Elder Law

Bending the Cost Curve or Breaking the Bank with Long-Term Care?

Published on: January 31, 2014 | by Ettinger Law Firm

While the Affordable Care Act attempted to “bend the cost curve”, the cost of long-term care remains high and is projected to skyrocket in the future. In Illinois, the median annual cost for a nursing home with a private room was $125,732. (Genworth Financial, Inc., survey). Figuring out how to prepare for your long-term care as well as how to pay for it are major life decisions. It is important to take the time to consider your options, discuss your thoughts with your loved ones, and take affirmative steps to put your plan into place without breaking the bank.

Insurance Options

Two of types of health insurance that many have enrolled in, Medicare or traditional health insurance, do not cover long-term care. Medicare and traditional health insurance provide only short-term solutions. Medicare and private health insurance will cover only skilled care that is medically necessary and relates to a recent hospitalization. Notably, disability insurance does not cover long-term care and often many policies end when you turn 65 since disability insurance is only to replace lost wages, not pay for healthcare costs.

Is There a Future in Outsourcing Elder Care?

Published on: January 28, 2014 | by Ettinger Law Firm

A somewhat bizarre story out of Europe is leading a few elder care experts in the United States to question whether “shipping away” seniors may be part of the future of long-term care for some families.

As reported by the BBC, one adult daughter in Switzerland ignited an ethical debate recently by deciding to send her mother to a long-term care home in Thailand for support. The daughter explained that her decision was based on both her mother’s specific condition and financial realities. The 91-year old mother apparently suffers from severe dementia, and is unable to remember much of anything about the present. In addition, the cost of care in Switzerland was incredibly high–similar to that in New York–while Thai care was far more affordable. The daughter felt that her mother could receive better services in Thailand where she now lives with a group of other Swiss and German seniors.

A Wave of the Future?

Did You Prepare for That?

Published on: January 24, 2014 | by Ettinger Law Firm

Screenwriter and director Woody Allen once said, “There are worse things in life than death.” Becoming incapacitated and unable to make medical treatment decisions for yourself may be one of those things. The case of Terry Schiavo is a perfect example of the problems that can arise when one does not plan for incapacitation. Following Mrs. Schiavo’s hospitalization and being found incapacitated, an emotional battle erupted between Mrs. Schiavo’s husband and her family over whether she would continue to receive life-sustaining treatment.

Good estate planning is all about preparing for the unthinkable. While a will or trust addresses what happens once you die, what about if you become incapacitated and unable to make your own medical decisions?

The Health Care Proxy – The Unsung Hero of Estate Planning

New York Medicaid “Look-Back” Period & Proper Records

Published on: January 22, 2014 | by Ettinger Law Firm

The price of nursing home care in New York is staggering. It is not uncommon for a stay to cost upwards of $15,000 – $20,000 per month. This is a burden that many New York seniors can not afford to pay. After all , many local residents are only living on small fixed incomes, and coming up with $180,000 – $240,000 per year to live in a skilled nursing facility is unthinkable.

For most resident the only alternative is support via the New York Medicaid system. But residents can usually only qualify for Medicaid if their non-exempt assets are “spent down.” In our state, the allowable amount of total assets is only $14,550. There are complex rules about what assets count toward this amount, but a NY Medicaid lawyer can explain whether things like a long-time family home can be saved or if retirement accounts must also be drained.

Look-Back Period

Avoiding Senior Isolation: The Julie Harris Case

Published on: January 14, 2014 | by Ettinger Law Firm

Elder law and estate planning often involve overlapping issues. This is not just because seniors are those in need of elder law support (like Medicaid planning) and also the one’s most likely to think seriously about estate planning. Instead, issues connected to securing proper senior care and thriving in one’s golden age can impact how inheritance and asset transfer matters are handled upon death.

Most notably, Will contests and other disputes after a passing are far more likely if the elder caregiving process was filled with confusion, anger, and disagreement.

Take, for example, the case of famed actress, Julie Harris. Harris was prolific in her many working years, starring in hits on Broadway, in television, and movies. Over her nearly sixty year career she won awards from virtually every major body, culminating in being named a Kennedy Center Honoree in 2005.

AARP Comment on Upcoming State of the State Address

Published on: January 8, 2014 | by Ettinger Law Firm

Today, New York Governor Andrew Cuomo will deliver his 2014 “State of the State” address. Just like the more well-known “State of the Union” address that President Obama will deliver later this month,the purpose of the event is for the Governor to lay out his vision for the upcoming year. It is intended to be a starting point in policymaking, usually outlining the issues that the Governor will attempt to advance within the state legislature in the upcoming session.

Earlier this week, the New York State AARP Director, Beth Finkel released a statement sharing information about what the advocacy organization hoped to hear included within the address. In particular, the statement discusses the policy issues that are likely to affect older New Yorkers. Considering the critical role that state policy has on so many elder law issues, from New York Medicaid to nursing home quality, the issues to be addressed her should be on the radar of most New York families.

Relevant New York Policy Issues

New York Nursing Homes Receive Failing Grade

Published on: January 3, 2014 | by Ettinger Law Firm

Senior citizens rely on experienced and trusted assisted living facilities to provide premier living conditions staffed with professional associates to provide the best medical and personal elder care. More than one-and-a-half million Americans live in nursing homes throughout the country, so that makes for many in search of quality assisted living. Over the next decade the number is expected to swell by as much as 40% as the baby boomers approach retirement. A report shows that many states, including New York, received a failing grade on its nursing home report card, alarming to elder law advocates.

Families for Better Care, a Florida-based nursing home resident advocacy group, released the report, which scored, ranked, and graded states on eight different federal quality measures. The report served the purpose applauding those states that provide good care while exposing, and motivating, those states with poor scores. The nursing home report card analyzes, compares and ranks state’s nursing home quality.

The report gave each state a final grade based on calculating the average grades in several areas of assisted living conditions, including:

Don’t Let Qualifying for Medicaid Force You Into Poverty

Published on: December 26, 2013 | by Ettinger Law Firm

If a New York senior is in immediate need of close, skilled, long-term care and lacks the resources to pay the (quite high) fees for such care are out of pocket, then the only recourse is usually the New York Medicaid system.

But far too many residents fail to appreciate the basic details of this system until they are confronted with the reality head-on. Most notably, Medicaid, unlike Medicare, is based on need–not age. Therefore, the only way to qualify is to have a set asset level that falls below a certain threshold. Many families who have spent a lifetime saving and investing in their home have assets above that threshold. Therefore they are forced to spend down their resources in order to qualify for needed Medicaid support.

A New York Times story from last month discussed how many elderly couples in the past were essentially forced into poverty in order to receive Medicaid help. One story from the 1980s is shared involving a couple who were married for 45 years before divorcing in the mid-1980s. The divorce was not pursued because the couple had fallen out of love, but because it was the only way to avoid the healthier partner from being forced into poverty to ensure the couple qualified for Medicaid.

The Challenges of Dementia Care Around the Holidays

Published on: December 24, 2013 | by Ettinger Law Firm

This time of the year generates mixed emotions for many New Yorkers. November and December are filled with many holiday celebrations, from Thanksgiving and Christmas to Hanukkah and New Years. There are work parties, gift exchanges, light displays, television specials, and more. Many local families have deep memories associated with this time of year, with fond recollections of joyous times with relatives–particularly mothers, fathers, and other older loved ones.

Yet, the happy memories are a double-edged sword. Recollections about fond times in the past may serve as a painful reminder of how things have changed in the present. This is a particularly acute situation for New York families with seniors dealing with cognitive conditions like dementia and Alzheimers. These ailments sometimes make it impossible to re-create the same holiday memories as in the past,

Caregiving Advice

Understanding Legal Capacity in New York

Published on: December 19, 2013 | by Ettinger Law Firm

New York elder law attorneys work with local families on a range of issues affecting seniors. Most notable among these is assistance arranging long-term care for seniors with physical and mental challenges. This frequently requires use of the Medicaid system, which itself comes with “spend down” requirements and other complications.

One general legal issue that comes up again and again in these cases is that of “capacity.” One must have legal capacity to enter into legal agreements and otherwise make decisions for their own well-being. But how do you know if a senior loved one has capacity? What if they have been diagnosed with Alzheimer’s or dementia? Is there a black line rule on when they can or cannot sign anything on their own behalf?

Legal Capacity in New York