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Different Types of Assisted Living Facilities Meet Different Needs

Tuesday, December 17th, 2013

Assisted living facilities are residences for senior citizens where help is provided with daily living activities, as needed. This can include making doctor’s appointments and taking medication, as well as bathing, dressing and grooming. Meals and housekeeping are also provided at such facilities. In the state of New York, all types of assisted living residences are licensed as adult care facilities by the Department of Health. However, there are different types of adult care facilities, which may also be called enriched housing programs or adult homes.

First, all adult care facilities are distinguished from nursing homes in that they are for people who do not need round-the-clock medical services or skilled nursing. People who need for medical staff to be present on a continuous basis are better served by a nursing home.

The two kinds of adult care facilities in New York, enriched housing programs and adult homes, both offer long-term care in a residential setting, including meals, laundry, housekeeping, supervision and assistance with personal care and medication. One major difference is that the law has stricter supervision requirements for adult homes, although a number of enriched housing programs may offer the same level of supervision. In addition, enriched housing programs usually provide apartment-style residences, while adult homes generally provide private rooms or two-person rooms.

The same types of service provided in enriched housing programs and adult homes may also be provided by assisted living residences and assisted living programs. In order to refer to themselves as providing “assisted living,” these facilities must meet additional requirements of providing certain disclosures and rights for residents. The goal of assisted living facilities is to provide the care necessary to allow individuals to live as independently as possible, emphasizing personal dignity and freedom of choice.

Finally, an assisted living residence that offers aging-in-place services and obtains additional certification may be designated an enhanced assisted living residence. A special needs assisted living residence is an assisted living residence that provides specialized care and meets additional certification requirements.

For more information, refer to the New York State Department of Health’s website on assisted living, available at http://www.health.ny.gov/facilities/assisted_living.

 

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New Program Enlists Doormen to Watch for Elder Abuse

Friday, December 13th, 2013

A new program in New York City is training doormen who work in apartment buildings to watch for elder abuse.

The Harry and Jeanette Weinberg Center for Elder Abuse Prevention, part of the Hebrew Home at Riverdale, developed the program, which offers free training for doormen, porters, concierges and other building staff, at the building where they work.

Joy Solomon, the director of the Weinberg Center, said that many elderly people who were being abused did not come forward on their own, so advocates realized they would have to reach out to others who might be likely to spot the signs of abuse. The center has already helped to educate people such as estate lawyers, speech therapists, and those who deliver hot meals to seniors. Now building staff are being enlisted to help as well.

Many buildings in the city have a growing population of elderly residents. An analysis of census data by Queens College found that by 2040, an estimated 21 percent of adults in New York City will be age 60 or older, an increase from 17 percent in 2010.

At a training she led recently, Ms. Solomon told of an elderly resident of an Upper East Side apartment building, who was taken advantage of by a woman. Building staff witnessed the woman removing valuables from the man’s apartment, but did not step forward, perhaps because they did not want to overstep their bounds. Solomon said that when a staff member knows that something is wrong, it is important to take action. Several older apartment building residents said they would much prefer that building staff say something about a situation that does not appear right, rather than staying quiet out of a fear of prying into someone else’s business.

For elderly residents who do not have frequent visits from friends and family, a doorman may be the first person to notice an injury, signs of confusion, or other evidence that the person needs help.

Solomon said that the training would be provided initially to buildings with large populations of older people, but would eventually be available to anyone requesting it.

 

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Sharing Caregiving Responsibilities Among Siblings

Thursday, November 14th, 2013

Caring for an elderly parent in declining health is a big responsibility, and one that can have a significant effect on the caregiver’s financial and emotional well-being. Having a sibling to share in that responsibility can make things easier, but it can also lead to conflict and resentment. It is important to understand the issues that may arise when two or more adult siblings are caring for an elderly parent, and the best ways to resolve problems.

One question that usually comes up at the outset is who will be the primary caregiver. If only one sibling lives close to the parent who needs care, that is often the deciding factor. When two or more siblings live close by, then the decision often depends on work schedules. If none of the siblings live close to the parent or have time available, then the question becomes how to divide the expense of hiring an in-home health aide or perhaps an assisted living facility, depending on the circumstances.

Good communication is probably the most important factor in making these decisions. Ideally, responsibilities will be divided in whatever way feels fair to everyone involved, and arriving at the best outcome depends on communication. Siblings should be encouraged to share exactly what they feel they should contribute and why. Factors such as an individual’s family income or work schedule are legitimate concerns that may play into decision-making. Feelings about this should be stated plainly so that later resentments can be avoided. Siblings should try their best not to let old sibling rivalries get in the way. Adult siblings caring for an elderly parent are taking on new roles, and they are best served by not replaying old ones.

In addition to family income and work schedules, siblings should consider each other’s particular skills. If one sibling is a more frugal money manager, it may make sense for him or her to hold the power of attorney for the parent. Someone with experience as a caregiver may do the best job handling day-to-day care. One fact that should not be forgotten is that caregiving is valuable and important work. Siblings who are not involved with day-to-day care may not be aware of just how much work is involved. The caregiving sibling should not be afraid to speak up and share with the others how much time goes into giving care for their parent. It can be easy for a sibling that is contributing more time or contributing more money to feel that his or her contribution is unfair or is going unrecognized. Full and frank discussion is the best solution.

Finally, as with most things, careful planning will save a lot of headaches. Just as mom or dad’s schedule of doctor’s appointments and daily medications needs to be kept track of, so should the finances be kept in careful order. An estate planning attorney or financial adviser can be invaluable in preparing a budget that accounts for the cost of different types of care that may be needed.

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Estate Planning & Elder Law: What You Should Be Aware of If You Live in New York and Florida

Thursday, October 10th, 2013

Many New Yorkers retire in Florida, and many others choose to spend the winter months there while maintaining a residence in New York. As part-time New Yorkers and part-time Floridians, retirees have the best of both worlds. But living in two different states can present certain complications when it comes to estate planning and elder law.

One important consideration is where your legal residence will be, which can be important for purposes of estate taxes. Where you spend the most time may not be as important as where you are registered to vote, what state issued your driver’s license, and what address you list on tax documents.

Your will and any trusts should be tied to the state where you are a legal resident. However, if you own real estate in another state, you should have your estate planning attorney make sure that you do not need additional documents to transfer the property when you die or to manage it if you become incapacitated.

It is also important to make sure that documents such as a living will and health care power of attorney are valid in both states. If you happen to be traveling through another state and are hospitalized, out-of-state documents will probably not cause a problem. But if you spend a significant amount of time in another state, it is advisable to be sure that such documents comply with the laws of both states. If you spend a good deal of time in a state far away from close family members, then you may also want to consider naming a local family member or trusted friend in health documents, so that someone can get to a hospital quickly in the event of an emergency.

Littman Krooks is well-positioned to help you with these matters. Because so many of our clients live both in New York and Florida, we have partnered with Solkoff Legal, P.A. a leading Florida elder law firm, to offer superior estate planning and elder law services to residents of both states. Contact us for more information. Click here to read more about our alliance with Solkoff Legal.

 

For more information about our legal services, visit www.elderlawnewyork.com.

 

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Milestones That Can Turn YOU Into A Caregiver (When Occasional Help Becomes Full-Time Assistance)

Tuesday, October 1st, 2013

In a third of all American homes, someone is providing care for a loved one. When a son or daughter is caring for an elderly parent, occasional help with some tasks can move rather quickly into regularly providing care for such essential daily activities as eating, bathing and dressing. The speed of the transition can sometimes be overwhelming for the person providing the care. It is important to recognize specific milestones that can mark the transition to full-time care, so that the caregiver is prepared and so that everyone involved can more easily recognize when help is needed.

Physical challenges are one such milestone. When a person is unable to walk without assistance, the need for full-time care quickly arises. Depending on the circumstances, it may not be safe for a particular caregiver to provide the lifting support necessary to help an older loved one in and out of chairs, automobiles and bed. Incontinence issues are another physical challenge that are often a tipping point for families to recognize that caregiving has become a full-time job and that help may be needed.

Behavioral and cognitive issues are another challenge that can quickly increase in significance. If an older loved one has symptoms of early Alzheimer’s disease or other dementia, the assistance he or she needs may be minor at first, but may progress quickly. If an elderly parent becomes prone to wandering or exhibits the aggressive behavior sometimes found in Alzheimer’s patients, this can be a turning point in the need for full-time care.

The needs of each individual and the way that each family provides care depend on individual circumstances, but it is important to recognize when the need for a little help has become the need for full-time care.

 

For more information about our legal services, visit www.elderlawnewyork.com.

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Procrastination & Debt Have Serious Effects on Estate Planning

Thursday, September 19th, 2013

Proper retirement and estate planning is the key to having the resources to enjoy one’s golden years and leave a legacy to one’s heirs. Two of the biggest obstacles to avoid on the way to these goals are procrastinating about saving for retirement, and accumulating unmanageable debt.

It may be understandable that retirement is the last thing on young people’s minds, but it is also regrettable, because the earlier one begins to save for retirement, the easier it is to build a comfortable nest egg. Someone who saves $100 per month beginning at age 25 will have saved over $300,000 by age 67, assuming a rate of return on investment of 7 percent. Saving the same amount of money per month but not starting to save until age 40 would result in savings of less than $100,000.

The Social Security system is more stable than some critics would lead one to believe, but Social Security retirement benefits provide only a safety net, not enough to retire in comfort. Employer pensions are very nearly a thing of the past. Much of the responsibility of providing for one’s retirement is up to the individual. A 401(k) plan, especially with an employer contribution, can be a tremendous help, and can motivate even young workers to save. The key is to avoid procrastination in saving for retirement.

Debt is the other major issue that can adversely impact retirement planning and estate planning. With too much debt, many older Americans find they cannot afford to retire, much less leave a substantial estate to their heirs. To get control of debt, it is important to focus on paying down high-interest debt first, such as credit cards.

Debt – even a healthy, manageable amount – can affect estate planning in less obvious ways as well. For instance, if you are planning to provide for some heirs through a trust and others through a will, you should be aware that debts must be paid from your estate and consider how that will affect your bequests.

 

For more information about our legal services, visit www.elderlawnewyork.com.

 

 

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Relocation and Estate Clearance Services: The Anatomy of a Virtual Clean Out

Wednesday, September 18th, 2013

This week’s guest blogger is Leslie Josel, a nationally recognized expert on chronic disorganization and hoarding issues. Leslie has appeared on several episodes of TLC’s hit television show, “Hoarding: Buried Alive,” the Cooking Channel’s television special, “Stuffed: Food Hoarders,” “dLife-TV” and the nationally syndicated “The Better Show” as an organizing expert. She is frequently quoted in mainstream news media such as MORE Magazine, Better Homes and Gardens, New York’s Daily News, Westchester magazine and other print media.

Losing a parent is difficult for anyone. But when you live thousands of miles away from your parents’ home and you are responsible for clearing out and selling it, the task can seem overwhelming. How are you going to take off work or leave your family? How are you going to be able to afford the multiple trips it might take to accomplish the clean out? Where do you even begin finding the resources you will need in a city that you don’t live in? By hiring a “transitions” or estate clearing company that works virtually. Yes, virtual is the answer! Let me take you through the anatomy of a virtual clean out.

Henry reached out to us to help him clear his parents’ home in Brooklyn. Due to personal issues, he was not able to make the trip east from his home in Texas. So we did our entire decision making by video, email and phone. We created a photo book of the home’s contents and their appraised value that was sent to Henry and his siblings. They were able to make the appropriate decisions at their leisure using our book as their guide.

With Henry’s involvement, we hired appraisers, cleaners, electricians, carting services and movers. We sold, donated and disposed of the contents of the home that Henry did not want to keep. In addition, through photos and video, we were able to advise Henry of the necessary repairs and renovations needed to get the home ready for sale and hired the appropriate contractors for the work. After extensive interviews with local realtors, we then hired a reliable realtor to sell the home. Through Virtual Organizing (E-mail, Skype and phone consultations), we enabled Henry to remain in Texas knowing that, while he was in capable hands, he would still be able to make critical decisions and stay in the loop every step of the way. End result? Henry’s parent’s home was sold within two months with Henry only needing to return to New York for the closing.

 

To find out more about Littman Krooks legal services, visit www.elderlawnewyork.com.

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Demand for Caregivers Increases

Wednesday, September 11th, 2013

A new study by the Pew Research Center and the California HealthCare Foundation found that the number of adult caregivers of family members has increased from 30 percent to 39 percent in the past year. The sluggish economy, an aging population and an increase in chronic illnesses all have contributed to an increased need for caregivers in the home. And more than ever, those family caregivers are turning to the internet for support and information.

Grandm_GranddThe U.S. population in 2000 included approximately 12 percent of adults 65 years and older; by 2020, adults 65 and older are expected to make up at least 19 percent of the population. The increased “graying” of the country means that more comprehensive services for elders and their caregivers, both professionals and family members, are an ongoing concern. Most of the adults who are caring for a family member – two-thirds – are either caring for a parent or a parent-in-law, researchers say. Caregivers typically are doing everything from managing finances to shuttling the elderly parent to medical appointments, and more.

Another cause for concern is that more seniors than ever before are living with complex chronic medical conditions, and living longer. Seniors are relying on family members to help with their medical issues, in large part due to the sluggish U.S. economy. More households are attempting to manage their care with limited funds and resources and caregivers are turning to the internet for information on illnesses, symptoms, medications and treatment. The study found that more than 70 percent of caregivers surveyed reported that they research issues online. Information on medical issues and the support of social media have never been more important to caregivers, researchers say.

But the Internet is only one resource, and not as comprehensive as many caregivers need. According to a 2012 estimate by the AARP, 50 percent of caregivers for the elderly are delivering complex medical and nursing care in their own homes.

The bottom line? The U.S. health care system and the social system are both struggling to keep up with the demand for elder care. For now, that need is still being met primarily at home.

 

 

Visit www.elderlawnewyork.com for more information.

 

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Study Finds High Disability Rates for Elderly

Tuesday, August 27th, 2013

Researchers at the University of California, San Francisco, have released a study recently published in JAMA Internal Medicine, after looking at more than 15 years of data. They examined the national Health and Retirement Study in order to discern how many elderly people are disabled in their last few years of life. The study looked at more than 8,000 adults over the age of 50 who died between the years 1995 and 2010, and how mobile they were, as well as any disabilities they had in their last years of life.

Gerontologists and other elder care professionals have been working on the “compression of morbidity:” keeping seniors healthy and active as long as possible so that there is little-to-no loss in quality of life until just before death. But despite their best efforts, the researchers believe that instead, people are living longer while also disabled. Though later-life disability can be slowed down, it cannot, it seems, be prevented entirely. According to the lead author, Dr. Alex Smith, most people who live to an older age, especially women, do so with a mobility issue or other disability for the last few years of life.

The study found that for the last two years before death, 28 percent of individuals were disabled in an area of “activities of daily living,” meaning they could not bathe, dress or toilet themselves without assistance. Twelve percent of that group was severely disabled; they needed assistance with all three of the activities of daily living, and other assistance, as well. The rate of disability rose sharply with the age ranges; of the group which died by age 69, only 15 percent were disabled in the two years prior to their deaths. Of the group which died after age 90, at least 50 percent were disabled within two years prior to their deaths.

Mobility issues occurred in most people in the study; 69 percent of the older group had reported that they could not walk more than several blocks, while 50 percent reported that they had trouble using stairs. Women overwhelming were more disabled in their later years compared to men the same age, possibly due to depression, osteoporosis and arthritis, all of which occur more commonly in elderly women than in elderly men. The study did not include the incidences of cognitive decline.

The study indicates that the U.S. needs better elder care facilities, comprehensive medical elder care and extensive support structures in place as the nation’s elderly population continues to grow.

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How Nursing Facilities Can Be Welcoming to LGBT Residents

Monday, August 19th, 2013

Nursing homes have always had lesbian, gay, bisexual or transgender residents, but they have not always felt comfortable identifying as such, for fear of how staff or other residents might react. It is important for nursing facilities to be open and welcoming to LGBT residents, and to this end the Alzheimer’s Association has published a guide for long-term care facilities welcoming LGBT residents. The guide is also useful for LGBT elders and their families considering a nursing facility, to determine how welcoming it will be.

According to the Alzheimer’s Association, a facility should first of all assume that there are LGBT residents, and not assume that staff can identify them. LGBT residents cannot necessarily be identified by external characteristics and they may have past life experiences such as being in a heterosexual marriage or having children that do not fit common assumptions about LGBT people.

The association also recommends that nursing home staff ask residents about their sexual orientation in a safe and confidential way, in the same way that any other factual though potentially sensitive question would be asked. However, if the resident appears uncomfortable, the matter should not be pushed, and staff should remember that sexual orientation is just one aspect of a person’s identity.

The association recommends – and LGBT elders should look for – signs of welcoming in a long-term care facility. A facility can show that LGBT elders are welcome by prominently posting its non-discrimination policy, including same-sex couples in marketing materials, and including LGBT-inclusive images or messages in the lobby and other public areas. Forms should include relationship options such as “significant other” and “partner.” Staff should be trained on how to recognize and address the needs of LGBT residents.

When nursing facilities take these steps, it will be apparent to LGBT elders and their families that the facility is welcoming to them.

 

For more information about our elder law services, visit www.elderlawnewyork.com.

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