Way to Manage Your Multi-Age Caregiver Schedule

Caring for people of multiple ages can pose a  challenge for even the most savvy caregiver. The simple reason why is that children and seniors require different types of care from their caregiver. If you are a caregiver member of The Sandwich Generation, then you know that juggling the various, much needed, responsibilities can be stressful.

We know our clients and their senior loved ones face these challenges each day. From balancing everyone’s schedule and attending appointments to providing emotional support and medication management, often the job can seem overwhelming. Let us share our five tips for managing a multi-age caregiver schedule.

1. Create a calendar and stick to it. One of the easiest ways to fall behind on responsibilities or miss important appointments is to not keep track of your schedule. Keep either a digital calendar that syncs with all of your devices or utilize a handwritten calendar you can take with you. Color coordinate by either level of importance or age group so you can easily see the responsibilities and priorities for each day and the week as a whole. Be sure to stick to your calendar and update it regularly! If you fall behind with adding in appointments or activities, your days will feel unorganized and jumbled.

2. Don’t procrastinate. While this may seem nearly impossible for many, try not to procrastinate. Procrastination makes tasks more complicated and rushed than they should be. This is not to say you should not take breaks. Giving yourself a little time to yourself each day is important as well.

3. Think of every “What-If?” scenario – and plan ahead. Life never works out exactly how you’ve planned. Don’t let unplanned situations derail your progress or get in your way. If something does not go as planned, make sure you always have a backup plan ready. For example, what if your car breaks down and you cannot get to your child’s soccer practice? Or what if your mom forgets to take her medicine at the proper time? Having a contingency plan for any situation is important to keep stress levels at a minimum when something goes awry.

4. Ask for help. Do not avoid asking for help and never feel bad when reaching out for assistance. Even the strongest and most organized of caregivers need support every once and awhile. Arrange a carpool for drop-offs and pick-ups from school. Ask a neighbor or friend to check on your parent while you run some errands. They say it takes a village…so use your village.

5. Take time for yourself. You will not be able to give full attention to multiple age groups if you have not given yourself some attention first. Whether you take a few extra minutes in the morning to get ready, join a gym or take time for lunch once a week, it is important to take a moment to live your life.

While it is a labor of unpaid love for the majority of family caregivers today, it is a much needed service. Do you need assistance right now? Do not wait to contact our firm so we can assist you and your family.

Long-term care planning when insurance doesn’t cover

You can’t assume that Medicare or Medicaid will cover your long-term care needs as you age. Most people – one in five, many studies say – should consider a long-term care plan in the event they become physically or mentally incapacitated.

Most health insurance plans do not cover nursing home care, nor does Medicare. Medicare covers temporary skilled or rehabilitative care for those older than 65, paying for up to 100 days in a facility with stipulations.

Medicaid can help pay for nursing home care, but not all nursing homes accept it as payment. And, if you even qualify, you may not like the choice of nursing home the government will approve.

It is crucial that you have a long-term care plan in place long before you ever need such services.

A majority of people choose to begin receiving their long-term care benefits once their Medicare coverage is exhausted. Long-term care insurance is an strong choice. You can delay the start of benefits for any length of time. Many people select a five-year benefit period, since studies show the average long-term care need is 2.5 years. Regardless, you should talk to an elder care attorney to make sure your policy provides enough coverage to make your daily benefits sufficient when you need them years from now.

In addition, men and women may choose to set aside some extra money for long-term care planning in a living trust. The funds in such trusts can help pay for expenses not covered by long-term care insurance, and they can pay for caregiver expenses if a person is able to stay in the home.

There are generally two kinds of living trusts that are useful. A revocable trust and an irrevocable trust. A revocable living trust means that you amend or change the terms of the trust whenever you want. Because you have options to tweak terms of the trust, you don’t get a break from estate tax.

An irrevocable living trust, as you may have guessed, is a trust you cannot change. It is usually only done to produce tax or asset protection. Long-term care insurance trusts are typically irrevocable trusts so everyone is aware of what the money must be used for.

Contact an experienced long-term care planning attorney today.

Our experienced and trusted estate planning attorneys have been serving Treasure Coast families for decades, and Michael Fowler is one of only nine attorneys in the state of Florida who is double board-certified in wills trusts and estates and in elder law.  Contact us for your initial consultation at one of our conveniently located offices in Fort Pierce, Stuart, Port St. Lucie, Vero Beach, and Okeechobee.

CMS proposal would rescind nursing home arbitration agreements

The Centers for Medicare and Medicaid Services and the Trump administration are proposing the removal of a federal law that would protect nursing homes from being sued by patients and their families.

The arbitration ban proposed by the Obama administration had been placed on hold while it was tied up in litigation. On its face, the rule keeps nursing homes from requiring patients and their families to sign arbitration agreements as a requirement of admission to a facility.

In May, the U.S. Supreme Court sided with a nursing home in Kentucky in a case that had challenged the validity of such arbitration agreements. Justices ruled that a lower court had erred when it didn’t give effect to agreements that two women had signed with power of attorney on behalf of their relatives.When each woman’s relatives died, they sued, claiming the care at the facility had been poor. The nursing home pushed to have the cases dismissed, citing the Federal Arbitration Act. Justices found that the lower court should have put the law on par with other contractual agreements.That left the women who had attempted to sue with no case, no matter how poor or good the nursing home care was. CMS has hinted that it favors arbitration over litigation, however, the American Health Care Association, which represents long-term care providers, called the initial ban an “overreach” and praised the CMS for rescinding it.

What happens next remains to be seen. The Obama White House in November had supported the rule, which was the first big change to care provider requirements in more than 25 years. There were other revisions as well – some that the Trump administration is looking to keep in place. Among those? Nursing homes must still go over contracts with patients and families. Furthermore, nursing homes cannot act in a way that discourages or tries to prevent patients and families from seeking help from federal, state or local authorities.

If you believe your loved one is experiencing poor or inadequate nursing home care, it’s important that you speak to an experienced elder care attorney as soon as possible.

Our experienced and trusted estate planning attorneys have been serving Treasure Coast families for decades, and Michael Fowler is one of only nine attorneys in the state of Florida who is double board-certified in wills trusts and estates and in elder law.  Contact us for your initial consultation at one of our conveniently located offices in Fort Pierce, Stuart, Port St. Lucie, Vero Beach, and Okeechobee.

How do I know if my elderly parent needs assisted living or nursing home care?

The effects of aging can seem to progress slowly, or it can seem to totally sneak up on families. An elderly mom or dad can seem fine one day, and mentally or physically challenged the next. It’s tough to know when it’s time for more care. Many elder care advocates say there are signs to watch for so you know when it’s time to think about assisted living or even a nursing home.

A Place for Mom outlines things to watch for:

  1. The house and yard need care / maintenance
  2. Disheveled clothing
  3. Broken appliances
  4. Changes in mood or extreme mood swings
  5. Spoiled / expired groceries that don’t get thrown away
  6. Poor personal hygiene
  7. Cluttered, dirty and/or disorganized house
  8. Depressed or low energy temperament
  9. Unexplained bruising
  10. Trouble getting up from a seated position
  11. Missing important appointments
  12. Uncertainty and confusion when performing once-familiar tasks
  13. Forgetfulness
  14. Poor diet or weight loss
  15. Late payment notices, bounced checks and calls from collections
  16. Loss of interest in hobbies and activities
  17. Forgetting to take medications
  18. Unexplained dents or scratches on car

If health or happiness seems to be compromised, it’s time to have a conversation and address problems, whether it’s finding in-home care, a retirement community or a senior living community. It’s important to find the right care options for each unique family situation and financial means. Nursing home and assisted living facilities can be expensive, and Medicare doesn’t cover it. Medicaid can come some care expenses, but only if a person qualifies.

For some – those who have assets worth $300,000 to $500,000 above and beyond the value of their homes — long-term care insurance can be a safety net safety net rather than as a financial investment, especially if the policy includes coverage for assisted living facilities.

As soon as possible, think about long-term care planning. Families who have not sought long-term care insurance should consider meeting with an experienced elder care attorney. The laws, regulations and policies for Medicare and Medicaid programs are ever changing and complicated. code. An elder care attorney can help you come up with an asset protection plan and determine the steps most appropriate for your elderly loved one.

Our experienced and trusted estate planning attorneys have been serving Treasure Coast families for decades, and Michael Fowler is one of only nine attorneys in the state of Florida who is double board-certified in wills trusts and estates and in elder law.  Contact us for your initial consultation at one of our conveniently located offices in Fort Pierce, Stuart, Port St. Lucie, Vero Beach, and Okeechobee.

Preventing financial elder abuse

When beloved actor Mickey Rooney died in 2014 at the age of 93, he had only $18,000 in the bank, according to media reports. He said he had been a victim of elder financial abuse by his stepson and the stepson’s wife, claiming that the couple deliberately misled him about his own finances, used threatening and abusive language and refused him basic necessities, such as food and medicine. Rooney’s conservator sued, and secured a $2.8 million stipulated judgment against the stepson and his wife.

Financial elder abuse costs its victims nearly $3 million a year. Senior are most often likely to be abused by family members, but they also are victims of fraud and telephone scams.

The Elder Justice Roadmap, a 40-page federal report that includes interviews with 750 elder abuse experts, outlines five ways to prevent elder abuse. Here is a brief look at steps to take, as listed on Next Avenue.

“1. Awareness: The report calls for an increase in public awareness of elder abuse — a multi-faceted problem that requires a holistic, well-coordinated response in services, education, policy and research.

  1. Brain health: It also wants to see more research into brain health, with an enhanced focus on cognitive capacity (and incapacity) and mental health. These are critical factors both for elder abuse victims and for perpetrators.
  2. Caregiving: There should be better support and training for the tens of millions of paid and unpaid caregivers who play a critical role in preventing elder abuse, the Elder Justice Roadmap says.
  3. Economics: The authors want to see the costs of elder abuse quantified, particularly because this national problem includes huge fiscal costs to victims, families and society.
  4. Resources: The report says the nation needs to strategically invest more resources in services, education, research and expanding knowledge in order to reduce elder abuse in America.”

Caregivers, social workers, medical professionals and financial advisors need to be aware of the signs of elder abuse and know what to do if they suspect it.

Starting in 2018, securities firms will be required to try to take steps to do their part in preventing elder financial abuse, including obtaining contact information of a person who is trusted by the elderly client.

Our experienced and trusted estate planning attorneys have been serving Treasure Coast families for decades, and Michael Fowler is one of only nine attorneys in the state of Florida who is double board-certified in wills trusts and estates and in elder law.  Contact us for your initial consultation at one of our conveniently located offices in Fort Pierce, Stuart, Port St. Lucie, Vero Beach, and Okeechobee.

Women are working longer, and putting off retirement

Nearly 30 percent of women between the ages of 65 and 69 are still in the workforce, choosing employment over retirement, according to the New York Times.

The Times, citing research by Harvard economists, found that women have become more likely to work into their 60s and 70s, and many do so because they love their jobs.

The number of women between 65 and 69 who are still working is up 15 percent from the late 80s, while working women between 70 and 74 are up 8 percent. Most often, those women were healthy, had higher education degrees and money in savings accounts. The ones who were not working, on the other hand, often were in poor health and had limited savings. The latter were more likely to be dependent on Social Security or disability payments, the research showed.

The two new studies draw their data from the Health and Retirement Study at the University of Michigan and from the Current Population Survey and the Survey of Income and Program Participation at the Census Bureau. The data included surveys that tracked the same women over time. The researchers sometimes studied respondents’ income tax and Social Security records.

Senior women who still work were really the first generation to enter the workforce in large numbers, mostly in the 1980s. They identify themselves by their chosen professions, the study found, and they are reluctant to give that up for retirement.

For some women, however, the decision to keep working was unexpected and created a hardship, though, due to a divorce, pension or real estate losses or changes in Social Security. A separate study found that women who were working into old age were forced to because they had more debt than in previous generations and lacked financial savvy. Older workers who lost their jobs during the recession were more likely to be unemployed long term.

Men’s employment after age 60 has also risen, since about 1994, with 60 percent of men between the ages of 60 to 64 working.

Whether you are planning to work into old age or not, it’s important to have your future planned. That includes creating an estate plan and a long-term care plan that will benefit you and your loved ones. Speak to an experienced Florida estate planning attorney today.

Our experienced and trusted estate planning attorneys have been serving Treasure Coast families for decades, and Michael Fowler is one of only nine attorneys in the state of Florida who is double board-certified in wills trusts and estates and in elder law.  Contact us for your initial consultation at one of our conveniently located offices in Fort Pierce, Stuart, Port St. Lucie, Vero Beach, and Okeechobee.

 

The National Health Law Project looks at the impact of the Medicaid pricing structure

A recent study by the National Health Law Project found that efforts by federal lawmakers to reduce Medicaid funding will put the lives of 74 million people at risk.

On the state level, the expansion of Medicaid programs, however, has made more resources available to help people, the study found, including the elderly, have access to the services they need for good health and the ability to live independently.

Medicaid is administered by the states, combining state and federal dollars to provide health services to low-income people, including children and their caretakers, pregnant women, the disabled, the blind, and those over the age of 65 who qualify. The coverage can vary by state, but the federal government requires it to include doctor’s visits and hospital expenses, among other services.

As of January, 31 states had expanded their Medicaid programs, the report says. Florida was not among them.

The states that did, though, initially received 200 percent federal reimbursement for the costs of these new enrollees. Over time, the federal share will drop to 90 percent. Congress is considering reducing federal funding below 90 percent.

Whatever lawmakers decide, Medicaid is often crucial in helping cover the costs of long-term care. The average cost of a nursing home or assisted-living facility in Florida can exceed $100,000 a year. Medicare only covers those costs for a limited time in most cases. It’s crucial that estate planning ensure factor in eligibility for Medicaid benefits, or else retirement assets – or your entire estate – could be consumed by long-term care costs.

Medicaid planning is a critical part of a comprehensive strategy to provide necessary care for seniors without dissipating assets that could be used for retirement or the needs of a healthy spouse, or passed on to loved ones. But qualifying for the Medicaid benefits that can cover long-term care costs is complicated, and any number of missteps could make a difficult financial situation even worse.

Since Medicaid is a needs-based program designed to provide medical care and assistance for low-income individuals, eligibility for the benefits that can pay for long-term care is based on your available assets. Medicaid planning involves structuring your assets and liabilities in such a way that they are excluded from the calculations used to determine Medicaid eligibility.

Our experienced and trusted estate planning attorneys have been serving Treasure Coast families for decades, and Michael Fowler is one of only nine attorneys in the state of Florida who is double board-certified in wills trusts and estates and in elder law.  Contact us for your initial consultation at one of our conveniently located offices in Fort Pierce, Stuart, Port St. Lucie, Vero Beach, and Okeechobee.

 

Medicare, Medicaid and long-term care

People are living longer and healthier than they ever have before. That is wonderful news for all of us as we put a focus on our health, vitality and the belief we are as young as we feel.

But at some point, everyone must consider a long-term care plan in the event they become physically or mentally incapacitated. Currently, one in five Americans experiences the need for long-term care, and as baby boomers age, that number is anticipated to increase substantially.

People of all ages cannot count on Medicare to cover them in the event they need nursing home care.

For example, Medicare covers temporary skilled or rehabilitative care for those older than 65, paying for up to 100 days in a facility. But, that is only if a patient has spent three days in the hospital first. Medicare usually does not cover long-term nursing home care.

Additionally, most health insurance plans do not cover nursing home care at all. Medicaid, if you are low-income and qualify, can help pay for nursing home care. However, not all nursing homes accept Medicaid as payment for long-term care.

There are many potential bumps in the road when it comes to long term care. That’s why it is crucial that you have a long-term care plan in place long before you ever need such services. Many planning experts say the best time to obtain long-term care insurance is 20 to 25 years before you need it. Your premiums will be lower if you start early. You’ll have to choose the daily benefit amount you want when you purchase your long-term care policy – the average daily cost of a private room in a Florida nursing home is $265, according to the Genworth 2015 Cost of Care Survey.

A majority of people choose to begin receiving their long-term care benefits once their Medicare coverage is exhausted, but you can delay the start of benefits for any length of time. Many people select a five-year benefit period, since studies show the average long-term care need is 2.5 years.

Perhaps most importantly, make sure your policy provides enough coverage to make your daily benefits sufficient when you need them years from now. Contact an experienced long-term care planning attorney today.

Our experienced and trusted estate planning attorneys have been serving Treasure Coast families for decades, and Michael Fowler is one of only nine attorneys in the state of Florida who is double board-certified in wills trusts and estates and in elder law.  Contact us for your initial consultation at one of our conveniently located offices in Fort Pierce, Stuart, Port St. Lucie, Vero Beach, and Okeechobee.

What is the difference between power of attorney and durable power of attorney in Florida?

We all hope that we won’t need to designate a power of attorney, or have to become a power of attorney for a loved one who needs help. In the state of Florida, like most other states, a power of attorney is a legal document in which you designate someone to act on your behalf, or when you are given power of attorney to act on someone else’s behalf.  In Florida, a power of attorney must be signed before two witnesses and a notary public to be considered a legal, binding document.

A power of attorney ends if the person it represents becomes incapacitated. That’s when a special kind of power of attorney, known as a durable power of attorney, is more appropriate, because it remains intact, or “durable,” even if a person suffers mental incapacity in the future.

A durable power of attorney is therefore the most important estate planning document a senior citizen can possess. A durable power of attorney can, in additional to handling all financial decisions, authorize medical care. That includes consent to proceed with or terminate all medical and surgical procedures on your behalf, including an agreement that falls under the Life-Prolonging Procedures Act of Florida. Again, a durable power of attorney lets someone act on your behalf if you cannot due to mental incapacity.

In 2011, the state made some changes to its power of attorney law. The changes gave a durable power of attorney signed after Oct. 1 of that year immediate power. That means once the power of attorney is signed, it goes into effect immediately and the person designated can exercise those powers. Incapacity of the person involved is not required. A springing power of attorney, or one that “springs” into action once a person becomes incapacitated, is no longer valid.

Include a durable power of attorney in your estate plan if you are getting older. We all hope it’s not needed, but you shouldn’t take that chance if you want to protect yourself and your family. See an experienced estate planning attorney for guidance in this complicated, yet necessary legal document.

Our experienced and trusted estate planning attorneys have been serving Treasure Coast families for decades, and Michael Fowler is one of only nine attorneys in the state of Florida who is double board-certified in wills trusts and estates and in elder law.  Contact us for your initial consultation at one of our conveniently located offices in Fort Pierce, Stuart, Port St. Lucie, Vero Beach, and Okeechobee.

Five steps to ensure your estate plan meets your needs

Creating a comprehensive Florida estate plan is the first step in protecting assets for you and your family. But don’t stop there. Here are some tips to ensure your estate is properly organized:

If you have a safe deposit box, name a trusted co-owner of the box so your family can access it without having to get a court order. When you die, your Durable Power of Attorney dies with you, so your executor will not have immediate access to the box.

If you are in the habit of hiding valuables in your home, tell a trusted family member where those hiding places are.

If you use a name that is not your legal name on your bank account or other financial accounts – i.e., Bob Brown instead of Robert Brown – be sure that your alternate name is on your estate planning documents.

If a Florida resident passes away in another state, be sure their Florida address is noted when the death is reported. An out-of-state address on a death certificate can lead to problems at probate.

Be sure the person you have named as your executor or trustee is willing and able to serve. There are many instances when estate planning documents have not been updated, and a named representative has passed away or become disabled, requiring the court to get involved.

Although estates may be smaller after the economic downturn of the last few years, there’s now more room for flexibility, and if you play your cards right, more of your estate will end up going to your heirs rather than to the government.

So what does it mean to play your cards right?

Be specific about the distribution of your estate. Questions about your estate will inevitably lead to fights between family members. Being clear in your will or trust means fewer questions and fewer fights.

Build flexibility into your estate plan. A revocable trust as opposed to an irrevocable trust will give your executor more flexibility to manage assets when they need to be managed.

Reassess (and possibly re-title) how you hold your assets and plan to take advantage of the current exemption ($5.49 million per person, $10.98 million for couples.)

Make gifts now, rather than after you’re gone. Gifting while you are still alive can remove taxable assets from your estate, and since the estate tax exemption is so high, it’s a good time to give. You may also want to consider how much you can accomplish with a pen and checkbook, including paying tuition and medical expenses for your grandchildren with no tax consequences.

But the first thing you need to do is dust off your existing estate plan and take it to a Florida estate planning attorney for review. If you haven’t done so in awhile, it’s time to reassess, revise, and take control again.

At The Estate, Trust and Elder Law Firm, P.L. we help our Treasure Coast clients develop and implement comprehensive estate planning strategies personally tailored to their unique situation, needs, and goals. Contact us for your free initial consultation at one of our conveniently located offices in Fort Pierce, Stuart, Port St. Lucie, Vero Beach, and Okeechobee.