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Sunday, May 22, 2011

Alternatives to the Joint Account: The Pros and Cons of a Power OF Attorney

 ALTERNATIVES TO THE JOINT ACCOUNT:

THE PROS AND CONS OF A POWER OF ATTORNEY

 

So, if you’re telling me not to put my daughter on my accounts, what are the alternatives?  How can I be sure I will have someone to take care of my financial affairs if I’m not able to?

In my last post, I told the story of Mary and her daughter, Nancy.  I pointed out the pitfalls to having adult children – or other people- as joint owners on real estate and bank accounts.  I promised I would share some alternatives to joint accounts.

One alternative is to appoint someone as an agent under a financial power of attorney.  The agent is authorized to make financial decisions for you if you are not able to make decisions – or if you just don’t want to make those decisions any more.  A financial power of attorney can be for a one-time transaction – like buying or selling your home – or it can be for any and all financial transactions.  A financial power of attorney should be durable, meaning that it will still be in effect even if you no longer have the mental capacity at the time of the transaction.  

Some advantages are that if you become suddenly incapacitated, you have someone with the legal authority to step in and make your financial decisions while you are incapacitated.  In addition, if you are okay but just need  someone to help you make sense of information, your agent can discuss your financial affairs with your insurance company, your financial institutions or your CPA.  Your agent can then explain the information and help you understand  so that you can make your own decisions. You can also appoint an agent under power of attorney to have authority to sign checks for you if you need some help paying your bills.

What are some downsides to the financial power of attorney?  We sometimes call a power of attorney document a “blank check.”  When you appoint someone as your agent under power of attorney, you are giving them lots of power with no instructions on how to use that power.  Imagine giving someone a blank check and telling them to go out and buy you a house without telling them where you want to live or how much you have to spend.  Chances are that person would buy a house in a neighborhood where you had no desire to live at a price you couldn’t afford.  Giving someone the authority to spend your money without giving them instructions can be frustrating and dangerous for both you and your agent.

Another downside is that the financial power of attorney dies when you do. The agent under a financial power of attorney has absolutely no legal authority to handle your finances after your death.  That means that upon your death, there is no one with the legal authority to deal with your finances, and your family must often wait until the probate court judge appoints someone to administer your estate before they can access your bank accounts.

I generally recommend that clients have an agent named in a durable power of attorney for finances, but I also warn them to have a discussion with the agent about when it is appropriate to use the power, and to point out the limits of that power.

In my next post, we’ll talk about another alternative to the joint account – the living trust.

 


Saturday, May 14, 2011

Should I Add My Daughter to My Account?

Should I Add My Daughter to My Account?

 

Mary and her daughter, Nancy, were very close.  Mary was still able to make all of her financial decisions, and paid all of her bills on time each month.  Keeping a high bank balance gave Mary comfort that she would be able to access money whenever she needed it.  She was worried that she might “lose it” at some point, so she asked Nancy to become a signer on her bank account.  She and Nancy became joint owners of Mary’s bank account, although Nancy acknowledged that her mother was the real owner of that money.

Nancy was not quite as meticulous about her finances as her mother.  She had used the overdraft protection on her bank account on many occasions when she forgot to record her purchases in her check register, or when she needed something and didn’t have the money to pay for it.  Nancy’s bank account was in the same bank as the account she and Mary owned together.

One day, Nancy overdrew her bank account by a significant amount.  Per the rules of the bank, money was withdrawn from the joint account of Mary and Nancy.

When Mary checked her account online, she was horrified.  What had happened to her money?  She could not imagine how her bank balance had gotten so low and raced to the bank to get to the bottom of what was obviously the bank’s mistake.  When the bank employee explained that the money had been transferred to Nancy’s account to cover an overdraft, Mary was horrified.  She had no idea that by letting Nancy become a joint owner of her account, she had given Nancy the right to use all of her money. Mary immediately closed the account and transferred her money to another bank.

 Nancy had no idea that her mother would be liable for her overdraft, and was ashamed that her mother knew about her bad money habits.  Over time, she was able to pay her mother back.

Many older clients tell me they want to add their children to their accounts and to their real estate.  They tell me that they do that so they can avoid probate, and so that their children will be able to manage their money for them should they become incapacitated.

I rarely recommend joint accounts for people who are not married or in a committed relationship.  There are a couple of reasons why I think it is usually a very bad idea.  First, just as with Mary and Nancy, the assets in a joint account are deemed to be owned equally by either party and are available to the creditors, predators, and ex-spouses of both parties.  Second, at the death of a joint account owner, the asset belongs to the surviving joint owner.  Most of my clients have more than one child, and their wills almost always leave everything equally to each of their children.  Yet, when they jointly own an asset with only one child, that asset belongs to that child alone at the time of the death.  You may be relying on the generosity of the surviving child to share the proceeds with his or her siblings.  If there are more than two joint owners, the asset belongs to whomever is the last man standing. That means that if one child predeceases the parent, the asset will belong to the surviving child when the parent dies. Since most of my clients intend for their grandchildren to inherit their deceased parent’s share, this type of planning usually defeats the intent.

 Finally, the joint owner can take the whole asset whenever she wants because a joint owner can withdraw the entire amount in the  account without the consent of the other owners. 

In my next post, I’ll talk about ways to manage money during incapacity and avoid probate without using jointly owned accounts.Should I add my daughter to my account?

 


Thursday, February 10, 2011

Managing A Wild Ride to the Emergency Room – A Checklist

My father is a pretty independent guy.  He loves to tell us that when he was young, he served as a ranch hand for a summer. I can just see him, riding horses and herding cattle.  I guess his professional career was similar to that cowboy summer.  As a high school principal, he spent a lot of his time herding kids.  Even today, he is still kind of a tough old cowboy.
He hates to go to the doctor, and I don’t remember him ever going when we were kids.  A few years ago, though, after suffering for about a week, he was in such excruciating pain that he could not hold out any longer and had to go to the emergency room at his local small town hospital.  None of his children were in town that night, so he drove himself to the hospital.

Of course, this being a Saturday night in rural South Dakota, they could not treat him at that small hospital and were forced to send him on a wild ride in an air ambulance to a larger hospital a couple of hours from his home.  Once he arrived at the hospital, they determined that they did not need to keep him overnight and dumped him out on the street without a car to find his own hotel room.  Thankfully, my sister was able to find him and help him get a hotel room where he stayed until demanding to be returned home the next morning.  Now, I really don’t have any advice for how to force stubborn cowboys to let their kids know when they need help, but I recently attended an excellent – and very practical- presentation by Dr. Thomas Price, Chief of Medicine, Wesley Woods Geriatric Hospital, Assistant Program Director, Fellowship in Geriatric Medicine, Assistant Professor, Emory University School of Medicine, and Medical Director of the AG Rhodes Home at Wesley Woods, (he does wear a lot of hats) on what to do when your aging loved one may need to go to the hospital.

The presentation is packed with good advice, but I found Dr. Price’s instructions for preparing for a trip to the emergency room to be invaluable.  Now, maybe other people know instinctively what to do, but when one of my loved ones is sick enough to require a trip to the emergency room, I’m not sure I would be able to think clearly enough to gather what is necessary for the trip.  Here, then, is Dr. Price’s checklist for taking a loved one to the emergency room:

I’ve posted Dr. Price’s presentation in .pdf form on my website.  You can find it at www.elrod-hillfirm.com.
 

  • First Step
    • Go by ambulance or car?
      • If poorly responsive or in distress, call 911!
    • If by car, have someone drive you
      • Allows you to help mom
      • Prevents you from being distracted as a driver if mom vomits, gets worse
  • Preparing for the Trip
    • Mom’s Bag
      • Ziploc of all the medications she is currently taking in their bottles
      • Contact info for her primary care doctor and other specialists she sees
      • Insurance cards (Medicare, Medicaid)
      • A change of clothes (preferably a track suit or other easy to put on activewear)
      • Dentures, glasses, hearing aids!
  • Preparing for the Trip
    • Your Bag
      • Any medications you take (at least two days worth)
      • Copy of mom’s living will/advance directive/POA
      • A book (sudoku, crosswords, novel)
      • Cell phone and charger
      • One change of clothes
      • Hygiene supplies
      • Water, snacks, or sandwich
  • The Drive
    • Bring blanket, plastic bag (for emesis), towel
    • Be calm, say supportive things to mom
    • Sit with her in back seat

I’ve posted Dr. Price’s presentation in .pdf form on my website.  You can find it at www.elrod-hillfirm.com.
 


Wednesday, May 13, 2009

The Alzheimer's Project - Review of The Memory Loss Tapes

The Alzheimer’s Project
A Review of The Memory Loss Tapes

 
Like most Baby Boomers, I have a fear of developing Alzheimer’s Disease. As an Elder Law attorney, I witness the struggles of the adult children of parents who have Alzheimer’s Disease (AD) as they try to understand what is happening to their parent and wrestle with the best way to care for their parent as the parent slowly fades away.
 
The Alzheimer’s Project is intended to open a dialogue about Alzheimer’s Disease, to show the disease from several perspectives – that of the person who has AD, the children and young teenagers who have relatives with the disease, the scientists and doctors struggling to find treatments and a cure, and from the caregivers.
 
The Memory Loss Tapes, the first episode in the documentary series airing on HBO this week, is viewed from the perspective of those who have been diagnosed with AD. Each segment shows someone in varying stages of the disease, starting with Bessie who is in the very early stages of the disease and ending with Cliff’s death from complications from the disease.
 
Although much of this episode is frightening, much of it is happy, sad, and hopeful – often all at the same time.
 
We are first introduced to Bessie, an 87-year-old widow living in a small town in Wisconsin who was diagnosed with AD two months before her part of the documentary was filmed. Bessie is still living her normal life – for the most part. She lives by herself with her dog, Skipper, and still drives, cooks and performs with a singing group. She struggles to remember the words to songs and forgets the names of people she has known for years. Bessie is aware that she is forgetting things, but she is determined to continue the activities she has enjoyed for years. Although she understands there is no cure for the disease, she hopes for a couple more good years with donepezil, (known by the brand name, Aricept) a medication prescribed by her doctor.
 
Fannie, an 82-year-old widow in St. Louis, represents the second phase of the disease. Fannie’s segment is probably the most familiar and the most disturbing to those who must care for a loved one with AD, because Fannie has little awareness that she is suffering from AD and is irritated with those who try to keep her safe. When we first meet Fannie, it is three months since her diagnosis. Fannie’s doctor told her to quit driving, which she says makes her feel “inadequate” and “completely dependent on someone else.” Fannie takes an assessment test to determine whether she must stop driving. When asked to rate her driving ability, Fannie chooses Above Average. As part of the assessment, Fannie must take a driving test. It is frightening to watch as we see that Fannie cannot remember how to put the car in reverse, sees traffic signs in places where there are none and cannot figure out a right turn from a left turn. After the test, Fannie believes that she will be able to continue to drive. When Fannie is told that she can no longer drive, she is very upset and says that “they” are taking away her independence.
 
The Joe’s Blog part of the documentary was very difficult to watch. Joe, just 63 years old, was diagnosed with AD two years before the documentary was filmed. He writes a blog he calls Living with Alzheimer’s. Before developing AD, Joe was involved in the computer industry. He describes himself as having been a genius, involved in helping some of the computer companies become the largest in the world. Now, Joe gets lost in his own backyard and is afraid to go out of the house because he may not be able to find his way home. Indeed, when he takes his young granddaughter to the park, he forgets how to get out of the park. Thankfully, his granddaughter remembers how to get home.
 
Joe very candidly tells the camera that the medication he takes for AD killed his sexual appetite. During a visit to his psychologist, Joe describes the disease as being like someone shaving slices of him – like at the deli when they shave the meat and little scrapings and pieces come off. The most difficult part for the viewer is to see Joe talk about taking his own life when he gets too far along. Joe feels that he will soon reach the point when he will end his life and he buys a wooden box – presumably for his ashes – and shows it to his family.
 
Yolanda Santomartino, age 75, represents AD in the later stages. Yolanda slumps in her wheelchair, no longer able to walk or to sit up straight. She talks to herself in the mirror, believing that she is talking to someone else named Ruth. Yolanda gets tired of talking to Ruth through the “window” because Ruth does not talk back to her. Yolanda is frightened by a ribbon on her chair, which she believes is an animal, and becomes agitated when she thinks snakes are in her wheelchair. Her caregivers struggle to calm her, and often play along with her fears by trying to mash the snakes in her chair. Family members will feel the pain that Yolanda’s son feels when his mother does not recognize him when he is sitting next to her. As Yolanda cries, “This is no life.”
 
Woody Geist, Age 81, was diagnosed 14 years before this documentary was filmed. He lives in a Sunrise assisted living memory care facility, and spends most of his day wandering around, whistling, and trying to figure out where he is going. Despite the fact that he is married, he has a “girlfriend” at the assisted living. She refers to Woody as her husband.  Old home movies show Woody hamming it up in front of the camera, singing with a men’s acapella singing group. We rejoice with Woody when he appears at a performance of his old singing group, and, although he cannot remember any of the members of the group, he does remember the words to the songs. Woody’s favorite phrase is “We’re lucky. I am glad we can be together.”
 
Josephine Mickow, age 77, does not talk much anymore. She makes sounds and whistles, but we barely hear her speak.  She lives with her daughter in a small house in a rural area.  Her daughter’s spinning group put a fence around the perimeter of the yard and now Josephine wanders aimlessly in her yard fiddling with the fence, as though trying to get out of the yard. Her daughter gave up her job in the city to care for Josephine, and now just gets by making yarn from the llamas and alpacas she raises and selling her goods at shops in her area. The most difficult part of Josephine’s piece is when Josephine puts a pebble in her mouth and her daughter has to stick her fingers in Josephine’s mouth to pry the pebble out. Josephine was an artist, and still leaves little vignettes of vegetables, glasses, and other found objects around the house. Her daughter preserves these vignettes through photographs.
 
The final segment features Cliff Holman, age 79, who was diagnosed 6 years before the documentary. We meet Cliff in the last stages of AD, being cared for at home by his wife with help from hospice nurses. Cliff was a children’s entertainer called “Cousin Cliff”, and had a daily children’s television show. He gets agitated because he believes he has to get to the television station to do a show. His wife struggles knowing that in his living will he asked that his life not be prolonged by artificial means, but feeling that she does not want to lose him. In the end, Cliff is taken to a hospice facility and we watch his family say their last goodbyes and grieve with them when the hospice nurse nods her head and says “he’s gone.”
 
 
The last scene shows Bessie searching for her car, and the viewer knows that she has just begun this incredibly difficult and painful journey, with Bessie just slipping away until her life end like Cliff’s.
 
Although some people may find this part of the documentary series difficult to watch, I found some hope here. The families of those suffering with AD, though stressed and grieving, also found joy and happiness in taking care of their loved ones. Though they often described their loved one as slipping away, I found that each person retained some part of their personality throughout the stages of the disease. Even as Cliff is in the final stages, he is waving to the camera and saying “I’ll see you on smellivision.”


Wednesday, May 13, 2009

The Alzheimer's Project - Review of Grandpa, Do You Know Who I Am?

The Alzheimer’s Project
 
Grandpa do you know who I am?

 
Of all the segments in the Alzheimer’s Project, I found this one the most difficult to watch. In fact, I cried all the way through. As a mother, it hurt to see all of those vulnerable children who love their grandparents unconditionally, struggle to understand why does my grandparent act this way? Why is this happening to this person that I love? If they love me, why are they acting like this?
 
As adults, we pretend that we understand this disease and that we are not hurt by the behavior of our loved one with AD.   However, many times the adult children and adult grandchildren of my clients tell me they cannot understand why their loved one is being so mean to them. Why is this person so angry? Why does this person hate me so much? Why can’t she remember my name?
 
In one segment of this episode, a grandchild tells that her grandmother had slapped her one day while the grandmother was in the nursing home. Although the granddaughter seemed to intellectually understand that the behavior was a result of the disease, it was apparent that that slap really hurt and that the memory of that slap would remain with the granddaughter for a very long time. Another segment shows a grandmother growling at her grandchild and telling the child to go home. The child’s older sister comforts her and reminds her that the grandmother is ill and does not really know what she is doing.
 
Throughout this segment, we see grandchildren taking care of their grandparents – combing their hair, walking with them, helping them to eat. Although it is painful for them to watch their grandparents deteriorate, I believe that each one of these children will be better for having learned compassion and service.
 
Maria Shriver’s narrative is compelling and true. Here is the daughter of one of the most accomplished, intelligent people in the U.S., and she tells us that she must introduce herself to her father every time she sees him. “Hello, Daddy, I’m your daughter, Maria.”

In the end, though, Maria says she is just happy that he is still here. And I believe that in the end, children and grandchildren of those who suffer with AD are just glad their loved one is still here.


Tuesday, February 10, 2009

Book Review: Memory Lessons: A Doctor's Story by Jerald Winakur

 

Book Review:
 
Memory Lessons: A Doctor’s Story by Jerald Winakur
 
I’m an admitted insomniac and a voracious reader. Thankfully, I can combine the two habits so that I can at least be productive during my periods of insomnia. I picked up Dr. Winakur’s book last night, and finished it by morning. Oh, I did get a few hours of sleep in between chapters.
 
 
Dr. Jerald Winakur, a seasoned geriatrician, writes a series of essays reflecting on his medical career and on the physical and mental decline of his father from Alzheimer’s disease. Dr. Winakur is a medical professional who treats the old-old, defined as those over the age of 85, but he is also a son facing the uncertainty of dealing with his old-old father’s declining mental and physical capacities. A son who, although not legally his father’s physician, is his father’s surrogate decision-maker.   Dr. Winakur exposes the human side of a physician - the side where the scientist and trained professional meets the man with doubts about the efficacy of the treatments prescribed for patients and the man with concerns about the ethics of those treatments. Dr. Winakur struggles with the lessons he learned early in his career – to keep the patient alive – with his life lessons. Those life lessons teach that sometimes it is better to let the patient go.
 
Those caring for loved ones with dementia will likely recognize the feelings of guilt and uncertainty that come with the day to day care of someone who no longer recognizes the caregiver. They will empathize with the family’s agony over deciding where the loved one should live, what treatments should be authorized, how to react to the repeated questions and how to deal with the endless wanderings in the night. 
 
Dr. Winakur also exposes some of the flaws in the medical profession, and ties many of those flaws to the system by which physicians are compensated. He raises concerns about the rising number of specialists who are well compensated for procedures, and the stingy compensation afforded family practice physicians, internal medicine specialists and geriatricians who are responsible for using their reasoning skills to diagnose and treat most of the nation’s patients. Specifically, he lays the blame on the Medicare system of reimbursement, the rates determined by a board of physicians heavily weighted with specialists earning their living by doing procedures on patients.
 
I recommend this book to those caregivers beginning their journey with the loved one with Alzheimer’s disease, for they can learn what may come. I also recommend this book for those who are at the end of the journey, for they can find a kindred soul.
 

Saturday, December 13, 2008

Veterans of World War II Remembered on Pearl Harbor Day

Sunday was the 67th anniversary of the attack on Pearl Harbor and I found a few articles on survivors of the attack in the Atlanta Journal Constitution and online. According to the Department of Veterans Affairs, there are less than 5,000 current members of the Pearl Harbor Survivors Association. At its peak, there were 20,000 members of the Association. As of Sept. 30, 2008, there were 2.6 million World War II veterans. Those veterans are dying at the average rate of 851 each day, with 310,777 expected to die by September 30, 2009. 

 
Therefore, it is important to capture the stories of those WWII veterans still living. The Library of Congress is conducting the Veterans History Project and seeks interviews, photographs, correspondence and other objects related to veterans. The website can be found at: http://www.loc.gov/vets/about.html and contains tips on conducting interviews of veterans to collect their first-hand account of their service. Here is a link to the Biographical Data form required by the Project: http://www.loc.gov/vets/pdf/biodata-fieldkit-2007.pdf. Here is a link to suggested questions to ask the veteran: http://www.loc.gov/vets/vetquestions.html
 
You may also learn about how to conduct an oral interview with your loved one at StoryCorps. http://www.nationaldayoflistening.org/
 
If you want to do some research on enlistment records or the Pearl Harbor Muster Rolls, check out the National Archives at: http://www.archives.gov/research/arc/topics/ww2/
 
For information about Veterans Pension and Aid & Attendance Benefits, please check out our brochure at: http://www.elrod-hillfirm.com/global_pictures/EHLF_Veterans%20handout.pdf or give us a call at 770-416-0776.

Saturday, December 13, 2008

DWE or Driving While Elderly

As the parent of a 16-year-old soon to be licensed driver, I think a lot about whether she will be safe on the roads -  and whether others who have to share the road with her will be safe!  At the same time, I worry about whether my aging clients are safe on the roads – and whether others are safe on the same roads with those aging drivers. In my practice I am regularly told stories –some funny and some frightening – about aging or impaired drivers. 

 

For my 16-year-old, the ability to get in the car and drive wherever she might like to go signals the ultimate freedom.  For my aging clients, the thought that they will no longer be able to drive wherever they want signals the end of that same freedom.  That is why the issues involved with the elderly drivers are so difficult and why we need to consider the options carefully before taking any action.

 

The families of the elderly often ask how they can get Mom or Dad to stop driving.  The story is usually that Dad or Mom runs stop signs, gets lost, or drives 25 miles an hour while other drivers zip by them at 75 miles an hour.  How do we know when its time to take away the keys?  And how do we take those keys away without a fight?

 

Clearly, there is no magic age at which driving skills decline, so what are some of the signs that Mom or Dad should either curtail some of their driving or stop altogether?

 

The website Aging Parents and Elder Care has a list of signs that a driver’s skills may be declining.  Among those signs are the following:

  

* Driving at inappropriate speeds, either too fast or too slow

 

* Having one or more near accidents or near misses

 

* Getting lost repeatedly, even in familiar areas

 

http://www.aging-parents-and-elder-care.com/Pages/Checklists/Elderly_Drivers.html

 

 

If Mom or Dad is showing some of the signs of declining skills, try to determine whether there is a medical reason for the decline that may be corrected with proper medical care.  Similarly, determine whether the elder may be able to modify their driving to accommodate the decline. 

 

Once you have determined that the problem is severe and the elder must completely stop driving, how can you get them off the road?

 

Here are a few suggestions:

 

* Confront Mom or Dad and let them know that you are afraid that they will injure themselves or others if they continue to drive.  Help them find alternative transportation options.  For help with this conversation, check out The Hartford’s Family Conversations with the Older Driver at:

 

http://www.thehartford.com/talkwitholderdrivers/having/main.htm

 

 

* Contact the Department of Motor Vehicles or have your loved ones doctor contact the Department of Motor Vehicles to report that the driver is no longer safe.

 

* Finally, you may have to either disable or take away the car. 

 

To help older drivers continue to drive as long as possible, consider driving classes offered through AARP.  You can find classes near you by checking out the AARP website at:  http://www.aarp.org/family/housing/driver_safety_program/


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