Bernard A. Krooks - Littman Krooks LLP > New York Elder Law Blog > Caregivers

Archive for the ‘Caregivers’ Category

« Older Entries
Newer Entries »

Guest Blog: Palliative Care and Palliative Care Laws in New York: What Patients Should Know

Friday, November 21st, 2014

Our guest blogger this week is David C. Leven, JD, Executive Director, Compassion & Choices of New York

Palliative care can help improve your quality of life. You should know what palliative care is and how two New York State laws effective in 2011can help you learn about your palliative care options and receive timely palliative care.  The Palliative Care Information Act (PCIA), Public Health Law Section 2997-c,and the Palliative Care Access Act (PCAA), Public Health Law Section 2997-d, define palliative care as “health Care treatment, including interdisciplinary end-of-life care, and consultation with patients and family members, to prevent or relieve pain and suffering and to enhance the patient’s quality of life, including hospice care.” The care provided can address not only pain and other symptoms but depression, anxiety, psycho-social and spiritual issues as well.

Palliative Care Access Act (PCAA)

The PCAA  requires that  hospitals, nursing homes, home care agencies and enhanced and special needs assisted living residences establish policies and procedure to provide patients with advanced, life limiting conditions and illnesses who might benefit from palliative care, with information and counseling regarding such options appropriate to the patient.. It also requires that they facilitate access to appropriate palliative care and pain management consultations and services including but not limited to referrals consistent with patient needs and preferences.

Palliative Care Information Act (PCIA)

Terminally ill patients now have a clearly defined right to receive information and counseling about their palliative care and end-of-life options, including hospice. This will enable them to make informed treatment decisions during the final months of their lives. The law states, in part:

“If a patient is diagnosed with a terminal illness or condition, the patient’s attending health care practitioner shall offer to provide the patient with information and counseling regarding palliative care and end-of-life options appropriate to the patient, including but not limited to: the range of options appropriate to the patient; the prognosis, risks and benefits of the various options; and the patient’s legal rights to comprehensive pain and symptom management at the end of life; and information regarding other appropriate treatment options should the patient wish to initiate or continue treatment.”

The information and counseling under both laws should be provided to those lawfully authorized to make decisions for patients who lack capacity to make medical decisions, such as a health care agent.

What You Can Do to Get Palliative Care and the Benefits Required Under the Laws 

If you are a patient and believe that you may qualify for the benefits of either law or both laws or if you are a health care agent or surrogate for a patient who you believe has or may have a terminal or advanced life limiting illness or condition, then you might consider discussing this with the appropriate health care practitioner. If you are a health care professional and you believe that a patient of yours has not yet benefitted by the requirements of the PCIA and/or PCAA, then you might consider discussing this with the appropriate health care practitioner responsible for compliance with the applicable law (s) after conferring with the patient.

Resource: The New York State Department of Health website, questions and answers and guidance.

 

Learn more about Palliative Care and the Palliative Care Laws in New York, by visiting  Compassion and Choices.

Learn more about our elder law services by clicking here,  www.elderlawnewyork.com.

 

Tags: , , ,
Posted in Caregivers, Elder Law, guest blog | Comments Off on Guest Blog: Palliative Care and Palliative Care Laws in New York: What Patients Should Know

Guest Blog: Universal Design Elements Assist Aging in Place

Friday, November 14th, 2014

Our guest blogger this week is Priscilla Toomey, Associate Broker, JD, Top 5, ABR, SRES, Certified EcoBroker, Julia B. Fee Sothebys International Realty.

PRT Headshot_web

While many of us have heard the terms “universal design” and “aging in place,” their meanings and implications may be vague to us. They are universal movements and also have implications for house design going forward.

Basically, universal design is the concept that spaces should be aesthetically pleasing but also be easy to use by people with (or without) disabilities and by the aging population. A few examples  that are commonplace are audiobooks, slip-resistant surfaces, automatic doors, closed captioned television, curb cuts at corners, low-floor busses, Velcro, cabinets with pull-out shelves, lever handles instead of knobs for opening doors, and no-stair access to housing.

A major benefit of universal design is that it makes it easier for people to continue living in their own homes. We are living with an aging population.  By 2030, the US population aged 65 and over is expected to grow to 71.5 million people, from about half that number in 2006.  More and more people want to “age in place” (AIP) rather than go into assisted living, if at all possible.

Aging in place is a world-wide movement, because populations everywhere are living longer. The idea is to enable people to remain in their own homes as they age by providing resources and support services, rather than having them move into assisted living, which is far more costly and more disruptive. Universal design elements can help them do that, while postponing the need for expensive institutional care.

There are more aging in place organizations in Westchester than you may have imagined. There are currently three aging in place models in Westchester County and several organizations in different parts of the county encouraging the formation of AIPs. One close-by example of an aging in place resource is Gramatan Village in Bronxville, NY.

For legal needs, there are lawyers who specialize in a relatively new field known as “elder law”.  For real estate, agents who are interested in working with older clients can become certified as Seniors Real Estate Specialists (SRES). When you need the expertise of one or the other, it’s nice to know they’re there.

 Click here to contact Priscilla.

Learn more about our elder law services by visiting www.elderlawnewyork.com.

Tags: ,
Posted in Caregivers, Elder Law | Comments Off on Guest Blog: Universal Design Elements Assist Aging in Place

Assets Can Be Spent Down Safely to Qualify for Medicaid

Friday, October 17th, 2014

Many seniors have to rely on Medicaid to pay the high cost of care in a skilled nursing facility. However, Medicaid is a needs-based program, which means that one must meet certain income and asset limits in order to qualify. Many seniors therefore find themselves needing to “spend down” their assets to become eligible, which can significantly affect their estate plans. Seniors cannot simply give assets to family members in order to qualify, as such transfers during Medicaid’s five-year “look back” period will trigger penalties.

By planning well ahead, many families are able to avoid the spend-down issue by purchasing long-term care insurance or transferring assets early enough that they are not affected by the look-back period. However, those who are in immediate need of long-term care do not have the luxury of protecting their assets in advance, and must focus on spending down assets in a way that enables them to qualify for Medicaid.

Certain “non-countable” assets do not have to be spent down or sold in order to qualify for Medicaid, including the home, a vehicle, household goods, personal effects, some prepaid funeral arrangements, and a limited amount of cash. In most states, therefore, one can safely spend down savings by using them to pay for non-countable assets. This may include paying off a mortgage or buying a new home, making repairs to a home, replacing home furnishings, replacing an old vehicle, or prepaying funeral expenses. In most cases, one may also pay off any legitimate debt, such as credit card debt.

In addition, most states permit a Medicaid applicant to make qualified payments for caregiving services in the home, when this helps the person stay at home and avoid nursing home costs. The caregiver who accepts such payments may be a family member, provided there is a written agreement and the caregiving services are not prepaid.

Medicaid rules can be complex, and they vary from state to state, so consultation with an experienced elder law or estate planning attorney is highly recommended.

 

Learn more about helping seniors and their families plan for the future by visiting www.elderlawnewyork.com.

Is this article of interest to you? If so, please LIKE our Facebook Page by clicking here.

Tags: ,
Posted in Caregivers, Elder Law | Comments Off on Assets Can Be Spent Down Safely to Qualify for Medicaid

What Household Employees Should Know About the Affordable Care Act

Tuesday, September 23rd, 2014

By Tom Breedlove, HomePay by Breedlove

Nannies, senior caregivers, housekeepers and other in-home providers are in a unique situation compared to most employees. They don’t work for a large company with a Human Resources department looking out for their best interest. So when it comes to something like purchasing health insurance, it’s not as simple as filling out a form and letting someone else do all the work on the back end. And with the implementation of the Affordable Care Act, many household employees have questions about what is required of them.

While millions of people signed up for health insurance policies via the federal and state online exchanges last October, many others did not and will have a decision to make once again in the next few weeks. Open enrollment for health coverage starting in 2015 is scheduled to begin on November 15th – both for those buying policies for the first time and those whose policies are set to expire at the end of the year.

The most important thing for employees to understand is that the law itself is not changing in 2015 compared to 2014. That means all individuals are still required to have health insurance policy in place or pay a fine. For 2014, the fine is $95 or 1 percent of income for those that remain uninsured, whichever is higher. For 2015, this fine increases to either $325 or 2 percent of income, whichever is greater. For example, someone earning $35,000 per year would face a fine of $700.

However, there is a silver lining to this cloud. There are subsidies that many employees will qualify for based on their income level that will allow them to obtain health insurance at a discounted rate. The Kaiser Family Foundation has a helpful calculator tool that any employee can use to estimate the subsidy they could receive. It takes into account several factors, including income, number of adults enrolling in coverage, number of children, the employee’s resident state, and others.

IMPORTANT NOTE: In order to qualify for a subsidy, the employee must have documented wages – meaning they have to be paid legally. In most trust situations and many senior care employment arrangements, this is already taken care of, but it warrants a reminder that this subsidy is available for those working so hard to care for a family’s loved one. It’s just another benefit of legal pay to go along with others, such as Social Security income, Medicare health coverage, unemployment benefits, disability benefits, and the ability to secure loans/credit.

To learn more about health insurance coverage, please visit Care.com or go to healthcare.gov.

To learn more about helping seniors and their families plan for the future, visit www.elderlawnewyork.com. If you liked this article, please like it on our Facebook page.

Tags: ,
Posted in Caregivers, Elder Law | Comments Off on What Household Employees Should Know About the Affordable Care Act

Four Ways Primary Family Caregivers Can Manage Stress

Monday, August 25th, 2014

Home care

 

 

 

Our latest guest blogger is Lou Giampa, is the President of Right at Home Westchester. Lou is a New York State Certified Nurse Aide (CNA) who volunteers in hospitals and nursing homes throughout Westchester County.  He also volunteers with the Alzheimer’s Association, Meals on Wheels, and the Aging in Place community.

 

First, Dad needed help monitoring his daily medications, and then he needed to be taken to physical therapy twice a week. During the next few months, Dad’s health continued to wane and he wrestled with losing his independence.

If you are a primary family caregiver, you understand the tough sacrifices and rewards of helping your elderly loved one maintain their independence. You are alongside them for the activities of daily living such as bathing, dressing and eating. You step in when there are medical and financial decisions to be made. You break the doctor’s news, you give the chin-up talks, you listen to the reminiscences of days gone by, and you love and are there without question.

Yet, like millions of other chief family caregivers, your life is expanding in scope and responsibility. If you juggle care-giving with your own family’s needs and a career, you sense the intense squeeze of time and commitments all the more. With your loved one’s care continually on the front burner, your care needs stay on the back-burner. Without realizing it, your efforts to comfort and support your senior may be eroding your own health. Primary family caregivers are more susceptible to high blood pressure, stroke, diabetes and anxiety. Stress from caring for an aging loved one also can increase the likelihood of headaches, disruptive sleep and depression.

“Primary family caregivers deserve a supportive round of applause because they work so tirelessly to serve their senior loved one, often without a break or even a “thank you,” said Lou Giampa, President of Right at Home Westchester.  “Our professional at-home caregivers understand the need for family caregivers to reserve time for their own mental, physical and emotional health. I encourage family caregivers, especially the main caregiver, to take care of themselves regularly and not wait until they hit the frazzled and fatigued state.”

Your aging loved one needs you functioning at your best, so relieving stress is vital to everyone’s health to manage day-to-day and long-term priorities. Giampa recommends the following stress busters for principal family caregivers:

  • Refresh your own health. Exercise at the gym or go for a brisk walk a few times a week. Be sure you maintain good nutrition and sleep habits. Check in with your own doctor on annual exams and ways to support your own optimal health.
  • Recruit help. Enlist the support of family members, friends and neighbors who can lend caregiving help. Also, rely on regular respite breaks through the assistance of a professional in-home caregiver. From getting help for a few hours a day to regular overnight care, securing adult home healthcare is a sign of wisdom and strength, not a sign of weakness or inability to care well.
  • Stay connected. Keep up your own family connections and friendships. Having a confidant who listens to you is crucial as you navigate the unknowns and challenges of caring for another person. Local or online caregiver support groups are another beneficial way to learn with others about realistic expectations and goals to prevent caregiver burnout.
  • Continue with your own life. To maintain balance, it’s important to stay active with your own interests, hobbies and social groups. Don’t skip the fun events or forgo your normal faith and community activities.

When primary family caregivers learn to relieve stress regularly – before health issues arise – they help safeguard their loved one’s care and preserve the relationship with their loved one – one shared meal, one doctor’s report and one fond memory at a time.

About Right at Home

Founded in 1995, Right at Home of provides in-home care and assistance to seniors and the disabled.  We help care for seniors who require some assistance in order to maintain their independence, improving their quality of life, and enabling them to remain in their homes.  Our caregivers help with all the activities of daily living, as well as cooking, light housekeeping, safety supervision, medication reminders, and transportation to medical appointments, grocery shopping, social activities, etc. Our caregivers are thoroughly screened, trained, and bonded/insured prior to entering a client’s home.

 

If you or someone you know could benefit from in-home care, please visit www.westchesterseniorcare.com. For more information, please contact our office at 914.468.1944

 

Was this article of interest to you? If so, please LIKE our Facebook Page by clicking here.

 

Tags: , ,
Posted in Caregivers | Comments Off on Four Ways Primary Family Caregivers Can Manage Stress

Guest Post: Staying Aware and Safe in the Summer Heat

Wednesday, July 23rd, 2014

By Susan Yubas, founder of FYI Senior Living Solutions, Inc.

My daughter and I walked into my mother’s apartment the other day and were hit by a wall of warm, humid air.  While my mother was wearing long sleeves and pants, my daughter began to roll up her sleeves due to the heat and I immediately went to see why the air conditioning was not working.

It was working fine – she had turned it off because she was comfortable and did not feel the heat.

Dangerous.

As we age, our bodies lose the ability to regulate temperature which makes us sensitive to seasonal weather changes.

Serious conditions are related to heat exposure – including heat exhaustion and heat stroke.  While the two share similar symptoms of headache, dizziness,  and fatigue, heat stroke is life threatening and may also include disorientation, agitation, seizures, fainting, rapid heartbeat and hallucinations among others.

Being dehydrated also increases the risk of exposure to heat for older adults and some medications for chronic medical conditions like diabetes, high blood pressure and heart disease may increase susceptibility to dehydration and also result in increased sensitivity to sunlight.

What can you do:

  • Make sure older adults drink plenty of fluids throughout the day.  If their doctor generally limits the amount of fluid they drink or they are on water pills, they will need to ask their doctor how much they should drink while the weather is hot.
  • Avoid direct exposure to the sun during the peak hours of the day
  • Limit exercise during the hottest part of the day
  • Cool down and rest in an air conditioned space.

Always seek medical attention if you are concerned about an older adult during the hot summer months ahead.

Susan Yubas is a Certified Senior Advisor and the founder of FYI Senior Living Solutions, Inc.  She will help you articulate your goals, identify issues you may not have considered and direct you to appropriate professionals to help you implement what is needed.

 

Was this article of interest to you? If so, please LIKE our Facebook Page by clicking here.

Tags: ,
Posted in Caregivers | Comments Off on Guest Post: Staying Aware and Safe in the Summer Heat

Advance Directives Need to Be Accessible

Tuesday, July 8th, 2014

When drafting advance directives, a common problem for many people is making these documents easily accessible for their loved ones.

What is an advance directive? A legal document in which a person specifies what arrangements should be taken for their health if they are no longer able to make decisions for themselves because of illness or incapacity. There are different ways of creating advance directives, including a living will, a durable power of attorney and also a health care proxy.

People may feel that their advance directive should be kept with their attorney or in a safe deposit box. However, decisions about medical treatment often need to be made quickly, so it is important that an advance directive be not only safe, but easy to get to.

If an individual’s advance directive appoints another person as health care proxy, then that person should have a copy of the document, or know where it is kept. If a patient is incapacitated, then it is important that the health care proxy be able to present the document to medical personnel.

It may also be wise to keep a copy of the document in electronic form, stored in such a way that it is accessible from a smartphone or other device. Such electronic copies have the same legal authority as the original paper document, and they can be accessed more easily. Ask your attorney what they recommend for digital or cloud storage for these documents to ensure the security of your private information. Learn more about our services within elder law and advance directives by clicking here.

If you enjoy our content, please share it on  Facebook.

Posted in advance directives, Alzheimers, Caregivers, Elder Law, Wills | Comments Off on Advance Directives Need to Be Accessible

Age-Related Financial and Planning Milestones that People Will Encounter in their Sixties

Friday, March 28th, 2014

As one nears retirement age, a number of important financial planning milestones begin to approach. It can be difficult to keep them all straight. Here is a timeline of what happens when:

  • At age 59 1/2, people can begin to make withdrawals from 401(k)s, traditional IRAs and similar retirement savings accounts, without an additional tax penalty of 10 percent. (Withdrawals are still taxed as income in any case.) Of course, just because one can begin to make withdrawals at this age does not mean one necessarily should.
  • At age 60, if one’s spouse has died, then one can begin to collect a Social Security survivor benefit. This is also true if an ex-spouse has died, if the marriage lasted at least 10 years and the survivor did not remarry.
  • Upon reaching age 62, people can take the option of early Social Security retirement benefits. Keep in mind that starting one’s benefits early results in lower payments, and it is usually better to wait a few years to receive a larger benefit. If one is eligible for a pension, these benefits also often kick in at this age.
  • At age 65, one becomes eligible for Medicare. There is a seven-month window around one’s 65th birthday to sign up for Medicare benefits and avoid a surcharge.
  •  Age 66, for most baby boomers, is full retirement age for the purposes of Social Security retirement benefits. Additionally, at this age, someone who chose early benefits can now suspend benefits in order to build up delayed retirement credits.
  •  Upon reaching age 70, there is no further advantage to delaying taking Social Security retirement benefits. People who wait until this age to begin receiving benefits maximize their monthly payments.
  • At age 70 1/2, required minimum distributions begin for 401(k)s and IRAs. A certain amount must be withdrawn from these accounts each year, based on the total value of all such accounts.

By paying close attention to these milestones, one can complete a more precise budget, an important part of retirement planning.

 

Was this article of interest to you? If so, please LIKE our Facebook Page by clicking here.

Posted in Caregivers, Elder Law, Estate Planning, Long Term Care, Medicaid, Social Security | Comments Off on Age-Related Financial and Planning Milestones that People Will Encounter in their Sixties

How Divorce and Remarriage Affect Social Security Retirement Benefits

Tuesday, March 11th, 2014

People considering divorce as their 10-year wedding anniversary approaches should know that delaying the split until after the decade mark can result in higher Social Security retirement benefits for a spouse with a lower earning record.

Taking the example of a divorced couple where the ex-husband had a higher earnings record, if the couple was married for 10 years or more, then the ex-wife can receive higher benefits based on his record, provided she is age 62 or older and has not remarried.

Even if the ex-husband has not applied for retirement benefits, the ex-wife may receive benefits based on his record, provided they have been divorced for more than two years. If the woman remarries, then she would no longer be able to collect the benefits unless the later marriage ends.lawyer-or-notary-with-cl

Recent years have seen a rise in both marriages and divorces later in life, and statistics suggest that divorcing couples may take retirement benefits into account, as there is a measurable increase in divorce after the 10-year mark. As might be expected, the effect is most pronounced for couples nearing retirement age. A recent study found that for people 55 and older, there is an 11.7 percent increase in the likelihood of divorce at about the decade mark. For couples age 35 to 55, that drops to a 6 percent increase in likelihood of divorce at 10 years, and for people under age 35, there is almost no effect.

Other researchers are skeptical that many people take retirement benefits into account in their divorce decisions, pointing to studies that show that only 13 percent of people are very knowledgeable about how Social Security benefits are calculated.

Whether divorcing couples currently consider retirement benefits in timing their divorce, many advisers agree that they should. Divorcing just short of the 10-year mark could result in thousands of dollars in lost benefits, so it may be worthwhile for some to delay the process.

Financial considerations are often part of making decisions about divorce, so it is important to be aware of how Social Security benefits can be affected.

 

Was this article of interest to you? If so, please LIKE our Facebook Page by clicking here.

 

Tags: ,
Posted in Alzheimers, Asset Protection, Caregivers, Elder Law, Estate Planning, LGBT, Long Term Care, Medicaid, Social Security, Tax Planning, Wills | Comments Off on How Divorce and Remarriage Affect Social Security Retirement Benefits

NY Connects: Long Term Care

Wednesday, February 12th, 2014

Choosing the right long term care services and supports can be difficult. If you are looking for long term care in New York State, you should be aware of NY Connects: Choices for Long Term Care. This is a free, state-funded service that can provide you with personalized information over the telephone about options such as assisted living residences, nursing homes, senior centers, adult day care, home care, hospice care, transportation, paying for medicine, and many other similar concerns.

Speaking with a NY Connects counselor can be very helpful if you know you need assistance but are not sure what kind of help is available or which long term care option is best for your situation.

The service is available whether you are eligible for a government program, using insurance, or paying for services yourself. Calls are confidential and are answered by trained specialists. Help is available in several different language, and TTY is available for the hearing impaired.

In Westchester County, NY Connects Can be reached at 914-813-6300. More information is available at www.nyconnects.ny.gov.

 

Was this article of interest to you? If so, please LIKE our Facebook Page by clicking here.

Tags: , ,
Posted in Caregivers, Elder Law, Long Term Care | Comments Off on NY Connects: Long Term Care

« Older Entries
Newer Entries »