Articles Posted in NY Elder Law

Last Thursday a group of elder care advocates, seniors, and local politicians held an event to raise awareness of the possible closure of area senior centers. According to a report in Staten Island Live, the gathering was specifically called to ask Governor Cuomo to refrain from making changes to state Title XX funding. The proposed changes would essentially cut roughly $25 million from the budgets of senior centers citywide. Held on the steps of City Hall, state Senator Diane Savino led the event where more than 15,000 letters were unveiled written by seniors explaining how the cuts would affect their lives. Our New York elder law attorneys are aware of the ways that many local elders rely on various support services offered at these facilities.

The Title XX funding accounts for about a third of the total financial support provided to these centers. However, the funding is discretionary and some are proposing that it be moved over to support child welfare services. If the changes are made over a hundred senior centers will be forced to close. Lillian Barrios-Paoli, the Department for the Aging Commissioner repeatedly emphasized that the lives of thousands of seniors would be made qualitatively worse if these proposals were to advance. She explained that “this is an issue that shouldn’t even be debated.”

Others are questioning why such a proposal would even be brought forward in light of the changing demographics. As we have often reported, the elderly population is the quickest growing age group nationwide. The trends are no different in our area. Baby Boomers are now beginning to retire–a trend that will last for decades. The growing senior population means that New York elder care planning needs to be conducted now in anticipation of the needs of this population. Eliminating services to this group would seem to be a step in the wrong direction. Senator Savino commented on the pressing concerns already facing seniors by noting that “we have enough things to worry about. Take this off the table.”

The results of a new long-term care planning survey were announced this week that shed light on both the perceptions and planning of Americans. As reported in Financial Advisor, the data suggests that a growing number of residents are aware of the need to conduct long-term care planning, but a majority admit that they still fail to plan as properly as they should. Specifically, the study found that eight out of ten Americans believe that it is vital to prepare ahead of time for the assistance they might need as they age. Yet, nearly half those respondents claimed that in their own case they remain unsure how they will provide for their long-term care when they reach their golden years.

Long-term care costs are high and rising. New York elder care in particular has often been noted as one of the most expensive in the country. Many local residents seem to understand the high costs. Almost two-thirds of survey respondents in the Northwestern Mutual Life Insurance Company survey believe that long-term care costs will rise faster than their savings, and they expect costs to double in the next fourteen years. Yet, even though most community members acknowledge the cost issues, fewer than one out of three survey respondents were actually saving for their long-term care or had plans in place to ensure that they would have access to the resources they need to receive the care that they prefer. As one survey organizer summarized, “There is a clear disconnect between what Americans understand about long-term care needs and the steps they’ve taken to prepare.”

With many local residents struggling to deal with their daily short-term issues, our New York elder law attorneys understand how long-term care planning can seem like a luxury more than a necessity. Yet, it remains unwise to treat these affairs as something that can be handled down the road. Preparing for these potential costs now often results in immense financial savings later. As the survey data reveals, this is particularly true for women. Women were 25% more likely than men to have acted as a caregiver for another. Women continue to live longer than men–five years longer on average according to the Center for Disease Control and Prevention. Unlike their male partners, there is less chance that they will have a spouse to care for them at home. Therefore woman have much to gain from ensuring that plans are in place so that they can maintain their lifestyle while retired. Yet only 24% of women are saving for their future needs as compared to 32% of men.

On Wednesday Congressman Ted Deutch published an editorial in Politico advocating on behalf of a stalled federal initiative known as the Community Living Assistance Services and Supports Act (CLASS). The measure was hailed as the first federal attempt to address the nation’s long-term care crisis. All those in our area who have dealt with the complexities and expense of finding proper New York elder care are likely familiar with this crisis. CLASS was part of the high-profile Affordable Care Act that passed Congress, but CLASS was recently suspended by the President.

The Representative explained that CLASS was essentially a means by which middle class families could have a voluntary and affordable long-term care insurance option. An important part of the CLASS program that needed to be addressed was the idea of “adverse selection”–the notion that insurance would only be bought by those who already needed the care. Of course, the maximum benefit is derived only when individuals have this insurance plan in place ahead of time. The measure is currently stalled specifically because of concerns about adverse selection. Yet, many, including Representative Deutch, believe that federal officials have statutory power to implement anti-adverse-selection measures.

CLASS was pushed by those who understand the looming problem facing the long-term care system. Only five percent of Americans have long-term care insurance, even though seventy to seventy five percent of all Americans will need some form of long-term care. The gap is often replaced by federal programs, like Medicaid. The Congressman explained that the reliance on Medicaid is unsustainable at the federal level. This is in addition to the fact that qualifying for Medicaid often requires residents to spend themselves into poverty, especially when planning is absent. Fixing the problem before it gets worse was the motivation behind CLASS. The measure hopes to steer residents away from the most expensive institutionalized care to more balanced programs that encourage cost-effective and resident-focused community care. Besides the cost savings, these programs are almost always preferred by seniors, because they allow them to live at home, maximizing their freedom.

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.”

Local residents who are diagnosed with Alzheimer’s or other cognitive diseases face a series of mental, medical, and emotional challenges. Our New York elder law estate planning attorneys work with many families who have loved ones battling these disabling diseases. Unfortunately, many area residents fail to take appropriate preparatory steps before a victim’s mental capacity is lost. As a result, these families often face difficulties with inheritances and have challenges defining who is in control of legal, financial, and medical issues. Many also struggle to protect the senior’s assets from long-term care costs.

Advocates are working to raise awareness of these issues to help the thousands of local families who are forced to deal with the situation each year after a dementia diagnosis. For example, the New York Chapter of the Alzheimer’s Association began programs this week to support September’s designation as World Alzheimer’s Month. The local organization is sponsoring a variety of activities to raise money for research, support those battling the disease, and educate local families on the importance of conducting New York Alzheimer’s planning. The local advocacy group is offering care consultation services to help families who face many challenges following an Alzheimer’s diagnosis. The organization explained that “the goal is for each family to develop a better understanding of the disease, make a plan to secure needed care, and develop strategies for the best possible symptom management and communication.”

For area community members, the necessary planning usually involves a visit to a New York elder law estate planning attorney to ensure that all the legal affairs are in order. Timing is important, because victims of these diseases often lose the ability to communicate. It is vital to work through these planning issues in the earliest stages of the disease.

America is at the beginning of what many have deemed a “demographic crisis” with tens of millions of Baby Boomers nearing retirement. Older community members have many different needs than younger residents, and many areas remain unprepared to meet those needs. Our New York elder law attorneys have spent decades working with residents on an individual level to help them plan for their long-term financial and healthcare needs. However, besides individual residents creating their own elder care plans, many advocates understand that preparation also needs to be conducted at the societal level to account for the changing character of the community.

This week Big Think explained a new World Health Organization initiative to encourage “age-friendly” urban zones that better integrate seniors into community life. New York City was spurred by the call and recently launched an effort known as the Age-Friendly NYC Initiative. In fact, the first “Aging Improving District” opened this month in Harlem. These districts are intended to complement traditional Business Improvement Districts and tap into the community resources of aging citizens. Advocates explain that the goal is to change the current impression of seniors as an economic burden on government into one where seniors are considered an economic asset that can contribute to a more vibrant society.

The initiative’s proponents explain that “the aging of America is a deep structural problem that requires big-picture thinking from social innovators.” Proper integration of seniors into community life requires consideration about all aspects of life, from transportation to housing. For example, in Harlem’s new Aging Improvement District, local businesses are changing shelving and signage, libraries are changing their hours, and other adaptations are being made all with an eye toward the needs of seniors. Much attention is also being given to a new housing option known as “MedCottage.” These are modular homes for the elderly that can be hooked up to the home of a younger caregiver–often an adult child. It is hoped that new ways to care for seniors at home will reduce the strain on medical facilities.

Caring for elderly parents is a challenge for many area families. Our New York elder law estate planning lawyers understand the complex mix of issues faced by seniors who need help with day-to-day activities but want to keep their independence. Adult children often struggle to strike the right balance between helping out and allowing a loved one to maintain their preferred lifestyle.

This morning Time’s “Moneyland” blog shared tips for families navigating this time in life. The author is currently helping his mother deal with dementia. He notes that preparation is essential. The problems associated with aging do not come instantaneously; most seniors only gradually need help with certain activities. It is helpful to plan for future aid at the first signs of struggle. Proper preparation includes a variety of things like ensuring wills or trusts are drafted, learning about your parent’s financial situation, obtaining lists of important password information, and similar tasks. Handling these estate planning issues while parents are still relatively healthy may save a lot of trouble down the road.

Families with multiple siblings must ensure that specific roles are defined and the workload is shared. It is not uncommon for one adult child to feel like they are doing all the work in caring for a parent. Harmony is most likely to reign when each individual contributes in a way that matches their strengths. One child may be good at doing routine chores around the house while another may be best at handling medical and legal issues. Fewer disputes arise when responsibilities are identified ahead of time.

Designating a Health Care Proxy is a vital part of a New York elder law estate plan. Earlier this month The New Old Age, the New York Times blog, discussed efforts by one local family to enact legislation to offer an “enhanced” Health Care Proxy to aid those who are taking care of elder loved ones.

The effort is being spearheaded by a New York nurse who is helping to care for her 91-year old mother. As the woman discovered, without proper legal documentation it is often difficult for concerned family members to act as a health care advocate and decision-maker for their older relatives. For example, the woman got the idea for a change in the law after having trouble dealing with her mother’s mail-order pharmacy company. The pharmacy had sent a different color pill than normal, and the daughter wanted to check that the change was intentional. However, the company would not answer even basic questions without the consent of the woman’s mother, because laws protecting patient privacy are strict.

The woman’s mother suffers from Parkinson’s disease, is hard of hearing, and talks slowly. However, she remains mentally sharp and is not legally incapacitated. Family members often have difficulty assisting older adults with financial and health case decisions unless the individual is officially deemed incapacitated. As the nurse leading the lobbying effort explained, “Family members and others should be able to help frail seniors or younger people navigate the health care system without abandoning them to its complexities or taking over as guardians.”

The enhanced proxy would allow seniors to designate someone–such as a family member, friend, or doctor–to help with health care decisions at any time. The senior would retain ultimate control and would have the power to revoke at any time.
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An unavoidable statistical reality is that area women may be much more affected by New York elder law and estate planning issues than men. Demographics and life patterns are at the heart of the explanation. Women have a longer life expectancy and more often marry older companions. This explains how of all Americans over 65 years of age, 42% of women but only 14% of men are widowed. On top of that, women still have lower average lifetime earnings.

Those characteristics have profound effects on the lives of many women in our area. As explained Thursday in a newly published Forbes article, women are much more likely than men to face compromised living situations following retirement. However, those who have taken time to conduct proper New York estate planning have a better chance at avoiding major decreases in living standards in their later years.

Many ways exist for a surviving spouse to maximize their financial protection, no matter what their future holds. In fact, the tools to plan for the future are frequently in flux.

For example, federal estate tax changes enacted late last year offer new opportunities and risks for spouses to ensure their assets are protected and preserved in as efficient a way possible. For one, starting this year there are new rules for the amount of unused estate tax exclusion a surviving spouse can add to their own. This “portability” option may double the amount of money that a spouse can pass on to heirs untaxed. However, the portability does not automatically occur. Without proper planning, some spouses may fail to take advantage.
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Opening up a joint bank account is one of the first things that some area seniors and their loved ones consider when they begin seriously analyzing their need to conduct New York estate planning. Providing a child or other trusted relative access to one’s finances is often the easiest way for a potential victim of elderly financial exploitation to provide an extra set of eyes on their finances. With many unscrupulous individuals willing to prey on vulnerable community members for their own financial advantage, some protection is better than none.

However, as was discussed in a March New York Times blog post, the joint bank account option is typically a dangerous and inadequate means of protecting a senior family members assets.

The joint bank account can create problems for both the senior and the co-signer. If for some reason the co-signer has financial problems, that individual’s creditors may be able to go after the senior’s account, regardless of the elder member’s connection to those debts. These accounts also include a right of survivorship, which entitles the family member who joins in the account to retain the proceeds following the older family member’s death. The potential for complicated family disagreements around that issue are clear and should be avoided.

Fortunately much more comprehensive, tailored, and effective means of protecting and preparing an estate are available. For example, a New York elder law attorney would be able to explain that a more logical solution may be for a family to create a durable power of attorney. This legal instrument often provides more balance to fill the needs of an aging senior–this option comes with both rights and responsibilities for the family members involved.
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