Long-Term Care Planning

What Does an Elder Law Attorney Really Do?

A knowledgeable elder law attorney will make certain that he represents the best interests of his senior client in a variety of situations that usually occur in an elderly person’s life.

An elder care attorney will also be very knowledgeable about several different areas of the law.

The Idaho Falls Spokesperson’s recent article, “What is an Elder Law Attorney and What Can They Do for You?” looks at some of the things an elder care attorney can do.

Elder care attorneys address long-term care issues, housing, quality of life, independence and autonomy—which are all critical issues concerning seniors.

Your elder law attorney knows that one of the main issues senior citizens face is sound estate planning. This may include planning for a minor or adult child, as well as probate proceedings, which is a process where a deceased person’s assets are collected and distributed to the heirs and creditors.

The probate process may also involve the Uniform Probate Code (UPC). The UPC is a set of inheritance rules written by national experts. A major responsibility of the probate process is to fully administer the entire estate, including appointing executors and ensuring that all assets are disbursed properly.

An experienced elder law attorney can also assist your family to make sure that your senior receives the best possible care arrangement, which may become more important as his or her medical needs increase.

An elder care law attorney also helps clients find the best nursing home to fully satisfy all their needs. Finally, they often will also work to safeguard assets to prevent spousal impoverishment, when one spouse must go to a nursing home.

A qualified elder care attorney can be a big asset to your family, as you journey through the elder care planning process. Working with an attorney to set up contingency plans can provide peace of mind and relief to you and your loved ones.

Reference: Idaho Falls Spokesperson (May 20, 2019) “What is an Elder Law Attorney and What Can They Do for You?”

Countdown to Retirement with Three Simple Questions

To help plan for retirement, it helps to move from asking global questions, like “Can I afford to retire?” to more specific questions, like “What’s my monthly cost of living right now?”

Sometimes retirement planning is so overwhelming that people just shrug their shoulders and hope that things work out. That’s a terrible way to plan for the last two or even three decades of your life. Plus, says Motley Fool in a recent article titled “Don't Even Think About Retiring Until You Can Answer These 3 Questions,” if you can’t answer three basic questions, maybe you’re not ready to start thinking about retirement.

MP900384841Can you believe that just 38% of Americans say they have a long-term financial plan, according to a recent survey? Let’s look at three important planning questions.

When to claim Social Security. Many people think that retirement and claiming Social Security benefits occur at the same time. However, they don't have to. You could elect to retire at age 60 but wait to claim your benefits until you reach 65. Remember that the amount of money you get in benefits is linked to the age at which you start claiming them. Age 62 is the earliest you can claim Social Security. However, if you do, your benefits will be reduced by up to 30% of what they could be. For every month you wait, you'll receive slightly more with each check up to age 70. Your full retirement age (FRA) is the age when you’ll get 100% of the benefits to which you’re entitled. Waiting can have its advantages, but there's no single right answer for when you should start claiming. It all depends on your personal circumstances.

Will your retirement savings last? Take a look at how far your savings will last during retirement. To determine how far your money will go, calculate the amount you'll need each year to get by during retirement. With a number in mind, you'll be able to better determine how long your current savings will last. You might realize that you need more than you anticipated, especially if you're going to be spending several decades in retirement.

Paying for healthcare costs. Healthcare costs are one of the largest expenses in retirement. Know that the average retiree spends about $4,300 per year on out-of-pocket healthcare expenses. A total of two-thirds of that is spent on premiums. It’s important to understand that Medicare will help cover many healthcare expenses you'll face, but it doesn't cover everything.

Circumstances often dictate when people retire; they lose a job in their mid to late 60s or illness prevents them from working. However, even when that is the case, understanding where you are from a financial perspective can help make your retirement work in your favor.

Reference: Motley Fool (October 9, 2018) “Don't Even Think About Retiring Until You Can Answer These 3 Questions”

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”

Blueprint for Senior Singles

Not having a built-in support system of a spouse, children, in-laws, etc., can lead to challenges for singles as they age.

Singles need to be more proactive about planning for long-term care and estate planning to protect themselves against some of the inevitable issues of aging.

MP900438735Not having a built-in support system of a spouse, children, in-laws, etc., can lead to challenges for singles as they age. About 35.4 million Americans lived alone in 2016, making up almost a third of all households, according to the U.S. Census Bureau, and about 20 million of them are 65 or older. For these aging singles, planning is key to being prepared for financial security and health issues, as reported by CNBCin “For aging singles, here's how to plan for your golden years,”

Saving as much as possible in a 401(k) plan or IRA while you can are important. You should also make certain that you have emergency savings, if you're still working. If you’re still employed, find out if your company offers group insurance for long-term disability. Those policies provide a portion of your income, in case you end up unable to work due to an accident or other medical condition.

There are other ways for singles to protect themselves, as they age.

In addition to an estate plan with a will, select someone to handle your finances, if you reach a point where you can’t. When you give someone durable power of attorney for your finances, he or she will be  responsible for paying your bills with your money.  It is, therefore, important to choose someone you trust.  You should also grant someone durable power of attorney for health care. That lets the individual make important health-care decisions, if you can’t. That is different from a living will. That document states your wishes, if you’re on life support or suffer from a terminal condition. This helps instruct your proxy’s decision-making. If you have no one named, your healthcare providers must follow your wishes in that document.

If you’re single and don’t have family close by who can assist, if you need help with daily living activities, you'll need to plan for how to pay for it. A person turning age 65 today has nearly a 70% chance of needing such long-term care in their remaining years, according to the Department of Health and Human Services. On average, women need care longer (3.7 years) than men (2.2 years).

You also need to understand that Medicare (which you generally sign up for when you’re 65) doesn’t pay for long-term care. It can be expensive. If you have no family to rely on, and you don’t want to spend down your assets, but you’re above the income threshold to qualify for Medicaid, long-term care insurance can be an option. LTC insurance will pay a daily amount, up to a predetermined dollar limit and length of time, for services. Policies can be expensive, costing up to $2,000 a year for younger applicants (in their 50s) and double that for those over age 65. As with all age and health related insurance, the younger you are when you look into it, the better.

Here's a critical point: if you have a medical emergency and you live alone, you could be at risk. There are many different ways to solve this problem, among them, a medical alert system or a tag team of peers who check on each other daily.

Reference: CNBC (July 2, 2018) “For aging singles, here's how to plan for your golden years”

When Children Grow Up and Parents Become the Children’s Responsibility

Let’s examine some of the things you can do, as your parents go through the aging cycle.

America is aging, and by 2050, there will be nearly 88 million seniors over age 65. With this huge demographic shift, adult children will find themselves with a new role.

It is not unusual in many families that as parents age, their children take on the role of caregivers. However, the sheer number of people who will be over age 65 in coming years, will make some big changes in our nation, as reported by Fox Businessin the recent article, “Aging parents are the new ‘children.’”

One concern is that aging parents can lose their mental abilities. The Alzheimer’s Association says that every 65 seconds, someone in the U.S. develops the disease. It’s now the sixth-leading cause of death. This can create additional long-term care needs for parents and result in an emotional and financial burden on adult children.

Parents with physical limitations may have difficulties living independently. Therefore, you should understand your parents’ long-term plans and how they will impact you. Let’s examine some of the things you can do, as your parents go through the aging cycle.

Family Conversations.While talking to your parents about these topics now may be uncomfortable, it will save you a lot of stress, time, and money in the future. Parents who want to preserve autonomy should express their wishes. Parents should discuss their healthcare wishes, the what ifs and finances now to discover what options they may have for care. It’s important that adult children understand details of their parents’ financial situations, before they’re unable to communicate due to incapacity or death.

Get the Family Affairs in Order.Create a system to help with gathering information. This should include medical histories and estate plans. Start to organize information with your parents as early as possible. Adult children should be sure that their parents have a will, a trust (or both), a durable power of attorney for property and a durable power of attorney for healthcare.

Determine Parents’ Long-Term Financial Needs.It’s extremely expensive to provide care for aging parents. Seek professional guidance to determine how much of your parent’s savings is currently allocated to pay for healthcare in retirement, not covered by Medicare. Look at long-term care insurance.

Have an Actively Involved Relationship.If you see your parents on a regular basis, keep your eyes open for any kind of change in their behavior or signs that things are not right: stacks of unopened mail, phone calls from people you don’t know, etc. If you do not live near your parents, ask an estate planning or elder care attorney for recommendations for social workers or elder care services to help your parents. They can do things like take parents to medical appointments, talk with care facilities on your behalf and keep you apprised of your parent’s well-being.

Your parents may or may not enjoy the “golden years” that we envision, but some preparation now, including having the tough discussions, will at the very least make it easier in the future.

Reference: Fox Business (May 25, 2018) “Aging parents are the new ‘children’”

What Should a Financial Plan Include?

You may need a guide—but how do you know who to choose?

Hit a spring pothole and you can lose a tire. But hit a pothole with your financial plan, and you may be in for a bigger problem than replacing a tire.

MP900398819Do you have an up-to-date roadmap to your retirement? Keeping your finances, investments and retirement plan on a smooth road has become more and more challenging. Every day seems to bring a new regulation, investment product, or app that claims to offer the best route. You may need a guide—but how do you know who to choose?

Kiplinger’srecent article, “5 Bases You Need Covered With Your Retirement Plan,”says there are plenty of financial professionals today who can get you started down the right path with investment advice. However, a professional who limits his or her professional life solely to investing advice, isn’t going to get you comfortably and confidently to your retirement goals. Be sure you have someone who will concentrate on these five key areas of your financial life:

Income Planning.Your retirement could last for decades. You must be certain that you’ll have reliable income streams to pay your monthly expenses. This area typically should cover things like Social Security maximization, income and expense analysis, inflation, a plan for the surviving spouse, longevity protection and investment planning. Once your income plan has been created, you need to analyze your remaining assets (those that you won’t have to draw from every month). This should cover your risk tolerance, adjusting your portfolio to reduce fees, volatility control, ways to reduce risk while still working toward your goals and comprehensive institutional money management.

Tax Planning. Your comprehensive retirement plan should include strategies to decrease tax liabilities, such as determining the taxable nature of your current portfolio, possible IRA planning, looking at ways to include tax-deferred or tax-free money in your plan, prioritizing tax categories from which to draw income initially to potentially reduce your tax burden and considering ways to leverage your qualified money to leave tax-free dollars to your beneficiaries.

Health Care Planning. Retirees today must have a plan to address rising health care costs with little expense. Strategies should include examining Medicare Parts A, B, and D, reviewing options for a long-term care plan and legacy planning.

It’s critical that your hard-earned assets go to heirs and loved ones in the most tax-efficient manner possible. Your financial adviser should work collaboratively with a qualified estate planning attorney to help with these tasks:

  • Maximize estate and income tax planning opportunities;
  • Protect any assets in trust and ensure that they’re distributed probate-free to beneficiaries and
  • Prevent your IRA and other qualified accounts from becoming fully taxable to beneficiaries upon death.

Your estate planning attorney should be able to give you some recommendations for trustworthy and respected professionals. You’ll also need to do your homework, and interview more than two or three to make sure that it’s a good fit. Ideally, this person will work with you, your estate planning attorney and your CPA, as part of a team, for many decades.

Reference: Kiplinger(May 4, 2018) “5 Bases You Need Covered With Your Retirement Plan”

New Study Shows Caregivers Use Their Own Savings to Help Elderly Loved Ones

New findings reveal 7 in 10 caregivers reduced their own living expenses to cover caregiving costs.

“New findings reveal 7 in 10 caregivers reduced their own living expenses to cover caregiving costs.”

MP900404926Americans are feeling more of a pinch in their finances and lifestyle, because of the need to care for an elderly relative or friend, according to a Northwestern Mutual study.

Think Advisor’sarticle, “Americans Are Spending More but Planning Less for Caregiving: Northwestern Mutual,”says the study found that Gen X and Millennials are the heart of the sandwich generation and are struggling with the competing pressures of caring for aging family members and their own children. At the same time, they are trying to create financial security and maintain a lifestyle.

The 2018 Northwestern Mutual C.A.R.E. (Costs, Accountabilities, Realities, Expectations) Study gathered the responses from more than a thousand American adults from the general population, with an oversample of 233 American adults age 35 to 49 (for a total of 413) and an oversample of 709 experienced caregivers (for a total of 987).

The study found that 30% of the respondents identify as current or past caregivers and 22% expect to become caregivers in the future.  However, even though half of American caregivers say the care event was planned, many are still not prepared for the financial obligations, which seem to be increasing each year.

The survey found that 70% of caregivers provide financial support. In addition, 34% of current caregivers spend between 21% and 100% of their monthly budgets on caregiving-related expenses. Of those expenses, on average, $273 is spent on medicine/medical supplies and $159 on food, the survey found.

To cover caregiving costs, roughly 66% of experienced caregivers said they decreased their living expenses (significantly higher than the 51% who said so last year), according to the survey. However, the survey also found that people who believe they will provide care in the future, aren’t getting ready. About 57% of future caregivers anticipate incurring personal costs as a function of providing care. A total of 48% have not planned at all—a big increase from 35% last year.

“While financial expectations for caregivers continue to grow, unfortunately planning is taking a backseat,” Williams-Kemp said in a statement. “In an environment of rising costs and fluctuating economic and health care realities, winging it isn’t an option. Being proactive before a long-term event happens can help ensure that you can still take care of your own needs, while caring for someone else’s well-being.”

Americans also aren’t planning for their own long-term care events. The study found that 75% of those surveyed said they haven’t planned for their own long-term care needs. Of those who did take steps to prepare, 52% included provisions in their financial plan, 42% purchased a long-term care product and 35% increased their savings.

 The study also revealed that while many Americans expect that their partner or children will be the ones to take care of them if and when they need help, more than two thirds have never actually discussed this with their family members. It’s not an easy subject to broach, but one that should be part of a larger conversation about aging and expectations.

Reference: Think Advisor (March 15, 2018) “Americans Are Spending More but Planning Less for Caregiving: Northwestern Mutual”

Finding the Right Assisted Living Facility for Now and the Future

People moving into an assisted living facility should do a lot of research to make sure they get the quality care and the services they need.

People moving into an assisted living facility should do a lot of research to make sure they get the quality care and the services they need. Their lives may depend on it.

MP900407501Life in an assisted living facility is a welcome alternative to aging seniors who are no longer able to remain in their own homes, but don’t want or need to live in a nursing home, which often feels like living in a hospital. They can receive the services they need, while enjoying a full roster of activities and the companionship of their peers. It sounds like a good plan, and in many cases, it is.

However,Consumer Reports’recent article, “5 Steps for Choosing the Right Assisted Living Community”says that finding the right residence can be a huge challenge.

Right off the bat, the cost is high. In 2017, the median fee for a private one-bedroom was $45,000 a year, according to Genworth, a long-term care insurer. Most residents pay out of pocket, although some qualify for Medicaid. Medicare generally does not cover long-term care services.

In addition, shortfalls in caregiving can be a problem for assisted living residents. A 2017 survey of state long-term-care ombudsmen conducted for Consumer Reports, which monitors senior living facilities nationwide, found the most common complaints dealt with understaffing and delays in response to calls for assistance. Ombudsman data show that complaints about assisted living have gone up 10% in recent years.

For families looking at into assisted living facilities for a family member, there are ways to find a facility that delivers quality care in a comfortable setting. The key is to conduct thorough research. You should egin by asking these five key questions:

  1. What Kind of Care is Required?Remember that different facilities offer varying levels of care. Is there a registered nurse on staff? Without this basic level of care, your loved one might end up going to the ER more often.
  2. What is the Quality of Care?Look at the residence’s licensing and inspection records, to see if there are any issues. To get a feel for the way things work, make several visits to the facility. Go for meals and during the weekends, when fewer staff are on duty. You should also talk to residents and their families about their experiences.
  3. Uncover the Real Costs of the Care. Get a written list of fees and charges from the residence and be sure that they’re included in the contract. It is recommended that you hire an elder law attorney, who’s familiar with local facilities, to review the terms of the contract.
  4. Can Your Parent or Family Member Age in Place? Find out what scenarios might trigger a discharge, and whether you could hire private aides, if more care is required. You should also ask what assistance the facility would be able to provide, if a move is needed.
  5. Is an Advocate Available? If family and friends are not able to visit on a frequent basis, the potential for problems increases. Care issues, from cleanliness to patient treatment, may not be readily apparent to an elderly resident, especially if they are suffering from dementia. Consider hiring an aging life-care expert or social worker to make frequent visits, if you are unable to. If the facility’s management knows someone is keeping a watchful eye, the quality of care will be better.

Reference: Consumer Reports (April 16, 2018) “5 Steps for Choosing the Right Assisted Living Community”

Diagnosis for Early Onset Alzheimer Not an Easy Matter

For younger patients, early-onset Alzheimer’s symptoms are usually disregarded or blamed on fatigue, depression or stress.

Bigstock-Beautiful-woman-looking-throug-20311445It often takes a very long time before a young person having problems with memory loss or confusion is diagnosed with Alzheimer’s disease. The Concord Monitor reports, in “Stolen Memories: Problems with diagnosis of younger-onset Alzheimer’s,the delay in diagnosis can lead to problems with work and health insurance coverage.

One-third of the people with younger-onset Alzheimer’s, who responded to a 2006 survey by the Alzheimer’s Association said it took them somewhere between one to six years to receive an accurate diagnosis of Alzheimer’s. Subsequent studies by the Alzheimer’s Association have estimated that as many as 50% of people of all ages with the disease neverreceive a diagnosis.

Unfortunately, there is no easy blood test that can be used to detect the brain disease. Diagnoses are usually confirmed through a combination of neuropsychological exams, analyses of a patient’s family history and costly spinal taps, MRIs, PET and CAT scans to view plaques and tangles in the brain.

Meanwhile, because of this delay, younger people can have issues at work because of the symptoms.

“Families will come in to meet with me and I’ll say, ‘Are you still working?’ and they’ll say, ‘No, I got laid off,’ or, ‘I took an early retirement, because I wasn’t sure what was going on,’ and lo and behold they realized later they had Alzheimer’s,” said Melissa Grenier, manager of the New Hampshire Alzheimer’s Association.

Because of the time it takes to get an accurate diagnosis, patients with early dementia frequently are fired or move from job to job. Most patients displaying symptoms are not aware of it at the time.  As a result, it can be discouraging and frustrating.

If a person had a heart condition, they would be aware of the illness and would be able to work with their employer to ensure that they continued to have a job and health insurance coverage and/or disability insurance coverage.  However, if they are fired or stop working before receiving an Alzheimer’s diagnosis, they will lose the financial safety net. Treating a condition like Alzheimer’s costs hundreds of thousands of dollars.

The person with Alzheimer’s is usually the last to know that there are issues. Those patients who are aware of changes in behavior, can be reluctant to speak with their employer. They fear that they could lose their positions.

Families facing early-onset Alzheimer’s should speak with an elder lawyer. This is not an easy situation, and professional help will be needed.

Reference: Concord Monitor(April 8, 2018) “Stolen Memories: Problems with diagnosis of younger-onset Alzheimer’s”

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