A New White House Report on Technology for Seniors



Technology is playing a larger role in the lives of seniors, enabling them to be engaged, connected, mentally active, and physically safe. In fact, boomers are a part of one of the fastest growing demographics in terms of usage of social media and other technologies.

It’s not surprising that the marketplace for technology for aging adults is expected to grow sharply from $2 billion today to more than $30 billion in the next few years. This enormous growth makes it increasingly important for our loved ones to keep in the high-tech loop. Below are ways in which seniors are embracing technology and where the most growth is taking place:

· Communication and engagement: For most baby boomers, and for almost everyone in the younger generations, life is unthinkable without e-mail, chat, web surfing, Facebook, smartphones, video games, Skype, and texting. For those who aren’t as tech savvy, simplified tech such as modified tablet interfaces and easier-to-use smartphones are helping seniors be in touch and in the know. For many, training is critical – with refreshers from the carrier or company that sold the device or, even better, with assistance from grandchildren.

· Safety and security: The ability to remain at home depends on whether the home is free from obstacles and dangers – and how risks are addressed. Thus, seniors are using mobile Personal Emergency Response Systems (PERS) services and fall detection programs, and this market continues to grow. With connected light bulbs to smart locks, smart home tech is evolving rapidly, and the growth potential is massive as home automation devices become easier to use.

· Health and wellness: The risks associated with obesity and lack of exercise only worsen with age. Online weight loss tools, such as MyFitnessPal and Weight Watchers have proven popular. For chronic disease management, tech firms like Medtronic or AliveCor offer systems for tracking diabetes and congestive heart failure, with the market for these tools expanding.

· Learning and contribution: Seniors who want to continue learning and contributing are taking advantage of online programs and auditable courses found through sites like SeniorNet.org, Osher Lifelong Learning Institutes, AARP TEK, OATS.org, and WorkReimagined, among others.

How the Federal Government Can Support Technology for Seniors

This month, PCAST released the “Report to the President: Independence, Technology, and Connection in Older Age.” In compiling the report, PCAST “sought to identify technologies and policies that will maximize the independence, productivity, and engagement of Americans in their later years,” with an emphasis on “technologies important to the key areas (described in the next paragraph), rather than specific diseases and situations,” and “technologies that could have an effect broadly and in the near future.”

PCAST identified three areas where aging adults experience change: social engagement and connectivity; cognitive function, and physical ability. PCAST released a report last October on technologies for hearing assistance.

Recommendations from the PCAST reports are as follows:

1. Federal action – The Office of Science and Technology Policy (OSTP) should create a one-year task force to study technologies that can help America’s senior population. In addition, a standing public-private council should be formed to advise the Health and Human Services Department on “sector-wide ways to advance technology in the service of improving quality of life for older people.”

2. Internet engagement – All seniors should have broadband Internet access, as set forth in a national plan developed by the Department of Commerce, National Telecommunications Information Administration (NTIA) and HHS’ Administration for Community Living. Seniors and school-aged children should also be included in any telecommunications projects overseen by the Federal Communications Commission.

3. Remote monitoring – The National Institute of Standards and Technology (NIST) should develop guidelines for monitoring technologies that help seniors age in place, and ensure that privacy and security concerns are met and don’t hinder innovations or adoption.

4. mHealth innovation – The National Institutes of Health, HHS Agency for Healthcare Research and Quality (AHRQ), National Science Foundation, Veterans Administration, Department of Defense, and Defense Advanced Research Projects Agency (DARPA) should support research in a wide range of new technologies and platforms, including home monitoring, robotics, advanced mobility technologies, cognitive training, and communications technology used in emergency situations.

5. Emergency response – The Federal Emergency Management Agency (FEMA) and Department of Homeland Security should develop communications capabilities to reach isolated and vulnerable seniors in times of emergency. In addition, HHS, the Office of the Assistant Secretary for Preparedness and Response (ASPR), the Office of the National Coordinator of Health IT and the Centers for Medicare and Medicaid Services (CMS) should ensure that medical records are accessible “whenever and wherever a patient may appear.” Finally, FEMA, CMS and the ASPR should make sure medical device interfaces are consistent and interoperable at all times and wherever they’re needed.

6. Telehealth regulation – HHS should work with the Federation of State Medical Boards and National Governors Association to ensure that telehealth providers have the right licenses to operate across state lines. CMS should also support its Innovation Center “to advance payment policies that support innovation in telehealth.”

7. Smart home design – HHS should work with the Department of Housing and Urban Development to ensure accessibility standards and promote technological innovation for independent living, especially in retirement communities.

8. Product design – The Consumer Product Safety Commission should work with AARP and other groups to ensure senior-friendly product development, including technology and medical supplies.

9. Assistive and robotic technologies – CMS should develop new support programs to help seniors access “higher-functioning products.” In addition, the VHA, DOD, DARPA and HHS should lead the effort – and create a 10-year roadmap – to develop better wheelchairs.

For more details, please read the executive summary of the PCAST report. I will continue to keep you up to date on outcomes from this report and additional report findings and recommendations from PCAST in the future.

Is Your Loved One Resistant to New Technology?

As our country ages, the needs of older adults interested in remaining independent and at home multiply. However, what happens if your loved one is resistant to adopting new technologies? Read our blog post, “Amazing Technology to Age-in-Place (But Mom is Reluctant)” for details on helping a loved one overcome their resistance, and for additional age-in-place technologies that are available.

When Aging-in-Place Technology is Not Enough

Most people want to stay in their home for as long as possible. However, if you or a loved one cannot live independently and are 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. Please contact us as soon as possible to make an appointment for a no-cost consultation:

Fairfax Medicaid Asset Protection Attorney: 703-691-1888
Fredericksburg Medicaid Asset Protection Attorney: 540-479-143
Rockville Medicaid Asset Protection Attorney: 301-519-8041
DC Medicaid Asset Protection Attorney: 202-587-2797

A Lawyer’s Legal Brief in a Recent Estate Probate Litigation Case

A Lawyer’s Legal Brief in a Recent Estate Probate Litigation Case

By Fredrick P. Niemann, Esq. of Hanlon Niemann Wright, a Freehold, NJ Estate Probate Attorney

Have you ever been interested to read an attorney’s legal brief involving a claim of undue influence in an estate litigation case?   If so, here you go.

As an introduction to the subject, be reminded that lawyer’s write briefs in order to support their legal positions in Court.  Often times, they will cite cases that have been reported going back 150 years, depending upon the legal issues and facts of the case.  Every case regardless of the legal principles cited in a brief are decided based upon the facts. It is the facts that control the outcome of the case and the judge’s decision coupled with the legal arguments made by the attorney.   I am making available a brief that our office recently filed in a case involving probate estate litigation where allegations of undue influence were made.   I hope that you will find this brief interesting with the objective of giving you an introduction to the broad based legal principles and case law concerning the subject of undue influences.   If your fact pattern involves a case of undue influences, give us a call.   We can evaluate the case for you.   Please understand that not all fact patterns are listed in this brief.  There are literally hundreds of cases with facts that are very similar to yours.   Therefore, the assistance of a qualified probate estate litigation attorney will be helpful to determine whether you have a case for or against contesting a Will, Trust or challenging a Power of Attorney, Guardianship action, etc.  Note also that these principles will be very significant if you are an Executor, Trustee, Power of Attorney, Guardian or other person in a fiduciary relationship and third party makes claims against you.


To discuss your estate probate litigation matter, please contact Fredrick P. Niemann, Esq. toll-free at (855) 376-5291 or email him at fniemann@hnlawfirm.com.  Please ask us about our video conferencing consultations if you are unable to come to our office.

Critter Corner: Would a Pet be Beneficial for my Mom with Alzheimer’s?


Dear Angel,

My mom has Alzheimer’s and I am thinking about bringing a cat into the house to help calm her down when she gets agitated. Is pet therapy effective for those with Alzheimer’s and do you think it’s a good idea for someone like her to have a pet like you?


Kat Formamma

According to the Alzheimer’s Associationpet therapy dates back to the 1860s, though the positive impact of animals on Alzheimer’s patients wasn’t studied in earnest until the 1980s.

Due to the anxiety that social situations can cause those with Alzheimer’s, they often avoid social situations altogether, including interacting with family and loved ones. Research shows that people with dementia recognize pets as friendly and non-threatening. When they have a pet with them, studies show they display more interactive behaviors. Check out this video which elaborates on the positive effects therapy animals can have on those with Alzheimer’s.

In addition to stimulating a social response, Alzheimer’s patients may benefit from the presence of therapy animals because of:

  • Reduced agitation. Agitation behaviors, including verbal or physical outbursts, general emotional distress, restlessness, pacing, shredding (paper or tissues) that are common among later stage dementia patients, are reduced in the presence of a pet.
  • Physical activity. People dealing with Alzheimer’s can lose motivation to maintain physical activity. Depending on a patient’s mobility, he or she may be able to brush the animal, toss a ball, or even go for a short walk.
  • Lower blood pressure. Spending time with an animal has even been correlated to lower blood pressure and increased odds of survival after a heart attack.
  • Improved eating and personal hygiene. Those with Alzheimer’s sometimes neglect necessary daily activities such as eating or basic personal hygiene. Alzheimer’s patients have been shown to eat more and pay closer attention to basic hygiene following a pet’s visit.
  • Pleasure. Some patients simply enjoy the presence of the pet and its human companion, as well as the tricks that some therapy animals can do.
  • Increased socialization. Many individuals with Alzheimer’s, who respond to little or nothing else in their environment, will respond to the non-threatening presence of a gentle therapy animal. An animal provides a natural and easy conversation topic for dementia patients, who often feel a great deal of strain from being put into social situations.

Although therapy animals for Alzheimer’s patients are a recently emerging therapeutic treatment, there are certifications and registrations that exist to uphold a high standard for these animals. Visit Pet Partners and Love On A Leash for more details about training and certification programs.

It is important to note that it takes a very special kind of animal to be used for therapy. It is crucial that the animal is of pleasant and suitable temperament. Therapy animals must be able to sit, stay, and resist distractions such as other animals or attractive smells. The animals must be bathed and groomed regularly, as the individuals they are interacting with on a daily basis are likely susceptible to disease and infection.

Hope this helps!


Take Your Emotional Support Animal with you ANYWHERE!


Q. Since my wife, Linda, and I retired, we travel a lot. A few weeks ago, when we flew to San Diego, we saw someone with a dog in the cabin of the plane, sitting on the owner’s lap, and the flight attendant didn’t say anything about it. The dog was small enough to fit under the owner’s seat in a pet travel bag, so we figured she must have just taken it out temporarily and maybe the flight attendant didn’t even notice.  However, on the way home, there was a woman with a large well-behaved German Shepherd that just laid in the aisle next to its owner.  The lady did not appear to be blind or disabled, nor was the dog wearing any special vest indicating it was a Service Animal.  Our Golden Retriever, Goldie, makes us happy whenever she’s around. I have PTSD from my time in Vietnam, and just petting her brings me comfort in immeasurable ways. My wife has suffered from depression throughout her life, and she sees Goldie as our third child (the other two got married and moved out a while ago). My children even accuse us of favoring Goldie over them, and replacing pics of the grandchildren with pictures of Goldie. And, I have to say, they may be right. What makes us really sad is that we have to leave her with a sitter when we travel (or even when we go out locally). We never thought we could bring her in the cabin of a plane because we had always thought that only small pets that fit under your seat are allowed in the cabin, and we don’t want Goldie locked up in a crate in the cargo hold.  We are planning on flying to visit the Grand Canyon soon, and it would be amazing if Goldie could come with us. Do you know what we can do to be able to bring Goldie on the plane, like the woman with the German Shepherd?

A. Most likely, both dogs you saw on the plane were Emotional Support Animals. The National Institute of Mental Health shows that more than 1 in 4 adults in the U.S. have some form of mental disorder. For some people suffering from an emotional or psychological condition, there is nothing more calming than an Emotional Support Animal.

Animals provide seniors with more than companionship. Emotional Support Animals are animals that provide comfort, support, affection, and companionship for people suffering from various mental and emotional conditions. They are meant solely for emotional stability and unconditional love and can assist with conditions such as anxiety, depression, bipolar disorder/mood disorder, panic attacks, fear/phobias (including fear of flying), and other psychological and emotional conditions, including PTSD.

Studies Show Emotional Support Animals Help Combat Senior Isolation and Help PTSD

A new Harvard study shows that Emotional Support Animals can help create human-to-human friendships and social support, both of which are good for long-term health and as a way to eliminate social isolation.

When paired with the right animal, veterans with PTSD are less likely to require drugs for their condition, or at least as many drugs or lower dosages (limiting side effects), and even less likely to commit suicide (a growing issue among veterans). In addition, researchers are accumulating evidence that bonding with animals has biological effects, such as elevated levels of the hormone oxytocin. Oxytocin improves trust, the ability to interpret facial expressions, the overcoming of paranoia and other pro-social effects — the opposite of PTSD symptoms. For more about PTSD Animals, please read our blog post, “Lending a Paw for Veterans.”

Emotional Support Animals Are Protected Under Federal Law

Under the Fair Housing Amendments Act (FHAA) and the Air Carrier Access Act (ACAA), an individual who meets the proper criteria is entitled to an Emotional Support Animal to assist them. The FHAA protects individuals by allowing their Emotional Support Animal to live with them (even when there are no pet policies in place), while the ACAA allows Emotional Support animals to fly with their owners in the cabin of an airplane (and without having to pay any additional fees).

When it comes to Emotional Support Animals or Service Animals, federal law prohibits discrimination of breed, size, and training level.  Unlike Service Animals that are specially trained for a specific task, such as helping the blind or detecting seizures, Emotional Support Animals do not have to be trained to perform any specific task. In other words, any animal can be an Emotional Support Animal, and Emotional Support Animals do not have to be professionally-trained or registered.
In addition, people with Emotional Support Animals must also be allowed access to all public accommodations. This right takes precedence over all state and local laws which might otherwise prohibit animals in those places such as stores, malls, restaurants, hotels/resorts, airlines, cruises, taxi cabs, and buses, just to name a few.

Identifying Emotional Support Animals for the Public

Emotional Support Animals are often identified by wearing an Emotional Support Animal vest or tag that lets the public know that it is an Emotional Support Animal. Some businesses, such as airlines, prefer to see an identification card or vest that indicates that the Animal is an Emotional Support Animal.  But these types of identification are not required.  All you need is a letter from a qualified medical or mental health professional stating that your animal is an Emotional Support Animal, and stating the reasons.

Getting Your Animal Qualified

In order to qualify your pet as an Emotional Support Animal, just Google the term “emotional support animal” and you will be presented with many options.  Do not be fooled by places touting themselves as “official” or “registries,” as there are no such things. As stated before, all you need is a letter from a qualified medical / mental health professional, and there are many legitimate services online that will connect you with such a qualified professional for as little as $125.  The letter that you get is only good for one year, so you will need to get a new letter each year, and some services charge less for a “recertification” letter.  Also, when flying, check airline policy because most airlines want at least 48 hours’ notice that you will be flying with an Emotional Support Animal. Although the law does not seem to allow airlines to require this kind of notice, it is a good idea to try to follow the airline’s policy.

Protecting Your Emotional Support Animal with a Pet Trust

When your Emotional Support Animal is “working” (such as accompanying you on a flight to help keep you calm), it is technically not a pet. However, at other times, your beloved Emotional Support Animal is a pet.  A Pet Trust is legal instrument that you can create to insure your pet receives proper care after you die or in the event of your disability.  Pet owners can have peace of mind knowing their pets will be cared for according to their instructions, since pet trusts are enforceable by law. The directions left in a pet trust can be very specific, and can even include your pet’s favorite brand of food, how many times you visit the veterinarian, and your pet’s walk/exercise schedule. A trust that goes into effect while the pet owner is still alive can provide instructions for the care of the animals in the event that the pet owner becomes gravely sick or injured. Since pet owners know the particular habits of their animals better than anyone else, they can describe the kind of care their pets should have and provide a list of the person(s) who would be willing to provide that care.

Unlike a Will, which has to wind through the nightmare of probate, a Pet Trust should be created along with your living trust and should be designed to take effect immediately upon your incapacity or death so that your beloved companion does not have to linger in a shelter while the courts cut through paperwork. Most pet owners opt to leave pets to family or a close friend. The main value of the pet trust is the fact it’s legally enforceable. If your designated caretaker does not live up to obligations, the courts can step in.

Since there are several states in which a pet trust is not valid, and other states where enforcement is discretionary, it is advisable to set up a trust with the help of a Certified Elder Law Attorney, such as myself, who specializes in estate planning. If you live in Virginia, the law (Virginia Va. Code Ann. § 55-544.08) states that “A trust may be created for the care of an animal or animals alive during the settlor’s lifetime.  The trust terminates upon the death of the animal, or upon the death of the last surviving animal covered by the trust.”

You can find out more at your no-cost initial consultation at The Farr Law Firm. You can then decide if the trust makes financial sense for you and your family. If so, we can work with you to include all of your pet’s needs and your wishes for your pet, and name a caretaker and a trust administrator for when the inevitable happens.

While you are in the office, be sure to visit with all of the animals who live here, including Angel (our adorable cat), Commander Bun Bun (our lop-eared love bunny), and Baxter (Justin’s dog who comes to the office from time-to-time). Also be sure to read our “Critter Corner” column in our Friday “Ask the Expert” newsletter each week. To make an appointment, please call us at:

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

Alzheimer’s Lost Memories May Be Recoverable



Jennifer was 42 years-old when she was diagnosed with early-onset Alzheimer’s.  She was heartbroken at first, wondering if she would remember the details of her first love, her child’s wobbly first steps, her overseas travels, or her 20-year career as a pediatric nurse. These things were all significant to the fabric of her life so far, and now all she can do is participate in trials, search for answers and, most of all, maintain hope.

Forgetting loved ones’ names, important dates or events, and details of one’s earlier life are all hallmarks of Alzheimer’s disease. Until recently, the scientific community generally accepted the idea that the disease destroys the process by which these memories are stored, resulting in their complete loss. However, new research conducted at the Massachusetts Institute of Technology (MIT) has uncovered evidence that these memories aren’t lost indefinitely­— they’re just inaccessible, with the potential to be retrieved.

How the Research was Conducted

The research involved two groups of mice: a control group and a group that was genetically engineered to have Alzheimer’s-like symptoms. Both groups were given a mild electric shock to their feet. The first group appeared to remember the trauma of the incident by showing fear when placed back in the box where they had been given the shock. The Alzheimer’s mice, on the other hand, seemed to quickly forget what happened and did not have an upset reaction to the box.

The researchers then located the cells associated with this specific memory — called engram cells — in the part of the brain that encodes short-term memories. They stimulated these cells with blue light. After doing so, when they placed the mice back in the box where they had first been shocked, the Alzheimer’s group appeared to remember the trauma they experienced and exhibited the same fear as the healthy group of mice.

The researchers were encouraged by the findings, but came to realize that the memories restored in this way faded within a day. They noted a reduction in the number of spines — small knobs on brain cells through which neurons pass along information. Restoring the lost spines with high-frequency bursts of light in the brain enabled the mice to remember the shock once again, for up to six days.

According to the researchers, “Directly activating the cells that are holding the memory gets them to retrieve it. This suggests that it is indeed an access problem to the information, not that they’re unable to learn or store this memory.” Head researcher, Susumu Tonegawa, a Nobel Prize winner, says “Basic research as conducted in this study provides information on cell populations to be targeted, which is critical for future treatments and technologies.”

Scientists at the Center for Neural Science at New York University, said the researchers used a “clever strategy.” They called the findings “exciting” and wrote that they “might help to guide engram-based strategies that rescue memory deficits in patients with early-stage Alzheimer’s disease.” Other experts caution that the technique is not something that can be translated into use for the 44 million people living with dementia worldwide anytime soon, and that the invasive light-based procedure is presently considered too dangerous for human trials. Still, researchers are hopeful about the potential of being able to reverse early-stage Alzheimer’s-induced memory loss—in humans—in the future.

There are many more promising research studies about Alzheimer’s and dementia and, like you, I am hopeful that these studies will yield a breakthrough soon. For more details on Alzheimer’s research, visit alz.org. Please also follow us on Twitter (@ElderLawExpert), as we post about new research and breakthroughs often. Please also read our blog posts, “How Close Are We to a Cure for Alzheimer’s?” and “Is Alzheimer’s in Your Future?,” for additional details on strides that are being made in treatment and prevention of the disease.

Early Detection is Key

Research suggests that the process of Alzheimer’s disease begins more than a decade before clinical symptoms appear. Early detection is important for planning for long-term care and participating in trials to help stave off the disease and possibly find a cure. Early detection may also have a major impact on the course of the disease, and in successfully treating symptoms. Please read our blog post that explains more about the importance of early detection. If you are worried about yourself or a loved one, be sure to make an appointment with a doctor for a medical evaluation, including mental status testing and a physical and neurological examination.

Medicaid Planning for Alzheimer’s and Other Types of Dementia

Alzheimer’s is the biggest health and social care challenge of our generation, and a diagnosis of the disease is life-changing.  When it comes to planning for long-term care needs, generally, the earlier someone with dementia plans, 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.

Medicaid planning 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.  Please understand that you never need to spend-down all of your assets and go broke in order to get Medicaid.

Medicaid Asset Protection

People with Alzheimer’s live on average four to eight years after they’re diagnosed, but some may live 20 years beyond their initial diagnosis. Do you have a loved one who is suffering from Alzheimer’s or any other type of dementia? Persons with dementia and their families face special legal and financial needs. At The Law Firm of Evan H. Farr, P.C., we are dedicated to easing the financial and emotional burden on those suffering from dementia and their loved ones.  We help protect the family’s hard-earned assets while maintaining your loved one’s comfort, dignity, and quality of life by ensuring eligibility for critical government benefits such as Medicaid and Veterans Aid and Attendance. Please call us 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

Can a Spouse Refuse the Support of His or Her Spouse to Qualify for Medicaid?

Can a Spouse Refuse the Support of His or Her Spouse to Qualify for Medicaid

By Fredrick P. Niemann, Esq. of Hanlon Niemann, a Freehold, NJ Medicaid Attorney


Federal Law (42 U.S.C.A. § 1396r-5 (c) (3)) allows a community spouse to refuse to pay for the institutionalized spouse, applying for Medicaid which if properly authorized, stops the State from considering his or her funds in the calculation of eligibility by the institutionalized spouse to qualify for Medicaid, live in a nursing home, assisted living residence or home based program.  The practical effect of this statute means New Jersey must then pursue collection action against the other spouse for support in order to be compensated for the case being provided.


There are 3 ways to declare spousal refusal.  The first is the infirmed spouse must assign “to the State any rights to support from the community spouse.”  42 U.S.C.A. § 1396r-5 (c) (3) (A).  If no express assignment is possible due to the physical or mental disability of the spouse, the State can still pursue a “support proceeding against a community spouse without such assignment.”  Id. at (B).  Finally, refusal can be granted if denial would cause an “undue hardship.”  Id. at (C).


Despite the federal existence of this procedure, many states’, including New Jersey, have on the books Medicaid regulations that have not enacted nor allow a procedure like this to be used by the community spouse.  See N.J.A.C. § 10:71–4.8.  However, the 2nd Circuit Court of Appeals ordered a neighboring state’s Department of Social Services to grant a couple’s request for the community spouse to refuse to help the institutionalized spouse under this procedure, assigning the infirmed spouse’s rights to the State of Connecticut and allowing that person to qualify for Medicaid.  Even though the state (Connecticut) does not have this assignability procedure available, the court held that the federal statute was unambiguous in allowing such a refusal to be performed for purposes of determining eligibility.  Id. at 234.  As long as there is adequate standing (denial of Medicaid by New Jersey) that would have been granted if this “spousal refusal option” were in place and used by the couple, there is a strong legal case to go to the federal courts and argue that it must be implemented and recognized in NJ.


To discuss your NJ Medicaid matter, please contact Fredrick P. Niemann, Esq. toll-free at (855) 376-5291 or email him at fniemann@hnlawfirm.com.  Please ask us about our video conferencing consultations if you are unable to come to our office.

Critter Corner: Is There a Federal Long-Term Care Insurance Option?

What Aging Parents Really Want from Their Adult Children

What Aging Parents Really Want from Their Adult Children

Image Source: CBS News

Ellen, 75, was thrilled … [Read More…]

Long-Term Care Insurance: Yes or No?

Yet Another Reason to Reconsider Long-Term Care Insurance: A Class Action Lawsuit

In the class-action lawsuit you referenced in your question, Gardner v. Continental Casualty Company (CNA), the insurer was being sued for acting in bad faith by changing its policy interpretation regarding coverage for assisted-living facilities without alerting policyholders.

The suit alleged the insurer acted illegally when it denied the claims of seniors who were insured by them, using “a scheme of fraud, deception and manipulation of policy terms” all while pursuing massive premium increases.

According to the complaint, Marie L. Gardner, 91, paid premiums on her long-term-care policy for 15 years before breaking her hip in 2008 and moving to an assisted-living facility.  She received benefits until February 2011 when CNA determined that her condition had improved.  After she fell down a flight of stairs at the facility a year later and fractured her sacrum, CNA denied her claim for benefits.

And, Gardner was not the only one. A class action suit of at least 20,000 CNA policyholders nationwide was brought to court, on behalf of the policyholders who claimed they were unfairly denied coverage. The lawsuit asked for class certification and an injunction to prevent the insurer from excluding claims for stays in Connecticut assisted living facilities, and the court ruled in favor of the plaintiffs. For the full text of this decision, go to: https://ecf.ctd.uscourts.gov/cgi-bin/show_public_doc?2013cv1918-168

Other Options to Pay for Long-Term Care

If you have done your research and decide long-term care insurance is still the right choice for you and your family, you should incorporate it as part of your long-term care plan, not as the only form of planning for long-term care.  Keep in mind that there are dozens of long-term care asset protection strategies other than long-term care insurance.

-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 assistance.  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.

-If you are still healthy and not yet on the “long-term care continuum,” then instead of Life Care Planning and Medicaid Asset Protection Planning you should consider our Living Trust Plus™ Asset Protection Trust, which is a simpler and less expensive method of asset protection for clients who will most likely not need any long-term care for at least five years. For most Americans, the Living Trust Plus™ is the preferable form of asset protection trust because, for purposes of Medicaid eligibility, this type of trust is the only type of self-settled asset protection trust that allows a settlor to retain an interest in the trust while also protecting the assets from being counted by state Medicaid agencies.

As always, 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 to make an appointment for a no-cost initial 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

“Just Say No” – Can a Spouse Refuse to Support Their Spouse to Avoid Paying Long Term Care Costs?

By Fredrick P. Niemann, Esq. of Hanlon Niemann Wright, a NJ Medicaid Attorney and Law Firm

New Jersey Medicaid laws are tough, especially as relates to the financial responsibility of spouses to financially support each other should one spouse get sick. There are published cases and a statute commonly cited that mandates that a spouse must pay for the necessities of the other (doctrine of necessities). So does that mean a spouse has to pay the $12,000 a month nursing home bill of their failing spouse? Generally speaking, the answer is yes but if you read my website on Medicaid strategies for long term care, you’ll see that there are many available strategies to minimize the devastating outcome. Another strategy that is seldom used (I’ve used it successfully several times) is called “Just Say No”, or “Spousal Refusal to Support”. Under federal law 42 USC §1996R-5(3)3 if the community spouse simply refuses to pay for the nursing home care of the ill spouse, New Jersey cannot consider the assets of the community spouse in determining the Medicaid eligibility of the nursing home spouse. While, what I just told seems fairly straightforward and simple, it’s not. There are a number of additional conditions and substantive/procedural legal requirements that must be followed but the bottom line is the strategy is legal and effective. New Jersey and other states hate it but when challenged (and I’ve done it) by way of threatened appeal and sanctions under federal law (specifically a 1983 Civil Rights lawsuit), New Jersey and other states will often consider the law and grant approval. New Jersey will then have to pursue a civil collection action against the community spouse for the support of the nursing home spouse but the nursing home spouse is immediately eligible for Medicaid and will be subject to the Medicaid reimbursement rate rather than the private pay rate. So even if the state pursues collection (often doubtful, especially for out of state spouses) and is successful (which is no certainty) the amount due the state will still be lower had the family not gone through the process.

Contact Fredrick P. Niemann, Esq. today with any questions you may have concerning NJ Medicaid. He can be reached toll-free at (855) 376-5291 or by email at fniemann@hnlawfirm.com. We look forward to hearing from you.

What Aging Parents Really Want from Their Adult Children

Source: CBS News

Image Source: CBS News

Ellen, 75, was thrilled at first when her daughter, Samantha, moved back to Northern Virginia with her family. She loved seeing her grandchildren and enjoyed being there for their concerts, soccer games, and birthday parties. Her feelings began to change, however, when Samantha began dropping by, acting overly critical, and assessing everything from the cleanliness of Ellen’s home to the food in her refrigerator. It got to a point where Ellen was not sure whether her daughter was coming to visit or to check up on her.

Samantha even had the grandkids go through Ellen’s cabinets to check ‘use by’ dates on Ellen’s food. For them it was a game, except Ellen didn’t feel like playing. Ten years ago, she probably would have joined in the fun.  Now she is much more sensitive to being criticized.

In the end, the only thing Samantha’s scrutiny accomplished was putting Ellen on edge when they spent time together. So, although Ellen still enjoyed seeing her daughter and grandchildren, she began looking for excuses to see them less often.

What Are Older Parents Looking for in Relationships with their Adult Children?

As parents get older, attempts to hold on to independence can be at odds with well-intentioned suggestions from their adult children. A study titled, “The Bitter with the Sweet”- Older Adults’ Strategies for Handling Ambivalence in Relations with Adult Children” conducted by public-health professor Mary Gallant and sociologist Glenna Spitze from the State University of New York at Albany, explored the issue of what aging parents really want from their adult children. The researchers conducted interviews with focus groups of older adults, and their findings were as follows:

  • Aging parents who live independently expressed a strong desire for both autonomy and connection in relations with their adult children, leading to ambivalence about receiving assistance from them.
  • Most seniors want to have control over their lives, but at the same time, they want to have their children intervene and offer help, if they express a need for it.
  • They might express some resistance from the help offered by their children but deep inside, they truly appreciate it.
  • They want to be treated normally and not as an incompetent.
  • They use a variety of strategies to deal with their ambivalent feelings, such as minimizing the help they receive and ignoring or resisting children’s attempts to control.

Advice for the Adult Child

As our parents age and need more help, it’s natural to want to lend a hand. However, when you get involved, you need to make sure that you don’t become domineering. Why? Seniors who feel like their children are trying to take over their lives get resentful and angry — and as a result often disregard their help just to spite them or assert their independence.

This is why it’s important that as our parents age and do start to lose some of their abilities, that we stay aware of how we’re communicating with them. Being respectful and mindful of boundaries are actually the cornerstones of all healthy relationships. So, when we want to get someone close to us to consider a new approach or solution, it’s imperative to consider their feelings and potential reactions and to let sensitivity and kindness guide our actions.
When communicating with aging parents:

  • Show respect: A big part of striking the right balance has to do with how we speak and act. It’s imperative that we show respect, not attempt to force our will, and to make everything a negotiation (or at least offer options).
  • Pick your battles: Let your parents do as much as they can and don’t sweat the small stuff. This way, when you have to focus on the important things, like health, finances and safety, you’re less likely to meet opposition.
  • Make suggestions, instead of giving orders: Ask questions about how they feel and what they need. If parents don’t feel infantilized or pushed into situations, they’re more likely to be open to solutions you work out together.
  • If you think your parents can do something by themselves, let them: But if they — or someone else — could be harmed, don’t feel guilty about getting involved.
  • Reframe, don’t blame: A slip of the tongue can unleash a world of hurt and ill will. As exasperating as aging parents can be, spouting off without thinking will only make them — and you — feel bad.
  • Stop and think how you would want to be treated: It’s important to keep things as positive as possible while we find ways to help our parents as they age.

Are You an Aging Parent or an Adult Child (or Both)?
Remember, the most important thing as we age, is that we go out of our way to maintain good relationships. And good relationships come with patience, understanding, and empathy. Be kind and respectful to each other and make the most of the time you have together as a family!

Planning for the Future is Important for ALL Families
We here at The Law Firm of Evan H. Farr, P.C. have strategies in place to help all types of families plan for themselves and their loved ones. With advance planning, each person, regardless of their family situation, can retain the income and assets it has taken a lifetime to accumulate and the peace of mind that their needs will be adequately and properly addressed. If you or members of your family have not done your Incapacity Planning, Estate Planning, or Long-Term Care Planning, or if you haven’t had your planning reviewed and updated in the last five years, please contact us as soon as possible to make an appointment for a no-cost initial 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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