How Do I Protect Property If I Need Long-Term Care?

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Nearly 90% of those over age 65 would say they’d prefer to stay in their home and live independently as they age. However, even if you are one of those people, you need to make certain that you have a long-term care plan in place to ensure your assets can go toward the things you want, rather than unexpected healthcare costs.

The Observer-Reporter’s recent article entitled “Protecting Your Assets is Only Half of Your Long-Term Plan” explains that there are many factors, like chronic conditions and lifestyle choices, that can increase healthcare expenditures as you get older. Understanding and planning for the potential costs now, could be the difference between spending your savings on health care expenses, instead of on the things you want.

You may be concerned about being a burden to family and friends as you age. That’s common since nearly three-quarters (72%) of parents expect their children to become their long-term caregivers. However, just 40% of those children are aware they were tapped for that role!

Research shows that when family and friends assume the role of primary caregivers, they have a 60% chance of exhibiting clinical signs of depression—six times more than the general population. Having your family and friends become your caregivers may be best for you financially, but it probably isn’t in their best interest.

You should have a sound understanding of the cost and burden that long-term care can put on your family and friends. This is the first step to preparing your long-term plan. It is important to understand that there are a few different long-term planning options available, with varying levels of care coverage. One is Medicaid, which is a means-tested government health insurance plan that can cover some or all of the care you may need in a skilled nursing facility. However, what it covers is income- and asset-based. Medicare may cover some limited long- term care for rehabilitation but typically not custodial care.

There is also long-term care insurance which can fill many of the gaps that Medicare and Medicaid may leave. Most plans are customizable and have options for full or partial coverage for all of the types of long-term care. However, there may still be gaps in your coverage.

Ask an elder law attorney about other options and resources.

Reference: (Washington, PA) Observer-Reporter (Feb. 17, 2020) “Protecting Your Assets is Only Half of Your Long-Term Plan”

How to Talk to a Parent Suffering from Alzheimer’s or Dementia during the Pandemic

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If you have a parent living in an assisted living facility or a nursing home, or they’re at home, caregivers need to know how to explain the current coronavirus pandemic in an appropriate and clear manner—and in a way that protects and cares for your own personal health.

Long Island Weekly’s recent article entitled “Caregiving During The Coronavirus” explains that older adults often have more health complications, like heart disease, diabetes, and hypertension. As a result, they’re more susceptible to the complications of the coronavirus. Review the recommendations of the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) for protecting you and your family from exposure.

And although some people suffering from Alzheimer’s or dementia may not fully understand the complexity and severity that the COVID-19 pandemic is having on our communities, they can sense what’s happening. They can read your personal energy and can sense your stress. This may cause them to show more symptoms of anxiety, agitation, cognitive decline, and confusion. Communicate as best you can to your parent frequently and clearly about what’s happening. While they may not need to have all the details, let them know that there’s a virus spreading within the community and that we need to wash our hands thoroughly and stay indoors.

For those still being cared for at home, take the necessary precautions as you’d do for yourself. Modify your grocery shopping trips, since stores are adding special senior hours, reschedule unnecessary doctor visits, stock up on needed medications, and talk to your doctors about any concerns.

For those in a facility, understand the visitation policies, because many have adjusted their policies to limit or prohibit personal visitation. Ask the administration about visitation and what the care facility is doing to ensure your parent’s care.

Although you might be frustrated that your parent’s facility is limiting or canceling visitation, remember that the new rules are designed to protect the residents. You may be able to schedule a time to speak with your mother or father on the phone every few days, or you can deliver food or items, like photos albums or other gifts to stay connected. Try to be reasonable and understand that these facilities may be understaffed.

Here are a few key points that may be helpful to get through this crisis:

  • Have a talk with your parent and with the facilities in which they’re living, so they can understand the new policies.
  • Be careful yourself. Take reasonable precautions for yourself and your family member.
  • Avoid public spaces. This includes routine, or non-essential doctor visits, grocery shopping, and other visits.
  • Stay upbeat. Know the latest news and guidelines but try to remain calm, because your parent may sense your stress and reflect that.

Be reasonable and understanding and try your best in these uncertain times—for yourself and your loved one.

Reference: Long Island Weekly (April 12, 2020) “Caregiving During The Coronavirus”

Keeping Ourselves and Our Elderly Loved Ones Safe

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We have all been warned that our elderly loved ones are at heightened risk during the coronavirus pandemic. If you are a caregiver for someone in this high-risk population, here are some tips from Dr. Alicia Arbaje, who specializes in internal medicine and geriatrics at Johns Hopkins.

  1. Keep Yourself Well
    Be sure to follow all the guidelines and precautions about social distancing, hand washing, and cleaning to keep yourself well.
  2. Limit In-Person Visits
    It may be emotionally challenging but keeping in-person visits to a minimum is the best way to reduce the risk of infection. When you can’t be there in-person, use technology to stay in touch. Teach your older loved ones how to use video chat applications. Remember to add captions to your videos if they are hearing-impaired. Also, encourage others to telephone or send cards or notes as well.
  3. Be Creative About Home-Based Projects
    Now may be a great time to encourage your loved ones to record their personal stories, organize family photos or reconnect with old friends online.
  4. Decide on a Plan
    Discuss now your emergency response plan. Who will be the emergency contact? Do you know where the estate planning documents are and can you quickly access them, especially health care directives?

If you or your loved one do not have an updated will or trust and health care documents, please reach out to our office. We can help get planning in place quickly and easily and are even offering virtual meetings now to keep everyone safe.

What if your elder loved one starts to develop symptoms?

If you or your loved one learn that you might have been exposed to someone diagnosed with COVID-19 or if anyone in your household develops symptoms such as cough, fever, or shortness of breath, call your family doctor, nurse helpline or urgent care facility. For a medical emergency such as severe shortness of breath or high fever, call 911.

Resource: Johns Hopkins Medicine, Coronavirus and COVID-19: Caregiving for the Elderly, https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-caregiving-for-the-elderly

Coronavirus Scams are Surfacing

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Maryland U.S. Attorney Robert K. Hur is “encouraging all Marylanders to be aware of individuals attempting to profit from the coronavirus pandemic,” reported Marcia Murphy, a USAO spokeswoman.

The Cecil Whig’s recent article entitled “Maryland U.S. attorney warns of COVID-19 scams; Cecil County remains vigilant” cautions that coronavirus scams are being uncovered around the country.

Scammers have been sending e-mails to people claiming to be from local hospitals offering coronavirus vaccines for a fee. However, no vaccine is currently available for the coronavirus. Some of these criminals are using websites that appear to be legitimate but are actually fake websites that infect the users’ computers with harmful malware or seek personal information that can be later used to commit fraud. Many of these scams prey on the most vulnerable, especially the elderly.

Seniors need to contact the police, if they think someone has targeted them for a scam and to educate themselves on the COVID-19-related scams by checking official government websites, like the CDC.gov for information.

Seniors need to scrutinize anyone who makes contact with them about a COVID-19 vaccine—which does not exist yet—and to report any such interaction to law enforcement.

Late last week, U.S. Attorney General William P. Barr sent a memo to all U.S. Attorneys, in which he made the investigation of these scams and the individuals perpetrating them a priority. Therefore, federal, state, and local law enforcement agencies are prepared to investigate these frauds.

The Federal Trade Commission has consumer information about coronavirus scams on its website, including a complaint form to report scammers. Elderly victims can also call the newly launched Elder Fraud Hotline at 833-FRAUD-11 (833-372-8311) if they believe they are victims of a coronavirus scam—or any other type of fraud.

In addition to selling bogus cures and infecting computers by using COVID-19-related communications, other examples of coronavirus schemes include:

  • Phishing emails from entities posing as the World Health Organization or the Centers for Disease Control and Prevention
  • Those asking for donations for fraudulently, illegitimate, or non-existent charitable organizations; and
  • Scammers posing as doctors, who ask for patient information for COVID-19 testing and then use that information to fraudulently bill for other tests and procedures.

Barr asked the public to report suspected fraud schemes related to COVID-19, by calling the National Center for Disaster Fraud (NCDF) hotline (1-866-720-5721) or by e-mailing the NCDF at disaster@leo.gov.

Reference:  Cecil Whig (March 23, 2020) “Maryland U.S. attorney warns of COVID-19 scams; Cecil County remains vigilant”

C19 UPDATE: Should You Bring Mom Home from the Nursing Home Now?

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If you have a loved one currently living in a nursing home, you’re probably worried about them right now. You may not be able to visit them or check in on their care. You may be afraid that the next COVID19 outbreak will strike their facility.

And … you may be struggling with the decision about whether it’s best for them to stay in the facility, or if you should bring them home.

These are all reasonable concerns. There have been more than 5,670 coronavirus deaths in long-term care facilities nationwide, according to state health data reported by NBC News on April 15.

But would Mom or Dad fare better, even with all due social distancing, in the family home?

Some issues to carefully consider if you are struggling with this question now:

  • Are you prepared to shoulder the entire burden of care for your loved one now? If not, are there other family or community resources that could help – and can you access them in the current situation?
  • What does your loved one want? Do the benefits of moving them out outweigh the stress of disruption and displacement?
  • Can you really keep your elderly loved one safer at home … especially if they have chronic conditions such as heart, lung, or kidney disease?
  • How long will you be able to keep up with your loved one’s care at home … and
  • Will your loved one be able to return to the facility if you cannot keep up … or after the danger has passed?
  • Will your loved one lose their Medicare or Medicaid benefits if they leave the nursing home?

These questions, and more, should be addressed before making the decision to remove your loved one from a nursing facility. Check with an elder law attorney who is familiar with your situation, state and federal laws, and nursing home policies who can explain your options and guide you to an informed decision.

Resources: NBC News, Coronavirus deaths in U.S. nursing homes soar to more than 5,500, April 15, 2020; March 18, 2020;

C19 UPDATE: CDC Recommends Care Plans for Both Older Adults and Caregivers

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Quick. You or your senior loved one is running a fever, coughing, and struggling to breathe. You suspect COVID-19 and a full-blown medical emergency starts to unfold. Medical professionals will need to quickly know the patient’s health conditions, medications, healthcare providers, and emergency contacts.

Are you ready?

The Centers for Disease (CDC) recommends developing a Care Plan now as part of your emergency preparedness.

What is a Care Plan?

A care plan is a document that summarizes a person’s health conditions and current treatments for their care. The CDC offers a handy form you can use, Complete Care Plan. This is a fill-able form you can complete on your computer or print and complete by hand.

How Do You Develop a Care Plan?

The CDC offers these tips

  • Start a conversation about care planning with the person you take care of.
  • Talk to the doctor of the person you care for or another health care provider.
  • Ask about what care options are relevant to the person you care for.
  • Discuss any needs you have as a caregiver.

And remember, care plans can reduce emergency room visits, hospitalizations, and improve overall medical management, especially during a medical emergency.

Resource: Centers for Disease Control, Coronavirus Disease 2019, https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/older-adults.html

How Do I Help My Parents with Money Problems?

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According to a 2019 study by the Transamerica Center for Retirement Studies, 8% of Gen Xers and 3% of Boomers say supporting their parents is a top financial priority in their lives.

Next Avenue’s recent article entitled “When Your Parents Need Financial Help” says that if this is a financial priority for you, try a respectful approach to see the extent of your parents’ money issues and what you might be able to do to help.

In reviewing their finances, keep an eye out for one financial issue in particular that your parents may have: they may have failed to set aside money for long-term care, because of their debts.

However, before you jump in with both feet, consider your own money situation. Remember that your own finances come first because you may otherwise risk your own long term stability by overcommitting. Therefore, if you can afford to help them, you have to establish boundaries. If you have siblings, bring them into the discussion and ask about sharing the responsibility. After you figure out to what extent you can afford to help financially, reach out to your parents — with care. You don’t want to come off as criticizing or judging them for making financial mistakes or bad financial decisions.

It’s important to begin the conversation early. You also may want to refer your parents to a financial planner or to a credit counselor. If housing is a major expense, it may be time for your parents to downsize to a more affordable home. You can also look into having them move in with you.

If not a topic of discussion, perhaps you’re able to review their expenses to see what they can cut and help them find ways to improve their financial situation. You should also look into federal, state, and local resources, like benefits for which your parents may be eligible.

After you’ve delved into all the resources, and you’re also ready to help your parents financially, make sure you incorporate all of this newfound research and knowledge into building your own financial plan. Instead of handing your parents cash or a check to pay outstanding bills, pay the bills yourself. This will allow you to be certain that the money is actually used for the bill, rather than something else.

For long-term care assistance, ask an elder law attorney for help. They can investigate your parents’ eligibility for Medicaid.

Ensure that your parents know that you have their best interests at heart when assisting them with long-term care. Be respectful of your parents and tell them you’re not trying to take over.

Reference: Next Avenue (Jan. 30, 2020) “When Your Parents Need Financial Help”

Family Gatherings Often Reveal Changes in Aging Family Members

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A look in the refrigerator finds expired foods and elderly family members are asking the same questions repeatedly. The same person who would never let you walk into the house with your shoes on now is living in a mess. The children agree Mom or Dad can’t live on their own anymore. It’s time to look into other options.

One of the biggest questions, according to the Cherokee Tribune & Ledger-News’ article is “How to pay for long-term care.”

The cost can depend significantly on the types of facilities being considered. There are many different options but the distinctions between them are often misunderstood. Assisted living facilities provide lodging, meals, assistance with eating, bathing, toileting, dressing, medication management, and transportation. However, a skilled nursing facility adds more comprehensive health care services. There’s also the personal care home, which provides assisted-living type accommodations, but on a smaller scale.

The question of how to pay for the residential care of an elderly family member weighs heavily on the family. That elderly person is often the one who did the caregiving for so many years, and the reversal of roles can be emotionally difficult.

There are a few different ways people pay for care for an elderly family member.

Long-term care insurance, or LTC insurance. Few elderly people have the insurance to cover their residential facility stay, but some do. Ask if such a policy exists, or go through the piles of paperwork to see if there is one. It will be worth the search.

Veteran’s benefits. If your loved one or their spouse served during certain times of war, is over 65 or is disabled and received an honorable discharge, he or she may be entitled to certain programs that pay for care through the Department of Veterans Affairs.

Private pay. If your loved one has financial accounts or other assets, they may need to pay the cost of their residential facility from these assets. If they don’t have assets, the family may wish to contribute to their care.

Apply for Medicaid/Medi-Cal. An elder law attorney in their state of residence will be able to help the individual and their family navigate the application, explore if there are any options to preserving assets like the family home, and help with the necessary legal strategy and documents that need to be prepared.

Meet with an elder law estate planning attorney to learn what the steps are to help your elderly loved one enjoy their quality of life, as they move into this next phase of their life.

Reference: Cherokee Tribune & Ledger-News (November 30, 2019) “How to pay for longterm care.”

4 Alternatives to Nursing Home Care

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As our parents continue to advance in years, questions about how best to care for them often come up, especially after whirling through the holidays. Maybe they’re slowing down a bit. Perhaps their memory is slipping. Is it time to shop for nursing homes? Maybe. However, there are alternatives to consider, when it comes to caring for aging parents.

Alternative #1 – In-Home Care

According to studies of aging Americans, this population prefers to remain in their own homes, if possible. They want to retain their personal autonomy, have familiar surroundings, and mostly, they don’t want to be filed away and forgotten. Most seniors that choose to remain in the home are cared for by family, and to a lesser extent, professional home healthcare workers.

While in-home care can be less expensive than a semi-or private-unit in a nursing home, it does have its downsides. This is particularly true when it is a family member that is providing care. A sense of inequality often arises in the family dynamic, when one person is taking on all of the caregiving duties. When considering in-home care, it is critical to communicate with all family members and come up with an agreement, as to the division of labor for mom and dad.

Alternative #2 – Adult Daycare

Adult daycare may be used as an alternative to nursing home care, or in concert with in-home care. These types of centers enable elderly members to maintain a sense of community. These community centers are growing in popularity, due to the fact that the cost of care is more than 50% less than nursing homes, according to the MetLife National Study of Adult Day Services. Studies have also shown that these types of facilities improve quality of life in older adults and their caregivers.

Adult daycare centers can provide social activities, door-to-door transportation services, meals and snacks, assistance with activities of daily living and other therapeutic services, as needed. There are even specialized facilities for people with dementia or other developmental disabilities.

Alternative #3 – Assisted Living Communities

If the family home has become a hazardous environment for your aging parents, the next step could be an assisted living community. This type of facility offers some of the autonomy that the older “young-at-heart” family members still crave while offering a scaled level of service onsite. These communities can provide:

  • Transportation
  • Medication Management
  • Healthcare monitoring
  • Entertainment
  • Community Activities
  • Help with Activities of Daily Living
  • Housekeeping
  • Laundry Services

These facilities are more affordable than nursing homes and offer active older people the assistance they need while encouraging autonomy.

Alternative #4 – Accessory Dwelling Units

Bridging the gap between in-home care and other offsite care facilities, the accessory dwelling unit can be a viable option for those with property that will accommodate an extra unit. Also referred to as “granny flats,” these smaller dwellings provide privacy and autonomy for an aging parent, while also providing proximity of family and caregivers.

Depending on the layout of your property, units may be built over garages or adjacent to the family home. Costs vary by location, property, and needs. However, in the long run it may be less expensive than full-time nursing home care.

Before deciding to place family members in a nursing home, do your research. There are plenty of alternatives out there that may be more affordable and socially-preferable to nursing home life.

Resources:

ElderLawAnswers. “Alternatives to Nursing Home Care” (Accessed November 28, 2019) https://www.elderlawanswers.com/elder-law-guides/7/alternatives-to-nursing-home-care

National Adult Day Services Association. “Comparing Long Term Care Services” (Accessed November 28, 2019) https://www.nadsa.org/

Caring on Demand. “7 Alternatives to Nursing Homes” Accessed November 28, 2019) https://www.caringondemand.com/blog/alternatives-nursing-homes