Category Archives: Alzheimer’s Planning

Alzheimer’s Treatment: Non-Drug Therapies That Can Help

Written by Evan Farr

There are treatments available now that most families coping with Alzheimer’s or other dementia never hear about that can significantly improve their quality of life.

Called non-pharmacologic therapies (NPTs), these treatments do not come in a pill. Instead, NPTs such as personal counseling and occupational therapy-based strategies are proven to improve the quality of life for people with dementia and their families. NPTs support families and teach them the skills they need to protect their own health and cope with the intense demands of caregiving and help people with dementia stay independent and safe for as long as possible. Some of the NPTs currently used are proven programs that are actually more effective than any known drugs for Alzheimer’s disease.

One example of an NPT, developed at NYU, includes individual and family counseling to reduce conflict and improve communication among family members. Those caring for a spouse with dementia who received the NYU Caregiver Intervention were more satisfied with social support and less depressed, less bothered by difficult behaviors, had better physical health and were able to keep their ill spouses at home longer than those receiving usual care.

Another model developed at Thomas Jefferson University in Philadelphia, employs occupational therapists to assess the patient with dementia and identify preserved capabilities as well as the caregiver’s needs. Families are then provided with strategies to manage day to day care, such as communication techniques, safe-proofing the home, establishing daily routines and engaging the individual with dementia in meaningful activities. Families who participated have reported feeling more confident and less upset, and found that their ill family member functions better and exhibits fewer challenging behaviors.

Another NPT that is now being used is a stimulator device surgically implanted into the brain of a patient in the early stages of Alzheimer’s disease. The implanted device is seen as a possible means of boosting memory and reversing cognitive decline, and has already been used in thousands of people with Parkinson’s. The surgery involves drilling holes into the skull to implant wires into the fornix on either side of the brain.  The wires are attached to a pacemaker-like device, which stimulates the brain with tiny electrical impulses generated 130 times a second. The patients don’t feel the current.

Lastly, another effective non-drug Alzheimer’s treatment used to jog memory is music. In nursing homes that use music, the personalized playlists are often meaningful songs chosen by loved ones.  According to Alzheimer’s experts, music helps patients become more alert, more cooperative, more attentive, and more engaged. In many cases, even if they can’t recognize loved ones and they’ve stopped speaking, when the patients hear music, they “come alive”.

Geri Hall, a clinical nurse specialist at the Banner Alzheimer’s Institute, explains how music activates a part of the brain that stays active despite the dementia. “There is something about music that gets through to Alzheimer’s patients right up until the very end of the disease,” she said, adding that “familiar music from the past can help people with dementia feel at home. It calms them, increases socialization, and even decreases the need for mood controlling medications.” Read our blog post about Alzheimer’s and Music.

Alzheimer’s slowly robs its victims of a lifetime of memories and the ability to perform simple daily tasks.  Instead of focusing on drug treatments, many of which have failed in clinical trials, it may be a good idea to try non-drug treatment options. These programs have been proven effective in randomized controlled trials. And, unlike drug therapy, there are no adverse side effects. There is also an economic argument to be made for better caregiver support. Nearly 11 million family and other unpaid caregivers provided an estimated 12.5 billion hours of care to people with dementia. This care is valued at nearly $144 billion. The country can’t afford the consequences of these caregivers becoming too burned out or sick to carry on. See our recent blog post about the rising cost of dementia.

Moving a person with dementia to a nursing home, while sometimes unavoidable, is expensive. The NPTs described have helped to delay nursing home placement for more than a year. Unfortunately, you cannot delay the inevitable forever, but what you can do is plan ahead for you and your loved ones. Do you or a loved one need nursing home care in the near future or are you looking to plan ahead? Call 703-691-1888 to make an appointment for a no-cost consultation at The Fairfax Elder Law Firm of Evan H. Farr, P.C.  We can meet with you, access your situation and determine strategies for your long-term care plan.

Important Medicare Change: Patients No Longer Need to Show Progress to Receive Nursing Coverage

Written by Evan Farr

Medicare coverage of short-term rehabilitation in a nursing home is about to undergo a major policy change, resulting in beneficiaries with chronic conditions such as Alzheimer’s disease, Parkinson’s disease, ALS (Lou Gehrig’s disease), diabetes, multiple sclerosis, hypertension, arthritis, heart disease, and stroke no longer need to show ongoing improvement to maintain Medicare coverage.

For decades, when short-term rehabilitation patients in nursing homes failed to show improvement but still needed skilled nursing in the form of custodial care or therapy, Medicare would routinely terminate their Medicare coverage, forcing these patients prematurely into private pay or, if they could financially qualify, Medicaid.  This need for ongoing “improvement” was a pervasive, though unwritten ”rule of thumb” followed by Medicare and by Medicare contractors when doing Medicare evaluations in nursing homes.  However, nothing in the Medicare statute or its regulations has ever stated that “improvement” is required for continued skilled care. 

A class action lawsuit, Jimmo v. Sebelius, was filed against the Obama administration in January 2011 in federal court. This case and a similar case in Pennsylvania aimed at ending the government’s use of the “improvement standard” were both settled by the Government.  This settlement should result in Medicare no longer focusing on “the presence or absence of an individual’s potential for improvement.”  Rather, Medicare must continue to provide short-term care whether or not the patient is improving, provided the patient needs skilled care.

It must be understood that Medicare coverage for nursing home care is still a very limited type of short-term benefit, as it only covers a maximum of 100 days per benefit period, and only if the patient requires skilled nursing care. However, under the new settlement, Medicare coverage should no longer be terminated just because the patient’s medical condition is no longer improving. On the contrary, coverage should remain available for services that are needed to maintain the person’s condition or to prevent further deterioration.

In summary, Medicare coverage in the past has often been erroneously denied for individuals with chronic conditions, for people who are not improving, or who are in need of services to maintain their condition. With this new government settlement, it should no longer be necessary for an individual’s underlying condition to be improving in order to continue to get Medicare coverage!   I emphasize the word should because the people who implement these policies may not conform to the new settlement as quickly as they should, so coverage appeals may be necessary in the short run until the local workers on the ground all get educated about this new shift in governmental policy. 

Luckily, the Medicare program has an appeal system to contest improper termination of coverage. Beneficiaries and their advocates should use this system to appeal Medicare determinations that unfairly deny or limit coverage.

For more information about this settlement, see: http://www.medicareadvocacy.org/hidden/highlight-improvment-standard

To appeal what you believe is an improper Medicare termination in a nursing home, please download this self-help packet:  

MEDICARE SKILLED NURSING FACILITY SELF HELP PACKET

To appeal what you believe is an improper Medicare termination of home health care, please download this self-help packet:  

MEDICARE HOME HEALTH SELF HELP PACKET

 

 

Planning for Long-Term Care (Part 5)

Written by Evan Farr

The Veteran’s Aid and Attendance Pension Benefit

The best advice that I can give you when planning for long-term care is not to delay. We never know what the future holds. While we are able, we must prepare for a variety of situations, and so it is imperative not just to plan for long-term care, but to plan properly.

Part 1 of this five part series began showing why establishing a good Long-Term Care Plan is a necessary and urgent matter. Part 2 outlined the three most essential documents found in a good Long-Term Care Plan and Part 3 explained how long-term care insurance might enhance that plan. The last installment, Part 4, discussed how a trust that is unique to our firm, the Living Trust PlusTM Asset Protection Trust, can protect your assets from the hassles and expenses of probate PLUS the expenses of long-term care. The Living Trust PlusTM is the only type of self-settled asset protection trust that allows a settlor to retain an interest in the trust while also protecting the assets from being counted according to state Medicaid laws. What I have just described is the single most prominent feature of the Living Trust PlusTM and it is also what makes this type of trust be the preferred form of asset protection for most people.

The final installment of this series will now discuss an under-utilized, special monthly pension benefit available to wartime veterans and surviving spouses of deceased wartime veterans who are incapable of self-support and in need of regular personal assistance.

Who Is Eligible for the Veteran’s Aid and Attendance Pension Benefit?

To receive the Veteran’s Special Pension Benefit for Aid & Attendance, a veteran must have served on active duty, at least 90 days, at least one day of which occurred during a period designated as wartime.

 Periods Designated As Wartime:

  • World War II — December 7, 1941 through December 31, 1946
  • Korean Conflict — June 27, 1950 through January 31, 1955
  • Vietnam Era — August 5, 1964 through May 7, 1975; for veterans who served “in country” before August 5, 1964, February 28, 1961 through May 7, 1975
  • Gulf War — August 2, 1990 through a date to be set by law or Presidential Proclamation

There must have been a not dishonorable discharge. If younger than 65, the veteran must be totally disabled. If age 65 and older, there is no requirement to prove disability. However, the veteran or spouse must be in need of regular aid and attendance due to: inability of claimant to dress or undress, or to keep clean and presentable; frequent need of adjustment of any special prosthetic or orthopedic appliances which by reason of the particular disability cannot be done without aid (this will not include the adjustment of appliances which normal persons would be unable to adjust without aid, such as supports, belts, lacing at the back etc.); inability to eat due to loss of coordination of upper extremities or through extreme weakness; inability to attend to the wants of nature; or incapacity, physical or mental, which requires care or assistance on a regular basis to protect the claimant from hazards or dangers incident to his or her daily environment.

Not all of the disabling conditions in the list above are required to exist. It is only necessary that the evidence establish that the veteran or spouse needs “regular” (scheduled and ongoing) aid and attendance from someone else, not that there be a 24-hour need.

Determinations of a need for the aid and attendance is based on medical reports and findings by private physicians or from hospital facilities.

What Is the Amount of the Aid and Attendance Benefit?

Effective December 1, 2011, the Veterans A&A Pension can provide:

  • $20,447 per year (~$1,704 per month) for a qualified veteran;
  • $24,239 per year (~$2,020 per month ) if the veteran is married;
  • $13,138 per year (~$1,095 per month ) for a surviving spouse of a qualified veteran;
  • $31,578 per year (~$2,631 per month ) if both spouses are qualified veterans.

Is Aid and Attendance Only For Low Income Veterans?

No, and this is the primary reason that this benefit is so widely misunderstood. If you speak to a Veterans Service Representative in a regional VA office and ask them about the Veterans Aid and Attendance benefit, they will typically ask for your household income. When you tell them your household income, they will compare it to a chart and most often tell you that you earn too much income to receive the benefit. While the information they provide may be technically accurate, what they typically don’t explain is the “income” for Veterans Administration purposes (sometimes called IVAP or “adjusted income”) is actually your household income minus your recurring, unreimbursed medical and long-term care expenses. These allowable, annualized medical expenses are such things as health insurance premiums, home care expenses, the cost of paying a family member or other person to provide care, the cost of adult day care, the cost of an assisted living facility, or the cost of a nursing home.

To be able to receive the Veterans Pension with Aid and Attendance benefit, the veteran household cannot have adjusted income (i.e., household income minus unreimbursed medical expenses) exceeding the Maximum Allowable Pension Rate — MAPR — for that veteran’s Pension income category. If the adjusted income exceeds MAPR, there is no benefit. If adjusted income is less than the MAPR, the veteran receives a Pension income that is equal to the difference between MAPR and the household income adjusted for unreimbursed medical expenses. The Pension income is calculated based on 12 months of future household income, but paid monthly.

How is the Aid and Attendance Benefit Calculated?

The monthly award is based on VA totaling 12 months of estimated future income and subtracting from that 12 months of estimated future recurring, unreimbursed medical expenses. Allowable medical expenses are reduced by a deductible to produce an adjusted medical expense which in turn is subtracted from the estimated 12 months of future income.

The new income derived from subtracting adjusted medical expenses from income is called “countable” income or IVAP (Income for Veterans Affairs Purposes). This countable income is then subtracted from the Maximum Allowable Pension Rate — MAPR — and that result is divided by 12 to determine the monthly income Pension award. This cash benefit is paid in addition to the family income that already exists.

Filing a Claim

Filing a claim for the Veterans Aid and Attendance Pension Benefit is complex and time-consuming. If you want to do it correctly, it’s important to get qualified assistance. Just knowing which form to fill out and how to complete it is a complex endeavor in itself. Even if the proper form is completed, failure to check a single box may result in a complete denial of your claim.

The application process involves: obtaining evidence of prospective, recurring medical expenses; appointments for VA powers of attorney and fiduciaries; and a thorough understanding of the application process. Often, qualification for this benefit involves reallocation of assets and shifting of income in order to qualify, and these re-allocations may have significant impact on Medicaid eligibility.

Given that many veterans who need the Aid and Attendance Benefit will eventually wind up also needing Medicaid, this process should not be attempted without the help of a qualified elder law attorney who thoroughly understands both the Veterans Aid and Attendance Benefit and the Medicaid program, as well as the interaction between these two benefit programs.

We assist Level 4 clients of our firm, at no charge, in completing the required paperwork.

Conclusion

Evan H. Farr is an Accredited Attorney with the U.S. Dept. of Veterans Affairs, and the Farr Law Firm is an Elder Law and Estate Planning Firm that helps Veterans and their spouses obtain the financial assistance to which they are entitled. If you are a Veteran or spouse of a Veteran and you need assistance in your home, or are living in or considering moving into an Assisted Living Facility or Continuing Care Retirement Community, please contact us to see if you might qualify for the Veterans Aid and Attendance Special Pension Benefit. Call us today and take the first step towards gaining the peace of mind that comes with a good Long-Term Care Plan. 

If You’d Like More Information About Veterans Aid & Attendance,
Please Fill Out the Form Below to Receive our Veterans Aid & Attendance Special Report!

Planning for Long-Term Care (Part 2)

Written by Evan Farr

“Long-Term Care” refers to the broad spectrum of medical and support services provided to persons who have lost some or all capacity to function on their own due to a chronic illness or disabling condition, and who are expected to need such services over a prolonged period of time. Long-term care can consist of care in the home by family members (assisted by voluntary or employed help), adult day health care, or care in assisted living facilities or nursing homes.

In Part 1 of this series I mentioned that 60% of us will need long-term care at some point in our lives. When this statistic is put in perspective with the relatively low likelihood of making an automobile or homeowner’s insurance claim, the risk that you or I will need long-term care at some point in the future is shocking. Unfortunately, the majority of Americans are either unaware of these statistics or refuse to plan for the often catastrophic costs of long-term care. Part 1 of this series outlined the necessity to create a good Long-Term Care Plan in addition to, or as part of, your Estate Plan; Part 2 will now discuss the three most essential documents found in a good Long-Term Care Plan, as well as two additional documents that are often also part of a Long-Term Care Plan.

General Power of Attorney

A General Durable Power of Attorney (POA) containing Asset Protection Powers is the first essential document. Not all POA’s are created equal; it is crucial that this document be prepared by a knowledgeable and experienced Elder Law Attorney. One way to ensure the qualifications of your attorney is to look for one who is Certified as an Elder Law Attorney by the National Elder Law Foundation, the only organization accredited by the American Bar Association to certify lawyers in the specialty area of Elder Law. For a list of Certified Elder Law Attorneys, please visit http://www.nelf.org/findcela.asp.

A POA (always “durable” when used in connection with estate planning and long-term care planning) authorizes your “Agent,” sometimes called an “Attorney in Fact,” to act on your behalf and sign your name to legal and financial documents. It is an essential tool in the event that, due to age, illness, or injury, you are unable to carry on your legal and financial affairs. Asset Protection Powers written into the POA are essential in order for your Agent to protect your assets from the often-catastrophic expenses of long-term care. Attorneys who are not experienced Elder Law Attorneys often fail to put these essential Asset Protection Powers into the POA.

A properly-drafted POA is designed to avoid the need to go through a court-supervised conservatorship proceeding, which is a time consuming, expensive, and publicly embarrassing process whereby someone goes to court to have you declared incompetent and to be appointed as your Conservator. The Conservatorship process is often referred to as a type of “living probate” because the Conservator is subject to all the rules of the probate court, including the onerous requirement of filing annual accountings with the Court. State laws vary regarding the use and acceptance of a power of attorney.

Advance Medical Directive

The second essential document in a good Long-Term Care Plan is an Advance Medical Directive (AMD) containing a Long-Term Care Directive. As with General Powers of Attorney, every lawyer drafts AMDs differently, and most attorneys do not include a Long-Term Care Directive within the AMD. Therefore, it is again in your best interest to have your AMD written by an attorney who specializes in long-term care planning, such as a Certified Elder Law Attorney.

An AMD (also called a Medical Power of Attorney or a Health Care Power of Attorney) authorizes another person (called your “Medical Agent”), to make decisions with respect to your medical care in the event that you are physically or mentally unable to do so. This document includes the type of provisions that used to be in what was commonly called a “Living Will,” allowing you to indicate your wishes concerning the use of artificial or extraordinary measures to prolong your life in the event of a terminal illness or injury. In the AMD you will also appoint a “Medical Agent” and give that person the power to consent to medical and health care decisions on your behalf with regard to providing, withholding, or withdrawing a specific medical treatment or course of treatment when you are incapable of making or communicating an informed decision on your own behalf. A comprehensive AMD will also allow you to indicate your wishes with regard to organ donation, disposition of bodily remains, and funeral arrangements.

A properly-drafted AMD is designed to avoid the need to go through a court-supervised guardianship proceeding, which is a time consuming, expensive, and publicly embarrassing process whereby someone goes to court to have you declared incompetent and to be appointed as your Guardian, typically at the same time they are requesting appointment as your Conservator.

Long-Term Care Directive

Most importantly for your Long-Term Care Plan, your AMD should include a Long-Term Care Directive (or this could be drafted as a separate document), which will allow you to make your desires known in the event you need long-term care in the future. For instance, do you want to remain at home and receive home-based care as long as possible, regardless of cost, even if it drastically reduces or entirely depletes your estate? Or would you prefer to remain at home and receive home-based care only if it doesn’t drastically reduce or entirely deplete your estate? If nursing home care is absolutely required, would you like to protect as much of your assets as can be legally protected so that you can qualify earlier for publicly-funded Medicaid benefits? If so, do you prefer that the protected assets be used to enhance your quality of care, or to provide an inheritance for the beneficiaries of your estate?

In order to be easily accessible when needed, your AMD should be registered with an electronic archive service that can immediately fax the document to any desired destination. Some Elder Law Attorneys, including our firm, provide such registrations to clients at no charge.

Lifestyle Care Plan

The third essential document that is found in a good Long-Term Care Plan is a document called a Lifestyle Care Plan, also known as an Advance Care Plan.  The Lifestyle Care Plan is a document that is created by special software that gathers, organizes, stores and disseminates information provided by you in an interview, in order to guide those who you will depend or for future care. The Lifestyle Care Plan identifies your specific needs, desires, habits and preferences and incorporates all of this information into a document that your future caregiver can use to provide you with the best possible long-term care.

As an example, Alice wrote in her Lifestyle Care Plan that if Alzheimer’s disease or some other type of dementia inhibited her mental abilities to communicate or recognize her surroundings, she wished to be in a respectable facility and only asked that she be visited and brought chocolates. To her children this request seemed silly at the time, but when her mental capacities did diminish, the instructions were there. No one had to wonder if they should try to take care of Alice at home and how they would do it. Without guilt or question they placed her in a respectable facility that took care of her needs. All they had to do was make loving visits, and of course they brought chocolates.

Because of the importance of the Lifestyle Care Plan, the Farr Law Firm provides one to all of our clients as part our comprehensive Long-Term Care Planning services. To learn more about the benefits of having an Advance Care Plan, please click here or visit our Web site at:  www.farrlawfirm.com/advance-care-plan.htm

Living Trusts

A good Long-Term Care Plan will always include the three documents mentioned above, and will typically also include a Living Trust — either a Revocable Living Trust (RLT) or the  Living Trust Plus™ (LTP).

An RLT generally provides for the creator of the trust to have full use of the trust income and principal for life. On the death of the creator, the assets may continue to be held in trust (or may be distributed) for the benefit of the named beneficiaries, such as the grantor’s children. Although the most important benefit of the RLT is to avoid probate, a well-drafted RLT also can help protect from incapacity and can therefore be an important part of a Long-Term Care Plan. Similar to a General Power of Attorney, an RLT can provide uninterrupted management of your assets by your trustee if you become incapacitated, sparing you and your family from having to go through the expense and complexities of a court-appointed conservatorship. It is important to note that an RLT does not protect your assets from the expenses of long-term care. On the contrary, the assets in an RLT must be spent, if necessary, in providing long-term care, even if that means spending down all of the assets in the RLT to provide such care. For more information on RLTs, please click here or visit our Web site at: www.farrlawfirm.com/revocable.html

The Living Trust Plus™ is a living trust that is designed to protect your assets from probate PLUS lawsuits, PLUS nursing home expenses.  In other words, the LTP protects your assets from the complications and hassles of probate and from other financial risks, including the threat of lawsuits, auto accidents, creditor attacks, extended hospitalization, and — most importantly – the catastrophic expenses associated with nursing home care. Part 4 of this series will explore the LTP in detail.

Conclusion

A good Long-Term Care Plan will always include a General Power of Attorney, Advance Medical Directive, and Advance Care Plan, and will typically also include a Living Trust — either a Revocable Living Trust or the Living Trust Plus™.   However, as mentioned in Part 1, these essential legal documents are only part of the requirements for a good Long-Term Care Plan. The other important component is a plan for how to pay for long-term care. The next installment in this series will discuss protecting your assets by purchasing long-term care insurance.

The Farr Law Firm specializes in long-term care planning and we would be happy to assist you in your preparations. Please visit us at www.VirginiaElderLaw.com or call us at 703-691-1888.

Planning for Long-Term Care (Part 1)

Written by Evan Farr

Are you one of the millions of Americans over age 50 who has not yet started planning for long-term care?

As financially responsible adults, most of us are prepared for some unexpected disasters – we pay for health and property damage insurance, and many of us have taken some steps toward funding for our retirement. But very few of us have prepared for one of the most devastating of unexpected events – the need for long-term care. According to most estimates, more than 60% of us will need long-term care at some point in our lives. If you are a member of the “sandwich generation” – responsible for an older parent – the odds that either you or your aging parent will need such care are even higher, and the costs to your lifestyle, finances, and security can be catastrophic. Consider the following long-term care statistics:

• About 70% of Americans who live to age 65 will need long-term care at some time in their lives, over 40 percent in a nursing home.
• As of 2011, the average cost of a nursing home in Northern Virginia was over $100,000 per year.
• A recent insurance company study found that 46 percent of its group long-term care claimants were under the age of 65 at the time of disability.

Contrast the above long-term care statistics with statistics for automobile accident claims and homeowner’s insurance claims:

• An average of only 7.2% of people per year file an automobile insurance claim.
• An average of only 6.15% of people per year file a claim on their homeowner’s insurance.

The need for long-term care drastically alters or completely eliminates the four principal retirement dreams of elderly Americans:

1. Remaining independent in the home without intervention from others
2. Maintaining good health and receiving adequate health care
3. Having enough money for everyday needs
4. Not outliving assets and income

Unfortunately, the reality is that the majority of Americans make no plans for long-term care. Not only does this lack of planning affect older Americans, but it also often has an adverse effect on the older person’s family, with sacrifices made in time, money, and family lifestyles. The stresses of being a caregiver for an older parent often result in a deterioration of the caregiver’s own physical and emotional health. Because of changing demographics and improved health care, the current generation — more than ever — needs to actively plan for long-term care.

So what are basics of a good Long-Term Care Plan? First and foremost are two critical documents that need to be prepared by an experienced and knowledgeable Elder Law Attorney. These two essential documents are:

• A Financial Durable Power of Attorney containing Asset Protection Powers; and
• An Advance Medical Directive containing a Long-Term Care Directive.

The third essential document, which you can prepare on your own, is a Lifestyle Care Plan.

Part 2 of this article will explain and explore these three critical documents to give you a greater understanding of the need for and importance of these vital long-term care planning instruments.

These essential legal documents, however, are only part of the requirements for a good Long-Term Care Plan. The other important component is a sound financial plan for how to pay for good long-term care. There are three primary ways to plan in advance for how to pay for long-term care: (1) build up your income and life savings in order to be able to self-fund your future care needs; (2) protect your assets by purchasing long-term care insurance; or (3) protect your assets by using an asset protection trust designed to legally protect your assets and allow you to qualify for Medicaid, the governmental program that pays for about 70% of people living in nursing homes. For some families, a fourth way to pay for long-term care is a type of Veteran’s pension benefit called “Aid & Attendance.”

Unfortunately, option 1 (building up your income and life savings to self-fund future care) is not feasible for most Americans, especially in these troubled economic times. Accordingly, Parts 3 through 5 of this series will explain and explore these three methods of paying for long-term care. Part 3 will focus primarily on using long-term care insurance to protect your assets; Part 4 will explore the use of a special type of asset protection trust to protect assets and gain early access to Medicaid; and Part 5 will explain the Veteran’s Aid & Attendance benefit.

There are many things that you can do now to begin to put together a good Long-Term Care Plan. The most important thing you can do is to act now! You may have limited resources in the future or health problems that will prevent you from taking care of the things you can easily take care of today. The Farr Law Firm specializes in long-term care planning and we would be happy to assist you in your preparations. Please visit us at www.virginiaelderlaw.com or call 703-691-1888.

Protect and Defend

Written by Evan Farr

STOP AND THINK! Do you know what legal steps you need to take to
safeguard… Your business? Your money? Your family? Maybe you were
caught in a car accident where you’re not sure of your rights, or
you’re looking for a lifetime of legal protection for your company,
your family or your wealth. Whatever the case, you need to know what
it takes to protect your rights and defend you and your loved ones
from unforeseen legal threats.

Over the last 8 months I’ve been working on a book with America’s
leading attorneys from across the country that will help answer these
vital questions. Protect and Defend is the book that delivers to you
practical advice based on their years of top-level experience.

In each chapter, you’ll get exclusive access to their expertise, as
they tackle some of today’s most crucial legal issues-issues that
affect us all every day. As you know, the law can be your best friend
or your worst enemy. And you absolutely need to know how to put it on
your side whether you’re facing an immediate emergency or looking for
long-term solutions. Protect and Defend brings you proven strategies
to help you do just that-before it’s too late.

We’ll be launching the book this week, Thursday, July 26th.
(don’t worry I’ll remind you!), and I’ve put together a huge bonus
package for you if you’ll help us launch the book on Thursday!

As I said, I’ll remind you, but if you are willing to help us launch
with great success, by buying the book (It’s only $19.95!), then I’ll
give you hundreds of dollars worth of bonuses in addition to the
great ideas you will get from reading the book.

I appreciate your support and I’ll get back with you in a couple of
days to remind you about the launch and to tell you more about the
bonuses I’m putting together!

Stay tuned!


Evan H. Farr, CELA
Certified in Elder Law by the National Elder Law Foundation
http://www.VirginiaElderLaw.com
http://www.VirginiaEstatePlanning.com
http://www.LivingTrustPlus.com
Farr Law Firm, 10640 Main St., Suite 200, Fairfax, VA 22030
Tel: 703-691-1888 | Fax: 703-940-9160

*Virginia has no procedure for approving certifying organizations

When a Nursing Home is the Best Choice for Everyone

Written by Evan Farr

As the Baby Boomer generation ages, more and more families are struggling to live with a loved-one suffering from Dementia or Alzheimer’s disease.  While memory loss can be a frightening experience for an aging parent or grandparent, its’ impact on the family can be equally frightening, particularly when there are young children in the home.

There are a host of reasons why people invite an aging parent or grandparent to move in with them and their family.  It might simply “feel” like the right thing to do; the home could be old and in need of serious repair, and perhaps they have fallen or have been injured as a result of the conditions of the premises.

It might be easy to dismiss occasional forgetfulness as normal – the elder may even laugh at, or make fun of their own inability to recall something.  However, when living with someone suffering from a progressive form of dementia, it does not take long to realize the differences between it, and mere forgetfulness.

The transition can be even more difficult when children are part of an active household.  When an aging relative has lived alone for many years, this can be especially pronounced.

Unfortunately, it can get to the point that it is not possible to care for one’s own children as well as an aging parent or grandparent at the same time. The needs of one are often diametrically opposed to the other.

Individuals placed in an environment catering to the specific needs of those with cognitive impairments such as dementia, quite often are truly better off.  Age-appropriate activities and companionship with people one’s own age is an important aspect not to be overlooked.  While it can be a painful reality to accept, quite often others are far better equipped to provide the care a patient with Alzheimer’s or other forms of dementia.

As our population ages, and people live far beyond the life expectancy of even 20 years ago, more and more families will be forced to acknowledge their limitations.  Choosing to place a family member in a nursing home is not an admission of failure, but an acceptance of the fact that prolonged life expectancy carries with it a need for more complex care than the vast majority of us can ever hope to provide.

 

Image Credits:

Image: graur codrin / FreeDigitalPhotos.net

Image: graur razvan ionut / FreeDigitalPhotos.net

Seminar Tomorrow: Families Coping with Alzheimer’s

Written by Evan Farr

Attention: Families Coping with Alzheimer’s:

You may be interested in attending an upcoming seminar that will combine the expertise of two well-known experts in their respective fields:  Elder Law Attorney Evan Farr and Financial Advisor Eric Bost.

Eric Bost

Attendees will learn:

• How to evaluate the costs of the various care options available
• What benefits you may receive to help offset these costs
• How to protect and invest your assets to maintain your lifestyle

When are the Seminars Taking Place?

Wednesday, February 22, 2012 or
Wednesday, March 21, 2012

What Time Should I Arrive?

6:30 p.m.

Where are the Seminars Taking Place?

Morgan Stanley Smith Barney,
1650 Tysons Blvd, Suite 1000
McLean, VA 22102

How do I RSVP?

Please contact Tu Nguyen, Registered Marketing Associate
at 703-556-8185 or e-mail tu1.nguyen@mssb.com
to reserve your space. Seating is limited.

Tackling the “Sibling Situation”

Written by Evan Farr

Siblings often have trouble agreeing on anything, so why should it be any different when it comes to Mom and Dad’s elder care?  Unfortunately those of us in elder law see quite often how families have a very difficult time when it comes to determining what is best for aging parents.

In some cases, one sibling may be expected to take on an unreasonable portion of the elder care with other siblings not recognizing (or possibly not caring) that it is a hardship. Perhaps it’s because of geographical closeness, or financial stability, or even perceived favoritism of a particular sibling. Other times, siblings simply can’t agree on the best course of medical intervention or the choice of an assisted living facility.

A certified elder law attorney like Evan Farr can actually help to avoid or work through some of these issues.

The best approach is to start early.  Most siblings can likely agree that having your parents make their wishes known in advance is a good thing. (And sticking to them, no matter what, when they become necessary.)  The attorney can help them draw up some very important documents before they are even needed. Such as:

  • Medical Power of Attorney – This names the person responsible for making medical decisions when the parent is unable to do it for himself or herself.
  • Financial Power of Attorney – This is used to determine who will have control of the parents’ finances in order to keep the household going, pay medical bills, etc. during an illness or crisis.
  • Living Will – A living will helps to outline the parents’ wishes when it comes to medical interventions and end-of-life care.  Having this in place takes some of the burden off of the adult children who would otherwise be making these choices.

If possible, it’s best to have all of the siblings aware of and in agreement about these documents, as it can cut down on the amount of frustration later. Of course, children must also realize and respect that it is entirely up to the parents who they want to nominate as their primary Agents, and whether they may act independently or if they must act in cooperation with one or more siblings.

When things do become more intense and these documents come into play, it is still likely that siblings will have disagreements about what is best.  The one who has the largest responsibility for day-to-day elder care may become resentful, while another may also harbor resentments that someone else was chosen to take care of the parents’ finances.  Throw in the emotions that surface when facing your parents’ mortality, and there is potential for a major explosion and grief.

In order to diffuse the situation, an elder law attorney can direct you to other forms of outside help.  For example, some families choose to hire a “geriatric care manager.”  This person is able to manage many aspects of the parent’s care, and because he or she isn’t a family member, much of the associated drama is mitigated.  When a situation has become too out of hand, the siblings may need to agree to use a mediator.  This impartial listener can help to determine the best course of action for getting the parents the care they need while meeting the needs and wishes of the siblings as appropriately as possible.

In order to salvage an uncomfortable family situation, it may be advisable for members to seek family counseling.  This is most likely to work when all of the members are invested in a positive outcome.  The staff at the Farr Law Firm can help direct you to many resources for counselors and mediators here in the Northern Virginia area.

If you’re a parent that would like to start laying the proper groundwork for your children now, contact the Farr Law Firm to discuss drawing up the proper documents to make future life transitions as smooth as possible for your family.

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3 Tips on Speaking to Parents About Long Term Care Options

Written by Evan Farr

Today’s  women are decision makers.  For some couples, the woman is THE decision maker, and there’s nothing wrong with that.  For example, in nearly 8 out of 10 cases where married couples purchase a vehicle, it is the woman who makes the final decision.  And because women outlive men by 5.4 years on average, women frequently make decisions that have long lasting effects upon their children, their spouse, and even their parents.

Today, I want to offer 3 tips to help open the lines of communication between parent and child when it comes to the difficult subject of long term care.

Tip 1: Explain that Elder Law Attorneys are Passionate About Their Clients – Elders!

Elder law attorneys have deliberately chosen a career in a specialized area of law to serve elders.  Moreover, Virginia Rules of Professional Conduct require lawyers to act in the best interests of their clients.  The client of an elder law attorney is the elder.  Not the child. 

Elder law attorneys are equipped to facilitate familial harmony; they place the client’s concerns at the forefront of any discussion, and they orchestrate a plan that can protect a nest egg from the catastrophic expenses of long term care and improve quality of life.  An inheritance is nice – and usually a much larger inheritance is a by-product of the plan devised by an excellent elder law attorney – but the first thing I explain to families I meet with is that the inheritance is not the focus.  My client’s quality and dignity of life is priority #1.

Tip 2: Gather Information with Parents in No-Pressure Environment

Parents love to do things with their kids, and adult children likewise value the time they have with their aging parents.  One easy way to spend time with your parents while gathering information is to attend a free seminar hosted by a local elder law attorney.  Don’t be afraid to research, communicate and explain important statistics to your parents.

Tip 3: Use Easy to Understand Statistics to Convey Your Message:

Did you know that if you are over age 65:

  • you have a 7.2% chance of having an auto accident every year;
  • a 6.15% chance of needing to file a homeowner’s insurance claim; and
  • a 70% chance of needing long-term care?

Over half of those who need long-term care will require a nursing home.

Here is the statistic you must be concerned with:

  • 13% of drivers are uninsured;
  • 15% of homeowners are uninsured; but
  • 90% of senior citizens are uninsured and unprotected against long term care needs.

This means;

  1. 87% of people insure themselves against an event that has a 7.2% annual probability;

  2. 85% of individuals protect themselves against an event with a 6.15% annual probability; but

  3. Only 10% protect themselves from an event with a 90% probability!

Why is it important to plan for long term care?  Primarily because the expenses of long term care are catastrophic and can wipe out a nest-egg in less than a year.  50% of couples and 70% of singles are impoverished (broke) after one year of entering a nursing home.

Medicaid is a government program meant for those who plan for it.  I encourage you to attend a free seminar on the subject, as it is shocking that so many smart people do not realize that Medicaid – not Medicare – can be used to pay for long term care.

One common misconception is, “We don’t need to plan for our long term care yet, we’re only 65.”  Almost half of all long-term care claimants are under age 65 at the time of disability.  Every day that goes by without a plan, the family is risking possible delay or even forfeiture of government benefits that are meant to pay for catastrophic long term care costs.

Talking to your parents about their long term care options can be understandably difficult, and no other generation has had to simultaneously balance so many familial responsibilities at one time.  But there is a new breed of estate planning and elder law that takes a family-friendly, solution-based approach making it easier to discuss difficult subjects.

Photographer: graur razvan ionut