Posted by admin on February 11, 2018 · Leave a Comment
The Online Lending Alliance–a group of internet loansharks is circling Virginia and telling your Delegate to vote for HB 1248. Tell you Delegate to vote NO to keep the internet loansharks out.
HB 1248 will allow internet lenders with no locations in Virginia to get a license under the Virginia Consumer Finance Act. This will allow these lenders, who could be located anywhere in the world, the opportunity to get a license to make loans to Virginians.
Although this Bill makes several changes to the Consumer Finance Act in order to accommodate internet lenders, it does not make any changes to the law that allows unregulated loans over $2,500. Loans over $2,500 have no interest rate cap and no restrictions of any kind.
If this Bill passes, internet lenders will be permitted to get a license to make loans at very high interest rates. Here are some examples of internet lenders that have already been making abusive loans in Virginia :
• Money Key was making loans at 399% interest until they were stopped by the Attorney General’s Office in 2016
• CashCall was making loans at over 200% interest to 10,000 Virginia borrowers until they settled a lawsuit with the Attorney General’s Office last year
Virginia has had responsible consumer finance companies operating all over the state for 100 years. Licensing lenders with no stores in Virginia with no interest rate caps and no restrictions will likely put many of these responsible lenders out of business resulting in loss of jobs and fewer affordable loan options for Virginians.
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Posted by admin on February 10, 2018 · Leave a Comment
Q. A couple of years ago, my aunt Linda applied for a Plan F Medigap plan and the insurance company approved her. The following year, she saw a specialist about some hip problems she was experiencing, went for an MRI, and ended up needing hip replacement surgery. Medicare paid 80% of the cost of her visit to the specialist, the MRI, and the surgery. Plan F covered the other 20% owed under Part B, so Linda owed nothing!
Following the surgery, Linda spent a couple of days in the hospital, and then she had a home health care nurse come out to her home several times.
The total cost for Linda’s surgery, hospital stay and follow-up care was $70,000. Medicare paid its share of the bills and sent the remainder of about $14,000 to Linda’s supplemental insurance carrier. The carrier paid the entire bill, and Linda owed absolutely nothing for any of these Part A and Part B services. Her only out of pocket expenses were for some medications. This was all because of her Medicare Plan F!
My question is: I am eligible for Medicare this year. I thought I knew what I needed to know based on my aunt’s experience, and was going to follow in her footsteps and opt for Plan F as a supplemental plan. But, I read that Plan F and another popular plan are being taken away. What is the timeline for this, why is it happening, and what actions can I take at this time?
Thanks so much for your help!
—
A. Just when you think you finally understand Medicare and what coverage is best for you, they change it!
For decades, people on Medicare have had the option to supplement their Medicare benefits with Medigap coverage, also known as Medicare supplement coverage. And, as you can imagine, the most popular supplement plan for many years has been Plan F, the plan your aunt was on when she had her hip surgery.
The reason Plan F is so popular is precisely because of situations similar to what happened to your aunt. It takes care of all the gaps in Medicare, while leaving you with $0 out of pocket. This kind of certainty helps make planning for your healthcare spending easy to predict.
Plan F Is Being Eliminated
Sadly, all good things must come to an end. As part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), Congress is eliminating Medigap plans that cover the Part B deductible, including Plan F and Plan C, effective in 2020. Another change is that Medicare premiums for higher income individuals will also be increasing. On a positive note, if this affects you, you have time to plan ahead to minimize the financial impact.
Why is Congress eliminating Plan F?
Medigap Plan F is the most popular of all supplement plans. Plan C is similar but doesn’t cover Medicare excess charges, so it is less popular. So, why is Congress eliminating these plans?
Some legislators fear that Plan F and Plan C policyholders visit their healthcare providers more often than someone who pays their own deductible. In other words, they worry that anyone with Part B deductible coverage will run to the doctor for every sneeze or paper cut. Conversely, if you were responsible for paying your own Part B deductible, then you might think twice about visiting your doctor for minor things, such as a cold.
But, will it cost more in the long run? Critics say that eliminating Plan F might cause some people to forego care, resulting in more expensive care later on. There could be health conditions that don’t get diagnosed early enough and end up costing Medicare big bucks down the road. While that may be true, it didn’t stop Congress from eliminating these plans in the next couple of years.
Good news: This change will only affect NEW Plan F Enrollees
Fortunately, these changes only affect new enrollees after January 1, 2020, so people currently on Plan F will be able to keep that plan in 2020 and beyond!
· Grandfathering will occur for current plan holders: While Medigap plans with deductibles are going away, enrollees with this coverage will be grandfathered in.
· Premiums will rise: Over time, you can probably expect Plan F premiums to slowly rise, since the total number of people enrolled will be shrinking each year.
· Enroll now: If you want this coverage, enroll in Plan F or C prior to 2020 so that you can then keep your policy.
· Consider alternatives: If you can handle a small Part B deductible, options such as Plan G and Plan N offer significantly lower premiums today and will also still be around after 2020. It’s still great coverage and you won’t find yourself stuck in an obsolete Medigap plan that might have rising costs over time.
Remember, selecting the right coverage now can help you attain rate stability down the road.
Higher Medicare premiums are coming for higher incomes.
The elimination of Medigap plans covering the Part B deductible is just one way that MACRA might affect you. The legislation also adjusts the income thresholds for Medicare Part B premiums beginning this year.
· Higher-income beneficiaries: This will largely affect higher-income beneficiaries, who will pay more for their Part B and D than they do now. Many in this group already pay higher premiums, and the MACRA legislation will increase those premiums further for individuals earning over $133,500 ($267,000 for married couples).
· A big increase for some: While this change affects only a small percentage of the Medicare population, the Kaiser Family Foundation reports that premiums for this group will be as much as 80% higher than the Part B base premium.
· If you’re affected, plan now: If you fall into this category, your health insurance costs in retirement may be higher than expected. Working out your estimated costs now will help you better plan for when you can retire.
If you are retired or about to retire, and are part of the estimated 2.9 million individuals who will pay income-related premium adjustments, it’s a wise idea to sit down with an experienced financial planner, such as myself, to discuss how you will handle these changes.
Medicare Doesn’t Pay One Penny for Long-Term Care
Regardless of the changes described, the fact remains that Medicare does not pay one penny, ever, for long-term care (often called custodial care) —which involves help with activities of daily living such as bathing, dressing, and using the bathroom; nor does Medicare pay for supervision needed by those suffering from dementia. And this is not changing. You can read more about this in our Critter Corner article, “Does Medicare Not Care about Long-Term Care?”
This means that, regardless of what is happening with Medigap policies in the future, it is wise to plan ahead for the catastrophic cost of long-term care ($10,000 – $14,000 a month in the DC Metro area)!
If you have not done Long-Term Care Planning, Incapacity Planning, or Estate Planning, or if you have a loved one who is nearing the need for long-term care or already receiving long- term care, please contact us to make an appointment for a no-cost introductory consultation.
Fairfax Elder Law: 703-691-1888
Fredericksburg Elder Law: 540-479-1435
Rockville Elder Law: 301-519-8041
DC Elder Law: 202-587-2797
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Posted by admin on February 10, 2018 · Leave a Comment
Dear Angel,
My mom is eligible for Medicare this year and is exploring her options. She is not sure whether to get a supplemental plan, or if original Medicare is enough. What are your thoughts on this?
Thanks,
Iz Ittanuff
—
Dear Iz,
Most people on Medicare feel that original Medicare is not sufficient, and have some source of coverage that supplements Medicare.
Original Medicare has been around for over 50 years and is run by the federal government. Part A and Part B make up the core of original Medicare, and cover the following:
•Part A Deductibles and Copays: In 2018, if you are admitted as an inpatient to the hospital, you will pay a deductible of $1,340 per benefit period. This deductible covers your inpatient hospitalization for the first 60 days. For days 61-90 you would be responsible for a $335 per day. If you need to stay in the hospital for longer than 90 days you can tap into your “Lifetime Reserve Days.” These days can only be used once in your lifetime, and once they are gone, you cannot use them again. While you are using your Lifetime Reserve Days you would be responsible for a co-pay of $670 per day. If hospitalized longer than 150 days, you are responsible for all costs.
Medicare Part A covers short-term skilled nursing care and rehabilitation. This is when you need round the clock medical attention to recover from an illness or injury. Skilled nursing facility stays are covered 100 percent by Medicare for the first 20 days, provided that you have been admitted to the hospital, as an inpatient, for a minimum of 3 days (actually 3 midnights). Once you’ve stayed in a skilled nursing facility for more than 20 days, you are responsible for a copay of $167.50 for days 21-100. You pay all costs if you are in a skilled nursing facility over 100 days. Medicare does not cover long-term care or any type of nursing home costs beyond the 100-day period.
•Part B Deductibles and Copays: In 2018, the Part B annual deductible is $183 and most beneficiaries pay a monthly Part B premium of $134. You may have to pay more if your income is above a certain threshold. Once you meet your deductible, you will pay a co-pay of approximately 20 percent for most of your medical expenses. There are some preventive services that are free and not subject to the Part B deductible.
Part A and Part B are not enough
Part A and Part B cost-sharing can really add up, especially when you consider what Medicare doesn’t cover (including eye exams, hearing evaluations, dental care, routine foot care, and more). And, original Medicare has no cap on out-of-pocket spending. So, it’s definitely not enough for most seniors!
Make sure you do your homework and explore all your options when selecting the Medicare supplemental plan that is right for you. See Medicare.gov for details and helpful tips. And see today’s other article for important information about supplemental plans that are going away in the next couple of years.
Hope this is helpful,
Angel
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Posted by admin on February 8, 2018 · Leave a Comment
Joseph and Carol are in their 80’s and are retired. Recently, their daughter Karen moved in after a tough divorce that left her broke. One of the reasons Karen’s husband left was because of her spending habits. Shortly after moving in with her parents, Karen began making bank withdrawals of money she didn’t intend to repay from her parent’s account without their knowledge, leaving them with thousands less in their savings. The withdrawals took place over a series of months, but the bank never reported them! If they had and action was taken sooner, the couple’s debt could have been less devastating.
What occurred in our example is a form of what’s known as financial exploitation. Financial exploitation occurs when a person misuses or takes the assets of a vulnerable adult for his/her own personal benefit. This frequently occurs without the knowledge or consent of a senior or disabled adult, depriving him or her of vital financial resources for his or her personal needs.
Common Forms of Financial Exploitation
Are you or a loved one a victim of financial exploitation? These are some of the most commonly reported forms that you should be aware of, as reported to Adult Protective Services agencies:
- Theft: involves assets taken without knowledge, consent or authorization; may include taking of cash, valuables, medications other personal property.
- Fraud: involves acts of dishonesty, often by persons entrusted to manage assets. who misappropriate assets for unintended uses; may include falsification of records, forgeries, unauthorized check-writing, and Ponzi-type financial schemes.
- Real Estate: involves unauthorized sales, transfers or changes to property title(s); may include unauthorized or invalid changes to estate documents.
- Contractor: includes building contractors or handymen who receive payment(s) for building repairs, but fail to initiate or complete the project; may include invalid liens by contractors.
- Lottery scams: involves payments (or transfer of funds) to collect unclaimed property or “prizes” from fake lotteries and sweepstakes.
- Electronic: includes “phishing” e-mail messages to trick persons into unwittingly surrendering bank passwords; may include faxes, wire transfers, telephonic communications.
- Mortgage: includes financial products which are unaffordable or out-of-compliance with regulatory requirements; may include loans issued against property by unauthorized parties.
- Investment: includes investments made without knowledge or consent; may include high-fee funds (front or back-loaded) or excessive trading activity to generate commissions for financial advisors.
- Insurance: involves sales of inappropriate products, such as a thirty-year annuity for a very elderly person; may include unauthorized trading of life insurance policies.
What’s Being Done to Stop Financial Exploitation?
The Senior $afe Act, a bipartisan bill with the goal of helping to protect older adults from financial exploitation and fraud, unanimously passed in the House of Representatives on Monday and is expected to be considered by the full Senate soon.
The Senior $afe Act would protect banks, credit unions, investment advisers, broker-dealers, insurance companies and insurance agencies from being sued for reporting suspected exploitation or fraud as long as they have trained their employees about how to identify the warning signs of common scams and make reports in good faith to the proper authorities. So, in our example above, the bank may have been more likely to report the financial abuse.
The bill has 26 co-sponsors in the Senate — Republicans, Democrats and an independent — and has been endorsed by the AARP and several financial, credit union, and banking-related organizations. We will keep you up to date on the status of the bill!
The federal government, states, commonwealths, territories and the District of Columbia currently all have laws designed to protect older adults from elder abuse and exploitation, and guide the practice of adult protective services agencies, law enforcement agencies, and others. These laws vary considerably from state to state. Visit the US Department of Justice website for details.
Additional Resources to Help
Know someone who is a victim of financial exploitation? Here are some resources to protect yourself or a loved one:
Tips from Virginia Department of Aging and Rehabilitative Services
Virginia Adult Protective Services
Maryland Adult Protective Services
DC Adult Protective Services
National Adult Protective Services Association
Elder Financial Exploitation and Response Network Guide
Federal Trade Commission- Spotting Elder Financial Abuse
For more resources about elder abuse prevention, check out the federal government’s Eldercare locator.
Planning to Protect Loved Ones
Protecting seniors from financial exploitation is very important, which is why we continually share information on the topic. It is also very important to plan for your future and for your loved ones. If you have not done Incapacity Planning, Estate Planning, or Long-Term Care Planning, or if you have a loved one who is nearing the need for long-term care or already receiving long- term care, please contact us to make an appointment for a no-cost introductory consultation.
Fairfax Elder Law: 703-691-1888
Fredericksburg Elder Law: 540-479-1435
Rockville Elder Law: 301-519-8041
DC Elder Law: 202-587-2797
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Posted by admin on February 6, 2018 · Leave a Comment
Ever get a sign from a deceased loved one or felt the person’s presence — perhaps a through a familiar scent, a tactile sensation, or the lights flickering at just the right moment? These feelings of contact can certainly be a comforting presence, and are more common than you might think.
After-Death Communication (ADC) is the clinical term for a visit from a deceased loved one. 1 in 3 people experience ADCs, with 75 percent of those experiences occurring in the year after a loved one dies. ADCs take a wide range of forms, as described in a recent Next Avenue article.
I also encourage you to read some or all of the books on my spiritual book list. If you have very limited time, start with either one of the first two listed.
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Posted by admin on February 6, 2018 · Leave a Comment
Keeping families together by helping relative foster families become legal guardians
When a child is placed in foster care by the court, sometimes a relative is approved to become the foster parent of the child. After the child has been placed in this relative foster home, in some circumstances—if the court determines that the child can never be returned to the parent, and the child cannot be adopted—it’s possible for that child to either stay in foster care with the relative foster family, OR for the relative foster parent(s) to become the child’s permanent legal guardian(s).
For these children, almost always teenagers, the opportunity to have a permanent family can become a reality. But many relatives, though they may wish to become the child’s permanent guardian, may hesitate to do so due to the costs. Relatives may have children of their own whose needs they are responsible or maybe their grandparents are on a fixed income.
Kinship Guardian Assistance Program (KinGAP) would allow those relative foster families to receive some funds to help support their relative child when the child leaves foster care and they become their legal guardian. They may need assistance to pay for a larger apartment, for bedroom furniture, or other costs.
Unlike in foster care, the relative family would not be entitled to receive the monthly foster care maintenance payment. They may receive an amount for fixed costs (such as furniture), or a monthly payment to cover ongoing expenses–which may change over time–but never more than what foster care payments would have been.
Kinship guardians provide one of the best opportunities for children to thrive when their parents are unable to care for them. In 2016, 71,000 kids in Virginia lived in the care of grandparents. That’s 4% of Virginia kids. An additional 55,000 live in kinship care with other relatives: 3% of Virginia kids. While fewer than 20 of these families would qualify for KinGAP, it’s a start.
Who is eligible?
Only a few kinship families would actually qualify for KinGAP payments under federal law.
● In order for a family to be eligible for KinGAP, the child must be related by blood, marriage, or adoption to the foster parent, have been placed with the relative in foster care for 6 months, and the options of reunification with the birth family or adoption must have been ruled out by the court. The relative must demonstrate a commitment to permanently care for the child.
● While there are many families who take in relative children, ONLY those children who were first in foster care placement with the kinship guardian, and who cannot be adopted, would be eligible. Children who come to live with relatives through other pathways would not be.
How is KinGAP funded?
Title IV-e of the federal Social Security Act provides approximately 50% of the funding for KinGAP for each child eligible. As in adoption and foster care, the additional funding is the responsibility of the state or locality.
How can we afford KinGAP?
Without KinGAP, the state is likely to continue to be responsible for payments to support the child in foster care. Under KinGAP, costs will be minimized when the child becomes permanently placed with the relative.
Why does KinGAP matter?
KinGAP provides another means for children to exit the foster care system when adoption is not an option– yet still provide a permanent placement for the child.
● Through KinGAP, trauma is reduced — children will no longer wonder where they belong or if someone is going to show up at the door and move them to a new placement.
● Children maintain a relationship with family even if their parents cannot parent them.
There are three KinGAP bills pending in the General Assembly: HB1333 (Brewer); SB44 (Favola); and SB636 (Dunnavant). The House version of the bill is pending in Appropriations; the Senate bills are on the Senate floor.
KinGAP will give these foster children a permanent home with members of their own family. Contact your legislator and ask them to support KinGAP funding.
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Posted by admin on February 3, 2018 · Leave a Comment
Dear Magic,
My dad is in a nursing home, and has dementia. I visited him a lot when he first got there, but my visits have tapered off a bit. I’m not sure if he knows who I am anymore, or if there is a benefit to him if I visit. Visiting him can be emotionally draining, but I’d gladly continue going if I knew it was beneficial for him. In his current state, is he getting anything out of my visits?
Thanks,
Cee Endad
—-
Dear Cee,
A recent survey found that 42% of the public think it’s pointless to stay in contact with loved ones who have dementia, after they are unable to recognize the faces of family and friends.
Contrary to what most people think, advocates and researchers stress that family and friends SHOULD stay active in the lives of their loved ones with Alzheimer’s or other forms of dementia. This is because, although it seems they may not recognize you, studies show that there is a strong emotional memory and long lasting benefits from visits from loved ones. Even people with advanced dementia can still hold an emotional and energetic memory, meaning that they remember how someone made them feel, and they sense a loved one’s energy, long after they have forgotten the event that brought those feelings.
Here are the top reasons, according to Evan Farr, to continue visiting your dad even though he has advanced dementia:
- First and most importantly, love is not a memory. Love is a feeling — the most powerful feeling in the universe— and love never goes away no matter whether your dad recognizes you or can verbally express his love.
- Even if he is unable to remember your name or your relationship, he still remembers the underlying YOU — your physical and emotional and energetic presence.
- On a spiritual level, your father’s soul — his true self — will continue to recognize your soul, no matter what is happening in his physical brain. If you are not a spiritual person who believe this, I encourage you to read some or all of the books on Evan Farr’s spiritual book list. Regardless of your current religious or spiritual views, if you have ANY doubt whatsoever about the reality of the soul or eternal life, Evan encourages you to read some or all of these books. If you have very limited time, start with either one of the first two listed.
- He probably enjoys your visits even if he can not remember who you are. If he smiles at you at any time, you can be assured that your visit is making a meaningful impact.
- Opportunities to socialize and visit might put him in a better mood and help him relax.
So, I encourage you to visit your father when you can. It probably means more to him than you know!
Hop this is helpful,
Magic
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Posted by admin on February 3, 2018 · Leave a Comment
Click Here to Read Magic’s to “My Dad Doesn’t Recognize Me – Is It Still Worth Visiting?”
Q. I remember the moment like it was yesterday. My mom, who had Parkinson’s for ten years at the time, was sitting at my kitchen table. I saw how challenging it was for her to get her wheelchair from the living room into the kitchen, to chew and swallow her food, and to even speak. I had to hold back tears, as I often do when I see her struggling.
I am not a great cook, so I jokingly compared my attempt at a more complicated breakfast that day to hospital food. Although, my intent at the time was self-deprecating humor, the mention of a hospital made my mother unhappy, as she really disliked being in the hospital, and preferred to be at home. I found myself making a promise to her that no matter what, I would never put her in a nursing home.
Ten years later, my mom’s Parkinson’s is worse, and now she has Lewy Body Dementia also. She is sometimes delusional. She forgets she can’t walk, and tries to get out of bed and falls. The ambulance came last week to help me lift her off the ground after a fall. I love and care about my mom, and wish I could keep my promise to her, but maybe I can’t. Maybe nursing home care is what’s best, but then how do I cope with the guilt of breaking my promise to her?
I am sure you’ve had this conversation with others in a similar situation. Any advice you can give? This situation is incredibly stressful and overwhelmingly difficult for me. My mom’s doctors and all of her friends and my doctors and my family all say that I need to put her in a nursing home, but I just don’t know if I can do it. Thanks so much for any guidance you can provide.
—-
A. Thank you for sharing your situation and for reaching out to us. As you likely know from other situations in your life, sometimes, no matter how many promises you make, the decision is eventually taken out of your hands. We all try to do our best, but sometimes we can’t keep these types of promises, no matter how well-meaning we are.
Thinking back to a couple of generations ago, families were more likely to care for their parents at home. This was ideal because people didn’t live as long. However, today, thanks to modern medicine, those with dementia and many other chronic diseases can live many years past their diagnoses. Yes, they are living longer. But, caring for them at home becomes increasingly difficult as cognition and self-care skills worsen. Safety and health of the patient and of other family members also becomes a factor.
You seem to realize that your mother needs more care than you can provide. But, what about that promise you made to her that you won’t put her in a nursing home?
Making a Promise You Can’t Keep
As you know, your mother may get to the point of not being able to remember the promise you made her. In fact, she may have already passed that point. However, as her daughter and caregiver, you obviously won’t forget.
Oftentimes, people feel duty-bound in these situations to do what they said they would do. But at the time they made the promise, they did not have all the facts and they had no idea what they were actual signing up for. “The feeling of being unable to keep the promise adds to the stress of placing someone in a facility, says Gary Small, director of the Division of Geriatric Psychology at UCLA’s School of Medicine. “It’s always best to not make promises you can’t keep or qualify,” he said. Don’t despair, though. In your situation, if the topic comes up with your mother and if she still is able to have a meaningful conversation, you could say something like, “Look, Mom, I know you want to stay in your home, and I’ve done everything possible to make that happen all these years, but things have changed now, things that we never anticipated 10 years ago, including the fact that my own health is suffering which makes it much harder for me to take care of you at home.”
Dealing with Feelings of Guilt
Whether you made a promise to your loved one or not, guilty feelings and worry are a normal response when we’ve been caring for someone on our own and nursing home care is needed. According to AgingCare.com, if you are struggling with a decision to place your loved one in a care facility, here’s how to deal with feelings of guilt:
1. Understand that sometimes professional care is necessary for the safety or comfort of your loved one and/or for you to have some life apart from caregiving.
2. Learn to understand that you can only help them so much. Total control of events isn’t in your hands, either. Do your best, and then try to let go when appropriate.
3. Realize that you didn’t cause your loved one’s illness or illnesses. He or she would continue to suffer from them whether you were the sole caregiver or there is outside help.
4. Know that few aging parents or spouses would want their loved ones to entirely give up living any kind of life apart from their needs. Try to remember that concept when you feel guilty about hiring outside help or placing a loved one in a nursing home.
5. Remember that you will still be part of the care team. You will still be your loved one’s most important advocate. Do what you can for your loved one, and then move forward with your own life. You’ll have more to bring to all of your relationships, and that benefits everyone.
Not Putting a Loved One in a Nursing Home When Needed Can Lead to Neglect
Ironically, the promise not to put a loved one in a nursing home when needed has led to significant amounts of abuse and neglect, often unintended. You think you are doing the right thing by keeping your loved one at home, but they may actually be worse off if you aren’t equipped or able to care for them properly at home.
Elder neglect, or failure to fulfill a caregiving obligation, constitutes more than half of all reported cases of elder abuse. It can be intentional or unintentional, based on factors such as ignorance or denial that a loved one needs as much care as he or she does.
In addition, the responsibilities and demands of caregiving, which escalate as your loved one’s condition deteriorates, can also be extremely stressful. The stress of elder care can lead to mental and physical health problems that make caregivers burnt out, impatient, and more susceptible to neglecting or lashing out at the elders in their care.
The following are signs of neglect. Again, neglect is often unintentional, resulting from an overburdened or untrained caregiver.
· Dirty clothes
· Soiled diapers
· Bedsores
· Unusual weight loss
· A home that’s unusually messy — especially if it wasn’t before
· Lack of needed medical aids, such as hearing aid, cane, glasses
In addition to the signs of neglect on this list, if the elder is disabled, especially cognitively disabled, and needs help taking medication or getting dressed, it can be considered neglect if their caregiver is not providing assistance.
Closing Words of Advice from a Farr Law Firm Staff Person Who has Been There
“We all have an aversion to placing a loved one in a nursing facility. However, in the long run it will be the safest option for your mom and the most loving thing you can do for the whole family. I have personally experienced the physical exhaustion and caregiver burnout resulting from long nights and being pulled in multiple directions. In the end, I regretted who I became because I had tried to do it all myself. I didn’t have time to take care of my daughter, my house or myself. I was very resentful. Rest assured you are doing the right thing. You have multiple responsibilities; arranging for your mother’s health care and a safe place to live is not the equivalent of abandoning her.”
Planning for Nursing Home Care
When you come to terms with the fact that nursing home care is right for your mother, a big concern for most of us is the affordability of nursing home care. This is a legitimate concern, as nursing homes in the Metro DC Area cost $10,000-14,000 a month. To protect your family’s hard-earned money and assets from these catastrophic costs, there is no time like the present to begin Medicaid Asset Protection Planning. Please call us to make an appointment for a no-cost initial consultation:
Fairfax Elder Law Attorney: 703-691-1888
Fredericksburg Elder Law Attorney: 540-479-1435
Rockville Elder Law Attorney: 301-519-8041
DC Elder Law Attorney: 202-587-2797
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Posted by admin on February 1, 2018 · Leave a Comment
Maria lived in a colonial-style townhome with 14 stairs up from the basement, and 14 more to her bedroom. It was wearing on her joints to go up and down all those steps. She was also beginning to feel lonely and isolated, since most of her friends had moved out of the neighborhood. After giving it a lot of thought, she moved to a senior living community, and is much happier. She swims daily, is involved in various committees, takes art classes, and loves all of the options she is presented with. For Maria, her new living situation has truly enhanced her happiness and quality of life.
Maria was lucky to find a housing option that meets the needs of her active lifestyle. For many of us, since there is a maze of senior care options currently available, it may be more difficult to find the right fit.
You’ve probably heard various senior housing and care terms — “Senior Living,” “Independent Living”, “Assisted Living”, “Nursing Home” — but you might not be completely clear about what, exactly, they mean or how they differ from each other. Below are descriptions of different housing and care options available to seniors today. Later in this article, we will look at what’s projected for senior care and housing in the future:
In-Home Care: When it comes to in-home care, there are two different broad types of services provides: assistance with ADLs (Activities of Daily Living) and assistance with IADLs (Instrumental Activities of Daily Living). Assistance with ADLs means help with bathing, dressing, toileting, incontinence care, and transferring (moving from bed to chair and back). Assistance with IADLs includes things such as transportation and errands, light housekeeping and laundry, meal planning and preparation, and medication reminders. A newer trend is to combine hands-on care from a professional caregiver with smart home technologies. The cost of in-home care ranges from $10 an hour up to $40 an hour, with the average being $20/hr – $24/hr in the Northern Virginia and DC metro area.
Senior Living Communities: Senior living community are typically for adults 55 and older who are simply looking for a lifestyle free from the noise of children and the worries of maintaining a household. These are typically rental community, with a variety of living options, such as apartments, townhouses, cottages, and even single-family home. These communities may have a shared clubhouse, swimming pool, or golf course, but typically no additional services beyond what you would find in a typical rental community.
Independent Living Communities: Independent living typically describes senior housing for residents who are usually ages 62 or older. Independent living communities focus on active living, offering lifestyles free from the worries of home maintenance and repairs. Services and amenities may include life enrichment programs, wellness opportunities, transportation options, trash removal, maintenance, and repairs. Some communities offer additional à la carte amenities such as housekeeping, meals, concierge services and laundry. The average cost of independent living varies. In rental communities with few benefits and services, monthly rental prices may be comparable to conventional apartments. Add more services and amenities, and costs rise.
Assisted Living Communities: These communities are a popular option for adults who need a little extra help with the tasks of daily living. Seniors who choose an assisted living community are able to maintain some sense of independence in a private apartment while having around-the-clock support from nearby caregivers. The most commonly needed services in an assisted living community are medication reminders and personal care (bathing, grooming, dressing). Housekeeping, meals, laundry and life enrichment programs are also included. Some form of transportation service is usually offered. In 2018, the average cost of assisted living in the Metro DC area is around $6,000 – $8,000/mo. This is one of the highest rates in the nation and is well above the national average rate of $3,650/month.
Memory Care: Memory care refers to dementia-care programs offering specially trained caregivers and a physical environment that supports safety and success of people with Alzheimer’s or other types of memory loss. Memory care programs are typically found inside of assisted living communities, but more and more are being developed inside of skilled nursing facilities. In addition to assistance with personal care, medication management, housekeeping, and laundry, residents in a memory care residence benefit from dementia-specific features, usually including specialty dining services and life enrichment activities.
Continuing Care Retirement Communities or Life Plan Communities: A CCRC, or life plan community, is home to a full continuum of senior care. That means it’s an integrated model that usually includes independent living, assisted living, memory care inside the assisted-living portion of the community, and skilled nursing, with a pricing structure that allows discounts on a range of services for those who enter the community as independent living residents. Many CCRCs also offer home care and hospice services.
There are many downsides to CCRCs, however. Some communities require hefty entrance fees, but promise to try to care for residents even if they run out of money. Others have no entrance fees, but higher monthly fees. Some CCRCs have run into financial troubles, make them risky. Please see our blog post —Another Continuing Care Retirement Community Bites the Dust? — from last week for details on a recent situation, and links to other posts about CCRCs. Families are strongly advised to review CCRC contracts carefully, ask a lot of questions, and meet with an attorney before providing any financial information to the CCRC, and certainly before signing any contract documents.
See our article, Non-Traditional Living Options for Seniors, for other options, such as villages, co-housing, NORCs, and niche communities.
So, now we know what’s available for senior housing today. But, what does the future have in store?
The Future of Senior Housing
Significant changes are coming as we move out of the World War II generation to the baby boomer generation. “Boomers have higher expectations as consumers and a history of having those expectations met,” according to Steve Maag, Director of Residential Communities at LeadingAge, a national association dedicated to advocacy, education and research on aging.
Keeping that in mind, A Place for Mom recently made projections about the future of senior living communities and technology. Here are some significant changes they believe you’ll see by 2028 and beyond:
Boomers demanding more: Customers of the past were more likely to accept the status quo when it came to housing, and weren’t as demanding. Customers of the future will push for more. Retirement and senior living communities will have to respond to consumer demand by providing a greater variety of services that include:
- Dining options and restaurant-menu meal variety with gluten-free, vegetarian and more culturally diverse foods;
- more lifestyle and wellness programs;
- better apartment fixtures, designs, and furnishings; and
- more ways to pay.
Better Technology: Technological advances will enable seniors to live healthier, richer lives.
- Advances in telehealth will break down transportation barriers for older adults, mitigate health care costs such as emergency room visits, and help older adults remain in their homes longer.
- Senior-focused computer systems will help keep long-term care residents happy and engaged, says Tom Bang, CEO of It’s Never 2 Late, a Colorado company that’s developed a picture-based, touchscreen computer interface system and installed the intuitive technology at approximately 2,300 senior living communities in the United States.
- More advanced sensing technology will also play a part in tracking heart rates and other vital signs.
Family Caregiving will change: In the future, family members will likely be less available to provide caregiving for aging loved ones.
- More women will likely remain in the labor force longer, restricting their family caregiving roles;
- There will be a much larger childless population of older adults;
- Divorce will disrupt family support networks among middle-aged and older people.
- The decline in family caregivers will put more pressure on formal care providers.
More Cost Transparency: More and more, senior living consumers will expect to obtain pricing information online as a critical part of their search and decision process.
Boomers may move into senior housing earlier than previously: Older adult communities of the future will trend toward becoming more attractive to boomers who’ve reached their late 60s or early 70s, and want to move into senior communities while they’re still healthy enough to enjoy the amenities.
When More Care is Needed
Now, and in the future, most seniors will want to stay in their home for as long as possible. However, if a loved one cannot live independently (even with the help of technology) and he or she is showing signs that living alone is a strain, it may be time to consider other alternatives.
Whether the outcome is in-home care, assisted living, or nursing home care in the future, it is always wise to work with an experienced Elder Law Attorney such as myself. Life Care Planning and Medicaid Asset Protection is the process of protecting assets from having to be spent down in connection with entry into assisted living or nursing home care, while also helping ensure that you and your loved ones get the best possible care and maintain the highest possible quality of life, whether at home, in an assisted living facility, or in a nursing home. As always, please contact us at any time for a no-cost initial consultation:
Fairfax Elder Law Attorney: 703-691-1888
Fredericksburg Elder Law Attorney: 540-479-143
Rockville Elder Law Attorney: 301-519-8041
DC Elder Law Attorney: 202-587-2797
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