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There is no easy way for a family to deal with a senior grappling with a cognitive mental disease like dementia or Alzheimer’s. Like any health problems faced by loved ones, a family’s initial reaction is to try to get the senior the help they need. However, each New York elder law attorney at our firm understands that cognitive conditions are tricky, because the injury is not physical and often the senior may not be fully aware that they are even suffering from the problem at all.

One elder law advocate recently discussed this challenge in response to a reader question explaining her family’s difficulty dealing with her mother’s dementia. As published in the L.A. Times, the reader revealed that her 82-year old mother, who has dementia, began accusing the family of spying on her. As a result, the mother admitted to her doctor that she wouldn’t share anything about her health with them. The family has been left wondering what to do to help their ailing matriarch get through this difficult phase. Many local families visit our New York elder law estate planning attorneys with the same concerns about helping relative with cognitive issues.

For one thing, in many cases a doctor will not be willing (or legally able) to discuss the mother’s condition without legal documents in place. This is particularly true when the doctor suspects that there may be a family rift. Creating those legal documents is a large part of the work done by elder law estate planning lawyers. The documents help ensure that the senior can receive help with their legal, financial, and healthcare decisions. Creating a trust may allow a third party to manage an ailing senior’s assets. A durable Power of Attorney allows financial decisions to be made by another. Health Care Proxies are needed to make key medical decision when another is unable to do it on their own.

The Defense of Marriage Act (DOMA) is a federal law passed in 1996 that defines marriage for federal purposes as only between one man and one woman. As our New York estate planning lawyers have often discussed, this means that same-sex couples married in our state are still not considered married for federal purposes. This has serious implications for tax preparation, estate planning, and a host of other concerns facing these residents. DOMA prevents married individuals from filing joint federal tax returns, receiving Social Security benefits, or having tax-free inheritances.

Many advocates on all sides of the aisle are working to overturn the law. Bills have been advanced in Congress which would repeal DOMA. However, with the current partisan split it appears unlikely that these legislative measures are likely to pass anytime soon. But that does not mean DOMA is here to stay. Most of the recent action on the issue has taken place in the courts. Several federal lawsuits have been filed which challenge the constitutionality of the legislation. President Obama has refused to defend the measure, and so the law is currently being defended under the auspices of the Republican leadership in the U.S. of Representatives.

Last month a U.S. District Court judge in one of those cases found that DOMA (or at least section 3 of the law) violates the equal protection clause of the U.S. Constitution. The case is being appealed to the federal appellate court. This particular ruling relates only to one provision of the law as applied to one couple. However, it is a clear indicator that the entirety of DOMA may one day–perhaps soon–be found unconstitutional.

One important part of the elder law estate planning process involves working out inheritance details. This comes with unique concerns for each family as various assets have different meanings for each individual, far beyond their market-value. Accounting for these emotional attachments is a delicate process that should not be done hastily. For example, one valuable that may present unique inheritance challenges are collections. Our New York estate planning lawyers appreciate that many residents have spent years building collections–from holiday villages and marbles to art–and have strong feelings about how they’d like to see the valuables handled after they are gone. A recent story in The Ledger argues that planning is paramount.

Collections, like other art and antique valuables, can present somewhat complex inheritance concerns. Large collections can be hard to physically manage, have difficult value estimates, and still may have tax implications. On top of all of that, collections are often laden with emotional value–some family members may love the collections, others may not. But it may not even be as simple as passing it on to one who cares for the objects. Some children may have no desire for the objects beforehand but may become emotionally attached after their parent’s passing because of the way that the collections helps them remember their loved one. In this way, family fights over what to do with collections–particularly large ones that are hard to manage–can be common.

For local residents, avoiding the potential inheritance mess comes down to one thing: have a specific New York inheritance plan in place. The planning process will involve asking tough questions about the best options for the future.

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.

A Reuters story late last week suggested that while estate planning feuds of the famous usually involve millions, the principle issues are the same as those faced by all local residents. Every case must be evaluated individually, but the same main issues are found again and again. That is why our New York estate planning lawyers urge residents to visit with experienced professionals when making preparations because they have likely seen similar issues in the past and can help anticipate problems that might come up down the road. As this latest story explained “anyone thinking about wealth transfer faces the same issues: dysfunctional families, potentially unequal positions in the family business, perhaps multiple marriages with kids from each.” This applies whether one has $50,000 or $50 million.

For example, second marriages often create planning problems. When crafting an estate plan, one must balance the needs of the second spouse with the children of the first marriage. If one doesn’t do it, as the author notes, “you’re basically buying a litigation case.” For example, the longest estate litigation case of the last century was that of Anna Nicole Smith. She was a second wife of a billionaire investor. The children from the man’s first marriage engaged in a prolonged battle to ensure that Ms. Smith did not receive any substantial portion of the man’s wealth. The case was still not resolved with Ms. Smith herself passed away.

Family businesses also present common issues for those in all income brackets. Much family wealth is wrapped up in a business. Often some of the children participate in the business while others do not. This often creates significant estate planning issues regarding who gets what share of the business. One of the most well-known examples of this is that of the Koch family in New York. The patriarch had created a fortune after developing a new cracking method in oil refinement. However, upon his death the man’s four sons engaged in a prolonged legal dispute over control of the business. As the article notes, “there are a lot of ticking time bombs in family businesses that creates litigation.”

One of the most well-known New York estate planning stories (and mysteries) of recent years is that of Huguette Clark. The extremely reclusive heiress recently passed away, leaving hundreds of millions of dollars with many wondering where exactly the money will end up. Of course, in most cases an inheritance will go to surviving close family members, dear friends, or well-known charitable causes. However, Ms. Clark had very few surviving family members, and it is now being reported that she only one “real” friend, a French woman named Suzanne Pierre.

Ms. Pierre had become somewhat of a liaison between Ms. Clark and the rest of the world. It was alleged that Ms. Pierre was one of the few people who was privy to the heiress’s estate planning documents. In fact, according to the New York Observer, Pierre once helped anonymously sell some of Ms. Clark’s impressive art collection. She was also the recipient of a $10 million gift of a rare painting from the estranged heiress. Before Ms. Clark’s passing some predicted that Ms. Pierre would actually be named heir to much of Ms. Clark’s fortune. However, that possibility vanished when Ms. Pierre herself passed away a few months before Ms. Clark moved on.

One of Ms. Pierre’s own most valuable assets, her Park Avenue apartment, was recently sold during the disposition of her estate. City records indicate that the unit sold for just under $2 million. The sale comes as many in the real estate world speculate on the prospects of Ms. Clark’s own, massive Park Avenue apartment. The 42-room unit is expected to fetch somewhere around $70 million. Many are calling the unit the most sought-after apartment in the entire city and “the listing of the young century.”

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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.

NuWire News published an interesting blog post last week that runs down a few ways that community members can use estate planning techniques to protect assets in “uncertain times.” Of course, our New York estate planning lawyers realize that uncertainty exists at all times, because no one knows for sure what tomorrow might bring. However, there are always some circumstances when future financial trouble seems particularly likely–such as when one might need long-term care either at home or a long-term care facility. The article authors note that it is always beneficial to shield assets before they become a target, otherwise, depending on the circumstances, there are a range of penalties that may attached to the conveyance. For example, when it comes to applying for New York Medicaid, it is vital that asset transfers be made at least five years before applying. Strategies exist to protect assets even when on the nursing home doorstep (without five years to wait), but there is much more than can be done the earlier one takes the time to plan for these issues.

Outside of the long-term care context, there is similar benefit from protecting assets well ahead of time, before they may be targeted by a creditor. The article discusses ten different techniques that may be applicable, depending on one’s circumstances. For example, the story discusses spousal gifting trusts. These are special trusts (also known as irrevocable grantor trusts) that allow married couples to protect assets from creditors and estate taxes while still retaining control and use of the assets.

Obviously insurance considerations are also important for protecting assets in uncertain times. After all, insurance is all about having security in the face of potential problems down the road. Long-term care insurance is clearly helpful to account for senior care costs. Unfortunately, that particular insurance is often out of reach for middle class community members. However, even basic life insurance should not be forgotten when thinking about estate plans. For younger families with children life insurance provides security in the case of untimely death. For wealthier families the insurance can also be important to protect assets from estate taxes.

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.

Estate planning usually doesn’t come to mind when one thinks about award winning Hollywood movies. Most popular films are about great adventures, tragedies, and disasters. Planning for one’s long term financial and medical well-being, on the contrary, is all about prudently working to avoid major crisis or drama. However, a film that many movie buffs believe has the inside track to win this year’s Academy Award for Best Film actually involves estate planning, with a trust and a trustee at the center of the action. This weekend the movie won the Golden Globe Award for Best Dramatic Film.

“The Descendants” tells the tale of a man who is dealing with the impending death of his wife who suffered a traumatic injury and is on life support. The film’s protagonist, played by George Clooney, is the victim’s husband. As his wife slips away he is forced to deal with the consequences of handling her estate. She had come from a very wealthy family, and the couple (along with their two children) had lived on acreage of land in Hawaii that was held in trust.

Clooney, as the husband, is the trustee of his wife’s multi-generational estate worth billions. The other trust heirs (his cousins) want to sell the land to generate income to meet their personal needs. However, Clooney remain unsure of the best long-term decision. He knows that the original intent of the family was to preserve the land for succeeding generations.

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