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Family Connection Is Vital to the Elderly

Family connections are extremely important to the elderly population. Family creates a consistent social network and connection that directly impacts the senior’s overall quality of life. Prioritizing family relationships provides continuity as a senior experiences change in their social network. Friends may change, become ill and unavailable, or even pass away, but family is multi-generational and, as such, has an enduring presence for an aging family member. The stability of family relations, even with the ups and downs of disputes, is a familiar source of social and emotional grounding, as well as practical help. A study by the United Health Group reports more than half of older Americans will cite faith or spirituality, and a loving family as the top reasons they have a positive outlook. That positive outlook brings tremendous benefits to a senior’s health and well-being.

Sadly, not all seniors have the benefit of a nuclear family or close extended family. Yet, these connections were deemed more important than financial resources, according to the majority of participants in the United Health Group survey. Aging seniors who integrate into their family system are more prone to live healthier and longer lives than those seniors who remain isolated from family.  Even in the case of those seniors living with later stages of dementia, family contact can reduce disease symptoms and may stave off faster mental decline. How is it that family brings about higher rates of longevity? 

Family contact helps to maintain a senior’s immune system. Family social connections create optimism, which in turn may lead to stronger cell-mediated immunity, the immune cells that are responsive to bacterial or viral invasions. The senior immune system can also become more adaptive and robust due to low-level exposure to a variety of pathogens when interacting with their family in person. Social seniors, even those in non-family settings, often have stronger immune systems because of human contact.

Other techniques to improve an aging immune system include nutritional supplements or vitamins along with a healthy, nutrient-rich diet. Also, regular exercise, maintaining vaccinations, reducing stress, restful sleep, proper hydration, washing hands, and a positive outlook can all boost a senior’s immune system. When a senior has an actively involved family, many of these health systems are put into play, especially the positive outlook. Having a family who cares about and cares for their elder members reduces feelings of depression, which feeds the cycle of optimism, improving overall health.    

A higher level of cognitive functioning is linked to a family connection, as well. Brain health acquires benefits from being happy and socially engaged in activities that challenge memory and thinking skills. Human interaction goes beyond the more repetitive brain teaser challenges and puzzles because the social dynamic is fluid and unpredictable. A senior must engage all of their senses when responding while being in a family group. Holiday meals, birthday celebrations, family reunions, and many other typical family activities are good brainwork for an aging family member.  According to a study published in the Public Library of Science, elderly and even middle-aged adults who maintain active social circles appear to be at a lower risk of developing dementia. A family system is the ultimate pre-made social connection. “This finding could feed into strategies to reduce everyone’s risk of developing dementia, adding yet another reason to promote connected communities and find ways to reduce isolation and loneliness,” said the study’s lead author, Andrew Sommerlad, Ph.D., of University College London.

Family roles shift throughout time. Parents who used to care for their children now experience an evolving family structure and the inevitability of their mortal decline. When the roles of parenting reverse, it brings challenges for all involved. Financial support is often needed when a parent is in declining health, and the ability of family members to contribute such help to the senior offers great relief and helps to reduce stress. Even if a family system is unable to provide financial support, emotional support does wonders for the aging process of a family member. Positive conversations and interactions can increase their level of contentment, reduce worry, and bring family inclusiveness and a sense of belonging to the senior.

Not all seniors have a family who can play an active role in their life. However, with extra effort, relationships can be forged that will be mutually beneficial, especially in the digital age of social media. While friendships oftentimes never replace an actual biological family, the adage that “friends are the family you give yourself” rings true and can create lasting and meaningful connections.

All of these connections are really about feeling loved. The benefits of being grounded in love, and what that brings to a person are profound. What if you never felt alone? What if you always felt loved? What if you could live your life knowing that someone was always in your corner, still there for you? The answer is the same to all of these questions – you would have a better chance at living your best life physically, mentally, and emotionally.

Strengthen family connections and friendship relations. Modern technology has made it easier than ever to be a part of someone’s life. Text, email, video chat, and social media platforms provide interaction when it is not possible to physically be with a family member.  However, do not overlook the more traditional methods of contact, which include personal visits, a phone call, and a handwritten letter or a card sent via snail mail. While these “old school” methods may not seem relevant to younger generations, they are particularly meaningful to a senior.

Every connection can make a difference. A close family can learn, share, and grow together. Outcomes from these shared experiences benefit all members, but in particular, the older family members.  Younger generations are also gaining an invaluable lesson. The digital world is reconfiguring human experiences electronically and is leaving many people wanting human connection.

If you have questions about a loved one or if you would like to talk about your particular situation, please contact our Reno office by calling us at (775) 853-5700.

Elder Law, Estate Planning, Healthcare

The Importance of Clear End-of-Life Care Instructions

You would hope your living will is properly prepared and your resuscitation instructions or DNR (do not resuscitate) are in order. While your wishes in a living will may be appropriately documented, that does not guarantee the instructions will be carried out as you stated. The frightening truth is that mistakes about your end-of-life instructions are made while you are at your most vulnerable. Dr. Monica Williams-Murphy, medical director of advance-care planning and end-of-life education for Huntsville Hospital Health System in Alabama has said, “Unfortunately, misunderstandings involving documents meant to guide end-of-life decision-making are surprisingly common.”

The underlying problem is that doctors and nurses have little if any training at all in understanding and interpreting living wills, DNR orders, and Physician Orders for Life-Sustaining Treatment (POLST) forms. Couple the medical professionals’ lack of training with communication breakdowns in high-stress environments like a hospital emergency ward where life and death decisions are often made within minutes, and you have scenarios that can lead to disastrous consequences.

In some instances, mix-ups in end-of-life document interpretation have seen doctors resuscitate patients that do not wish to be. In other cases, medical personnel may not revive a patient when there is the instruction to do so resulting in their death. Still other cases of “near misses” occur where problems were identified and corrected before there was a chance to cause permanent harm. 

There are some frightening worst-case scenarios, yet you are still better off with legal end-of-life documents than without them. It is imperative to understand the differences between them and at what point in your life you may change your choices based on your age or overall health. To understand all of the options available it’s important to meet with trusted counsel for document preparation and to review your documented decisions often as you age. In particular, have discussions with your physician and your appointed medical decision-maker about your end-of-life documents and reiterate what your expectations are. These discussions bring about an understanding of your choices before you may have an unforeseen adverse health event, and provides you with the best advocates while you are unable to speak for yourself.

There are several documents that may be appropriate as part of your overall plan. Each of those is discussed below, and we are available to answer any questions you may have about them.

A living will is a document that allows you to express your wishes about your end-of-life care. For example, you can document whether you want to be given food and hydration to be kept comfortable, or whether you want to be kept alive by artificial means.

A living will is not a binding medical order and thus will allow medical staff to interpret the document based on the situation at hand. Input from your family and your designated living will appointee are also taken into account in your best decision-making strategy while you are incapacitated. A living will become activated when a person is terminally ill and unconscious or in a permanent vegetative state. Terminal illness is defined as an illness from which a person is not expected to recover even though they are receiving treatment. If your illness can be treated this would be regarded as a critical but not terminal illness and would not activate the terms of your living will.

Do not resuscitate orders (DNRs) are binding medical orders that are signed by a physician. This order has a specific application to cardiopulmonary resuscitation (CPR) and directs medical professionals to either administer chest compression techniques or not in the event you stop breathing or your heart stops beating. While your living will may express a preference regarding CPR it is not the same thing as a DNR order. A DNR order is specifically for a person who has gone into cardiac arrest and has no application to other medical assistance such as mechanical ventilation, defibrillation, intubation, medical testing, intravenous antibiotic, or other medical treatments. Unfortunately, many DNR orders are wrongly interpreted by medical professionals to mean not to treat at all.

Physician orders for life-sustaining treatment forms (POLST forms) are specific sets of medical orders for a seriously ill or frail patient who may not survive a year. This form must be signed by a physician, physician assistant, or nurse practitioner to be legally binding. The form will vary from state to state and of the three instructive documents the POLST is the most detailed about a patient’s prognosis, goals, and values, as well as the potential benefits and risks various treatment options may bring about.

A power of attorney for a health care decision, sometimes referred to as a health care directive, allows you to name an agent to make decisions for you if you are unable to. Unlike a living will which only covers end-of-life decisions, a power of attorney for health care decisions allows the agent to act at any time that you cannot make decisions for yourself.

We can help you determine which documents best suit your current needs, and help you clearly state your wishes in those documents. We look forward to hearing from you and helping you with these important planning steps. If you have questions or would like to discuss your personal situation, please don’t hesitate to contact us. Please contact our Reno office by calling us at (775) 853-5700.

Elder Law, Estate Planning

Understanding the Role of an Elder Law Attorney 

As seniors grow older, the dependency on their family to handle financial and health matters rises. They often believe that their family members will be able to take care of any issues that arise. While consulting with loved ones about plans and wishes can be beneficial, relying solely on them can cause problems in the long run for both seniors and their families.

Instead, it is best to seek the advice of an elder law attorney when it comes to putting proper planning in place. The issues around retirement, wills, and estate planning are often complex. Working with a legal professional can help seniors navigate these details to ensure that decisions and plans are suited to their specific situation.

Having legal arrangements in place related to retirement benefits, assets, and determining who will be responsible for the welfare of an aging loved one can also help to avoid family disputes, and ensure that assets are preserved as intended. And although we’d like to assume family members always have seniors’ best interests at heart, legally binding arrangements also protect against abuse and financial exploitation.

But it isn’t just seniors that benefit from working with a legal professional. Elder law attorneys can also assist heirs and beneficiaries by ensuring that assets don’t fall into wrongful hands due to debts, divorces, or other extenuating circumstances. They can also help beneficiaries avoid the long and complicated probate process.

Elder law attorney expertise

Elder law attorneys have the expertise to help seniors and their loved ones navigate all of the legal issues impacting the elderly. They can help clients to better understand Medicare and Medicaid programs and laws, and assist clients and families with all of the legal aspects of planning, including drafting wills, estate plans, and trusts.

Below is a list of some of the services elder law attorneys provide:

  • Medicaid Eligibility, Applications, and Planning
  • Medicare Eligibility and Claims
  • Social security and disability claims and appeals
  • Long-term care planning
  • Financial planning for long-term care
  • Drafting wills and trusts
  • Medical Power of Attorney
  • Financial Power of Attorney
  • Elder abuse case management
  • Patient rights
  • Nursing home issues and disputes
  • Establishing and managing Estates and Trusts
  • Tax advice and planning strategies
  • Probate services
  • Asset protection

… and more

Seniors tend to procrastinate planning due to the unpleasant associations of illness and death. Elder law attorneys can alleviate that discomfort by facilitating family conversations and shifting the focus to the positive benefits of planning and preparedness. Cost can also deter seniors from seeking legal advice and services, however, failing to plan can ultimately end up being far more expensive.

No matter the issue at hand, seniors and their loved ones will benefit from working with a legal professional. If you’d like to learn more about how elder law services can help you or an aging loved one, contact our firm today. If you have questions or would like to discuss your personal situation, please don’t hesitate to contact us. Please contact our Reno office by calling us at (775) 853-5700.

Estate Planning, Healthcare

Considerations for Choosing Co-Agents

I have to decide between my two children, who should be my power of attorney when I need help communicating with doctors and handling my financial matters. Can’t I just name them both?

You can, but please don’t. You risk creating conflict or chaos if you name more than one child to serve simultaneously. Instead, pick one child at a time.

What to Consider When Deciding Your Health Care Agent

Think about which child is better suited to the responsibilities. For health care decision-making, your agent should ideally be calm in stressful situations and be able to advocate courteously but firmly with doctors and nurses for the treatment you want. For financial management, your agent should be organized, careful, and good with numbers.

Your health care agent should live nearby, but if the child who lives locally is terrified of things like needles and blood, the other, sturdier child might be a better choice. On the other hand, who can manage finances from afar, but if that child didn’t cope with a checkbook, the other would be better. So if one child is good in one area and the other child is good in the other, the dilemma is solved. You can name the number-proficient daughter for the financial side and your son for the health care. Or, if just one child is altogether more capable than the other, name that one child for both health care and financial powers.

But you do not want to create a situation where children who share the job start arguing about what health care you would want. Busy physicians have little time or patience to mediate fights like that. Likewise, you do not want your children quarreling about how you would want your money to be spent.

That’s why it’s best to give one child decision-making authority at a time. You can name the other as a backup in case the first child becomes unavailable, but naming both to serve simultaneously is generally not a good idea. If you have questions or would like to discuss your personal situation, please don’t hesitate to contact us. Please contact our Reno office by calling us at (775) 853-5700.

Elder Living

The Benefits of Tech Apps to the Senior Population

Changes in technology are occurring continuously and it may seem hard to keep up. For many seniors, these changes can be so daunting that they tend to avoid technology altogether.

While seniors have increasingly embraced technology in recent years, data from Pew Research shows that as many as one-third of those over the age of 65 do not use the Internet, and nearly half do not have home broadband services.

Still, technology can be a key aspect of keeping seniors — who tend to spend more time alone than their younger counterparts — engaged and connected. It can also help caregivers to stay connected to their patients or loved ones.

Let’s take a look at some of the benefits of tech apps for the aging population.

Staying connected. Social connections are healthy for people of all ages, and this can be especially true for seniors. While there is no substitute for human interaction, technology can help to fill the gap for seniors who are away from family members or friends. Whether in person or online via video or messaging technology, social interaction can potentially lower blood pressure and reduce the risk of cardiovascular disease and Alzheimer’s, according to medical professionals. Apps such as Facebook and Instagram can help seniors connect with loved ones and caregivers.

Keeping active. There is no shortage of apps to help people stay active these days and seniors can certainly benefit from this technology. For those who can no longer drive or who do not have a neighborhood rec center with fitness classes, technologies such as those provided by the Nintendo Wii can help to get seniors moving wherever they are. Whether it’s tennis or yoga, these apps also offer fun activities for seniors and their loved ones or caregivers to do together.

Staying mentally sharp. Mental exercise is just as important as physical for the elderly. We’ve all heard how crossword and Sudoku puzzles can help thwart memory problems, but today there are countless other online games and mobile apps seniors can use to help stay mentally sharp. Not only can seniors do a crossword puzzle on the computer or mobile device, but they can also play solitaire, trivia, and memory games.

Managing medical records and medication. Today just about every doctor’s office offers records and correspondence online. This makes it easier for seniors to keep track of appointments and health records. There are also plenty of apps available — such as Medisafe — to help seniors keep track of medication dosing, schedules, and pharmacy refills. These types of apps help seniors make sure they don’t miss a dosage or inadvertently double up on medication if they’re having trouble keeping track due to memory problems or illness.

Keeping seniors safe at home. Most seniors want to retain their independence for as long as possible. That means remaining in their own homes as they age. By using technology they can better ensure their safety and their loved ones’ peace of mind while remaining independent.  Seniors living alone should always have some type of personal emergency response system or PERS. These are devices that help a person call for help by pushing a button, and connected mobile apps can alert family members or caregivers in the event of an emergency. These technologies activate the appropriate emergency response, helping seniors to avoid the frightening situation of trying to handle a medical or another emergency on their own and giving their loved ones peace of mind.

Managing finances and bills. Seniors are often reluctant to hand over the reins when it comes to managing their budget and finances. Maintaining that control helps instill a stronger sense of independence. Apps like Mint can help seniors manage these tasks and help ensure due dates aren’t missed or payments aren’t overlooked altogether. These apps can also help caregivers maintain a repository of their loved one’s budget and financial obligations.

While tech apps can seem daunting for seniors (48 percent of those over 65 say that they need assistance using new technologies and devices), with the proper support and training they can be a powerful tool for helping seniors maintain their health and independence.

If you’d like to learn more about empowering yourself and your loved ones with proper care and planning, our firm can help. Please contact our Reno office by calling us at (775) 853-5700.

Elder Law, Estate Planning

How Do I Know if I Need a Trust?

This article will help you decide if a trust fits your particular circumstances. For example, maybe you have a disabled child and you want a trust to permit that child to inherit without losing government benefits. Maybe your own or your spouse’s health is heading into difficulties, and you can foresee eventually needing long-term care benefits. Trusts can avoid an expensive, public, and lengthy probate process before your beneficiaries can inherit after you pass. Or, you might be in the classic “trust fund” situation, where you’re concerned that your children won’t be able to manage money wisely.

All these are excellent reasons to consider a trust. But what kind of trust? A quick count shows there are at least thirteen different varieties. Which one is best suited to your needs? Call us.

Here’s the basic idea behind trusts, to help you understand why you might or might not need one.

What is a Trust?

Think of a trust like a treasure chest. You originally bought property or earned money in your own name. You then transfer those assets into the trust’s name – into your treasure chest, in other words. The trust treasure chest becomes a legal entity separate from you, which now holds your property in its, and no longer in your, name.

Then you identify people who will occupy the three roles involved in managing trust property. First, you are the grantor, or settlor, or trustmaker – all those words mean the same thing, the “you” in this case. Second, you appoint a trustee. That person or entity is responsible for managing trust assets and following directions contained in the trust document. Third, you decide whom you want to receive trust assets – your beneficiary or beneficiaries, in other words.

In legal terms, a trust is a fiduciary agreement among you the original property owner, your trustee, and your beneficiary. The trust document contains instructions for what you want to be done with trust property, both for how you want it invested and, also, for how you want trust assets to be distributed when you pass. Trusts are, thus, a highly efficient hybrid between a power of attorney, an asset-management vehicle, and a last will and testament, all rolled into one legal entity and document.

There are two basic kinds of trusts to understand before they split off into their thirteen-or-more different flavors: revocable or irrevocable trusts.

The Revocable Trust

A revocable trust can be thought of like a treasure chest with an open lid. As grantor/settlor/trustmaker of a revocable trust, you can get at trust assets freely.

You yourself can also occupy all three roles in a revocable trust – grantor, trustee, and beneficiary. If need be, you can also tinker with trust terms, by freely amending them to change the directions, beneficiaries, or trustees. Or, you can revoke the whole thing. Before that point, though, the trust document will be there to take care of everything you want it to.

If you should meet with an accident and lose capacity, the terms of your trust will designate a person to step in on your behalf and, thus, avoid the need to go to court to get a guardian for you. The trust will also direct who inherits, thus keeping your affairs private and out of probate court. This feature is especially important if you (formerly) and then the trust (after you created it) own real property in various states. The savings in court costs in that situation could be significant.

The Irrevocable Trust

This is the trust for you if you’re seeing the need for Medicaid long-term care benefits in your future, or you work in a field where suits are common, such as owning a small business or in the construction industry.

The disadvantage to an irrevocable trust, however, is that you will be sacrificing all or almost all control over trust assets, unlike in the revocable-trust situation. Once an irrevocable trust is established, you as grantor/settlor/trustmaker cannot directly alter the terms and, generally speaking, your access to trust money is restricted or entirely precluded – as is required in order to enjoy the potent benefits of this kind of trust.

Think of an irrevocable trust as being like the treasure chest with the locked lid. Your trustee – who generally cannot be you – is the one with the key. You yourself can no longer reach your assets. This relinquishment of control is necessary to shelter your assets from creditors or to protect your assets when entitlement to government benefits would otherwise require you to spend almost all you own first.

There are ways to draft an irrevocable trust carefully, so you can still exert your will over how assets are to be used. Just as in the revocable situation, you can impose conditions that must be met before a beneficiary can receive funds. You can designate how trust income is to be used for specific purposes like college tuition, business start-up, or travel. You can also authorize a person or entity as a “trust protector,” who can alter trust language, correct drafting errors, or create a new similar trust if the law changes.

And there you have the basics. Now you’re ready to decide whether you need a credit shelter trust, or a charitable trust, or a qualified terminable interest trust, or a blind trust, or – just come see us to figure out all the rest!

Trust Caveats

Some sophisticated trusts do convey tax benefits, but, for the most part, IRS considers revocable trusts to be invisible. You as grantor/settlor/trustmaker will still pay tax on the revocable-trust income, albeit at your individual rate and not at the prohibitive trust rate.

As for estate taxes, trusts have no effect – but, at least regarding federal estate taxes, those are currently moot for most people. They are not incurred until the value of the estate exceeds $11.4 million as of 2019. Some states do impose estate and/or inheritance taxes; for those states, please consult this website:

Also, keep in mind that revocable trusts provide no protection against creditors. If you lose a legal action, a judge can force you to change the beneficiary of your trust to the winner. Irrevocable trusts are free from that kind of interference.

Still, irrevocable trusts must be established long before you run into that kind of trouble. If you create such a trust while credit problems are looming or have already arrived, you risk that your trust will be undone as a fraudulent conveyance.

Trust Your Attorney

Consult lawyers like us, who have experience and expertise in the trusts and estates area. Custom-constructing a treasure chest to fit your specific needs is a job for our specific skills.

If you have questions or would like to discuss your personal situation, please don’t hesitate to contact us. Please contact our Reno office by calling us at (775) 853-5700.

Elder Law, Elder Living

Medicare Scams and How to Avoid Them

Insurance companies are frequently subject to being scammed. Scammers frequently target government insurance like Medicare by stealing newly issued medical ID cards and then stealing identities. The Coalition Against Insurance Fraud estimates that tens of billions of dollars are lost annually to these types of fraud. Additionally, medical identity theft is now a top complaint received by the Federal Trade Commission. Billing fraud is also responsible for huge losses to Medicare funds and is difficult to assess as it can be a billing error or intentional fraud.

How does this affect a senior on an individual level? Scammers typically pose as Medicare officials and ask people to pay for their new cards which in reality are free. Or they phone a potential victim with false news of a refund and ask for the person’s ID number and bank account number to deposit the refund. “Right now … everyone is being inundated with TV commercials, brochures, and other official-looking documents in the mail about all the Medicare Advantage plans. It’s so confusing, and in an environment like that, fraud is rampant,” says Micki Nozaki of the California Senior Medicare Patrol. There are more than 50 million Medicare beneficiaries who can annually opt to swap Medicare Advantage and Part D prescription drug plans which provide scammers with the opportunity to prey on vast numbers of seniors.

The Centers for Medicare and Medicaid Services have a list of tips to help prevent fraud. The first and foremost is to protect your Medicare and Social Security numbers vigilantly. It suggests treating your Medicare card like you would a credit card and do not provide the number to anyone other than your doctor, or people you know should have it. Become educated about Medicare with regards to your rights and what a provider can and cannot bill to Medicare. Review your doctor bills carefully, looking for services billed for but not provided to you. Remember that nothing is free with regards to medical care; never accept offers of money or gifts of free services. Be suspicious of your provider if they tell you they know how to “bill Medicare” to pay for a procedure or a service that is not typically covered. Before leaving your pharmacy check to be sure your medication is correct, including the full amount prescribed and whether or not you received a generic or brand name medicine. If your prescription is in error report the problem to the pharmacist before leaving.

Remember Medicare will never visit, call, or email you and ask for personal information such as your Medicare number, Social Security Number, address, or bank account number. Medicare already has this information and does not need you to provide it. Even when Medicare issues new cards that no longer contain your social security number in April of 2019 you will not be required to do anything. You can assume that anyone who claims to be helping you with Medicare and asks for your personal or financial information is a scam artist so close the door, hang up the phone, or delete the email.

When it is time to compare plans be sure to meet with a trustworthy advisor. Some insurance representatives give the industry a bad name by selling you a policy or plan that does not suit your needs or your budget. Some agents go so far as to ask you to sign a release form allowing them to make decisions on your behalf. Never sign anything related to Medicare without first reading it carefully. Additionally, it is a good practice to have a family member or lawyer review the document before signing it.  The non-profit National Council on Aging (NCOA) has a free, brief assessment that allows you to compare plans online. You can also contact your local State Health Insurance Assistance Program (SHIP). SHIP is a provider of free, federally-funded Medicare counseling via a trained volunteer or staff member.

Medicare fraud wastes billions of taxpayer dollars annually. Carefully review your medical bills and have inaccuracies corrected. Guard your personal information vigilantly and be wary of people asking you to provide that information. Meet with a trusted insurance advisor or compare medical plan options using the sites listed above. If you are unsure about something call Medicare directly for clarification.

If you have questions or would like to discuss anything you’ve read, please don’t hesitate to contact us. Please contact our Reno office by calling us at (775) 853-5700 with any questions.

Elder Law, Elder Living

Nursing Homes and COVID-19 Deaths

Because aging Americans are more susceptible to the coronavirus, deaths in this age group are high. Although nursing home residents are less than one percent of the total US population, according to a report from the CDC, they account for more than 40 percent or approximately 45,500 of the US 115,000 COVID-19 deaths.

Seema Verma, the administrator for the Centers for Medicare and Medicaid Services (CMS), asserts that nursing homes following federal infection control guidelines were largely able to contain the coronavirus.

Harvard researcher David Grabowski, a member of a nonpartisan commission, advising Congress about Medicare, states that “The federal government needs to own this issue,” about the need for federal efforts to routinely test nursing home staff and residents for COVID-19 and make more protective gear available. Grabowski agrees with other advocates for the elderly that the federal government has not provided consistent virus testing and sufficient protective equipment to nursing homes, its staff, and residents.

High Risk for Elderly Care During This Election Year

In this Presidential election year, the stakes could not be higher to garner support from older voters. Partisan overtones affect the discussion and subsequent policies to guide safer nursing home outcomes from the ravages of COVID-19. The blame game is on between political parties fighting for votes and states legally protecting health care workers and facilities from coronavirus lawsuits by residents or their families.

The Trump administration deflects accountability by criticizing nursing home facilities with low federal ratings for infection control and a handful of Democratic governors, New York in particular, who mandated that nursing homes accept recovering coronavirus patients. The number two House Republican, Steve Scalise of Louisiana, states that this NY policy, and other states with similar policies, “ended up being a death sentence.” Verma echoes the nursing homes with low federal rating criticism, saying CMS has data equating low safety ratings with outbreaks of COVID-19. Several academic researchers dispute this data citing their research has found no such link. Amid the finger-pointing, shamefully, more vulnerable senior nursing home residents are dying because of the coronavirus.

Nursing Home Concerns During Coronavirus

In agreement with other academic researchers, Harvard’s David Grabowski opined that neither state policies nor proverbial bad apples among nursing homes were responsible for driving the coronavirus outbreaks. The reason is simply because of the virus’s nature, which can spread via individuals displaying no symptoms and do not feel unwell. The illness’s very nature indicates it is already spread throughout communities. Without routine testing, nursing home staff can unknowingly bring COVID-19 into a facility where it then spreads easily among frail residents living in tight quarters. Ricardo Alonso-Zaldivar of the Associated Press quotes Grabowski, “The secret weapon behind COVID is that it spreads in the absence of any symptoms,” Grabowski told lawmakers at a recent briefing. “If COVID is in a community where staff lives, it is soon to be in the facility where they work.”

Advocacy group Justice in Aging’s long-term care expert Eric Carlson cites the lack of federal coordination as impeding the ability to identify people who are infected by and require care for the coronavirus. Other advocates agree that the White House directive for the testing of all residents and staff has had an uneven response, accounting for why some facilities suffer higher rates of infection than others. The Associated Press report from the end of May 2020 concurs with these opinions reporting “White House goal on testing nursing homes unmet.”

Meanwhile, at CMS, administrator Verma believes her agency has provided necessary safety guidelines, COVID-19 reporting requirements, and Medicare payment for testing residents since the outset of the virus. She continues that states have the money required from the federal government to support the nursing home staff’s testing. Let’s hope that is the case, as the nursing home industry reports one-time testing for every resident and staffer would cost 440 million dollars.

The coronavirus pandemic is not going to go away. New spikes of cases across the country are being reported and not even considered the “second wave” of infection that many experts anticipate. Third-ranking House Democrat Representative and chairman of a special panel on the coronavirus pandemic James Clyburn of South Carolina seems to match wisdom with temperance about the finger-pointing saying that the crisis in nursing homes should not be a partisan issue. Instead, stating, “Nursing home residents have died from the coronavirus in states governed by Republicans and Democrats, in big cities and in small towns, in rural and urban communities.” Capitol Hill law and policymakers seem to be very adept at identifying problems but slow in resolving them. In the meantime, our vulnerable senior nursing home population and their families are paying the price. We help families with loved ones in a nursing home deal with a variety of issues. If you have a loved one in a nursing home, please don’t hesitate to reach out to see how we can help. Please contact our Reno office by calling us at (775) 853-5700.

Elder Living

Silver Bills Help Seniors With Their Bill Paying Process

Silver Bills is a service that assists seniors in the process of paying their monthly bills. As many baby boomers continue to opt for aging in place, home administrative tasks can become problematic.  Family members who would like to help may live out of state or are too busy in their own careers to manage a loved one’s household bills. SilverBills has created a seamless service that will receive your bills, carefully review them, and ensure that your bills are correctly paid.

At your direction, SilverBills will mail you an enrollment packet. You will have to provide bills and one voided check to SilverBills in the envelope they provide. Once SilverBills receives the envelope they will convert your bills to “ebills”. Once enrolled in the service you will have a dedicated customer service representative that will assist you with any concerns or questions. SilverBills service will now receive, review, and ensure that your bills are paid for properly. The service guarantees that you will not incur late fees or penalties. In the event you do the service charge or late fee will be paid for by SilverBills.

No more getting to the mailbox or PO Box on a regular basis to look for bills. No more US Post Office trips to purchase stamps. No more calendaring due dates of bills and check writing. Once a month you will receive a statement showing your bills have been paid. There are no contracts; you can cancel your service at any time. SilverBills uses the same 256-bit encryption used by banks so that your transactions are secure.

Automating your bills through a bill-paying service is becoming more commonplace particularly for seniors 75 and older. It is easy for a senior to mistakenly pay a bill twice or not at all and have needed electricity or water services shut off. The ability to manage money is often one of the first skill sets that go when someone is experiencing mild cognitive impairment. By the time a person reaches their seventies, there is a 20 % chance of cognition troubles. That percentage increases to 50% in our eighties.

SilverBills is one of a growing number of daily money management companies. The services are typically expensive ($100 and up, per month) but the peace of mind a family can have knowing the day-to-day bills are being correctly handled is worth the price to many. The American Association of Daily Money Managers is an online resource that can help you find the right professional service for you or your loved one. Always ask for references and check accreditations before allowing access to your banking information and remember these bill-paying services do not act as accountants or financial advisers. They are more akin to a personal financial assistant with the added bonus of consumer advocacy; looking for bill errors and potential fraud.

There are many reasons that accurate bill-paying becomes unmanageable for seniors. SilverBills and services like them are becoming increasingly popular for proper bill payment. Talk with your family or trusted counsel to see if it is the right choice for you. Feel free to contact us if you have any questions or would like help with your planning needs. Please contact our Reno office by calling us at (775) 853-5700.

Elder Living

Older Americans are Experiencing Higher Levels of Bankruptcy

Many retired and older Americans are filing for bankruptcy at higher rates than ever before. While medical advances are keeping seniors alive longer, the associated healthcare costs in the quest for longevity are being off-loaded onto the older individual at a time when reduced income is a hallmark of senior living.  Older Americans are increasingly filing for consumer bankruptcy. According to the Consumer Bankruptcy Project, the population aged 65 or more is filing for bankruptcy at a two-fold increase, and there is nearly a five-fold increase in the percentage of seniors in the US bankruptcy system. The economic risk for seniors is running rampant, and the sad truth is currently 97 out of 100 people aged 65 and over are not able to write a check for $600 or more due to insufficient funds.

The sentiment among Americans is that their standard of living will increase at the age of retirement when it is quite the opposite. The typical retiree has set aside about $60,000 for their old age living, and more than 50% over the age of 55 have saved less them $50,000; as much as 40% of these workers have less than $25,000 set aside. The stark reality is none of these “nest eggs” are enough to see a senior through old age and the unforeseen disasters that can deplete what little has been saved.

One of the more common financial obstacles that create this bankruptcy scenario is a health issue. Medicare is not comprehensive. In the absence of a supplemental insurance plan picking up the non-Medicare funded 20 percent cost, a senior can be left with unforeseen operation and rehabilitation costs. Without full health care coverage, the cost of staying alive as a senior is practically prohibitive between prescriptions, treatments, surgeries, rehabilitation, and assisted care. The primary two options available to a senior to cover these costs of survival are credit card debt and loans.  Suddenly, at a time when most seniors should have very low monthly living costs, they find themselves back in a debt slave scenario with little or no income to address their healthcare debt. 

Many seniors have concluded that retirement is not a part of their future as they will need a viable stream of income to avoid financial disaster. While this seems reasonable, it is not a good plan to assume one will be healthy enough to work forever. As we age, there is an increased probability that working will become impossible due to unforeseen illnesses. When this happens, debts begin to mount, and bankruptcy becomes a likely result. Additionally, the era of stable pensions afforded to a long-time employee has gone by the wayside. Fewer companies even offer them anymore and those that do often modify and reduce pension benefits to meet corporate expectations of financial profits.

The cost of living rarely if ever is reduced over time and while social security benefits seem like the answer to a senior’s retirement years; these benefits seldom cover basic living expenses no matter how long an individual may have worked or how much they paid into the system. The senior who is faced with government social security benefits and very little additional income usually turn to credit cards to address the gap between low income and living expenses. This scenario takes a senior right back to debt slave mode. As many as two out of three seniors who file for bankruptcy cite credit card debt as one of the primary reasons.

Scams that target the senior population are becoming more sophisticated and prolific with the advent of technology. What used to be a “one to one” scam can now be distributed via email to thousands of targeted seniors who are online in greater numbers than ever before. Often the unsuspecting senior will make passwords or personal bank information available to what they believe is a legitimate request for information from what appears to be a valid email. Seniors can also fall prey to predatory lenders as many seniors cannot read the fine print or understand the consequences of their actions. When scam artists victimize a senior, the senior often lose a large chunk of their assets which in turn can put them in a bankruptcy scenario.

While it is impossible to know the exact future, it is possible to make reasonable plans for it. Learn the ways that you can protect yourself from becoming part of these bankruptcy statistics in your senior years. Even a modest plan is better than no plan at all. Seek the advice of trusted legal and financial professionals to help you understand what you can do to protect your future. Please feel free to contact our office today to discuss how we can help you with your planning. Please contact our Reno office by calling us at (775) 853-5700.

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