Elder Law

First-Ever LGBT White House Conference on Aging Held

Published on: May 9, 2012 | by Ettinger Law Firm

Earlier this year New York City welcomed the opening of the nation’s first ever LGBT Senior facility. The SAGE Center (Services and Advocacy for GLBT Elders) is located in Manhattan on 27th Street in North Chelsea. As our New York elder law attorneys noted in a previous post on the center (see here) the facility will provide a range of services for the often-vulnerable members of this community. Many LGBT seniors have an increased need for support at this time because they are less likely to have adult children providing help when they age.

Fortunately, more and more advocates and community members across the county are recognizing the unique needs of this community. As reported by GSFLA News this week, the nation’s first White House LGBT Conference on Aging was held on Monday. The three day conference was opened by U.S. Representative and chairwoman of the Democratic National Committee, Debbie Wasserman-Schultz. In her remarks, Rep. Wasserman-Schultz noted that the long-term care needs of this community always existed, but they previously existed “in the shadows.” She went on to note the important of elder law issues, explained that, like all senior communities, LGBT elders need a wide range of support services down the road.

Other speakers at the event included an administrator at the U.S. Health and Human Services Department and an assistant secretary for policy development and research at the Housing & Urban Development Department. The two spoke on the crucial issues of senior healthcare and housing.

Do-It-Yourself Legal Planning–The Dangers

Published on: April 24, 2012 | by Ettinger Law Firm

One wouldn’t choose a surgeon who had never performed that particular surgery before. Experience and training matter when it comes to medical health, and the same principles should apply to legal planning efforts. New York elder law planning requires first-hand knowledge of the process as well as familiarity with common pitfalls to help craft overall strategies that provide the maximum benefit to meet one’s specific needs. There is rarely a “one-sized-fits all” approach to any of these issues, because no family is identical. That is why is it usually counterproductive to try to deal with elder care issues using do-it-yourself form legal documents.

Two of the most important documents in any elder law plan are powers of attorney and health care proxies. While the concepts behind these legal documents seem simple, failure to get help crafting them can have significant consequences. For example, New York has a statutorily created form to guide powers of attorney. The form is long and includes various features of which residents might not be aware. For one thing, to protect seniors from being taken advantage of, the statutory form restricts the power that the agent has over financial issues. Any additional powers needed in addition to those in the statutory form must be added individually. In addition, when not done correctly banks or other financial institutions may fail to recognize it.

A do-it-yourself health care proxy may come with similar issues. For example, under state law an agent cannot make decision about withholding certain extreme life support measures even when they have a valid health care proxy. The principal’s wishes about the withholding must be explicitly stated in a living will. When the proxy is crafted without proper legal help, this feature is often left out. Unfortunately, this error is usually only uncovered at the exact moment when it is needed–which is too late.

Editorial Calls for Keeping “Spousal Refusal” Option for New York Medicaid

Published on: April 16, 2012 | by Ettinger Law Firm

New York is one of three states that provide a Medicaid planning option known as “spousal refusal.” Essentially the option provides a way for a healthy spouse to save assets and income beyond that originally exempt from Medicaid while still having an ill spouse receive necessary long-term care under the New York Medicaid program. Our New York Medicaid attorneys have helped many families plan in just this way. We often advise clients that there are some potential complications following use of this tool–like a possible lawsuit from the Department of Social Services. However, regardless of the risks, for a variety of reasons the spousal refusal option is a prudent tool for families in many different situations.

However, there is a chance that spousal refusal may not be available to couples in the future. That is because New York Governor Andrew Cuomo recently proposed removing the spousal refusal option in the state. Financial concerns are driving this plan. Some estimates suggest that $34 million a year may be saved by eliminating the state’s spousal refusal.

Many senior advocates have voiced fierce opposition to the proposal, suggesting that the cost to local families would be devastating. Assemblywoman Nicole Malliotakis–a member of the Assembly Committee on Aging–explained that the proposed policy change would force some couples to lose everything that they have built up over a lifetime. Forcing healthier spouses to spend down their assets may have serious adverse effects on the healthy senior’s own well-being. That individual may then require even costlier care themselves than if they had been allowed to keep their assets instead of losing them so their ill spouse qualified for New York Medicaid.

Defending Seniors–Consumer Financial Protection Bureau’s Office of Older Americans

Published on: April 12, 2012 | by Ettinger Law Firm

The Star Tribune recently profiled Hubert Humphrey III–a former favorite son of Minnesota–who is now in a new role in Washington D.C. helping to enact national senior care policy that might affect older Americans across the country. Humphrey was recently chosen to lead the Consumer Financial Protection Bureau’s Office of Older Americans. He was chosen for the position in large part because of his previous advocacy on the AARP’s national board of directors.

The new federal office is engaged in many different battles, all aimed at improving the lives of the growing class of American seniors and protecting them from falling victim to financial predators. Our New York elder law attorneys understand the challenges faced by so many older Americans and appreciate the need to enact common sense safety steps at the federal level.

The Office of Older Americans was actually created as part of the Dodd-Frank Wall Street Reform and Consumer Protection Act. It was created to safeguard the rights of those over 62 and ensure they are properly educated about their financial options. Assistance in these and similar matters is all the more important now in a world with stagnant retirement accounts and rising healthcare costs. Each New York elder law attorney at our firm works first-hand on many of these goals, helping local residents seeking to craft plans to protect their long-term financial and medical well-being.

Alzheimer’s Association Focuses on Providing Senior Care Assistance & Support

Published on: April 5, 2012 | by Ettinger Law Firm

There were 39.6 million individuals in the U.S. over 65 years old in 2009. In roughly twenty years that number is expected to increase to 72.1 million. At that point the senior population will constitute roughly 19% of the total American populace. The changing demographics are placing significant strain on public Medicare and Medicaid resources. That is why many observers have focused more attention on the ways that outside not-for-profit groups are working to help seniors in need. Our New York elder law attorneys realize that tremendous good work is performed by so many local groups on these issues. It remains unclear if public programs will be able to fully handle the influx of seniors, and it is likely that local nonprofit groups will continue to play a vital role in ensuring that particularly vulnerable elderly community members receive the care they need.

A new Western Edition article recently summarized some organizations that provide various types of aid to seniors. For example, the Alzheimer’s Association is the nation’s leading organization raising awareness of this cognitive disease that affects so many local residents. Beyond advocating for support in research, the organization provides patient and family services to help those dealing with the effects of the condition which causes memory, thinking, and behavior challenges. The agency has a 24-hour a day help line where families can call for information and referrals.

5.4 million Americans are currently living with Alzheimer’s and the number is expected to more than triple in the next few decades. It is currently the sixth leading cause of death in the United States. Our elder law attorneys have worked with many families whose loved ones are dealing with various stages of the disease. According to the Alzheimer’s Association, more than $210 billion worth of unpaid care is currently being supplied by family members helping loved ones with different forms of dementia.

Is Medicaid Funding Getting Harder to Come By?

Published on: April 3, 2012 | by Ettinger Law Firm

A Wall Street Journal article this weekend asked some tough questions about the availability of Medicaid nationwide. Our New York Medicaid attorneys realize that many local residents are understandably concerned about the program in our state–it is an essential lifeline for many seniors. The latest WSJ article suggest that some states are making it harder for individuals to receive Medicaid help to pay for long-term care costs–however, the “crack down” on Medicaid expenditures is advancing very differently in certain states.

According to the Kaiser Family Foundation, Medicaid now accounts for about 40% of long-term care spending nationwide. The program is a joint state and federal effort that provides healthcare resources for those unable to afford it. There are federal qualification guidelines, but states are free to work within those guidelines to set specific standards about what is required before a resident is able to receive Medicaid support. As a result of this state flexibility, there can be significant differences in qualification factors in different parts of the country.

Considering that most state are experiencing budget shortfalls, many are looking into different ways to save on these costs. Of course, New York Medicaid changes and proposals are frequently in the news, as local policymakers continue to explore various ways to save money. As the article notes, some of those proposed changes include tinkering with the ways that the state can recover costs from the estates of those who used the program. Our New York elder law estate planning attorneys work closely on those issues, following along with all changes in the law so that local families are best positioned to receive the care they need while saving as many assets as allowable under the law.

Elder Law is Not Just for the Elderly

Published on: March 30, 2012 | by Ettinger Law Firm

Some mistakenly dismiss elder law issues as something with which they need not concern themselves until they personally need help getting by each day. However, our New York City elder law attorneys have worked with many local residents on these issues decades before they need care themselves. That is because many adult children are forced to deal with these concerns on behalf of their parents–many of whom have serious health concerns that arise quite quickly.

With demographic changes leading to a boom in the elderly population, the need to care for aging parents is catching more and more adult children by surprise. According to the AARP, more than 42 million individuals (usually adult children) provide caregiving for elderly friends and family. Another 61.6 million provide partial caregiving support at various times throughout the year. A story from Life Stages discussed the very serious worries faced by those who are unexpectedly forced to wade through a myriad of confusing and complex issues (including many related to elder law) when their parents can no longer get by on their own each day.

The story profiles one woman whose story is shared by many in our area. Her eighty three year old mother had a massive stroke last summer which led to her becoming paralyzed. Her father, also eighty-three years old, was unable to provide the care that she needed. The hospital recommended that the mother be moved into a nursing home. Before taking that step, the daughter wanted to learn if she had any other options.

Money for Senior Care Services Fails to Keep Pace with Rising Need

Published on: March 28, 2012 | by Ettinger Law Firm

Surveys from the AARP suggest that more than ninety percent of seniors would prefer to stay in their own homes as they age instead of moving into a nursing home or assisted living facility. Our New York elder law estate planning attorneys work with many seniors who take preparations specifically to avoid being forced to move in the future.

Unfortunately, access to the support services that allow seniors to stay at home is getting harder and harder to come by. Transportation services, meal delivery programs, adult day care centers, and similar programs are finding it tougher to stretch stagnant resources to aid a growing number of seniors. The Times Herald-Record touched on these New York elder care concerns in a story this week.

For example, at the end of this month the Dial-A-Bus service will no longer be providing support to elderly community members in New Windsor, Cornwall, and many nearby towns. Senior care workers explain that it is hard to underestimate the value of those sorts of services. For some isolated seniors, the bus service was not simply the only way they had to get to doctors appointments, but it was often the only chance these seniors had to socialize and interact with those in the community.

Green House Project: Nursing Homes Shift Away From Institutional Settings

Published on: March 26, 2012 | by Ettinger Law Firm

Nursing homes can be intimidating places. The traditional model for these facilities is institutional, with facility designs and procedures based on mass efficiency instead of individual concern for the well-being of each resident. Our New York elder law attorneys appreciate that this “regimented” lifestyle is feared by many local residents who likely have personal stories of friends or family members who lived unhappily in one of these facilities. Some resident even put off elder law estate planning specifically because thinking about these issues is unpleasant and many would prefer to just avoid the issue altogether.

Of course, failure to plan for long-term care issues actually has the opposite effect–making it more likely that one will be forced to live in a less than ideal location. In fact, so long as resources are available, there is a growing chance that around-the-clock care can be provided for even the most ailing seniors in locations that reject the old model and prioritize individual care and personal well-being.

For example, the Democrat & Chronicle published a story on a new national movement to improve elder long-term care. The Green House Project is a program originally funded by the Robert Wood Johnson Foundation. It seeks to phase out the old nursing home model for one that focuses on more intimate settings. New homes built as part of the project have clusters of seven to ten residents who each have their own room and are given more autonomy. While projects like Green House are growing in popularity, it is undeniable that there is still a long way to go before all nursing home residents have care that places emphasis on their individual quality of life.

Mom Has Dementia and We Don’t Know What to Do

Published on: March 14, 2012 | by Ettinger Law Firm

There is no easy way for a family to deal with a senior grappling with a cognitive mental disease like dementia or Alzheimer’s. Like any health problems faced by loved ones, a family’s initial reaction is to try to get the senior the help they need. However, each New York elder law attorney at our firm understands that cognitive conditions are tricky, because the injury is not physical and often the senior may not be fully aware that they are even suffering from the problem at all.

One elder law advocate recently discussed this challenge in response to a reader question explaining her family’s difficulty dealing with her mother’s dementia. As published in the L.A. Times, the reader revealed that her 82-year old mother, who has dementia, began accusing the family of spying on her. As a result, the mother admitted to her doctor that she wouldn’t share anything about her health with them. The family has been left wondering what to do to help their ailing matriarch get through this difficult phase. Many local families visit our New York elder law estate planning attorneys with the same concerns about helping relative with cognitive issues.

For one thing, in many cases a doctor will not be willing (or legally able) to discuss the mother’s condition without legal documents in place. This is particularly true when the doctor suspects that there may be a family rift. Creating those legal documents is a large part of the work done by elder law estate planning lawyers. The documents help ensure that the senior can receive help with their legal, financial, and healthcare decisions. Creating a trust may allow a third party to manage an ailing senior’s assets. A durable Power of Attorney allows financial decisions to be made by another. Health Care Proxies are needed to make key medical decision when another is unable to do it on their own.