Category: Long Term Care

The 10 Point Nursing Home Checklist You and Your Loved Ones Need

Do you have loved ones that you care for and now need skilled nursing care? Are you finding this discussion with your loved ones the most difficult thing you have ever done? We realize that the decision to move your loved ones to a nursing home is hard. How do you find the right one? Will there be challenges? How do you make sure that the needs of your loved ones, both now and in the future, will be met by the facility?

Finding the right facility for your loved ones, that can meet their health care needs, is only the starting place in your research. In addition, what other factors will you and your loved ones need to consider that you may not be aware of yet. Right now, in this blog, we would like to share our 10 Point Checklist that you and your loved ones can read and use in your research as you assess your choices.

1. Financial programs and health care services. Are programs such as Medicaid and long-term care insurance, that can help offset the high cost of care, accepted? Find out early in your evaluation process. Be aware that not all nursing homes provide the same health care services. Make a list of the health care services your loved ones need and use this list to determine if the facility is a fit for them.

2. Location may be important. If your loved ones want to stay in the community where they have always lived, then you must try to find a good nursing home in their community.

3. Change in levels of care and medication management. If the health of your loved ones declines or improves, will they be able to stay in the facility? You need to know this now, so that any moving later on can be avoided. Does the nursing home manage medications or is it considered an additional service? Most skilled nursing homes include this service, but some do not, so be sure to ask.

4. Programs, activities and ways to engage the residents. Knowing that loneliness and isolation are a leading cause of death for Older Americans, it is crucial that the facility offers opportunities for your loved ones to be active and engaged.

5. Communication plan. How does the facility communicate with the families of their residents? Does the facility report to one designated family member about the needs of the resident? Will the facility talk with multiple family members, as well as the agent(s) under the durable powers of attorney of your loved ones? Communication is vital and you need to know the facility’s plan.

6. Online connection plan. Will you be able to connect online with your loved one? Will you and your loved ones be able to use FaceTime, Skype, Messenger, or other methods of online communication? Be sure to see if the facility has a plan to ensure you can connect with your loved ones once they become residents.

7. Licensed by the state. Be sure to look into the facility’s licensing. Is it up-to-date? Have there been any problems? How were challenges addressed?

8. Disaster management and updates on Covid-19. All nursing homes you visit should have a plan for how it will manage disasters. Disasters can range from viruses to natural disasters to power outages, and in Florida, to hurricanes. You need to discuss what to expect and the facility’s plan for handling these issues before signing the contract.

9. Take a tour, read reviews and ask for opinions. Before visiting the nursing home read any reviews you can find online. Once you are onsite, if possible, ask residents their opinions. Get the opinions of family and friends about the facility. Be sure to schedule a tour, but also consider an unscheduled tour so that you can evaluate the facility without it having time to prepare for your arrival.

10. Staff, turnover, and health care provider permissions. Find out about the people working in the facility. Do they seem happy? Caring? Busy? Is there frequent staff turnover? Also, find out if your loved ones’ current health care provider will be able to enter into the facility to treat your loved ones.

These 10 points are just the beginning of the research you will want to finish before placing your loved ones in a long-term care facility. We encourage you to discuss your potential choices, as well as your goals, with your Florida elder law attorney. Your attorney can help guide you in this critical decision so your loved ones can find and access good long-term care.

Elder and Estate Planning Attorneys, PA, is a law office small enough to provide personal service but large enough to provide service in Jupiter, as well as Palm Beach, Martin, St. Lucie, and Indian River Counties in Florida. Our law firm will guide you through legal challenges involving elder law, estate planning, trusts, veterans benefits, real estate, and more. We encourage you to contact us and schedule a meeting with our attorneys.

How to Start Important Conversations About Medical Care with Aging Loved Ones

Are you the adult child of aging parents? Do you know if your loved ones have a current estate plan in place? Have you had any conversations with your aging parents about planning for their future? If you are uncertain of the plans of your aging parents it is important for you to know what they would want in the event of a sudden crisis or incapacity. We encourage you to set aside time, as soon as possible, to have conversations with your aging loved ones about their personal preferences for medical and long-term care.

Are you having a difficult time starting the conversation with your parents about their plans for their future healthcare? You could begin your conversation with these questions.

• Do you have someone you trust to make medical decisions on your behalf?
• Do you have someone you absolutely DO NOT want to make decisions for you?
• Do you want to use feeding tubes, life support, and other artificial life-saving devices?
• Is there any type of medical care you would NEVER want?
• If you were permanently disabled or incapacitated, what would help or take away from your “quality of life?”
• If you had a choice, would you prefer skilled nursing home care or in-home healthcare?
• If co-pays become excessive or insurance does not cover your treatment how would you want your family to pay for your care?

As your aging loved ones make their choices, they must be sure to document all of their decisions and choices in their estate plan.  Your parents should make an appointment to meet with an experienced and qualified Florida estate planning attorney as soon as possible. Their estate planning attorney will be able to offer advice and assistance as they choose a healthcare decision maker.

Do you have questions? Elder and Estate Planning Attorneys, PA, is a law office small enough to provide personal service but large enough to provide service in Jupiter, as well as Palm Beach, Martin, St. Lucie, and Indian River Counties in Florida. Our law firm will guide you through legal challenges involving elder law, estate planning, trusts, veterans benefits, real estate, and more. We encourage you to contact us and schedule a meeting with our attorneys.

What Are The Differences Between A Skilled Nursing Home And An Assisted Living Facility?

Have you or a senior loved one reached the point where it may no longer be safe or appropriate to live at home without assistance? If so, you may be considering moving into a skilled nursing home or an assisted living facility and find yourself wondering what is the difference between the two? Although both facilities offer medical care and assistance with activities of daily living, there are a few essential differences that are important to understand.

First, an assisted living facility may be more of a residential setting and a skilled nursing home may be more of a clinical setting. The difference in settings may be due to the fact that those in a skilled nursing home typically require constant medical care and attention.

Another key difference can be the amount of independence afforded by the facilities. Those in an assisted living facility may be able to live a bit more independently and, thus, are given the opportunity to cook their own meals and participate in a wide range of social and recreational activities. In a skilled nursing facility, residents do not have access to their own kitchen for meal preparation and all meals are instead prepared by the staff. While nursing home residents are given the opportunity to socialize and participate in activities, they are often more limited based on the physical health and condition of the residents.

Finally, nursing home and assisted living facilities differ in cost and insurance coverage. According to the American Health Care Association and the National Center for Assisted Living, the cost of a skilled nursing home is nearly double the cost of an assisted living community and can amount to over $100,000.00 annually for a private room. Paying for either senior care option can impose an enormous financial burden on seniors and their families. Medicare will not pay for assisted living costs and full Medicaid benefits might not be available. You should start investigating your coverage options as soon as possible. Fortunately, an elder law attorney will be able to analyze your financial circumstances and medical needs and help you come up with a plan to pay for whatever care option is right for you.

Do you have questions? Please contact our law practice to learn more. We are here for you. Elder and Estate Planning Attorneys PA is a law office small enough to provide personal service but large enough to provide service in Palm Beach, Martin, St. Lucie and Indian River Counties.

Protect Your Parents Before They Enter A Nursing Home

Do you anticipate that your parents may require full-time nursing home care due to their age or their health condition? If so, you should consider helping them put a plan in place now.  According to Genworth’s Cost of Care Survey, the average cost for a private room in a nursing home facility is over $100,000.00 per year. Although nursing home care can be incredibly expensive, there may be ways that you can help ensure that the assets of your parents are protected and that they do not lose all of their savings paying those exorbitant nursing home bills.   

There may be a variety of ways in which you can help protect your parents by planning for nursing home care payments. Long-term care insurance plans can be an affordable option to offset the costs of care, especially if your parents are young enough and healthy enough to qualify for the best rate. Veterans benefit programs, if available to your parents, can help cover the costs of nursing home care. Medicare also provides coverage in limited situations. Primarily, however, people depend upon Medicaid coverage to pay for nursing home care. Access to Medicaid coverage, however, requires that the nursing home patient fall below a certain asset and income threshold. An elder law attorney can help you and your parents understand what benefits and coverage options are available and ensure your parents are protected.

Even if you do not think your parents would qualify for Medicaid with their current assets and income levels, it may be important that you contact an elder law attorney because there are many strategies that can be employed to protect your parents’ assets and still allow them to qualify for Medicaid coverage. Because May is National Elder Law Month, now may be the perfect time to do so and help your parents take this significant step towards protecting their future. 

Do you have questions? Please contact our law practice to learn more. We are here for you. Elder and Estate Planning Attorneys PA is a law office small enough to provide personal service but large enough to provide service in Palm Beach, Martin, St. Lucie and Indian River Counties.

Establishing a Third-Party Special Needs Trust for a Disabled Grandchild

Have you considered creating a special needs trust that can be used to provide financially for a grandchild with special needs without jeopardizing the receipt or continued receipt of government benefits? There are different types of special needs trusts, each better suited to some situations than others. A qualified special needs estate planning attorney can guide you through the options. If you are a grandparent with a special needs grandchild, a third-party special needs trust may be the best choice.

A first-party trust and can be used when the beneficiary of the special needs trust is the person whose assets or property are going to fund the trust. This type is often utilized by a disabled individual in order to allow them to qualify for medical assistance from the state. As the grandparent of the special needs individual, this is probably not the right choice for you. Another type of special needs trust is a third-party trust. A third-party special needs trust can be used when you have decided to fund a trust for another special needs beneficiary, in this case your grandchild. A third-party trust is often also called a supplemental needs trust. This is because the trust is intended for you to provide funds to supplement the needs of your grandchild, rather than provide for all of their expenses or replace any assistance they might currently receive. 

If you decide to set up a third-party special needs trust, the trustee can be you, your spouse, your child (the parent of your grandchild) or another relative or friend. The trustee will be responsible for informing your local authority that the trust exists if your grandchild applies for any type of medical assistance, and the appropriate agency will decide whether it should count when determining your grandchild’s eligibility for services. The existence of the trust should not impact any responsibility of your grandchild’s school district to provide them with services, but it can be important to talk to a qualified attorney to understand the specifics. The main thing to keep in mind may be that, if you are considering leaving money to your grandchild with special needs, creating a third-party special needs trust will likely allow them to use the money you intend to leave them without jeopardizing other assistance they currently receive.

Do you have questions? Please contact our law practice to learn more. We are here for you. Elder and Estate Planning Attorneys PA is a law office small enough to provide personal service but large enough to provide service in Palm Beach, Martin, St. Lucie and Indian River Counties.

3 Reasons Why Updating Your Florida Long-Term Care Planning Should Be a New Year’s Resolution in 2020

A new year is an exciting time for all of us. No matter what your resolutions are, this is the time to set your ideas in motion for what you want to achieve not just this year, but this decade. As a Florida senior, however, do you have concerns about your health or a potential need for long-term care in the future?

We understand this concern. Many of our clients share with us that they did not know that they could plan forward for long-term care issues until it was too late. We are here to tell you that you can be proactive and start Florida long-term care planning now. You can work with both your elder law attorney and your loved ones to ensure that you are protected under all circumstances. 

Let us share with you three reasons why updating your Florida long-term care planning, or creating it for the first time, should be at the top of your to do list this year.

  1. Your life can change unexpectedly. None of us are guaranteed a future. We are also not guaranteed to be healthy in our future. Health care crises can occur overnight and, unfortunately, when we least expect them. Formally healthy aging parents, spouses, and friends, can suddenly find themselves facing significant health concerns. Knowing what you want to do and how you will handle a crisis is critical to ensuring that you are able to access the best care possible should this happen to you or to a loved one. Do not put off thinking about the unexpected and take the time you need to complete Florida long-term care planning.
  2. Medicare does not pay for most long-term care needs. For many Florida seniors and their loved ones, they are relying on Medicare to help pay for most healthcare costs. Medicare, however, is an acute payor system. This means that it is not set up to pay for long-term custodial care. In a crisis you may need to pay for care out of pocket or seek to become eligible for public benefits programs, such as Medicaid. Learning what you will need when it comes to Florida long-term care planning early, can help everyone involved.
  3. Estate planning is not enough. Many of us have estate planning. We believe, mistakenly, that this will be enough to protect us in the event of a long-term care issue. Unfortunately, it is not enough. While estate planning is critical, and you need it to ensure you and your loved ones are protected, it is equally important to plan with your elder law attorney to understand how you will be able to find good care and afford it in the event of a crisis.

We know this article may raise more questions than it answers. There is never a wrong time to plan forward for both Florida long-term care planning and estate planning. We encourage you not to wait to get the advice you need. You may contact us to schedule a meeting at any time with us now, or in the future.

How Do We Plan Ahead to Afford Long-Term Care Outside the Home?

Planning to afford long-term care is important because it is estimated that one out of every two of us will need some form of long-term care before we die. Most of us cannot depend on our children to fund these needs since they have their own bills to pay and family dependents to provide for. In addition, government assistance for long-term care is only available to those who are impoverished. 

 

For most of us, however, long-term care expenses will be initially affordable. Unless a person is afflicted by a paralyzing stroke or a quick onset of Alzheimer’s Disease, initial long-term care expenses can be met by paying for the cost of temporary caregivers. These caregivers can attend to basic chores within the home setting that we are physically incapable of easily performing. There are even times, in Florida, when a county funded agency can pay for or help us with the cost of these initial services. This is true if we are financially below the county’s maximum income or asset limit and there are hours available. 

 

In planning to pay for future long-term care outside the home, however, we should plan as early as possible. Where do you find care? There are several options outside of the traditional nursing home setting. For example, one could visit the owner of a family group home in his or her community where four to six persons are cared for at the owner’s home. The resident receives his or her own room with benefits such as housekeeping, assistance with activities of daily living, someone to drive the residents to doctor appointments, and well balanced meals. All of this is in exchange for a reasonable monthly charge. Armed with this information from the local community, the prospective resident could then begin saving monthly to cover the nominal cost of the family group home when this expenditure becomes necessary. 

 

Another example would be when one visits the administrator of assisted living facilities where thirty to forty persons are cared for at the assisted living facility. Again, the resident receives his or her own room that is cleaned every day, assistance with activities of daily living and driving, plus well balanced meals. If a person making the visit or their spouse was a veteran of the armed services during war-time, there may be a monthly VA Pension with Aid and Attendance available if the prospective resident’s assets and income are below the government threshold. 

 

Again, the key is to start planning early. Researching the costs of these options plus the daily cost of the nursing home should be done before the need arises in the family. We encourage you to meet with a member of our legal team to discuss your concerns about where to live and how to pay for the care you may need. Further, do not wait to discuss your durable power of attorney in this meeting as it is important that this document is written to contemplate long-term care so the agent can sign the application for benefits if you are incapacitated. 

Helping Your Loved One Plan After a Chronic Condition Diagnosis

Did you know that approximately 60 percent of Older Americans live with a chronic condition? Conditions such as arthritis, asthma, and diabetes can require frequent medical treatment, close monitoring, and costly medications. As such, your loved one may feel overwhelmed with the increasing cost of care and new challenges he or she may be facing. One of the best ways to put your loved one’s mind at ease is to help him or her with the planning process. To help get you started, let us share with you a few tips for helping your loved one plan after a chronic condition diagnosis.

Perhaps the most important first step is to talk to your loved one about his or her diagnosis. Your loved one may be uncertain about the impact this could have on his or her life. To help educate you both about the condition in question, we encourage you to take some time to research the condition together. Be sure to determine the symptoms your loved one may present and the challenges he or she may face as a result of the condition. You may also wish to research treatment plans that may help make your loved one more comfortable as the condition progresses. 

Once you and your loved one have a better understanding of your loved one’s condition, it is important to review any planning he or she has already completed. Evaluate whether his or her current estate plan has protections in place, right now, for this type of unexpected situation, including any long-term care plans. Some important components to look out for include your loved one’s health care coverage, insurance, and whether he or she has a durable power of attorney.

Above all, do not hesitate to speak with an experienced estate planning attorney to help guide you and your loved one through this challenging time. Further, an estate planning attorney can advise you on the steps you could take to plan for a loved one with a chronic condition and account for his or her specific needs.

If this article raises more questions than it answers for you, do not hesitate to ask us your questions. Your loved one’s safety is important to us, and we are here to be a resource for you. We look forward to discussing your questions and supporting you with your particular needs.

Tips for Florida Seniors in Light of the Changes to the VA Pension Rules

The concept of paying for long-term care in Florida can be daunting. According to the Genworth Long-Term Care Study for 2018, assisted living costs per month average $3,500 while the cost of a semi-private room in a nursing home is approximately $8,150.  For the majority of Florida seniors, they do not have these additional funds available in their monthly income and are looking to pay for care either through savings or public benefits assistance.

 

When the need for long-term care arises, it is often a crisis. For example, the Florida senior may have a fall that results in a broken bone and the need for rehabilitation in a skilled nursing facility. If the need for assistance becomes more permanent, he or she may not be able to leave the facility or require extensive hands-on care upon the return home.

 

How do we plan now to afford long-term care in the future? Are we able to plan for what we may need in advance? Further, how can we ensure that we have a plan in place so that we, as Florida seniors, are making our decisions of how we want to be cared for and not leaving the choices to our adult children or decision makers?

 

Elder law planning contemplates all these needs. Together, we can design a plan that may not only find a way to pay for care but also ensure that you receive good care. In Florida, programs such as Medicaid exist to help us pay for the cost of long-term care. If you are a Florida veteran, however, there also may be additional funds available to you.

 

For wartime veterans, the VA pension program exists to provide monthly, tax-free income to veterans with a qualifying service record. The VA pension program is in no way tied to a service-connected injury or disability. Instead, it is tied to the service record of the veteran. To begin to qualify, the veteran must have 90 days of active military service with one day during a period of war. Further, the veteran must have been discharged under conditions that were other than dishonorable.

 

The rules governing the eligibility for the VA pension program change substantially last year on October 18, 2018. Prior to this date there was no set amount that the veteran, or his or her surviving spouse, could have in countable assets. Now, for 2019, the new rules created a limit. The veteran may only have $126,240, less excluded assets that he or she is allowed to own. We anticipate this amount will change each year with a cost of living increase similar to the Social Security program.

 

Another way this program changed was to create a “look back” period. A “look back” period is the time period in which the VA may look at the veterans bank records to determine if he or she gave away money that could have been used to pay for care. This type of program is currently in place for the Florida Medicaid program, although it operates slightly differently. Under the new VA rules, the “look back” period will be for the thirty-six months prior to application.

 

We know this article may raise more questions than it answers. We encourage you to reach out and ask us your questions on this, or any elder care issue. When it comes to finding ways to access good long-term care in our community and be able to afford it, we are your local law firm here to help you.

Going Through a “Gray Divorce” Requires Keeping an Eye on Retirement

We know that going through a divorce can be a traumatic experience for anyone at any age. Younger and middle-aged couples often face the unfortunate challenge of splitting up with children involved. Older couples face their own harrowing challenges, particularly if they have been married for a long time and are beyond their prime working years.

Many older adults no longer possess the desire to climb the corporate ladder or compete in the job market, if they are able to work at all. Further, with their shared nest eggs and investments that can be greatly reduced through a separation, it is recommended that older couples keep an eye on their retirement accounts when going through a “Gray” Divorce.

As always, meeting with an experienced attorney should be one of your first steps if you are considering a divorce. When it comes to separating later in life a consultation with an estate planning and elder law attorney is critical so you may discuss the impact on your long-term care options. Let us share a few tips to help you through this process.

1. Seek wise counsel. Obtaining a qualified attorney is a must, but a financial advisor or attorney with estate planning experience can be an added advantage. They can help organize long-term retirement goals, set up estate documents, and provide information and guidance for negotiating a favorable divorce settlement.

2. Obtain documents. Whether you or your spouse was in charge of your legal, financial, insurance and tax documents, it can be critically important to obtain copies for your divorce negotiations and retirement planning. Think of these items as the bedrock for your financial future.

3. Be financially prudent. It is true that there is more to life than money, as evidenced by the love and compassion that once led to your marriage. Money, however, is an inescapable part of life, and the older one gets the more important financial stability becomes.

4. Make sound financial decisions. This is important throughout the course of a “Gray” Divorce proceeding, as well as, with post-divorce decisions about the lifestyle one can realistically afford. A healthy goal would be the funding a comfortable, long-term retirement and building up from there. It may be easier said than done, but it is not impossible.

Knowing that you are financially supported in your latter, non-working years can bring peace of mind during a difficult time. It may also allow you to live out your golden years with a greater sense of enjoyment amid your new family circumstances. Do not wait to contact us with your questions