Remodel or Relocate?

When Steve and Joanna bought their family home thirty-five years ago, their plan was to live there all through their retirement years. Joanna recently broke her hip. Now with her return from the hospital in a wheelchair, Steve is facing the overwhelming task of making their home accessible for her wheelchair and safe for both of them.

Remodeling for wheelchair access and reorganizing furniture and belongings is a huge task that many senior home owners face. Sometimes the need to do so is brought on by injury or age-related illness. Home and yard maintenance is difficult for even the healthiest of seniors, requiring them to decide whether to stay or make a downsizing decision.

If you, like Steve and Joanna, are trying to decide whether or not to stay in your home, what can you do to make it work in this type of situation?

• Think about hiring a Professional Organizer. Relocating furniture, and removing hazards such as electrical cords and throw rugs are some of the ways they make a home more senior friendly. Professional Organizers can help find or create a convenient, easy-to-reach place for everything. Professional Organizers can also help you part with clutter or items that have no use; this makes rooms less crowded and therefore less of a trip hazard. You can find a directory of Certified Professional Organizers (CPO) by visiting the website http://www.certifiedprofessionalorganizers.org.
• Find an Aging in Place Specialist to make your home accessible. These building specialists offer help with tasks such as adding wheelchair ramps, widening doorways, making bathrooms more accessible with hand rails, walk-in bath facilities, and easier access to toilets. You can find a directory of Certified Aging in Place Specialist (CAPS) by visiting the website of the certifying organization – the National Association of Home Builders, at http://www.nahb.org.

Sometimes remodeling isn’t enough and a move is required.  A Senior Move Manager can assess and identify items to keep, arrange for auction or other disposal, clean the home, move the belongings, and set up the new residence. The Senior Move Manager may also work closely with a real estate agent to arrange for the sale of the home and may also be involved in the financial transactions necessary to move into a new living arrangement.  You can find a directory of http://www.nasmm.org/ by visiting the website of NASMM – the National Association of Senior Move Managers.

All the help available to seniors may in itself be overwhelming. How do seniors choose the right service provider for their needs? If you live in Northern Virginia, be sure to check out the Trusted Referrals listed on The Fairfax Elder Law Firm of Evan H. Farr, P.C. website. 

Now that the house is accessible or the family has downsized to a smaller residence, what would happen if nursing home care is needed? Nursing homes in Northern Virginia cost $12,000 - $15,000 per month. Life Care Planning and Medicaid Asset Protection is the process of protecting you from having to go broke to pay for nursing home care, while also helping ensure that you get the best possible care and maintain the highest possible quality of life, whether at home, in an assisted living facility, or in a nursing home. Learn more at The Fairfax Elder Law Firm of Evan H. Farr, P.C. website. Call 703-691-1888 to make an appointment for a no-cost consultation.

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Nursing Homes May Face Readmission Penalties Similar to Hospitals

According to the Medicare Payment Advisory Commission, nearly 14% of individuals on Medicare that are discharged from a hospital to a skilled nursing setting are readmitted to the hospital for conditions that could potentially have been avoided. In an effort to promote quality care and reduce expenses, the Affordable Care Act (ACA) mandated payment reductions for hospitals with high rates of readmissions. Now it appears that nursing homes may also be held accountable for hospital readmissions. 
 

The U.S. Department of Health and Human Services (HHS) 2014 budget proposal includes a package of Medicare legislative proposals that could save $371 billion over ten years. The HHS 2014 budget proposal recommends reducing payments by up to 3% for skilled nursing facilities that are determined to have high rates of preventable hospital readmissions. The proposed penalties would take effect in 2017, with an estimated $2.2 billion in savings over 10 years.

Find out more here Department of Health and Human Services 2014 budget proposal.

Do you have a loved one who is in a nursing home or nearing the need for nursing home care? Or are you simply looking to plan ahead in the event nursing home care is needed in the future? Nursing homes in Northern Virginia cost $12,000 - $15,000 per month. Life Care Planning and Medicaid Asset Protection is the process of is the process of protecting you from having to go broke to pay for nursing home care, while also helping ensure that you get the best possible care and maintain the highest possible quality of life, whether at home, in an assisted living facility, or in a nursing home, whether at home, in an assisted living facility, or in a nursing home. Learn more at The Fairfax Elder Law Firm of Evan H. Farr, P.C. website. Call 703-691-1888 to make an appointment for a no-cost consultation. 

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The U.S. could be spending $511 billion on dementia by 2040

Dementia costs in the United States account for a whopping $109 billion for direct care. This does not include the costs of caring for a person with dementia, usually provided by family members, which would add an additional $50 - $106 billion to that number. Why is dementia care so expensive?

A recent study found that nearly 15% of people age 71 and older (3.8 million people in the U.S.) suffer from dementia, which includes Alzheimer's and other mental disorders. By 2040, the number will jump to 9.1 million people at a cost of $511 billion, according to a recent Bloomberg BusinessWeek article.

Without a way to prevent, cure, or effectively treat dementia, the costs for helping patients in nursing homes or at home manage the most basic activities of life as they become increasingly impaired is only going to get worse as the baby boomer generation ages.

 “We need more research into interventions to delay or halt the onset of dementia,” said Michael Hurd, an author of the study and director of Rand Corp.’s Center of the Study of Aging, in an interview. According to Rand, “right now we don’t really have anything at all.”  The hope is that research initiatives and funding, including the $100 million President Obama committed to, will help researchers make some progress on a cure before the baby boomer generation overwhelms the system.

Evan H. Farr is a Certified Elder Law Attorney with a focus on the financial and legal issues surrounding Alzheimer’s and dementia. At the Fairfax Elder Law Firm of Evan H. Farr, our Alzheimer’s and Dementia Planning Team provides life-long guidance, management, and oversight on vital issues such as medical and nursing care, housing options, financial management, estate planning, asset protection, Medicaid eligibility, and more.  Call us at 703-691-1888 to make an appointment for a complimentary consultation.

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Listen to Evan H. Farr, CELA being interviewed on 1500 AM (Federal News Radio) on Sunday, April 28!

 On Sunday, April 28 at 10:30 p.m, Evan H. Farr, CELA will be the guest on "Of Consuming Interest" hosted by Shirley Rooker, radio host and President of Call For Action, Inc. On her show, Ms. Rooker typically interviews top government officials, CEOs, and experts in their respective fields about topics that are of interest to consumers.

 

Mr. Farr, one of the leading Elder Law Attorneys in Virginia and foremost experts in the Country in the field of Medicaid Asset Protection and related Trusts will talk all about using the Living Trust Plus(TM) so adult children can avoid becoming responsible for the nursing home care of their parents.

Hear Mr. Farr's interview this Sunday at 10:30 p.m. Tune your radio to WFED (1500 AM) or listen online.

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When Your Pet Can Visit

Ruth London, 74, was in the hospital with severe pneumonia. She was delirious and hallucinated that she was in jail. With the permission of a doctor on the unit, her husband brought the family Maltese, Delilah, to see if the pet could calm his wife down.

The hospital staff didn’t let Mr. London in at first, but eventually did after a call to the doctor. In the hospital room, the dog ran to Mrs. London’s side and nuzzled her hand. From that point on, she seemed to take a turn for the better.

It was a one-time deal at this particular hospital, and the “no pets” policy is in force at most hospitals across the country. But a few medical institutions have taken a different approach and opened their doors to patients’ own dogs and cats, letting them visit along with spouses, children and friends. For example, The University of Maryland Medical Center, Virginia Commonwealth University Hospital and several other hospitals now let family pets visit their owners, as long as certain requirements are met. A hospital in Long Island even allows pets to stay with patients around the clock.

Policies vary at the institutions that allow visits by patients’ pets, but many share some of the same requirements:

·         A doctor’s order allowing the family pet to visit;

·         An attestation from a veterinarian that the animal is healthy and up to date on all its shots;

·         Grooming within a day or so of a visit;

·         Dogs must be on a leash when they walk through hospital corridors and cats must be taken in and out of the institution in a carrier.

In the hospitals that allow pets, if an animal seems agitated or distressed when it comes into the hospital, staff members who meet the family and escort them to the patient’s room have the right to turn it away. If the patient shares a room with someone, that person must agree before a pet may visit. If someone has an open wound or an active infection, a visit from pets is discouraged.

Research on the value of personal pets visiting patients has found a relaxation response and reduction in blood pressure and levels of cortisol, a stress-related hormone, according to Dr. Sandra Barker, director of the center and a professor of psychiatry at the University of Maryland.

What will happen to your pets if something happens to you? Unlike a Will, which has to wind through the probate process, a Pet Trust can be created along with your living trust and should be designed to take effect immediately upon your death so that your beloved companion does not have to linger in a shelter while the courts cut through paperwork. To get started, you should meet with a Certified Elder Law Attorney, such as Evan H. Farr, CELA.  After finding out more information, you can decide if a pet trust makes sense for you and your family. Then, you can work with TheFairfax Elder Law Firm of Evan H. Farr, P.C. to include all of your pet’s needs and your wishes for your pet, and name a caretaker and a trustee for when the inevitable happens. Read our recent blogpost about Pet Trusts.

If you haven’t done so already, please call 703-691-1888 to make an appointment for a no-cost consultation to plan for yourself and your loved ones, including your precious pet(s).

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Evan H. Farr, CELA, is awarded The Martindale-Hubbell® Client Distinction Award

Fairfax, Va. – April 18, 2013 – Certified Elder Law Attorney Evan H. Farr has been awarded the Martindale-Hubbell® Client Distinction Award.  Selection for the award is based on Client Review Ratings in the categories of communications ability, responsiveness, quality of service, and value for money.  The results of reviews from Mr. Farr’s clients were compiled and he earned a Client Review Rating Score of 4.8 on a scale of 1-5. Mr. Farr has also earned a 4.8/5.0 peer rating, or an AV®Preeminent rating, the highest an attorney can achieve.  View Mr. Farr’s Martindale-Hubbell® profile.  Clients of Mr. Farr can submit a review on his profile page.


Martindale-Hubbell® has been facilitating Peer Review Ratings™ for more than 130 years. A few years ago they introduced Client Review Ratings. Client Review is a service featuring client feedback that complements their Peer Review Ratings program. Together these ratings programs provide prospective clients with a 360-degree view of an attorney’s professional credentials. Martindale-Hubbell® reviews show that clients have confidence in an attorney’s work, validate an attorney’s credibility as a lawyer and highlight their skill set in their area of practice.

Read the complete press release on The Fairfax Elder Law Firm of Evan H. Farr, P.C. website. Call 703-691-1888 to make an appointment for a no-cost consultation.

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Long Term Care Costs Rising as Demand Increases

As demand for long-term care services is increasing, the cost of home health aides, adult day care, and nursing homes is also rising, according to results of a recent Genworth survey. These increasing expenses aren't likely to slow as Americans live longer and have more health problems later in life, experts say.

An estimated seven in 10 Americans are expected to need long-term care after the age of 65, and this number is expected to more than double, from about 12 million in 2012 to 27 million in 2050.

According to Genworth “There are many factors that go into rising care costs, from the number of available skilled professionals to real estate prices.”

In Virginia, the median annual cost of an assisted living facility is $45,300, an increase of 5 percent annually over the past five years (costs are typically higher in Northern Virginia). The national average is $41,400 and has increased about 4 percent annually over the past five years.

The median cost of a private nursing home room has risen 4.7 percent annually over the past five years in Virginia to $83,950 ($120-144K a year in Northern Virginia).

The report includes an online map showing the cost of various services by state, and a summary of the median costs for the various types of care.

Are you currently paying for home health care, assisted living, or nursing home care or do you have a loved one who is nearing the need for nursing home care? Are you simply looking to plan ahead in the event nursing home care is needed in the future? As you can see from the survey results above, nursing homes in Northern Virginia cost $10-$12K per month, and costs are rising. Life Care Planning and Medicaid Asset Protection is the process of protecting assets from having to be spent down in connection with entry into a nursing home, while also helping ensure that you or your loved one get the best possible care and maintain the highest possible quality of life, whether at home, in an assisted living facility, or in a nursing home. Learn more at The Fairfax Elder Law Firm of Evan H. Farr, P.C. website. Call 703-691-1888 to make an appointment for a no-cost consultation. 

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Obama Proposes Estate Tax Change

In January of this year, as part of the Fiscal Cliff deal, President Obama and Republican lawmakers on Capitol Hill agreed to tax estates at 40% with an exemption of $5.25 million ($10.5 million for couples). This was an increase from 35% and a $5.25 million exemption. 
 

President Obama’s new budget proposal aims to turn things back around. It would raise the estate tax rate to 45 percent from 40 percent in 2018. And it would lower the per-person estate tax exemption from $5.25 million to $3.5 million. The White House says that only three people out of every 1,000 would be affected by the change and that the tax increase would raise an extra $79 billion over a decade.

According to a recent Wall Street Journal article, the $3.5 million exemption in Obama’s budget isn’t indexed for inflation.  The WSJ says Republicans are unlikely to go along with the idea.

You can’t take it with you when you go, as the saying says, but at least for the time being, you can leave it to your heirs. Since the future is so unpredictable and laws are frequently changing, it’s never too early to get started with your planning today. Call 703-691-1888 to make an appointment for a no-cost consultation at The Fairfax Elder Law Firm of Evan H. Farr, P.C. today!

For the White House budget proposal, click here.

Read the Wall Street Journal Article.

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New Affordable Care Act Rule Increases Transparency In Health Care

The Centers for Medicare & Medicaid Services (CMS) announced recently that it will increase public awareness of financial relationships between drug and device manufacturers and certain health care providers. This rule, referred to as the “National Physician Payment Transparency Program: Open Payments,” is one of many steps in the Affordable Care Act (ACA) designed to create greater transparency in the health care market.

Under this new rule, doctors are required to report to CMS when they have a financial relationship with the companies that manufacture or supply the medicines or medical devices. Disclosure of these relationships allows patients to have more informed discussions with their doctors.

Manufacturers are also required to disclose to CMS physician ownership or investment interests. This increased transparency is intended to help reduce the potential for conflicts of interest that physicians or teaching hospitals could face as a result of their relationships with manufacturers. CMS will release all data on a public website by September 30, 2014.

We here at The Fairfax Elder Law Firm of Evan H. Farr agree that there should be transparency in healthcare, similar to the transparency of information that is readily available for nursing home care. Nursing homes are currently rated annually by Medicare, and the quality of care ratings for more than 17,000 nursing homes is available publically on the web on Medicare.gov’s Nursing Home Compare website.  

Do you or a loved one need nursing home care in the near future or are you looking to plan ahead? Call 703-691-1888 to make an appointment for a no-cost consultation. We can meet with you, access your situation and determine strategies for your long-term care plan.

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