TALK WITH PARENTS AND FAMILY MEMBERS ABOUT ESTATE PLANNING

It is very important to discuss estate planning with parents and other members of the family while they are all mentally healthy, if families wait to make arrangements until after one parent is incapacitated in some way, it limits their choices. Talking with parents and other family members about your financial and estate plans could be the catalyst for the others in the family to start thinking about and discussing their own estate plans. Remember that the discussion may reveal estate plans that you may not like but it is each person’s prerogative to make their own individual plan. Estate plans do not always result in people being treated equally, it's very important—to avoid conflict later—that family members know and understand what plans are in place.

Here are a few tips to help you, your parents, and other members in your family start talking:

Focus on life, not death. While the topics of estate planning and death are intertwined, it doesn't mean that death has to be the focus of the discussion, rather focus the discussion on planning to live well, instead of planning to die well.

Encourage your parents and other family members to discuss their wishes. It is important that your family discuss what they want to have done and who they want to do it. Ask your family what it is they would like you and/or others in the family to do in the event of an emergency.

Ask them what documents are needed to assist them properly and where are they located. If your family members are unable to communicate, it is important to know where their important papers are kept and who they wish to assist in managing their affairs, for example the name, address and phone number of their Accountant; Lawyer; Primary Care Physician; Clergy; and Funeral Director. Ask your family who they want to make their health care and/or financial decisions, if they are unable to articulate or make them for themselves. To ensure that each family member’s individual goals are met, all members of the family should be absolutely clear about their wishes and that they want.

The need for protection for the entire family should be emphasized. A formal estate plan helps to protect the entire family from creditors and possible predators.

Encourage parents and all family members to seek expert legal and financial advice. By YOU doing so, you are setting an example while at the same time sending a message that you trust everyone else to handle their own affairs, this will more than likely help them breathe easier by knowing you don't want to control the situation. Offer to help them with their search for a qualified attorney.

Be patient and understanding. Be realistic, the initial conversation with parents and other members of the family about estate planning will not be easy and it will not be, nor should it be, the last one. It may take several discussions before even a little bit of headway is made, and even after estate plans are in place, it does not mean that these plans will always remain relevant in the future, it is an ongoing dialogue and process.

Average Monthly Cost of Nursing Home Care Goes Up

Average Monthly Cost of Nursing Home Care Goes Up
 

Effective:  April 1, 2013

MassHealth increased its penalty divisor from $279.00 transferred to $300.00.  The daily divisor is how MassHealth determines the average daily cost of nursing home care in the Commonwealth of Massachusetts and this figure is then used in determining how long a nursing home resident will be denied benefits for having made a transfer of assets.    

For instance, someone who made a gift of $30,000 will now be ineligible for MassHealth nursing home benefits for 100 days under the new divisor as opposed to 108 days under the old divisor.  The penalty period does not begin until the person making the gift has moved into a nursing home and has spent down their countable assets to less than $2,000.00. 

VACANT LOT YIELDS HIDDEN TREASURE FOR MEDICAID OFFICIALS IN MASSACHISETTS

Cash-strapped states are leaving no stone unturned when it comes to recovering from the estates of deceased Medicaid long-term care recipients. Still, few would think to search in vacant lots, but that’s where $178,496.00 was found that a Massachusetts judge recently ruled belongs to the Commonwealth as reimbursement for Medicaid payments to a nursing home resident who died a decade ago.

The cash was in a safe that had been dumped in a lot located in the city of Lawrence, which is near the Massachusetts' border with New Hampshire. The safe had once belonged to Sally Daher, a local shoe store owner who spent her last five years in a nursing home.

The safe ended up in the lot because a shoe repairman who rented Ms. Daher’s old store wanted to get rid of it, believing it was a target for burglars. Apparently assuming Ms. Daher had emptied the safe of its contents, the repairman paid a tow truck driver $200.00 to haul it away. When the driver couldn’t sell the safe for scrap, he dumped it in a lot next to his home.

There it lay until Lawrence firefighters noticed it in November 2008. After an hour of work with a metal cutting torch, a jack hammer and an air hammer, the firefighters managed to pry the safe open. Inside they found $178,496.00 in cash packed in plastic shopping bags from Ms. Daher’s old store. The newest bill was from 1982.

At that point, several people laid claim to the cash, including Ms. Daher’s relatives and the tow truck driver. But when Massachusetts Medicaid officials learned that the safe was linked to Ms. Daher, they filed a claim to recover Medicaid funds they had spent on her while she was in the nursing home.

A superior court judge ruled that the cash found in the safe belonged to Ms. Daher and that it was part of her “probate estate.” This means, the judge said, that the safe’s contents are now the property of the Massachusetts Division of Medical Assistance as repayment for medical bills Ms. Daher incurred.

Ken Daher, one of Ms. Daher's surviving children, told the Eagle-Tribune, a local newspaper, that the family would not contest the judge’s ruling.

"I am ecstatic. This is the best Christmas present I could get," said Mr. Daher. "My mother wouldn't have wanted money owed or a handout in a million years . . . My mother did not live like that."

December 26, 2011
Judge: State gets $178K found in safe
By Jill Harmacinski of the Eagle-Tribune

The GIFT of Time for a Caregiver is Appreciated

Caregiving and when to know you need outside help is difficult to determine and caregivers have a hard time admitting they need that help. Caregivers often don’t recognize when they are in over their heads, and they normally get to a breaking point. After a prolonged period of time, caregiving can become too difficult to endure any longer. Short-term the caregiver may be able to handle it. Long-term, help is needed. Outside help at this point is considered necessary.

The common scenario with an overloaded caregiver frequently is as follows:

• 1 to 18 months - the caregiver is confident, has everything under control and is coping well. Other friends and family are lending support.
• 20 to 36 months - the caregiver may be taking medication to sleep and control mood swings. Outside help dwindles away and, except for trips to the store or doctor, the caregiver has severed most social contacts. The caregiver begins to feel alone and helpless.
• 38 to 50 months - Besides needing tranquilizers or antidepressants, the caregiver's physical health is beginning to deteriorate. Lack of focus and sheer fatigue cloud judgment and the caregiver is often unable to make rational decisions or ask for help.

At this stage family or friends intercede and find other solutions for care. This may include respite care, hiring home health aides or putting the disabled loved one in a facility. Without intervention, the "caregiver" may become a candidate for long-term care as well as the disabled family member.


It is important to note that hiring a professional caregiver can provide valuable ongoing support to an overloaded family caregiver. A professional care manager can guide the family and the caregiver through the maze of long-term care issues. The care manager has been there many times -- the family is experiencing it for the first time.

An elder law attorney can help iron out legal problems.

There are also cash benefits for Veterans, who served during a period of war, and their spouses, that pay for home care or assisted living.

If you are the one providing daily care for a loved one, your ailing family member would want you to seek help. Take care of yourself and your needs, both physically and mentally. Seek out professional help that will ease your burden and look for community service organizations that offer respite help.

Good Reasons to Update or make a New Last Will and Testament

Our lives continually change over time and so do your estate-planning needs.
Update your Last Will and Testament to reflect family births, deaths, separations, or divorces. Review guardian, trustee, and personal-representative designations. Examine the types of specific gifts to people or groups you have made or wish to make; and recalculate how much life insurance you need, if any.

Even if you have created your Will and an estate plan, it is always a good idea to revisit them as your life circumstances change. Some momentous events in your life will require revisions to these documents and plans such as when:

You Get Married
Your new spouse does not always become your primary heir automatically. For instance, if you don't have children, your parents or siblings would inherit your estate. If you wish to leave all your property to your spouse, a new Will is required. Keep in mind that you cannot disinherit a spouse without his or her consent.

Additionally, if you are living with someone but are not married and you want your significant other to inherit any of your property, you need a Will.

You Become a Parent
How will your children be cared for both financially and physically if both you and your spouse pass away. A Will is required to name a guardian for your children at your death.

You could also consider using testamentary trusts, a trust in your Will, to handle assets that would go to your children.

The execution of a durable power of attorney naming your spouse, or someone else to act for you in financial matters when you cannot, serves to operate during your lifetime but ceases to be useful at your death.

You Approach Middle Age
As you Age, your assets are growing, therefore some tax planning is an excellent way to save your heirs thousands in federal estate taxes. The time to make these tax plans is when you and your spouse have a combined net worth, including house, retirement plans, and insurance proceeds, that comes close to the amount subject to the federal estate tax. You can give an unlimited amount to your spouse tax-free, by designating it in your Will, or by owning all assets jointly, but with a little more planning, a married couple can leave twice the amount of the estate-tax exemption--up to $7 million after the second spouse dies, assuming that Congress reinstates the estate tax that lapsed at the end of 2009 and continues the $3.5 million exemption in effect at that time.

You Get Divorced
Once you are divorced you should review absolutely everything in your estate plan. The people in your life will change and that is why you must change your estate plan. You need a new Will altogether because in most states a divorce automatically revokes the provisions of a Will that apply to a former spouse. In some states a divorce may revoke the entire Will.

You may want to set up trusts to control the assets you plan to leave your children without your former spouse’s involvement and access and you will want to revise any existing Trusts created prior to the divorce, to remove your former spouse as a beneficiary or trustee.

Additionally you should change your durable power of attorney or a Living Will and, unless restricted by a divorce decree, make sure you change the beneficiaries on your life insurance, pensions, and IRA.

You Remarry
You and your new spouse may need to plan for your blended families from prior marriages and you may need a plan for additional children you have together. A prenuptial agreement may be an excellent part of your estate plan, should you want to keep assets separate and nullify your inheritance rights to each other's estates or you may want to provide for your new spouse yet still be certain your children are taken care of adequately.

You Retire or Move to Another State
If you retire and/or move to another state, you should always have your estate-planning documents reviewed taking into account that new state's laws and your current financial and medical needs.

Durable powers of attorney become even more important during your retirement years. For example, if you are stricken with a stroke or Alzheimer's disease, you may become unable to give the required consent for financial transactions, so you want to be sure that you designate an agent to make these important transactions for you if you cannot do it yourself.

Life insurance coverage may not be needed anymore. But if your estate faces an estate-tax liability or if your spouse is dependent on retirement income that will end with your death, consider keeping some coverage. Also, consider taking out a long-term-care insurance policy to help with medical costs.

Your Spouse Dies
This loss can leave you emotionally vulnerable to financial mistakes. Take your time in making any changes. For at least six months, avoid selling your house or making other drastic changes to your lifestyle.

If your spouse's estate is subject to the federal estate tax seek expert tax advice; there may be tax benefits to disclaiming some of your inheritance in favor of alternate beneficiaries, such as your children. You'll need to make a new Will and possibly a Trust.

It is a good idea to review and execute a new durable power of attorney and a Living Will (which expresses your wishes in case of an illness that leaves you permanently incapacitated) every five years so the date of signing is not stale and they continually reflect your current wishes and life’s circumstances.

Put all of your estate planning documents in a safe place, and tell people who need to know where they can be found when needed

CELEBRATING FAMILY CAREGIVERS

CELEBRATING FAMILY CAREGIVERS

Debbie turned the ringing alarm off. It was 6:00AM and time to get herself ready for the day. Her son would be there soon to help her shower and dress her husband Jim. Her son came every day before work to help because Debbie, at 75 years old and suffering with arthritis, could not lift Jim out of bed or help him to the shower. This has been the daily routine since Jim’s stroke a year ago. When her son leaves for work, Debbie spends the day caring for Jim’s needs.

President Barack Obama, in his Presidential Proclamation of National Family Caregivers Month -2011 states:

“Across our country, millions of family members, neighbors, and friends provide care and support for their loved ones during times of need. With profound compassion and selflessness, these caregivers sustain American men, women, and children at their most vulnerable moments, and through their devoted acts, they exemplify the best of the American spirit.”

Statistics from the Administration On Aging show that the population 65 and older is expected to grow from its current 13% to 19% of the total population by 2030. With the older population increasing, the need for elder caregiving will continue to increase. Family caregivers play a vital role in filling these caregiving needs. Who better than family can understand the needs and ensure the best care of their loved ones.

Caregiving can be very stressful and demanding. In the case of a healthy spouse or a child living with the disabled person at home, caregiving can be a 24 hour, 7 day a week commitment. But even for the caregiver not living in the home, looking after a loved one or friend can consume all of the caregiver's free time.

Surveys and studies consistently show that depression is a major problem with full-time informal caregivers. This is typically brought on by stress and fatigue as well as social isolation from family and friends. If allowed to go on too long, the caregiver can sometimes break down and may end up needing long term care as well.

A typical pattern may unfold as follows:

1 to 18 months--the caregiver is confident, has everything under control and is coping well. Other friends and family are lending support.

20 to 36 months--the caregiver is taking medication to sleep and control mood swings. Outside help dwindles away and except for trips to the store or doctor, the caregiver has severed most social contacts. The caregiver feels alone and helpless.

38 to 50 months--Besides needing tranquilizers or antidepressants, the caregiver's physical health is beginning to deteriorate. Lack of focus and sheer fatigue cloud judgment and the caregiver is often unable to make rational decisions or ask for help. It is often at this stage that family or friends intercede and find other solutions for care. This may include respite care, hiring home health aides or putting the disabled care recipient in a facility. Without intervention, the family caregiver may become a candidate for long term care as well.

Since most family members go into informal caregiving without training or counseling, they often aren't aware of the possible outcome described above. It is therefore extremely important to seek counseling and to formulate a plan of action prior to making a caregiving commitment.

According to the National Care Planning Council:

" In 1965, Congress passed the Older Americans Act which provides guidance and funding to the States to give help to caregivers. All states offer programs at no cost or very low cost which might include: counseling, caregiver training, respite care, adult day care, meals, support groups and much, much more. It is vital for the health and longevity of all caregivers to make use of these services."

In 1994 President Clinton proclaimed a week in November as National Family Caregivers week to be observed with appropriate programs and activities. It has since been changed to the whole month of November with each President giving a yearly proclamation for its observance.

Government assistance is available all over the country. Area Agencies on Aging and local senior centers give aid and support to family caregivers. Numerous religious and community organizations also lend their support.

This month of November 2011, as individuals, we can take note of those around us, in our families and community, who are family caregivers. A note of acknowledgement of their service, a gift of thanks or even an offering of our time to give them a needed break would let them know their service is recognized and appreciated.

Be Wary of Generic Health Care Proxy Forms

Hospitals often give patients a health care proxy form to sign on being admitted. While it might seem easy to sign a generic health care proxy form, having a document that is specifically tailored to your needs is very important.

A health care proxy allows you to appoint someone else to act as your agent for medical decisions. In general, a health care proxy takes effect only when you require medical treatment and a physician determines that you are unable to communicate your own wishes concerning what that treatment should be. Appointing someone to serve as your agent helps to ensure that your medical treatment instructions will be carried out exactly as you wish them to be.

While a health care proxy serves to appoint an agent to speak for you, you can also use it to give the agent guidance about your medical wishes. The following are some issues that can be addressed in a health care proxy:

* The name of the person authorized to act for you. It is important to appoint an alternate as well.
* If you are terminally ill, in a coma, or have brain damage with no hope of recovery, you can explain the kind of treatment you do NOT want. For example, do you want feeding tubes, resuscitation, dialysis, or blood transfusions?
* Whether or not you want to be kept alive by machines if you are in a persistent vegetative state.
* Under what circumstances would you want pain medication to be administered.
* Whether or not you want to donate your organs.
* Whether you want to be cremated or buried . . . where and how your remains should be disposed of.
* HIPAA designation so your physician can speak to your Agent(s).
* Guardianship and Conservatorship nominations to eliminate time in Probate Court.

Whatever choices you make, it is important that you take time to consider your health care wishes before putting your signature on a health care proxy. For this reason, signing a generic hospital form is not a good idea, because such a form may not take your individual wishes into account. Additionally, and very importantly, if you already have a health care proxy as a part of your estate plan, the generic form will revoke your more personal health care proxy that you gives you more protections.

A qualified attorney can help you create a document that addresses your situation.

ELDER LAW; WOMEN'S ISSUES; and THE UPC

ELDER LAW; WOMEN'S ISSUES; AND THE UPC

UMass School of Law - Dartmouth333 Faunce Corner Rd North Dartmouth, MA 02747

June 3, 2011
8:30 am - 5:00 pm

UMass School of Law - Dartmouth (fka SNESL) Alumni Association and the Massachusetts Chapter of NAELA have brought together experienced practitioners to share their knowledge and expertise. The morning sessions will include an overview and Introduction to Elder Law, MassHealth, and Women's Issues in Retirement. The afternoon sessions will include discussions on the UPC, "Where We Have Been" and "Where We Are Going."

Both sessions will include ample time for questions and answers. The schedule for the morning and afternoon sessions can be found at www.umassd.edu/pce/law/registration.pdf

Click here for registration information and payment method.

Online payment is preferred, however you may also Mail or Phone in your registration form and payment to:
UMass Dartmouth
Attn: Christine Carreiro
139 South Main Street
Fall River, MA 02721

If you pay by check but would like to register before the event go to umassd.edu/pce/law. Check is required within 7 days after registration otherwise registration is void.

Questions about the program:
Attorney Patricia Bloom-McDonald
Phone: 781-713-4709 E-mail: McBloomLaw@McBloomLaw.com

Questions about registration:
Christine Carreiro
Phone: 508.910.9062 E-mail:ccarreiro@umassd.edu

Sincerely,

Attorney Patricia Bloom-McDonald
Co-sponsored by the Massachusetts Chapter of the National Academy of Elder Law Attorneys and the UMass School of Law - Dartmouth.

Emotional Attachments and Other Reasons Seniors May Accumulate Clutter

Home Instead CAREGiverSM Betty Collins remembers the half a dozen strips of yarn she found on her client's rug. When she bent down to pick up and discard the yarn, her client stopped her with a resounding "no, no, no." "She told me that her daughter, who has since died, played with the yarn when she was little," Collins said. "She had to see that every day." Seniors hang on to their possessions for a variety of reasons from sentimental attachment to health issues that stand in the way of home upkeep and even safety. "In addition, older adults are often set in their ways and everything to them becomes important," Collins said. "Junk to us is their life. That builds up and some seniors just don't know what to do with it. A lot of older adults walk with a walker and live by themselves. They just set things aside and then become overwhelmed."

Getting rid of possessions is actually a two-step process: sorting and deciding, on the one hand, and disposing on the other. But convincing seniors can be a challenge that requires a measured approach. Katherine "Kit" Anderson, CPO-CD, president of the National Study Group on Chronic Disorganization (NSGCD), and Vickie Dellaquila, certified professional organizer, offer these strategies for helping seniors let go.
Arrange and cheer small victories.
Conduct an "experiment."
Gently approach the idea of health and safety.
Draft an agreement. Consider the control issue.

How to Spot "Clutter Creep"

If you notice the following characteristics about seniors or their homes, clutter could start creeping up on them.

Piles of mail and unpaid bills;

Difficulty walking safely through a home;

Frustration trying to organize;

Difficulty managing activities of daily living;

• Expired food in the refrigerator;
• Jammed closets and drawers;
• Compulsive shopping;
• Difficulty deciding whether to discard items;
• health episode such as a stroke or dementia;
• Loneliness.

The Empty Office

The sign on the glass door reads “Elder Law Attorney.” You peer through that door but the office is empty–where is the elder law attorney?

She is probably in the community making a house call – yes, elder law attorneys still make house calls. A paralegal and the elder law attorney first witnessed a dying man sign legal documents and immediately afterwards heard his daughter call the hospital asking for an ambulance to take him there. She explained that he wanted pain killing medication but no treatment to lengthen his life.

This is all part of a normal day in the life of an elder law attorney. Elder law attorneys are often found in the halls of nursing homes because their clients can’t come to them–it goes with the territory. At other times, the office may be empty because the elder law attorney is visiting a client in an intensive care unit. In this case an elderly individual is unconscious and no clear written advance directives have been given about their health care. The lawyer then becomes a combination social worker, spiritual advisor and counselor to work with the doctors, the hospital administration and family members who may disagree on the proper treatment for the patient in an attempt to work out a solution that sustains the dignity of the elderly individual.

You will also find the elder law attorney in his/her office. People may be creating a living trust to avoid probate and to implement a plan for the management of assets or families whose loved one is about to go into a nursing home may be seeking advice regarding the best way to give the elderly person the most comfortable and satisfying lifestyle possible taking into account physical, mental and economic factors.

The attorney may be in the office counseling with the family whose parent desperately needs institutional care but is unwilling to go there voluntarily and doesn’t understand how serious the situation is. The elder law attorney may advise the family to file a guardianship in court to lovingly seek court approval for their aging parent to get the kind of help that they so need.

The next time that we peer through that office door, the elder law attorney may not be there because he/she will be in Court actively pursuing the guardianship for the betterment of the elderly individual.

Elder law attorneys generally consider their practice to be a sacred trust for the betterment of clients–they genuinely try to treat each client as if he or she were a family member.

The month of May has been declared “National Elder Law Month” by the Tucson, Arizona-based National Academy of Elder Law Attorneys. For more information on elder law or National Elder Law Month, contact the Attorney Patricia Bloom-McDonald at 781-713-4709 or 508-636-6097 or email her at: McBloomLaw@McBloomLaw.com.

PET Trusts

1. What is a “pet trust”?

A pet trust is legal technique you may use to be sure your pet receives proper care after you die or in the event of your disability.

2. How does a pet trust work?

You (the “settlor”) give your pet and enough money or other property to a trusted person or bank (the “trustee”) who is under a duty to make arrangements for the proper care of your pet according to your instructions. The trustee will deliver the pet to your designated caregiver (the “beneficiary”) and then use the property you transferred to the trust to pay for your pet’s expenses.

3. What are the main types of pet trusts?

There are two main types of pet trusts.

The first type, called a “traditional pet trust,” is effective in all states. You tell the trustee to help the person who is providing care to your pet after you die (the beneficiary) by paying for the pet’s expenses according to your directions as long as the beneficiary takes proper care of your pet.

The second type of pet trust, called a “statutory pet trust,” is authorized in almost 40 states. A statutory pet trust is a basic plan and does not require the pet owner to make as many decisions regarding the terms of the trust. The state law “fills in the gaps” and thus a simple provision in a will such as, “I leave $1,000 in trust for the care of my dog, Rover” may be effective.

4. Which type of pet trust is “better”?

Many pet owners will prefer the traditional pet trust because it provides the pet owner with the ability to have tremendous control over the pet’s care. For example, you may specify who manages the property (the trustee), the pet’s caregiver (the beneficiary), what type of expenses relating to the pet the trustee will pay, the type of care the animal will receive, what happens if the beneficiary can no longer care for the animal, and the disposition of the pet after the pet dies.

5. What if my state does not have a special law authorizing pet trusts?

You may still create a traditional pet trust even if your state does not have a pet trust statute.

6. When is a pet trust created?

You may create a pet trust either (1) while you are still alive (an “inter vivos” or “living” trust) or (2) when you die by including the trust provisions in your will (a “testamentary” trust).

7. Which is better – an inter vivos or testamentary pet trust?

Both options have their advantages and disadvantages.

An inter vivos trust takes effect immediately and thus will be functioning when you die or become disabled. This avoids delay between your death and the property being available for the pet’s care. However, an inter vivos trust often has additional start-up costs and administration fees.

A testamentary trust is the less expensive option because the trust does not take effect until you die and your will is declared valid by a court (“probating the will”). However, there may not be funds available to care for the pet during the gap between when you die and your will is probated. In addition, a testamentary trust does not protect your pet if you become disabled and unable to care for your pet.

8. What does it mean to “fund” your pet trust?

Funding means to transfer money or other property into your trust for the care of your pet. Without funding, the trustee will not be able to provide your pet with care if you become disabled and after you die.

9. How much property do I need to fund my pet trust?

You need to consider many factors in deciding how much money or other property to transfer to your pet trust. These factors include the type of animal, the animal’s life expectancy (especially important in case of long-lived animals), the standard of living you wish to provide for the animal, the need for potentially expensive medical treatment, and whether the trustee is to be paid for his or her services. Adequate funds should also be included to provide the animal with proper care, be it an animal-sitter or a professional boarding business, when the caregiver is on vacation, out-of-town on business, receiving care in a hospital, or is otherwise temporarily unable personally to provide for the animal.

The size of your estate must also be considered. If your estate is relatively large, you could transfer sufficient property so the trustee could make payments primarily from the income and use the principal only for emergencies. On the other hand, if your estate is small, you may wish to transfer a lesser amount and anticipate that the trustee will supplement trust income with principal invasions as necessary.

You should avoid transferring an unreasonably large amount of money or other property to your pet trust because such a gift is likely to encourage your heirs and beneficiaries to contest the trust. If the amount of property left to the trust is unreasonably large, the court may reduce the amount to what it considers to be a reasonable amount.

10. When do I fund my pet trust?

If you create an inter vivos pet trust, that is, a trust which takes effect while you are alive, you need to fund the trust at the time it is created. You may also add additional funds to the trust at a later time or use the techniques discussed below.

If you create a testamentary pet trust, that is, the trust is contained in your will and does not take effect until you die, then you need to fund the trust by a provision in your will or by using one of the techniques discussed below.

11. How do I fund my pet trust?

Direct transfers: If you create your trust while you are alive, you need to transfer money or other property to the trustee. You need to be certain to document the transfer and follow the appropriate steps based on the type of property. For example, if you are transferring money, write a check which shows the payee as, “[name of trustee], trustee of the [name of pet trust], in trust” and then indicate on the memo line that the money is for “contribution to [name of pet trust].” If you are transferring land, your attorney should prepare a deed naming the grantee with language such as “[name of trustee], in trust, under the terms of the [name of pet trust].”

If you create the trust in your will, you should include a provision in the property distribution section of your will which transfers both your pet and the assets to care for your pet to the trust. For example, “I leave [description of pet] and [amount of money and/or description of property] to the trustee, in trust, under the terms of the [name of pet trust] created under Article [number] of this will.”

Pour over will provision: If you create your pet trust while you are alive, you may add property (a “pour over”) from your estate to the trust.

Life insurance: You may fund both inter vivos and testamentary pet trusts by naming the trustee of the trust, in trust, as the beneficiary of a life insurance policy. This policy may be one you take out just to fund your pet trust or you may have a certain portion of an existing policy payable to your pet trust. This technique is particularly useful if you do not have or anticipate having sufficient property to transfer for your pet’s care. Life insurance “creates” property when you die which you may then use to fund your pet trust. Be sure to consult with your lawyer or life insurance agent about the correct way of naming the trustee of your pet trust as a beneficiary.

Pay on death accounts, annuities, retirement plans, and other contracts: You may have money in the bank, an annuity, a retirement plan, or other contractual arrangement which permits you to name a person to receive the property after you die. You may use these assets to fund both inter vivos and testamentary trusts by naming the trustee of your pet trust as the recipient of a designated portion or amount of these assets. Be sure to consult with your lawyer, banker, or broker about the correct way of naming the trustee of your pet trust as the recipient of these funds.

12. How do I decide on the individual to name as my pet’s caregiver?

The selection of the caregiver for your pet is extremely important. Here are some of the key considerations:
· Willingness to assume the responsibilities associated with caring for your pet.
· Ability to provide a stable home for your pet.
· Harmonious relationship between the caregiver’s family members and your pet.

13. Should I name alternate caregivers?

Yes. You should name at least one, preferably two or three, alternate caregivers in case your first choice is unable or unwilling to serve as your pet’s caregiver. To avoid having your pet end up without a home, consider naming a sanctuary or no-kill shelter as your last choice.

14. What types of instructions should I include in my pet trust regarding the care of my pet?

Here are some examples of the types of concerns about which you may wish to provide instructions:
· Food and diet.
· Daily routines.
· Toys.
· Cages.
· Grooming.
· Socialization.
· Medical care, including preferred veterinarian.
· Compensation, if any, for the caregiver.
· Method the caregiver must use to document expenditures for reimbursement.
· Whether the trust will pay for liability insurance in case the animal bites or otherwise injures someone.
· How the trustee is to monitor caregiver’s services.
· How to identify the animal.
· Disposition of the pet’s remains, e.g., burial, cremation, memorial, etc.

15. Who should be the trustee of my pet trust?

The trustee needs to be an individual or corporation that you trust to manage your property prudently and make sure the beneficiary is doing a good job taking care of your pet. A family member or friend may be willing to take on these responsibilities at little or no cost. However, it may be a better choice to select a professional trustee or corporation which has experience in managing trusts even though a trustee fee will need to be paid.

16. Should I name alternate trustees?

Yes. You should name at least one, preferable two or three, alternate trustees in case your first choice is unable or unwilling to serve as a trustee.

17. Is it a good idea to check with the trustees before naming them in my pet trust?

Yes. Serving as a trustee can be a potentially burdensome position with many responsibilities associated with it. You want to be sure the persons you name as your trustees will be willing to do the job when the time comes.

18. What happens to the property remaining in the trust when my pet dies?

You should name a “remainder beneficiary,” that is, someone who will receive any remaining trust property after your pet dies. Note that it is not a good idea to name the caregiver or trustee because then the person has less of an incentive to keep your pet alive. Many pet owners elect to have any remaining property pass to a charitable organization that assists the same type of animal that was covered by the trust.

19. What happens if the trust runs out of property before my pet dies?

If no property remains in the trust, the trustee will not be able to pay for your pet’s care. Perhaps the caregiver will continue to do with his or her own funds. If the caregiver is unwilling or unable to do so, you should indicate in your pet trust the person or organization to whom you would like to donate your pet.

20. How do I get a pet trust?

You should consult with an attorney who specializes in estate planning and, if possible, who also has experience with pet trusts. You may find it helpful to give your attorney a copy of this article.

Letting a Computer Plan Your Estate:

Is It Worth the Risk?
A White Paper From ElderLawAnswers

Software programs and Web sites selling customized, do-it-yourself wills and other estate planning documents seemingly offer a cost-effective and convenient alternative to visiting an estate planning attorney. After all, does anyone really want to discuss their dying wishes and health care directives with a perfect stranger? On top of that, most people are wary of the fees an attorney would charge. In times of economic uncertainty, families tend to be even more concerned about the cost of legal advice and often put off planning that they hope will not be necessary until they are much older. A simple will, durable power of attorney and health care proxy prepared by an attorney can cost several hundred dollars per person. Online services promise the same basic estate planning documents for a fraction of that. Such services have the virtue of encouraging people who might not otherwise do so to create a will and other essential planning documents. But is online estate planning worth the initial cost savings? Are the documents created an adequate replacement for a consultation with a qualified attorney? To help answer these questions, ElderLawAnswers recently reviewed three leading online estate planning services. As is outlined in detail below, we found that while the documents these programs produced were adequate, each online service had significant limitations in the information-gathering process that could lead to defects in the final product received. Moreover, no pre-packaged program can take account of crucial differences in state laws or encompass the complicated family arrangements so common in modern society. As a result, the use of these off-the-shelf programs can lead to unfortunate results for their users and their families. We conclude that while online estate planning could possibly work for people who have little or no property, small savings or investments, and a traditional family tree, the significant remainder of the population should not rest easy using one of these programs and should instead consult with a qualified estate planning attorney. In other words, in all but the most commonplace estate planning situations (and only an attorney can determine what is "commonplace"), do-it-yourself estate planning programs can be a risky, and often quite costly, substitute for in-person planning with an experienced estate planning attorney.

Online Programs Are Easy to Use
We reviewed three leading online estate planning programs: Nolo's Online Will, BuildaWill and LegalZoom. We purchased wills from all three, and also ordered a "living trust" from LegalZoom. Two experienced estate planning and elder law attorneys completed the documents and evaluated the programs. All three offer easy-to-use interfaces and provide help via e-mail or over the phone if a user runs into trouble preparing the documents. Nolo and BuildaWill both allow users to download their wills instantly, while LegalZoom ships the documents in a personalized estate planning binder.

Nolo
Nolo's Online Will package can be purchased for $69.95 at www.nolo.com, and took about 30 minutes from start to finish. Once we created an account, Nolo walked us through eight steps, with multiple questions in each step that were designed to fill in our will. Every time Nolo asked a question, a text box next to the question clarified what the program was looking for in greater detail and often offered links to more specific questions. For instance, when filling in a spouse's name, the program offered hints for spouses who are known by more than one last name, as well as what to do if one's marital status changes. When we finished creating the will, Nolo not only saved it, but allowed us to go back and edit the will for up to a year after purchasing it. Nolo's Online Will allows users to name a registered domestic partner in place of a spouse, and
properly provides a warning about the legal status of those partners in states that refuse to recognize them. Unfortunately, Nolo's program does not address the legal implications of leaving all of a user's property to a spouse under one of their simplified property distribution options. For families with large estates, leaving the property directly to a spouse can lead to avoidable estate taxes upon the spouse's death. Even leaving a more modest estate to a spouse can have unintended consequences, as explained in the discussion below of "Mixed Marriages." Later on in the estate planning form, Nolo's system does suggest speaking with an estate planning attorney if a user is concerned about the size of her estate, but the warning is not prominent; in order to find it, we had to poke around more than the typical consumer is likely to do.

BuildaWill
BuildaWill, found at www.buildawill.com, was the most basic program and at $19.95 it was by far the least expensive, but it performed a pre-screening evaluation before allowing customers to create a will – an important step that the other two sites neglected. This questionnaire checked to make sure the customer was a U.S. resident, and asked several questions about the possibility of the will being challenged and the mental capacity of the person creating the document. The BuildaWill questionnaire was easy and took only 15 minutes to complete. On the other hand, BuildaWill often simplified complicated decisions, such as allowing us to pick either an executor and an alternate or up to three executors to serve together, without really explaining the difficulties of having several people serve at the same time. Like Nolo, BuildaWill ignored the
ramifications of leaving property to a surviving spouse. Unlike the Nolo will, the BuildaWill document did not include trusts for minor children. If a parent dies without such a trust, the child could get all ofthe money outright, in his name. Leaving it in trust is a much better option.

LegalZoom
We used LegalZoom to prepare the more complicated document, a "living trust" designed to hold assets while someone is still alive and then pass on any residual estate when the individual dies. The living trust, which also comes with a will designed to pour into the trust, costs $228.95 at www.legalzoom.com. Living trusts can hold substantial assets and are often used to avoid probate and reduce or eliminate estate taxes. LegalZoom offered the option of what it called an "A-B" trust as part of an overall estate tax plan, but the Web site did not adequately explain the implications of funding such a trust, including the possibility that the surviving spouse would need to request funds from an independent trustee if her own funds ran out. The LegalZoom questionnaire was the most extensive of the three Web-based programs (no doubt because a living trust is typically more detailed than a will). The program's interface was easy to use but required us to look for help if we needed it, usually by clicking on a help icon. Since the trust is designed to hold property, the site asked us to complete a quite detailed list of the property we were planning to transfer into the trust, including information about that property. While doing so, the Web site explained that it could also prepare deeds to transfer property into the trust, for an additional fee. When our documents arrived weeks later, via standard shipping, the package included detailed instructions for executing the estate planning instruments, along with guides for executors and trustees. However, LegalZoom (as well as the other two programs) never offered advice about who would be appropriate to name as trustee or executor. This means that a user could name a minor child or someone with diminished capacity as the protector of their assets, leading to the need for a replacement trustee and resulting in unnecessary expenses.

Assessment
While all three programs make it very easy to create basic documents, they do not perform a detailed analysis of the user's true estate planning needs. Estate planning attorneys generally have detailed discussions with their clients about their situation, hopes and goals, including their relationships with their children. If a child has problems with debt, or is anticipating a divorce, or has special needs, certain portions of the estate plan must be adjusted. The online programs didn't ask these questions or address these potentially crucial issues. Outside of the specific pluses and minuses of each site, the online programs suffered from a number of significant general defects.

State Probate Laws Vary
First and foremost, most estate planning programs do not address complicated and often unyielding variations in state law. Since there is no national probate code, a computer program or Web site cannot hope to replicate the knowledge of a qualified local estate planning attorney who knows the intricacies of state law.

For example, Florida law allows those making a will to attach a separate written memorandum, which can save money by not requiring the will to be redrafted every time a change is needed. But making proper use of this option is tricky and those executing wills can easily end up failing to effectively transfer items included in the memorandum.

In Texas it’s important to state in your will that you want an executor who is independent, something most generalized forms won't mention. “You’re not going to have somebody who is Texas-specific on the other end of your e-mails,” Aric Short, associate professor of law at Texas Wesleyan University, has commented. "There’s nobody to answer specific questions, and that’s what a lawyer does. You might have all kinds of issues that, to you, don’t seem notable but to an attorney who practices in this area they might require special attention in your estate plan.”

Undesired Results Abound
Using a do-it-yourself will or other estate planning document may have undesired consequences. There was the Massachusetts man who used a pre-packaged will form to leave his home to his wife and his four grown children. This sounds fine, except that the will didn't give the wife the option to remain in the house for the rest of her life. A court case ensued because the children, who possessed the majority interest in the property, could have legally forced the wife to move. In another case, after a man passed away his son found his will, which the father had purchased online. The will left specific items and bank accounts to certain people. But in the years after the man had executed the will, some of his beneficiaries had died and some of the specific items mentioned in the will dropped out of his estate. Cars were sold, accounts closed and new ones opened. His will had made no provision for what to do if a beneficiary died and it had no "residuary clause" to tell his executor where items not specifically mentioned in the will should go. Much of what was in the man's estate passed according to his state's intestacy laws, as if he had never made a will at all. Trying to save money, the man had cost his intended heirs dearly. In yet another case, a man executed a trust form leaving his substantial estate to one niece, but because he never funded the trust or executed a will, everything was divided among all of his nieces and nephews, including one he didn’t know who lived on the other side of the country. A 2004 court case from the state of Washington, Woodard v. Gramlow, offers a particularly costly example of how do-it-yourself estate planning instruments can backfire on the preparer. In June 1998, Charlene Young's half-sister, Jacqueline Gramlow, helped Ms. Young plan her estate. Using a legal software program, Ms. Gramlow prepared three documents: (1) Ms. Young's will; (2) an attachment; and (3) a living trust. Ms. Gramlow was not a trained legal advisor. The attachment provided that the proceeds of Ms. Young's life insurance policy should be used to pay funeral costs and other debts normally paid by an estate. When Ms. Young died, the question became whether the attachment was a part of her will and, if so, whether it created a trust that held the insurance proceeds. If the attachment was part of the will, then the insurance proceeds would be under the control of Ms. Young's estate to pay its debts. If the attachment was determined not to be incorporated into the will, then Ms. Gramlow would receive all the life insurance proceeds. In the end, a state appeals court determined that the insurance was part of Ms. Young's estate, and Ms. Gramlow lost a portion of her inheritance. This conclusion was reached at great expense and could have been avoided with a visit to a qualified attorney.

Programs Often Overlook Tax Issues
Many states also have their own estate tax systems that have wildly different thresholds. For
instance, Massachusetts currently taxes estates holding more than $1 million, even though the federal estate tax for those dying in 2009 does not take effect until an estate reaches $3.5 million. An estate planning Web site that prepares basic wills for customers without regard to the size of the estate could miss this distinction, resulting in tens or hundreds of thousands of dollars in increased estate tax liability. Tax issues also play a part in any decision about whether to incorporate trusts into an estate plan. If planning software addresses trusts at all, it inevitably produces a rudimentary and risky document. But well-off families, or even families without many liquid assets but with substantial real estate holdings, farms or businesses must engage in far more complicated tax planning. Qualified estate planning attorneys know how to structure intricate trust instruments to properly manage, and in many cases avoid, an estate tax burden. These trusts often allow couples to maximize their separate estate tax credits so that the surviving spouse's estate does not get hit with a large tax bill. Computerized estate planning programs are not designed to provide estate tax advice or planning, and the programs do not draft complicated trust instruments. With the federal estate tax rate close to 50 percent, families need to consider whether the "convenience" of a computerized estate plan outweighs the risks of improper estate tax planning.

Mixed Marriages Muddy the Waters
The classic "Ozzie and Harriet" family paradigm is rapidly ceasing to be the norm. Many parents have been married more than once or have had more than one relationship that either produced children or that brings with it non-biological children who are viewed as part of the family. Many parents in these so-called "mixed marriages" run into problems with do-it-yourself estate planning documents because they often think of their stepchildren, whom they may not have legally adopted, as their own children. When the parents then draft do-it-yourself wills or trusts leaving their estate to their "children," legal chaos can ensue and it often takes a court to sort out what a parent actually wanted to accomplish with the estate plan. Did he want to leave his property to his entire, extended, family (including stepchildren) or merely to his biological children? Litigation in this area can be prohibitively expensive and often ends up squandering the parent's estate. In one recent case, stepchildren paid $100,000 in legal fees to claim their inheritance. Second marriages, especially those in which one or both partners have children from a previous relationship, add planning concerns not addressed in these programs. While husbands and wives generally want to provide for one another, when they’re both gone they want their respective children and grandchildren to receive their shares of their combined estate. This is unlikely to occur if they have so-called “I love you” wills giving everything they have to the surviving spouse. Then, at the death of the surviving spouse, in most cases everything will go to his or her family (or to the new spouse) rather than being split evenly. Or else it will be eaten up by the surviving spouse’s long-term care costs. All of these possibilities can be protected against through proper estate planning, not provided for in these programs. Same-sex relationships, with or without children and with or without state sanction, can create the need for more complicated estate planning. The large number of grandparents raising grandchildren creates the need for “handmade" as opposed to computer-generated documents. For a rigid, forms based system to anticipate all of the alternatives is difficult or impossible.

Strategies for Shielding a Child's Inheritance
None of the online programs we reviewed offered parents the opportunity to protect their adult children from some of the financial consequences of divorce, bankruptcy and illness. Rather than giving an inheritance to a child outright and risk the child's later losing it to creditors or in a divorce settlement, parents can create "spendthrift" or "family protection" trusts that hold assets for the child. This shields the inherited assets from some (but not all) creditors.

Special Rules for Special Needs Children
One of the most delicate areas of estate planning involves families of children with special needs. In most cases, especially when the child with special needs receives or anticipates receiving government benefits, it is essential to avoid leaving money to the child directly. An entire category of trusts, known as supplemental needs or special needs trusts, are designed to work within the arcane rules and restrictions of governing disability benefits. Once again, the do-it-yourself estate planning tools we reviewed don't account for these special, and very complicated, rules. When a child with special needs is involved, an improper distribution from a parent's do-it-yourself estate plan could result in the loss of the child's health insurance, education, and supported living arrangement, along with the disappearance of the inheritance due to mismanagement or to unscrupulous individuals taking advantage of the child.

Liability
Every day, families prepare their most important estate planning documents using computerized
estate planning programs that issue standard disclaimers. Companies selling these documents want to make sure customers understand that they are not applying the law to the facts in their particular situation, that they are not giving legal advice, and that the information they provide is not guaranteed to be correct, complete or up-to-date. Although no one likes to talk about it, occasionally estate planning attorneys make mistakes as well. But when they do, the legal system offers a remedy through a malpractice suit and damages, paid for through professional liability insurance. Unfortunately, online estate planning programs are merely tools for consumers to use to draft their own documents. If there are errors, there is no remedy and no recovery.

Conclusion: Is It Worth the Risk?
The documents produced by the online programs we tested were good. The problem is that estate planning involves a lot more than producing documents. As the examples in this paper illustrate, it is impossible to know, without a legal education and years of experience, what the right legal solution is to any particular situation and what planning opportunities are available. The actual documents produced are simply tools to put into effect the plan developed based on each client’s particular situation and goals. If there is anything about a family situation that's not commonplace, using a DIY estate planning program means taking a large risk that can affect one’s family for generations to come. And only an attorney can determine whether a particular situation qualifies as commonplace. The problems created by not getting competent legal advice probably won't be borne by the person creating the will, but they may well be shouldered by the person's children and grandchildren.

If the choice is using an online program or doing nothing, use the online program. But if you want to make certain that you are taking the right steps for yourself and your family, seek the advice of an experienced estate planning, elder law or special needs planning attorney.

Prepared by ElderLawAnswers http://www.elderlawanswers.com/
©2010 ElderLawNet, Inc.

Effective Collaboration and Elder / Adult Care Mediation

What kind of message is sent when we are reluctant to use the terms "elder", "senior" or "older adult" for fear of offending those of us who have been blessed to age. As we all age, we understand that there are unique issues for which important decisions must be made to avoid default and crisis outcomes.

Instead of avoiding the use of terms such as "elder," we should embraced it. After all, the term "elder" creates perceptions of great respect, wisdom, and status in our society. Consumer education and outreach will then be focused on the natural aspects and issues of aging and the variety of approaches to support older adults, their families, and caregivers in making informed decisions addressing their respective life transitions.

It is key that older adults be given opportunities to have their voices heard to the fullest extent possible, regardless of age and/or their disability. It is the attitudes and mind sets going along with language about aging and older adults that will impact ageism over time.

With a focus on neutralizing the long-held negative perceptions of "being old" or "getting old" by highlighting aging issues and quality of life and care decisions as a natural part of living, there is tremendous creativity as we communicate to the older generation and their families. Facing the tiger with the use of respectful and honest terms can be powerful in the long run.

Elder/Adult Care Mediation typically works by involving a senior family member. Adult family communication and conflict resolution not only may involve family members, but may also include the "family" of a church or other religious organization, relatives in some combination, or other disputes that are relational and pertinent to aging issues.

Often, Adult children of elderly parents are not trying to make a specific decision but rather are interested in crafting an effective way to communicate with one another or to develop a decision making process for the future.

If you or someone you know would like to know more about the mediation process, contact McBloomLaw@McBloomLaw.com. Attorney Patricia Bloom-McDonald is a trained Collaborative Law and Mediation facilitator and consultant.

Long Distance Care Givers Receive Help

Living in a different city or state -- miles from aging parents -- can be very difficult. Keeping in touch by telephone and making long trips to help parents or aging relatives with their needs can be time consuming and not nearly as effective as being available full time in person.

Mark Sessions spent two years juggling his restaurant business with multiple daily phone calls to his elderly parents, checking on their needs and answering their questions. Family vacations were spent traveling the 500 miles to his parent's home to personally take care of home maintenance and provide health care visits to their doctor. During his last visit, Mark noticed his father had difficulty walking and his mother was confused as to which medications she was to take and at what time. This alarming change in his parent's condition concerned Mark that his parents' care needs required more than frequent phone calls and vacation visits. Running his business and handling his parent's long distance care was now becoming very challenging.
According to a report by the Alzheimer's Association of Los Angeles & Riverside, California, there are approximately 3.3 million long distance caregivers in this country with an average distance of 480 miles from the people they care for. The report also states that 15 million days are missed from work each year because of long distance care giving. Seven million Americans provide 80% of the care to ailing family members and the number of long distance caregivers will DOUBLE over the next 15 years. Long Distance Caregiver Project – Alzheimer's Association LA & Riverside, Los Angeles, CA (May 15, 2002, National Web Seminar by Judith Delaney, MFT, Clinical Coordinator)

The long distance caregiver is a new role that is thrust upon children and younger family members. Families used to live closer together, with children residing and working near their parents. But nowadays family members are more distant from each other. Society, today, is recognizing this. Some caregiver services have tweaked their programs to work as liaisons between long distance caregivers, senior loved ones and local medical professionals.

Professional care managers -- a lso known as Geriatric Care Managers, Elder Care Managers or Aging Care Managers -- represent a growing trend to help full time, employed family caregivers provide care for loved ones. Care managers are expert in assisting caregivers, friends or family members find government-paid and private resources to help with long term care decisions.
They are professionals -- trained to evaluate and recommend care for the aged. A care manager might be a nurse, social worker, psychologist, or gerontologist who specializes in assessing the abilities and needs of the elderly. Care manger professionals are also becoming extremely popular as the caretaker liaison between long distant family members and their aging elder loved ones.

Jacqueline Marcell -- author of "Elder Rage, or Take My Father...Please! How to Survive Caring for Aging Parents" (Impressive, 2000) -- says, "The most important thing to do is to find a geriatric care manager in the area where your loved one lives. She will have knowledge of all the services in the area and can be your eyes."

Below is a partial list of what a care manager or Professional Geriatric Care Manager might do:
Assess the level and type of care needed and develop a care plan.
Take steps to start the care plan and keep it functioning.
Make sure care is in a safe and disability friendly environment.
Resolve family conflicts and other issues with long term care.
Become an advocate for the care recipient and the caregiver.
Manage care for a loved one for out-of-town families .
Conduct ongoing assessments to implement changes in care.
Oversee and direct care provided at home.
Coordinate the efforts of key support systems.
Provide personal counseling.
Help with Medicaid qualification and application.
Arrange for services of legal and financial advisors.
Provide placement in assisted living facilities or nursing homes.
Monitor the care received in a nursing home or in assisted living.
Assist with the monitoring of medications.
Find appropriate solutions to avoid a crisis.
Coordinate medical appointments and medical information.
Provide transportation to medical appointments
Assist families in positive decision making.
Develop care plans for older loved ones not now needing care “The 4 Steps of Long Term Care Planning,” National Care Planning Council

Services offered will depend on the educational and professional background of the care manager, but most are qualified to cover items in the list above or can recommend a professional who can. Fees may vary. There is often an initial consultation fee that is followed by hourly fees for services. Health insurance does not generally cover these fees but long-term care insurance might.

In 2002, the AARP published a survey from geriatric care mangers about their fees:
“Respondents were asked how much they charged for their services, which might include: an initial consultation; fees on an hourly or per visit basis; fees for development of a care plan; and fees on a fixed-price contract basis. Hourly fees averaged $74 an hour. GCMs charged an average $168 to develop a care plan. Initial consultations averaged $175. Seven of ten current GCMs responded in the affirmative when asked if they had a statement that listed their fees. ” Written by Robyn Stone, DrPH, Principal Investigator; Susan Reinhard, RN, PhD, Co-Principal Investigator; Jean Machemer, MSG, Research Associate; and Danylle Rudin, MSW, Research Associate of The Institute for the Future of Aging Services, Washington, D.C.Barbara Coleman, Project Manager, AARP Public Policy Institute November 2002

When you take into account the time absent from work and time to find the right care resources for your loved ones, along with the cost of travel expenses to monitor their care, you will probably concur that using a caregiver is money well spent. Add on to this the stress of handling your own life circumstances combined with being a caregiver and you will probably wonder how you could have ever done without the care manager.

A professional or geriatric care manager can be an important asset to all families in elder care situations. Here is an example of how a care manager can help.

Mary is taking care of her aging husband at home. He has diabetes and is overweight. Because of the diabetes, her husband has severe neuropathy in his legs and feet and it is difficult for him to walk. He also has diabetic retinopathy and, therefore, cannot see very well. She has to be careful that he does not injure his feet, since the last time that happened he was in the hospital for four weeks with a severe infection. She is having difficulty helping him out of bed and with dressing and using the bathroom. She relies heavily on her son, who lives nearby, to help her manage her husband's care.

On the advice of a friend, Mary is told about a professional care manager, Sharon Brown. The cost of an initial assessment and care plan from the care manager is $175.00. Mary thinks she has the situation under control and $175.00 for someone from the outside to come in and tell her how to deal with her situation seems ridiculous.

One day Mary is trying to lift her husband and injures her back severely. She is bedridden and cannot care for her husband. Her son, who works fulltime, now has two parents to care for. On the advice of the same friend, he decides to bring in Sharon Brown and pay her fee himself.
Sharon does a thorough assessment of the family's needs. She arranges for Mary's doctor to order Medicare home care during Mary's recovery. Therapists come in and help Mary with exercises and advice on lifting. Sharon advertises for and finds a private individual who is willing to live in the home for a period of time to help Mary with her recovery and watch over her husband. Sharon makes sure the new caregiver is reliable and honest and that taxes are paid for the employment. Sharon enlists the support of the local area agency on aging and makes sure all services available are provided for the family.

Sharon also calls a meeting with Mary's family and explains to them the care needs and how they need to commit to help with those needs. Sharon makes arrangements to rent or purchase medical equipment for lifting, moving and easier use of the bathroom facilities. Medicare will pay much of this cost. Sharon also works closely with an elder law attorney and a financial planner who specializes in the elderly. The attorney prepares documents for the family including powers of attorney, a living will and advice on preserving Mary's remaining assets. The financial planner recommends a reverse mortgage specialist to help Mary and her husband tap unused assets in their home's equity. Some reverse mortgage proceeds are used to pay off debt. The remaining proceeds are converted into income with a single premium immediate income annuity in order to provide Mary adequate income when her husband is gone and she looses one of the Social Security payments.

With the help of the care manager, Mary's life and future have been significantly improved. Her husband as well, if he adheres to the care plan, may end up having a better quality of life for his remaining years. “The 4 Steps of Long Term Care Planning,” National Care Planning Council

WHY BUY LONG TERM CARE INSURANCE?

1. It will help you keep your independence and dignity and allow you to make choices. When the time comes for paying for your long term care needs, you may end up spending your savings and then relying on Medicaid for assistance.

2. If you are married and you have a need for long term care, your spouse may be forced to pay for an outside caregiver. The cost is likely to come from your combined income and assets. This may leave your spouse with minimal funds in the future. Insurance solves this problem and allows the healthy spouse to keep the assets.

3. Many healthy care-giving spouses won't spend their money and choose to "tough it out" on their own without help. If care of a disabled spouse drags on too long, this can have a devastating effect on the physical and emotion health of the caregiver. Insurance will help to pay for professional care for the disabled spouse and allow the caregiver spouse needed rest.

4. If your children promise to take care of you when the time comes that you need care, insurance will help them do that. Probably neither you nor your children have thought of the prospects of moving you from place to place, changing your dirty diapers, cleaning up after "accidents" in the bathroom or helping you with bathing and dressing. Insurance will pay for aides to help your children with these tasks.

5. If you are single and a need for long term care arises, insurance can pay for and coordinate that care. With insurance you won't have to feel you would be a burden for family or friends.

6. If you have the desire to leave assets behind when you die, insurance will help preserve those assets from the cost of long term care.