Wednesday, August 31, 2011

Boomers: Complex Strategies Save Hundreds of Thousands in Long-Term Care Costs

If you know or suspect you are at a high risk for developing cancer – or if you are one of the brave individuals or families already battling the disease – I cannot stress enough how critical it is for you implement a proper Asset Protection Plan as soon as you can.  Even for those individuals who are not facing imminent crisis, planning is just as critical.

 Asset Protection Planning and Incapacity Planning are the vital legal services where an Elder Law attorney guides the individual (or couple) through the complex Medicaid qualification, application, and approval processes.   It may be necessary to employ a complex set of asset protection strategies, saving hundreds of thousands of dollars in many cases.   

Example:  The median net worth of the average 65 year-old is $232,000. If you live in Northern Virginian, the average cost of a private nursing home room in 2010 was nearly $100,000. 

If planning is engaged in soon enough, assets can be 100% protected from nursing home creditors, lawsuits, and general creditors.  The good news is, even if someone is already in a nursing home paying the monthly bill, their remaining assets can be protected! 

Here is the truth:
Proper planning can protect the assets from nursing home creditors, allowing Americans from all walks of life to legally and ethically qualify for Medicaid and Veterans Benefits, passing on an inheritance if they so choose, and enjoy the standard of living and quality of life they prefer.

Resources: Met Life, 2010 | Cancer Facts & Figures, 2011, available at

Tuesday, August 30, 2011

3 tips to talk to your parents about long-term care

1 - Explain that Elder Law attorneys are not “regular” lawyers

Elder Law attorneys have deliberately selected a career in a specialized area of law to serve elders.  Moreover,  the client of an Elder Law attorney is the elder.  Not the children.  An inheritance is nice – and usually a much larger inheritance is a by-product of the plan devised by an excellent Elder Law attorney – but the inheritance is not the focus of ethical planning.  The client’s quality and dignity of life should always remain priority #1

2 - Gather information in a zero pressure environment.
An easy way to spend time with your a parent, while at the same time, gathering information, is to look for a free seminar in your area.  Look in local publications for living trust" or "estate planning" seminars.  Alternatively, you may want to look for a Living Trust Plus™ licensed attorney in your area.  Don’t be afraid to research, communicate, and explain important statistics to your parents.

Did you know that if you are over age 65: you have a 7.2% chance of having an auto accident every year; a 6.15% chance of needing to file a homeowner’s insurance claim; and a 70% chance of needing long-term care?  Over half of those who need long-term care will require a nursing home.

3 - Explain matters using real, truthful data
13% of drivers are uninsured;
of homeowners are uninsured;
of senior citizens are uninsured and unprotected against long term care needs.

Why is it important to plan for long term care?  Primarily because the expenses of long term care are catastrophic and can wipe out a nest-egg in less than a year. 

50% of couples and 70% of singles are impoverished (broke) after one year of entering a nursing home!

Thursday, August 25, 2011

Those who are aware of Medicaid, but misinformed and confused

If you are confused or mistaken about the rules of gifting in the context of Medicaid qualification, you likely won't ever venture into the practice of Medicaid Asset Protection.  If you do practice Medicaid Asset Protection, but your potential clients are confused or mistaken about the rules of gifting in the context of Medicaid qualification, they likely won't ever show up at your door.

The most common gifting misconceptions I encounter in my daily practice are:

Those who are completely unaware of any gifting rules:

- Can’t I just give all of my assets away to my children?

- How can the government tell me what I can do with my own money?

Those who are vaguely aware of the tax rules and assume they apply to Medicaid:

- If I give any gifts to my children, won't they have to pay a lot of taxes?
- Isn’t it true I can only give away $13,000 per year?
- Isn't it illegal if I give away more than $13,000 per year?

Those who are aware of Medicaid, but misinformed and confused:

- If I've made any gifts in the past 5 years, doesn't that mean I can't qualify for Medicaid?
- Once my spouse qualifies for Medicaid, doesn't that mean I can’t ever make any more gifts?
- If I make any gifts to my family, doesn't that mean I won’t ever qualify for Medicaid?

Most potential clients, and many attorneys who don't practice regularly in the field of Medicaid Asset Protection, harbor some or all of these misconceptions.  Understanding the realities of gifting in the context of Medicaid Asset Protection is extremely important, because any one of these misconceptions can influence your decision as to whether to practice in this area, and can influence the decision of a potential client as to whether to hire you and engage in Medicaid Asset Protection.

Although it is true that some gifts will disqualify a person from receiving Medicaid for a specific period of time, there are extremely important exceptions and extremely complex Medicaid rules that apply.  The misunderstanding that gifting is capped at $13,000 per year is of course a complete fallacy.  As most attorneys understand, the annual gift tax exclusion only applies for tax purposes, and has nothing whatsoever to do with Medicaid.

Depending on the donee and the type of property, gifts of any amount may be just fine under your state’s Medicaid rules.  For example, the following types of gifts are generally not penalized at all:  gifting assets to a spouse; gifting assets to a disabled child or a trust for a disabled child; making regular gifts in certain small amounts; gifting a residence to a caregiver child; gifting a residence to a sibling on title; and numerous other exceptions.  There are also many asset protection strategies that involve making intentional gifts that are penalized, but doing so in a controlled fashion under the guidance and supervision of an knowledgeable Elder Law attorney.

There are complex Medicaid considerations underlying all of these gifting strategies, and understanding these considerations, along with all of the complex and myriad Medicaid rules and requirements, is a daunting task for any Elder Law attorney. 

Tuesday, August 23, 2011

5 Basic Reasons to Consider a Revocable Living Trust

 A revocable living trust can function as a Will, but it also offers other benefits that you should consider. If you pass away without a Will or Trust, the laws of your state will determine who receives your property, and in what amount. Moreover, your heirs will be required to wait a minimum of 1 year in Virginia. Not only can probate be time-consuming, it also can be very expensive. Proper estate planning can allow you to distribute your assets with peace of mind.

#1 - Avoid Expenses and Probate Tax: Probate is a court supervised proceeding that can be expensive and lengthy. How long? Anywhere from one to three years in most cases!

#2 - Enable Your Heirs to Receive Your Property More Quickly: Your loved ones can receive your assets much more quickly than if they are required to go through the probate process.

#3 - Ensure Your Trusted Family Members Oversee Your Estate Distribution, Not the Court: When you plan properly, you can select the persons responsible for overseeing the distribution of your estate. If you leave it up to the court system, there is no guarantee that what you expect to happen, will in fact take place.

#4 - Maintain Your Privacy: The distribution of your estate can be a highly personal matter. If you wish, you can maintain your privacy.

#5 - NO Annual Fee Required: Fees are only associated with amendments to the trust. Although there is no fee associated with maintaining a trust, our firm offers an optional Estate Plan Protection Program. We feel that such an option generates the most peace of mind for clients.

Photo Courtesy healingdream /

Monday, August 22, 2011

Estate Planning Attorneys Warn About Matching Beneficiaries to Those Named in Your Will or Trust

As an estate planning attorney in Virginia, I have unfortunately seen many circumstances where a person goes through the time and expense of having an estate plan done, only to fail to update their beneficiaries on their financial or retirement accounts before they pass away.

An example of this would be Mary naming her brother Bill as the beneficiary of her life insurance policy in her trust, but at the time of her death, she had a different beneficiary named on the policy itself.

Just as life changes, so do your relationships, which can affect who you want to receive your assets --especially if you do not have children. Changing the beneficiary on assets such as bank accounts or life insurance policies is not uncommon, but you must remember to make sure that your will or trust reflects that change also.

Keeping your estate planning documents and beneficiaries up-to-date and coordinated is a quick and painless way to prevent legal headaches from occurring after you are gone.
Having two different named beneficiaries on two different documents can result in a lengthy and costly process to fix it – especially if each named person believes that they should be the one to inherit the asset.

The best way to avoid problems like this is to have a lawyer who focuses on wills and trusts handle every aspect of your estate.

Image: worradmu /

Friday, August 19, 2011

6 tips that can help delay or prevent cataracts

The world's leading cause of blindness, cataracts occur when the lens of the eye becomes clouded. In most cases, lens fibers clump together due to age-related deterioration.

Cataracts, however, can develop in younger individuals due to eye injuries, eye diseases or inflammation.

Here are six tips that can help delay or prevent cataracts from causes other than aging.

1. Protect your eyes from trauma. An injury to the eye can cause cataracts to form. Wear safety glasses when the situation calls for them.

2. Protect your eyes from the side effects of medications, including prolonged use of steroids, tranquilizers, and psoriasis medications, which can cause cataracts when taken in large doses over a long period of time.

3. Don't smoke, say doctors at the Mayo Clinic.

4. People with diabetes should keep their blood sugar under control. Diabetics often get cataracts at an earlier age than other adults.

5. Protect your eyes from the ultraviolet rays of the sun. They accelerate the development of cataracts. Wear ultraviolet-protective sunglasses outside.

6. Antioxidant vitamins, such as vitamin C, vitamin E and beta carotene, have been shown to slow the development of cataracts. Get plenty of omega-3 fatty acids, which can help to shield your eyes from inflammation.

Dr. Eye Treatment
Dark Circles Cure

Thursday, August 18, 2011

Pain should never be considered a “normal” part of the aging process

Pain should never be considered a “normal” part of the aging process.  It is a symptom, and can be a sign of a serious problem and should never be left untreated or under-treatedIn both cases, the pain can lead to depression, fear, anxiety, and even suicide. This is especially true for senior citizens.

Over-medication of the elderly has been widely reported and is an issue that many seniors, caregivers, and family-members take seriously. 

On the other hand, under treatment of pain can lead to equally serious consequences, both for the patient and the caregiver alike.   According to a recent study, as many as 40% to 80% of elderly nursing home residents are inadequately treated for pain. Note that under-treating the pain of an elderly patient has been considered a form of elder abuse.
According to the American Geriatric Society - “pain has no objective biological markers.”  It is essential for caregivers and family members to recognize signs of pain.
Fortunately, there are legal mechanisms to achieve peace of mind for you or a loved one.   Services offered by Certified Elder Law Attorneys -to protect assets and provide peace of mind.  Protected assets do not have to be “spent down” in connection with entry into a nursing home.  Once Medicaid is paying for long-term care, the protected funds can be used to purchase items not covered by Medicaid, which can include the hiring of a “helper” or “sitter” to monitor an individual for signs of pain, medication administration, and more.  Other things not covered by Medicaid include hearing aids, glasses, and dental work.  

The goal of any Elder Law Attorney should be to keep his client’s interests at the forefront of all conversations related to asset protection.  If you or a loved one is experiencing pain – or if you believe a loved one is experiencing pain but you are not sure, your first step should be to contact a licensed Medical Practitioner immediately, and then call your local Elder Law Attorney.

An important safeguard some families may want to consider is an asset protection plan – by preserving assets in contemplation of Medicaid down the road, extra items and services can be obtained as needed – items and services which could otherwise be unaffordable and not paid for by Medicaid.

Wednesday, August 17, 2011

Quick and Easy Steps to Monitor Medications

Pills, pills, and more pills. Senior citizens take an average of 6 to 8 prescription medications, herbal supplements, and over-the-counter drugs per day. For some people, it can be an overwhelming responsibility to manage. To compound the problem, many elders avoid going back to their physicians to have their medication dosages monitored, evaluated, and changed when necessary, or when new medications are added by different physicians.                                                                                                     

With the prevalence of Alzheimer’s disease and other forms of dementia on the rise, it is imperative to ensure you or your elder family member does not suffer from unintended symptoms associated with over medication. Not only is over medication and drug interaction potentially fatal, they both can cause memory loss, confusion, and other symptoms which resemble forms of dementia. Since individuals with Alzheimer’s or other forms of dementia require special care, it is critical to know precisely the root cause of any medical symptoms or side-effects. Did you know that even seemingly harmless foods, such as grapefruit juice for example, can interact dangerously with some medications? 

1.  Make a list of all prescriptions, supplements, and over-the-counter drugs you or your elder parent takes. Then, provide this list to ALL physicians.

2. Make copies of the medication list. Give a copy to each physician, keep one for your records, and make sure your parent has a copy that is easily accessible. 

3. Use the same pharmacy. Pharmacies keep records of medicines prescribed by physicians. By always using the same pharmacy, records will be easier to access and hopefully consolidated

4. Use a daily pill dispenser or pill box  

5.  Check-up on your elder parent periodically to ensure that they understand which medicines to take at what times, and in what dosage. If you are an elder patient yourself, update your list as soon as a new medication is prescribed and record any side-effects or symptoms you experience.

If you have a parent who is beginning to suffer memory loss and/or mental confusion, be sure to have a physician review your parent’s medications.  If medication errors are not at fault and a dementia diagnosis is made, the proper legal planning should be done as soon as possible

Tuesday, August 16, 2011

5 Ways to Ease the Burden When Caring for Kids and Aging Parents

5 Ways to Ease the Burden When Caring for Kids and Aging Parents

Did you know we just completed National Sandwich Generation Month? You may have never heard of it before, but if you care for aging parents and young children, you are part of this rapidly growing demographic.  The burden of shouldering so much responsibility can be overwhelming.  

Common struggles include having to pay for mom or dad’s long-term care, shielding mom or dad’s assets from nursing home facilities and cleaning up a financial or legal mess in the absence of proper planning. If you are facing these same struggles right now, there are a number of planning steps you can take to ease the legal and financial pain. Here are 5 suggestions to ease the transition, both for you and your parents:

1. Don’t Wait.  Find out what type of estate planning documents your parents have in place (i.e. will, trust, power of attorney) while there is still time to update them. If their medical directives were created pre-HIPPA, they should be reviewed immediately by an attorney. 

2. Sit Down With Parents Every 2-3 Years to Review their Estate Plan. Make sure their wishes are the same and that they still approve of the people they chose to make important end-of-life decisions on their behalf.  Make sure your parents have an Advance Medical Directive so they may communicate desires to physicians and family members regarding all forms of medical treatment, including preferences as life support, organ donation, funeral arrangements, and disposition of remains.  There has been some concern among attorneys as to whether the public will understand the need to properly plan a will or trust in light of these large exemptions.  On the contrary, the new tax laws that are in-flux should, if anything, prompt families to seek an updated assessment of their existing will or trust documents. 

3. Consider a Trust.  Not a Will.  Consider placing all of mom or dad’s assets into the right kind of trust so they stay protected and out of the equation if your parents ever need to apply for Medicaid benefits or go into a nursing home.  A Certified Elder Law Attorney can help with this and save your family substantial sums of money.  Medicaid is not just for the “poor,” but is a government program meant to pay for the long-term care needs of Middle Class Americans, too.     

4. Locate Existing Documents Immediately.  If your parents expect you to fulfill a particular role or carry out an important task upon their death, the documents giving you these rights should be stored somewhere safe. Taking these steps will help ease the pressure of being “Sandwiched” between caring for young children and aging parents. They will also help to ensure that mom or dad’s assets stay protected and that you are in the best position to honor their wishes during the later stages of life. 

5. Consider Mediation.  Have the tough conversations with mom or dad about their wishes now while they are still active and in good health. Find out what type of long-term care they want (or don’t want) and be sure to document their wishes accordingly.

Sometimes the consequence of dealing with the final years of elderly parents can break families apart and create long-lasting animosity.  Suspicions or distrust often lead to anger and the anger often leads to severing the channels of communication between family members. This can occur between parent and child or between siblings or between all of them.

Mediation allows parents to focus on their abilities rather than their limitations; allows children to come up with and consider options not thought of previously; encourages uninvolved family members to become involved; and allows parents to express wishes and desires that had previously gone unuttered.

Members of the Sandwich Generation have a lot on their plate (no pun intended).  But with proper planning you can give your family and your parents the peace of mind they deserve.  

Unfortunately, true asset protection can only be achieved through complex strategies.  A living trust isn't enough, and a will most definitely isn't either.  A Living Trust Plus™, however, just might be the answer for many Americans.  You see, it's capable of *not just* probate avoidance, but also protection from the biggest creditors most Americans face during their lifetimes - nursing homes. Here is the page if you are interested in asking your attorney if he or she is a part of this network. 

Monday, August 15, 2011

National Assisted Living Week

Americans are living longer than ever before.  Ultimately, many of us will require nursing home care or assisted living. How many? Studies indicate that one in two women and one in four men will live in a nursing home at some point in their lives.

The National Center for Assisted Living (NCAL), a division of the American Health Care Association (AHCA), helps Americans celebrate our aging citizens each year with an official National Assisted Living Week. In 2011, the celebration runs from September 11th through the 17th. During this time, assisted living facilities and nursing homes across the country will bring together nursing home residents, staff, families and community members for events, promotions and games honoring seniors.

This year’s theme is Forever Proud. It was chosen, in part, to remember the tragic events of 9/11/01ten years ago and how our country pulled together in a spirit of unity and pride afterwards. On another level, the theme was chosen to address pride in other areas as well: pride in a lifetime of work well done; pride in skills mastered and goals accomplished; pride in the achievements of family and friends.

As estate planning attorneys, we applaud the efforts of the NCAL and hope that you will take part in this year’s celebration. We also hope that National Assisted Living Week serves as a reminder to you about the importance of long-term planning. If your current plan does not incorporate legal tools and strategies to protect your assets against the high cost of nursing home or assisted living care, now would be a good time to contact an estate planning firm in your city or town. 

Tuesday, August 9, 2011

Social Support Activities Lead to Better Quality of Life As One Ages

How important is social support as a person ages? This may seem like an easy question to answer. Most people would not choose isolation and loneliness versus spending time with companions. However, can lack of social support really hinder a person’s overall quality of life?

Lack of social support is related to negative impacts on health and well being, especially for older people. Having a variety of positive social supports can contribute to psychological and physical wellness of elderly individuals. Support from others can be important in reducing stress, increasing physical health and defeating psychological problems such as depression and anxiety.

When considering who provides social support for an elderly individual our first thoughts are of family members. While it is true that most support does come from family members, there are many circumstances in which family members cannot be supportive (stress due to responsibilities, illness, death, financial problems, job relocation). In the United States the fastest growing age group of individuals are those 85 years and older. Due to this fact, family supports will inevitable decrease for these older individuals. A need for community-based services is more important now then ever before.

Community-based services can be extremely useful for elderly individuals. Services for older persons can encompass many areas, but one of the most important areas as discussed previously is social support. Support for elderly persons can be found in many places including: senior centers, assisted living facilities, meal delivery, religious affiliations, adult day care centers, etc. These services can provide positive social supports that can help older persons defeat loneliness and isolation. However, social support must encompass more then physical presence or conversation. Studies have shown that social support services should contain quality activities. These activities should promote positive self-awareness.

Self-awareness is key to a person’s overall quality of life and satisfaction. Many leisure social activities can be used to help increase an individual’s self-awareness. Activities for elderly individuals may include reminiscence groups, journal writing, readings of favorite book passages, group exercise, singing groups, etc. Individuals may also feel more self-satisfied if they are part of the planning of social activities that take place.
Two of these community-based service centers that provide quality social support services for elderly individuals are discussed below.

Senior Citizen Centers

Today, there are estimated to be about 15,000 senior centers across the United States. Senior centers act as a focal point for older Americans to receive many aging services. The most common services offered at a senior center include health programs (including Zumba and Yoga), arts/humanities activities, intergenerational programs, employment assistance, community action opportunities, transportation services, volunteer opportunities, education opportunities, financial assistance, senior rights counseling/legal services, travel programs and meal programs. These programs and activities can help promote positive self-awareness.

Lori Beckle describes how participating in her local senior citizens center has given her the independence and life satisfaction she thought was lost when her husband died in 2009. “ I was devastated and so frightened for my future without Ed. He was my only friend and the one I turned to when I felt alone. My daughter invited me to attend our local senior center where a bereavement group was being held for those who had lost a loved one. I met Phyllis during the group and now I have a new friend I call when I become afraid. Phyllis has helped me develop the skills to get through the tough times and focus on my immediate happiness.”

Adult Day Care Centers

According to the National Adult Day Services Association (NADSA), there are currently more than 4,600 adult day care centers nationwide. Adult day care is a program in which activities are provided to promote social support and health services to an older adult during the daytime. Most centers operate Monday through Friday during daytime hours. Social support services at an adult day care can consist of musical entertainment and singing groups, group games such as cards, gentle exercise, discussion groups (books, films, current events), holiday/birthday celebrations and local outings. Not only are these social activities provided, but participants of the program can also develop lasting relationships with staff and other participants. Adult day care centers also provide meals and health services. Adult day care centers differ from other programs for elderly individuals, because they allow the participants to develop and increase self-awareness by encouraging independence.

Amanda describes her experience as a volunteer at her local adult day care center. She stated, “ I was involved in planning the activities for Thursday afternoons. I wasn’t sure what kind of activities my older friends would enjoy so I had them share their favorite activities they participated in when they were my age (23). I soon realized that I was hearing the most fascinating stories of hopping trains, college dances, swimming in the lake, etc We decided Thursday afternoons would be spotlights of each individuals’ lives as a twenty-something. One of the participants told me that Thursdays became a highlight for her week.”

Adult Day Care Centers and Senior Citizen Centers help to provide an elderly individual the opportunity to participate in social support activities. Social support activities found in these programs can be beneficial to a person’s quality of life and overall satisfaction. With a higher self-awareness and quality of life an individual can reduce the risks of mental and physical health problems as they age.