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The medically recommended protocols for social distancing and government mandates that restrict large gatherings of Americans to slow the spread of the coronavirus are minimizing our abilities to interact with each other. This isolation holds especially true for those seniors who live alone or in long term health care facilities. Human beings are, by nature, designed for close contact and social interaction. Maintaining human connection, whether it be family or casual acquaintances, can help boost immunity, combat anxiety and stress, and can even lower health risks that are exacerbated by stress like heart attacks and hypertension.

The Association of Health Care Journalists reports that it is critical for older adults’ wellbeing to maintain social ties. Those seniors who experience loneliness and social isolation are more likely to develop dementia, more likely to fall, have an increase in hospital readmissions, and an increase in mortality. Because of the COVID-19 pandemic, health care facilities and hospitals across the country have put a pause on in-person visitation. This separation will protect the most vulnerable populations, such as older adults and those individuals with chronic health conditions.

To help your loved ones in a facility or living on their own during this challenging time of COVID-19 Right at Home, a leader in the in-home senior care industry, has some ideas to stay connected to those you love who are isolated during this outbreak.

• Set up phone dates. Scheduling a regular call at a prescribed time and date brings you closer through conversation and also gives a senior something to look forward to experiencing. Do not over-promise. It is better to have two calls a week that you always attend rather than to miss a promised chat session because you overscheduled your time.
• Write letters to each other. Getting postal mail is fun for all ages, especially when it is a letter, filled with memories of shared times. Include self-addressed stamped envelopes back and forth to encourage continuing the exchange. Lonely seniors will usually re-read these notes and treasure them.
• Set up chatty technology. Whether it’s a tablet, home device, or smartphone, you can use your digital device to use apps like Facebook Messenger, Alexa, FaceTime, Skype, and more to videoconference with your senior. If your senior needs some technical help, most health care workers will be able to help get them started as you will not be permitted to be onsite.
• Virtually watch movies together. If you and your senior have a desktop computer or laptop that uses the Chrome browser, Netflix Party will synchronize video playback and add group chat capability to your chosen show or movie. It’s like having a long-distance movie night or tv watching party.
• Attend online events and activities. Participating online is a big deal when faced with isolation. There are thousands of people online who have similar interests as you. Meetup.com is a free membership group that has 24 separate categories, like dance, language, and culture, photography, family, tech, health and wellness, music, and more. All of these categories host multiple online events in which your senior can participate.
• Attend virtual religious services. Faith is so important right now, especially for some seniors. If your loved one has a worship service they used to attend, see if they are now providing their services online. Many houses of worship have Facebook pages where a service is a click away. It will lift your senior’s spirits immensely to see and listen to their familiar pastor, rabbi, or priest.
• Make use of the public library online. More than ever, libraries are offering their services for things like movies, e-books, and audiobooks.
• Stay physically active. Log into a virtual exercise class online. Most of the classes are free, and they are found everywhere on YouTube. Just be sure to search for an exercise class that is appropriate for your age and physical abilities. As with any new exercise regime, always consult your doctor first.
• Get outdoors, even for 5 minutes. If at all possible to do safely, step outside on the porch, patio, or balcony and encourage your loved one to do the same. Take in some sunshine and fresh air, take a deep breath and see the bigger picture of life.

Prolonged loneliness can bring about depression and even dementia. However, social distancing does not have to bring about social disconnection. Employ some of these ideas in the world of your senior to protect them from isolation during this pandemic. It is crucial to your loved one’s wellbeing to have direction and routine, hope, and human connection.

We are also using video technology for our meetings so we can continue to help with planning needs of our community.

If you have questions or need guidance in your planning or planning for a loved one, please do not hesitate to contact our office by calling us at (775) 853-5700.

The sudden rise of the coronavirus, COVID-19, has left many unprepared and confused. There are numerous reports of shortages of antibacterial hand sanitizer, disinfecting wipes, and even toilet paper. While we can’t predict when something like COVID-19 might strike, we can take steps to prepare for an unexpected crisis to help reduce the stress on ourselves and family members.

Designate a family member who will check on elderly relatives. Make sure everyone knows who will responsible for checking in with an elderly loved one each day. Also set up a process for notifying other family members of an elderly loved one’s condition – this may include sending an email, text messaging, or phone calls. The method is not as important as agreeing to a process and sticking to it so all family members stay informed.

Seek medical advice in the event of a health care crisis. There has been a great deal of reporting about COVID-19, and some of it has been inconsistent. Reach out to your trusted medical team to understand what you and your loved ones should be doing in this, or any, health care crisis.

Make sure someone knows how to get your bills paid if you are unable to. This type of power can be provided to an agent under a financial power of attorney. Powers of attorney can include numerous powers, so it is critical to talk with legal counsel before signing any type of legal document that gives someone else authority over your finances.

Be sure there is an accurate list of medical prescriptions readily available in your home. If you become ill, it is important that someone knows the medicines you take and the dosage. Keep this in your home where others can find it, and make sure the list is dated, noting any time it is updated. Many of us assume that our doctor has an updated prescription list, but if you are seeing multiple specialists, that may not be true.

Designate someone you trust to make medical decisions for you if you are unable to. This should not be a form that is downloaded from the internet. Deciding what type of treatment you want, where you want to live, and what should happen if you have a terminal illness are serious topics that should be considered carefully, then translated into a proper legal document.

Planning for an unexpected health care or financial crisis can help relieve a great deal of stress for you and your family. We would welcome the opportunity to help you come up with a plan that works for you.

If you have questions or need guidance in your planning or planning for a loved one, please do not hesitate to contact our office by calling us at (775) 853-5700.

All Veterans Benefits Administration (VBA) Regional Offices are closed to the public for veteran walk-in claim assistance, counseling, scheduled appointments, and other in-person services in response to the COVID-19 pandemic. The offices will remain open to essential personnel as services will be provided to veterans through the Veterans Administration website (VA). Specific claim question information can be addressed through the Inquiry Routing & Information System (IRIS) or via telephone at 1-800-827-1000. The VBA also has a presence on Facebook and Twitter that you can follow for updates. This social distancing effort will protect veterans who are older, who have underlying health conditions, or both, as well as on-site VA personnel. Though the delivery mechanisms to provide benefits and services are now focused via online services, veterans, families, and survivors will continue to receive assistance during the COVID-19 outbreak.

Hearings with a veteran’s law judge will continue in a videoconferencing format. Family members, outside advocates such as the American Legion’s service officers, as well as attorneys who may be representing a veteran, must now videoconference to guide veterans through their claim process. This process works very well except in the instances when a veteran does not have a smartphone or other internet device or has one but are uncomfortable or unfamiliar with using the technology. The VA is allowing veterans to cancel their meetings with the judge though it will delay the process. This delay, however, will not jeopardize their claim. Family, formal advocate groups, and attorneys, either for free or for a fee, must step in to assist the many veterans who are senior or near senior age who are unable to navigate benefits claims in these formats.

To make ends meet from layoffs and the national economic fallout due to the COVID-19 pandemic, many veterans who have been eligible but never filed for disability ratings are doing so now. All new disability claims require, at minimum, one examination by a physician. An appointment can be tough to schedule as doctors are currently prioritizing emergency and sick calls over non-emergency appointments. The important thing for a veteran to do is to schedule the appointment anyway because beginning the process identifies the start date for retroactive payment for their disability should the veteran become approved.

The Veteran Benefits Administration also handles GI Bill benefits, VA home loans, as well as disability claims. All of these services are being funneled into online, videoconferencing, and telephone formats until further notice. VA hospitals and clinics will remain open to veterans but have new restrictions, so be aware of what they are before trying to walk into a VA healthcare facility.

If you have questions or would like to discuss your current legal needs, please don’t hesitate to reach out by calling our office at (775) 853-5700.

You have probably heard about the astronomical costs of nursing-home care if you become seriously ill or injured. You might also know that Medicare would cover only a minimal amount of those costs. Private insurance doesn’t seem like a good bet either, if you’ve heard horror stories about skyrocketing premium costs and difficulties in even obtaining long-term care (LTC) insurance in the first place.

There may be a better way. “Hybrid” policies essentially combine life insurance or an annuity with LTC coverage. (The benefits can be known as “accelerated death benefits” or “living benefits,” or the coverage can be called “life/long term care,” “linked benefits,” or a “combo” policy.)

This type of policy will pay if you need nursing care, but, if you never need that, then the policy functions like standard whole-life coverage. It’s a win-win. Say, for example, you buy a hybrid policy with a $100,000 death benefit. You eventually need $50,000 of that coverage to pay for LTC. Then, when you pass, your beneficiary would receive a $50,000 payout from what’s left of the original $100,000 coverage.

Some plans offer tax-free death benefits to your heirs if your LTC benefits are not fully used or needed. They may return your premiums if you change your mind down the road. Premiums can be locked in from the initial purchase date, with a guarantee that they will never increase. Those who already hold a legacy policy with a large cash value may be able to roll that value over, tax free, into a new hybrid policy.

For those who can afford to pay premiums in a lump sum in advance, LTC coverage could amount to as much as twice the face value of the policy. Compare that with simply setting money aside for LTC expenses at a rate of five percent interest. It could take as long as thirty years to save for what this policy offered on its face.

There is a wide range of coverage, depending on the policies. They may cover different services, delivered at-home, in a facility, or both. The monthly or daily benefits can vary. Some policies require an elimination period (a delay between the time a doctor qualifies you for coverage, and actual payment); some do not. Some provide inflation protection. Some provide adjustable rates, depending on how much the insured might need LTC as against the death benefit.

Always also remember that the carrier must have the long-term financial stability to pay claims, and to remain in business, for decades to come.

To sort through all these intricacies, the National Association of Insurance Commissioners has issued a free and comprehensive Shopper’s Guide to LTC Insurance. It provides especially helpful shopping tips at pp. 31-36. Find the publication here.

We can create a long-term care plan that incorporates a hybrid plan like this with an irrevocable trust that will protect all of your bank accounts and real property (like your home) in the event you need long term care. If you are interested in protecting your savings and your home, we would welcome the opportunity to discuss a plan that works for you.

Please contact our office by calling us at (775) 853-5700.

Couples often bring children into a marriage from a prior marriage or union and then have children together. This is often referred to as a blended family. Blended families highlight the need for careful estate planning to make sure the needs of each spouse are met, as well as the needs of each parents’ children.

If one spouse is significantly younger, this sometimes means that the older spouse’s children are close in age to the younger.  There can also be sibling rivalry between children of a parent and stepchildren. These relationships can cause more than friction between the stepparent and stepchildren.

Most parents want to ensure that their assets will pass to their children and/or grandchildren, and maybe not their stepchildren.  However, without careful estate planning, there is no guarantee that their children will inherit their assets.  In fact, if the couple creates identical wills such that their assets pass to the survivor of them, there is a significant likelihood their children will be disinherited.

This is because all of their assets will pass to the surviving spouse to do with as he or she pleases. This can result in the surviving spouse excluding the stepchildren, who then receive nothing.

Poor planning can lead to a race for survival between spouses. A will can be changed at any time; therefore, a surviving spouse could change his will after the death of the first spouse, leaving nothing for the first spouse’s children.

Another common occurrence is for each spouse to name the other as a beneficiary on accounts or pieces of real property. Doing so will not allow the bank account, piece of property or other type of asset to pass to anyone else, regardless of what their estate planning documents provide.

A trust, however, can allow a spouse/parent to “rule from the grave.” At the death of the first spouse half of the trust assets can be locked down. With this type of planning, each spouse can have the assurance that their share of the trust assets (or one half) will pass to their children, grandchildren or any other person they wish. The remaining assets are used for the surviving spouse and will then pass as that spouse wishes.

We help families of all types plan so that their savings, home and other property passes the way they intend. This involves getting to know you and your family and having a complete understanding of each spouse’s wishes. If you’d like to discuss your particular situation, please contact our office by calling us at (775) 853-5700.

Alzheimer’s disease is becoming more prevalent among aging Americans, and there are more aging Americans than ever before. Alzheimer’s disease has three typical biomarkers: plaques of beta-amyloid protein, tangles of tau protein, and loss of connections in the synapses that communicate information between brain cells. Now a simple blood test may be able to detect early signs of Alzheimer’s years before any symptoms, like memory and thinking decline, become apparent. The test involves the identification of changes in levels of NfL a neurofilament light chain protein found in the brain. This protein is part of the internal skeleton and resides inside neurons and brain cells, but when damaged or dying NfL leaks into the cerebrospinal fluid (CSF), it becomes circulated into the bloodstream.  CSF provides essential mechanical and immunological protection to the brain inside of the skull.

Prior testing to determine elevated levels of NfL in the cerebrospinal fluid involved a lumbar puncture or a spinal tap which is a procedure many people are reluctant to undergo. Still, this raised level of NfL is a reliable indicator that brain damage has occurred and that the person is at an elevated risk of Alzheimer’s presymptomatic stages. Testing of NfL “…could be,” says co-first study author Stephanie A. Schultz, who is a graduate student at Washington University, “a good preclinical biomarker to identify those who will go on to develop clinical symptoms.”

Recent data from the National Institute on Aging Alzheimer’s disease fact sheet estimates Alzheimer’s may rank as the third leading cause of death for older people following heart disease and cancer. It is also the most common form of dementia among seniors aged 65 or more. A simple blood test can detect the future state of you and Alzheimer’s, but do you want to know? Currently, there is no cure for the disease, and depending on the levels of optimism an individual displays, knowing their NfL status could be a blessing or a curse.

The blood test gives pre-diagnosis years ahead of the onset of symptoms. There is a percentage of seniors who would find this information disheartening and feel burdensome and full of worry for what is about to come. These individuals can receive protection from knowing at their request if the information would make them fearful and angst-ridden. Other seniors might want to have a pre-diagnosis to relish the time that they have left with full faculties. They may want to get their affairs in order, handling day to day living choices and extension of life choices when they are no longer mentally competent to do so. Many components divide the two camps of thought; wanting or not wanting to know. Family structure, faith, financial independence, education level, and general health and well-being typically play a factor in the decision.

What of the family who may want or may need to know of the future advent of Alzheimer’s to plan for the care of their spouse or parent? As a spouse and as a child, it is crucial that medical directives be in place for when their loved one can no longer make a sound decision but can be comforted by the fact that they participated in the planning years before. A spouse must prepare when their loved one enters a full-time care facility, they may no longer recall their marriage and their spouse and unknowingly, may strike up a “relationship” with another resident. Retired Supreme Court Justice Sandra Day O’Connor encountered this with her husband and famously became involved in raising awareness of Alzheimer’s disease. Subsequently, she was diagnosed with Alzheimer’s disease in 2018 and retired from public life.

Outside of the emotional realm of not having an Alzheimer’s stricken spouse or parent recognize who you are there is a substantial financial component to caring for individuals with Alzheimer’s. For practical and economic reasons, a family should be able to establish the biomarker for a loved one’s likelihood to develop the disease through this simple blood test. To that end, health information is private and protected by law. To ascertain your spouse or parents’ risk of Alzheimer’s requires conversation, acceptance of the blood test, and careful planning with elder counsel for proper legal documentation.

If you have questions or need guidance in your planning or planning for a loved one, please don’t hesitate to contact our Reno office by calling us at (775) 853-5700.

While aging in place is very popular among the baby boomer generation, about one-third of those retirees would choose to live elsewhere. The family remains the most significant factor when deciding where retirees live, followed by the general livability of an area and desirable weather conditions. The decision about where to live should be a high priority as you approach retirement age. According to www.AgeFriendly.com, two out of three retirees feel they did not do the necessary in-depth research when determining where to live out their retirement years. Three out of four of the same group of retirees indicated that an online tool such as Age Friendly Advisor (a section of www.AgeFriendly.com) would be handy to determine what a location is really like from its current residents. This online crowdsourcing site designed for those aged 50 or more allows the user to tap into advice about good cities to live in, get care, and even get a retirement job to improve and enhance the quality of life.

This user review approach is similar to other sites where consumers can give product reviews and read opinions about the product before purchasing. This approach provides an “upvote” function that allows easier navigation of the more popular and valuable topics addressed. Age Friendly Advisor answers questions for three distinct purposes: everyday living, working and volunteering, and caregiving. The living section helps older adults connect with available resources, engage with one another and communicate with their city or town. The working and volunteering section connect the user to a list of age-friendly employers and businesses including customer/employee reviews and job listings. The caregiving section is for those who opt to age in place while staying connected to their communities. The cities and towns support of the elderly community are assessed and rated by Age Friendly Advisor. As a location becomes responsive to their older citizens, the steps taken to improve their support is recognized.

This website is part of a larger corporate entity known as Age Friendly Ventures, and the use of and information from their websites are free. Age Friendly Ventures operates other retirement friendly sites such as RetirementJobs.com and MatureCaregivers.com. The sites are all geared toward persons age 50 or more and support the mission to fight ageism and provide resources for a successful aging experience. “When managed well, user-contributed reviews reveal an extraordinary wisdom of the crowd,” Age Friendly Ventures founder and CEO Tim Driver said in a statement. “Just as consumers read and give product reviews on Amazon and restaurant and hotel ratings on Yelp and TripAdvisor, Americans can now go to agefriendly.com to read and publish crowd sourced reviews tackling complicated topics around aging.”

Age Friendly Ventures and their subsidiary websites currently enjoy the support of at least one major senior living operator and other corporate entities. More will surely follow as these websites gain traction on influencing the process of and choices about aging. Sponsorship and brand exposure to the baby boomer (and older) community while providing them with a reliable and free set of information services is destined to become more popular as the corporate world chases retirees’ purchasing power and retirement dollars. Finding trusted information about health and wellness, lifestyle and retirement options with the bonus of user reviews can help a senior successfully navigate the many options available to them and make an informed decision.

Gathering trusted peer-reviewed information from sites like agefriendly.com is one of the first steps to take in your plan for successful aging. Your choice may lead you to a new state or just a new town. Wherever it takes you, a trusted elder law attorney can help you review your plan and make any necessary adjustments.

If you have questions or need guidance in your planning or planning for a loved one, please do not hesitate to contact our Reno office by calling us at (775) 853-5700.

We are living in confusing and scary times. The senior population has been identified as the most at-risk demographic for COVID-19. Information coming out about COVID-19 is very fluid, which can also contribute to overall stress. Thankfully there are ways to try and manage stress and stay as healthy as possible during this time thanks to advice from several federal agencies monitoring the situation and the impact of COVID-19 on the senior population. This article highlights some of the advice provided from those agencies monitoring this situation closely.

For those living in a nursing home or long-term care living facility, new protocols have been established by the federal government to curb the spread of Coronavirus. A new preparedness checklist is available on the Centers for Disease Control and Prevention (CDC). It includes staff education and training for the rapid identification and management of ill residents, as well as an increase in supplies and resources. There are also restrictions on all visitation, excepting some circumstances like an end of life situation.  Other restrictions have been placed on volunteers and non-essential health care personnel, and the cancellation of all group activities and communal dining.

Before the identification and dissemination of information about Coronavirus, the CDC had identified the 2019-2020 flu season as being particularly challenging. Now many seniors wonder whether they have a different type of flu, allergies, or are experiencing the Coronavirus. Not knowing is particularly frightening since seniors have been identified as the demographic with the highest mortality rate. The CDC has a straightforward checklist of symptoms of respiratory infection, including COVID-19: fever, cough, and shortness of breath

Because other types of flu have similar symptoms and there is no Coronavirus vaccine, and its test is in very short supply, many older adults will only be able to treat their symptoms without full knowledge as to the contagion.

One their website under “How to Prepare” the CDC provides information on protecting yourself, your family, your home, and managing anxiety and stress. According to the CDC, there are some things that seniors can do whether or not they are in a facility or living at home that can help reduce their risk of catching the Coronavirus or any other virus for that matter in this bad flu season. The first line of defense sounds counterintuitive to a global pandemic, but it is crucial, stay calm and try to relax.

Getting quality sleep during this outbreak will allow your body the time it needs to restore immunity responses to contagions. Stay well hydrated by drinking plenty of water. Staying calm, getting restful sleep, and remaining hydrated will allow your body’s natural defense mechanisms to protect itself.

Have someone near you help you stock up on supplies. Stay in your home as much as possible. If the weather permits, open a window for fresh air. If you have a home with a porch or patio, take in some sun for vitamin D. You want your immune system to be as robust as possible. Take everyday precautions to keep space between yourself and others. If it is not necessary, don’t go out in public, avoid crowds, stay away from anyone who is sick, and wash your hands often. Cancel any cruise or non-essential air travel and do not use public transportation.

The Environmental Protection Agency (EPA) has posted a list of disinfectants for use against the Coronavirus. Proper disinfecting of often-used surfaces is critical as this particular Coronavirus can live for long periods, up to 72 hours on some surfaces. As of now, the EPA reports no detection of COVID-19 in drinking water supplies and believes the risk to the water supply is low based on current evidence.

The CDC is reporting that seniors with chronic medical conditions like heart disease, lung disease, and diabetes are at higher risk of contracting COVID-19 and should take extra precautions about self-isolating. Those seniors with these conditions in a nursing home or long-term care facility will be triaged according to CDC guidelines for best practices with the elderly who are the highest risk.

If you feel worried and panic is taking over your rational responses, seek a loved one or trusted friend to guide you through the steps you can take. There is a great deal that is unknown about the Coronavirus, but there is a great deal known about what you can do as an individual senior to combat the threat and remain healthy.

If you have questions or need guidance in your planning or planning for a loved one, please do not hesitate to contact our Reno office by calling us at (775) 853-5700.

Congress passed the Achieving a Better Life Experience (ABLE) Act in 2014. This created tax advantaged accounts for people with disabilities. These accounts grow and are tax free. The money in the accounts can be used for qualifying expenses. Before the passing of the ABLE Act in 2014, if a person with disabilities had more than $2000 in their name, they would lose Medicaid coverage or Supplemental Security Income (SSI). ABLE accounts allow people with disabilities to have more than the $2000 in their name within the guidelines without losing these benefits.

In order to qualify for an ABLE account, the beneficiary must have become blind or disabled before the age of 26. When opening an account, a person with disabilities may or may not be asked to provide documentation if they are not already receiving Medicaid coverage or SSI.  In order to self-certify, the person with the disability will just need documentation from the doctor. Those already receiving Medicaid coverage or SSI should not have to provide documentation in order to open an account.

The ABLE account limit is $14,000 per year. This keeps the account from incurring the gift tax. ABLE accounts cannot grow above $100,000 without affecting other benefits. If the account grows above $100,000, Social Security payments are suspended until the account falls below the $100,000. These accounts are administered at the state level, but this does not mean that the account must be acquired in the home state. It is beneficial to investigate and find the account that best fits the needs of the disabled person. Fees are one consideration. Another is how the funds are accessed. If immediate access is necessary, an account that offers a debit card option may be important. This is something that must be explored individually. An elder law attorney and financial planner can be helpful in deciding which plan best meets an individual’s needs.

Funds in the ABLE account can, according to the ABLE Act, be used for “qualified disability expenses.” It further defines qualified disability expenses as “expenses related to the eligible individual’s blindness or disability which are made for the benefit of an eligible individual who is the designated beneficiary.” ABLE accounts can be used to pay for housing, transportation, assistive technology, support services, health, prevention and wellness, employment training, education, funeral and burial expenses, among others. It is important for a disabled person to speak with an expert, in order to take advantage of the full benefit of the account, as many people may be unaware of expenses the account can cover.

It is recommended that receipts and records for the expenses paid for with an ABLE account are kept as a record for the account. The IRS is responsible for regulating the accounts. Having records of the expenses the account was used for is very helpful in case of an audit. It may also be beneficial to keep a record of how each expense is related to the disability. Taking these measures will provide documentation if any expense covered by the ABLE account is ever questioned or if the account is audited.

ABLE accounts can benefit many Americans with disabilities. Many people continue to choose special needs trusts and other financial options. There is no limitation for one or the other. For those who can afford both, this may be an option to explore. The benefits of both outweigh one or the other. ABLE accounts are just one tool for those planning for the future of people with disabilities.

If you have questions or need guidance in your planning or planning for a loved one, please do not hesitate to contact our Reno office by calling us at (775) 853-5700.