Etiquette to Remember When Visiting Nursing Homes During Holidays
December 10, 2011
Nursing homes during the holiday season tend to see a little more activity than they do during the rest of the year, whether because of families coming to visit loved ones, or local groups or individuals bringing holiday cheer to residents who may not have family living nearby. Taking time to visit with nursing home residents during this time of year can be an immensely rewarding experience for all involved, especially if new or infrequent visitors keep a few simple rules of etiquette in mind:
1. Call the nursing home staff ahead of time to schedule your visit. This not only ensures that you won’t be interrupting any previously scheduled mealtimes or activities, it also gives the residents something to look forward to (and prepare for, if necessary.)
2. Be aware of what to expect. Some will have physical disabilities such as trouble with their hearing, eyesight, or ability to move freely. Some residents may have Alzheimer’s or dementia and may have trouble remembering people or conversations. If you aren’t sure how to respond in certain situations you can ask a member of the nursing staff for advice.
3. Knock before you enter a room. The residents’ rooms are their homes and should be treated as their personal and private space. It is polite to ask permission before entering a room or before handling personal objects on display, but residents will likely welcome queries or questions about photos or personal objects, and this is an excellent way to get a conversation started.
4. Be a good listener. Elderly residents have a lot of history and experience to share, and providing a friendly and attentive ear will be gratifying not only to your elderly friend or relative, but will likely be a fascinating experience for you as well.
5. Be aware of your host’s energy level. Nursing home residents can often tire quickly and 20-30 minutes may be a tiring visit for them. (On the other hand, if you and your host are in the middle of a conversation or game there is no need to rush through to stick to an arbitrary schedule.)
6. Bring photos, cards, or board games with you. Conversation will not always flow easily and freely, and having a back-up plan such as a deck of cards can dispel awkward silences. You may also consider offering to write or read letters for residents who may have trouble with these activities.
7. Don’t promise to visit again unless you truly intend to follow through and can even put it on your calendar right then and there. Nursing home residents may not get many visitors, breaking an appointment can be a heavy disappointment for your friend or relative.
Seniors To Receive a 3.6% Raise in Social Security. Finally!
October 24, 2011
There is good news today for senior citizens! Finally, seniors will receive a long awaited Cost-Of-Living increase in their social security benefits.
According to this article in CNN Money, “Social Security recipients will receive a cost of living adjustment of 3.6% starting in January.” This will be the first “raise” recipients have seen in three years, and most welcome the increase. “Many seniors have felt squeezed since banks are paying virtually no interest on savings accounts and stock market declines has eroded their retirement accounts.”
Unfortunately, many seniors may not see a useful increase in their social security income thanks to a hike in Medicare premiums expected to be announced next month. “For the past two years when Social Security benefits stayed the same, many seniors were shielded from the increase in Medicare premiums because of a “hold harmless” provision that protects more than 70% of beneficiaries… However, high-income beneficiaries and new enrollees did see their benefits reduced because they are not covered under the provision.”
Even with the expected increase to Medicare premiums, most seniors are simply glad to see the Cost-Of-Living increase in their social security. Those receiving Supplemental Security Income (“SSI”) will also see an increase, and we expect that the Department of Veterans’ Affairs will shortly announce an increase in Veterans Pension Benefits, as well. Stay tuned.
For more complete information about the coming changes in Social Security please read the full article.
Meeting The Challenges of Caregiving For Your Aging Parents
October 9, 2011
As senior issues and caregiver concerns get more media attention, more and more families are making the question of who becomes mom or dad’s primary caregiver a family decision. Although one sibling may still take on the role of “primary caregiver,” families are making the conscious decision to try to share caregiving responsibilities more equally. This is definitely a step in the right direction, but as this article from the Family Caregiver Alliance points out, there are still likely to be challenges.
Choosing a Primary Caregiver. The primary caregiver often ends up being the sibling who lives closest to mom or dad; it may start with a ride to the doctor here and there, but before you know it one sibling is shouldering almost all the responsibilities. Discussing the role of primary caregiver as a family can make everyone feel more involved and result in more support for mom or dad. The local sibling may still choose to care for parents’ daily needs, but out of town siblings may choose to take mom or dad on annual vacations or provide financial support.
Making Financial Decisions. Hopefully your parents have made arrangements for their long-term care expenses; but if not, you and your siblings may feel honor-bound to take care of the expenses yourselves. While the most logical route may seem to be an equal division of expenses between siblings, this may not be feasible or fair for every family. Siblings should take the time (and perhaps consult with an advisor) to discuss the various medical and care expenses, payment options, and financial strategies. Check to see if any public benefits may be available to help, such as Veterans Pension Benefits.
Living Arrangements and Long Term Care. Facing the reality that mom can no longer care for herself is a painful revelation for any family; making the decision to move a parent to a nursing home or long term care facility can be fraught with feelings of anger, guilt, or even denial, and siblings may be tempted to lash out at each other during this emotional time. Consulting with a Geriatric Care Manager or another trusted advisor at this time can help the entire family understand the situation, manage expectations, and keep emotions in check.
Making decisions as a committee can be difficult, especially when some members of the “committee” live far away, but when everyone is involved in the decision-making process then everyone is more likely to support a final outcome. Getting together with your sibling on a regular basis—even if it’s only by phone—to discuss the care of elderly parents can not only keep everyone on the same page and minimize disagreements, it can also provide a rare opportunity to grow closer as a family.
How Does California Rank on the Long-Term Care Scorecard?
September 15, 2011
One of the primary concerns of the aging population is long-term care. As the life expectancy of Americans goes up so does the expectation that they will someday need some form of long-term care. You may not know whether that care will happen in a hospital, a nursing home, or in your own home, but you can be sure that it will be expensive.
How expensive will long term care be? It turns out the answer to this question depends a great deal on where you live. The AARP, The Commonwealth Fund, and The SCAN Foundation recently released a report which they call “The Long Term Scorecard,” which compares states and ranks them according to categories. The website Web MD has an article explaining how to use the scorecard and what it means.
The article in Web MD states that “Long-term care is unaffordable for middle income families, according to [The Long Term Scorecard report.] Even in states where nursing home care is most affordable, such care averages 171% of an older person’s household income. The national average is 241%.”
Some states, however, have been making the issue of long-term care a priority, and have been wrestling with questions such as how to make it more affordable to residents and how to provide support to family caregivers. According to the article in Web MD, they’ve broken down the information in “The Scorecard” to help readers understand which states provide the best support (either financial, social, emotional or legal) for the elderly and their caregivers.
The article “ranks states’ performance according to four categories: 1. Affordability and access, 2. Patient choice of both provider and setting, 3. Quality of life and care, and 4. Support for family caregivers.” The states ranked highest overall were Minnesota, Washington, Oregon, Hawaii and Wisconsin; while the lowest ranking states turned out to be Mississippi, Alabama, West Virginia, Oklahoma and Indiana. California ranked 15th. (For more information on how the states were ranked and what each ranking means please read the article here.)
Perhaps the most important lesson to take from all this is that no matter where you live, or what your health is like right now, it is very likely that you will need some kind of long-term care in the future, and that that care will be expensive. Burying your head in the sand or choosing to “think about it when the time comes” will only make things worse for you and for your family. Take steps now to prepare now for whatever the future may bring. We would be happy to help you take those steps.
War Veterans May Be Unaware They Qualify For VA Aid and Attendance Benefits
August 4, 2011
One of the services Elder Law and Estate Planning attorneys often provide is helping clients navigate the application procedures and bureaucratic systems for the various state and federal medical insurance programs; and one thing that remains a surprise throughout the years is how many people forget about the VA Aid and Attendance Program for war veterans.
According to the Department of Veterans Affairs website, VA Aid and Attendance is “a benefit paid to wartime veterans [or their spouses] who have limited or no income, and who are age 65 or older, or, if under 65, who are permanently and totally disabled.” Unfortunately, too many veterans and their spouses are unaware that they qualify for this benefit, or even worse, have never been informed that the program exists.
An informative article in the Washington Post quotes the VA’s deputy undersecretary for disability assistance as saying that he believes they are only reaching “about one in four eligible veterans.” Part of the reason for this is that “there are a lot of veterans where it’s been 40 years or more since they’ve been on active duty. It just doesn’t occur to them there may be a benefit from the VA.”
If you are a war veteran over the age of 65 it is very likely that you and/or your spouse qualify for Aid and Attendance Benefits. Eligibility requirements include:
- You served at least 90 days of active military service 1 day of which was during a war time period. (If you entered active duty after September 7, 1980, generally you must have served at least 24 months, or the full period for which called or ordered to active duty.)
- You were discharged from service under conditions other than dishonorable.
- Your countable family income — after subtracting care and medical expenses — is below a yearly limit set by law (The yearly limit on income is set by Congress.)
- You must need help with at least one activity of daily living: dressing, eating, walking, bathing, adjusting prosthetic devices or using the toilet. Those who are blind, living in nursing homes or require in-home care may also be eligible.
For many veterans and their families the financial assistance they receive from their VA Aid and Attendance benefits can be an incredible help. Unfortunately, the application process required to receive the benefits can be daunting. “It’s not a simple process. A&A applicants must mail the forms, copies of service records, marriage certificates, proof of insurance and medical records to the regional VA office. If a third party is making the application, an additional form, 21-22-a or 21-0845, must be completed.”
This is why many veterans ask a knowledgeable Elder Law or Estate Planning attorney to help with the application process. The right attorney can help you find and fill out the correct forms, gather the necessary records and materials, and keep track of progress throughout the entire process. If you think you may be eligible for VA Aid & Attendance Benefits, check out the information on VA Pension Benefits by clicking this link: VA Pension Benefits.
What to Do When Dad’s Ability To Manage His Finances Begins To Slow Down
May 27, 2011
One of the most difficult aspects of caring for an elderly parent (or helping an aging parent who lives far away) is keeping one step ahead when that parent begins to lose the ability to manage his or her own finances. Many seniors can be very resistant to discussing what they feel is an extremely private and sensitive topic. Furthermore, according to this article in AgingCare.com, “for many elders, being able to take care of their own finances is an important symbol of independence and self-worth,” and one that they are not likely to relinquish easily.
Unfortunately, an elderly parent’s ability to manage their own money may cease before they are willing to ask for help. In these cases, it may be up to their children and loved ones to step in and help as best they can. What follows is a list of some non-invasive, non-offensive steps adult children and caregivers can take to help aging parents manage their finances.
- Ask for a list of important people and information you might need in case of emergency. This list would include contact information for an attorney, financial advisor, primary care physician, and insurance agent.
- Ask where your parent keeps important documents and how an executor or advisor could access those documents upon your parent’s death or incapacity.
- If your parent is willing, discuss their estate plan with them, including who they have chosen as their agent or executor, and what you can do if something happens.
- Ask your parent to make a list of monthly bills, expenses and account numbers. Although your parent may not want to hand over this information right away, the list should be stored with other important estate planning documents so that it can be accessed in case of emergency.
- As you keep track of your own financial deadlines (tax filing deadlines and the like) set up reminders for your parent as well.
- Ask that your parent list you as an “emergency contact” with their utility services, so that you would be informed if your parent’s service is in danger of being terminated.
- And finally, talk to your parent as often as you can. Keeping open lines of communication is the very best way to stay informed about the abilities and well-being of your aging parent.
Making Room For Mom & Dad: Checklist For The “Multi-Generational Household”
April 8, 2011
Throughout history, the multi-generational household has always had its place in our society. At times the multi-generational family has been common and plentiful, at other times rare and seen only on the fringes of society. In the past few years, for reasons of both economy and practicality, the percentage of Americans living in multi-generational households has been steadily rising. In fact, a recent article in the Wall Street Journal states that “In 2008, a record 49 million Americans, or 16.1% of the population, lived in households with at least two adult generations or a grandparent plus one other generation, according to the nonprofit Pew Research Center in Washington. That is up 17% from 2000.”
Although multi-generational living had fallen out of fashion in the decades prior to this, there are a number of reasons why inviting elderly parents to live with you can benefit the entire family. “By living together, families say they are better able to meet one another’s needs for child and elder care. Moreover, money saved on rent can help finance a graduate degree, a job search or a down payment on a house, or offset the costs of long-term care.”
But setting up housekeeping with your parents (or your kids) isn’t as simple as merely moving furniture, often there are financial—or even legal—details to be worked out. Here are some of the things you should discuss before you build the “in-law extension” in your home:
Will the situation be permanent or temporary? Whether your kids are moving back in until they find that dream job, or your parents are coming to live with you until they find the right retirement community, it’s important to discuss these goals and practical steps that will be taken to reach them. “Those who prefer a temporary arrangement should work out an exit strategy—for example, by estimating how long it will take a person experiencing financial problems to regain his or her footing.”
Will the “new tenants” pay rent, or make any other contribution to household expenses? If so, it is absolutely imperative to work out a rental agreement before hand. Also, the “landlord” will need to ascertain whether the rent they collect should be reported to the IRS as income. “Some landlords simply aim to cover the extra expenses they incur. In that case, they owe no taxes on the payments they receive, ” according to the source quoted in the article.
If two generations are looking to purchase a new property together, there are completely different details to be considered. “When generations join forces to purchase or modify a property, each should retain an advisor to review the tax and estate-planning consequences and protect their investment in the event the union dissolves.” Additionally, “joint ownership can pose problems for those who may need to rely on Medicaid to cover future nursing-home costs.” It is a good idea to consult with an elder law attorney before signing any contracts.
There are many benefits to living in a multi-generational household, but even with all these benefits it is hardly an agreement to be entered into lightly. Families considering taking this step should discuss it not only with the entire family, but with their financial and legal advisors.
Jinies.com