Articles Posted in Elder Law

This week the New York Times published a story that will likely ring true to all those who have gone through the process of helping a loved one figure out how to secure the ideal long-term care. It is one of those issues that is easy to talk about in the abstract but that comes packed with intense emotion when one is actually thrust into it and forced to help those closest to them.

One of the scariest aspects to this situation is that it can arise virtually overnight. The NYT story shares the example of one man whose 81-year old parents seemed to go from swimming and playing sports to both becoming frail the next day. Their ailments struck at the same time. His mother developed dementia and passed away within a year of first falling ill. This left the family in a very tough spot. In the midst of grief, they had to make tough choices about how to ensure their father had proper care. Fortunately, the family was in a much better position than many, because the patriarch had purchased a long-term care insurance policy nearly three decades before. That insurance has been able to provide at-home caregivers for the last two years.

That is a key reason why the NY elder law attorneys at our firm encourage families to use long-term care insurance when possible while crafting long-term care plans.

As most know, the March 1st “sequester” cut deadline came and went without much serious action by policymakers to avert the automatic cuts. This was not unexpected considering policymakers have been very far off on goals for a compromise and because the $85 billion in first year cuts will not necessarily take effect immediately. The real layoffs and consequences that might be felt by most community members will roll out slowly throughout the year, stalling the public outrage and pushing off the political pressure that might force an ultimate budget agreement.

It is important to clarify that while Medicaid cuts were not part of the sequester, potential changes to Medicaid are very much part of potential compromise that could be reached in the coming weeks and months. For that reason, it is important for all local families who rely in any way on New York Medicaid (or who expect to in the future) to understand how potential changes may alter their options.

Latest GOP Proposal

Many of the changes and new rules associated with health insurance as part of the “Affordable Care Act” (Obamacare) will only take effect over the next year or two. One of those new rules prohibits most health insurance providers from making premium pricing decisions based on one’s gender. However, those rules do not apply to companies that provide long-term care insurance.

Therefore it does not come as a huge surprise that the nation’s largest provider of such insurance–Genworth Financial–announced that they will soon being change rate plans to account for the fact that women are more likely to need paid long-term care. According to a Washington Post story, women seeking such insurance on their own will likely see anywhere from a twenty to forty percent increases in yearly long-term care insurance payments. Importantly, the change will only affect new policyholders, as current members should not be affected. Observers note that other long-term care insurance providers will likely follow suit.

The policy change was made, say the company, because of the fact that over ⅔ of all claims on the insurance are made by women. In order to stabilize prices, the company claims that the premium rates needed to better reflect the risk and ultimate need for long-term care. The increased claims by women are likely a product of the fact that they generally live longer and provide care to their own spouses. Men are far likelier to avoid having to make claims on the insurance because their health declines sooner and their spouse often provides care. Elderly women, however, often come to need support after their spouse has passed, and they do not have the luxury of receiving free care from a relative.

The challenges of securing appropriate long-term care are often only understood at the exact moment when that care is needed. After a sudden medical emergency, accident, or other change in condition, many families discover that an elder loved one is in need of long-term help to get by each day. These families then face two difficult questIons: (1) How are we going to pay for it?; (2) How do we know that the quality of the caregivers is sufficient?

For one thing, the financing of long-term care can be secured in many different ways. A NY elder law attorney can explain what options are available in your specific case. Those options may involve insurance, the use of Medicaid Asset Protection trusts, or other unique strategies to save funds even when on the nursing home doorstep. There is no getting around the fact that elder care is quite expensive–startling so–but planning ahead with professionals can save significant sums.

But paying for care is only part of the battle. It is also critical that family members ensure their love ones actually receive the care they deserve, no matter what facility they enter. Sadly, without proper oversight, seniors may face severe neglect or outright abuse by those charged with their well being.

There is no getting around the fact that certain costs will be incurred near the end of life. Even if you are in great health, live at home until the very end, and require no extra caregiving of any kind, your passing will come with certain financial challenges for your family. Most obviously, there are burial and funeral details to be paid for. Yet, more frequently than many realize, local families are forced to struggle and scrape just to put together enough money for those final arrangements. The challenge can be particularly tough for elderly individuals who have very limited incomes and no means to earn more.

The struggle was highlighted in a sad case discussed this week by KOMO News. The story details an estate sale that an elderly woman is having in order to pay for the burial costs of her recently-passed husband. Her husband of 46 years recently died after living his final two years with Alzheimer’s. As families with relatives facing cognitive mental issues know, the costs associated with this care can be staggering. It doesn’t take much for middle class families to be financially wiped out in short order when dealing with the ancillary costs of Alzheimer’s care.

In this case, the 88-year old widow, Elsie, had only $9 to her name at the time of her husband’s passing. In describing the sad situation the article author explained, “Elsie is alone in this world. At 91, she has outlived all her friends. She has no children, no relatives of any kind, and she is broke.”

It is commonly understood that elder abuse is a serious concern that often goes unreported. But there remains less certainty about the best ways to address the problem. A recent Buffalo News editorial argued that more needs to be done at the state and federal level to tackle the issues.

For one thing, New York is one of only three states in the country that does not have a law which requires reporting of elder abuse and financial exploitation. The idea is that community members–particularly those in situations where elder abuse might be observed–must be made aware of the gravity of the situation and effectively forced via the law to report their suspicions.

The story points to recent research by Cornell University academics entitled “Under the Radar: New York State Elder Abuse Prevention Study.” Disturbingly, the report found that for every case of elder abuse that is reported to authorities, another 44 cases are never shared. That estimate is similar to those made by previous researchers. When all forms of elder abuse are considered (including financial exploitation by family members), other studies have found that upwards of 95-99% of exploitation is not reported.

Many seniors and their families only learn about the significant cost of nursing home care when they begin planning for it later in life. New York is one of the most expensive in the country, with annually costs reaching $100,000 or more to live in a skilled nursing facility. NY elder law attorneys and other senior advocates always recommend as early preparation as possible, because getting a jump on the issue keeps more options open. For the majority of residents, Medicaid support is usually needed. The earlier this is planned for, the more property can be spared for being “spent down” to qualify for Medicaid.

Conversely, some seniors of more means (or more early planning), may have saved enough personal assets to pay for nursing home care on their own. Some pay for care for a few years and then switch over to Medicaid when their resources are exhausted.

Unfair “Granny Tax?”

The legal professionals at our firm provide elder law and estate planning services. Many community members are familiar with the basics of estate planning. Tasks like designing wills, creating trusts, and putting inheritance plans into place are understood by most when thinking about “later in life” legal issues. However, elder law is a bit less clear. What does it actually mean?

While there are many definitions, a good one was put forward on a recent story on the issue published in Wealth Management. Essentially, the authors of the material suggested that elder law can be reconsidered as “quality of life planning” to maximize the value the last two to three decades of one’s life.

In general this focuses on long-term care. Securing the proper care is critical for seniors to thrive in their golden years. But even though seventy percent of Americans will need long-term care at some point in their lives, the process of obtaining it can be incredibly confusing, complex, and, in some cases, downright impossible. An elder law attorney is responsible for assisting at these times by either putting plans in place early on so that the long-term care is available in the future or working when “on the nursing home doorstep” to protect assets while ensuring the necessary care is available.

The fiscal cliff crisis dominated the last month of 2012. Even though an agreement was reached on New Years Day, the compromise is far from the end of partisan political battles and confusion. Observers are already making predictions about the possible implications of the looming “debt ceiling” fight between the White House and certain members of the Republican caucus which must be resolved in the next month or two. The outcome may have significant impacts on the nation’s long-term stability and the performance of the financial sector.

It is easy to see how New Yorkers thinking about their long-term care planning and retirement might be uneasy about the state of affairs. While some things are simply out of your hands, it is critical not to forget that there are smart ways to plan for retirement regardless of the flux in national politics. A recent Forbes article is worth a look, as it explores five of the best way to protect one’s retirement from the federal government’s “fiscal follies.”

Plan Ahead

One aspect of the “compromise bill” passed last week to avert the fiscal cliff may eventually have impact on planning for New York long-term care costs. While it does not have any immediate effects for local residents, it is important to discuss as it could lead to proposals down the road to tackle the problem of paying for long-term care. Specifically, a portion of the compromise bill did two things: formally ended the CLASS Act and also created a federal commission to study the issue of financing senior care. Both components are worth discussing more fully.

First, the CLASS Act was a bill passed as part of the comprehensive healthcare law of 2010. The idea was that the measure would create a voluntary, national long-term care insurance program. Our elder law attorneys frequently share information on the merits of long-term care insurance, as it is often the premier way for local residents to ensure they receive high-quality senior care in whatever manner is best for them with minimal disruption of their lives. The major downside, of course, is the costs, which can be prohibitive to many.

Those same cost concerns seem to have been the main problem with the CLASS Act as well. Even though the law was passed in 2010, it had essentially already been abandoned by even its supporters before this formal axing via the fiscal cliff compromise bill. That is mostly because actuaries had determined the program to be far too expensive for most residents to participate anyway.

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