Showing posts with label Eldercare. Show all posts
Showing posts with label Eldercare. Show all posts

Friday, December 21, 2012

Single? You Still Need an Estate Plan

Single People Need Estate Plans Too

Many people believe that if they are single, they don't need a will and other estate planning documents. However, estate planning is just as important for single people as it is for couples and families.

Estate planning allows you to ensure that your property will go to the people you want, in the way you want, and when you want. If you do not have an estate plan, the state will decide who gets your property and who will make decisions for you should you become incapacitated. An estate plan can also help you save on estate taxes and on court costs for your loved ones.

The most basic estate planning document is a will. If you do not have a will directing who will inherit your assets, your estate will be distributed according to state law. If you are single, most states provide that your estate will go to your children or to other living relatives if you don't have children.

If you have absolutely no living relatives, then your estate will go to the state. You may not want to leave your entire estate to relatives -- you may have close friends or charities that you feel should get something. Without a will, you have no way of directing where your property goes.

The next most important document is a durable power of attorney. A power of attorney allows a person you appoint -- your "attorney-in-fact" or "agent" -- to act in your place for financial purposes when and if you ever become incapacitated. In that case, the person you choose will be able to step in and take care of your financial affairs. Without a durable power of attorney, no one can represent you unless a court appoints a conservator or guardian. That court process takes time, costs money, and the judge may not choose the person you would prefer.

In addition, you should have a health care proxy. Similar to a power of attorney, a health care proxy allows an individual to appoint someone else to act as their agent, but for medical, as opposed to financial, decisions. Unlike married individuals, unmarried partners or friends usually can't make decisions for each other without signed authorization.

If you are planning to give away a lot of your money, there are ways to do that efficiently through the annual gift tax exclusion and charitable remainder trusts. Other estate planning documents to consider are a revocable living trust and a living will.

Don't think that because you are single, you don't need an estate plan. Contact your elder law attorney to find out what estate planning documents you need.
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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.


Wednesday, November 7, 2012

Medicare's Open Enrollment Season Is Coming

It is that time of year again -- time to reassess whether your Medicare plan is working for you. 

Medicare's open enrollment period runs from October 15 to December 7.

During this period, you may enroll in a Medicare Part D plan or, if you currently have a plan, you may change plans. In addition, you can switch out of a Medicare Advantage (managed care) plan and return to traditional Medicare (Parts A and B), enroll in a Medicare Advantage plan from traditional Medicare, or change Medicare Advantage plans.  If you are in traditional Medicare, are happy there and don’t have or want a prescription drug plan, you don’t need to do anything. 

Beneficiaries can go to www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to make changes in their Medicare prescription drug and health plan coverage.

During the open enrollment period, you should review your current plan by looking at the costs and coverage for next year to determine if it is still the right plan for you. It is especially important to shop around for the best drug plan. The Washington Post is reporting that prescription drug plan premiums are expected to go up significantly. According to an analysis by Avalere Health, seven of the current top 10 prescription drug plans will have double-digit increases in premiums.

Remember that fraud perpetrators will inevitably use the Open Enrollment Period to try to gain access to individuals' personal financial information.  Medicare beneficiaries should never give their personal information out to anyone making unsolicited phone calls selling Medicare-related products or services or showing up on their doorstep uninvited.  If you think you've been a victim of fraud or identity theft, contact Medicare.  For more information on Medicare fraud, click here or here. 

In addition, you can now get the same information found in the handbook "Medicare & You" online.

Find out what’s new for the year, how Medicare works with your other insurance, get Medicare costs, and find out what Medicare covers. The handbook information on the Web is updated regularly, so it will always find the most up-to-date Medicare information.
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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.





Wednesday, September 5, 2012

Elderly Losing Homes for Owing a Few Hundred Dollars in Back Taxes

Outdated Laws Causing Seniors to Lose Homes

In what a new report is calling “a second nationwide foreclosure crisis,” homeowners, particularly the elderly, are losing their homes because they owe as little as a few hundred dollars in back property taxes.  At the same time, big banks and other investors are snatching up these homes for pennies on the dollar and reaping huge profits.

The blame, says the National Consumer Law Center (NCLC) in its groundbreaking report, lies with outdated state laws that permit local governments to sell property through a tax lien foreclosure process if the owner falls behind on property taxes, even if the homeowner owes as little as $400.

When a home is foreclosed on for back taxes, banks or speculators responding to “get-rich-quick” Internet schemes swoop in to buy the tax lien.  The homeowner has a limited time to redeem their property by paying the investors the lien’s purchase price, plus interest and fees.  But many state laws permit tax lien purchasers to charge homeowners extremely high interest rates that were set decades ago -- as high as 20 to 50 percent.  If, as often happens, the homeowner can’t come up with the cash, the investor sells the house at a huge profit compared to the cost of the tax lien.

For example, an 81-year-old Rhode Island woman was evicted two weeks before Christmas from the home she had lived in for more than 40 years because she had fallen behind on a $474 sewer bill, the report says. A corporation bought her house at a tax sale for $836.39 and then resold it for $85,000.

The report charges that individual tax sale purchasers and large investment companies, including Bank of America and JPMorgan Chase, have used the tax sale process as a profit center.

Most vulnerable are elderly individuals who have fallen into default because they are incapable of managing their financial affairs due to Alzheimer’s, dementia, or other cognitive disorders, the report states.  The loss of a home is particularly devastating for seniors, whose only retirement savings may be their home equity.  Meanwhile, the rules for property tax sales are complex and confusing.

The report estimates that tax lien sales nationwide total about $15 billion a year and are on the rise due to the weak job market, depressed home values, and an increase in mortgage foreclosures.
The NCLC makes a number of recommendations for preserving homeownership while ensuring payment of local taxes, including redemption payment programs, lower investor profits so it is easier for homeowners to redeem their homes, and court supervision of any property sales.

For more on the report, including a press release, a summary of state tax laws and the report itself, titled “The Other Foreclosure Crisis,” click here.

For a CBS News article on the report, click here.

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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.

Friday, June 29, 2012

Music Soothes Dementia Sufferers


For Elders With Dementia, Musical Awakenings

Henry, an elderly Alzheimer's patient in an American nursing home, recently became a viral star. In a short video that has been viewed millions of times online, he starts out slumped over and unresponsive — but undergoes a remarkable transformation as he listens to music on a pair of headphones.

The clip is part of a documentary called Alive Inside, which follows social worker Dan Cohen as he creates personalized iPod playlists for people in elder care facilities, hoping to reconnect them with the music they love. Cohen tells NPR's Melissa Block that the video of Henry is a great example of the link between music and memory.

"He is able to actually answer questions and speak about his youth, and this is sort of the magic of music that's familiar for those with dementia," Cohen says. "Even though Alzheimer's and various forms of dementia will ravage many parts of the brain, long-term memory of music from when one was young remains very often. So if you tap that, you really get that kind of awakening response. It's pretty exciting to see."

Cohen says his goal is to make access to personalized music the standard of care at nursing facilities. An early concern, he says, was that headphones might isolate the patients even further. But when he first implemented the project on a large scale in 2008, putting 200 iPods in four facilities around New York, he got the opposite result: a flood of stories from the staff about increased socialization.

"People wanted to share their music with others: 'Here, you've gotta listen to this,' or 'What was the name of that song?' " Cohen says. "The music is great, but to me, perhaps the even bigger win is people having better and more relationships with those around them."

Read more HERE

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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.

Wednesday, May 16, 2012

MEDICAID DIVESTMENT PENALTY DIVISOR UPDATE

Medicaid Divestment Penalty Update

One of the most important pieces of advice that we give to those clients who come to us for Medicaid planning is to be extremely cautious when making gifts or transfers for less than fair market value.

When a nursing home resident applies for Medicaid assistance, one of the first questions he or she is asked is whether any gifts or transfers were made within the past five years.  This is the infamous “look-back” period which can result in a penalty imposed upon the applicant.

For example:  Mr. Smith is a resident of a nursing home and is otherwise eligible for Medicaid assistance.  However, three years ago, he gave his daughter $100,000.00 as a gift.  The state uses the current divisor of $8,492.00 (up from $7,777.00 previously) to determine how many months Mr. Smith will have to wait before he can receive Medicaid.  $100,000 divided by $8,492.00 equals 11.8.

For the next 11.8 months, Mr. Smith will be ineligible for Medicaid assistance to pay for his nursing home care.  The penalty will create a huge problem for Mr. Smith and his family if the family has no other means of paying for nursing home care.

Before you or your parents make any gifts or transfers for less than fair market value, consider how these gifts may impact Medicaid assistance in the future. 

Please call our office if you have questions about the Medicaid application process or how the rules might affect you.


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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.

Friday, March 9, 2012

Medicare Beneficiaries: Make Sure Your Equipment Supplier Works With Medicare

Attention Medicare Beneficiaries

Read original HERE

In October, Medicare beneficiary David P. (not his real name), was shocked to see a charge of more than $1,000 on his credit card statement. The charge was for the complete cost of renting a machine he needed to help him recover from knee replacement surgery. The equipment is covered by Medicare, so Mr. P. thought he would be responsible only for his 20 percent co-payment.
But it turns out that the equipment supplier who rented him the machine never informed him that it is not a registered Medicare provider and that therefore Mr. P. may be responsible for the full cost of the rental.

"It is a problem that beneficiaries often do not know that they are using a non-participating supplier," says Alfred J. Chiplin, Senior Policy Attorney at the Center for Medicare Advocacy and co-author of The Medicare Handbook (Wolters Kluwer).

The good news is that Chiplin says a new Medicare program that has been launched in a few areas of the country will keep people like Mr. P. from unwittingly being liable for the full cost of such "durable medical equipment (DME)," which includes oxygen equipment, wheelchairs, walkers, and similar devices.

In the few areas of the country with the new program, which is called the “Medicare DMEPOS Competitive Bidding Program,” Medicare beneficiaries who expect any reimbursement may rent or buy certain durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) only from suppliers who contract with Medicare. In addition, non-contracting suppliers are required to tell Medicare beneficiaries that they don't work with Medicare and the beneficiaries must sign a waiver form stating they are aware of this. If the supplier fails to do this, the beneficiary is not liable for the charge.

Chiplin told ElderLawAnswers that equipment suppliers in the DMEPOS program areas are getting better at providing Medicare beneficiaries with the required notice that they are not contracting providers, and he says Medicare is stepping up its fraud and sanctions activity. (For more on the DMEPOS program, click here. To see if your zip code is in a coverage area, click here.)
Seek Medicare Reimbursement Anyway

But in the vast majority of the country not currently covered by the DMEPOS program, it is unclear whether suppliers who don't work with Medicare are under any obligation to alert Medicare beneficiaries of this fact. The best defense, then, is for beneficiaries to always make certain the supplier has a relationship with Medicare – something Mr. P. had no idea he should do.
If you are caught in the situation Mr. P. found himself in, you can submit your bill from the supplier and seek as much reimbursement as you can get, Chiplin says. (Mr. P. is still awaiting word from Medicare.)

"Once the DMEPOS program is fully implemented, beneficiaries should experience a greater reduction in DME out-of-pocket expenses as they will be required to use certified and registered DMEPOS providers in order to obtain Medicare-covered items," Chiplin says.
"It’s always best for beneficiaries to use certified suppliers and those who are Medicare participating suppliers," Chiplin counsels.

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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.

Wednesday, March 7, 2012

When Should You Update Your Estate Plan?

Is it Time to Update Your Estate Plan?

Read original post HERE

Once you've created an estate plan, it is important to keep it up to date. You will need to revisit your plan after certain key life events.

Marriage

Whether it is your first or a later marriage, you will need to update your estate plan after you get married. A spouse does not automatically become your heir once you get married. Depending on state law, your spouse may get one-third to one-half of your estate, and the rest will go to other relatives. You need a will to spell out how much you wish your spouse to get.

Your estate plan will get more complicated if your marriage is not your first. You and your new spouse need to figure out where each of you wants your assets to go when you die. If you have children from a previous marriage, this can be a difficult discussion. There is no guarantee that if you leave your assets to your new spouse, he or she will provide for your children after you are gone. There are a number of options to ensure your children are provided for, including creating a trust for your children, making your children beneficiaries of life insurance policies, or giving your children joint ownership of property.

Even if you don't have children, there may be family heirlooms or mementos that you want to keep in your family. For more information on estate planning before remarrying, click here.

Children

Once you have children, it is important to name a guardian for your children in your will. If you don't name someone to act as guardian, the court will choose the guardian. Because the court doesn't know your kids like you do, the person they choose may not be ideal. In addition to naming a guardian, you may also want to set up a trust for your children so that your assets are set aside for your children when they get older.

Similarly, when your children reach adulthood, you will want to update your plan to reflect the changes. They will no longer need a guardian, and they may not need a trust. You may even want your children to act as executors or hold a power of attorney.

Divorce or Death of a Spouse

If you get divorced or your spouse dies, you will need to revisit your entire estate plan. It is likely that your spouse is named in some capacity in your estate plan -- for example, as beneficiary, executor, or power of attorney. If you have a trust, you will need to make sure your spouse is no longer a trustee or beneficiary of the trust. You will also need to change the beneficiary on your retirement plans and insurance policies.

Increase or Decrease in Assets

One part of estate planning is estate tax planning. When your estate is small, you don't usually have to worry about estate taxes because only estates over a certain amount, depending on current state and federal law, are subject to estate taxes. As your estate grows, you may want to create a plan that minimizes your estate taxes. If you have a plan that focuses on tax planning, but you experience a decrease in assets, you may want to change your plan to focus on other things. For more information about estate taxes, click here.

Other

Other reasons to have your estate plan updated could include:
  • You move to another state
  • Federal or state estate tax laws have changed
  • A guardian, executor, or trustee is no longer able to serve
  • You wish to change your beneficiaries
  • It has been more than 5 years since the plan has been reviewed by an attorney
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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.


Wednesday, February 15, 2012

New Bottom Limit of the Minimum Monthly Maintenance Needs Allowance

Minimum Monthly Maintenance Needs Allowance

Announced by the Department of Health and Human Services 

If a nursing home recipient of Medicaid assistance is married, he or she is called the Institutionalized Spouse (IS) and his or her spouse is the Community Spouse (CS). The income of the CS is not deemed available to the IS at any time for the IS’s care. Although the CS is able to keep all of his or her own income, if the CS has no income or insufficient income, then other rules apply. In such a case, the CS is entitled to receive a Minimum Monthly Maintenance Allowance which is comprised of a basic monthly allowance and a monthly excess shelter allowance.

The Department of Health and Human Services recently announced new poverty income guidelines for 2012. The new guidelines mean that the lower limit of the Minimum Monthly Maintenance Needs Allowance will rise to $1891.25, effective no later than July 1, 2012. The current amount is $1838.75.

Please call our office if you have questions about the Medicaid application process or how the rules might affect you.
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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.







Wednesday, November 2, 2011

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.

Thursday, October 20, 2011

The CLASS Act Is “Dead on Arrival”

CLASS Act  News

The publication Special Needs Answers  reported that The Obama administration has suspended implementation of the CLASS Act, a proposed national long-term care insurance program that was part of the health reform law.

The CLASS Act is the first big part of the health overhaul to be killed. Health and Human Services Secretary Kathleen Sebelius described the intended program as a voluntary program wherein workers could pay premiums and would be eligible after years for a benefit that could help pay for long-term care services.

The theory sounded good: “CLASS would not only give Americans who knew they were likely to require long-term services and supports an affordable way to prepare for the future. It would also give young and middle-aged Americans a way to insure against the possibility that they would someday require this kind of care themselves. Because all benefits would be paid out of premiums, it wouldn't cost taxpayers a dime (emphasis supplied) and CLASS would provide relief for State and federal budgets, which currently … bridge the long-term care coverage gap with scarce Medicaid dollars.”

The Secretary and her analysts could not develop a program that would meet the program’s financial objectives: “When it became clear that most basic benefit plans wouldn't work, we looked at other possibilities. But …, we have not identified a way to make CLASS work at this time.” Speaking for myself and for others who work in the field, it is clear that our leaders and legislators do not understand the import of the laws they are proposing and passing and they try to accomplish things that are near impossible.

The cost of nursing home care and long-term care has risen dramatically in the past two years. How are legislators to structure a program that will predict the economic realities of long term care in the future?

I respectfully suggest that they are out of their league.

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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.

Monday, May 16, 2011

Law Offices of Jeremy Howe, Ltd. Participating in Alzheimer's Awareness Events

Elder Law Specialist Jeremy Howe Lectures on Alzheimer's

May, 2011 - Newport, RI - Attorney Jeremy Howe lectured on May 11, 2011 at the Alzheimer's Awareness Events at Calvary United Methodist Church on the topics of Eldercare Legal Issues, Wills, Power of Attorney, Guardianship, Health Care Proxy, and other Elder and Probate Law related issues.

The events continued on Sunday May 15, 2011 with a Community Homecare Services Fair with agencies on hand to discuss their services for families caring for elderly or ill persons in their home.

Attorney Howe said, "Caring for an elderly parent or relative is often one of the most stressful events in a person's life. The expenses involved, coupled with time management and many other issues can create difficult obstacles to providing the best for loved ones. Having a plan in place can significantly help alleviate these stresses by providing a road map for care of aged relatives. I accept every opportunity to help educate families about their options with regard to caring for their elderly relatives."
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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.

Thursday, December 16, 2010

Newport RI Estate Lawyers to Participate in Holiday Charity Event

December, 2010 – Newport, RI

From November through December 10, 2010, Attorney Kristy Garside on behalf of the Law Offices of Jeremy Howe will participate in Elves for Elders, a charitable event organized and facilitated by Seniors RULE (Resources Unlimited-Liaisons for Elders). Seniors RULE is a non-profit organization whose members provide services for seniors. The services provided can be found at seniorsrule@myway.com.

The event involves a secret-Santa program whereby the names of elderly individuals in nursing homes in Rhode Island who may not receive a gift during the holiday season are gathered and placed on a Christmas tree for others to purchase a gift. The trees are placed throughout the states at various locations, and will come down on December 10. The gifts will then be wrapped and distributed by Seniors RULE members.

When asked what prompted the office’s involvement in the group, the attorney replied, “This is the time of the year when a lot of elderly people feel the most isolated, some of them literally. We take full advantage of every opportunity to become involved in community outreach programs and donate our time. I think we would all like our communities to be there for all its members, even if they have no loved ones who are able to be there for them. You never know whose life you're going to touch.”


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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.

Wednesday, November 17, 2010

Choices for End-of Life Caregiving

PlanForCare.org
November 5, 2010

There are many decisions to be made when imminent death is approaching for a loved one. Questions regarding what type of care, medical assistance and even physical location for their last days confront us.

If care at home has been given, should loved ones be moved to a facility or remain at home? If in a care facility should they be moved home for their last days? Will 24-hour care become necessary and more medical assistance be required?

If you are asking these questions, a Hospice service might be a good solution. Hospice can be provided to a person who has a life-limiting illness wherever that person lives. A nursing facility or long-term care facility can receive visits from hospice personnel in addition to the other care and services provided by the facility.

Hospice care is a special way of caring for a patient who is in the last stages of life. Hospice provides a team of professionals who aid the patient and family caregivers. This could include nurses, social workers, physicians, clergy and aides who all work together to plan and coordinate care, 24 hours a day or as needed.

The Hospice Foundation of America outlines the following services of hospice:


  • Hospice is a special concept of care designed to provide comfort and support to patients and their families when a life-limiting illness no longer responds to cure-oriented treatments.
  • Hospice care neither prolongs life nor hastens death. Hospice staff and volunteers offer a specialized knowledge of medical care, including pain management.
  • The goal of hospice care is to improve the quality of a patient's last days by offering comfort and dignity.
  • Hospice care is provided by a team-oriented group of specially trained professionals, volunteers and family members.
  • Hospice addresses all symptoms of a disease, with a special emphasis on controlling a patient's pain and discomfort.
  • Hospice deals with the emotional, social and spiritual impact of the disease on the patient and the patient's family and friends.
  • Hospice offers a variety of bereavement and counseling services to families before and after a patient's death.

To be eligible for hospice a physician must certify the patient to be terminally ill with a life expectancy of six months or less and treatment for a cure is no longer provided.
The focus for the patient has changed to supportive care and quality of remaining life.

Hospice is paid for by private insurance, Medicare or Medicaid Hospice Benefit or personal funds.


Here are the conditions that apply for Medicare Hospice Benefits:


  • You are eligible for Medicare Part A (Hospital Insurance)
  • Your doctor and the hospice medical director certify that you’re terminally ill and have 6 months or less to live if your illness runs its normal course.
  • You sign a statement choosing hospice care instead of other Medicare-covered benefits to treat your terminal illness.
  • You get care from a Medicare-approved hospice program
  • You understand that Medicare will still pay for covered benefits for any health problems that aren’t related to your terminal illness. Medicare.gov

Special benefit periods apply to Medicare hospice care and some services do not apply.
Be sure to understand the rules and requirements of Medicare payment before you commit.

Hospice is available to anyone, regardless of age or illness. If Medicare or private insurance is not available, hospice services may be available for low income individuals through grants or charitable donations. Many hospices are non-profit and will provide services to anyone in need.

“Many families or their loved ones' doctors often wait too long to order hospice. Hospice is a very valuable service and should be ordered at an earlier stage of illness. Many do not consider hospice for Alzheimer's, degenerative old age or other debilitating illnesses where a person is going downhill fast. They should.

It is unfortunate that many people who died in a hospital emergency room or who received heroic treatments to prolong life in a hospital may have had the alternative of dying at home in familiar surroundings, with family or other loved ones at their side.

When someone is in crisis or appears to be going downhill fast but there really is no hope for recovery, family often call 911 and start a process which can result in great stress and great emotional discomfort. The loved one who is dying ends up in a hospital and may die there or be transferred to a nursing home where death eventually occurs.

When there is no longer hope for prolonging life, especially when this decision is made months in advance, hospice is usually a better alternative to other medical intervention”. National Care Planning Council

The days leading up to the moment of death of a loved one can be rich with meaning and expressions of love. Family and caregivers should allow others to help with the care and daily responsibilities. They need to free themselves from the details of caregiving and instead need to use hospice to allow more time to reminisce, give thanks for a life shared and say goodbye.

http://www.planforcare.org
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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.