Today you're going to learn how to select someone who's fluent in elder law. Why is this important for you? An Elder Law attorney concentrates their practice in the area of estate and longevity planning, Medicaid, special needs trusts, and VA benefits for the over 65. Anyone nearing or over that age should know what steps they may need to take to get the right documents in place so that their plans for their finances and their family can be realized.
I recently looked at a bar association listing of attorneys who identify themselves as elder law attorneys. Frankly, I was a little surprised to see that some individuals who are really general practitioners also consider themselves to be elder law attorneys. I was a little disturbed when I saw this, because drafting simple wills and trusts does not qualify an attorney to be an elder law attorney. Wills and trusts may be part of the elder law process at times - but there is so much more involved than that!
Really, wills are what I call "death planning" - they really only control what happens after you die. Today's seniors need an estate and longevity plan - this will help their families know what their wishes are in the event that they become incapacitated before they die. If you are married, then it's highly probable that one of the two of you will spend a substantial amount of time in a nursing home before you die.
Will the real elder law attorney please stand up?
When trying to find an elder law-focused attorney, it's important to understand how elder law differs from traditional estate planning (death planning). A traditional estate plan is typically designed to do three things:
1. Minimize estate taxes
2. Avoid probate court
3. Distribute assets from the deceased person to his or her heirs.
Elder law, on the other hand, is death planning plus long-term disability and care planning - what I call "longevity planning." The elder law attorney is not only dealing with your estate plan, but must also think ahead for life care issues in the event that you or your spouse has long term health care needs during your lifetime.
These days, it is quite common to see families spend several hundreds of thousands of dollars when both a husband and wife have long term care needs. The key focus of an elder law attorney is to help the family to try to protect their assets during their lifetime, to avoid such a catastrophic loss.
No one wants to be out of money and out of options before they are out of breath. While it's not possible to guarantee specific results, the elder law attorney works with clients and families to guide them through the minefield of public benefits, veteran's benefits, Medicare, Social Security, special needs trusts, powers of attorney, and Medicaid. Our job is to increase the quality of life of our clients, not just to figure out who-gets-what after you pass away.
So if you are trying to figure out who is the real elder law attorney, please ask these questions:
- How many Medicaid applications does your firm do in a year?
- How many veterans does your firm assist with the VA aid and attendance benefits per year?
- How many elder law oriented estate plans has your firm done this year?
If you are looking for an elder law attorney to do any of these things, please use an attorney who can demonstrate that he or she is working in that area every day. The issues are complex, and you deserve to work with someone who is fluent in elder law.
Talk to you soon!
Tuesday, July 26, 2011
Monday, July 25, 2011
Medicaid Myths and Misperceptions
My husband, being a rabbi (see www.rabbimitch.com), often attends meetings with religious leaders of different faiths. At a recent meeting, the subject of nursing home care came up. One pastor in the group opined that, in order to get Medicaid to pay for such care, a person must have spent all his money. My husband (who’s been enlightened by his elder-law attorney/wife!) immediately corrected the pastor, advising him that this was not true. He then also advised him to get Nursing Home Medicaid advice from an elder law attorney.
Incidents such as these are, unfortunately, not rare. In fact, many seniors (or near-seniors) still maintain outdated – and dangerously inaccurate – views as to exactly what Medicaid can and can’t do, and how to become eligible for it. And many end up paying a severe price for believing in what are, essentially, myths.
Clergy, of course, answer to a higher authority than the rest of us. And, justifiably, we put a lot of trust in them. But clergy, too, are only human. And the incident at the meeting proved that they can be as vulnerable to Medicaid Myths and Misperceptions as the rest of us.
When my husband told me about this incident, I began to think about the powerful influence of the clergy in our lives…and how they can inadvertently harm people when they give out inaccurate information. We put trust in our clergy that we don’t put in anyone else. After all, this isn’t the same as getting advice from a neighbor who “knows someone.” This is someone we rely on, a person with wisdom, a person with vision, and a person whose advice we’ve come to trust.
But – clergy or not - this is also very dangerous. Everyone in my office can recite horror stories of families spending down thousands of dollars needlessly, because they received bad advice and believed it. (Thankfully, everyone in my office can also recite stories about all the money we’ve saved our clients!)
Take a minute to think about it. Would you trust your health care to an accountant? Would you trust your tax planning to a writer? Would you trust your estate planning to a teacher? (Or, conversely, would you trust your children’s education to a lawyer?)
My message is simple: Don’t take elder-care advice from someone who “knows someone.” Don’t take it from a clergyman. Don’t take it from anyone, in fact – no matter how well-intentioned – who’s not an elder law attorney. Get your advice on Medicaid and Veteran’s benefits from people who know - elder law attorneys. That’s what we do. And it’s the only thing we do.
It’s one investment you’ll be glad you made. And you’ll be happy with the results for years to come.
Will Your Loved One's Decisions Be Made By A Stranger?
I always try to emphasize the importance of planning ahead... you and your family want to be prepared in case something should happen to you. A “guardianship” is a situation that some families find themselves in... and it means that your loved one’s healthcare and financial decisions may be made by a perfect stranger, appointed by the courts. So, what is the difference between a power of attorney and a guardianship?
A power of attorney is a legal document where one person (the principal) authorizes another person (the agent) to act on his or her behalf, either for health care decisions or for financial decisions.
Guardianship is a legal relationship whereby a court gives a person (the guardian) the power to make personal decisions for another (the ward). A family member or friend initiates the proceedings by filing a petition in the circuit court in the county where the individual resides. A medical examination by a licensed physician is necessary to establish the individual’s condition. A court of law then determines whether the individual is unable to meet the essential requirements for his or her health and safety. If so, the court appoints a guardian to make personal decisions for the individual. Unless limited by the court, the guardian has the same rights, powers and duties over his ward as parents have over their minor children. The guardian is required to report to the court annually.
A conservatorship is a legal relationship whereby a court gives a person (the conservator) the power to make financial decisions for another (the protectee). The court proceedings are very similar to those of a guardianship, except the court of law determines whether an individual lacks the capacity to manage his or her financial affairs. If so, the court appoints a conservator to make financial decisions for the individual. Often the court appoints the same person to act as both guardian and conservator for the individual. Like the guardian, the conservator is required to report to the court annually.
Powers of attorney for health care and property/financial decisions are relatively low cost and private ways to decide which family member or trusted friend will have the legal authority to carry out your wishes if you can no longer speak or act for yourself. If you do not have power of attorney, or if your powers of attorney are not drafted properly and something happens that results in your inability to make decisions, your loved ones may later face court proceedings and court-supervised guardianships and/or conservatorships. A court proceeding is not only costly, but the person appointed as your guardian/conservator may not be the person whom you would have chosen yourself.
Don’t let this happen to you or your loved one... put the right documents in place now, or it may be too late!
A power of attorney is a legal document where one person (the principal) authorizes another person (the agent) to act on his or her behalf, either for health care decisions or for financial decisions.
Guardianship is a legal relationship whereby a court gives a person (the guardian) the power to make personal decisions for another (the ward). A family member or friend initiates the proceedings by filing a petition in the circuit court in the county where the individual resides. A medical examination by a licensed physician is necessary to establish the individual’s condition. A court of law then determines whether the individual is unable to meet the essential requirements for his or her health and safety. If so, the court appoints a guardian to make personal decisions for the individual. Unless limited by the court, the guardian has the same rights, powers and duties over his ward as parents have over their minor children. The guardian is required to report to the court annually.
A conservatorship is a legal relationship whereby a court gives a person (the conservator) the power to make financial decisions for another (the protectee). The court proceedings are very similar to those of a guardianship, except the court of law determines whether an individual lacks the capacity to manage his or her financial affairs. If so, the court appoints a conservator to make financial decisions for the individual. Often the court appoints the same person to act as both guardian and conservator for the individual. Like the guardian, the conservator is required to report to the court annually.
Powers of attorney for health care and property/financial decisions are relatively low cost and private ways to decide which family member or trusted friend will have the legal authority to carry out your wishes if you can no longer speak or act for yourself. If you do not have power of attorney, or if your powers of attorney are not drafted properly and something happens that results in your inability to make decisions, your loved ones may later face court proceedings and court-supervised guardianships and/or conservatorships. A court proceeding is not only costly, but the person appointed as your guardian/conservator may not be the person whom you would have chosen yourself.
Don’t let this happen to you or your loved one... put the right documents in place now, or it may be too late!
Friday, July 22, 2011
How to Best Communicate With Your Loved One With Memory Problems
Good communication can decrease or even prevent many behavior problems. So what’s the best way to communicate with your loved one?
The number one tip to remember is to treat your loved one as an individual with a disease, not a diseased individual. He has an entire history of life that stays with him throughout this journey. He will continue to have many of the same characteristics he had before. If he was laid back before, he may be more so now. If he had high energy/anxiety, he may be tightly wound now as well.
All people need to have their feelings validated. A person with Alzheimer’s is no different. In fact, because of memory loss and insecurity issues, he or she may need it even more. An example: Your father who has Alzheimer’s is angry with your husband most of the time. They have had a great relationship in the past, but now your father blames him for everything. As difficult as it is, keep in mind that it’s the dementia talking, not your father. You can say, “I don’t blame you for being angry” and then move on. What he is feeling is real to him, even if it is not accurate. You will probably have to coach your husband as well. Let him know that this action isn’t against him personally; it is the nature of the illness and “this too shall pass.”
Individuals with Alzheimer’s respond well to affirmation. When they do anything, no matter how insignificant it may be to you, praise them with “good job” or “thank you.”
Other tips:
- When beginning a conversation, identify yourself. If your loved one says “I know who you are,” laugh or say something humorous.
- Slow down when you speak and use short simple sentences.
- Ask one question at a time. Give adequate time for response. Yes/no questions are best.
- When speaking, maintain eye contact.
- Lower the tone of your voice; a high pitch may be interpreted as anger.
- Eliminate distracting noise. Turn off the TV or radio, or go to another room to talk.
- Smile and be pleasant.
- Use touch to get attention (hand on shoulder, hand on knee, hand on hand).
- When your loved one is upset and you can’t communicate, try a hug. Soon anger will be forgotten and you can try again.
- Be aware of their body language. A sudden sit-to-stand change in position may indicate the need to go to the bathroom or some other kind of discomfort. Be aware of your body language too - try not to appear tense.
- Don’t argue.
- Don’t order the person around or be condescending.
- Don’t talk about your loved one as if he isn’t there; you never know just how aware he might be
The number one tip to remember is to treat your loved one as an individual with a disease, not a diseased individual. He has an entire history of life that stays with him throughout this journey. He will continue to have many of the same characteristics he had before. If he was laid back before, he may be more so now. If he had high energy/anxiety, he may be tightly wound now as well.
All people need to have their feelings validated. A person with Alzheimer’s is no different. In fact, because of memory loss and insecurity issues, he or she may need it even more. An example: Your father who has Alzheimer’s is angry with your husband most of the time. They have had a great relationship in the past, but now your father blames him for everything. As difficult as it is, keep in mind that it’s the dementia talking, not your father. You can say, “I don’t blame you for being angry” and then move on. What he is feeling is real to him, even if it is not accurate. You will probably have to coach your husband as well. Let him know that this action isn’t against him personally; it is the nature of the illness and “this too shall pass.”
Individuals with Alzheimer’s respond well to affirmation. When they do anything, no matter how insignificant it may be to you, praise them with “good job” or “thank you.”
Other tips:
- When beginning a conversation, identify yourself. If your loved one says “I know who you are,” laugh or say something humorous.
- Slow down when you speak and use short simple sentences.
- Ask one question at a time. Give adequate time for response. Yes/no questions are best.
- When speaking, maintain eye contact.
- Lower the tone of your voice; a high pitch may be interpreted as anger.
- Eliminate distracting noise. Turn off the TV or radio, or go to another room to talk.
- Smile and be pleasant.
- Use touch to get attention (hand on shoulder, hand on knee, hand on hand).
- When your loved one is upset and you can’t communicate, try a hug. Soon anger will be forgotten and you can try again.
- Be aware of their body language. A sudden sit-to-stand change in position may indicate the need to go to the bathroom or some other kind of discomfort. Be aware of your body language too - try not to appear tense.
- Don’t argue.
- Don’t order the person around or be condescending.
- Don’t talk about your loved one as if he isn’t there; you never know just how aware he might be
Thursday, July 21, 2011
How Do You Know....A Message for Caregivers
Caregivers often want to know: how do you know what your loved one is feeling and experiencing as they progress in the disease? No one can truly empathize with any situation without having been there themselves. Even then, each person handles life differently. Perhaps the best way to try to understand how your loved one is feeling is to read what several people with Alzheimer’s disease have written and published to educate those who want to know.
These books walk you through their personal journeys. It can be heart-wrenching to read about the devastating things they go through, but it is good for learning and understanding. Reading these books may bring out many of your own emotions, but it may also help you know how your loved one feels.
- Living In The Labyrinth: A Personal Journey Through the Maze of Alzheimer’s
by Diana Friel McGowin
Copyright 1993, Dell Publishing/ Doubleday Dell Publishing Group
- Show Me The Way To Go Home
by Larry Rose
Copyright 1996, Elder Books, Forest Knolls, California
You can find these books at your nearest Alzheimer’s Association or at any bookstore or online book source.
These books walk you through their personal journeys. It can be heart-wrenching to read about the devastating things they go through, but it is good for learning and understanding. Reading these books may bring out many of your own emotions, but it may also help you know how your loved one feels.
- Living In The Labyrinth: A Personal Journey Through the Maze of Alzheimer’s
by Diana Friel McGowin
Copyright 1993, Dell Publishing/ Doubleday Dell Publishing Group
- Show Me The Way To Go Home
by Larry Rose
Copyright 1996, Elder Books, Forest Knolls, California
You can find these books at your nearest Alzheimer’s Association or at any bookstore or online book source.
Wednesday, July 20, 2011
Plan and Protect
Last week, a client, along with his wife, came to see me about making some changes in his estate planning documents. It had been six years since I had last seen Mr. K. And I immediately saw the change in him. From the moment he walked in, he seemed very agitated. And within a minute of sitting down, he was dictating what I needed to do to accomplish his goals.
But that’s not the way I work. I like to have an open discussion with my clients about their goals – because each client’s goals are different. So I told Mr. K. that, before making any changes, I thought we should chat for a few minutes. I believe such a chat is essential…because it helps me do a better job of servicing my clients.
He wasn’t happy about my suggestion – to put it mildly. His mind was made up. But I hadn’t seen him in six years. And I wanted to spend a little time talking with him, asking him questions, and making sure I had the right answers. I do this for two main reasons:
- The first is because it’s best for the client. If your doctor hasn’t seen you for a while, he’ll probably tell you it’s time for a check-up. And if I haven’t seen you for a while, it’s probably time for an estate-planning check-up. It’s time to make sure the plan we came up with a few years back is still appropriate for you today. And it’s time to see if we need to make some changes based on age, physical condition, assets, income, death of a loved one, etc.
- The second (albeit more selfish) reason I want to have this conversation is because if I don’t ask these questions, and I don’t address these issues, I’m going to hear from my clients (or, more likely, their children) later on. And they’re going to want to know why I didn’t tell them how to properly plan and protect themselves.
So I asked Mr. K. about his health. He responded that he was “fine.” I asked him about his assets, and he refused to answer. I asked him if he had plans in case he became incapacitated. He announced that the VA would take care of him. And he refused to listen when I informed him this wasn’t necessarily the case.
I’ve been working with older people my entire professional life. And I know the signs of Alzheimer’s when I see them. I turned to his wife and asked her if he had been exhibiting any memory loss. And she affirmed my suspicions. He was indeed, it turned out, exhibiting the early signs of Alzheimer’s.
Why am I sharing this story with you? Well, it’s not to brag about myself. Rather, it’s to point out how important these regular “legal” check-ups can be. When looking at Mr. K., I saw belligerence, paranoia, discomfort at my questions (for fear he wouldn’t be able to answer them), and a man who kept asking me the same questions…over and over.
The conversation wasn’t necessarily a happy one. But it will help both of them. As a result of our conversation, I will now be able to provide his wife with much-needed support, resources, and information on Alzheimer’s. I’ll be able to encourage her to seek the advice of a neurologist. And I’ll be able to help prepare her for the long and difficult road ahead.
Mr. K., needless to say, was not at all happy with my observations. Who would be? No one wants to hear they may have Alzheimer’s. Life being life, I told him, I can’t always talk about happy things. But I told him that I would always be totally honest with him. And that I would always give him my best advice.
He then asked me a question about his will - a question he’d already asked me three times before.
Our firm advocates for seniors and senior care, so we have made a significant investment in acquiring the best materials and resources that address the unique needs of these communities. We also offer a unique suite of resources to aide the caregivers to Alzheimer’s patients. We are pleased to make these valuable resources available to you COMPLETELY FREE OF CHARGE. These materials represent the initial steps you need to take to provide the best possible care for yourself, your family members, clients, patients and friends. Sign up for one or all of these unique and valuable online resource centers:
and
www.southfloridamemorylawyer.com for caregivers to Alzheimer’s patients.
You may also visit our website any time for access to information on all of the areas of law we practice under “The Elder Law Umbrella” at www.florida-elderlaw.com or follow our blog: www.southfloridaelderlaw.blogspot.com
Monday, July 11, 2011
Medicare Targets South Florida
Five Florida hospitals, including Memorial in Hollywood and Jackson in Miami
Hospital Readmissions has become such a problem that the new health care bill includes sanctions for hospitals who do not address this issue.
Obviously hospital readmissions are very costly for Medicare and are often preventable with concentration on a “team approach” to making discharge more comprehensive, educating the patients and family and using all resources in the community. This comprehensive approach has also shown to reduce the patients stay in the hospital.
Obviously addressing these issues is not only good for Medicare but for the patients as well. We routinely get calls from frantic family members whose elderly relative is being released from a hospital and they have no idea what to do next. Typically the elder was independent before; now they may need a higher lever of care.
We appreciate the overwhelming burden discharge planners have and work with them and the family with regard to placement, public benefits and a myriad of issues a family has when an elderly loved one is discharged from a hospital. Putting the elder law attorney as part of the comprehensive team approach can reduce readmissions to hospitals, benefiting Medicare, the patient, their family and the hospital.
Our firm advocates for seniors and senior care, so we have made a significant investment in acquiring the best materials and resources that address the unique needs of these communities. We also offer a unique suite of resources to aide the Caregivers to Alzheimer’s patients. We are pleased to make these valuable resources available to you COMPLETELY FREE OF CHARGE. These materials represent the initial steps you need to take to provide the best possible care for yourself, your family members, clients, patients and friends. Sign up for one or all of these unique and valuable online resource centers:
and
www.southfloridamemorylawyer.com for caregivers to Alzheimer’s patients.
You may also visit our website any time for access to information on all of the areas of law we practice under “The Elder Law Umbrella” at www.florida-elderlaw.com or follow our blog: www.southfloridaelderlaw.blogspot.com
Tuesday, July 5, 2011
On days like this it’s hard to love the law.
A few months ago a colleague and I were chatting and I remarked to him that I love the law. An attorney as well, he remarked that he never had the love of the law that so many attorneys have.
When a decision like the one in the Casey Anthony trial comes down, my immediate reaction is not to love the law; in fact it’s to agree with the bloggers that our system of justice is dead.
But it is not. Thomas Friedman once said, “If only America could be China
For our criminal justice system to work we must accept less efficiency and unjust verdicts. It’s the price we pay for the personal freedoms that come with being an American.
So, yes, I still love the law. On days like today (or when OJ was acquitted), I remind myself that we all win when Casey Anthony is acquitted. It just doesn’t feel like it.
There Are Other Veteran's Benefits
Aid and Attendance offers up to nearly $2000 per month to a veteran who has long term care needs and costs associated with this care. A surviving spouse can be entitled to a benefit of up to approximately $1000. For more information on these useful benefits to which many qualified veteran’s and their surviving spouses may be eligible, visit our firm's website (or go directly to: http://www.florida-elderlaw.com/VABenefits.html.) Our firm also offers a FREE email series that provides further details. Sign up here: www.learnvabenefits.com/reiterfeld.
In our practice we see a great percentage of our clients seek assistance in procuring Aid and Attendance benefits. There are, however, other VA benefits available. Below is a clipping from an article that I came across recently offering interesting insight into this subject:
THE VA HEALTH CARE SYSTEM operates the largest health care system in the United States
A veteran should attempt to enroll in the system despite the fact that the veteran has been told that s/he is not eligible or that there is a long waiting list. The system can be inconsistent and I have had many clients receive benefits such as prescription drugs for which they otherwise would have had to pay. Veterans who have a service connected disability in excess of 50% receive priority in enrollment. Additionally, veterans who receive increased pension based on their need for aid and attendance or are housebound also receive a higher priority and are entitled to receive free medication from a VA pharmacy even if they are not otherwise receiving medical care.
The VA medical benefits package includes prescription drugs and medical exams. Since veterans with a higher percentage of disability have a higher priority, the veteran should consider filing for an increased rating. While the amount of money received on a monthly basis will increase minimally, the health care benefits can be enormous.
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