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.

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. 

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 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.

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.

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.

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.

Automatic workplace pensions. This would require employers (with the exception of very small businesses) that do not currently offer a retirement plan to enroll their employees in a direct-deposit IRA account. Employees would have the ability to opt-out if desired.

Tax incentives to create retirement plans. This proposal would increase the value of the tax credit to small businesses that start new retirement plans.  The current maximum credit is $500/year for up to 3 years, the new proposal would increase that to $1000/year.

More Social-Security funding. Obama’s budget would allocate $12.5 billion to the Social Security Administration, up $1 billion since 2010. The primary aim of this increase would be to “reduce the backlog of disability claims and decrease Social Security fraud.”

But not all of the proposals included in the budget are beneficial to retirees.  Here are a few things you may want to watch out for:

Pension insurance premium increases. “The budget proposes giving the Pension Benefit Guaranty Corporation… the authority to adjust premiums and take into account a company’s financial condition when setting premiums.” Although this is certain to result in premium increases, the increases would be gradually phased in.

Senior Community Service Employment Program funding cut. The proposed budget would reduce funding for the Senior Community Service Employment Program by 45 percent, and would transfer the program from the Department of Labor to the Department of Health and Human Services. Seniors who hope to retrain for new jobs in their retirement years may find this more difficult to do than they expected.

According to the article, “A huge wave of baby boomers may need long-term care in their golden years — and yet fewer than half have taken steps to prepare for it… two-thirds of Americans believe it’s important to plan for long-term care, but only 44% have taken steps to protect themselves.”  Part of the reason for this lack of preparedness is that Baby Boomers underestimate the likelihood that they’ll need long-term care, or they overestimate the likelihood that their children or families will be able (or willing) to provide that care.

But there’s another reason why Baby Boomers are statistically unprepared for the crisis of old age; to put it simply, there aren’t any clear avenues to solid and reliable financial preparedness.  “While it’s clear that not enough people are thinking about preparing for their long-term-care needs, it’s not at all clear what, if any, the best solutions are.”

Some think that extra savings in the bank will cover the cost of long-term care; others believe that government programs such as Medi-Cal or Medicare will take care of them.  Unfortunately, both of these beliefs are mistaken. “The average cost of a nursing home ranges from $85,000 to $120,000 a year, while hiring an aide to spend six hours a day on average in the home starts around $40,000 a year… Medicare, meanwhile, only covers up to 100 days of long-term care and often involves co-payments. Medicaid [Medi-Cal in California]will cover long-term nursing-home care but only after the person has drained his or her savings account.”

Another solution is long-term care insurance; but even with long-term care insurance, nothing is clear cut, and too many people have found themselves paying into a policy and ending up with no return on their investment. You also need to be healthy enough to qualify for the policy.  Long-term care insurance is still one of the best options out there, but “There have been horror stories of people paying premiums on long-term-care insurance policies for years, only to find the benefits won’t cover their needs 20 or 30 years down the road when health care and long-term-care costs are significantly higher.”

Another option may be Medi-Cal for those who need nursing level care.  Our firm has been a leader in assisting clients with qualification,  and with helping them plan their estates to enable qualification when need later arises.  There are many myths associated with Medi-Cal. For more information, we invite you to download a free copy of our “Consumer’s Guide To Medi-Cal Planning“.

The best advice we can give is to do your research and ask for the help of an advisor with experience in elder law, elder care, and senior financial planning.  Be prepared.



“In order to avoid conflict, parents [should] sit down with their children and spell out who has been appointed and why… It’s something that really has to be thought out in advance, hopefully before a crisis has arisen and while the parent is still able to express their goals.”

Open communication can go a long way toward smoothing relationships between family members, but if that by itself isn’t enough to keep the fights to a minimum, the advice of a trusted advisor can often dispel suspicions that may be brewing just beneath the surface. But don’t wait until arguments have already exploded, the best course of action is to consult with your advisor before intervention is necessary.  Asking your advisor to sit down with yourself and your family members gives each child a chance to ask questions and voice their concerns; it also gives them a chance to hear from your own lips what you’re planning and why you’re planning it. Sometimes a simple explanation may go a long way.

Support System- Do you have family or friends nearby who can check on you regularly and help when home maintenance issues crop up? Having someone close to you who can provide you with transportation is helpful as well, although many cities have public transportation services that may be an option.

Home Renovations- Is your home senior or handicap friendly? Are doorways and hallways wide enough to accommodate a wheelchair?  Could you easily add ramps or lifts in place of stairs, if necessary? Do your kitchen and bathrooms facilitate easy maneuverability with as little reaching or bending over as possible?

Security or Medical Alert System- Having a security or medical alert system in place can provide immeasurable comfort to an elderly homeowner and his or her family.  The technology for this is improving by leaps and bounds, and there are a number of different options available.

In-Home Care Services- The length of time you can remain in your home can be greatly increased if you have the financial means for (and access to) quality in-home care services.  Someone to do basic cleaning and cooking, and help with daily activities, can prolong your time spent at home… but you have to plan for it.

Getting older shouldn’t mean you have to give up your home, your friends and neighbors, or your independence.  For more information about what you may need to stay in your home as you age check out the website for the National Aging In Place Council.

Karen Stabiner, in her article “Elder Tech: What’s Important” argues that it doesn’t have to be this way.  Stabiner states that the key to getting elderly relatives involved in high-tech  communication is to get out of our own heads and look at it from their point of view. “For technology to become ‘sticky’ with the older generation, we have to get into their heads and understand what would make them think this is fun… The bells and whistles that might attract us are too often counterintuitive [for them.]”

The younger, tech-savvy generations tend to look for high-tech devices that do everything, but that’s not necessarily what’s going to be appealing to grandma or grandpa.  This article in GrayTimes.com suggests that single-purpose gadgets—devices designed only for e-mail or only for sharing photos—are more intuitive for elderly users.

New high-tech devices may be harder for parents or grandparents to use, but being able to connect with their loved ones can be a huge motivating factor.  Being able to communicate with family makes our elderly parents and grandparents happy, but it also helps keep them safe.  Adult children who communicate with their parents on a regular basis are better able to recognize and respond when mom or dad suddenly have trouble caring for themselves.