So often, when working with families who are struggling to care for a loved one with dementia or Alzheimer's, the most frustrating aspect is the uncertainty of their loved one's condition from day to day. The recent case of Verne G. from Minnesota highlights these uncertainties very clearly.
Verne was a prominent professional wrestler in the American Wrestling Association (AWA) 1960's and 1970's, and later became a wrestling promoter. The AWA eventually lost all its big starts, such as Hulk Hogan and Jesse Ventura, to the World Wrestling Federation. Verne is now 82 and suffers from Alzheimer's disease. 
He lives in a nursing home where he had an altercation with a 97 year old patient. Verne put the 97 year old man in a wrestling hold and slammed him to the ground, breaking the man's hip. The man Verne slammed to the ground eventually died a few weeks later. The police investigated the incident, but there was a consensus of opinion that Verne should not be charged with a crime because he didnt know what he was doing.
Verne's story is tragic, but it is all to familar to stories that many families dealing with Dementia or Alzheimer's. It is the uncertain, sometime violent and erratic, behavior that can be most frustrating and frightening.
Although no one can be sure what caused Verne to act the way he did, we do know that Alzheimer's patients very often lose their short-term memory but are able to conjure memories of events and people from 40 or 50 years ago. Verne's skill as a wrestler made him more dangerous than the average resident. He was more physically fit than most of the other residents and while Verne was losing he short-term memory he was able to recall his days wrestling. Perhaps it was those memories, programmed into his brain, that caused Verne to perform a wrestling move on his roommate.
It is this type of unpredictability that can turn a family's world upside down. Dad can be living comfortably in a nursing home one day and become extremely aggitated and aggressive, causing the facility to ask the family to move him because they cannot accomodate his needs or because they are concerned for the safety of the other residents.
Families simply cannot sit back, wait, and react to a loved one's long-term care needs. Whenever possible, preventative measures need to be taken. So often, we see families plan as if Mom or Dad's current condition, while tragic and upsetting, will remain static and unchanged. That is just not the case, and misjudging the situation can be worse than anyone imagined.
Seeing families go through this time and again is why we have made the Complete Alzheimer's Resource Kit available for free online. The helpful guides and reports included will help families and caretakers learn what to expect when a loved one has Alzheimer's or other for of dementia. To order your free copy of the Complete Alzheimer's Resource Kit, a $200 value, go to www.BostonMemoryLawyer.com. We also encourage anyone who has a loved one with long-term care needs to register to attend one of our Free, Educational Workshops hosted in Wellesley, Massachusetts by registering online or by calling (800)-964-4295. Upcoming Dates Include:
Thursday March 1 @ 10 a.m. & 2 p.m.
Thursday March 15 @ 10 a.m. & 2 p.m.
Navigating through the long term care system usually requires a team of advisors. Although the attorney is, no doubt, a pivotal person, the accountant, financial advisor, and insurance specialist are equally important. And when one piece isn’t properly in place, it can be catastrophic.
Mrs. Jones' story is illustrative. Mr. & Mrs. Jones decided to sell the home in which they raised their four children. They invested the money in annuities and decided to rent and live on the income from their investments and Social Security. Mr. Jones, however, had already exhibited some signs of Alzheimer's.
After the sale of their home, Mr. Jones' condition deteriorated rapidly. He became restless and at times physical with Mrs. Jones. She could no longer keep her husband at home. Mrs. Jones came to us for help, thinking she could get her husband on Medicaid (MassHealth) in a nursing home. She didn’t realize that their assets would have to be spent down to $109,560 before Mr. Jones could qualify for Medicaid.
Mrs. Jones was distraught, "How can I live on $100,000? I'm only 65." As part of our planning we told Mrs. Jones to cash in the annuities and buy a new home with the money, because the home would not be a countable asset for Medicaid purposes. There was however an issue with cashing in the annuities because the Jones would have to pay a 7% penalty for cashing in the annuities. However, they decided it was more important to protect what they could for the rest of Mrs. Jones' lifetime.
We were able to help Mrs. Jones get her husband into a quality nursing home. She privately paid for a few months, cashed in the annuities, paid the surrender fees, and bought a home. Through this and other planning we were able to help Mrs. Jones preserve the majority of her savings - money she will need to provide for her own care down the road.
The lesson to be learned here is that the Jones could have achieved much better results if they had simply come to us before they sold their home and bought annuities. No one thought to ask what would happen if Mr. or Mrs. Jones needed care sooner than later.
As you can see having a team of advisors work together is important. As we progress on the Elder Care Journey, our needs change and evolve. That is why the team of elder law professionals at Dennis Sullivan & Associates offers clients a unique, total care plan called the Life Care Plan.
We also host a free educational Trust, Estate, and Asset Protection Workshop twice a month in Wellesley, Massachusetts where experienced elder law lawyer and estate planning attorney Dennis B. Sullivan will reveal how you can protect your home, spouse and life savings from the rising cost of nursing home care. To learn how to avoid nursing home poverty, call 800-964-4295 (24/7) and reserve your seat today or register online.
The Question
My father fought in WWII and died in January 1993. My mom presently lives in an Assisted Living Community. My mom is 92 years old and cannot live on her own anymore. Would she qualify for a VA benefit of any kind? How would I go about obtaining this information to help my mom. Her Assisted Living Community costs her more than $3500 a month. Mom sold her house but once the money runs out I worry what will happen and how she will be cared for? I would appreciate any information you could give me.
Answers for Massachusetts Veterans
The good news is as a surviving spouse your mother may be eligible for an “Aid and Attendance” benefit. In order to qualify for this benefit your mother must have limited assets and low yearly Income for Veteran’s Administration Purposes (IVAP). You should locate your town or region’s Veteran’s Service Officer who is critical to the filing of an application with the local VA regional office.
Qualification:
There is a two-part test for qualification, an assets test and an income test.
I. The Asset Test
In order to qualify to receive benefits your mothers total net worth, less certain exemptions allowed by the Veteran’s Association, should be under $50,000 (home, vehicles, life insurance policies). It may be possible to qualify for benefits if your
total net worth is greater than $50,000 but being under that number greatly increase an applicant’s chances of qualification.
II. The Income Test
The countable income for veterans’ benefits is determined by taking an individual’s gross income and subtracting from that all of their unreimbursed medical expenses to determine their IVAP, which is ultimately used to determine whether or not a person qualifies. For your mother, a surviving spouse with no dependents, her IVAP cannot exceed $1,056 per month.
The cost of an assisted living facility, and even part or all of the cost of an independent living facility, can also be an allowable medical deduction to reduce a veteran’s gross income to a much lower net countable income that may qualify him or her for veterans’ benefits. It is very important to meet with a knowledgeable veteran’s service officer or an experienced elder law attorney for a pre-filing consultation to determine whether or not a veteran may qualify. It is also important to review the estate planning work to see what may be done to assist the veteran in qualifying for this particular benefit. There may be planning steps that can be implemented before applying that will help a veteran or widow to qualify and or obtain an increased benefit.
Determining what is the countable income as measured by the Veterans Administration is very confusing to many individuals in. An attorney skilled in elder law and accredited with the Veteran’s Administration can provide a veteran and the veteran’s family with appropriate pre-filing consultations to determine the appropriate steps that must be taken to be able to determine if it would be right to apply for this VA benefit.
If you are in Massachusetts and would like to discuss Veteran’s Benefits more extensively, please call our office at (781)-237-2815 or register to attend one of our free educational workshops. You can also access our free Nuts & Bolts Guide to Veteran’s Benefits and learn what you can do to maximize your benefit.
The Question: Homstead...Protection?
Q: My 93 y/o grandfather who is in good health moved in with my family 9 months ago. My (absentee) Brother and I are the only heirs. My husband and I are 
purchasing a new home to increase space for our new family. He wants to give us 200k toward the house and to spend down a portion of his cash savings. Should we include him on the deed and homestead him or simply receive as a "gift"? My husband and I are financially independent and while we appreciate the gift, we do not need the gift to purchase new home.
The Answer: Homestead in Massachusetts
A: There is a 5 year look back period for Medicaid. Any asset transfers, including gifts, made within this 5 year look back window will trigger a penalty period of ineligibility to receive Medicaid benefits. There are ways to avoid triggering these penalties but an outright gift is not one of the ways.
As an example of the problem with making an outright gift, if your grandfather gifts to you $200,000 today and in 3 years requires skilled care, the gift of $200,000 will render him ineligible for Medicaid benefits for a significant period. During the period of ineligibility he, or you, will have to pay for any nursing home care.
In Massachusetts, the homestead protection will not keep your grandfather’s $200,000 from the reach of nursing homes, but a primary residence is often an exempt asset for Medicaid (Mass Health). In Massachusetts however, the nursing home or skilled care facility will be able to put a lien on your home if you use a portion of his $200,000 gift to purchase the home and put his name on the deed.
If your grandfather is truly seeking to protect assets from the reach of nursing homes, setting up an asset protection trust is often the recommended option. Creating an irrevocable trust starts the 5 year look back clock as soon as the trust is funded. Once the property is in the trust, your grandfather can make any type of gift or transfer he so chooses without “resetting” the 5 year look back period. In addition the irrevocable trust allows your grandfather to protect ALL of his assets while allowing access to income. As another added benefit, your grandfather’s life savings will be left to his loved ones without the need for probate.
Take the crucial steps to protect your life savings from the reach of state and federal estate taxes. Register online to attend a free educational workshop hosted by Dennis B. Sullivan, Esq, CPA, LLM or by calling 800-964-4295 (24 hours a day). You can also check out Free Elder Law Guides developed by the team of professional at Dennis Sullivan & Associates. By planning now you can save you and your family the stress of having to worry about the future.
When you pass away, who do you want as the primary beneficary of your estate, your loved ones or the government?
Estate Tax Facts
Many people, as you may guess, do not want their life savings and legacy to be swallowed by estate taxes. What most people are not aware of however, is the fact that if they passed away today their heirs would be forced to pay state and federal estate taxes, even if the deceased is far from what most would consider "wealthy". They also do not realize that an experienced estate planning attorney can help them AVOID taxes ENTIRELY.
Massacusetts Estate Tax
Massachusetts taxes every dollar in an estate above the $2 million threshold, recently increased from $1 million. What 
this means is in an estate worth $2.5 million dollars, $500,000 will be subject to a Massachusetts estate tax. Many are concerned with budget cuts and sweeping reform that state legislators will consider dropping the tax exempt amount, thus subjecting more estate to a tax. within the last 10 years, the federal estate tax exemption, which now stands at $5 million, has been as low as $675,000.
If your current estate exceeds the state and federal tax exempt amount, without proper planning you can expect to lose 50 cents of every dollar to the government.
You may be reading this, thinking that your estate is not in jeopardy of being destroyed by taxes because you are well under the exemption amount. You may think your estate is well under, but there are several catagories of non-obvious wealth you need to include in your estate valuation. The most common of these are life insurance death benefits and retirement accounts such as 401(k)'s and IRA's.
An Example on the Impact of Estate Taxes
Person A is married, has 2 college age children and belives his estate to be worth $700,000. Person A failed to take into consideration his IRAs and life insurance policies. Believing their net worth to be well below the $2 million Person A and his wife executed simple wills with no consideration paid to tax planning.
Tragedy stirkes and Person A dies. After his death his wife collects a $2 million life insurance benefit and his $500,000 IRA. In another tragic turn, Person A's wife dies shortly after him. Their estate, which they believed to be under the Massachusetts exempt amount, is now worth $3.2 million, leaving $1.2 million subject to estate tax, even if the state and federal thresholds are not lowered.
Avoid Massachusetts Estate Tax
Luckily, many people like Person A and his family can completely avoid paying any estate taxes. To take steps to protect your life savings from the reach of state and federal estate taxes, register online to attend a free educational workshop hosted by Dennis B. Sullivan, Esq, CPA, LLM or by calling 800-964-4295 (24 hours a day). You can also check out Free Elder Law Guides developed by the team of professional at Dennis Sullivan & Associates. By planning now you can save you and your family the stress of having to worry about the future.
The official handbook, "Medicare & You 2011," says that "Medicare covers two types of physical exams — one when you're new to Medicare and one each year after that." It describes these as the initial "Welcome to Medicare" physical exam and the yearly "wellness" exam. Then why are some patients going to the doctors for the physical and leaving with a bill in excess of $400?
Until Jan. 1 this year, Medicare did not cover any routine exams except for the "Welcome to Medicare" exam for new beneficiaries. The Affordable Care Act created the once-a-year wellness visit as a new benefit.
Theese new check ups are not what people think however. The check up considered by Medicare an "annual wellness visit" can be performed in just a few minutes, without the patient having to undress at all. Typically, the doctor will measure the patient's height, weight, body mass and blood pressure — and perhaps listens to his heart through his clothes. The rest is a discussion of the patient's medical and family history.
While doctors and patients are both thrilled Medicare is now paying for preventative check ups. As was mentioned earlier in this post, patients are leaving their doctor's office thinking what they got was a free visit, paid for by Medicaid, and then receiving bills in excess of $400. To be sure this doesn't happen to you, be 100% sure when talking to your doctor to tell them you only want the free Medicare check up and mention the billing code G0438.
Prevent Senior Health Issues
Doctors have said it is difficult to work a 45-minute wellness visit into an already overstretched schedule. They've been covering its elements for years in other ways, by working a discussion of preventive measures into a regular visit when examining a patient. They also say that by avoiding a sedintary life style and making better choices at the dinner table, seniors can avoid many of the more serious and expensive health risks such as heart disease and diabetes.
To take steps to protect your spouse, home and life savings today register online to attend a free educational workshop hosted by Dennis B. Sullivan, Esq, CPA, LLM or by calling 800-964-4295 (24 hours a day). You can also check out Free Elder Law Guides developed by the team of professional at Dennis Sullivan & Associates. By planning now you can save you and your family the stress of having to worry about the future.
Since the signing of the Budget Control Act of 2011, the Act which includes the increase in the national debt ceiling, senior advocates have been working to determine its effect on programs including Medicare, Social Security and Medicaid.
Brief Background
Congress has voted to raise the debt ceiling 10 times since 2001. The ceiling was raised in 2002, 2003, 2004, 2006, 2007 and twice in 2008. Why all the debate this time around? One side was insisting on reducing spending by cutting federal assitance to programs like Medicare, Medicaid, and Social Security to decrease the defecit, while the other was insiting on an increase in revenue (read taxes) while maintaining those programs. Many questions remain on whether funding for senior programs will continue or in what amounts.
The Act's Impact on the Future
There are still many questions left unasnwered regarding what impact the Budget Control Act will have moving forward. The Act consists of three steps:
STEP ONE:
The national debt ceiling is going to be raised $400 billion initially. The President also has the option to institute an additional increase of $500 billion moving forward. Congress is slated to reduce spending by $917 billion over the next 10 years. In 2012, $21 billion is to be cut from federal spending. Many people do not seem overly concerned with the scheduled reduction for 2012 because budget reduction occurs frequently and legislation is often amended.
STEP TWO:
A Joint Select Committee on Defecit Reduction is to be put together of 6 Democrats and 6 Republicans. The Committee must come up with debt reduction legislation on or before November 23 of this year. Their goal is to cut $1.5 trillion dollars of debt over the next 10 years, with a required reduction of at least $1.2 trillion. Any proposal the Committee creates will be voted on by Congress before the end of 2011, and many speculate will include cuts to Medicare, Medicaid and Social Security spending.
STEP THREE:
If no plan is put in place to reduce at least $1.2 trillion over 10 years, whether Committe member do not agree or Congress refuses to pass their proposal, there would be sweeping federal spending reduction. The reducution would equal the full amount, up to $1.2 trillion, that can not be agreed upon by the Reduction Committe and Congress. Medicaid, Medicare, and Social Security as well as veterans's benefits are all protected from large spending reduction if the process reaches this stage.
What Can You Do Today ?
No on knows how these reduction will effect senior programs such as Medicaid, Medicare, and Social Security. One thing is clear, the future is alot less certain. To take steps to protect your spouse, home and life savings today register online to attend a free educational workshop hosted by Dennis B. Sullivan, Esq, CPA, LLM or by calling 800-964-4295 (24 hours a day). You can also check out Free Elder Law Guides developed by the team of professional at Dennis Sullivan & Associates. By planning now you can save you and your family the stress of having to worry about the future.
It is essential that everyone understand annuities because they are an example of a retirement income device and are one of the most common methods for insuring a stable retirement income.
What is an annuity?
An annuity is a contract between you and usually an insurance company. You make a lump-sum payment or a series of payments to an insurer, and the insurer agrees to give you regular payments, starting right away or at a later date. Here are the ABCs of annuities:
1. There are 2 types of annuities: immediate and deferred. With the immediate annuity, the insurer begins paying you immediately. With the deferred annuity, you schedule a future date with the insurer to begin payments.
2. There are 2 types of returns available: fixed and variable. The fixed guarantees a specific dollar amount for each payment; whereas the variable can change based on the investment returns of the insurer.
3. There are also different time periods to choose from for the payouts: single life, joint life, specific term, life with certain term. The single life pays you for the remainder of your life only. The joint life pays for whichever is longer - your life or the life of your beneficiaries. Certain term pays you for a finite number of years. Life with certain term pays you for the rest of your life or to your beneficiaries for the remainder of a specific number of years.
4. Annuities are NOT FDIC insured but many states provide insurance up to $100,000. The Wharton School has an 11-page guide entitled "Investing Your Lump Sum at Retirement." You can down load it here. Please note that this paper was co-sponsored by New York Life Insurance Company; however, it is quite informative.
As you can see, annuities are understandable and can be very useful in retirement planning. For more information on estate and retirement planning, watch Dennis Sullivan, Esq., CPA, LLM discuss this topic on the national talk show, "Ask The Experts."
To learn about this topic along with how to protect your home and assets from avoidable taxes, probate, and the increasing costs of nursing homes and medical care, call 800-964-4295 (24/7) or register online for one of our Trust, Estate & Asset Protection workshops.
The Basics
Reverse mortgages can be a useful option for homeowners who are in need of cash. However, most financial experts warn against these and suggest liquidating your portfolio and reducing your living expenses before going this route. To many they are usually considered a last resort. This option was introduced in 1989 and allows Americans age 62 and older to access a portion of their home equity without having to move.
Benefits of a Reverse Mortgage
The bank pays the borrower throughout his or her lifetime according to the amount of accumulated home equity. The loan balance does not have to be repaid until the borrower dies, sells the home or permanently moves out. Because of the nature of the loan, you can never owe more than the value of your home, and if the balance is less than the value of your home at the time of repayment, you or your heirs keep the difference.
To be eligible, the property in question must be your primary residence, and you must either own it outright or have a low mortgage balance that can be paid off at the closing with proceeds from the reverse loan. Generally, the older you are and the more valuable your home, the more money you can get.
You may want to check out AARP's calculator which helps retirees figure out how much money they might be eligible to receive. There are no restrictions for how the money from a reverse mortgage must be used, and the proceeds can be received in a lump sum or some type of monthly payment.
What's the catch?
Reverse mortgages are complex and can affect eligibility for Medicaid and Supplemental Security Income benefits. The closing costs and interest rates involved are often higher than with a usual mortgage.
Needless to say, if you are spending the equity in your home, you are reducing that value of that asset when it ultimately passes on to your heirs.
For more information on planning for retirement,
watch Dennis Sullivan, Esq., CPA, LLM talk about estate and retirement planning on the national talk show, "Ask The Experts." To learn firsthand how to plan for and protect your assets and life-savings,
register online or call 800-964-4295 (24/7) to attend for one of our Trust, Estate & Asset Protection workshops.
Yet another life-changing decision that pre-retirees need to ponder - Where to retire? Stay at home? Move far away? Go south? Go north? Move to the city? Move to the country? In response to this question, William P. Barrett writes an article in the August 1 issue of FORBES Magazine that looks at a less common option: moving to a suburb in another state.
In his article he proposes a list of the top 25 suburbs for retirement. They cover 22 states and were evaluated based on home prices, tax advantages for retirees, the availablility of hospitals and universities, cost of living, crime rate, air quality, and public transportation. Although none of the places listed has all the attributes, all of them have some.
In some cases, there can be real savings and value created by moving as a result of different tax environments among the states. For example, Florida and Texas have no income tax and Florida and Pennsylvania have special tax incentives for retirees.
In this article the top 25 places are: Allen, TX; Beaverton, OR; Brentwood, MO; Broomfield, CO; Cary, NC; Davis, CA; Edmond, OK; Fayetteville, GA; Fishers, IN; Ft. Thomas, KY; Friendswood, TX; West Chester, PA; Gilbert, AZ; Henderson, NV; Lauderdale, MN; Meridian, ID; Munster, IN; Naperville, IL; Overland Park, KS; Plano, TX; Rio Rancho, NM; Roswell, GA; Smyrna, TN, South Jordan, UT; Tamarac, FL. For details on each area, follow this link to the article.
For more information on other options to consider before retiring, call our office (781-237-2815) to request a copy of our latest DVD entitled, "Life-Care Planning and the Elder Care Continuum." To learn more about planning and asset protection options, register online or call 800-964-4295 (24/7) to attend one of our Trust, Estate & Asset Protection workshop.