Seniors
What Are the Pros and Cons of Reverse Mortgages? | Print |  E-mail
Thursday, 22 January 2015 15:38

012215sen1By Jason Alderman • Special to the Times

Over the last decade, reverse mortgages have been marketed as an easy way for seniors to cash in their home equity to pay for living expenses.

However, many have learned that improper use of the product — such as pulling all their cash out at one time to pay bills — has led to significant financial problems later, including foreclosure.

In actuality, there are some cases where reverse mortgages can be helpful to borrowers. However, it is imperative to do extensive research on these products before you sign.

Reverse mortgages are special kinds of home loans that let borrowers convert some of their home equity into cash. They come in three varieties: single-purpose reverse mortgages, Home Equity Conversion Mortgages (HECMs) and proprietary reverse mortgages.

Who can apply?

Homeowners can apply for a reverse mortgage if they are at least 62 years old, own their home outright or have a low mortgage balance that can be paid off with the proceeds of the reverse loan.

Qualifying homeowners also must have no delinquent federal debt, the financial resources to pay for upkeep, taxes and insurance, and live in the home during the life of the loan.

Consider the following pros and cons as a starting point for trying or bypassing this loan choice. Even though HECM loans require a discussion with a loan counselor, you should bring in your own financial, tax or estate advisor to help you decide whether you have a safe and appropriate use for this product.

Pros of reverse mortgages:

• They’re a source of cash. Borrowers can select that the amount of the loan be payable in a lump sum or regular payments.

• Proceeds are generally tax-free. Final tax treatment may rely on a variety of personal factors, so check with a tax professional.

• Generally, they don’t impact Social Security or Medicare payments. Again, it’s important to check personal circumstances.

• You won’t owe more than the home is worth. Most reverse mortgages have a “nonrecourse” clause, which prevents you or your estate from owing more than the value of your home when the loan becomes due and the home is sold.

• Reverse mortgages may be a smarter borrowing option for some downsizing seniors. With proper advice, some borrowers use them to buy new homes.

Cons of reverse mortgages:

• You may outlive your equity. Reverse mortgages are viewed as a “last-resort” loan option and certainly not a singular solution to spending problems.

• You and your heirs won’t get to keep your house unless you repay the loan. If your children hope to inherit your home outright, try to find some other funding solution (family loans, other conventional loan products) first.

• Fees can be more expensive than conventional loans. Reverse mortgage lenders typically charge an origination fee and higher closing costs than conventional loans. This adds up to several percentage points of your home’s value.

• Many reverse mortgages are adjustable-rate products. Adjustable rates affect the cost of the loan over time.

• If you have to move out for any reason, your loan becomes due. If you have to suddenly move into a nursing home or assisted-living facility, the loan becomes due after you’ve left your home for a continuous year.

Bottom line: Reverse mortgages have become a popular, if controversial, loan option for senior homeowners. For some, they may be a good fit, but all applicants should get qualified financial advice before they apply.

Jason Alderman directs Visa’s financial education programs.


 
What Medicare Doesn’t Cover | Print |  E-mail
Thursday, 22 January 2015 15:37

By Jim Miller • Special to the Times

While Medicare covers a wide array of health care services, it certainly doesn’t cover everything. If you need or want certain services that aren’t covered, you’ll have to pay for them yourself unless you have other insurance or you’re in a Medicare Advantage health plan, which may cover some of these services.

Here’s a rundown of what original Medicare generally does not cover.

Alternative medicine: This includes acupuncture or chiropractic services (except to fix subluxation of the spine), and other types of alternative or complementary care.

Cosmetic surgery: Elective cosmetic procedures are not covered, however, certain surgeries may be if necessary to fix a malformation. For example, breast prostheses are covered if you had a mastectomy due to breast cancer.

Long-term care: This includes nursing home care, the costs of assisted living facilities and adult day care. Medicare does, however, help pay up to 100 days of skilled nursing or rehabilitation care immediately following a three-day inpatient hospital stay.

Personal care: The cost of hiring help for bathing, toileting and dressing are not covered unless you are homebound and are also receiving skilled nursing care. Housekeeping services, such as shopping, meal preparation and cleaning, are not covered either unless you are receiving hospice care.

Routine dental and vision care: Medicare will not cover routine dental checkups, cleanings, fillings or dentures. Nor do they cover routine vision care like eye exams, eye refractions, contact lenses or eyeglasses – except when following cataract surgery.

Hearing: Routine hearing exams and hearing aids are not covered either, although some hearing implants to treat a severe hearing loss may be covered.

Foot care: Medicare does not cover most routine foot care, like the cutting or removing of corns and calluses, nor does it pay for most orthopedic shoes or other foot supports (orthotics). Medicare will, however, cover foot injuries or diseases like hammertoes, bunion deformities and heel spurs, along with foot exams and treatments if you have diabetes-related nerve damage.

Non-emergency services: Medicare does not pay for copies of X-rays or most non-emergency transportation including ambulette services.

Overseas coverage: In most cases, health care you receive outside of the United States is not covered.

The best way to find out if Medicare covers what you need, visit medicare.gov/coverage and type in your test, item or service, to get a breakdown of what is and isn’t covered.

Also keep in mind that even if Medicare covers a service or item, they don’t usually pay 100 percent of the cost. Unless you have supplemental insurance, you’ll have to pay monthly premiums as well as annual deductibles and copayments. Most preventive services, however, are covered by original Medicare with no copays or deductibles.

For more information on what original Medicare does and doesn’t cover, see the “Medicare and You” 2015 booklet that you should receive in the mail a few months before you turn 65, or you can see it online at medicare.gov/pubs/pdf/10050.pdf.

You can also get help over the phone by calling Medicare at 800-633-4227. If you enroll in a Medicare Advantage plan, you’ll need to contact you plan administrator for details.

Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.


 
Does California Recognize Right-to-Die? | Print |  E-mail
Thursday, 22 January 2015 15:35

By Gene L. Osofsky, Esq. • Special to the Times

Q: I recently read about a young lady from California, who had been diagnosed with terminal brain cancer and had to relocate to Oregon to arrange her own death with dignity. Why did she have to move? I thought each of us had the right to control our own end-of-life decisions?

A: I believe you refer to Brittany Maynard, who was diagnosed with an aggressive brain cancer which began to rob her of cognitive function and subjected her to progressively painful seizures. Her doctors had given her six months to live.

In coming to terms with her decision to die with dignity before the pain became too great to bear, she made a YouTube video and uploaded it to the internet. It quickly went viral, renewing the debate over right-to-die laws.

The reason she had to relocate was to take advantage of Oregon’s “Death with Dignity Act,” which allowed her to obtain physician-prescribed drugs to peacefully end her life at the time and in the manner of her choosing. By contrast, in California physicians are prohibited from prescribing death inducing medications, as doing so is viewed as assisting suicide, which is a crime in this state.

So, in California there are limits on our right to control our end-of-life, and I understand your confusion.

True, as counselors we do encourage clients to complete an Advanced Health Care Directive and/or a Physician’s Order for Life-Sustaining Treatment (POLST), both of which express the client’s wishes regarding end-of-life care.

But California draws a distinction between our right to accept or reject life sustaining medical treatment, on the one hand, and our right to self-administer physician-prescribed lethal drugs, on the other. We have the right to the former, but not to the latter.

So the question really becomes what is considered to be “medical treatment.” Under California law, this includes medical procedures and medications, but also includes artificial nutrition and hydration (food and water) as well as palliative, hospice and comfort care including medication for pain.

Thus, for example, we can direct the removal of a feeding tube, and instead opt for pain medication and hospice care and thereby allow “nature to take its course,” even if doing so hastens the moment of death.  But we cannot go so far as to ask our doctor to prescribe death inducing drugs.

For most of us, knowing that in California we retain the right to control our end-of-life care by directing the extent to which we want life-sustaining medical treatment (including nutrition, hydration and comfort care), is reason enough for each of us to sign an Advance Healthcare Directive. Yet, we fall short of the law in states like Oregon, which extends this right further by allowing terminally ill, but mentally competent, patients to actively end their life with physician prescribed drugs.

But even in Oregon, the patient — and not the doctor — must self-administer the lethal dose of medication.

Ironically, a Gallup Poll has found that about 70 percent of Americans support allowing physicians to help terminally ill patients end their lives by some “painless means.” A Field Poll in California found similar approval. Yet, attempts to pass legislation in California to offer this option to dying patients has thus far been defeated by outcries from vocal interest groups.

So, for those exceptional patients like Brittany Maynard, states like Oregon may be a refuge of last resort.

Gene L. Osofsky is an elder law and estate planning attorney in Hayward. Visit his website at www.LawyerForSeniors.com.


 
Don’t Let a Fall Trip You Up | Print |  E-mail
Thursday, 08 January 2015 16:30

010815senFalls can become more common and more serious as people age. The good news is that there are steps you can take to help prevent them. Here are some tips.

•Identify the health factors that can increase your risk for falling — poor eyesight, reduced reaction time, a decline in muscle strength and limited movement can all contribute to putting a person at risk for falling, particularly if they are ignored.

• Don’t be afraid to use a cane or walker if you are feeling unsteady — and promptly replace worn rubber tips of these devices.

• Be careful around pets. They can get underfoot or jump on you.

• Don’t leave clothes or newspapers on the floor.

A Safety Checklist

Falls are often due to hazards that are easy to overlook, but many times, they are just as easy to fix. Interim HealthCare has developed a checklist that can be used to help you find and fix home hazards.

Go through the list and check off each item that describes your home situation. Each item that gets checked represents a step you have taken to reduce a potential hazard:

Bathroom Safety:

• There are grab bars on the bathroom walls, near the toilet or along the bathtub or shower.

• A slip-resistant rug is next to the bathtub or shower.

• A mounted or suction liquid-soap dispenser is on the bathtub/shower wall.

• Nonskid adhesive-textured strips are on the bathtub/shower floor.

• A sturdy plastic seat (shower chair) is placed in the bathtub.

• There is a raised toilet seat or a toilet seat with armrests to maintain balance when getting on or off the toilet.

• An extra-long mirror over the sink to be used when sitting.

Bedroom Safety:

• Clutter is cleared from the floor so that nothing is in the way.

• A lamp, flashlight and telephone are within easy reach near the bed.

• Night-lights are placed along the path from the bedroom to the bath.

• A raised mattress is available to get in and out of bed more easily.

Download More:

To download your own copy of the Home Fall Prevention Checklist, visit www.interimhealthcare.com/ and click on “Education.”


 
New Law Will Enhance Life of Disabled | Print |  E-mail
Thursday, 08 January 2015 16:27

By Gene L. Osofsky, Esq. • Special to the Times

Q: I hear that President Obama just signed a new law that will make life easier for persons with a disability. Do you know anything about this? We would like to set up something for our grandchild, who has a disability and is on SSI.

A: Yes. It is called “Achieving a Better Life Experience Act,” or the “ABLE Act” of 2014. It was passed by Congress by an overwhelming majority and signed into law by the president on Dec. 19, 2014.

The ABLE Act allows eligible persons with disabilities to open tax-free savings accounts which are structured much like 529 Education Savings Plans. The savings in the account, up to certain maximums, will not disqualify the beneficiary with a disability from the receipt of government benefits, such as Medi-Cal and SSI.

The Act’s purpose is to create a supplemental source of income to help individuals with a disability meet supplemental needs beyond those very basic needs provided by government programs.

For perhaps the first time, the ABLE Act recognizes the extra costs incurred by persons living with a disability.

Under existing law, to be eligible for public benefits an eligible individual generally must meet certain resource limitations, such as having no more than $2,000 in savings. This resource limitation has long left very little assets available for those essential needs not fully covered by governmental programs, and even less to cover emergencies.

When the law is fully implemented, an ABLE Account may be established by the eligible individual or his family. There are some limitations:

(1) it can only be established for a beneficiary whose disability began before turning age 26;

(2) the annual contributions are limited to $14,000 per year;

(3) the total contributions to the account may not exceed $100,000 in order to maintain eligibility for SSI, nor more than $371,000 (in California) to maintain  eligibility for Medi-Cal; and

(4) amounts remaining in the account at the death of the beneficiary are reimbursed to Medi-Cal to the extent of Medi-Cal benefits received by the beneficiary after creation of the account.

While the annual contributions are not tax-exempt, the interest income generated by the savings will be tax-exempt so long as distributions from the account are used only for qualifying expenses as defined by the legislation.

Until now, the family of a beneficiary with a disability had limited options to provide for their loved one’s financial security.

Now, the beneficiary with a disability and his family have a new estate planning tool to enable planning for the future: an ABLE Act Savings Account.

Note: the federal statute will not be fully effective until implementing regulations are adopted, and not until the beneficiary’s home state adopts state legislation in conformity with the ABLE Act.

Advocates for persons with a disability expect that these requirements will be in place for California citizens sometime during the year 2015. Until then, eligible persons and their families should watch state developments closely, so that they can act as soon as the legislation is fully operational.

Gene L.  Osofsky is an estate planning and elder law attorney in Hayward. Visit his website at www.LawyerForSeniors.com.


 
Consider Tax-Savvy Year-End Gifts to Family | Print |  E-mail
Thursday, 18 December 2014 14:03

By Gene L. Osofsky, Esq. • Special to the Times

Q: My wife and I are considering making large gifts to our children and grandchildren. Do you have any tax advice for us?

A: Yes. Many people mistakenly believe that you cannot gift more than $14,000 per year without incurring a gift tax. Not so. In fact, individuals can gift more than $5 million during a lifetime without incurring a gift tax. Here is the way gift taxes work:

Annual Exclusion Gifts: No Gift Tax Return Required:

1) $14,000 Per Year: Each of you can gift up to $14,000 per year per recipient without the need to file a Gift Tax Return. Such gifts are called Annual Exclusion Gifts and you can make such gifts to as many persons as you wish each year.

2) “Doubling Up”:  If you and your wife are in a position to do so, together, you can actually double that amount for each gift recipient. So, together, you could gift a total of $28,000 to each recipient for a total of $168,000 to your loved ones ($14,000 x 2 donors x 6 recipients).

3) Year End Straddle: On or after January 1, 2015, you and your wife could do the same thing once again, as you would then be in a different tax year. So, over the course of a period as short as a calendar week — provided that the week straddles both the last days of this year and the early days of next year — the two of you could gift a total of $336,000 ($168,000 x 2 donors) to your loved ones without the need to file a Gift Tax Return or use any of your lifetime exemptions. I call this strategy the Year-End Gift Straddle.

Gifts Above the Annual Exclusion: Gift Tax Return Required

1) Lifetime Exemption: If you choose to make gifts above the Annual Exclusion amount, then you can still make them gift-tax-free by using a portion of your Lifetime Exemption (also called the “Unified Credit” or Lifetime Exclusion).

That Lifetime Exemption is currently $5,340,000 per person for U.S. citizens, and increases to $5,430,000 next year. Annual Exclusion Gifts do not count against this exemption; they can be made in addition to Lifetime Exemption gifts.

Also, by making a timely election, a surviving spouse can opt to preserve the deceased spouse’s unused exemption for the survivor’s own use, thereby effectively doubling it.

2) Gift Tax Return: To the extent that your gifts exceed the Annual Exclusion amounts, you must file a Gift Tax Return even though no actual gift tax would be due. Reason: the IRS wants to track your use of your lifetime exemption, so that it knows how much you have left to use upon death.

Example: if you used $1 million of your lifetime exemption to make excess gifts during life, then your remaining exemption to apply against estate taxes upon death would be $1 million less.

Cautions: Before making large gifts, be sure that you can afford to do so. Lastly, if there is a possibility that either of you may need to apply for a Medi-Cal subsidy for nursing home care in the near future, you should consult a professional with special knowledge about the Medi-Cal program before making those gifts: Gift transfers may adversely affect your ability to qualify for a Medi-Cal subsidy unless those gifts are handled in a very special manner.

Gene L. Osofsky is an elder law and estate planning attorney in Hayward.  Visit his website at www.LawyerForSeniors.com.


 
Shared Housing Can Help Seniors in Many Ways | Print |  E-mail
Thursday, 18 December 2014 14:01

By Jim Miller • Special to the Times

Shared housing among older adults has gotten a lot of attention lately as more and more people are recognizing that they can use their home to get help with a variety of needs, such as generating income, getting help with household chores, and even finding some much needed companionship.

But home sharing isn’t for everyone. You need to carefully consider the pros and cons of renting out a room in your house, and make a list of what you want (and don’t want) in a housemate/renter.

To help sort this out, the National Shared Housing Resource Center offers a 16-page “Consumers Guide to Home Sharing” that provides a self-questionnaire to those considering renting their home, along with a list of renter’s questions and important points to discuss, and a sample home-sharing lease agreement that lays out the details in writing. This guide costs $10 and can be ordered at nationalsharedhousing.org.

Finding a Renter

After going through the guide, if you want to proceed in finding a renter, a good first step is to contact a home-sharing program in the area that matches adults who are looking for shared housing with older adults who are looking to rent.

These programs handle background checks and other screenings, and consider lifestyle criteria when making matches. They can also help with the leasing agreement that the renter would sign that covers issues like smoking, pets, chores, overnight guests, use of common rooms, etc.

Most home-sharing programs are free to use or request a small donation. Others, however, may charge the homeowner and potential renter a fee for this service.

There are dozens of home-sharing programs throughout the U.S. You can find a list at: nationalsharedhousing.org.

You can also search for housemates through national resources like Let’s Share Housing (letssharehousing.com), the Golden Girls Network (goldengirlsnetwork.com) and Roommates 4 Boomers (roommates4boomers.com). All of these programs offer national internet-based matching programs and charge membership fees that run anywhere between $30 and $39.

If you find someone on your own that you’re interested in renting to, ask the prospective renter to fill out a “rental application” (see rentalleaseagreement.org to download and print one for free) and run a full tenant background check, and then call their references. Background checks can be ordered online through companies like starpointtenantscreening.com and screeningworks.com for a small fee.

Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.



 
Remember When... | Print |  E-mail
Thursday, 04 December 2014 09:15
120414sen
 
Child Caregiver Needs Help with Medi-Cal Claim | Print |  E-mail
Thursday, 04 December 2014 09:12

By Gene L. Osofsky, Esq. Special to the Times

Q: When Dad became unable to care for himself, I moved in with him and cared for him for as long as I could. When his care needs increased, we had to place him in a nursing home. He lived there about a year, on a Medi-Cal subsidy, before he passed. Recently, I received a reimbursement  claim from Medi-Cal for about $90,000. Help! Is there anything I can do about this? We would like to fix up and sell his home, as Dad intended.

A: Perhaps, depending upon the facts. Background: Medi-Cal will subsidize the cost of a nursing home stay for individuals who are financially eligible. However, when that person dies, Medi-Cal will generally seek reimbursement from his estate for the amount of benefits paid out.  However, there are exceptions to reimbursement including the following:

(1) Medi-Cal will waive its claim if the beneficiary is survived by a minor, blind or disabled child;

(2) Medi-Cal will defer its claim if the beneficiary is survived by a spouse, but only until the death of the surviving spouse; and

(3) Medi-Cal will waive a portion of its claim, based on hardship, if the beneficiary is survived by a child who qualifies as a “caregiver child.”

To qualify as a “caregiver child” you must have (a) moved in with your father, (b) rendered care to him for at least two years while residing in his home, and, (c) later prove to Medi-Cal, via letters from healthcare providers, that your in-home care actually delayed your father’s entry into a nursing home.

Also, you must continue to reside in your parent’s home through the time of Medi-Cal’s determination on your application for waiver. This exception seemingly recognizes that, by caring for your father and delaying his entry into a nursing home, you have saved the state money and are deserving of a benefit in that he will now have a larger net estate to pass on to you.

Unfortunately, qualification for this exemption is difficult for most child-caregivers, partly because of the requirement that the child providing care must actually reside in the parent’s home during the entire time that care is rendered. If the child also maintains his or her own separate residence, Medi-Cal may deny the claim, forcing the matter to an administrative or judicial hearing with an uncertain outcome.

Also, if a waiver is granted, it would be only as to your proportionate share of your parent’s estate. For example, if you are one of three children designated to receive your parent’s estate, the waiver will be – at best – only as to one-third of the Medi-Cal claim.

If the waiver is denied, remember that the claim is against your father’s estate, and you would not have personal responsibility to pay from your own assets.  Also, there may be other options, such as a voluntary lien with a payment plan.

Had your father been able to take proactive planning steps during his lifetime, lawful strategies could have been implemented to protect the home from a Medi-Cal recovery claim entirely, avoiding the need to apply for waiver.

Unfortunately, many people are not aware that preplanning is often the key to avoiding a Medi-Cal recovery claim. For those parents who wish to pass on as much as possible to their children without burdening their estate with a Medi-Cal recovery claim, know that lawful steps can be taken during lifetime to do just that.

Gene L.  Osofsky is an estate planning and elder law attorney in Hayward.  Visit his website at www.LawyerForSeniors.com



 
Quit Smoking with the Help of Medicare and Other Tools | Print |  E-mail
Friday, 21 November 2014 15:56

112014sen1By Jim Miller • Special to the Times

Medicare actually covers up to eight face-to-face counseling sessions a year to help beneficiaries quit smoking. And, if you have a Medicare Part D prescription drug plan, certain smoking-cessation medications are covered too. Here are some other tips that can help you kick the habit.

Never Too Late

Of the 46 million Americans who smoke, about 5.5 million are Medicare beneficiaries. According to the Center of Disease Control and Prevention (CDC), about 50 percent of smokers, age 65 and older, indicate they would like to completely quit, but because of the nicotine, which is considered to be more addictive than heroin, it’s very difficult to do.

Tobacco use is the leading cause of preventable illness, responsible for an estimated one-fifth of deaths in the United States each year.

But research shows that quitting, even after age 65, greatly reduces your risk of heart disease, stroke, cancer, osteoporosis and many other diseases.

It also helps you breathe easier, smell and taste food better, not to mention saves you quite a bit of money. A $5 pack-a-day smoker, for example, saves about $150 after one month without cigarettes, and more than $1,800 after one year.

How to Quit

The first step you need to take is to set a “quit date,” but give yourself a few weeks to get ready. During that time you may want to start by reducing the number or the strength of cigarettes you smoke to begin weaning yourself.

Also check out over-the-counter nicotine replacement products — patches, gum and lozenges — to help curb your cravings. And, just prior to your quit day, get rid of all cigarettes and ashtrays in your home, car and place of work, and try to clean up and even spray air freshener. The smell of smoke can be a powerful trigger.

Get Help

Studies have shown that you have a much better chance of quitting if you have help. So tell your friends, family and coworkers of your plan to quit. Others knowing can be a helpful reminder and motivator.

Then get some counseling. Don’t go it alone. Start by contacting your doctor about smoking cessation counseling covered by Medicare, and find out about the prescription anti-smoking drugs that can help reduce your nicotine craving.

You can also get free one-on-one telephone counseling and referrals to local smoking cessation programs through your state quit line at 800-QUIT-NOW, or call the National Cancer Institute free smoking quit line at 877-44U-QUIT.

It’s also important to identify and write down the times and situations you’re most likely to smoke and make a list of things to do to replace it or distract yourself.

Some helpful suggestions when the smoking urge arises are to call a friend or one of the free quit lines, keep your mouth occupied with some sugar-free gum, sunflower seeds, carrots, fruit or hard candy, go for a walk, read a magazine, listen to music or take a hot bath.

The intense urge to smoke lasts about three to five minutes, so do what you can to wait it out. It’s also wise to avoid drinking alcohol and steer clear of other smokers while you’re trying to quit. Both can trigger powerful urges to smoke.

For more tips on how to quit, including managing your cravings, withdrawal symptoms and what to do if you relapse, visit smokefree.gov and nihseniorhealth.gov/quittingsmoking. If you’re a smartphone user, there are also a number of apps that can help like LIVESTRONG MyQuit Coach, Cessation Nation and Quit It Lite.

 

 
Engage Family Members Suffering from Dementia on Holidays | Print |  E-mail
Friday, 21 November 2014 15:55

112014sen2Whether it’s Mom, Dad, Grandma or Grandpa — or your spouse — holidays can present special challenges for families with a loved one suffering from dementia.

“We have an expectation that loved ones should never change from the person we’ve perceived them to be for years, but everyone changes significantly over an extended period, especially those diagnosed with dementia,” says Kerry Mills, a researcher in best-care practices for people with dementia, which includes Alzheimer’s.

“Dementia encompasses a wide range of brain diseases, which means it’s not the fault of a Grandma if she has trouble remembering things or gets flustered. Empathy for what she’s experiencing on the level of the brain will help your relationship with her. Do not expect her to meet you halfway to your world; you have to enter her world.”

Spouses have a particularly difficult time coping with their partner’s dementia, Mills says. A spousal relationship is a team and is central to the identities of both people. So, while you’re paying special attention to a parent’s or grandparent’s condition, extend it to his or her spouse, she says.

Families tend to have a hard time coping with a loved one’s dementia during holiday gatherings. Mills offers these suggestions for how to interact with a loved one — say, Grandma — whose brain is deteriorating.

• Do not get frustrated. “First, do no harm” — the excellent maxim taught to medical students, is also a great first principle for those interacting with Grandma, who may be experiencing a level of frustration and anxiety you cannot comprehend adequately.

She simply doesn’t have access to certain details, but she is still a conscious and feeling person who has plenty to offer. If you get frustrated, she’ll pick up on it.

• Dedicate someone to Grandma during the gathering. Of course, loving families will want to include Grandma in the group, but be careful not to overwhelm her with attention. Her brain, which has trouble processing some information, could use assistance — a liaison to help her process things. A son or daughter may be the best handler during a gathering.

• Give Grandma purpose; give her a task in the kitchen. Keep her engaged! Simple tasks, such as mashing potatoes or stirring gravy, may be best. Engage her in conversation about the food.

If it’s Grandpa whose suffering dementia, include him in a group. Engage him in a conversation about football, which may allow him on his own terms to recall details from the past.

• Use visual imagery and do not ask yes-or-no questions. Don’t expect someone with Alzheimer’s to remember a specific incident 23 years ago — it may be physically impossible. Direct the conversation; say things to stimulate recollection, but don’t push a memory that may not be there. Pictures are often an excellent tool.

• Safety is your biggest priority. Whether during a holiday gathering or in general, Grandma may commit herself to activities she shouldn’t be doing, such as driving. This major safety concern applies to any potentially dangerous aspect to life.

“Currently, there’s a stigma with the condition,” Mills says. “As with other medical conditions, Alzheimer’s should not be about waiting to die — patients often live 15 years or more after a diagnosis. It should be about living with it.”

 

 
Make Plans Now for Your Trustee Succession | Print |  E-mail
Friday, 21 November 2014 15:52

By Gene L. Osofsky, Esq. • Special to the Times

Q: I have a Living Trust. I am the original trustee and my children are the successor trustees. Do you have any thoughts about easing the transition of trustee duties from me to my children when the management of my finances has become too much for me?

A: Yes. It is important for that transition to be as seamless as possible, so that your assets can be managed and bills paid without delay. Here are some suggestions:

(1) Simplify Succession “Trigger”: Take a look at your trust to determine what triggers the change of trustees from you to your children.

Typically, it may be the written determination by one, or perhaps two, physicians, reciting your inability to handle your financial affairs.

If your trust requires a letter from two physicians, I suggest changing that requirement to only one. Reason: If you are then residing in a nursing home, where patient care is typically monitored by one physician, it may be difficult to arrange an evaluation for this purpose by a second physician.

Reducing the requirement to only one doctor may save your children much grief with medical logistics.

(2) HIPAA Release. Make sure that your trust, or related document, provides a HIPAA privacy release authorizing your doctor to disclose information about your ability to manage your affairs. Absent a privacy release, some physicians may be reluctant to write a letter regarding your capacity.

(3) Add Co-Trustee. At some point, consider adding one of your children as a co-trustee and recite in your trust, or in an amendment to your trust, that any single trustee has the power to write checks or take other action on behalf of the trust.

This would then authorize your child to gradually take over more responsibility for managing trust assets without a formal certification of your incapacity. Doing so sooner than later also allows you the opportunity to watch your child perform his or her duty, and afford you the opportunity to provide pointers to them based upon your years of accumulated wisdom.

(4) Consider Resignation. Alternatively, when you feel that managing your trust has become too much for you, you might consider the proactive approach of resigning. A formal resignation triggers the succession of trustee duties to your child without a formal finding of incapacity. It, too, can accomplish a smooth transition without the need for doctors’ letters.

(5) Minimize Successor Liability. To encourage a successor trustee to step into the shoes of the predecessor, recite in your trust that the successor is not responsible for any acts or omissions of his predecessor. You might also recite that whoever is serving as trustee is not liable for any action taken in good faith.

These two protective clauses would help induce your designated nominee to assume their duties when appropriate, whether that successor is one of your children or the trust department of your favorite bank.

(6) Inform Your Bank: Make sure that your financial custodians have your list of successors on file, so that when they step forward to assume their duties their identity is known to the bank. You might even introduce your nominees to your bank officers, and suggest that they take a sample signature and make note of the child’s address and driver’s license.

By taking some or all of the above steps, you will have taken proactive steps toward a seamless transition of trustees when the time comes.

Gene L. Osofsky is an elder law and estate planning attorney in Hayward.  Visit his website at www.LawyerForSeniors.com.



 

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