Category Archives: Nursing Home Planning

Planning Sooner Not Later

By Attorney Mitch Adel

Recently a life insurance company conducted a survey and found that 80 percent of Americans acknowledge that there will be a need in the future for Long Term Care planning and half of those surveyed believe that the costs of this type of care will double in the next 14 years.  Yet, despite this realization, less than half are sure of ways to prepare and, less than half are currently setting aside funds in the event that it happens to them.  The larger problem is that this is a bigger concern for women, yet only a quarter of women are saving for their future needs compared to a third of men.

I personally have met with hundreds of families who do not realize this potential problem until it is pointed out during our meetings.  The problem lies in the fact that women on average have a longer life expectancy than men.  When the husband has a catastrophic health care issue or long term health care need, his wife will likely be able to be his caregiver in an effort to keep him in the home longer and when the husband eventually goes into a facility, the assets are available for the surviving spouse will be greatly reduced. The problem is that when the wife has the same need, if her husband has predeceased her, there is no one living in the home to be her caregiver. Many children step up to help, but more often, it is difficult for the children to care for their parents because they must care for their own families or they live far away from their parents.

What is the solution?  Families need to start planning sooner.   Specifically people need to start working with attorneys and financial advisors that assist in both the growth of assets and the preservation of assets.

In an effort to protect client’s assets, attorneys create trusts, but no trust can give you financial growth.  Financial advisors sell products designed to give you financial growth, but no financial product can protect your assets.  However, when you marry the two concepts, Trusts and Financial products, you can achieve both – growth and protection!

Last year, in an effort to make sure that our clients could achieve both, my partner, Thom Cooper, and I started Cooper & Adel Financial.

If you would like to learn more about the above study please visit http://www.fa-mag.com/fa-news/9046-most-americans-dont-prepare-for-long-term-care-planning-survey-says.html

If you would like to learn more about Cooper & Adel Financial please call our office at 800-798-5297

Will the county nursing home be there for your long term care?

By Attorney Liz Durnell

As an Ohio Elder Law Attorney, I keep up with nursing home changes across in the state. Last year, several Ohio nursing homes closed or announced they will be closing.  County nursing homes were among these closures, including the Morrow County Hospital Extended Care Facility.

Some people assume that they will be able to go to the county nursing home, if they need long term care, because the cost is lower, on average, than a private pay facility. However, as is evidenced by the recent closures of these nursing homes, this strategy is probably not an effective one.

Please contact Cooper, Adel and Associates to set up a free consultation to examine your estate planning strategy and make sure your plan is the best for you and your family.

The Costs of End-of-Life Care

by Jordan Myers

Dealing with an aging loved one is never easy. Whether it is your spouse or a parent, the complex issues that arise can easily start to seem unmanageable. The following excerpt was found in an article posed on the Wall Street Journal: “These things often creep up on families,” says Kenneth Covinsky, who specializes in geriatrics at the University of California, San Francisco. “And often it’s a situation where you are simultaneously wondering, ‘How am I going to provide care?’ and having the personal trauma of seeing someone you love having trouble.”

What is the proper planning that one should take when trying to stay ahead of the curve with respect to the issues of aging? Many family members have nothing but good intentions when trying to help in the situations, however there are just so many complexities and issues that most won’t know how to handle.

Carol Levine, director of the Families and Health Care Project at the United Hospital Fund says, “Whatever you think health-care costs are going to be toward the end of life, you’ve probably underestimated. “There is so much that people assume is covered and isn’t.”

The best thing that you can do to protect yourself and your loved ones is plan. The best way to do that is to consult with an Elder Law Attorney. At Cooper, Adel & Associates, we have a staff of Ohio Elder Law Attorneys that specialize in the needs of the elder community. Whether you need help with basic estate planning or are in a crisis situation, contact our office for a FREE consultation and see what the best options are for you and your family.

 

Alzheimer’s is “a kind of death”

By Atorney Elizabeth Durnell

Ohio Medicaid AttorneyDuring my experiences as an Ohio Elder Law Attorney, I have seen many different kinds of illnesses and the many different responses to these illnesses.  We recently had a client whose husband was in a nursing home due to a completely debilitating stroke.  Her husband barely recognized her anymore.  She was very distraught when she learned that she would lose a significant portion of her assets to the nursing home and wondered how she would continue to pay for her home.  She asked us if divorce was an option for them.  It is becoming a mainstream option.  It was recently discussed by Religious broadcaster Pat Robinson on the “700 Club.”

Following is an excerpt from the Associated Press by Tom Breen.

Religious broadcaster Pat Robertson told his “700 Club” viewers that divorcing a spouse with Alzheimer’s is justifiable because the disease is “a kind of death.”

During the portion of the show where the one-time Republican presidential candidate takes questions from viewers, Robertson was asked what advice a man should give to a friend who began seeing another woman after his wife started suffering from the incurable neurological disorder.

“I know it sounds cruel, but if he’s going to do something, he should divorce her and start all over again, but make sure she has custodial care and somebody looking after her,” Robertson said.

The chairman of the Christian Broadcasting Network, which airs the “700 Club,” said he wouldn’t “put a guilt trip” on anyone who divorces a spouse who suffers from the illness, but added, “Get some ethicist besides me to give you the answer.”

Most Christian denominations at least discourage divorce, citing Jesus’ words in the Gospel of Mark that equate divorce and remarriage with adultery.

Terry Meeuwsen, Robertson’s co-host, asked him about couples’ marriage vows to take care of each other “for better or for worse” and “in sickness and in health.”

“If you respect that vow, you say ’til death do us part,’” Robertson said during the Tuesday broadcast. “This is a kind of death.”

A network spokesman said Wednesday that Robertson had no further statement.

Divorce is uncommon among couples where one partner is suffering from Alzheimer’s, said Beth Kallmyer, director of constituent services for the Alzheimer’s Association, which provides resources to sufferers and their families.

“We don’t hear a lot of people saying ‘I’m going to get divorced,’” she told The Associated Press. “Families typically respond the way they do to any other fatal disease.”

The stress can be significant in marriages though, Kallmyer said, because it results in the gradual loss of a person’s mental faculties.

“The caregiving can be really stressful on a couple of levels,” she said. “There’s the physical level. There’s also the emotional level of feeling like you’re losing that person you love.”

As a result, she said, it’s important for couples to make decisions about care together in the early stages of the illness, when its effects aren’t as prominent.

It is likely you have more options than simply divorcing a spouse with Alzheimer’s, but you need to find out about them.   If you and your loved ones are suffering through this horrible disease, please contact Cooper, Adel and Associates for a free consultation to determine your options.

 

The Housing Bust and Senior Health Care

By Attorney Nathan Simpson

As fallout from the housing bust continues, many seniors are beginning to feel the impact.

With rising medical costs, an increasing number of seniors are finding themselves unable to come up with the financial resources to pay for long-term care.  In better financial times, many people saw their homes as a sound investment that would eventually be sold in order to raise money later in life.  With the decline of the real estate market, many of these seniors who otherwise would have sold their home are finding it difficult or impossible to do so.   This has left them unable to secure much needed resources to pay for vital services such as In-Home Care, Assisted Living, or Nursing Homes.

However, by working with an Elder Law Attorney, it may be possible to secure the resources you or a loved one need to pay for their medical needs, without selling the family home.  Additionally, there may be ways to protect the family home and save it for the enjoyment of your children and grandchildren.

If you are interested in receiving needed medical services and protecting your family’s assets, please call the Elder Law Attorneys at Cooper, Adel & Associates.

 

Can My Parents Keep Their Home If They Have To Go Into A Nursing Facility?

By Jordan Myers

The simple answer to this question is, “yes”. However, If you have spent any time at all helping your parents plan for the unfortunate event that they might have to enter a nursing home, you know that “simplicity” is a luxury not often afforded in this situation. In today’s blog, I will elaborate on some of the restrictions that you must keep in mind when planning for you parents, or yourself, to enter a long-term care facility.

To pass the “asset test” for qualifying for Medicaid in Ohio an individual must have less than $1,500 in assets. The primary place of residence and one car are exempted from making this determination. If only one parent is going into a care facility then the other can remain in the home, but not free and clear. Any individual that receives Medicaid assistance is subject to Estate Recovery.

Estate Recovery is a program through the Office of the Attorney General that attempts to recoup any cost associated with providing Medicaid assistance at the time of the recipient’s death. The restriction with Estate Recovery is that the liens can be placed for no more than the amount spent on the individual’s care. With the rising costs of health care, a one to two year stay in a facility can deplete the majority, if not all, of the value of the home!

In the scenario where a parent’s spouse has pre-deceased them and there are no dependents, the home will then be considered to be a “countable” asset. This means that the equity in the home must be used to pay for the homeowner’s healthcare costs. The Ohio Administrative Code (OAC) does, however, allow each Medicaid recipient a 13-month “right to return home” in which the home cannot be considered a countable resource.

There are many complex scenarios and restrictions on the treatment of the home for Medicaid purposes, and many strategic plans that can be used to protect the parent’s home and the family’s heirs. The best way to discuss your specific scenario and develop the best overall plan is to meet with the experienced staff of Elder Law Attorneys at Cooper Adel & Associates. Call today to schedule your FREE consultation.

As always, remember that it is better to look ahead with preparedness than to look back with regret!

 

Choosing between assisted living or a nursing home

(from NYTimes.com)

Too often there is a gray line between when a loved one should enter an assisted living facility vs. a nursing home. Paula Span wrote and interesting article that was recently featured in the NewYork Times discusses this issue.

“Like so many adult children, Catherine Hawes confronted The Promise. You may have experienced this fraught conversation, too: Your elderly parent grasps your hand and pleads, “Promise me you’ll never put me in a nursing home.”

Dr. Hawes, a professor of health policy and management at the Texas A&M Health Science Center, happens to be one of the nation’s leading experts on long-term care. “I’ve been in this business for 35 years, but when my mother said, ‘I’d rather die than go to a nursing home — promise me you’ll never put me in a nursing home,’ I felt like every other child feels. It’s a knife to the heart.”

The great interest in assisted living over the past 20 years stems, in part, from families making The Promise. Assisted living — a term encompassing a bewildering variety of facilities, from small family-operated homes to 100-unit complexes -– has advantages and disadvantages, but chief among its attractions is that it’s not a nursing home.

When families can no longer keep an older adult in his own home (the almost universal preference) and are investigating congregate living, that’s everyone’s first thought. Everyone says, ‘My mom doesn’t belong in a nursing home,’ so they think assisted living, regardless of her medical needs or prognosis.

“Good nursing home” is not a contradiction, by the way, despite the industry’s longstanding and well-documented problems. “Nursing homes have gotten a bad rap,” says Lisa Gwyther, the veteran social worker who directs the Duke Family Support Program in Durham, N.C. There are good ones, and there are seniors who need them.

For instance, “anyone with moderate to severe cognitive impairment and problem behaviors like resisting care or becoming alarmed if someone tries to help them shower generally belongs in either a dementia unit with well-trained staff or in a nursing home. In standard assisted living, there’s not enough staff to help.”

Dr. Hawes says the ideal candidate for assisted living was Miss Daisy, the character in the play and the film starring Jessica Tandy. Miss Daisy, lucid and opinionated, didn’t need extensive nursing or personal care, just transportation, light housekeeping and meals, and the attention of the courtly Morgan Freeman. If that’s your mother, she may not need a nursing home.

At least, not yet. Families shopping for facilities hear a lot about “aging in place.” Marketing directors may imply, or even say, that this will be your parent’s last home. But however suitable assisted living may be when a resident moves in, the average stay is a little over two years, and the most common reason for moving out is needing more care than it can provide.”

If you find the decision between assisted living or a nursing home to be a stressful one, think about the financial aspect of it as well. Don’t wait for “crisis planning” and get your ducks in a row by scheduling a free consultation with the Thom L. Cooper Company.

Home Care as an Alternative to Nursing Homes

By: Attorney Nathan Simpson

According to a recent article in the Cincinnati Enquirer, more seniors are receiving home-based care rather than entering nursing homes.  This is due to an expansion of Ohio’s Passport program, which provides seniors with home-based care paid for by Medicaid.  The program has proved to be incredibly popular, and the number of seniors receiving home-based care from Medicaid has more than quadrupled since 1993.

The program is beneficial to both seniors and the taxpayers, allowing seniors to remain in their homes longer while saving Ohio millions of dollars.  However, despite the savings and official’s desire to further expand the program it is facing potential funding cuts in the state budget.  This could mean longer waits and service cuts for Ohio seniors.

If you or a loved one are in need of home-based care, an experienced Elder Law Attorney from Cooper, Adel, and Associates may be able to help you qualify and apply for Ohio’s Passport program.  Contact us today for a free consultation.

 

How Do I Pay for Long Term Care?

By Jordan Myers

Many senior citizens and adults reaching retirement age have a lot on their minds. “How should I manage my money when exiting the work force?” “How can I protect my assets?” and “How can I get high-quality healthcare without spending every dollar that I’ve worked my entire life to earn?” The answers to these questions can be difficult to answer, but answering them and planning ahead can make a world of difference!

In today’s blog I would like to talk about a common misconception concerning long term care for seniors and how planning is key in preventing a financial disaster. Some seniors believe that once they reach age 65 they will be entitled to Medicare benefits that will cover their medical expenses. While Medicare and Medicare supplemental insurance will pay out for doctor visits and prescription medication, it will NOT pay for long-term care in a nursing home or assisted living facility. Under certain specific circumstances, Medicare can pay for up to 100 days in a facility if discharged from a hospital into the facility, but after that you would be responsible to pay for the duration of the stay.

Did you know that, according to AARP.org, approximately 70% of Americans age 65 and older will spend at least some of their lifetime in a nursing home? One in ten of those seniors will spend at least 5 years in a facility. The current Average Private Pay Rate (APPR) for nursing homes in Ohio is $6,023 per month. That is over $360,000 over a five-year period, and I am asking you to consider that is using only the average. Many facilities have costs that are much higher.

Now let’s talk about the alternative resource that is used to pay for long term care, which is Medicaid. In an article from the website MoneyForVets.com, Medicaid is described as a government program that “pays for long term care expenses primarily for nursing home care.  However, there are some exceptions where Medicaid will pay for home care or assisted living expenses.” The exceptions mentioned in the article refer to ‘Assisted Living Waiver” and a program called “Passport”.

Medicaid is a highly regulated program and can sometimes seem complicated. Many eligible seniors never receive the benefit because they simply never apply. While the program is invaluable to many seniors, applying on your own without understanding how the program works, or consulting an elder law professional, can have devastating consequences. That is why I am asking you to contact our office and schedule a free consultation to discuss your plans with an experienced elder law attorney.

Until next time! Remember, that it is better to look ahead with preparedness than to look back with regret.

 

The decision to move your parent to a nursing home

By Attorney Liz Durnell

It is a very difficult decision to move your parent into a nursing home, but sometimes it is a necessary decision. In the story of Leslie and Lois Baum, Leslie Baum exhausted all of her service options before moving her mother into a nursing home.

Following is an excerpt from an article on Cincinnati.com by Peggy O’Farrell entitled “The Burden of Alzheimer’s.”

Lois Baum was diagnosed with Alzheimer’s in 2003, shortly after her daughter moved in with her. Before she entered the nursing home in 2007, Lois Baum got in-home care three days a week at an adult day program through Hamilton County’s Elderly Services Program. The program allowed her daughter to keep working.

Even with aides coming in to care for her mother while she went to work, Leslie Baum never stopped worrying.

By 2007, Lois Baum was falling more often. At 200 pounds, she was almost too heavy for her daughter to help up. She could no longer remain at home.

Lois Baum had already set up the paperwork that would allow her children to make legal and medical decisions for her. She had set up advance directives dictating what kind of end-of-life care she wanted.

When Lois Baum went into the nursing home, she had a little savings, her Social Security check and a life insurance policy worth $3,000. All of it was turned over to the nursing home. Leslie Baum put her mother’s house on the market and found a new home for herself in Madisonville.

Within about a year, Lois Baum was broke. Now Medicaid picks up the tab for her nursing home, which costs between $6,000 and $7,000 per month.

Most days, Lois Baum doesn’t know her own daughter.

In the preceding article, Leslie had no other option but to move her mother into the nursing home, however, if Leslie had consulted an elder law attorney, she would have been informed about options that might have saved some her mother’s property.  In Ohio there are exceptions that can be used when a child has been their parent’s live-in caregiver.  If you find yourself in a similar situation, please contact Cooper, Adel & Associates, LPA to schedule your free consultation.



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