Selecting a Long Term Care Facility with Long Term Care Insurance

My mother, Rose, painting with Dementia

My mom is back at Sunrise Assisted Living and is thrilled to be back home. The only problem she has been facing currently, is that she is now what they call, “a fall risk”. In fact, since she returned home from rehab at Fox Run, she has fallen four times. This means that her level of care is going up and so will her monthly costs. I have a dilemma to deal with. Since my mother has a long term care policy that pays $90/day for an assisted living facility and $150/day for a skilled care facilitity, my question is: Should I move mom to a skilled facility and collect the extra $60/day benefit or $1800/month for her, or do I use her savings to make up the difference in rent?

Sunrise is not considered a Skilled Care Facility, so the most my mother can receive from her policy is 60% of her monthly $150/day benefit. If she were to move to a Skilled Care Facility like Fox Run (owned by Erikson), for example, she could receive the $150/day. Another issue: Fox Run also requires a $100,000 deposit to move in. Not all facilities do this, however, the deposit is returned to the resident when they leave, OR to their estate when they died. Plus there is an added benefit. The resident will never be forced to leave because they run out of money. Once the deposit is used up, the facility takes care of their expenses.

There is a lot to consider, right? My mom spent three weeks at Fox Run in rehabilitation and what I found is they are an excellent medical model facility. The care, however, is totally different than where she currently lives. Fox Run provides a “Medical Model” of care and Sunrise follows a “Social Model”. While my mom was at Fox Run, she was bored and spent all her time in her bed sleeping. Now that I have brought her home to Sunrise, she has spent her days dressed, socializing and very active. We both like the model so much better.

Be sure to consider this when you are looking for a long term care facility for your loved one. It’s amazing not only how many choices there are, but also how the type of facility you select can affect your long term care policy. Let me explain.

When my step father was diagnosed with lung cancer and my mother with Dementia in the fall of 2005, they moved from their private home to an “Independent Retirement Community”. Here they had a two bedroom apartment and even though they had a kitchen in their apartment, lunch and dinners were provided in a beautiful formal dining room with the other residents. When my father became very ill, the facility actually managed the medications and helped with custodial care for an additional fee. He paid for his expenses out of pocket, and then applied to his long term care policy for some small “home care benefits” that the policy provided.

While they were living in an “Independent Living Facility”, my mother was diagnosed with Dementia and qualified for benefits under her long term care policy. The problem we found out was that Independence Village was neither an Assisted Living Facility or Skilled Care Facility even though they had full time nursing staff. It actually had something to do with the construction of the building!

At this point, although my step-father qualified for his long term care benefits, we would have had to move him a new facility to collect his long term care policy benefits. We decided that peace of mind (staying in place) was more important that collecting insurance benefits during his final nine months of life. Had we known about this issue in advance, we would have selected another facility that offered multiple levels of care. This is a good thing to consider before selecting a facility when you own a long term care policy.

So when my step-father passed away, I moved mom to my house temporarily and began to look for a long term care facility that would work best for her situation. This is when we chose Sunrise. The West Bloomfield Facility was just 10 minutes away and she woudl have a wonderful studio apartment, three meals a day and lots of social activities. Her policy would pay 60% of her long term care policy daily benefit which was $150/day.

So this is where mom stands today: She is moving to another wing of Sunrise where they offer a much higher level of care AND she will not be in a nursing home envirnoment. Instead, she will remain very active and spend her days with the other residents in a “home style” area and just go to her room to nap or sleep at night.

Her rent, however will jump from $4800/month to $6330/month. Again, I can collect another $1800/month for her by moving to a Skilled Nursing Facility, but she would be back to the Medical Model. I have decided to run a financial time line to compare the difference between moving and staying to see how long her money will last both ways. And I have also put her on a list to move to the first semi private room when it becomes available. This will save her around $1200/month.

So the question is would you rather be in a Medical Model Skilled Cafe Facility collecting $150/day benefit (probably still in a shared room), or would you rather be in a very large “studio apartment” style shared room in a Social Model Facility for $600 more per month? My choice is the social model. We will start out paying around $6000/month initially for a private room, and then around $5000/month as soon as a semi private room is available. This sounds like a reasonable solution.

My mother is very fortunate. Because she and my step-father came to me for financial planning right after they were married 20 years ago, they were able to do a financial and estate plan when many options were available and insurance costs wereaffordable.

My mother’s long term care policy premium at age 58 (20 years ago) was under $100/month for a lifetime benefit period, and with an inflation rider (so her policy benefit would increase every year by 4%). If she had waited until she was 70 to purchase the policy, it would have been too expensive and she would have been uninsurable.

The secret is starting to plan as early as possible…beginning with our own planning….and realizing that no matter what your situtuation is today, there is always an appropriate plan of action. The key is finding a caring and knowledgeable advisor to help you through the process.

I would like to hear your experiences. Feel free to share them with us. If you are interested in help with these types of questions and situations, email me at katana@designateddaughter.com or call me at 248-366-0137. Either I or one of our Contributing Experts will be able to help you with your situation. Also, be sure to sign up for my Caregiver’s Manual right here on the website. It’s a great tool for helping you prepare for this entire process.

Who is watching over mom when you’re not there?

My parents: Dale and Rose

Women today are faced with a real dilemma as Caregivers:  How do we manage all our roles: as wife, life partner, mother, business owner or career woman, volunteer and more often as primary caregiver to our parents?  This is known as living in the Sandwich Generation.  I call it being the Designated Daughter.

My Story:  Last Sunday, I went to check up on my mother who resides at a local, very upscale, assisted living facility.  What happened next was scary.  Because of my professional training as a Certified Financial Planner and Certified Senior Advisor and my recent experience helping my step-father during his final year long struggle with lung cancer, I may have been more prepared to notice “red flags” in her care.  I just wonder, however, what would have happened had I not stopped by that night, or had been living out-of-state.  Let me first fill you in. 

What happened two nights before (Friday night):  My mother who suffers from Dementia had been in the hospital just two night prior after complaining about heart pain.  She had been receiving the physical therapy that I had requested after her last hospital visit only 30 days prior.  The facility had given her a nitro glycerine pill which had caused her heart rate to drop dramatically.  The facility called an ambulance and sent her to the hospital.

I was called, and when I arrived at the hospital, I found her disoriented, exhausted, in a weakened condition andin very poor hygiene.  I won’t go into detail, but I was very embarrassed for her, and after her vitals were normal again, I took her back home to the facility, where I made sure that she received a shower.   I had not idea at this time, that she had a low grade urinary tract infection and that she should have stayed at the hospital.

Caregiver Red Flags:   This was still Friday night after bringing my mother back to the facility for a shower and helping her get settled.  I went to the nurses station and requested to see her personal file and medical file.  This is when I found that she was still receiving Vicodent to manage her pain on a daily basis.  The Vicodent had been prescribed about a month ago for the pain related to “old” compression fractions. 

Next, I went out to talk with the employees of the facility to see if they had noticed any changes changes in her health or ability to take care of herself, this is what I was told:

• She had been more tired than normal
• Spending a lot of time in bed complaining about pain
• She also seemed to be “out of it” most of the time

My mother has always been very social and very active.  On July 4th, she had played pool with my husband for a couple of hours, helped me in the kitchen and garden.  In addition, she would play cards with her friends for hours.  I would often join them after dinner and we would play until 10 pm.  I was told that in the last month, she would sit at the card table and not even be able to play the cards in her hand because she was “so high or out of it”.

What they were referring to was the combination of prescriptions she was taking, plust the added dose of Vicodent that she had been prescribed for a urinary tract infection last month.   This also explains why she was getting weaker and weaker.  I noticed that over the last month, she had been riding around in a wheel chair, but I had no idea that Vicodent had been prescribed for long term pain management.

So on Sunday night, after receiving a call from the nurse that my mom was not feelling very well, I decided that I would  stop in to check on her.  To my horror, she seemed to be close to death.  She was lying in bed shaking (she had a high fever from a urinary tract infection)

• She was dehydrated (I gave her a 12 oz. glass of water with a straw and she sucked it down in one gulp)
• She could only speak in a whisper and had no idea anything was wrong with her. 
• She looked as frail as a little bird and I knew she was dying. 

Right then, her caregiver walked in. 

• I asked her if my mom was receiving food or water.  She said that the day before, my mother was in so much pain, that she was not really eating or drinking. 
• The young, pregnant caregiver also said that when she tried to help my mother get to the bathroom, my mother had put her arms around her and lifted her legs like a little monkey to be carried.
• My monther was also in a diaper because she could not control her bladder.

This is when I walked out into the lobby and asked for an ambulance immediately.  It was now almost 7 pm, Sunday night.  Thank God I had stopped by.

When we arrived to the hospital, she was put on an IV and given antibiotics.  She had a very high fever and a urinary tract infection.  This is when the nurse discussed the dangers of the sepsis infection with me.  The high levels of Vicodent may have been masking the pain she was experiencing from the urinary tract infection.  In addition, she had not been drinking enough fluids because of the drugs causing her to be “high”.  This may have caused the UTI to simply get worse and continue unnoticed.

This story has ended up okay, my mom is now safe and recuperating well at Fox Run in the skilled care section.  Because I am experienced in issues related to caregiving, this is what was going through my mind when she first arrived to the hospital on Sunday:

• my mother needed a three day hospital stay to qualify for Medicare to cover rehab/skilled care for up to 100 days.  
• She was very week and needed to build her strength and get back to her prior level of strength, but there was no exercise equipment at her current facility and this may have  attributed to her declining health.
• I better get busy and figure out where I wanted her to live when she left the hospital, because although I loved the social aspect of her current facility, they may not have  a proper protocol when someone’s health is on the decline.
• I contacted Fox Run, an Erickson facility that had a new skilled care/rehab center and also offered 5 levels of custodial care and I wanted to make sure she could go there, even though the hospital care manager would request 3 different rehab facilities
• I would need to check my mother’s assets because Fox Run requires residents of the Assisted Living Facility to come up with a $99,000 cash deposit and then go through financial underwriting to see if she qualified.
• Also, my mother had a long term care policy that paid $150/day benefit for a skilled care facility.  Currently she was only receiving 60% of the benefit since her current facility was classified “assisted living”.

There are so many decisions a caregiver is required to make when dealing with a loved one.  I just hope by sharing this information, I will be able to help others “be prepared for that call in the night”.  Currently, I am working with the management at the assisted living facility where my mother is living to help them see what went wrong so it won’t happen to another resident.  I honestly have loved her current facility…they have been wonderful and this is her home. The problem is that by simply missing a few red flags, a resident’s health can change very quickly.  Also, I needed to be contacted more frequently with important information about her wellbeing. 

Be sure to download your free copy of, “Your Caregiver’s Manual” right here on this website.  It will take you step by step how to get organized financially when helping a loved one.  If you would like a consultation about your own personal situation, please feel free to email me at katana@designateddaughter.com   

I am interested in your stories.  In fact, I am currently writing my new book, The Designated Daughter:  How to Be Prepared for that Call in the Night and interested in your challenges, and success stories of being a caregiver.  I would love to hear from you on this blog, so please leave a reply. Thank you!

Beautifully Imperfect

by Steve Pender, video biographer & personal historian, Family Legacy Video, Inc.

At the end of the day, what it is you’ll remember about your loved ones? Great accomplishments? Public acclaim? Perhaps. More than likely, though, it’ll be their endearing and “imperfect” qualities – like in this commercial commissioned by the government of Singapore. Enjoy!

An Olympic Family History Moment

by Steve Pender, video biographer & personal historian, Family Legacy Video, Inc.

Imagine finally seeing your father run in the Olympics – the 1912 Olympics, that is.

Creating video biographies is always fulfilling for me. But occasionally I can provide a special service that really gives me the warm fuzzies. Here’s an example:

Just before Christmas of 2004 I completed a Family Legacy Video for a wonderful couple, Mary-Lou and Dick, in Tucson, Arizona. It turns out that Mary-Lou’s dad was a college track star in the 1910s, held the record for the mile for a number of years and placed fourth in the 1500m run in the 1912 Olympic Games in Stockholm, Sweden.

After I finished the video, Dick asked me if I thought film footage of the race might exist. I told him I’d check around. I contacted a few film archives with no success, then managed to find my way to the Web site of the International Olympic Committee. I submitted a query through the site, and then went on to other things.

After about a month, I received an e-mail from an archivist at the IOC. Believe it or not there was a film clip, thirty seconds long, of the race I was looking for!

Long story short, the IOC sent me the clip. The quality of the film was surprisingly good and gave views of the starting line, the mid point of the race and the finish. I added a title screen and created two versions of the clip, one running at normal speed and one in slow motion, adding a freeze frame of Mary-Lou’s father crossing the finish line. Then I put it all on DVD.

After watching the footage, Mary-Lou wrote me, saying, “You can’t imagine what a thrill it was to see Dad running. That was an amazing thing you did for us but it meant the most to me. Thank you again and again.”

I feel great knowing I helped make a very special and unique addition to a family’s archive.

Women Educating Women Miniseries

Smart Women’s Coaching’s Own Contributing Experts Danielle Mayoras and Jill Jordan are proud panelists for the miniseries: What Every Women Needs to Know to Care for Loved Ones Now and in the Future

Rochester, Michigan – September 15, 2009 A series of three free workshops focused on the financial, estate and care planning issues women face every day. This community program will take place at the Rochester Community Center, 816 Ludlow St, Rochester, MI Workshop dates are September 15th, 22nd and 29th, 2009 All three workshops will run from 6:30 P.M. to 8:00 P.M. This educational series is presented by the Women Educating Women Consortium. Attendees, should RSVP to 1-877-PLAN-758.

The Women Educating Women Consortium is a collaborative effort of female professionals, for the purpose of educating women in areas in which they are the decision maker.  These are the life circumstances and issues affecting them daily.  The material to be covered in this community event will address and answer questions women have which impact their families.  Some of the areas to be discussed are; indicators which should lead to taking an active role in a loved one’s life, senior care options, what to look for in a senior community,  Medicare and Medicaid and their relationship to funding care,  what are the Veteran’s benefits, information about long term care insurance and retirement and estate planning.

Presenters: Danielle Mayoras – Attorney and Counselor,  The Center for Elder Law Jill Jordan – Founder and Principal of Get Ahead by Getting Known Mary Jo Fresard – Director of Community Relations at Sunrise Senior Living Rochester Joann Lagman – Owner of  Home Helpers & Direct Link’s  Washington/Romeo office Nancy Salvia – Financial Advisor, Merrill Lynch Candius Stearns – Owner of DFBenefits Call 1-877-PLAN-758 to RSVP, Space is limited – reserve your seat today!

Announcing the Designated Daughter Radio Show

Join Katana Abbott, Midlife Millionaire and Danielle Mayoras, Elder Law Expert as they co-host their new and highly requested radio show “Designated Daughter” on Smart Women Talk Radio.

The first show airs Tuesday, August 25th, 8:00 am (PST)/11:00am (EST).

You must tune in to this show if you are a caregiver, a future caregiver, baby boomer, or a professional who services caregivers.  As two highly acclaimed experts in their fields, Katana and Danielle will discuss topics that are surrounding today’s aging population.  Expert guests will join them addressing how to overcome the most common hurdles caregivers, and professionals servicing the aging and caregiving population face.

Katana Abbott, CFP, CSA

Smart Women Talk Radio teaches you to live with Purpose, Passion and Prosperity.

Katana Abbott knows firsthand the powers of an organized financial strategy. She left her $100 million investment management and financial planning practice to become founder and vision coach of Smart Women’s Coaching, a global online coaching, consulting, leadership and membership resource. Rising from a life of poverty and adversity to one of abundance, Katana spent 20 years with Ameriprise Financial as a Certified Financial Planner. At the age of 48, Katana retired financially independent. She and her partner of 15 years managed over $100 million which placed them in the top 1 percent of money managers nationally. She began pursuing her dream and created Smart Women’s Coaching in 2006, which has prospered into www.SmartWomensCafe.com, the free online networking community that is helping women in mid-life transition all around the world find their niche.

For more information, please visit www.SmartWomensCafe.com or email Katana directly at katana@smartwomenscoaching.com.

Danielle Mayoras, Attorney and Counselor, CPG (Credentialed Professional Gerontologist), Director of Education, for The Center for Elder Law, The Center for Probate Litigation and The Center for Special Needs Planning

Danielle Mayoras has dedicated her legal career to educating professionals and businesses as well as the general public on the topics of elder law, special needs planning, and general estate planning through presentations, print, and broadcast media across the United States.  She is a founding partner of The Center for Elder Law, The Center for Probate Litigation, and The Center for Special Needs Planning.

Additionally, Danielle is the co-author of the upcoming book Trial & Heirs: Famous Fortune Fights which you can learn more about at http://www.trialandheirs.com. Trial & Heirs uses real celebrity stories to help you avoid any errors when planning to leave your legacy to YOUR heirs.

Some of Danielle’s recent publications include: Exceptional Parent Magazine, Michigan Lawyers Weekly, and the Detroit Free Press.  She is also an active member of National Association of Elder Law Attorneys, The Michigan Dementia Coalition, National Speakers Association, Institute of Gerontology’s Elder Law and Finance Committee, and National Association for Professional Gerontologists.

Danielle is a founding partner of The Center for Elder Law, The Center for Probate Litigation, and The Center for Special Needs Planning.

For more information, email Danielle at  dmayoras@brmmlaw.com, or call 1-877-PLAN-758.

www.thecenterforelderlaw.com www.thecenterforprobatelitigation.com www.thecenterforspecialneedsplanning.com www.probatelawyerblog.com http://www.trialandheirs.com

A Legacy of Tulips

by Steve Pender, video biographer & personal historian, Family Legacy Video, Inc.
Did you ever play Wiffle Ball? Growing up, it was the summer pastime of choice in my suburban New Jersey neighborhood. Every day, kids would congregate on the side street by my house, choose sides and have at it. Games were noisy affairs, punctuated by lots of arguments over close calls, and could last for hours. It wasn’t unusual for us to suspend a game for dinner and then reconvene afterwards. In fact, I remember finishing one game under the glare of a neighbor’s headlights.

It was a pretty safe game, too, thanks to the hollow plastic Wiffle Ball. It would glance harmlessly off just about anything it hit.

The exception was Mr. Daly’s tulips.

Mr. and Mrs. Daly lived on the other side of the street. They were a very pleasant, elderly couple and they tolerated us kids pretty well. Unfortunately, Mr. Daly insisted on planting tulips outside the chain link fence bordering his backyard. He was quite proud of those tulips and the bright red and yellow blooms they provided each spring – and he became quite upset whenever a sharply hit foul ball lopped the top off one of them. Or two. Or three. Not that we wanted to damage the flowers; they were just innocent bystanders that occasionally got caught in our Wiffle Ball crossfire.

The 1960s, as well as Mr. and Mrs. Daly, are long gone. But a recent experience brought all those memories back to me. In early July, my wife Halina and I traveled back to New Jersey to visit family. One day, we drove through my old neighborhood. I couldn’t resist stopping to look at my old house, now vastly enlarged from the little bungalow in which I grew up. I walked around the house and took a few pictures – and it wasn’t long before I caught the attention of one of the neighbors, who probably figured I was casing the place for a robbery.

He strolled over, a glass of beer in hand, and asked if I needed some help. I introduced myself and told him I grew up in the neighborhood. We started chatting, and soon I found myself in the middle of a small crowd of neighbors, answering questions about what things were like in the old days, and who used to live where. During the course of our chat, I mentioned our Wiffle Ball games and the many tulips we beheaded.

Finally, the time came to say goodbye. As I was about to leave, the neighbor currently living in the Daly’s old house said, “You know, I’m glad you mentioned about the tulips. They keep sprouting up and I had no idea where they came from.”

As Halina and I drove away, the thought of those tulips – Mr. Daly’s legacy to the neighborhood – filled me with a warm glow. The experience reminded me that legacies can take many forms, be they video biographies or tulips – and that they enrich and inform the lives of the generations that follow.

Nice job, Mr. Daly.

Family Legacy in Poetry

by Steve Pender, video biographer & personal historian, Family Legacy Video, Inc.

Several years ago, my local paper, the Arizona Daily Star, published a wonderful poem by a poet named Andrei Guruianu that relates to family history in a very personal way. The poem really resonates with me; I hope you enjoy it.

Grandfather
by Andrei Guruianu

Dead before I came into this world, grandfather,
I carry your name, yet I’ve never met you.
I hear my name, and know
that somehow they refer to you.
When I scribble those six letters
fast, to sign some document
or print them neatly in a box,
I feel your presence flow with the ink
stain and burn through the paper,
forever imprinted in my mind.
Late summer nights
gathered around the dinner table,
leftovers being cleared away,
faces clouded in cigarette smoke,
I hear voices pass the word
back and forth in reverence.
Somehow I know it’s not me
the little one grabbing for attention.
They speak of you, Andrei,
the one I’ve never met,
whose name I carry.

The Timeline of Your Life

by Steve Pender, video biographer & personal historian, Family Legacy Video, Inc.

I just found a site where you can generate your own personal historical timeline.

If you have a few minutes and want to see how your personal history intersects with world events, head on over to OurTimelines.com. Enter in your name, the date of your birth and the current year, and the site generates a timeline of historical events – and tells you what your age was when these events occurred.

Enjoy!

Ethical Wills on Video

by Steve Pender, video biographer & personal historian, Family Legacy Video, Inc.

We’ve seen the scene in movies countless times. Bereaved relatives gather in a lawyer’s office. An attorney picks up a sheet of paper and begins to read, “I (insert name here) being of sound mind, do hereby bequeath my estate to…” And so on and so forth. A last will and testament, the document that details how a person disposes of his or her physical property after death, is a pretty common concept. But there’s another kind of will gaining popularity, one that focuses on spiritual and moral values as opposed to physical assets. And this will is often passed along before the will’s writer passes on.

It’s called an ethical will. Ethical wills have actually been around for three thousand years, but they’ve gained newfound popularity since 9/11. They can take the form of personal letters written to a child, grandchild, niece or nephew, an audio recording or a video. Ethical wills can incorporate anything a person believes is meaningful enough to pass on. The Web site www.ethicalwill.com lists some common themes:

Important personal values and beliefs
Important spiritual values
Hopes and blessings for future generations
Life’s lessons
Expressions of love
Forgiving others and asking for forgiveness

 

Why create an ethical will? According to http://www.ethicalwill.com, some reasons are:

We all want to be remembered, and we all will leave something behind
If we don’t tell our stories, no one else will and they will be lost forever
It helps you identify what you value most and what you stand for
By articulating what we value now, we can take steps to insure the continuation of those values for future generations
You learn a lot about yourself in the process of writing an ethical will
It helps us come to terms with our mortality by creating something of meaning that will live on after we are gone
It provides a sense of completion in our lives

Video can be a powerful medium for passing along your values to a loved one. The conviction in your words and the passion in your eyes will leave a profound impression on the person for whom you create your video ethical will, as well as the generations that follow. You don’t have to do anything fancy from a video standpoint. To ensure a good quality video, either hire a professional or do-it-yoursef employing some of the basic organization, lighting and sound techniques described in the Family Legacy Video™ Producer’s Guide.

An ethical will can be a wonderful gift and a long lasting legacy, made all the more powerful by the use of video.

Video biography project leads to a high-flying experience

by Steve Pender, video biographer & personal historian, Family Legacy Video, Inc.

In 2006 I interviewed Charlie Wilson. Charlie is a former B-17 pilot and a large part of his interview focused on his exploits during WWII. Little did I realize that Charlie’s video biography would lead to my own flight in a reconditioned B-17 – and a chance to experience, in a very small way, the aircraft that Charlie and his crews flew under very perilous conditions.

Charlie’s video biography featured a large amount of archival footage showing B-17 crews in action during the war. The more footage I watched, the more I marveled at the daring, bravery and resilience of both the crews and the machines they flew. I’m sure I remarked to my wife, more than a few times I’m sure, how exciting it would be to fly in a B-17. Then, as a 50th birthday gift, Halina gave me a ticket to what turned out to be the ride of my life.

The Collings Foundation, an organization that preserves vintage aircraft, brought three WWII bombers, all in working order, to Tucson: a B-25 Mitchell; a B-24 Liberator; and a B-17 Flying Fortress. Halina, myself, my mom and brother arrived to find all three planes sitting on the airstrip and open for inspection. We spent some time climbing in and out of each plane – and then it was flight time.

As the flight crew slowly rotated the props to get the oil circulating, my group of ten passengers climbed into the plane. I was lucky to get a seat behind the co-pilot (not a seat, really, just a patch of deck with a seat belt). Across from me, behind the pilot, was a fellow, now retired, who was only six years old when his brother died while piloting a B-17 over Germany. He was flying as a way to honor and remember his brother. His story reminded me how many men sacrificed their lives in planes just like the one we were about to fly.

Then, one by one, the engines kicked in. The plane began to vibrate, the roar from the engines grew and the scents of fuel and oil wafted through the air. Then we were aloft and got the signal to unbuckle and move about the aircraft. My seat mate and I made a beeline for the nose. There, in the area once occupied by a bombardier and gunners, we gazed through the Plexiglas covering at a panoramic view of mountains and homes.

Moving back towards the aft end of the plane, I popped my head through an open hatch and was treated to a breathtaking view of the B-17’s tail and the mountains and desert landscape beyond. It was a challenge squeezing my 6’2″ frame through the tight confines of the Flying Fortress – but I managed to look out every window and sit or stand in every crew position available (except for pilot and co-pilot, of course).

And then, all too quickly, we were given the signal to buckle up and prepare to land. After a gentle touch down I swung myself out of the hatch and, adrenalin still pumping, rejoined my family.

The ride brought me a much deeper and visceral understanding of the B-17 and also a greater appreciation for the tight and uncomfortable conditions endured by the plane’s crews. It was, truly, the ride of a lifetime – one for which I have to thank my wife, the Collings Foundation, Charlie Wilson and all the B-17 crews that risked and sacrificed so much to preserve our freedom.

Advice from a former hospice nurse: Capture your loved one on video now

by Steve Pender, video biographer & personal historian, Family Legacy Video, Inc.

I was on the phone with a sales rep not too long ago. We got to talking about my business and as soon as she heard what Family Legacy Video was all about, she said, “I think what you’re doing is wonderful!” Turns out that, prior to her sales career, she was a nurse at a hospice.

She went on to say that she always tried to get families of hospice patients to tape remembrances with their loved ones and that so few families did. She hated to see so many memories and family stories lost. She was very passionate about the subject; I could certainly hear the emotion in her voice.

I can only imagine how emotionally trying having a family member in hospice care can be. But I encourage you, as does the former hospice nurse with whom I spoke, to spend some of those final days or hours capturing your loved ones family stories on video. They’ll be a lasting legacy you’ll treasure for years to come.

Bridge the generation gap with a family history video

by Steve Pender, video biographer & personal historian, Family Legacy Video, Inc.

Most elder family members are great sources of family stories and family history, but have little interest or experience with video technology. Many younger family members know little family history but are aces when it comes to computers and video. What can bring them together? Try a family history video project.

There I was, at a local Rotary Club, in the middle of a talk about creating family history videos, when one of the older members, a fellow in his mid-seventies, piped up. “This digital stuff seems like a lot of bother to me,” he said. “There’s tape, there’s discs – I really don’t know what’s what. Technology keeps changing and I can’t be bothered transferring from one format to another. I’ve locked all my family films in a cabinet, along with a projector, and when a family historian wants to watch them, that’s where they’ll be.”

I congratulated him for safely storing his family films and I had to admit he had a point when it came to technology. Rapid advances in computer and video hardware and software have been dizzying and sometimes confusing. BUT, when the choice is between preserving a precious video record of your family stories and history or losing them for all time, I don’t think the fear of a little technology should be allowed to get in the way.

So what do you do if you view technology as a hindrance rather than a help?

Look for the nearest teenager or preteen. Grandkids, grandnieces and grandnephews grew up with this computer stuff. To them it’s second nature. Why not enlist their help in creating a family history video they’ll treasure in years to come (kids being kids, they might not see the value in it now – but when they get older, they will). So butter them up a bit. Play to their pride in their computer and video expertise. And if that doesn’t work, have their parents make them help you. Once you get some momentum going, a family history video project is sure to spark their interest and creativity. You may find them getting just as excited about it as you.

Of course, collaborating with a younger family member on a family history video is much more than just a means to an end. It provides a great bonding experience, a chance to share quality time, to laugh and learn together and to create something of which you’ll both be proud. You’ll end up with a living legacy your family will love and with wonderful new memories that will last a lifetime.

Maps can chart your way to video biography success

by Steve Pender, video biographer & personal historian, Family Legacy Video, Inc.

Whether you’re setting out on a cross country driving tour or wondering how to visually “navigate” through your next video biography, a good map can be a real asset. You can use maps to establish the locations important to your subject’s story and also use them to impart a sense of movement to illustrate someone’s travels.

For example, I recently used maps to help tell the story of a married couple. The wife was born in the Philippines prior to World War II. I used a map of the Philippines to establish the length and breadth of the island chain and also to show the location of her home island and the areas on that island that figured prominently in her story.

Her husband, a bomber pilot during WWII, hitched rides from Texas to Canada in order to volunteer for the Canadian Royal Air Force. I combined two moving maps, one of Texas and one showing the border of the U.S. and Canada, to help visualize his journey.

Where can you get good maps? I recently found a great resource, a company called Maps.com, which offers a variety of digital maps available for download. They’re already digital, which offers convenience (no scanning) and great image quality. I recommend downloading the PDF versions. First, they’re inexpensive (many starting around $6.95). Second, if you have Adobe Photoshop, you can open the maps there and scale and crop them to whatever size you need. You can also add effects to give the maps an aged or period look, add locations, etc. Then, import the map into your editing software, give it some motion, and you’ve got a great-looking, low cost visual.

Bring new life to those old family films

by Steve Pender, video biographer & personal historian, Family Legacy Video, Inc.

At my Rotary meeting the other day, a fellow member turned to me and said, “Steve, I’ve got lots of home movies from the 40s and 50s. What I can do with them?” The answer: Lots!

If all you want to do is free your old 16mm, 8mm and Super 8mm films from the back closet and make it possible for you to view them again (without having to set up a screen and projector), have them transferred to DVD. You probably have a local company that’ll do this for you (check with photo developers or with companies advertising video production services). The great thing about this is you’ll be able to pop a DVD into your player and watch your long-ago relatives once again. The downside is that your movies might be transferred in no particular order. You may find yourself jumping decades forward and backward as the reels change. But if all you want to do is preserve your films, this option may be the one for you.

Another option: Use your films to tell stories. Instead of having your footage transferred directly to DVD, get it put on miniDV or Digital 8. These are formats that you’ll be able to use in conjunction with a computer that has digital video editing software. Once your films are on tape, review them. Think about the events they chronicle, the stories they bring to mind and the people they feature. Then transfer your films-on-video into your computer. Once you’ve done this, you’re ready to use your films to tell some stories.

There are a number of techniques you can use. You and/or other family members can narrate the films, describing the events and the people as you see them on screen. You can interview family members on videotape and ask them questions about the events and people in the films. Then you can combine the interviews with the films, and with family photos, to create a family documentary. You can also incorporate titles, sound effects and music. Once you’re done, you can output the finished program to tape or burn your own DVD.

Be as creative as time and your ambition allow. Whatever you do, please realize that there’s no reason to let those old family films continue to collect dust. And if you’re not technically or creatively inclined, remember that Family Legacy Video is here to help.

Unexpected benefits of video biographies

by Steve Pender, video biographer & personal historian, Family Legacy Video, Inc.

Video biographies are certainly wonderful ways to capture and preserve your precious personal stories and family history. They also tend to generate surprise benefits as well. Here are a few examples from Family Legacy Video’s files:

Uncovering an Olympic moment.
Mary-Lou and Dick are a wonderful couple here in Tucson, Arizona. Mary-Lou’s dad was a track star for Cornell around 1910. He also ran in the 1912 Olympic Games in Stockholm. During the course of producing their video biography, the couple asked me if I thought there might be film of the 1912 race. I checked with the International Olympic Committee – and sure enough, they uncovered a film clip from that long-ago event. Long story short: A copy of that race, on DVD, now occupies a place of honor in Mary-Lou and Dick’s family archives. By the way, when Mary-Lou, who is in her eighties, watched the clip of the race, it was the first time she saw her dad run. Her reaction: “You can’t imagine what a thrill it was to see Dad running. That was an amazing thing you did for us but it meant the most to me. Thank you again and again.”

Reconnecting with family.
Doug hired Family Legacy Video to create a video bio featuring his mom, Marion. She detailed events that her kid sister never knew occurred. After watching the video, her sister and other relatives rekindled their relationships with Marion. Here’s how Doug described what happened: “Mother’s only surviving sister, who is seventeen years younger, was not aware of the Washington adventures and many other items that the three older children had experienced. Mother and her sister are now much closer because of the video. Many nieces and nephews with whom she’d had little contact are now in touch with her again. Thank you for providing us with a Family Legacy Video that will be passed down and enjoyed by our family throughout the coming generations.”

Inspiring a new interest in family history.
Family Legacy Video recently taped a conversation between two brothers, Will and Pren. They had a great time recounting their family history and adventures. The project inspired Pren to do even more to preserve his family history. According to his daughter: “One of the hidden benefits of this project was the search for family photos to include in the video. I really enjoyed looking through them all with my parents, and labeling them for future generations. What a treasure! I am so glad we did this now. My father has been so inspired that he has taken on a new project – he found boxes and boxes of slides in the basement of his Illinois home and has been scanning them. He’s really enjoying it and it’s been great to see those old photos too.”

Finally telling the full story.
Len made his fortune in Peru, arriving there early in 1940. He had many fascinating adventures, both business and personal, to relate. He was most interested in detailing his business success. At the end of his interview (which stretched over three days) he had this to say: “I am very appreciative. I look forward to giving my children my background. I’ve always told them a little bit here and a little bit there, but never the complete story.”

Every video biography project Family Legacy Video undertakes results in benefits like those above. So don’t wait – get started on your family video biography project today. The benefits, both apparent and unexpected, will thrill you.

By the way, you’re invited to view sample legacy video clips at Family Legacy Video’s Web site.

Personal History: Work of the Soul

by Steve Pender, video biographer & personal historian, Family Legacy Video, Inc.

“The work that personal historians do is sacred. It’s the work of the soul. It’s blissful and heartfelt work.”

So said James Walsh as he began his presentation at an annual conference of the Association of Personal Historians. Walsh teaches history at the University of Colorado in Denver. He focuses on the oral tradition. This tradition – passing along history through the stories of the participants – is near and dear to the hearts of all of us creating video biographies, whether we do it as a profession or as a hobby.

Walsh continued by recounting an African proverb that says there are two stages of death. The first stage is sasha. Sasha are people who have passed away physically – but the living still remember them and tell their stories. So the sasha are not yet dead. The second stage is zamani. Zamani are people who have also passed away physically. However, the living no longer remember them, nor do they tell their stories. Zamani are truly dead.

What a powerful proverb – and it connects perfectly with the quote at the beginning of this article. Speaking for myself, the work I do as a personal historian, as a video biographer working through Family Legacy Video, does make me feel blissful and is certainly heartfelt. It is indeed sacred and the work of the soul. And it is dedicated to making sure my clients and my family remain sasha, not zamani, after they depart this physical world.

And yet there are many who feel they have nothing to say, that their life stories don’t merit telling and preserving. To this I offer another story related by James Walsh. He was a young man from a Pennyslvania steel town, blue collar through and through, plopped down in the middle of Duke University thanks to a wrestling scholarship. He had little in common with his classmates and felt quite insecure in class. As a result he sat in the back, saying little.

One day, his professor pulled him out of class. “Walsh,” asked the professor. “Why aren’t you talking in class?” “Well professor,” the young man answered, “I guess I don’t think my ideas are very good.” With that, the professor slammed down his fist. “Let me ask you this,” he exclaimed. “How many people in the history of the planet will ever see the world from your perspective?” Walsh thought for a moment and then answered, “No one.” “So,” said the professor. “If you won’t tell us what the view is like, who will?”

Exactly – who will describe the unique views and perspectives of your life, or those of your parents, grandparents or other relatives if you or they do not?

The answer is obvious. By capturing and preserving our stories through video biographies we celebrate our unique views of the world and of our places in it. We share and relish our video bios while we’re alive. And then, after we depart this earthly coil, our stories, as told by us, remain to be enjoyed by future generations of our families, keeping our memories alive, connecting our family past with its present and future – and keeping us sasha.

If this isn’t sacred, the work of the soul, I don’t know what is.

If you’ve already started preserving your family storytellers on video, bravo! If you haven’t begun yet – start. Now.

And remember that Family Legacy Video is here to help.

On quilts and life stories.

by Steve Pender, video biographer & personal historian, Family Legacy Video, Inc.

My wife, Halina, visited a quilting expo recently. She came back with vivid descriptions of the many beautiful, handmade quilts on display. As she spoke, some of the patchwork quilts I’ve seen in the past came to mind. You probably know the kind, the ones composed of fabric swatches of all shapes and colors. And I realized these quilts had parallels to family history.

How? As I see it, our families certainly are “crazy quilts,” composed of people of all shapes, sizes and colors; sporting a wide range of political leanings, philosophies and religions. In our family quilts, life stories are the swatches; memories are the threads that bind those swatches one to another. Stitched together, each life story becomes an integral part of the whole. And just like the quilts created at quilting bees, each of our “family quilts” has its own personality and character.

But fail to record those life stories and memories will begin to fade; the ties that bind, that tell us who we are and where we come from will loosen. Our family quilt will lose one swatch, then two, then more. Pretty soon our quilt will start looking like Swiss cheese. Eventually we may have no quilt at all.

That’s why I think recording family history, particularly through video biographies, also known as legacy videos, is so important. Video serves to keep our stories and storytellers alive. The greater the number of life stories we collect and pass on, the more complete our family quilts will be. And as the years pass, our quilts will grow larger, keeping each of us warm in the knowledge of where we came from and where we fit into the fabric our own family history.

Like to see some video biography samples? You’ll find clips from a variety of legacy videos at Family Legacy Video.

Family Legacy Video and Financial Planning

By Katana Abbott, Certified Fiancial Planner and founder Designated Daughter

Almost 20 years ago, my mother remarried the most wonderful man who changed her life.  It was a marriage made in heaven… 20 years later; they were still in love at 86 and 72. 

Since I was a Certified Financial Planner, when they married, Dale asked me to do a financial plan; he was 72 and my mom was 58.  He created a living trust that gave my mother a life interest, but the principle transferred to his children at his death.  He also purchased life insurance and long term care for both him and my mom.  My mother’s long term care policy was $100/day with a 5% inflation rider and lifetime benefits. 

In the fall of 2005, at 86, Dale was diagnosed with lung cancer.    If we had left things the way he originally set them up, when they were first married, which was the typical joint ownership with rights of survivorship, his children would have been disinherited, my mother would not have had long term care insurance and would have used up all his assets.

Because his estate planning had been in place for years, and reviewed annually, we were able to focus on his quality of life and quality of care that last year. 

During the last three months of his life, Hospice was with us daily, we had moved his bed into the living room, so he could look out at the ducks on the pond.

The week before Dale died; he looked up at me and whispered, “You’re my miracle worker”.  I will never forget his words or the impact his planning has had on his loved ones lives.

He knew that he had done a great job; my mom was set for life and I know he had overheard us talking when we received the call from the insurance company that my mother had been approved for her long term care insurance claim.  She had recently been diagnosed with dementia and the insurance would provide her with up to $150/day for life—with an increasing benefit to keep up with inflation.  This was almost $55,000 a year of additional income that would be tax free.

Between her survivor pension and tax free long term care benefits, my mother was able to move into Sunrise Assisted Living without using any of her investment income.  In addition, we saw that she would probably never need the assets from my step father’s trust, so we made an immediate gift of $100,000 to his children who were just a few years younger than my mother. 

I am so thankful that Dale had agreed to do this planning decades before when they had many options, and were not under stress. 

I was able to play a video that I had taped of my step-father and mother for Dale’s children and grandchildren the Christmas after his death.  He still looked great in the video; the lake and flowers in the background were cheery as my step father told stories about his past, as well as stories about his father and grandfather.

His children may never have known these stories if I had not taped that video that day.  In addition, I came across some wonderful photos of his father and grandfather in northern Michigan working as loggers at the turn of the century.  I will be creating a professional legacy video this year and giving the video and some prints to his family this Christmas. 

I had always wanted to be able to do this for my clients during my 20 years as a financial planner, but I did not have this process in place at the time.

I think passing the story along with the money could help many financial and legal professionals develop a deeper relationship with their clients as well as with the next generation. 

What do you think?  What is your story?  I would love to hear from you!

Visit www.SmartWomensCafe.com for an interactive on-line community featuring  the Designated Daughter Caregiving, Legacy and Aging Experts who work together as a team in the Designated Daughter Tea Room!

How Parents Can Provide Financially for a Special Needs Child in This Uncertain Economy

by Danielle Mayoras and Don Rosenberg

Have you ever wondered what would happen to your special needs loved one if you passed away tomorrow? Have you done everything possible to ensure that your loved one with special needs will maintain his or her government benefits and receive an inheritance from you? For many parents with special needs children, whether the children are minors or adults, these questions linger in the back of their minds. Estate planning is always important to do, however, when one of our beneficiaries is a special needs loved one, the planning becomes critical.

When a parent leaves an inheritance over $2,000 to an individual with special needs, then that inheritance is actually a gift to the government because it eliminates that child’s qualification for government benefits. Parents and attorneys armed with the basic knowledge, that you cannot have assets in excess of $2,000 and still qualify for government benefits, often think that the only reliable method to protect a special needs loved one is to disinherit them. They believe, or are counseled, that leaving their inheritance to another child or individual who will morally take care of their special needs loved one solves the problem. In most cases, however, this does not solve the problem, but only makes it worse. Leaving everything to your daughter “Susie” if “Johnny” has special needs, would allow Susie’s creditors to attach Johnny’s money. In addition, if Susie is having a bad year financially, there is nothing to stop her from using the money for herself. Furthermore, if Susie passes away, this money would go on to her beneficiaries and not to Johnny.

Parents can solve all of these problems by creating a Special Needs Trust. A properly drafted Special Needs Trust allows the special needs individual to maintain government benefits and to use the inheritance for everything but food and shelter. The Special Needs Trust is the perfect solution and the only reliable method to make sure that your inheritance benefits your child with special needs. The Special Needs Trust keeps assets in a form that will be available for your child and allows your child to maintain and receive government benefits.

A properly drafted Special Needs Trust will specify that funds from the Trust only supplement and do not replace the government benefits. These funds can be used for extra medical care, personal items, such as t.v.s, radios, computers, vacations, companionship, advocates or any other item or service to enhance your child’s self-esteem and situation, anything except food and shelter. With respect to shelter, your child can use the money to purchase a home, but cannot use the money for rent.

Oftentimes, parents who have minor or adult children with Cerebral Palsy wonder what the future will hold for their special loved one. Will they be productive in society, will they need governmental benefits, who will take care of them and be responsible for their financial needs? We have developed a very unique approach to address these questions – the Wait and See Special Needs Trust. A Special Needs Trust would be set up as a vessel for an inheritance to go into, however, a decision would be made by the trustee at the time that the parents pass away whether or not this individual is likely to need government benefits in the future. Specifically the Wait and See Trust requires the trustee to test and have your special needs loved one evaluated educationally, cognitively, rehabilitatively, physically and emotionally. These evaluations also include, but are not limited to, a physical and psychological evaluation, an evaluation of education and training programs, work opportunities and earnings, recreation, leisure time, and social needs. If he or she is not likely to need government benefits, then the Special Needs Trust would not be used and the assets can then be used for basic needs as well as special needs. The benefit of this, of course, is that we have the advantage of planning for an unknown future.

As a parent, not only do you want to provide an inheritance for you child or your children, but when you have a child with special needs, you often are the only one who knows their medical needs i.e. doctors, prescriptions, as well as the child’s likes and dislikes. The Special Needs Trust incorporates a Letter of Guidance that addresses all of the information that caregivers so vitally need.

While government agencies recognize Special Needs Trusts, there are strict rules and it is critical that you work with an experienced special needs attorney to draft the Trust. We have reviewed countless Special Needs Trusts that do not comply with Social Security Insurance and Medicaid rules. One wrong word or phrase can make the difference between an inheritance that benefits your child and one that causes your child to lose the many services, assistance and benefits available.
We know that a parent’s greatest worry is what will happen after I am gone. One parent shares his experience as follows:

“It had been in the back of my mind for years, soon after I found out my son had this lifelong disability. What would the future hold for him when I wasn’t there anymore to be his advocate, friend and supporter? It was both a big and little worry. Big, because it gave me a hole in my gut whenever the question crept in. And little, in the sense that I tried not to think about it. I’d think: I’ll worry about that tomorrow, next week, when he’s older, when I’m older.

Of course, I’ve done things to prepare for that future he’s going to have without me, things like teaching him how to wash clothes and shop. But should I write a Will? Make an estate plan? No, for years, I dodged that one totally. But you know, it’s funny. Now that we’re finished setting up our estate and only need periodically to review our plans, I feel like an enormous burden has been lifted up from me. The big, black, scary shadow is gone. Well, not totally gone, I suppose. I still worry about Samuel, what will happen to him in his life. I guess every parent does that. But now I don’t worry in the same way. I know I’ve done all I can do for that part of his future, something that was extremely important to do, and I am very relieved. Now I feel like we can deal fully with the present day and see to the other things that need to be done to prepare our child for life as an adult.

And that’s very exciting.”

Parents of special needs children can solve their greatest worry with a properly drafted Special Needs Trust.

Please contact Danielle Mayoras for additional information or questions at dmayoras@brmmlaw.com or 1-877-PLAN-758.

You can also visit:

www.TheCenterForElderLaw.com, www.TheCenterForSpecialNeedsPlanning.com,
www.TheCenterforProbateLitigation.com and subscribe to our bi-monthly e-letter, The Insight: News, Stories, and Thoughts on Elder, Special Needs, and Probate Law.

Reprinted from Alzheimer’s Disease & Related Dementias: a Guidebook for Care, Comfort, Legal and Financial Security.

How Proper Estate Planning Can Preserve and Protect Assets for Families

What is a Will and How Does a Will Work?

It is more critical than ever with our unpredictable economy that families do the proper estate planning. Otherwise, all of the assets that they worked so long and hard to build and preserve, could be wasted on probate court, taxes, attorneys, long term care costs, and too many other costs to mention. This article will examine how families can preserve the assets that they want to pass on to their loved ones in spite of the threatening economy.

Many people assume that once they execute a will, all of their affairs are in order for when they pass away. It is a myth that a will provides for our future and the security of our loved ones. Nothing can be further from the truth. A will does not provide protection from a lifetime disability. A will only becomes effective when we die and it is given life by the probate court. A WILL IS A GUARANTEE TO PROBATE. The only good thing about probate court is that you
can avoid it. However, a lot of people do not realize the following:

• every will has to go through probate court if an individual dies with assets in his or her individual name without a co-owner, owned by a trust, or have beneficiary designation;

• a will is a public document and therefore, anyone can go to the courthouse and look up what someone owned when they passed away and to whom they left their money to;

• probate court can be a time consuming process;

• unhappy family members (i.e. individuals that have been disinherited or that have received less money than other beneficiaries) can contest the will; and

• probate court can be expensive.

Notwithstanding the same, if you have a will and pass away, the Personal Representative of your will must take your will to the appropriate probate court and file it along with all of the accompanying probate paperwork. Sometimes a Personal Representative will have to post a bond. In the event that an “interested party” wants to contest any portion of the will, a hearing will be set. In order to open an estate in probate court, there is a filing fee. In order to close the estate in probate court, an inventory fee must be paid which is calculated on the value of the assets. Under Michigan law, an
estate in probate court can be closed as soon as four months after publication, once the period for creditor objections has expired, but the average probate estate in Michigan takes approximately 1 year from start to finish.

Revocable Living Trust:
What You Need to Know
If you think that a revocable living trust is only for millionaires, you couldn’t be more wrong. Whether you earn $25,000.00 or $1,000,000.00 per year, whether your assets are large or small, a revocable living trust will save you money and increase the value of your estate. A revocable living trust can offer benefits to just about everyone. Do you want to avoid probate court? Minimize estate taxes? Do you need to boost the protected spousal resource allowance for Medicaid? Do you need protection for a disabled child, adult, or relative? Do you want to prevent your beneficiaries
from paying substantial capital gains taxes for appreciated property such as real estate and stocks? Do you want to prevent a “will contest”? Do you want to keep your estate private after you pass away? If your answer to any or all of these questions is “yes”, a revocable living trust may be for you.
A revocable living trust is a trust that you control. You are the trustee, the manager of your living trust, just as you are the manager of your assets now, nothing changes. The “revocable” aspect of a living trust means that you are in control. It means once you create it, you can always change it. You can revoke it or amend all or part of it.
The “living” aspect means that it is created and funded while you are alive and provides for you during your lifetime. If drafted properly, a living trust, in the event of a lifetime disability, can help you avoid the need for a “living probate” (conservatorship) over your assets. This means that you only change title to your property to your name as trustee.
This does not mean that all your assets must be sold and invested in a bank or company. You change only the title. It is that simple.
Remember the agony created at death from an estate that goes through probate court is caused when your name is taken off the title and property is transferred to your heirs. It is costly, time consuming and a matter of public record. In a living trust, title does not change at death, just the name of the trustee changes. There is no delay, minimal cost, no publicity, no probate and if possible, estate taxes are minimized.
A living trust has been praised by our nation’s leading financial planners, and reported in publications such as The Wall Street Journal, Money Magazine, Business Week and many other publications.
A revocable living trust offers the following benefits:
• Your assets will not be subject to probate, either during your lifetime, in the event that you become disabled, or once you pass away.
• Your wishes and plans are private. Remember, if you do not have a trust, your assets will most likely be probated upon your death. Probate documents are public records that can be accessed by anyone.
• A revocable living trust is easy to create, change, administer and maintain. You maintain complete control of your assets.
• You can eliminate costly legal and court fees with a living trust. And you don’t have to be rich to enjoy its benefits.
• You maintain complete control of your assets, are able to buy and sell assets as before, and will file the same tax returns.
• Upon your death, your assets can be quickly distributed, if the trust so instructs. Alternatively, your assets can be held in the trust and administered pursuant to your wishes.
• In the event of your disability, the successor trustee will administer the trust for your benefit without needing a conservatorship from the probate court.
• By including special needs provisions you can protect children and adults with a disability from losing their governmental benefits such as Medicaid and SSI while still providing for their special needs.
• A revocable living trust is difficult to contest and can contain a provision that should a beneficiary contest the provisions of the trust, he or she will be disinherited.
• A married couple establishing separate revocable living trusts with estate tax provisions can be used to minimize estate taxes.
• A revocable living trust provides the caregiver spouse the opportunity to protect and preserve assets in the event that they predecease their disabled spouse.
• The distribution of a living trust is limited to one’s imagination. You can include provisions: that match a beneficiary’s income, provide for retirement, test for drugs, provide for a down payment to purchase a home or for an accredited education.
A revocable living trust offers many benefits that a will and joint ownership of assets do not. Oftentimes, a revocable living trust is the best type of estate planning.

Pitfalls of Joint Ownership
You may have heard of the terms “joint tenants with right of survivorship,” “tenants in common,” or “tenants by the entireties.” All of these are forms of what is known as “joint tenancy.” Joint tenancy means that more than one person owns the property. Many people own property together with someone else, such as a spouse or child, often believing that upon the death of one, the other will take immediate ownership of the property without the probate court. Joint ownership is generally not the best method of passing your property to your heirs and often results in many pitfalls.
However, effective estate planning, including a living trust, can overcome the pitfalls and avoid the intervention of the courts. If you add a person to the title of your assets, you will become partners with their life problems. If a child or other joint owner has creditor problems, such as a divorce or a lawsuit, the child’s creditors can legally come after the parents’ money and assets when the child is a joint owner. Also, if a child refuses to allow the parents to sell an asset, which requires the signature of all owners, such as real estate or stocks, the parent would be unable to access the equity in
those assets. In addition, if a child becomes disabled, the parents may not be able to sell their assets unless they obtain a conservatorship over their child, allowing the parent to legally handle the child’s financial affairs and to sign legal documents on behalf of the child. Finally, children will, most likely, be required to pay capital gains taxes upon the parents’ death in addition to any estate taxes that may be due. Joint ownership may avoid probate court, but ultimately,
more taxes may be paid!

Many people think, “How simple. I will just put my child’s name on this property and my beneficiaries will avoid all of the hassles of probate court upon my death. That way, I do not need to worry about a will.” Sometimes, it is advisable to title some or all of one’s property jointly with another. Frequently, however, it can cause an unexpected disaster. The manner in which you hold title to property needs to be carefully considered and designed as a part of your overall estate
planning goals. There are a variety of risks or pitfalls that can arise through joint property ownership.
Also, there is also a common belief that by adding a child’s name to a parent’s assets that it can be protected from Medicaid and the nursing home, which in most cases is untrue. Using a will or trust avoids the problems described above and for most families is more advantageous than the joint
ownership of assets.

Medical and End of Life Decisions
(Durable power of attorney for Health care)
How many of us plan for a lifetime disability? Leaving your planning to chance and unforeseen circumstances will only breed disaster. If you are unable to make your own medical decisions who will do so for you? Chances are that we will all suffer a debilitating illness such as Alzheimer’s or dementia or physical illness, before we die. Many of us have heard the term “living will” as the name of a document used to address our life support wishes. In Michigan, however, under our state statutory laws, we must use something called a “patient advocate” as living wills are not valid
in Michigan. A patient advocate is a document in which you appoint an individual to make your end-of-life decisions, in the event that you become unable to make these decisions yourself and a living will is a general statement of your end of life wishes.
Did you know that if you do become incapacitated you will become subject to a LIVING PROBATE? A probate proceeding for your health care and personal decisions is called a guardianship. It is a common misunderstanding to believe that your spouse, child or relative can act for you during a disability. The truth is, if you cannot make your own decisions or sign your name, a court will.

“Guardianship is a drastic remedy, a cannon used to swat a fly.”
Frankly, a Guardianship is not necessary. In fact, the probate court process is optional. It is your choice. Everyone over the age of 18 can avoid a guardianship by creating a comprehensive patient advocate, more commonly known as a durable power of attorney for health care. The word “durable” means that it is different from an ordinary power of attorney in that it is not affected by incapacity. Once you grant a durable power of attorney, as long as you are competent you can revoke it. The only time a durable power of attorney terminates is upon death, voluntary revocation
or by Court order. Simply put, a durable power of attorney is a legal document that allows you to delegate your personal health care responsibilities to an agent.
A proper patient advocate should cover all possible situations. Specifically your patient advocate should address end of life, everyday medical and mental health decisions. You also want to make sure that your patient advocate contains upto-date provisions. Michigan and the Congress has passed several new laws, such as the Do-Not-Resuscitate, Hospice Care, and HIPAA (medical privacy) laws, which may not be reflected in Patient advocates that were prepared prior to
2002.
As elder law attorneys, we draft medical durable powers of attorneys to address end of life and mental health decisions when one is unable to participate in their decisions (is incapacitated). However, in light of federal privacy acts such as HIPAA and the need to be involved in one’s care before a crisis we address day to day medical decisions to be effective immediately. We cannot stress the importance of this oversight by most attorneys!
Estate Planning is more important than ever with our unstable economy. Families who do the proper planning will be able to preserve more money in a time where every dollar counts more than ever.

Please contact Danielle Mayoras for additional information or questions at dmayoras@brmmlaw.com or 1-877-PLAN-758.

You can also visit:

www.TheCenterForElderLaw.com, www.TheCenterForSpecialNeedsPlanning.com,
www.TheCenterforProbateLitigation.com and subscribe to our bi-monthly e-letter, The
Insight: News, Stories, and Thoughts on Elder, Special Needs, and Probate Law.

Reprinted from Alzheimer’s Disease & Related Dementias: a Guidebook for Care, Comfort, Legal
and Financial Security.

How Special Needs Individuals Can Afford Long Term Care Costs with Our Current Economy

By: Danielle B. Mayoras & Matthew L. Joswick

A lot of articles explore Special Needs Trusts and the wonderful benefits that they provide to both parents and individuals with special needs who are on government benefits. When a parent leaves an inheritance over $2,000 to an individual with special needs, the inheritance is actually a gift to the government because it eliminates that child’s qualification for government benefits.

The use of a Special Needs Trust eliminates this disqualification because the inheritance is not left to the special needs individual, but rather to his or her trust. As a result, the individual maintains his or her government benefits and receives an inheritance. These trusts provide peace of mind to the
parents and an additional fund for the individual with special needs. The Special Needs Trust answers questions, such as follows:
Who will look after my loved one with special needs when I pass away?
How will my loved one’s extras be paid after I pass away?

This article, however, goes beyond the basic Special Needs Trust and also focuses on the planning for an individual with special needs from mid life and beyond. In addition to the general concerns that parents of special needs children have, parents also worry about the long term care costs of their special needs loved ones. Specifically, what if the individual with special needs outlives his or her parent and needs long term care? What if the parents are not around to provide the long term care? How will the long term care costs be paid?

The statistics show that it is likely that an individual with special needs will require some type of long term care. They are currently 1.2 million disabled Medicaid enrollees either receiving acute care or long term care. There are several different long term care options including home care, assisted living, adult foster care, and nursing homes.
Each of these will be addressed separately below.

Home care is health and supportive care provided to an individual in their own home by a licensed medical professional. The advantages of home care are obvious – your loved one receives care in the comfort of their own home. This ensures more privacy for your special needs loved one and also allows the family to better monitor the quality of health care that their special needs loved one is receiving.
Assisted living facilities are a middle ground between home care and nursing home care. Typically residents of assisted living facilities require help with their activities of daily living, but do not need skilled nursing home care.
The advantages of receiving care in an assisted living facility are clear – the environment is more residential and less restrictive with a greater emphasis on privacy and autonomy.
With the average hourly rate for home care at $19.18 per hour, and the average cost of assisted living at nearly $40,000.00 per year, receiving care in these environments will be cost prohibitive for most families. Some long term care alternatives to these high costs are Adult Foster Care and nursing homes.
Adult Foster Care (AFC) is a licensed, sheltered living arrangement for adults with special needs who are unable to live alone. AFC homes provide five basic services: room, board, supervision, protection, and household services (laundry, cleaning, etc). Additionally, adult foster care homes may provide the following services:
1. Assistance with dressing, personal hygiene, and/or eating;
2. Transportation to appointments, senior centers, shopping, or activities;
3. Medication reminders of administration; and
4. Assistance with money management.
Typically there is a minimum room and board payment made to providers per month, which is set by the State. This amount is typically equal to the monthly income that the adult with special needs receives in governmental benefits.
Adult foster care may be a cost-effective alternative to nursing homes or larger assisted-living facilities. For many special needs individuals who need long term care, Adult Foster Care is appropriate medically and financially is a good long term care option as well.
On the other hand, nursing care facilities are places of residence for people who require constant care and assistance with their activities of daily living. Residents include both the elderly and individuals with special needs. The numbers are startling – the average cost of nursing home care in the United States exceeds $77,000.00 per year and is expected to reach $190,000 per year in 2030. Furthermore, almost 56% of nursing home residents spend at least one year in the nursing home, with another almost 26% spending at least three years in the nursing home. Many parents
wonder how their special needs loved one will be able to afford it.
One way is to qualify your adult child with special needs for Medicaid. Medicaid is a state administered program that pays for long term care costs if certain eligibility requirements are met. Although this is a Federal program, each state has its own guidelines regarding eligibility and services. Therefore, it is critical to consult with a special needs attorney who is familiar with the specialized Medicaid laws in the state where your loved one resides.
Certain requirements must be met to qualify for Medicaid. These may include your age, whether you are disabled, blind, or aged; your income and resources; whether you are a United States citizen or a lawfully admitted immigrant.
The rules for counting your income and resources vary from state to state and from group to group. There are special rules for those who live in nursing homes and for disabled children living at home.
A single individual who resides in a nursing home may own certain assets, which Medicaid views as exempt assets, and still qualify for Medicaid. For example, in the State of Michigan, those exempt assets for Medicaid eligibility are as follows:
1. Home (with certain restrictions);
2. Car;
3. Personal Property;
4. Burial Blot and Burial Space items;
5. Funeral Contract worth up to $11,072.00;
6. Life Insurance with face value of $1,500.00;
7. $2,000 in cash assets;
8. Assets that are in a Special Needs Trust, an OBRA Trust or a Pooled Income Trust; and
9. Immediate Annuity.
All other assets are countable and an adult child with special needs will not be Medicaid eligible until those assets are spent down or converted into one of the above exempt assets.
You can ensure that your child with special needs qualifies for Medicaid upon your death by planning ahead. By completing a full estate plan, parents are able to place the adult child=s portion of their inheritance into a Special Needs Trust. This trust allows the adult child to maintain government benefits as the Trust is an exempt asset under Medicaid guidelines. When the parents create their own estate plan, their revocable living trust will provide the inheritance, for the benefit of their special needs child, be funneled into the Special Needs Trust
The Special Needs Trust has a trustee, who is responsible for administering the trust and ensuring that the adult child’s needs are met. Assets in a trust of this nature are not countable and in the event that the child requires long term care and needs to qualify for Medicaid, these trust assets will be preserved for the adult child=s benefit. A trust of this nature can be used for most any item the adult child may need with the exception of food and shelter. For example, the trustee can purchase clothing, an automobile, electronic equipment, furniture, fitness equipment, funeral expenses, vacation and travel costs, vocational programs, therapy, personal care items and much more. The
trustee can also use the funds from the trust for non-reimbursed medical expenses.
While government agencies recognize Special Needs Trusts, there are strict rules and it is critical that you work with an experienced special needs attorney to draft the Trust. We have reviewed countless Special Needs Trusts that do not comply with Social Security Insurance and Medicaid Rules. If the funds are used for food or shelter, however, then there is the potential that the adult child=s governmental benefits may be reduced or eliminated. With respect to shelter, your child can use the money to purchase a home, but cannot use the money for rent. In fact, one wrong
word or phrase can make the difference between an inheritance that benefits your child and one that causes your child to lose the many services, assistance, and benefits available.
In the event that the parents pass away without having the proper estate planning in place, there are still planning strategies that can be implemented to preserve the inheritance of the adult child with special needs allowing the adult child to maintain or qualify for government benefits. The inheritance can be placed into an OBRA Disability Payback Trust or into a Pooled Income Trust. These trusts provide the same protections as the above discussed special needs trust with one important difference – both of these trusts have a provision that require the assets to be used for specific purposes after the death of the adult child with special needs. The OBRA Trust requires that in the event there are any funds remaining in the trust at the death of the adult child with special needs, Medicaid is paid back for any services rendered up to the full amount of assets in the trust. The Pooled Income Trust, which is run by a non profit organization, requires that the organization be the remainder beneficiary of the trust.
Something else to keep in mind is the possibility of your special needs loved one executing Durable Powers of Attorney. If your adult child with special needs is competent, then he or she can execute Durable Powers of Attorney. There are two types of Durable Power of Attorney: Financial Durable Power of Attorney and Medical Durable Power of Attorney/Patient Advocate Designation. By executing a Financial Durable Power of Attorney, your child appoints an attorney-in-fact to handle his or her financial affairs in the event that he or she is physically or mentally unable to do so. For example, this may include banking, real estate, signing tax returns, hiring and firing agents, and commencing litigation.
The Medical Durable Power of Attorney/Patient Advocate Designation addresses all of your loved one’s medical decisions including, residential placement, surgery and treatment, and daily medical decisions. If your adult child with special needs is able to execute Durable Powers of Attorney, this will generally eliminate the need to go through the probate court system to obtain a guardianship or conservatorship. These documents cannot be executed by your child until he or she is an adult and is 18 years of age. As probate court can be expensive (legal fees and court costs), burdensome (annual report requirements and multiple trips to court), and time consuming, it is highly
advisable that if your adult child with special needs has the requisite capacity to execute legal documents that they do so. Most importantly, he or she would be able to maintain control of his or her financial and medical decisions.
We know that every parent’s greatest worry is what will happen to their special needs loved one after they are gone. With the proper planning, there are government programs that can ensure that your adult child with special needs receives long term care after you are gone and receives an inheritance from you that does not disqualify them from government benefits. Estate planning is always important to do; however, when one of the beneficiaries is a special needs loved one, the planning becomes critical.

Please contact Danielle Mayoras for additional information or questions at dmayoras@brmmlaw.com or 1-877-PLAN-758.

You can also visit:

www.TheCenterForElderLaw.com, www.TheCenterForSpecialNeedsPlanning.com, www.TheCenterforProbateLitigation.com and subscribe to our bi-monthly e-letter, The Insight: News, Stories, and Thoughts on Elder, Special Needs, and Probate Law.

Reprinted from Alzheimer’s Disease & Related Dementias: a Guidebook for Care, Comfort,

Is Your Wallet Feeling a Little Light?

The Best Kept Secret:
Improved Pension Benefits for Veterans and Surviving Spouses
Most families have no idea that if an individual is a veteran, he or she is entitled to additional income. As individuals age, the rising long term costs make it very difficult to maintain financial security, especially in these rocky financial times. This article explores the often unclaimed income waiting for veterans. For most veterans, the idea of collecting a pension benefit from the military does not seem like a real possibility unless the veteran suffered a service connected disability. However, there is a veteran’s pension benefit program available to all veterans, and their families, which is available to pay for unreimbursed home health and medical expenses and the
unreimbursed cost of assisted living. This program is called the “Aid and Attendance Program” (“AA”).
Eligibility for the AA Program. In order to be eligible for the AA Program, a veteran must have served 90 days on active duty with at least one day during wartime, and must have been discharged under conditions other than dishonorable. Additionally, the veteran must be “permanently and totally disabled” because of a non-service connected condition.

Periods of Wartime Service:
WWI: April 6, 1917 to November 11, 1918
WWII: December 7, 1941 to December 31, 1946
Korean Conflict: June 27, 1950 to January 31, 1955
Vietnam Era: August 5, 1964 (February 28, 1961, for veterans who served “in country” before August 4, 1964) to May 7, 1975
Gulf War: August 2, 1990 – TBA
Permanently and Totally Disabled. “Permanently and totally disabled” means that a veteran must require “care or assistance on a regular basis,” which protects him or her from dangers of a daily living environment. The term can be established by showing one, or more, of the following conditions:
The veteran is blind or has a visual impairment;
The veteran is a patient in a nursing home or hospice facility because of mental or physical incapacity;
The veteran is unable to dress or undress or keep himself or herself clean and presentable;
The veteran needs adjustments to any special prosthetic, orthopedic appliance, or is not able to attend to the prosthetic,
or appliance;
The veteran has a physical or mental incapacity (dementia) that requires assistance on a regular basis to protect the veteran from the hazards of his or her environment.
Furthermore, it is generally presumed that a veteran who is residing in an assisted living facility does meet one, or more, of the aforementioned conditions. However, a letter from the veteran’s personal physician substantiating the veteran’s disability will greatly enhance the benefits process.

Current AA Monthly Pension Benefits

The current approximate maximum monthly AA pension benefits are as follows:
Veteran & Spouse: $1,800.00
Veteran: $1,500.00
Surviving Spouse: $950.00

Unreimbursed Medical Expenses. Unreimbursed medical expenses are generally defined to include the costs associated to health and Medicare insurance premiums, prescriptions drugs, dental and vision care, and expenses related to an assisted living facility, and in-home care aid, and/or adult day care.
Net Worth Valuation. Finally, assuming a veteran, and/or his or her spouse, has tentatively qualified for the AA monthly pension benefit, the final test to fulfill the qualification process related to the net worth of the applicant. With the exception of the applicant’s home, an automobile, traditional household furnishings and personal property, which are treated as non-countable, attorneys who advise clients on veterans benefits are allowing the applicants to maintain
no more than one of the following cash asset levels without jeopardizing his or her opportunity to collect the maximum monthly AA pension benefit:
Couple: $80,000.00
Individual: $50,000.00
However, in practice, if a person’s assets are a home plus $40,000.00 in other assets, there are usually no issues. The home is not counted. In other words, the VA will rarely deny a claim if the net worth is below this number.
AA Pre-Planning. Lastly, with the Veterans Administration only looking at the applicant’s net worth at the time of the actual AA application, and with there being no penalty period for the transfer of assets prior to the time of the application, it is fair to conclude that with proper planning, just about any veteran, and/or his or her spouse, can qualify for a monthly AA pension benefit.
Medicaid Benefits. With the Medicaid program having stricter rules and regulations regarding asset transfers than the Veterans AA Program, it is very important that clients engage a qualified elder law attorney when developing a Long Term Care Plan. For instance, transferring assets to qualify for AA Benefits could result in a five year ineligibility for Medicaid benefits.

Please contact Danielle Mayoras for additional information or questions at dmayoras@brmmlaw.com or 1-877-PLAN-758.

You can also visit:

www.TheCenterForElderLaw.com, www.TheCenterForSpecialNeedsPlanning.com,
www.TheCenterforProbateLitigation.com and subscribe to our bi-monthly e-letter, The Insight:
News, Stories, and Thoughts on Elder, Special Needs, and Probate Law.

Reprinted from Alzheimer’s Disease & Related Dementias: a Guidebook for Care, Comfort, Legal
and Financial Security.

The Cost Of Feuding Families

In this economy it is more important than ever for families to have their estate planning needs in order. As this article illustrates, families who don’t are subject to both emotional heartache and monetary loss. These family feuds erupt frequently and happen more than people think.

What Happens When The Family Can’t Get Along?
Dealing with a loved one with Alzheimer’s or dementia is difficult enough, but the problem becomes even more troublesome when the condition acts as a spark to ignite family conflict. Sibling rivalries, second marriages, denied incompetence, and simple greed are but some of the situations that add fuel to the fire and foster dramatic family feuds.
Often the fire grows so great that families become torn in half, spending months – or even years – battling in probate court. Sadly, many families are never able to repair the damage, emotionally or financially.
No one wants to end up in probate court fighting in a public family squabble. What can be done to avoid it?
Sometimes nothing. If someone else is determined to steal from, cheat, or improperly care for someone suffering from Alzheimer’s or dementia, you may have no choice but to go to court. Other times, probate court battles can be prevented, or at least minimized. How? Two ways: know when to call an experienced probate litigation attorney and know your legal rights.

The first one is easy. Anytime you suspect that someone is not acting properly towards an elderly loved one in a way that will either jeopardize that persons’ care or well-being, or may result in a loss of assets, then you should call an attorney who regularly represents clients in contested probate matters. Many such attorneys offer a low-cost or even free consultation. For example, the experienced attorneys at The Center for Probate Litigation will provide a free consultation to discuss your specific situation and let you know whether action is required. Too many families regret waiting and doing nothing – when in doubt, call an expert.

The second way to protect your family and often avoid court is to become educated about your legal rights. The following is an overview of the basic concepts that families of a loved one with Alzheimer’s or dementia may face when a family dispute or conflict threatens to surface.
Challenging a Power of Attorney or Patient Advocate Designation Many people believe that once someone signs a power of attorney, for either health care or financial decisions, or a patient advocate designation, then all control has been surrendered to the person designated to make decisions (called the attorney-in-fact or agent) and the rest of the family has no choice but to step aside. In reality, the appointment of an attorney-in-fact or agent is often just the beginning.
A power of attorney or patient advocate designation is only valid if it was executed in compliance with Michigan law, and the person was legally competent at the time of execution. If a power of attorney or patient advocate was signed by someone who was not competent, then the document can be voided.
Even when dealing with a valid power of attorney or patient advocate designation, the attorney-in-fact has a legal responsibility to act in the best interest of the principal. For health care decisions, this means deciding where to live and whom to provide care, based on what is best for the person in need of care, not what is most convenient for the agents. Often the person appointed to make these decisions want to make these decisions based on what will maximize their inheritance or what is easiest for them. This does not fulfill their responsibility.
For financial decisions, this requires the attorney-in-fact to invest prudently and refrain from self-dealing. Often, a person with Alzheimer’s or dementia requires much more conservative investments than he or she had previously chosen earlier in life. This may require a sale of annuities or securities, and insuring the portfolio is diversified, liquid and protected from extreme market fluctuations.
When the loved one has significant assets, following the advice of a credentialed, knowledgeable and ethical financial planner is essential. But Agents must use common sense too – just because a licensed stock broker or annuity salesmen recommends an investment does not make it suitable for a senior citizen with Alzheimer’s or dementia.

Guardianship & Conservatorship Disputes
What do you do when you discover an invalid power of attorney or patient advocate designation, or that the attorney-infact is not acting in the best interests of your loved one with Alzheimer’s or dementia? The only way to make sure that control is taken away from an agent who is not acting appropriately is to initiate guardianship and/or conservatorship proceedings.
Both proceedings are handled in probate court and involve someone asking for a decision maker to be appointed. Guardians make medical, placement and other life decisions, while Conservators make financial decisions. One person can serve in both functions, but courts can appoint different people as well.
Who gets appointed in these roles?
Most often, it is a family member or another loved one of the individual in need of protection, or ward. And, the ward’s choice does matter! This is especially true for someone with early stages
Alzheimer’s or dementia who still retains some decision-making ability, but requires some assistance. Even an incompetent person’s choice will carry great weight if it was expressed through a power of attorney or patient advocate signed while the person was still competent.
Judges who make this decision often have a difficult time when the family disputes who should act in that role. Sibling rivalries and second marriages present significant challenges. Because probate judges have a great deal of discretion in making decisions, family members vying for appointment must do everything they can to convince the judge that they are the most suitable, and that their opponent is not. This process is not fun for anyone who participates, but sometimes is necessary.
Once the guardian and/or conservator is appointed, those who serve have similar fiduciary obligations as an Attorneyin-Fact. The big difference is that they are monitored by the probate court, and file detailed reports on an annual basis, so that the probate court can make sure that the ward is properly protected. Probate courts often also require bonds to be posted when the protected person has significant assets.
Certainly, no one should choose to initiate a guardianship or conservatorships proceeding unless they have no other good choice. But when diplomacy has failed, or when a loved one’s Alzheimer’s or dementia causes them to be too stubborn to admit that they need help making decisions, it is the only safe choice. With an experienced attorney guiding the family, protective proceedings through probate court helps many people sleep at night knowing their loved one is safe.

Theft and Loss of Assets
Court disputes are not always done to safeguard a person’s well-being. Often they are necessary to help a loved one from losing assets, either through mismanagement caused by their dementia or Alzheimer’s, or theft or exploitation from an unsavory family member or annuity salesman. Knowing when to intervene or not is not always easy.
Many seniors suffering from Alzheimer’s or dementia do not want to admit that they need help with their financial decisions. Often, their children do not want to insult them by asking too many questions. But when you have a loved one diagnosed with dementia or Alzheimer’s, you owe it to them to probe. Make sure their investments are secure and appropriate, and their assets are protected.
In doing so, pay attention to warning signs of exploitation. The National Center on Elder Abuse lists many warning signs of exploitation, including sudden changes in banking practice, unexplained withdrawal of large sums of money, the addition of names on a bank signature card, unauthorized withdrawal of the elder’s funds using an ATM card, abrupt changes in a will or other financial document; substandard care being provided or bills unpaid despite the availability of adequate financial resources, forged signatures, and unexplained transfers of assets, among others.
If you discover any of these warning signs, talk to an elder law attorney with knowledge in financial matters immediately. Often, children or other trusted family members are the ones exploiting or even stealing money from someone suffering from Alzheimer’s or dementia. In other cases, there are greedy financial planners who target vulnerable adults with high-commission, inappropriate investments. Financial exploitation is not always easy to spot.
Being on guard and proactive is the best defense.

Challenging Changes to a Joint Asset, Will or Trust
What do you do when you discover financial exploitation in a way that is not as overt as theft? What do you do when your father with Alzheimer’s or dementia has added his second wife’s name to a bank account that was always meant for the family, or your mother changed her will or trust to omit you in favor of your brother or sister?
All of these can be successfully challenged in court under the right circumstances, with the help of an experienced probate litigation attorney, but only if the help is sought before it is too late. Sometimes, it is not too late even after the exploited senior passes away. Will and trust changes, joint assets — including bank accounts and real estate, and even outright gifts can be set aside and undone on the basis of incompetence, undue influence, fraud and other reasons.
Incompetence – The test for competency varies depending on the document challenged, but for every situation, the crucial factor is whether the individual reasonably understood the nature of the document or transaction when it was signed. For someone in the early stages of Alzheimer’s or dementia, this is not a bright line test with an easy answer.
Undue Influence – When a person is compelled to make a decision that he or she would not have made, the decision is often the product of undue influence, which is a basis to set it aside. In fact, the law presumes undue influence has occurred when the beneficiary was acting as the power-of-attorney, or otherwise occupied a position of confidence and trust, before the decision or document was made.
Fraud – Even when competent, vulnerable adults with Alzheimer’s or dementia can be tricked into transferring assets, or changing bank accounts or estate planning documents, based on material statements of fact that are false. When someone relies on a material and false representation, the transaction or document can be set aside as invalid.
Accounts of Convenience – For joint bank accounts in particular, and sometimes other joint assets (sometimes even real estate), a loved one with Alzheimer’s or dementia may add the name of a child or other trusted relative as a convenience to help will bill paying, financial management or as a “poor man’s will” to save costs. If the person did not intend the joint owner to keep the asset on death, but instead only added the joint name as a convenience, then courts can and do order the asset to be turned over to the estate and shared with the other beneficiaries.
The decision whether or not to contest the joint nature of an asset, or a new estate planning document, is not always an easy one, and certainly should not be made lightly. Court battles seeking to set aside documents or transactions can be costly and time-consuming. But sometimes, honoring the true wishes of a loved one with Alzheimer’s or dementia is worth the fight.

Please contact Andrew W. Mayoras for additional information or questions at
awmayoras@brmmlaw.com or 1-877-PLAN-758.

You can also visit:
www.TheCenterForElderLaw.com, www.TheCenterForSpecialNeedsPlanning.com,
www.TheCenterforProbateLitigation.com and subscribe to our bi-monthly e-letter, The Insight:
News, Stories, and Thoughts on Elder, Special Needs, and Probate Law.

For more stories on probate and celebrity cases, visit: www.probatelawyerblog.com.

Reprinted from Alzheimer’s Disease & Related Dementias: a Guidebook for Care, Comfort, Legal

and Financial Security.

What Every Caregiver Must Know In These Uncertain Financial Times

Introduction to
Elder Law for Caregivers

Caregiving for someone with Alzheimer’s or a related dementia is one of the most difficult jobs in the world. In addition to making sure that your loved one is safe and their daily needs are met, you are also faced with the fact that there are many financial and legal issues that must be addressed. As if that was not enough, you also are trying provide the best quality of care at the least cost to the family. Caregiving is expensive and stressful, especially in these uncertain financial times. Hopefully, this article can provide you the financial and legal answers you need to do a better job.
Elder law is not just for senior citizens who are no longer independent or who are about to enter a nursing home. Elder law is for anyone who is middle aged and beyond — and sometimes even younger.
There are now more than 5 million people in the United States living with Alzheimer’s. This is a 10% increase from 5 years ago, and clearly supports the long forecasted dementia epidemic. One in eight persons age 65 and over have Alzheimer’s disease and nearly half of all persons over the age of 85 have Alzheimer’s. Every 72 seconds someone develops Alzheimer’s disease; by mid-century someone will develop Alzheimer’s every 33 seconds.
You are not alone. There are over 50 million caregivers in this county. Studies show that 12 million people in this country need long term care. Twenty-one percent of American adults provide free caregiving for loved ones. Fiftynine percent of these caregivers either work outside the home, or have worked outside the home, while providing care.
It has been estimated that the value of free services given by caregivers is in excess of $310 billion a year.
Additionally, as a result of caregivers, businesses are also effected by the caregiving epidemic. Specifically, over 60% of caregivers work and dedicate on average 18 hours per week to provide care. Family caregivers account for 73% of early departures and late arrivals in the workplace. Caregiving by an employee costs the average employer $2,100 per employee or for all employers as much as $33 billion annually. These services are provided by family members without regard to cost because of the love and respect they have for their loved ones.
These statistics only represent the economic cost of caregiving. It does not even address the emotional and physical toll on caregivers. The fact is that 70% of all caregivers over the age of 70 die first. People generally do not think about the health of the caregiver or plan for the unthinkable – – the caregiver having health problems or passing away before their loved one with dementia. It is for this reason that we approach each situation from the worst case scenario. We plan for the worst and hope for the best, that way our clients are always protected.
We know that age is the biggest risk factor for Alzheimer’s and dementia related diseases, however, these diseases do not discriminate. We have helped clients who have loved ones suffering from Alzheimer’s and dementia related diseases, some as young as their late 30’s. The time to look down the road and make major decisions regarding your health, well-being and finances is now.
It is important to understand the difference between an elder law attorney and an estate planning attorney. While estate planning attorneys are concerned with what happens to your estate upon your death, elder law attorneys ensure that your affairs can be managed in the event of your disability as well as once you pass away. Specifically, an experienced elder law attorney addresses the following tough questions like:
Who will make my medical decisions when I am no longer able to make them?
If I am unable to care for myself, how can I achieve the greatest quality of care without bankrupting myself or my family?
Who will be able to talk to my doctors and the hospital when I require guidance even though I am able to make my own medical decisions?
Who will make my end of life decisions?
What happens if I get sick and cannot stay in my home anymore?
How am I going to pay for it?
For caregivers of loved ones with Alzheimer’s and related dementia, information regarding Medicaid and estate planning is a necessity. It is our hope that this guidebook will answer many common legal questions and that it will eliminate the belief that it is never too late to plan.
In these uncertain financial times, the proper long term care planning is more important than ever. Families who seek the proper professional advice will be able to protect significant portions of their assets, possibly all of their assets, in spite of these rocky financial times. However, families who fail to do the proper planning, will rapidly deplete their assets with the rising nursing home costs.

Medicaid Basics
We wanted to use this opportunity to explain Medicaid basics and to correct some of the most frequently misunderstood concepts of Medicaid. Please keep in mind, however, that the Medicaid laws are constantly changing. A brief summary of the most recent changes are discussed in the next Chapter. The discussion below is based on the current Medicaid laws as of January 2008. Prior to implementing any of the strategies discussed below, it is imperative that you contact an experienced elder law attorney. There are many common questions we are asked, such as:
What is the difference between a countable asset and a non-countable asset?
A countable asset means that Medicaid looks at it and it effects your Medicaid eligibility whereas a non-countable asset does not effect your Medicaid eligibility.
If I am single and trying to qualify for Medicaid, what assets can I keep?
A single individual can keep:
• $2,000.00 cash;
• a home if it is not owned by a living trust;
• all personal property and jewelry;
• one vehicle;
• life insurance with a combined face value up to $1,500.00;
• an irrevocable funeral contract up to a maximum of $11,072.00;
• burial space plan;
• OBRA ’93 Payback Trust, Pooled Income Trust; and
• in certain circumstances immediate annuities.
If my spouse goes into a nursing home, what assets can I keep?
For 2008, if your spouse goes into a nursing home,
then you may keep one-half of the countable assets, up to a maximum of $104,400.00 and no less than $20,880.00.
These numbers are adjusted annually. Medicaid will make this assessment based upon the value of your assets on the “snapshot date,” which is the first day that your spouse goes into the hospital or nursing home and receives continuous care for 30 days or more or commonly know as the date the last night your spouse slept at home.
Are there any other special planning tools for married couples?
There is very specialized technique called a “Trust for the Sole Benefit of the Community Spouse” that can be used in some circumstances to protect a significant portion of a married couple’s assets. This is an irrevocable trust with many requirements.
If my spouse goes into a nursing home, can I receive his or her Social Security and pension benefits?
It is possible. Sometimes, Medicaid will allow “shelter and utility allowances,” which means that it will divert a portion or all of your spouse’s income to you to help you pay your bills. For 2008, the maximum amount that you can receive as a
shelter allowance is $2,610.00 per month. In some circumstance where this is not enough, a probate court can increase the income allowance.
Does my mother have to wait five years to qualify for Medicaid?
No. The five year period is not a waiting period, but only an examination period. Therefore, if your mother enters a nursing home on November 1st and spends down her assets by January 1st, she may be eligible for Medicaid on January 1st.
Will Medicaid be able to recover the cost of care (Estate Recovery) from the home?
Yes, if you do not plan properly. Michigan recently enacted a probate Estate Recovery, which allows the State to file a claim against any assets that pass through the probate process. However, the residence and any other assets that pass to beneficiaries outside of probate court are not subject to Estate Recovery. Elder law attorneys accomplish this goal of protecting the home, through the preparation of a special deed. This deed allows your loved one to maintain ownership of the home
while living, and avoids probate court and Estate Recovery upon death, while remaining an exempt asset from Medicaid.
My mother applied for Medicaid and even though she had less than $2,000.00 in the bank, she was denied. The Medicaid office informed us that it was because her house was in a trust. Is it true that her house has to be sold before she can qualify for Medicaid?
Her house does not necessarily have to be sold. Your mother could execute a  quit claim deed transferring the home out of her trust. Many people do not realize that when a home is owned by a trust, it is a countable asset. When a home is not owned by a trust, it is a non-countable asset for Medicaid purposes. However, it will then go through the probate court process and be subject to Estate Recovery, unless one plans properly as explained in the question above. It is important to be certain that any attorney you work with is familiar with the Medicaid laws. Additionally, not to complicate matters more, there are circumstances when titling a house in a trust can be very advantageous.
Is it true that if I gift money to my children before applying for Medicaid, it will disqualify me from receiving Medicaid?
Not necessarily; it depends on when the gift was made and how it was done. Even though the laws
regarding gifting and Medicaid have change, it is important to understand that you can make gifts and still qualify for
Medicaid if the gifting is done properly. Gifting should only be done with the advice of an elder law attorney. See the next chapter titled “Recent Changes in Medicaid Laws.”
If my father added my name to his assets and now he needs to qualify for Medicaid, does that mean that I can keep half of the assets? The answer is: it depends. This is a very complicated area of Medicaid planning. It depends on whether the asset is available to your father without another’s consent and when your name was added to it. If your father added your name to his assets and he still has access to them, then the assets remain his irrespective of when he added your name. For instance, joint bank accounts are available to all owners and are countable. On the other hand, if
your father added your name to the cottage over five years ago, the asset may not be available for Medicaid purposes.

Recent Changes in Medicaid Laws (full of traps and pitfalls for the uninformed)
Every so often, Congress changes the rules of Medicaid eligibility for nursing home coverage. In recent years the rules have been relatively stable, with no changes in federal law since 1993. However, on February 8, 2006, the Deficit Reduction Act of 2005 (“DRA”) was enacted and it substantially changed Medicaid laws.
In our collective experience of 37 years of practicing elder law, we have never seen such drastic changes when it comes to providing benefits to the elderly, disabled, and poor. Michigan enacted the DRA on July 1, 2007, effective retroactively to February 8, 2006. In addition to the drastic changes imposed by DRA, Michigan has implemented additional significant changes in April 2007, September 2007, October 2007 and in January 2008. This Chapter is intended to provide a brief summary and is not meant as a comprehensive summary of the changes.
Here is a brief summary of some of these new laws:
Increased Look-back Period.
All transfers under the new law, whether to individuals or to trusts, will be subject to a
five year look-back period rather than the previous look-back period (three years for individuals and five years for trusts). This has made the Medicaid application process more difficult and could result in more applicants being denied for lack of documentation, given that they will need to produce five years, instead of three years, worth of records. This will be particularly true for families that have a loved one with Alzheimer’s and related dementia as their record keeping skills are likely to have been poor. Keep in mind, if you work with an experienced elder law attorney, there may be ways to reduce the documentation burden of the five year look-back period.
Altered Penalty Start Date.
For asset transfers that are less than fair market value, the penalty period now begins on the
date that the individual would otherwise have been eligible for long term care services (Medicaid as well as the home based community waiver) but for the asset transfers, rather than the previous penalty period start date of the asset transfer itself. Simply put, Medicaid will penalize from the date of the Medicaid application instead of the date of the gift. Further, all transfers during the look-back period will be added together to determine the total transfer penalty.
With respect to asset transfers that occurred prior to February 8, 2006 the old penalty start date, the date of the gift, still applies.
Charitable and political contributions as well as innocent gifts to family members under the tax laws are some of the types of transfers that could result in a Medicaid ineligibility period.
For example, a semi-healthy grandmother gives her granddaughter $20,000 to assist with her college education. Three years later, the grandmother, as a result of Alzheimer’s disease or dementia, requires nursing home care. Over the next eighteen months, she spends her life savings on her own care. Forty-eight months after her gift to her granddaughter, the grandmother has depleted her assets and applies for Medicaid. She will be penalized for about four months before
she receives Medicaid benefits, even though she has no money remaining to pay for her care. How her care will be paid for during that four month period of ineligibility is anyone’s guess.
Hardship Waivers. To mitigate the effect of these new rules, Congress has mandated that each state institute a process for seeking a hardship waiver for those instances when the application of the transfer penalty would result in a deprivation of medical care that would endanger the applicant’s health or life, or for “food, clothing, shelter, or other necessities of life.” Michigan currently considers hardship when a delay in treatment may result in the person’s death or permanent impairment of the person’s health. The current standard is much stricter than that imposed upon by the new. Unfortunately, we do not anticipate that Michigan will change their hardship exception anytime soon.
Home Equity.
Medicaid previously disregarded the value of a primary residence regardless of its value in counting
assets. Under the DRA, individuals with more than $500,000 in home equity are now ineligible for Medicaid nursing home benefits. Keep in mind that under pre and post-DRA laws, any home owned by a revocable living trust is considered a countable asset and must be removed from the trust before the applicant can qualify for Medicaid. The cap on equity does not apply if there is a spouse or child under 21 or a blind or disabled child residing in the home.
These exceptions apply regardless of the equity value of the home.
Treatment of Annuities.
The DRA has set forth changes concerning annuities which are very complex and as of this date, it is unclear how they will be interpreted. The gist of these changes is to provide a requirement that the State of Michigan be named as a beneficiary to the extent medical services have been paid by Medicaid as well as instituting reporting requirements for the annuity companies. Previously, certain annuities were treated as exempt assets and did not require that the State of Michigan be named as the beneficiary. In the event that the Medicaid applicant has a spouse, however, Medicaid will only have to be named as a remainder beneficiary.
Long Term Care Insurance Partnership.
Under the DRA, Medicaid disregards any assets or resources in an amount equal to the insurance benefit payments that are made to or on behalf of an individual who is a beneficiary under a long term care insurance policy. This will most likely be implemented in Michigan sometime in the 2008 calendar year.

Danielle Mayoras • dmayoras@brmmlaw.com •1-877-PLAN-758 •
http://www.TheCenterForElderLaw.com

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