Family Elder Law Expert Blog
Family Elder Law is pleased to offer the legal blog entitled “The Family Elder Law Expert Blog,” authored by Jason A. Penrod, B.C.S., CELA. Jason is board certified as an Elder Law Expert by the Florida Bar and the National Elder Law Foundation. He is also the founder of Family Elder Law with offices in Lake Wales, Lakeland, and Sebring, Florida. The blog addresses legal issues of particular interest to our readers. In addition, the blog will answer individual questions from the readership on a wide range of topics.
As I’ve written previously, no one desires to contemplate a future that involves needing long-term care. This is especially true for married couples who don’t want to imagine that their spouse will need such care. However, the statistics demonstrate that it is likely that at least one spouse will need long-term care and that their respective spouse will be one of the providers.
Decades ago in America, it was prevalent that extended family members lived near to one another, providing a system of general support and care for the family young and old. Now many families live far out of reach from the daily lives of their elderly parents save for the internet and internet of things allowing for digital contact. Even those living near to their aging parents are generally immersed in a world where work and nuclear family commitments preclude them from having the time to devote to their parents. So the advent of Continuing Care Retirement Communities (CCRC) began to meet the living needs of these seniors. A community that allows for stages of aging with minimal disruption to the resident is a great way to offset the adult child’s responsibility of daily care to a parent but still ensuring best practices for the parent’s health and well being.
The astronomical expense of long-term nursing care is no longer news. Costs can run around $7,000.00 or more per month, depending on location. Hundreds of thousands of people presently need that kind of care and the numbers are rising. Ten thousand “baby boomers” a day turn 65, and it’s projected that seven of ten of those people will need long-term care.
There is an entire senior industry built around preventative measures and responses to protect older people from falling, and with good reason. According to the National Council on Aging Falls Prevention Facts, “falls remain the leading cause of fatal and nonfatal injuries for older Americans.” Aside from grievous and sometimes fatal injuries, falls are costing money, lots of money. In 2015 Medicare and Medicaid paid 75 percent of the 50 billion dollars in total cost due to fall injuries. With an ever-aging US population, the financial toll is projected to reach 67.7 billion dollars in 2020.
Discrimination comes in various forms – race, religion, color, national origin, sex, disability, and even age. Age-related discrimination has become more and more apparent with the growing number of baby boomers inching into the class eldest to our population. The attention to the mounting presence of ageism has triggered a renewed concern with the discrimination of our aging population.
The gift tax is a tax on the transfer of assets, cash or property, to another without receiving something of equal value. The asset has to be of a certain value for the tax to apply; otherwise, it falls under the gift tax exclusion, either annual or lifetime. If the gift is above a certain value, you will have to fix out a tax form, but you may still be able to avoid the tax.
Welcome to the new decade, replete with new challenges to protect yourself against ever-inventive scam artists. One concern has a simple fix but requires your commitment to add two additional digits when signing or writing documents, letters, emails, and more. The National Association of Consumer Advocates (NACA) is reporting that the dawn of this decade creates unique opportunities for scammers when you abbreviate the year 2020 on official forms and documents to its shortened form xx/xx/20. The numbers representing the year are easily manipulated by nefarious individuals looking to exploit others, leaving them vulnerable to potential fraud.
Americans are facing an escalating long-term care (LTC) crisis. Industry driven, massively underpriced policies are playing fiscal catch up with hefty premium rate increases. This price increase is forcing some aging Americans to abandon their policy while others struggle to reduce their amount of LTC coverage to keep their rates affordable or reduce their future lifestyle by dipping into their retirement savings. Abandoning LTC policies turns out to be the last resort for many policyholders as they understand how valuable they are and that a policy lapse would cause them to lose all of their monies paid to the insurer.
Caring for a seriously ill spouse can trigger relationship challenges. In the process of change, you can lose your best friend, your love, and your future as you both had imagined it. Promises will change from words spoken in oath on your wedding day to deeds of care in your mostly, but not exclusively, older years. The new caregiver morphs from a loving spouse into their new role, which is an entirely different sort of relationship of primary service. In more tragic cases, the caregiver can become distant to the marital bond, struggling with feelings of loss, fear, anger, resentment, or misunderstanding.
Although it can be useful to have another party available to keep track of bills when you’re sick or away, adding a child’s name to a bank account may be more of a hassle than it’s worth. Doing so may have unintended consequences for both you and the child.
Federal spousal impoverishment protections were set to lapse in March 2019. Two bills were proposed to deal with that issue. H.R. 1343 is still sitting in the House, but H.R. 3253 was enacted on August 6, 2019.
As Gen Xers enter into their 40s and 50s, it is time for them to become active in the creation and execution of their retirement planning. There are many things to consider, including finances, investments, insurance policies, legal documents, living arrangements, and healthcare. It is advisable to make a detailed checklist within these categories and take action on each item. Meeting with an attorney can help you establish overall goals for your retirement and legacy planning while ensuring the steps you take will lead you to retirement success.
It is essential to bring up a parent's aging expectations and set goals together even though initial discussions may be uncomfortable. Often, an exploration into a parent’s future thoughts about health, finances, and residential plans can make the difference between reacting to a crisis or following an established plan that can bring both the parent and their children peace of mind. The sooner an identified caregiver begins a dialogue, the better the outcome for all involved.
Concerns about your memory or that of a loved one should never be ignored. There are many resources available through a simple internet search, and professional associations that provide education and guidance through a maze of questions you may have regarding how to approach someone you suspect may be experiencing memory loss, or how to ask for help if that someone is you. There is even a free online memory test you can take in the privacy of your own home. But, did you also know that through many years of research, there is a link between diet, exercise and Alzheimer’s disease? It is never too late to start making proactive changes to your diet and lifestyle now to help lessen the risk of developing Alzheimer’s. Even if you have been given an Alzheimer’s diagnosis, a study published in late October by Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, noted that it is possible to improve cognition with modifications to diet, exercise, and sleep.
Aging is something you cannot escape, and it affects all family systems. It can be challenging for adult children to imagine their parents as seniors and to understand and respond to the reality that each parent will age differently. Even if you are in the fortunate circumstance where your aging parents can go it alone for a long time there will come a day when assistance or long term care will be needed. There are things to consider as you help your parents live their best possible aging scenario. Managing their welfare takes time, research, and planning.
America experienced its worst financial crisis since the great depression between 2007 and 2010. Known as the subprime mortgage crisis, it happened because home prices fell in 2006, triggering loan defaults. Then the risk spread into pension funds, mutual funds, and corporations who owned the derivatives. It also spread into the global credit market resulting in higher interest rates and reduced availability of credit. Quantitative easing was necessary for several years to lower interest rates and spur economic growth. The cautionary tale to all Americans was learning to live beneath their means and do not carry excessive amounts of debt. Many Americans did not take heed and as a result, they are in substantial debt. One of the saddest cases of all of the debtors is the senior in their 60s and 70s in retirement years, and generally on a fixed income.
During the Vietnam War (1962-1975), the United States military, as well as the Republic of Vietnam, used defoliants for tactical purposes to reduce cover for enemy forces, improve perimeter visibility of military installations, and even to kill enemy food crops. Agent Orange is the most infamous of the tactical herbicides whose names became shortened to the identifying color band on the drum in which they were shipped and stored. These toxic herbicides have created a host of health problems in Vietnam Veterans who are now in and around their sixtieth decade. The illnesses are even linked to the offspring of these veterans.
In 2017, then Veterans Administration Secretary David Shulkin decided to add more diseases like bladder cancer, hypothyroidism, and symptoms akin to Parkinson's to the VA's growing list of illnesses and health concerns with highly likely links to the toxic herbicide according to an Institute of Medicine 2016 report (IOM). In addition to these findings, in 2018, the National Academies of Sciences found evidence linking Agent Orange to more diseases like hypertension and associated stroke. The Academy also links Agent Orange to monoclonal gammopathy of undetermined significance (MGUS), which is the presence of abnormal proteins in the bloodstream. The addition of these health concerns and diseases is in large part due to the change of their evidence classifications from the "limited or suggested" to "sufficient" category.
Earlier in 2019, then acting head of the Veterans Health Administration, Dr. Richard Stone, informed Congress that the VA was hoping to make a final decision on these "new addition" illnesses within 90 days. 90 days came and went. At a time when giving ailing senior veterans quicker access to rightful disability compensation and health benefits, thousands of veterans have lost hope. Unfortunately, for some, the culpability delay tactics are costing veteran lives; the longer the delay, the fewer lives to be addressed.
The Military Times is reporting these documents, obtained through the Freedom of Information Act by a veteran, are being broadly overlooked or objected to by the White House. According to the documents, there are about 83,000 veterans currently experiencing one of the three newly proposed presumptive illnesses. However, the current director of the Office of Management and Budget (OMB), Mick Mulvaney, expressed concerns regarding the budgetary impact of disease expansion within the current program and its potential adverse effects on the existing disability benefits program. Budgetary concerns seem to be overriding over 40 supportive scientific studies, peer-reviewed studies and additional documents Shulkin presented in a letter addressed to Mulvaney. The position of the White House remains to expand veteran care through the private sector.
Much of the inability to form a consensus in providing additional benefits revolves around the use of the term “presumptive” in describing the illness. Presumptively linking hypertension to Agent Orange exposure may be scientifically valid; however, the case can also be made linking hypertension as a disease typically found in older people, like Vietnam Veterans. Thus as Vietnam Veterans age, presumptive illnesses and their sources become difficult to isolate. The Veterans Health Administration, upon reviewing the results of their Vietnam Veteran Morbidity Study and the Vietnam Mortality study, concluded in May of 2018 that there is insufficient scientific data and information to overcome the limitations that exist in the scientific support requirement for rulemaking.
The years go on, and the back and forth continues as more Vietnam Veterans suffer Agent Orange-related illnesses and die. The longer political ploys are used to delay the approval of adding presumptive disease, the more intact the Veterans Health Administration budget will remain. This country’s policy and legislative process should not hinder America’s support of its veteran population. It is unconscionable to use delay tactics in the hopes this issue will self-resolve with the impending deaths of tens of thousands of sick Vietnam Veterans who may be fully deserving of additional medical care and benefits, but not receiving them. The VA must redouble its efforts to free up more benefit monies to right this egregious wrong.
According to the Centers for Disease Control and Prevention (CDC), heart disease in the US accounts for one in every four deaths or about 610,000 people. It is the leading cause of death for both men and women. And yet, mcknightsseniorliving.com is reporting that in the United States, Alzheimer’s disease deaths have increased by 123 percent while deaths from heart disease have decreased by 11 percent. Alzheimer's is currently the sixth-leading cause of death in the US, and one of every three seniors dies with some form of dementia. These numbers should give the government, and the health care industry pause as the silver tsunami of baby boomers continues into retirement. Current projections of Alzheimer’s disease-associated costs could be as much as 1.1 trillion dollars.
Diminishing brain function due to the onset of dementia can lead to the destruction of your financial well-being. If you are age 50 or older, easy access to your financial assets like stocks and bonds, checking and savings accounts, money market accounts, and other assets can lead to loss of these funds if an unauthorized person gains access to them, or if they are mismanaged. Family members are often unaware their loved one needs help before the unintentionally mismanaged assets, now gone, bring about devastating consequences for both the person living with dementia as well as their family. The Alzheimer’s Association reports that from diagnosis to death, Alzheimer’s disease (AD) care will cost an average of $424,000 per individual, and 70 percent of that cost is out of pocket expenses to the family system of the affected loved one.
Most people who work in healthcare may recognize the acronym LASA, which stands for “look-alike-sound-alike” and is usually seen when referencing medications. When it comes to federal programs, Medicaid and Medicare, in written form, look alike and they do sound alike but work very differently.