Long Term Care Planning

Bronx Nursing Home Offers One-of-a-Kind Dementia Care

Published on: October 2, 2012 | by Ettinger Law Firm

In recent years there has been a push to alter care for seniors with dementia. Most arguments about superior elder care focus on limiting medication-only treatment options. These “chemical restraints” are still overused, with seniors in many nursing homes lulled into a near-stupor as a result of antipsychotic medication. In overcrowded or understaffed long-term care facilities, these drugs are often the only way that caregivers feel that they can handle the challenges that come with dementia and Alzheimer’s care.

However, just because medication is the most common way to deal with a resident with dementia does not mean that it is the best way. In fact, many elder care advocates argue that the best care steers clear of overuse of medication and provides tailored care that focuses on the individual senior and not the cognitive disease.

What does that individual care look like? One Bronx nursing home is receiving national plaudits for its work on the issue.

Failure to Update a Plan Nightmare

Published on: August 3, 2012 | by Ettinger Law Firm

Estate planning takes time. Unfortunately, considering the daily time stresses faced by all local residents, our New York elder law estate planning attorneys appreciate that there is often not a sense of “urgency” with this planning. It is usually a task that gets pushed to the side while day-to-day choeres are dealt with.

Yet, there are many individuals out there who can testify about the consequences of failing to plan their estate.

For example, one recent editorial shared that story of a husband and wife who had been married for one year. The husband was waiting for a liver transplant and despite his precarious health situation the couple did not do any estate planning, thinking they had “plenty of time.” This would prove incredibly harmful for the family.

Defending Seniors–Consumer Financial Protection Bureau’s Office of Older Americans

Published on: April 12, 2012 | by Ettinger Law Firm

The Star Tribune recently profiled Hubert Humphrey III–a former favorite son of Minnesota–who is now in a new role in Washington D.C. helping to enact national senior care policy that might affect older Americans across the country. Humphrey was recently chosen to lead the Consumer Financial Protection Bureau’s Office of Older Americans. He was chosen for the position in large part because of his previous advocacy on the AARP’s national board of directors.

The new federal office is engaged in many different battles, all aimed at improving the lives of the growing class of American seniors and protecting them from falling victim to financial predators. Our New York elder law attorneys understand the challenges faced by so many older Americans and appreciate the need to enact common sense safety steps at the federal level.

The Office of Older Americans was actually created as part of the Dodd-Frank Wall Street Reform and Consumer Protection Act. It was created to safeguard the rights of those over 62 and ensure they are properly educated about their financial options. Assistance in these and similar matters is all the more important now in a world with stagnant retirement accounts and rising healthcare costs. Each New York elder law attorney at our firm works first-hand on many of these goals, helping local residents seeking to craft plans to protect their long-term financial and medical well-being.

Elder Law is Not Just for the Elderly

Published on: March 30, 2012 | by Ettinger Law Firm

Some mistakenly dismiss elder law issues as something with which they need not concern themselves until they personally need help getting by each day. However, our New York City elder law attorneys have worked with many local residents on these issues decades before they need care themselves. That is because many adult children are forced to deal with these concerns on behalf of their parents–many of whom have serious health concerns that arise quite quickly.

With demographic changes leading to a boom in the elderly population, the need to care for aging parents is catching more and more adult children by surprise. According to the AARP, more than 42 million individuals (usually adult children) provide caregiving for elderly friends and family. Another 61.6 million provide partial caregiving support at various times throughout the year. A story from Life Stages discussed the very serious worries faced by those who are unexpectedly forced to wade through a myriad of confusing and complex issues (including many related to elder law) when their parents can no longer get by on their own each day.

The story profiles one woman whose story is shared by many in our area. Her eighty three year old mother had a massive stroke last summer which led to her becoming paralyzed. Her father, also eighty-three years old, was unable to provide the care that she needed. The hospital recommended that the mother be moved into a nursing home. Before taking that step, the daughter wanted to learn if she had any other options.

Green House Project: Nursing Homes Shift Away From Institutional Settings

Published on: March 26, 2012 | by Ettinger Law Firm

Nursing homes can be intimidating places. The traditional model for these facilities is institutional, with facility designs and procedures based on mass efficiency instead of individual concern for the well-being of each resident. Our New York elder law attorneys appreciate that this “regimented” lifestyle is feared by many local residents who likely have personal stories of friends or family members who lived unhappily in one of these facilities. Some resident even put off elder law estate planning specifically because thinking about these issues is unpleasant and many would prefer to just avoid the issue altogether.

Of course, failure to plan for long-term care issues actually has the opposite effect–making it more likely that one will be forced to live in a less than ideal location. In fact, so long as resources are available, there is a growing chance that around-the-clock care can be provided for even the most ailing seniors in locations that reject the old model and prioritize individual care and personal well-being.

For example, the Democrat & Chronicle published a story on a new national movement to improve elder long-term care. The Green House Project is a program originally funded by the Robert Wood Johnson Foundation. It seeks to phase out the old nursing home model for one that focuses on more intimate settings. New homes built as part of the project have clusters of seven to ten residents who each have their own room and are given more autonomy. While projects like Green House are growing in popularity, it is undeniable that there is still a long way to go before all nursing home residents have care that places emphasis on their individual quality of life.

Elder Law Associations Announce Support for Older American Act

Published on: January 31, 2012 | by Ettinger Law Firm

Advisor One reported his week on a push by a variety of national legal associations to support the “Older Americans Act of 2011.” The Older Americans Act (OAA) was first passed over 45 years ago, in 1965, to support seniors nationwide with a range of community planning and social services. The Administration on Aging was established as part of the legislation. Many New York elder law attorneys have joined in the advocacy effort to reauthorize the bill. In fact, just this week the National Academy of Elder Law Attorneys (NAEL) announced their support for the measure. NAEL is a professional association of elder law attorneys that work with the elderly and those with special needs.

Over the years many advocates have come to appreciate the important role that the OAA plays in the lives of vulnerable seniors throughout the country. However, the law was set to expire in 2011. That is why Senator Bernie Sanders from Vermont proposed legislation which would reauthorize the Act. It is difficult t get anything passed through the gridlocked Congress these days. However, that has not stopped those supporting these important efforts from trying to get it through the system. Many elder law advocates believe that the reauthorization effort is actually gaining steam.

A separate bill–the Older American Act Amendments of 2012–would make a few important changes to the original measure. For one thing, it calls for a revision of the ‘Experimental Price Index for the Elderly.” This initiative would change the index so that it more accurately reflects the costs which impact seniors at this stage in their lives. Other changes include altering the definition of “economic security” as it applies to determinations for housing, transportation, and long-term care assistance. A Meals on Wheels program would also be established along with a senior center community planning grant program.

Another Study Emphasizes the High Costs of Long-Term Care

Published on: January 24, 2012 | by Ettinger Law Firm

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Yet another company, Northwestern Mutual, has recently issued a “Cost of Long-Term Care” study. Of course, the results indicate that the actual cost depends on a range of factors including what part of the country one lives, whether an at-home aide is hired, or whether one moves into a skilled nursing facility. As any New York elder law attorney can attest, our area is always at the very top of the list when it comes to long-term care costs. It is for that reason that it is particularly incumbent upon area resident to meet with an elder law attorney to plan ahead before the costs actually need to be paid. It is simply impossible for most families to bear the financial burden of this care on their own.

This latest research effort from Northwestern Mutual involved surveys from 6,000 different sources, including a mix of assisted living facilities, home health care organizations, and nursing homes. The researchers found that the hourly rate for home healthcare workers was anywhere from $33 per hour to $15 per hour. New York assistance was near the highest of the group.

Elder Caregivers Found To Have Higher Levels of Stress & Health Issues

Published on: January 20, 2012 | by Ettinger Law Firm

The focus of most New York elder care planning discussions naturally revolves around the needs of seniors. Are they receiving proper nutrition? Do their caregivers timely attend to their dressing, bathing, and washroom needs? Do they remain connected to the community with opportunities to use their unique skills and abilities? Our New York elder law attorneys know that for far too many seniors, even these basic needs remain unmet. The problem of elder neglect and abuse is troubling, and it will likely become more of a concern in the coming years as the population ages and the total number of seniors in need of extra help skyrockets.

However, a holistic approach to senior care requires not just consideration of the senior’s needs but also understanding of the effects on senior caregivers. A CNN Living article this week examined the way that helping an elder resident impacts adult family members. The story of one woman was shared who took her 72-year old father out of a nursing home out of concerns for his well-being. Instead she moved him into her on own two bedroom apartment. The woman admits that she put her life on hold, because the obligations of working full-time while helping her father was overwhelming. She was often required to miss work to take him to a wide range of appointments with medical professionals. In addition, she used her lunch breaks to ensure he took his medications and made it to his dialysis appointments. She confesses, “It was like ‘oh my, what did I get myself into?’ Sometimes I would just go into the bathroom and cry.”

Her situation is not unique as a new “Stress in America” survey from the American Psychological Association found that at least 55% of senior caregivers feel overwhelmed by the task. Not only did the caregivers report higher levels of personal stress, but they were also found to be in poorer health themselves. Caregivers were more likely to engage in unhealthy behaviors in an attempt to alleviate the stress.

Happiest Nursing Home Staff Members Work at Nonprofit Facilities

Published on: January 5, 2012 | by Ettinger Law Firm

Making the decision to place a loved one in a nursing home is no routine matter. Emotions run deep during this time, when families struggle to balance the senior’s need for close care and safety with their concerns about the quality of life available in these assisted-living facilities. Our New York elder law estate planning attorneys have helped many families with this process. We appreciate that there are usually two big questions that come up: (1) What is the best facility for our loved one? and (2) How are we going to pay for it?

In answering the latter question, New York elder law attorneys will explain that the costs can either be paid out of pocket, via use of private long-term care insurance, or through the New York Medicaid system. The former question is a bit more challenging, because so much subjectivity is involved. The answer for each family is different. The exact type of care needed, proximity to loved ones, and similar details need to be considered when choosing which nursing home is best. Of course, as a general matter, every family will want to ensure that the nursing home they chose is one free of chronic neglect, mistreatment, and abuse. Many elder care advocates have explained that when it comes to safety measures, study after study has found that nonprofit nursing homes outperform for-profit facilities. One long-term care doctor explained, “Most studies show that nonprofits do a better job of caring for patients, but we’re not sure why that happens.” This is an important consideration for families deciding where to send their loved one.

A post this week in the New Old Age blog from the New York Times recently discussed another interesting comparison between for-profit and nonprofit homes: the employees are happiest at nonprofit nursing homes. This may be part of the reason why care at these facilities is superior. At the end of the day, the quality of life for those in these facilities is dependent on the work performed by the hands-on caregivers. Therefore, how those caregivers perceive their job is likely to play a key role in their day-to-day actions. The nonprofit employees were happier overall for a variety of reasons: their ability to help set policy, more supportive managers, and availability of adequate resources.

Advocates Call for More GLBT Friendly Senior Housing Options

Published on: January 3, 2012 | by Ettinger Law Firm

Many writers have taken to calling the upcoming wave of baby boomer retirements as the “silver tsunami.” Like real tsunamis, the demographic shift is expected to have many ripple effects in communities across the country. Each New York elder law attorney at our firm has seen first-hand the challenges faced by many in our area when trying to figure out where they will receive long-term senior care and how they will pay for it. These issues are common to all local families who have loved ones about to leave the work force to enjoy time in their golden years.

However, some senior community members have even more unique concerns.

The Associated Press published an interesting article this week discussing the struggles of senior GLBT community members. Public opinion data consistently shows that the younger generation is much more open and supportive of their gay, lesbian, bisexual, and transgendered community members. Older Americans are less approving. That is leading many gay seniors to wonder how they might be treated if they end up in a traditional nursing home or long-term care facility. One expert summarized that many of these “seniors fear discrimination, disrespect or worse by health care workers and residents of elder housing facilities, ultimately leading many back into the closet after years of being open.” In addition, GLBT seniors are much less likely to have biological family members to help them through this time of their life. Estrangement and childlessness are more common for gay seniors, making them more dependent on outside services.