Q. I grew up in Northern Virginia and raised three children here. Now, they’re spread out across the world – one in Florida, one in Oregon, and one in Texas. All three children have invited me to move closer to them, but I prefer to remain in the area that has been my home for 65 years, even if it means continuing to live alone.
The only problems I foresee is the fact that I have arthritis and cannot see very well. My daughter in Florida has offered to hire a contractor to make my home more accessible for me. Still, if something comes up and I need someone, who can I call for help? Assisted living or nursing home care may be in my future, but right now I would like to live independently for as long as I can, and am exploring other options.
I heard about senior villages in Northern Virginia. Do you know anything about them? Also, how can I plan for the future in case assisted living and/or nursing home care becomes necessary for me. There is no way I can afford these options with the savings I have and I want it all to go to my grandchildren for college. Thanks for your help!
A. A generation or two ago, many Americans assumed that when they grew old and frail, they would go to a nursing home or assisted-living facility. According to an AARP study , aging looks different now, with 88% of those 65 and up choosing to stay in their residence for as long as possible. With the increasing numbers of seniors wishing to remain at home, came the grass-roots movement of senior villages, often just called “villages.”
Since the early 2000s, villages have emerged as an innovative model to help people remain in their homes and to connect with their communities throughout later life. According to the Village to Village Network, villages are defined as “self-governing, grassroots, community-based organizations that coordinate access to a variety of supportive services to promote aging in place, social integration, health, and well-being.”
Senior villages in the DC area are organized in neighborhoods that offer older residents a variety of volunteer services, including grocery delivery, lawn mowing, and transportation . As the movement matures, villages have added additional services, including social work, discounts with local merchants, trips, cultural activities and, at one area village, a program in which volunteers accompany members to doctor’s appointments to take notes. Membership fees in the DC area are usually several hundred dollars a year, and are often determined on a case-by-case basis.
The DC area is actually leading the country in the surge of these villages, going from about five in 2010 to 40 that are up and running or currently in development. Nationally, the number of villages registered with the network has increased from 50 in 2010 to 124 this year, with more in development. In a recent study, the Village to Village Network found that the Washington area is an ideal area for these types of villages because it is a more transient place than many metropolitan areas, with close relatives often living far away. The DC area also attracts many career government and nonprofit workers, who are often interested in volunteering when they retire, in order to remain physically active and involved in the community.
Many seniors who reside in these villages are in situations similar to yours. According to Barbara Sullivan, executive director at Mount Vernon at Home, “we have a lot of members who raised their children here and the children have moved away.” The village where she works, Mount Vernon at Home, is a five-year-old village of 190 members whose average age is 82. The Mount Vernon at Home village spans 14 square miles, and consists of services including driving people to medical appointments, grocery stores and social events. The village also offers technology classes and has added care management to its services, helping people find close-by rehabilitation centers and figure out which ones accept their insurance.
In many cases, the social component has become as important as the services provided, and area villages even offer activities such as architectural tours, lectures and performances, as well as happy hours. At the same time, some villages have taken a more active role in medical care. Capitol Hill Village, for example, has a care coordinator who matches trained volunteers with people with special needs. Foggy Bottom West End Village plans to start a quick-response team, training and aligning specific volunteers with members who are identified as needing more attention.
The village phenomenon has become so popular in this area, that Fairfax has designated a liaison to assist people who want to start a village and to help connect villages in the area. Libraries in Montgomery County offer a guide to starting a village, and the county is also hiring a villages coordinator.
What happens when the village model is no longer enough to meet your needs? Nursing homes in Northern Virginia cost $9,000-$12,000 a month, which can be catastrophic for most families, especially if your desire is to help pay for your grandchildren’s education. Whether or not you move to a village community in the area, in your situation, it would be prudent to plan ahead in the event that assisted living or nursing home care is needed in the future. Life Care Planning and Medicaid Asset Protection is the process of protecting your assets from having to be spent down in connection with entry into a nursing home, while also helping ensure that you or your loved one get the best possible care and maintain the highest possible quality of life, whether at home, in an assisted living facility, or in a nursing home. Learn more at The Fairfax and Fredericksburg Elder Law Firm of Evan H. Farr, P.C. website. Call 703-691-1888 in Fairfax or 540-479-1435 in Fredericksburg to make an appointment for an introductory consultation.
Self-esteem and confidence issues are often associated with teenagers experiencing growing pains. However, seniors can also experience difficulty with their feelings of worth as they grow older. Studies have shown that self-esteem begins to decline in old age as people start to deal with retirement, empty nests, and health concerns.
Good self-esteem in seniors is important for both the body and the mind. In fact, a recent study by Concordia University’s Center for Research in Human Development suggests that feelings of self-confidence and self-worth correlate to a lower incidence of health problems.
The study looked at 147 adults over the age of 60 and measured their self-esteem, cortisol, perceived stress levels, and any depressive symptoms they have had over a four-year period. The findings were that participants with lower self-esteem and a history of depression and stress had higher cortisol levels. Too much of the stress hormone, cortisol, can have negative side effects like weight gain, sleep problems, digestive issues, and even memory impairment.
One way seniors can maintain and improve their self-esteem is to socialize and prevent isolation, researchers suggested, as loneliness can be a major health concern in older adults. Another University of Chicago study suggests that loneliness can increase the chances of premature death by up to 14%. Health experts say older people can increase their self esteem by taking care of their health and appearance, spending time with friends and family, volunteering, and managing their free time. Please read our blog post about mental wellness for some suggestions on how to live life to the fullest with less stress and a positive attitude.
Part of mental and emotional well-being is having a plan in place for your future and for your loved ones. The greatest peace of mind comes with making sure your wishes are met and your loved ones are taken care of, especially if you should become incapacitated or need long-term care. If you or a loved one is nearing the need for long-term care or already receiving long-term care or if you have not done Long-Term Care Planning, Estate Planning or Incapacity Planning (or had your Planning documents reviewed in the past several years), please call The Fairfax and Fredericksburg Long-Term Care Planning Law Firm of Evan H. Farr, P.C. at 703-691-1888 in Fairfax or 540-479-1435 in Fredericksburg to make an appointment for an introductory consultation.
For many Americans today, later life provides an opportunity to re-imagine possibilities, learn new skills, and take on new challenges. To address a generation that has challenged conventional wisdom, a major focus at the recent American Society on Aging (ASA) “Aging in America” conference was on how technology is contributing to greater independence, expanded personal connections, and healthier lifestyles for seniors.
As the number of professional and family caregivers is dwindling, technology can mitigate costs while allowing people to stay active and live independently longer. New possibilities, including the option to plug into healthcare information from home, track symptoms, and access therapy remotely, are making it easier for older adults who are living life more independently.
At the ASA conference, Gail Hunt, president and CEO of the National Alliance for Families, told participants that “the entrepreneurial community has finally woken up to the aging demographic opportunity.” Below are some examples of technological innovations that confirm this statement.
- Personal airbags for fall protection: ActiveProtective created smart garments, which are underwear that contain 3-D motion sensors to detect falls. If someone’s activity deviates from the norm, indicating a fall, a micro-airbag deploys from the underwear to protect the wearer from injury. The garment also issues a call for help.
- UTI detecting briefs: Pixie Scientific, the company that developed smart diapers for infants, is now catering to an older audience. Their disposable briefs for seniors contain an indicator panel on the front that screens for urinary tract infections (UTI’s) and monitors hydration. This product is particularly helpful when it comes to identifying conditions before symptoms occur, so treatment can begin early. To screen for UTI’s or dehydration, the senior wearing the disposable brief or his or her caregiver can scan the code on the front of the undergarment with a smartphone, receiving data in less than 10 seconds. If the indicator panel senses a health problem, the person scanning the code is alerted. It takes only one disposable undergarment a day to collect data.
- Smart pill bottle: AdhereTech has created smart pill bottles that send real-time alerts to seniors when it is time for them to take their pills. For example, when someone is supposed to take his or her medicine, the bottle glows blue. If it isn’t opened, it turns red and begins to beep. AdhereTech’s system also issues reminders via text message or phone call.
- Remote physical therapy software: Reflexion Health makes physical therapy more effective for patients and more measurable for clinicians. It pairs Kinect for Windows sensor technology with its proprietary software to deliver an interactive solution that helps patients and physicians improve physical therapy results. Patients often receive individual sessions from physical therapists, but do much of their rehab alone, only guided by papers with stick figures that illustrate how to perform the prescribed exercises. This new technology delivers customized therapy plans to help these patients remotely.
- Parkinson’s spoon: Liftlabs Design developed a special spoon to balance tremors, designed to help those with essential tremor and Parkinson’s disease eat independently. Sensors in the handle detect the tremor, then the spoon steadies the user’s hand.
- Smart footwear: Plantiga invented Suspnd footwear that supply real-time data, with information on weight transfer, distribution, and other movement patterns. Data can be sent to various smartphone apps, and used for diagnostics, improving sports performance, in addition to other purposes. As Plantiga says on its website: “Bio-sensing from footwear enables better decisions for people who suffer musculoskeletal problems, diabetic neuropathy and plantar fasciitis, among other” conditions.
- Specialized Mental Health Help: ThriveOn, an online and mobile service, offers counseling for people with mental health issues without long wait times, in-person interactions, or high fees. When you sign up, you take an assessment that examines your mood, stress, anxiety level, body image, and sleep habits. Then, you begin a personalized program that combines reading, interactive exercises, mood and behavior tracking, and weekly feedback from a ThriveOn coach.
- Smart thermometer: Kinsa is a thermometer that integrates with your smartphone. It shows degree-by-degree rise in body temperature and it helps make sense of your symptoms. It taps into “health weather,” a database that considers, for example, if the flu or strep throat is affecting your community. You can show your phone to your doctor, and he or she will have instant access to the data Kinsa has collected.
- Thermometer that reads vitals: The Scanadu Scout measures temperature, heart rate and hemoglobin, which carries oxygen to your blood, in 10 seconds. That information is then transmitted to your smartphone, so you can track and analyze your vitals.
- Alzheimer’s test: The Self-Administered Gerocognitive Examination (SAGE test) is an Alzheimer’s test that can be administered at home or in group settings (such as health fairs), and has proven to be reliable. Please read our blog post, “Do you have Alzheimer’s? There’s a new tool to help you check” for more details.
Most people want to stay in their home for as long as possible. However, if you or a loved one cannot live independently and are showing signs that living alone is a strain, it may be time to consider other alternatives. Broaching this subject with loved ones can be challenging. Please read our blog post, “When Dad is Resistant About Assisted Living” for more details on how to have a conversation with a loved one about long-term care options.
If, on the other hand, you or your loved one has a full life, a close neighborhood and community connections, and seems to be thriving, it’s worth exploring as many in-home care options as possible.
Whether the outcome is in-home care, assisted living, or nursing home care in the future, it is always wise to plan ahead. Life Care Planning and Medicaid Asset Protection is the process of protecting assets from having to be spent down in connection with entry into assisted living or nursing home care, while also helping ensure that you or your loved one get the best possible care and maintain the highest possible quality of life, whether at home, in an assisted living facility, or in a nursing home. Learn more at http://www.VirginiaElderLaw.com and call us at our Virginia Elder Law Fairfax office at 703-691-1888 or at our Virginia Elder Law Fredericksburg office at 540-479-1435 to make an appointment for an introductory consultation.
Q. My mother, Sheila, and my father, Tim, always lived in the moment and steered clear of discussions about getting older, retirement, and planning for the future. They lived in a rural part of Virginia and were convinced that Social Security and Medicare would be enough for them to get by on when they retired. They never did any estate planning, incapacity planning, or long-term-care planning. Dad ended up needing nursing home care and they depleted almost all of their assets to pay for the nursing home. After mom died, what little was left of their estate went through probate, which was a real nightmare for my sister and me. I do not want to same fate for my family.
My husband and I are both in our mid-40’s, and both work for the government, so financially we’re a lot better off than my parents, and we’ve already started saving for college for our three children (ages 5, 7, and 10) and we both have retirement accounts with the government. As far as other planning goes, we haven’t done anything yet. When it comes to incapacity planning and estate planning, what should we be thinking about?
A. Planning for incapacity, disability, and death are things that most people never think about until they (or their loved ones) are forced to grapple with an emergency situation. However, every adult over the age of 18 should have an Incapacity Plan that includes a Financial Power of Attorney, an Advance Medical Directive, and an Advance Care Plan. Many people think that estate plans are for someone else, not them. They may rationalize that they are too young or don’t have enough money to reap the tax benefits of a plan. But as the following list makes clear, estate planning is for everyone, regardless of age or net worth.
1. Loss of capacity. What if you become incompetent and unable to manage your own affairs? Without a plan the courts will select the person to manage your affairs. With a plan, you pick that person (through a power of attorney).
2. Minor children. Who will raise your children if you die? Without a plan, a court will make that decision. With a plan, you are able to nominate the guardian of your choice.
3. Dying without a Living Trust. Without a proper estate plan using a Living Trust, your assets will go through the nightmare of probate.
4. Blended families. What if your family is the result of multiple marriages? Without a proper estate plan using a Living Trust, children from different marriages may not be treated as you would wish. With a proper plan, you determine what goes to your current spouse and to the children from a prior marriage or marriages.
5. Children with special needs. Without a plan, a child with special needs risks being disqualified from receiving Medicaid or SSI benefits, and may have to use his or her inheritance to pay for care. With a plan, you can set up a Supplemental Needs Trust that will allow the child to remain eligible for government benefits while using the trust assets to pay for non-covered expenses.
6. Keeping assets in the family. Would you prefer that your assets stay in your own family? Without a proper plan, your child’s spouse may wind up with your money if your child passes away prematurely. If your child divorces his or her current spouse, half of your assets could go to the spouse. With a proper plan, you can set up a trust that ensures that your assets will stay in your family.
7. Financial security. Will your spouse and children be able to survive financially? Without a plan for long-term care and disability in place, your family may be unable to maintain its current living standard.
8. Retirement accounts. Do you have an IRA or similar retirement account? Without a plan, your designated beneficiary for the retirement account funds may not reflect your current wishes and may result in burdensome tax consequences for your heirs (although the rules regarding the designation of a beneficiary have been eased considerably). With a plan, you can choose the optimal beneficiary.
9. Business ownership. Do you own a business? Without a plan, you don’t name a successor, thus risking that your family could lose control of the business. With a plan, you choose who will own and control the business after you are gone.
10. Avoiding probate. Without a plan, your estate may be subject to delays and excess fees (depending on the state), and your assets will be a matter of public record. With a plan, you can structure things so that probate can be avoided entirely.
Estate Planning for Parents with Minor Children
Parents of Minor Children Need a Child Protection Plan.
If you’re a mom or dad with one or more children at home under the age of 18 (as I am), you need a Child Protection Plan. Without such a plan, if you are killed or incapacitated in an accident, the police will typically show up at your house to notify the family. If the police find your kids home alone, or with a babysitter, they will have no choice but to call in Child Protective Services and have your kids removed from your home until the system can figure out what to do, and that may take weeks or even months.
Doesn’t a Will Naming Guardians Suffice?
Having a Last Will and Testament to name permanent, long-term guardians for your minor children is vitally important, but it is not sufficient to protect your children in these situations. First of all, the police typically won’t know where to find your Will, so your kids will often wind up in the hands of strangers until everyone can figure out what to do. Even if the police did somehow obtain a copy of your Will, a Will doesn’t actually appoint guardians. A Will only nominates guardians for your children after your death; a Court must make the actual legal appointment. And a Will only works if you die, not if you become temporarily or permanently incapacitated.
A Will doesn’t even become effective until it is admitted to probate (which often occurs weeks or months after death), and then it can take additional weeks or months for the Court to officially appoint your guardians. In the meantime, who is going to take care of your children? Who is going to be authorized to obtain medical treatment if a child requires it? Unfortunately, it is typically the Child Protective Services system, through its network of Foster Care volunteers.
A Child Protection Plan addresses who is authorized to take charge of your children immediately and comfort them in those terrible first hours, days and weeks after your death or incapacity, so that you can have the peace of mind of knowing that your children will be taken care of by trusted and loving family or friends who you decide on, not random strangers that the overworked government system foists upon your children.
What is a Child Protection Plan?
A Child Protection Plan is a set of legal documents that includes an Appointment of Temporary Guardian for someone you choose to take immediate custody of your children, a Parental Consent for Medical Treatment form, and a Medical Information form containing information on your child’s medical allergies and conditions, pediatrician information, health insurance information, immunization record, and medication list. Your Child Protection Plan will also include a special wallet card. The wallet card will be registered with a national database that contains all of the above information on file for each child.
If you are in an accident, your Child Protection Plan will help ensure that your children are never turned over to Child Protective Services because the police don’t have clear instructions from you and, if the unthinkable happens, your Child Protection Plan will help ensure that your children are not turned over to Foster Care strangers chosen by a overburden social services system that doesn’t care about your wishes or who you would prefer to take custody of your children.
Elder Law doesn’t start when you are “elderly”– it is something that should start when you first become an adult and continue throughout your lifetime. Your life goes through incredible changes each decade; therefore, you should look at Elder Law and Estate Planning as gradual processes, rather than a one-time ordeal. If you haven’t done so already, now is the time to begin your process. Learn more at http://www.VirginiaElderLaw.com and call us at our Virginia Elder Law Fairfax office at 703-691-1888 or at our Virginia Elder Law Fredericksburg office at 540-479-1435 to make an appointment for an introductory consultation.
Did you know that every 67 seconds someone in the U.S. develops Alzheimer’s and that more than 5 million Americans are currently living with the disease? The “2014 Alzheimer’s Facts and Figures” report, released recently by the Alzheimer’s Association, reveals staggering new data on the cost of the disease, death rates, facts by state, the impact on caregivers, and projections for the future.
Below is a sampling of data from the report:
- Of the 5 million people age 65 and older with Alzheimer’s in the United States, 3.2 million are women and 1.8 million are men.
- Approximately 500,000 people die each year from Alzheimer’s.
- In 2013, 15.5 million caregivers provided an estimated 17.7 billion hours of unpaid care valued at more than $220 billion.
- Nearly 19% of women Alzheimer’s caregivers had to quit work either to become a caregiver or because their caregiving duties became too burdensome
- Unless something is done to change the course of the disease, there could be as many as 16 million Americans living with Alzheimer’s in 2050, at a cost of $1.2 trillion (in current dollars).
Watch this video for more details from this year’s report.
According to Angela Geiger, Alzheimer’s Association chief strategy officer, “[d]espite being the nation’s biggest health threat, Alzheimer’s disease is still largely misunderstood. Everyone with a brain – male or female, family history or not – is at risk for Alzheimer’s.”
Have you or a loved one been diagnosed with Alzheimer’s? Persons with Alzheimer’s and their families face special legal and financial needs. At The Fairfax and Fredericksburg Alzheimer’s Planning Law Firm of Evan H. Farr, P.C., we are dedicated to easing the financial and emotional burden on those suffering from Alzheimer’s or other dementias. If you have a loved one who is suffering from Alzheimer’s, or a family member who is nearing the need for long-term care or already receiving long-term care, call us at 703-691-1888 in Fairfax or 540-479-1435 in Fredericksburg to make an appointment for an introductory consultation.
During the March 5 Academy Awards show, John Travolta took the stage and introduced Idina Menzel, but as he read her name from the teleprompter, he said ”Adele Dazeem” instead. An estimated 43 million people saw the flub, and the media has been mocking him relentlessly ever since, especially since he attended rehearsals.
Menzel, who acted in ”Rent” onstage and on-screen in “Wicked,” recently became a household name with her hit song,”Let It Go,” from the animated film “Frozen.”
The incident placed dyslexia in the spotlight as the possible reason for Travolta’s “oops” moment. Dyslexia is a life-long condition, characterized by difficulties in reading, writing, and spelling. Experts explain that dyslectics have difficulty in accurately interpreting the printed word and in matching the words with their appropriate sounds.
However, dyslexia may not be the culprit after all. Members of the media also mentioned the possibility of aphasia. According to the American Speech-Language-Hearing Association, aphasia is a disorder that results from damage to the parts of the brain that contain language. Aphasia can cause problems with spoken and written language, and some people with aphasia have trouble using words and sentences. A person with mild aphasia may have trouble finding the words (called “anomia”) to express an idea or explain himself/herself, similar to having a word “on the tip of your tongue.”
Aphasia is sometimes the result of a stroke, a severe head injury, or other types of cognitive problems, such as memory loss or confusion. Sometimes temporary episodes of aphasia can occur, which can be due to migraines or seizures.
What if not being able to recognize someone famous was more than a “tip-of-the-tongue” moment? Primary progressive aphasia is a form of dementia typically found in people younger than 65 that affects communication and language function, such as the ability to express thoughts or find the correct word. Although media sources have not indicated that Travolta has any type of dementia, the incident at the Academy Awards calls attention to aphasia, including primary progressive aphasia.
Would you be able to recognize the names and faces of famous people, such as Oprah, Bill Gates or John F. Kennedy? In research published in the journal “Neurology,” scientists developed a test involving 30 people, ages 40-65, who have primary progressive aphasia, and a group of 27 people without dementia. All were asked to identify photos of famous faces, likely to be known by 40-60 year-old Americans, by name or, if they couldn’t name them, to provide at least two relevant details about them.
Brain scans taken during the exam showed those who had trouble naming faces had deterioration in the left and right temporal lobe of the brain. Researchers found that those with dementia were only able to name the faces 46% of the time and provide some details 79% of the time, while those without dementia averaged 93% and 97% respectively.
Early-onset dementia can be difficult to diagnose because there are many different types of dementia with overlapping symptoms that are sometimes attributed to normal lifestyle factors like stress. In Alzheimer’s, the most common type of dementia, about 4% of the estimated 5 million cases in the U.S. are people in their 40s and 50s, according to the Alzheimer’s Association.
As for Travolta, it is unknown whether he might have dyslexia, aphasia, or something else entirely, or whether it was just a one-time “oops” moment.
Have you or a family member been having ”oops” moments? If these types of ”oops” moments happen regularly, it may be time to see a neurologist or other specialist for a screening and possible diagnosis. Persons with dementia and their families face special legal and financial needs. At The Fairfax and Fredericksburg Dementia Planning Law Firm of Evan H. Farr, P.C., we are dedicated to easing the financial and emotional burden on those suffering from dementia and their loved ones. If you have a loved one who is suffering from dementia, we can help you prepare for your future financial and long-term care needs. We help protect the family’s hard-earned assets while maintaining your loved one’s comfort, dignity, and quality of life by ensuring eligibility for critical government benefits. If you have not done Long-Term Care Planning, Estate Planning or Incapacity Planning (or had your Planning documents reviewed in the past several years), or if you have a loved one who is nearing the need for long-term care or already receiving long-term care, call us at 703-691-1888 in Fairfax or 540-479-1435 in Fredericksburg to make an appointment for a no-cost consultation.
The Farr Law Firm, a busy, dynamic, and growing Elder Law firm in Fairfax City, seeks a Full-Time Legal Assistant to assist with helping our clients obtain Long-Term Care Medicaid and Veterans Benefits. Position entails significant personal contact with elderly and/or disabled clients and their family members. Medicaid training will be provided if necessary, but applicant must be a fast learner and be able to work both independently and as part of a team.
Duties will include:
- Analyzing, understanding, categorizing, and sorting all types of financial documents;
- Scanning said documents and organizing them into electronic folders using established naming conventions;
- Entering extracted data into Excel spreadsheets;
- Maintainting frequent contact with clients to:
- obtain financial, personal, and health-related information from them as needed;
- inform them of all case developments and update them regularly on case status;
- explain asset protection strategies the firm is recommending;
- assist with implementation of desired asset protection strategies;
- have strong financial skills, analytical skills, and organizational skills;
- have strong phone experience and a very pleasant phone personality;
- be extremely personable and patient — a true “people person”;
- be a detail-oriented quick learner, self-starter, and hard worker who enjoys working with and serving as part of a dedicated team of professionals;
- be a good and accurate typist, eager and excited to learn how to use new software programs;
- have highly-developed interpersonal skills; – have a true desire to work in a service-oriented environment where helping our clients is our number one priority;
- be a non-smoker, must not live with a smoker, and must not wear fragrances.
All candidates will be considered, but the ideal applicant would have excellent academic credentials and at least 5 years of relevant experience. Primary software programs we use are Time Matters, Hot Docs, and WordPerfect. Experience with any or all of these programs would be a plus.
1. Please review our Web site — http://www.VirginiaElderLaw.com — to understand as much as possible about our firm, including a review of the items listed under About Our Firm.
2. Please take a short skills test by visiting the following link: http://es.eskill.com/es/quiz/?testId=4616d2ef9a84b7b5. Provide your name and email, then click “Take Test.” If the link doesn’t work, you can go to http://www.eskill.com and under “Here for a Test?” click Enter and provide the following ID: 4616d2ef9a84b7b5. The test is timed to take no longer than 60 minutes to complete; most applicants are able to complete it in approximately 50 minutes.
3. Once you’ve completed the test, please email your cover letter and resume to “jeannie at farrlawfirm.com,” (of course replacing ” at ” with the “@” symbol). In your cover letter, please explain why this job interests you, and please confirm that you do not smoke, do not live with or frequently associate with smokers, and do not wear fragrances, either at work or elsewhere.
Compensation: based on experience
Q. My 6-year-old son, Jackson, was recently diagnosed with an autism spectrum disorder (ASD). To better his chances for a productive life, I signed him up for play therapy, occupational therapy, and speech therapy, as the developmental pediatrician suggested. However, despite all of the help and suggestions from the therapists, it is often hard to understand his perplexing and often difficult behaviors. Honestly, I wish I could know what is going on inside his head and what an ASD is really like for someone who has it. In a recent newsletter, you discussed ways to experience what it is like to have dementia. To truly understand my son and relate to him, I was wondering if there is any way to know what ASD is really like. Also, howdo you plan for someone with ASD?
A. Autism is a complex disorder, and, as you probably know, no two children with ASD are completely alike. Every person with ASD has a unique set of needs. Below are some powerful resources that present what it feels like to have some of the symptoms of ASD, including sensory processing challenges, speech/language delays and impairments, social interaction issues, and some of the other ASD symptoms.
- An interactive simulator, called Auti-Sim, aims to provide a hint at what it is like to experience the sensory overload someone with autism experiences. The simulator takes the user through a playground as an autistic child with auditory sensitivities. To try the simulator, click here.
- The video, Sensory Overload, created by Miguel Jiron, is part of the Interacting With Autism Project. The project is a government-sponsored effort to build an interactive, video-intensive website to focus on the best available treatments for autism.
- The Atlantic Magazine recently ran a story entitled, “What it’s like on the Autism Spectrum,” which features thoughtful responses from readers who have experience with the disorder in their own lives or in their families, how the diagnosis has affected them, and what the changes in the DSM-V mean to them.
- Temple Grandin, PhD, a famous author, speaker, and inventor with ASD wrote “Thinking in Pictures.” In the book, she describes how people with ASD are visual thinkers. Read a summary about the book, where she explains more about what it’s like living with ASD.
- Pulitzer Prize-winning journalist Ron Suskind will publish a memoir “Life, Animated” on April 1. Suskind’s memoir follows his 20-year journey in connecting with his son Owen, who has ASD. Learn more and watch a New York Times video about Suskind and his son on the Autism Speaks website.
We’ll never be completely able to simulate autism properly, since as I mentioned previously, the symptoms are unique for every individual with ASD. However, the hope is that projects and resources such as those described above might help create empathy and provide at the very least a small degree of insight and understanding into what it must be like to live with ASD.
You asked about planning for your son with ASD. Parents of those with special needs are tasked with planning for their children throughout their lifetime, as many of them will outlive their parents but might not be able to support themselves and live independently.
As a parent or guardian, you want to ensure that your child with special needs will remain financially secure even when you are no longer there to provide support. A Special Needs Trust is a vehicle that provides assets from which a disabled person can maintain his or her quality of life, while still remaining eligible for needs-based programs that will cover basic health and living expenses.
More than $13 billion a year is spent to care for individuals with ASD and other special needs. For the average affected family, this translates to $30K per year. Fortunately, there are many ways to plan for the long-term care of a disabled child. As Jackson gets older, if he will likely need care for life, it’s important to provide legal protections for your child. The Fairfax and Fredericksburg Elder Law Firm of Evan H. Farr, P.C. can guide you through this process. Be sure to check out our dedicated Special Needs Website at http://VirginiaSpecialNeeds.com. If you have a loved one with special needs, call 703-691-1888 in Fairfax or 540-479-1435 in Fredericksburg to make an appointment for an introductory consultation.
An estimated 5.4 million people in the United States have Alzheimer’s disease and other types of dementia, and 70% are cared for in the community by family members and friends. Unfortunately, most people with dementia who live at home have multiple unmet health needs, any number of which could jeopardize their ability to remain home for as long as they desire.
A recent Johns Hopkins School of Medicine study published in the Journal of the American Geriatrics Society examined the unmet needs of people with dementia living at home. The study included in-home assessments and surveys of 254 people with dementia living at home in Baltimore and also interviewed 246 of their informal, non-professional caregivers. Researchers found that nearly all of the patients and caregivers had one or more unmet needs, involving safety, health, meaningful activities, legal issues and estate planning, assistance with activities of daily living, and medication management. Significant findings include:
- 99% had at least one unmet need for care, services or support;
- 90% had personal or home safety issues that could be met with simple fixes, including grab bars in the bathroom, carpets safely tacked down to prevent falls, guns locked away etc. Please read our blog post entitled, “Making Home Safe for Dad” for more details.
- More than 60% had unmet needs for medical care, including the need to see a primary care doctor, specialist, dentist or audiologist;
- More than half of the patients had inadequate meaningful daily activities at a senior center or at home;
- One-third still needed a dementia evaluation or diagnosis;
- Unmet needs were significantly greater in those with higher cognitive function, most likely because many of them did not realize they had dementia and were not yet being closely cared for or monitored.
The study also found that most caregivers have multiple unmet needs, including lack of access to resources and referrals to support services and education about how to best care for their loved one. Please read our recent article on caregiver training for some helpful resources.
Insufficient care, supports, or services can often lead to poor health outcomes, hospitalization, and early placement in a nursing home. Therefore, it is always a good idea to plan for the future, just in case your loved one needs more adaptations and assistance than you can provide. Nursing homes in Northern Virginia cost $9,000 – $12,000 per month. Life Care Planning and Medicaid Asset Protection is the process of protecting your loved one from having to go broke paying for nursing home care, while also helping ensure that he or she gets the best possible care and maintains the highest possible quality of life, whether at home or, in the future, in an assisted living facility or nursing home. Learn more at http://www.VirginiaElderLaw.com and call us at our Virginia Elder Law Fairfax office at 703-691-1888 or at our Virginia Elder Law Fredericksburg office at 540-479-1435 to make an appointment for an introductory consultation.
The Medicaid program is our country’s largest health and long-term care insurer, covering one in six Americans, including two-thirds of nursing home residents and one in five persons under 65 with chronic disabilities. A look at the facts about Medicaid uncovers many common misconceptions about the program that are simply myths. Today, we will take a look at and dispel some of myths about exactly who qualifies for Medicaid, what coverage it provides, and how you can plan for long-term care for yourself or for a loved one.
- Myth #1: “Medicare will cover my nursing home expenses.” It is important to understand that Medicare, the public health insurance system for seniors over 65 and disabled adults, does not pay one penny for long-term care. Medicare only pays for medical care delivered by doctors and hospitals, and in certain cases short-term rehabilitation which might take place in a nursing home. Medicare covers, at most, 100 days of short-term rehabilitation, and does not cover help with activities of daily life, such as eating and bathing, that the aged can need for years. Please read our blog post, “Ask the Expert: Medicare’s 100-Day Rule vs. Long-Term Care” for more details.
- Myth #2: “Medicaid is for poor people.” Medicaid does serve as a program for millions of low-income Americans, but it also benefits many middle class seniors, primarily by covering the catastrophic costs of nursing-homes so families don’t have to deplete the assets it took a lifetime for them to earn. Please read our blog post, “Medicaid is NOT just for Poor People” for more details.
- Myth #3: “Medicaid Planning is Not Ethical” If you or a loved one become a client of the Farr Law Firm, you may rest assured that everything that we do is absolutely, unquestionably, 100% legal and ethical. Attorneys in general have the highest ethical rules of any profession, and as a member of NAELA and a Certified Elder Law Attorney, we and our Elder Law colleagues subscribe to the NAELA Aspirational Standards for the Practice of Elder Law, which articulate ethical standards that raise the level of practice above the floor established by the basic rules of professional conduct. See http://www.naela.org/pdffiles/AspirationalStandards.pdf. Read more on our website about Why Medicaid Planning is Ethical.
- Myth #4: “I have to dispose of all my resources to get Medicaid.” While in general a Medicaid applicant can have no more than $2,000 in assets to in order to qualify, there are many assets that don’t count toward this limit, and with good legal representation you do NOT have to go broke in order to get Medicaid — a married couple can legally and ethically protect all of their assets and a single person can legally and ethically protect 40% to 70% of their assets and still get Medicaid.
- Myth #5: To qualify for Medicaid, you should transfer your money to your children. By transferring assets within five years of needing benefits, you may disqualify yourself from receiving Medicaid benefits. For example, if you give your house worth $450,000 to your children, this gift will result in a 58 month penalty (period of ineligibility for Medicaid) in Fairfax, Virginia and the rest of Northern Virginia and an almost 76 month penalty in the Fredericksburg, Virginia and the Rest of the State. Please read our blog post, “Should I Give My Home to My Children” for more details.
- Myth #6: “Once I am in a nursing home it is too late to start Medicaid Planning.” Medicaid planning can be started while you are still able to make legal and financial decisions, or can be initiated by an adult child acting as agent under a properly-drafted Power of Attorney, even if you are already in a nursing home or receiving other long-term care assistance. In fact, the majority of our Life Care Planning and Medicaid Asset Protection clients come to us when nursing home care is already in place or is imminent.
- Myth # 7: “If my assets are owned by a Revocable Living Trust, they are protected from nursing homes.” A Revocable Living Trust (RLT) generally provides for the creator of the trust (and, if applicable, the creator’s spouse) 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. The major benefits of the RLT are protection from probate and incapacity. Although an RLT does a terrific job of avoiding probate, what most people don’t realize is that an RLT does not protect your assets from creditors or from the expenses of long-term care. The Living Trust PlusTM maintains much of the flexibility of a revocable living trust, but protects your assets from the expenses and difficulties of probate PLUS the expenses of long-term care while you’re alive, PLUS lawsuits and a multitude of other financial risks during your lifetime. If you’re a client or potential client who would like more information about the Living Trust PlusTM, visit http://www.farrlawfirm.com/seminars.html to register for one of our upcoming Living Trust PlusTM informational seminars.
- Myth # 8: “I will get better care if I private pay.” It is illegal to treat Medicaid patients differently than private pay patients and it is illegal to discriminate against Medicaid patients. There may be no “Medicaid wing” and no public identification of a “Medicaid bed.” Typically, the staff does not know which patient is a Medicaid recipient. In actuality, the nursing home residents who get the best care are those who have done Medicaid Asset Protection, because a loving family member can then use those protected assets to provide a higher level of care for the nursing home resident. In fact, Elder Law, including Medicaid Planning and Medicaid Asset Protection, is all about preserving dignity and quality of life for Elders.
- Myth #9: “The rules that applied to my friend will also apply to me.” Medicaid rules change frequently, and the rules also vary from state to state. There may also be facts about the friend’s situation that the client does not know, and these facts may result in implementing different strategies than those that apply to the client’s situation.
- Myth #10: “I don’t need any help.” Medicaid laws are the most complex and confusing laws in existence, and impossible to understand without highly experienced legal assistance. Without proper planning and legal advice from an experienced elder law attorney, many people spend much more than they should on long-term care, and unnecessarily jeopardize their future care and well-being, as well as the security of their family. Please read the Medicaid Complexity page on our Website for more details.
Nursing homes in Northern Virginia cost $9,000-$12,000 a month, which can be catastrophic for most families. Do you have a loved one who is in a nursing home or nearing the need for nursing home care? Or are you simply looking to plan ahead in the event nursing home care is needed in the future? Life Care Planning and Medicaid Asset Protection is the process of protecting your assets from having to be spent down in connection with entry into a nursing home, while also helping ensure that you or your loved one get the best possible care and maintain the highest possible quality of life, whether at home, in an assisted living facility, or in a nursing home. Learn more at The Fairfax and Fredericksburg Elder Law Firm of Evan H. Farr, P.C. website. Call 703-691-1888 in Fairfax or 540-479-1435 in Fredericksburg to make an appointment for an introductory consultation.