Home Care Agencies Hiring Unqualified Caregivers, Study Finds

Unqualified Caregivers

A new survey has shed light on the hiring practices of private home care agencies, and the news is not good.  In many cases, agencies are sending to the homes of vulnerable elderly patients workers with little or no experience or knowledge, no training, and inadequate background checks.

The study, which was carried out by researchers at Northwestern University, surveyed 180 private home care agencies in Illinois, California, Florida, Colorado, Arizona, Wisconsin, and Indiana.  (The study did not include agencies that are certified by Medicare and are subject to federal regulations.)

The researchers posed as people calling the agency to obtain assistance for a family member, and they queried the agencies about their hiring and oversight of their caregivers.  The results may surprise families who assume that agencies follow strict hiring guidelines.

For instance, none of the agencies assessed their caregivers' ability to understand medical terminology, and only 15 percent provided their caregivers with any training prior to sending them out to clients.  Although slightly more than half (55.8 percent) of the agencies surveyed ran criminal background checks on their caregivers, none conducted checks outside of their own states, meaning that caregivers with criminal records in other states could still be employed.  According to a summary of the study in the Senior Journal, more than one agency told the researchers that they used screening tests that don't exist, such as the “National Scantron Test for Inappropriate Behavior” and the “Assessment of Christian Morality Test.”

"People have a false sense of security when they hire a caregiver from an agency," the study’s lead author Lee Lindquist, M.D., said in a statement. "There are good agencies out there, but there are plenty of bad ones and consumers need to be aware that they may not be getting the safe, qualified caregiver they expect. It's dangerous for the elderly patient who may be cognitively impaired."
"Some of the paid caregivers are so unqualified it's scary and really puts the senior at risk" for elder abuse, Lindquist said.

Only a third drug-tested their workers.  "Considering that seniors often take pain medications, including narcotics, this is risky," Lindquist said. "Some of the paid caregivers may be illicit drug users and could easily use or steal the seniors' drugs to support their own habits."

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.

May Someone With Dementia Sign a Will?

Signing a Will with Dementia?

Millions of people are affected by dementia, and unfortunately many of them do not have all their estate planning affairs in order before the symptoms start. If you or a loved one has dementia, it may not be too late to sign a will or other documents, but certain criteria must be met to ensure that the signer is mentally competent.

In order for a will to be valid, the person signing must have "testamentary capacity," which means he or she must understand the implications of what is being signed. Simply because you have a form of mental illness or disease does not mean that you automatically lack the required mental capacity. As long as you have periods of lucidity, you may still be competent to sign a will.
Generally, you are considered mentally competent to sign a will if the following criteria are met:

• You understand the nature and extent of your property, which means you know what you own and how much of it.   
• You remember and understand who your relatives and descendants are and are able to articulate who should inherit your property.  
• You understand what a will is and how it disposes of property.  
• You understand how all these things relate to each other and come together to form a plan.

Family members may contest the will if they are unhappy with the distributions and believe you lacked mental capacity to sign it. If a will is found to be invalid, a prior will may be reinstated or the estate may pass through the state's intestacy laws (as if no will existed). To prevent a will contest, your attorney should help make it as clear as possible that the person signing the will is competent. The attorney may have a series of questions to ask you to assess your competency. In addition, the attorney can have the will signing videotaped or arrange for witnesses to speak to your competency.

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.

Medicaid Expansion: What If a State Opts Out?

 Affordable Care Act News (ObamaCare)

One of the key provisions of the Affordable Care Act, the new health reform law, gives money to states to expand Medicaid to adults and families with low incomes – a total of about 17 million additional people.

However, the Supreme Court recently ruled that the federal government cannot effectively coerce states into accepting the Medicaid expansion by withdrawing all a state’s Medicaid funds if it refuses.  Although elderly and disabled individuals who currently receive Medicaid aren't affected by the Court's ruling, it could leave millions of others without any options for health coverage -- and possibly cost lives.

The Affordable Care Act expands Medicaid eligibility starting in 2014 to individuals and families with incomes up to 133 percent of the poverty line, which is $14,856 for an individual in 2012. (Most states currently limit Medicaid to certain categories of people at or below the poverty line, including children, pregnant women, parents of eligible children, people with disabilities and elderly needing long-term care.) The federal government will pay the complete cost for the Medicaid expansion for three years for newly eligible beneficiaries, and 90 percent of a state’s costs thereafter.

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.

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.

"Standing to Sue the Attorney-in-Fact Named in a Power-of-Attorney Document"

"Rhode Island has not adopted the Uniform Power of Attorney Act. Perhaps it is time." Jeremy Howe

"Several states have adopted the Uniform Power of Attorney Act.... aimed at making it easier for family members and others who have genuine concerns about the welfare of an elderly person to seek judicial redress against a fiduciary who is suspected to have abused his or her powers over an elderly person's financial affairs.

Those parties include the lprincipal him- or herself or an agent; a fiduciary acting for the principal; someone authorized to make healthcare decisions for the principal; the principal's spouse, parent, or descendant; a presumptive heir or named beneficiary; a governental agency having regulatory authority to protect the welfare of the principal; the principal's
caregiver; and a person asked to accept to the power.

By adopting statutes that give standing to a wide varety of parties or persons who can seek the aid of a court in protecting the interests and rights of the principal under a power-of-attorney instrument, states have recognized the problems associated with limiting the standing to sue, an attorney-in-fact to the principal, the principal's guardian, or the principal's estate. In short, section 116(a) represents a big step toward protecting elderly or incapacitated persons from unscrupulous conduct by attorneys-in-fact who are supposed to act solely in the principals' best interests."

Brad Pettit~Senior Attorney
The Lawletter
National Legal Research Group

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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.

“2013 Veteran COLA Passes House”

Week of July 16, 2012

The House of Representatives passed the Veterans' Compensation Cost-of-Living Adjustment Act of 2012 (H.R. 4114). 

Although this is seen by many as a formality, passing the COLA is often pushed to the end of the year. According to House Committee on Veterans' Affairs press release, taking care of this now ensures that Vets will be given the benefits they were promised without any last minute "political tug-of-war." If signed into law, H.R. 4114 would increase the annual cost-of-living rate for veterans, which goes into effect on December 1, 2012. It is estimated that this year's COLA will be approximately 1.9 percent. The legislation now heads to the Senate for consideration.

For complete guides to all veterans benefits, visit the Military.com Benefits Center.
 
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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.

“Part 2. When your loved one changes...coping with Alzheimer's Disease”

Coping With Alzheimer's Disease

It's important to remember that the disease, not the person with Alzheimer's Disease, causes these changes.

Part. 2 Changes in personality and behavior

Because Alzheilmer's Disease causes brain cells to die, the brain works less well over time. This changes how a person acts. You will notice that he or she will have good days and bad days.

Here are some common personality changes you may see:

• Getting upset, worried, and angry more easily
• Acting depressed or not interested in things
• Hiding things or believing other people are hiding things
• Imagining things that aren't there
• Wandering away from home
• Pacing a lot of the time
• Showing unusual sexual behavior
• Hitting you or other people
• Misunderstanding what he or she sees or hears

Also, you may notice that the person stops caring about how he or she looks, stops bathing, and wants to wear the same clothes every day.

Other factors that may affect how people with Alzheimer's Disease behave

In addition to changes in the brain, the following things may affect how people with Alzheilmer's Disease behave.
How they feel:

• Sadness, fear, or a feeling of being overwhelmed
• Stress caused by something or someone
• Confusion after a change in routine, including travel
• Anxiety about going to a certain place

Health-related problems:

• Illness or pain
• New medications
• Lack of sleep
• Infections, constipation, hunger, or thirst
• Poor eyesight or hearing
• Alcohol abuse
• Too much caffeine

Problems in their surroundings:

• Being in a place he or she doesn't know well.
• Too much noise, such as TV, radio, or many people talking at once. Noise can cause confusion or frustration.
• Stepping from one type of flooring to another. The change in texture or the way the floor looks may make the person think he or she needs to take a step down.
• Misunderstanding signs.
• Some signs may cause confusion. For example, one person with Alzheimer's Disease thought a sign reading "wet floor" meant he should urinate on the floor.
• Mirrors.
• Someone with Alzheilmer's Disease may think that a mirror image is another person in the room.

How to cope with personality and behavior changes

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.