Myths and Facts About Pain and Older Adults

Article provided by: Senior Helpers (see contact info at end of article)

Answers to "Myths and Facts About Pain and Older Adults"

1. Pain is a normal part of aging.
Myth. Although older adults are more likely to experience pain, it is not a "symptom" of aging, and should not be considered as inevitable.

2. It would be great to eliminate all pain!
Myth. Pain is a signal to the brain that something threatens the well-being of the body. It is the mechanism that warns us of injury or illness. Without it, we could not survive.

3. Sometimes pain is caused by injury to the nerves themselves.
Fact. Sometimes the nerves send "false signals" that something is wrong with a body part or organ. Damage to the nerves, spinal cord, and brain can cause this persistent pain.

4. Pain can be "all in your head." Myth...and Fact. While most pain is the result of physical causes, how we think about pain can make a difference. Stress and anxiety magnify our perception of pain, which leads to more stress and anxiety. But the cycle can be broken through pain control techniques.

5. Medication is the only treatment that can relieve pain. Myth. There are many other options for pain treatment--physical therapy, massage, exercise, regional anesthesia, relaxation training, yoga, and biofeedback, to name a few.

6. Antidepressant medications can be effective in treating pain. Fact. Low doses of antidepressants can be especially effective against nerve pain, possibly because they affect the chemical reaction of nerve cells.

7. Because of the danger of addiction, many pain medications should be avoided. Myth. Certain medications (morphine, codeine, and related drugs) can cause physical dependency, and are prescribed with caution. But researchers now believe that these drugs can have a positive impact on quality of life when used exclusively for the treatment of pain.

8. Older adults are less likely than younger people to ask their healthcare providers for pain relief.
Fact. While older adults are the most likely to experience pain, they are the group that is least likely to ask for help. This can stem from the mistaken belief that they are "just getting old," or "don't want to be a bother." In reality, treating pain can improve the quality of life for older adults, and preserve function and independence.

9. The recommended dosage of pain medication remains the same as we age. Myth. Decreased kidney function may cause substances to be excreted more slowly, which could allow a toxic dose to build up. Side effects of medications are also more common in older adults. And for people taking drugs for multiple conditions, it's important that the pharmacist and healthcare provider have a complete list of all their medications, to avoid harmful interactions.

10. To protect the joints, a person with arthritis pain should not exercise.
Myth. Exercise is actually the most important treatment for controlling pain and preventing disability in people with conditions such as arthritis. Increased strength and flexibility bring a better blood supply to muscles and joints. The person's healthcare provider can "prescribe" an appropriate exercise program.

Untreated pain can cause a significant decline in the well-being and quality of life of older adults, resulting in fatigue and depression, anxiety, withdrawal from social life and reduced ability to perform the activities of daily living. So if you or someone you know is experiencing chronic pain, it is important to work with the healthcare provider to determine the most effective treatment. Pain relief is an essential part of good healthcare!

Contact Information
Chad Neighbors
(401) 825-7200
cneighbors@seniorhelpers.com
Warwick, Rhode Island


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The Law Offices of Jeremy W. Howe, LTD. are Elder Law Attorneys in Newport, Rhode Island who specialize in Wills and Trusts, Estate Planning, Guardianship, Probate, and Veterans Aid and Attendance Benefits.

They also are Newport Rhode Island Divorce Lawyers, Attorneys, Mediators, and Arbitrators providing services for Family Law issues such as divorce, child custody and visitation, support, and Military Family Law.

Call them today at 401-841-5700 or visit them on the web at http://www.counselfirst.com

Estate Planning Issues to Consider

Estate Planning

In May, 2011, I was asked to speak at the United States Coast Guard’s Senior Executive Leadership Conference on the key issues facing our generation as they relate to elder law and elder care. Many in our generation are taking care of themselves and their children, as well as elderly parents, so I focused on advance care and estate planning.

Just recently I met with the Coast Guard officer who had invited me to the conference. He told me that the “reviews” of my talk were very positive and he asked if I would be willing to come to the next conference since so many of the attendees found the subject matter of personal interest. Of course I was flattered by the invitation, but more importantly, I was reminded how “timely” the subject of estate planning is and how critical it is that people learn now what they should have in place for the future.

Simply put we need to start asking the following:

• What type of medical care do I want towards the end of my life?
• Where do I want to be cared for?
• How can I ensure that my desires will be honored if I am not able to speak or act for myself?
• What financial arrangements should I make now to ensure that I can receive the care I want?
• What resources are available for my care?
• What will happen if I outlive my assets?
• What do I want to happen after my death?

The practice of elder law attempts to assist people in formulating the answers to these questions by articulating goals for care while you are alive and plans for taking care of your estate upon your death. At the very least your planning should include the drafting of Durable Powers of Attorney for Medical Care and Finances and executing a Will or Trust. Our office can help by initiating the discussion that leads to plans that will meet your individual needs.

- Hilary



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The Law Offices of Jeremy W. Howe, LTD. are Elder Law Attorneys in Newport, Rhode Island who specialize in Wills and Trusts, Estate Planning, Guardianship, Probate, and Veterans Aid and Attendance Benefits.

They also are Newport Rhode Island Divorce Lawyers, Attorneys, Mediators, and Arbitrators providing services for Family Law issues such as divorce, child custody and visitation, support, and Military Family Law.

Call them today at 401-841-5700 or visit them on the web at http://www.counselfirst.com

Bank of America Says Power of Attorney Does Not Grant Access to Online Banking

Newport Rhode Island Durable Power of Attorney

See the link below for this Article entitled,

"Bank of America Says Power of Attorney Does Not Grant Access to Online Banking"

which was provided by ElderLaw Answers.

As an elder law attorney, I would like to know whether Bank of America would allow her to access the account online if there was language in the power of attorney that specifically allowed her that power. The key to most powers of attorney is the language. If it was not specifically listed but the powers given are general, then I would suggest pushing Bank of America's legal advisers to provide the authority for making up their own rules as they go along.

Article: http://www.elderlawanswers.com/resources/article.asp?id=9197


If you or your loved ones do not have a durable power of attorney, medical durable power of attorney and executed living will, call us to make an appointment at 401-841-5700.
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The Law Offices of Jeremy W. Howe, LTD. are Elder Law Attorneys in Newport, Rhode Island who specialize in Wills and Trusts, Estate Planning, Guardianship, Probate, and Veterans Aid and Attendance Benefits.

They also are Newport Rhode Island Divorce Lawyers, Attorneys, Mediators, and Arbitrators providing services for Family Law issues such as divorce, child custody and visitation, support, and Military Family Law.

Call them today at 401-841-5700 or visit them on the web at http://www.counselfirst.com

Medicaid Planning in Rhode Island

Medicaid Planning Newport Rhode Island

Medicaid covers a variety of programs but when we speak of “Medicaid Planning” we are most often discussing long-term care. About 49% of all long-term care is financed by Medicaid. Medicaid is a federal-state program and states have wide discretion in how they will administer Medicaid in their state. Rhode Island is an “SSI State”. In RI a person receiving SSI is automatically eligible for Medicaid and the income and resource rules of SSI are used to determine Medicaid eligibility. Other individuals who qualify are “medically needy” individuals. They are allowed to “spend down” excess income for medical expenses to qualify for Medicaid. They can also spend down by paying off debts, paying for services, prepay funeral expenses, pay real estate taxes, purchase an automobile, converting an IRA to a Roth IRA, making home improvements, buying household goods or personal effects.

Some programs provide “Home or Community-based Services (HCBS) for those who would require nursing home care but for the program. Assisted living costs are covered under a Medicaid waiver program.

Most Medicaid Planning looks to the resources of the individual (and the spouse ). Not all resources are counted although all resources are disclosed. “Countable Resources” can be converted to “noncountable resources”. Some assets are noncountable resources because they are exempt such as: One automobile, the family home if the applicant “intends to return home”, property used in a trade or business, property used for self-support or employment and personal effects and household goods up to $2,000, an account of $4,000, wedding and engagement rings, life insurance with a face value of $1,500 or less. Certain income producing property is also exempt. “Qualified” assets such as an IRA are not countable assets. The “community spouse” who still resides at home is entitled to a “Minimum Monthly Maintenance Needs Allowance (MMMNA)”. In October, 2011 it was raised to a maximum of $2,841 per month and a minimum of $1,828.75. The MMMNA may be increased at a “Fair Hearing”. The Community Spouse Resource allowance (the CSRA) provides for the pooling and division of the resources of husband and wife and allows the “community spouse” to retain a share of the couple’s countable resources. This is composed of countable resources only. The new minimum CSRA in Rhode Island is $22,728 and the new maximum is $113,640. This is in addition to the $4,000 that the institutional spouse may retain. The minimum and maximum home equity limits used by Medicaid have increased to $525,000 and $786,000, respectively.

The Medicaid “look-back period” for transfers of assets is 60 months if the transfer occurred after February 8, 2006. In cases where it is too late to transfer assets there are transfer strategies used by Medicaid planners. There are risks and costs also when assets are irrevocably transferred so it is wise to consult an expert before transferring any asset. There are exempt transfers from the period of ineligibility such as transfers of the family home in certain circumstances, transfers to the community spouse, transfers to a blind or permanently and totally disabled child. There are transfers for value not subject to penalty such as: the purchase of an annuity; a “self-cancelling Installment Note (SCIN), the sale of a remainder interest in a home, modification of a child’s home for the parent before the need for a nursing home, reimbursement of a pro rata share of expenses, compensation for caregiving services and cost of other living arrangements. Medicaid planners also consider the use of a reverse mortgage or a family reverse mortgage and non-negotiable promissory notes.

The foregoing list is not exhaustive and any person or family who wishes to begin planning with reference to Medicaid should remember: “The sooner the better!”
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The Law Offices of Jeremy W. Howe, LTD. are Elder Law Attorneys in Newport, Rhode Island who specialize in Wills and Trusts, Estate Planning, Guardianship, Probate, and Veterans Aid and Attendance Benefits.

They also are Newport Rhode Island Divorce Lawyers, Attorneys, Mediators, and Arbitrators providing services for Family Law issues such as divorce, child custody and visitation, support, and Military Family Law.

Call them today at 401-841-5700 or visit them on the web at http://www.counselfirst.com

Verterans' Benefits

Veteran's Benefits

I recently attended a Continuing Education Seminar with regard to Veterans Benefits.

We covered benefits available to the military member, their spouse and/or children if they die while enlisted, disabled military members, and other benefits for retired Veterans.

It continues to amaze me that there are benefits available that the military members and their families may or may not be aware of.

Top Five Things I Took Away From the Program

1. A military member must complete a DD Form 93, together with their estate planning documents, in order to determine who will get the $100,000 death benefit if the member is killed on duty; who will get their remains, who will get the flag at the funeral, and even letting the military know who should be told first in the event you are killed. The military will follow the Form, regardless of the terms of the Member's Will.

2. Disabled Veterans claims can take several months, or even years to complete. If appealed with the help of an attorney or Veterans' Group, there is a high success rate to overturn the original decisions.

3. The Veteran can get disability benefits for drug and/or alcohol abuse of they can prove that such abuse is directly caused from another diagnosis as a result of a service connected disability.

4. There are new diagnoses added to the list that a Veteran can collect for, where payments can be made retroactively from the original claim.

5. If you know Veteran or a Military Member (or their family) that have questions, please do not hesitate to contact our office or direct them to their nearest Veteran Administration Office.
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The Law Offices of Jeremy W. Howe, LTD. are Elder Law Attorneys in Newport, Rhode Island who specialize in Wills and Trusts, Estate Planning, Guardianship, Probate, and Veterans Aid and Attendance Benefits.

They also are Newport Rhode Island Divorce Lawyers, Attorneys, Mediators, and Arbitrators providing services for Family Law issues such as divorce, child custody and visitation, support, and Military Family Law.

Call them today at 401-841-5700 or visit them on the web at http://www.counselfirst.com

Newport RI Divorce Case Results

Barrington Divorce Attorney Results

We represented our client as the seller’s agent at a real estate closing on the marital home, several months after the Final Judgment had entered. Our client had since moved out of state, and needed to appoint a Power of Attorney to attend the closing on his behalf.

We also reviewed the closing settlement statement with regard to disbursement of the final proceeds. We were able to point out that overdue motor vehicle taxes should have been allocated to the ex-Wife’s portion, and that our client should not be responsible for those.

This resulted in a savings of more than $800.00 to our client.

Kristy J. Garside, Esq.
Associate Attorney
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The Law Offices of Jeremy W. Howe, LTD. are Elder Law Attorneys in Newport, Rhode Island who specialize in Wills and Trusts, Estate Planning, Guardianship, Probate, and Veterans Aid and Attendance Benefits.

They also are Newport Rhode Island Divorce Lawyers, Attorneys, Mediators, and Arbitrators providing services for Family Law issues such as divorce, child custody and visitation, support, and Military Family Law.

Call them today at 401-841-5700 or visit them on the web at http://www.counselfirst.com

RI Division of Taxation Announces Estate Tax Changes

Rhode Island Estate Tax Threshold Increased

The Rhode Island Division of Taxation has announced that the estate tax threshold for the estates of decedents dying in 2012 will be increased to $892,865.  This is a 3.9% increase over the current threshold of $859,350.

Rhode Island state law requires that the threshold amount be adjusted each January, based on annual inflation, compounded annually, and rounded to the nearest $5 increment.

Generally speaking, for a person dying in 2012, his or her net taxable estate, if valued at $892,865 or less, will not be subject to Rhode Island’s estate tax.  Rhode Island’s General Laws Chapter 44-22 provides full details on the computation of the estate tax, including such factors as the marital and charitable deductions.
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The Law Offices of Jeremy W. Howe, LTD. are Elder Law Attorneys in Newport, Rhode Island who specialize in Wills and Trusts, Estate Planning, Guardianship, Probate, and Veterans Aid and Attendance Benefits.

They also are Newport Rhode Island Divorce Lawyers, Attorneys, Mediators, and Arbitrators providing services for Family Law issues such as divorce, child custody and visitation, support, and Military Family Law.

Call them today at 401-841-5700 or visit them on the web at http://www.counselfirst.com

New Medicare and Medicaid Allowances for 2012

New Medicare and medicaid Allowances for 2012

ElderLaw Answers reported today that the Centers for Medicare & Medicaid Services has announced that the community spouse resource allowance (CSRA) and the maximum monthly maintenance needs allowance will rise in 2012,.  The Medicaid home equity limits will go up as well. These allowances have remained flat for two years.

The new minimum CSRA is $22,728 and the new maximum is $113,640. The new maximum monthly maintenance needs allowance is $2,841. The minimum monthly maintenance needs allowance remains $1,828.75 until July 1, 2012.

In addition, the minimum and maximum home equity limits used by Medicaid will increase to $525,000 and $786,000, respectively.

The new figures are effective January 1, 2012, and reflect an increase in the Consumer Price Index (CPI) of 3.7 percent from September 2010 to September 2011.

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 The Law Offices of Jeremy W. Howe, LTD. are ElderLaw attorneys in Rhode Island who specialize in Wills and Trusts, Estate Planning, Guardianship, Probate, and Veterans Aid and Attendance Benefits.

They also are Newport Rhode Island Divorce Lawyers, Attorneys, Mediators, and Arbitrators providing services for Family Law issues such as Divorce, Child Custody and Visitation, Support, and Military Family Law. 

Call them today at 401-841-5700 or visit them on the web at http://www.CounselFirst.com.