Articles Posted in Elder Law

This week the Washington Post published an interesting, extended story seeking to share information on life in assisted-living facilities. The article, written by a man living in one of these homes, paints a grim picture of life for seniors needing extra day-to-day care. The text was adapted from a literary journal, The Feathered Flounder, which showcases work of people over sixty years old.

Each New York elder law attorney at our firm appreciates that it is important for local residents to understand the realities of long-term care so that decisions can be made as early as possible to plan for the ideal care.

The man in this case suffered from early-onset Parkinson’s disease in his 40s. For a decade he lived at his home, able to manage with at-home care. However, as his condition deteriorated, and he ended up in a wheelchair, the man decided to move into an assisted-living facility. He was only 53 years old. He admits knowing that it was a unique choice, considering that most residents were decades older and facing far more severe health problems.

Elder law professionals agree that preventing senior financial exploitation requires acting fast–it is never too early to investigate suspicions about a senior loved one’s finances. As reported in a recent Star-Telegram article, many adult children begin asking questions about their parents finances only when it is too late–after they’ve already been swindled out of a fortune. For example, the article shared the story of a woman who waited to learn mor after noticing some red flags with her parents money management. By the time she started investigating the elderly couple had already had nearly $100,000 taken by another family member over a ten year period.

Unfortunately, each New York elder law attorney at our firm knows that this situation is far from unique. Many seniors, particularly those without outside observers keeping an eye on their finances, find themselves exploited in their golden years. The wrongdoers can be anyone, from family members and caregivers to strangers who gain the senior’s trust.

Financial exploitation takes many forms. In the case described in the article, the elderly parents, in their 80s at the time, had more than 35 different credit-card accounts taken out in their names unknowingly. It took their daughter almost two years to sort out the mess. The solution included giving the daughter a Power of Attorney over the couple’s finances so that the daughter could monitor the situation and identify any problematic issues.

There is no shortage of news stories about the changing demographics in the United States. Advances in healthcare and slowed birth rates mean that a much larger percentage of the country is elderly than ever before–the trend will continue for years to come. Our New York elder law attorneys understand that most discussion of these issues revolves around fear about what these changing demographics mean. However, an interesting New York Times article this week took a different look at the issue, noting that it is wrong to “assume defeat” when considering the challenges posed by an aging population. Instead of dwelling on the challenges, we instead need to embrace the benefits of our increasing longevity and buckle down to get the financial, social, and healthcare concerns raised by the demographics in check.

The article included an interview with Dr. Linda P. Fried, an epidemiologist and geriatrician. She noted that new research needs to “reframe our understanding of the benefits and costs of aging.” Dr. Fried notes an increased focus on science into the aging process, with the potential for positive impacts on social and political policies that address these issues–including many elder law concerns.

Dr. Friend is at the forefront of exciting new research into the aging process, with implications in many different fields, from nationwide healthcare policy to nursing home abuse prevention.

Many local residents consider a single issue when hearing about New York elder law planning: who is going to pay for nursing home care? Of course elder law includes much more than simply figuring out the finances of necessary long-term care. But for many families, the crux of this work is receiving help with Medicaid applications, protecting assets, and otherwise putting seniors in the best position possible to ensure comfortable care in old age.

There are different ways to provide for the care. Long-term care insurance is worthwhile for those who plan ahead, while the New York Medicaid program provides support to seniors who have no insurance and otherwise cannot afford the care on their own. Many middle-class seniors are forced to ‘spend down’ their assets in order to qualify for Medicaid. Various legal tools exists, however, (like Medicaid Asset Protection Trusts) to help keep assets in the family while still receiving Medicaid support.

This week many headlines were made across the country as an appellate court upheld a ruling that forced a son to pay a nearly $100,000 nursing home bill for his mother. The nursing home instigated the legal matter by seeking to enforce a “filial law” to collect unpaid long-term care bills.

Every New York estate plan is slightly different, because no two individuals are identical. Yet, many similar situations and challenges present themselves to different couples which often involve similar planning strategies. For example, one issue facing some residents is planning for married couples who have a significant age difference.

Perhaps the most obvious issue involves overall financial planning. With age differences, one spouse is likely to outlive the other, perhaps by a considerable length of time. The younger spouse may therefore feel more comfortable taking on certain risk than the older spouse who is more likely to suffer from short-term financial dips. It is important to balance the interests of both partners.

For New York elder law estate planning purposes specifically, couples of different ages require unique planning so that time horizons are meshed. Retirement planning can be tricky if one spouse plans on working longer. Similarly, long-term health care planning will be implicated by the age differential. One spouse may need extra care earlier, though it is usually not prudent to automatically assume that the younger spouse will be able to provide the needed care.

New York elder care advocates rallied this weekend in an attempt to save the Horace Nye nursing home in Elizabethtown. The public facility may be the latest in our state to be privatized as a cost-cutting measure by the county. The Essex County supervisors are set to vote this week on whether to move forward with the plan to sell the public facility to private owners and operators.

All those working on New York elder law and Medicaid issues appreciate the concerns of those fighting the change. Studies from a wide-range of sources find that residents at private facilities are more likely than those in public homes to suffer nursing home abuse or neglect. Most point to staffing levels and compensation for direct-care workers as the difference. Private owners are more likely to lower pay and cut staffing levels in order to increase the facility’s profitability.

Regardless of the worries, there is a very clear trend in local governments getting out of the nursing home business. Facilities in Warren County, Washington County, and Saratoga County all may be sold in coming months. The motivation is obvious: local government budgets are tight. For example, those supporting the Essex County sale explain that the facility loses $2 million every year. A property tax cap is in place, and so it is difficult for the County to absorb rising costs.

Main Street had a helpful story this week discussing the risk that many seniors face from credit card fraud. The story was published in awareness of May as “Older Americans Month.” Each New York elder law attorney at our firm appreciates the need to increase community understanding of the various issues affecting seniors, including financial exploitation.

Credit card fraud is common because it is relatively straight-forward. A thief gets the senior’s credit card information and uses it to make a string of purchases. The culprit usually continues until the senior catches on to the problem and puts a stop to it. Depending on the senior’s living situation, it may be quite some time before the theft is identified. Thousands and thousands of dollars can be lost in these simple scams.

Prevention measures take two forms: minimizing risks that the credit card information will be obtained and putting steps in place to catch wrongdoing soon after it occurs.

Legal incapacity is an important term in New York elder law estate planning. An crucial part of the process is ensuring that another is able to handle legal, financial, and medical affairs in case one is unable to do so on their own. “Incapacity” is the term used to delineate when that alternative decision-making kicks in, giving an agent the power to act on another’s behalf. There is not necessarily a bright-line rule when it comes to identifying incapacity on a case-by-case basis. Therefore, many local residents might wonder how incapacity is defined in the law.

Defining Capacity

The New York Department of Health is a good starting point, as the agency website provides an overview of how incapacity is determined in our state for medical decision-making purposes. The resource explains that for health care purposes capacity to make medical decisions is “the ability to understand and appreciate the nature and consequences of health care decisions, including benefits and risks of and alternatives to any proposed health care and to reach an informed decision.” When a patient lacks capacity, then an identified agent (often via a New York Health Care Proxy) is able to act on the patient’s behalf. An elder law attorney can help create the Health Care Proxy so that the desired agent is able to make decisions in the event of disability.