Articles Posted in Elder Law

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.

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.

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.

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.

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.

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.

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.

Advisor One reported his week on a push by a variety of national legal associations to support the “Older Americans Act of 2011.” The Older Americans Act (OAA) was first passed over 45 years ago, in 1965, to support seniors nationwide with a range of community planning and social services. The Administration on Aging was established as part of the legislation. Many New York elder law attorneys have joined in the advocacy effort to reauthorize the bill. In fact, just this week the National Academy of Elder Law Attorneys (NAEL) announced their support for the measure. NAEL is a professional association of elder law attorneys that work with the elderly and those with special needs.

Over the years many advocates have come to appreciate the important role that the OAA plays in the lives of vulnerable seniors throughout the country. However, the law was set to expire in 2011. That is why Senator Bernie Sanders from Vermont proposed legislation which would reauthorize the Act. It is difficult t get anything passed through the gridlocked Congress these days. However, that has not stopped those supporting these important efforts from trying to get it through the system. Many elder law advocates believe that the reauthorization effort is actually gaining steam.

A separate bill–the Older American Act Amendments of 2012–would make a few important changes to the original measure. For one thing, it calls for a revision of the ‘Experimental Price Index for the Elderly.” This initiative would change the index so that it more accurately reflects the costs which impact seniors at this stage in their lives. Other changes include altering the definition of “economic security” as it applies to determinations for housing, transportation, and long-term care assistance. A Meals on Wheels program would also be established along with a senior center community planning grant program.

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Yet another company, Northwestern Mutual, has recently issued a “Cost of Long-Term Care” study. Of course, the results indicate that the actual cost depends on a range of factors including what part of the country one lives, whether an at-home aide is hired, or whether one moves into a skilled nursing facility. As any New York elder law attorney can attest, our area is always at the very top of the list when it comes to long-term care costs. It is for that reason that it is particularly incumbent upon area resident to meet with an elder law attorney to plan ahead before the costs actually need to be paid. It is simply impossible for most families to bear the financial burden of this care on their own.

This latest research effort from Northwestern Mutual involved surveys from 6,000 different sources, including a mix of assisted living facilities, home health care organizations, and nursing homes. The researchers found that the hourly rate for home healthcare workers was anywhere from $33 per hour to $15 per hour. New York assistance was near the highest of the group.

The focus of most New York elder care planning discussions naturally revolves around the needs of seniors. Are they receiving proper nutrition? Do their caregivers timely attend to their dressing, bathing, and washroom needs? Do they remain connected to the community with opportunities to use their unique skills and abilities? Our New York elder law attorneys know that for far too many seniors, even these basic needs remain unmet. The problem of elder neglect and abuse is troubling, and it will likely become more of a concern in the coming years as the population ages and the total number of seniors in need of extra help skyrockets.

However, a holistic approach to senior care requires not just consideration of the senior’s needs but also understanding of the effects on senior caregivers. A CNN Living article this week examined the way that helping an elder resident impacts adult family members. The story of one woman was shared who took her 72-year old father out of a nursing home out of concerns for his well-being. Instead she moved him into her on own two bedroom apartment. The woman admits that she put her life on hold, because the obligations of working full-time while helping her father was overwhelming. She was often required to miss work to take him to a wide range of appointments with medical professionals. In addition, she used her lunch breaks to ensure he took his medications and made it to his dialysis appointments. She confesses, “It was like ‘oh my, what did I get myself into?’ Sometimes I would just go into the bathroom and cry.”

Her situation is not unique as a new “Stress in America” survey from the American Psychological Association found that at least 55% of senior caregivers feel overwhelmed by the task. Not only did the caregivers report higher levels of personal stress, but they were also found to be in poorer health themselves. Caregivers were more likely to engage in unhealthy behaviors in an attempt to alleviate the stress.

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