Thursday, May 19, 2016

Today's ElderCare Matters Q&A Focuses on Whether Living Longer is Worth It If You’re Not Living Healthy

Question:  Is Living Longer Worth It If You’re Not Living Healthy?


Answer:  While more people are celebrating triple-digit birthdays than ever before, many have to take their insulin shot before enjoying a piece of birthday cake. Older adults are the largest consumer of medications with more than 40 percent of people over age 65 taking five or more prescriptions. While new medical interventions have significantly improved longevity, in some cases Western medicine may be a crutch for living with chronic diseases rather than making lifestyle changes.


According to seven papers published recently by the Lancet, people worldwide are living longer but sicker. Advances in medical science and drastic improvements in sanitation have decreased the amount of premature deaths and allowed people to live into old age—but at what cost?


The report is the first expansive, global look at life expectancy and health threats involving more than 480 researchers in 50 countries. Based on the data they gathered from surveys, censuses, and studies, the greatest global contributors to the health burden are chronic disease, injuries, mental health conditions, and joint and bone diseases. To give perspective, take a look at some of the eye-opening statistics presented in the report:


  • In people aged 15-49, diabetes is a bigger killer in Africa than in Western Europe (8.8 deaths vs. 1 death per 100,000).

  • Globally, heart disease and stroke remain the top killers.

  • Lung cancer moved to the 5th cause of death globally, while other cancers including those of the stomach, liver, and colon are also in the top 20.

This report begs the question, “Is living longer worth it if you are not living healthy?” Preventative medicine is a growing trend in which diet, exercise, and lifestyle play a major role. Instead of treating medical conditions when they arise, incorporating a healthy lifestyle may decrease your risk of health complications and increase your quality of life as you age.


With about four out of five seniors affected by a chronic condition such as heart disease, hypertension, and diabetes, decreased quality of life is not the only consequence—medical care is extremely costly. According to the American Hospital Association, Medicare costs are skyrocketing. “People with chronic disease are more likely to be hospitalized than those without, and the resources required for each episode of care are greater. This translates into higher spending overall.”


Healthy Living does not just add years to your life, but adds life to your years. In the end, your health is your choice. Choose wisely.


If you are looking for solutions to help you with weight loss, energy & performance, healthy aging and wealth creation, then please contact us so that we may guide you along your path to a healthier, happier YOU.



Today"s ElderCare Matters Q&A Focuses on Whether Living Longer is Worth It If You’re Not Living Healthy

This Week's Elder Care / Senior Care Article

TITLE:  Medicaid Planning: The Importance of a Well Drafted Power of Attorney


This is a recent Pennsylvania Superior Court case that highlights how important a power of attorney can be in proper planning. In this case an executor who was also the agent under a power of attorney for the decedent was forced to account for his use of the power of attorney prior to the death of the decedent. The objections to how the power of attorney was used were not appealed so we did not get all of the details on the document itself. However, the opinion does shed some light, at least by inference, on Medicaid planning with a power of attorney.


Briefly, Medicaid planning is a process where someone accelerates their eligibility for Medicaid (Medical Assistance in PA) by restructuring or transferring assets so that they meet the financial qualifications for Medicaid eligibility sooner and preserve more resources for their loved ones. Sometimes this restructuring is done directly by the applicant (usually an older or disabled adult), through their agent under a power of attorney or by their legal guardian. Today courts are more likely to allow guardians to engage in this planning to protect the healthy spouse, less so to protect an inheritance for the children unless one or more is disabled or a minor. There has been some discussion, but few cases, as to whether a guardian has the power to engage in this planning for other purposes given that a guardian should be able to do anything the incapacitated person can do for him or herself.


Frequently this type of planning is performed via a power of attorney as in the Binnig case. While the details were not provided in the case as to the terms of the power of attorney, it was abundantly clear that the power of attorney lacked certain provisions that allowed for the transfer of assets that occurred prior to death (thereby reducing the size of the estate and causing another beneficiary to object). Not only does the power of attorney need to allow the administrative function of the transfers (i.e. the ability to convey real estate or transfer assets in a bank or brokerage account) but it needs to clearly identify the reasons why the transfers may occur (Medicaid or Asset Protection Planning). An agent under a power has a fiduciary obligation to the principal (the person who authorizes the agent to act on the principal’s behalf). Therefore he or she cannot simply transfer assets of the principal to him or herself unless doing so is in the best interest of the principal absent authority in the power of attorney to do so.


One can infer from the Court’s opinion that, had the power of attorney been properly drafted with this type of planning in mind and discussed with the principal at the time of execution, the plan would have been carried out and the objections dismissed. Particularly after Act 95 of 2014 where sweeping changes were made to the requirements of powers of attorney in Pennsylvania, it is important that you review your financial powers of attorney to make sure your agent has the ability to do what you would want them to do if you are unable to act.


This article was written by Robert M. Slutsky, Esq., of the law firm Robert Slutsky Associates in Plymouth Meeting, Pennsylvania.  Mr. Slutsky is a Partner member of the national ElderCare Matters Alliance.


21 “Mobile Friendly” Elder Care / Senior Care Directories


If you need help in planning for and/or dealing with this Elder Care Matter or or with any Elder Care / Senior Care issue, you can find the professional help you need in one of the following 21Mobile Friendly” Elder Care / Senior Care Directories. These Elder Care / Senior Care – specific Directories are sponsored by the National ElderCare Matters Alliance, an organization of thousands of America’s TOP Elder Care / Senior Care Professsionals who help families plan for and deal with a wide range of Elder Care Matters.


  1. ElderCareMatters.com

  2. ElderCareMattersBlog.com

  3. ElderCareWebsites.com

  4. ElderCareAnswers.us

  5. ElderCareArticles.us

  6. ElderCareProfessionals.us

  7. ElderLawAttorneys.us

  8. EstatePlanningAttorneys.us

  9. FindDailyMoneyManagers.net

  10. FindElderCareMediators.net

  11. FindElderLawAttorneys.net

  12. FindEstatePlanningAttorneys.net

  13. FindGeriatricCareManagers.net

  14. FindHomeCareProviders.net

  15. FindLongTermCareInsurance.net

  16. FindMedicaidAttorneys.net

  17. FindProbateAttorneys.net

  18. FindSeniorLivingCommunities.net

  19. FindSeniorMoveManagers.net

  20. FindSpecialNeedsAttorneys.net

  21. FindVAAccreditedAttorneys.net

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This Week"s Elder Care / Senior Care Article

Monday, May 2, 2016

Today's Elder Care Matters Q&A is about Transferring Title of Home for Medicaid Purposes

My mother is 83 with dementia. It’s to the point that she needs nursing home care. I have been her caretaker for the last 4 years. The home we live in is in both of our names. We want to transfer into my name only. She will have to go on Medicaid.  May I have your advice please as to the proper way of handling this?


Answer: You need to meet immediately with an Elder Law Attorney who is knowledgeable about Medicaid in your state. First it is necessary to address the issue of authority to transfer the home. Does your mother have mental capacity to sign legal documents? It is important to understand that capacity is a legal issue, not a medical one. Further, there are multiple forms of capacity, most commonly testamentary capacity and contractual capacity. A medical diagnosis is not determinative of capacity. There are set rules for determining capacity. However it is important to understand that capacity can fluctuate from day to day or based upon the hour of the day. Individuals with dementia can suffer from something called sundowners, whereby they may have capacity early in the morning, but lack it by the end of the day. So, the first thing you need to do is work with an Elder Law Attorney to determine if your mother currently has legal capacity. If your mother currently has capacity, she can sign the deed without the need for a power of attorney, though you certainly want Durable Powers of Attorney for Health and Durable Powers of Attorney for Property to be able to assist her.


Assuming that she lacks capacity, but has Powers of Attorney in place, the next question is whether the Durable Power of Attorney grants the agent authority to gift or transfer property and if you are the named agent whether it also allows for self-dealing in certain circumstances. Most people do not understand that all Durable Powers of Attorney are not the same. While most States have a statutory form, which is what many people use without modification, the Durable Power of Attorney statutes are designed to allow significant modifications to the extent and nature of the powers granted. Many people and Attorneys believe that a standard form covers everything, frequently relying on the apparent broad authority granted on the face of the document. Unfortunately that is not true. As an Elder Law Attorney the Durable Powers of Attorney I prepare for my Clients contain substantial modifications which allow the agent to take specific actions, including steps to transfer property to a child caregiver under Medicaid.


It is also essential to understand that Medicaid, unlike Medicare, is not a matter of right. You must understand that the burden of proof is on you to establish that you meet all the criteria to qualify. Unfortunately while the laws are published, the State agencies in charge of Medicaid frequently do not publish or advise you what exactly is required to establish your rights. In most States there has been active efforts to reduce the number of people on Medicaid and whether it has been done by changing the statutes or by modifying the procedural requirements, both written and unwritten, large numbers of qualified individuals that have had their applications denied because of a naïve belief that since they meet the general legal standards that the State will automatically approve them. Jointly owning the property with your Mother does not mean that you can keep the house and protect your mother. It is imperative that you retain an experienced Elder Law Attorney immediately if you seek to protect your claim to the home while still getting your mother qualified for Medicaid payment for her care. Good Luck.


Illinois Medicaid Attorney




Today’s Answer was provided by James C. Siebert, Esq., of The Law Office of James C. Siebert & Associates in Arlington Heights, Illinois.  Attorney Siebert is a
Partner Member in the National ElderCare Matters Alliance.


 


 


21 “Mobile Friendly” Elder Care / Senior Care Directories


If you need help in planning for and/or dealing with Medicaid Issues or with any Elder Care / Senior Care matter, you can find the professional help you need in one of the following 21Mobile Friendly” Elder Care / Senior Care Directories. These Elder Care / Senior Care – specific Directories are sponsored by the National ElderCare Matters Alliance, an organization of thousands of America’s TOP Elder Care / Senior Care Professsionals who help families plan for and deal with a wide range of Elder Care Matters.



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Today"s Elder Care Matters Q&A is about Transferring Title of Home for Medicaid Purposes

Monday, March 14, 2016

Today's Elder Care Matters Q&A is about the VA Aid and Attendance Pension

How much disability is required for a Claimant to receive the VA Aid and Attendance Pension?


ANSWER:  In order to receive the VA Aid and Attendance Pension, the claimant must show that he or she requires the “aid and attendance” of another person in order to perform some of the basic activities of daily living. The medical evidence must be provided by a physician. Additionally, if the claimant resides in a facility, then the facility must also provide a letter stating that the individual resides in the facility because of the need for assistance with the activities of daily living. The VA defines the need for aid and attendance as:


  1. Requiring the aid of another person to perform at least two activities of daily living, such as grooming, transferring, eating, bathing, dressing or toileting;

  2. Being blind or nearly blind; or

  3. Being a patient in a nursing home.

One of the great beauties of the VA pension is that it can be used for any type of chronic care providers including: in home paid caregivers, personal care homes or assisted living facilities, adult day care or skilled nursing facilities.


VA Aid & Attendance Pension

Today’s Answer was provided by Kevin Pillion, Esq., of Life Planning Law Firm in Sarasota, Florida.  Attorney Pillion is a
Partner Member in the National ElderCare Matters Alliance.


 


 


21 “Mobile Friendly” Elder Care / Senior Care Directories


If you need help in planning for and/or dealing with VA Aid and Attendance Issues or with any Elder Care / Senior Care matter, you can find the professional help you need in one of the following 21Mobile Friendly” Elder Care / Senior Care Directories. These Elder Care / Senior Care – specific Directories are sponsored by the National ElderCare Matters Alliance, an organization of thousands of America’s TOP Elder Care / Senior Care Professsionals who help families plan for and deal with a wide range of Elder Care Matters.



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Today"s Elder Care Matters Q&A is about the VA Aid and Attendance Pension

Thursday, March 10, 2016

Today's Elder Care Matters Q&A is about the role of a Patient Advocate

QUESTION:  What Is a Patient Advocate?


ANSWER: What happens if you or a family member is too injured or ill to make medical decisions for themselves? In Michigan, you can designate someone to be your “patient advocate” in the event that you lose the mental capacity to make healthcare decisions for yourself. You can designate any adult over the age of 18, but it is important to choose this person wisely.


Whether or not you have a patient advocate is up to you, but it can be a useful component of an overall estate plan. If you choose not to have a patient advocate you may have difficulty with the course of your medical care. Sometimes a spouse or child will have a say, but by law, even close family members do not have the right to make your decisions for you without the proper patient advocate designation or health care power of attorney. Instead, the family may have to file a proceeding in probate court to appoint a guardianship, which could result in decisions that are not what you would have preferred had you planned ahead.


How Do I Start?


Meet with your elder law and estate planning attorney, who can talk with you about choosing a patient advocate. Your attorney will help you through the process, which will include drafting an advance directive expressing your wishes, along with a health care power of attorney.


There are some requirements that must be met to validly designate a patient advocate. You must be of sound mind when you choose your patient advocate. You must have two witnesses sign, and the person you choose to be your patient advocate must also sign to accept the responsibility.


What Can I Have My Patient Advocate Do on My Behalf?


Your patient advocate can be empowered to make healthcare decisions that are in your best interest for you if you are too injured or ill to do so for yourself. This can include giving informed consent to medical treatment, refusing consent, and arrange for care or treatment in a hospital or nursing home. There are also optional abilities you can give such as arranging and deciding on mental health treatment, arranging for organ or body donation after you pass away, and withdrawing or withholding life support (except, under Michigan law, if you are pregnant).


In an optional section, you can make clear your “Statement of Wishes” that details the type of care you would like to receive and what your preferences are.


When a person has not designated a proper patient advocate, or otherwise made clear his or her end-of-life wishes, the law requires that life support is maintained even if that’s not what you would have wanted.


Steps Once You Have Designated a Patient Advocate


Keep the signed original for yourself in a safe place so that you can take it with you and present it to individuals who may need to see it.


Make copies and either mail or bring them to:


  • The Peace of Mind Registry, a state-wide registry that holds records of these designations

  • Your primary care provider

  • Close family members who would need to know who your designated patient advocate is and how to contact them if necessary.

  • The hospitals you visit or the hospital in closest proximity to your residence.

  • Any other medical facilities such as nursing homes or clinics where you regularly receive medical care or anticipate needing to.

Patient Advocate


Today’s Answer was provided by Don L. Rosenberg, Attorney and Counselor, of the Law Firm Barron, Rosenberg, Mayoras & Mayoras in Troy, Michigan.  Attorney Rosenberg is a Partner Member in the National ElderCare Matters Alliance.


 


21 “Mobile Friendly” Elder Care / Senior Care Directories


If you need help in planning for and/or dealing with this issue or with any Elder Care / Senior Care matter, you can find the professional help you need in one of the following 21Mobile Friendly” Elder Care / Senior Care Directories. These Elder Care / Senior Care – specific Directories are sponsored by the National ElderCare Matters Alliance, an organization of thousands of America’s TOP Elder Care / Senior Care Professsionals who help families plan for and deal with a wide range of Elder Care Matters.



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Today"s Elder Care Matters Q&A is about the role of a Patient Advocate

Wednesday, March 9, 2016

Today's Elder Care / Senior Care Q&A is about Avoiding Taxes with a Revocable Living Trust

QUESTION:  Will a Revocable Living Trust Help to Avoid Taxes?


revocable living trustToday’s Answer was provided by Scott A. Makuakane, Esq., CFP, of Est8 Planning Counsel LLLC in Honolulu, Hawaii.  Attorney Makuakane is a Partner Member in the National ElderCare Matters Alliance.


ANSWER:  In and of themselves, trusts do not avoid taxes, but they help to carry out good tax planning. As far as income taxes go, revocable living trusts are “tax neutral.” During your lifetime, your trust will not need to file its own income tax returns. The taxpayer identification number for your trust is your Social Security Number, and you simply report all trust income on your individual Federal and State income tax returns.


Whether you have a trust or not, your estate may be subject to estate tax and generation-skipping transfer tax. The estate tax is a tax on your failure to spend your last nickel by the same time as you exhale your last breath. If you are a U.S. resident, the law gives you an exclusion from the Federal estate tax (we like to call it your estate tax “coupon”) that enables you to shelter a certain amount of assets from the tax. The aptly-named generation-skipping transfer tax (“GST”) is piled on top of any applicable gift or estate taxes on transfers to individuals who are two or more generations younger than you and can result in a lot more going to the IRS than goes to your loved ones.


21 “Mobile Friendly” Elder Care / Senior Care Directories


If you need help in planning for and/or dealing with this issue or with any Elder Care / Senior Care matter, you can find the professional help you need in one of the following 21Mobile Friendly” Elder Care / Senior Care Directories. These Elder Care / Senior Care – specific Directories are sponsored by the National ElderCare Matters Alliance, an organization of thousands of America’s TOP Elder Care / Senior Care Professsionals who help families plan for and deal with a wide range of Elder Care Matters.



#eldercarematters, #eldercare, #eldercareanswers, #seniorcareanswers,  #eldercaredirectories, #seniorcaredirectories, #findseniorcareprofessionals, #findseniorcareexperts, #elderlawanswers, #seniorcare, #seniorcarematters, #findeldercareprofessionals, #findelderlawattorneys, #findestateplanningattorneys



Today"s Elder Care / Senior Care Q&A is about Avoiding Taxes with a Revocable Living Trust

Tuesday, March 8, 2016

Today's Elder Care / Senior Care Q&A is about Elder Care Warning Signs

Elder Care warning signs


 


 


 


 


QUESTION:  What are some Warning Signs that my parents may need help with their Elder Care?


ANSWER:  Below are some warning signs that your loved one may need help with their Elder Care:


  • Deteriorating hygiene or appearance

  • Erratic or inappropriate behavior changes

  • Increasing confusion or disorientation

  • Depression with tearfulness, loss of appetite

  • Signs of insufficient nutrition, dehydration, or weight loss

  • Inability to manage money

  • Friends or neighbors express concern

  • Inability to manage medications

  • Unclean or unsafe living environment

  • Falling, lack of mobility, wandering, or significant vision or hearing difficulties

  • Wears same clothing more than two days in a row

  • Difficulty getting out of bed and preparing for the day

  • Noted changes in short term memory loss

Today’s Answer was provided by Lauren Spiglanin, Founder of Family Connect Care in Rancho Palos Verdes, California.   Ms. Spiglanin is a Partner Member in the national ElderCare Matters Alliance.


21 “Mobile Friendly” Elder Care / Senior Care Directories


If you need help in planning for and/or dealing with this issue or with any Elder Care / Senior Care matter, you can find the professional help you need in one of the following 21Mobile Friendly” Elder Care / Senior Care Directories. These Elder Care / Senior Care – specific Directories are sponsored by the National ElderCare Matters Alliance, an organization of thousands of America’s TOP Elder Care / Senior Care Professsionals who help families plan for and deal with a wide range of Elder Care Matters.



#eldercarematters, #eldercare, #eldercareanswers, #seniorcareanswers,  #eldercaredirectories, #seniorcaredirectories, #findseniorcareprofessionals, #findseniorcareexperts, #elderlawanswers, #seniorcare, #seniorcarematters, #findeldercareprofessionals


 



Today"s Elder Care / Senior Care Q&A is about Elder Care Warning Signs