Articles Posted in Elder Law

AARP Report Finds Expanding Costs of Family Elder Caregiving

Published on: November 15, 2011 | by Ettinger Law Firm

The AARP Public Policy Institute recently released a new report discussing the contributions that family members nationwide make to caring for their elderly family members. Recent news has focused on how local, state, and federal governments will handle the burdens of caring for an aging population. Yet, as this new report points out, the costs bore by family caregivers actually dwarfs that spent by these public bodies. It is a reminder that long-term care planning remains more than just a necessity for seniors but also for their entire family.

The size of the numbers is undeniable. Roughly 42 million family members are acting as caregivers for their senior loved ones at any point in time, with nearly 62 million providing at least some support throughout the year. In economic terms, these caregivers provide over $450 billion in annual, unpaid care. That total is up 20% from two years before ($375 billion). These totals include the contributions of millions of area residents who provide support for aging family members whose New York elder care planning went awry or whose plan was nonexistent. The financial estimates are actually conservative. They do not account for care given by those under the age of 18. They also do not include caregivers who provide assistance outside of basic daily living tasks, like help with bathing, dressing, managing medications, and aid with finances.

It is helpful to put these family-provided long-term elder care costs into context. The $450 billion annual sum is more than the total Medicaid spending, for both basic health and long-term support services. When looking only at Medicaid support for senior care, the costs bore by families is four times larger. Researchers believe that the $75 billion increase in the previous two years was primarily caused by an increase in the total number of caregivers and hours of care provided. In other words, the allotted value of the work ($11.16 per hour) remained constant over that period of time.

Congressman Shares Information About Federal Attempt to Solve Long-Term Care Crisis

Published on: November 4, 2011 | by Ettinger Law Firm

On Wednesday Congressman Ted Deutch published an editorial in Politico advocating on behalf of a stalled federal initiative known as the Community Living Assistance Services and Supports Act (CLASS). The measure was hailed as the first federal attempt to address the nation’s long-term care crisis. All those in our area who have dealt with the complexities and expense of finding proper New York elder care are likely familiar with this crisis. CLASS was part of the high-profile Affordable Care Act that passed Congress, but CLASS was recently suspended by the President.

The Representative explained that CLASS was essentially a means by which middle class families could have a voluntary and affordable long-term care insurance option. An important part of the CLASS program that needed to be addressed was the idea of “adverse selection”–the notion that insurance would only be bought by those who already needed the care. Of course, the maximum benefit is derived only when individuals have this insurance plan in place ahead of time. The measure is currently stalled specifically because of concerns about adverse selection. Yet, many, including Representative Deutch, believe that federal officials have statutory power to implement anti-adverse-selection measures.

CLASS was pushed by those who understand the looming problem facing the long-term care system. Only five percent of Americans have long-term care insurance, even though seventy to seventy five percent of all Americans will need some form of long-term care. The gap is often replaced by federal programs, like Medicaid. The Congressman explained that the reliance on Medicaid is unsustainable at the federal level. This is in addition to the fact that qualifying for Medicaid often requires residents to spend themselves into poverty, especially when planning is absent. Fixing the problem before it gets worse was the motivation behind CLASS. The measure hopes to steer residents away from the most expensive institutionalized care to more balanced programs that encourage cost-effective and resident-focused community care. Besides the cost savings, these programs are almost always preferred by seniors, because they allow them to live at home, maximizing their freedom.

More Americans Financially Supporting Aging Parents

Published on: October 31, 2011 | by Ettinger Law Firm

Last week Reuters discussed the growing number of adult Americans who are financially supporting their senior parents. As the author quips, many of these residents have becomes the “Bank of Sons and Daughters” after the recent financial crisis decimated the savings of many elderly family members. According to MetLife‘s new National Health and Retirement Study, the percentage of adult children spending time and money on their parent’s care has tripled in the last decade and a half. This comes as no surprise to our New York elder law attorneys who know that rising long-term care costs, the economic downturn, and failure to plan ahead for senior care places many families in tough situations when a loved one ages and needs extra day-to-day care.

The MetLife data found that roughly a quarter of all adults are currently providing at least some financial assistance to their parents. A similar survey from Caring.com suggests that adult children may be providing even more support, as thirty two percent of respondents said they’ve spent at least $5,000 on their parents’ living expenses within the last year. A large majority of that group admitted that supporting their parents leads them to worry about their own long-term financial situation. As one researcher involved in the data collection explained, “There are just a ton of families where the second or third generation needs to help the first generation. People are asking, a lot, about how to do it.”

Not only does financially supporting aging parents often place stress on the finances of the adult children, but, if not done properly, it may actually be harmful to the senior. As each New York elder law attorney at our firm has explained to local residents, it is important to properly tailor financial gifts such that they don’t inadvertently disqualify the parent from government benefits. Certain programs are in place to help seniors receive the care they need even if they do not have the resources to purchase it. However, qualification for those programs, such as New York Medicaid, is based on need. If adult children do not take those qualifications into account, they may unknowingly complicate their parent’s program participation.

Baby Boomers Discuss Retirement and Long-Term Living Plans Amid Tough Economy

Published on: October 28, 2011 | by Ettinger Law Firm

It is no surprise that only 9% of Baby Boomers stated in a new Associated Press poll that they were “strongly convinced” that they would be able to live comfortably when they retired. With financial affairs in flux for many members of the 77-million strong Baby Boomer generation, many are beginning to reevaluate their retirement plans. Our New York elder law estate planning attorneys know that a growing number of local residents find themselves worrying about whether they will be able to live out their golden years in comfort.

One single 53-year old woman profiled in an Associated Press story on the Baby Boomer retirement situation explained that she once planned to retire at sixty and move to the beach. Those plans changed when her pension was eliminated five years ago, her personal investments tanked, and her home of 21 years lost half its value. Now she is not sure what her future holds, but she doesn’t expect to move any time soon. When asked about potentially moving when he retired, a 60-year old small business owner explained, “It just depends on what happens to the economy. I’d like to find someplace warmer and doesn’t have the high taxes, but we’ll just have to see.” Many local residents find themselves in the same situation.

The latest poll on the topic found that about 60% of Boomers had retirement plans, personal investments, and real estate that lost value in the latest recession. As a result, more than half of that group expects to delay their retirement. According to the research, 73% of respondents claimed that they will continue to do some work even after they retire. These delayed retirement plans have also led many Boomers to admit that they no longer expect to move out of their current home, and a majority claim that they plan to live out their golden years exactly where they are now. Other priorities for soon-to-be retirees include living near their children and being close to necessary medical care.

New Companion Service Provides New York Elder Care at Senior’s Own Home

Published on: October 26, 2011 | by Ettinger Law Firm

The aging of the population both in our state and throughout the country is leading many community members to re-think the best way to provide long-term care for seniors when they reach their golden years. In the past, options for seniors were few and far between. In most cases a senior lived on their own for as long as they could. When extra care was needed it was provided by a close relative if possible. If no relative was able to provide the care, or the senior’s needs were more than a relative could handle, then the individual ended up in a nursing home. Most seniors in our area were unable to pay for that nursing home care on their own, and so it was paid for by New York Medicaid programs. However, most of the seniors’ assets built up over a lifetime were lost to pay for the care or to qualify for Medicaid participation.

Recently, there has been an explosion in new options available to area seniors and their families, particularly for those families that take the time to visit with a New York elder law attorney to plan ahead for this stage in life. For example, many assisted-living facilities have been built which allow seniors to receive day-to-day aid from professionals while keeping much more independence than that found in traditional nursing homes. Other services are popping up which allow seniors to receive extra care without leaving their home at all.

For example, this week Bright Days Home Care, a new “senior companion” service announced that it was opening its doors to provide assistance for local residents. The New York elder care service provides companions to visit the homes of seniors on a particular schedule to provide any manner of aid necessary. This new service provides non-medical care, which may include anything from buying groceries and making dinner to cleaning the house and chatting with the senior about their day. In addition, the company’s founder explains that the at-home service also helps local families find other resources. She notes that they “are committed to ensuring that people are aware of the plethora of options that are available.”

New York Elder Center Opens for GLBT Seniors

Published on: October 24, 2011 | by Ettinger Law Firm

The New York elder law estate planning attorneys at our firm have worked for years with local GLBT residents on the unique issues that they face when planning for their long-term financial, social, and physical well being. Even though New York leveled the playing field this year by passing legislation which allowed same sex couples to marry, these families continue to face complexities in their planning because of inequalities at the federal level. Same sex couples still need to take special steps to ensure that their assets are protected and distributed according to their wishes.

Beyond estate planning needs, senior members of the GBLT community also continue to face unique challenges when planning for their long-term well being. The latest research reported in MetLife’s “Out and Aging Study” found that three out of four GLBT seniors lived alone. In addition, these seniors are much less likely to have children than their heterosexual counterparts. As a result they are often less likely to have relatives able to help care for them as they age. Of course, GLBT seniors encounter the same problems as they as age as the rest of the community, and so these demographic differences mean that they have a particular need to conduct New York elder care planning to ensure necessary resources will be available in their golden years.

Unfortunately, our New York elder law attorneys know that many GLBT seniors fail to properly plan for their long-term healthcare needs. Many elder care advocates recognize the unique vulnerabilities of these seniors and are working to help. In an effort to provide the necessary aid, this weekend local officials announced the opening of the nation’s first GLBT Senior Center. As explained in the New York Examiner, the Services and Advocacy for GLBT Elders Center (SAGE) is expected to open in January in Manhattan. GLBT seniors in all five New York City boroughs will be able to benefit from the facility. As Mayor Bloomberg noted during the announcement, “The needs of seniors have evolved since senior centers were created fifty years ago, and now is the time to re-envision the one-size-fits-all approach that has traditionally shaped many of our centers.”

Daughters Disproportionately Assume Elder Caregiver Role For Aging Parents

Published on: October 18, 2011 | by Ettinger Law Firm

An article yesterday at Forbes explored an issue that has been dubbed “the ticking time bomb of eldercare.” It is well known that many families are forced to adapt their lifestyle once they start having children to make concessions for childcare. However, our New York elder law attorneys know that many families are also forced to make similarly tough decisions to account for eldercare when aging parents are in need of day-to-day assistance. Many local residents still fail to appreciate the demands placed upon adult children and other loved ones when a senior reaches the point where they cannot live on their own without help. The challenges are particularly harsh for local residents when no elder care planning has been conducted ahead of time to ensure that resources are available to provide the needed aid.

Yesterday’s article explains how eldercare expectations are very much rooted in old cultural norms. Specifically, in many families it is assumed that daughters will take care of parents as they age. Decades ago this was more logical as women were far less likely to be in the workforce and were more often available in their homes to assist parents throughout the day. However, those old realities are less and less true. Many more women have careers just as demanding as men. It is no longer easier for many adult daughters fit the care of their elderly parents into their lifestyle. Yet, cultural expectations persist, often making daughters disproportionately more responsible than sons for ensuring the well-being of their elders.

This cultural pressure may affect some women more than others. In particular, women with family backgrounds rooted in certain cultures–including Russia, India, China, and others–often face immense pressure to provide eldercare. For some that means ending a career that has taken a lifetime to build. As the authors of one study on the topic noted, “Eldercare is a serious issue…because its obligations and attendant guilt derail woman who are just hitting the peak of their careers.”

Advocates Call for Tighter New York Medicaid Rule Enforcement

Published on: September 27, 2011 | by Ettinger Law Firm

Last week state legislators proposed New York Medicaid changes which would eliminate the financial involvement of local county governments–a state take-over of the program. However, this change would do nothing to curb the overall costs of the program. Lawmakers explain that reigning in Medicaid costs remains a top priority, and so additional alterations to the program are likely. Many observers are calling for tighter enforcement rules to root out fraud. Stricter enforcement of the program will likely target medical care providers who seek to collect money, but these changes may also affect individual residents who are working through the New York Medicaid application process.

An editorial in last Friday’s Albany Times Union called upon the legislature not to go “soft” on Medicaid users. Recent problems of fraud in institutions serving those with developmental disabilities were used to highlight the current problem with the program. Some observers believe that homes for those who are unable to live independently because of age or disability are the site of the clearest patterns of excessive Medicaid utilization. Several years ago the New York Commission on Quality of Care and Advocacy for the Mentally Disabled noted that Medicaid billing for these services were “costly, fragmented, sometimes unnecessary, and often appeared to be revenue-driven, rather than based on medical necessity.”

Senior care advocates believe that many disabled seniors find themselves in need of dental care, hearing aids, and similar basic services only to be shuffled to alternative medical appointments not of their choosing or tailored to their need. These advocates claim that Medicaid changes are necessary to correct the disconnect between needed services and the ones actually provided. On top of the programmatic problems, the state’s Long Term Care Coalition noted that the Health Department lacks the resources to oversee these adult homes properly. The state body struggles to ensure that nursing homes and senior living facilities are abiding by state rules and regulations. The quality of elder care suffers as a result.

Medicaid Asset Protection Trust Is Important Tool for New York Seniors

Published on: September 19, 2011 | by Ettinger Law Firm

A Medicaid Asset Protection Trust (MAPT) is one of the best tools available for seniors who do not have long-term care insurance to protect their assets from the staggering cost of nursing home care. This weekend our New York elder law attorney, Bonnie Kraham Esq., had a story published in the Times Herald-Record where she explained the value of this trust for local residents. The article highlighted the specific ways that a MAPT can help local seniors save assets for their family and dispelled misconceptions that some have about creating the trust.

A MAPT is a legal entity that a resident creates with the help of a professional to protect assets from being consumed in order to pay for long-term caregiving costs in the future–usually nursing home care. To create the trust, a resident transfers assets (such as the family home) into the separate legal entity and names someone other than themselves or their spouse as trustee to manage the assets in the trust. The senior may then be able to keep those assets down the road while still qualifying for Medicaid assistance if needed to pay for nursing home care.

Contrary to some misperceptions, local seniors who create a New York Medicaid Asset Protection Trust do not forever “lock up” all of their assets or lose the power to alter what happens to their property. The lifestyle of the senior who creates the trust is usually unaffected, because they still receive pension checks and Social Security checks directly, and they retain the exclusive right to use their home just as before while keeping their home tax exemptions. These trusts are irrevocable, but New York law actually allows the trust to be revoked with written consent of all involved parties. In addition, the individual who creates the trust can amend it to change the beneficiaries at any time.

Grandparents Day is Reminder of Importance of Long-term Care Planning

Published on: September 15, 2011 | by Ettinger Law Firm

While it slipped under the radar this year for many families, the first Sunday after Labor Day is Grandparents Day. As explained this week in the Daily Local, the holiday has been the topic of a presidential proclamation every year since 1978. More recently it has been used as a time to raise awareness of the continuing needs of many grandparents in nursing homes and the importance of helping our elders conduct long-term care planning. Considering that the majority of area seniors remain concerned about their future quality of life, our New York elder care attorneys know that all occasions are good ones to discuss these long-term care issues.

The non-profit association which champions Grandparents Day each year explained how the group has been working to help families take steps that will keep their elders in their own homes, instead of nursing homes. Efforts to transition away from nursing home care are growing in popularity nationwide. Our New York elder law estate planning lawyers have long recognized that most area seniors would prefer to “age in place,” receiving the additional care that they need without being forced to move into a nursing home or other long-term care facility.

However, the financial realities of these situations often mean that it is only those who have taken steps to prepare for this time in their lives that ultimately have the freedom to stay at home. For example, residents who visit a professional early enough to discuss these matters often decide to invest in long-term care insurance (LTCI). This insurance can ensure that the resources will be available when necessary to pay for at-home care when a senior is in need of extra assistance with day-to-day tasks. It is difficult to put a price tag on the peace of mind that comes with knowing one has done everything in their power to ensure that their quality of life will remain as high as possible no matter what the future holds.