Special Needs Trusts: How Much Money Should You Include?

Jonathan is 20 years old, has autism, and is currently receiving government benefits. He is still living at home with his parents, receiving SSI equal to $628 per month, as well as a monthly stipend of $30.

His parents want to make sure he is provided for should something happen to them and are considering a Special Needs Trust. They are not sure how much to include to ensure their son can maintain his quality of life, while still remaining eligible for needs-based programs that will cover basic health and living expenses.

What are some considerations in planning for how much to provide for his needs above and beyond what the state is providing? The following questions can help them make their decision:

• Will he live at home, with another family member or caregiver, or in a community facility where his SSI would go to the facility for living expenses?
• Are there medical expenses that are not typically covered by his benefits that are necessary? (e.g. allergy medication or assistive devices that are not covered by insurance)
• What social activities are important to your child that you would want to ensure continues? ( e.g. going to movies or baseball games with siblings)
• Are there things such as a computer, tablet, DVDs, video games, etc. that improve his quality of life?

The easiest way is to keep track of everything you spend on your special needs child above and beyond his benefits is to keep a record over the course of the month to see how much is spent. After you have that amount, go back and add in periodic expenses that might come up quarterly or annually.

Once you decide on the amount, how can you ensure that your wishes on how the funds in the Special Needs Trust should be used are made known? You can include an optional letter of intent attached to the trust that allows you to express your wishes, along with special notes about the beneficiary's preferences.

More than $13 billion a year is spent to care for individuals with Autism Spectrum Disorder and other special needs.  For the average affected family, this translates to $30K per year. Fortunately, there are many ways to plan for the long-term care of a disabled child. If you have a special needs child who will likely need care for life, it’s important to provide legal protections for your child. The Fairfax Special Needs Law Firm of Evan H. Farr, P.C. can guide you through this process. Be sure to check out our dedicated Special Needs Website at http://VirginiaSpecialNeeds.com. If you have a loved one with special needs, call 703-691-1888 to make an appointment for a no-cost consultation.

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What Happens to Credit Card Debt When You Die?

No one wants to face a situation where they have to deal with losing someone they care about. It’s only made worse if debt is involved. What happens to debt after you die depends on who has signed for it, as well as the laws in your individual state.

• If you have a joint account with your deceased loved one, which you have co-signed for, then you become responsible for that debt. Keep in mind that “authorized users” who aren’t joint account holders are not responsible for the debt.
• If you aren’t on the account, you don’t inherit the debt. Instead, the debt should be paid off with assets from the estate. In cases where there are unpaid debts when your loved one dies, the Successor Trustee of your trust or the Executor of your Will should use the assets to pay off debts. Secured debts (mortgage, car) are paid first, and unsecured debts, such as credit cards, are tackled next.   
• If there is not enough money to pay all the debts, some creditors might have to take a loss – every state has laws specifying which types of creditors have priority over others.

It’s always a good idea to talk to an estate attorney and get an expert opinion regarding your specific situation. Did you know that more than 120 million Americans do not have estate plans to protect themselves or their families from the unexpected?  For peace of mind, the time to address or update your estate plan is now. If you live in Virginia, DC, or Maryland, please call the DC Metro Estate Planning Law Firm of Evan H. Farr, P.C. today at 703-691-1888 to set up a no-cost consultation.

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Can We Help The Self-Neglecting Senior?

Guest Blog Post by Jennifer FitzPatrick, MSW, LCSW-C

Attorneys, because of the doctrine of attorney-client privilege, are generally forbidden from reporting any private or confidential information about a client, including reporting suspected self-neglect to Adult Protective Services. However, many other senior-serving professionals are classified as “mandated reporters,” meaning they are required to report suspected abuse, exploitation or neglect (including self-neglect). If, in the course of his or her professional duties, a mandated reporter is made aware of neglect or abuse, he or she is required to report these concerns to APS.  According to the National Adult Protective Services Association, some of the most common mandated reporters include:

 • Social Service Agencies
 • Law Enforcement Personnel
 • Emergency Response Service Providers
 • Healthcare, Medical or Dental Service Providers
 • Mental Health Providers
 • Financial Services Providers
 • Clergy

When these professionals who are mandated reporters make a referral to their local Adult Protective Services (APS), often they are frustrated with the results.  They may see a problem such as a client hoarding, a patient neglecting a serious health condition, or an 86-year old man financially supporting a malingering 62-year old daughter instead of paying his own bills. When these professionals report these matters as they are required to, the assumption is that APS will go in and resolve the situation.  These professionals tend to see APS as the police for older adults not following societal rules.  Of course the client should stop supporting his drug addicted daughter and pay his electric bill thinks the financial services provider.  Certainly the patient should take his insulin and lose some weight thinks the healthcare provider.  The wealthy patient living in squalor should clean up and live “normally” thinks the Emergency Response Service Provider.

There is no doubt that self-neglect in older adults is a serious issue; in fact, several studies suggest that it is highly associated with increased mortality. The larger problem that some professionals grapple with is that older patients who refuse to follow their recommendations usually have every right to refuse to do so.  In most jurisdictions, APS can only investigate if an older adult is categorized as vulnerable.  According to the Administration on Aging’s National Center on Elder Abuse, “a vulnerable adult is defined as a person who is being mistreated or is in danger of mistreatment and who, due to age and/or disability, is unable to protect himself or herself.” 
Professionals often have to balance their belief about what’s best for the older adult clinically, financially, or legally while also respecting the older adult’s right to make his or her own decisions, even if those decisions demonstrate egregiously poor judgment.  Referring to APS may be appropriate at times, but we need to keep our expectations in check.  APS has a mandate to investigate self-neglect, but APS does not possess a magic wand.  Sometimes APS won’t investigate because the referral does not fall under its mandate.  Other times APS will investigate but be legally unable to take much more action than the professional who initially referred because the older adult is competent to make his or her own decisions.

So how do mandated reporters ultimately help the self-neglecting older adult?

1.    Show respect for the older adult and his decisions, no matter how much you disagree with them.  During the aging process, so much can feel out of a person’s control.  An older adult can be more open to hearing what a professional says when there’s acknowledgement that the older adult is still an adult.  Many tend to infantilize older adults, but when they are treated with dignity there is a better chance for your message to be heard.

2.    Encourage and persuade.  Give the older adult examples of when others in similar situations did not change and what the consequences were.  For example, if an older woman does not use her prescribed walker and is hoarding, she is at additional risk for falls.  The professional might consider sharing a story of when a patient in similar circumstances did this and it led to a broken hip and a long term stay in a nursing home.  These types of stories can sometimes motivate clients to at least consider changing or accepting more help.

3.    Keep referring to APS.  Although APS are not the “fixers” many mandated reporters hope them to be, APS does typically keep good records of referrals.  Even if APS may be unable to investigate today, or even though the investigation may not lead to immediate improvement, a referral begins a file. Perhaps APS cannot investigate today because the client doesn’t meet the required criteria. But what if three more people refer that client to APS in the next six months?  This may give APS the information it needs to open an investigation and help improve the client’s situation.

When APS workers are unable to investigate a case because it does not meet their criteria, they often are able to give helpful suggestions and ideas on other ways the professional could help the client.  The APS worker may recommend a service or strategy the referring professional had not considered.
Self-neglect in older adults is one of the most challenging and common situations that many senior-serving professionals encounter; we must remember that older adults are still adults who are allowed to make poor decisions.  There are very few circumstances in which it is legal or ethical for a professional to force an older client to change.  Dedicated senior-serving professionals must sometimes simply accept that only a serious crisis will lead to a real change.  Professionals should treat the self-neglecting senior with empathy and respect, and remain open to helping the client when he or she is ready to accept the help.
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About the author:

Jennifer FitzPatrick, MSW, LCSW-C is a speaker, author and consultant on aging & caregiving.  For more information, please see www.jenerationshealth.com.


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Suggesting a Memory Screening to a Resistant Loved One

What happens when you notice changes in your loved one’s cognitive abilities and you want to suggest a memory screening, but are met with resistance? 

When a loved one’s faltering memory causes problems finding words, a detachment from people, irritability, confusion, forgotten appointments or difficulty with everyday affairs such as grocery shopping, cooking or paying bills, then it’s time to broach the subject of a memory screening. 

When you suggest to a loved one that they should have their memory evaluated, the loved one may respond with fear, denial or sometimes even hostility. In some cases, the loved one may fear that the screening will reveal memory problems and lead to a loss of independence. It’s a very difficult issue for older people and it’s important to choose the right way to talk about it.

The most effective way to suggest a screening is by involving a medical or mental health professional. The recommendation process can occur, as follows:

• The family meets with the loved one along with their primary care doctor, neurologist or psychologist.
• The medical professional makes the recommendation.
• Since the statement comes from an objective expert—and not a family member—the loved one is more likely to accept it.
• The entire family can listen to the recommendations together and ask their loved one to have a memory screening.

Do you have a loved one who is suffering from dementia? Persons with dementia and their families face special legal and financial needs. At The Fairfax Elder Law Firm of Evan H. Farr, P.C., we are dedicated to easing the financial and emotional burden on those suffering from dementia and their loved ones.  If you have a loved one who is suffering from dementia, we can help you prepare for your future financial and long-term care needs.  We help protect the family’s hard-earned assets while maintaining your loved one’s comfort, dignity, and quality of life by ensuring eligibility for critical government benefits. Call 703-691-1888 to make an appointment for a free consultation.

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Facebook Gives Seniors a Cognitive Boost, Study Finds

Research findings suggest that men and women older than 65 who learn to use Facebook could see a boost in cognitive function. Currently, one in three online seniors use a social networking site like Facebook, according to the Pew Internet & American Life Project.

In a preliminary study of older adults aged 68 to 91, researchers out of the University of Arizona noticed a 25 percent improvement in tasks related to working memory among new Facebook users.

Participants were divided into three groups. In the first, 14 seniors were trained to use the social media platform and were asked to post at least once day. Participants were instructed to befriend people within the group. A second group of 14 adults was instructed to use an online diary site, in which entries were kept private with no ability to share. Participants were instructed to post entries of no more than three to five sentences -- to mimic the length of status updates on Facebook -- a minimum of once daily. And the third group, which acted as a control group,were told they were on a non-existent "waiting list."

Prior to learning any new technologies, study participants, who ranged in age from 68 to 91, completed a series of questionnaires and neuropsychological tests measuring social variables, such as their levels of loneliness and social support, as well as their cognitive abilities. The assessments were done again at the end of the study, eight weeks later.

By the end of the experiment, those who learned how to use Facebook showed a 25 percent improvement in mental "updating" skills -- the ability to quickly add or delete contents of their working memory -- researchers noted. Participants in the other groups saw no significant change in performance.

"There's also a large body of literature showing that people who are more socially engaged are less lonely, have more social support and are more socially integrated are also doing better cognitively in older age," points out lead author Janelle Wohltmann.

Wohltmann says she also sees Facebook as a potential alternative to some online games marketed to seniors to help boost mental acuity. “This might be a new activity for people to learn that’s more interesting and keeps them socially engaged,” she said, adding that it can also help older adults stay connected with grandchildren and other family and friends.

Meanwhile, another study published last year in the journal Cyberpsychology, Behavior, and Social Networking found that visiting social networking sites like Facebook provided positive emotional experiences, as measured by breathing rates, brain activation and pupil dilation.

We here at the Fairfax Elder Law Firm of Evan H. Farr, P.C. are pleased to see the social and cognitive advantages of social networking sites, such as Facebook. Now that you are posting pictures of your cruise, playing Candy Crush Saga with your grandchildren, and making plans to reconnect with old friends on Facebook, it is time to plan for your future and for your loved ones. Evan H. Farr is a Certified Elder Law Attorney with a focus on helping protect seniors and their families by preserving dignity, quality of life, and financial security. Call the Fairfax Elder Care Law Firm of Evan H. Farr, CELA at 703-691-1888 to make an appointment for a complimentary consultation. 

P.S. Like us on Facebook and receive a 10% discount on your next set of new legal services we provide. 

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Long-Term Care Insurance is not for everyone--CNBC Nightly Business Report Three-Part Series

With Americans living longer and baby boomers hitting retirement age, the demand for long-term care is expected to surge. Long-term care (LTC) insurance is one way to pay for long-term care. But according to a recent three-part series aired on CNBC’s Nightly Business Report, LTC insurance is not ideal for everyone.

Watch the CNBC videos:

View Part 1        View Part 2        View Part 3

Is LTC right for you? According to the Nightly Business Report “If you have less than $200,000 - $250,000 in total assets, the chances are very good that the premiums you would lay out for long-term care insurance would be cost prohibitive relative to the risk that you’re actually shielding your assets from, because you don’t have enough assets. On the other end of the spectrum, people with over $2 million in assets may want to consider self-insurance as part of their long-term care plan. Those in the middle should consider some form of long-term care plan, but it may or may not include insurance.”

If you are considering LTC insurance, first look at each policy very closely because each one is written differently. Also, look closely at the insurer’s claims payment history and whether they have been increasing premiums for existing policy holders.

Keep in mind how LTC insurance has failed some consumers:

• About half of all LTC policies lapsed before any benefits were paid; policy holders were unable or unwilling to continue paying their premiums.
• Of those people who bought insurance and later entered a nursing facility, about half never collected a dollar from their LTC policies.
• No benefits were ever paid to the many people who bought nursing facility coverage but instead received home care or entered a residential facility not covered by the insurance.
• When LTC benefits were paid, they were usually far below the actual cost of care.For many of the longest-term residents, benefits were used up before the nursing facility stay ended.

In all of these situations, LTC insurance failed to live up to its promise to help people avoid using up their savings or relying on Medicaid to pay for long-term care.

There is a 71 percent chance for people over the age of 65, that at some point in their lives, they will need long-term care services. That alone says that you have to have a contingency plan in place. With long-term care costs rising faster than inflation, insurers have been raising premiums sharply. As mentioned previously, if you have done your research and decide LTC insurance is right for you and your family, you should incorporate it as part of your long-term care plan, not as the only form of planning for long-term care.  There are dozens of long-term care asset protection strategies other than long-term care insurance. For example, the Living Trust Plus™ Medicaid Asset Protection Trust is just one of many long-term care asset protection strategies.

If you have not done Long-Term Care Planning, Estate Planning or Incapacity Planning (or had your Planning documents reviewed in the past several years), or if you have a loved one who is nearing the need for long-term care or already receiving long-term care, call The Fairfax Medicaid Asset Protection Law Firm of Evan H. Farr, P.C. at 703-691-1888 to make an appointment for a no-cost consultation.

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Is Assisted Living Safe for Your Parents?

Eric’s mother Joan died after being moved out of an assisted living facility, where she sustained life-threatening wounds. Cheryl’s husband, George — who suffered from dementia — died after he was left unsupervised and drank industrial strength dishwashing fluid.  These true stories and others are exposed on Life and Death in Assisted Living, a documentary where FRONTLINE correspondent and ProPublica reporter A.C. Thompson goes behind the closed doors of assisted living facilities.

As America’s senior population grows faster and lives longer, more families are turning to assisted living facilities to help their loved ones age in comfort and safety.  Assisted living is also a multi-billion dollar, loosely-regulated industry. The FRONTLINE documentary begs the question: who can we trust to care for our aging parents? Should assisted living facilities — home to 750,000 American seniors — be subject to more oversight?

Assisted living underwent a big growth spurt in the 1990s as major corporations built and bought facilities. The documentary focuses on one of the largest American assisted living chains, Emeritus, a company that made nearly $1.6 billion in revenue last year. In making the documentary, ProPublica and PBS FRONTLINE sifted through thousands of pages of regulatory records from seven states — Texas, California, Iowa, Mississippi, Georgia, Ohio and Florida.  Since 2007, inspectors in each state have cited Emeritus for housing seniors who should have been moved out. According to the documentary, although they feature attractive grounds and amenities, the care that some assisted living facilities provide tends to be mediocre at best.

What were some of the issues found?

•  Many of these communities don’t hire or retain enough adequately trained staff to support their residents multiple health problems and high rates of cognitive loss;
• Unlike federally regulated nursing homes, assisted living facilities are governed by state laws and some provide decent oversight, while others remain quite lax;
• Pressure to keep apartments filled, labor costs low, and shareholders happy increases the likelihood of someone who is too old and frail remaining in an assisted living facility, and a tragedy occurring.

Assisted living remains a reasonable option for people who can’t manage their own households any longer, who need help with personal care, but who aren’t so ill that they require 24/7 nursing.  If you are looking into assisted living facilities for a loved one, be sure to pay attention to state regulations, as assisted living facilities are not federally-regulated like nursing homes. Ask questions, such as how often a nurse is on the premises, the extent of staff training, and what happens should a health problem arise. For more details about the documentary, please read the NY Times Post, A Dark View of Assisted Living.

If you have a loved one who is nearing the need for long-term care or already receiving long-term care, please call The Fairfax Medicaid Asset Protection Law Firm of Evan H. Farr, P.C. at 703-691-1888 to make an appointment for a no-cost consultation. 

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