Elder Law

Dental Care and Old Age

Published on: April 13, 2017 | by Ettinger Law Firm

As we continue to age, there are a number of ailments that develop and health issues that we are forced to address and adapt to. While we anticipate problems such as achy joints and the occasional stiff legs, we do often forget about the continued upkeep associated with dental hygiene. Dental checkups are easy to forget about and avoid, especially when you do not feel like anything is wrong, however, as soon as something starts to ache, the check up can turn into a very expensive visit. Many elderly individuals avoid going to the dentist due to the associated fear of costs and lack of coverage.

Medicare does not provide dental care coverage for their insured beneficiaries, which leads many to either go without coverage or to retain an independent plan that could cost them more than they can afford in their budget. Millions of elderly Americans rely on Social Security and Medicaid or Medicare to support them in their old age, however, these programs continue to shrink in size and will not be able to provide for all of those soon to be retirees. Medicare does provide dental care for some chronic medical conditions such as reconstruction following an accidental injury, or extraction due to radiation exposure for neoplastic diseases of the jaw, a very specific list. Even with those exceptions, the reimbursement rate is so low that some doctors will not accept Medicare coverage in their offices because they know how difficult it becomes to get paid.
The National Center for Health Statistics has found that 20% of Americans over 65 years old have cavities that are currently going untreated, with the numbers steadily increasing with old age. With teeth becoming more brittle and procedures performed decades earlier needing maintenance, many elders find themselves in the Emergency Room due to the pain. There are a number of nonprofits however across the nation that offer free or discounted dental cleanings for elderly patients that do not have dental coverage and cannot afford it. Additionally, many universities offer discounted cleanings as well as procedures by having elderly patients be seen by their class of graduating dentists. They will offer up front costs of services as well as payment plans in an effort to avoid having the individual rack up debt.

Meals on Wheels Funding Gets Threatened

Published on: April 11, 2017 | by Ettinger Law Firm

Meals on Wheels is a government program that started in the 1950s that has assisted elderly citizens by delivering food to them when in need, either by providing the meals in the elderly individual’s home or in a community senior center. They not only provide the meal but also provide safety checks and visit with the senior, critical actions that have been shown to help elders live longer. There are over 5,000 independent organizations across America that help administer the program, and it has for decades, had much success. In order to receive funding local communities as well as the Older Americans Act help to keep the program afloat.

As the new budget is proposed, many programs are in jeopardy of being cut. One program that is may see a threat to funding is Meals on Wheels, due to the program not providing results. However, the nature of the program is not a results oriented initiative. The program services 2.4 million Americans, a number that will undoubtedly grow in the coming decades due to the large number of baby boomers beginning the retirement age. These cuts are the result of discretionary spending decisions related to the Community Development Block Grant that allocates a portion of the block grant money to elderly through Meals on Wheels. There have been numerous studies conducted that have showed the effectiveness of Meals on Wheels decreasing loneliness scores and also decreasing reliance on traditional care, while allowing elderly individuals to remain in their homes longer.

However, there are conflicting opinions about how much influence this will actually have on the institution. From financial statements released last year, only about 3% of the total funding was made from the block grant. On a local level, there is much more monetary influence, with federal funds accounting for 30% of the expenses relating to the home delivered meals. While the program’s costs and returns are currently being debated, it is evident that although it may not be the most lucrative on it’s face, Meals on Wheels can provide a number of benefits. One study even found that if there was a 1% increase in elderly individuals receiving Meals on Wheels, states would saved over $109 million, due to reductions in need for nursing home care.

Overzealous Powers of Attorney and How to Handle Them

Published on: March 22, 2017 | by Ettinger Law Firm

When determining how you want your estate and assets administered upon your death, it is also important to consider how you want decisions made in the event that you cannot make them for yourself. Naming a power of attorney has a number of benefits that will avoid any drawn out court proceedings to name an agent in the event of your incapacitation. Power of attorney documents name an individual, also known as an agent, to perform specific tasks when you cannot. These powers can vary, as there is medical/health care power of attorney and also property or financial power of attorney powers.

Medical power of attorney gives an individual the ability to make your health care decisions, such as where you should receive care, if you should receive a specific treatment in the event your wishes are not listed, as well as dealing with your insurance and medical premiums. Financial powers of attorney allow an individual, upon a specific event, to handle a variety of your financial matters on your behalf. While many people will name someone as power of attorney in the event of incapacitation, some will name a power of attorney to take effect immediately, thus, delegating decision making power.

These situations are predisposed to undue influence, something the court is very suspect of and will closely monitor in the event they believe an individual is abusing their power of attorney role over an elderly individual. In the event that you are competent and have named someone as a power of attorney, but due to a number of circumstances, including the end to a relationship or a possibility of undue influence, you wish to revoke the power of attorney, you can do so by delivering a notice to the power of attorney, your estate attorney, as well as other interested parties notified of the document.

The Basics – Guardianship and the Elderly

Published on: March 15, 2017 | by Ettinger Law Firm

As we continue to age, it can be difficult to admit when you are no longer able to handle personal affairs and financial matters on your own. There are a number of alternatives available to those seeking to have their affairs managed by another party, depending upon the individual’s mental capacity to comply with assigning these rights. Those providing caregiver services to the individual, commonly a loved one, may seek retaining legal guardianship of the elderly individual, assigning durable power of attorney and health care power of attorney to specific individuals, or establishing a trust.

Guardianship

Guardianship is a legal status given by the court to create a relationship between someone who is incapacitated or unable to care for themselves and a person determined to be suitable to administer and manage the incapacitated person’s affairs. In order to get a guardianship order, a person must file a petition with the court to review the case at hand. The court assesses the situation, the petitioner, as well as the elderly person to determine what will be the least restrictive method of guardianship. The appointment may include only managing financial affairs, but may also assign responsibility for day to day decision making including support, maintenance, and personal care.

Are Illegitimate Children Considered Beneficiaries?

Published on: February 24, 2017 | by Ettinger Law Firm

The legal rights of illegitimate children and their ability to take under the terms of a trust have for years been the subject of many litigation proceedings. Illegitimate children are traditionally known as children who are born out of wedlock or to unmarried parents, however, the most widely known cases are those children who were born as the result of an affair by either or both parents. When one parent is the beneficiary of the grantor of a trust, the other spouse of the child, when old enough, may try to assert claims that they are also entitled to access the trust due to blood relation.

How Does an Illegitimate Child Take?

While traditionally under common law, an illegitimate child was not seen as a legal child of either parent, with no right of parental support or right of inheritance, today the laws have changed to better reflect the rights of an illegitimate child. Although states differ regarding their laws on wills and trusts, many now favor giving children rights, under statutes such as The Status of the Children Act as well as the Equal Protection Act. Under the Status of the Children Act, there is a presumption that any reference to children not further defined in a will includes both legitimate and illegitimate children, regardless of their relationship to the father.

Elderly Abandonment: An Issue Around the World

Published on: February 17, 2017 | by Ettinger Law Firm

Aging comes with a wide variety of issues and relying on the care of your family is not a resource available to all. Whether it is due to lack of accessibility, estranged familial relationships, or advanced care requirements, many elderly find themselves alone in their older age.

This is not a phenomenon specific to America, it is an issue experienced by countries across the world. Certain cultures are more focused on caring for their elders, much like those elders helped raise them, while others have a less integrated idea of family including care for their elders.

In fact, the issue of elderly abandonment was such a large problem in Japan it was deemed “granny dumping”. While this practice, where senile senior citizens were taken up to the top of mountains and left there by loved ones due to the inability to care for them, is a very old practice, the modern version of abandonment is once against becoming a problem. Today, elderly individuals are being taken to local hospitals, churches and charities, and being left like they used to in the mountains.

Medicare Changes Under New Administration

Published on: February 1, 2017 | by Ettinger Law Firm

Another major platform that President Trump ran under was the promise to repeal the widely contested Obamacare plans, and to instead bolster Medicare and Medicaid eligibility and benefits. Since taking office, the businessman has changed his position multiple times regarding whether an overhaul of the system will be made or whether he will keep his promise to leave Social Security and Medicare alone.

Medicare Proposals by the House

House Speaker Paul Ryan has been an avid supporter of overhauling the system, by combining Medicare Parts A and B and also increasing the Medicare age of retirement to that of the full retirement age that one must qualify for with Social Security. Additionally, this proposal would allow Medicare beneficiaries to choose which plan they wish to elect between private plans or traditional plans, based on their health needs, but would not take effect until 2024.

Death Tolls Rise in Winter Months

Published on: January 26, 2017 | by Ettinger Law Firm

Winter months are difficult on many of those who live in areas that experience great seasonal changes. The National Center for Health Services actually found that death rates are twice as high in the winter than the hottest part of summer. Not only do we have bundle up and face the chilling weather, there is also a major threat of seasonal illness.

Thus, it is not surprising that individuals have the highest risk of dying from natural causes in the end of December and beginning of January. In fact, one study showed that those who die from natural causes, circulatory problems, respiratory diseases, nutritional/metabolic problems, digestive diseases and cancer have a greater chance of dying between Christmas and New Years than any other time of year.

Not Just in America

Medical Devices and Infection

Published on: January 23, 2017 | by Ettinger Law Firm

Recent Recalls

Open heart surgery has saved the lives of thousands of patients across America, as well as the world. Performing this task takes a highly skilled team of doctors well equipped with the right medical devices to assist them. All of these tools require FDA approval and specific cleaning procedures prior to their implementation during surgery. The Center of Disease Control and Prevention announced that a heater cooler unit that has been used in the majority of these surgeries since 2012, could have been contaminated when it was in the manufacturing process.

Heater Cooler Units for Open Heart Surgery

Death with Dignity Act Gains More Approval

Published on: January 19, 2017 | by Ettinger Law Firm

Physician assisted suicide has been a controversial topic across the world, however as the reasoning behind it becomes better understood, many countries have chosen to legalize the practice for reasons outside of terminal illness. In the United States, in the past few decades, the public began to take notice with news headlines such as those regarding Dr. Jack Kevorkian, the Michigan physician who helped assist numerous patients chose when they would die from terminal illnesses and subsequently served eight years for his acts.

Today, physician assistance in dying is legal in Washington, Vermont, Montana, Oregon, with California recently signing in their aid in dying legislation in June 2016, Colorado approving a ballot measure in the most recent November 2016 election by two thirds majority, as well as the District of Columbia signing in their version of the same aid in dying law in December 2016. With a not so surprising passage of these laws comes the realization that Americans as a whole see the reasoning or at least themselves would want the option, in the circumstance they were to become terminally ill.

What is different with the United States’ various aid in dying laws in place is that they are all for those patients that are terminally ill, requiring certain validation steps through physicians and therapists.