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Ten Military Benefits you May Not Know About

The US Department of Veterans, through Tricare and the GI Bill, offers numerous education and basic health care benefits to veterans. Even with these programs that help veterans and their families, other little-known services can improve their lives and ease the financial burden of medical care and other expenses. Check your veteran status to see if you qualify for the following ten benefits:

Long-term Care

It is well documented that long-term care is expensive, but it is often necessary to provide aging relatives. Through the Aid and Attendance program, many veterans can receive money that covers the cost of assisted living programs, nursing homes, and other long-term care facility options. Currently, couples can receive up to $25,020 annually, which can defray a significant portion of the costs associated with long-term care. A veteran’s surviving spouse is also eligible to receive up to $13,560 annually to cover their long-term care costs.

Caregiver Support

Suppose you decide to provide care for your ailing veteran at home, then check into the Veterans Affairs Caregiver Support program. While the program does not offer monetary support, it does give the caregivers a no-cost support line and a caregiver support coordinator who can provide invaluable information when navigating military benefits and learning stress-reducing techniques while caregiving.

Death Benefits

Burial benefits for veterans provide a family with a way to open and close the gravesite of their loved one in any of the 148 national cemeteries with available space and provide perpetual gravesite care at no cost. Additionally, the program provides a government headstone or marker, a burial flag, and a Presidential Memorial Certificate.

Non-College Degree Certificates and Programs

Many veterans are looking for jobs to increase their income or boost their retirement savings.  The GI bill can provide training certification courses and vocational training programs for emergency medical training, barber/beautician school, truck driving, HVAC repair, etc. The VET TEC program offers other non-college degree programs with accelerated learning in coding boot camps and other associated information science programs and software training. There are also free certification programs in information technology for qualifying veterans.

Free Tax Preparation Services

Veterans and their families can use the free tax preparation services available on military bases through the Volunteer Income Tax Assistance offices. The tax preparers in these offices have expertise working with the complex nature of military-related tax issues.

GI Bill Credits Transfers

As a veteran, if you have unused credits through the GI Bill, you may transfer them to your spouse or dependents. If you qualify for the service limits, then you can transfer the benefits.

Life Insurance

Traditional life insurance can be difficult for a veteran to get; this is particularly true in sustaining an injury during their time of service. The Servicemembers’ and Veterans’ Group, Life Insurance Program, can provide up to $400,000 in life insurance and offer competitive premium rates. To learn more, visit the VA’s Group Life Insurance website for servicemembers and veterans.

Delinquent Mortgage Help

Repayment assistance is available for veterans having trouble making their mortgage payments. Some of the options available include special repayment plans, loan modification, and loan forbearance programs. There are also benefits for veterans with VA loans as well as for homeless veterans.

VA Foreclosures

Veterans can search the list of VA acquired properties and purchase these homes at a discount. The VA maintains this list of homes that are serviced through VA Home Loans and are in foreclosure. Although you do not have to be a veteran to search the property list, all qualify for VA financing.

American Corporate Partners

Veterans can connect their skill sets to job opportunities in top companies through American Corporate Partners. This service also provides one-on-one mentoring, interview coaching, resume assistance, and more. If you are looking to start a second career, this service can help you identify the best move for you.

Benefit opportunities for a veteran can make a big difference in lifestyle for themselves and their family members. Understanding the process of veteran qualification/eligibility and properly submitting paperwork for approval can be difficult to navigate. Identify the programs that can help your veteran and then contact an elder law attorney specializing in veterans’ benefits, like us. We’d be honored to help. 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

AARP Creates New COVID-19 Dashboard

As COVID-19 continues to spread among nursing home residents and staff, valuable and accurate data pinpointing areas of concern is often rife with haphazard data collection providing skewed information. The most recent Kaiser Family Foundation data analysis indicates that federal policymakers are slow in meaningful response to the nursing home coronavirus crisis. The increasing loss of life is often due to this inadequate federal and state response during this fall flu season. To better address the concerns, AARP has created a COVID-19 Dashboard that will standardize information collection and provide better data integrity. The 5-point plan aims to save lives by better protecting nursing home and long-term care facility residents at state and federal levels through more accurate data collection and its use in timely responsiveness.

  1. Ongoing testing and sufficient personal protective equipment (PPE) for residents and staff must be a priority. PPE must also be readily available for inspectors and any visitors.
  2. Create better transparency with a focus on the daily public reporting of COVID-19 cases and deaths in facilities. Improving communication with families about transfers and discharges and increase accountability for state and federal funding provided to facilities.
  3. Following federal and state guidelines for safety, ensure access to in-person visitation as well as the continuation of virtual visitation for all residents.
  4. Ensure residents’ quality care via adequate oversight, staffing, and access to in-person formal advocates known as long-term care Ombudsmen.
  5. Reject immunity as it relates to COVID-19 for long-term care facilities.

The AARP Nursing Home COVID-19 Dashboard is a collaboration between the AARP Public Policy Institute and the Scripps Gerontology Center at Miami University in Ohio. The dashboard is a four-week snapshot of the coronavirus infiltration into nursing homes and its impact on residents and staff. The goal is to promptly identify specific areas of concern at a state and national level.

A second dashboard will aggregate and analyze the self-reported data from nursing homes provided by the Centers for Medicare and Medicaid Services (CMS) that cover specific three 4-week time intervals from mid-summer into autumn. This dashboard will specifically gather five key measures from nursing homes: resident death per 100 residents, resident cases per 100 residents, staff cases per 100 residents, percentage of nursing homes without a one-week supply of PPE, and percentage of nursing homes with staffing shortages. There will also be an additional 33 data points providing more information about each category and updated every month. As tracking continues and trends present themselves, additional categories will evolve to follow other measures of interest.

The second dashboard already presents five key findings, including:

  1. Nursing home resident and staff COVID-19 deaths and cases had been on the decline at a national level during the summer. The 2020 flu season brings an uptick to cases, and coronavirus community spread continues to rise rapidly throughout most of the country, increasing vulnerability to nursing homes, staff, and residents.
  2. State trends vary dramatically. Many states with previously high death and infection rates in the summer are improved in the most recent weeks; however other states, particularly in the Midwest, see rapidly increasing rates of cases and deaths in nursing homes.
  3. The variation across states can be as high as about 1 out of every 52 nursing home residents to no resident deaths in the four weeks between September 21 to October 18. Nationally, the same reporting period reported an average death rate of one in every 215 residents.
  4. Direct care staff continues to have infections at a very high rate during this same period from September to October. While more than one-quarter (26 percent) of nursing home residents had confirmed COVID-19 cases, twice as many (53 percent) had confirmed staff cases. More than 90 percent of the nursing home staff tested positive for the coronavirus in the hardest-hit states.
  5. All states indicate nursing homes have a PPE shortage, which is defined as not having a one-week supply of surgical masks, N95 masks, gloves, gowns, and eye protection. In the best-performing state, only 5 percent of nursing homes reported a PPE shortage, while the lowest-performing state had 53 percent of nursing homes reporting a PPE shortage.

Reliable, timely data regarding nursing homes and COVID-19 can help facility operators and personnel gain a better understanding of the crisis facing nursing homes and other long-term care facilities. The federal government has begun to require nursing homes to self-report COVID-19 cases and deaths at the national level and ordering testing, providing PPE, issuing guidance for the re-instituting of in-person visits, and more. However, as cases and deaths continue to rise, AARP and other organizations will continue to accumulate data and shine a light on the tragedy befalling nursing home residents to make policy and lawmakers accountable to the crisis. AARP has a webpage providing more information for you or a loved one in a nursing home.

If you have questions about anything you have read or would like to speak to us about planning for you or a loved one, please don’t hesitate to reach out.Please contact our Reno office by calling us at (775) 853-5700.

Uncategorized

Power of attorney after 18 years old

When your child turns 18 (in most states), it might be hard to imagine that your little kid who once needed you for everything. Now your child is free to vote, marry, apply for a credit card, make medical and financial decisions, sign contracts, and live independently. No wonder the law calls this coming of age “emancipation.”

But if your adult child is hurt in an accident and needs somebody to make critical medical decisions, you cannot be the one to do that without your child having named you as power of attorney, even if you’re still paying for your child’s health insurance. If that child is so injured that a guardian is needed, you would not automatically be that person. Court proceedings would be required and those are expensive and time-consuming. A health care power of attorney would avoid that headache and would give you the standing you need, in one efficient document.

In money matters, you will not be permitted access to your adult child’s bank accounts unless your child has made you agent in a financial power of attorney.

Even if you’re paying for your child’s education, schools are not permitted to release educational records without a signed “FERPA” disclosure statement when your child reaches majority. See:

Becoming an adult is a major milestone. Your child’s 18th birthday would be a good time to explain about paying bills, getting a copy of the child’s social security card and birth certificate, living independently, registering to vote, and signing contracts to rent apartments, for example, or make major purchases like a car.

Remember to include the powers of attorney in that discussion. They are invaluable when your adult child needs you, at a stressful time when you do not want to hear any “no’s.” Powers of attorney could save you and your child delay, heartache, and expense.

We would be happy to help you or your child with the proper powers of attorney, as well as other planning needs that become more urgent as we grow older. If you’d like to discuss your particular situation in a confidential setting, please schedule time with us to do so.

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, Healthcare

Creating an effective COVID-19 Vaccine for Seniors is a Challenge

Older Americans, who are the most at risk of COVID-19, are the least likely demographic to respond well to a vaccine. A vaccine shot works by fooling the body into believing it has been infected with a virus, thereby prompting its immune system to fight the intruding pathogen by making antibodies. Unfortunately, as we age, antibody production weakens, part of the process known as immunosenescence. A compromised immune system makes older adults more susceptible to viral and bacterial infections. The Wall Street Journal reports that 90 percent of flu deaths in the US every year are people over the age of 65.

What’s age got to do with the COVID-19 Vaccine?

The thymus, located center of your chest just below the neckline between the lungs, is a major source of pathogen fighting T-cells. Some of these specialized cells help the immune system make additional defenses against infection called antibodies. As we age, the thymus production of adaptable T-cells is depleted as the thymus fills with fatty tissue. The result is an old immune system that is ill-equipped to fight off new viruses. The Center for Disease Control and Prevention (CDC) posted a July 17 analysis of more than 50,000 COVID-19 deaths in the US, identifying that 80 percent were people age 65 or more.

An aging thymus also complicates the development of a COVID-19 vaccine. A vaccine’s design provides instructions to our immune system, which T-cells help to guide appropriately. However, the thymus has exhausted most of its reserve T-cells that adapt to recognize unknown pathogens by the age of 50; thus, the ability to “train” other immune cells to fight is lost. Many vaccines rely on the skill sets of fully functional T-cells.

A Shift from Traditional Methods of Developing Vaccines

Traditionally, the biopharmaceutical vaccine market has concentrated efforts on childhood vaccines. Martin Friede, a coordinator for vaccine and product and delivery research with the World Health Organization (WHO), states, “Up until very recently most of the focus of the vaccine community has been on saving lives of young children. The people who need the vaccine the most may actually be the people in whom the vaccine might not work.” Friede further comments that it isn’t solely about the thymus as individual vitality can translate into different vaccine responses. Some older people may be off to play a round of golf while others may be too frail to walk unaided.

Deputy director of clinical research for the Institute of Vaccine Safety at Johns Hopkins Bloomberg School of Public Health, Dr. Kawsar Talaat, echoes Friede’s sentiments, “We hadn’t been designing vaccines for the elderly for a long time.” Dr. Talaat is helping to facilitate coronavirus vaccine developers to test their shots in older adults. The Food and Drug Administration (FDA) is also working with drug and biotech companies easing restrictions for experimental vaccines to be tested earlier during clinical trials on older adults.

Updates on Testing COVID-19 Vaccine Options

The New York biopharmaceutical giant Pfizer is currently conducting tests for potential COVID-19 vaccines in older people. The company is studying whether increasing the vaccine dosage could better protect the elderly as higher doses in existing flu vaccines make them more effective in older populations. At Moderna Therapeutics, results from a phase-one trial of its novel mRNA vaccine are in; however, a second phase two trial is being conducted specifically for adults age 55 and older. Many biotech and pharmaceutical companies are eager to be the first to introduce a successful FDA approved COVID-19 vaccine.

If the development of a COVID-19 vaccine specifically for the elderly remains elusive, scientists are hopeful that immunizing others around them can make a difference. Vaccinating children, health care workers, and potentially silent coronavirus carriers, could create enough herd immunity and would lower the risk of older people becoming infected. Sometimes it is possible to protect a vulnerable group by targeting other groups around them. Meanwhile, the work continues to find a workable COVID-19 vaccine for the most vulnerable Americans, the elderly.

We help seniors and their families deal with challenges around appropriate care and how to pay for it. If you would like to discuss your situation with us, please don’t hesitate to reach out.

If you’d like to discuss your particular situation, please don’t hesitate to reach out. Please contact our Reno office by calling us at (775) 853-5700 with any questions.

Uncategorized

Aging Veterans and VA Benefits

More than 18.2 million veterans live in the United States, and 38 percent of them are 65 and older according to the US Census Bureau. Additionally, the Census Bureau reports that more than 9 million veterans receive services from the Department of Veteran’s Affairs (VA) annually. If you are a veteran or have a loved one who is, it is important to understand all the VA resources and aid that is available. Beyond education programs, home loans, and job search and training resources, the VA also provides a host of other resources to assist you as you transition to your retirement years.

Wartime Veterans Supplemental Income (Veterans Pension)

Supplemental income is available for wartime veterans through the VA pension benefit. If you served at least 90 days of active duty before September 7, 1980, or 24 months after that date, or served the full period for which you were summoned or ordered to active duty with at least one day of wartime, you may qualify.  You must have also been discharged under conditions other than dishonorable. There are strict income and asset requirements attached to this benefit as well as the survivors pension and the housebound or aid and attendance allowance discussed below.

Survivors pension

If your late parent or spouse served during wartime, you might qualify for the survivor’s pension. This tax-free program provides relief for unmarried children or a widow or widower who has low income. The deceased military veteran must have served a minimum of 90 days active service with a minimum of one day served during a period of wartime before September 7, 1980, and been dishonorably discharged. After that September date, the deceased veteran must have served a minimum of 24 months or the full period summoned or ordered to serve active duty. Pensions are based on annual family income and under a designated amount set by Congress. More details regarding military pension eligibility are found on the VA website.

Housebound Allowance and Aid & Attendance Benefit

If you are eligible for or are already receiving a veterans’ pension, you may qualify for additional monetary benefits. If you are permanently disabled and must remain in your current home, the Housebound Allowance will increase your monthly pension. Aid & Attendance (A&A) will compensate a veteran who is either residing in a nursing home, bedridden, requires assistance for activities in their day to day life, or whose eyesight problems meet specific thresholds of degradation. More details for Housebound Allowance and A&A eligibility can be found on the VA website.

Veterans Life Insurance Options

There is a wide variety of life insurance offerings through the Veterans Administration. Servicemembers’ Group Life Insurance (SGLI, VA form SGLV8286) is a group term life insurance that is low cost and is automatic for most active-duty service members. It is also available for those veterans who serve at least 12 periods of inactive training per year with the Ready Reserve or the National Guard. Other automatic qualifiers include belonging to the Commissioned Corps of the National Oceanic and Atmospheric Administration or the Public Health Service, and for midshipmen and cadets of the US military academies and ROTC members. You can extend the coverage up to two years if you are fully disabled at separation. Veterans’ Group Life Insurance (VGLI, VA form SGLV 8286A) allows you to convert your SGLI to a civilian program of lifetime renewable term coverage after leaving military service.

Family Servicemembers’ Group Life Insurance

If you qualify for SGLI, your spouse and children are qualified for Family Servicemembers’ Group Life Insurance (FSGLI, VA form SGLV 8286A). This insurance covers your dependent children free of charge, although the coverage for your spouse cannot surpass your amount of coverage.

Servicemembers’ Group Life Insurance Traumatic Injury Protection

If you sustain a traumatic injury during your service that leads to amputation, blindness, or paraplegia, you qualify for benefit payments made through Servicemembers’ Group Life Insurance Traumatic Injury Protection (TSGLI, VA form SGLV8600).

Service-Disabled Veterans’ Life Insurance

The Service-Disabled Veterans’ Life Insurance(S-DVI, VA Form 29-4364) coverage is provided to veterans who have been given a VA rating for what is called a new service-connected disability within the past two years. Coverage is free for eligible veterans who are fully disabled, and you can purchase additional life insurance.

Veterans’ Mortgage Life Insurance

As a veteran, if you are disabled and approved for a VA Specially Adapted Housing (SAH) grant, you may receive mortgage life insurance coverage through the Veterans’ Mortgage Life Insurance (VMLI, VA Form 29-8636).

This link takes you to an overview of these VA insurance benefits. You can click on the insurance program by name and be automatically redirected to the appropriate VA web page for that benefit.

Disability Compensation

Tax-free Dependency and Indemnity Compensation(DIC, VA Form 21-534EZ) is available to veterans who sustain or aggravate an injury or disease during their active service. The disability may include physical and mental health issues and secondary or related items diagnosed after your discharge. Your child may be eligible for DIC if they are not included in the spouse’s DIC, and there is an income-based DIC for parents. A disability can also qualify you for a higher, tax-free Special Monthly Compensation if you are housebound and need special assistance or have trouble performing daily living activities. Additionally, housing and insurance benefits through the VA, like Veterans’ Mortgage Life Insurance, Service-Disabled Veterans’ Insurance, and Adapted Housing Grants may be available.

Geriatrics and Extended Care Services

The Geriatrics and Extended Care Services (GEC) provides help to veterans with life-limiting illnesses, multiple chronic conditions, or disabilities associated with aging, injury, or chronic disease. The GEC will assist a veteran living at home or in a nursing home, assisted living, or other residential community care facilities. GEC services include home health aide care, daily care, telehealth care, palliative care, respite care, hospice care, and even veteran-directed care.

Military Burial

Veteran burial benefits include a gravesite in a national veteran’s cemetery, a government marker or headstone, the opening and closing of that grave and its perpetual care, and a Presidential Memorial Certificate. The marker, headstone, burial flag and certificate are provided at no cost the veteran. Additionally, dependents and spouses buried in a national veteran’s cemetery may also qualify for some benefits such as burial with the veteran, inscription on their headstone, and perpetual care. For a complete description of your veteran benefits, check this VA website link.

Percentages of veterans receiving benefits:

  • 25-34 years 24.7 percent
  • 36-44 years 21.5 percent
  • 45-54 years 25.8 percent
  • 55-64 years 19.8 percent
  • 65-74 years 5.0 percent
  • 75+ years 1.3 percent

If you are a veteran or have a loved one who is, it is crucial to understand that veteran resources go far beyond career and end-of-life issues. Many veterans are not taking full advantage of VA offerings. Many VA age-related programs can benefit a veteran’s life beyond simply planning their future care. Become acquainted with the many options available and determine which programs you qualify for and best serve your interests. With so many benefits available through the VA, you can improve your living situation during your retirement.

The overview is just a summary of what may be available to a wartime veteran or a veteran who is disabled as a result of their prior service. If you or a loved one would like to explore whether you are eligible for benefits, please don’t hesitate to reach out. Please contact our Reno office by calling us at (775) 853-5700 with any questions.

Elder Law, Elder Living

Seniors Stay Socially Engaged While Socially Distancing with the help of Technology

We have come to know that successful, healthy aging is contingent upon connection to those around us. The opportunities for people to laugh, move, and learn together is foundational to aging success. Enter the coronavirus pandemic to change all of that. Now aging Americans must stay socially engaged while maintaining a physical distance. This issue touches us all from senior wellness professionals, medical staff, families, inter-resident connections, and those aging in place at home and alone. The internet of things, and the virtual links it creates, is a great solution to implement in a socially distanced, troubling pandemic world.

Virtual technology tools were becoming more ubiquitous before the coronavirus. Yet, the need for emotional well-being as the especially vulnerable aging population of America became isolated was the accelerant solution to address the problem. Fitness classes ranging from tai chi to yoga and other forms of movement became available in droves of senior online classes. Connecting with family members or health professionals through telemedicine also became crucial as regular visitations and routine medical appointments became impossible.

Virtual tools provide a great advantage for social distancing as no meeting space is required. Senior interaction with tech tools has brought new learning and skills opportunities, providing a sense of connection, purpose, and pride. Older adults share their newfound prowess in video messages, multi online person chats, and more. Grandparents and grandchildren find common ground in a technological world, and grateful parents/adult children are happy for the means to address the social isolation problem and create stronger inter-generational family ties.

Beyond the connection of friends and family, technology brings email, instant messaging, social media sites, brain games, wellness bingo cards, music, even virtual cruises with daily ports of call to keep seniors connected in isolation. Many aging adults associate full-length feature films with a movie theater and do not realize they can watch nearly anything they want via streaming services, 24 hours a day, whenever they choose.

While the internet and these technology tools provide virtual interaction and entertainment, not every senior who needs it can afford a tablet computer or laptop. Many communities are holding campaigns to raise funds for those in need of these digital devices. Nursing homes can receive a stipend from the Centers for Medicare and Medicaid (CMS) through the Civil Monetary Penalty (CMP) fund. Funding through CMP provides communication aids such as tablet devices and webcams that enable virtual visits. However, each facility has a limit of $3,000 to ensure a balance in distributing CMP funds. Because these items may be shared among negative COVID-19 residents, it is critical to avoid entering highly personal information into device applications or programs. Shared tablets are not a good way to check bank accounts, shop online, or have your senior pay bills.

Be wary of too much learning too quickly for a senior. Don’t overwhelm the aging adult with the technology, rather focus on what it provides. Slowly introduce different aspects of the technology and be certain the senior has a firm understanding of how to repeat the process to get online or risk creating frustration. Also, educate them that even though they can Skype, Zoom, et al. with others does not mean their loved ones or friends will be available at all times for them. Set a schedule for meaningful connections, managing their expectations to keep them from cycles of disappointment. Share successes, experiences, even failures with residential staff, other family members, and residents. Find out what works the best overall. Keep the strategy simple for the best results.

Be aware that seniors without strong social connections before covid-19 may feel incredibly left out. The technology connecting people doesn’t work if there is no one to communicate with on the other end of the virtual line. Residents without existing social networks typically rely on the now non-existent shared dining room and community events for interaction, and they may now be left behind. These residents need more assistance in learning how to join online classes and interactive communities that share like interests. Senior Americans unfamiliar with the internet of things do not understand the scope of what is available to them. CMS Administrator Seema Verma states, “While we must remain steadfast in our fight to shield nursing home residents from this virus, it is becoming clear that prolonged isolation and separation from family is also taking a deadly toll on our aging loved ones.”  Help your loved one to leverage digital technology and the internet to stay connected during the coronavirus pandemic. There is still hope and human connection available, and vulnerable and isolated seniors are in desperate need of both.

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.

Healthcare

Virtual Care: The Changing Face of Telemedicine

Telemedicine is the digital information distribution of healthcare-related services. Not long-ago telemedicine was an innovative practice, primarily a supplement to hospitals’ information strategy managing patient care and their data more efficiently. During the coronavirus pandemic and its associated urgent healthcare needs, hospitals and medical offices are making telehealth capabilities more available than ever before. Long-distance patient and clinician contact, advice, reminders, care, education, intervention, monitoring, and remote admissions have become the norm.

Increasing Shift to Virtual Medical Care

The push for comprehensive virtual medical care quickly without a standardized platform has left many healthcare facilities struggling to meet demand with technological data integrity and consistent user interface. Just as individual’s panic led to purchasing toilet paper, hand sanitizer, and other essential household items creating shortages, hospitals “pandemic-purchased” telehealth solutions to ride out the crisis led to a hodgepodge of tech solutions. This situation led to medical information security breaches, dropped call and video conferencing, poor audio and video quality, and distorted or incorrect information relayed to patients and health insurance companies alike.

Patients who were sheltering in place and rather fearful at the outset of the pandemic were initially forgiving of technological glitches. Today, however, patients have higher expectations of telemedicine and seek seamless experiences. Patients are also taking advantage of the ability to test-drive options from home, exploring physician expertise, availability, disposition, and price point before committing to a particular doctor, health care practitioner, or hospital facility. Additionally, patients are enjoying the experience and are now more likely to seek virtual care. It turns out that a patient using telehealth is more likely to adhere to prescription and wellness regimes, which is an advantage to public health overall. On average, telemedicine saves a patient more than 90 minutes otherwise wasted in commuting to an appointment and waiting to be seen by a doctor.

Telemedicine Being Embraced by Clinics and Hospitals

Clinics and hospitals are also embracing the benefits of telemedicine. Virtual medicine has played a vital role in quickly flattening the curve by getting to as many patients as possible without compromising social distancing and urgent care only protocols. Patients with chronic conditions and other non-urgent care, including routine follow-ups, can still engage with their physicians, allowing medical care, decreased patient anxiety, and maintaining facility reputation through patient retention. This continuity of care is essential, especially for urgent non-COVID-19 related health issues.

Health care facilities and medical professionals are now able to reach a new demographic of patients through telemedicine, particularly those in rural areas or those who list time, convenience, and proximity as barriers to making an initial consultation. Fully 76 percent of hospitals now employ telemedicine services, and two-thirds of patients report a willingness to use telehealth in the future, even after the pandemic ends.

Telemedicine Saves Time and Money

Telemedicine also yields significant savings of time and money for healthcare organizations and patients. An average in-office visit is 121 minutes, including 101 minutes of commute and waiting time. Therefore, a patient is only experiencing about 20 minutes of interaction with their doctor. A full one-third of patients have left a doctor’s office because the wait was too long. Telemedicine reduces wait times, no-shows, and cancellations saving time and money. There are also flexible insurance benefits to take advantage of when using telehealth.

What Telemedicine Platforms and Service are Right for You?

How can you best assess your hospital or doctor’s office telemedicine platform and service? Medicaleconomics.com cites four questions that you must ask to find the service best suited to your needs. Telemedicine can vary drastically among categories such as compliance, quality, convenience, and features, so keep the following in mind as you search for the right fit.

  1. Look for easy to use technology. As a patient, you should have no trouble downloading and accessing a telehealth app. It should be easy to use and intuitive and be available on multiple digital devices such as a tablet, phone, or laptop.
  2. Is the software provide HIPPA compliant and secure? Privacy issues are a major concern when using non-healthcare specific solutions like Zoom, Skype, FaceTime, and others. Ensure your telehealth provider keeps your sensitive information digitally safe.
  3. Make sure that the platform provides quality audio and video transmission. You will feel more comfortable, and your session will yield the best results knowing that communication is clear. Miscommunication can lead to misdiagnosis and have tragic health consequences.
  4. Shop around before committing. Read online reviews and speak to others about their telehealth experiences. Finding reputable healthcare facilities doesn’t stop with a board-certified physician. Facility reputation can be the difference between ease of interaction, diagnosis, and follow-up regarding insurance.

Embracing telemedicine can open your healthcare to expert physicians, save you time, and maintain the significant benefit of social distancing. Look for a healthcare organization with the right telemedicine framework for you. It will help you stay current with your routine medical care despite the coronavirus pandemic.

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.

Healthcare

Understanding Gains in Alzheimer’s and ALS Research

Good news on the health front is so welcome these days. Now there is some, for the huge numbers of people suffering from Alzheimer’s dementia and ALS (Amyotrophic Lateral Sclerosis, commonly known as Lou Gehrig’s disease). Researchers have found links between those two dread illnesses, and the new understanding is showing promising results in the laboratory using drugs and genetic alteration.

New Insights on The Alzheimer’s Disease Research

The developments for both conditions center around relatively new insights into brain function. It seems that brain cells require a certain fluidity or agility to move between two rates of neuronal firing. Any further explanation plunges into the deep weeds of physics and neurology, but a recent interview on National Public Radio with researchers likened the healthy process as similar to the fluidity with which water changes from vapor to dewdrop to ice. In the case of the two illnesses, it seems that brain cells that should act with comparable fluency turn “sticky” instead. Dr. J. Paul Taylor, a neurogeneticist at St. Jude Children’s Research Hospital in Memphis and with the Howard Hughes Medical Institute, likened the disease process to what happens when honey is left in the refrigerator. Dr. Taylor won the 2020 Potamkin Prize for Alzheimer’s research.

Also quoted in the NPR interview was biophysical engineer Cliff Brangwynne, of Princeton and also with the Howard Hughes Medical Institute. He likened a healthy brain cell to acting like people coming and going at a party, chatting with each other, but the cells in ill brains have lost that ability to communicate fluidly.

Millions stand to benefit. According to the Alzheimer’s Association, one in three seniors dies with Alzheimer’s or other dementia. More than 16 million Americans provide unpaid care for such people. Between 2000 and 2018, deaths from heart disease have decreased 7.8% while deaths from Alzheimer’s have increased 146%.

New Insights on ALS Research

As for ALS, Johns Hopkins estimates that the illness affects as many as 30,000 in the United States, with 5,000 new cases diagnosed each year. Estimates suggest that ALS is responsible for as many as five of every 100,000 deaths in people aged twenty or older, most commonly in people over age sixty. The disease process causes terrible suffering.

Pharmaceutical company Bayer and Dewpoint Therapeutics are partnering to produce treatments using this new technology for dementia, ALS, and other cancer conditions as well.

Diseases like Alzheimer’s and ALS can cause not only emotional stress for families, but financial stress as well. We help families deal with legal and financial issues related to caring for a loved one with a serious disease. If you’d like to discuss your particular situation, please don’t hesitate to reach out. Please contact our Reno office by calling us at (775) 853-5700 with any questions.

Healthcare

Why You Should Have a Strategy for Your Aging Parents Before a Medical Crisis Hits

Many adult children in the US live far away from their parents. Managing aging parents or in-law medical events can be a serious challenge without proper preparation and understanding of what your parents’ strategy may or may not be, no matter where you live. Do you know what legal documentation your parents have in place regarding their medical care? Do they have advance directives that can help guide your medical decision-making process? Do you and your spouse openly discuss the situations of each other’s parents?

Medical advancements facilitate aging Americans’ longevity even with comorbidities such as high blood pressure, diabetes, kidney disease, atrial fibrillation, and other health issues. Hospitals can typically fix non-life-threatening conditions easily enough, but what happens when a parent is released to return home? Are you prepared? Is there a plan? Many adult children tend to practice avoidance, denial, and wishful thinking when thinking about their aging parents’ behalf in a potential medical crisis. It is advisable to organize and prepare for the changes that inevitably come to your parents’ health.

More than ever, seniors are choosing to live independently and with autonomy about their life decisions. Even if your parents are in a well-run continuing care retirement community, there will come a day when their health will force a change in their lifestyle and living arrangements. Many parents will resist “help,” which they may consider more as interference. Whether they believe they are being a burden to you or decline a geriatric care manager’s services due to “cost” concerns, most older people do not want others interfering in their private affairs. 

The goal is to find a way to help while still affording your parents the dignity and respect they want and deserve. To achieve a comprehensive plan on your parents’ behalf, travel to them for an honest discussion. If this is not possible due to COVID-19 restrictions, then virtual meetings are best, followed by phone calls as hearing loss typically makes communicating useful information difficult. Even on a screen, a face-to-face connection allows a parent to read lips, which is a typical strategy for older people experiencing hearing loss.

Review what legal paperwork your parents have and make sure it is in order. Many documents have a signature from many years ago, and things may have changed. If there is no designation of a medical power of attorney, be sure there is a document naming a “personal representative” to address restrictions outlined in the Health Insurance Portability and Accountability Act of 1996 (HIPAA). This document allows the waiving of privacy concerns that permits access to a parent’s medical information while the parent is in the hospital.

Create an up-to-date list of all your parents’ doctors. The list should include medical contact information and all medicines (prescription or otherwise) that the parents take. If their general physician is not a geriatric specialist, it will help to find them one. Post-hospital fog and newly prescribed medications from an adverse health event can create confusion in an older parent. A geriatric doctor will know to look for and resolve these types of issues. Ask about the parameters for health care intervention, such as dialysis, post-hospital during the time of COVID-19?

Explain to your parents that being released from a hospital for a non-life-threatening, yet serious health episode is usually followed by the need for a care manager, at-home nursing care, or at least companion care. This additional care should not fall to a spouse if the parents live together. A spouse has their unique role to fill as well as personal health challenges with which to contend. Heaping an increased responsibility for spousal health care upon them may be damaging to their health.

Before an unforeseen medical crisis can occur, identify several qualified agencies in your parents’ hometown. Review each agency and candidate carefully. It is easier to integrate a suitable candidate at the outset than having the chaos of retaining and releasing multiple workers. Remember that a candidate who works for one parent may not be another parent’s preference in the future. Maintain a strong relationship with the agency provider. They are an essential resource, and you will probably need them in the future.

Take the time to learn the specifics of your parents’ healthcare and living arrangements. Coordinating your plan of response is contingent upon whether your parents live independently, in assisted living, or a retirement community. Wherever it is your parents live, their first desire will be to go home after an unexpected hospitalization. The desire to return home is a universal truth. Knowing the agencies that can quickly provide the type of care your parent needs in their home setting will go a long way to a successful transition. The road to recovery may require a few weeks of nurse visits, physical or occupational therapists, or simply companionship. The faster you can meet the need, the easier it will be on your parent.

If a full recovery is not possible, what will be your plan to address the new status of their normal? How much more medical oversight and assistance will they require? Know that in these instances, a parent can quickly spend through Medicare allotments afforded for temporary care. If they do not have long-term care, and many aging Americans do not, you will have to find ways to help them receive the care that they require.

If there are multiple adult children, is there an expectation that all siblings share information and work on the problems at hand, or is one in charge? Is this designation formally documented? Managing sibling relationships is key to avoiding family conflict. Also, understand your parents’ financial arrangements. Most parents will ask about the cost of any new healthcare service being arranged and decline using it. It is hard for a parent to spend down the money they worked their entire life to amass.

Knowing your parents’ aging strategies will not address every issue you might encounter because they may not have all the necessary decisions and documents in order. You can only work within the authority they choose to provide. As attorneys, we can help identify gaps in their planning and recommend ways to fill those gaps so everyone can have peace of mind.  If you’d like to discuss ways we can help, please don’t hesitate to reach out. Please contact our Reno office by calling us at (775) 853-5700 to learn more about your Medicaid planning needs.

Estate Planning

The Importance of Keeping Your Estate Plan Current

You should check your estate planning documents every so often, to make sure they’re still good, especially with big life changes like births, marriages, divorces, and moving to another state. Children grow up, marriages dissolve, property gets sold, residences change. That’s why we recommend that you consult us for an estate-plan check-up every five years or so.

What Happens If You Retire in Another State?

If you retire to another state, your will would probably be good, but powers of attorney vary from state to state. Documents from the “old” state might not work in the “new” one, and your documents would not be there for you when you need them.

How Does a Spouse or Ex-spouse Effect My Estate Plan?

Suppose you willed your property to your spouse and appointed that person to be your power of attorney. You got divorced, but you never got around to changing your plan. The law would usually step in to prevent your ex-spouse from inheriting, but you might be stuck with that person holding power of attorney over your property and health care.

Maybe you named your ex-spouse’s father as your executor and agent. Now he can’t stand you and blames you for the break-up.

How Do I Divide my Assets Equally to my Children?

Perhaps you willed your property to your two children equally – but now one child is addicted to opioids. Your will did not restrict how money should be spent. If your addicted child inherits a lot of money in one chunk, that money could vanish to drugs and your child’s survival might be at risk.

Or, you deeded your house to one child and made a will leaving money to your other child. Then you forgot about the deed and made another will, years later. That will split everything equally. The law would invalidate the second will as to the house, because deeds supplant wills. Consequently, one child might end up receiving more value than the other. That unfairness might sour the children against each other forever.

If you got divorced, sold property, moved to another state, or did your documents more than five years ago, come see us for an estate plan check-up.

When it comes to estate planning, “once is not done.” Please contact our Reno office by calling us at (775) 853-5700 to learn more about your estate planning options.