Articles Posted in Caregiving

More so than any physical transformation, memory loss is one of the most severe consequences of aging. Aging at its core, affects how information is processed in the brain. Older people are often told that they are slow – in thought and in movement. While it is true that it may be more difficult to move, see, or hear as people age, people are surprised to learn that their senses are also slower and continue to slow down as they age.

Changes in memory storage and retrieval

According to Dr. Mark E. Williams, changes in memory storage and retrieval of information occur for all age groups as human beings mature and age. Over time however, recall gets worse. Recall involves the searching and retrieving of factual information.

Entering into a nursing home or other residential skilled care facility can be hard enough on a beloved older family member without having to worry about having to leave that facility and moved into another one. Unfortunately, this is a reality all too many seniors face these days as nursing homes do not always make guarantees about being able to offer the type of care the individual needs to live a comfortable, dignified life.

Fortunately, Continuing Care Retirement Communities (CCRC) are able to guarantee residents a lifelong place to live without having to worry about transfering to a new and unfamiliar environment due to factors outside of his or her control. CCRCs offer the entire residential continuum, from independent housing to assisted living to round-the-clock nursing services, under one roof to allow residents to remain in place and create a stable living environment.

These types of arrangements allow residents to age in place and typically work by having the individual pay a an entry fee and an adjustable monthly rent in return for the guarantee of care for the rest of their life. CCRCs also maintain an assortment of on site medical and social services which allow residents to live in one part of the community while in good health and then transfer to another part of the community better equipped to handle lifestyle and health changes.

The Internal Revenue Service recently issued a notice to people with disabilities who are employed that for the first time they can now deposit extra money into their ABLE accounts without losing Social Security, Medicaid, or other government benefits. Annual contributions to ABLE accounts are currently capped at $15,000 but under new legislation passed in late 2017 individuals with disabilities who are employed may now accrue at least some of their wages as well.

This year, Americans living in the lower 48 states may now deposit an additional $12,140 from their income which means workers with disabilities are allowed to save up to $27,140 in their ABLE account in 2018. Hawaii residents can save an additional $13,390 and Alaska residents can save an additional $15,180, according to the release put out by the IRS this month.

Additionally, the IRS has announced that workers with disabilities and an ABLE account may now qualify for a Saver’s Credit to help reduce their federal tax bill. Formerly known as the Retirement Savings Contributions Credit, the Saver’s Credit gives special tax breaks to low and moderate income taxpayers saving for retirement. The Saver’s Credit can be taken for contributions to a traditional or Roth IRA, a 401(k), SIMPLE IRA, SARSEP, 403(b), 501(c)(18) or governmental 457(b) plan.

Having a last will and testament is something that every single person needs to have, regardless of how substantial or modest they feel their estate may be. This because a last will and testament does much more than spell out who receives what part of an estate. A last will and testament can and should go on to set out contingencies for many practical scenarios and life events that the average person can find himself or herself in.

First and foremost, a last will and testament allows individuals to direct portions of their estate to whomever they choose. When individuals pass away without a will it is known as intestacy and will be distributed according to the laws of the state where that person resides. Generally, this means that the deceased’s property will be distributed among his or her immediate family, regardless of what his or her final wishes would have been.

Once a person passes away, his or her estate will generally need to pass through probate court, known in New York as Surrogate’s Court. Without a last will and testament, this process can be more costly and time consuming than if the deceased had clearly expressed to the court his or her final wishes on how to divide the estate in question.

Medicare helps seniors pay for a whole host of mental health treatment services, including both inpatient and outpatient treatment services to help diagnose and treat mental health conditions. Depending on the type of care needed, beneficiaries may incur some out of pocket costs, including deductibles, and are subject to some limitations on the length of treatment you can receive at in patient centers.

Medicare Part A will cover inpatient mental health services at either a psychiatric hospital or a general hospital, depending on the type of care determined by the primary care doctor. Medicare will cover up to 190-days of treatment at a psychiatric hospital during a person’s lifetime and may cover additional inpatient care at a general hospital if necessary.

When receiving inpatient care with Medicare Part A, beneficiaries will need to pay an out of pocket deductible before they enter the facility. As of 2018, that cost is estimated to be $1,340. After paying the deductible, Medicare Part A will pay the first 60-days of inpatient treatment in full. The next 30-days require the patient pay a daily co-insurance of $355 and the remaining 90-days require a daily co-insurance of $670.

If you have a beloved elder who currently needs or will eventually need long term, in-home health care, you need to know about new changes to federal labor laws that may not only raise the cost of these services but potentially alter quality aspects. In addition to federal labor and wage laws, state and even local laws may impact what you pay for in home health care and who provides it.

When a person suffers from dementia, alzheimer’s, or or another cognitive health condition, he or she will likely need the aid of a home health care aide to provide even the most basic of care needs. For many years, home health care providers who also lived in the patient’s home were subject to different portions of the federal Fair Labor Standards Act (FLSA) which made them exempt from overtime and would essentially earn less than minimum wage because the individual was expected to be on call even during the evening.

However, a recent legal decision determined these in-home health care workers were not overtime exempt and must be paid one and a half times their average hourly wage when working more than 40-hours per week. This meant that it became economically feasible for many families to maintain constant care to their loved one from a familiar person that could be counted on to provide attentive, individualized service to the patient.

The Trump administration recently issued a directive to revoke the Temporary Protected Status (TPS) for tens of thousands of immigrants from poverty stricken countries living in the country, many of whom who have found roles in the home healthcare market. With the cost of in-home and assisted living facility growing every year, the change could potentially add to those costs and put seniors and the disabled in a more difficult financial situation.

Approximately 59,000 Haitians came to live in the United States after the 2010 earthquake which devastated the country. Nursing homes and in-home care providers are already reporting staffing shortfalls as immigrants who found employment in their sectors have returned home for fear of forced deportation after losing their legal status. Even despite the threat of deportation, many immigrants working in nursing homes and as in-home health aides do not stay long in these jobs as they find professions in much higher paying sectors of the economy.

In Boston, Massachusetts for example, some elder care providers are speaking out about the selfless, hard work that their immigrant employees living on TPS status perform for long hours and modest pay. With many coming from nations where the witnessed humanitarian crises and seek to give back as part of the aid they themselves received in their times of need.

The dream of Americans is to age with dignity and independence while enjoying their golden years with family and friends and avoiding the need for any type of long term institutionalized care. However, trends in aging show that more and more Americans these days are relying on some type of intermediate institutionalized care before eventually moving into a nursing home to receive the attentive services they need.

However, despite receiving an estimated $10 billion in federal funding from the Centers for Medicare and Medicaid Studies (CMS), states encounter little oversight from regulators over the quality of care residents receive. Furthermore, over half the states do not report “critical incidents” to the federal government that include unexplained deaths, abuse, neglect or financial exploitation. All of that is according to a recent report from the Government Accountability Office (GAO).

Advocacy group Justice for Aging issued its own response to the GAO report to highlight the lack of accountability from many states and facilities receiving CMS funding. The directing attorney for Justice in Aging went as far as to point out that even among the 22 states that do provide the federal government with data on critical incidents the information is hard for the public to obtain and may not even illuminating enough.

The U.S. Department of Justice recently announced hundreds of indictments against individuals engaged in often elaborate schemes to defraud hundreds of thousands of elders across the country. The Justice Department said in a statement that it levied charges against over 250 defendants for their roles that contributed to an estimated $500 million in total financial damages against victims.

“Today’s actions send a clear message: We will hold perpetrators of elder fraud schemes accountable wherever they are,” Attorney General Jeff Sessions said in announcing the charges at a press conference. The Department of Justice coordinated with dozens of federal and local agencies to make the arrests, including working with Federal Bureau of Investigations, the Federal Trade Commission and state attorneys generals.

The perpetrators of the scheme allegedly used everything from mass mailing system and telemarketing schemes to identity theft to commit financial crimes against some of the most vulnerable portions of the population. In the past several years, the Senate Aging Committee received thousands of calls from individuals complaining they were either victims or an attempted target of some type of elder fraud.

Retirement is a time to relax and enjoy the things you have worked hard for all of your life. For many people, that means spending more time at the golf course or spoiling grandchildren. For others, it means adventure and traveling to places they have always wanted to go. In many cases, a person or couple’s objectives in retirement can best be met by retiring abroad. Whether you are doing so for the cost of living, to be closer to family, or just because you want to there are important considerations to keep in mind when it comes to your comprehensive estate plan.

Taxes

No matter what country they live in, citizens of the United States are still required to pay taxes to Uncle Sam. If you maintain residence in a state, that state may also continue to impose taxes on you. While you would likely be paying those taxes if you remained in the United States, living abroad could also subject you to taxes in the host country. That means you may face issues of double taxation, and that can have a significant impact on the assets you retain within your estate.

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