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Monday, January 09, 2012

Happy 2012! Make Getting Your Affairs in Order Your Goal for the New Year

Each year, I make a list of goals that I want to accomplish for the year.  Some years, the goals have a theme – unfortunately, the theme is almost always the same:  lose weight, exercise more. . .

This year, I’m challenging you to make one of your New Year’s goals to get your estate planning affairs in order.  This is one goal that is easy to accomplish – I promise!

Here are 5 easy steps you can take to accomplish this goal.

1.         Get educated about estate planning.  Attend an estate planning workshop or two.  Estate planning attorneys like me are always giving seminars and workshops to educate people about estate planning.  Yes, these workshops help attorneys attract clients, but the goal of these workshops is really to educate people about the basics of estate planning so clients can have meaningful conversations and can make thoughtful decisions about their own estates. 

2.         Review your old documents.  Do you have a will or trust?  Advanced Directives or Healthcare Powers of Attorney and Living Wills?  Do you have a Durable Financial Power of Attorney?  How old are your documents?  If your wills name guardians for your children who are now 30 years old, your documents are definitely out of date.  Did you name an executor who is now dead or is your ex-wife named as your executor?  Probably time to revise your will. 

            What about your health care documents? If they were done in Georgia before 2007, you may want to update them to the Advance Health Care Directive that went into effect in 2007.  Who have you named to make healthcare decisions for you?  Is that person still the right person to make decisions for you?           

3.         Look at the ownership of all of your accounts.  How is your bank account titled?  Title indicates who owns the account.  Are you the sole owner or is it a joint account?  Who is the joint owner and is this someone who should be a joint owner of your account?  Here’s a link to a blog I wrote last year about the pros and cons of joint ownership of accounts:  http://bit.ly/xm8W5o. 

4.         Check the beneficiary designations of your accounts.  The beneficiary is the person who would receive the proceeds of the account at your death.  Is the beneficiary your estate?  If so, why did you make your estate the beneficiary?  Having your estate as the beneficiary pretty much ensures that your estate will have to be probated.  Is your beneficiary under the age of 18 or someone with special needs?  It may not be the best thing to give someone under the age of 18 a large inheritance.  Although the court will put protections in place for those under 18, those protections can be expensive and once the beneficiary has their 18^th birthday, the money is all theirs – to spend however they wish. Yikes!

             If the beneficiary has special needs, a gift may mean they lose governmental benefits.

            Distributions from IRA’s and 401(k)’s have income tax consequences, so have you considered how your beneficiary designations will affect the tax liability of your beneficiaries?

5.         Make an appointment with an estate planning lawyer, a CPA and your financial advisor.  A good, comprehensive plan involves a group of professionals who can guide  and counsel you in making decisions about your estate. 

Will you accept thechallenge to make getting your New Years Goal getting your affairs in order?

Here's to a great new year!

Tuesday, December 20, 2011

Holiday Traditions: Really Check in With Your Neighbors and Relatives

On Friday night, we gathered with neighbors old and new to celebrate a cherished tradition – our annual progressive dinner.  Traditionally, we begin the year.  We find out about the new babies, weddings and graduations to come.  We learn what colleges the children will attend, and where soon-to-be college graduates will start their careers.  We also check in on aging neighbors to find out about their health scares, their difficulties, the loss of their loved ones.  After moving from house to house for salads, and main courses, we end up with more wine and sweet treats to reminisce about dinners past.  How many have we had?  No one can remember.  But by the end of the evening, we’re looking forward to next year’s dinner, and assigning tasks to make it happen.

Continuing this tradition is important to my family and my neighborhood because it allows us to connect with our neighbors, to get to know them when times are good so that we can help each other when times are not so good.  Without our traditional yearly gathering, we might not realize when our neighbors need our help.

In my practice, I see many people who see their aging or ill family members and friends at the holidays and realize that all is not well.  Sometimes, all has not been well for so long that those family members are now in crisis.

If you are visiting family members who are aging or ill, take the time to talk with them to find out about their health.  Are they seeing a doctor?  What medications are they taking?  How do they keep track of their medications on a daily basis?  Ask them if they have a healthcare proxy or advance directive for healthcare?  Who will make healthcare decisions for them if they are not able?

Although it can be difficult to have a conversation with parents about their finances, ask them if they have appointed someone to make financial decisions for them if they are not able.  Look around the house and see if there are stacks of unopened bills.  Find out if they have long-term care insurance.  Ask where their important financial and legal documents can be found.  If they haven’t appointed anyone to make decisions for them, urge them to do that while they still can.

If your aging family members are still driving, ride with them to see if they are still able to drive safely.  Are they stopping at the stop signs?  Do they forget to look before making a turn?  Do they still remember how to get to places they have been to many times before or do they forget where they are going?  If they are having trouble driving, would a driving school help?  Or, can you help them find transportation so they won’t need to drive anymore?

With married couples, try to talk with each one alone.  Sometimes couples get so good at covering for each other, you don’t realize that one of them might be suffering from dementia.  If one of the couple is ailing, find out how the well spouse is coping.  Is he or she eating and sleeping right?  Is he or she getting help in the home so he or she can get out to see friends, or just get some time to rest and recharge?

Look in the refrigerator, freezer and cupboard.  Is the food in the refrigerator or cupboards moldy or out of date?  Are they going to the grocery store on a regular basis?  If you suspect that they are not eating right, is there a meals-on-wheels program that they might qualify for?

I hope that you will enjoy holiday traditions with family, friends, and neighbors this year.  Will you take time to talk with your family and friends to see whether they might need help in the coming year?

Happy Holidays!

Patti Elrod-Hill

Sunday, December 04, 2011

Medicare: Treat it as Part of Your Financial Plan

Here is the basic Medicare alphabet:

Medicare Part A covers hospital insurance that can help pay for inpatient care at hospitals, skilled nursing facilities, hospice, and home health care.

Medicare Part B covers medically-necessary service such as doctor’s services, outpatient care, home health services, and some other services.  You will pay a premium to be covered by Part B.

Medicare Part C is a Medicare Advantage Plan.

Medicare Part D is the prescription drug coverage.

In order to become eligible for Medicare, you must be age 65, or you must have been receiving Social Security Disability benefits for 24 months.  Most people who are on Social Security or Railroad Retirement benefits will automatically get Medicare Part A and B starting on the first day they turn 65, or when they have completed the full 24 months after beginning to receive Social Security Disability.  One exception is that if you have ALS – Lou Gehrig’s disease- you are eligible for Part A and B in the month your disability begins.

Every year, for those who are qualified for Medicare, there is an open enrollment time when you have the ability to sign up for a new Medicare Part C or Part D plan. 

Normally, the open enrollment period begins in January.  However, this year the open enrollment period began on October 15 and ends on December 7.  If you want to know when to enroll in Social Security Part A and Part B, and when to enroll in Part C and Part D here is a handy chart:  http://www.medicare.gov/Publications/Pubs/pdf/11219.pdf

Medicare Part D is probably the most confusing of the Medicare Alphabet Programs.  Medicare Part D is the program that offers prescription drug coverage to those who are qualified for Medicare.  In order to get the drug coverage, an eligible person must join a plan.  The plans are run by private insurers or other private companies approved by Medicare.

Medicare Part D is available if you are otherwise-eligible for Medicare A & B.  If you don’t enroll in Part D when you become eligible, you might have to pay a slight penalty when you do join at a later date.  You can enroll in two basic types of plans:  Medicare Prescription Plans or Medicare Advantage Plans.  The Medicare Advantage Plans are usually HMO’s or PPO’s that give you all of your Part A and B coverage, and in addition may give you drug coverage.  If you choose another Part D plan while already enrolled in a Medicare Advantage Plan that offers a drug plan, you may become disenrolled from your HMO or PPO plan and returned to regular Medicare.

How can you choose the right Medicare Part D plan?  The plans are run by private insurance plans, or private companies, and the cost of the plan is generally based on the prescriptions you use, the “formulary” of the plan, and whether you go to a pharmacy that is within your plan’s network.  The formulary is the list of drugs that a Medicare plan covers.

The Medicare.gov website is full of information about the plans that are available, and is also full of advice on how to choose a plan.  To choose a plan, you can enter your zip code and your prescriptions in the formulary finder on Medicare’s website.  http://plancompare.medicare.gov/pfdn/PlanFinder/DrugSearch.  The plan finder will then give you a list of providers and will tell you the cost of the plan and the cost of the drugs.  You can then call the providers with any questions you might have.

Erica Dumpel, with Czajkowski Dumpel & Associates, Inc. http://cdainc.net/ an experienced healthcare plan advisor, emphasizes that you should research the plans on a yearly basis.  If you have a number of prescriptions, hunting down the right plan can take a lot of time – but can also save you a significant amount of money each year. 

If you miss this year’s open enrollment period, or if you decide not to change plans, be sure to put a reminder on your calendar to review your plan again next year.  In fact, I recommend that you schedule a yearly financial and legal checkup, which should include a thorough review of all of your insurance premiums, co-pays and prescription costs.

Will you start treating your Medicare Plan as part of your Financial Plan?

Sunday, November 20, 2011

Paying for Long-term Care: VA Benefits for Surviving Spouses

 When she was approaching her 85^th birthday, Sarah began to worry.  Until that time, she believed she had plenty of money to last through her lifetime.  Now, she saw her life’s savings slipping away.

It started when she realized she was forgetting things.  First, she forgot to pay her utilities, and didn’t realize it until the power company threatened to turn off her power.  Next, she was driving to the grocery store and forgot how to get back home.  After that nice young man called her son to ask him where Sarah lived so he could help her get home, her son demanded that she give up her car keys.  Once she gave up the car keys, she had to hire someone to take her to the grocery store and to the doctor.  When she burned the soup on the stove, her family made her hire a caregiver to come in for eight hours every day.   Sarah’s family was now talking about moving her into an assisted living facility so that she could be safe at night.

For the first time in her life, Sarah was spending more than her income every single month.  She was dipping into her savings each month to pay the caregiver, and that scared her.

VA “Death Pension” for Surviving Spouses

When Sarah and her children came to see me, I told them that Sarah, the widow of a World War II veteran, could qualify for a Veteran’s Pension for surviving spouses – called a “Death Pension.”  In 2012, when the VA makes a cost of living adjustment, the Death Pension can pay up to $1094.00 each month to the surviving spouse of a veteran who served during wartime.

The requirements for the Death Pension are that the veteran had to have served for 90 days on active duty, one day of which was during a declared war.  The veteran had to have been discharged with an honorable, general, or medical discharge.  The surviving spouse must have been married to the veteran for at least one year preceding death,  still married at the time of  death, and not remarried after the death.

There are some asset and income limitations, too.  The asset limitations are not hard and fast, and depend on each individual circumstance.  For most cases, the surviving spouse must have less than about $50,000 in his or her name, not including the car, the home, and the personal property inside the home.  The VA uses a life expectancy chart and considers other information, such as cost of care, to determine acceptable asset amounts, so the VA can use a different asset limit for each applicant.  Although assets can be transferred to achieve eligibility, I recommend that people see an attorney before doing any transfers.  Asset transfers can affect Medicaid eligibility, and improper transfers can cause serious difficulties down the road.

The Death Pension is a three level pension, and the amount a surviving spouse may be eligible for depends on the level of care required.  The basic pension is available to a surviving spouse over the age of 65, who otherwise meets the income and asset limitations.  In 2012, the top rate for the basic Death Pension will be about $684.00 per month.

A higher level of pension is available to someone who is classified as “Housebound”.  The VA defines housebound as being substantially confined to the home or immediate premises due to a disability that will likely remain throughout the claimant’s lifetime. In 2012, a surviving spouse with no dependent children who is housebound is eligible for benefits of up to $837 per month. 

The highest level of pension, referred to as Aid and Attendance, is available when a surviving spouse requires the assistance of another person to perform activities of daily living, or is blind or nearly so, or is a patient in a nursing home.  That monthly rate in 2012 will be about $1094.00.

Income Limitations

Income limitations apply, but the definition of income for VA purposes is all of the income received by the person applying for the benefit, minus recurring unreimbursed medical expenses.  In Sarah’s case, her only income was her monthly Social Security plus a little bit of interest income she received on her savings.  Every month, Sarah was spending her entire Social Security check, plus some of her savings, to pay for a caregiver to come into the home.  So, for VA purposes Sarah had no income and, based on the fact that she now needed the assistance of another person on a regular basis, Sarah could qualify for the highest level of the Death Pension. 

If Sarah decides to move into an assisted living facility, the cost of that facility will be considered an unreimbursed medical expense, too.

The process of applying for benefits can be daunting, and a decision from the VA can take quite a few months.  However, once an application is filed, if the applicant is qualified, the benefit will be retroactive to the first day of the month following the application and the surviving spouse can get a lump sum for all of the months it has taken the VA to make that decision.

Sarah was relieved to know about the VA benefit and that $1094.00 each month will allow her to pay for homecare for a while longer, until she decides whether she wants to go into an assisted living.  Then, that money, along with her social security, will allow her to choose a good and safe facility.

Wednesday, November 02, 2011

Minor Guardianships: Letters of Instruction In Case of the Unimaginable

Writing Instructions to Potential Guardians

If you have minor children, or children with disabilities, the thought of leaving them suddenly is unimaginable.  Parents know their children- their schedules, their health, their likes and dislikes- but keep most of that knowledge in their heads.  When my kids were growing up, I knew when they needed to be at soccer practice and church, who their doctor was and how to reach her, and how to tell when they were sick.  Other than abbreviations on my calendar and names in my database, there was no formal written schedule of activities or list of important contacts.

Most parents can’t imagine how someone would be able to step in and take care of their children.  It is difficult to comprehend that someone else would have to figure out your children’s complicated schedule, let alone how to raise your child with the values you want them to have.

One of the ways you can help someone who might have to take over for you is to create a letter of instruction for a potential guardian.  What should go in that letter?  Here are some suggestions:

1.  Healthcare Information

The letter should include a detailed guide to your child’s healthcare, including vaccination records, contact information for their physicians and dentists, information about any allergies or prescriptions.  Note which pharmacy you have used in the past, and any over-the-counter medications your child uses on a regular basis.

2.  Your child’s Preferred Activities and the Important People who help with those activities

Although your children’s schedules will change monthly and yearly, the letter could include information about the activities your child enjoys, contact information for coaches, scout leaders and church youth leaders.  You might include a sample of the weekly, monthly or yearly schedule you and your family currently follow.  If your child goes to a summer camp, include information about deadlines for registering for camp.

3.  How to find Important Papers

The letter should include instructions on where to find the child’s birth certificate and passport, and should include the child’s social security number and a copy of the social security card.

4.  Religious Philosophy

If you practice a religion, include instructions on your religious philosophy along with contact information for the church you attend.  Let the potential guardian know if you would like your child to continue to be involved in the religion you practice, or whether you would like your child to accompany the guardian to their religious activities.

5.  Educational Philosophy

Discuss your thoughts and hopes for your child’s education.  Do you want your child to go to public or private school?  What are your plans for secondary education for your child?

6.  Family Tree and Other Important People

List all of the important people in your child’s life – and include contact information for those people.  If you nominate a person who is not a family member, will they know who your family is and how to reach them?  Let the guardian know if it is important for your child to be able to spend time with grandparents, aunts and uncles, or other important people.   

7.   Things that Comfort

What does your child like to do when he or she is upset, unhappy or frightened?  Do they have a special toy or piece of clothing?  Do you read a certain book to them or play music?  Do they have any pets that they rely on for comfort?

8.  Food Likes and Dislikes

Maybe the guardian won’t want to fix macaroni and cheese every night, but they may wonder why your child won’t eat what they fix for dinner.  Let them know any food preferences – as well as quirky food habits.  Be sure to mention any food allergies your child has and any reactions they’ve had to foods in the past.

Of course, this list is just a suggestion for some basic points you might want to cover.  Remember that the information in the letter will need to be updated on a regular basis as your child grows and changes.  If the letter is never needed, you will have a great written record of your child’s life that you can give them when they are adults and don’t remember that they refused to eat anything but hot dogs and used to love to cuddle with Winnie the Pooh when they were sad!

Monday, October 24, 2011

Naming Guardians for Minor Children

Phew!  I’ve reached that point in life where I can relax – not much, but a little- because both of my children are adults and, for the most part, out of the nest.  Until just a couple of years ago, I broke out in a sweat every time I had to go out of town on business by myself.  Not only did I worry about whether my kids would get fed, get their homework done and make it to soccer practice on time, but I also worried about what would happen to them if I had an accident and didn’t make it home. 

If you have minor children, children under the age of 18, I’m sure you worry about that, too.  If you are not around, who will feed them, help them with their homework and get them to soccer practice?

Choosing someone to care for your children is difficult.  No one will care for and love your children the way you do, and, as far as I know, we can’t clone you.  However, if you don’t choose someone to raise your children if you’re not there, the probate court will have to make that choice and the court may not choose someone that you would like to raise your children. 

The only way to nominate a guardian in Georgia is in a will.  However, many people put off doing their estate plan because this choice is so difficult.  Here are a few tips for choosing guardians for your children.

First, make a list of everyone you would trust to take care of your children.  When making this list, don’t restrict yourself to the obvious choices.  Remember that if you choose no one, your children could end up in foster care.  If you had the choice of this person or foster care, would you choose this person?  If so, put them on the list. 

Most people limit their list to family members – parents and siblings- but think about your extended family.  Maybe your aunts, cousins, nieces or nephews would be good choices.  Try to think about whether their philosophy about raising children is similar to yours.

Second, would any of these people truly love your children?  Would they raise the children with the religious, social, and moral values that you would like?

Third, look at the personality.  Are they affectionate?  Good role models?

Fourth, be practical.  Would raising children hamper their lifestyle?  If a couple divorced, or one died, would you choose either one of them?

Fifth, look for someone who’s good, not necessarily perfect.  Remember, as we discussed above, you cannot be cloned.

Sixth, talk to everyone you are thinking of naming.  Make sure they are willing to serve, and explain what will be required of them.  Let them know that they should tell you now if they do not want to be nominated as a guardian of your children.

Finally, above all, make sure that you are the one that makes the choice – not the court.

In the next blog post, we’ll talk about writing letters of instruction for guardians.

Sunday, August 28, 2011

Protecting People with Special Needs: Guardianship of Young Adults

Most parents are conflicted when their children reach their 18^th birthday.  For many families, that means their child will soon be leaving home for college, a new job, or the military.  For parents of children with developmental disabilities, it can be very scary when that child turns 18, because the law presumes an 18-year-old is an adult with the legal rights and responsibilities that come with adulthood.  When a child turns18, the parent no longer has the legal authority to make decisions for that child.

Joshua, a good-looking young man with a developmental disability, turned 18 six months ago.  Josh is friendly and outgoing.  They say he never met a stranger.  Josh, who functions intellectually on the level of a second grader, has been known to give his lunch money away on more than one occasion.  Josh does not tell his parents when he is feeling sick, and once cut his arm and used the wall to stop the bleeding. His parents came to me because they are conflicted about whether to seek guardianship of Josh.

Guardianship is a legal relationship created by a court. The guardian has the legal authority to make decisions about the healthcare and living arrangements of another person, called a ward.  The guardian also has the duty to look out for the welfare of the ward.  The relationship is very much like that of parent and child, where the law presumes that the ward is not able to make his or her own decisions about his or her healthcare or living arrangements.

Whether to seek a guardianship can be a difficult decision because parents want their children to gain independence, to learn to function in the world on their own and to make their own decisions.  When someone becomes a ward, they lose the legal ability to make healthcare decisions, to choose where to live, to enter into contracts, and to marry. 

Guardianship in Georgia is granted if the adult “lacks significant capacity to make or communicate significant responsible decisions” about his or her health or safety.  In order to decide whether to grant a guardianship, the court reviews a petition filed by the proposed guardian, appoints a professional to evaluate the proposed ward, and then holds a hearing in the courthouse to gather evidence about the decision-making ability of the proposed ward.

Josh’s parents ultimately decided that they need to become Josh’s guardians in order to continue to make decisions about his healthcare and where he lives, but also to ensure that he would not be enticed into signing any contracts that might bind him to spending money he doesn’t have.  Although they would like for Josh to get married some day, I explained that they can petition the court if and when Josh meets the right person and they believe he is mature enough to marry.

Please give our office a call if you have questions about whether you might need to seek guardianship of a young adult.

Next week, we’ll talk about when guardianship of minors, when that  might be necessary and how to choose guardians for your minor children.

Sunday, July 31, 2011

Caring for Children with Special Needs: Combating Autism Reauthorization Act of 2011

 Caring for Children with Special Needs

Combating Autism Reauthorization Act of 2011

You can’t turn on the television or radio without hearing about the negotiations – or lack of negotiations- in Congress regarding the looming budget crisis.  We are all concerned about whether our elected representatives in Washington can come to a compromise that will help the country out of the current debt crisis.  Of great concern to those of us who work with families who have family members with special needs is whether, and how, the few programs left to support these families will be affected.

Assuming Congress gets through these negotiations and gets back to work on other  important issues, Congress has the opportunity to address a significant issue that the United States faces today.  That issue is that the number of persons diagnosed as being on the Autism spectrum is increasing at an alarming rate.  It is estimated that 1.5 million Americans are currently on the Autism spectrum.  That number is expected to increase by 10-17% annually. 

A growing concern is that the number of autistic children entering adulthood is also increasing rapidly.   By 2023, the number of autistic children entering adulthood is estimated to be 380,000.  The cost of care for these adults is said to be around $27 million, or about the budget of the state of Tennessee. 

On August 3, 2011, the U.S. Senate Committee on Health, Education, Labor and Pensions (HELP) is scheduled to meet for hearings on the Reauthorization of the Combating Autism Act, originally passed in 2006.  The Combating Autism Act allocated $950 million dollars over the five year period for the Centers for Disease Control (CDC), National Institutes of Health (NIH), and other governmental agencies to conduct research on the autism spectrum.  The Act required the Director of NIH to develop and implement a strategic plan for autism research.  If the Act is not reauthorized by September 30, 2011, the federal commitment will disappear.

The current bill, named the Combating Autism Reauthorization Act (CARA), would allocate the federal funding of $1billion and create a National Institute of Spectrum Disorders Research within the NIH.

If CARA is not passed, research on the spectrum will likely be thrown into disorder.  We cannot afford to let this bill die.  Research into the reasons for the disorders on the spectrum, and especially research into treatment and therapies, is crucial. 

If you would like to find out more about CARA, and how you might be able to help make sure this Act is passed, see http://www.autismvotes.org/site/c.frKNI3PCImE/b.6376831/k.ACFC/CARA.htm.

Sunday, July 10, 2011

Planning For a Loved One With Special Needs

 If the last few years have taught us anything, it is that life is not predictable.   The economic crash seemed to come out of nowhere.  The weather appears to be totally weird and unpredictable, with tornadoes and floods occurring with fierce and dangerous intensity.

So, too, our health and physical wellbeing are not entirely predictable.  Despite our best efforts to eat healthy food and exercise regularly, we can have a car accident or suffer a bad reaction to medication and become ill or disabled.

For some of us, our financial resources and health insurance may not be enough to cover our care needs.  When that happens, we sometimes have to seek governmental assistance to provide for our healthcare.

Many of my clients had no idea they would end up depending on Supplemental Security Insurance (SSI) or Medicaid for assistance, but those progams can be a lifeline for those with disabilities and longterm care needs.

How can we plan for our loved ones and family members who are on governmental assistance programs?  How can we provide for their needs without jeopardizing their public benefits programs?

One way is to establish a special needs trust for the benefit of the person with a disability.  A special – or supplemental needs trust, as I’ll call it- is an entity established to hold assets so that those assets are available for  the needs of the person with a disability that are not provided by the governmental benefit.  The person with the disability is not the trustee, does not own the assets, and cannot control the assets, so the assets aren’t counted for purposes of qualifying for benefits.

SSI and Medicaid generally restrict the recipient of those programs from having more than about $2,000 in assets, but the assets in the trust aren’t calculated in that $2,000.  Most of the time, the trust is established by a parent or grandparent, but If the assets did not belong to the person with a disability to begin with, anyone can establish the supplemental needs trust and anyone can contribute assets to that trust.  The trust can be the recipient of gifts or inheritance.

We’ve discussed how to choose a trustee in previous blogposts,

http://bit.ly/rfPKWc  but for a supplemental needs trust I usually recommend appointing a professional trustee to manage the assets in the trust.  The intricacies of public benefits programs can be daunting for most people, so even though they charge for the management,  professionals with experience with supplemental needs trusts can save money in the long run.

So, even though life seems unpredictable, you can at least plan for some of the supplemental needs of your loved one with a disability.

Sunday, July 03, 2011

When Bridget Came To Visit: On Being Prepared

 When Bridget came to visit, she wanted to take my blue and white teacups home with her.  They were shiny and pretty, and fit in her hand just perfectly.  Dick promised they would go to the mall and buy some teacups just like them.

Bridget was in the mid to late stages of Alzheimer’s disease when she and Dick first visited my office.  Dick, a wonderful, patient husband and caregiver to Bridget, was determined to be prepared for whatever legal and financial zingers might hit the couple.  Years before, after Bridget was first diagnosed with Cognitive Memory Impairment, Dick and Bridget had prepared living trusts, powers of attorneys, and healthcare directives.  They came to me to make a few changes to Dick’s living trust and financial power of attorney.   I always recommend that clients update advance directives and powers of attorney to avoid having someone decide that the documents are “stale” and, therefore, not valid.  We prepared new advance directives for Bridget and Dick.  On the day Bridget came to sign, she could not remember that the children whom she had nominated as agents were adults.  In fact, I’m really not sure she could remember who her children were.

With sadness, I told Dick that Bridget could not sign any documents that day.  We agreed to try another day, since those with dementia often have times when they are very alert, and other times when they are not.  Bridget never was able to sign her new advance directive, and soon went to stay in a wonderful memory care facility.   The health care and financial proxies she had already signed worked fine for her, and Dick was able to make her healthcare and financial decisions without any challenges.

Susan, on the other hand, had never executed advance directives for healthcare, financial powers of attorney, or any wills or trusts.  She didn’t think she needed to, since her husband made most of the financial decisions for the couple.  Her family did not push her to do any planning, since they thought it would upset her.  When I visited Susan at the nursing home after her husband died, she told me the nurses were stealing her underwear, she no longer recognized her family members, and she wondered why I was visiting her at work.   Susan swore like a sailor, and insisted that she would not sign “any g. . d. . . papers”, believing that I was trying to steal from her, too.

As a result, her family had to spend months and thousands of dollars to seek guardianship and conservatorship of Susan, a court proceeding which is expensive financially and emotionally for all involved. 

Many folks with Alzheimer’s and other dementias become paranoid and distrustful.  When they hit that stage, it is extremely difficult to get them to agree to do advance directives, financial powers of attorney, or wills.  Why would they agree to sign something that they believe allows folks to steal from them?

As an attorney, I preach that every adult needs to have an advance directive for healthcare, a financial power of attorney, and at least a basic will.   In Susan’s case, her fear of planning led to heartache and hardship for her family.   Could all of this expense and difficulty have been avoided by visiting an attorney’s office while Susan was able to plan for her and her family’s future?

As a footnote, I want to tell you all about Dick, Richard J. Farrell, whom I mentioned above.  Dick has written a book Alzheimer’s Caregiving about his life with Bridget, joys and trials of caregiving, and about his grief when Bridget died after living with Alzheimer’s for nearly 20 years.  Check out his website at www.alzheimerscaregivingbook.com to see how you can order a copy.