Nevada Estate Planning

A Look at an Elder Law Answer

On the topic of disclosures, a reader inquired about what to do about her family of eight siblings and one elderly father. Long ago the siblings got together and put two of the sisters in charge of their father, largely because his will and other directives advised as much. As a result, they were granted power-of-attorney and access to his accounts.

Now, the reader has discovered that they aren’t forthcoming with information about their father, his care, and his finances. The reader is worried that she won’t hear anything until there’s a demand for money to care for their elderly father, and, perhaps, that the original funds weren’t adequately used.

The response of Craig Reaves is tailored to the reader’s unique situation, but his advice is applicable for many in this same or similar position. As a preliminary caveat, there are specific state laws (i.e., like those regarding “powers of  attorney”) that govern the authority, responsibility and liability of agents and fiduciaries.  The laws for powers of attorney documents in Nevada changed in 2009.  Are yours updated?  If not, it may be time for a consultation.

For more information on Elder law in Nevada, click here.  Then read Craig Reaves’ enlightening response in his original post.

Reference: The New York Times – The New Old Age Blog ( January 18, 2012) “Ask the Elder Law Attorney: Disclosures and Loans”

Tax Breaks for Caregivers Worth A Look

If you have had to arrange for a caregiver for an aging loved one, then you have some appreciation of the enormity of the costs often involved. It’s important, then, not to overlook tax breaks that just might help reduce the economic pain.

A recent article from Forbes offers a helpful reminder. The costs of a caregiver, under certain circumstances, can be partially tax deductible as medical expenses. After all, they are, in fact, very important and very costly medical expenses. However, conditions for taking the deduction essentially amount to proving that fact to the IRS.

So, what are some of these key conditions?

For one, you must document a care regimen for someone who is chronically ill. This means a licensed health care practitioner has to prescribe it. Unfortunately, it can’t be up to your own discretion, but such prescriptions and suggestions are common for aging persons, especially when they suffer from dementia.

Next, there is an expense threshold. Medical expenses are deductible only to folks who itemize, and then only to the extent that the expenses exceed 7.5% of adjusted gross income. Itemizing taxes can be a little more of a burden, but with the associated medical costs involved it is generally easy to qualify. Caregiving expenses are generally rather expensive and include the wages, employment taxes, and actual medical costs along with the associated living costs from meals to even costs of rent, if live-in care is needed.

Finally, this deduction is not without caveats and the IRS watches those who try to abuse it. For example, if the cost of the caregiver is covered by insurance (e.g., long-term care or medical insurance) then you can’t double-dip and claim both costs.

This is a complicated issue. There are many moving pieces.

Fortunately, the Forbes article shares some anecdotes from some illustrative cases and tax court challenges. Nevertheless, if you’re using a caregiver now (or will in the future), don’t overlook this potentially valuable deduction.

For more interesting articles, visit my newsletter archives.  While there, sign up for my monthly e-newsletters.

Reference: Forbes (December 8, 2011) “Tax Breaks For Caregiving Expenses Help Sandwich Generation”

Old Age Costs Rising

U.S. long-term health-care costs rose as much as 5.6 percent this year, led by assisted-living expenses, and are climbing at a steeper rate during a weak economy, MetLife Inc. said.

Are you planning for your old age or perhaps the old age of a loved one? If yes, then you know that such planning is all about getting a handle on healthcare. Unfortunately, the most recent study from MetLife indicates that the costs for long-term care and assisted living are rising at an even faster rate than in previous years despite the weak economy.

According to the MetLife study:

 

• The national average daily rate for a private room in a nursing home rose 4.4% from $229 in 2010 to $239 in 2011.
• The national average monthly base rate in an assisted living community rose 5.6% from $3,293 in 2010 to $3,477 in 2011.
•  The national average daily rate for adult day services rose 4.5% from $67 in 2010 to $70 in 2011.
• The national average hourly rates for home health aides ($21) and homemakers ($19) were unchanged from 2010.

Businessweek offers some coverage of the development, along with the words of the director of the MetLife Mature Market Institute, Sandra Timmermann. According to Timmermann, "The state of the economy, combined with rising health-care and energy costs, are having a significant impact on long-term care rates."

Indeed, even though MetLife is the largest life insurer in the U.S., it also has discontinued its long-term care insurance policies for these very reasons. Likewise, the CLASS Act (the first public-option long-term care insurance) recently shut down. In the end, this is rather grim news for those planning for their old age or an elder loved one.

For more information on Elder issues, visit the Elder Law page of my website found here. While you are there, sign up for our free monthly e-letter here.

Reference: Businessweek (October 26, 2011) "Long-Term Care Costs Rise at Faster Pace, Metlife Says"

Alzheimer’s: Be Prepared!

Living with Alzheimer’s disease is very difficult for the individuals affected and their loved ones. But by dedicating some time early on in the diagnosis and fighting for the cause during World Alzheimer’s Month and beyond, a family can know they have done everything to support their loved one to live a full life and protect their legacy.

You may not have known but September was World Alzheimer’s Month. Even though we are into October, it’s important not to forget about Alzheimer’s. Medical research and advocacy are vital causes to uphold. Nevertheless, it is a disease that you and your loved ones might have to face directly, if you have not already. The reality of Alzheimer’s or dementia striking close to home, then some understanding and prior planning can help you in terms of the extensive economic toll and the unique legal ramifications.

According to a recent Forbes article, Alzheimer’s is as widespread as it is demanding. Consider this: Another American citizen will develop Alzheimer’s every 69 seconds. The symptoms are oftentimes subtle, at least initially. Some estimate that more than 13 million Americans will have the disease by 2050 and run up as much as $1 trillion in costs. Because of the progressive nature of the disease, most of the costs and problems won’t develop until later on. Nevertheless, significant planning must take place at the time of diagnosis, if not anticipated beforehand.

So, what is the scope of this “significant planning”? First, you will need to secure medical care, both for now and for the future. That means fundamental financial planning need to be addressed, to include securing government benefits like Medicare and Social Security Disability Insurance. For more information on Elder Law, see here.  Second, because of Alzheimer’s progressive cognitive degeneration, estate planning must occur early in the process to secure and protect family assets.  For more information on estate planning, see here.

Fundamentally, it’s important to understand that Alzheimer’s is not the same as other diseases. Through it all, competent counsel will be necessary to properly assess the needs and possibilities, as well as to ensure that everything is in place when needed most.

Reference: Forbes (September 21, 2011) “September Marks World Alzheimer's Month as Advocates Push for Early Diagnosis and Health Care Planning”

Do Your Research When Choosing a Nursing Home

Reference: Reuters (August 23, 2011) “For-profit or not: what to consider when choosing a nursing home”

The GAO study reinforced that for-profit nursing homes – which account for more than two-thirds of nursing homes nationwide – had more frequent and serious deficiencies than non-profit homes.

Choosing the right nursing home for a loved one is no easy choice. There are simply so many factors involved, not least of which is cost, and there is always the ultimate concern that your loved one receive the proper care. Still, there are ways of determining the good from the bad. Reuters collected advice from several experts in a recent article and specifically pointed out the controversy surrounding the difference between for-profit and non-profit facilities.

The article dwells on the legal battles of a former Florida state-appointed consumer advocate, Brian Lee, and the controversy there, but the central kernel is a suspicion of for-profit nursing homes. Last month the U.S. Government Accountability Office published a study indicating that for-profits had more frequent and serious deficiencies than non-profits. Indeed, it is not the first such study to come to that conclusion (see here and here, amongst many others.).

Unfortunately, these decisions are seldom simple. For-profit nursing homes make up more than two-thirds of all nursing homes. So, most of us will probably be using a for-profit facility – but forewarned is fore-armed, so be sure to do your research. Experts indicate that a good starting point is the Medicare website and the ratings there, but you will also want to visit the facility to do your own fact-finding. Indeed, many say that you should visit at various times, the evening especially, and to do so unannounced to see what things are really like. Cleanliness, accessibility, and a pleasant environment are all important, but what is more important is to be sure that the residents themselves are happy and aware. It’s often not enough to simply trust a hospital discharge practitioner since they might not know best.  Patience and persistence are key.

Careful planning can help protect your loved one’s and your assets.  Refer to our website to read more about Pre-Medicaid Planning.  If you or your loved one is not in immediate need for long-term care assistance, you may be able to distribute or protect assets now so that when the long-term care assistance is needed, the qualification process can go quickly. It is impossible to give general guidelines for Medicaid planning because every client's case is different and there are stringent rules and penalties associated with it, which is why most traditional "revocable" trust planning will not help with that option.  However, we offer a free consultation to discuss other available options with you.  For further information, please call our office at 702-384-3767.

Warmly,

Lizette

 

Poor Housing Market Causing Further Issues for Nevada's Seniors

Reference:  Kaiser Health News (August 21, 2011) “Housing Bust Derails Some Seniors’ Assisted-Living Care”

In the fourth year of a depressed real estate market, experts say thousands of seniors remain unable to move into senior housing because they can’t sell their homes quickly enough or for the price they need.

After four years or so the housing market is still idling at terribly low levels, but even if we’re all feeling it, it’s our nation’s seniors that seem to be uniquely hurt. The problem has been growing over those years, and I’ve written about it here, but the Kaiser Health News recently put out an article taking stock of the situation and new reactions from assisted-living and nursing home facilities.

With housing prices and market demand so low, seniors simply can’t get up and enter into a facility, even if they need it. For many seniors, the plan had always been to use the equity in their home as the investment to keep them afloat in retirement but the value in those homes simply dropped in 2008. Even if you can forget how much the house was worth in 2007, before the crash, it’s simply not easy to sell a house these days and they tend to just sit on the market for years, or fetch too little money to make the sale possible. It’s causing seniors to wait that much longer before they can enter into a facility, and that’s time on top of however long it took them to finally make the decision to give up the home in the first place. It isn’t good for finances, and it is especially bad for health.

The facilities themselves aren’t happy with the trend and some are working to help ease the transition. In certain facilities across the parts of the country that were hit hardest by the housing bubble the occupancy rate has dropped as much as 10%, with nursing homes and continuing care facilities hit the hardest and assisted-living only slightly better. In response, some of those facilities have begun incentive programs from simple real estate education classes to more fluid contracts that allow the entrance costs of the facility (usually something like the cost of a home itself)  to be paid whenever the house is sold. One management company, Brookdale Senior Living, has even begun offering to buy seniors’ houses at pre-determined prices if they do not sell within a set amount of time on the market.

For you or a loved one it means that there are a number of possibilities to plan for. Those that can’t quite get out of their homes might consider bringing the care to them through in-home care services or perhaps living with loved ones. Still, if a facility is necessary then there may be options out there, depending on the facility and your part of the country, and it might be possible to work with the administration; chances are you’re not the only one with the problem and they may offer a solution.

As always, be sure your loved one's have up to date power of attorney's and healthcare directives.  Regardless of in home care or facility care, you want to know they are getting the best care possible.   We are here to assist you and we offer a free consultation to get you started.  Our office is available to take your call at 702-384-3767.

Warmly,

Lizette Sundvick

Uncovering Dementia and Alzheimer's Cover-ups

Reference: Forbes (August 11, 2011) “The Danger of Your Aging Parent Covering Up Dementia”

Here’s what’s important: it doesn’t matter if you have a diagnosis for your aging parent or not. It matters how your aging parent functions. It matters how you deal with what you see.

Dementia and Alzheimer’s are becoming increasingly common, but even if we are beginning to become more and more aware of how to spot them, it doesn’t make it any easier. Many a reader will be familiar with the terrible uncertainty and concern over their elderly parent’s thinking. Fortunately, Carolyn Rosenblatt of Forbes has more advice to give in her recent article.

Among the many dangers to keep in mind when an elderly loved one starts “slipping” it that they may begin “hiding” it. For one thing, it is not something with which any senior looks forward to acknowledging, even if they are aware of some telltale symptoms. It is human nature.

We all compensate or distract when there is something to hide, both from ourselves and from others. But when something like Alzheimer’s is at stake, it can be all the more difficult to get past and harmful to hide. Indeed, since there is no actual test for dementia or Alzheimer’s, it is possible that a doctor will be unable to diagnose those conditions.

It is important, therefore, to observe how your loved one functions. Keep a keen eye on them and know what you are seeing, for their own sake. The original article has more advice and anecdotes to offer, but Ms. Rosenblatt sums up the steps in four points. As soon as you begin to worry you must, first, persuade your loved one to visit a doctor, and a specialist if possible, to detect it early. Second, you must secure their estate planning documents while they have legal capacity to know and understand what they are doing. Third, you must secure proper care for them. Fourth and last, you have to discuss the circumstances openly with all family members, so all may be aware of the circumstances and can work together to protect your loved one.

Our estate planning takes into consideration the healthcare and power of attorney documents needed to insure a smoother transition for proper care in this type of situation.  If you or your loved one needs to update an existing plan or design a new plan, we can schedule a free consultation.  Our office is available to take your call at (702) 384-3767.

Warmly,

Lizette Sundvick

Revised Government Website Makes Nursing Home Comparisons Easier

Reference: Forbes (August 1, 2011) “Feds Update Website to Help Families Choose Nursing Home”

The federal government recently overhauled one of its web services to help families better evaluate nursing homes.

If you and your family are screening nursing homes for a loved one, then you already know what a daunting process it can be. It may just be a little easier now with the federal government’s newly-revised Nursing Home Compare web service.

As Forbes recently pointed out, the comparison tool offered through Medicare.gov has been simplified and expanded. Under advisement from the Centers for Medicare and Medicaid Services, the old criteria of 17 points has been replaced with a new set of 21 points based on specific issues like infections, falls, general well-being, and pressure ulcers – the very issues that residents and families may deal with directly once admitted to the facility. The idea is to make it easier for families to research their area and get an accurate understanding of quality and performance in possible nursing homes for their loved ones. Hopefully it can help you and your family as well.

These kinds of decisions are difficult for any family.  Most of all, we understand that your goal is for your loved one to receive the best care possible.  If your loved one is mentally alert and has not set up a will or estate plan with clear health care power of attorney and living will directives, the time to do so is right now.  We offer a free consultation.  Our office is available to take your call at (702) 384-3767.

Warmly,

Lizette Sundvick

Website:  www.SundvickLegacyCenter.com  or Office:  (702) 384-3767

Estate Planning/Power of Attorney

Reference: Forbes – Bernard A. Krooks (July 7, 2011) “Power of Attorney Does Not Grant Access to Online Banking, Says Bank of America”

Rules such as Bank of America’s power of attorney policy are increasingly significant as the financial world increases its Web presence…

Some people who thought they had covered all their bases and acted responsibly to care for loved ones in the event of a debilitating illness or incapacity are finding their plans un-done by strict banking policies. Bank of America recently updated their online security procedures, and no longer accepts a power of attorney for online banking.

As Bernard Krooks wrote last week for Forbes, this strict policy came to light when Chicago resident Eva Kripke was blocked from accessing her husband’s Bank of America account. According to Krooks, Mrs. Kripke had been handling her husband Sidney’s bank accounts as agent under a power of attorney ever since he was diagnosed with Lew body dementia four years ago. Suddenly now, however, she is denied access under the bank’s updated security procedures.

The bank suggested she to go to her local branch and get a printout of her husband’s account information. Unfortunately, Mrs. Kripke felt this was unacceptable because her husband’s health status requires close financial oversight. Perhaps more unfortunate, her options are limited because her husband’s illness has rendered him incompetent.

Rules such as these are becoming increasingly prevalent and significant as more people are called upon to care for an aging population and their attendant disabilities. An experienced elder law attorney can provide guidance in situations where powers of attorney are limited.

You can learn more about powers of attorney in the Fundamental Estate Planning Practice Center on our website.

If you would like to discuss guardianship and power of attorney issues, we can schedule a free consultation.  Our office is available to take your call at (702) 384-3767.

Warmly,

Lizette Sundvick

Website:  www.SundvickLegacyCenter.com  or Office:  (702) 384-3767

ELDER LAW / SCAMS

A return to tax returns — that's the theme of a new round of scams. You're promised you'll get money from the government if you'll just file new forms with the IRS. You waste your time and pay a fee as well, putting money into the pocket of no one but the crooked tax preparers who run the scams.

Did you hear the one about the government sending out free money to seniors who just fill out a new tax return, and pay a processing fee? Ugh! Apparently, this is the latest scheme crooks have been playing on seniors, preying on their anxieties about the Cost Of Living Adjustment (COLA) – or lack thereof.

According to the IRS and a recent warning from AARP, the summer has seen a dramatic increase in filing scams. Crooks spread false information that by filing again with the IRS and using new forms you can get government money. The most widespread one claims that the government is offering money to offset the lack of the annual COLA, and that by paying a $60 processing fee to a preparer with a new form you can receive as much as $3000.

There is no such program, and in fact the current debt talks are already chipping away at the COLA anew rather than seeking to pay it out. That “tax preparer” just pocketed the money as well as a document laying out all your personal and financial information.

One good way to protect yourself and your loved ones from these types of scams is to check with the IRS and the AARP website for information about both legitimate programs and scam or fraud warnings.   

Reference: AARP.org (July 25, 2011) “No COLA? Crooks Promise Help”

If you have questions concerning Elder Law, we can schedule a free consultation.  Our office is available to take your call at (702) 384-3767.

Warmly,

Lizette Sundvick

Website:  www.SundvickLegacyCenter.com  or Office:  (702) 384-3767