Paying for Alzheimer’s: Medicare, Medicaid, and Long-Term Care

Few diagnoses are more devastating than Alzheimer’s, both in terms of its health toll and its extraordinary financial imposition on families.

Paying for long-term care isn’t easy, especially if you or your parents haven’t already been saving for years. Even well in advance, finding the extra money to set aside for a long-term care fund can be tough.

There is hope, though.

A new article over at USA Today’s makes that very point. Yes, it is a challenge. Yes, it is expensive. But resources and assistance are available. Paying for long-term care is possible, even if you aren’t wealthy.

“It’s a myth that you have to spend all your money and sell your home to qualify for government assistance,” the News-Press piece says. “Attorneys can work with families to set aside certain funds and make sure a healthy spouse does not live in poverty.”

Medicaid and the VA (Veterans Administration) provide financial assistance for in-home care, as well as assisted living and long-term nursing. Medicare, meanwhile, will pay for temporary skilled-nursing care (if medically necessary).

Applying for that assistance isn’t easy either, though. The requirements are cumbersome, and inexperienced applicants can make mistakes in one process that might work against them in others.

As New Jersey Medicaid attorneys, we at Medina Law Group offer both crisis planning and pre-crisis planning to help people fund their long-term care. We help seniors to qualify and apply for government assistance in a way that will protect their assets while alleviating some of the financial burden of long-term care.

Dementia is a frightening disease, but it does not have to invite financial ruin. There are avenues for help. It is our belief that people who’ve worked hard to earn and save money their whole lives should not have to lose those assets and turn entirely to their loved ones just because of a medical diagnosis.

There is a right way to approach government assistance. If you are interested in either applying now or planning for long-term care in the future, our office can help. Give us a call today.

Posted in Alzheimer's, Elder Care, Long Term Care, Medicaid Planning, Medicare, Seniors | Leave a comment

How Outer-Space Research May Lead to Better Care for Old Age

Space may be the “final frontier,” but we’re still far away from reaping its whole harvest. Indeed, the distant discoveries of outer space continue to pay major dividends here at home. Take senior healthcare, for example.

The Washington Post recently reported on scientist Millie Hughes-Fulford, who is currently conducting remote experiments aboard the International Space Station, more than 200 miles above the Earth.

Specifically, Hughes-Fulford is studying the behavior of cells in zero gravity, observations she hopes to apply in developing new treatments for age-related illnesses in our world.

It all started when she came to the brilliant realization one day that senior citizens are lot like astronauts. How’s that, you ask?

Well when astronauts are in space, zero gravity has a curious effect on their immune systems. Their T-cells (responsible for motivating the body’s immune responses) are about half as active in space as they would be on Earth. That means the astronauts have a harder time fighting against illness and infection — but only while they’re in space.

Back here at home, meanwhile, the elderly endure a similar compromise in T-cell activity. The difference, of course, is that zero gravity clearly isn’t to blame in their case, as gravity affects the elderly on Earth just like the rest of us.

But understanding how zero gravity alters otherwise young and healthy adults’ T-cells could lead to a major breakthrough in understanding the vulnerabilities of the human immune system.

Ultimately, Hughes-Fulford hopes her space experiments will lead directly to new and improved treatment for age-related illness on Earth. Fascinating! Sometimes the best ideas are the ones that are simply out of this world!

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Do People Really Die of “Old Age”?

We’ve all heard about people who die of “old age.” In fact, for many, that is our wish — to live long and healthy lives and, when our time eventually comes, to pass away gracefully in the swan song of old age.

But a new (and very funny) article from Medical Daily pokes some very scientific holes in our not-so-scientific fantasy of the “old age death.” According to columnist Chris Weller, there just isn’t any truth to the idea.

Weller says that we all ultimately die of something. The older we get, the more susceptible we become to routine illness. Death by “old age” really just means that our bodies have broken down to the point that some other cause of death is able to take hold.

“The idea that people die of pure aging, without pathology, is nuts,” says David Gems, deputy director at the Institute of Healthy Aging. (Weller points out that Gems defines “pathology” as any disease, condition, or ailment.)

But if that idea feels discomforting or depressing, it shouldn’t.

On the contrary, the fact that we as humans cannot be killed by “old age” itself offers hope — we may be able to find ways to strengthen the aging body against pathology in order to prolong healthy life beyond its current outer limits. In fact, Weller reports that research along those lines is already underway.

In the meantime, we can also take comfort in knowing that old age is not some malady to be fought against or feared. Rather, it is yet another stage in life — one that can be healthy, long, and thoroughly enjoyable.

Even after eight or nine dozen of them, then, birthdays are still causes for celebration.

Posted in Aging, Elder Care, Seniors | Leave a comment

Questions to Ask Yourself About Your Estate Plan

The Wall Street Journal is running an ongoing series of expert op/eds on the subject of estate planning, and it makes for intriguing reading. One of last month’s entries came from investment guru Mike Piper, entitled “Estate Planning Is About More Than Estate Taxes.”

Piper nails the Number One reason that most people don’t put together an adequate estate plan: they figure that since their estate is smaller than the exclusion amount ($5.43 million for 2015), estate planning isn’t really relevant for them. It’s the old “estates are only for the rich” myth.

“What this line of thinking overlooks,” he writes, “is that there’s a lot more to estate planning than just estate taxes.”

Indeed! In truth, taxes occupy only one corner in the giant arena that is estate planning. A comprehensive plan should also address everything from beneficiary designations and minors’ guardianship to powers of attorney, retirement planning, and whether you’ll be kept on life support in the event of severe injury or coma.

Most interestingly, Piper raises a number of questions that help to illustrate the important of an estate plan even for those whose assets don’t add up to millions. Synthesized, some of those questions include:

  • When did you last update the beneficiaries for your insurance policies and retirement accounts? (For example, is an ex-wife still on the list? Is a newborn child missing?)
  • Would a trust make sense for you and/or your family? If so, which kind of trust?
  • Does your executor know where to find your end-of-life documents, keys, passwords, and important papers? You’d be surprised how often survivors can’t find these after a loved one’s death.
  • Do you understand your retirement spending priorities? For example, should you spend first from taxable accounts, tax-deferred accounts, or a Roth?

These are but a few of the many questions that might come up as you engage yourself in an internal dialogue regarding your estate. We find that in almost all cases, it makes sense to have at least the basic estate planning documents duly executed as soon as possible. If you haven’t done that yet and need help — or if you’re due for an update — give us a call. We’re here for you.

Posted in Estate Planning, Estate Tax, Trust vs. Will | Leave a comment

The Many Demands Facing Family Caregivers

Even for professional caregivers, helping the elderly take care of themselves isn’t always easy. But more than half of the caregiving in this country is rendered by unpaid family members (at least in part).

In fact, more than 22 million people in the U.S. currently provide informal care for an elderly or disabled person without receiving compensation, according to About Health. That’s a significant chunk of our entire national population, and all those hours of volunteer aid can add up to significant stress.

Writing for About, Registered Nurse Angela Morrow itemized some of the most common causes of informal-family-caregiver burnout.

First and foremost are probably the physical demands, which Morrow says can include:

  • Bathing
  • Cooking
  • Feeding
  • Shopping
  • Turning the patient from side to side
  • Lifting the patient in and out bed (not to mention vehicles, bathtubs, wheelchairs, and more)

There are emotional demands, too. The sheer responsibility can weigh on a caregiver’s daily existence. And that’s to say nothing of the tremendous financial responsibility, sometimes adding up to tens of thousands of dollars a year.

If you’re currently caring for a disabled or elderly person, you should know that it’s okay if you sometimes feel frustrated. You aren’t alone. That knowledge can prove therapeutic by itself.

Take a deep breath, schedule some time for solitude whenever possible, and remember to tend to your own needs along the way as well.

Looking for more comprehensive stress relief? Consult Morrow’s list of resources to get some ideas. Remember, to give good care, you need to care for yourself too.

Posted in Elder Care, Family, Seniors | Leave a comment

Silicon Valley and the Sandwich Generation: Apps for the Elderly

They call them the sandwich generation: adults who are simultaneously caring for their children and their aging parents.

You find “sandwichers” everywhere, from factories to firms, and that includes Silicon Valley — home to the country’s leading tech giants.

Reuters recently chronicled Stephanie Tilenius’s journey from her role as Google’s Commerce Chief to the head of her own startup. It’s called Vida, and for $15 a week, it gives elderly patients direct access to doctors, nurses, and nutritionists through their smartphones. Available as a mobile app, Vida even includes regularly scheduled medication reminders.

Tilenius is one of many from the Silicon crowd who’ve ventured into the “elder app” market over the last few years. While the senior population has been relatively slow to embrace smartphone technology, there is now enough utility and demand there to justify a swift influx of former tech execs.

We may very well be on the cusp of a major explosion of IT for the elderly. As it has in most other facets of modern live, handheld technology could absolutely revolutionize elder care in America. It’s an exciting time for the field, and I can’t wait to see what waits in store.

Posted in Elder Care, Tech | Leave a comment

Lost in the Water

Swim meets are best summed up as sitting on a hard concrete bench for 4.5 hours for a total of two-ish minutes of excitement watching your child. The only other time to reap any rewards as a parent at a swim meet is during “warmups” – which last a lot longer than any of the individual events. Maybe as long as 20 minutes. (I’ve been too focused on watching my son to bother timing it.) 

If you’ve never been to a swim meet, you can’t quite understand the assault on the senses that occurs. The walls are all tile and concrete, leading to an overwhelming roar that forces your hearing to shut off as you focus on your child swimming in the warmup lane. (Pro-tip, noise canceling headphones are a wise investment.)

The warmup lane is its own form of chaos as 40 gangly 10, 11, and 12 year olds cram into 3 yards of water wide and 25 yards long. Swimmers jockey for position as their natural talent carries them faster than people in front of them. There is an elegant sportsmanship as slower swimmers make way for speedsters motoring through. And kids who jumped off fifth from the block, might be 12th in the blink of an eye, and then eighth in another blink. 

Making things worse for me (as a parent) is that everyone on my son’s team wears the same red cap and same black and red swimsuit. The girls have a suit that covers more of them, but picking that out in a literal sea of swimmers takes time and a lifetime of eating carrots. 

With warm ups being the longest time to watch my son at a meet, I hate it when I lose him in the lane (because it’s so crowded, because there’s jockeying for position, because they all look the same). I tend to rely on my instinct as a parent — the instinct all parents have — to instantly pick out the form of my child from a distance. We spend so much time with them, watching their gait and outline — we know which one is “ours” at a quick glance, in a crowd, and from more than  a football field away. 

Today, though, I keep losing him. And it takes me a lot of time to pick him back up. And I realize why I can’t find him in the water — his form and shape are longer and bigger than my heart tells me I should be looking for. 

At 11, and in 5th grade (which is to say “on the cusp of middle school and pre-teen-ville”), he’s no longer my boy, nor really even “mine”. I’ve had him belted into my sidecar as we have hurtled down life and he’s now got to start to steer his own way. It’s something that he’s started to demand as the person he is has become revealed like a sculpture from a block of marble. And I’m encouraged by what I see. 

It’s time. I can still provide the guardrails to make sure he doesn’t steer directly into oncoming traffic. But, he’s got to take the wheel and learn the controls. Because sooner than I’d like, even the guardrails disappear. 

For today, I’m going to make sure I don’t lose him in the water. 

Posted by Victor Medina
Medina Law Group, LLC

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Old Age Is Something to Look Forward To

Barbra Streisand famously sang about memories of “the way we were.” But what if our best memories are still to come?

An interesting debate recently played out on the op/ed page of The New York Times. In response to noted professor Ezekiel Emanuel’s assertion that it’s best to die by one’s mid-70s and avoid years of gradual decline, columnist David Brooks argued that our last years are actually our best.

“If [Professor Emanuel] dies at 75,” Brooks opined, “he’ll likely be missing his happiest years. People in their 20s rate [their happiness] highly. Then there’s a decline…. bottoming out around age 50. But then happiness levels shoot up… the people who rate themselves most highly are those ages 82 to 85.”

Indeed, week after week, we see new stories and studies about the ever-blossoming elder population in America. The Times cites scientific studies about changes in the brain that actually cause increased happiness in elders. But much of it, Brooks reckons, is the result of a long life well lived.

Take Streisand, for instance. At age 72, she just released one of the bestselling albums of her career, becoming the first recording artist in history to score a #1 album in six different decades. It’s already gone Gold!

While promoting the album, Streisand rounded the late-night circuit in high spirits, talking at great length about the hard-earned happiness she feels.

We may not all sell half a million records before we’re 80, but there’s no reason to think we won’t have that same glow of fulfillment on our faces.

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A Retroactive Resolution for New Year’s

Did you forget to make your New Year’s resolutions? Or maybe you’ve already broken them? (Hey, statistically speaking, more than half the population will have already broken theirs by now!)

Well it still isn’t too late to turn over a new leaf!

I recently came across an article out of Wisconsin’s Beloit Daily News that asked why people focus so much on fitness in their New Year’s resolutions rather than finances?

Estate planning is particularly overlooked in the resolution routine, perhaps because it doesn’t feel like a “fun” way to kick off a new beginning. But, as the Daily News points out, there are thousands of totally unexpected deaths every year.

When people pass away without an adequate plan in place, they leave their loved ones a complicated and often-expensive hurdle. That can be avoided by simply spending a little time on a comprehensive estate plan.

After all, New Year’s is the time for taking stock of all those little items we’ve left unmarked on life’s checklist. January is a prime opportunity to finally tackle all our do-it-laters. For many, “estate planning” still has a glaringly empty checkbox beside it.

There is still time to change that! As 2015 gets underway, we encourage you to give your estate plan a little time and attention. You and your loved ones will be glad you did.

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What Does “Elder Law” Mean, Anyway?

Ever wonder what “elder law” really means? I suspect you’re not alone.

Elder law is one of those terms that we all hear a lot but which rarely get defined… maybe because there isn’t any single definition that would work. Elder law is so many things.

As an elder law attorney, I end up working with countless areas of law. The field I find myself in on a given day is really determined by the field my clients need me in. Whether it’s housing, healthcare, property, family law, or financial planning, so-called “elder law” really does run the gamut.

You might even say it’s more a type of client than it is a kind of law – a point a fellow attorney recently made in Michigan’s Times Herald. His column defines “elder law” as “the legal matters affecting seniors,” and that’s not a bad way to put it.

At the end of the day, elderly people are just that: people. And just like all the rest of us people, their interests and needs intersect with virtually aspect of modern living.

An older person’s perspective on business, health, insurance, investments, and more may differ from a very young person’s, but their needs are no more confined to “old stuff” than anyone else’s.

It’s not just about nursing homes or estates. Those play important parts, yes, but they are only pieces in a much bigger puzzle.

The important thing for my clients to realize is that I’m here to help them in life’s many different arenas. Elder law is ultimately a practice of various, intersecting legal fields, and I am here to help protect my clients’ best interests in all of them.

So whatever it is you might have questions about, please don’t hesitate to ask. Even if it doesn’t sound like something you’d call “elder,” there’s a good chance it still falls within an elder law attorney’s fields of practice and passion.

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