New Study Identifies Four Possible Tools to Stave Off Mental Decline

With more than 47.5 million individuals affected by dementia worldwide and 7.7 million new cases annually, research is targeting ways to prevent or limit the impacts of the disease. Researchers in Finland believe they have identified four ways to stave off the mental decline that is becoming more common with older age. shutterstock_89751901

The study involved 1,260 people between the ages of 60 and 77. The participants were put into a gym program, an eating regimen based on a Nordic diet heavy in fish, and brain training over the course of two years. Researchers found that at the end of two years, those participating in these activities scored 25 percent higher than their peers. In certain tests, the difference between the two testing groups was even more pronounced: for tests involving the brain’s ability to regulate thought processes and organize, the group of individual participating in the plan developed by researchers scored 85 percent higher.

Activities that were a good match for the older individuals participating in the study included dancing, doing crosswords, computer games, and Sudoku. If you are concerned about your elderly family member’s health or if your family has already been impacted by the serious nature of dementia, meeting with an elder law attorney can help you understand your options. Set up a meeting today to learn more about planning for long term care and managing the health needs of a loved one with dementia through Medicaid planning. We can help at (601) 925-9797.

Why Would I Need an Elder Law Attorney?

Elder law refers to a practice that is devoted to the needs of older clients. Elder law attorneys have specialized knowledge about long-term care planning, advance health care directives, powers of attorney, probate and trusts, guardianships, and asset protection. While many elder law clients turn to an attorney in the midst of an elder care planning crisis, you might also reach out to an attorney with experience in this field so that you can plan ahead. shutterstock_183409916

There are many reasons that you might need an elder law attorney. If you or a loved one has concerns over the cost of long-term care and how you will be able to pay for it, then it’s pertinent that you speak to an elder law attorney as soon as possible. Your attorney can walk you through the various options to pay for long-term care, including any government programs for which you or your loved one may be eligible.

An elder law attorney can be crucial for helping you learn about qualifying for these programs and walking you through your options to ensure that your wishes are carried out in the manner that you intend.

These are just a handful of the ways that an elder law attorney can help you. Whether you’re in a crisis situation or looking ahead to plan for the future, contact an elder law attorney to get the information you need to make these important decisions. Get help today at (601) 925-9797.

Even though there are often situations where these two practices blend into one another, talking about estate planning and elder law does not always mean exactly the same thing. One key way to look at what makes these two kinds of practice unique is to consider the critical questions that each aims to answer:

  • What happens if I die?
  • What happens if I live?

Invariably, both elder law and estate planning in some ways address both life and death. Increasingly, estate planning tools help individuals capitalize on plans while they are still alive. Estate planning, however, has a much sharper focus on what happens when you die, especially when it comes to the transfer of your assets. A lot of the questions addressed in elder law, however, have to do with helping people plan for the future within their own life. As longevity is a major concern for today’s elderly, planning in advance for aging and long-term care are just as important as factoring in estate planning. shutterstock_196636610

Estate planning and elder law work together. Imagine it this way: what benefit is putting so much effort into planning for the transfer of your assets on death when you pass away if all of those assets are put in jeopardy by one major health event? Elder law works to protect those assets and get you thinking about these concerns early on so that you can meet your estate planning goals. Contact us today to get help: (601) 925-9797.

Think You Don’t Qualify for Medicaid Benefits? Think Again!

Morton Law Firm Medicaid help

As we mentioned a short while ago, there are some very particular federal and state Medicaid requirements to meet if you want to receive Medicaid benefits.

First, you need to be a resident of Mississippi and a US national, citizen, permanent resident, or legal alien.

Second, you need to be at least one of the following:

  • Pregnant
  • The caretaker of a dependent child or children under nineteen
  • Blind
  • Disabled
  • Over sixty-five years of age

If you’re eligible based on these factors, then it’s time to consider your income and assets and whether they’re low enough for you to qualify.

Tragically, many people who would otherwise qualify for Medicaid give up at this point, thinking they can’t qualify because their incomes or asset levels are too high. But the fact is, with a little strategizing, they could qualify!

How to Qualify

Here are the 2014 Mississippi income and asset eligibility requirements for long-term care patients:

Income cap: $2,163

Asset cap: $4,000

Community Spouse Resource Allowance (CSRA): $117,240

Monthly Maintenance Needs Allowance: $2,931

Let’s look at a hypothetical situation:

Hypothetically we have an elderly couple, the wife needs nursing home care and is looking to get covered by Medicaid.

However, this isn’t possible if the couple has a high enough income level or net worth (excluding their primary residence and the value of their car). Medicaid is designed for those who need care and can’t afford it, which is why you have to demonstrate need.

Of course, just because you’ve accumulated a sizable nest egg doesn’t mean you can afford long-term care for years on end with no help. You deserve some financial assistance for long-term nursing care.

The question is, how do you do it? If you currently have income or assets that make you ineligible, you don’t want to just throw all that away in order to qualify for Medicaid assistance. There has to be a better way!

Restructuring Assets

Fortunately, there are many possible strategies for restructuring your finances to qualify for Medicaid, and I’m going to outline one of them here.

Say you have $300,000 in the bank, and your spouse is going into nursing-home care. Based on community property rules, you can’t have more than $117,240, and your spouse can’t have more than $4,000 in assets.

Morton Law Firm Receiving Medicaid

If you came to me with this dilemma, I would discuss with you the merits of turning these assets into income streams that don’t count toward the asset limit.

One way to do this is with an annuity. You can purchase an annuity that pays you an income from that $300,000 lump sum, and the lump sum itself is no longer considered a countable asset.

Another way to shield that $300,000 is with something called a promissory note. Here, you’d essentially loan out your money to someone you trust and collect a small monthly stipend from him or her. As with the annuity, the money would no longer be counted as an asset toward your asset limit. However, it would add to your monthly income, so we’d need to look at it closely to figure out the optimal course of action.

This isn’t intended to be legal advice, but just an example of what can be done if you think you could qualify for Medicaid but aren’t quite there yet. I encourage you to speak with us and see if there’s a way for you to qualify. More often than not, there are ways we can get you the financial support you deserve!

~ Ronald Morton

Can a Family Member Be Paid for In-Home Care?

In our last blog, we provided a few tips for finding the right in-home care provider for your loved one. One thing we didn’t discuss was hiring a family member as an in-home care provider.

There’s a misconception out there that you’re not allowed to use a family member, but in reality, you may be able to do so.

The issue is that the family member needs to be a legitimate provider. You can take care of a loved one informally and without pay whenever you want, but getting paid for it is a little more complicated.

Morton Law Firm in-home care

Keep in mind, if you ask a Medicaid caseworker if it’s possible to pay a family member for in-home care, the answer will almost certainly be no. Look at federal regulations, however, and  you’ll see that it is allowable, as long as:

  • you have a written contract in place between the family member and the patient
  • the family member provides recognizable in-home care services (e.g. personal care, health care, and so on.)
  • the family member is paid a reasonable wage that’s in line with what an in-home care provider would earn

The key point to understand is that this is not a casual arrangement. The family member needs to treat it as a job, complete with hours, payroll taxes, and services rendered to the patient.

With that said, it’s a great way to help your family as a whole. It’s wonderful to hire a caregiver your loved one already knows and loves. The patient needs high-quality care from someone trustworthy, and the in-home caregiver needs to earn money while devoting time to caring for a loved one.

As you can tell, it’s not the simplest arrangement to hire a family member as an in-home care provider for a patient on Medicaid, and you can lose the opportunity if you don’t approach it properly. That’s why it’s wise to consult an elder law attorney to help with everything from the contract to the requisite government red tape.

Contact us today if you are facing this situation and need professional help!

~ Ronald Morton

Talk With Your Clinton, Flowood and Metro Jackson Area Elder Lawyer about Recent Medicare Changes

Recent changes to Medicare are giving elder lawyers and their clients some new options, and you may want to meet with your Mississippi attorney to see if they apply to you.  A class-action lawsuit was brought, and the proposed settlement has some big implications for those with disabilities and chronic conditions.

For decades, standard Medicare practice was to not provide skilled nursing and therapy for those whose conditions were unlikely to improve.  This has caused considerable problems for those with chronic or terminal conditions or with disabilities who would still have benefited from these services.  Now, home health care, outpatient therapy, and skilled nursing are much more likely to be covered for a chronic illness or disability.

The class-action suit was brought by a large group of people, with plaintiffs including organizations such as the National Multiple Sclerosis Society, the Parkinson’s Action Network, Paralyzed Veterans of America, and others.  As a result of the outcome, it appears that more than 10,000 individuals who had claims denied earlier may be able to have those same claims reviewed again with different results.

According to the agreement, Medicare will begin to cover these services when they “maintain the patient’s current condition or prevent or slow further deterioration.”  This is great news for those whose condition isn’t expected to improve but who still require assistance to improve their quality of life.

According to the New York Times, this change has potential to help those with:

  • Alzheimer’s
  • Multiple Sclerosis
  • Parkinson’s
  • Spinal Cord Injuries
  • Stroke
  • Traumatic Brain Injury

Elder lawyers in Clinton, Flowood and Metro Jackson Area  and the rest of the country see this as a positive change for clients who were often denied care because they simply couldn’t afford it and Medicare wouldn’t cover their needs.  There is still a potential for Medicare contractors to use more restrictive guidelines that could deny coverage for therapy or skilled nursing if the patient isn’t showing improvement.

The proposed changes are geared toward those in the traditional Medicare program, as well as to those with private Medicare Advantage.  Most Medicare recipients are 65 and older, which is why a skilled elder lawyer in Clinton, Flowood and Metro Jackson Area keeps abreast of these kinds of changes that might affect clients.

Clinton Elder Lawyer’s Advice: Create a Personalized Healthcare Directive

When a Clinton elder lawyer’s clients enter a hospital or other medical facility, they have the peace of mind that comes from knowing their healthcare wishes will be made clear to the staff.  This is because the attorney and the client were able to sit down and go through various situations and scenarios to put together a personalized healthcare directive.  When you don’t have one of these in place, the hospital will likely ask you to use their forms to create something similar.

While it’s better to fill out their form than to have no healthcare directive at all, it’s important to remember that it will not be personalized to fit your needs.  When the hospital or other institution puts their forms together, they do so for a wide, unknown audience.  The topics covered will be those which the hospital (or its lawyers) find important, rather than those which are meaningful to you and your family.

Basically, this document is where you name the person that you want to make medical decisions should you become unable to do so yourself.  Oftentimes, this person is a spouse, but if you are unmarried or simply want to appoint someone else, then a healthcare directive is especially important.  Remember that if you don’t assign the role, the legal system will do so for you, choosing a “close” blood relative, such as your adult children (or your parents, for younger folks) to make the medical decisions you are unable to make at the time.

Provide Guidance about Your Wishes

Your Hinds County elder lawyer will not only have you appoint someone, he or she will also help you to make many medical decisions in advance.  By recognizing potential medical situations and declaring your wishes, you can lessen the burden for the individual who will ultimately be responsible for your care.  For example, what are your feelings about life-sustaining measures such as feeding tubes and respirators?  Are there situations in which you would want these used and/or situations where you would not?

This is also a good place to make any religious or cultural restrictions known.  For example, some groups do not agree to have blood transfusions performed.  If this is the case for you, then your healthcare directive would be the place to make it known.  Ideally, you would discuss your thoughts and decisions with the person you have named so that he or she is aware of your feelings and can use that understanding to guide him or her if other circumstances were to happen.  Obviously, your healthcare proxy won’t cover every potential situation, so it’s beneficial for the appointed person to have a good understanding of your beliefs in order to make decisions which are in alignment with what your wishes would be.

Important to Remember

If you have gone through the effort to work with your Hinds County elder lawyer to create your personalized health care directive, make sure that it isn’t undone by filling in one of the generic healthcare proxy forms at the hospital.  If you use their form, you can negate the one you created with your attorney.

Families are Primary Long Term Care Providers

The American Association for Marriage and Family Therapy states that “more than ever before, families are providing long-term care to older adults with limitations in the ability to perform tasks necessary for independent living. Nearly 25% of American households are providing care to people age 50 years and over.  The Jackson, Mississippi metro are is no exception.  Families are the alternative foundation for a stressed healthcare system. Hospital stays are shorter than ever and family caregivers are often expected to do what healthcare professionals once did.”

Family caregivers in Mississippi take over various responsibilities for their elders.  It may be just handling finances, running errands, going to doctor appointments or taking on full 24 hour care services.  In most cases one sibling in the family will become the main caregiver, but most successful ventures are supported by the entire family.  Many times this duty falls on the child who lives in the same city, such as Jackson, Mississippi.  More frequently than not, it is the oldest daughter.

There is a saying that it takes a village to raise a child.  This may be true, but it takes a family to care for an aging parent.  As seniors lose physical and cognitive function they become vulnerable and unable to manage their own care.  Who better to know their needs and desires than their own children.  Even if professional care givers are providing services, family involvement makes the difference in quality of life for their parents.

“If one family member has been designated caregiver other members can give support with respite care, transportation to doctors, etc., everyone needs to be aware of all that is needed and be in total agreement to do it.”  “The 4 Steps of Long Term Care Planning

Experience has shown that even families that are close can quickly grow angry, jealous and hostile towards each other when an aging parent begins to need long term care. If a sibling moves into the parent’s home, others can easily be suspicious of ulterior motives and fear to lose their inheritance. On the other hand, the child doing the entire care taking becomes bitter and feels there is no support or help from siblings.

One example of a family misunderstanding is that of a brother accusing his sister of stealing all of the money from the sale of his parent’s home.

Karen, who was a single mom with two children, moved in with her parents when her father had a stroke to help her mother take care of him. Her mother was also disabled. Needing money to pay for a home care service, Karen helped her mother do a reverse mortgage on the home, which gave the needed funds. If communication had been open and Karen’s brother had known the need and been involved with his parents care, he would not have reacted so negatively when he eventually found out about the reverse mortgage.

Every family is different. Some families are close and some have never been compatible. If your communication is strained, consider having a professional mediator present at a family meeting. The mediator will be able to keep things calm and running smoothly and help work out each persons concern.

Family matters.  The experience of working together for their parents care can give aging parents and family members a peaceful, memorable experience.

CLASS Act Casualty of “Fiscal Cliff” Deal

The final budget deal Congress passed to avert the “fiscal cliff” repeals a long-term care insurance program that would have helped keep the elderly and disabled out of nursing homes and off the Medicaid rolls.  In its place, the budget bill establishes a commission to come up with an alternative plan to make long-term care available for those who need it.

The Community Living Assistance Services and Supports (CLASS) Act, part of the health reform bill and Sen. Edward M. Kennedy’s final legislative legacy, would have established a voluntary national long-term care insurance program offering basic help for the elderly and disabled. Employees who wished to participate would have paid into it, much like they pay into Social Security, and would have received a modest daily benefit if they required long-term care.

The Obama administration suspended implementation of the CLASS Act in October 2011 over concerns that the program could not be self-supporting, but the administration had resisted calls to repeal the law, hoping that changes could make it financially viable.

But the administration’s resistance ended during negotiations over legislation to avert higher tax rates for all Americans.  According to The New York Times, repeal of the CLASS Act was one of the “sweetener” provisions thrown in by both parties to attract votes.  The Times notes that Senate Republican leader, Mitch McConnell (R-KY), who was an architect of the budget deal, had criticized the CLASS Act, saying it was “destined to fail in the real world.”

But reportedly at the insistence of Sen. Jay Rockefeller, (D-W.Va.), the measure establishes a 15-member Commission on Long-Term Care that is to recommend legislation in about six months.  (The Commission’s mission and powers are described beginning on page 120 of the budget bill.)  The Commission will be a bipartisan body consisting of members to be appointed by the President and congressional leaders within one month of the budget bill’s enactment.  Members will represent the interests of the elderly, consumers of long-term care services, family caregivers, private long-term care insurance providers and employers, among others.

Elder Care Law in Hinds County Offers Important Strategies for Dementia Patients

Elder care lawyers in Hinds County and surrounding areas work with families to prepare for any number of situations in the estate planning process.  One circumstance which is especially relevant to elder care law is dementia.  After all, Alzheimer’s and other forms of dementia are almost exclusively conditions which appear or worsen with age.

Along with the emotional turmoil on the patient and family members, dementia also takes quite a financial toll.  Alzheimer’s and related illnesses are typically degenerative, progressing slowly over time, while requiring considerable medical and personal care.  Elder care lawyers in Hinds County, Mississippi have experience helping clients create plans which provide for both the medical and the quality-of-life aspects of these expenses.

Of course, early planning is of utmost importance.  If it is suspected that you or a family member is developing Alzheimer’s, estate planning and other provisions should be arranged with an elder care lawyer as soon as possible.  A dementia patient’s mental capacity will decline, and in order for predefined wishes to be followed, his or her current capacity cannot be in question.  Getting started as soon as an issue is suspected is one of the best ways to ensure having the greatest say in the future.

Because of the progression of the disease, some of the most important decisions to be made are those of a medical nature.  For example, a “health care power of attorney” needs to be drawn up to designate a trustworthy person to make medical decisions for the patient when he or she is no longer able to do so.  If this person is not chosen in advance, it is likely the courts will need to appoint one at a later date.  Again, taking care of this issue with an elder care lawyer in Hinds County, Mississippi now means that you have more control over what happens later.

Asset protection is another major concern for dementia patients here in Hinds County, Mississippi.  The physical progression of Alzheimer’s can take many years, while the mental progression may be much faster.  This means the individual may require specialized care (including monitoring, nursing, and other personal needs) for a very long time, therefore depleting existing finances.  Learning how to maximize the value of assets now can vastly affect the quality of care one can afford later, and the funds available to other family members who depend on the sick individual, such as a spouse or disabled child. Without careful planning with a Mississippi elder care attorney, the individual’s illness can easily leave the entire family in poverty.  There is also concern regarding estate planning, as the costs associated with dementia can easily wipe out any potential inheritance unless the proper plans have been put into place.  Consultation with a qualified elder care attorney in Mississippi, such as a Mississippi Certified Elder Law Attorney, can show you and your family the options that are available to you.

When it comes to elder care, it makes good sense to seek a qualified attorney in Hinds County, Mississippi who can help navigate the ins and outs of the system as it relates the special needs of those with Alzheimer’s and other forms of dementia.  If you are ready to get started, simply call our Clinton estate planning and elder law firm and ask to schedule a complimentary Legacy Planning Session with the mention of this article.