Critter Corner: Want to lower your risk for Alzheimer’s? Babysit your grandkids!

Dear Commander Bun Bun,

I take care of my 3 year old grandson, Jake, every day, and boy does he keep me moving. I read somewhere that spending time with grandchildren can help stave off Alzheimer’s. Have you heard anything about this?

B.Z. Nanna


Dear B.Z.,

Grandchildren keep seniors joyful and active. And you are right. A recent study shows that spending time with them may actually prevent Alzheimer’s disease!

In a recent study, researchers from the Women’s Health Aging Project in Australia observed the cognitive function of over 180 women who cared for grandchildren. The results showed that postmenopausal women who spend one day a week caring for their grandchildren may have a lower risk of developing Alzheimer’s and other cognitive disorders.

This is the first study to examine the role of grandparenting on cognition. While the reason for the correlation is not clear, it is thought that regular social interaction can have a positive effect on the mental health of seniors. Caring for grandchildren can also help to prevent the social isolation that can cause depression, and even an earlier death.

In addition to preventing Alzheimer’s and avoiding social isolation, other research suggests that a strong grandchild and grandparent bond has anti-depressive benefits for both seniors and children. A study from the Institute on Aging at Boston College observed the habits of 376 grandparents and 340 children for 19 years. They found that “the closer the relationship between the two, the less likely either were to develop depression and that grandparents who both gave and received support had the fewest symptoms of depression.”

Check out this video from CBS morning news for more details!

Hop you and your grandson are having a great day!

Commander Bun Bun

Have a Piece of Cake. . .

It’s Medicaid’s 50th Birthday!

Q.  My son, Sam, turns 50 this year. Besides his birth, I know that something else significant happened in 1965 — President Lyndon Johnson signed Medicaid into law. I know you help people apply for Medicaid to protect their hard-earned assets from the catastrophic costs of long-term care, so I thought you would be the right person to ask. With all the budget cuts, is it likely that Medicaid will be around for another 50 years (and hopefully even longer than that)? Thanks!

A. In 1965, President Johnson addressed a joint session of Congress asking that we honor a basic commitment to our seniors. He asked that the later years of their lives not be filled with “despondency and drift, or fear of financial hardship in the event of illness,” but rather with “security and dignity.” His words were followed that year by the signing of Medicaid (and Social Security and Medicare) into law.

Fifty years later, we’re a stronger country because nearly 70 million Americans (6 million seniors) are covered by Medicaid. Since its passage in 1965, Medicaid has become the nation’s main source of coverage and financing of long-term care services for the middle class — both the elderly middle class  and individuals with disabilities at all income levels.  Medicaid plays many different roles in our healthcare system and was recently expanded significantly as a base of health care coverage for low-income persons under the Affordable Care Act.  But it is vitally important to understand that the type of Medicaid that covers long-term care is NOT a program for those with low income, but rather is available to cover the vast majority of middle class Americans — so long as the Medicaid applicant’s income is below the cost of private nursing home care.

A Sampling of Medicaid History

Watch this video for a more in-depth look at Medicaid’s first 50 years.

1965: President Johnson signs H.R. 6675 (Public Law 89-97) to establish Medicare and Medicaid. Medicaid (Title 19 of the Social Security Act) becomes a federal-state partnership program, in which voluntarily participating states receive grants for eligible residents to access a defined set of medical and long-term care benefits.

1971: States are given the option to cover both services in intermediate care facilities (ICFs) for the elderly and individuals with disabilities with lower level of care needs than those available in skilled nursing facilities and to cover services in facilities for individuals with mental retardation (MR).

1972: President Nixon signs the Social Security Amendments of 1972 (Public Law 92-603), which establishes the Supplemental Security Income (SSI) program for individuals with disabilities.

1981: Joe Califano, Secretary of the Department of Health, Education and Welfare, creates the Health Care Financing Administration (HCFA) to administer both the Medicare and Medicaid programs.

1982: Arizona becomes the last state in the country to start participating in Medicaid. The Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA, Public Law 97-248) expands states’ abilities to impose nominal cost-sharing on certain Medicaid beneficiaries and services.

1987: The Medicare and Medicaid Patient and Program Protection Act of 1987 (Public Law 100-93) is signed into law with the goal of improving antifraud efforts and strengthening beneficiary protection programs.

1993: The Omnibus Budget Reconciliation Act of 1993 (OBRA 93, Public Law 103-66) lays the groundwork for allowing Medicaid asset protection for he middle class through use of an “income-only trust,” which later forms the basis for my proprietary Living Trust Plus(TM) Asset Protection Trust.

1996: The Personal Responsibility and Work Opportunity Act of 1996 (PRWORA, Public Law 104-193) develops the Temporary Assistance for Needy Families (TANF) block grant to states, ending the formal linkage between cash assistance (welfare) and Medicaid eligibility.

1999: The U.S. Supreme Court rules in Olmstead v. L.C. (527 U.S. 581) that the Americans with Disabilities Act (ADA) can, under certain circumstances, require states to provide community-based services to individuals for whom institutional care is inappropriate.

2001: Secretary of Health and Human Services, Tommy Thompson, renames HCFA to The Centers for Medicare Medicaid Services (CMS).

2003: The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108-173) establishes a new Medicare Part D prescription drug program.

2010: President Obama signs into law The Patient Protection and Affordable Care Act of 2010 (ACA, PL 111-148) to reform the country’s health care system and extend health coverage to uninsured individuals across the country.

2014: Coverage becomes effective for millions of those who have enrolled through the new Marketplaces and who have become newly eligible through Medicaid expansion.

2015: By January 2015, a total of 28 states and DC had adopted Medicaid expansion. Medicaid now covers 69 million people nationally and enrollment has grown by ten million from the period leading up to year 1 of open enrollment to the following open enrollment period.

Medicaid Today

Over the last five decades, both Congress and the states have expanded and reformed Medicaid significantly to more effectively cover the nation’s uninsured and underinsured citizens. The following describes Medicaid today:

Medicaid for Seniors:

• The Medicaid long-term care program is a federal-state program that covers medical expenses for aged, blind, and disabled individuals.

• The federal-state Medicaid partnership has served to advance a variety of both federal and state goals. However, it has also led to substantial state variation with large implications for access to coverage and care for those who qualify.

• The Medicaid program is the second-largest item in state budgets, after elementary and secondary education, and the third-largest federal domestic program, after Social Security and Medicare. In FY 2013, combined state and federal Medicaid spending totaled $438 billion.

• Medicaid covers close to 2 million elderly beneficiaries who use long-term care services – about 1 million who mostly use institutional care and another 1 million who mostly use home and community-based services and supports.

• Medicaid revenues provide core funding for health and long-term care institutions and providers, including a safety-net for hospitals, emergency departments, health centers, the mental health system, and nursing homes.

• Most elderly Medicaid recipients have multiple chronic conditions, such as hypertension, heart disease, and diabetes; nearly one-quarter have Alzheimer’s disease or another kind of dementia; and 1 in 5 have depression.

Medicaid for people with disabilities

Although Medicaid beneficiaries with disabilities make up only 15% of all enrollees, they account for more than 40% of total Medicaid spending. This is how Medicaid helps those with disabilities:

• Medicaid helps children with significant disabilities remain with their families and receive services at home or in community settings.

• Working adults with disabilities with modest earnings can retain their Medicaid coverage or buy it at low cost, an outcome that promotes independent living and more integrated workplaces and communities.

• The availability of home and community-based services in Medicaid prevents unnecessary and unwanted institutionalization of people with physical impairments, severe mental illnesses, developmental and intellectual disabilities, and other disabling conditions, and fosters community integration, as desired by many.

Please read more about special needs planning and eligibility for Medicaid, SS,I and SSDI benefits on our Website.

The future of Medicaid for seniors

With no benefits for long-term care coverage under the Medicare program and few affordable options in the private long-term care insurance market, Medicaid continues to be the main payer for institutional and community-based long-term services and supports for eligible seniors. This trend is likely to continue into the foreseeable future, because with increased life expectancy and advances in technology and medical care, the demand for long-term services will continue and financing needs will grow.

Medicaid Asset Protection

Medicaid planning can be started while you are still able to make legal and financial decisions, or can be initiated by an adult child acting as agent under a properly-drafted Power of Attorney, even if you are already in a nursing home or receiving other long-term care.  In fact, the majority of our Life Care Planning and Medicaid Asset Protection clients come to us when nursing home care is already in place or is imminent.

Generally, the earlier someone plans for long-term care needs, the better.  But it is never too late to begin the process of  Long-term Care Planning, also called Lifecare Planning and Medicaid Asset Protection Planning.

Planning for long-term care will not eliminate the risk of needing it, but it enables you to sort options and make smarter decisions ahead of time. As a result, you’ll have the peace of mind that no matter what happens, you will know what to do as a family. If you or your parents have not done Long-Term Care Planning, Estate Planning, or Incapacity Planning (or had your Planning documents reviewed in the past several years), please call us as soon as possible to make an appointment for a no-cost consultation:

Fairfax Medicaid Planning Attorney: 703-691-1888
Fredericksburg Medicaid Planning Attorney: 540-479-143
Rockville Medicaid Planning Attorney: 301-519-804
DC Medicaid Planning Attorney: 202-587-2797

Going to the Hammer Store

What if there were a store that only sold hammers.  When you go to the store with your particular problem, the answer was “you need a hammer”.  You might have a nail that needs to be driven, so, yes, you are in the right place.  But what if you needed to change a tire.  ”Oh, yes, you need a hammer.  Just bang those nuts till they come loose”.  What if you need to mow your yard?  ”Yep, this hammer will do the job”.  What?  You need to get the back off of your watch.  ”Absolutely, this hammer will work”.  Ridiculous, right?

Well, I am writing this in response to a “financial services” person that I heard is saying bad things about me since I did not agree to do an “exclusive relationship” with him/her, meaning, I send him/her all my clients and he/she sends me all of his/hers.  The problem with this (and a few other) “financial” services provider is that they work in the hammer store.  Their hammer though is an annuity.  It’s amazing how this “advisor’s” solution to every financial situation is an annuity.  It really doesn’t matter what your problem is, an annuity is the fix.

Why is this?  Annuities pay really good commissions.  ”But wait Todd, the advisor told me that there was no fee.  She said when I get my statement, you will see that all of the money was deposited into the account”.  That is true.  However, the person who sold you this got a commission of near 10% and possibly 15%.  Where did that money come from?  The company paid them.  If you notice (and listen or ask the right question) there is a surrender charge for the next number of years where you will lose a certain percentage of the investment if you want your money back.  Usually, the numbers of years of the penalty for cashing in is the percentage amount the advisor got of your investment.  So, if you cannot get to your money (all of your money, not the 10% they brag about) for 10 years, your advisor most likely got a 10% commission of what you gave them.  The company is not going to lose money.  They know that they will get that commission back if you cash in early.  They will invest your money to make back that 1% per year commission and get significantly more than the 1%.  That’s how they make money.

People (and these advisors) sometimes get upset when I charge maybe $7500 to save them hundreds of thousands of dollars which require me to do many months of work, but that is because they are writing me a check directly.  However, if you gave your annuity salesman $100,000, there a good chance he or she made that much off that sale, basically for filling out an application.  What if you invested a few hundred thousand?  Commissions could easily reach tens of thousands of dollars.   The commission on other products is not nearly as lucrative since your money is not locked away for a period of time.  Now you see why they work in the hammer store?

I’m not saying all annuities are bad.  There is one particular annuity we use in Medicaid planning but it’s not used as an investment but as a huge exemption in the Medicaid policy that is dictated by Congress.  This is the ONLY annuity that works with Medicaid.  If your advisor tells you that the annuity they are selling you prior to the need of Medicaid will protect you from Medicaid, please have them call me and discuss this.  The DHS policy does have some language that would make you think that annuity payments are not counted, but that is not how it works.

I don’t sell financial services.  There may be a time when you do need an annuity but I think that is only after you have been given all of the options of the different financial devices available with legitimate pros and cons of each.  When an “advisor” i.e. annuity salesman, answers every question with “you need this annuity” just think of the hammer store and wonder, “am I driving a nail or am I needing to change my tire?”.

Critter Corner: Services for Family Caregivers of Post 9/11 Veterans

Dear Baxter,I am a caregiver for my mother, who is a post-9/11 veteran and sustained a traumatic brain injury in the line of duty. Do you know of any benefits for caregivers in my situation?Thanks,

Karen Forr-Mahero


Dear Karen,

Please thank your mother for her service to our country, and thanks to you for serving as her caregiver.

Caregivers, including yourself, provide crucial support in caring for veterans. Under the “Caregivers and Veterans Omnibus Health Services Act of 2010,” VA services are now available to injured post-9/11 veterans and their family caregivers through a new program of Comprehensive Assistance for Family Caregivers.

Who Is Eligible?

-Veterans eligible for this program are those who sustained a serious injury – including traumatic brain injury, psychological trauma or other mental disorder – incurred or aggravated in the line of duty, on or after September 11, 2001.

-Veterans eligible for this program must also be in need of personal care services because of an inability to perform one or more activities of daily living and/or need supervision or protection based on symptoms or residuals of neurological impairment or injury.

-To be eligible for the Program of Comprehensive Assistance for Family Caregivers, Veterans must first be enrolled for VA health services, if not enrolled previously.

Services include:

-Monthly stipend Travel expenses (including lodging and per diem while accompanying Veterans undergoing care)

-Access to health care insurance (if the Caregiver is not already entitled to care or services under a health care plan)

-Mental health services and counseling

-Comprehensive VA Caregiver training provided by Easter Seals Respite care (not less than 30 days per year)

If you think you fit the criteria for these services, click here to answer some preliminary questions and download an application. The application enables Veterans to designate one primary Family Caregiver and up to two secondary Family Caregivers, if desired. Caregiver Support Coordinators are available at every VA Medical Center to assist Veterans and their Family Caregivers with the application process. Additional application assistance is available here or at 1-877-222 VETS (8387).

Additionally, VA has many other programs and services already in place that support veterans and their family caregivers at home. At you will find a description of more than two dozen programs for all caregivers, training tips, and advice on caregiving, including the importance of taking time to take care of yourself.

Did you know that later this year, all veteran’s benefits will be on one Website? You can read more about this and the Veteran’s Aid and Attendance benefit in our recent blog post.

Hope you both have a nice memorial day weekend!

Doggy licks and hugs,


Can Family Caregivers Get Compensated?



Q. My father, Jack, is in the early stages of Alzheimer’s and has limited mobility due to other ailments. He currently lives alone at home and needs a lot of assistance. He has been a great dad, always putting my needs before his own. Now, I am doing the same for him.

I recently got approval from my boss to work from home, part-time, so I can move in with my father. I help him get dressed in the morning, cook meals, and administer his medicine. I am so glad I can be there for my father; however, the loss of half my salary has been tough. I have been struggling to pay back loans and take care of my own financial responsibilities.

I read somewhere that there are ways caregivers can get compensated. Is this true, and if so, can you tell me more about programs and benefits that are out there? Thanks for your help!

A.  I commend you on the sacrifices you are making to care for your father. As you know, most caregiving starts out as a labor of love, but it can quickly grow into an expensive obligation. Caregivers such as yourself are struggling with heavy financial responsibilities, especially if they’ve had to quit their jobs or reduce their hours to provide care.

Imagine that you could get compensated for driving your father to the doctor, helping him get dressed, and administering his medications.  I am happy to say that in some places, and in some cases, you can. Here are ways your commitment to your father can result in more money in your pocket — either from direct cash payments or federal income tax breaks:

Dependent tax exemptions

You may be able to claim your father as a dependent on your income tax return. To do so, you must provide more than 50% of his basic living expenses, including housing, food, clothing and other necessities.

The exemption is the same as what you’d get for a child: $3,950 for the 2014 tax year for each care recipient. But here’s the caveat: Your father’s earnings, excluding Social Security, cannot exceed the deduction amount, in this case $3,950. So if your father’s pension or investment income totals more than that amount, you cannot claim him.

If you are not married and your parent qualifies as a dependent, you can also save on your taxes by filing as head of household, which is a more favorable tax filing status than single and it makes people eligible for lower tax rates, more credits, and sometimes more tax breaks.

Deductible medical expenses

Do you use your vehicle to drive your father to medical appointments? Did you pay to put in an accessible bathtub for him or a ramp for a wheelchair?  These costs are deductible on your return, as long as the cost exceeds 10% of your gross adjusted income. This is the case even if your father doesn’t qualify as a dependent, as long as you are paying more than 50% of his medical expenses.

Medicaid Waivers

Most states offer programs that use a Medicaid waiver to allow direct federal payments to family caregivers for their services.

The Medicaid home and community based waivers are programs offered to eligible individuals who require assistance with activities of daily living and/or supportive services and would prefer to live in their own home rather than in a nursing home.

Virginia’s Elderly or Disabled with Consumer Direction Waiver (EDCD) allows Medicaid to pay for a wide variety of services for people of all ages who have disabilities so that they may remain in their homes and communities with the supports they need rather than having to receive services in a nursing home or large facility. Luckily, in Virginia there is no limit on the number of EDCD Waiver slots that will be granted.

Other services in Virginia include:

Washington DC also offers an Elderly and Persons with Disabilities Waiver (EPD) that helps local residents with home care; however, it has a limited number of slots and there is typically a waiting list.  Additional options include:

Maryland’s Medicaid Waiver for Older Adults pays for personal care at home as well as covers the cost of some home modifications to increase the safety and accessibility of the home and allow the participant greater independence.  However, Maryland has a very limited number of slots and there is a very long waiting list for this program.  Two newer programs also provide help at home.  These are Community Pathways and Community Personal Assistance. Additional programs in Maryland include:

Direct private pay

Your father could also pay you directly for hours spent helping him with domestic, personal care, and medical-related duties. If you go this route, a caregiver agreement proves that a parent is paying for a service and not giving a gift. Keep in mind that a history of cash gifts can disqualify your father for future Medicaid eligibility.

If you do decide to enter a private pay relationship, you should:

-Have the agreement drafted by an experienced Elder Law Attorney with a view towards ensuring that the agreement will help with future Medicaid eligibility for your father.

-Pay tax on your earnings, and your father must report the payment on their income tax forms.

-Make your hourly rate and the services you provide are both justified in advanced by having an independent report done by a Geriatric Care Manager.

You may be tempted to accept payment off the books from your father, but that is risky when it comes to qualifying for Medicaid, because off-the-books payments will be considered gifts.

Medicaid Cash and Counseling (Participant/Consumer or Self-Directed Programs)

If your father is eligible for Medicaid, Medicaid’s Cash and Counseling program may enable direct payments to be made to you, the caregiver. Unfortunately, this program is not yet available in Virginia, Maryland, or Washington, D.C., but there may be similar programs. For more details, contact your nearest Area Agency on Aging and ask them who to call in your state to learn about direct payment programs for in-home care.

Caregiver Agreements in Virginia and other States

Medicaid rules change frequently, and the eligibility rules also vary from state to state.  To play it safe, when it comes to caregiving, it is important that if personal services are going to be rendered by a family member or someone unrelated, there needs to be a written agreement in advance of the services, and the services must be needed. It is prudent to consult with a Certified Elder Law Attorney, such as myself, that specializes in Medicaid Asset Protection, in advance.

Medicaid Complexity in Virginia and other States

The Medicaid program is our country’s largest health and long-term care benefits program, covering one in six Americans, including 70% of nursing home residents and 20% of persons under age 65 with chronic disabilities. Medicaid laws are the most complex and confusing laws in existence, and impossible to understand without highly experienced legal assistance. Without proper planning and legal advice from an experienced Elder Law attorney, many people spend much more than they should on long-term care, and unnecessarily jeopardize their future care and well-being, as well as the security of their family. Please read the Medicaid Complexity page on our Website for more details.

Medicaid Planning in Virginia and other States.

Medicaid planning can be started while you are still able to make legal and financial decisions, or can be initiated by an adult child acting as agent under a properly-drafted Power of Attorney, even if you are already in a nursing home or receiving other long-term care.  In fact, the majority of our Life Care Planning and Medicaid Asset Protection clients come to us when nursing home care is already in place or is imminent.

Nursing homes in Metro DC area cost $10,000- $12,000 a month. To protect your family’s hard-earned assets from these catastrophic costs, the best time to create your own long-term care strategy is NOW.  Generally, the earlier someone plans for long-term care needs, the better.  But it is never too late to begin the process of  Long-term Care Planning, also called Lifecare Planning and Medicaid Asset Protection Planning.

If you or a family member nearing the need for long-term care or already getting long-term care or if you have not done Long-Term Care Planning, Estate Planning, or Incapacity Planning (or had your Planning documents reviewed in the past several years), please call us as soon as possible to make an appointment for a no-cost consultation:

Fairfax Medicaid Planning: 703-691-1888
Fredericksburg Medicaid Planning: 540-479-1435
Rockville Medicaid Planning: 301-519-8041
DC Medicaid Planning: 202-587-2797

Appliances That Speak to Each Other, and Other Incredible Aging-in-Place Technology

Robear Robot

When Carol’s mother, Eleanor, had a stroke a few years back, she and her husband moved in with her. Eleanor was not very steady on her feet, and surfed the furniture to get around. Carol and her husband were always worried about her falling, especially in the bathroom. They became reluctant to leave her alone so, like Eleanor, they too became housebound.

Carol and her husband realized that with their own day-to-day responsibilities, the situation wasn’t ideal. Carol’s husband, Jeff, is in IT, so he set up some motion sensors around Eleanor’s house and linked them to a computer. He also set up a system to send a text message to his and Carol’s cell phone, when Eleanor was in the bathroom for more than 30 minutes. With this and other age-in-place technology, Carol and her husband were able to care for her mother and have peace of mind, while resuming their own productive lives. 

Last week’s AARP Life@50+ National Event in Miami explored some of the newest technology startups and their inventions. Below are some examples:

• Ollo Wearables: Controlled by voice, Ollo is a wearable 4G smartphone that combines a personal digital assistant with real time health monitoring. 

• AlzhUp seeks to improve the quality of life of people with Alzheimer’s by integrating actual memories and scientifically-proven therapies in a single platform, slowing the cognitive decline of the patient, as well as facilitating the active participation of the entire family and care team in the treatment process. 

• Video-call doctors’ visits are a boon to those who live in rural areas. The technology extends patient care beyond the office, enables patients to access previously inaccessible specialists, and reduces travel for patients needing frequent visits. According to USA Today, about 10 million people already rely on telemedicine, often from doctors who live in another state.

• Robots as caregivers: A Japanese engineer has developed a Robot-Teddy Bear. It looks adorable and is intended to perform tasks like lifting an elderly person out of bed and helping them stand up or move into a wheelchair. Robear is the brainchild of Toshiharu Mukai, head of the Robot Sensor Systems Research Team at the Riken-SRK Collaboration Center for Human-Interactive Robot Research since 2007. Health workers typically perform the lifting task with patients about 40 times a day.

•  LED light handbag: Can’t find your keys at the bottom of your purse. No problem. Forgot to charge your phone. No worries. Companies such as Ralph Lauren are releasing stylish handbags with lights and chargers inside to accomplish both these things.

Sensor technology:  Motion sensors monitor the speed and frequency of movement throughout the house and can let a caregiver know if someone hasn’t gotten out of bed. The sensors can also track when seniors visit the fridge to make sure they are eating. And sensors near the stove know if a pot was removed and the burner left on. “In the future, expect sensors that alert you to things like the garage door being left open or that the front door is unlocked. Finders for the TV remote, the telephone, and your car keys will all be a standard part of home design. Lights will turn on as soon as your feet hit the floor when you get up to use the bathroom at 1 a.m. Appliances will “speak” to each other: Your refrigerator will send your TV a message saying you left its door open.” (source: Huffington Post)


Medicaid Asset Protection


Critter Corner: Are There Monetary Benefits for Veterans with Post-Traumatic Stress Disorder (PTSD)?


Dear Commander Bun Bun,

I write to you because I too was a Commander (in the U.S. Navy). I suffer from PTSD, and often have severe nightmares and flashbacks. I have been going to therapy for years, and even tried biofeedback, but it is becoming quite costly. Do you know of any benefits available to veteran’s with PTSD, like myself?

Mil O’Terry


Dear Mil,

Thank you for your service to our country.

Due to the severity of emotional problems that PTSD can cause, the Veteran’s Administration (VA) enacted regulations that classify PTSD as an injury, enabling veterans to receive monetary benefits – but only in limited cases.

VA services are provided to all veterans who have completed active military service and those who were discharged under other than dishonorable conditions.  A veteran must file a formal claim using forms provided by the VA’s Veterans Benefits Administration.  Although many vets won’t qualify for monetary compensation, they are eligible for PTSD support, provided by PTSD treatment programs nationwide that offer mental health assessments and testing, psychotherapy, family therapy, and group therapy.

Additionally, the VA offers Specialized Intensive PTSD Programs, which provide treatment in a “therapeutic community,” many in a live-in residence. The VA has nearly 200 PTSD treatment programs. A referral is usually needed to access the specialty programs. Learn more and find resources on The National Center for PTSD section of the VA Website.

Did you know that a benefit that you may be eligible for is Veteran’s Aid and Attendance? Nearly 182,000 veterans and their spouses take advantage of the Veteran’s Aid and Attendance benefit, but VA officials say that many more are eligible. I urge you to make an appointment for a no-cost consultation with Mr. Farr, who is an Accredited Attorney with the U.S. Dept. of Veterans Affairs, to learn more.


Commander Bun Bun

Ask the Expert: VA to Offer One-Stop Website for Veteran’s Benefits

Q. My father, Joe, is a Vietnam veteran. He gets frustrated and confused when he tries to navigate all the veteran’s benefits websites and figure out what he may be eligible for. Even the VA Website doesn’t have everything he needs, and he has had bad experiences calling them, sitting on hold, getting transferred to different departments, and given other phone numbers to call. Do you know of any one stop website for veterans to find out about benefits? And if there isn’t one, can you outline some of the benefits available to veterans. Also, I read somewhere that you handle Veteran’s Aid and Attendance. Can you tell me more about that benefit?

A. Since a scandal last year that showed some VA employees were manipulating patient wait lists in order to improve performance measures, the Department of Veterans Affairs has been pushing to improve customer service. To do so, the VA is working towards a single unified digital experience that makes it easier for veterans to access information and get the benefits they deserve.

Veterans will soon hopefully be able to log in to just one website to manage their benefits, apply for doctors’ appointments, and determine their eligibility for programs. In fact, the website will be open to around 50 veterans to help beta test the new portal next week, and it should go live shortly thereafter. By the end of the year, all veterans should theoretically be able to use to manage more than 350 benefit programs without having to switch websites, call multiple numbers, or file large amounts of redundant paperwork.

Once a veteran registers, the website should (theoretically) automatically know his or her eligibility for different programs and should (theoretically) tailor the user experience using that information. Veterans will eventually be able to add a dependent, change an address, schedule an appointment, or check on a claim status and get everything done online in a seamless way, versus what veterans are doing today across multiple websites.

The VA will supposedly be adding new functions to the website monthly, until they have a working model that serves veterans in an easy-to-understand and streamlined way. To do so, the VA is integrating more than 200 different databases across the agency in order to gather information related to military service, contract information, demographics, and how Veterans are currently using VA services in order to make sure the agency has the information it needs to provide good customer service.

The VA is also working on consolidating more than 1,000 hotlines available to veterans across the agency. Instead, veterans will just call one phone number, and the person answering will have access to all the information they need to help. If a veteran requires special assistance, he or she will simply be transferred to someone who can help, instead of having to call a different number.

This one-stop website couldn’t have come at a better time – assuming it works. Earlier this year, NPR (along with seven public radio stations around the country) chronicled the lives of America’s retired military and released a three-part series about veterans benefits. The project, called “Back at Base,” examines how many veterans and their families are missing out on the benefits for which they are entitled because they don’t know about them or do not understand them. The story offers ways to navigate the complex processes involved in applying for benefits.

Currently, there are more than 25 million veterans, like your father, who served our country during wartime and may be eligible for some form of veteran’s benefits. As in the NPR story, at the Farr Law Firm, our goal is to provide information about programs that veterans and their families may be entitled to.

Veteran’s Aid and Attendance

You asked about Veteran’s Aid and Attendance. As an Accredited Attorney with the U.S. Dept. of Veterans Affairs, I understand both the Aid and Attendance Benefit and the Medicaid program and the interaction between both benefit programs. The Veterans Aid and Attendance benefit, which is actually a type of Special Pension Benefit, can provide more than $25,000 annually for an eligible married veteran, more than $21,000 annually for a single veteran, and over $13,000 annually for the surviving spouse of a qualified veteran. (Please visit our website to see the 2015 figures.)

Eligibility criteria includes:

  • Those over 65 do not have to be disabled. However, the veteran or spouse must be in need of regular aid and attendance due to inability to dress oneself, feed oneself, loss of coordination or other conditions, as described on our website, and there must be actual ongoing caregiving services being received from someone else.
  • You or your spouse must have served on active duty for at least 90 days, at least one day of which occurred during a period designated as wartime (see our website). There must have been a non-dishonorable discharge as well. Single surviving spouses of such veterans are also eligible.

For more details about Veteran’s Aid and Attendance and other veterans’ benefits, please watch this video. If you would like to sign up to receive my Aid Attendance 4-Part Mini Series via e-mail, please click here.

Since the veteran’s one-stop website is not yet available, I will briefly outline just two of the other benefits available to veterans:

Medical Benefits

The VA operates the nation’s largest healthcare system, with more than 1700 hospitals and clinics, caring for more than 6.3 million veterans annually. Those who qualify based on household income and assets receive free care. Others use their VA benefits to supplement private health insurance and cover co-payments required with private policies.

In recent years, mental health benefits for veterans have been expanded. While the system is not perfect, the VA does provide a significant healthcare benefit that should not be overlooked.

Burial and Memorial Benefits

The Veterans Administration offers a number of burial and memorial benefits to veterans who were honorably discharged, as follows:

  • National and State Cemetery Benefits: Eligible veterans can be buried in one of the 131 national or 93 state VA cemeteries at no cost to the family. This includes a gravesite; opening and closing of the grave; perpetual gravesite care; a government headstone or marker; a United States burial flag that can be used to drape the casket or accompany the urn (after the funeral service, the flag is given to the next-of-kin as a keepsake); and a Presidential memorial certificate, which is an engraved paper certificate signed by the current President expressing the country’s grateful recognition of the veteran’s service. National cemetery burial benefits are also available to spouses and dependents of veterans.
  • Private Cemetery Benefits: Benefits available include a free government headstone or marker, or a medallion that can be affixed to an existing privately purchased headstone or marker; a burial flag; and a Presidential memorial certificate. There are no benefits offered to spouses and dependents that are buried in private cemeteries.
  • Burial Allowances: In addition to the many burial benefits, some veterans may also qualify for a $734 burial and funeral expense allowance (if hospitalized by VA at time of death), or $300 (if not hospitalized by VA at time of death), and a $734 plot-interment allowance to those who choose to be buried in a private cemetery. To learn more about eligibility, see

Certain forms may need to be completed which are always better to be done in advance. For a complete rundown of burial and memorial benefits, eligibility details and required forms, visit or call 800-827-1000.

Applying for veteran’s benefits, such as Veteran’s Aid and Attendance, is always a confusing and arduous task, fraught with perils along the way. Here at the Farr Law Firm, we work with veterans and their spouses to evaluate whether they qualify for the Veterans Aid and Attendance Benefit and/or Medicaid, and we take care of all the paperwork. Please contact The Law Firm of Evan H. Farr, P.C. as soon as possible to make an appointment for a no-cost consultation:

Fairfax Veteran’s Attorney: 703-691-1888
Fredericksburg Veteran’s Attorney: 540-479-143
Rockville Veteran’s Attorney: 301-519-8041
DC Veteran’s Attorney: 202-587-2797

P.S. Another benefit of being a veteran is a 15% discount off all services at the Farr Law Firm. We hope to see your family soon!

PBS Releases “Caring for Mom and Dad” Documentary

Graphic from

Chris Olson was recently diagnosed with Alzheimer’s, and her husband, Brent, has prostate cancer.  They lived alone, 300 miles away from their nearest daughter, and needed assistance. Their daughter, Breanna, who was beginning a promising political career, and her sister Shanna, a working mother of two, decided to put their careers on hold and move back home to take care of their parents. According to Shanna, “I didn’t realize at my age—mid 30s—that I would be caring for my mom. I knew that at some point in time that would be necessary; however not when I was just beginning to have a family of my own.”

In another instance, at 100 years of age, Janet Wolfe lives alone at home in her New York City apartment. The former actress has until recently been very independent. When she took a fall at age 97, she resisted help from her two daughters, one of whom lives with her own family in the building. Now, her daughter, Alisa, and her sister who lives in the same building as her mother, rely on geriatric care managers to mediate the situation between her and her mother to relieve some of the stresses of caregiving. According to Alisa, “I don’t take care of her on my own. My sister and I have brought in aides to do mom’s day-to-day care, but we all work as a team. For example, my sister—who lives across the hall from Mom—will heat up and serve Mom the dinner that has been prepared by one of the aides. Or my nephews will come by and watch TV with her.”

Americans are living longer than ever before, and soon older adults will outnumber the young. Most of us will be touched by caregiving in some way at some point in our lives — as a caregiver, as a care recipient, or as someone who is supporting a caregiver. The new documentary, Caring for Mom and Dad, which airs on PBS stations around the country this month,  explores the emotional, health and financial challenges that many caregivers, including those in our examples above, face every day.

The film (check local listings or watch online at is narrated by actress Meryl Streep and highlights several adult children’s experiences as they work and care for parents who are dealing with strokes, dementia, and other health challenges as they age. The film illustrates the rewarding, yet often challenging, road that all family caregivers travel.

Lessons learned from the film include:

You can’t always say yes: Alisa, one of the daughters in our example above, shares her angst in the film, as her mother frequently asks her to come visit, have dinner, and spend the night. She has work and her children pulling her in other directions. She is coming to realize that saying “no” is okay once in a while, and that it is also okay to ask for help and seek respite when needed.

There may be workplace options that support caregivers: The documentary also touches on the challenges of maintaining a job while caring for a loved one — and the financial sacrifices, as well. In fact, professionals over age 50 who leave the workplace to care for a parent stand to lose an average of more than $300,000 in wages and benefits over their lifetime. The film highlights several employees and employers who have benefited from workplace options that support family caregivers.

There are also moments of intense joy that are part of the caregiving experience. The film communicates that those moments are what keep most of us going. In the film, a daughter caring for her mother with dementia expressed that, “It’s those treasured times that outweigh those challenging moments. There is a rainbow where that storm and that peace collide. It produces such a beautiful thing.”

More options for caregivers are needed: The film stresses that we must have more options for affordable services to supplement the unpaid work of family caregivers who shoulder the vast majority of the care. Equally as important are the critical caregiver supports — such as the geriatric care managers, medical advocates, family caregiver intervention programs and flexible workplace policies shown in the film — that are vital to helping us navigate family conflicts and continue to work as we care for our loved ones.

Local Programs and Community Resources for Caregivers

How do we take care of the caregiver who has little support? The following are local programs and community resources that offer family caregivers support, respite, coping strategies, and introductions to other caregivers.

Fairfax County Elder Care

In Fairfax County, caregiver respite service provides an opportunity for family caregivers to take a well-deserved break. They can run errands, work out at the gym, have coffee with a friend or take in a movie, knowing that their loved one is safe.

Help from a Certified Nursing Assistant: Fairfax County provides up to 6 hours of care per week from a certified nursing assistant to relieve a full-time family caregiver. There are income and functional requirements.

Help from a Volunteer: The county also provides up to 6 hours a month from a trained volunteer. The volunteer provides oversight and companionship. This service is free and there is no income requirement.

Adult Day Health Care Center: Using adult day services (ADS) just twice a week can reap surprising psychological and physical benefits for family caregivers. Fairfax County operates five centers that offer medical oversight, recreation and companionship to participants needing supervision during the day. Participants can attend 2-5 days a week.

Fredericksburg, VA Elder Care

The Fredericksburg, VA area has at least 29 Adult Day Care Centers that offer meaningful activities, new friendships, and peace of mind for caregivers and seniors.

Rockville, MD Elder Care

In Rockville, MD, Respite Services of Montgomery County allows family members and other unpaid, live-in caregivers to take a break from their regular chores and routines, so they can take care of their own needs, meet the needs of their family, or simply enjoy a few hours “off-duty.” Montgomery County also has some helpful resources on their county Website.

Washington, DC Elder Care

In Washington, DC, the DC Office on Aging offers caregiver respite programs, and resources for “beating the caregiver blues.” Learn more here.

Fairfax, Virginia Caregiver Support

Fairfax County provides support for the physical and emotional challenges involved with caregiving. Support groups – whether by phone or in person – can help build relationship and remove barriers to health and well-being.

Caregiver Support Groups in the Annandale, McLean and Mt. Vernon areas are led by nurses and take place at three of the county’s Adult Day Health Care Centers. You do not need a family member enrolled in one of the centers to join.

A Caregiver Telephone Support Group is available from the comfort of your own home. Caregivers can join a free support group facilitated by a county social worker each month on second Tuesdays. Register online or call 703-324-5484, TTY 711.

Fredericksburg, Virginia Caregiver Support

In Spotsylvania County, a Caregiver Support Group meets on the 2nd and 4th Wednesdays in Fredericksburg.

Rockville, MD Caregiver Support

In Rockville, MD, the Montgomery County “Senior Site” provides various resources on Caregiver Support, including safety, social support, and more.

Washington, DC Caregiver Support

In Washington, DC, through the DC Caregivers Institute and family caregiver program, Home Care Partners supports and educates family members to ease some of the stresses of caregiving while providing the concrete services they need to continue caring for their relatives at home. Caregivers must be DC residents caring for a DC Senior (60 years and older). Support includes in-home hands-on practical skills and tips for managing health problems, telephone support groups, seminars on practical topics, and more.

National Caregiver Support

Nationally, The Caregiver Community Action Network (CCAN) is a group of over 100 volunteers in more than 40 states. CCAN volunteers reach out to family caregivers to provide education and support. They also teach caregivers to be advocates for themselves and their loved ones. The U.S. Administration on Aging also offers a comprehensive listing of caregiving resources. In addition, the Family Caregiver Alliance offers a calendar of events and trainings for caregivers.

Caregiving can be both emotionally and mentally taxing, and can easily lead to caregiver burnout. Please encourage your family caregivers to take advantage of services that offer respite and support, and thank them for their strength, courage and commitment in providing long-term patient care.

At the Farr Law Firm, we recognize that caring for a loved one strains even the most resilient people. If you’re a caregiver, take steps to preserve your own health and well-being.  Part of taking care of yourself is planning for your future and for the future needs of your loved ones.

If you’re a caregiver or a loved one who has not done incapacity planning, estate planning, or long-term care planning (or needs to update your documents), please contact The Law Firm of Evan H. Farr, P.C. as soon as possible to make an appointment for a no-cost 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

Critter Corner: Protecting My Mother from Scams


Dear Angel,

I recently visited my 80-year old mother, who is in the early stages of dementia. I noticed boxes of items that were mailed to her, including tons of magazines about body building and deep sea fishing (both of which don’t interest her), and a pile of sweepstakes she entered. I would like to help educate her about scams, since I cannot be there with her to stop her from sending money to these people. Do you know about the major scams targeting seniors today and how I can help my mother?


Don Targett-Mymomm


Dear Don,

Sadly, there are unscrupulous criminals out there that prey on seniors such as your mother. According to a survey on elder fraud from Investor Protection Trust, 20% of unsuspecting retirees become victims of financial fraud. The same study reveals that one in every five Americans over 65, or about 7.5 million people, has lost money through financial fraud.

As we age, our ability to discern the credible from the not-so-credible decreases. And retirees in the early stages of diseases such as Alzheimer’s or other types of dementia, such as your mother, are more prone to fall for fraudulent phone, mail, or email-based money-grabbing schemes.

As a rule of thumb, if it seems too good to be true, it’s almost certainly a scam. With that in mind, since you can’t be around all the time, gently remind your mother not to sign up for sweepstakes, travel giveaways, or suspicious free gift offers. According to the National Consumers League fraud center, once the scam bait has been taken, her contact information may end up on a “suckers list,” where it’s collected and then sold to outside parties. From that time onward, she will likely find herself receiving a plethora of fake mailings and phone calls.

The following are some common scams that target seniors:

  • Telemarketing or mail fraud: Dishonest scammers use the phone to sell seniors goods that either never arrive or are worthless junk. In addition, they often conduct investment and credit card fraud, lottery scams, and identity theft. Telemarketers take in an estimated $40 billion each year, bilking one in six American consumers. AARP claims that about 80% of them are 50 or older.
  • Health Care/Medicare/Health Insurance Fraud: In these types of scams, perpetrators may pose as a Medicare representative to get older people to give them their personal information, or they will provide bogus services for elderly people at makeshift mobile clinics, then use the personal information they provide to bill Medicare and pocket the money.
  • Grandparent Scam: The criminals often do intensive research on the potential victim’s family, so their story may sound credible. If this happens to your mom, tell her to ask the person if you can call them back later and immediately check the facts with your family. Suggest to your mother that she should NEVER give money to anyone without verifying their identity.
  • Using Fraudulent Legal Documents: Many scammers cloak their actions in legal authority, procuring a Power of Attorney or Will or other legal document giving them access to a senior’s property. They get seniors to sign these documents by lying, intimidation, or threatening of the seniors. To ensure that this does not happen, make sure that your documents are done in a safe and ethical manner by a Certified Elder Law Attorney, such as my owner, Evan Farr.

Of course, there are plenty of other scams out there, including phony charities asking for donations, advance-fee loans, fake checks, fake lottery scans, and identity theft. Read the FBI Common Fraud Schemes Web page  or the Better Business Bureau Scam Stopper Web page for more details and be sure to report any internet scams to the FBI and all scams to the Council of Better Business Bureaus.

Hope this is helpful!



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