specially trained pharmacists review the use of each patient’s medications, how they are responding, train facility staff on proper dosing of medications, side-effect  monitoring and documenting and they make recommendations to the prescriber for changes in orders or labs. 

The role of the long term care pharmacist is extremely important in maximizing the benefits of the medicines that are used while avoiding or minimizing the risks from those same medicines. Today there are other pharmacists who provide that same detailed review and consults for seniors who continue to live independently in their community, in their home, at a retirement center or assisted living facility.  

Today more seniors are taking increasing numbers of medications, these medications are more chemically complex. Seniors often use more than one physician and as they age, have many more medical conditions.  Seniors also take non-prescription medications that a few years back required a prescription, counseling to assure better use and greater understanding of the side effects that could develop.  

Studies have shown that if a senior takes 2 medications, the chances of a medication related problem is 6%, if they take 5, it’s 50%.  If a senior takes more than eight medications, there is a 100% chance that they will experience a medication related problem.  Eight (8) or more medications, that list of medications includes any prescription, non-prescription, over the counters, supplements, and nutritionals.  

Although a medicine can make you feel better and maintain your health, we must be aware that all medicines have both benefits and risks. You are encouraged to visit my website for more details on medications related problems in the today’s seniors.  Our first step in addressing this problematic issue is greater awareness of the problem.

William "Bill" Brown, Attorney at Law
2999 E. Dublin-Granville Road
Suite 217
Columbus, Ohio  43231-4030
614-890-9099

Sheri Samotin, President
LifeBridge Solutions, LLC
999 Vanderbilt Beach Road
Naples, Florida  34108
239-325-1880

Member of the Florida chapter of the national ElderCare Matters Alliance

Taking Charge Without Taking Over:  Five Tips For Helping Your Aging Parent

Whether you are teaching your young daughter how to knit, or helping your aging mother balance her checkbook, how do you take charge without taking over?  How many times have you found yourself “showing” someone how to do something by doing it for them?   It’s human nature.   But while it might make sense to show by doing when you are “teaching” someone younger or less familiar with a particular topic than you are, it usually leads to anger when you do this when you are “assisting” someone with a task that he previously has been perfectly capable of handling himself.

It was probably hard enough for your mom to agree to let you help her pay her bills and balance her checkbook.  And even once she agreed, it wouldn’t be surprising if she told you that she didn’t know why you were insisting on helping her since she is perfectly capable of doing it herself.   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 knows that this is the beginning of the end of her independence as she has come to know it. 

So, how do you take charge without taking over?

1. If possible, do the tasks alongside your mom rather than doing it for her.  While this approach might take longer than doing it yourself, you allow mom to retain some self esteem by letting her take the lead.
2. Let your dad tell you what aspects of a particular activity he needs your help with, and if possible, try to limit your assistance to just those things, at least for now.  Of course, if your dad doesn’t have a realistic picture of what he can do for himself, you will need to gently find a way to help him 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 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.

John E. Settle, Jr., Esq.
John E. Settle, Jr., Attorney at Law
1915 Citizens Bank Drive
Bossier City, Louisiana  71111
318-742-5513
Member of the Louisiana chapter of the national ElderCare Matters Alliance

The Internet and Elder Law 

          In the words of Charles Dinkens, “it is best of times, and the worst of times” when one thinks of using the internet to get answers to important questions on law, medicine and/or investments.  The internet is one of the most important developments of modern civilization, and not a day (Q: hour?) goes by without more expansion, and sometimes invasion, by internet “tools” that are supposed to make our lives better. 

          As an attorney who has practiced more than thirty years, I always welcome a client who has some knowledge on the topics that are the subject of my consultation – - be it from a neighbor, his uncle Charley or a jailhouse lawyer.  Generally it is fairly easy to have a client focus on my education and experience versus these “sources” of law.  However when it comes to “internet law” it is often much more difficult to rebut, differentiate or explain the “real” law versus PC downloads. 

          Unfortunately, a false sense of authenticity is often given to internet documents – - without serious inquiry as to who put this information on the internet.  Many individuals do not realize /understand that the internet is not like Encyclopedia Britannica, and  that there is no scholarly screening body/agency to ensure accuracy of what can be found on the “net”. 

          When presented with an internet Will, Trust, Power of Attorney or any other legal document, I always ask my client the following questions:

          1.  Do you know if this document is drawn in accordance with the laws, and legal requirements of your state of residence?

          2.  How do you know if this is the document(s) you really need?

          3.  And who are you going to complain to if you utilize this document and it doesn’t “work” the way you intended? 

          It is important for all seniors to know that the laws of each State on inheritance – - with or without a Will – are generally quite different, as well as the requirements for proper  execution of the Will.  Furthermore, generic powers of attorneys can sometimes cause challenges, especially in the area of health care.  Similarly, the so-called advantages of a Living Trust to transfer assets after death vis a vis a Will are generally overstated, and frequently do not obviate the need for succession proceedings to be instituted to transfer title to real estate. 

          The same is true for Medicaid eligibility, and what the maximum reliable assets can be owned by the senior seeking Medicaid assistance and/or the senior’s spouse.  There are fifty different sets of Medicaid rules – one for each of the fifty states in the union.  Thus much of the “water cooler” scuttlebutt about Medicaid eligibility is just that – - misinformation. 

          The internet is a great tool for learning, but it should not be considered to be the expert on life and death planning documents.  The one size fits all mentality of most internet articles  and legal forms on the internet are trips for the unwary.  Seniors should  seek the advice and counsel of licensed attorneys in the state of their residences.   After all, an actual dialogue with an individual is much better than reading a computer screen when making major life decisions.

Angela N. Manz, Attorney at Law
The Law Office of Angela N. Manz
Virginia Beach, Virginia  23452
757-271-6275

Member of the national ElderCare Matters Alliance

There are several government benefits available to seniors who need help paying for extended care.  However, the qualifications and requirements for these benefits can often be complicated and confusing, leaving many people unsure of how to qualify or whether they are applying for right benefit for their family. 

When seniors and their families first meet with me, I like to find out about their current care needs, how much they are paying for care, their income, and their concerns for the future. This helps me determine whether they are eligible for the VA pension or Medicaid and allows me to focus on any future family changes or problems that we may need to plan for. After we talk about their concerns, I help the family match their care needs with their financial situation and create a plan that will preserve their assets, protect their family and get them the care that they need.  Every family is unique and the plan for your family should be unique as well. 

Two of the most important benefits available to seniors are Medicaid and the Department of Veterans Affairs (VA) Aid and Attendance Pension.  While the programs may seem similar, the eligibility requirements and the benefits are quite different.  

VA Aid and Attendance Pension

The VA pension is available for veterans and their surviving spouses.  It pays a monthly dollar amount and that money can be used to help pay for a nursing home, assisted living rent, adult day care, in-home care, including when a child is caring for a parent, and other medical expenses.  For a married veteran, the maximum pension is $1,949 per month. A single veteran may receive a maximum of $1644 per month and a surviving spouse may receive $1056. 

In order to be eligible, the veteran must have served 90 days of active duty in the military, with one day during a period of wartime. The VA has established specific dates that constitute a “wartime period,” but generally veterans who served during World War II, the Korean War, the Vietnam War, and the Persian Gulf War will be eligible. Veterans also must not have been dishonorable discharged.  

Next, the veteran or surviving spouse must show that they need the assistance of another person in order to perform daily tasks, such as eating, bathing, dressing, cooking, taking medications, or driving.  Veterans and surviving spouses needing assistance or a protective environment to stay safe because of dementia may also qualify for the benefit. 

Finally, in order to receive the pension, all applicants must meet the asset restriction.  Unlike Medicaid, the VA does not have a set asset limit for this pension.  Instead, the VA will look at many factors to determine if assets are too high.  The VA does not include the value of the home or a car. 

Even though there is an asset limitation, the VA does not penalize for transferring assets outside of the veteran or spouse’s name, if done correctly.  This means that there are many planning options available to help families become eligible for the benefit.  However, you must be careful.  When assets are transferred to secure eligibility for VA benefits, the family must have a plan ready in the event that their loved one needs Medicaid in the future to pay for extended nursing care.  Medicaid imposes a penalty for assets that are gifted away or moved into certain types of trusts and I strongly suggest that you work with an experienced elder law attorney before making any gifts or transfers. 

When should you consider VA Aid and Attendance?

I generally recommend that families apply for Aid and Attendance when they have medical expenses that exceed a large portion of their income and using the pension would help bridge that gap.  For example, if Mom and Dad have a monthly income of $2,500, and they move into an assisted living facility that costs $3,500 per month, I would recommend that they apply for the VA pension.  For a married veteran, the maximum pension is $1,949 per month.  Therefore, the VA pension, combined with their income, would give them enough money to pay for their assisted living community. Further, in many states there is little or no Medicaid help for assisted living, making the VA benefit even more valuable. 

What if your loved one is in a nursing home?  Typically, the cost of nursing home care is often so high that the VA pension does not pay enough to cover that cost, even when combined with your loved one’s monthly income.  However, if your parent is going through a Medicaid penalty period or needs time to spend down assets before he can be eligible for Medicaid, the VA pension can be of great help during that transitional period. 

What is Medicaid?

While Medicaid is also designed to help with the cost of long-term care, it differs from the VA pension.  Medicaid does not pay a monthly pension.  Instead, Medicaid directly pays the care provider, i.e. the nursing home.  

Many people believe that they can only get Medicaid once they have spent all of their money in the nursing home, but this is absolutely not true.  To be eligible for Medicaid, the applicant may only have $2,000 in countable assets.  However, not all assets are “countable” assets. In Virginia for example, non-countable assets include up to $2,000 cash, your home (under certain circumstances), one car, personal property, certain funeral and burial funds (including a pre-paid funeral or burial), certain property used in a trade or business, some life insurance (up to $1,500 cash value), and certain annuities.

Further, even though the Medicaid applicant may only have $2,000, we still have many options for legally sheltering and protecting assets.  Unfortunately, Medicaid does not pay for everything that someone needs while they are in a nursing home.  Therefore, it is important to be able to keep some assets for the benefit of the Medicaid applicant so that they can have what they need, as well as those things that bring them comfort and enjoyment.  Typically, a married couple can protect most, if not all, of their assets and have one spouse become eligible for Medicaid.  A single person can typically protect half of their assets and then become eligible Medicaid.  Never assume that your parent or loved one is not eligible. 

When should you consider Medicaid?

I typically recommend Medicaid when someone needs extended care in a nursing home.  This is because the cost of the nursing home is generally so high that the person’s income, even coupled with the VA benefit, is not enough to pay for the care without depleting their assets. 

I may also recommend Medicaid for home care when the household income is high, but the person requiring care has a low income. The VA considers the total household income, while Medicaid typically only looks at the income of the person needing care.  For example, if Dad has a monthly income of $4,500, and Mom’s monthly income is only $500, it may not be wise to apply for the VA pension.  To get VA benefits, Mom and Dad would have to spend a large amount of their income each month on Mom’s care.  If they can’t afford that much care or if Mom doesn’t need that much care, I may recommend that Mom apply for Medicaid home care benefits.  Because Medicaid only looks at Mom’s income, in many states Mom would qualify regardless of Dad’s high monthly income. However, it is important to make sure that Mom still meets the asset requirement for Medicaid, which may require sheltering assets before she could become eligible. 

In Closing

While these benefits are complex, they can be a tremendous help for your family and you should never assume that your loved one cannot qualify.  Caring for a senior parent can be difficult, but taking the time to fully explore all of the benefit options is worth the effort so that your loved one can preserve their assets, protect their family and get the care they need.

Amy Cameron O'Rourke, MPH, CMC
The Cameron Group
Orlando, Florida  32803
1-888-896-2010

Member of the national ElderCare Matters Alliance

Watching a parent grow older, become more frail and maybe more vulnerable can be an enriching experience when there is a framework for understanding the stage they are in. Without understanding some of the common stages, however, it can be a time fraught with frustration and anxiety. This time of life for an elder is called “late life” and one of the books that best describes and supports this time is the pioneering book, “ My Mother, Your Mother”, by Dr. Dennis McCullough. 

The stage that will be the focus of this article is the crisis stage. This stage is characterized by an acute medical episode such as a fall or a stroke. It can be something non-medical but just as devastating such as loss of driving privileges, loss of memory; some life change that has begun significantly altering the elders’ lifestyle. Typically the elder is in denial of the severity of the change and the children are overly anxious as they are projecting the worst case scenario on to the elder. Communications frequently breakdown as anxieties collide. The elder does not want the children telling them what to do and the children want a permanent solution placed on their parent so they don’t have to worry anymore. 

Strategies for the Crisis Stage: Bring in an objective third party to guide these communications, which are usually fraught with emotions. Professional Geriatric Care Managers are elder care experts who understand the complex systems that care for the elder (hospitals, nursing homes, assisted living facilities) and can help the family successfully resolve the immediate problem and coordinate a plan of care for after the crisis is over. They listen carefully to each family member and the elder to help the family come to a consensus. 

Family meetings for are set up on a regular basis for the future with the following recommended components. First, time in the beginning of the call should be allowed for each family member’s concerns to get verbalized. Secondly, prioritize the concerns and list the responsibilities associated with the concerns. Lastly, divide the responsibilities for the care of the elder. For example, long distance siblings may be responsible for communicating to other family members via e mail, phone or Facebook. They may also take on the insurance issues, or financial issues that arise. This leaves the hands on care for the child who lives locally. The Care Manager can be on the calls to help with the decision making and also provide guidance and assistance in implementing some of the solutions the family members decide upon. 

After the crisis, the family meetings should be continued to maintain continuity of communication and to maintain the plan of care for the parent.

Philip C. Benedict, CFP
Benedict Financial Advisors, Inc.
Atlanta, Georgia  30328
770-671-8228

Member of the national ElderCare Matters Alliance

What would make most people happier? Better health? More friends? More time with children and grandchildren? 

Most people of any age would like more of the above, but one thing that would definitely improve the financial and emotional quality of the lives of many people, especially seniors, is more monthly cash flow. Think about it.

If you have plenty of monthly cash flow you can hire people to do the things you can no longer do. If you have insufficient monthly cash flow you are dependent on family, friends and government programs.  

I don’t know about you, but, I want to be able to control my own financial destiny as much as humanly possible.  

The time to act to create a higher monthly cash flow isn’t when you are elderly, it is right now. Right now, no matter what your age. It isn’t when interest rates are higher, it isn’t when the stock market is higher, it isn’t when Congress finally does something right, it is RIGHT NOW.  

Every person and every family that dreams of a retirement of leisure and a dignified ending needs to start creating their future monthly cash flow today.   

At the core of creating this future monthly cash flow is the strategy of investing in dividend paying common stocks of globally dominant companies. Of course everyone needs some savings in the bank and maybe some interest paying bonds, but it is getting comfortable with investing in dividend paying stocks and doing it that will potentially give you the cash flow you want during your retirement years.  

What? You say owning common stocks are too risky to count on during retirement. Maybe that is because you are focused on the daily share price movements of the stocks rather than the cash flow the stocks are expected to generate. You have to learn to differentiate between the stock price and the underlying value of the operating company. 

For a simple example, let’s take a look at a giant consumer products company’s actual history and see if we can focus on the company and not the stock. 

Let’s look at the COMPANY over the last ten years:

• Revenues have more than doubled
• Dividends are almost three times higher
• “Free Cash Flow” is over eight times higher  

Let’s look at the STOCK:

• It is currently selling for a little over $60 per share.
• Eleven years ago the stock was selling for almost $60 per share. 
• Twice since January 2000 the share price has declined more than 40% in value.   

This company has been very successful. Management has done about everything an owner (shareholder) could expect it to do. It has increased revenues, profits and the amount of benefits to the shareholder (dividends). 

What can corporate management NOT control? It cannot control the share price, which is a function of the euphoria-and-panic of the financial marketplace. 

If you are retired or planning to retire, your investment accounts are probably an important source of your retirement income. And, what do you really need in retirement? For most people it is the monthly cash-flow. 

What has this company done for shareholder cash-flow (dividends) since 2000? It has more than tripled.  

There are no guarantees in the world of investing but IF this company can triple it’s dividend over the next ten to twelve years, then the shareholder will be earning about 9% to 10% annually based on today’s investment. That will be a nice retirement cash-flow. 

Own the company and not the stock.

I realize we can only own the “stock” of a publicly traded company, so it is more accurate to say FOCUS on the company and not the stock price.  

But, you may be saying, “This country is in a giant mess and the mess seems to be getting worse every day.”

The original roots of this company go back to the year 1837. It has survived the war-between-the-states, two world wars, various terrorist attacks, and all sorts of natural disasters and the leadership of a lot of inept politicians over the years. It was able to prosper during the terrible inflation years of the late 1970’s and early 80’s. Today, most of its revenues are earned outside of this country, thus it is not overly dependent on the domestic economy. 

However, despite this resilience, the share price of this company has declined in value rather dramatically many times during its history.  And we would expect the same in the future. Own the company and not the stock; it is the key to your financial contentment during your retirement years.  

Even a great company can stumble, so you need to consider owning a group of stocks similar to the one above and enjoy the quarterly dividends. We believe no other asset class is likely to adapt to the rapidly changing and challenging world economic environment as well as these globally dominate international companies. They need to be a core part of almost every investor’s retirement income.

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

Member of the national ElderCare Matters Alliance

Do you remember the uncomfortable feeling you had when your mom or dad sat you down to have “the talk”?  Well, I want you to have a talk of a different kind with your parents.  This next talk may make you and your parents just as uncomfortable as the first one, but it’s equally as important.  I want you to talk to your parents about their estate plan. More on Article of the Week on ElderCareMatters.com: "THE SECOND TALK"

J. Michael Bishop, JD
Smiley Bishop & Porter, LLP
1050 Crowne Pointe Parkway
Suite 1250
Atlanta, GA  30338
770-829-3850

Member of the national ElderCare Matters Alliance

Interest rates on bank CDs and money market funds have been at historic lows over the last several years. Sure, everyone wants to make more income from their assets. But always remember there is no free lunch. No matter what a salesman might tell you, with bigger returns come bigger risks.

In an effort to attract seniors’ retirement funds, Wall Street has introduced an array of increasingly complex products that promise investors higher yields than are available from CDs or government bonds. Unfortunately, most of these products carry the danger that an investor can lose most or all of his or her principal investment. In many instances, higher yielding investments are simply inappropriate for seniors seeking to preserve their assets and should not be recommended by stockbrokers, financial advisors or investment advisors.  More on Article of the week: "Beware: Higher Yielding Investments Can Have Higher Risks"

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

The collective goals of Mr. and Mrs. Marlowe are to protect their family assets for the future benefit of Mrs. Marlowe, their grown children and grandchildren, and accomplished this while at the same time establishing compensability for Mr. Marlowe for Medicaid benefits.  The Marlowe family estimate that Mr. Marlowe will need to transition into a long-term skilled care facility in the next two to five years.  More on Article of the Week: "An Elder Law Case Study – Medicaid and Estate Planning for Mr. and Mrs. Marlowe"

Dagmar M. Pollex, Esq.
The Law Offices of Dagmar M. Pollex, P.C.
Braintree, Massachusetts  02184
781-535-6490

Member of the national ElderCare Matters Alliance, Massachusetts chapter

Today, the risk of losing your life savings to a long term care illness looms as the largest threat to your future security. That’s why one of the biggest questions and concerns many people have about their lifetime financial security is what would happen if they suffer a long term disabling illness, such as Parkinson’s disease or Alzheimer’s. More on Article of the Week: Protecting Your Savings From the Devastating Cost of Long Term Care

Joseph F. Pippen, Jr., Attorney at Law
Law Office of Joseph F. Pippen, Jr. & Associates
Largo, Florida  33771
727-586-3306

Member of the national ElderCare Matters Alliance, Florida chapter

1. What are my options in estate planning?

A. Everyone has three options in estate planning. Each option is discussed below.

OPTION I: DO NOTHING

The most popular option is to put off planning indefinitely and hope that the need to plan will go away. This is clearly the worst option, although 60-70 percent of Americans choose this option .If a person fails to plan his estate, the state he resides in plans it for him. Every state has written a Will for every person who fails to create his own. This is called a statutory Will. The statutory Will that the state creates for you decides how your estate will be distributed and who will be named your personal representative. The state also decides who the guardian of minor children will be and makes many decisions that individuals should make for themselves. More on Article of the Week: There are Options in Estate Planning

Shannon Martin, M.S.W., CMC
Aging Wisely, LLC
Clearwater, Florida  33756
727-447-5845

Member of the national ElderCare Matters Alliance, Florida chapter

If your loved one is hospitalized, the hospital discharge process is a key transition time.  Within 90 days of hospital discharge, as many as 35% of Medicare recipients will be readmitted to the hospital.

Without proper support and resources as well as good understanding of follow up instructions, many individuals will return to the hospital for reasons that could have been avoided.  No one wants this, and it can be especially dangerous for elders and persons with chronic conditions.

If you are a family caregiver and an elderly loved one is hospitalized what can you do to ensure a safe transition after the hospital stay? More on Article of the Week: Ensuring a Safe Transition for Your Loved One After a Hospital Stay

Kerry R. Peck, Esq., Managing Partner
Peck Bloom, LLC
Chicago, Illinois  60603
1-877-845-1743

Member of the national ElderCare Matter Alliance, Illinois chapter

THE DIAGNOSIS: Stan was 68 years old when he was diagnosed with Alzheimer’s disease. A successful banker, Stan had made a nice life for his wife and children and was an integral part of his neighborhood. He was an active member of his church and the local school board. Despite a family history of Alzheimer’s disease, Stan’s world was shattered when the doctor delivered the test results. He was thrown into a whirlwind of doctor’s appointments and new medications. He was uncertain whether to keep his diagnosis a secret or tell his friends. Before he even began to battle the disease, Stan felt his life was already becoming less of his own. He decided to take back control of his life and called an old friend who was a practicing elder law attorney. Within the week, he and his family were sitting in the elder law attorney’s office to discuss his options.

A heartbreaking diagnosis of Alzheimer’s disease requires prompt action. Those diagnosed are unprepared to deal with the disease, let alone the financial and legal consequences the entire family needs to face. Unfortunately, the only certainty about Alzheimer’s disease is that the progressive nature affects the mental and physical functions of each patient differently.  Therefore, there is no time to waste in planning for the family’s future. Advanced legal planning protects the individual’s right to participate in the decision-making process and protects the family from unnecessary court intervention. More on Article of the Week: "Now What? A Diagnosis of Alzheimer's Disease and the Legal Issues That Require Prompt Attention"

Ben A. Neiburger, JD, CPA
Neiburger Law, Ltd.
Elmhurst, Illinois  60126
630-782-1766

Member of the national ElderCare Matters Alliance, Illinois chapter

In my elder law practice, a frequent topic of conversation with my clients is how to pay for long-term care.  This is an understandable concern given that many long-term care facilities in Northern Illinois charge between $6000 and $8000 per month for care – that’s $72,000 to $96,000 per year!).  A typical married couple in their 70’s may have only $50,000 to $200,000 in life savings plus their home.  This means that if one spouse needs to spend some time in a long-term care facility, he or she could burn through the couple’s life savings in a year or two – a very scary thought. 

The need for long-term care begins when people lose the ability to manage some of their “activities of daily living.”  An activity of daily living is a basic task that someone does in everyday life, such as eating, bathing, dressing, toileting, and getting in and out of chairs and beds.  As a person loses these activities of daily living, and their loved ones can no longer help because of their own health issues or time commitments, the person must look outside the home for help.  Since full-time home healthcare costs are also high (between $90 and $250 per day—or $2700 to $7500 per month), many people leave their home and enter a long-term care facility such as nursing home. 

There are four ways to pay for long-term care: long-term care insurance, pay with your own savings, Medicare, and Medicaid. More on Article of the Week: Paying for Long-Term Care – Can it be done?

Bert Cave
President of Support For Home
Sacramento, California  95825
916-482-8484

Member of the national ElderCare Matters Alliance, California chapter

In the third article in this series, we discussed the first four Instrumental Activities of Daily Living (IADLs):

• Ability to use a telephone
• Shopping for food and other necessities
• Food preparation
• Housekeeping and organization

Today we will cover the last four:

• Doing laundry
• Meeting needs for transportation
• Managing medication
• Handling finances More on Article: Advance Living Directive™ Part IV

Bert Cave
President of Support For Home
Sacramento, California  95825
916-482-8484

Member of the national ElderCare Matters Alliance, California chapter

In this article, we will discuss what are called Instrumental Activities of Daily Living (IADLs).  We consider these as important as ADLs, in terms of establishing the need for home care or alternative living arrangements.  We wish that providers of Long Term Care Insurance took them more seriously, as well.

The distinction from “basic” Activities of Daily Living is subtle, in our view, and there is a tendency in the insurance and medical communities to underestimate their importance, frankly.  When Long-Term Care Insurance companies perform an assessment as to whether their clients are eligible for benefits to begin, the insurance companies require that assistance is needed for at least two of the basic ADLs that we discussed in Part II: More on Article: Advance Living Directive™ Part III

Bert Cave
President of Support For Home
Sacramento, California  95825
916-482-8484

Member of the national ElderCare Matters Alliance, California chapter

We introduced the Advance Living Directive™ Support For Home developed in our last article.  It is neither a commercial product nor a sole creation of our agency.  Like most good things, it is collaborative, adapted from an article by M.P. Lawton and E.M. Brody.  This tool allows individuals and families to look at all of the Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) that we perform virtually every day.

We really do encourage families to participate in this exercise together, applying it not just to Mom and Dad, but to themselves, as well.  Using the tool together and discussing the results as a family goes through the exercise will generate some excellent discussion and make the outcome more meaningful for all. More on Article: Advance Living Directive™ Part II

Bert Cave
President of Support For Home
Sacramento, California  95825
916-482-8484

Member of the national ElderCare Matters Alliance, California chapter

At Support For Home and other good home care agencies, our mission is to help people live at home just as long as they want to and safely can. We, along with the courts and gerontologists, believe that home is normally the place where quality of life is the highest.  However, we believe that every individual and every family should, in advance, determine the criteria which establishes home as a viable living space – either independently or with home care services.

In this series of four articles, we will talk about what we consider some of those criteria. There are very few solid lines (“If I’m on this side of the line, all is OK; on that side, I need assisted living or …”). However, there are a number of factors we feel individuals and their families need to bake into a fairly formal plan.  That word is key.  Where we live, what help we need, if any, should be part of a plan for our life, and plans are made in advance. More on Article: Advance Living Directive (Part 1 of 4)

Shay Jacobson, RN, MA, NMG
President of Lifecare Innovations, Inc.
Burr Ridge, Illinois  60527
630-953-2154

Member of the national ElderCare Matters Alliance, Illinois chapter 

In a perfect world, everyone would have a plan, and every part of it would come into effective play as we age and become less able to manage our own affairs.  Those who are named as Trustees and Powers of Attorney for Health Care and Property would be alive, well, and ready to serve at the appointed time. 

Real life can, however, offer some exceptions to this ideal.  Sometimes the family members or friends designated to oversee our affairs are encountering health problems of their own, at precisely the time we need them.  Occasionally, they pass away before we do.  In some terrible instances, they will take our money and use it as their own.  And, surprisingly, many people arrive at old age without ever having made a plan. More on Article: Everybody Has a Plan, so Why is There Guardianship?

Shelley A. Elder, Esq.
Elder Law Firm, PLLC
Kennesaw, Georgia 30152
404-783-2244

Member of the national ElderCare Matters Alliance, Georgia chapter

There are few things more stressful and worrisome than treating and supporting a special needs child. Parents must spend, save, and plan for their own retirement while considering the impact that their decisions may have on their special needs child and any other children they may have. They also think about what will happen to that child when they are no longer able to care for them.

What are some options that a family may have? Each family’s situation is different, but a special needs trust may be the answer, especially for those individuals who may be or become eligible for public benefits, including Supplemental Security Income (SSI) and Medicaid. These programs help pay for basic health and living expenses. More on Article: Planning for a Special Needs Child

Elayne Forgie, M.S., CMC
ElderCare at Home
Lakeworth, Florida  33461
1-800-209-4342

Member of the national ElderCare Matters Alliance, Florida chapter

Alzheimer's disease can have devastating consequences for patients and their families. Counseling tailored to the manifestations of each stage of Alzheimer's disease is one approach clinicians can adopt to help meet patients' needs. In the early stage, treatment options and the development of advance directives should be the focus. Problems that arise with declining cognitive function, personality changes, and communication deficits should be addressed during the long second stage. During the final stage, the family will need support while they make the difficult decisions regarding end-of-life care. More on Counseling Alzheimer's Patients and Their Families

Susana Lannik, Attorney at Law
Lannik Law, LLC
Newton, Massachusetts  02458
617-658-2980

Member of the national ElderCare Matters Alliance, Massachusetts chapter

Joe and Henrietta, ages 80 and 75, have been married for fifty years. They have two children, Joe, Jr. and Liz. Joe and Henrietta own their own home and have savings of $170,000. The home is held jointly; the bank accounts are also held jointly with right of survivorship to each other. Joe is a World War II veteran and has Social Security benefits of $1,200 per month, while Henrietta receives $600 per month. Liz lives with her parents, but works outside the home. More on CASE STUDY: Developing an Estate and Elder Law Plan for Joe and Henrietta

Susana Lannik, Attorney at Law
Lannik Law, LLC
Newton, MA  02458
617-658-2980

Member of the national ElderCare Matters Alliance, Massachusetts chapter

What is Probate? Probate is the legal process overseen by a court to ensure your debts are paid and your assets are distributed to beneficiaries as specified in your will.  If you do not have a will, the court still oversees the distribution of your assets in accordance with a state law called the Intestacy Statute. More on Why Is Avoiding Probate Important? How Can You Avoid It?

Scott A. Makuakane, Esq., CFP
Est8Planning Counsel LLLC
Honolulu, Hawaii
808-587-8227

Member of the national ElderCare Matters Alliance, Hawaii chapter

Callie Rogers, age 16, won $3.1 million in a British lottery.  By the age of 22, the unwed mother of two, having attempted suicide twice, and having spent over $400,000 on cocaine alone (in addition to more conventional luxuries), was broke, living with her mother, and working three cleaning jobs.  She described her sudden windfall as having ruined her life, and she was looking forward to finding happiness once her winnings were gone. More on Easy Come . . . Easy Go. There are Ways to Protect Your Legacy

Alex Chamberlain
EasyLiving, Inc.
Clearwater, Florida
727-448-0900

Member of the national ElderCare Matters Alliance,
Florida chapter

Aging in place has grown increasingly popular throughout the country. According to an AARP survey, 70-80% of respondents say they would prefer to live out their days in their own homes.  It is understandable that so many people choose to age comfortably in their own home rather than re-locating to a nursing home or assisted living facility. However, many matters must be considered when financing longevity. Below are some points to take into consideration in order to adequately plan for one’s future:  More on How to Finance for Longevity and Aging in Place

Wayne Abraham
Personal Care, Inc.
Greensboro, North Carolina
336-274-9200

Member of the national ElderCare Matters Alliance,
North Carolina chapter

If you or a family member reach a point when you believe it is time to use that long term care insurance policy that was purchased, what do you do? All too often people don’t read the fine print on their policies and aren’t sure how to go about accessing them when they need them.

There are some basic things to keep in mind when you have reached this point. First of all, do you qualify? Different policies have different requirements for what constitutes eligibility. The industry standard is that you must need help with at least two activities of daily living or ADLs. These include tasks such as bathing, dressing, toileting, and others.

When you contact your long term care insurance company about activating your policy and receiving benefits they will send an RN out to do an assessment as well as contacting your doctor. Below is a list of items that insurance companies use in order to determine whether or not you are eligible to receive those benefits. More on How to Access Your Long Term Care Insurance Benefits

Kenneth C. King, Jr., Esq.
King Law Group, P.C.
Roanoke, Virginia 
1-866-985-1123

Member of the national ElderCare Matters Alliance, Virginia chapter

The holidays are the best time of the year for talking T-U-R-K-E-Y.  As you savor turkey and gravy and once again remember how good the green bean casserole really tastes, gather your family into a "Time to Talk Turkey" about your family's Love 'n Money.  The holidays are the right time to formulate and discuss your family's plans, including your estate plans.

To get you started, during a large helping of mashed potatoes and gravy, here is a simple formula for family discussion: talk T-U-R-K-E-Y(the "Turkey" topics are in the following paragraphs).  For each Turkey topic, discuss who, what, when, where and how.  It is that simple.  So, let's get talking T-U-R-K-E-Y about your family's Love 'n Money.  For each letter in "Turkey", we'll get you started with some questions.  Now, it is your turn to provide the discussion. More on Time to Talk T-U-R-K-E-Y

Linda S. Melancon, Attorney at Law
Legacy Center of Louisiana, LLC
Prairieville, Lousiana  70769
225-744-0027 

Member of the national ElderCare Matters Alliance, Louisiana chapter

While it may be the rare individual who can afford to retire during the "Great Recession," for those close to retirement age or contemplating retirement, a basic understanding of retirement planning terms and options is imperative. There are many different things that you need to understand regarding retirement planning, but some of the most important are: understanding what type of plan you have and when distributions can or must be taken; understanding spousal rights in employment plans; understanding social security retirement benefits; and understanding if and when any unused retirement benefits will pass to your heirs.

More on Retirement Planning Basics

David Paul Pollan, Esq.
The Pollan Law Firm
Atlanta, Georgia  30309
877-302-9780
  

Nursing Home care can cost $8,500 to $10,000 per month.  Few people can afford to pay privately for long-term care indefinitely. 

All too often, elders assume Medicare will cover continuous nursing home care should the need arise.  In fact, Medicare has a very limited "skilled rehabilitation" benefit and for only a maximum of 100 days per spell of illness.  Beyond the 100 day maximum benefit period, an individual will either pay privately or seek eligibility for "Nursing Home" Medicaid.  Nursing Home Medicaid is an available payment source for  continuous nursing home placement for those individuals who meet financial eligibility criteria.  More on Nursing Home Medicaid and Estate Planning Considerations

Sheri Abrams, Attorney at Law
Needham Mitnick & Pollack, PLC
Falls Church, Virginia  22046
703-536-7778

Member of the national ElderCare Matters Alliance, Virginia chapter

WHAT ARE SOCIAL SECURITY DISABILITY BENEFITS?

Social Security Disability is a benefit received from the Social Security Administration by disabled workers and in some cases their dependents, similar to those received by retired workers.

WHO QUALIFIES?

To receive benefits under the Social Security Disability program, you must have a physical or mental health problem (or a combination of problems) severe enough to keep you from working in any regular paying job for at least one year. The test isn't whether or not you are able to go back to your old job, and the test isn't whether or not you have been able to find a job lately. Rather, the test is whether you are capable of doing any job available in the national economy. By using an extensive set of regulations, the Social Security Administration takes into account your medical condition, your age, your abilities, your training and your work experience in deciding your case. More on Answers to your Social Security Disability Questions

Allen Kampf, RFC, CLTC
Wealth Advocacy Partners
Sparks, Maryland  21152
410-527-1171

Member of the national ElderCare Matters Alliance, Maryland chapter

As the number of elderly Americans increases, long-term care (LTC) needs and costs are likely to grow.  Many believe that private long-term care insurance can and should play a more significant role in the financing of home care and nursing home services.  Wider use of such insurance could shift the burden from individuals, who are often ill-prepared to pay for such care out-of-pocket, as well as from state Medicaid programs, which often serve as a default financier of long-term-care services. More on Long Term Care Partnership Programs

Martha M. Kern
Director, Lifecare Home Solutions
Oakbrook Terrace, Illinois  60181
630-932-4032

Member of the national ElderCare Matters Alliance, Illinois chapter

The problem of hoarding has recently garnered a great deal of attention, particularly since becoming the subject of an A&E television show.  It is not, however, a new problem.  It pre-dates the Depression (and is not caused by Depression-Era upbringings), has been documented all over the world, and is believed to afflict 15 million Americans to a clinically-significant degree.  Hoarding causes trouble not just for the hoarder, but for everyone in their lives.  Paradoxically, allowing a hoarder to get into trouble rather than working to get them out of trouble may just be the key to lasting change. More on The Hoarding Dilemma: When and How to Help

Richard M. Morgan, JD, LLM
Morgan and DiSalvo, P.C.
Alpharetta, GA  30022
678-720-0750

Member of the national ElderCare Matters Alliance, Georgia chapter

Executive Summary:  Converting your investments in traditional IRAs to a Roth IRA during 2010 can be an important planning opportunity for many tax payers.  This conversion allows you to move from a tax deferred environment into a tax free environment.  While this opportunity is normally open to those with income below a certain cap amount, during 2010 no such income cap exists.  Further, while such conversion is an income taxable event (but without any penalties), conversions during 2010 give you the option to defer the taxable income by recognizing 1/2 in 2011 and 1/2 in 2012.  More on Window of Opportunity: Convert Traditional IRA to a Roth IRA During 2010

Sally Allen
A Place for Everything, LLC
Golden, Colorado
303-526-5357

Member of the national ElderCare Matters Alliance, Colorado chapter

If you or your parents are at the stage of life to consider downsizing, you've got a lot of company.  Nearly 40 million people in the United States, or 13 percent of the total population, were 65 or older in 2007, according to the U.S. Census Bureau.

As individuals live longer and families are often geographically dispersed, more elderly adults are faced with the trauma of relocating, often from a place they've called home for decades.  Every nook and cranny holds special memories.  The thought of leaving them behind can be overwhelming. More on Tips to Make Downsizing Easier

Marilyn Ellis
Lighthouse Organizers, LLC
Walnut Creek, California
1-866-379-6440

Member of the national ElderCare Matters Alliance, California chapter

Moving into an assisted living community isn't the end of the road – it's a new beginning.

While seniors might desire to stay in their homes, practicalities often dominate: hard to walk up stairs, inadequate bathroom, or the home is in disrepair or is too big or too costly to keep up.  Perhaps they have suffered an unexpected and permanent loss in function.  Moving in with you or having someone live with them may not be an option.

If you've neither visited an assisted living community nor done so in several years, you are in for a happy surprise.  They are nothing like the early 20th century horrors of a nursing home. More on What to take when moving into assisted living

Scott Makuakane, JD, CFP
Est8Planning Counsel LLLC
Honolulu, HI  96813
808-587-8227

Member of the national ElderCare Matters Alliance, Hawaii chapter

What is a trust?

A trust is the legal relationship that is created when a person transfers property to a trustee with the understanding that the trustee will manage the property for the benefit of one or more beneficiaries.

The term "property" is used here in its broadest sense to include both real property – such as land and buildings – and personal property – such as bank accounts, stocks and bonds, and personal effects.

The person who transfers the property to the trustee is called a trustmaker.  This person is also known as a settlor, grantor, or trustor. More on Answers to frequently asked questions about revocable living trusts

Allen Kampf, RFC
Wealth Advocacy Partners
Sparks, Maryland
410-527-1171

Member of the national ElderCare Matters Alliance, Maryland chapter

As a result of medical technology, we are definitely living longer.  When we continue living, we age; when we age, we need care.  It isn't a question of who will care for you.  The question is, "What impact will that care have on your family – physically, emotionally and financially?" More on Who Pays for Long-Term Care?

Jonathan Ginsberg, Esq.
Ginsberg Law Offices
Atlanta, Georgia
770-393-4985

Member of the national ElderCare Matters Alliance,
Georgia chapter

The recession of 2008-2009 has especially affected retirees whose fixed income investments no longer provide enough money to live.

For many retirees, credit card balances have increased the past several years and they can't even afford the minimum payments.  Others make mortgage payments on homes that are now worth less than the total mortgage debt.  Selling and downsizing is no longer viable.

As an option to help retirees out of their financial troubles, bankruptcy is often met with ambivalence.  Moreover, and not surprisingly, to hardworking, industrious men and women, bankruptcy represents both a financial and a personal failure.

Complicating the issue, many retirees hide debt problems from their adult children, or they make ill-advised decisions, such as liquidating retirement plans, long before they meet with their legal or financial advisors.

But before you dismiss the idea of bankruptcy, let's learn a little more about it. More on Special considerations for seniors facing bankruptcy

Paul T. Czepiga, J.D.
Czepiga Daly Dillman, LLC
Newington & Wethersfield , Connecticut
860-563-4070

Member of the national ElderCare Matters Alliance,
Connecticut chapter

 Editor's note:  The following article about the probate process is a case study of the system in Connecticut.  Although not nati0nal in scope, the steps examined in this article may be useful when doing estate planning in whatever state you live in and for generating questions for your financial and legal advisors.

Many people believe it is important is avoid probate.  Some have heard that using a "living trust" avoids probate.  Others may have had a particularly bad experience with a probate court.

To understand why one might want to use or avoid probate, let's first understand what the probate court's role is in processing estates of decedents, sometimes called the estate administration process. More on The Probate Process – Connecticut's 6 steps can help you understand your state's procedures

Ben A. Neiburger, JD, CPA
Neiburger Law, Ltd.
Elmhurst, Illinois
630-782-1766

Member of the national ElderCare Matters Alliance, Illinois chapter

Estate planning helps ensure your assets go to your desired beneficiaries after you pass away.  This article describes the tools, such as gifts, wills, beneficiary designations, trusts, and strategies that elder law attorneys use to create an estate plan. More on Estate Planning Tools to Transfer Assets After Death

By Sanford J. Mall, JD, CELA
Mall Malisow & Cooney, P.C.
Farmington Hills, Michigan
248-538-1800

Member of the national ElderCare Matters Alliance, Michigan chapter

Elder law is a specialized area of law that focuses on assisting older individuals and those with disabilities preserve their dignity, protect their assets, and make good decisions despite increasingly complicated laws.  This specialty encompasses such areas as planning and paying for long-term care, asset preservation, housing options, disability planning, estate planning (including the use of financial and health care durable powers of attorney), and when necessary, the involvement of the probate court.

More on Understanding Elder Law

By John Stewart
Director of Estate and Asset Services
American Cancer Society
1-877-227-1598

Member of the national ElderCare Matters Alliance, Georgia chapter

An estate plan aims to preserve the maximum wealth possible for the intended beneficiaries, while providing financial flexibility for the plan's owners throughout their lives. 

Most Americans can benefit from estate plans, but more than half don't have one in place.

More on Value of estate planning is lost to half the population

Shay Jacobson, RN, MA
Life Care Innovations
Oakbrook Terrace, Illinois
630-953-2154

Member of the national ElderCare Matters Alliance, Illinois chapter

Long term care has evolved into a "catch all" phrase that is confusing to the lay as well as the professional community.  The boundaries among primary, acute, and long term care have blurred.  Instead of concentrating on acute care in hospitals, our health care system's focus has switched to managing chronic conditions in a variety of settings from home to rehabilitation hospitals.  The long term care goal switches from curing illness to helping individuals function as well as possible while maintaining dignity and independence.  Individuals that require long term care have a compromised ability to live on their own due to their condition.  Long term care encompasses help with activities of daily living (ADLs), such as bathing, dressing, eating, and toileting. More on Medical Issues and Terminology in Long Term Care

By Philip C. Benedict, CFP
Benedict Financial Advisors
Atlanta, Georgia
770-671-8228

Member of the national ElderCare Matters Alliance, Georgia chapter

Over the years, I have brought up the topic of long-term care insurance with my clients and friends.   Some got coverage, but many did nothing.  So, I asked a few of the "do nothings" why they took no action.

More on Long-term care insurance is not only for nursing homes

 By Jeff Bernier, CFP, ChFC, CFS
TandemGrowth Financial Advisors, LLC
Roswell, Georgia
770-641-6360

Member of the national ElderCare Matters Alliance,
Georgia chapter

In the face of volatile investment markets, rising medical costs, increased taxes, and uncertain social security benefits, many retirees are looking for solutions.

This article is designed to assist retirees in planning for retirement while taking a critical look at the financial services industry's packaged solutions. More on Take a critical look at financial instruments

By Mandy Merkel, MMSc, CCC-SLP
Senior Resource Consulting
Atlanta, Georgia
404-786-7789

Member of the national ElderCare Matters Alliance,
Georgia chapter

After my parents retired to Florida, we thought things would be fine; if something happened to them, we could hop on a plane and take care of things.

Unfortunately, it was not that simple.  Dad broke his hip and needed short term rehab – unbeknownst to us, he had been taking care of Mom as her dementia advanced.

Like many parents, he had kept us in the dark about how much she depended on him and like many children, we chose not to see the realities of her decline.

Now we were in a crisis: More on Distance caregiving is new baby boomer challenge

By Gary Figiel, MD
Southeastern Geriatric Healthcare Group
Atlanta, Georgia
404-497-1830

Member of the national ElderCare Matters Alliance,
Georgia chapter

Depression is a serious life threatening illness, which without question increases the risk of mortality in elderly patients and is linked with increased mortality of residents in nursing and assisted living homes, along with other long-term care facilities.
More on Diagnosing and Managing Depression in the Elderly

By Tom Olsen
St. George Village
Roswell, Georgia
770-645-2340

Member of the national ElderCare Matters Alliance, Georgia chapter

What is a CCRC?

A "CCRC" is a Continuing Care Retirement Community, the most comprehensive retirement living option available to seniors in America today.

A CCRC combines the services of an independent living retirement community with an assisted-living facility and a nursing home at a single location. More on CCRCs combine independent living with assisted living and nursing home care

By Ginny Helms
Alzheimer's Association, Georgia Chapter
Atlanta, Georgia
404-728-1181   
                                                    
Member of the national ElderCare Matters Alliance,
Georgia chapter

Of all the issues of aging, none has been more emotionally or medically challenging than Alzheimer's disease.  And because we are living longer, the incidence of Alzheimer's is on the rise.  More than 1,000 cases are diagnosed each day in the U.S., In Georgia alone, the Alzheimer's Association counts more than 160,000 cases. More on ALZHEIMER'S DISEASE: Significant Progress toward Prevention and Cure

By Phillip G. Sanders, MBA, MSHA, CPA
Georgia ElderCare Advisors, LLC
Atlanta, Georgia
770-379-4500

Member of the national ElderCare Matters Alliance,
Georgia chapter

If you really want to understand what ElderCare is all about, talk to someone like Jeanette Johnson.  In 1990, her husband, a Navy veteran of 24 years, passed away.  In 2001, she suffered two strokes within 20 days.  While many might have given up, the self-described "stubborn" Mrs. Johnson persevered.  

More on Finding the right ElderCare professional can make a difference in a life

By Gary Figiel, MD
Southeastern Geriatric Healthcare Group
Atlanta, Georgia
404-497-1830

Member of the national ElderCare Matters Alliance,
Georgia chapter

This is the second most asked question from a patient's loved one: "Am I going to get it too?" 

The most frequently asked question is: "What is the difference between Alzheimer's Disease (AD) and Dementia?" More on My parent has Alzheimer's Disease – Am I going to get it too?

By Robert M. Bregitzer, CPA
Southeast Mortgage
Dunwoody, Georgia
770-399-7775

Member of the national ElderCare Matters Alliance,
Georgia chapter

When Mildred Austin inquired about a reverse mortgage, she did not know much about them. "All I knew was that this could help me; I needed someone to explain it to me". After talking with a Department of Housing and Urban Development (HUD) Counselor, meeting with a reverse mortgage specialist, and discussing the options with her advisors, she decided that a reverse mortgage was her best option. "I was able to make needed repairs to my house, pay-off my existing mortgage loan and several medical bills and obtain a monthly check to supplement my social security. This loan has been a blessing."

More on The Reverse Mortgage: Some Seniors Can't Stay Home Without It

By Phillip G. Sanders, MBA, MSHA, CPA
Georgia ElderCare Advisors, LLC
Atlanta, Georgia
770-379-4500

Member of the national ElderCare Matters Alliance,
Georgia chapter

During the last several years, I have had the honor to address my colleagues at the AICPA's (American Institute of Certified Public Accountants) National ElderCare conference in Phoenix, and to serve as a panelist at the day-long nationally televised symposium for ElderCare professionals in Dallas.  The overriding message I heard from fellow CPAs and attorneys was the importance of setting into place NOW a long-term care plan — a plan that details how you will finance your and your family's future ElderCare needs.

More on Experts Agree: Plan Now for Future ElderCare Needs

By Philip C. Benedict, CFP
Benedict Financial Advisors, Inc.
Atlanta, Georgia
770-671-8228

Member of the national ElderCare Matters Alliance,
Georgia chapter

Raymond and Sally are what almost everyone wants to look like and act like when they pass their 80th birthday.

Sally still volunteers at the local elementary school and Ray is a landmark at the local golf club. They seem to have everything – good health, a fine daughter and son-in-law and three adorable grandchildren. Their lifestyle, while not extravagant, could not be considered modest either. More on Overspending is more than simply spending your children's inheritance

By Michelle Ettenger
Elmcroft of Roswell
Roswell, Georgia
770-650-0555

Member of the national ElderCare Matters Alliance, Georgia chapter

Not too long ago, families had few choices for senior housing. If an elderly person was unable to manage in their own home or could not be cared for by his family, then the nursing home for the infirm and the most frail was the only housing option available.

Today, it is quite different. More on When is assisted living the right choice?

By Lane Tharp, SRES, CSA
Coldwell Banker
Atlanta, Georgia
770-804-7805

Member of the national ElderCare Matters Alliance,
Georgia chapter

It is exciting to move to a more manageable home after years of maintaining a large home and yard. The choices for downsizing are much greater now than ever before.

Downsizing may involve moving to a smaller home, a ranch condominium, or even a larger home on a smaller lot. It may also involve changing your community from a single-family home in an established neighborhood to an apartment home, a golf or lake community, a retirement community, or an assisted living facility.

The savvy home seller will want to approach this transition with a plan so that the move goes as smoothly as possible. More on Get marketing know-how when you're downsizing

By J. Michael Bishop, JD
Smiley Bishop & Porter, LLP
Atlanta, Georgia
770-829-3850

Member of the national ElderCare Matters Alliance,
Georgia chapter

Six months have passed since Betty's husband Joe died. Betty always let Joe handle the money matters. He had always been a savvy investor, but in the last several years, it had become obvious that Joe really was not on top of his game.

Now, Betty asked her daughter Sarah to help her look through the couple's financial papers. Things are a mess. There are piles of unopened envelopes from brokerage firms, mutual fund companies and banks. As Sarah opens the statements, she becomes distressed because the brokerage accounts have suffered some significant losses due to a downturn in the stock market or is something else wrong? How can she tell? More on Caveat emptor – Stockbroker fraud

By Jeff Bernier, CFP, ChFC, CFS
TandemGrowth Financial Advisors, LLC
Roswell, Georgia
770-641-6360

Member of the national ElderCare Matters Alliance,
Georgia chapter

When was the last time you talked with an investment professional who didn't promote diversification? Stocks, bonds, cash, real estate, some international as well as domestic investments–it's called asset class diversification and it's a principle of sound investing.

More on INVESTING: Avoiding Long-Term as well as Short-Term Risk

By Charles J. Hampton, Esq.
Charles J. Hampton, PC
Atlanta, Georgia
770-804-8000

Member of the national ElderCare Matters Alliance,
Georgia chapter

You might have already gotten the pitch: Come for a free dinner and learn how to avoid probate. The sale is typically a living or revocable trust — transfer your assets now so when you die they will be distributed as you wish without having to pass through the probate court.

More on FEAR FACTOR: Probate!

By Debra A. Robinson, JD
Robinson & Miller, PC
Alpharetta, Georgia
770-817-4999

Member of the national ElderCare Matters Alliance,
Georgia chapter

Women, may we have your attention?

Women are so busy caring for others, they often forget to take care of themselves.

As a result, many women fail to properly plan for the distribution of their assets at death and fail to make their health care decisions in the event of incapacity. More on Women Often Fail to Plan for End of Life Decisions

By Stephen C. Andrews, JD
Bodker, Ramsey, Andrews, Winograd & Wildstein, PC
Atlanta, Georgia
404-351-1615

Member of the national ElderCare Matters Alliance,
Georgia chapter

What do you do when you suspect that a loved one is being subjected to undue influence or other pressures to change their will?

 Georgia law provides that a will must be freely and voluntarily executed. That is, a will may be invalidated if it is the result of “undue influence,” More on Are Your Loved One's Being Pressured to Change Their Wills?