home aging

Aging in Place vs. Nursing Home Care: Important Factors to Make the Right Choice

home aging

A growing portion of the older population wants to stay in their homes as long as possible. This is known as “aging in place” and has several benefits when it is appropriate for the individual. However, there are some other care concerns to consider when deciding whether someone is at the point of needing additional help.

COMFORT AND FAMILIARITY

Most people want to remain in their homes because of the comfort, familiarity, and memories within it. Moving into assisted living or a nursing home is a big change for anyone, but especially for a senior who feels the loss of their independence during this transition. Remember that, when it is safe for them to stay there, someone’s home can support their overall mental and physical health.

If staying in the same place is important to your loved one, look for ways to ease your mind while also protecting their independence. Is there a neighbor or friend who can check on them each week? Can you drop in every other weekend to make sure things are going well?

SAFETY CONCERNS

Many adult children or other loved ones start thinking about these issues because they’re concerned over safety. Triggering events prompting a conversation about additional care needs include a loved one beginning to show signs of dementia or suffering one or more physical incidents like a fall in their home.

YOUR TIME AND PROXIMITY

As a family member, it’s natural to want to do everything you can to care for a loved one. Caregiving, however, can be very difficult and time consuming. It can be even more challenging if you don’t live nearby. If your time and that of other family members can no longer support a loved one, a nursing home or assisted living may be the answer.

FINANCES

Whether or not your loved one owns their home is the first consideration. Ongoing mortgage payments are just part of the puzzle. It can be hard for people to part with their home, but maintenance concerns and costs can be problematic. Evaluate the age of appliances and yard maintenance required, too. At some point a home might be more trouble than it’s worth to the occupant.

MEDICAL SUPPORT NEEDED

If a loved one only needs help with light housekeeping or meal preparation, they may not need to move to another location, especially a nursing home. Local organizations or a part-time hire could help with these needs while allowing your loved one to stay in their home.

However, if they have more advanced medical needs or challenges with multiple activities of daily living, in-home care from a medical professional could bridge the gap. For more advanced situations, a nursing home might be appropriate.

There are other care options along the spectrum in between care services provided by family and a nursing home. Part-time help from someone local such as a nurse, in-home care providers, assisted living, and adult day care are just a few. For someone who needs extra support but does not require the support of a formal nursing home, these options are well worth exploring.

Contact a New York Elder Law Attorney

An experienced elder law attorney can help you to assess your unique needs and goals. Contact Amoruso & Amoruso, LLP for a personal meeting.

Senior woman dealing with a medicaid crisis

The Rising Costs of Medicaid and Managing a Medicaid Crisis

 

Senior woman dealing with a medicaid crisis

Did you know that in the United States, the median monthly cost of a semi-private room in a nursing home is currently more than $7,900? And the cost of a private room exceeds $9,000 per month! Plus, depending on where you live, costs can even be considerably higher.

Making matters worse, costs rise according to the level of care needed and they are expected to continue increasing dramatically in the future. (You can see the current costs for home care, adult day care, assisted living, and nursing home care in your area by visiting https://www.genworth.com/aging-and-you/finances/cost-of-care.html.)

Despite the exorbitant costs of long-term care, nearly 70 percent of those over the age of 65 will require long-term care at some point in their lives, and 20 percent will need long-term care for five years or more. Given this, it’s easy to see why many families exhaust their life savings within a few years of a family member entering a nursing home, and why more than half of all nursing home stays are now funded by Medicaid.

But planning for your loved one’s future care isn’t always easy. If they have already moved into a nursing home, or must enter one in the very near future, and you have been informed that they own too many assets to qualify for assistance from Medicaid then your family is in a Medicaid Crisis situation.

Such a situation is indeed a financial crisis for all but the wealthiest families. If you or a loved one is facing a Medicaid Crisis, try to remain calm. Much of the information we hear about Medicaid from friends, relatives, nursing home staff, caregivers, and many others is outdated or incorrect.

There is hope! A qualified elder law attorney can help you by assessing your unique case, strategizing the options that are best for you and your family, and obtaining assistance from Medicaid. It is possible to get Medicaid assistance even if you are already in a nursing home or will need to enter one next month, next week, or even tomorrow. Even if you have applied for Medicaid assistance in the past but were rejected, it is entirely possible that a qualified elder law attorney can still obtain the financial assistance you need.

Contact a New York Elder Law Attorney

You’ve worked too hard to lose your life savings to the nursing home. Let an experienced elder law attorney help you secure the financial assistance you need and deserve. Contact us today for a consultation to discuss your plan.

married, marrying

Estate Planning for Couples Marrying Later in Life

married, marrying

Here are some factors to consider when marrying, or remarrying, later in life.

Should You Have a Prenuptial Agreement?

In most situations, the answer is yes, particularly if you and your betrothed have children from previous marriages, a disparity in financial resources, or substantial assets. When couples marry, assets and income typically become community property. A prenuptial agreement makes provisions for dividing assets if the marriage ends. You should discuss your prenuptial agreement well in advance, and each party should have their own attorney.

Should You Have Separate Wills?

Rather than a joint will, it is wise for you and your future spouse to draft separate wills. This can reduce the potential for conflict over property distribution in the future.

Update Existing Estate Plans.

It is important to update your estate plan when you get married, whether you’re marrying late in life or not. Doing so helps ensure your assets will be distributed according to your wishes when you pass away. You’ll want to review your powers of attorney, of course, and pay particular attention to your beneficiary designations on all legal and financial documents. If your ex-spouse is still named as beneficiary on, say, your life insurance policy or retirement plan, the ex could inherit these assets rather than your current spouse.

Protect Income Streams.

Marriage can impact your income from Social Security, Medicaid, the Veterans Administration, alimony, and more. If you have a dependent loved one with special needs, his or her eligibility for public benefits could be impacted as well.

Don’t Ignore the Possibility of Needing Expensive Long-Term Care.

Most of us will require some form of long-term care after age 65. For couples marrying later in life, the obvious question is who will pay for it. If you and your future spouse are creating a prenuptial agreement, you may want to include language requiring each of you to purchase long-term care insurance (assuming such policies are affordable in your case). With the annual cost of a private room in a nursing home averaging over $105,000 in the United States, you can’t afford to ignore the possibility that one or both of you will eventually need long-term care.

Contact a New York Estate Planning Attorney

An experienced estate planning attorney can help you to assess your unique needs and goals. Contact Amoruso & Amoruso, LLP for a personal meeting.

long term insurance

With Premiums Rising Dramatically, Should You Keep Your Long-Term Care Insurance?

long term insurance

When clients ask us whether it is right for them, we consider their overall plan and unique situation. Sometimes we recommend long-term care insurance, sometimes we don’t, depending on the client’s needs and goals.

But what if you’ve already purchased long-term care insurance, and you’ve seen your premiums rise dramatically in recent years? First of all, you’re not alone. In some cases, premiums have gone up as much as 40 to 60 percent in recent years. The reason is that many insurance companies have suffered major losses on policies written more than ten years ago, and they are looking to recoup those losses. (A number of companies no longer offer long-term care insurance at all.)

If your premiums have increased, should you keep the policy? Make changes to it? Look for a cheaper one? Here are some factors to consider:

  • If your policy is more than two years old, you probably will not be able to find a cheaper one to replace it if you choose to cancel the existing policy. It may also be harder to qualify for a new policy
  • If your premiums have risen more than 20%, you may want to reduce your daily benefit to try and keep the premium down
  • You might be able to reduce your premium by lowering the rate of inflation protection. However, make sure it is not applied retroactively

Contact a New York Elder Law Attorney

Given that every family is unique, with particular needs and goals, it is advisable to discuss matters such as long-term care insurance with an experienced elder law attorney. We can review your policy and your existing plan to determine whether it is in your best interests to keep your existing policy. We can also recommend other tools and strategies that can help ensure you get the long-term care you need without losing your life savings. Contact us today for a consultation.

Elderly couple thinking about retirement planning

Myths and Misconceptions about Retirement Planning

Numerous studies have shown that Americans’ greatest fear regarding retirement is running out of money. Even so, myths abound about planning for retirement, Social Security, the cost of medical care, and more. Let’s explore the reality behind some of the most common retirement planning myths.

Elderly couple thinking about retirement planning

Social Security is going broke.

Approximately 50 percent of elderly Americans derive at least half of their income from Social Security. For decades, Social Security has collected more than it paid out, with excess income going into the Social Security Trust Fund. According to the Social Security Administration, this fund held $2.91 trillion by the end of 2020. However, due to the retiree population growing faster than the working population, as well as the fact that people are living longer, Social Security is starting to pay out more than it takes in. Without changes to the way Social Security is financed, the trust fund is projected to run out in 2034.

Of course, Social Security still collects taxes and pays benefits. According to recent estimates, however, it will only be able to cover 78% of scheduled benefits after 2034. To avoid that scenario, Congress will have to take measures to strengthen Social Security’s finances, as it did in 1983 when the program’s reserves were nearly exhausted. Given the program’s importance to retirees, and the fact that millions of older Americans have been paying into the system for decades, it is highly unlikely Congress would fail to take the necessary steps to protect it.

You can receive your full Social Security benefit when you turn 62.

While it is true that you can begin taking Social Security benefits at age 62, this will lead to a lower monthly benefit than if you wait until full retirement age. What is your full retirement age? It depends on when you were born. If you were born:

  • In 1960 or later, your full retirement age is 67
  • Between 1955 and 1960, full retirement age ranges from 66 and two months to 66 and 10 months
  • Between 1943 and 1954, full retirement age is 66
  • Between 1938 and 1942, full retirement age ranges from 65 and two months to 65 and 10 months
  • Before 1938, full retirement age is 65

Should you take your benefits at age 62? “Expert opinion” differs, but the consensus seems to be that if you are in good health, and you have enough money to live comfortably without Social Security benefits, you may want to delay taking them to maximize your monthly benefit later on.

All of your medical care will eventually be covered by Medicare.

Medicare does not pay for all of a person’s medical care. Original Medicare (Parts A and B) covers hospital visits and outpatient care but not dental and vision care. Nor does it cover the cost of prescription drugs. Although Medicare Advantage plans can provide greater coverage, they generally have high premiums. Most Americans fail to include enough money in their retirement budget to cover the expense of annual medical care, let alone the cost of long-term, in-facility care. It is estimated that for a couple aged 65, out-of-pocket medical costs will approach $600,000 over the course retirement.

You don’t have to plan for retirement because you want to keep working.

This may seem like a reasonable assumption when you have a well-paying and satisfying job, you’re young, and you’re healthy. The reality is quite different. According to a Retirement Confidence Survey, 43 percent of current retirees left the workforce earlier than they expected. While mandatory retirement at a set age was abolished in 1986 by an amendment to the federal Age Discrimination in Employment Act, many of us lose our jobs for other reasons or cannot continue to work due to health problems. Simply put, you may not be able to work as long as you want. The best protection against running out of money in retirement is to have a realistic, detailed retirement plan.

We’re here to help with your retirement planning needs

You’ve worked hard to save for retirement – and deserve to enjoy it with peace of mind. As you plan for these years, know you can lean on an Amoruso & Amoruso estate planning attorney for personalized advice based on your goals and needs. To learn more about our approach to retirement planning, contact us for a personal meeting.

What to Do When a Loved One is Diagnosed with Dementia

A dementia diagnosis is a traumatic time for any family. Dementia happens slowly and progressively over time. In the early stages, some symptoms are often thought of as just signs of aging. Beginning signs can be as simple as losing car keys, forgetting where the car is parked, or even forgetting to turn off the oven. Unfortunately, dementia is incurable and progresses over time. It is important to have difficult conversations sooner than later. There are a few things you can do to protect your loved one during this challenging time.

Gather Financial Documents

There are several advantages to having all financial documents in one place during an early diagnosis of dementia. Dementia patients usually have difficulty remembering where they put things. It is important to not only put all financial documents in one place, but to also make copies and have them kept with a trusted member of the family. It is a good idea to make a binder that consists of insurance documents, health care wishes, will, power of attorney, bank statements, and car titles. Original documents should be kept in a safe place. It is important to have discussions early on, while your loved one can remember important financial information.

Protect Their Assets

Elderly individuals are often a target for financial fraud. A dementia diagnosis could mean even more risk for your loved one. Financial fraud is not always done by strangers. It is important to keep a close watch on new “friends” your loved one starts spending time with. Keep a close watch on their finances to ensure they are not a victim of fraud.

Establish a Power of Attorney

Dementia can be scary. Your loved one will likely feel like they are losing control and may be reluctant to freely give their perceived freedoms away. However it is important to create a Power of Attorney. This will allow a trusted loved one to make financial decisions, conduct banking transactions and pay bills when the time comes.

Create a Health Care Directive

After a diagnosis such as dementia, it is important to understand your loved ones wishes. Health care, long-term care, and end-of-life treatment are very personal. Every person has different beliefs and concerns regarding what they would like to occur in the event they are not able to make decisions for themselves. These wishes should be very clear and stated in writing.

Does your loved one want to be put on life support? Do they want to be resuscitated? Do they prefer an assisted living facility or in-home care? A Health Care Directive will outline the person’s wishes and it will also appoint a person that will make healthcare decisions when the time comes. Be sure to post health care wishes somewhere visible in the house and in your loved one’s wallet, in the event that emergency services are needed.

Review Estate Plan

Estate planning in the best of situations can seem overwhelming. There are financial implications for present and future generations. Emotional stressors include preparing for one’s own passing and trying to equitably distribute properties, investments, cash, and family heirlooms. However, when a spouse or loved one begins to suffer from dementia, forming a comprehensive estate plan is more important than ever. A basic understanding of the legal rights of someone suffering from dementia can help smooth the process. Having the trusted advice of an elder law and estate planning attorney can help navigate the process.

Contact an Experienced Elder Law Attorney

If you have additional questions or concerns regarding a loved one and dementia, contact the experienced New York Elder Law attorney at Amoruso & Amoruso LLP by calling (914) 253-9255 to schedule an appointment.

Filial Responsibility: Are Children Responsible for Their Parents’ Long-Term Care?

Filial Responsibility Laws, also known as Filial Support Laws, are relatively unknown. More than half of US states (including Puerto Rico) could hold adult children financially responsible for their parents’ long-term care. If your parents live in one of the following states, you could be held legally responsible for their healthcare: Alaska, Arkansas, California, Connecticut, Delaware, Georgia, Indiana, Kentucky, Louisiana, Massachusetts, Mississippi, Montana, Nevada, New Jersey, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Puerto Rico, Rhode Island, South Dakota, Tennessee, Utah, Vermont, Virginia, and West Virginia.

At one point, 45 US states had statutes that left adult children responsible for their parents’ nursing home care. After Medicaid was established in 1965, many states repealed these laws. The filial law system was adopted from England’s “Poor Laws”, a set of social measures meant to support low income citizens that could not afford care. Medicaid and Social Security helped to reduce the need for these laws.

While filial laws are rarely enforced, the rising cost of healthcare and longer life expectancies increase the likelihood of elderly individuals outliving their savings, which could rekindle these laws’ implementation. If your parents live in a state with filial responsibility laws and they start to accumulate healthcare bills they cannot afford, the provider may be within their rights to sue you for payment, and win. Some states can even extend criminal penalties to children who deny covering care. For example, according to North Carolina law, refusal to support your parents could result in a Class 2 misdemeanor that could earn you up to 120 days in jail.

If a parent becomes eligible for Medicaid, then the government will pay for nursing home care in most cases, and these laws become irrelevant. The Medicaid Estate Recovery Program (MERP) will sometimes try to recover the cost through the recipient’s estate after death. However, Medicaid does not require that adult children contribute directly to their parents’ care. In cases where the child and parent share assets, such as joint bank accounts or jointly owned real estate, the state may take action against these assets when trying to recover long-term care costs.

The best way to avoid issues with these laws is to get involved with your parents’ financial planning to ensure they have a plan to pay for long-term care themselves. An estate planning and elder law attorney can help create a plan to protect your parents’ assets while alleviating you of your filial responsibility. It is also important for families to consult with an attorney when applying for Medicaid or when beginning to plan Medicaid strategies, such as changing asset ownership or spending down assets.

Senior Woman Comforting Man With Depression At Home

A Designer Has Created Tableware to Help People With Dementia

Senior woman comforting man with Dementia at home

Alzheimer’s and other neurodegenerative diseases can make even basic tasks extraordinarily difficult. Designer Sha Yao saw this firsthand when her grandmother was diagnosed with Alzheimer’s disease. In response, she created Eatwell, a seven-piece tableware set. It features bright, primary colors, which Yao chose based on a Boston University study that showed individuals with cognitive impairment consumed 84 percent more liquid and 24 percent more food when they were served in brightly-colored containers.

Other features of the tableware set include cups and bowls with angled bases. This allows contents to shift naturally to one side and make them easier to drink or scoop up. The accompanying spoons are ergonomically designed to correspond to the contours of the bowls. In addition, the tableware set has holes with flaps at the edge of the tray where a napkin, bib or apron can be tucked to prevent spills. The set’s drinkware features wide bases, reducing the likelihood that they will be knocked over.

“Raising awareness and addressing the needs of people with impairments will allow them to maintain their dignity, retain as much independence as possible, and reduce the burden on their caretakers,” said Yao. “That’s what made designing the Eatwell tableware set so rewarding.”

Learn more about the set here.

Contact Us

If you have additional questions or concerns regarding estate planning and Dementia, contact the experienced New York Elder Law attorneys at Amoruso & Amoruso LLP by calling (914) 253-9255 to schedule an appointment.

Smiling young man

The Gift That Keeps on Giving: Paying Your Grandchildren’s College Tuition

Paying your grandchildren’s (or adult children’s) college tuition is one of the greatest gifts you can make. The education lasts a lifetime and opens a world of opportunity for your grandchildren. In a way, it is like giving a gift to your children as well, since it alleviates their concerns about paying for their children’s education on their own. And when done correctly, the gift of a college education can be an excellent estate planning tool.

Smiling young man

One way to help pay for your grandchildren’s education is to simply give them part or all of the money to cover tuition. The gift tax exclusion is currently $15,000 per person per year, and $30,000 for a married couple, which can go a long way toward covering the tuition for most colleges. Of course, giving the money to your grandchildren directly carries with it a big risk. Are they genuinely interested in using the money to get an education, or will they suddenly decide a year abroad, funded by your gift, might “better prepare them” for college?

A safer approach is to pay the college directly. In this case, the tuition payment is exempt from gift taxes, meaning you could also make a gift to cover other expenses such as room and board, books and other fees. The same $15,000/$30,000 gift tax exemption mentioned above still applies.

Finally, you could contribute to a 529 college savings plan, which is offered on the state level. A 529 plan is a college savings account that is exempt from federal taxes. 529 plans were introduced in 1996 to help taxpayers set aside college expenses for a designated beneficiary. Named for Section 529 of the federal tax code, these plans often have tax benefits at the state level for in-state residents. (This applies only in states that have an income tax.) If the maximum deduction is exceeded in a calendar year, the deduction can often roll over into later years. It is important to note that each state enforces a specific total contribution limit, which are typically between $235,000 and $520,000.

Some of these plans allow for the use of various investment options. Others, known as prepaid tuition plans, let you lock in at the current cost of tuition in place of the future cost. A 529 account is not owned by the grandchild—in most cases, one of the parents owns the account, so if your grandchild does not attend college when the time comes, he or she cannot access the money. Similarly, if your grandchild doesn’t want to attend a university covered by the 529 account, allowances can be made to use the funds elsewhere.

Before deciding whether to pay your grandchildren’s tuition using any of these strategies, you must first ask yourself one very important question: “Can I afford it?” You need to consider not just if you can afford it today, but whether you will be able to afford it ten, twenty years down the road. We can help you determine whether you can indeed afford to help your grandchildren pay for college, and if so, the best strategy for your particular situation. Contact us today to schedule a consultation.

family man

Managing Your Loved One’s Legal Needs: A Checklist for Caregivers

Serving as a caregiver may require you to oversee your loved one’s legal affairs. A recent article on AARP’s website addressed this issue and included a legal checklist for Caregivers. Here are the highlights.

Obtain Essential Legal Documents

Your loved one should have the following key legal documents: a Will, a Power of Attorney, and  Advance Directives. We will discuss these documents in greater detail later. For now, it is important to note that these documents should be created, signed, and witnessed while your loved one is still capable of making legal decisions on his or her own.

Get the Whole Family Involved

It is important to have everyone in the family participate in caregiving decisions whenever possible. You may even want to put into writing “who is responsible for what.” While this is not a legal document, it can help avoid disagreements in the future.

Love One Another - Focus on the Family

Organize Your Loved One’s Important Papers

In addition to the essential legal documents mentioned above, you’ll want to find and organize a number of other documents, including:

  • Birth and Marriage Certificates
  • Divorce Decree
  • Citizenship Papers
  • Death Certificate of a Spouse or Parent
  • Deeds to Cemetery Plots
  • Military Discharge Papers
  • Insurance Policies
  • Pension Benefits

Investigate Opportunities for Financial Assistance

There are a number of programs and services available to elders and/or individuals with disabilities. These include Social Security Disability Insurance (SSDI), Supplemental Security Income (SSI), veterans benefits, the Supplemental Nutrition Assistance Program, Medicare, and Medicaid. You can use online tools like the AARP Foundation’s Local Assistance Directory and the National Council on Aging’s Benefits Checkup to determine local, state, and federal programs for which your loved one might be eligible.

 

You should also examine your loved one’s retirement and insurance plans to see if any of them cover in-home care, skilled nursing care, mental health services, physical therapy, and other forms of short-term assistance. Your loved one’s life insurance policy might even provide accelerated death payments to help pay for long-term care.

 

Also, if you must take a leave of absence from your job to care for a loved one, you may be eligible for up to 12 weeks of unpaid leave under the federal Family and Medical Leave Act. In addition, some employers offer paid family leave, and five states (New York, New Jersey, Rhode Island, Washington, and California) plus the District of Columbia have laws mandating paid leave for caregiving. Several other states are set to implement such laws by 2023.

Explore Tax Breaks and Life Insurance Deals

Your loved one may be able to receive federal tax deductions for health care expenses such as a wheelchair or hospital bed, remodeling the home to make it more accessible, and hiring a short-term or part-time home health aide to provide respite for the primary caregiver. Be sure to save receipts for all medical expenses.

 

You can read the entire AARP article here:

https://www.aarp.org/caregiving/financial-legal/info-2020/caregivers-legal-checklist.html