Articles Posted in Elder Law

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.

Our New York elder law estate planning lawyers understand that handling long-term planning issues can be particularly delicate when there are second marriages involved. However, it is in these situations, with blended families, when this sort of planning is absolutely critical. Many adult children have natural concern when their parent remarries. Obviously there are inheritance planning issues, and it is vital that seniors who remarry make their wishes very clear about who they’d like to receive what. Failure to do so opens the door to strong disagreement and infighting between those involved. The family glue can come undone even among blood relatives, and there are often even less ties keeping fights in check when blended families are involved.

Beyond inheritance issues, local families should also take note of the New York elder law concerns which are implicated by second marriages and blended families. Decisions about naming a Health Care Proxy and Power of Attorney in the event of disability can present some disagreement when seniors remarry.

An article this weekend in the Laurel Leader-Call referred to another issue regarding the long-term care planning problem in the context of second marriages. The story discussed two seniors who met at an assisted living facility, fell in love, and married. Eventually one of the partners began a physical and mental decline and needed to be moved to a nursing home. The couple did not realize that Medicaid could have been applied for to help support those nursing home costs. If the partner whose health deteriorated passes away, their life savings may be entirely exhausted in providing for the long-term care. As a result, the surviving spouse is often left in dire straits when his or her own health deteriorates and they have a need for skilled nursing care. What often happens is that adult children are forced to scramble in crisis mode to figure out how to pay for the care the elder needs. A range of issues are present when those adult children are step-children who may not have as close a connection with the senior.

Many writers have taken to calling the upcoming wave of baby boomer retirements as the “silver tsunami.” Like real tsunamis, the demographic shift is expected to have many ripple effects in communities across the country. Each New York elder law attorney at our firm has seen first-hand the challenges faced by many in our area when trying to figure out where they will receive long-term senior care and how they will pay for it. These issues are common to all local families who have loved ones about to leave the work force to enjoy time in their golden years.

However, some senior community members have even more unique concerns.

The Associated Press published an interesting article this week discussing the struggles of senior GLBT community members. Public opinion data consistently shows that the younger generation is much more open and supportive of their gay, lesbian, bisexual, and transgendered community members. Older Americans are less approving. That is leading many gay seniors to wonder how they might be treated if they end up in a traditional nursing home or long-term care facility. One expert summarized that many of these “seniors fear discrimination, disrespect or worse by health care workers and residents of elder housing facilities, ultimately leading many back into the closet after years of being open.” In addition, GLBT seniors are much less likely to have biological family members to help them through this time of their life. Estrangement and childlessness are more common for gay seniors, making them more dependent on outside services.

Local seniors obtain peace of mind knowing that they will be able to receive late-in-life care in an ideal setting and that the care will be of top quality. These simple goals should not be out of reach for any elder community member. However each New York elder law attorney at our firm knows that many seniors will be forced to deal with less than adequate care, often in institutional settings where they would rather not live.

Part of the problem is that many local residents will not have visited with a New York elder law professional ahead of time to plan for this time in life. Staying in one’s home while aging usually requires advance planning. However, it is not enough to merely have the aid of a home care worker–one must ensure that the worker is actually providing an appropriate level of care. A recent article from Aging Parents explained that there has been a shortage of quality home care workers. One of the problems, argues the author, is the fact that for a period these workers were exempt from minimum wage laws. When Congress passed minimum rights legislation, all home care workers were lumped into the category of exempt employees who acted as “companions.” This was the case even for workers who engaged in a wide range of physical labor helping seniors bathe, dress, use the facilities, walk, get exercise, and eat properly. Of course, it seems intuitively unfair for these workers to be forced to live in dire poverty at incredibly low wages and no overtime pay.

Fortunately, the legal error was recently corrected. The author suggests that part of the reason the law took so long to change was that many of the individuals who fill these roles have few advocates, often including women and those who are not native English speakers. Also, as a result of the prolonged period of abysmal pay, advocates are worried that there is a shortage of well-trained, capable home health care workers. The need for these workers is expected to skyrocket in the coming decades.

Each New York elder law attorney at our firm understands that maximizing the quality of life for local seniors requires both proper individual planning and common sense elder law policy proposals at the local, state, and federal levels. On the planning side, all local residents should visit with a New York elder care lawyer to prepare for disability, save taxes from Medicaid costs, and deal with similar issues. When it comes to policy, it is helpful to stay up to date with changes that are being proposed which may affect the lives of seniors. One of the key governmental bodies related to these issues is the U.S. Special Committee on Aging. This Senate committee has been at the center of all important federal elder law issues over the past half century.

Last week the National Academy of Elder Law Attorneys (NAELA) issued a special proclamation honoring the 50th Anniversary of the U.S. Special Committee on Aging. NAELA, a nationwide group of elder law attorneys, also co-sponsored an event in Washington D.C. honoring the committee’s achievements.

The Special Committee was first created in 1961 as a central national clearinghouse to discuss and deliberate on a wide range of issues that affect senior citizens. Over the years the committee has been involved in any number of senior issues, from health care problems and elder financial exploitation to retirement security and nursing home abuse. In recent years the Special Committee on Aging has led the way in passage of the Elder Justice Act, Older Americans Act, and a wide range of issues seeking to improve the care at long-term skilled nursing facilities. Last year the committee brought national attention to senior housing issues during its hearing entitled “Continuing Care, Retirement Communities: Secure Retirement or Risky Investment?” In recent years the Committee served as the center of other important debates such as during the hearings “Exploitation of Seniors: America’s Ailing Guardianship System” and “Sound Policy, Smart Solutions: Saving Money in Medicaid.”

This month the AARP’s Public Policy Institute, in conjunction with the National Conference of State Legislatures, released a new report that is of direct applicability to all those concerned about their New York long-term care plans. Entitled, “Aging in Place: A State Survey of Livability Policies and Practices,” the project is focused entirely on analyzing what states are doing (or not doing) to help seniors stay in their own homes as they age. As the report authors note, the vast majority of seniors prefer to age in place, but their ability to do so is in many ways dependent on how communities are designed and senior care programs implemented. Toward that end, the report took a look at land use policies, transportation services, and housing options across to country which are helping seniors meet their goal of avoiding the need to move.

When it comes to land use, the report found it crucial to integrate necessary services with transportation planning to reduce automobile travel. If older adults can more easily walk or otherwise reach necessary support services, they will be able to live in place longer. Also found to be helpful were requirements for implementing transit-oriented development within a half mile of transit stops and joint use of community facilities for senior centers and health clinics. Similarly, increased public transportation options are important to the efforts of many seniors to stay in place. “Complete street” policies are in place in some states requiring designs which allow travelers of all ages and abilities to navigate the street. The policy institute also suggested better coordination between human service transportation agencies. The coordination allows these agencies to do more with fewer resources.

When it comes to housing, many elder care plans are created specifically to help seniors have access to preferable living situations–usually outside of the nursing home. However, the AARP report found that there is a shortfall in affordable and accessible housing for seniors, making it difficult to avoid the institutional setting. To help, the authors suggested states make use of the federal Low-Income Housing Tax Credit programs to obtain more funds to increase the affordable housing supply. Similarly, developers should be encouraged to increase accessibility by altering building standards.

The Nieman Watchdog–Harvard’s journalism faculty blog–recently published a commentary speaking to the looming “retirement crisis” and the problems with the federal government’s current approach to dealing with it. The author notes that retirement planning is not what it used to be as many workers today are “facing a grim future in which the kind of retirement plans their parents were able to take for granted is out of reach.” Our New York elder law attorneys have discussed these changing dynamics and the demand they place on thinking about long-term care plans in new ways.

The commentary notes that it is folly to presume that one will be taken care of in the future, because the growth of “defined contribution plans” (as opposed to “defined benefits plans”) means that retirement savings often hinge on the performance of the markets. It is argued that this shift has made income from private pensions smaller and less reliable than in the past. That issue, coupled with rising health care costs, places a real strain on many retirement plans.

Considering those concerns, it is perhaps surprising that federal policymakers have spent most of their time discussing cuts to Social Security, Medicare, and Medicaid. The problem also exists at the state level, as New York Medicaid planners have been forced to watch as state policymakers consider a wide range of proposals to revamp the healthcare system that so many local seniors rely on for long-term care support.

Last Thursday a group of elder care advocates, seniors, and local politicians held an event to raise awareness of the possible closure of area senior centers. According to a report in Staten Island Live, the gathering was specifically called to ask Governor Cuomo to refrain from making changes to state Title XX funding. The proposed changes would essentially cut roughly $25 million from the budgets of senior centers citywide. Held on the steps of City Hall, state Senator Diane Savino led the event where more than 15,000 letters were unveiled written by seniors explaining how the cuts would affect their lives. Our New York elder law attorneys are aware of the ways that many local elders rely on various support services offered at these facilities.

The Title XX funding accounts for about a third of the total financial support provided to these centers. However, the funding is discretionary and some are proposing that it be moved over to support child welfare services. If the changes are made over a hundred senior centers will be forced to close. Lillian Barrios-Paoli, the Department for the Aging Commissioner repeatedly emphasized that the lives of thousands of seniors would be made qualitatively worse if these proposals were to advance. She explained that “this is an issue that shouldn’t even be debated.”

Others are questioning why such a proposal would even be brought forward in light of the changing demographics. As we have often reported, the elderly population is the quickest growing age group nationwide. The trends are no different in our area. Baby Boomers are now beginning to retire–a trend that will last for decades. The growing senior population means that New York elder care planning needs to be conducted now in anticipation of the needs of this population. Eliminating services to this group would seem to be a step in the wrong direction. Senator Savino commented on the pressing concerns already facing seniors by noting that “we have enough things to worry about. Take this off the table.”

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