Friday, March 04, 2011 Advance Elder Law Conference
I am currntly attending an advanced elder law and Medicaid planning conference in Tempe, Arizona. The conference is hosted by ElderCounsel of which I am a charter member. Some of the best and brightest attorneys througout the country are here and we are discussing the most advanced techniques to help our clients protect and preserve their hard earned assets agains the devastating costs of long term care. For most of my elderly couples, if one of them needs nursing home care, the $5,000 to $6,000 monthly cost could greatly affect the finances of the spouse that is still able to stay at home. Creative and legal steps can be taken, even in a crisis situation, to help protect those assets for the benefit of the well spouse. Too often I see couples making outright gifts of assets to their children. These gifts will not only cause a penalty period for Medicaid but will subject the gifted assets to the claims of children's creditors and could subject the assets to loss if the child later goes through a divorce. There are special trusts that can be used to protect assets against long-term care costs and also protect against loss from a child's creditors or divorcing spouse.
We are also covering a little known VA benefit referred to as "aid and attendance" that is available for war time veterans and their widows. This VA benefit can help these elderly individuals cover their long-term care costs, whether in-home care, assisted living, or nursing home care. These benefits are not automatic however. But, there are planning techniques that can be implemented to help qualify a person for this valuable benefit. Friday, October 08, 2010 Ethical Considerations in Dementia
I am currently attending the Advanced Elder Law Institute in Indianapolis. This is a two-day continuing education seminar with a variety of speakers on various elder law related topics. Currently, Dr. Patrick Healey, a physician at the St. Vincent Center for Health and Aging, is presenting on ethical considerations for patients with dementia. He stated that in these cases there are often no "black & white" answers. Dementia is not the disease, but rather the symptom. There are a number of diseases where memory loss and confusion may be the symptom. However, 60% of people with dementia have Alzheimer's disease, according to Dr. Healy.
Dr. Healy also stated that 60% to 80% of nursing home patients have some form of dementia and over five-million people over the age of 65 have some form of dementia. He believes early diagnosis is very important which can allow the patient to get some treatment that may help him or her, there can be help put in place to protect the safety of the patient and others, and appropriate legal planning can be put in place before the person's mental capacity is severely affected. He relies a lot on what family members and loved ones notice about the patient and often times the first indication of problems exhibit themselves as a change in behavior. He encourages those loved ones to provide, in writing, a list of their concerns and the changes in behavior that they have noticed.
Dr. Healy also offered tips on dealing with persons with dementia and issues surrounding caregivers. Caregivers need to recognize the need for help and he has seen all too often when caregivers may work themselves into the ground by trying to provide all the care without any respite relief or other help. Obviously this is not good for the caregiver nor their loved one.
The bottom line is that if you suspect a family member or loved one may have some form of dementia you should put your concerns in writing to your loved one's doctor and try to get an assessment performed. Early diagnosis is key to helping your loved one. Of course, the apropriate legal planning should be done as well to avoid court guardianship matters and putting in place advanced medical directives as well as other planning steps that may be appropriate.
Thursday, October 07, 2010 Attendance at Elder Law Institute
I am currently attending a two-day Elder Law Institute in Indianapolis, Indiana. The speakers are covering a wide variety of elder law issues and laws. One of the speakers was Rich Adams. Mr. Adams works at the Indiana Family and Social Services Administration and was able to discuss how the FSSA is working to improve the Medicaid application process. His presentation helped us better understand how the state of Indiana handles Medicaid applications and the inner workings of the FSSA.
Another presenter was a doctor who discussed end of life decisions and the role of the patient's doctor. His presentation was insightful and added credence to the idea of how limited living wills are in practice. Many of the terms used in the Indiana living will statute are undefined and difficult in practice for the medical profession to handle. The main take away from his presentation was that there needs to be a conversation between the client and the medical decision maker.
More to come later. |