New York Elder Law Attorney Blog

Last week Reuters discussed the growing number of adult Americans who are financially supporting their senior parents. As the author quips, many of these residents have becomes the "Bank of Sons and Daughters" after the recent financial crisis decimated the savings of many elderly family members. According to MetLife's new National Health and Retirement Study, the percentage of adult children spending time and money on their parent's care has tripled in the last decade and a half. This comes as no surprise to our New York elder law attorneys who know that rising long-term care costs, the economic downturn, and failure to plan ahead for senior care places many families in tough situations when a loved one ages and needs extra day-to-day care.

The MetLife data found that roughly a quarter of all adults are currently providing at least some financial assistance to their parents. A similar survey from Caring.com suggests that adult children may be providing even more support, as thirty two percent of respondents said they've spent at least $5,000 on their parents' living expenses within the last year. A large majority of that group admitted that supporting their parents leads them to worry about their own long-term financial situation. As one researcher involved in the data collection explained, "There are just a ton of families where the second or third generation needs to help the first generation. People are asking, a lot, about how to do it."

Not only does financially supporting aging parents often place stress on the finances of the adult children, but, if not done properly, it may actually be harmful to the senior. As each New York elder law attorney at our firm has explained to local residents, it is important to properly tailor financial gifts such that they don't inadvertently disqualify the parent from government benefits. Certain programs are in place to help seniors receive the care they need even if they do not have the resources to purchase it. However, qualification for those programs, such as New York Medicaid, is based on need. If adult children do not take those qualifications into account, they may unknowingly complicate their parent's program participation.

Consultation with a professional in the area is necessary to learn smart ways to provide financial aid. For instance, if small annual gifts are given--up to $13,000 a year--then there are no gift tax consequences. That amount may double if you are married, as both spouses have separate tax-free limits. In other situations, it may be appropriate to help parents with a loan. This avoids gift complications and may be useful to help with specific issues--such as paying off accumulated credit card debt. As one expert explained, "Giving your parents a loan helps them avoid exorbitant interest rates, but they're still responsible for their own debts."

See Our Related Blog Posts:

Adult Children Often Remind Senior Parents of Estate Planning Importance

Tips for Giving Financial Aid to Family and Friends

It is no surprise that only 9% of Baby Boomers stated in a new Associated Press poll that they were "strongly convinced" that they would be able to live comfortably when they retired. With financial affairs in flux for many members of the 77-million strong Baby Boomer generation, many are beginning to reevaluate their retirement plans. Our New York elder law estate planning attorneys know that a growing number of local residents find themselves worrying about whether they will be able to live out their golden years in comfort.

One single 53-year old woman profiled in an Associated Press story on the Baby Boomer retirement situation explained that she once planned to retire at sixty and move to the beach. Those plans changed when her pension was eliminated five years ago, her personal investments tanked, and her home of 21 years lost half its value. Now she is not sure what her future holds, but she doesn't expect to move any time soon. When asked about potentially moving when he retired, a 60-year old small business owner explained, "It just depends on what happens to the economy. I'd like to find someplace warmer and doesn't have the high taxes, but we'll just have to see." Many local residents find themselves in the same situation.

The latest poll on the topic found that about 60% of Boomers had retirement plans, personal investments, and real estate that lost value in the latest recession. As a result, more than half of that group expects to delay their retirement. According to the research, 73% of respondents claimed that they will continue to do some work even after they retire. These delayed retirement plans have also led many Boomers to admit that they no longer expect to move out of their current home, and a majority claim that they plan to live out their golden years exactly where they are now. Other priorities for soon-to-be retirees include living near their children and being close to necessary medical care.

The New York elder law attorneys at our firm know that while the goal of many local seniors and older residents is to age in place, that plan may be altered if proper New York long-term care planning is not conducted. The costs of services that a senior may likely need are often quite high. However, steps can be taken ahead of time to ensure that resources are available to pay for those services. No matter how close one is to retirement or how much the recession has affected investments, it is wise to visit with an experienced professional to prepare for long-term living and healthcare needs.

See Our Related Blog Posts:

When Considering an Inheritance, Baby Boomers Fear Children's Financial Acumen

Now Remains a Good Time for Baby Boomers to Conduct Estate Planning

The aging of the population both in our state and throughout the country is leading many community members to re-think the best way to provide long-term care for seniors when they reach their golden years. In the past, options for seniors were few and far between. In most cases a senior lived on their own for as long as they could. When extra care was needed it was provided by a close relative if possible. If no relative was able to provide the care, or the senior's needs were more than a relative could handle, then the individual ended up in a nursing home. Most seniors in our area were unable to pay for that nursing home care on their own, and so it was paid for by New York Medicaid programs. However, most of the seniors' assets built up over a lifetime were lost to pay for the care or to qualify for Medicaid participation.

Recently, there has been an explosion in new options available to area seniors and their families, particularly for those families that take the time to visit with a New York elder law attorney to plan ahead for this stage in life. For example, many assisted-living facilities have been built which allow seniors to receive day-to-day aid from professionals while keeping much more independence than that found in traditional nursing homes. Other services are popping up which allow seniors to receive extra care without leaving their home at all.

For example, this week Bright Days Home Care, a new "senior companion" service announced that it was opening its doors to provide assistance for local residents. The New York elder care service provides companions to visit the homes of seniors on a particular schedule to provide any manner of aid necessary. This new service provides non-medical care, which may include anything from buying groceries and making dinner to cleaning the house and chatting with the senior about their day. In addition, the company's founder explains that the at-home service also helps local families find other resources. She notes that they "are committed to ensuring that people are aware of the plethora of options that are available."

Many local seniors may be able to live at home longer by utilizing this or similar services. At-home companion care can also compliment medically-based at-home assistance to provide even more comprehensive support for the resident. That medical assistance could include home nurse visits or installation of technologically advanced tools that allow medical caregivers to monitor a senior from afar. Whatever combination is ultimately best for you or your loved one, the first step is ensuring that you will have the resources necessary to pay for this care when it is needed.

See Our Related Blog Posts:

Long-Term Care Insurance is Key Medicaid Strategy to Protect Assets & Allow Home Care

Hire Your Children For Caretaking Duties

The New York elder law estate planning attorneys at our firm have worked for years with local GLBT residents on the unique issues that they face when planning for their long-term financial, social, and physical well being. Even though New York leveled the playing field this year by passing legislation which allowed same sex couples to marry, these families continue to face complexities in their planning because of inequalities at the federal level. Same sex couples still need to take special steps to ensure that their assets are protected and distributed according to their wishes.

Beyond estate planning needs, senior members of the GBLT community also continue to face unique challenges when planning for their long-term well being. The latest research reported in MetLife's "Out and Aging Study" found that three out of four GLBT seniors lived alone. In addition, these seniors are much less likely to have children than their heterosexual counterparts. As a result they are often less likely to have relatives able to help care for them as they age. Of course, GLBT seniors encounter the same problems as they as age as the rest of the community, and so these demographic differences mean that they have a particular need to conduct New York elder care planning to ensure necessary resources will be available in their golden years.

Unfortunately, our New York elder law attorneys know that many GLBT seniors fail to properly plan for their long-term healthcare needs. Many elder care advocates recognize the unique vulnerabilities of these seniors and are working to help. In an effort to provide the necessary aid, this weekend local officials announced the opening of the nation's first GLBT Senior Center. As explained in the New York Examiner, the Services and Advocacy for GLBT Elders Center (SAGE) is expected to open in January in Manhattan. GLBT seniors in all five New York City boroughs will be able to benefit from the facility. As Mayor Bloomberg noted during the announcement, "The needs of seniors have evolved since senior centers were created fifty years ago, and now is the time to re-envision the one-size-fits-all approach that has traditionally shaped many of our centers."

The new facility will provide a range of services from health and wellness programs and social activities to work skills training and hot meals. As with the rest of the population, the gay senior population is expected to rise considerably in the coming years and demand for these unique services is expected to increase steadily. The new director of the center revealed that the facility has been a long time in the making. He explained that the organization "was thrilled to be part of a bold initiative that emphasizes innovation in aging services."

See Our Related Blog Posts:

Estate Tax Issues Continue to Plague Married New York Same Sex Couples

Married Same Sex Couples Need to Consider Effect of Defense of Marriage Act

Syracuse News reported this week on public concern over changes that are about to take effect within the New York Medicaid system. Per the planned alterations, many local residents with developmental disabilities will lose their caseworkers as that task is soon to be outsourced to non-profit agencies in the state. Currently, many of these residents receive assistance from a group of public employees known as Medicaid service coordinators. However, these residents have been instructed that by the end of this week they must select a non-profit to take over this function.

Many community members are concerned about the effect the changes will have on their vulnerable family members with disabilities who have grown familiar with their personal caseworkers over many years. The service coordinators function as advocates for program participants, developing relationships with the clients and helping their family find the services that they need. Many coordinators have helped families find appropriate educational opportunities, arrange for respite care, and have linked participants with employment programs. Our New York Medicaid attorneys are aware of the complications that are intrinsic in working through the Medicaid system, as we also devote our time helping local residents work within the system to protect their assets while receiving the resources that they need to get by each day.

Cost-cutting is the state's motivation for changing the way the services are provided. The state spokesman for the Office for People with Developmental Disabilities reported that non-profit agencies already handle roughly eighty percent of Medicaid service coordination in the state. Nonprofit agencies explain that they are prepared to handle their expanded role. However, they also report that it may be difficult to complete the transition in a month--which is the goal of the administration. Even if the changes go through, there is a chance that families may be able to remain with the same service coordinator if that coordinator is hired by a nonprofit after leaving the state payroll. The program shift will allow the state to cut 300 service coordinators who had previously served about 10,000 local residents. Current service coordinators may try to approve an amended contract and submit it to the state in an effort to halt the layoffs. However, there is no guarantee that the privatization effort will be halted.

These latest New York Medicaid changes are part of a wide range of alterations that will likely take place over the coming years in an effort to help the state absorb the program's growing costs. Other proposed changes may affect the way that seniors and other program participants use the service to receive the extra care they need. Our New York Medicaid lawyers urge all local residents to visit with professionals to plan ahead for all long-terms health and financial concerns.

See Our Related Blog Posts:

Nonprofit Innovators Try to Shift Senior Care Away From the Nursing Home

New York Long-Term Care Near the Most Expensive in the Country

An article yesterday at Forbes explored an issue that has been dubbed "the ticking time bomb of eldercare." It is well known that many families are forced to adapt their lifestyle once they start having children to make concessions for childcare. However, our New York elder law attorneys know that many families are also forced to make similarly tough decisions to account for eldercare when aging parents are in need of day-to-day assistance. Many local residents still fail to appreciate the demands placed upon adult children and other loved ones when a senior reaches the point where they cannot live on their own without help. The challenges are particularly harsh for local residents when no elder care planning has been conducted ahead of time to ensure that resources are available to provide the needed aid.

Yesterday's article explains how eldercare expectations are very much rooted in old cultural norms. Specifically, in many families it is assumed that daughters will take care of parents as they age. Decades ago this was more logical as women were far less likely to be in the workforce and were more often available in their homes to assist parents throughout the day. However, those old realities are less and less true. Many more women have careers just as demanding as men. It is no longer easier for many adult daughters fit the care of their elderly parents into their lifestyle. Yet, cultural expectations persist, often making daughters disproportionately more responsible than sons for ensuring the well-being of their elders.

This cultural pressure may affect some women more than others. In particular, women with family backgrounds rooted in certain cultures--including Russia, India, China, and others--often face immense pressure to provide eldercare. For some that means ending a career that has taken a lifetime to build. As the authors of one study on the topic noted, "Eldercare is a serious issue...because its obligations and attendant guilt derail woman who are just hitting the peak of their careers."

With the percentage of the senior population expected to increase radically in the coming years, many more families will be forced to make difficult choices about eldercare. There is no answer that is best for every family, as every situation is a bit different, demanding tailored solutions. However, our New York elder law attorneys have worked with enough families on these issues to know that far too often the financial pressures involved in eldercare limit the options available. Everyone should visit a professional in this area to ensure that steps are taken so that resources will be there to accommodate whatever eldercare decision the family agrees is best when the time comes.

See Our Related Blog Posts:

Long-Term Care Insurance is Key Medicaid Strategy to Protect Assets & Allow Home Care

Hire Your Children For Caretaking Duties

The Wall Street Journal reported this week on an approaching milestone as the New York Medicaid program expects to enroll its five millionth member in the coming days. Enrollment totals were last released in August, at which point there were 4,963,000 people participating in the healthcare program. Membership has only increased as of late, and experts predict that the total will actually top six million by the end of Governor Cuomo's first term in office. The increasing popularity of the program has placed a strain on state and local budgets--it remains the single biggest spending area for the state government.

As it now stands roughly 26% of all state residents utilize New York Medicaid services in some form. That rate is 10% higher than the national average. Many government officials predict that changes are going to have to be made to account for the increased use of Medicaid. The head of the state's Association of Counties explained, "It's an unsustainable trend. The revenues from all levels of government just aren't there to sustain this growth."

However, members of Governor's Cuomo's team were more optimistic about the state's ability to handle the program's finances. The chief executive announced earlier this year a plan to cap state-funded Medicaid spending growth at 4% a year. The Governor's spokesman explained this week that the Medicaid Redesign Team had already been able to enact dramatic changes, and the program spending is running below the current cap. Unlike political leaders in many other states, the Governor has yet to enact any changes to Medicaid benefits or eligibility rules. Instead, Governor Cuomo has tried to account for the costs by lowering rates and shifting certain patients to managed care instead of fee-for-service coverage.

Program advocates explain that the ongoing recession, high unemployment rate, and decrease in employer coverage has made the program more important than ever for many local residents. Our New York elder law attorneys know that the staggering cost of long-term care makes it impossible for many middle-class seniors to receive the care they need outside of the Medicaid system. The program is a lifeline for many vulnerable elderly residents. However, it is the increase in seniors on Medicaid that is causing observers to fear for the program long-term fiscal stability. Seniors are more expensive to treat than nonelderly adults. Yet, over the next two decades demographic trends predict that there will be a 36% increase in the number of residents over 85 years old, likely adding to the overall cost of the program.

See Our Related Blog Posts:

Advocates Call For Tighter New York Medicaid Rule Enforcement

New York Lawmakers Discuss Possible Medicaid Changes

Virtually all seniors would prefer to enjoy their golden years at home instead of in a nursing facility. When helping local residents craft their New York long-term care plan, our New York elder law attorneys often advise community members on the ways that they can be financially prepared to age at home whatever the future might bring. In most cases the earlier that one properly plans, the greater likelihood that they will have the resources necessary to receive extra care at home without moving into a skilled nursing facility. However, for many seniors, at-home care remains out of reach.

Fortunately, those involved in elder care have been at work on alternative programs that will allow seniors to age gracefully at home whenever possible. Last week Healthcare IT News reported on a new subscription-based telehealth service that was launched in New York. The initiative includes a platform of new information technology tools to help seniors stay at home by tracking vital signs and allowing seniors to virtually communicate with caregivers. The comprehensive mix of services is intended to expand the group of community members who are able to stay in their house on their own while still receiving some day-to-day assistance.

The program is called "Virtual Living" and will use FDA approved caregiving services to allow medical providers to remotely monitor vital signs at home. From checking blood pressure and blood-glucose levels to evaluating a resident's weight, these tools are intended to ensure that help is dispatched in a timely fashion whenever problems are noticed by those monitoring the senior's health from afar. This monitoring will be combined with additional services including nutritional aid and social work. The program is set to begin this month in New York with plans to expand the nationwide in the next couple months.

As our New York elder law estate planning lawyers often advise clients, the majority of health plans and Medicaid programs do not reimburse the cost of services for home-bound seniors. This is one of the main reasons why many local residents decide to move into nursing homes even though they'd usually prefer to stay in their house. This initiative seeks to help those in that situation. The new company explains that the cost of the program starts at about ten percent of the cost of an average assisted living center contract. If the program is successful, this may make it possible for more seniors who plan accordingly to have the home elder care they want at the time that they need it.

See Our Related Blog Posts:

Long-Term Care Insurance is Key Medicaid Strategy to Protect Assets & Allow Home Care

Hire Your Children For Caretaking Duties

When local residents conduct New York long-term care planning they usually want to ensure that they will have the resources to pay for the needed care and that it will be of the highest quality possible. It is one thing to have access to caregivers to provide day-to-day assistance when age takes its toll. It is another to have the peace of mind of knowing that the care will allow them to maximize their quality of life. When discussing these issues one advocate has echoed a common songwriter's refrain, "there is a difference between living and living well."

Proper preparation often makes all the difference and allows community members to ensure that their well-being will be prioritized in their golden years. Our New York elder law attorneys have worked for decades on these issues. For example, it is appropriate for some residents to obtain long-term care insurance (LTCI). LTCI serves two purposes: It protects assets from the costs of elder care and it provides resources for that care. For a variety of reasons, LTCI may be out of reach for some community members. In those cases it is usually beneficial to create a Medicaid Asset Protection Trust to shelter assets while still qualifying for Medicaid benefits.

Long-term care insurance often allows residents to maximize their quality of life, because it provides resources to pay for things like at-home care. At-home care has consistently been shown to be the preferable method of aging for those given a choice. However, even with LTCI, at some point a senior may need to move into a nursing home to have access to emergency services to survive each day. Yet, when at a nursing home those with private insurance may be treated differently than those on Medicaid according to new research from the University of Rochester Medical Center. The latest study, summarized this week in McKnight's Long-Term Care News, revealed that those in nursing homes on Medicaid are sent to the hospital 27% more than those receiving private insurance.

At first researchers assumed that the difference was caused by the fact that Medicaid residents are more likely to live in nursing homes that have fewer resources. Therefore, those residents might require extra hospital care while privately insured residents would more often be treated on-site at their skilled nursing facility. However, now experts believe that the difference relates back to finances. Nursing homes are usually reimbursed less when they provide treatment to a New York Medicaid resident as opposed to one covered by private insurance. Therefore, they have a financial incentive to pass on the cost to hospitals of treating certain residents as opposed to others. The study's authors explain that this new data is important, noting that the hospitalization differences actually have "significant impact on the long-term health of residents."

See Our Related Blog Posts:

Nonprofit Innovators Try to Shift Senior Care Away From the Nursing Home

New York Long-Term Care Near the Most Expensive in the Country

Virtually all recent news stories about the New York Medicaid system include a reference to the program's troubling financial problems. This weekend Lower Hudson News explained how last year alone the state paid $53 billion on Medicaid services--the highest figure in the country. The budgetary concerns have been exacerbated as of late as demand continues to increase. There were 46,000 new enrollees in the program in the four-month stretch from April to July alone. The cost of the program is leading policymakers at all levels to propose alterations to protect its long-term viability. Most of those proposals include changing the way that payments are made, limiting those who qualify for the program, and shrinking the services available to participants.

Our New York elder law attorneys are well aware of the impact that Medicaid changes may have on many residents. Medicaid is the only option for most elderly patients who do not have insurance to pay for nursing home costs which average over $120,000 a year. Unfortunately, many families fail to plan ahead for these situations, ultimately ending up on Medicaid when they discover that a loved one is in immediate need of long-term care. On top of that, many families are forced to spend down their assets in order to qualify, because they fail to utilize a New York Medicaid Asset Protection Trust to shelter their property ahead of time.

The need to maintain personal assets may become even more important for local families as cuts to the services provided mean that residents will need to pay for supplemental care on their own. A state task force known as the Medicaid Redesign Team will apparently soon enact managed care and spending caps. The task force has reportedly saved the state over $100 million as of August through various efforts, and many more changes on the horizon. For example, one popular initiative seeks to transition some residents out of institutional care and into community-based services.

In addition to spending caps, price controls, and expanded managed-care programs, local lawmakers are also seeking to ease the Medicaid burden on county governments. Local property taxes in many areas are skyrocketing because counties are on the hook for billions of dollars in Medicaid costs with little flexibility in how that money is spent. Several state lawmakers were actually in White Plains yesterday drumming up support for a proposal which would slowly shift Medicaid costs entirely onto the state. New York Medicaid changes will likely remain a top priority for area legislators for the foreseeable future.

See Our Related Blog Posts:

Advocates Call For Tighter New York Medicaid Rule Enforcement

New York Lawmakers Discuss Possible Medicaid Changes