Governor David A. Paterson signed into law three Governor’s Program bills that will make health insurance more affordable and improve access to health care for New Yorkers. The first extends the period of time for COBRA (Consolidation Omnibus Budget Reconciliation Act of 1985) coverage from 18 to 36 months; the second permits families to cover their young adult dependents through age 29 under their job-based insurance; and the third enacts a series of managed care reforms to make health insurance work better for consumers and permit timely access to necessary health services. The Governor signed the legislation at the University of Rochester Medical Center and was joined by members of the Senate, Assembly and community.
“By enhancing access to group health insurance, these reforms will make health insurance more affordable for everyday New Yorkers. More than 2.5 million of our residents do not have health insurance, partly because of the high cost of coverage,” said Governor Paterson. “We must take the necessary steps to improve our broken health care system. By making insurance coverage more accessible, we bring people into the system before they need emergency treatment, reducing the overall cost of health care to the State.”
The bills signed into law will:
• Expand COBRA for Employees to 36 months: this law will increase the period for employees who lose their jobs to continue their health insurance under COBRA from 18 to 36 months. Workers who lose their jobs can continue purchasing group health insurance provided by their former employers’ group health plans for limited periods of time under certain circumstances for themselves and their families. Federal COBRA generally applies to employers with 20 or more employees, while the State’s “mini-COBRA” law requires that smaller employers - those who have fewer than 20 employees - offer the same continuation coverage. This allows employees to maintain health insurance at a lower cost than if they had to buy it independently on the open market. The Governor’s new law will allow New Yorkers who lose their jobs to extend their health insurance coverage for a longer period of time, which is particularly important in the current economy with its record high level of unemployment.
• Insure Dependents through Age 29: This law, outlined by the Governor in his State of the State address, requires insurers to allow unmarried children through age 29 - regardless of financial dependence - to be covered under a parent’s group health insurance policy. Young adults ages 19 to 29 represent 31 percent of uninsured New Yorkers. They often become ineligible for coverage under their parents’ policies at age 19 or upon high school or college graduation, find themselves in entry-level jobs that do not provide employer-based health insurance, and cannot afford to pay premiums for individual insurance policies - which are much more expensive than group policies. Under the new law, premiums will be paid for by families, not employers, and would cost less because coverage is under group policies rather than individual policies. The law also requires insurers to offer employers an option to purchase coverage that includes young adults as dependents in family policies through age 29.
• Managed Care Reform: This bill will implement reforms that help consumers receive the care they need and cut some of the red tape that results in inappropriately delayed or denied claims. There are many protections that will now benefit consumers, some of which include: prohibiting insurers from treating in-network providers as out-of-network providers because the referring provider was out-of-network; reducing prompt-pay time frame from 45 days to 30 days; requiring HMOs and providers to give providers notice of adverse reimbursement changes to provider contracts so that they may have the opportunity to cancel and much more. For the complete list, go to http://www.ny.gov/governor/press/press_0729095.html .
The bills signed into law on July 29, 2009 build upon other initiatives aimed at increasing the availability and affordability of health insurance. In March, Governor Paterson signed into law his Program Bill to help New Yorkers who lost their jobs at small businesses take advantage of a COBRA subsidy made available under the Federal American Recovery and Reinvestment Act (ARRA). In addition, the 2009-10 budget eliminated certain barriers to enrolling in public health insurance coverage such as face-to-face interviews, finger imaging, and asset tests and authorized the Department of Health to seek federal support for expanded coverage for low-income adults. Moreover, as of September 1, 2008, all of New York’s uninsured children became eligible for moderate or no-cost health care coverage under Child Health Plus.
Source: 7/29/09 Press Release, www.ny.gov
Wednesday, August 19, 2009
Thursday, August 6, 2009
LETTER OF INTENT
You have signed your last will and testament or revocable trust, created a special needs trust for your child with disabilities and selected an appropriate trustee to manage assets and make necessary trust distributions for your child's care. Now you are done, correct? Not exactly, because ensuring your child's financial future is only one facet of a comprehensive plan designed to care for your child with special needs.
An important companion piece to a special needs trust is a "letter of intent" or "letter of instruction." This is a document that actually ensures your trustee knows your child's functional abilities, routines, interests, and particular likes and dislikes. In addition to describing your special child, the letter of intent identifies specific doctors, services and resources that will help your child enjoy the highest level of independence and self-reliance. The document is a valuable tool that communicates knowledge only parents may know, including specific hopes and desires for their child's future well being, to the very people who will be caring for the child after the parents no longer are able to do so. After all, who knows a child better than a parent?
The letter of intent serves as the foundation of any comprehensive life-plan for a child with special needs. By compiling as much information as possible, parents are equipping future care providers with the knowledge and insight needed to increase the likelihood of good choices in order to maximize the child's quality of life and avoid the need for caregivers to learn by trial and error. A child also may participate in creating the letter of intent so that his or her own wishes are acknowledged and recorded.
A well thought out letter of intent often includes a medical component and a practical piece and, at a minimum, should contain the following:
A family history, including where and when parents were born, raised, and married, as well as a description of siblings, grandparents, other relatives and special friends, with current contact information for all.
Resources that provide assistance to persons with disabilities in your child's local area, including public agencies, churches, individuals and private organizations.
Residential care needs for your child, including past and present accommodations and expected future needs.
Educational information, including past records, current enrollment, specialty teachers, future educational goals, special interests and talents, extra-curricular activities, as well as types of educational emphasis, for example, vocational, academic or communication.
Employment guidance, including the work your child may enjoy, sheltered workshops, activity centers and companies that provide employment in the community which may be of interest to your child.
Social, behavioral and personal relationships that are important to your family and child, including relatives, special friends, teachers and care providers.
Social and recreational activities your child enjoys, including sports, dance, music or movies. Parents also might want to mention whether their child should have his or her own spending money.
A typical day in the life of your child, including his or her favorite foods, music, books, television shows and routines.
Medical information, including current doctors, therapists, clinics, hospitals, current medications and therapies. The parents should explain how the medications are given and for what purpose and describe medications that have not worked in the past.
Parents' final expression of love, hope and desires for their child.
Parents should not be inhibited when writing a letter of intent, and a clear, conversational voice that avoids legalese is best. In addition, the document should be reviewed periodically to reflect any changes. Below is an excerpt from an actual letter of intent, published with a client's permission, to help other families with their own drafting:
"...Bill can dress himself, but needs some help picking an appropriate outfit for the weather. Once his clothes are laid out he can dress himself. May need some help with buttons or other fasteners. He prefers pullover shirts and t-shirts rather than shirts with buttons. He prefers athletic pants that he can pull up such as track pants rather than jeans or slacks. He can put on his own socks. He struggles with tying shoes and we have switched exclusively to zip up or pull-on shoes. He is able to zip his own coat, but may need help at times. Using zippers, snaps and buttons are a continuous goal for him to work on manipulating them independently.
He needs to be reminded to brush his teeth and wipe his face, but can do these tasks independently both in the morning and at night. He hates mint toothpaste and uses the kids' flavors. Right now he is using Kids Crest- Sparkle Fun flavor. He hates getting a lot of water on his face and needs a washcloth and wipes all over his face and then rinses with a damp cloth. He can do all this himself, but hates it and needs supervision and verbal prompts/encouragement. Bill is doing well with taking showers. It has been a long process. He can wash himself fairly well with the washcloth and can now wash his own hair. He continues to need someone checking in on him and providing verbal cues to wash and rinse his hair well. He gets upset if a lot of water goes on his face so rinsing his hair is an issue..."
Although writing a letter of intent may be an emotional experience, once the process is complete, parents may rest easier knowing they have left a detailed road map for later care providers and trustees to ensure the highest quality of life for their child and the fewest interruptions in his or her daily routine.
Source: www.specialneedsalliance.com, 6/09, Vol. 3 Issue 6
An important companion piece to a special needs trust is a "letter of intent" or "letter of instruction." This is a document that actually ensures your trustee knows your child's functional abilities, routines, interests, and particular likes and dislikes. In addition to describing your special child, the letter of intent identifies specific doctors, services and resources that will help your child enjoy the highest level of independence and self-reliance. The document is a valuable tool that communicates knowledge only parents may know, including specific hopes and desires for their child's future well being, to the very people who will be caring for the child after the parents no longer are able to do so. After all, who knows a child better than a parent?
The letter of intent serves as the foundation of any comprehensive life-plan for a child with special needs. By compiling as much information as possible, parents are equipping future care providers with the knowledge and insight needed to increase the likelihood of good choices in order to maximize the child's quality of life and avoid the need for caregivers to learn by trial and error. A child also may participate in creating the letter of intent so that his or her own wishes are acknowledged and recorded.
A well thought out letter of intent often includes a medical component and a practical piece and, at a minimum, should contain the following:
A family history, including where and when parents were born, raised, and married, as well as a description of siblings, grandparents, other relatives and special friends, with current contact information for all.
Resources that provide assistance to persons with disabilities in your child's local area, including public agencies, churches, individuals and private organizations.
Residential care needs for your child, including past and present accommodations and expected future needs.
Educational information, including past records, current enrollment, specialty teachers, future educational goals, special interests and talents, extra-curricular activities, as well as types of educational emphasis, for example, vocational, academic or communication.
Employment guidance, including the work your child may enjoy, sheltered workshops, activity centers and companies that provide employment in the community which may be of interest to your child.
Social, behavioral and personal relationships that are important to your family and child, including relatives, special friends, teachers and care providers.
Social and recreational activities your child enjoys, including sports, dance, music or movies. Parents also might want to mention whether their child should have his or her own spending money.
A typical day in the life of your child, including his or her favorite foods, music, books, television shows and routines.
Medical information, including current doctors, therapists, clinics, hospitals, current medications and therapies. The parents should explain how the medications are given and for what purpose and describe medications that have not worked in the past.
Parents' final expression of love, hope and desires for their child.
Parents should not be inhibited when writing a letter of intent, and a clear, conversational voice that avoids legalese is best. In addition, the document should be reviewed periodically to reflect any changes. Below is an excerpt from an actual letter of intent, published with a client's permission, to help other families with their own drafting:
"...Bill can dress himself, but needs some help picking an appropriate outfit for the weather. Once his clothes are laid out he can dress himself. May need some help with buttons or other fasteners. He prefers pullover shirts and t-shirts rather than shirts with buttons. He prefers athletic pants that he can pull up such as track pants rather than jeans or slacks. He can put on his own socks. He struggles with tying shoes and we have switched exclusively to zip up or pull-on shoes. He is able to zip his own coat, but may need help at times. Using zippers, snaps and buttons are a continuous goal for him to work on manipulating them independently.
He needs to be reminded to brush his teeth and wipe his face, but can do these tasks independently both in the morning and at night. He hates mint toothpaste and uses the kids' flavors. Right now he is using Kids Crest- Sparkle Fun flavor. He hates getting a lot of water on his face and needs a washcloth and wipes all over his face and then rinses with a damp cloth. He can do all this himself, but hates it and needs supervision and verbal prompts/encouragement. Bill is doing well with taking showers. It has been a long process. He can wash himself fairly well with the washcloth and can now wash his own hair. He continues to need someone checking in on him and providing verbal cues to wash and rinse his hair well. He gets upset if a lot of water goes on his face so rinsing his hair is an issue..."
Although writing a letter of intent may be an emotional experience, once the process is complete, parents may rest easier knowing they have left a detailed road map for later care providers and trustees to ensure the highest quality of life for their child and the fewest interruptions in his or her daily routine.
Source: www.specialneedsalliance.com, 6/09, Vol. 3 Issue 6
Thursday, July 23, 2009
Marketing of Reverse Mortgages Lacks Adequate Consumer Protections
As the economy has slowed and housing values have dropped, reverse mortgages have become even more attractive to seniors looking for ways to use the equity in their homes without moving. But a new study by the Government Accountability Office (GAO) raises concerns about the adequacy of consumer protections for reverse mortgage borrowers, who are sometimes subjected to misleading marketing and inappropriate cross-selling of other financial products that may be unsuitable for them.
A reverse mortgage allows homeowners 62 or older to convert the equity in their home to a flexible cash advance that does not have to be repaid until the homeowner moves, sells, or dies. Almost all reverse mortgages are made under the Home Equity Conversion Mortgage (HECM) program, which is administered by the Department of Housing and Urban Development (HUD). In the first quarter of 2009, HUD backed about $7.8 billion worth of reverse mortgages, the largest amount in any quarter since the agency launched the program in 1988, the Washington Post reports.
While reverse mortgages look like no-lose propositions at first glance, they are complex products that have significant downsides for some. For example, these loans carry large insurance and origination costs, they may affect eligibility for government benefits like Medicaid, and they are not ideal for parents whose major objective is to safeguard an inheritance for their children.
GAO reviewed marketing materials used by reverse mortgage lenders and found some claims that were "potentially misleading because they were inaccurate, incomplete, or employed questionable sales tactics."
GAO also found evidence that potentially unsuitable financial products like annuities are being sold in conjunction with reverse mortgages. The Housing and Economic Recovery Act of 2008 is intended to restrict this inappropriate cross-selling, but HUD is still in the early stages of developing regulations.
To help seniors make informed decisions about whether to obtain a reverse mortgage, Congress requires prospective borrowers to obtain adequate counseling by an independent third party. As part of its investigation, the GAO employees went undercover to receive such counseling. While the GAO found that the counselors generally conveyed accurate and useful information, none of the counselors covered all of the topics required by HUD and in nearly half the sessions the counselors did not discuss required information about alternatives to reverse mortgages.
The GAO concludes that these issues pose "emerging consumer protection risks" for reverse mortgage borrowers and the agency makes a number of recommendations to improve consumer protections.
Source: www.elderlawanswers.com; 7/3/09
A reverse mortgage allows homeowners 62 or older to convert the equity in their home to a flexible cash advance that does not have to be repaid until the homeowner moves, sells, or dies. Almost all reverse mortgages are made under the Home Equity Conversion Mortgage (HECM) program, which is administered by the Department of Housing and Urban Development (HUD). In the first quarter of 2009, HUD backed about $7.8 billion worth of reverse mortgages, the largest amount in any quarter since the agency launched the program in 1988, the Washington Post reports.
While reverse mortgages look like no-lose propositions at first glance, they are complex products that have significant downsides for some. For example, these loans carry large insurance and origination costs, they may affect eligibility for government benefits like Medicaid, and they are not ideal for parents whose major objective is to safeguard an inheritance for their children.
GAO reviewed marketing materials used by reverse mortgage lenders and found some claims that were "potentially misleading because they were inaccurate, incomplete, or employed questionable sales tactics."
GAO also found evidence that potentially unsuitable financial products like annuities are being sold in conjunction with reverse mortgages. The Housing and Economic Recovery Act of 2008 is intended to restrict this inappropriate cross-selling, but HUD is still in the early stages of developing regulations.
To help seniors make informed decisions about whether to obtain a reverse mortgage, Congress requires prospective borrowers to obtain adequate counseling by an independent third party. As part of its investigation, the GAO employees went undercover to receive such counseling. While the GAO found that the counselors generally conveyed accurate and useful information, none of the counselors covered all of the topics required by HUD and in nearly half the sessions the counselors did not discuss required information about alternatives to reverse mortgages.
The GAO concludes that these issues pose "emerging consumer protection risks" for reverse mortgage borrowers and the agency makes a number of recommendations to improve consumer protections.
Source: www.elderlawanswers.com; 7/3/09
Thursday, July 9, 2009
OBAMA BACKING PLAN TO INCLUDE MODEST LONG-TERM CARE INSURANCE IN HEALTH REFORM
President Barack Obama has given his support to a proposal for new national long-term care insurance program that would offer basic help for the elderly and disabled. The President's support could be key to making long-term care coverage a part of the final health reform legislation.
1. Proposed by Sen. Edward M. Kennedy (D-MA) as part of his health care reform bill, the plan would set up a new, voluntary social insurance program to help people insure against the high costs of long-term care. Americans would pay a premium of roughly $65 per month, although the Congressional Budget Office has said the premium could end up being as much as $110 a month -- still far less than the typical cost of private long-term care insurance. After participants had contributed for at least five years, they would be eligible for a benefit of not less than $50 a day to cover long-term care costs.
While the benefit is modest compared to the average cost of nursing home care, it could be used instead to pay for a range of services that would help people remain in their homes. All working Americans would automatically be enrolled in Kennedy's plan, known as the Community Living Assistance Services and Supports (CLASS) Act, but they could choose to opt out. Students and the poor would pay only $5 a month.
In a letter to Kennedy, Health and Human Services Secretary Kathleen Sebelius said that President Obama considers the long-term care program an "innovative" idea that should be "part of health reform."
"Enactment of this important legislation would expand resources available to individuals and families to purchase long-term services and supports to enable them to remain in their own homes in the community," wrote Sebelius.
For many middle-income Americans, the Kennedy plan could be just enough to allow them to stay at home or to afford assisted living care. Medicaid "waiver" programs that offer home health services often have long waiting lists in the states that offer them. Many elderly or disabled individuals end up in nursing homes at government expense when all they actually need is help around the house or home nurse visits.
Source: www.elderlawanswers.com, 7/9/09
1. Proposed by Sen. Edward M. Kennedy (D-MA) as part of his health care reform bill, the plan would set up a new, voluntary social insurance program to help people insure against the high costs of long-term care. Americans would pay a premium of roughly $65 per month, although the Congressional Budget Office has said the premium could end up being as much as $110 a month -- still far less than the typical cost of private long-term care insurance. After participants had contributed for at least five years, they would be eligible for a benefit of not less than $50 a day to cover long-term care costs.
While the benefit is modest compared to the average cost of nursing home care, it could be used instead to pay for a range of services that would help people remain in their homes. All working Americans would automatically be enrolled in Kennedy's plan, known as the Community Living Assistance Services and Supports (CLASS) Act, but they could choose to opt out. Students and the poor would pay only $5 a month.
In a letter to Kennedy, Health and Human Services Secretary Kathleen Sebelius said that President Obama considers the long-term care program an "innovative" idea that should be "part of health reform."
"Enactment of this important legislation would expand resources available to individuals and families to purchase long-term services and supports to enable them to remain in their own homes in the community," wrote Sebelius.
For many middle-income Americans, the Kennedy plan could be just enough to allow them to stay at home or to afford assisted living care. Medicaid "waiver" programs that offer home health services often have long waiting lists in the states that offer them. Many elderly or disabled individuals end up in nursing homes at government expense when all they actually need is help around the house or home nurse visits.
Source: www.elderlawanswers.com, 7/9/09
Monday, June 22, 2009
Redo your Estate Plan Before you Remarry
Redo your Estate Plan Before you Remarry
If you are getting remarried, you obviously want to celebrate, but it is also important to focus on less exciting matters like redoing your estate plan. You may have created an estate plan during your first marriage, but this time it will probably be more complicated – especially if you have children from your first marriage or more assets. The following are some pointers for ensuring your interests are taken care of when you remarry:
• Take an inventory. The first thing you and your partner should do is each take an inventory of your assets and debts and share it with the other person. Don’t forget to include life insurance policies and retirement plans in your inventories. It is important to be open and honest about money if you want to prevent bad feelings in the future.
• Decide how you want to handle finances. Once you know what you are dealing with, then you need to decide if you want to combine (or not combine) assets when you are married. For example, if one partner is selling a house and moving in with the other partner, will he or she contribute to the cost of the house? If one partner has significant debt, you may not want to combine finances or make any joint purchases. These decisions need to be made up front so everyone is clear on what to expect.
• Decide what you want to happen when you die. You and your future spouse need to figure out where each of you wants your assets to go when you die. If you have children from a previous marriage, this can be a complicated discussion. There is no guarantee that if you leave your assets to your new spouse, he or she will provide for your children after you are gone. There are a number of options to ensure your children are provided for, including creating a trust for your children, making your children beneficiaries of life insurance policies, or giving your children joint ownership of property. Even if you don’t have children, there may be family heirlooms or mementos that you want to keep in your family. Again, open discussions can prevent problems in the future.
• Consult an elder law or estate planning attorney. Even if you don’t have a lot of assets, you should consult an attorney, especially if you have children. You will definitely need to update your will. You may also need to update or create other estate planning documents such as a durable power of attorney and a health care proxy. If you have significant assets, a prenuptial agreement may be appropriate. In addition, the attorney can help you decide if a trust is necessary to protect your children’s interests.
• Change your beneficiaries. You may want to change the beneficiaries on your life insurance policy, annuity, and/or retirement plan. If you are divorced, however, you may not be able to change some of the beneficiaries. Bring your divorce decree with you to the attorney so he or she can make sure you do not violate the decree. If you can’t change your beneficiaries, you may want to buy additional life insurance or retirement plans that will include your new spouse.
The most important thing to remember is to be open and honest with your future spouse and your family members about your wishes.
Source: www.elderlawanswers.com
If you are getting remarried, you obviously want to celebrate, but it is also important to focus on less exciting matters like redoing your estate plan. You may have created an estate plan during your first marriage, but this time it will probably be more complicated – especially if you have children from your first marriage or more assets. The following are some pointers for ensuring your interests are taken care of when you remarry:
• Take an inventory. The first thing you and your partner should do is each take an inventory of your assets and debts and share it with the other person. Don’t forget to include life insurance policies and retirement plans in your inventories. It is important to be open and honest about money if you want to prevent bad feelings in the future.
• Decide how you want to handle finances. Once you know what you are dealing with, then you need to decide if you want to combine (or not combine) assets when you are married. For example, if one partner is selling a house and moving in with the other partner, will he or she contribute to the cost of the house? If one partner has significant debt, you may not want to combine finances or make any joint purchases. These decisions need to be made up front so everyone is clear on what to expect.
• Decide what you want to happen when you die. You and your future spouse need to figure out where each of you wants your assets to go when you die. If you have children from a previous marriage, this can be a complicated discussion. There is no guarantee that if you leave your assets to your new spouse, he or she will provide for your children after you are gone. There are a number of options to ensure your children are provided for, including creating a trust for your children, making your children beneficiaries of life insurance policies, or giving your children joint ownership of property. Even if you don’t have children, there may be family heirlooms or mementos that you want to keep in your family. Again, open discussions can prevent problems in the future.
• Consult an elder law or estate planning attorney. Even if you don’t have a lot of assets, you should consult an attorney, especially if you have children. You will definitely need to update your will. You may also need to update or create other estate planning documents such as a durable power of attorney and a health care proxy. If you have significant assets, a prenuptial agreement may be appropriate. In addition, the attorney can help you decide if a trust is necessary to protect your children’s interests.
• Change your beneficiaries. You may want to change the beneficiaries on your life insurance policy, annuity, and/or retirement plan. If you are divorced, however, you may not be able to change some of the beneficiaries. Bring your divorce decree with you to the attorney so he or she can make sure you do not violate the decree. If you can’t change your beneficiaries, you may want to buy additional life insurance or retirement plans that will include your new spouse.
The most important thing to remember is to be open and honest with your future spouse and your family members about your wishes.
Source: www.elderlawanswers.com
Friday, May 29, 2009
The Top 10 Health Care Mistakes Made by the Elderly
The Top 10 Health Care Mistakes Made By the Elderly
Americans are living longer than ever before, but many older Americans could better deal with their health problems, according to the Institute for Healthcare Advancement (IHA). To help the elderly stay healthier longer, the IHA has identified the 10 most common mistakes older Americans make in caring for their health.
The Institute is a non-profit organization based in La Habra, California, that demonstrates innovative health care practices and educates health care professionals and consumers.
The IHA's 10 most common health care mistakes made by the elderly are:
Driving when it's no longer safe
The elderly often associate mobility in a car with their independence, but knowing when it is time to stop driving is important for the safety of everyone on the road. Decisions about when to stop driving should be made together with a family physician because chronological age alone does not determine someone's fitness to drive.
Fighting the aging process and its appearance
Refusing to wear a hearing aid, eyeglasses or dentures, and reluctance to ask for help or to use walking aids are all examples of this type of denial. This behavior may prevent the senior from obtaining helpful assistance with some of the problems of aging.
Reluctance to discuss intimate health problems with the doctor or health care provider
Older Americans may not want to bring up sexual or urinary difficulties. Sometimes problems that the individual thinks are trivial, such as stomach upsets, constipation, or jaw pain, may require further evaluation.
Not understanding what the doctor told them about their health problem or medical treatment plan
"I could not understand the doctor," or "He told me what to do, but you know me, I can't remember what he said‚" are typical complaints. Reluctance to ask the doctor to repeat information or to admit that they do not understand what is being said can result in serious health consequences.
Disregarding the serious potential for a fall
Falls result in fractures and painful injuries, which sometimes take months to heal. To help guard against falling, the elderly should remove scatter rugs from the home and have adequate lighting in the home and work areas. They should wear sturdy and well-fitting shoes, and watch for slopes and cracks in sidewalks. Participating in exercise programs to improve muscle tone and strength is also helpful.
Failure to have a system or a plan for managing medicines
Missed medication doses can result in inadequate treatment of a medical condition. By using daily schedules, pill box reminders or check-off records, seniors can avoid missing medication doses. Because health care providers need to know all of the medicines that an elderly patient is taking, patients should maintain a complete list of all their prescription and over-the-counter medicines, including dose and the reason that the medicine is being taken.
Not having a single primary care physician who looks at the overall medical plan of treatmentHealth problems may be overlooked when a senior goes to several different doctors or treatment programs, and multiple treatment regimens may cause adverse responses. The patient may be over- or under-treated if a single physician is not evaluating the full medical treatment program.
Not seeking medical attention when early possible warning signs occur
Reasons for such inaction and denial may include lack of money or reduced self worth due to age. "I am so old it doesn't matter anymore." Of course, such treatment delays can result in a more advanced stage of illness and a poorer prognosis.
Failure to participate in prevention programs
Flu and pneumonia shots, routine breast and prostate exams are examples of readily available preventive health measures that seniors should utilize to remain healthy.
Not asking loved ones for help
Many older Americans are simply too stubborn to ask for help, whether due to an understandable need for independence or because of early signs of dementia. It's important that elderly people alert family members or other loved ones to any signs of ill health or unusual feelings so that they can be assessed before the problem advances.
In an effort to help older Americans become less fearful of medical conditions and more empowered about their health, the IHA has published What To Do For Senior Health, an easy-to-understand, self-help medical book for senior citizens. For more information or to order the book, call (800) 434-4633 or go to www.iha4health.org.
Source: www.elderlawanswers.com
Americans are living longer than ever before, but many older Americans could better deal with their health problems, according to the Institute for Healthcare Advancement (IHA). To help the elderly stay healthier longer, the IHA has identified the 10 most common mistakes older Americans make in caring for their health.
The Institute is a non-profit organization based in La Habra, California, that demonstrates innovative health care practices and educates health care professionals and consumers.
The IHA's 10 most common health care mistakes made by the elderly are:
Driving when it's no longer safe
The elderly often associate mobility in a car with their independence, but knowing when it is time to stop driving is important for the safety of everyone on the road. Decisions about when to stop driving should be made together with a family physician because chronological age alone does not determine someone's fitness to drive.
Fighting the aging process and its appearance
Refusing to wear a hearing aid, eyeglasses or dentures, and reluctance to ask for help or to use walking aids are all examples of this type of denial. This behavior may prevent the senior from obtaining helpful assistance with some of the problems of aging.
Reluctance to discuss intimate health problems with the doctor or health care provider
Older Americans may not want to bring up sexual or urinary difficulties. Sometimes problems that the individual thinks are trivial, such as stomach upsets, constipation, or jaw pain, may require further evaluation.
Not understanding what the doctor told them about their health problem or medical treatment plan
"I could not understand the doctor," or "He told me what to do, but you know me, I can't remember what he said‚" are typical complaints. Reluctance to ask the doctor to repeat information or to admit that they do not understand what is being said can result in serious health consequences.
Disregarding the serious potential for a fall
Falls result in fractures and painful injuries, which sometimes take months to heal. To help guard against falling, the elderly should remove scatter rugs from the home and have adequate lighting in the home and work areas. They should wear sturdy and well-fitting shoes, and watch for slopes and cracks in sidewalks. Participating in exercise programs to improve muscle tone and strength is also helpful.
Failure to have a system or a plan for managing medicines
Missed medication doses can result in inadequate treatment of a medical condition. By using daily schedules, pill box reminders or check-off records, seniors can avoid missing medication doses. Because health care providers need to know all of the medicines that an elderly patient is taking, patients should maintain a complete list of all their prescription and over-the-counter medicines, including dose and the reason that the medicine is being taken.
Not having a single primary care physician who looks at the overall medical plan of treatmentHealth problems may be overlooked when a senior goes to several different doctors or treatment programs, and multiple treatment regimens may cause adverse responses. The patient may be over- or under-treated if a single physician is not evaluating the full medical treatment program.
Not seeking medical attention when early possible warning signs occur
Reasons for such inaction and denial may include lack of money or reduced self worth due to age. "I am so old it doesn't matter anymore." Of course, such treatment delays can result in a more advanced stage of illness and a poorer prognosis.
Failure to participate in prevention programs
Flu and pneumonia shots, routine breast and prostate exams are examples of readily available preventive health measures that seniors should utilize to remain healthy.
Not asking loved ones for help
Many older Americans are simply too stubborn to ask for help, whether due to an understandable need for independence or because of early signs of dementia. It's important that elderly people alert family members or other loved ones to any signs of ill health or unusual feelings so that they can be assessed before the problem advances.
In an effort to help older Americans become less fearful of medical conditions and more empowered about their health, the IHA has published What To Do For Senior Health, an easy-to-understand, self-help medical book for senior citizens. For more information or to order the book, call (800) 434-4633 or go to www.iha4health.org.
Source: www.elderlawanswers.com
Thursday, May 7, 2009
Why Not Just Use an Off-the-Shelf Power of Attorney Form?
A durable power of attorney is one of the most important estate planning documents you can have. It allows you to appoint someone to act for you (your "agent" or "attorney-in-fact") if you become incapacitated. Without a power of attorney, your loved ones would not be able to make decisions for you or manage your finances without asking the court to appoint a guardian or conservator, which is an expensive and time-consuming process.
There are many do-it-yourself power of attorney forms available; however, it is a good idea to have an attorney draft the form for you. There are many issues to consider and one size does not fit all. Working with an attorney from the Elder Law and Estate Planning firm of Davidow, Davidow, Siegel & Stern ensures that you will be covered.
The agent's powers
The power of attorney document sets out the agent's powers. Powers given to an agent typically include buying or selling property, managing a business, paying debts, investing money, engaging in legal proceedings, borrowing money, cashing checks, and collecting debts. They may also include the power to consent to medical treatment. Some powers will not be included unless they are specifically mentioned. This includes the power to make gifts and the power to designate beneficiaries of your insurance policies.
The power to make gifts of your money and property is a particularly important power. If you want to ensure your agent has the authority to do Medicaid planning on your behalf in the event you need to enter a nursing home, then the power of attorney must give the agent the power to modify trusts and make gifts. The wording in a power of attorney can be significant, so it is necessary to consult an attorney.
Springing or immediate
The power of attorney can take affect immediately or it can become effective only once you are disabled, called a "springing" power of attorney. While a springing power seems like a good idea, it can cause delays and extra expense because incapacity will need to be determined. If the power of attorney is springing, it is very important that the method for determining incapacity is clearly spelled out in the document.
Joint agents
While it is possible to name more than one person as your agent, this can lead to confusion. If you do have more than one person named, you need to be clear whether both parties need to act together or whether they can each act independently. It might make more sense and be less confusing to name an alternative agent to act in case the first agent is unable to.
Appointing a guardian
Another use of a power of attorney can be to nominate a guardian in case guardianship proceedings become necessary. Including your preference for a guardian can allow you to have some say over who will be managing your affairs. Usually, the court decides who will be chosen as a guardian, but in most circumstances, the court will abide by your nomination in the durable power of attorney.
Executing the power of attorney
To be valid a power of attorney must be executed properly. Some states may require a signature, others may require the power of attorney to be notarized, and still others may require witnesses. It is important to consult with an estate planning attorney in your state to ensure your power of attorney is executed properly.
Accepting a power of attorney
Even if you do everything exactly right, some banks and other institutions are reluctant to accept a power of attorney. These institutions are afraid of a lawsuit if the power of attorney is no longer valid. Many banks or other financial institutions have their own standard power of attorney forms. To avoid problems, you may want to execute the forms offered by the institutions with which you have accounts. According to a MarketWatch.com article, you need to be careful that you don't sign a bank's document that inadvertently restricts a power of attorney's ability to deal with other assets, and you should check that any documents you sign with a bank match the original power of attorney.
Source: www.elderlawanswers.com
There are many do-it-yourself power of attorney forms available; however, it is a good idea to have an attorney draft the form for you. There are many issues to consider and one size does not fit all. Working with an attorney from the Elder Law and Estate Planning firm of Davidow, Davidow, Siegel & Stern ensures that you will be covered.
The agent's powers
The power of attorney document sets out the agent's powers. Powers given to an agent typically include buying or selling property, managing a business, paying debts, investing money, engaging in legal proceedings, borrowing money, cashing checks, and collecting debts. They may also include the power to consent to medical treatment. Some powers will not be included unless they are specifically mentioned. This includes the power to make gifts and the power to designate beneficiaries of your insurance policies.
The power to make gifts of your money and property is a particularly important power. If you want to ensure your agent has the authority to do Medicaid planning on your behalf in the event you need to enter a nursing home, then the power of attorney must give the agent the power to modify trusts and make gifts. The wording in a power of attorney can be significant, so it is necessary to consult an attorney.
Springing or immediate
The power of attorney can take affect immediately or it can become effective only once you are disabled, called a "springing" power of attorney. While a springing power seems like a good idea, it can cause delays and extra expense because incapacity will need to be determined. If the power of attorney is springing, it is very important that the method for determining incapacity is clearly spelled out in the document.
Joint agents
While it is possible to name more than one person as your agent, this can lead to confusion. If you do have more than one person named, you need to be clear whether both parties need to act together or whether they can each act independently. It might make more sense and be less confusing to name an alternative agent to act in case the first agent is unable to.
Appointing a guardian
Another use of a power of attorney can be to nominate a guardian in case guardianship proceedings become necessary. Including your preference for a guardian can allow you to have some say over who will be managing your affairs. Usually, the court decides who will be chosen as a guardian, but in most circumstances, the court will abide by your nomination in the durable power of attorney.
Executing the power of attorney
To be valid a power of attorney must be executed properly. Some states may require a signature, others may require the power of attorney to be notarized, and still others may require witnesses. It is important to consult with an estate planning attorney in your state to ensure your power of attorney is executed properly.
Accepting a power of attorney
Even if you do everything exactly right, some banks and other institutions are reluctant to accept a power of attorney. These institutions are afraid of a lawsuit if the power of attorney is no longer valid. Many banks or other financial institutions have their own standard power of attorney forms. To avoid problems, you may want to execute the forms offered by the institutions with which you have accounts. According to a MarketWatch.com article, you need to be careful that you don't sign a bank's document that inadvertently restricts a power of attorney's ability to deal with other assets, and you should check that any documents you sign with a bank match the original power of attorney.
Source: www.elderlawanswers.com
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