Articles Posted in NY Elder Law

The results of a new long-term care planning survey were announced this week that shed light on both the perceptions and planning of Americans. As reported in Financial Advisor, the data suggests that a growing number of residents are aware of the need to conduct long-term care planning, but a majority admit that they still fail to plan as properly as they should. Specifically, the study found that eight out of ten Americans believe that it is vital to prepare ahead of time for the assistance they might need as they age. Yet, nearly half those respondents claimed that in their own case they remain unsure how they will provide for their long-term care when they reach their golden years.

Long-term care costs are high and rising. New York elder care in particular has often been noted as one of the most expensive in the country. Many local residents seem to understand the high costs. Almost two-thirds of survey respondents in the Northwestern Mutual Life Insurance Company survey believe that long-term care costs will rise faster than their savings, and they expect costs to double in the next fourteen years. Yet, even though most community members acknowledge the cost issues, fewer than one out of three survey respondents were actually saving for their long-term care or had plans in place to ensure that they would have access to the resources they need to receive the care that they prefer. As one survey organizer summarized, “There is a clear disconnect between what Americans understand about long-term care needs and the steps they’ve taken to prepare.”

With many local residents struggling to deal with their daily short-term issues, our New York elder law attorneys understand how long-term care planning can seem like a luxury more than a necessity. Yet, it remains unwise to treat these affairs as something that can be handled down the road. Preparing for these potential costs now often results in immense financial savings later. As the survey data reveals, this is particularly true for women. Women were 25% more likely than men to have acted as a caregiver for another. Women continue to live longer than men–five years longer on average according to the Center for Disease Control and Prevention. Unlike their male partners, there is less chance that they will have a spouse to care for them at home. Therefore woman have much to gain from ensuring that plans are in place so that they can maintain their lifestyle while retired. Yet only 24% of women are saving for their future needs as compared to 32% of men.

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.

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.”

Local residents who are diagnosed with Alzheimer’s or other cognitive diseases face a series of mental, medical, and emotional challenges. Our New York elder law estate planning attorneys work with many families who have loved ones battling these disabling diseases. Unfortunately, many area residents fail to take appropriate preparatory steps before a victim’s mental capacity is lost. As a result, these families often face difficulties with inheritances and have challenges defining who is in control of legal, financial, and medical issues. Many also struggle to protect the senior’s assets from long-term care costs.

Advocates are working to raise awareness of these issues to help the thousands of local families who are forced to deal with the situation each year after a dementia diagnosis. For example, the New York Chapter of the Alzheimer’s Association began programs this week to support September’s designation as World Alzheimer’s Month. The local organization is sponsoring a variety of activities to raise money for research, support those battling the disease, and educate local families on the importance of conducting New York Alzheimer’s planning. The local advocacy group is offering care consultation services to help families who face many challenges following an Alzheimer’s diagnosis. The organization explained that “the goal is for each family to develop a better understanding of the disease, make a plan to secure needed care, and develop strategies for the best possible symptom management and communication.”

For area community members, the necessary planning usually involves a visit to a New York elder law estate planning attorney to ensure that all the legal affairs are in order. Timing is important, because victims of these diseases often lose the ability to communicate. It is vital to work through these planning issues in the earliest stages of the disease.

America is at the beginning of what many have deemed a “demographic crisis” with tens of millions of Baby Boomers nearing retirement. Older community members have many different needs than younger residents, and many areas remain unprepared to meet those needs. Our New York elder law attorneys have spent decades working with residents on an individual level to help them plan for their long-term financial and healthcare needs. However, besides individual residents creating their own elder care plans, many advocates understand that preparation also needs to be conducted at the societal level to account for the changing character of the community.

This week Big Think explained a new World Health Organization initiative to encourage “age-friendly” urban zones that better integrate seniors into community life. New York City was spurred by the call and recently launched an effort known as the Age-Friendly NYC Initiative. In fact, the first “Aging Improving District” opened this month in Harlem. These districts are intended to complement traditional Business Improvement Districts and tap into the community resources of aging citizens. Advocates explain that the goal is to change the current impression of seniors as an economic burden on government into one where seniors are considered an economic asset that can contribute to a more vibrant society.

The initiative’s proponents explain that “the aging of America is a deep structural problem that requires big-picture thinking from social innovators.” Proper integration of seniors into community life requires consideration about all aspects of life, from transportation to housing. For example, in Harlem’s new Aging Improvement District, local businesses are changing shelving and signage, libraries are changing their hours, and other adaptations are being made all with an eye toward the needs of seniors. Much attention is also being given to a new housing option known as “MedCottage.” These are modular homes for the elderly that can be hooked up to the home of a younger caregiver–often an adult child. It is hoped that new ways to care for seniors at home will reduce the strain on medical facilities.

Every New York elder law estate plan should likely include a Power of Attorney and Health Care Proxy. These documents allow another person to handle a variety of legal, financial, and medical affairs on your behalf in the event of disability. Our New York elder law attorneys know that preparing for all possible contingencies is the main purpose of this planning, and so inclusion of these documents remains essential.

Some residents are less familiar with the importance of these decision-making tools and may assume them to be unnecessary in their particular case. They may believe that their friends or family members will step up and handle affairs appropriately without the need for formal legal documents. Unfortunately, that assessment is misguided because very often family disagreement arises among these individuals under the stress of dealing with the disability–setting the stage for conflict without prior delegation of decision-making power. The director of a local public aging services center explained that “the last thing you want is if you age and lose capacity, to become a pod in a power struggle between your kids or your grandkids.” On top that, even if one’s family members do not disagree on any financial or medical issue, the law will not automatically grant these powers to a certain friend or family member. In many cases, the disability requires court intervention to appoint a guardian which is a situation that should always be avoided.

Failure to provide this legal clarity ahead of time can have wide ranging effects. For example, KFBB News reported late last week on one man who is facing felony kidnapping charges after allegedly taking his 92-year old mother out of her long-term care facility and bringing her into another state without permission. The man was not his mother’s Power of Attorney. The family was confused about the local elder care laws, and the man assumed he had the right to move his mother. He didn’t. He is now awaiting extradition to face possible criminal sanctions for his conduct. It is likely that the man would not be facing any charges at all had a Power of Attorney been drafted.

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