Long Term Care Planning

Niche Retirement Communities on the Rise

Published on: April 18, 2012 | by Ettinger Law Firm

We’ve all seen the ads: smiling seniors lounging at the pool or playing golf, laughing, and enjoying the sunshine as a voice-over speaker describes the available space at a new senior living location. Retirement communities have long been popular, but many New York elder care advocates explain that these assisted living locations are becoming more sought-after than ever. Unique senior communities are popping up across the country at a steady clip catering to more and more specific niches in an attempt to closely meet the needs of certain segments of the senior population.

Some of the most popular niche senior living facilities (besides those around beaches or golf courses) are “university-based retirement communities.” These locations are built around college campuses in order to provide seniors with the opportunity to attend campus events and even sit in on classes. Many local residents have opted for this choice when conducting New York senior care planning.

Many other communities are being built that center around specific hobbies and activities. Across the country new facilities have recently been built targeting seniors who want to become artists, providing help for those seeking to learn how to paint or write their first novel. Another senior facility is even referred to as an “astronomer’s village” and is geared toward stargazers with every living unit equipped with a built-in telescope. Yet another targets “aging hippies” where residents are encouraged to make their own living space and practice sustainability techniques.

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.

U.S. Health Care Reform Law & New York Senior Care

Published on: April 9, 2012 | by Ettinger Law Firm

The legal world was aflutter in recent weeks over the United States Supreme Court’s consideration of the constitutionality of the Affordable Care Act (Obamacare). As most are aware, the high court held three days of hearings on the law (an unprecedented move), and they are expected to release their ruling in the coming months. Either all or part of the landmark legislation may ultimately be struck down as an unconstitutional federal overreach. Our New York senior care attorneys know that most of the focus has been on whether or not the court will invalidate the portion of the law that mandates that individuals possess health insurance or pay a penalty (the individual mandate). Many observers have predicted that the court will in fact strike down the individual mandate. However, those predictions have been wrong in the past, and so no one will actually know the outcome until the opinion is issued.

However, it is important to also consider what would happen to the rest of the law if the individual mandate is struck down. The rest of the bill may be in jeopardy. New York long-term care planning may well be affected. A recent Forbes articles touched on the potential impact. A few points worth noting…

–Home & Community Care: The bill included various state incentives that sought to expand Medicaid support of alternative care arrangements. These incentives were intended to steer Medicaid dollars away from nursing home and towards the more flexible care options that seniors actually want.

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.

New Television Program: Aging Well in America

Published on: March 16, 2012 | by Ettinger Law Firm

Elder law issues are growing in importance on a daily basis. The “graying” of America is a well-documented demographic trend. However, many still under-appreciate the true scope of the situation and the way in which it will continue for decades. For example, according to the AARP, more than 7,000 Americans turn sixty five years old every day. Clearly the number of seniors in the country is growing larger–but they are also living longer. Today there are roughly 5.5 million residents eighty five years or older–by 2050 there will be 20 million people in the country over eighty five. Our New York elder law attorneys appreciate the challenges we already face in providing appropriate care to seniors today. The challenge will only magnify in the years to come.

Making accommodations for the aging population will require work at all levels–from changes inside individual families up to federal government policy adaptations. Many believe that the task will fall heaviest on local communities, which are often on the front lines of these social policy situations, working to ensure senior community members actually have basic services available to maximize their quality of life. A new television program has recently been launched to share information about these concerns, entitled “Aging Well in America.” As discussed last week in Gross Pointe Today, the show is being spearheaded by a professor at the Institute of Gerontology at Wayne State University.

The show includes discussions of many issues similar to those faced by local families who have visited our New York elder law attorneys. For example, one program details the issue of “downsizing” where seniors move from long-time residences to smaller, more manageable homes. The gerontology professor explained that it is important for adult children not to rush aging parents through this process. Mental adjustments have to be made even before logistical adjustments.

New York Shifting to At-Home Managed Care for Seniors

Published on: February 28, 2012 | by Ettinger Law Firm

Last week the New York Times discussed changes in the nursing home industry that may affect how some local residents conduct elder care planning. In a time when nursing home care is becoming more expensive–and Medicare and Medicaid funding shrinks–many facilities are experimenting with at-home models of care. Our New York elder law attorneys understand that the nursing home is a rarely the location that seniors would prefer to age if they had a choice. Now, however, many health care experts and senior advocates are joining the call and explaining that nursing homes are rarely medically necessary or financially smart.

Instead, more and more resources are being put into advances in home care. Instead of living in an institutional-like facility, the new model essentially uses traveling doctors, social workers and therapists to provide care at the senior’s home or adult day-care centers. An at-home senior care program run by CenterLight Health System in New York City now has over 2,500 participating residents. New York State Medicaid program director Jason Helgerson explained that in the past the state “was institutionalizing service for people, many of whom didn’t need 24-hour nursing care. If a person can get a service like home health care or Meals on Wheels, they can stay in an apartment and thrive in that environment, and it’s a lower cost to taxpayers.” It is no surprise then that the state of New York plans to shift upwards of 80,000 Medicaid participants into at-home, managed care models over the next three years.

The Archdiocese of New York–one of the state’s largest nursing home providers–recently announced a shift away from nursing home ownership. In the announcement, Cardinal Timothy Dolan explained, “Seniors and others who have chronic health needs should not have to give up their homes and independence just to get the medical care and other attention they need to live safely and comfortably.”

Are Presidential Candidates Forgetting About Long-Term Care Issues?

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

As election season continues, local residents are likely to hear discussion of many different issues from all those vying for office. There is a big different between a candidate having a stance on an issue and the law actually being changed to affect community members. However, the discussions and conversations during the election process often set the tone for actual governing down the road. Estate planning issues are often implicated, because taxes are a hot topic every election. Usually there are many elder law issues brought up as well, considering long-term care planning is a common concern that affects millions of residents across the country at any given moment.

However, some observers have noted that there has been a surprising (and disappointing) lack of debate about these senior citizen concerns. A Forbes article this week summarized by noting that elder law issues “are not on the front burner…not on the back burner…not even on the stove” this presidential campaign. As a result, it is difficult to understand where the candidates stand on the issues. A survey was sent to all of the current Republican candidates and to President Obama by fifteen national advocacy groups. Only Newt Gingrich and the President even bothered to respond to the survey questions regarding long-term care. Even then, the responses were very brief, shedding little light on how New York elder law or senior care planning might be changed depending on the outcome of the election.

Former House Speaker Gingrich has been the only candidate offering any specifics about what he’d like to do with issues affecting long-term care. In responding to the survey from the advocacy groups he called for improving senior care by repealing the President’s Affordable Care Act and replacing Medicaid with a federal block grant. He also believes that residents should be able to use certain tax breaks to pay for long-term care insurance. However, Gingrich has also proposed support for a flat tax system, which would end those tax breaks–so there is a bit of contradiction in his pronouncements on the issue.

Long-Term Care Insurer Sued for Not Providing Benefits

Published on: February 13, 2012 | by Ettinger Law Firm

Ensuring that resources will be available to provide day to day caregiving during one’s golden years is one of the main reasons local residents visit a New York elder law attorney. To accomplish that goal we often explain how tools like long-term care insurance and a Medicaid Asset Protection Trust (MAPT) can be used in combination. The insurance provides actual payments so that seniors can have at-home care when necessary. The MAPT does not provide resources, but it protects some assets that the individual already has from potential long-term care costs in the future.

Because the insurance both protects assets and provides resources, long-term care insurance is generally the superior method of protection. However, long-term care insurance can be expensive, particularly when it is sought by one who is already reaching on in years or is in poor health. The earlier that this insurance is sought the more likely that it will be within one’s financial reach.

When a client visits a New York elder law lawyer in our office, we share information about these insurance options. We appreciate that residents want to feel comfortable with their insurance providers–insurance companies are not thought of highly by some residents. Horror stories abound of individuals who dutifully paid premiums only to have difficulty receiving the help they needed. One benefit of having legal professionals involved in the process is the extra set of eyes that will be watching the senior’s finances, ensuring that they are not taken advantage of by anyone, including insurance companies.

Family Input Can Lead to Earlier Dementia Detection

Published on: February 8, 2012 | by Ettinger Law Firm

This week the USA Today reminded readers of the role that family members play in catching the onset of cognitive mental diseases in seniors, such as dementia and Alzheimer’s. As any New York elder law estate planning attorney can attest, these issues are of particular importance in the legal context because mental issues can affect one’s legal capacity. The ability to conduct estate planning, receive New York Medicaid help, or otherwise make prudent decisions for the future will be made more difficult if begun after dementia or Alzheimer’s has set in.

By the very nature of the condition, the one who is suffering from these issues has difficultly identifying the problem themselves. That is why a family plays a crucial role in identifying the cognition problem and addressing it. As the article notes, “dementia can sneak up on families. Its sufferers are pretty adept at covering lapses early on.” Often it is not until there is some major accident or life-threatening complication that adult children, spouses, and others become fully aware of the problem.

To combat the challenges of early detection, experts are calling on family members to be more involved. As part of the first “National Alzheimer’s Plan,” advocates are trying to raise awareness about the need for relatives to be diligent about a senior’s actions to ensure mental cognition issues are caught as soon as possible. One advocate noted, “family input should be mandatory…it’s the only way to know if the person really is eating enough and taking her medicines as she claims, and not forgetting to turn off the stove.”