Articles Posted in Elder Law

In Citrus County, Florida, more than one-third of the residents are senior citizens which is one of the highest rates in the country. However, in just fifteen years over one-quarter of the state will be 65 years old or older. Seeing how Citrus County operates now is giving policy makers and researchers a glimpse into the future of how the entire country will look in just a couple of decades.

A Look at Citrus County

Billboards across the county advertise home health care services, and health care is the dominating labor force for people still working. In addition, lawyers and doctors make house calls, and elderly citizens that can still get around use the county minivan system to be transported to and from the store.

In late February, the New York State Department of Financial Services (DFS) issued guidelines to financial institutions located within the state regarding prevention of elder financial exploitation. The guidelines were issued to remind banks and other lending institutions that they are allowed to report possible instances of elder financial exploitation to New York’s Adult Protective Services (APS) in addition to outlining the best practices used to identify, investigate, and report instances of elder financial abuse to the authorities.

Federal and State Reporting Law

While not mandated, DFS strongly recommended that financial institutions report any suspected elder financial abuse to APS. A joint task force of the federal OCC and FDIC released their own report in 2013 that clarified that it is not a violation of state or federal law to report suspected elder financial abuse to the relevant authorities.

In January, the Department of Veterans Affairs proposed new regulations regarding when and how a veteran is entitled to the VA pension. The proposed regulations have sparked considerable controversy and outrage over the potential penalties involved with making gifts and eligibility for the pension program.

VA Pension Program

The Department of Veterans Affairs established the VA pension as a way to help veterans and their families once a person has retired from the military. It provides tax-free, supplemental income through the pension program. Additional benefits through the pension program called “Aid and Attendance Benefits” are also offered to veterans who are unable to perform daily living activities, such as bathing, eating, dressing, and so forth. One of the main purposes of the Aid and Attendance benefits is to help veterans offset the high costs of nursing home care.

Two weeks after major surgeries, medical treatments, and life-saving procedures a doctor found his patient’s advance directive in his medical chart. Suffering from dementia and unable to communicate, the patient was unable to tell his doctors about the document that stated “he wanted comfort care only, no heroics.” This story illustrates one of a number of growing problems that medical professionals have with advance directives.

Advance Directives and Living Wills

Advance directives, which commonly include living wills and advance healthcare proxies, dictate the wishes of a person’s future care. A living will is used to communicate which treatments and procedures you would like performed in the case that you are unable to communicate them yourself. It is most commonly known for dictating whether a person wishes to be resuscitated in life threatening situations.

While it is important for everyone to plan for their future, it is especially important for a person that has been diagnosed with Alzheimer’s or other forms of dementia. The sooner that the planning begins after a diagnosis, the more likely that the person can contribute to the conversation and it becomes the less likely that problems will arise in the future. The Alzheimer’s Association has many resources available for seniors that have Alzheimer’s or other forms of dementia as well as for their loved ones, including steps to take regarding legal plans for the future.

Legal Capacity

In most cases, a person who is suffering from dementia is able to understand the meaning and importance of a legal document. As such, they possess the legal capacity to execute the document. So long as the person suffering from Alzheimer’s possesses the legal capacity to make decisions regarding their care, they should take part in legal planning.

At the American Academy of Hospice and Palliative Medicine conference earlier this month, Dr. Perla Macip spoke at a talk entitled “The 30-Day Mortality Rule in Surgery: Does This Number Prolong Unnecessary Suffering in Vulnerable Elderly Patients?” In recent years, a number of doctors and other medical professionals have questioned the thirty day mortality standard as a measure of success, particularly when it comes to elderly patients. Some go as far as argue that the standard of thirty days alive after surgery may undermine appropriate care for seniors.

Example of the Thirty Day Standard

One of Dr. Macip’s patients, “Mrs. S.” was a 94 year old patient who prior to surgery was fit and still lived in her own home. She consented to a valve replacement surgery and told physicians that her main goal was to return home. During the surgery, Mrs. S. sustained cardiopulmonary arrest and needed resuscitation. A series of complications followed, including an irregular heartbeat, fluid in her lungs, kidney damage, and pneumonia. Then, Mrs. S. had a stroke and was moved in and out of the intensive care unit, off and on a ventilator.

Last year, medical identity theft increased 22% as more U.S. patient health data becomes electronic. While it is easier for doctors and other medical professionals to readily access patient data, the process is also making it easier for cyber criminals to hack into doctors’ offices, hospitals, and insurance companies for personal information.

Medical Identity Theft

In 2014, more than 500,000 people were victimized by medical identity theft frauds and hacks. Those who gained access to the data then proceeded to use it for insurance fraud, free medical care, and other health-related illegal activities. According to the Ponemon Institute, resolving each incident of fraud costs around $13,500 in expenses. In almost twenty percent of the cases, the victims found additional or erroneous medical information added to their records by an imposter. Things like positive drug tests and other damaging information cost some victims job opportunities and caused other significant issues.

According to the Long Term Care Consumer Price Index, the overall costs for long-term care insurance coverage increased 8.6% compared to the costs last year. Researchers found that these costs affected both men and women at varying age levels that are currently paying for or are interested in purchasing long-term care insurance for possibly future needs.

Increased Costs for Long-Term Care Insurance

The American Association for Long-Term Care Insurance group has estimated that a healthy 55 year old man can expect to pay $1,060 per year for $164,000 in long-term care insurance benefits. This amount is fifteen percent higher than the 2014 cost of $925. However, the 2014 figure was a fifteen percent decline from 2013, which means that for healthy middle age men the annual premium has stayed steady between 2013 and 2015.

In a report released last week by the National Institute on Retirement Security (NIRI), fewer Americans are concerned that they will not have enough money to live on in their retirement. While 86% of Americans agree that the country is in the midst of a retirement crisis, a number that increases to 92% for millennials, more people are taking control of their retirement savings and feeling better about their living expenses once they stop working.

Results of the Report

Every two years, NIRI polls thousands of Americans to see how they feel about their financial security for retirement. They also poll people about their views on government policies and legislation that could help those reaching retirement age. Compared to the results in 2013, the overall percentage of people concerned about their retirement outlook fell from 85% down to 74%. In addition, more people polled expect the money in their pension plans to be there when they retire at 84%, up from 79% in 2013.

While some say that it takes a village to raise a child, others are now saying that it takes a crowd to pay for rising medical costs. As more caregivers are expected to pay for their loved one’s medical costs out of pocket, they are turning to the internet and crowdfunding websites for help. Certain crowdfunding websites are now dedicated portions of their sites specifically for health care expenses or specific diseases that need treatment.

Crowdfunding Websites

Crowdfunding, also known as crowdsourcing, uses a page on the internet to talk about the issue at hand and raise money for costs. It relies on friends, family, and strangers alike to donate money to the particular cause. Websites like YouCaring.com, GiveForward.com, GoFundMe.com, and Fundly.com are all examples of websites where people can go online and ask for help.