Medicaid Myths

Is it true you can give $10,000 to each child without penalty? Can't you just put your kids' names on your accounts? Is it true there's an annuity that allows you to "flip the switch" and solve all your payment problems?

The answers? NO! NO! NO! The $10,000 is now $13,000... and it's an IRS rule, not a Medicaid rule. Putting your children's names on your accounts protects none of the money. Annuities? The laws have changed - and there is no magic switch.

Often, out of sheer frustration, retirees tell me they're going to solve the problem of qualifying for Medicaid by just giving it all to their kids. But that opens up the possibility of your kids' problems - with their spouses, for example - impacting your money. My golden rule has always been, don't give to your son or daughter what you wouldn't give to your son - or daughter-in-law.

In addition, most retirees have no idea about the tax implications. For instance, transferring a house to a child changes the property tax classification to non-owner-occupied - and property taxes will go up.

To qualify for Medicaid, you do have to spend down. Each state has different rules; but, generally, you're allowed to keep around $2,000.

The only exempt assets are:

• Home (equity up to $500,000) if "intent to return" is established
• Personal belongings, household goods
• One car or truck
• Burial spaces and certain related items for applicant and spouse
• Irrevocable pre-paid funeral contract
• Up to $1,500 of face value life insurance; if the face value exceeds $1,500, the cash value is considered a means of payment

All other assets are generally non-exempt - any item that can be turned into cash is a countable asset.

Non-exempt items would include:

• Cash, savings and checking accounts
• Credit union share and draft accounts
• Certificates of deposit
• U.S. Savings Bonds
• IRAs, 401(k), Keogh plans, 403(b) and all other defined compensation plans
• Pre-paid funeral contracts that can be canceled
• Trusts (depending on the terms and conditions of the trust)
• Real estate (other than primary residence)
• More than one car
• Boat or recreational vehicles
• Stocks, bonds and mutual funds
• Land contracts or mortgages held on real estate sold

Sound confusing? Well, it is!

The Elder Law Journey can be a very complex one - especially Medicaid. And no one should try to navigate this road alone. It's too easy to crash and burn.

We can help. At The Law Offices of Alice Reiter Feld & Associates, we practice Elder Law - and only Elder Law. We've been doing it for 33 years. And we've walked thousands of South Florida families through the Medicaid Maze... along with providing them with comprehensive estate planning, wills, trusts, powers of attorney, long-term care planning, asset protection programs, and assistance with the VA.

We know the way. And we'll get you through.

We're just a phone call away.

Medicare Vs. Medicaid

The words may sound similar... but the meanings are very different.

Medicare is a public health insurance program for people 65 and older, and it takes the place of the private coverage you've had previously. However, Medicare does not pay for long-term care - and, unfortunately, many seniors are not aware of this. And a lot of bad decisions are made based upon this ignorance.

Unless you're an Elder Law attorney, the regulations regarding Medicare (and especially Medicaid) can definitely seem like "all Greek" to you! Adding to the confusion is the fact that Medicare does pay for rehabilitation - up to a hundred days of it, anyway. However, if you don't show signs of improvement during that hundred days, Medicare will determine that you need long-term care. And your funding will stop.

Then there's the small print; you'll pay a deductible of about $120 per day.

Medicare coverage, really, is based on the probability of rehabilitation. Of course, diseases such as Alzheimer's have no possibility of rehabilitation at this time. So, if you're diagnosed with it, Medicare assistance will come to an abrupt halt.

Medicaid, on the other hand, is funded by both federal and state governments, but administered by the latter. As a result, eligibility rules can vary dramatically among states.

Medicaid is designed to pay for long term nursing-home care, and, occasionally, home-care. Because of the onerous application process, though, if you're diagnosed with diseases like Alzheimer's or Parkinson's, your family might have to pay until coverage kicks in.

Here are the main points of each program

MEDICARE

• Health insurance if you're 65 or older
• Federal program, standard requirements
• Pays maximum of 100 days nursing-home care
• Pays for primary hospital care, medically-necessary services
• You must have contributed to the Medicare system to be eligible

MEDICAID

• Needs-based program
• Administered by states; widely-varying eligibility requirements
• Covers long-term care
• Covers medications
• Strict income and asset requirements; must be 65 or over, disabled, or blind

As in pretty much everything else related to Elder Law, the devil's in the details. And what you don't know can cost you every cent you've got.

But we can help.

At The Law Offices of Alice Reiter Feld & Associates, we're Elder Law attorneys... and we've been helping South Florida families deal with the Medicare/Medicaid maze for 33 years. We've guided thousands of them through it successfully... in addition to providing comprehensive estate planning, wills, trusts, powers of attorney, long-term-care plans, asset protection programs, and assistance with the VA.

We're just a phone call away.

Should I Wipe Out My Family's Assets? In Order To Pay For Nursing Home Expenses?

As an Elder Law attorney, I get asked this question all the time. Often, the "asker" is someone who thinks it's necessary to spend down their assets. And, often, if they haven't come to me in time, they're forced to live the rest of their life in poverty.


The truth is that it is possible to get benefits without spending down... but only if you know the right away.

The wrong decision can result in disaster for you and your family... which is why you should check with an Elder Law attorney before making any decision!

There are actually three ways to pay for care...

PRIVATE PAY: Pretty simple - you use your own funds. You might draw from retirement-income (pensions, Social Security); retirement savings (IRA, bank accounts); or from stocks, bonds, mutual funds, etc.

LONG-TERM CARE INSURANCE: - If you've got $200-$300 a day to make the payments - especially if you start while you're relatively young - this makes sense. Tragically, though, most seniors don't have long term care insurance. And if you're diagnosed with Alzheimer's or dementia, don't bother applying.

MEDICAID: This is a program funded jointly by the Federal Government and the state, created specifically for seniors. You'll have to pass strict asset and income requirements. And to make sure you will, you should consult with a person who knows those guidelines better than anyone else - an Elder Law attorney.

At The Law Offices of Alice Reiter Feld & Associates, we practice Elder Law - and only Elder Law. We've been practicing it, in fact, for 33 years. And we've helped thousands of South Florida families qualify for Medicaid and other government benefits... in addition to assisting them with estate planning, wills, trusts, powers of attorney, long-term care planning, and asset protection.

We know the Medicaid rules. And we're just a phone call away.

Mike Wallace Had Dementia

Mike Wallace was a man who suffered no fools or liars. And a man whose raised eyebrow and disbelieving "come onnnnn..." could turn even the toughest interviewee into an incoherent pile of mush.

Mike Wallace suffered from dementia at the end of his life. And spent much of those last few years in a facility.

In a recent interview, FOX's Chris Wallace revealed that his Dad - who, like many of us, probably devoted far too much time to work at the expense of family - could no longer seem to remember his work. Only his family!

Being the well-prepared professional he was, it's probably safe to assume that Mike Wallace had been studious about his estate planning.

What about you? Are you preparing for your later years - and your eventual demise - as much as you should be? Are you comfortable that your family will be provided for, and that your wishes will be honored?

If you're a Baby Boomer, next time you're at a gathering of fellow Boomers, take a look around. One of every eight people in the room will eventually get Alzheimer's. And the "one" may be you.

If you do become mentally incapacitated, it's too late to make changes in your estate planning documents. And unless you've made other arrangements, your family may be subject to an expensive, embarrassing, and possibly acrimonious (among themselves) proceeding in the courts.

Do you have Powers of Attorney for both your healthcare and your financial/legal mattes? If so, are the agents you chose then still the ones you'd chose today? Have you named second agents for each area, in case your designated agent(s) is unable to do the job?


Do you have a living will/advance directive, so your family will know your end-of-life care choices?


Are your assets enough to require a living (revocable) trust to manage them if you can't?


Have you updated your will recently, to reflect your present circumstances and choices?


Are you completely confident that your assets are protected?

Have you provided for long-term care for yourself and your spouse? (Statistics say one or both of you will need it!)

At The Law Offices of Alice Reiter Feld & Associates, this is what we do... and only what we do. We're Elder Law attorneys. And for the past 33 years, we've walked thousands of South Florida families through the Elder Care Maze... with comprehensive estate planning, wills, trusts, powers of attorney, asset protection, long-term care planning, Alzheimer's/dementia assistance, and issues with the VA or Medicaid.

We'll walk you and your family through the maze... with professionalism, with compassion, and with a soft shoulder when you need it.

And we're just a phone call away.

How Can I Get My Father To Give Up His Car Keys?

If you have an aging loved one, sooner or later you're going to be pondering this question. It's a question all of us dread asking - and being asked - because it's a direct threat to the independence of any senior.


But - like it or not - there will come a time when it can't be put off any longer.

If your loved one has a trusting relationship with his physician, he may feel less threatened if the subject is brought up by the doctor rather than a caregiver. The physician can focus on the medical condition(s) affecting the ability to drive safely. Coming from an objective person, the advice may be a bit easier for the senior to listen to... and to hear. (Or, on the other hand... it may not!)

But, at the least, hearing it from a doctor rather than a caregiver may cut some of the emotion out of the equation.

You might want to speak with other caregivers who've been in the same position, to get a handle on how they did it. No two seniors, of course, will respond in the same way. So, what worked for one may not work for someone else. Nonetheless, it can't hurt to get a few different perspectives.

The Alzheimer's Association is a good source for information about how to approach this situation; local agencies such as your Area Agency on Aging may also be able to help. And if you're really desperate, you can purchase items to disable a car engine, from sites such as www.alzstore.com.

Getting your loved off the road can be a very daunting - and very depressing - task. But we can help.

At The Law Offices of Alice Reiter Feld & Associates, we've been helping South Florida families deal with situations like this for the past 33 years. In fact, we've asked about these situations every day - and we've helped thousands of families deal with them. we're Elder Law attorneys. We have one of the largest Alzheimer's/dementia libraries in South Florida. And we have answers to your questions.


From comprehensive estate planning, wills, trusts, and powers of attorney to asset protection, long-term care planning, and issues with the VA or Medicaid, we can help.

And we're just a phone call away.

My Husband Has Alzheimer's. How Can I Set Up Our Financial Affairs To Avoid Probate When We Die?

When someone who's written a will passes on, and he/she owns property in his or her own name, a court process known as probate is generally required to determine who will receive the property. Conversely, if someone dies intestate (without a will), a probate process is also required.

However, it is possible to legally avoid probate, and still pass your property on. Here are a few ways. (Keep in mind, though, that probate can actually be preferable in certain circumstances; only an Elder Law attorney can tell you for sure.)

JOINT TENANCY: Adding another person as joint owner - "joint tenant with rights to survivorship" - will negate the need for probate. The only problem? Even while you're still alive, the other "owner" has access to the assets... and those assets are not only subject to his claims, but those of his creditors, as well.


BENEFICIARY DESIGNATIONS: This allows you to add, for example, a Transfer On Death (TOD) beneficiary to your car, Pay on Death (POD) beneficiaries to your bank accounts; and Beneficiary Deeds to real estate (in certain states). Simply put, Beneficiary Designations allow you to name individuals to inherit your property when you die, without allowing them current ownership. Possible drawbacks? Sometimes the estate doesn't end up divided according to your wishes.


REVOCABLE LIVING TRUST: This document allows you to name someone (generally yourself) or a bank as "trustee." You can then transfer property into the trust, and manage/distribute it according to the terms in the trust. This mechanism affords you the opportunity to specify to whom your property should pass on your death... lessening the possibility of family conflict. And it affords you the opportunity, as well, to avoid some of the tax hits associated with joint titling and beneficiary designations.

LAST WILL AND TESTAMENT: Remember - If you've listed beneficiaries for your assets, and there's a conflict between those designations and your Will, those assets will be distributed to those beneficiaries on your death. They will not be subject to your Will!

INCOMPETENCY: This is when it's important to have an effective Power of Attorney. If you're incompetent to make decisions regarding your property or finances, a Power of Attorney will have already designated someone - of your choice - to make these decisions. Among these decisions are changing a trust, or adding a beneficiary. Keep in mind that your designee (agent) must act according to the wishes expressed in your Will.

SPOUSAL ELECTIVE SHARE: If you're married, you need to consider what your spouse is entitled to inherit from you by law, before titling/adding beneficiaries to your assets. A word of warning: If you or your spouse applies for Medicaid may nonetheless view that as a transfer of assets. And your spouse may not qualify for benefits.

Avoiding probate can be very tricky, very time-consuming, and - if you make the wrong moves - it can cost you everything you've worked for.

The best solution? An Elder Care attorney.

At The Law Offices of Alice Reiter Feld & Associates, we've been practicing Elder Law - and only Elder Law - for 33 years. That's the only thing we do. And we've helped thousands of South Florida families navigate the winding Elder Care Journey - from probate, estate planning, powers of attorney, wills, and trusts, to asset protection, long-term care planning, and Medicaid and the VA.

We've been here for 33 years... and we'll be here for you. We're only a phone call away.

Help! My Loved One Has Legal And Financial Issues... But No Estate Planning Documents!

The bad news is that your loved one - and you - are in a very leaky boat. The good news, though, is that your boat isn't the "Titanic." There is something you can do (if you don't wait too long)!


You can call an Elder Law attorney. An attorney who practices Elder Law - and only Elder Law - will be familiar with all these issues facing you and your loved one. And she'll have an arsenal of options at her disposal... options you probably would never have imagined otherwise.

An Elder Law attorney can prepare healthcare and financial powers of attorney customized for your loved one, according to his wishes and his needs. A power of attorney, however, is just one way the attorney can help. An Elder Law attorney can also advise you on how to create a comprehensive estate plan that will protect your loved one (and his/her life savings!)... on wills, trusts, long-term care planning, asset preservation, and possible issues with Medicaid or the VA.

Again, an Elder Law attorney will have suggestions that can help ensure your loved one will never be out of time, out of money, and out of options. And which can help protect the family from having to make decisions under crisis conditions.

Your state bar association will have a list of Elder Law attorneys. And so will the National Academy of Elder Law attorneys; just go to www.naela.org and click on "Locate an Elder Law Attorney."

If you have a senior loved one whose financial affairs are not yet in order, don't wait. If they eventually lose their ability to make decisions regarding their own affairs, you'll find yourself in court... and decisions about your loved one will be made by an impersonal legal system.

At The Law Offices of Alice Reiter Feld & Associates, we've been practicing Elder Law - and only Elder Law - for 33 years. And we've walked thousands of South Florida families through the Elder Care Journey, with comprehensive estate planning, powers of attorney, wills, trusts, long-term care planning, asset protection, and assistance with the VA or Medicaid.

It's never too late. And we're just a phone call away.

What, Exactly, Is Hospice? And When Do I Call Them?

"Hospice" sounds like "hospital." But the resemblance ends there! Hospice serves only terminally-ill patients and their families. And it does so with warmth and compassion.

This organization provides a holistic approach to pain management, through emotional and spiritual care as much as physical. It provides a soft, warm atmosphere in which the patient can spend his/her final days. And it can even bring that atmosphere to the patient's home or long-term care facility. (In fact, some long-term care facilities have their own hospice programs.) There's no attempt at a cure. Instead, there's a focus on pain-relief... and at affording the patient the chance to die with dignity.

When your loved one's physician determines that he/she has six months or less to live, he may call in hospice. At this point, the "cure" protocol stops. The hospice team (generally consisting of a chaplain, certified nursing assistants, a doctor, registered nurse, and social worker) then creates a palliative care plan, coordinating with the personal physician on an ongoing basis.

The services of many hospice agencies continue even beyond death, with grief counseling on both individual and group levels. At the end of this counseling, many participants are ready to start "living" again.

If you'd like your loved one to die with dignity - and to leave the decision up to her instead of doctors - then you should consider hospice when the time comes.

This will certainly be one of the most difficult times of your life. But you don't have to go through it alone. At The Law Offices of Alice Reiter Feld & Associates, we have the resources to show you the way. We can help you when your loved one reaches the end-of-life stage - just as we can help you long before that, with estate planning, wills, trusts, powers of attorney, asset protection, long-term care planning, and issues with the VA or Medicaid. Over the past 33 years, we've helped thousands of South Florida families navigate the "Elder Care Maze." And we've done it with professionalism, compassion, and, when necessary, a soft shoulder.

You don't have to navigate the Elder Care Maze alone. We're just a phone call away.

What's The Difference Between A Power of Attorney And A Guardianship?

Here are a few definitions that you really need to know.

Power of Attorney: This is a legal document in which you (the principal) designate someone (your agent) to act on your behalf if you're no longer able to, for healthcare and financial decisions.

Guardianship: In this scenario - which usually happens if you don't have a Power of Attorney - the court designates a person (the guardian) to make these decisions for you (the ward). It's usually initiated by a family member or friend, who files a petition. After that, you'll be examined by a physician, and a court will determine whether you're able to make decisions regarding your health and/or property. If the court decides you're not, they'll appoint a guardian to make these decisions for you.

Conservatorship: This takes place when a court gives someone (the conservator) the power to make financial decisions for you (the protectee). The proceedings and relationships are similar to a guardianship; however, a conservatorship applies to financial affairs only. Sometimes, the court will appoint one person to be both guardian and conservator. Each designee is required to report to the court annually.

Given the choice, which one would you pick? Pretty simple question, isn't it? I'd pick the option of creating my own Power of Attorney - in an instant!

Powers of Attorney for healthcare and financial decisions are not only relatively inexpensive (especially compared to a court case!), but also relatively simple. And they give you the power to decide for yourself who should manage your affairs if you can't.

Without a Power of Attorney, you - and your family - will be dragged through an unfriendly, impersonal, and very expensive court process. In addition, the court may appoint a person who you would not have appointed.

At The Law Offices of Alice Reiter Feld & Associates, we've been helping people create personalized Powers of Attorney - along with estate plans, wills, trusts, long-term care plans, asset preservation, and planning for the VA or Medicaid - for the past 33 years. And we've helped thousands of South Floridians protect themselves and their families.


We're just a phone call away.

What's A Durable Power of Attorney For Property/Financial Decisions? And Do I Need An Attorney To Draft It?

A Durable Power of Attorney for financial and property decisions is a legal tool in which you authorize another person (your agent) to act on your behalf if you're no longer able to make financial decisions. It affords you the opportunity to safeguard your finances and your property!

In the arsenal of estate planning weapons, Powers of Attorney may be the single most important one. If you can no longer speak or act for yourself, they allow a trusted family member of friend to do it f or you...according to your wishes. Without this document, your family may have to go through the trauma of court proceedings...and, even worse, a court-supervised guardianship and/or conservatorship.

Technically, you don't need an attorney to draft the powers of attorney. However, without certain specific wording, your document may not provide your agent with the powers to carry out your wishes. And the time and energy you'll have invested in drawing it up will be wasted.

Some people buy a 'powers of attorney' form online or from an office supply store. But this type of document may not address some important issues. In fact, the law states that your agent cannot handle certain matters without specific wording granting him those powers - among them making gifts, and removing or adding assets to a trust. And these won't appear in a "form" document.

This is especially a big problem in Florida where the Durable Power of Attorney rules completely changed in October, 2011. We are recommending that all our clients update these very important documents. And it must be done by an attorney familiar with the new laws.

Powers of Attorney can be especially critical if a loved one has Alzheimer's or dementia. That's why you should have this document done now...before it's too late. Because once it is, your family will be put through the wringer!

At The Law Offices of Alice Reiter Feld & Associates, we've been helping families avoid that fate for 33 years. In fact, we've helped thousands of South Florida families craft effective, iron-clad Powers of Attorney. And we've helped them, as well, with wills, trusts, comprehensive estate plans, long-term-care plans, asset protection plans, and assistance with the VA or Medicaid. That's what we do - we're Elder Law attorneys.

Your family doesn't have to be put through the wringer. We're only a phone call away.

What's An Advanced Directive?

If you're a senior - or have a loved one who's a senior - you've probably heard the term. Many of us, though, don't really understand what it means.

An Advance Directive allows you to designate someone to make health care choices for you, after you're no longer able to make them for yourself. However, you've got to designate this person before this happens.

These documents can include items such as power of attorney for health care decisions, living wills, and more-informal directives that might be expressed in letters, conversations, and even your conduct.

Simply put, your Advance Directive is a document that will ensure your wishes are being followed! It affords you the opportunity to state, ahead of time, whether you'd like to receive life-prolonging procedures or donate organs, for example, and, if not, the person who should express your wishes to medical staff.

There should be no surprises for the people involved, though! You've go to discuss your wishes with them ahead of time. And "the people involved" include your family, friends, and health care providers.

The most-frequently used directive in this document is the Power of Attorney for Health Care Decisions. This allows you to actually appoint someone to make decisions for you. And it doesn't take effect until you're no longer able to make - or communicate - these decisions yourself. (In case of changing family circumstances, however, your document can be revoked and re-written.)

An Advance Directive won't do you much good, though, if it's locked away in a file cabinet where no one can find it! You need to give copies to your physician(s), family, friends, clergy, and attorney. Ask your doctor to enter it in her records. And when you go to the hospital..."don't leave home without it!"

Although valid in every state, it's a good idea to have this document witnessed and notarized.

At The Law Offices of Alice Reiter Feld & Associates, we've done thousands of Advance Directives over the past 33 years. And we've helped thousands of South Florida families with comprehensive estate planning, wills, trusts, powers of attorney, asset protection, long-term care planning, and assistance with Medicaid or the VA. We don't just "specialize" in Elder Law...Elder Law is the only thing we do!


And we're just a phone call away.

My Father's Applying For Medicaid To Pay For A Nursing Home

In 2005, eligibility requirements for Medicaid were changed for couples in which one spouse required a nursing home. Basically, the law is focused on avoiding impoverishment for both spouses when only one of them needs to qualify for Medicaid assistance.

Exempt assets are usually considered the home, household and personal belongings, one vehicle, burial plots and irrevocable funeral plans, cash value of life insurance (up to $1,500), and a certain amount of cash.

The non-exempt are added up and the spouse in the community can keep approximately $113,000.


Florida also sets a monthly minimum level for the healthy spouse, called the Minimum Monthly Maintenance Needs Allowance (MMMNA). This allows a minimum monthly income varying from about $1,750 to $2,650.

If the healthy ("community") spouse doesn't earn at least $1,750, he/she is allowed to take enough income from the nursing home spouse to at least reach the minimum levels stipulated by the MMMNA. This helps the healthy spouse to avoid having to use up their savings.

Confusing? You bet! And that's not even the half of it! You pretty much need to be an Elder Law attorney to understand all the rules and regulations. And that's where we come in.

At The Law Offices of Alice Reiter Feld & Associates, we are Elder Law attorneys. That's all we do. We've been working with South Florida families on issues such as these - along with estate planning, wills, trusts, powers of attorney, asset preservation, long-term care planning, Medicaid and VA issues - for 33 years. And we've helped thousands of them make the decisions that are best for their loved ones, and best for their families.


This process doesn't have to be overwhelming, if you have a partner that knows the ropes. We know the ropes. And we're just a phone call away. 

Can A Nursing Home Kick My Mother Out When She Runs Out Of Money?

What son or daughter hasn't worried about their loved one running out of money while in a nursing home...particularly if their loved one has Alzheimer's? If you have a senior parent with mental health issues who's in a nursing home, and you haven't thought about it...you're a very lucky person!

If your loved one does run out of money in this situation, it can create a crisis situation - for you. And that's why this is an issue that should be resolved before your parent enters a nursing home. You need to ask this question - "What if my mother/father runs out of money?" - before you pick a center. (And if you don't need to ask the question...again, you're a very lucky person!)

Most nursing homes in South Florida accept Medicaid. But Assisted Living Facilities are not funded by Medicaid. So you have to check this out. You don't want to have to move your loved one to a second home if possible.

It would be a very stressful experience for the whole family, as well. And that's why it's important for your family to have an experienced guide lead the way.

At The Law Offices of Alice Reiter Feld & Associates, we've been guiding South Florida families through this process for 33 years. And we've helped thousands of them...not only with nursing home issues, but also with estate planning, wills, trusts, powers of attorney, asset protection, long-term care planning, Medicaid, and the VA.

We practice Elder Law - and only Elder Law. And we can be your guide through the long and winding road of the Elder Care Journey.

We're here when you need us. And we're just a phone call away.

Could My Loved One Actually Be Happier In A Nursing Home Than At Home?

Sounds like a dumb question, doesn't it? But you'd be surprised at the answer!

The fact is that many seniors with declining physical and cognitive abilities actually do feel happier in a nursing home.

In nursing home environments, seniors may feel less insecure about their decreasing abilities...and more secure about their opportunities to socialize. In nursing homes, dining rooms are not just for dining; they're often the center of social life, where seniors can mix and mingle and feel comfortable. In fact, many seniors who were not very "social" in their earlier lives become social butterflies at nursing homes!

Some seniors with declining abilities are actually bored at home...often because the rest of the family is frantically going about their daily activities. In a nursing home, though, daily activities revolve around the seniors. In a good nursing home, group activities are frequent and fun. And, since they'll have full use of any of the facility's amenities and services, seniors won't lack for individual pursuits, either; there'll be plenty of games, puzzles, newspapers, magazines, CD's, DVD's etc.

Residents are monitored all day, and there's a nurse on premises. Medications are given by the staff, so the senior (or his/her loved ones) never have to worry about missing a dose.

Many seniors at nursing homes, because they're less dependent on family, actually feel a renewed sense of independence...a very important thing to a senior. Seniors no longer have that nagging feeling of being a burden to their families.

You may be sad about sending your loved one to a nursing home. But they might not be!


When it's time to think about nursing homes - or estate planning, wills, trusts, powers of attorney, asset protection, Alzheimer's/dementia assistance, long-term care options, or Medicaid or VA assistance - we can help. At The Law Offices of Alice Reiter Feld & Associates, we've been helping South Florida families for 33 years. We're Elder Law attorneys...and we know the ropes of the Elder Care Journey.

We've helped thousands of South Florida families on this journey. We can help you, too. And we're just a phone call away.

How Do I Choose The Right Assisted Living Facility Or Nursing Home For My Loved One?

If your loved one needs more care than you can give, this is a difficult time - especially if Alzheimer's or dementia is involved. It may be time to find a good assisted living or nursing facility.

The places to start your research are your local Alzheimer's Resource Center, Area Agency on Aging, and Alzheimer's Association. And the time to start is before you need help...not under the pressure of a crisis situation.

Take notes when you visit, so you can compare who said what, at which place. Bring someone with you who can be objective. Visit at different times of the day.

Is the place pleasant and inviting? Does the staff interact with patients? Are they responsive to patients' needs? Is the facility spotless (inside and out)? Look. Listen. Touch. And smell. Are there secure outdoor areas for the residents? Do they have an open-door policy? Ask to see the most recent state report on the center. And make certain any deficiencies have been corrected.

You'd ask for references when hiring a contractor, right? So do the same here - get contact information for at least three families with residents at the facility. (And call them!) In addition, ask around the community.

Find a center nearby; you don't want to travel an hour or two - especially in case of emergency.

If your loved one has Alzheimer's, there may be waiting lists at the better centers. Put your name down. If  you're not ready when they call, don't worry - they'll keep your name on the list.

Perhaps the most important thing you can do at this uncertain time, though, is to get assistance from people who know the ropes.

At The Law Offices of Alice Reiter Feld & Associates, we've been climbing these ropes with South Florida families for 33 years. And we've helped thousands of them.


We practice Elder Law - and only Elder Law. Whether it's navigating the Elder Care maze for a loved one with Alzheimer's, or securing their (or your) future with estate planning, wills, trusts, powers of attorney, long-term care planning, or assistance with Medicaid or the VA - we can help.

And we're only a phone call away.

When Is It Time For Nursing Home Placement?

If you have an aging loved one, it's a question you've probably been dreading. And if you have an aging loved one whose mental health is failing, it's a question you may have to ask - and answer - now.

It's generally best to keep the senior at home as long as possible. But there often comes a time - either because of the senior's declining condition or the caregiver's declining ability to provide continued care - when a nursing home is the obvious answer.

When a senior becomes incontinent, it may be time. It might be time when feeding becomes too difficult. Or when the senior starts to wander. Unwarranted bursts of anger - or even violence - are an indication that it may be time. If your loved one can no longer recognize family members, it may be time. And if the role of caregiver puts too much strain on the caregiver's own health, it may be time.

On the other hand, though, you may find that your tolerance-threshold is higher than you thought. In fact, if the caregiver has a strong enough support system, the loved one may be able to remain at home indefinitely...or even permanently.

However, if 24/7 caregiving is affecting your own physical and emotional health, it may not be the best decision. Often, caregivers are too close to the situation - and devoting too much of themselves - to see the effects on themselves. But if your family expresses concerns, you should listen. It's not helping your loved one if you're endangering your own health!

At The Law Offices of Alice Reiter Feld & Associates, we see families frightened by Alzheimer's diagnoses every day. Over the past 33 years, in fact, we've seen thousands of them. It's the start of a long, lonely road for many South Florida families. But not the ones who come to us.

We'll guide you down that long, hard road. With answers to your questions. With plans for any contingency. With the expertise to safeguard your loved one's rights. With support for the caregiver as well as the senior. And with a soft shoulder, when you need it.

Give us a call. We'll get you down that long, hard road.

When Should I Start Looking At Nursing Homes?

Deciding when to put your father or mother into a nursing home is one of the most difficult decisions you'll ever have to make. And, if you're like many people, you'll probably try to put it off as long as possible (ditto for the conversation you'll have to have with your parent about it).

There will come a time, though, when you won't be able to put it off any longer. You'll know.

"When it's time," however, is not when you should begin planning. You should begin planning well in advance.

Give yourself a little time to get more comfortable with the idea. But only a little time - because these are the sorts of decisions you don't want to have to make under pressure, or in a crisis situation.

A good Elder Law firm will have a list of local nursing homes. So will your local Alzheimer's Association, Area Agency on Aging, Department on Aging, or your state's facility regulatory department. Most likely, these organizations will also have a list of those nursing homes with a dementia care unit.

Naturally, you'll want to visit a few. And you'll want to visit with a friend - not a family member - because they can be more objective, and can notice things you may not.

One thing you should ask a nursing home - even before your loved one actually needs it - is whether they offer respite care for short-term stays. This will afford you time to take a vacation or a break (as well as time to get sick). In addition, this will allow you to be prepared for sudden emergencies...say, if you need surgery.

If you're a caregiver to an aging parent, you're entering a very stressful, and often confusing, period of your life. But we can help.

We're The Law Offices of Alice Reiter Feld & Associates. And we've helped thousands of South Florida families over the past 33 years - not only with answers to their questions about nursing homes, but also wills, trusts, power of attorney, comprehensive estate planning, long-term care planning, asset protection, Medicaid, and the VA.

We can be your guide through the Elder Care maze.

How Do I Choose The Right Adult Day Care Center For My Loved One?

It's a difficult decision. But there are steps you can take to make sure that you - and your loved one - will feel comfortable.

Your local Area Agency on Aging has a listing of the day care centers in your area. If your loved one has Alzheimer's or dementia, be sure to ask if the staff is trained to work with such people.

Once you've picked out a few centers, make an unannounced visit, and ask for a tour. Take a good look at the seniors - do they appear content? Are they involved in engaging activities, and engaging with each other? Or are they just sitting and staring at TV's? Is the staff professional and involved? Are they encouraging the participants to be independent?

You'll probably need to show a medical history, a physical exam, and a current TB test or chest x-ray. If your loved one hasn't had a TB test within the past year, ask if the center will do it (and if there's a fee). Sit down with someone who can fully explain the admissions process, and the center's policies and procedures. And ask about fees... not only  how much, but when they're billed, and whether they're levied in cases of absence.

Make sure the center's license (if applicable) is current. Ask to see the results of their state inspection. And make certain that any deficiencies noted in the inspection have been corrected.

Ask about the staff/client ratio! For Alzheimer's patients, the ratio should be no higher than 8:1. Make sure you meet the director, and as many of the staff as you can.

Among the questions you should ask...

• How do you handle participants who wander?
• How many people are you licensed for?
• Your mission statement or philosophy?
• Staff turnover rate?
• Emergency procedures?
• How are meals prepared? Onsite? Offsite? What about special dietary requirements?
• Staff credentials? Is there a certified Nurse Aide?
• Describe a typical day.
• Is there a secure outdoor area where seniors can walk and socialize (particularly important for Alzheimer's patients!)?
• Is there a charge for late pick-up?
• Any rules regarding attendance?
• Tell me how I can be involved.
• Do you ever take them off-site, on field trips, etc.? If so, who provides the transportation?
• Is there a social worker on staff...someone who can assist with resources, financial assistance, discharge planning, counseling, etc.?

Finding a good center can seem overwhelming. But we can help!

At The Law Offices of Alice Reiter Feld & Associates, we've been guiding South Florida families through this process for 33 years. We know the right questions. And we know the right answers. In fact, we can walk you through the whole Elder Care journey - from wills, trusts, powers of attorney, and estate planning to asset preservation, long-term care planning, and issues with Medicaid or the VA.

And we're just a phone call away.

If You've Got An Old Estate Plan - Or No Estate Plan - It's Time To Act!

Let’s speak bluntly here: After you’re gone, it’s too late to create an Estate Plan. So if you’re approaching your senior years and you still don’t have one – or you have one that’s old – what, exactly, are you waiting for?

If you use a qualified Elder Law attorney to help you, it’s not a difficult process at all. And, to paraphrase that TV ad for a credit card – “Peace of mind? Priceless.”

Many people, unfortunately, put off creating an Estate Plan. (I often wonder if they know something the rest of us don’t…how much time they have left.) I end up seeing some of these people in my office a few years later…in crisis, overwhelmed, and nearly-broke from foolishly giving away their money in the hopes of qualifying for Medicaid.

The choice is up to you. Do you want to take the time now to make an Estate Plan that will protect you, your money, and your family? Or would you rather do it later, in a crisis situation?

We can provide guidance to you in areas such as these:

• Basic estate planning documents such as powers of attorney, wills, and trusts
• Basic analysis of any income tax, estate tax, and gift tax issues
• Care options available for both an ill senior and the spouse
• A review of Medicare and Medicaid as they apply to your particular circumstances
• A true understanding of the personal and family finances available to pay for care
• Analysis of financial suitability of any retained income tools
• Analysis of all the tools and planning options available to meet your specific needs
• A calculation of the actual dollar benefits and costs of any option discussed
• We can give you a good idea of whether you might qualify for veterans benefits
• Planning for long-term care
• Protecting and preserving assets

I’m Alice Reiter Feld. During the 33-year history of The Law Offices of Alice Reiter Feld & Associates, we’ve helped thousands of South Florida seniors build customized Estate Plans…to protect themselves, their families, and the money for which they’ve worked so hard.

You need an Estate Plan. And you need it before anything happens! All you need to do is pick up the phone. We’ll do the rest.  

Planning Your Estate: What To Bring To Your First Meeting

Even before you see us to start planning your estate…you’ve got homework to do!

Here’s a handy checklist for you…

ASSETS

• Pension or individual retirement account balances
• Bank account balances
• Certificates of deposit
• Value of stocks and mutual funds
• Value of U.S. Savings Bonds or other bonds
• Life insurance policies (face value, beneficiaries, cash value)
• Any other financial assets

INCOME

• Social Security and pensions, listed separately for each spouse
• If there’s a person with Alzheimer’s, any other income for that person
• Any other income for the spouse

LIABILITIES

• Credit card balances (list separately)
• Mortgage balance and monthly payment
• Vehicle loans
• Loans against insurance policies (list separately)
• Other liabilities

After you’ve got everything together, we’ll be able to create an estate plan customized for your needs (and wants!). During our first consultation, we’ll offer a possible plan of action, and we’ll detail what we can do to achieve that plan. Don’t be afraid to ask about our fees…how they’re calculated, if a retainer is required, etc.

Attorney fees are usually calculated in one of two ways, or a combination of both. The first is an hourly billing rate. The second is value billing, in which an attorney charges a flat fee for each specific service provided. Or, fees may be based on a mixture of both methods. For instance, she might charge a flat fee for specific services, but an hourly rate if you need a Medicaid appeal.

You should also ask if different rates apply for work being done by administrative staff.

At The Law Offices of Alice Reiter Feld & Associates, we believe one of the most important things we can do is LISTEN! We’ve been listening, in fact, to South Florida families for the past 33 years. By doing so, we’ve created customized estate plans – and wills, trusts, powers of attorney, long-term care planning, asset protection plans, and assistance with VA or Medicaid issues – for the individual circumstances of each client. This isn’t a one-size-fits-all solution.

We’ll help you reach you goal of never being out of money, and never being out of options. And we’re just a phone call away.  

Veteran's Benefits And The Medicaid Time Bomb

Many veterans are unaware of a benefit called Aid and Attendance, which helps pay for in-home care or nursing home care.

If you’re a veteran, however, you probably know about land mines. This provision, unfortunately, has a bunch. And to get this benefit, you have to know how to avoid them.

The Aid & Attendance program has been boosted by financial planners in recent years, who promote certain products in conjunction with long-term care facilities. On the surface, it sounds like a good deal for veterans. But it could turn out to be a nightmare. This is what I call the “Medicaid Time Bomb.”

Many seniors are advised by financial professionals to give away assets (generally to their children) and then have them placed in annuities, in order to qualify for VA benefits. However, what these seniors may not realize is that giving away assets may disqualify you for Medicaid…and cost you your life savings if you have to pay for long-term care.

Of course, the annuities could be cashed in, and then given back to the veteran. But cashing in annuities early can result in huge penalties – so you might not get enough money back to satisfy the Medicaid penalties. It truly is a ticking Medicaid time bomb.

Elder Law attorneys work for the best interests of the client tomorrow as well as today…not only with the VA and Medicaid, but also with estate planning, trusts, wills, powers of attorney, asset protection, and long-term care. We know that annuities can often be useful in VA and Medicaid planning…but only if used wisely. And only if used at the right time.

Want more information? Just give us a call. At the Law Offices of Alice Reiter Feld & Associates, Elder Law is all we do. Over the past 33 years, we’ve worked with thousands of South Florida veterans and their families, to help them make the choices that are right for them.

VA and Medicaid issues can be among the most complex in Elder Law. But that’s what we’re here for. We’ll get you through those minefields! 

Disabled Child? You Need A Special Needs Trust!

In our office, we frequently come across aging parents who are primary caregivers of a chronically-disabled child. And these parents live in dread – because they’re uncertain who’s going to care for their child once they’re gone.

Many seniors, in fact, are still caring for their disabled children while now requiring care themselves. In fact, in many cases, both parent and child have the same care-giver!

We’re talking about disabilities such as autism, cerebral palsy, hearing loss, mental retardation, vision impairment, muscular dystrophy, generic or chromosomal disorders, Down’s syndrome, or mental illness. Some attorneys will recommend that parents leave everything to a different child, and name that child the caregiver. But that often leads to an unfair burden on the new caregiver…and problems with the rest of the family.

So how can parents be assured that once they’re in long-term care – or gone – their disabled child will still be cared for? I generally recommend a special needs trust, sometimes called a Tender Loving Care Trust. This is an irrevocable trust specifically for this purpose.

A special needs trust works in partnership with public benefits. But it can also provide benefits that public assistance wouldn’t…such as with pets, recreation, social activities, special therapies, entertainment, and vacations. And it can be used to purchase professional care management to enhance the quality of life of the disabled child.

Elder Law attorneys are the ones who can create such trusts. That’s what they do - along with wills, living wills, comprehensive estate plans, powers of attorney, long-term care plans, and assistance with Medicaid and the VA. They’re the ones who best know the (constantly-changing) laws affecting seniors and their families. A good Elder Law attorney can create a trust that will give you peace of mind about your child – while also helping you get any benefits to which you’re entitled for your own care!

At the Law Offices of Alice Reiter Feld & Associates, we’ve been creating these trusts for 33 years. And we’ve helped thousands of South Florida parents find peace of mind. Elder Law is what we do. And it’s the only thing we do.

If you have a disabled child, we can show you the way. And we’re just a phone call away.

Child-Proofing Your Estate: The Love And Protection Trust

We’re not talking about kids here. We’re talking about adults. Adult children who may have destructive habits, such as alcohol- or drug addiction or gambling. It could even be a mental health issue. Quite often, parents want to provide for their children after they’re gone…but don’t want to provide money to fuel the fire that’s’ consuming their child. And, often, they come to me for advice.

The answer is what I call the Lifetime Love and Protection Trust (LPT).

A Love and Protection Trust is a legal tool, based on your written instructions, that can protect an adult child who may not manage his/her money wisely. Financial professionals will manage the money, while a professional trustee will make the decisions necessary to protect both your child and your trust.

The LPT, basically, prevents an adult child from blowing the money you’ve left him. And it protects your estate from failed marriages, creditors, and others who may want a slice.

Because of past mistakes, some adult children are vulnerable to lawsuits. But an LPT can address this issue…as well as serve as a barrier to drug or alcohol abuse, by offering more involvement to your child if he/she can change his life. It can build a protective wall around your legacy…and provide for the special needs of your child.

A Love and Protection Trust will be there for your child after you can’t. And your legacy will give your child the chance to flourish if they choose to seek help. This type of trust can be a vital part of an estate plan that includes a will, long-term care planning, asset protection, and Medicaid/VA assistance.

It’s one of the greatest gifts you can leave a child who’s made some irresponsible choices. And it’s a gift for yourself, as well…the gift of knowing your estate will not be drained in an irresponsible manner.

At The Law Offices of Alice Reiter Feld & Associates, we’ve been doing these types of trusts for 33 years. And we’ve helped thousands of seniors feel more secure about their financial legacies…and more hopeful for their children. We’re Elder Law attorneys. And we know how to protect both your legacy and your children.

We can help you do both, too. Just give us a call.

Giving Stuff To Your Kids Could Leave You Broke, Sick, And On The Street!

Trust me – I’ve seen it happen.

I recently met with a couple in which the wife needed long-term care. They told me they had given financial help to their divorced daughter. When I told them their gifts were going to cause them severe penalties now that the wife needed care, they were devastated.

In fact, the Deficit Reduction Act of 2006 (DRA) has caused devastation for a lot of senior couples.

Imagine a healthy senior couple who had given $10,000 to a grandchild, say, for a semester overseas. Totally innocent, and very sweet, right? Well, the DRA doesn’t see it that way. They tend to believe that money is given away in order to qualify for Medicaid. So if either Grandma or Grandpa apply for Medicaid during the next five years, their Uncle Sam is going to ask why they gave money away. And if this not-so-kindly uncle sees that they’ve given away more than $500, he’ll figure out a penalty period during which they won’t be eligible for benefits.

The gift to their grandchild is attributed to both Grandma and Grandpa – no matter who actually signed the check. And their “crime” could be punishable as long as five years later!

I call this the “Medicaid time-bomb.” A gift that you gave out of love could come back to haunt you five years later. And, even though you may now need long-term care, and may not have the money to pay for it…that’s not the government’s problem. You’re on your own.

In this imaginary case, the gift was $10,000. The State of Florida figures long-term care costs as about $5,000 a month. So Medicaid will not pay benefits for the first two months.

The moral? Don’t even think about applying for Medicaid without seeing an Elder Law attorney who specializes in long-term care benefits and estate planning! At The Law Offices of Alice Reiter Feld & Associates, we’ve succeeded in reducing the penalty period for many of our clients – and, in some cases, even getting it dismissed.

Over the last 33 years, we’ve helped thousands of South Florida families ensure that their loved ones are not broke, sick, and on the street!

And we’re just a phone call away.

Was Mom Right About Medicare? Maybe. Maybe Not.

Medicare. Medicaid. Two words we’ll hear a lot as we age. Two words with different meanings. But many of us, unfortunately, have trouble understanding the difference.

In my Elder Law practice, I frequently run across people who think Medicare will “care” forever. Boy, are they in for a surprise.

One of those people, in fact, was my own mother, who, at the beginning of my law career, asked me why I was choosing Elder Law, because there couldn’t “be any kind of money to be made helping people with those issues.” She’s just about the brightest woman I know…but even she didn’t understand the difference. And even she, apparently, thought Medicare could take care of a senior indefinitely.

Not so! Medicare is meant for the over-65, disabled, or blind. Medicaid provides benefits for the poor. Medicare is pubic health insurance for those over 65. But many of those over 65 don’t realize that it doesn’t cover long-term care. It does pay for rehabilitation – but only up to 100 days. And if the patient isn’t responding well before then, they can kick you out – and into long-term care – before the hundred days!

Medicare only really works if you can get better. If you can’t – and, of course, people with diseases like Alzheimer’s or Parkinson’s can’t – Medicare won’t provide nursing home coverage. You’d have to apply for Medicaid, or pay out of your own pocket. The rules for applying for Medicaid are complicated to begin with. But, since they vary from state to state, and, often, county to county…good luck understanding them!

At this point, it’s time to get an Elder Law attorney on your side. At The Law Offices of Alice Reiter Feld & Associates, we know that the time to start planning for situations like this is before they happen. And we know that the only solution is to have an effective, comprehensive estate plan in place…not only a will, but also power of attorney, trusts (if necessary,) surviving-spouse protection, asset protection, long-term care planning, and Medicaid and VA assistance.

I’ve been an Elder Law attorney for 33 years. And during that time, we’ve guided thousands of South Florida families through the Medicare/Medicaid/Elder Care maze. With professionalism. And with compassion.

Give us a call. We know the way.  

Where Are You In The Elder Care Journey?

This is one journey where the ending is certain you’re going to die. Furthermore, the odds are more than 50% that, if your passing doesn’t come before the age of 65, you’re going to spend a long time in a long-term care facility.

If you’re lucky, your passing will be quick and painless. But if you’re not, it could be slower and tougher, and you’ll need to be in a nursing home, at great cost to your family.

The second-worst thing about a longer death – after the longer death itself - is that our healthcare system wasn’t designed for that eventuality. You’re pretty much on your own. And you’ve got to use up pretty much all your assets before our government will help.

I refer to the aging path as “the Elder Care Journey.” Many of us moved to Florida to start our early retirement years as healthy, vigorous seniors. Once we start having mobility or memory issues, we become (in my parlance) “declining seniors.” And it’s worth noting that 90% of declining seniors will need substantial in-home or nursing-home care.

In my opinion, we don’t spend enough time thinking about – or providing for – the surviving spouse. This spouse will lose one of the two Social Security checks, of course. She may also lose some – or all – of the deceased spouse’s pension.

I see it all the time. While focusing on the needy senior, families sometimes lose sight of the fact that the surviving spouse might live many more years…but with financial resources that have been drained by the ill one’s needs.

There are options, though…if you have an attorney who knows where to look. If you’ve put together a thorough estate plan – not only a will, but also power of attorney, a trust if necessary, long-term care planning, asset protection – there are ways to protect yourself, and your loved ones.

At The Law Offices of Alice Reiter Feld & Associates, we know where to look. We’re Elder Law attorneys…and only Elder Law attorneys. We’ve been doing this for 33 years. And, during that time, we’ve helped thousands of South Florida families provide for their loved ones who are surviving spouses.

All you have to do is pick up the phone. We’ll do the rest.

Do You Need An Irrevocable Protection Trust?

At first glance, this trust looks pretty much like the one I wrote about in our last blog – the irrevocable trust. But it’s not. In fact, just to highlight the difference, let’s call this one a “Medicaid Retained Income Trust.”

So, you may be asking, “What is the difference? And what the heck does ‘Medicaid Retained Income’ mean, anyway?”

It means you can – despite the “irrevocable” - transfer some of your assets into this trust. Of course, “irrevocable” means you can’t get it back again. But this “irrevocable” trust has sort of a back door. In reality, this type of trust can give you back some of the assets you put into it (shhh!), such as income from rental properties or bond funds…so you can have the money you may need later on. But the nice thing about is that this back-door is not open to your creditors or Medicaid; they can’t get in! The assets in this type of trust are off-limits to them.

Most of the people who come to see me are people who’ve done right by their communities and by their families. They’ve worked hard, planned well, raised their kids, and their homes are paid off. They just want to be reassured that some of their assets will be available when they need them – for them only! And that’s where the Retained Income Trust comes in. It’s a hybrid between an irrevocable trust and a revocable trust. And it allows you the flexibility either one by itself might not.

In fact, there are a number of more-flexible types of trusts that are helping our clients, because they can be tailored to a variety of situations. And if you don’t at least look into them…you may be at risk for losing everything you’ve worked for.

But you don’t have to be at risk! And you don’t have to be confused.

At the Law Offices of Alice Reiter Feld & Associates, we’ve been minimizing risks for South Florida families for 33 years. We practice Elder Law – and only Elder Law. And we’ve designed pretty much every type of trust you can imagine for our families…along with other estate planning tools such as wills and asset protection, and assistance with long-term care planning, Medicaid, and the VA.

Give us a call. We can help protect you, too.