Articles Tagged with manhattan elder law

Aging comes with a wide variety of issues and relying on the care of your family is not a resource available to all. Whether it is due to lack of accessibility, estranged familial relationships, or advanced care requirements, many elderly find themselves alone in their older age.

This is not a phenomenon specific to America, it is an issue experienced by countries across the world. Certain cultures are more focused on caring for their elders, much like those elders helped raise them, while others have a less integrated idea of family including care for their elders.

In fact, the issue of elderly abandonment was such a large problem in Japan it was deemed “granny dumping”. While this practice, where senile senior citizens were taken up to the top of mountains and left there by loved ones due to the inability to care for them, is a very old practice, the modern version of abandonment is once against becoming a problem. Today, elderly individuals are being taken to local hospitals, churches and charities, and being left like they used to in the mountains.

The cost of living continues to grow every year, making it difficult for those who have saved for the future, but did not anticipate how dramatically their expenses would increase. Several of our previous posts have noted the concern that have been raised regarding our nation’s ability to cover the costs of our aging adults through Social Security, Medicare and Medicaid, however a recently released study by the Joint Center for Housing Studies at Harvard University further confirms those notions. The study found that there the current generation that has retired or is coming upon retirement is facing greater financial trouble, leading to a lack of accessible and adequate housing, a problem for a population that will double in size.

There are specific elements of housing that need to be considered for the aging population, including accessibility to entrances either by ramp or walk up, single floor housing, whether that is in an apartment or a home, as well as wider entrances and doorways and walk in bathroom units, that are compatible with the size of wheelchairs and healthcare devices. However, according to the Center, only 3.5% of homes right now currently adhere to these elements of architectural design that are critical to elders staying in their homes. While a simple fix that many may propose would be to renovate the home in order to make it accessible, these types of renovations cost thousands of dollars that many elderly individuals cannot allocate out of their budget.

In an effort to maintain their housing situation, some elderly individuals have decided to cut back on transportation, refilling medicine that may be critical to maintain their health, as well as cutting back on buying food. All of these consequences lead elders to seclude themselves, which can further exacerbate health problems. Up to 95% of informal care for elders being taken on by family members, thus, it is important for elders to continue to maintain those relationships and for family members to be able to access their elderly family member and provide assistance in a safe environment.

Recently, in Ocean County, New Jersey, a well known elder law attorney was arrested and charged with stealing money from his clients. The attorney, considered an older adult himself, is charged with stealing over 1.2 million dollars over the course of five years from a number of elderly clients he served. A court order allowed officials to freeze the firm’s numerous bank accounts, seize billings records, and a number of other records implicating his crimes.

This attorney had a particular target on the elder population, however, he did not discriminate who he took money from when it came to clients. Notably, the attorney stole hundreds of thousands of dollars from clients suffering from dementia, clients who had elected him power of attorney (or so he had claimed) which allowed him to write checks from their accounts, depositing annuities proceeds into his account instead of the client, and misfiling legal fees. His behavior did not go unnoticed by some family members of clients, and when confronted, he claimed there were administrators errors and would issue repayments.

Important Questions to Ask Your Elder Law Attorney

2017 Projected Increases

Those individuals receiving social security benefits can expect another disappointing increase in their benefits in 2017. While this increase is another record low over the past five years, some view it as a win since social security beneficiaries failed to see any increase in their benefits in 2016, although costs of living continued to rise. The projected increase, coming at .3%, or $4 a month, was assessed by the federal government in response to adjusted costs of living.

How this Affects Elders

Special needs trust are a type of trust by which the beneficiary is provided for through the trust income, but has no control over the distributions of the trust. Generally, special needs, or supplemental needs trusts, have been used to provide for those loved ones with disabilities or who are unable to care for themselves any longer.

Once a special needs trust is established, family or a loved one can put the assets in the trust for the benefit of the beneficiary in order to provide them with any number of resources they feel the beneficiary deserves. The trust funds can be used to compensate for additional medical bills not fully covered by insurance, for personal leisure, travel, or anything the grantor feels the beneficiary may want or benefit from.

Eligibility for Benefits & Being a Beneficiary

There are many factors that go into maintaining a budget in a family while also trying to save for the future. For Americans, the cost of maintaining a household has gotten continuously more expensive; the average cost of raising a child born in 2013 now costs roughly $245,000 for a middle income family in the United States, with housing for the child accounting for about 30% of those costs. This is compared to a study done in 1960 by the United States Department of Agriculture that stated middle income families could expect the average cost of raising a child to be a little more than $25,000 until age 18. Interestingly in both studies, housing accounted for the largest expense for the families surveyed. The children once focused on in these 1960s studies have now become the focus of our article, and one thing remains the same, housing is still the biggest expense they must account for.

As the aging population refocuses their priorities for housing, they must consider factors such as accessibility to stores, services, transportation, medical care if they experience chronic conditions, as well as access to social settings and connections. The worry of many aging people is that they will be forced to leave their home and instead reside in an assisted living or nursing home in order to retain government assistance with healthcare. There will also need to be a refocus on the ability to provide for a more diverse population of elderly people; with the thousands of individuals turning 65 years old daily over the next two decades will come a much more diverse population that has had drastically different housing situations.

Possible Solutions

While most of us know that the baby boomer population is vast, many do not realize the impact this population will have as they start to retire over the next few decades. In fact, over the next 20 years, 10,000 baby boomers will turn 65 everyday. Between 65-70 years old has been the age of retirement for many, with some retiring early and some pushing through another decade of work. However, as this generation gets older, their need for care will continue to grow.

Federal Level

In late June, the Supreme Court decided not to hear Home Care Association of America v. Weil, a case that was attempting to deprive home care workers of their ability to qualify for minimum wage and additionally, for overtime pay for those hours worked over 40 per week. These home care workers have been part of the ‘Fight for 15’ movement to get equal pay and higher pay for minimum wage. Home care workers have previously been labeled by the Labor Department as ‘companions,’ which does not allow them to qualify as employees who are subject to minimum wage and overtime pay. The rules governing home care workers were not fixed until this past year, when the Labor Department determined that home care employers needed to follow the same rules as any other employer and pay their employees according to minimum wage standards.

In 1999, the United States Supreme Court ruled in Olmstead v. L.C. that, consistent with the Americans with Disabilities Act, individuals with mental disabilities have a right to live within their community as opposed to an institution, if professionals have determined that the patient’s ability to adapt and live in their community is appropriate, the patient can be reasonably accommodated and the move to community living offers a less restrictive setting. Following this ruling, President Clinton then directed all states to evaluate individuals in mental hospitals, as well as nursing homes and state institutions to determine whether they could too be acclimated back into their communities. Due not only to the major expenses facing Medicaid and maintaining nursing homes, this was thought to be a possible solution to overcrowding and retaining civil rights for those affected individuals.

However, in the decade and a half since the Supreme Court ruling and the President’s policy statement, the government has done little comparatively to remedy the problem. This has resulted in too many disabled and handicapped people remaining in institutions against their will and left without a method of recourse. While the federal government can control state spending for nursing homes and how Medicaid is spent, the community based care programs that so many disabled and handicapped people are seeking care from are optional.

Yet, Medicaid only pays for about 40% of all long term care services, thus, major bills are still piling up on patients, and in states such as South Dakota, the state with the highest percentage of individuals in nursing homes that have a low need or no need at all the services provided for the institution, they are forced to remain in the institution to receive any kind of care. With over 1.4 million individuals in nursing homes throughout the United States, some states are taking active steps to address the issue by allocating a portion of Medicaid funds to in-home care.

FURTHER INVESTIGATION INTO NEW YORK NURSING HOMES

Nurses are often on the frontline of dealing with issues of elder law, with their often compassionate personal sacrifices, mixed with their almost always professional approach to the care and treatment of their patients in any number of nursing homes across the state.  They deal with some of the most intimate, personal and human experiences up front and personal.  The vast majority of nurses across the state that work in nursing homes and with the elderly (as well as in other fields and venues) are quiet professionals who are content to simply do their job and move one in life.  

New York, however, is one of only a handful of states that has lax licensing regulations and enforcement.  New York’s nursing licensure schema requires nurses to self report any criminal convictions and may take years before it actually disciplines a nurse for egregious conduct.  Currently the New York state Department of Education, Office of Professions sets the rules and regulations for nurses and issues nursing licenses in the state.  This blog explored a well reported ProPublica investigation into nursing home abuse almost three months ago.  Following the extensive investigative journalism piece, the federal government opened its own investigation on several different levels.  

GROWING NEED

More ten million elderly Americans rely exclusively on their Social Security pension as their sole means of support. Approximately 90 percent of senior citizens receive some sort of income from Social Security and approximately half of those relied on Social Security for at least half of their monthly income. It keeps approximately 35 percent of elderly Americans from dipping below the federal poverty line. To say that Social Security is vital to this population is an understatement. Included within that population are a subset of individuals who do not directly receive their income from the Social Security Administration but instead rely on a representative payee to manage their money and pay their bills.

The incidence of Alzheimer’s disease and other related cognitive impairments increases with age and with people living longer, there will naturally be an increase in such conditions and thus a greater need for more Social Security representative payees. The Social Security Administration’s own Inspector General estimated in 2010 that at least one million elderly Americans over the age of 85 need a representative payee but did not have one. Within this group there is concern that there are de facto representative payee who were not formally approved or vetted by the Social Security Administration and could be perpetuating financial abuse of the beneficiary. Of the existing pool of representative payees, approximately three out of four are family members.

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