Monday, August 31, 2015

Elder Lawyers Help with the Later Seasons of Life

An important practice area at Geyer Law is elder law, which deals with health, long-term care, and estate planning issues. Many of our clients need assistance which extends beyond the legal aspects of planning. As part of the compassionate care offered by Rebecca W. Geyer & Associates, we look for resources which seniors and their families can use to assist them with the issues they confront with aging.

For example, when it’s time to make decisions regarding senior housing and elder care, there are many factors that come into play and important choices to be made. For today’s blog post, we’re recapping our blog team’s interview with Lona Newton, owner of Senior Living Advisor.



Ronnie: What exactly does an independent senior living and elder care consultant like you do?

Lona Newton:   Over the years of working with family caregivers – especially those in the “sandwich generation” who are taking care of both children and of parents – I’ve seen those adult children filled with anxiety when it comes to make the right choices for the health and safety of their senior loved ones. What we do is help those caregivers find – and check out – the best senior housing solutions.

Ronnie: So how does your process work?

Lona:  We start by conducting a basic needs assessment, which includes healthcare needs, financial parameters, and space requirements. While often it’s an adult child who calls upon us, we actually meet with the seniors themselves to build rapport and to obtain and provide essential information.  From there, we research different senior living communities that are most likely to meet each person’s particular needs, and actually take the senior for a visit to that senior living community, and we’re there to assist on the day of move-in.

Ronnie: We hear from many of our clients that there are so many options that they dread doing the research and it’s hard to make a decision. How do you take the pain out of the process?

Lona:  My whole idea in starting Senior Living Advisor was to make senior housing and senior care decision-making less frightening and frustrating. You asked about consultants “like me”, but actually, we are unlike other senior care consultants in that our services are paid for by our clients, not by any senior living communities.  That allows us to work independently with only the best interests of the senior and of the family as our guides.
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The elder law attorneys at Geyer Law have the experience and expertise to prepare the legal groundwork to assist seniors as they and their families cope with complex health, long-term care, and estate planning issues. When it comes to researching senior living facilities, we often refer clients and their family members to a senior living advisor.
- by  Ronnie of the Rebecca W. Geyer & Associates blog team

Tuesday, August 25, 2015

Activity Helps Alzheimers' Patients, Elder Lawyers Share



Anything that helps our estate and elder law clients protect and help the people most important to them is important to  Rebecca W. Geyer & Associates. In the course of offering compassionate counsel, it’s common for us to hear stories of family members suffering from Alzheimer’s disease.

Alzheimer’s, according to the Alzheimer’s Association, accounts for 50%-80% of dementia cases. And, while dementia can cause seniors to withdraw from activities, we were heartened to learn that stimulating activities can reduce the effects of severe cognitive impairment and lead to a better quality of life for Alzheimer’s patients.

Jennifer Wegerer, writing in the Alzheimer’s Association newsletter,  reminds family members and other caregivers how important it is “to create meaningful activities, not just fill time.”  For an activity to be meaningful it must:
  • stir memories
  • foster emotional connections with others
  • encourage self-expression
  • lessen anxiety and irritability
  • make people feel engaged with life

Activities might include:
  1. Arts and crafts with simple tools and patterns
  2. Organizational tasks
  3. Household cleaning tasks
  4. Gardening
  5. Looking at books
  6. Cooking or baking simple recipes
  7. Puzzles
  8. Reading the newspaper
  9. Watching family videos
  10. Playing music
Take a supportive, flexible approach, Wegerer advises, taking breaks and perhaps changing the activity to make it more enjoyable.  Remember, she says, concentrate on the process and not the results.  “What matters is that your loved one enjoyed the time spent on it and felt useful.”


Wednesday, August 19, 2015

"Trying Out the Wheelchair" Elder Care Planning

 “Old age is like everything else.  To make a success of it, you’ve got to start young,” Theodore Roosevelt once quipped, and as Indiana elder law professionals, we know how very right he was.
                   
Despite the fact that today’s seniors are living longer and healthier lives than was true in past generations, elderly and disabled individuals face very complex health and long term care issues. Reality is that most seniors will require some form of long term care before death. Every day in our work at Geyer Law, we help our clients deal with issues including

  • Medicare, Veterans Aid and Attendance, and Medicaid benefits
  • Long term care insurance
  • Advanced directives

Whether we are helping seniors prepare for their later years, navigating the more complex and restrictive rules in place today, or assisting in dealing with their parents’ issues, one thing is crystal clear: To make a “success” of them, families must address these issues before they arise.

It’s inevitable, as Health in Aging points out, that older people will feel loss of control when strangers are involved with their intimate daily lives. That’s why it’s so important to involve the older person as much as possible in planning their own care.

Without in any way minimizing how difficult and even awkward talking about long term care and end of life issues can be for parents, we encourage seniors to embark on what author Tim Proesch calls “The Other Talk”.

Here at Rebecca W. Geyer & Associates, we’ve adopted an empathetic and compassionate approach. Compassion is the opposite of avoidance, however.  We understand the fears and family dynamics that can come into play when legal and health issues are concerned. That’s precisely why we encourage our clients to “try out the wheelchair”, facing up to even the scariest of “what if” scenarios.

- Corinne of Rebecca W. Geyer & Associates

Monday, August 17, 2015

Billing Advocate Helps Ease the Way for Elders

Elder law is an important practice area for Rebecca W. Geyer and Associates. Elder Law deals with the complex health, long-term care, and estate planning issues faced by elderly and disabled individuals and their families. Early on, we discovered that many of our clients needed assistance which extended beyond the legal aspects of planning.

When you’re dealing with a health crisis, the challenge of resolving all the medical bills and dealing with all the paperwork generated by the health care system can be overwhelming. Often adult children live far away and cannot offer budgeting assistance or review bills. For today’s blog, we’re recapping our blog team’s interview with Sharon Gall, owner of My Billing Advocate.

Ronnie: What are some signals that indicate a senior could use help from a medical billing advocate,  and what services do you actually provide?

Sharon Gall: We help organize the medical paperwork.  We compare your medical bills to their corresponding insurance explanation of benefits. We make sure your insurance has processed all claims according to your plan benefits. If your insurer denied a claim for something you thought would be covered, our team researches the issue and works with your medical provider and/or the insurance company to make any wrongs right.

Ronnie:  What professional background and training do medical billing advocates receive?
Sharon Gall:  We have extensive medical billing and coding experience, and continually study the new healthcare regulations and coding changes that occur each year.  My Billing Advocate is a proud member of the Alliance of Professional Health Advocates and of the Healthcare Financial Management Association.

Ronnie:  A senior doesn’t need to have been in the hospital in order to need help managing all the financial paperwork, right? What about elders residing in assisted living facilities or nursing homes?

Sharon Gall:  Reviewing nursing home bills is a very big part of what we do at My Billing Advocate. First of all, Medicare may categorize things differently, causing elders to have unnecessary out of pocket costs. Some nursing homes may charge as much as $250 when the senior’s monthly payment has not come in on time. As independent patient advocates, our entire focus is on getting the client the benefits he or she deserves and saving the elders – and their adult children – a lot of hassle, worry, and unnecessary expense.



The elder law attorneys at Geyer Law have the experience and expertise to help avoid the financial ruin that can be associated with high health care costs. For ongoing budgeting assistance and daily financial management, we often refer clients to medical billing advocates.

Friday, August 14, 2015

It May Be Time to Have That Other Talk

                          
“Do you remember how difficult – and absolutely necessary – it was when it came time to sit with your kids to have ‘the Talk’, the one about the birds and the bees?” asks Tim Prosch.
In his book The Other Talk, Prosch says it may be time to have another talk about the “facts of life”, but this time it’s about the end of life – yours.

The National Hospice Foundation has found that 75% of Americans don’t make their end-of-life decisions known to their families through either verbal or written communication; a Pew Research Center survey revealed that only 55% of adult children have talked to their parents about what to do if the parents become unable to live independently.

“The unfortunate consequence of protecting your kids is that, when circumstances eventually force your family to confront reality… you (but most likely your kids) will be reacting in crisis mode,” Prosch cautions.

“What you need to remember,” he adds, “is that the Other Talk isn’t just about the orderly distribution of your assets while you’re alive and when you are gone.  It’s also a means to an end: how to get the most out of the rest of your life and how to involve your kids in that adventure.”

Since Rebecca W. Geyer & Associates is an estate planning and elder law firm, we couldn’t agree more.  As part of becoming a resource for clients, we aim to combine clear and concise legal recommendations with responsiveness.  Since elder law involves planning for the complex health, long-term care, and other issues faced by aging individuals and their families, we know how crucially important that Other Talk can be. We understand the challenges, fears, and family dynamics that inevitably come into play as part of “the Talk”, and do everything in our power to encourage and enable the process for our clients (who may be the children or the parents)..

As Tim Prosch so aptly describes the process, the Other Talk gives parents and kids the tools to develop a strong partnership to plan for the rest of the parents’ lives.

- By Ronnie of the Rebecca Geyer & Associates blog team

Wednesday, August 12, 2015

Joint Ownership Can't Replace Estate Planning

 In the process of buying an automobile, Denise thought it would be a good idea to title the car in her daughter Ann’s name along with her own.  That way, Mom thought, if something happened to her, Ann could just take the car and use it without any legal “hassles”.
Just how good an idea was that?  “Joint ownership of property should not be created or used as a substitute for a will or living trust,” attorney Harvey J. Platt reminds readers in Your Living Trust & Estate Plan. Why not? Well, for one thing, if joint property owners were to die simultaneously and there is no will or living trust, the assets would pass to those that perhaps weren’t intended (the nearest blood relatives of each joint owner).

At Rebecca W. Geyer and Associates, we agree that, while joint asset ownership may help assets avoid probate, it is no substitute for comprehensive estate planning. Even if the owners don’t die simultaneously, there are a number of reasons “blanket” joint ownership of all assets can create more problems than it solves:
  •  The creation of a joint interest may cause there to be a gift taxWhen the money to buy the assets comes from just one of the owners, the other owner is receiving a gift.  Yes, in 2015, gifts of up to $14,000 per recipient escape that tax. (If the car Denise had bought had a market value of less than $28,000 – well, no problem.)
  • Creating a joint interest can cause the “step-up” in basis to be lost. Suppose the property put into joint ownership had been a building, a farm, or stock that Denise had owned for years, rather than a car she was buying. Over the years Mom owned it, let’s imagine that property had greatly appreciated in value. At the time Denise puts the property in joint name with Ann, Ann’s cost basis becomes half that of Denise’s. When, sometime in the future, Denise dies, there will not be a step-up in basis on the half interest Ann receives from Denise.  Should Ann later sell the asset, she will pay capital gains tax on the difference between the sales price and Denise’s basis in the property on Denise’s half interest.

Then is joint ownership of property necessarily a “bad idea”? Not at all.  At Geyer Law, our focus is on understanding the particulars of your situation so that we can design an estate plan that accomplishes your objectives. With proper planning, your assets can pass to your loved ones in a way that is quick, private, and which preserves all the appropriate tax advantages.

Joint ownership may, in fact, be part of your estate planning, but it certainly isn’t an “instead of” for comprehensive planning!


Saturday, August 8, 2015

Special Planning for Special Needs Children on Child Support

Providing for children with special needs through an estate plan involves unique
considerations. That is particularly true when the child’s parents are divorced and child support is involved. “There are few challenges more difficult than going through divorce and having a child with special needs,” Lili Vasileff of the Special Needs Alliance writes. “From a legal perspective, the goal is to identify and understand how to determine the child’s best interests….Alimony and child support payments need to consider the child’s eligibility for government benefits,” she adds.

Ideally, a special needs trust should be set up even before the divorce decree is finalized. The concept (see our blog post of a few days ago on the subject of special needs trust planning) is for the child to be able to continue receiving governmental benefits (Supplemental Security Income and Medicaid) and still be able to receive parental support to help pay for services and care over and above what the government provides.

The set-up and administration of a Special Needs Trust is no simple matter.  There are many laws, both state and federal, that govern the way SNTs are created, how they are funded, how they need to be run, and how they end. This is certainly one type of planning best done with the help of an estate planning attorney.

In the context of divorce, failing to irrevocably assign child support payments to a special needs trust may reduce that child’s Supplemental Security Income (SSI) benefits, create a Medicaid spend down, or make them ineligible for governmental benefits in some cases.  It is not uncommon for a judge to order a noncustodial parent to continue paying support after a child with special needs reaches majority.  Once a child with disabilities reaches the age of 18, Social Security determines the child’s SSI eligibility based on the child’s own income and resources.  Support payments paid to or on behalf of the child and not assigned to a trust can reduce the amount of SSI the child is eligible to receive.  Further, if those benefits accumulate in the child’s name, they could run the risk of violating SSI’s resource limit of $2,000.  The receipt of support which is not assigned to a special needs trust can also effect Medicaid eligibility before and after a child’s 18th birthday.

“It is essential that your family law attorney work with a special needs attorney,” Vasileff cautions. “Divorce attorneys do not always know how child support payments made directly to the custodial parents interact (negatively) with ‘means tested’ government benefit programs,” she stresses.

At Rebecca W. Geyer & Associates, we couldn’t agree more. Our attorneys often coordinate efforts with family law professionals and financial planners to help parents of special needs children navigate through the complex maze of laws and provide clear solutions.

Providing for special needs children is one area of the law that absolutely requires compassionate – and knowledgeable counsel!




 - by Ronnie of the Rebecca W. Geyer blog team

Thursday, August 6, 2015

Special Needs Planning for Children

For parents of children with special needs, estate planning involves a special set of challenges. How will a child with a physical or mental disability be taken care of after the parents have died? Importantly, how can the child continue to receive governmental benefits (such as SSI and Medicaid) and still benefit from a gift or inheritance from the parent(s) or from a personal injury settlement?

The answer is called a special needs trust. The assets in that trust can provide a more comfortable standard of living for either a minor or adult child without jeopardizing the receiving of services through governmental benefits.
Needs not covered by SSI or Medicaid that can be satisfied out of the trust include:
  • Dental expenses
  • Special dietary needs
  • Equipment requirements
  • Insurance
  • Hours of home health care in addition to those covered by Medicaid

Lifestyle-enhancing benefits that a special needs trust can finance include:
  • Education expenses
  • Electronic equipment
  • Vacations
  • Entertainment
  • Gifts for others
Designing a special needs trust isn’t simple, and involves navigating the complex maze of federal and state laws concerning government benefits. In fact, americanbar.orghttp://www.americanbar.org/newsletter/publications cautions attorneys that “even the best special needs trust can cause ineligibility for public benefits if it is improperly administered”.

At Rebecca W. Geyer & Associates, we’ve seen what an enormous positive impact special needs trusts can have in terms of improving a disabled heir’s quality of life. We consider special needs trust planning a particularly gratifying aspect of our work.

There are three basic types of special needs trust:
  1. Stand-alone trust (funded now with property belonging to someone other than the disabled beneficiary) created by parents, grandparents, or a court-appointed legal guardian
  2. Testamentary trust funded when the parent or guardian dies, created through the will.
  3. Self-settled trust created for the disabled individual out of assets he/she has received from an inheritance or personal injury settlement.

Are there limits on the amount of money or assets that can fund a special needs trust? The answer is no. Of course, the funds in the trust must be used exclusively for the benefit of the disabled beneficiary.

There are special rules special needs trusts must follow in order to preserve the disabled person’s right to public benefits, including:
  • The trust must be irrevocable
  • The trustee must have sole and absolute discretion to use the funds for sole benefit of the recipient of public benefits, without being required to make any regular payments of income of principal to the disabled recipient

It’s reassuring to know that the lives of special needs children can be improved with special needs estate planning strategies!  For further information about planning for your special needs child, please contact Geyer & Associates.

Monday, August 3, 2015

Putting Your Money Where Your Trust Is

More than 125 years ago, the great Oliver Wendell Holmes had this to say about estate planning: “Put not your trust in money, but put your money in trust”.

“Trusts are the most useful and unique devices available in the field of estate planning,” according to Harvey J. Platt, author of Your Living Trust & Estate Plan. “Trusts have become the superstars of estate planning,” he adds.

Platt lists some of the many ways trusts can be used, including:
  • To fund a child’s education
  • To provide for a spendthrift beneficiary
  • Provide for a spouse that cannot manage property
  • To provide continuity in case of incapacity
  • Provide unusual tax benefits
  • Provide for disabled persons to protect their entitlements
  • To avoid probate
  • To maintain control postmortem (ruling from the grave)
Our work at Geyer & Associates often includes trusts.  Similar to wills, trusts allow you to designate the person in charge of administering and distributing your estate and to determine how you wish your assets to be distributed. The most common type of trust is the revocable living trust.  That arrangement allows you to re-title assets to the trust’s name during your lifetime, eliminating the need for probate when you die.

As we often explain to new clients of Rebecca W. Geyer & Associates, even the most basic estate plan should include more than just a living trust.  Other basic estate planning documents include:
  • Wills
  • General Durable Powers of Attorney
  • Appointments of Healthcare Representatives
  • HIPAA Authorizations
  • Living Wills
Documents, of course, are nothing but tools, each designed to accomplish a specific task as part of your overall plan. As Indiana estate planning and elder law attorneys, we believe a well-crafted estate plan should provide for you and for your loved ones in an effective and efficient manner, giving you the peace of mind that you’ve put a safety net in place for the benefit of the people, and possibly the charities, you care about most.


- by Ronnie of the Rebecca W. Geyer & Associates blog team