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    Category Archives: Elder Care

    “And the Estate Planning Oscar Goes To…” Lessons on Film About Family

    The film “Black Heirlooms” has not received any Oscar nominations. It was made by 32-year-old Amanda Brown, whose grandmother’s long-term illness ripped her once close-knit family apart for lack of long-term care planning. grandmother

    Profiled recently in the New York Times, the film is “about the extended uncomfortable, intergenerational conversations that we do not have enough of and that her family did not have until it was too late.”

    Vonley and Edna Mae Royal raised eight children and saw them all graduate from college. Vonley had several businesses that provided a small inheritance for his wife after he died. Following his death, the Royal children tried to get Edna Mae to talk about how she wanted her estate divided after she died. However, when she proved resistant to such a discussion, her children backed off. “We didn’t want to give her the impression that we were trying to gain some kind of advantage,” said her son Gary.

    Edna Mae had a stroke in 2009 and her children soon became divided on how she should be taken care of once she was discharged from the hospital, whether or not she could make that decision for herself and who should have power of attorney over her affairs. The family eventually wound up in court, exhausting any inheritance they might have had on legal fees and dividing many family members.

    Today, 90-year-old Edna Mae is taken care of by five of her eight children; the other three do not speak to their siblings and rarely see their mother. The inheritance that Edna Mae worked so hard to maintain for her own care and her children’s inheritance is gone. In the film, her granddaughter Amanda wonders, “Now that the family is divided, what was the point of working so hard to keep everything intact?”

    If you have been putting off this conversation in your family, we can help. Executing a plan for your own health care can be extremely fulfilling, knowing that you are making your wishes known and alleviating family of the burden of guessing the right health care choices for you.

    If you would like to have a talk about estate and long-term care planning for your family, call our office today to schedule a time for us to sit down and talk about a Family Wealth Planning Session.  We can not only guide you through the creation of your own plan, we can also assist you with that all-important family discussion.

    The Conversation You Must Have With Your Kids and Your Parents

    Every single adult needs to have an advance health care directive written, signed and in place. This includes your children, as soon as they turn 18.  This includes you. This includes your parents.

    Without an advance health care directive in place, you would not be able to access your child’s medical records, if they are unable to communicate permission. You would not be able to ensure your health care decisions will be made the way you choose. And your parents lose the ability to communicate their wishes and remain in control as long as care decisions

    Here is what you can do to have the conversation you need to have about advance healthcare planning:

    1.  Look inward.  Before executing an advance healthcare directive with the help of your Personal Family Lawyer®, think about what you do – or don’t – want to happen if you were unable to make your own decisions.  Think about the people you would want to carry out those decisions and if the person you have in mind will follow your wishes.

    2.  Talk to your family.  One of the most tormenting things for families is having to make healthcare decisions for a loved one by having to guess what they would want.  Communicate your wishes to your family so you don’t put them in this stressful position.

    3.  Talk to your healthcare providers.  Let your primary physician and any other healthcare provider know about your decisions about your healthcare.  Ask any questions to alleviate any concerns you or your family may have.

    4.  Execute your advance healthcare directive.  Once you have decided upon your healthcare options and have chosen an agent, meet with your Personal Family Lawyer® to complete your official advance healthcare directive.  Have copies made for your family and your primary healthcare provider.

    Call 949.718.0420 to schedule a time to prepare a health care directive for your parent(s) or your adult child(ren).

    Casey Kasem’s Estate Planning Not in Anyone’s Top 40

    Casey Kasem, the celebrity radio host who counted down America’s Top 40 popular songs for years, died on June 15 at the age of 82 and left behind an estimated $80 million fortune.  He also left a family feud of biblical proportions between his surviving spouse and his three children from a prior marriage.  This is why we do what we do — to keep your family out of court and connected in love, not conflict.

    Kasem married his second wife, Jean, who is 22 years his junior, in 1980.  Together, they had one child, Liberty Kasem.  Casey also had three children from a prior marriage: Kerri, Mike and Julie.  The family was apparently in discord prior to Casey’s death; in mid-May, Mike and Julie filed a missing persons case with the Santa Monica police department saying they could not locate their father.  At that time, Kerri was fighting with Jean over control of his care.

    After Kasem died, news broke that his body had been taken from the Washington state funeral home and a judge awarded Kerri a temporary restraining order preventing Jean from removing his remains or having him cremated before an autopsy had been performed.  Kerri hired a private investigator who says the body has been moved to Montreal, the hometown of a man that Jean has allegedly been involved with for the past two years.

    A mess, right?  And they haven’t even gotten to the money yet!                lawyer confused

    A little advance estate planning could have helped prevent this scenario, which is not uncommon when an older man takes a second wife who is significantly younger and has children from a prior marriage.

    A recent WSJ article outlined four estate planning tools that could have helped to head off this disaster:

    Revocable trust.  Placing assets in a revocable trust can help protect the trust owner’s wealth transfer wishes, and provides the flexibility to make changes as long as the trust owner has the legal capacity to make those decisions.  Upon the owner’s death, the assets are dispersed as outlined in the trust without having to go through probate.  A trust is also more difficult to contest than a will.

    Life insurance.   A life insurance policy can be a good way to provide for a surviving spouse while leaving the rest of the estate to children from a previous marriage, or vice versa.

    QTIP trust.  A qualified terminal interest property (QTIP) trust is used to set aside assets for a surviving spouse’s benefit while that spouse is alive.  After the surviving spouse passes, the remaining assets in the trust are passed on according to the trust terms.

    Family meeting.  Having a family meeting so that everyone knows their beneficiary status and what will happen to the estate after the estate owner dies is a good way to head off conflict.  An estate planning attorney can mediate these meetings, which is usually advisable when there is a potential for conflict.

    One of the main goals of our law practice is to help families like yours plan for the safe, successful transfer of wealth to the next generation without conflict or concern.  Call our office today to schedule a time for us to sit down and talk about a Family Wealth Planning Session, where we can identify the best strategies for you and your family to ensure your legacy of love and financial security.

    Medicare Won’t Pay Your Claim in Newport Beach? Appeal It!

    processed 906 billion outpatient insurance claims in 2010 – and refused to pay
    10 percent of them. But if you're a senior on Medicare with a denied claim,
    your odds of turning that around are surprisingly good if you appeal.

    Elderly Woman with NurseFew things are more frustrating
    than battling bureaucracy. But if you’ve had a Medicare claim denied – and
    about 10 percent of Medicare claims are denied – you’re well-advised to hang in
    there and fight the good fight!

    Reuters recently published an article explaining “How to appeal when Medicare won't pay.” It is
    not an uncomplicated process, but if Medicare refuses to pay for services your
    doctor recommends it’s certainly worth your while to fight. The numbers are
    fairly enlightening:

    In 2010, 40 percent of
    Part A appeals and 53 percent of Part B appeals were granted, according to the
    Centers for Medicare & Medicaid Services, which administers Medicare (CMS).
    Even in the case of big ticket durable medical equipment appeals, 44 percent of
    appeals were successful. More than half of appeals to Medicare Advantage and
    prescription drug plans are successful, too.

    Medicare consumer advocates offer these tips for filing an appeal:

    1. Send a letter. Your paper trail starts with the summary
      notice of coverage you get in the mail. Take this notice, circle the erroneous
      denial, and write out why you think it should be covered. Make a copy, and mail
    2. Don’t waste time. You have 120 days to file an appeal
      for Medicare Part B claims, and only 60 days for Medicare Advantage or Part D.
      If you filed for pre-approval and were denied, you have only 14 days to
      initiate your appeal.
    3. Be persistent. You have a right to four levels of
      appeal, so don’t quit until you have exhausted all of your options.
    4. Get help. For appeals beyond the first level, you may
      want to seek help from an elder law attorney.

    Contact your Newport Beach
    estate planning attorneys at Meier Law Firm to discuss all of your estate planning

    Reference: Reuters
    (November 13, 2012) “How to appeal when Medicare won't pay

    Checking On Your Elders in Newport Beach This Holiday Season

    Pay close attention to your aging parents on a holiday visit this year. Does the normally tidy house now seem neglected? Is there hoarding? Do you notice memory problems, confusion or physical unsteadiness? Discovering that a parent's physical or mental health is declining can be heavy on the
    heart. It also can be hard on your finances.

    The turkey is practically in the oven and whether you’re waiting in the airport or preparing the guestroom, everyone is getting ready for the first family event of the Holidays. When it comes to meeting our elderly loved ones, however, it’s also important to remember to observe and ensure that they are fully supporting themselves

    It’s an unfortunate burden of thought during the holidays, but that doesn’t mean it isn’t an important one to bear in mind: as written by the Wall Street Journal not too long ago, you’ve got to ask, is it “Time for Elder Care?”  And then there’s the other half of it: you’ve got to observe, understand, and react in such a way as to truly help the situation. It’s easy to over-react when the well-being of your loved ones is at stake.

    Take the opportunity this holiday season to assess their needs and then, if something is amiss, work to find specific solutions. Your loved ones might not need full-time care, but perhaps a housekeeper or even gift cards for a few restaurant meals might help. If additional assistance is needed, assess the situation and look for the most appropriate benefits – local, state, veteran, or specific group benefits are important first steps – and be careful in your timing.

    For more to think about, the original article is worth a read through. And as every year, be sure to fully enjoy your time with them and make the best of the holidays!

    Contact your Newport Beach estate planning attorneys at Meier Law Firm to discuss all of your estate
    planning needs

    Reference: The Wall Street Journal (November 4, 2012) “Time for Elder Care?

    Walking and Alzheimer’s – Check Your Gait

    The way people walk appears to speak volumes about the way they think, so much so that changes in an older person’s gait appear to be an early indicator of cognitive impairment, including Alzheimer’s disease.

    Cognitive impairments, like Alzheimer’s and dementia, are difficult to diagnose, let alone manage. Still, these impairments are a reality for millions of Americans and their loved ones, not to mention many more of us in the future. Consequently, we must remain informed and vigilant.

    Cognitive disease symptoms steadily destroy our ability to plan for the disease itself. This troubling fact carries over to the legal issues of “mental capacity” when it comes time to plan your estate. So, what are the outward warning signs of present or future issues?

    Some new studies have come to light about walking and dementia. The New York Times recently addressed this connection in an article titled “Footprints to Cognitive Decline and Alzheimer’s Are Seen in Gait.” According to recent findings, a person’s gait – the way he or she walks – can be an early indicator of oncoming impairment for some. It seems the more difficulty a person has walking, the more difficult it is to process certain information.

    In fact, the results of testing were even more dramatic when persons where required to engage in various mental exercises while walking. Although neither conclusive nor confirmed, there seems to be a link between exercise and cognitive impairments.

    Contact Meier Law Firm to discuss how we can help you with your estate planning.

    Reference: The New York Times (July 16, 2012) “Footprints to Cognitive Decline and Alzheimer’s Are Seen in Gait

    Avoiding the (Medicare) “Doughnut Hole”

    Depressed Medicare beneficiaries in the so-called coverage doughnut hole were more likely to cut back on their antidepressants than those who had full insurance coverage, a study has found.

    Even with the Affordable Care Act (ACA) – Obamacare by any other name – in place and affirmed by the Supreme Court, the costs paid and lifestyles lived by many is being tied to the “doughnut hole.” This is especially true for seniors taking depression medications.

    As recently reported in Med Page Today, a new study by Yuting Zhang, PhD, of the University of Pittsburgh, Medicare may not fully cover depression medications for seniors, despite the ACA. The article is titled “Antidepressants 'Fall' Through Doughnut Hole.”

    If you are unfamiliar with the “doughnut hole” issue, you are not alone. It is the coverage gap created by Medicare Part D. For those whose income is at the lower end, there tends to be coverage. Likewise, for those who have an upper-end income, there is still coverage…with a gap in between.

    According to the new study, and sheer intuition, patients that fall within the doughnut hole are associated with a significant drop in medication use – 12% on average. That is always relevant, but perhaps especially so in the case of depression medication. While discontinuing any prescribed medication is never advisable, it is often easier to justify foregoing depression medication than other medications.

    I recommend reading the original article for more details regarding this study, should this issue be relevant to you or someone you love.

    Contact Meier Law Firm to discuss how we can help you protect everyone you love.

    Reference: Med Page Today (July 5, 2012) “Antidepressants 'Fall' Through Doughnut Hole

    Government Now Tracks Time Spent Providing Elder Care

    Every day, Bureau of Labor Statistics interviewers ask Americans to detail how they spent the previous 24 hours, how many minutes and hours they devoted to everything from shopping to child care to phone calls. The results, culled from 12,500 respondents, make up the American Time Use Survey. It began in 2003, but only last year did the bureau start asking about a key activity for millions of people — elder care.

    There’s rarely a shortage of personal stories about giving care to an elderly loved one. While there has been some private sector data on the subject, now there is official governmental information directly from the Bureau of Labor Statistics.

    The Bureau is the very same agency that publishes information on the Consumer Price Index, the Producer Price Index, and just about every government statistic, including the American Time Use Survey. This survey works to quantify how much time Americans devote to various tasks – and have to devote to those tasks in the first place. Interestingly, the survey has begun to include the activity of providing unpaid care to someone over age 65 “because of a condition relating to aging.”

    As reported in a recent post in The New York Times – The New Old Age Blog in an article titled “New Numbers on Elder Care,” the Bureau has wanted to track this activity since 2003. Nevertheless, the addition is fairly recent and the results for 2011 have been published. The summaries shed light on the experiences of many Americans.

    One of the key lessons to learn is that it is never too early to plan for the caregiving of elder ones loved ones. Contact Meier Law Firm to discuss how you can help care for your loved ones.

    Reference: The New York Times – The New Old Age Blog (July 5, 2012) “New Numbers on Elder Care

    Art Therapy for Alzheimer’s Patients

    “Art offers [patients with dementia] a way of communication that doesn’t rely on their verbal skills and allows them to contribute in a way that they don’t often get to do,” said Nancy Lee Hendley, dementia care trainer for the New York City chapter of the Alzheimer’s Association.

    Caring for an elderly loved one with dementia or Alzheimer’s is a difficult thing, often both for the caregiver and the patient. This is especially true when it comes to effective communication. Enter “art therapy.”

    According to a recent article in The New York Times (The New Old Age Blog) titled "Art Therapy For Alzheimer's Patients," art helps to comfort and often even invigorate a patient by giving them “something” with which to associate that does not require verbal interaction. As a result, various museums have begun programs with care professionals to provide guided tours for patients. These tours through exhibits offer patients the opportunity to associate with and discuss the art on display.

    According to the article, the experience also has proven to be a pleasurable activity for the caregivers, even if neither the caregiver nor the patient was an art-buff beforehand.

    So, if you have a loved one who has Alzheimer’s or dementia, then you might check with your local art museum and inquire about an art therapy program. Who knows, perhaps your suggestion just might initiate a similar program in your hometown.

    Reference: The New York Times – The New Old Age Blog (April 13, 2012) “Reconnecting Through Art

    Seniors and Singles Without Family – Consider A Care Committee

    People without much family simply plan the best they can, setting up advance directives and crossing their fingers, hoping they can afford paid care when they need it. Ms. Cotter has taken her preparations a step further, however. When she consulted [with her elder law attorney] for help with estate planning, he made a suggestion: She could set up a Care Committee.

    Unfortunately for many elderly and single persons, the legal system and, perhaps to an even greater extent, the healthcare system, are designed around family-based persons. The primary caregiver and decision-maker for so many of our elderly is an unpaid family member, usually an adult child. So, to whom can the single elderly person turn when they have no children?

    This is a question that comes up often, but the answers tend to be sparse and inadequate. Enter a relatively new development: the Care Committee. The New Old Age Blog on the New York Times recently addressed this concept in an article titled Care by Consensus.

    More likely than not, an elderly person without children already turns to other people in his or her life for advice and counsel. These other people serve as surrogate family members. In a sense that is all a Care Committee is, with the added benefit of legal organization.

    Here’s how it works: You ask and appoint members of your Care Committee and task them with carrying out your intentions when you are not able to articulate them yourself. Accordingly, they assume these powers only when you are incapacitated. Think of it as establishing an extended type of living will, or advanced directive. You can even spell out your intentions and simply ask your committee to follow them, or else appoint a guardian or care manager to follow them instead.

    It is at least one possible solution for a fairly intractable problem. Nevertheless, committees always have their drawbacks, especially when there are disagreements. Of course, your family members also can (and likely will) disagree at times.

    Another practical problem concerns the very friends you would appoint to your Care Committee. Unless they are significantly younger, they may have their own medical care emergencies and concerns, causing you to constantly revise and refine your committee choices.

    Nevertheless, forming a Care Committee may be a solid option for an elderly person in the right situation. Certainly, this is an option worth considering. I would recommend the original article for your reading. At any rate, if you are considering a Care Committee, be sure to engage competent elder law counsel to help evaluate this option and prepare the proper legal instruments.

    Reference: The New York Times (March 21, 2012) “Care by Consensus

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