Articles Posted in New York Elder Law

Advocating for better long-term care is not just a concern of NY elder law attorneys. Policymakers at all levels and of all political persuasions are also keenly aware of the impact that the growing need for long-term care will have on communities nationwide.

There are few challenges more acute than figuring out how to ensure adequate senior care for all community members. As most know, we are on the cusp of a “gray wave” with demographics changes requiring an increased commitment to skilled care and assistance for seniors. The need extends to all facets of elder care, from ensuring there are enough physical spaces for those in need to coming up with ways to pay for the care.

Federal LTC Commission

A non-profit group called “Families for Better Care” recently released a comprehensive report card that ranks the skilled nursing care in all 50 states. The report, one of the most comprehensive ever, was based on a mountain of data taken from federal reports from 2013. Every state received a letter grade. Sadly, New York grade was far from passing–we received an F. The state was listed in the bottom as one of the worst places for nursing home care in the country.

The report also gave individual state grades on eight different criteria. Those factors included deficiencies identified in state inspections, staffing hours, ombudsman complaints, and more. Those individual grades were then combined to come up with the overall state grade.

The full report can be viewed online here.

Long-term care is big business. For many years now, companies that work in these fields have grown in size, scope, and influence, emerging as powerful entities making significant profits. There is nothing inherently good or bad about the changing nature of the industry so long quality, affordable options exist for seniors and their families.

Yet, in recent years observers have noticed that the increase in need for senior care services creates a natural business opportunity which are leading to some questionable practices. Take, for example, the growth of “pop up” senior centers in New York. The Brooklyn Eagle recently reported on these facilities and the scrutiny that is being directed their way.

City Council Questioning

Over the last few years elder care advocates have issued a steady drumbeat of concern: mistreatment of seniors is on the rise. The rates of neglect and abuse are not necessarily rising, but the total number of seniors affected are–a product of the changing demographics. The problem is only expected to get worse in the coming years.

It is important to keep in mind that research consistently shows that even “minor” forms of neglect can prove deadly. The U.S. Department of Human Services’ Administration for Community Living points out the stark difference in morbidity rates for abused versus non-abused seniors. Even when split only between those who received adequate care and those who received “modest forms of abuse” there is a 300% increase in the death rate for the mistreated seniors.

In other words, even small difference between the quality of long-term care facilities–both nursing homes and less-intensive assisted living facilities–can have life or death consequences. All of this makes the process of choosing a proper facility a critical task for seniors and their families.

This is a heated time for local politics, as various high-profile public officials jockey to replace Michael Bloomberg in the Mayor’s Office. As part of the process, the candidates share different ideas about the challenges facing the city and the ways to fix them. This can be a helpful endeavor, focusing public attention on needed concerns and providing a burst of new ideas to, hopefully, enact change.

For example, one of the front-runners in the race, City Council Speaker Christine Quinn recently pointed to the risks faced by New York City seniors and the need for more proactive steps to keep those seniors safe. As reported in a NY Daily News story late last week, Quinn believes that a database of homebound seniors is necessary to ensure that those at-risk individuals receive the aid they need–particularly during natural disasters. This need was put in perspective following the many stranded seniors caught in the middle of Hurricane Sandy last year.

Quinn explained: “There were many reports that people were stuck in buildings without water, food, heat, and we want to be able to target those individuals. Some of these individuals were elderly or disabled, and it took the city, everyone would admit, longer than it should have to start outreach to locate them.”

ElderCare Locator recently released a helpful new brochure that offers basic (but important) reminders about the need to be vigilant to prevent senior financial exploitation. The guide provides information about the scope of the problem, information on what to do if you suspect financial abuse, and prevention tips. You can download your own copy of the guide by clicking this link.

The Scope of the Problem

Getting accurate information of the significance of the problem is notoriously difficult. The vast majority of these incidents are never reported. In fact, one study found that even seniors who did report the misconduct, later denied ever having been victimized by financial exploitation in follow-up surveys. There remains a cloud of embarrassment, confusion, and shame surrounding these issues. That is unfortunate. The more discussion about these issues between family members, the more likely we are to tackle the problem.

What do you want to do when you retire? Where do you want to live? Obviously there are no easy answers to these questions. Everyone will have different plans based on their hobbies, family, financial situation, and more. There is no one-sized-fits all approach to these issues.

However, that did not stop one well-known financial services firm, Money Rates, from putting out a list ranking each state as the best and worst for retirement. Survey results constituted the crux of the rankings, but those questions were centered on four different factors: economic climate, crime rate, longevity, and climate. The report on the survey explains that those four categories were not weighed equally. Economic factors accounted for nearly half the score (47%), with climate accounting for a third and health and crime factored in 12% and 8% respectively.

Texas and Kentucky came out on top of the rankings, with Maine and Michigan listed as the worst? So where did New York come out? Near the bottom.

A new book is being released entitled “The Adventures of a Free Lunch Junkie.” The author, an 86-year old retired man, wrote the interesting tome based on his goal of eating at 50 “free lunches” over the course of a year. Most of the lunches were obtained during seminars, explaining concepts like estate planning, elder law, financial planning and more. Local seniors obviously know how popular these events are for learning about issues that may affect your latter years. In fact, many clients at our firm first learned about our services after attending one of these seminars.

The author is quick to point out that the book is not an “expose” but a simple satire. It was recently summarized in a LifeHealthPro article.

The book is chalk-full of humor, often highlighting the good (and bad) of the specific meals he received. However, the author importantly notes that there was one free seminar he attended that hit home on the need to plan for senior healthcare. He notes that while he was attending many events as part of his book project, the lessons shared were not ignored. In particular, he was convinced of the immense value in having a long-term care insurance policy. The elder law attorneys at our firm often recommend LTCI as part of prudent senior planning.

It is perhaps every senior’s worst nightmare: a dispute over their finances influences the care they receive in their later years. It seems self-evident that nothing should get in the way of making medical and caregiving decisions based on maximizing a senior’s quality of life–not maximizing an inheritance for others once a senior passes on. Unfortunately, case after case demonstrates that some elderly community members suffer in their later years unnecessarily for financial reasons–not because they cannot afford proper care but because other want their money.

This confluence of elder law and estate planning was perhaps most vividly illustrated by a case discussed this week in SF Gate.

According to the story, a 63-year old woman was staying at a local care center because she was not able to care for herself at home. The details of her family situation are not known, however, she had been dating a 67-year old man for the past three years. Unfortunately, the boyfriend appears to have been motivated in the relationship mostly by the way that it could benefit him financially.

Earlier this year a featured article in Atlanta Magazine offered a uniquely detailed and accurate portrait of what it is really like to help an ailing parent or loved one as their heath deteriorates. Entitled, “The Long Goodbye,” the article shares the author’s own story of heartbreak, worry, stress, financial loss, and confusion while caring for his ailing father. Each New York elder law attorney at our firm understands that it is often helpful to hear real, individual stories about the aging and caregiving process. Discussing numbers–assets saved, taxes avoided–is necessary, but at the end of the day this process is very much about emotions and family values.

The author explains that he thought his father was going to die in 2001. The elderly man had fallen while trying to get the mail, hitting his head hard on the ground and temporarily losing consciousness. The man then skinned his knees as he crawled back up his driveway to the front door of his house. It was that incident that prompted his family to take him to the hospital where he was diagnosed with a deteriorating spine. Not only that, but doctors also found prostate cancer. A risky operation was undertaken, and the family was warned that the man was likely in his final days.

However, he was not actually in his final days.

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