Elder Care

Spiderman Creator Stan Lee’s Estate Needs Untangling

It’s going to take more than a super hero to unravel the mess that Stan Lee left behind.

The passing of Stan Lee, famed Marvel Comics publisher and chairman, was sad for his legions of fans. For his 68-year-old daughter J.C., there’s grief and a challenging estate to be settled. His last years were hard, with ill health, the passing of his wife of nearly 70 years and accusations of sexual harassment from nurses and home aides.

Stan LeeIn addition, Lee reportedly said that $1.4 million dollars was missing from his bank accounts and that a large chunk of the money had been used to purchase a condo.

MarketWatch’srecent article, “Stan Lee’s tangled web of estate planning and how to avoid it in your own life,”reports that Lee had also hired and fired several business managers and attorneys in this time.

“I learned later on in life, you need advisors, if you’re making any money at all,” he told the Daily Beastin a 2018 interview. He also remarked that he’d done much of his own money management at the start of his career.

“But then, a little money started coming in, and I realized I needed help. And I needed people I could trust. And I had made some big mistakes. And my first bunch of people were people that I shouldn’t have trusted.”

It’s not known at this point, if Lee had a will or any trusts in place. If he did not, then he’s joining other late celebrities like performers Aretha Franklin and Prince who failed to draft these documents. As a result, their heirs and potential beneficiaries have had to go to court to straighten things out.

Keeping track of an estate plan can become harder as a person ages, because he or she could suffer cognitive decline, or a professional or family member may think he or she is suffering from this. Stan Lee was the subject of this type of inquiry: in February, he signed a document declaring that his daughter spent too much money, yelled at him, and befriended three men who wanted to take advantage of him, the Hollywood Reporterreported. However, a few days later, Lee took it back.

Seniors can become get less confident in what they’re doing, and they are more susceptible to the influence of others who may not have the best of intentions. However, you can easily create an estate plan with which you’re comfortable, with the help of an experienced estate panning attorney.

A big rat’s nest that will need to be addressed by Lee’s daughter will be dealing with the many business documents that may be floating around from his current and past business managers and attorneys. To avoid this, work with an estate planning attorney and ask some specific questions, such as:

  • How do we organize and simplify my assets?
  • Will we need a trust, and how will they be managed?
  • How will you coordinate with my executor and/or attorney-in-fact while I’m well, and after I’m sick or gone?
  • How do you determine cognitive decline in an individual? What would you do, if you believed my ability to answer questions and manage my funds was diminished? What would you do once you’ve made this decision?
  • How often will we review my beneficiary designations and estate planning documents?
  • How should we coordinate a team of financial and legal professionals to make sure all are working towards the same goals?
  • How much or how little information about my estate should be discussed with family members?

Reference: MarketWatch(November 17, 2018) “Stan Lee’s tangled web of estate planning and how to avoid it in your own life”

300,000 Americans to Gain Medicaid Benefits

Most of those who will be eligible in 2019 are over age 50 and would otherwise have no healthcare.

Ballot measures in three states—Idaho, Nebraska, and Utah—will extend the federal- and state-funded healthcare program to allow access to approximately three hundred thousand low-income Americans.

MedicaidAARP’s recent article, “Medicaid to Expand in 3 States,” reports that with the passage of ballot measures in those three states, 37 states, including DC, have now expanded the Medicaid program, since the Affordable Care Act (ACA) created the opportunity to offer more people coverage.

The success of the three ballot measures “is a recognition that Medicaid plays an important role in our society for those who are in need and that it’s an issue that has changed a great deal over the past five or six years from a political standpoint,” says John Hishta, AARP senior vice president for campaigns. “I think the voters have led the way in some of these states.”

Montana voters rejected a measure that would have increased tobacco taxes on cigarettes and taxed other tobacco products to pay for the state’s share of Medicaid expansion, veterans’ mental health, and home- and community-based services. Nearly 130,000 low-income residents in that state may now lose their Medicaid eligibility in 2019, if the state Legislature doesn’t act.

The mid-term election results in three other states could have implications for their Medicaid programs as well. Maine’s Democratic Governor-elect Janet Mills supports expanding Medicaid. The state’s voters decided in 2017 to expand the program, but the current governor, Republican Paul LePage, refused to implement the expansion.

Kansas’ Democrat Governor-elect Laura Kelly stated in the campaign that she’d push for legislation to expand Medicaid during her first year in office. In 2017 the Republican-controlled Kansas House of Representatives and Senate passed legislation to extend Medicaid, but the current Governor Sam Brownback vetoed it. The Legislature couldn’t override his veto.

Wisconsin’s Governor-elect Tony Evers says he wants to expand Medicaid, which would provide coverage to at least an additional 80,000 people in that state.

Most of the people who apply for Medicaid work but do not earn enough to cannot afford health insurance. The program allows people between 50—64 years of age to get health care coverage.

Reference: AARP (November 8, 2018) “Medicaid to Expand in 3 States”

Ohio Expands Mandatory Reporters of Elder Abuse

It makes sense that the people who come in contact with the elderly about their health and property be required to report any kind of elder abuse. After all, they are on the front lines where abuse often occurs.

Ohio has expanded the number of professionals who are now required to report elder abuse, adding bank employees, financial planners and notary publics, who you might expect to be on the list, as well as pharmacists, dialysis technicians, firefighters, first responders, building inspectors, CPAs and real estate agents.

MP900383004Their ability to spot issues from many different perspectives, increases the chances that more cases of elder abuse will be reported and addressed.

The Dayton Daily News’recent article, “This new law means many more Ohio officials are watching out for elder abuse. Here’s why it was passed,”explains that elder abuse can include exploiting another person’s resources; physical, emotional, or sexual abuse; or neglecting to meet a person’s basic needs. There were more than 16,000 reports of abuse, neglect, and exploitation of Ohio adults aged 60 and older in 2017. However, only one in 14 cases is reported, according to National Institutes of Health estimates.

“This expansion of mandatory reporters will help us in our goal of protecting our vulnerable family members, friends and neighbors from harm,” said Cynthia Dungey, director of the Ohio Department of Job and Family Services, which supervises Ohio’s Adult Protective Services program.

Financial institutions are one of the main places where exploitation can be recognized. Officials are educating tellers to identify the signs, such as an older customer appearing confused or distant or withdrawing unusual amounts of money.

Other signals of elder abuse can include seniors living in isolation, missing appointments, appearing frightened or avoiding specific people.

Whenever there is a dramatic change in behavior patterns, including a withdrawal from their usual activities, a change in mood or temperament or flinching at any kind of physical contact, elder abuse may be occurring.

Elder abuse risks increase when poverty, declining health, dementia, domestic violence or other traumatic events are present. The elderly person with no family, support system or access to community services is more likely to become a victim.

Reference: Dayton Daily News (September 29, 2018) “This new law means many more Ohio officials are watching out for elder abuse. Here’s why it was passed.”

Preparing for the Realities of Aging

A healthy life where you retain all your faculties and enjoy yourself, is definitely preferred to decades of dementia. We don’t get to choose, but we can plan.

As Baby Boomers continue to change the face of aging, and so many embrace the idea of genetic testing, many are confronted with a harsh picture of what their future may bring. If that includes dementia, there are facts you need to know and myths that need to be uncovered.

MP900439289The (Bryan TX) Eagle’s recent article, “Alzheimer’s disease: Five common myths, busted,”reports that, according to the Alzheimer’s Association, one in three seniors dies with Alzheimer’s or another type of dementia. There are up to 5.7 million individuals who live and die with the disease, which makes it the sixth leading cause of death in the United States. The article provides five common myths about Alzheimer’s disease.

Myth # 1: Memory loss is a normal part of growing older. A slip of the memory may well be a normal part of growing older. While these forgetful moments may cause a bit of frustration and embarrassment, they don’t affect our ability to live an independent life. However, if a loved one has trouble remembering commonly used words or loses the ability to communicate, it could be a potential symptom rather than a natural senior side-effect.

Myth # 2: Alzheimer’s can be reversed if it’s diagnosed early.No. Unfortunately, there's no treatment that will reverse the progress of Alzheimer’s disease. However, although there are therapies and drugs that can slow down the neurodegeneration associated with Alzheimer’s, there is no known cure. Even so, early diagnosis has its benefits, like better symptom management, a safer patient environment and the ability to plan for the future.

Myth # 3: Alzheimer’s just affects older people. Some Alzheimer’s patients can get diagnosed in their 40’s or 50’s. The early onset Alzheimer’s is uncommon (just 5% of patients are diagnosed before age 65); an accurate diagnosis is important to help the family cope with the realities of the disease.

Myth # 4: A diagnosis of Alzheimer’s means your life is over. Many people live years or even decades, before the disease claims their lives. Alzheimer’s effects each patient differently. The disease is commonly divided into three stages. The first or “mild” stage is where the patient is able to live a mostly normal life. The middle or “moderate” stage requires more extensive care. And in the late or “severe” stage, the patient needs 24/7 supervision and medical assistance. Life many never be the same with an Alzheimer’s diagnosis, but it’s far from over.

Myth # 5: There’s little you can do to protect yourself financially, if you are diagnosed with the disease. A serious diagnosis of any type can drastically impact a family, but it’s important to understand that there are things you can and should do to help your loved ones manage what comes next, emotionally as well as financially. Look at these ways you can help:

  • Create a list of all financial accounts;
  • Review the titles and names on each account;
  • Look at your options for paying for medical care, such as existing insurance policies, Medicare coverage, or other sources of funding;
  • Consider designating a Durable Power of Attorney for Healthcare, so that a trusted person can make decisions for the patient if there’s an accident or incapacitation;
  • Communicating preferences for living arrangements, medical assistance, and end-of-life care; and
  • Be sure your will is up to date.

Speak with an elder law attorney, who will be able to help you and your family navigate this process. He or she will also be able to recommend local resources that will help make this journey as good as it can be.

Reference: The (Bryan TX) Eagle (October 4, 2018) “Alzheimer’s disease: Five common myths, busted”

How Does Medicaid Treat College Savings Funds?

Saving for college but needing to receive Medicaid is a complicated equation.

The answer “It depends” is not much of a comfort when considering how college savings accounts will be treated for Medicaid purposes.  However, it is, unfortunately, the most accurate answer. There are several factors that must be considered:

  • What type of account you used to set aside the college money;
  • How and when you funded the account; and
  • Whether you still have access to the money.

A recentnj.com article asks, “Will my college savings be counted for Medicaid?” If you can liquidate an account and access the money that you deposited, Medicaid will typically expect you to do so to fund your own care for as long as possible. Another challenge is that Medicaid will always penalize gifts. Odds are good that the funds you added to these college accounts are gifts.

MedicaidHowever, there may be an exception: if the account was funded prior to the 60-month lookback period, the applicant can’t be penalized for making a gift.

Let’s examine why the type of account is also important.

If the money was put into a 529 plan, the funds aren’t part of the donor's taxable estate, and the assets aren’t includible. However, if the funds are invested in an account “ITF” (“in trust for”) a grandchild, then the funds would be includible. It its calculations, Medicaid examines all assets in the name of the applicant. Assets held in 529 plans—although the donor's name may be shown as the participant—are deemed to be a gift, when the assets are transferred and, therefore, are no longer the donor's asset.

To be safe, grandparents who set up 529 plans for their grandkids should change the participant to the grandchild's parent or guardian. This entirely disconnects the donor's name with the account.

If the grandparent just added a grandchild's name on one of his savings accounts, then that would be includable. This is true even if it were completed more than 60 months earlier, because it wouldn’t be deemed to be a completed gift.

When it comes to the intersection of college savings and Medicaid, you may need to speak with an elder law attorney who will be able to review how the college savings assets are owned, and whether or not they’ll impact your Medicaid eligibility.

Reference: nj.com (September 19, 2018) “Will my college savings be counted for Medicaid?”

LOVE Artist’s Estate in Litigation

The man who took care of Robert Indiana in the last years of his life, told a probate court hearing Wednesday that he was paid roughly $250,000 a year to tend to the aging artist, whose estate and legacy are now the subject of acrimony and lawsuits.

Under questioning by a lawyer representing the estate, caretaker, Jamie L. Thomas said he’d been earning $1,000 a week in 2013, when he started taking care of artist Robert Indiana, who lived alone on a Maine island, until his death in May at 89.

LOVEThe New York Times’ recent article entitled “Robert Indiana’s Estate: Generosity, Acrimony and Questions” reported that by 2016, Thomas said the artist had raised his salary to $5,000 a week for round-the-clock work that included bringing him meals, taking care of his dog and helping him to bed. He was also granted Indiana’s power of attorney.

Thomas said Indiana was a generous employer and that the artist had given him at least 118 pieces of art since 2010.

At the hearing, Thomas said that over the last two years he’d withdrawn $615,000 from Indiana’s accounts at his request. He didn’t say for what Indiana used the cash, but that the artist gave him $35,000 to buy a car.

James Brannan, the lawyer who’s the executor of Indiana’s estate, said he was surprised by the large cash withdrawals. Brannan said when he visited the artist’s home soon after his death, Thomas’s wife gave him a gym bag filled with $189,000 in cash. “This is yours,” she told him, “It belongs to the estate.”

Brannan isn’t certain if that cash is part of the $615,000 that was withdrawn.

John Frumer, the lawyer representing Thomas, said the hearing paints an incomplete picture.

“There’s much more to the story than it appears,” Frumer said. “Because it’s a limited proceeding, not all of the facts came out, and they will in time.”

Brannan asked the Knox County Probate Court to help clear up multiple questions that have swirled about Indiana’s finances in recent months. He said he wanted to clarify whether any money is owed to the estate, get an inventory of all the art works Indiana left behind and to address accusations that are contained in a separate lawsuit claiming Thomas and a New York art publisher made unauthorized works under Indiana’s name in recent years. That action was filed a day before Indiana’s death, by Morgan Art Foundation, an international dealer that claims the rights to many of the artist’s works, including the famous LOVE image. The suit claims that publisher Michael McKenzie and Thomas intentionally isolated Indiana from friends and business associates to sell inauthentic artwork attributed to him.

McKenzie said he had returned to the estate all the Indiana artworks that might belong to it. However, Brannan has said that he wants a full accounting of whether the Morgan company owes the estate money for royalty payments due on Indiana items it sold.

Indiana’s LOVE sculpture, with the letters stacked two-on-two and the tilted “O,” became one of the best-known images of the 20th century. The sculpture brought Indiana fame, but he left the New York art scene behind in 1978. He lived on the Maine island of Vinalhaven, an hour by ferry from the mainland, where the reclusive artist lived and worked, surrounded by a crew of studio assistants and workers.

Reference: New York Times (September 12, 2018) “Robert Indiana’s Estate: Generosity, Acrimony and Questions”

Are You or Will You Become a “Solo Ager”?

“Solo agers face unique challenges, as their needs begin to change.”

Did you know that a study from the Pew Research Center says about 20% of the 75 million baby boomers don’t have children—a figure that’s double what it was in the 1970s and one that’s expected to keep rising.

MP900427632We mention this because these people need someone to count on to always be there, if they need help making decisions and managing their affairs as they get older.

NH Magazine’s recent article entitled “The Difficulties That Come With Solo Aging” says that, for those without children or parents who’re estranged from them, it’s frequently a tough question to answer.

Our country’s 15 million “solo agers” or “elder orphans” now comprise a demographic that’s unprecedented in American history. This relatively new segment of society has a unique set of challenges.

As your physical, intellectual, and emotional capacities diminish, a person on his own must determine how he will be able to make sound decisions on financial and legal issues, relationships, housing and healthcare. There are also more cases being reported of elder fraud, and new scams are designed to take money from seniors. An elderly person could also wind up lonely and penniless.

However, there is help. Professional guardians can assist the elderly in reviewing their financial statements, creating budgets, paying bills, keeping keep them organized and sorting mail and email to see what’s a legitimate bill or a solicitation or potential scam.

A guardianship, which is also known as a conservatorship, is a legal process that’s used when a senior can no longer make or communicate safe or sound decisions about himself person and/or his property, he’s become susceptible to fraud or undue influence. The fact that establishing a guardianship can remove substantial rights from a person means that it should only be considered after other alternatives have proven ineffective or are unavailable.

In addition to a court-ordered guardianship, there are other options. There are also certified geriatric care managers, certified daily money managers, as well as attorneys who specialize in elder law.

Solo agers should arrange a future legal guardianship for themselves, a person who will assume control in a fiduciary capacity, if they’re unable to make decisions for themselves. This may be a relative or a friend, as well as a professional fiduciary or private guardian.

In addition, everyone should have a healthcare directive and an estate plan. However, solo agers have a more urgent need to have these important documents in place, while they’re still somewhat young and healthy—because they don’t have an adult child who will fly in from the other side of the country to provide that assistance and guidance.

Talk to several potential guardians or fiduciaries and go with the one whose skills most closely fit your needs and with whom you feel the most comfortable. Check their references and credentials thoroughly. You can also select different people for different tasks, which gives you a critical system of checks and balances. Be certain that you understand exactly what services each will provide and their fees and get it all in writing.

Reference: NH Magazine(October 2018) “The Difficulties That Come With Solo Aging”

New Law in Massachusetts Enhances Treatment and Support for Alzheimer’s and Dementia

A ceremonial signing took place in Massachusetts Governor Baker’s office

“H.4116 An Act Relative to Alzheimer’s And Related Dementias in The Commonwealth” is now law in Massachusetts, following an August 15 ceremony.

LawA ceremonial signing took place in Massachusetts Governor Baker’s office as community members, legislators and members of the administration gathered at the Alzheimer’s Association’s Waltham office, where the governor signed the new bill into law.

“Raising awareness about Alzheimer’s and dementia is key to supporting the Massachusetts families who are impacted by this horrible disease,” Governor Baker remarked in an article in theFramingham Source,“Governor Baker Signs Law Strengthening Alzheimer’s and Dementia Treatment in Massachusetts.”

“This legislation will enhance efforts to train front line caregivers on recognizing and treating dementia more effectively, and work with families of loved ones to prepare and manage the effects of Alzheimer’s.”

Senate President Karen E. Spilka noted that the important legislation acknowledges that Alzheimer’s and other dementia affect not just individuals but also communities and families. She went on to say, “as someone who has been affected personally by Alzheimer’s and dementia in my family, I am grateful for this comprehensive approach.”

There are more than 130,000 Massachusetts residents living with dementia.

“Despite its widespread impact, lack of information, fear, and stigma can prevent those affected from feeling safe, socially connected, and able to thrive in their communities. Family members often carry the financial and emotional burden from caring for their loved ones,” said Massachusetts Health and Human Services Secretary Marylou Sudders.

Sudders also said that the law brings the diseases of Alzheimer’s and dementia to the forefront.  It will promote early detection and diagnosis, reduce risk, prevent avoidable hospitalizations, support caregivers and mitigate health disparities.”

The law will create an advisory council and an integrated state plan to effectively address Alzheimer’s disease, and will require that content about Alzheimer’s and related dementias be incorporated into physicians, physician’s assistants, registered nurses and practical nurses continuing medical education programs that are required for the granting or renewal of licensure.

With the new law, doctors will now be able to share a diagnosis and treatment plan with a family member or a personal representative, within the existing framework of federal and state privacy laws. Hospitals will now be required to have an operational plan in place for recognizing and managing individuals with dementia within three years of the law’s enactment, and elder protective services caseworkers will be required to have training on Alzheimer’s disease.

Reference: Framingham Source (August 15, 2018) “Governor Baker Signs Law Strengthening Alzheimer’s and Dementia Treatment in Massachusetts”

When the Diagnosis is Alzheimer’s, What Should You Do?

The authors of a new book, “Better Living With Dementia,” say it’s time to break the “cycle of despair”

People who receive a diagnosis of Alzheimer’s disease, an incurable type of dementia, are overwhelmed by hopelessness. But two authors want to change that.

MP900407501The authors of a new book, “Better Living With Dementia,” say it’s time to break the “cycle of despair” that accompanies an Alzheimer’s diagnosis. The Washington Post discussed this new perspective with the well-credentialed authors in a recent article, “Learning To Live Well With Dementia.”

Author Laura Gitlin is dean of the College of Nursing and Health Professions at Drexel University and Chair of the Department of Health and Human Services advisory council on Alzheimer’s Research, Care and Human Services. Her co-author is Nancy Hodgson, the Anthony Buividas endowed term chair in gerontology at the University of Pennsylvania.

These leading experts on care for people with cognitive impairment, say that while there’s no cure for Alzheimer’s, there are many things that can be done to make life better for people with dementia and their caregivers.

At a minimum, people newly diagnosed with dementia should consult with the Alzheimer’s Association, the Lewy Body Dementia Association, the Association for Frontotemporal Degeneration and the government’s website, alzheimers.gov. These are all great sources of information and potential assistance. Individuals and families should also get referrals to elder law attorneys, financial planners, adult day centers, respite services, caregiver support services and other resources.

About 70% of people with Alzheimer’s and other types of dementia live at home. Few professionals ask about patients’ living conditions, even though these environments play a major role in shaping people’s safety and well-being. It’s not uncommon for professionals to fail to let patients know what to expect as dementia progresses. This can fosters isolation, which worsens their sense of despair.

Even small steps could help improve quality of life. For example, give focused attention to the home setting itself. Hire an occupational therapist, ideally with expertise in dementia, to do a home assessment and recommend modifications. It’s also important to know what to expect. Individuals with dementia and their caregivers will find their needs changing as their illness progresses.

Initially, the most critical need may be getting a reliable diagnosis and understanding more about the type of dementia identified by your physician. A new study by Johns Hopkins University reports that 60% of people with dementia haven’t been diagnosed or aren’t aware of their diagnosis.

Further, depression and anxiety may need to be addressed, because people can struggle with the reality of a diagnosis, withdraw from work or social activities and worry about the future. Looking for ways to keep people engaged with meaningful activities can become a challenge.

In the final stage, severe dementia, people need sensory stimulation, like enjoyable music or a fragrant bouquet of flowers. Addressing distress, discomfort and pain are the big care challenges.

The challenge for family members and caregivers is to let dementia patients know that they belong and are surrounded with warmth and affection, at every stage of the disease. Even if they cannot acknowledge the presence of family and friends, their company is important.

Reference: The Washington Post (August 9, 2018) “Learning To Live Well With Dementia”

Need Something Else to Worry About? Try Long-Term Care

A recent article from Think Advisor paints a dismal picture of Americans who are just not preparing themselves for the inevitable facts of aging.

The statistics aren’t encouraging. About three quarters of Americans are likely to need long-term care, but very few are ready for the costs.

Bigstock-Beautiful-woman-looking-throug-20311445A recent article from Think Advisor paints a dismal picture of Americans who are just not preparing themselves for the inevitable facts of aging. The article, “Now You Can Add Long-Term Care to Death and Taxes,” says this may be one of the biggest disconnects in the USA: the gap between how many Americans will need long-term care versus what people actually think they’ll need.

Just 46% think they’ll need it, according to a new study that surveyed 2,000 people to see how prepared Americans were for the realities of long-term care.

Another misconception is the out-of-pocket cost of long-term care. The study found that the actual out-of-pocket cost of long-term care is more than $47,000.  However, many Americans think it’s about half that, $25,350.

In addition, $47,000 is the low end of the scale for the yearly cost per stay. While some assisted living costs may be $45,000, semi-private nursing homes are closer to $85,000. Private nursing home care is $97,455, according to the study, which was conducted by Digital Third Coast. The study was made up of 57.7% males and 42.3% females, while 56% were age 35 and younger, 33% were 36 to 55 years old and 11% were 56 and older.

Can you believe that 64% have nothing saved for long-term care, and 67% can’t contribute to a parent’s long-term care? The study found that Americans intend to save about $657 per month for long-term care.

Another issue between reality and perception, is the age that people think they’ll be when they need any sort of long-term care. Most study participants say it’s 79 years old.  However, it’s actually 73 years old, according to the study. Women will require long-term care on average for 3.7 years, and men will need it for about 2.2 years.

People in our country also have worries about putting relatives in long-term care, the study found. For example, 73% are concerned about physical/sexual mental abuse. About 41% said the cost was more than anticipated, and 48% hadn’t expected to put loved ones in long-term care. Only 33% actually have had discussions with family about when care is necessary.

One thing we do know is what we want when it comes to long-term care. We want quality of care, but we also want low costs, and we want facilities that are not too far from family members.

We just don’t want to think about how that’s going to be paid for.

Reference: Think Advisor (August 6, 2018)“Now You Can Add Long-Term Care to Death and Taxes”

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