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Comparing Life Care Planning to Traditional Elder Law

This year, we are getting the word out there about the Life Care Planning we offer that involves a licensed social worker to act as the Client Care Advocate. A question that we keep getting is what is “What is the difference between Life Care Planning and Elder Law and why did you make the change?” The way that I explain it is that a traditional elder law firm prepares documents for an individual and then either waits until the client passes or until they need to go to a nursing home and will qualify them for public benefits.

A life care planning firm is a more holistic approach to providing care. Our licensed social worker, Meg Motter, works with families to assist in figuring out ways to keep their loved ones home and how to receive care in a home or in a less restrictive environment than a nursing home. A licensed social worker will be able to provide different cognitive assessments and evaluate safety and necessity of levels of care, unlike an attorney. The elder care coordinator allows the firm to provide a more comprehensive approach, separate from just estate planning documents or qualification for Medicaid. The care coordinator allows the firm to provide information and advice that was not otherwise available to the firm prior to becoming a life care planning model firm.

We are ecstatic to have Meg Motter onboard as our elder care coordinator and we look forward to assisting you and your family in the future.

Please feel free to give us a call if you have any questions or comments at 717-845-5390.

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Keep Our Loved Ones at Home

I have never had a client tell me that they want to go to a nursing home. Almost daily in my practice I hear that my clients want to remain in their home as long as possible. Unfortunately, some clients do not want to bring outside caregivers into the home for a myriad of reasons. The old days of the children taking care of the parents needs to make a comeback. Caring for parents to keep them home is extremely rewarding for both the child and the parent.

Being a family caregiver is one of the most rewarding, amazing experiences that children can provide to their loved ones. I have heard time and time again from children who are able to provide caregiving how rewarding it is, particularly in cases when it keeps their loved ones out of a nursing home.

For a number of reasons, children who provide caregiving should enter into a written caregiver agreement with their parents.

First, it is the best way to ensure that there are not mis-expectations and hurt feelings later.

Second, if done properly, it will actually provide, for both VA purposes Medicaid purposes, a legitimate spend-down of resources which would otherwise go to the government, and the monies paid will not be considered a gift. Therefore, no penalty will be assessed for the money paid to the child.

The one thing to remember is for the child caregiver monies that are received will be income taxable to the child; it is very important that the child claim those monies as income on their tax return so that it clearly shows that it was not intended to be a gift.

However, family caregiving is certainly not without its downsides to caregivers. In most cases the caregivers could make more money if they stayed in the workforce and did not leave to provide care. In a situation where they are trying to continue to work and provide care, the increased stress added to the caregivers can be detrimental their physical and/or emotional health.

There are often cases where family dynamics become an issue, either because one child is doing the caregiving and that child feels like they’re being taken advantage of, or others feel as though that child is taking advantage of Mom and Dad because they are getting paid.
Either way, a lot of times it provides an additional stress to family members that they weren’t expecting. There are times where a caregiver will be out-of-pocket as well for certain costs, and getting reimbursed may surely be an allowable thing under the law, but having other children understand why money is being distributed to one child versus them is often not an easy conversation.

There is no doubt that for those people who are able to provide care to their loved ones, care in the home it is a wonderful gift. However, I highly recommend that everything be put in writing for all of the reasons stated above, but mostly so that there are no missed expectations among the people receiving the care, the people providing the care, and the other family members.

To those who have been able to keep their family members home, thank you for everything, all that you do is appreciated. To those who are considering it, give it a try. It could be the best decision you have ever made.

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With premiums increasing drastically, should I keep my long-term care insurance?

This is a question that I receive on a regular basis in my estate planning and elder law practice. By way of full disclosure, I am not a licensed insurance agent and I am not licensed to be able to sell long-term care insurance or any other insurance product. I am an attorney with approximately 20 years of experience in estate planning and elder law and I happen to be a Certified Elder Law Attorney under the authorization of the Pennsylvania Supreme Court. While I am not the person who will sell the products, I am certainly an individual who has been advising numerous clients over the years and definitely believe in the benefits of a long-term care policy and what they can provide. We have done numerous other logs about long-term care insurance and the benefits of said policies.

When long-term care insurance first gained popularity, many companies completely missed out on the actuarial tables and in predicting what people were going to need. Because of this drastic miscalculation, most of the companies who originally were in the markets for long-term care insurance are no longer there. The few standing companies that are left are trying to figure out ways to make up for the mistakes of the past. Because of that, they are often forced to increase premiums and decrease benefits. Although these companies do have to get permission from the insurance board, it is not a very difficult proposition and in most cases, they will almost always be able to receive permission. The most difficult part is that individuals have been paying into a plan for a number of years and now are learning that they’re going to have to decrease their benefits and even then they may have to increase the premiums that they are paying. It is heart-wrenching to have to provide guidance in these situations and ultimately I always encourage them to bring in their financial professionals to try to make the decisions.  This is as much about the numbers and common sense as it is about the emotion involved. This becomes very easy for us to get disgusted and upset about what is occurring, but it is a cold, harsh reality of the miscalculations that were made in the past.  In some instances increasing premiums and decreasing benefits is the only way some of these companies will survive. 

My best advice to any and all people who are faced with this dilemma is to write out the pros and cons and to try to make the evaluation and determination about numbers and as little as possible about the emotion of the situation. It is too easy to get hung up on the principle of the manner, but the truth is principals are expensive and cause wars. Make the best decision for you and your family based upon the information that you have in front of you. Long-term care is not going away and dropping the policy out of spite is not going to help anyone. 

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My Loved One Will Stay Home Forever

This is a statement that we hear on a regular basis in our office when we talk about aging and potentially needing assistance for our loved ones in the future.  Most people, if asked, would choose or want to stay home as long as they possibly can.  We often are abruptly interrupted when we start talking about alternatives such as assisted living facilities or personal care homes or long-term care facilities.  

It is certainly admirable to want to stay home as long as possible and there are a lot of things that can be done to help ensure that that can occur.  The time to start discussing what it is going to look like for a loved one to stay home is now.  Take a look at the house and the configurations of the house to determine if it is suitable and adaptable to allow somebody to age there.  Is there a possibility of putting ramps in or having a stair lift installed to assist with getting up and down steps within the home.  Are there appropriate handrails or grab bars in bathrooms and other places.  We highly recommend that you ask a geriatric care manager to come to your home to assist with evaluating its adaptability and suitability for people as they age.  

If you find yourself in a situation where a loved one needs care now, we highly recommend that you look at non-medical options to have someone come into the person’s home to assist them with their needs.  Non-medical options are plentiful in the York and surrounding areas and allow families to know that their loved ones will have a companion during the day and potentially get reminders throughout the day about taking medication, going to the restroom, or getting meals.   Oftentimes all that people need is simple reminders and someone just taking a look to make sure that they are remaining safe in their home.  If the situation gets worse and the individual begins to need medical care we are also very lucky in our area that we have several medical options for care in the home.  I would highly recommend that you research both the medical and non-medical options in our area to see how plentiful and wonderful these companies are. 

As a person ages in place, and as their care needs increase, sometimes it is impossible to have somebody continue to remain in their home because it may become unsafe.  There are certainly a lot of options before this becomes a possibility but if a person begins to wander from the home or if the home is not able to be adapted to be safe for them we may have no choice but to move them into another type of setting.  However, with proper planning and assistance from outside companies and family members it is possible to age in place in your home for a long time.   We highly encourage you to have these conversations ahead of time so that you’re not having them in a crisis situation which makes the conversation much more difficult.  

If you would like to learn more about estate planning and elder law, please give our office a call at 717-845-5390.

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Taking Care of an Elderly Parent Can be a Full-time Undertaking

Old lady gardening“Each year over 43 million Americans provide unpaid care to a family member, usually a parent.”

Adult children who care for an elderly parent will typically be asked to oversee and provide medical care and finances. However, sometimes the caregiving goes far beyond this.  As a result, many adult children caregivers fail to think about the financial impact that this can have on their own monthly budgets and retirement funds.

MarketWatch’s article, “Read this before becoming your parents’ caregiver,” reports that, in many instances, the adult child caregiver is still able to maintain a full career and family life. However, in certain situations, the family member who’s assumed the role of a full-time caregiver must reduce his or her work hours or forego a promotion because of the time commitment. In the majority of situations, we see adult children answer the call of caregiving in a crisis when there’s an imminent need. A short-term assignment can be doable for a professional with his or her other family and personal responsibilities, but when the duties last longer, he or she will realize there isn’t enough time or resources to do it all.

A caregiver needs to take the actions necessary to help without putting his or her own family’s financial future at issue. When there are siblings and other family members involved, it is necessary to communicate realistic expectations of what areas of care are needed, responsibilities, time commitments and whether there will be any financial compensation.

A Personal Care Agreement can be a good guideline.  It will help to detail which individuals are responsible for various aspects of care, the amount of time required and any compensation. The biggest question that people have about this agreement, is how to get paid to be a family caregiver.

A Personal Care Agreement can give an adult child caregiver the peace of mind and security that he or she won’t suffer undue financial consequences, as well as provide clear details for other family members as to the expectations when assuming these important caregiving responsibilities.

This agreement can help avoid some of the misunderstandings that can occur when many siblings and loved ones are trying to help (or fail to pitch in). It also can protect a family member who is losing his or her own income and time to provide caregiving. This is because reduced hours or an exit from the workforce to care for a loved one, can have a major personal financial impact. In addition, the time for a personal and immediate family life with one’s own spouse and children can nearly evaporate with caregiving demands.

You can work with an Elder Law attorney to draft a Personal Care Agreement. Having an attorney review your Personal Care Agreement can even help to confirm that care payments were a legitimate and necessary expense, rather than a way to conceal assets from Medicaid.

Reference: MarketWatch (February 22, 2017) “Read this before becoming your parents’ caregiver”

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