Massachusetts Estate Planning & Asset Protection Blog

The High Cost of Seniors Living Longer

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Fri, Sep 05, 2014

 

The Cost of Living Longer | Massachusetts Eldercare Attorney

 

 planning, estate, eldercare

 

A Pachyderm of Problems

Every day, we see clients for whom long-term care is the elephant in the room. They feel they can’t afford the costs, but they also feel they can’t afford not to have it either. So their solution is to pretend they don’t see the elephant and try to ignore the problem until it goes away on its own. This unfortunately often leads to our metaphorical elephant trampling their life savings and any future inheritance they are trying to leave behind. The older you are, the more expensive a long-term care policy gets and if you get sick before you have long-term care protection in place, it’s too late. Insurance companies are looking out for their bottom line, and an already ill senior will scare them off.

The costs for these policies are rising faster than inflation too. Therein lies the conundrum for Boomers and seniors: They’re living longer than their parents did but that means they need more money to make it through “old age”. Finding long-term care is a tough and complicated process. You’ll need to find a place that cares for people with your (or your loved one’s) circumstances. You need to find a place with the right facilities and staff, a place that leaves you with a good, safe feeling. And you have to be able to afford it too. This is not any sort of one-size-fits-all situation. Everyone has their own specific services and conditions that they or their loved ones will need met. Remember, what we call “long-term care” is a broad category, with options ranging from live-in facilities to your own home.

Lurking Complications With Long Term Care

The greatest threat to the financial security of Boomers and seniors is the cost of long-term care (and Obamacare will not assist with this). Assisted-living facilities are now climbing toward the $7,500-a-month mark. Many have started bundling more services together, rather than charging for each individually. Bundling might be a good idea from the nursing home’s perspective, but just like pre-packaged cable TV you will wind up paying for a lot of services you don’t need and don’t want. A private room at a nursing home will range from $500 - $600 a day.

The cost of home healthcare is rising, too. Some people choose independent-living apartments. These facilities typically don’t require lump-sum payments, and residents can contract with home health-services independently. Medicaid may be there for those who qualify but if you ever want to learn the true meaning of “jumping through hoops” just try qualifying! The best thing, of course, is long-term care insurance, but that’s getting more expensive too as companies raise their rates while cutting back on their coverage. In addition, this insurance is getting more complicated, now encompassing aspects such as protection of the surviving spouse, caregiver issues, scams/ID theft, and making sure you have an advocate to fight for your rights in a system that’s slanted against you.

In short, we’re living longer, and unlike previous generations, people are generally not living with or even near their children. Seniors are going to need more money for this longer life and for any unforeseen medical problems that may arise.

A Magic Trick No One Wants to See

Do you know the fastest way for a Boomer or senior couple to become an impoverished Boomer or senior couple is? Simple, one of them just needs to become ill before they get long-term care insurance. We see it every day, people who’ve worked hard and saved money all their lives are forced to see it wash away in a flood of medical bills as they age. It is truly heart-breaking, because, if you’ve managed to squirrel some money away, you could probably have afforded long-term care. 

The Downside to Living Longer

Our life expectancies are going up these days and so is the cost of healthcare, the distance seniors are living from their children and families, and the financial pressures on Medicare and Medicaid. The new Affordable Care Act, in fact, stipulates $500 billion in Medicare cuts over the next decade! Where do you turn if you or your spouse gets ill? Home health care? Adult day-care? Assisted-living? A nursing facility? Respite-care services, which allow the caregiver to drop off the senior for a limited period? Who’s going to pay for it? And for how long?  These are the questions to ask now, while you still have time to plan. If you haven’t purchased long-term care before you or your spouse become ill…forget about it. No one will insure you once you’re sick! If this happens to you, you’re going to be out of time, out of options, and very quickly out of money. And if you’ve planned to leave something for your heirs, there may be nothing left to leave to them other than a pile of bills. 

 

It’s an old (but true) cliché: those who fail to plan, are planning to fail. When it comes to healthcare expenses as you age, you fail to plan at the risk of yourself and those you love.  

 

At the Estate Planning & Asset Protection Law Center, we provide a unique education and counseling process which includes our unique 19 Point Trust, Estate and Asset Protection Review to help people and their families learn how to protect their home, spouse, life-savings, and legacy for their loved ones, click here for more information. We provide clients with a unique approach so they understand where opportunities exist to eliminate problems now as they implement plans for a protected future.

We encourage you to attend one of our free educational workshops, call 800-964-4295 and register to learn more about what you can do to enhance the security of your spouse, home, life savings and legacy.

Click Here to Register For Our Trust, Estate & Asset  Protection Workshop 

 

Tags: living will, Estate Planning, Estate Planning, asset protection, Massacusetts Estate Tax, long term care, life insurance, Medicaid, MassHealth, in-home care, marriage, Estate Planning Tip, seniors, assisted living, life-care plan, hospice, Massachusetts, assets, in home, incapacity, asset, home, surviving spouse, Estate Planning Recommendations, in-home care, long term care insurance, Inheritance

Can Your Will Protect You When You Don't Die?

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Thu, Aug 07, 2014

 

What Happens When You Don’t Die?

medicare, medicaid, wills, spouse

 

Is your “I love you” will capable of protecting you or your spouse from long-term care costs?

You know the kinds of wills we’re talking about: The husband leaves everything to the wife, the wife leaves everything to the husband and after they both die, everything goes to the kids. This works well in situations where the spouses are healthy one day and are deceased the next. 

However, as most of us know, life usually doesn’t work that way very often. Research indicates that nearly 70% of individuals over 65 will require some kind of long-term care in their lifetimes.

Thus, many spouses worry that if they predecease an ill spouse who is currently in a nursing home or will require long-term care at some point in the near future, there will be insufficient funds available to provide for their institutionalized spouses’ needs. This is an especially relevant concern for expenses that are not covered under Medicaid such as: care managers, private nurses, single rooms, as well as certain therapies and drugs.

Another concern is that the availability of funds from “I love you” wills and trusts will disqualify the surviving ill spouse from eligibility for Medicare benefits. As you know from prior articles, Medicare (MassHealth in Massachusetts) is the only long-term-care governmental program in the United States and does not cover long-term custodial care.

To solve this problem many of our clients rely on a “testamentary trust”. This is a trust built into the will of each spouse. For many estate planners, this is counterintuitive because much of the estate planning occurs within the context of a revocable living trust. In order to preserve access to Medicaid eligibility without requiring that the surviving spouse spend down the assets and lose the chance to maintain a “rainy day fund”, creating a testamentary trust in the will of the pre-deceasing spouse is essential.

What this means is that around age 55, you have to completely revise your wills and trusts to accommodate a different paradigm of thought. The thinking process is no longer “What happens when I die?” Now the question becomes “What happens if I don’t die and live a long time with expensive long-term care?”

The new paradigm requires a new estate plan. If you consider yourself middle-class (meaning that your net worth will be significantly impacted by the cost of long-term care for you and/or your spouse) and are over age 55, we suggest that you revise and update your estate plan to reflect your current and future needs as soon as possible.

At the Estate Planning & Asset Protection Law Center, we help people and their families learn how to protect their home, spouse, life-savings, and legacy for their loved ones.  We provide clients with a unique educational and counseling approach so they understand where opportunities exist to eliminate problems now as they implement plans for a protected future.

We encourage you to attend one of our free educational workshops, call 800-964-4295 and register to learn more about what you can do to enhance the security of your spouse, home, life savings and legacy.

 Click Here to Register For Our Trust, Estate & Asset  Protection Workshop

Tags: will, living will, Estate Planning, Estate Planning, Alzheimer's Disease, Elder Law, asset protection, long term care, Medicaid, in-home care, Health Care, estate reduction, estate, elder care journey, hospice, Alzheimers Disease, medicaid qualification, Wills, assets, Medicaid penalties, alzheimer's activities, in home, incapacity, Elder Law, Attorney, myths, Alzheimer's, alzheimers, financial, Attorney, income, Alzheimer's, federal, health, surviving spouse, in-home care, long term care insurance

Hiring a Health Care Aide - Independent Contractor or Employee?

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Tue, May 13, 2014

 

MassHealth, In Home Care, Massachusetts

It’s a conversation we have with most of our clients at some point when guiding them through what we call the elder care journey.  Dad wants to stay at home but needs assistance with some of what are known as the activities of daily living – eating, bathing, dressing, walking and toileting.

We recommend to our clients that they hire a home health agency for a variety of reasons which I have written about in previous blog posts.  That aide is going to be coming into Dad’s home.  The agency does background checks before hiring.  Proof of spend down for Medicaid isn’t an issue when hiring an agency.  The contract and payment to the agency is all that needs to be shown, unlike the cash payments that families often make when hiring an undocumented aide.

There is another concern we discuss with clients and their families, but which they then generally push aside, and that is the question whether the aide they hire is an employee or an independent contractor.

In many cases the line between the two is easy to draw.  For example, the contractor you hire to do work on your home is not your employee.  He is hired to do a specific job, controls the manner in which he does it and upon completion he is paid.  Similarly, most professionals such as doctors, lawyers and architects are paid the same way.

The question is more difficult to answer, however, when we consider someone who comes into your home regularly to perform a service.  For example, a landscaper who cuts your lawn or the person that comes to clean your home every week will generally be treated as an independent contractor.

What are the commonalities to an independent contractor?  If only the worker can control how the work is done, the worker provides his or her own tools and offers his or her services to the general public as an independent business, then it is clear that he is treated as an independent contractor.

The line becomes more blurred, however, when we consider the aide hired to provide care for Dad.  Does the aide work for more than one person at time?  Is the aide a live in?  Who controls the manner in which the work is performed?  And what laws might a family be concerned with if the aide is considered an employee?  We’ll discuss all that next time.

At the Estate Planning & Asset Protection Law Center, we help people and their families learn how to protect their home, spouse, life-savings, and legacy for their loved ones.  We provide clients with a unique educational and counseling approach so they understand where opportunities exist to eliminate problems now as they implement plans for a protected future.

We encourage you to attend one of our free educational workshops, call 800-964-4295 and register to learn more about what you can do to enhance the security of your spouse, home, life savings and legacy.

Click Here to Register For Our Trust, Estate & Asset  Protection Workshop

Tags: MassHealth, Health Care, 2014, in-home care

Caring for an Elder Parent | Massachusetts Elder Law Attorney

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Tue, Aug 21, 2012

 What happens when the child becomes the parent?

Elderly Man Thinking

This is something I explain frequently to families when discussing long term care. Last month I had a conversation with Dad’s three children who came to meet with me regarding his placement in an assisted living facility.

The discussion centered on what Dad wants versus what is in his best interest.  Son, Stephen was uncomfortable about moving Dad to a facility against his wish to remain at home.  We discussed bringing in home aides, which they had tried without success.  Dad wouldn’t let anyone in the home.  And since none of the children live nearby, managing a rebellious parent long distance becomes an impossible task.

I told Stephen that he and his siblings need to take on more of a parental role at this point.  Similar to a 5 year old child who insists he can cross the street without holding the parent’s hand, Dad’s insistence that he is OK to live alone is no longer enough to insure his safety.  It is clear that he can’t appreciate his limitations and the danger to his health that his refusal to accept help poses.

Many children are understandably uncomfortable in this role, especially if the parent expresses anger and pushes back.  Independence is something we value greatly as Americans, as individuals.  But just as we step in when our young children assert independence before they are mature enough to handle it, we must also step in when our parents no longer have the capacity to maintain their independence.

It’s hard enough to do that when, for so long, our parents were the one guiding and protecting us.  But the task is made more difficult because, so often, the decline is gradual.  It might begin with poor financial decisions or bounced checks or perhaps the clutter of a once immaculately kept home. 

When is the right time to step in?

I told Stephen that no one is going to tap him on the shoulder and tell him that “tomorrow your dad will fall down the stairs so you better put safety measures in place today”.  He and his siblings need to be proactive.  If they wait for Dad to tell them he is ready, that day will probably never come.  I told him that they need a plan in place now that will provide for adequate supervision, even if Dad initially resists.  I recommended a geriatric care manager to assist the family in determining the best placement for Dad.  The GCM can also be essential to families who don’t live “around the corner” from their aging loved one, acting as the “eyes and ears” and reporting back to the children.

Stephen understood what I was saying.  He still wasn’t comfortable in the role of parent to his dad, but with our help and the support services available he felt better about he and his siblings’ decision to step into an active role in caring for Dad.

To gain free online access to the Complete Alzheimer's Resource Kit, which contains care tips as well as other useful information on Alzheimer’s disease, please visit www.BostonMemoryLawyer.com

Click Here to Download  The Alzheimer's Resource Kit

At the Estate Planning & Asset Protection Law Center of Dennis Sullivan & Associates, we help people and their families concerned with losing their homes and life savings to increasing medical and nursing home costs, taxes and the costs and time delays of probate. We also protect clients from losing control of their own health and financial decisions.

We encourage you to attend one of our free educational workshops to learn more about our process and what you can do to enhance the security of your spouse, home, life savings and legacy. To register for a seat at an upcoming workshop call (800) 964-4295 (24/7) or register online at www.SeniorWorkshop.com.

Click Here to Register For Our Trust, Estate & Asset  Protection Workshop

Tags: Estate Planning, Nursing Home Costs, Alzheimer's Disease, Elder Law, Nursing Homes, in-home care, Financial Planning, elder care, elder care journey

Boston Elder Law Attorney | Part Two - Feeling the Pressure of Caring for Mom & Dad?

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Fri, Jul 06, 2012

ANSWER:

Dear Feeling Pressured,

elder law, estate planning attorney, boston lawyer, massachusettsIsn't family wonderful.  Your sister's enthusiasm to pass responsibility on to you and your children is comical.  One of the caregiver tips from Alzheimer's Master Caregiver Jo Huey, in the Complete Alzheimer's Resource Kit, is to maintain your sense of humor.

You mentioned in your letter that you noticed a "significant decline" in your father's mental heakth.  It is critical for your family to stay on top of the situation, it is possible that your mother may be hiding her concerns from the family.  She is dealing with many new challanges as a result of your father's declining mental health.  Perhaps she does not want you to think she feels you should be responsible for their care.  I want to be sure that you and your mother are clear that she does not have to handle your father's care alone.

After a lifetime of caring for each other, spouses are often reluctant to ask for help from children or an outside agency.  The epxectation, responsibilities and even the change in roles can be overwhelming.  In your father's case, he has become dependent rather than a provider. 

As Elder Law professionals, our main conern isn't that you move in with your mother and provide support but that your mother receives support from somewhere.  Your parents may be at "that stage", when it is time for you and your family to make a family plan.  We have helped a number of families in Massachusetts with our unique Life Care Plan.  We like to think of the life care plan as a GPS that guides you and your family along the often times difficult Elder Care Journey.  For more information on how a Life Care Plan from Dennis Sullivan & Associates can provide peace of mind for you and your loved one register to attend a free educational workshop hosted by our team of Estate Planning & Elder Law professionals. 

Your mother may be so upset by your sister's phone calls because the calls make her aware of the seriousness of the situation.  The behaviors you see on a visit are likely very different from the burdens of day to day care.

Remember, being a good daughter does not mean you have to surrender your own life.  It does however, require that you take some action to ensure your parents are safe and comfortable as the progress down the Elder Care Journey.  There are resources and help available, and our job as elder law professionals is to help families find and make the best choices for their unique situation.

Feeling Pressured, we wish you and your family all the best.

Sincerely,

The Dennis Sullivan & Associates Team

 

At the Estate Planning & Asset Protection Law Center of Dennis Sullivan & Associates, we help people and their families concerned with losing their homes and life savings to increasing medical and nursing home costs, taxes and the costs and time delays of probate. We also protect clients from losing control of their own health and financial decisions.

We encourage you to attend one of our free educational workshops to learn more about our process and what you can do to enhance the security of your spouse, home, life savings and legacy. To register for a seat at an upcoming workshop call (800) 964-4295 (24/7) or register online at www.SeniorWorkshop.com

Tags: Alzheimer's Disease, long term care, Baby Boomers, Nursing Home Guide, in-home care, Health Care, family, elder care, assisted living, life-care plan, elder care journey

Massachusetts Elder Law Attorney | Feeling the Pressure of Caring for Mom & Dad?

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Fri, Jul 06, 2012

Question:

I am the youngest of 7 children.  boston estate planning attorneyBeing the youngest, I was very close with my parents.  In fact, I still live within 7 miles of their home.  I am a single mother with 2 kids of my own still living with me and I work a full-time job. Because of my close proximity to my parents, I have spent the most time with them.

Recently, my older sister, who is 18 years my senior, noticed that my father's mental health is not as sharp as it used to be.  I do agree with her that he has shown some decline.  That however, is not the problem.  The problem is that she is telling my mother that I should move into their home so that I can take care of them.

I love my parents, but a move would be ridiculous.  It would disrupt my children's school and social routines and I would be further away from my job.  My mother is on top of the situation in her home, for now, but in time a decision will have to be made. 

My mother has not asked for my help, and I have not offered.  Everytime my sister calls my mother becomes anxious and agitated.  These phone calls really seem to upset my mother.  How do I get my sister to stop with these upsetting phone calls.  My mother and I honestly believe that she is able to handle her own life right now.

From,

Feeling Pressured.

Stay Tuned for Our Answer in Part 2 to follow

At the Estate Planning & Asset Protection Law Center, we help people and their families learn how to protect their home, spouse, life-savings, and legacy for their loved ones. We provide clients with a unique educational and counseling approach so they understand where opportunities exist to eliminate problems now as they implement plans for a protected future.

To gain free online access to the Complete Alzheimer's Resource Kit, which contains care tips as well as other useful information on Alzheimer’s disease, please visit www.BostonMemoryLawyer.com.  We also invite you to visit www.bostonelderlaw.org for more information on Elder Law and what an Elder Law Attorney can do for you

We encourage you to attend one of our free educational workshops, call 800-964-4295 and register to learn more about what you can do to enhance the security of your spouse, home, life savings and legacy.

Register Now and receive a free Unique Self-Guided 19-Point Trust, Estate, & Asset Protection

Legal Guide with accompanying DVD

Nursing home care is more than $140,000 per year! Attend this FREE educational seminar to learn:

  • How to protect your home and assets from the costs of long-term care
  • How to stay out of the nursing home and access in-home care
  • How to make sure your spouse is not left financially ruined if you need nursing home care
  • How to access Veterans benefits to pay for long-term care

       To register or call (800) 964-4295 (24/7 or online at www.SeniorWorkshop.com 

Tags: Alzheimer's Disease, in-home care, family, elder care, life-care plan, elder care journey

Does your loved one need to be evaluated? And by whom? | Massachusetts Elder Law Attorney

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Fri, Jun 29, 2012

elder care physician, alzheimer's disease, caregiver

Does your loved one need to be evaluated? And by whom?

Yes. When the first symptoms of dementia (more-than-mild forgetfulness or confusion) occur, a complete work-up and evaluation by a physician is mandatory. This exam will determine whether symptoms are due to such things as depression, poor nutrition, drug intoxication, alcohol abuse, or organ dysfunction. If your loved one has never been evaluated, a neurologist or geriatrician is your best bet. Those who have been diagnosed with Alzheimer’s should see a geriatric psychiatrist for anxiety, depression, agitation, or any other behavioral issues.

Physician referral services can provide a list of these physicians. Some caregivers receive information and referrals at their support group meetings. It is comforting to see a physician that you know other caregivers have used and liked.

Everyone is different, so if you are not happy with the physician, look for another. Being comfortable with the doctor is important in order for you to ask any questions you need to ask at any time. Early diagnosis of dementia can indicate treatment to help slow the progression of the disease with appropriate medication. A complete work-up includes: physical examination, medical history, neurological tests, laboratory tests, brain imaging, and function tests.

Once diagnosis is made, inform the primary physician. Your loved one will continue to see a primary care physician for general checkups. The geriatrician, neurologist, or psychiatrist will be seen for issues directly related to dementia.

The best, most effective doctors in this field are also concerned about the health and well-being of the caregiver. Alzheimer’s is a family illness. The doctor needs to be aware of the caregiver’s stress level and be willing to offer support, suggestions, and encouragement to the caregiver. Making sure the caregiver is looked after is the greatest proactive intervention to promoting successful caregiving in the home.

To gain free online access to the Complete Alzheimer's Resource Kit, which contains care tips as well as other useful information on Alzheimer’s disease, please visit www.BostonMemoryLawyer.com.

At the Estate Planning & Asset Protection Law Center, we help people and their families learn how to protect their home, spouse, life-savings, and legacy for their loved ones.  We provide clients with a unique educational and counseling approach so they understand where opportunities exist to eliminate problems now as they implement plans for a protected future.

We encourage you to attend one of our free educational workshops, call 800-964-4295 and register to learn more about what you can do to enhance the security of your spouse, home, life savings and legacy.

and receive a free Unique Self-Guided 19-Point Trust, Estate, & Asset Protection

Legal Guide with accompanying DVD

Attend this FREE educational seminar to learn:

  • How to protect your home and assets from the costs of long-term care
  • How to stay out of the nursing home and access in-home care
  • How to make sure your spouse is not left financially ruined if you need nursing home care
  • How to access Veterans benefits to pay for long-term care

       To register or call (800) 964-4295 (24/7 or online at www.SeniorWorkshop.com 

Tags: Estate Planning, Alzheimer's Disease, Elder Law, Massacusetts Estate Tax, in-home care, Estate Planning Tip, elder care

Boston Elder Law Lawyer | Medicaid & The "Murky Paper Trail" - Part 2

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Tue, Jun 26, 2012

Last week we were discussing Eve’s difficulty getting Medicaid for her mom.  She had spent down Mom’s assets but because there was not a clear paper trail, Medicaid was approved, but with a 6 month penalty.  This meant that Eve would be on the hook for 6 more months of Mom’s nursing home care at a total cost of approximately $90,000.

Elder Law Attorney, Medicaid, MassHealth Eve insisted that she had legitimately spent her mother’s assets on care as well as to repair damage Mom had caused to Eve’s home while she was living there.   The problem was that she didn’t have the documentation to prove it when we filed the application and still didn’t have it when the State ruled on our application.  Anything we couldn’t prove, they treated as a transfer for less than fair value and that’s how the end result was a Medicaid penalty.  So, was that it?  Would Eve have to pay?

We explained to Eve that we could appeal the decision and go thru what is called a fair hearing before an administrative law judge.  This would give us more time to gather the necessary paperwork but the result would be the same unless she produced the documentation we needed.

Eve chased down contractors to get invoices for the work that had been done to her home.  However, we had to carefully outline which work was to repair damage caused by Mom because only that was a permissible spend down.  Any other work performed on Eve’s home and paid for by Mom would, in fact, be a transfer subject to a penalty.

Eve made purchases of carpet, furniture and appliances.  Tracking down those receipts and how she paid for them was not easy.   The receipts often didn’t clearly indicate what was purchased.  In other instances, money spent wouldn’t count towards the spend down.  For example, Mom caused damage to carpet, which had to be replaced.  However, other  “interior decoration” changes as a result of the change in carpet wouldn’t count as a spend down.

Then there remained the issue of the stock held jointly by Mom and her grandson, Steve.  For starters, we had to determine if Mom owned all of it or only one-half.  Since Eve cashed it and deposited it in her account were we starting with a potential $50,000 transfer for less than fair value or only a $25,000 transfer?

 In conversations with the Medicaid office, we explained that as a joint account holder Steve owned one-half of the account.  The Medicaid caseworker insisted that she needed a statement from the stock transfer company indicating that as a joint account holder, Steve owned 50% of the assets in the account and that each account owner must consent to selling the shares.   

So, when Eve deposited the proceeds in her account, only $25,000 of it was subject to a transfer for less than fair value.  Once we obtained the statement, we had that as our starting number and were able to produce more than $25,000 in bills and expenses, which Eve paid for on Mom’s behalf, wiping out the penalty.

It wasn’t easy, and at times, it looked like we would fall short of producing the necessary documents, but there is a lesson to be learned.  As previously, you can’t walk into the Medicaid office completely unprepared and expect to get a quick approval.  Everything you submit will be closely scrutinized and your lack of knowledge of the rules could cost you tens or even hundreds of thousands of dollars.  Luckily, Eve had us to guide her on exactly what we needed to eliminate the penalty and to her credit Eve was able to go out and get it.  Certainly, at a potential cost to her of $90,000, she had the motivation.

To learn more about how the Estate Planning & Asset Protection Law Center can help you or a family member avoid nursing home poverty attend a free educational workshop hosted by our dedicated team of elder law specialists.  The Elder Care Journey is not an easy one to take alone.  Take the first step to understanding how to avoid nursing home poverty and other common dangers and attend a workshop.  To register please visit www.MASeniorWorkshop.com or call (800) 964-4295 (24/7). 

 

Tags: Estate Planning, Elder Law, long term care, Medicare, Medicaid, MassHealth, in-home care, family, elder care, elder care journey

The Realities of Long-Term Care

Posted by Wellesley Estate Planning Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Tue, Apr 24, 2012

Carla called me only after much urging from her friend.  Carla’s husband, David, had lung cancer and it had spread throughout his body.  The end of his battle was nearing and he had been approved for placement on hospice, an approach to medical care where the goal is to enhance the quality of life for patients with terminal illness but who are likely to die within 6 months.  It appeared that David only had weeks to live and a long term nursing home stay wasn’t a likely scenario. So, why was she calling me?  Let’s take a closer look.

 Carla told me the last several years have really taken a toll on her health.  She is 70 but starting to slow down physically.  She said she has put knee replacement surgery on hold.  It was clear that Carla’s focus was completely on David but her friend recognized that she also needs to focus on “life after David”.  That’s why Carla was calling, although I don’t think she realized it entirely.

 I asked her about her finances.  David had a pension of $2500 and Social Security of $1500.  Carla, who didn’t work outside the home during the years she raised their 3 children, only received Social Security of $750 and no pension.  She also told me that David’ pension would stop once he died.  She remembered that he took the maximum pension option when he retired a few years ago but that there would be no survivor option if she outlived him.  I told her that she would lose one Social Security check as well, keeping the larger one.

 I asked Carla about their assets.  She and David owned their home which she estimated to be worth approximately $300,000 with no mortgage.  They also had savings totaling $250,000.  They had no life insurance and no long term care insurance.  I asked about their legal documents.  Carla said she and David had both executed powers of attorney and health care directives several years ago.  Their wills she estimated to be about 20 years old, prepared when her children were of school age.  Their wills left everything to the surviving spouse and then alternatively to the children.

 Long Term CareAs I mentioned, David was now on hospice.  Carla had set up a hospital bed on the first floor and brought David home.  At this point he was bedridden.  A hospice nurse was coming to the home several times a week.  Although very tired, Carla said that David was completely lucid.  She then asked me what exactly I could do to help her.

 It was clear from her question that her focus was on David.  She wasn’t thinking about her own needs but I was.  Although not easy for her to do, I asked Carla to shift her focus for a few minutes.  I asked her about her own health and long term care needs.   She again told me she would address it after David’ passing.

 “Who will care for you”, I asked, “if you need long term care in the future.”  Carla told me her children don’t live nearby and she never really thought about it.  She wants to be cared for at home, just as she is doing for David, but she recognized that it won’t be easy.  I then told Carla that we could help her try to accomplish that but there are steps that we need to take immediately, without delay.  Next week I’ll give you the details.

For more information on how to effectively plan for you and your spouse's trip on the elder care journey visit www.MASeniorWorkshop.com.  There you will find dates and times for upcoming workshops on estate planning, elder law, and veteran's benefits hosted by the team of professionals at The Estate Planning & Asset Protection Law Center of Dennis Sullivan & Associates. 

Tags: living will, health care proxy, Estate Planning, Elder Law, asset protection, long term care, Medicaid, MassHealth, in-home care, Health Care, durable power of attorney, family, Lifetime Protection Program, elder care, assisted living, elder care journey

Technology Benefits You and Your Family Now and Later

Posted by Dennis Sullivan & Associates on Tue, Aug 02, 2011

Today more seniors are spending their golden years in the best possible place  – home – and technology is playing an ever-increasing role in helping those numbers grow.

As Baby Boomers retire, both homes and assisted-living facilities are taking advantage of new technology that reduces medical costs, comforts patients, and limits the time relatives must take to supervise their elders. Technological advances have been able to  monitor chronic disease.  For example, Remote Patient Monitoring (RPM) home devices monitor heart function, blood pressure, glucose and other vital signs.  Other advances provide early detection of illness, remind seniors to take pills, coordinate care, and even improve brain function. This phenomenon is referred to as “Telehealth.”

“We find the awareness level of telehealth solutions is pretty low,” said Lynn Redington, senior program director for the Center for Technology and Aging.  As the numbers of older Americans increases, health care providers continue to be overwhelmed by the care demanded by that population.  Technology can streamline the supply of health care to meet its demand. 

One such technology provider, Intel-GE Care Innovations, offers four products: a monitor that collects vital signs, a device that tracks patient movement and provides alerts if someone falls, a wellness and social-networking hub for assisted-living facilities, and a reader to translate text to spoken words. Telehealth also helps patients with transportation conflicts; monitoring health care conditions at home removes the strain from family members to take time off from work, which causes added tension.

As with everything, there is a down side.  The costs of these technologies usually is not covered by Medicare or private health insurance.  However, it is a good idea for private health care plans to use these tools because they help to control costs and to keep a person at home, which is far less expensive than a skilled nursing facility or hospital.

The longer aging Americans stay at home, the less expensive the cost of health care. Keeping seniors in their homes is beneficial to everyone: families, health care officials, and politicians trying to balance budgets.

For more information on planning for long-term care expenses and avoiding Medicaid mistakes and Life-Care Planning, visit our website.  To learn firsthand about protecting your home and life-savings from avoidable taxes and the increasing cost of medical care and nursing homes, register online for one of our Trust, Estate & Asset Protection workshops or call 800-964-4295.

Tags: long term care, in-home care, Health Care, technology

Sign-Up Below To Receive Your Free Report

Follow Me

Browse by Tag



Follow DennisBSullivan on Twitter