Elder’s Can Lawfully Retain More Assets

July 13th, 2009 at 10:11am Under Elder Law

Attorney Tobin is a nursing home attorney. As a nursing home lawyer, he often advises clients on various legal techniques including achieving Medicaid (MassHealth) approval, retaining the maximum amount of the elder’s assets, protecting the community spouse, and preventing liens on the elder’s home. It is never too late to act, even if the elder has already entered a nursing home. For example, a technique nursing home lawyers utilize is a present transfer of assets to the client’s heirs, which benefits both parties: the heir will have the ability to enjoy the assets sooner, and the assets will no longer be considered owned by the elder, which in turn may allow the elder to qualify for Medicaid. Many of these transfers can take place in trust, thereby, protecting the family from other legal issues. However, the rules for these transfers are extremely complex and are governed by various “look back” periods depending on the date of transfer.The Medicaid field changes often, the most significant changes happening recently with the deficit reduction act. However, even after the deficit reduction act there are several techniques available to help save and conserve your family assets. A nursing home lawyer can help analyze and implement the current strategies available, including but not limited, to:

 

In many circumstances it is also necessary to have a nursing home attorney modify the wills, life insurance contracts, and title to real estate in order to allow the elder to be cared for if the healthy spouse predeceases the sick spouse. To ensure you are lawfully retaining the highest level of assets it is advisable to contact a professional nursing home attorney or nursing home lawyer as they are referred to. Nursing home attorneys will be intimately familiar with the limits of the complex laws and how to protect your family to the fullest extent.

Old Colony Elderly Services Explains Question 1 on November 4th Ballot for Elders, Caregivers and Their Families

July 13th, 2009 at 04:12am Under Elder Law

DATELINE: PLYMOUTH COUNTY AND AVON, EASTON AND STOUGHTON, MA.

Question 1 proposes a law to reduce the state personal income tax rate to 2.65% as of January 1, 2009 and to eliminate the tax beginning January 1, 2010. A “yes” vote will enact these reductions; a “no” vote will make no change to the state’s income tax laws.

OCES employs 130 staff and provides services to more than 4,600 elders, caregivers and families each month. These services include home health aide, personal care and medical transportation that are vital to many home-bound, frail elders in our communities. In addition, every month we respond to more than 600 inquiries for information and referral, perform 150 long-term care screenings and deliver approximately 23,000 lunches through the meals-on-wheels program.

According to most reports, the income tax produces $12.5 billion, or 40%, of the entire state budget. If OCES’ budget is reduced by 40%, we will be forced to decrease services to some of our most vulnerable citizens and eliminate jobs. This could mean that 1,800 elders will lose home care services, 9,000 meals will not be delivered and at least 50 employees will lose their jobs.

Elders already impacted by the high costs of fuel and food are wondering how they will manage on fixed incomes. The workforce is trying to balance these costs too while watching their commuting costs increase and their savings and home values decrease. With state funding to cities and towns reduced, localities may raise property taxes and impose other fees, thereby placing another burden on homeowners – including elders and others on fixed incomes.

According to analysis by the Massachusetts Taxpayers Foundation, the estimated 40% budget reduction is too low. They contend that “after accounting for five legally mandated programs, the rest of state government would bear across-the-board cuts of 71.1% with the loss of $12.5 billion in state income tax revenue”. Private, non-profit agencies like OCES will be unable to continue providing needed human services after that level of funding cut.

“I urge registered voters to learn all they can about the impacts of Question 1 so they may make informed decisions before casting their votes on November 4th,” said Diana L. DiGiorgi, Executive Director of OCES.

To read the full version of this proposed law and the other 2 ballot questions, visit www.mass.gov and click on the Secretary of State’s page, select Elections Division and then 2008 Statewide Ballot Questions.

About Old Colony Elderly Services

Incorporated in 1974, Old Colony Elderly Services (OCES) is one of 27 private, non-profit Aging Services Access Points (ASAPs) in the Commonwealth of Massachusetts.

OCES serves elders, their families and caregivers in the towns of Abington, Avon, Bridgewater, Brockton, Carver, Duxbury, East Bridgewater, Easton, Halifax, Hanover, Hanson, Kingston, Lakeville, Marshfield, Middleboro, Pembroke, Plymouth, Plympton, Rockland, Stoughton, Wareham, West Bridgewater and Whitman.

The organization’s mission is to provide services that support the dignity and independence of elders by helping them maximize their quality of life; live safely and in good health; and, prevent unnecessary or premature institutionalization.

The agency has 130 employees and operates more than 12 programs serving elders, their families and caregivers. For more information call (508) 584-1561 or visit the website at www.oc-elderly.org

Caring for our Elderly Parents in the Sandwich Generation

July 12th, 2009 at 10:12pm Under Elder Law

I have spent weeks, if not longer, researching a variety of topics relating to caring for our elderly parents. As important as it is to lovingly care for our elderly parents, it is also a daunting task at best. While researching the various aspects and responsibilities involved with caring for elderly parents, I was surprised to find little information regarding the care of elderly parents who, due to their own personalities and tendencies, make it extremely difficult if not impossible to have the parent living in your home.

There is a vast array of information, including message boards, that discuss in great detail the importance of providing all the necessary medical attention to our parents, being sure that their medications are being taken, in the right amounts, and at the right times. There’s also much information on giving our elderly parents our time and attention, involving them in a variety of activities in and out of the home. Being sure to create and allow for opportunities where our parent can assist with a variety of tasks, whether it be helping prepare or cook a meal, picking up around the house, gardening, etc.

There is also no shortage of posts on message boards and blogs alike wherein writers are barraged with respondents comments about how “unloving, uncaring, unappreciative” some writers supposedly are when commenting on the difficulties they face while fulfilling their responsibilities towards their elderly parents.

We will all be old one day. We all will want and need our children to help us, care for us, love us, be attentive towards us, help with our “needs”, when the time comes that we are deemed an “elderly parent.” We all hope that our children will render us this needed love and care, putting aside any old hurts or slights of the past. Unfortunately, some people choose to hold onto old memories of previous hurts and perhaps even devastating traumas from childhood, choosing not to forgive and forget, but continuing to hold it against their parent/parents as an excuse to forfeit their responsibilities towards their now elderly parent.

Often this leaves most, if not all, the responsibilities on another sibling to carry the heavy and oftentimes burdensome load of providing care for their parents. Some even go so far as to move away so as to make it appear that they “just live too far away”, when in reality they never intended to help in the first place.

Although I do believe that the adult children carry primary responsibility to care for their elderly parents, I also believe there is much to be accomplished with the assistance of grandchildren with respect to their age and abilities. Making it a point to keep in close contact with their grandparents, making regular phone calls and visits, sending cards if for no reason other than to say, “I love you” or “I’m thinking of you”.

There is an abundance of opinion on whether to have elderly parents living with you in your home. Although this is a personal decision for each family, carefully considering all possibilities, the pro’s and con’s of such a venture, sometimes it is determined not to be in the best interests of the family as a whole. It is of this perspective and opinion that I write today.

On two separate occasions, lasting about a year and a half each time, my husband and I and his father lived together. Initially, we all lived together in my father in-law’s house. The floor plan provided private quarters for us, our room and bathroom on the opposite side of the house from his. Being newlyweds, we needed some time to be alone, to become accustomed to each other’s ways, and to settle into married life. My mother in-law had passed away in 1998, three years prior to my meeting my now-husband, having been married over fifty years to my father in-law. It quickly became apparent that having much time alone with my husband would be virtually impossible.

Over a period of time, I began to refer to my husband and his father as “Siamese Twins”, attached at the hip by an invisible umbilical cord. Every step my husband took, my father in-law was in close pursuit. It mattered not if my husband were going from the living room to the front door, from the kitchen to the den, from outside the house to inside the house, to or from the car. “Everywhere that Mary went, Mary went, Mary went…., everywhere that Mary went, her sheep was sure to go.”

My father in-law is a capable man. He is capable of fixing himself something to eat, even if just a sandwich. But, he won’t. He wants and expects someone/anyone, preferably my husband, to do it for him, as my mother in-law had done for the many years of their marriage. This attitude did not sit well with me or my husband, as we firmly believe that my father in-law should do for himself what he is capable of and not expect to be catered to the rest of his life.

The energy and exertion expelled to go to the pantry and retrieve cookies, brownies, Ding-Dong’s etc, is better used slapping two slices of bread together, with cold-cuts and cheese in between. To suggest such an absurd notion inevitably leads to a staring contest, followed by his quick exit with sugar-coated goodies stuffed into both hands.

Maintaining privacy was often a matter of discord, as we would return home from work to find “evidence” that someone had been in our bedroom. Items moved around in dresser drawers, desk drawers, files disrupted. After several attempts to resolve these bothersome problems, we decided to move and got our own apartment. A few months later we learned that my father in-law sold his house, and reluctantly moved in with his daughter, the eldest of the two children. For several months, phone calls were exchanged between my husband and his sister, with her explaining the same behaviors and problems we found to be so unbearable. It was creating problems for her family and marriage, as it had done to us, and we understood all too well what she was dealing with.

A few months later, my father in-law privately begged my husband to allow him to move back in with us, our having just bought a house with rooms to spare. Thinking my husband had experienced temporary insanity at the mere suggestion, I made my displeasure and disagreement crystal clear. Perhaps it was the fierce expression on my face; or perhaps it was my sounding like a screaming banshee; or maybe the sound of a door slamming behind me.

Nevertheless, we discussed it when my blood pressure returned to normal, and determined we would allow my father in-law to move in with us again, only with some firm stipulations. It was to be understood that although he would be living with us in our house, that he was to lead his own life, come and go as he pleased, go and do things/visit with friends etc, fix himself something to eat when hungry (unless we were obviously already preparing a family meal), clean up after himself, do his own laundry etc. But, no more catering to his wants and whims.

Ask any of my friends, co-workers or family, and they will tell you that I am normally “cool and collected” or “even-keeled”. It takes a lot to make me blow my stack, but if pushed to that point, look out. It didn’t take long at all to find that the attitude and behaviors were not going to change, that my father in-law would not follow any of the stipulations set for him. My husband and I actually began timing how many minutes it would take before my father in-law would appear wherever we were, trying to have a private conversation. Two minutes maximum. I began to search for our marriage decree, so I could look to see if someone had secretly added my father in-law’s name to the marriage document next my husband’s name.

I normally was the first person to get home after work, and within a few minutes, my father in-law was checking his watch and looking to see if I was about to begin rattling pans in the kitchen, since he “hadn’t eaten all day long”. After finishing dinner, while my husband and I began to clean up the kitchen and load the dishwasher, my father in-law would inevitably make his quick exit to ‘parts unknown’, or right back in front of the television where he’d been all day. Any attempt on our part to retrieve the remote and switch channels (it was always on some sort of sports show), would be met with heavy sighs and protests “I was watching that!”. We were guests in our own house. We continued to find that “someone” was rummaging in dresser drawers, private files in the office, and various other intrepid explorations throughout the house.

My father in-law is now eighty-four years young, and for the last year or so he’s been living in an Independent Living apartment on his own, a few short miles from our house. We visit him often, have him over for dinner often, pick him up and take him out to dinner often, have him over to spend the night every couple of weeks, but it’s never enough. We filled his freezer with healthy, frozen meals, that he only needs to nuke in the microwave for a few minutes.

They are all still there in his freezer, left untouched to this day. We keep him supplied with bread, cold-cuts, cheese, fruit, healthy cereals, etc, a fully-stocked refrigerator. Healthy, fresh foods rot and sit waiting for “someone” to throw it out. He is fully capable, physically capable, mentally capable, of fixing himself healthy meals. But, he won’t. A few days ago, he told me that he wants my husband to move in with HIM. That isn’t happening.

Florida Medicaid Law Changes Enacted

July 12th, 2009 at 04:10pm Under Elder Law

On February 1, 2006 the House of Representatives passed the 776 page Deficit Reduction Act of 2005 which includes those Florida Medicaid changes we wrote about last time. President Bush signed the legislation on February 8, 2006 thus making these changes the law of the land.

As with any major legislative initiative, the full ramifications of these changes won’t be known for several months. As the ramifications become clear, we will advise you as planning for the changes is now critically important. We will dissect them one by one and point out the major changes and Medicaid planning opportunities under the new law.

In the meantime, certain aspects of the bill are clear at this time. The first is that the Medicaid gifting or asset transfer rules have been changed so that the “lookback” period for all asset transfers is now 5 years. This includes any transfers made on or transfers which did not involve a trust resulted in asset transfer penalties of no more than 3 years. Now, under the new legislation, all asset transfers will have a look back period of 5 years.

In addition, the start of the Florida Medicaid penalty period won’t begin until the Medicaid applicant is already spent down. For instance, under the old rules…a gift of $30,000 would create a penalty period of approximately 7 months from the date of the gift.

Under the new law, that period of Medicaid ineligibility will not begin until the gift has been made and the spend down has been completed. Only then will the Medicaid penalty period begin, meaning that the gifted funds may have to be given back to pay for care. You can imagine the nightmares this may cause for unsuspecting nursing home residents and their families!

In addition, the new Florida Medicaid law make any individual with home equity of more than $500,000 (or if the states elect, they can raise this to $750,000) ineligible for Florida Medicaid. In other words, under the old Florida Medicaid law the home was an exempt asset. Under the new Florida Medicaid law the home may be exempt asset, but only so long as the home equity is not greater than $500,000.

The new Florida Medicaid law also changes the annuity rules. Annuities will be treated differently under the new law. In addition, the Medicaid law will require the State to be named as the remainder beneficiary on annuities.

The bottom line, as we will explain in coming months, is that the new Florida Medicaid laws will greatly complicate the Medicaid application process. Individuals may find that inadvertent transfers may prevent them from qualifying for Florida Medicaid. The advice of an experienced elder law attorney will now become more important than ever under these new rules. It is more critical than ever to begin planning early. Don’t wait!

MedicaidSecrets.Info Copyright 2008

Commonwealth Advisory Group Concentrates on Helping Frail Elders Stay at Home

July 12th, 2009 at 10:11am Under Elder Law

In order for a frail elder to remain at home, s/he typically need the assistance of a Personal Care Attendant (PCA) to help with their activities of daily living such as bathing, dressing and cooking.  But, in order to qualify for a PCA, a frail elder must receive the approval of an Aging Services Access Point agency and be on Medicaid. 

The Commonwealth Advisory Group helps frail elders to qualify for Medicaid.  Attorney Phil Amaru and Executive Director Laureen Vaughn work with a frail elder and set up a special trust program to protect their home, life savings, stocks and bonds, etc.  Once all these items are protected, a frail elder will then be eligible for Medicaid.

“Essentially, once it has been determined by the Aging Services Access Point that the elder qualifies for the Frail Elder Waiver, the elder must then qualify for Medicaid in order to receive the services of a PCA.  Oftentimes a frail elder’s monthly income exceeds Medicaid’s income limits and s/he is denied Medicaid.  That’s where we come in,” explained Attorney Amaru.  “We will qualify the elder for Medicaid.”

Taking the Right Steps

In order to determine eligibility as a Frail Elder, the elder’s physician should refer him/her to an Aging Services Access Point (elder services agency) that serves the elder’s town.  The agency will then assess the frail elder.  If a frail elder is approved by the agency to retain the services of a PCA, they then must be on Medicaid to receive services.

“Frail elders shouldn’t revert to spending down their assets in order to qualify for benefits.  There are ways to preserve assets for the present as well as the next generation. We can help,” noted Amaru.

With offices in Dedham, the Commonwealth Advisory Group provides professional guidance to seniors and their families with regard to asset preservation and Medicaid regulations prior to nursing home admission.

For more information contact Laureen Vaughn at 800-705-1415.

Asset Preservation Planning

For 16 years, the Commonwealth Advisory Group has helped over 1,500 clients save their assets (which includes property, gifted assets, retirement accounts, insurance policies, investments and savings) prior to and during an admission to a nursing home.  Unlike financial planners, Commonwealth Advisory Group specializes in asset preservation for elders and their families.

In addition to providing asset protection services to clients, Attorney Amaru and Executive Director Laureen Vaughn serve as educational speakers for hospitals, elder agencies and businesses throughout Southeastern Massachusetts.   Commonwealth Advisory Group has appeared with Jordan Rich of WBZ News Radio 1030 in variety of seminars on the topic of Senior Asset Protection.

Attorney Amaru is a member of the National Academy of Elder Law Attorneys; the National Network of Estate Planning Attorneys; the Massachusetts Academy of Trial Attorneys; the Massachusetts Bar Association and the American Bar Association.

Commonwealth Advisory Group is located just off Route 128 at 3 Allied Drive, Ste. 125, Dedham, MA.  For more information, contact 800-705-1415 or visit www.CommAdvise.com.

Commonwealth Advisory Group Concentrates on Helping Frail Elders Stay at Home

July 12th, 2009 at 10:11am Under Elder Law

In order for a frail elder to remain at home, s/he typically need the assistance of a Personal Care Attendant (PCA) to help with their activities of daily living such as bathing, dressing and cooking.  But, in order to qualify for a PCA, a frail elder must receive the approval of an Aging Services Access Point agency and be on Medicaid. 

The Commonwealth Advisory Group helps frail elders to qualify for Medicaid.  Attorney Phil Amaru and Executive Director Laureen Vaughn work with a frail elder and set up a special trust program to protect their home, life savings, stocks and bonds, etc.  Once all these items are protected, a frail elder will then be eligible for Medicaid.

“Essentially, once it has been determined by the Aging Services Access Point that the elder qualifies for the Frail Elder Waiver, the elder must then qualify for Medicaid in order to receive the services of a PCA.  Oftentimes a frail elder’s monthly income exceeds Medicaid’s income limits and s/he is denied Medicaid.  That’s where we come in,” explained Attorney Amaru.  “We will qualify the elder for Medicaid.”

Taking the Right Steps

In order to determine eligibility as a Frail Elder, the elder’s physician should refer him/her to an Aging Services Access Point (elder services agency) that serves the elder’s town.  The agency will then assess the frail elder.  If a frail elder is approved by the agency to retain the services of a PCA, they then must be on Medicaid to receive services.

“Frail elders shouldn’t revert to spending down their assets in order to qualify for benefits.  There are ways to preserve assets for the present as well as the next generation. We can help,” noted Amaru.

With offices in Dedham, the Commonwealth Advisory Group provides professional guidance to seniors and their families with regard to asset preservation and Medicaid regulations prior to nursing home admission.

For more information contact Laureen Vaughn at 800-705-1415.

Asset Preservation Planning

For 16 years, the Commonwealth Advisory Group has helped over 1,500 clients save their assets (which includes property, gifted assets, retirement accounts, insurance policies, investments and savings) prior to and during an admission to a nursing home.  Unlike financial planners, Commonwealth Advisory Group specializes in asset preservation for elders and their families.

In addition to providing asset protection services to clients, Attorney Amaru and Executive Director Laureen Vaughn serve as educational speakers for hospitals, elder agencies and businesses throughout Southeastern Massachusetts.   Commonwealth Advisory Group has appeared with Jordan Rich of WBZ News Radio 1030 in variety of seminars on the topic of Senior Asset Protection.

Attorney Amaru is a member of the National Academy of Elder Law Attorneys; the National Network of Estate Planning Attorneys; the Massachusetts Academy of Trial Attorneys; the Massachusetts Bar Association and the American Bar Association.

Commonwealth Advisory Group is located just off Route 128 at 3 Allied Drive, Ste. 125, Dedham, MA.  For more information, contact 800-705-1415 or visit www.CommAdvise.com.

Your Law Firm – Marketing Your Way to the Top

July 12th, 2009 at 04:10am Under Elder Law

I Just Can’t Do it Anymore: Depression Associated With Caring for Elderly Parents

July 11th, 2009 at 04:10pm Under Elder Law

Carol parked outside the two-door garage of her mother’s house  noticing that the usually perfectly pristine lawn was now full of sprouting weeds and wilting begonias. She went through the unexpectedly unlocked door as she called out to her mother.  As she walked into the kitchen she noticed her mother’s solitary figure hunched over a kitchen stool while the elderly woman stared out the skylight window.

“Mom didn’t you hear me calling you?” Carol asked as she stood in front of her mother. Ruth, a widowed, 70 year young mother of 3, grandmother of 7, retired high school teacher, avid gardener, international art film-buff and baker of the world’s best  pumpkin pie blankly stared at her daughter. “Did you speak to your father about that prom dress you wanted?” Ruth finally whispered. “Yeah I did mom….yeah I did”, Carol resignedly said as she gently guided her mother to the living room couch.

It had started with a little spacing out, forgetting birthdays, appointments, and even town bake sale events that she had never missed. Then a couple of months ago, Ruth began talking about her husband whom she had lost 5 years ago to colon cancer, as if he were alive and somewhere in the house busying himself with some household task. Alzheimer’s disease became a legitimate suspicion when just last week Sue’s 18 year-old daughter found Nana sleeping on a park bench 20 miles away from her home.

This is the story of millions of Americans caring for elderly parents, having to suddenly become experts in home health care, medications, elder laws, hospital and nursing home regulations, all the while fighting personal feelings of anger, abandonment, guilt, depression, and disappointment.

A USA TODAY/ABC News/Gallup Poll of baby boomers reports that 41% of those with a living parent are providing financial and/or personal care and 8% of boomers say their parents have moved in with them.

The USA TODAY poll finds a significant portion of the boomers who are helping their parents report the responsibility as only a “minor sacrifice” or “no sacrifice at all”. However, the remaining boomers polled report deleterious personal physical and emotional health consequences, such as high blood pressure, that is nearly double the risk of their American peers who are not caring for an elder parent. Alarmingly, 91% of boomers who report worsened physical health due to caring for an elderly parent, also report debilitating depressive symptomatology.

Caring for elderly parents can greatly threaten the physical and emotional health of caregivers and their families. The tasks caregivers face range from providing emotional support (such as frequent “checking in” telephone calls), to helping with the instrumental activities of daily living (such as transportation, shopping, housekeeping, meal preparation, and bill paying), to helping with personal care tasks (such as bathing and dressing). Care giving becomes all the more stressful when the elder parent is impaired by challenging emotional limitations such as dementia, as families must deal with impaired cognitive abilities, difficult behaviors, and the pain of personality changes in a loved one. If the elder’s behavior is embarrassing, the caregiver may become isolated and drop previously enjoyed activities.  The caregiver can become so engrossed in caring for the elder parent that other family members, such as children and spouses are neglected. When caring for an elder exceeds the family’s capacity, it is not surprising that family members react with fear, anger, shame, doubt, and sadness.  If the elder must ultimately be cared for in a nursing home, the caregiver must then deal with the nagging feelings of  guilt and  ambivalence over the decision not to mention the potentially devastating financial distress.

Before the boomer reaches the point of “I just can’t take it anymore”, just like the support they provide for their aging parents, caregivers,  need to seek support for themselves. Don’t be afraid or ashamed to ask for help (emotional or financial) from other family members, neighbors, church members and other support groups. Becoming a parent to your parent can be a difficult and painful process but also one that can be quite reparative in that it presents an opportunity to work through old wounds, close intergenerational misunderstandings, and bring a new found family closeness.

Want to learn more helpful tips or have a personal elder caregiving experience you’d like to share? Come join www.boomeryearbook.com and connect with other boomers. We understand.