Providing asset protection, support and guidance to families, I realize that the cost of care is not usually understood. Our typical client is not aware that planning for care is similar to planning for a child's education; there is a need to plan ahead or you may not end up where you want to be or end up paying too much. The need for planning is becoming more important as our nation's demographics are evolving to a situation that has never been seen before. The nation's population of senior citizens is about to rise to historic levels. By year's end,…
A disaster may vary by size and intensity, tornado, hurricane, or earthquake. However, the direct effect to a senior (due to evacuations, loss of care and home) is detrimental on their quality of life. Evacuations effect and disrupt their daily activities. Assisted living, long-term care facilities and caregivers have clients who may be immobile, require medical equipment, medications and nursing care. There is jtress does not magnify the issues already being dealt with by both patient and caregiver. The Joint Commission on Accreditation of Healthcare Organizations identified evacuations and multiple transfers as a major problem for seniors i.e. wildfires in…
Making effective decisions about the care of a loved one often takes more time than expected and requires an understanding of the long-term-care system. But a proactive approach can yield better options when the time comes and can head off a family emergency: Talk early and often. Understand your parents’ preferences as they age. Don’t make assumptions about what type of care they may or may not accept. Instead, respect their autonomy. Rather than starting off with an admonition (for example, “You have to …”), lead with an empathic statement such as, “I am worried about you because … if…
As some of you may know, the guidelines surrounding eligibility for Medicare or Medicaid can be fairly rigid. They exist to ensure people aren’t gaming the program, but sometimes even who aren’t gaming the program (and have legitimate need) can unintentionally run afoul of the rules. For another example of what not to do, the case of Jackson v. Director of Office of Medicaid (Mass. App. Ct., No. 10P706, July 19, 2011). When Raymond Duclos was entering a nursing home, his wife was making transfers to their children: $176,000 to their daughter, Susan; $11,787.83 to their son, Raymond, Jr.; and…
Being responsible for an elderly loved one can mean adopting a rather rigid schedule and lifestyle, especially if you are the primary caregiver. How, then, do you travel? It can be a logistical nightmare, whether the travel is elective or necessary. Regardless, understanding some of the challenges and workarounds in advance can make the travel more manageable. The New Old Age blog at The New York Times recently offered some food for thought on this important subject. The big question is whether your elderly parent is traveling with you. If the travel involves you alone for business or pleasure, then…
Growing numbers of families are compensating relatives who serve as caregivers. According to a report by the National Alliance for Caregiving and AARP, 43.5 million Americans looked after a friend or relative age 50 or older in 2009, 28% more than in 2004. In a survey conducted for Home Instead Senior Care, a home-care franchiser, nearly 7% of respondents said they receive compensation for providing care to a relative. Feeding this trend is the high unemployment rate, the costs of nursing-home care, and the 2006 changes in Medicaid law that affects asset protection strategies. Some 37% of caregivers surveyed by…
If you have an elderly loved one living in a nursing home, especially if they suffer from dementia, you may want to double-check their prescription medications. A recent government audit on Medicare spending shows some rather alarming practices in regard to the use of powerful atypical antipsychotic drugs. As The New York Times reports, nearly 1 in 7 nursing home patients, nearly all of them with dementia, are given powerful antipsychotic drugs even though the drugs are not approved for such use and are known to increase the risk of death, especially in patients with dementia. Ostensibly, the purpose of…
Choosing the right nursing home for a loved one is never an easy task. It can be both emotionally draining and logistically daunting. Still, this legwork is vital, especially in light of recent research reported in The New England Journal of Medicine (NEJM) and here in the New York Times Blogs – about the ineffectiveness of nursing home litigation and legal standards. As the NY Times points out, “We tend to think of a lawsuit as a kind of slingshot allowing the little guy to take on a daunting Goliath – a large nursing home chain, say. If you can’t…
A five-year look-back period retroactively for all gifts or other transfers made for less than fair market value (FMV). Grandfather made gifts of $200 to each of his five grandchildren on each of their birthdays and on one of their religious holidays in 2006, 2007, 2008, 2009 and 2010. He is unaware of the Medicaid laws. Grandfather requires nursing home care. Under the Medicaid rules, Grandfather is penalized for all gifts made within a five year period. Therefore, Grandfather is penalized for approximately one and a half months, during which time Medicaid will not pay for his care in the…
Frederick, MD 
301-663-9230
