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 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.
If you have an elderly family member or friend living in an assisted living or skilled nursing facility, it is imperative that you stay attuned to the signs of abuse to your loved one. The National Center on Elder Abuse reports the most common types of abuse include physical (29%), psychological (21%), gross neglect (14%), financial exploitation (14%), and sexual abuse (7%). While the facility's staff perpetrates the majority of these abuse cases, 22 percent of cases are a result of resident on resident abuse. However, these statistics reveal only part of the story.
A non-partisan advocacy group called The Senior Citizens League (TSCL) has a new analysis that asserts the federal government measuring tool to calculate the Cost-of-Living Adjustment (COLA) is flawed. The decrease in social security benefit monies that are paid to seniors is eroding their financial protection against rising costs. Changes in the COLA is tethered to the Consumer Price Index for Urban Wage Earners and Clerical Workers Index (CPI-W), which determines the inflation rate for a basket of goods and services from one year to the next, affecting more than 64 million beneficiaries next year. The Bureau of Labor Statistics (BLS) has released its annual CPI-W data from Quarter 3 since 1975, providing the final inflation number needed by the Social Security Administration (SSA) to calculate a given year’s COLA.
Kiplinger.com is suggesting it is time to rethink your financial retirement portfolio. You may have built up a significant nest egg in a 401(k) plan, but it does come with serious baggage during your golden years. It is impossible to argue against the early stages of a 401(k) when employers match your contribution to the plan. You can take advantage of the tax breaks because contribution money comes out of your paycheck before calculating taxes and that money compounds every year. When you retire, however, the tax impact of a 401(k), 403(b), or traditional IRA can become significant.
If you are a part of the millennial generation or younger, there is a steady path you can pick that can over time make you a self-made millionaire. It does not require a unique set of skills, specialized knowledge, or even excessive risks. Americans who achieve millionaire and multi-millionaire status using this technique took an average of about 32 years to accumulate multi-million dollar wealth with some achieving it in as early as 18 years. They are called saver-investors, and when you encounter one, at first glance, they might not seem that rich.
Much attention over the last ten years has been given to the research for causes and treatment of Autism Spectrum Disorder, also known as ASD. The Combating Autism Act became a law in 2006, was reauthorized in 2011, then again reauthorized and renamed to Autism CARES Act in 2014 (Autism Collaboration, Accountability, Research, Education and Support Act) which provided federal funding for research and monitoring the prevalence of autism and for training providers in detecting and diagnosing autism. Even still, there is no one single test for autism, no definitive cause for autism in general, and no cure yet. To be able to continue valuable research, education, social programs, and services to support the autism community, the law needed to be updated so certain parts of it would not expire by the end of September 2019. With bi-partisan backing and passage through the U.S. Senate, President Trump signed the Autism CARES Act of 2019 into law on September 30, 2019. The 1.8 billion afforded by this law will allow the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), and the Health Resources and Services Administration (HRSA) to continue their work on autism.
Data breaches have been one of the hot topics this year in the wake of the Capital One data breach which compromised nearly 100 million Americans. But what hasn’t been receiving much major media coverage are the recent breaches affecting seniors.
The increasing number of seniors and near-seniors experiencing dementia in the United States is on a rapid rise. A hallmark of cognitive decline is a long pre-clinical phase followed by an actual medical diagnosis that progresses from early to middle and late-stage dementia. Poor memory, agitation, confusion, and understandable fear of the future are some of the first characteristics a senior may experience as cognitive decline takes hold. It is a frightening diagnosis for anyone’s future well-being.
No one likes to contemplate a future that involves needing long-term care. In fact, I have yet to meet a client that aims to achieve the goal of residing in a nursing home one day. When sitting with clients, and their families, it seems as though most would like to skip the long-term care conversation altogether.
When you dial 911 for emergency medical services (EMS) your transport may route you to a hospital that is not near your home. While you have the right to ask to be transported to the hospital of your choice, either out of preference or to stay in your insurance network of doctors, you might not be permitted to do so. While you do have rights, you also have limitations, so it is best to understand how these decisions are made before experiencing a medical emergency.
Most people understand that by paying into Social Security throughout their careers, they can receive health care benefits through Medicare starting at age 65. Individuals under age 65 who qualify to receive Social Security Disability benefits are also covered under Medicare, as well as anyone of any age who has Lou Gehrigs disease, known as Amyotrophic Lateral Sclerosis (ALS), or has been diagnosed with permanent kidney disease (end-stage renal disease) that requires dialysis or a kidney transplant. But many people may not understand what is covered when long term care is needed.
According to the American Psychological Society, elder abuse is the infliction of physical, emotional/psychological, sexual or financial harm on an older adult. Elder abuse can also take the form of intentional or unintentional neglect of an older adult by the caregiver. Elder abuse has a variety of causes. It is important that family members and caregivers of senior adults be aware of the causes of elder abuse in order to prevent abuse and keep senior loved ones safe and secure.