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Aid & Attendance

Thursday, July 16, 2015

The Zen of a Family Meeting: The Five Things You Must Cover When Planning for Your Aging Parents’ Care

 

 

July is Sandwich Generation Awareness Month.  The Sandwich Generation refers to those people, mostly in their mid-40’s to late 50’s, who are caring for aging parents as well as caring for young children or dependent young adult children.  If you are the meat or peanut butter in that sandwich, you might be looking for help from your siblings or other family members.  One of the best ways to plan the care for an aging or disabled family member is by holding a family meeting.  The meeting is designed to do many things:  get information from the aging or disabled person about their needs, figure out what kind of care is needed and brainstorm about ways to find that care, gauge the financial resources available for care, and assign duties to various family members so that one caregiver does not get burned out.

Who should attend the meeting?  I recommend that all of the parents and siblings attend a meeting, preferably where they can meet face to face to talk about the issues facing the aging parent now, and those issues that may come up in the future.  If grandchildren, aunts and uncles or friends will be responsible for some of the care, invite them along.    The parent or person with a disability should be in attendance so long as they are physically able to be there. 

It is usually best to hold the meeting in a neutral place, such as a meeting room in a hotel or community center.  I also recommend there be a fairly impartial facilitator to keep the meeting on track, if possible.  And, there should be plenty of snacks and drinks so people won’t want to leave before you’ve discussed all the important points.

With so many families spread out over the world, it can be difficult to get everyone together.  If the family has a regular family reunion, perhaps the reunion time can be extended to allow the family to get together for this meeting.  If there is no regularly scheduled reunion, you can use scheduling programs such as www.doodle.com to find out when the most attendees will be available. If some family members absolutely cannot meet in person, you can use tools such as Skype www.skype.com or Google Hangouts www.google.com/hangouts‎ to bring those other family members in by video.

Once you have set the time and place, have everyone agree to an agenda.  Appoint someone to come up with a proposed agenda in advance of the meeting, and then circulate that proposed agenda for comments, additions and changes.

Here are the five basic items that should be covered in the meeting:

 

  1. The Health and Safety of the aging parent or person with a disability

     

    How do they feel about their own healthcare and safety and what are they concerned about?

    Are there any disease or illness diagnoses?

    Are they paying attention to personal hygiene?

    Have there been any instances where the safety of the parent has been compromised, such as falling, leaving the stove on, wandering, etc.?

    Who are their physicians, dentists, therapists, professional and volunteer caregivers?

    What medications are they taking and are they remembering to take them regularly? 

     

    What health insurance do they have?  If they are on Medicare, is there supplemental insurance or prescription medication coverage?

    How are the premiums paid and is there someone who will be informed if the premiums are not paid?

     

    How are their finances? 

    What financial resources do they have? 

    What are their regular bills and how do those bills get paid?  How will you know if they forget to pay the bills?

     

  2. The current living and care arrangements, whether those arrangements are working, and a plan for future living arrangements

 

 If the parent’s condition is changing, what living and care arrangements will be necessary in the future?

How will you find appropriate housing and care?

 

  1. The legal documents do they have and the legal documents they need

     

    Who is their lawyer and when was the last time they saw a lawyer?  Where are the legal documents stored?

    Who is named as Agent, Personal Representative, etc. in those documents?

    Who are their beneficiaries on their IRA’s, 401(k)’s, life insurance policies and annuities?

     

  2. A plan to pay for long-term care

    Is there long-term insurance available?  If so, what are the terms?  Where is the policy and how are the premiums paid for? 

    If there is no long-term care insurance, can the parent or person with disability afford to pay for care by him or herself?  Are there any government programs, such as Veterans benefits or Medicaid, that can help pay for long-term care?

     

  3. The family caregivers – who will do what and when

Sometimes family members volunteer to perform the tasks for which they have talent.  The brother who is a nurse may be the natural fit for the person to oversee the parent’s healthcare and the sister who is the CPA will take over the finances.  What if it isn’t so clear or if no one wants to take on the tasks?  Can people be hired to perform some of the tasks such as paying the bills? 

Can the family agree that it may not be fair to one of the children to take on all of the responsibility for care?

If one family member is taking on the bulk of the care, can the others agree to take a turn to provide relief to the primary caregiver? 

 

The topics may vary from family to family, and for those families who may find it especially hard to discuss these items you might consider having a professional or a mediator to assist in these discussions.

 

 

 

 


Monday, March 18, 2013

Come hear Patti speak Tuesday, March 26th!

Come join us at the Tapestry House of Alpharetta Tuesday, March 26th at 6:30pm.

Patti will be speaking about the difference between being housebound with a  caregiver vs moving into an Assisted Living Facility. 

All are welcome!

 

 

 

 

 


Tuesday, March 12, 2013

March is Social Work Month!

Featured Article by Thom Corrigan, MSW, CMC

Each March we are asked to celebrate Social Work month. For some, this means sending a note or an e-mail to a social worker we may know. For others, it may be treating a social work colleague to lunch or bringing them a plant or some flowers to show our appreciation for them.

But this year, I invite you all to celebrate what social workers do, in addition to who they are. Social workers possess many traits and skills. These include being trained to serve as advocates and brokers for our clients. Social workers have developed skills in the areas of empowerment, resourcefulness, problem solving and helping people with transition. They help people to learn new skills while at the same time, helping them to regain confidence, self-esteem, self-determination and resilience. Social workers do this in part by modeling, teaching, empowering, counseling and developing in a person the traits and characteristics that will lead to better outcomes and create a heightened sense of accomplishment and independence.

Each year, the National Association of Social Workers (NASW) creates a theme as part of its celebration for social work. This year's theme is "Weaving Threads of Resilience and Advocacy: The Power of Social Work."   Lastly, did you know that Social Work is the only profession that has the word "WORK" in its name? I find that interesting-

Happy Social Work Month to all my professional peers and colleagues and thanks for all that you do to help people with their everyday needs and challenges!

Thom Corrigan, MSW, CMC
Certified Care Manager


Wednesday, February 20, 2013

Caregiver Appreciation

Expressing appreciation for the assistance received from caregivers is something that not many think about, but is certainly needed. Now some may say, “Why should I be grateful for help from someone I am paying?” Or in the case of family caregivers, “Aren’t family members supposed to take care of each other?” Research shows, however, that not only does expressing appreciation make the caregiver feel better about what they do, but also that the people expressing gratitude have a greater sense of well-being.

Expressing appreciation for something your caregiver has done for you does not require the eloquence of a public speaker, only a few words are all that it takes. Examples of some things to say thank you for are : “Your gentleness when helping me change positions really minimizes my pain. Thank you.” “The way you talk to me as a person, rather than a patient, really makes me feel good.”  By giving sincere words of affirmation  will not only allow the caregiver to feel appreciated, but will help them to have a know how you liked to be cared for.

Expressing gratitude is a choice. This month, show some appreciation to someone who helps care for those in need.


Monday, February 18, 2013

Is it possible to establish a Trust for your Pet?

Laws on the subject of pet trusts vary from state to state.  Since animals are not allowed to be beneficiaries of a trust, various legislative devices have been employed in the past.  Some states authorized the creation of “honorary trusts” which could be used to provide for the care of a pet, but were not enforceable by a court.  The Uniform Probate Code recognized “pet trusts” in 1990, and the Uniform Trust Code added a pet trust provision in 2000.  However, the Uniform Codes are only recommendations, and each state chooses whether or not to adopt any of their provisions.  As of the end of 2009, 42 states and the District of Columbia have adopted some type of provision which allows creation of a pet trust, some based on the Uniform Trust Code provisions, and some on neither, including some remaining “honorary trust” provisions.

The law has traditionally regarded pets as “property” and thus not possessing any rights.  In the past, individuals had to do such things as leaving money to a person with instructions to care for their animals, and hope that their wishes would be carried out, since there was no legal way to enforce such a provision.  However, a growing recognition of the importance of companion animals to people has led to several advancements in legislative establishment of means to protect animals left behind.  Call if you have questions!  Our office can help with your pet planning needs (770)416-0776.

 


Monday, January 21, 2013

Can A Special Needs Trust Pay for things such as Credit Card Bills or Security Deposits?

   Administering a "special needs" trust can be a challenge. The rules often seem vague, and they occasionally shift. What may seem like a simple question might actually involve layers of complexity. Sometimes expenditures might be permissible under the rules of, say, the Social Security Administration, but not acceptable to AHCCCS, the Arizona Medicaid agency -- or vice versa. Trustees work in an environment of many constantly-moving parts.

Take these two examples:

Example 1:  Being the trustee of a Self-Settled Special Needs Trust for a sister. Can you pay her credit card bills?

Maybe (don't you just love lawyers' answers?). Let's break the question down a little bit.

    First, identify the trust as "self-settled." That means the money once belonged to your sister (it might have been an inheritance, or a personal injury settlement, or her accumulated wealth before she became disabled). That also means the rules are somewhat more restrictive.

We will assume that the bills are for a credit card in her name alone. If the card belongs to someone else, the rules may be different. Not many special needs trust beneficiaries can qualify for a credit card; when they can, it can be a very useful way to get things paid for (as you will soon see).

The next question requires a look at the trust document itself. It might be that it prohibits payments like the one you would like to make. That would be uncommon, but not unheard of. We will assume that the trust does not expressly prohibit paying her credit card bills.

What benefits does your sister receive? Social Security Disability and Medicare: Not a problem.But if it is Supplemental Security Income (SSI) and AHCCCS (Medicaid) there could be a problem.

    Next, we need to know what was charged to the credit card. Was it food or shelter? If it was used for meals at restaurants, or grocery shopping, or for utility bills, you probably do not want to pay the credit card bill from the trust. If you do (and assuming the trust permits it) then you will face a reduction of any SSI she receives, and possible loss of AHCCCS benefits.

Were the credit card bills for clothes, medical supplies, gasoline for her vehicle, even car repairs? There is probably no problem with paying the credit card statement. Even home repairs should be OK in most cases (just not rent, mortgage, utilities, etc. -- and the rules might be different if anyone else lives with your sister).

As you can see, what started out as a simple question turns out to have a lot of complexity. You might want to talk with a lawyer about your sister could use the credit card. When it works, though, it can be quite beneficial.

Example 2: Can a special needs trust pay the security deposit on a new apartment?

What an interesting question. We think the answer is probably "yes."

Once again we need to look at the trust document itself. Was it funded with your own money (like a personal injury settlement), or was the trust set up by a relative or friend with their own money? Is there language prohibiting payment for anything related to your apartment?

Assuming no trust language prohibits the payment, we can turn to the effect such a payment would have on your benefits. Social Security Disability and Medicare? Once again, no problem. SSI and AHCCCS/Medicaid? Your benefits might be reduced, but the payment can probably be made.

The key question is whether a "security deposit" is "rent." Arguably, it is not, rather it is an advance payment for cleaning. A special needs trust, even a self-settled special needs trust ,can pay for cleaning. Social Security's rules treat payment of "rent" as what's called "In-Kind Support and Maintenance (ISM)." This payment, we think, should not be characterized as ISM.

If it is not ISM, then it should have no effect on your SSI or your AHCCCS benefits. If it does, it might simply reduce your SSI payment (by the amount of the deposit, but capped at about $250). So long as you still get SSI it should not have any effect on your AHCCCS benefits.

Are these rules unnecessarily complicated? Yes. Does it sometimes end up costing more in legal fees to figure out what to do than it would to just pay the bills? Yes. Welcome to the complex world of Special Needs Trust Administration. Would it be possible to write simplified rules that allowed limited use of special needs trust funds while saving a bundle on administrative expenses? Yes, but please don't hold your breath while waiting for them.

 


Wednesday, January 9, 2013

Speaking Engagement! Come learn about the new changes to the Veterans' Pension Benefits!

Patti will be speaking at the Benton House of Johns Creek about the new changes for 2013.

Learn about valuable information that can help you plan for this year!

Patti will be there from 6:30pm-7:30pm and will be availiable for questions after.

Refreshments provided


Wednesday, January 2, 2013

The start to a new life for the Mentally Disabled

   It is a new strategy for Georgia, one of several states responding to mounting pressure from the Justice Department, which in recent years has threatened legal action against states accused of violating the civil rights of thousands of developmentally disabled people by needlessly segregating them in public hospitals, nursing homes and day programs.

   For a family with a loved one who is mentally disabled, one of the hardest decisions they will have to face is determining the proper care for their loved one. Until recently, many mentally disabled persons have been placed in hospitals to live for the rest of their lie. While they are under constant care, there are social elements that are missing when living in a hospitals. These social elements, such as sense of community, friendships, and acitivies like dancing, are essential for personal growth.

  The link below is a story that exemplifies the importance of providing better living options for those who need it most.

 

 

 

http://www.nytimes.com/2012/09/30/us/ending-segregation-of-the-mentally-disabled.html?pagewanted=all&_r=0


Thursday, December 6, 2012

The Importance of Getting Vaccinations

              It is that time of season again! While we fret over  getting gifts for our children or doing more cleaning than we have done all year because the in-laws are coming, we are forgetting one imporatant thing this holiday: our health. I am sure you have seen the advertisements Pharmacies and Drug Stores put out about getting the flu vaccine, but how imporant is it?

              The CDC says that, 'Influenza is a serious disease that can lead to hospitalization and sometimes even death.'  Even I have to admit, I did not think that the Flu was serious enough to cause death, but in reality it does. In fact, over a period of 31 seasons between 1976 and 2007, estimates of flu-associated deaths in the United States range from a low of about 3,000 to a high of about 49,000 people. That is not a small number. It is especially important that our Seniors get the vaccination because during a regular flu season about 90 percent of deaths occur in people 65 years and older.

               The CDC has named this week (December 2-8th) as National Influenza Vaccination Week. It is a national observance that was established to highlight the importance of continuing influenza vaccination, as well as fostering greater use of flu vaccine after the holiday season into January and beyond.

As we prepare for this holiday season, may we give the most imporant gift of all, the gift of good health.

The US Department of Veteran Affairs has some helpful tips and links for our seniors.

http://www.va.gov/health/NewsFeatures/20121203a.asp


Monday, November 12, 2012

Seniors Beware: How Much Salt are you Eating?

      Just like with most things in life, salt is best in moderation. Salt has been around for thousands of years and has served multiple purposes from being a means to preserve meats to adding flavor to a dish. But did you know that too much salt can create health problems including high blood pressure and heart disease? It is not just the french fries or the potato chips that we have to watch out for, but items that are packadged and heavy card-based.  On National Eating Healthy Day, the American Heart Association developed a list of six items that we should be mindful of consuming because of their above average levels of sodium. Please click the link to find out what are the 'Salty Six'.

 

http://seniorjournal.com/NEWS/Nutrition-Vitamins/2012/20121107-Seniors_Take_Heed.htm


Sunday, November 20, 2011

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

When she was approaching her 85th 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.

Read more . . .


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The Elrod-Hill Law Firm,LLC assists clients with Estate Planning, Veterans Benefits, Medicaid, Elder Care Law, Probate, Special Needs Planning and Pet Trusts in the North Atlanta area including the counties of Dekalb, Gwinnett and Fulton.



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