RI Elder Law News

New Bottom Limit of the Minimum Monthly Maintenance Needs Allowance

2012-02-15T09:29:00.000-05:00

If you are in need of an Estate Planning Attorney or Elder Law Attorney, contact The Law Offices of Jeremy W. Howe, LTD now at (401) 841-5700 for a consultation.

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.

Losing the Forest for the Trees

2012-02-08T09:30:00.000-05:00

This common quote means that if you are so engrossed in looking at individual trees, you might forget that each tree is one of thousands and thus lose sight of the big picture-the forest. It is much the same in elderlaw. For example, if you focus on the rules of the VA in order to obtain Aid & Attendance Benefits, you can make a mistake and jeopardize your M edicaid eligibility in the future (if you should require assistance to remain in a nursing home). In elder-law, the trees are Medicaid rules, estate & gift tax laws, income tax laws, VA Aid & Attendance rules, state Probate rules, state statutes and case law. The forest is the comprehensive view of a clients needs, goals, health, and desires or the estate plan of a client.

We saw an example this week. Our client's son and daughter had been advised to spend down their mothers assets by making gifts in the allowed annual amount of $13,000 so that she would qualify for Medicaid nursing home assistance in the future due to lack of assets. Our clients advisors were confusing one tree (Medicaid allowable spend-down) with another tree (estate & gift tax law). Her gifts would disqualify her from receiving Medicaid assistance for five years from the date of the gifts due to the penalty period imposed by the Medicaid rules. Our client would never have had an estate tax issue because her assets would never reach $900,000, the approximate Rhode Island credit amount. On the other hand, it was possible that she could run out of funds within the five years and need Medicaid assistance to remain in a nursing home but not be qualified for that assistance due to the penalty.

We help our clients by making a comprehensive view of their estate plan. We Make Housecalls anywhere in Rhode Island for a nominal, flat fee. We assist our clients in viewing all the trees so that the forest is not lost.

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The Law Offices of Jeremy W. Howe, LTD. are ElderLaw attorneys in RI for wills and trusts, estate planning, guardianship, probate, and Veterans Aid and Attendance Benefits. They practice Pension and Retirement law as well with a focus on Qualified Domestic Relations Orders (QDRO), Military Pension Orders, Civil Service Orders, as well as Consultation on Pension issues. They also are Newport RI Divorce lawyers, attorneys, mediators, and arbitrators providing services for family law issues such as divorce, child custody and visitation, support, and Military family law.

They offer Elderlaw Mediation for disputes and intergenerational issues as well as probate court resolution. They also do Superior Court Mediation and Arbitration as well as Pension Mediation. Mediation and Arbitration is also offered by the firm for divorce mediation, separation, and all family law issues pre and post divorce.

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

Short Term Loan Secured By the Equity in Your Home

2012-02-03T09:30:00.000-05:00

I was at a meeting this week at Sakonnet Bay Manor, which is an assisted living facility in Tiverton, Rhode Island.

One thing we talked about that I was not familiar with, was a new short term equity line of credit that could be available to home owners, in a couple of days.

Such a loan could be utilized in the following example:

Mom lives alone and she owns a home with no mortgage. She suffers a fall and is likely not to return to the home because she should no longer live on her own. She and the family decide she would be more comfortable in an assisted living facility. She does not have the liquid assets to pay for the facility, but she does have all the equity available in her home. Since the market is not prime for a sale, or repairs need to be made to the house before it could be sold and mom does not have the funds, this type of loan could be helpful. With the funds, mom could get into the facility quickly, and the loan is paid from the equity from the house.

If this sounds tempting, please contact our office 401-841-5700 for more information, and we can put you in touch with a broker. This type of loan may not be for everyone, but it could be an option for you or a family member that should at least be considered.
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The Law Offices of Jeremy W. Howe, LTD. are ElderLaw attorneys in RI for wills and trusts, estate planning, guardianship, probate, and Veterans Aid and Attendance Benefits. They practice Pension and Retirement law as well with a focus on Qualified Domestic Relations Orders (QDRO), Military Pension Orders, Civil Service Orders, as well as Consultation on Pension issues. They also are Newport RI Divorce lawyers, attorneys, mediators, and arbitrators providing services for family law issues such as divorce, child custody and visitation, support, and Military family law.

They offer Elderlaw Mediation for disputes and intergenerational issues as well as probate court resolution. They also do Superior Court Mediation and Arbitration as well as Pension Mediation. Mediation and Arbitration is also offered by the firm for divorce mediation, separation, and all family law issues pre and post divorce.

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

Is a Reverse Mortgage Right for You?

2012-02-01T09:30:00.000-05:00

Attached please find an article that was received by our office as part of an e-newsletter called "Pathways to Independent Living," which is sent to us from a Rhode Island business out of Warwick called Senior Helpers. Senior Helpers provide "companion care" to seniors in their own homes. To reach Senior Helpers, contact Chad Neighbors at (401) 825-7200, or by email at cneighbors@seniorhelpers.com. To contact our office, call 401-841-5700 or visits our website at www.CounselFirst.com

Is a Reverse Mortgage Right For You?

If you are a senior who is age 62 or older and you are living in fear that some day, when you need help, you'll have to sell your house to pay for it, there is a solution. You may still be able to stay in your home while paying for home care, home improvements or medical bills.

How? If your home is paid off or you have only a small mortgage left, you can get a reverse mortgage to tap the equity in your home without selling or moving. These mortgages are called reverse mortgages because the lender makes payments to you, the homeowner, not the other way around.

The money you will receive is tax-free and will not affect Social Security payments or Medicare benefits. You do not have to pay off the loan until you move out of the house or the home is sold. You will never owe more than the value of the home at the time of repayment, even if the loan balance is higher than the value of your property. No debt will be passed on to your heirs. Reverse mortgage funds are available to spend any way you choose.

Who Is Eligible?

To be eligible, you must be 62 years or older. (If you are a married couple the youngest partner must be age 62.) You must also either own the home outright or have a low mortgage balance that can be paid off with the proceeds from the reverse loan. You must also live in the home. Like all homeowners, you still are required to pay your real estate taxes and other conventional payments like utilities.

Cautions and Things To Remember

Be sure to work with a reputable lender, consult with your financial advisor if you have one, and do your homework before you make any commitments or sign any documents.

Investigate the costs involved in a reverse mortgage before making the decision.

Closing costs and fees may amount to more than 5% of your home's value. If you plan to live in your home for more than three years, a reverse mortgage can make good financial sense. However, if you know you won't stay in your home that long, then the cost of the loan plus interest may make seeking a reverse mortgage an unwise choice.

Using the equity in your home will reduce the amount of money you leave to your family as inheritance.

If you live alone and need to stay in a nursing facility for more than a year, your loan will come due.

It takes 45 to 90 days to apply for and receive a reverse mortgage. It may be better to receive one when you do not urgently need the money for immediate home repairs or in-home care.

For More Information the AARP offers information about reverse mortgages, including an online calculator you can use to find out how much money you may get from a reverse mortgage. The National Reverse Mortgage Lenders Association (NRMLA) includes information for consumers interested in learning more about reverse mortgages.

You can also call our office for a referral for someone to speak with about Reverse Mortgages if you think this could be an option for you. We can also accompany you to a meeting with your reverse mortgage broker, or review the documents before you sign, or answer any questions you might have.

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The Law Offices of Jeremy W. Howe, LTD. are ElderLaw attorneys in RI for wills and trusts, estate planning, guardianship, probate, and Veterans Aid and Attendance Benefits. They practice Pension and Retirement law as well with a focus on Qualified Domestic Relations Orders (QDRO), Military Pension Orders, Civil Service Orders, as well as Consultation on Pension issues. They also are Newport RI Divorce lawyers, attorneys, mediators, and arbitrators providing services for family law issues such as divorce, child custody and visitation, support, and Military family law.

They offer Elderlaw Mediation for disputes and intergenerational issues as well as probate court resolution. They also do Superior Court Mediation and Arbitration as well as Pension Mediation. Mediation and Arbitration is also offered by the firm for divorce mediation, separation, and all family law issues pre and post divorce.

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

Eligibility Verification Reports (EVRs) are DUE Soon!

2012-01-20T09:30:00.000-05:00

We thought our clients and friends may find this information useful. It was provided to us by the Veterans Advocate Group of America (VAGA), and written by Victoria L. Collier, of Collier & St. Clair, LLP. She is a co-founder of VAGA, co-author of VisPro, author of 47 Secret Veterans Benefits for Seniors...Benefits You Have Earned but Don't Know About, and a national speaker and educator of VA Improved Pension benefits. Learn more about Victoria at www.elderlawgeorgia.com

Article:

It is that time of year to reach out to your veteran clients and either remind them or guide them in completing their annual EVR.

What is an EVR? The Eligibility Verification Report is an annual report due no later than March 1st of each year for beneficiaries who are receiving the Improved Pension. Because eligibility for this program is based on disability status and financial criteria, the VA must ensure that the beneficiary remains eligible from year to year. The EVR provides a report of actual income and dependency status in order to verify that the payment the beneficiary is receiving is correct.

What are the required forms to complete and return to the VA? The VA will send the required forms to the beneficiary in late December or early January. One of the following forms should be completed, based on the type of beneficiary:

21-0510 EVR Instructions
21-0516-1 Improved Pension EVR (veteran without children)
21-0517-1 Improved Pension EVR (veteran with children)
21-0518-1 Improved Pension EVR (surviving spouse without children)
21-0519s-1 Improved Pension EVR (surviving spouse with children)

In addition to the aforementioned forms, the beneficiary must also complete a Medical Expense Report on VA Form 21P-8416 (NOTE: THIS FORM WAS UPDATED DECEMBER 2011). This form must be completed twice. The first one is to report actual medical expenses paid out of pocket by the beneficiary during the EVR reporting period. The second one is for the beneficiary to report the next 12 month's projected medical expenses. This form must also be signed by the beneficiary or the fiduciary if one has been appointed.

Where are EVRs Processed? There are three Pension Management Centers (PMC), Philadelphia, Milwaukee, and St. Paul. Whichever PMC adjudicated the initial application for pension benefits will be the same PMC to process the EVR.

Is Anyone Exempt from Filing an EVR? Annual EVRs are not required for Improved Pension recipients who have no countable income, or whose only countable income is from VA or Social Security. However, filing an EVR may be helpful even in this situation if the beneficiary is not receiving the maximum VA pension due to the amount of medical expenses projected at the beginning of the year. If the medical expenses increased throughout the year, or if the beneficiary paid out of pocket for medical expenses that are not considered "recurring" (i.e. doctor co-pays, prescriptions, travel expenses, hearing aids, expenses related to burial of spouse or dependent child, etc.), then these expenses can be reported on the EVR and the VA will recalculate what the monthly pension should have been. If the pension amount for prior months should have been higher based on the medical expenses reported in the EVR, the VA will pay a lump sum payment to the beneficiary for the appropriate amount.

Termination of Benefits. If a person does not return the EVR, benefits will be terminated as of the beginning of the EVR reporting period. Because of that, the beneficiary will receive notice that the VA overpaid them and, thus, they will owe the money they received back to the VA. Clients are usually not able to return the money because it has been spent on their high cost of medical care. It is essential that the EVR is returned by March 1st, that it is completed accurately, and that it is signed by either the beneficiary of the benefits or by the fiduciary if one has been appointed (neither a 21-22a representative, a power of attorney agent, nor a guardian can sign the EVR).

For more information, refer to M21-1MR, Part V, Subpart iii, Chapter 7 and 38 CFR 3.277.

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The Law Offices of Jeremy W. Howe, LTD. are ElderLaw attorneys in RI for wills and trusts, estate planning, guardianship, probate, and Veterans Aid and Attendance Benefits. They practice Pension and Retirement law as well with a focus on Qualified Domestic Relations Orders (QDRO), Military Pension Orders, Civil Service Orders, as well as Consultation on Pension issues. They also are Newport RI Divorce lawyers, attorneys, mediators, and arbitrators providing services for family law issues such as divorce, child custody and visitation, support, and Military family law.

They offer Elderlaw Mediation for disputes and intergenerational issues as well as probate court resolution. They also do Superior Court Mediation and Arbitration as well as Pension Mediation. Mediation and Arbitration is also offered by the firm for divorce mediation, separation, and all family law issues pre and post divorce.

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

Insurance and Medical Bill Advocacy

2012-01-13T09:30:00.000-05:00

I received this article as part of a monthly newsletter this week, and I thought it could be useful to our clients and friends. The contact person is Robin at Robin G Smith Consulting. Call her at 888-363-3914 or go to her website at is www.robingsmith.com for more information, or call us!

As 2012 begins, many people will find themselves with new health benefits and higher deductibles, or, increasingly, with no health insurance at all, particularly in the 50—64 year old age category. Additionally, the latest focus of healthcare reform has become prevention, or wellness, vs “sickness” care. Companies are struggling to find solutions to health cost inflation, and new paradigms are emerging that feature “worksite” clinics, and direct, af?fordable pre-paid primary care (another story here). I offer one such program, Medical Membership Plans (MMP).

A MMP is a prepaid primary care plan for companies and individuals ($84/month individual, $99/family), where care is delivered by a national network of urgent care centers. There are no copays, no deductibles, no pre-existing conditions, and care generally includes all services that can be delivered at the urgent care center (x-rays, injections, labs, etc.) This plan is open to all, and is a membership plan, not health insurance. Many clinics are available, al?though, geographically, some areas are better covered than others— e.g. Worcester and Boston area, MA, great, Cape Cod, not so good. RI has many clinics available, and CT has good coverage in the urban areas. Call me (Robin) for more information, or a list of participating providers in your area. The MMP model may help drive down health costs.

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The Law Offices of Jeremy W. Howe, LTD. are ElderLaw attorneys in RI for wills and trusts, estate planning, guardianship, probate, and Veterans Aid and Attendance Benefits. They practice Pension and Retirement law as well with a focus on Qualified Domestic Relations Orders (QDRO), Military Pension Orders, Civil Service Orders, as well as Consultation on Pension issues. They also are Newport RI Divorce lawyers, attorneys, mediators, and arbitrators providing services for family law issues such as divorce, child custody and visitation, support, and Military family law.

They offer Elderlaw Mediation for disputes and intergenerational issues as well as probate court resolution. They also do Superior Court Mediation and Arbitration as well as Pension Mediation. Mediation and Arbitration is also offered by the firm for divorce mediation, separation, and all family law issues pre and post divorce.

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

Recognizing the Need for Outside Help in Caregiving

2011-12-15T10:21:00.004-05:00

Article: Recognizing the Need for Outside Help in Caregiving

Caregivers often don’t recognize when they are in over their heads, and often get to a breaking point. After a prolonged period of time, caregiving can become too difficult to endure any longer. Short-term, the caregiver can handle it. Long-term, support is needed. Outside help at this point is often necessary.

A typical pattern with an overloaded caregiver may unfold as follows:

· 1 to 18 months--the caregiver is confident, has everything under control and is coping well. Other friends and family are lending support.

· 20 to 36 months--the caregiver may be taking medication to sleep and control mood swings. Outside help dwindles away and except for trips to the store or doctor, the caregiver has severed most social contacts. The caregiver feels alone and helpless.

· 38 to 50 months--Besides needing tranquilizers or antidepressants, the caregiver's physical health is beginning to deteriorate. Lack of focus and sheer fatigue cloud judgment and the caregiver is often unable to make rational decisions or ask for help.

It is often at this stage that family or friends intercede and find other solutions for care. This may include respite care, hiring home health aides or putting the disabled loved one in a facility. Without intervention, the caregiver may become a candidate for long term care as well...

Please read the entire article and previous articles: Either click on the link http://www.planforcare.org or copy and paste the following into your browser: http://www.planforcare.org.

Please note: This article is provided for informational purposes only, and the resources provided when you follow the applicable "link" may or may not be recommended by our office. If you have any questions, you should contact us at (401)841-5700 or visit our website at www.CounselFirst.com.

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The Law Offices of Jeremy W. Howe, LTD. are ElderLaw attorneys in RI for wills and trusts, estate planning, guardianship, probate, and Veterans Aid and Attendance Benefits. They practice Pension and Retirement law as well with a focus on Qualified Domestic Relations Orders (QDRO), Military Pension Orders, Civil Service Orders, as well as Consultation on Pension issues. They also are Newport RI Divorce lawyers, attorneys, mediators, and arbitrators providing services for family law issues such as divorce, child custody and visitation, support, and Military family law.

They offer Elderlaw Mediation for disputes and intergenerational issues as well as probate court resolution. They also do Superior Court Mediation and Arbitration as well as Pension Mediation. Mediation and Arbitration is also offered by the firm for divorce mediation, separation, and all family law issues pre and post divorce.

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

Safe Voyage! Travel For Older Adults

2011-12-08T15:01:00.003-05:00

This is an article from our friends at Senior Helpers that our readers may find helpful. Contact Information: Chad Neighbors (401)825-7200 cneighbors@seniorhelpers.com in Warwick, Rhode Island.

Safe Voyage! Travel for Older Adults
Staying physically active and connecting with other people are two important keys to successful aging, and travel is a great way to do both at once! Discounted travel packages designed for seniors are one of the "perks" of being an older traveler. And with the generations spread across the country, visits keep families connected. But some seniors hesitate to travel because they are afraid of illness or injury, or of getting lost, or encountering hazards along the way.

Even if an older adult's physical condition makes travel more of a challenge, many obstacles and potential problems can easily be overcome with a little advance planning. It is important to:

-review the traveler's health insurance policy before the trip. What are the conditions for receiving medical care out of the service area? Do benefits apply when traveling abroad?

-make sure immunizations are up to date, including the specific immunizations recommended or required for the area being visited.

-bring along enough medication for the trip, packed in carry-on luggage. Especially if traveling abroad, leave medications in their original prescription containers.

Special Assistance for Disabled Travelers

Some seniors are reluctant to travel because they feel insecure negotiating the crowded service desks and corridors of busy airports and other transportation terminals. A person with hearing difficulty often has the hardest time when there is significant background noise. A person with dizziness, limited vision, or mobility problems may fear falling or being jostled by crowds. But people who are basically able to travel and just need a little extra assistance can take advantage of these services available to travelers:

Boarding assistance-
Most airlines and rail lines have wheelchairs available for those unable to walk long distances, and some also offer formal "meet and assist" programs. It is best to confirm these services when booking tickets. At the gate, pre-boarding is usually available for persons who need extra time or feel unsafe in the crowding of general boarding.

Oxygen-
Persons with medical conditions requiring the use of an oxygen tank can travel safely on most kinds of public transport. Airlines have strict requirements about oxygen use. These usually include a letter from a physician explaining the person's oxygen requirement and a statement certifying that the oxygen provided by the airline is acceptable.

Disabled accessibility-
Most aircraft are wheelchair-accessible, though some small commuter planes are not. Trains and ships generally have a limited number of disabled-accessible cabins or compartments. Many resorts offer specially designed rooms and suites for use by persons in wheelchairs. Reservations for special facilities should be confirmed in writing before the trip begins.

Five Health Tips for Airline Passengers

Gone are the days when traveling by plane was a pampering treat! Nowadays, long security lines, delays and cramped seats are the norm. You can minimize discomfort by following a few steps:

-Get plenty of sleep before you leave.
-Drink water and avoid alcohol and caffeinated beverages to avoid becoming dehydrated.
-Change sitting position frequently and walk down the aisle occasionally to avoid stiff joints or (in rare cases) dangerous blood clots.
-If you have a cold, take a decongestant and chew gum on takeoff and landing to avoid ear pain.
-Check with your doctor ahead of time if you have any questions about flying with your medical conditions.

(c)2008 IlluminAge Communication Partners

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The Law Offices of Jeremy W. Howe, LTD. are ElderLaw attorneys in RI for wills and trusts, estate planning, guardianship, probate, and Veterans Aid and Attendance Benefits. They practice Pension and Retirement law as well with a focus on Qualified Domestic Relations Orders (QDRO), Military Pension Orders, Civil Service Orders, as well as Consultation on Pension issues. They also are Newport RI Divorce lawyers, attorneys, mediators, and arbitrators providing services for family law issues such as divorce, child custody and visitation, support, and Military family law.

They offer Elderlaw Mediation for disputes and intergenerational issues as well as probate court resolution. They also do Superior Court Mediation and Arbitration as well as Pension Mediation. Mediation and Arbitration is also offered by the firm for divorce mediation, separation, and all family law issues pre and post divorce.

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

TAX DEDUCTION FOR FAMILY CAREGIVER SERVICES

2011-12-02T10:45:00.004-05:00

TAX DEDUCTION FOR FAMILY CAREGIVER SERVICES

The following Article was written by: Kim Boyer, CELA, BOYER LAW GROUP, www.elderlawnv.com and provided to our office via the Veterans Advocates Group of America monthly e-newsletter called VAGA News.

If you have questions about the folowing information and you are in Rhode Island, please call our office at 401-841-5700 or visit our website at www.CounselFirst.com for more information about our office.

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Many times family members or friends provide care to a loved one for a fee. These family members or friends are typically unlicensed caregivers. Can the person paying for the care deduct the payments as a medical expense on their income tax return?

Medical expenses, not compensated for by insurance or otherwise, may be allowed as a deduction to the extent that the expenses exceed 7.5% of the taxpayer's adjusted gross income. Medical care can include amounts paid for "qualified long-term care services" as defined herein. The taxpayer must be certified as "chronically ill" by a licensed health care professional. The services must be provided pursuant to a plan of care prescribed by a licensed health care professional.

The U.S. Tax Court recently ruled on the issue of whether payments to unlicensed care providers were deductible. Estate of Lillian Baral v. Commissioner of Internal Revenue (July 5, 2011).

The tax court examined whether payments totaling $49,580 made by Lillian to Ms. Pzevorski and Ms. Jakubowski were deductible. Neither of them were licensed healthcare providers. Thus, the payments were not deductible as medical expenses. However, the court found that payments to them could be deducted if their services qualified as "long-term care services" as defined under the tax code.

After analyzing the tax code, the Court found that the care provided constituted "maintenance or personal care services" for a "chronically ill individual" provided pursuant to a "plan of care prescribed by a licensed health care professional." Thus, Lillian could deduct $43,273 of the payments made to the care providers (the amount paid which exceeded 7.5% of her adjusted gross income).

For Medicaid purposes the payments will be considered gratuitous when provided by a family member, unless there is a written contract. It is advisable that there be a written contract providing for reasonable compensation and specifying the nature of services to be provided.

**This article/newsletter is not intended as a substitute for VA, legal, or other professional advice. Every effort has been made to make the content of this newsletter accurate; however, neither VAGA, nor any of its founders, assume any responsibility for errors in content or damages that may occur as the result of using the information contained within this newsletter or from any associated website or e-mail links.

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The Law Offices of Jeremy W. Howe, LTD. are ElderLaw attorneys in RI for wills and trusts, estate planning, guardianship, probate, and Veterans Aid and Attendance Benefits. They practice Pension and Retirement law as well with a focus on Qualified Domestic Relations Orders (QDRO), Military Pension Orders, Civil Service Orders, as well as Consultation on Pension issues. They also are Newport RI Divorce lawyers, attorneys, mediators, and arbitrators providing services for family law issues such as divorce, child custody and visitation, support, and Military family law.

They offer Elderlaw Mediation for disputes and intergenerational issues as well as probate court resolution. They also do Superior Court Mediation and Arbitration as well as Pension Mediation. Mediation and Arbitration is also offered by the firm for divorce mediation, separation, and all family law issues pre and post divorce.

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

Myths and Facts About Pain and Older Adults

2011-11-30T11:42:00.002-05:00

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 ElderLaw attorneys in RI for wills and trusts, estate planning, guardianship, probate, and Veterans Aid and Attendance Benefits. They practice Pension and Retirement law as well with a focus on Qualified Domestic Relations Orders (QDRO), Military Pension Orders, Civil Service Orders, as well as Consultation on Pension issues. They also are Newport RI Divorce lawyers, attorneys, mediators, and arbitrators providing services for family law issues such as divorce, child custody and visitation, support, and Military family law.

They offer Elderlaw Mediation for disputes and intergenerational issues as well as probate court resolution. They also do Superior Court Mediation and Arbitration as well as Pension Mediation. Mediation and Arbitration is also offered by the firm for divorce mediation, separation, and all family law issues pre and post divorce.

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

Estate Planning Issues to Consider

2011-11-28T13:50:00.003-05:00

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

Please call Jeremy, Hilary or Kristy at (401) 841-5700.

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The Law Offices of Jeremy W. Howe, LTD. are ElderLaw attorneys in RI for wills and trusts, estate planning, guardianship, probate, and Veterans Aid and Attendance Benefits. They practice Pension and Retirement law as well with a focus on Qualified Domestic Relations Orders (QDRO), Military Pension Orders, Civil Service Orders, as well as Consultation on Pension issues. They also are Newport RI Divorce lawyers, attorneys, mediators, and arbitrators providing services for family law issues such as divorce, child custody and visitation, support, and Military family law.

They offer Elderlaw Mediation for disputes and intergenerational issues as well as probate court resolution. They also do Superior Court Mediation and Arbitration as well as Pension Mediation. Mediation and Arbitration is also offered by the firm for divorce mediation, separation, and all family law issues pre and post divorce.

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

2011-11-16T09:30:00.001-05:00

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. You can also learn more about us at www.CounselFirst.com.
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The Law Offices of Jeremy W. Howe, LTD. are ElderLaw attorneys in RI for wills and trusts, estate planning, guardianship, probate, and Veterans Aid and Attendance Benefits. They practice Pension and Retirement law as well with a focus on Qualified Domestic Relations Orders (QDRO), Military Pension Orders, Civil Service Orders, as well as Consultation on Pension issues. They also are Newport RI Divorce lawyers, attorneys, mediators, and arbitrators providing services for family law issues such as divorce, child custody and visitation, support, and Military family law.

They offer Elderlaw Mediation for disputes and intergenerational issues as well as probate court resolution. They also do Superior Court Mediation and Arbitration as well as Pension Mediation. Mediation and Arbitration is also offered by the firm for divorce mediation, separation, and all family law issues pre and post divorce.

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

Medicaid Planning in Rhode Island

2011-11-11T09:30:00.000-05:00

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 ElderLaw attorneys in RI for wills and trusts, estate planning, guardianship, probate, and Veterans Aid and Attendance Benefits. They practice Pension and Retirement law as well with a focus on Qualified Domestic Relations Orders (QDRO), Military Pension Orders, Civil Service Orders, as well as Consultation on Pension issues. They also are Newport RI Divorce lawyers, attorneys, mediators, and arbitrators providing services for family law issues such as divorce, child custody and visitation, support, and Military family law.

They offer Elderlaw Mediation for disputes and intergenerational issues as well as probate court resolution. They also do Superior Court Mediation and Arbitration as well as Pension Mediation. Mediation and Arbitration is also offered by the firm for divorce mediation, separation, and all family law issues pre and post divorce.

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

Verterans' Benefits

2011-11-10T10:11:00.006-05:00

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 ElderLaw attorneys in RI for wills and trusts, estate planning, guardianship, probate, and Veterans Aid and Attendance Benefits. They practice Pension and Retirement law as well with a focus on Qualified Domestic Relations Orders (QDRO), Military Pension Orders, Civil Service Orders, as well as Consultation on Pension issues. They also are Newport RI Divorce lawyers, attorneys, mediators, and arbitrators providing services for family law issues such as divorce, child custody and visitation, support, and Military family law.

They offer Elderlaw Mediation for disputes and intergenerational issues as well as probate court resolution. They also do Superior Court Mediation and Arbitration as well as Pension Mediation. Mediation and Arbitration is also offered by the firm for divorce mediation, separation, and all family law issues pre and post divorce.

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

Newport RI Divorce Case Results

2011-11-09T09:30:00.000-05:00

If you need a RI Divorce, Real Estate, or Probate Attorney, contact The Law Offices of Jeremy W. Howe, LTD at (401) 841-5700

Barrington divorce/ real estate.

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 ElderLaw attorneys in RI for wills and trusts, estate planning, guardianship, probate, and Veterans Aid and Attendance Benefits. They practice Pension and Retirement law as well with a focus on Qualified Domestic Relations Orders (QDRO), Military Pension Orders, Civil Service Orders, as well as Consultation on Pension issues. They also are Newport RI Divorce lawyers, attorneys, mediators, and arbitrators providing services for family law issues such as divorce, child custody and visitation, support, and Military family law.

They offer Elderlaw Mediation for disputes and intergenerational issues as well as probate court resolution. They also do Superior Court Mediation and Arbitration as well as Pension Mediation. Mediation and Arbitration is also offered by the firm for divorce mediation, separation, and all family law issues pre and post divorce.

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

2011-11-04T09:30:00.000-04:00

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.

If you have any questions call Jeremy, Hilary or Kristy at 401-841-5700.

New Medicare and Medicaid Allowances for 2012

2011-11-02T11:45:00.001-04:00

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.

If you have questions about these allowances and limits call Jeremy, Hilary or Kristy at 401-841-5700.

The CLASS Act Is “Dead on Arrival”

2011-10-20T14:13:00.001-04:00

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.

Tips on How to "Age In Place"

2011-08-17T10:29:00.008-04:00

Attached please find an article that was received by our office as part of an e-newsletter called "Pathways to Independent Living," which is sent to us from a Rhode Island business out of Warwick called Senior Helpers. Senior Helpers provide "companion care" to seniors in their own homes. To reach Senior Helpers, contact Chad Neighbors at (401) 825-7200, or by email at cneighbors@seniorhelpers.com.

If you would like more information about how you, your parent, other family member or neighbor might pay for these types of services or other services that might be available, please call our office at 401-841-5700 for a consultation. You can also learn more about us at www.CounselFirst.com. We often tell our clients, if it is possible, try not to wait for a crisis to ask your questions!

Prepare to 'Age in Place'
Take Action Today, for Independent Living Tomorrow

When asked what they fear most, senior citizens ranked losing their independence (26%) and moving into a nursing home (13%) higher than fear of death (only 3%), according to a commissioned study, "Aging in Place in America," conducted by independent research company Prince Market Research. An overwhelming majority of seniors want to grow older in their own homes, yet over half are concerned about their ability to do so.

It may or may not become evident over time that you (or your loved ones) need assistance to continue living in your own home. Often, a major event will cause you to recognize such a need. It might be death of a spouse, a stroke, a broken limb from a fall, or concern from a relative or neighbor following a visit during which they recognize things are just not right.

It is important to take steps today to help ensure that you can "age in place" tomorrow. Some of the easiest things that can be done include simply organizing documents and creating reference sheets.

Organize Documents. The following documents should be assembled in one place so they are available when needed:

· Medicare, Social Security, and health insurance cards
· Copy of birth certificate
· Names, phone numbers, and addresses of doctor(s)
· List of health conditions
· List of current medications with contact information for pharmacy and prescribing physician
· Allergies to food or medications
· Will, living will, and powers of attorney
· Copies of insurance policies, including life insurance and long-term care insurance
· Financial information, including contact information for tax preparer or accountant

Create a Laminated Reference Sheet. Create a complete list of emergency telephone numbers and information. Laminate the list and put it in an obvious place so it will be available for Emergency Medical Technicians (EMTs) or others who may need it. The sheet should contain the following:
· Name, address, telephone number, birth date, social security number, and medical insurance information.
· Primary and specialist physicians' names and contact information.
· A list of medications and dosages.
· Name and phone number of your pharmacy.
· Names and contact information for caregivers, relatives, and close neighbors.
· Whether you have a living will and/or a durable power of attorney that allows another person(s) to make financial and/or medical decisions if you are unable to do so (include contact information).

Develop a Plan for Help. Recognize when you need help and list needs in the following areas:
· Housekeeping-laundry, shopping, and household paperwork.
· Nutrition-meal planning, cooking, and meal delivery
· Health care-nursing, social work, physical and rehabilitative therapy, and medication monitoring
· Personal care-assistance with personal hygiene, medical equipment, dressing, bathing, and exercise
· Other-transportation, companionship, and daily telephone checks
Once you have compiled the list, decide if a friend or family member can assist you or if you need outside help.

Make Your Home Safe(r). According to The American Academy of Orthopaedic Surgeons (AAOS), one in every three seniors fall each year. Falls cause many seniors to lose their independence, requiring a change in living arrangements such as moving to a nursing home or assisted living facility.

Although falls can happen to anybody, anytime, and anyplace, you can prevent many falls by recognizing and correcting common hazards in the home. Senior Helpers has developed a "Home Safety Checklist" that provides tips for fall-proofing each room in the house.
· Use good lighting. Put light switches at the top and bottom of every staircase.
· Use grip bars and install handrails in bathtub and toilet areas.
· Use a bed that is easy to get in to and out of
without injury.
· Secure throw rugs and fasten loose area rugs with double-sided tape or slip-resistant backing.
· Clean up spills, dropped food, etc. from floors
immediately.

Exercise. Regular, moderate physical activity is very important. Physical activity can reduce pain in joints and muscles and improve mobility and balance. The benefits of exercise help reduce the risk of falling. Talk with your doctor about starting an exercise program that fits your level of ability and meets your needs.

Sources: www.orthoinfo.aaos.org/, www.metlife.com

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The Law Offices of Jeremy W. Howe, LTD. are ElderLaw attorneys in RI for wills and trusts, estate planning, guardianship, probate, and Veterans Aid and Attendance Benefits. They practice Pension and Retirement law as well with a focus on Qualified Domestic Relations Orders (QDRO), Military Pension Orders, Civil Service Orders, as well as Consultation on Pension issues. They also are Newport RI Divorce lawyers, attorneys, mediators, and arbitrators providing services for family law issues such as divorce, child custody and visitation, support, and Military family law.

They offer Elderlaw Mediation for disputes and intergenerational issues as well as probate court resolution. They also do Superior Court Mediation and Arbitration as well as Pension Mediation. Mediation and Arbitration is also offered by the firm for divorce mediation, separation, and all family law issues pre and post divorce.

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

ARTICLE: Why Care Managers Should Understand VA

2011-08-09T10:33:00.005-04:00

We received this article as part of our monthly newsletter from the Veterans Advocates Group of America and thought our clients and colleagues would find it interesting. Visit their website at http://www.vagamembers.com for more information about their group. Please contact our office if you would like more information on Veterans Benefits available to your family members or your clients, and how we can educate you about how to qualify for these benefits.

Why Care Managers Should Understand VA

When adult children of seniors turn to a geriatric care manager for help, they are typically lost in a sea of issues, dilemmas, decisions and questions about the multitude of resources and services now advertised in our society for the elderly. Often, the very first task of the care manager is to provide emotional support to the adult child, so that the person can think logically and rationally again, as often the decisions to be made can de-stabilize the family, old conflicts can arise again and the senior also reacts to the adult child "stepping in" and taking new actions.

The next task of the care manager is to educate - about what resources/services are out there and very importantly, WHEN they are to be tapped. Knowing about Veterans Benefits is critical to so many families being able to either keep their loved one in the home safely with the in-home benefits or to move their elder out of the home with the Aid and Attendance Benefit for assisted living and personal care homes. In my experience, I have been privileged to see the utter relief of many middle class family members when the senior qualifies for the Benefit, as the financial assistance the benefit provides literally makes the move to assisted living possible.

It is key for the geriatric care manager to educate the family or point them to a resource that can educate them about the timing of many factors that must come together property to qualify for VA benefits. When the family understands the financial parameters that must be met, then the family can make sound financial decision s that support getting to the goal of financial qualification. If not, then qualifications may not ever happen.

Geriatric care managers are experts in helping educate the adult children about the physical/medical status of the senior and this is also a critical factor in deciding when to apply for the Veteran's benefits. For example, it is very common for family members to wait too long to address their loved one's situation and often the veteran may need nursing home placement by the time the family is willing to act versus acting sooner and allowing the veteran to use his or her benefit for assisting living and enjoying this more independent, less intrusive level of care for perhaps years.

With knowledge about Veteran's benefits and all the factors that influence decisions the family must make to qualify, the geriatric care manager has served that Veteran in a critical time -Our veterans deserve no less!

Mallory Long, Geriatric Case Manager
Atlanta, Georgia

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The Law Offices of Jeremy W. Howe, LTD. are ElderLaw attorneys in RI for wills and trusts, estate planning, guardianship, probate, and Veterans Aid and Attendance Benefits. They practice Pension and Retirement law as well with a focus on Qualified Domestic Relations Orders (QDRO), Military Pension Orders, Civil Service Orders, as well as Consultation on Pension issues. They also are Newport RI Divorce lawyers, attorneys, mediators, and arbitrators providing services for family law issues such as divorce, child custody and visitation, support, and Military family law.

They offer Elderlaw Mediation for disputes and intergenerational issues as well as probate court resolution. They also do Superior Court Mediation and Arbitration as well as Pension Mediation. Mediation and Arbitration is also offered by the firm for divorce mediation, separation, and all family law issues pre and post divorce.

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

It Has Been a Year Since We Filed for Aid & Attendance for My Father

2011-07-14T11:21:00.006-04:00

We thought our clients and friends would be interested in the following comment that was posted on one of the monthly newsletters we receive with regard to the Veterans Aid and Attendance Benefits.

In addition to letting people know whether they might qualify for the benefit, the advantage of speaking with us that we will also let you know what to expect if you begin to receive the benefit.

"It Has Been a Year Since We Filed for Aid & Attendance for My Father."

It has been a year since we filed for the Aid and Attendance Pension Benefit for my Father-in-law, John. He is still comfortably situated in his assisted living apartment and receiving good health care from the staff. An important document that our Veteran Consultant let us know about was a form called the “Eligibility Verification Report” (EVR) which VA sends at the beginning of the year and must be filled out every year in order to continue receiving benefits.

After my initial help with his original application John was the only one to receive correspondence from VA, so I asked him to start watching for any letters from them starting in December. He received the form in January. We gathered all of our receipts from his Assisted Living and other medical bills to sum up the correct amount that he had paid that year. The original application could only be an estimate, so this new form establishes the actual amount he is paying. We did not need to send in the receipts, but we filed them away in case VA wanted to see them for proof.

It was very helpful to have our Consultant answer any questions and make us aware of this very important form. Many people are not aware that once applied for and receiving the benefit the “EVR” has to be completed yearly to keep it. One concern to address is that if income or assets increased the past year, the benefit may be reduced or eliminated. On the other hand, if medical expenses have increased since the last year, the benefit may also increase. ....read the entire article by going to the link below.

Please go to the following URL for the entire article and previous articles: Either click on the link http://www.planforcare.org or copy and paste the following into your browser: http://www.planforcare.org

If you would like more information about the Veterans Aid and Attendance Benefit or to speak to one of our Elder Law attorneys, please call us at 401-841-5700 or visit our website at www.CounselFirst.com.
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The Law Offices of Jeremy W. Howe, LTD. are ElderLaw attorneys in RI for wills and trusts, estate planning, guardianship, probate, and Veterans Aid and Attendance Benefits. They practice Pension and Retirement law as well with a focus on Qualified Domestic Relations Orders (QDRO), Military Pension Orders, Civil Service Orders, as well as Consultation on Pension issues. They also are Newport RI Divorce lawyers, attorneys, mediators, and arbitrators providing services for family law issues such as divorce, child custody and visitation, support, and Military family law.

They offer Elderlaw Mediation for disputes and intergenerational issues as well as probate court resolution. They also do Superior Court Mediation and Arbitration as well as Pension Mediation. Mediation and Arbitration is also offered by the firm for divorce mediation, separation, and all family law issues pre and post divorce.

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

What Expenses Can’t a Special Needs Trust Pay For?

2011-07-05T11:00:00.002-04:00

Our office received this article as part of the monthly newsletter from Special Needs Answers, a community resource provided by the Academy of Special Needs Planners. They can be contacted via email at ken@specialneedsplanners.com; or on their website at http://www.specialneedsanswers.com

What Expenses Can’t a Special Needs Trust Pay For?

Special needs trusts are designed to supplement, not replace, the kind of basic support provided by government programs like Medicaid and Supplemental Security Income (SSI). Special needs trusts pay for comforts and luxuries -- "special needs" -- that could not be paid for by public assistance funds.

This means that if money from the trust is used for food or shelter costs on a regular basis or distributed directly to the beneficiary, such payments will count as income to the beneficiary. This can affect eligibility for government benefits like Medicaid and SSI. One of the trustee's most important jobs is to use discretion in making distributions from the trust so as not to jeopardize the beneficiary's eligibility for these government benefits.

If the beneficiary receives SSI, here are some basic expenses that should not be paid through a special needs trust without consultation with a special needs attorney. (List developed by Life Plan Trust, Inc., Apex, N.C.)

 Cash given directly to the beneficiary for any purpose
 Food or groceries
 Restaurant meals (except if given as an occasional gift)
 Rent or mortgage payments
 Property taxes
 Homeowners or condo association dues
 Homeowners insurance if the insurance is a mortgage requirement
 Utilities such as electricity, gas, and water
 Utilities hookup or connection charges

However, many of these payments will only cause a one-third reduction in SSI benefits. The trustee may determine that the benefit of the trust making these payments far outweighs the loss of income.

If you have any questions about this article or special needs trusts, please contact one of our attorneys at the Law Offices of Jeremy Howe, Ltd. 401-841-5700, or visit our website at www.CounselFirst.com for more information about our office.

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The Law Offices of Jeremy W. Howe, LTD. are ElderLaw attorneys in RI for wills and trusts, estate planning, guardianship, probate, and Veterans Aid and Attendance Benefits. They practice Pension and Retirement law as well with a focus on Qualified Domestic Relations Orders (QDRO), Military Pension Orders, Civil Service Orders, as well as Consultation on Pension issues. They also are Newport RI Divorce lawyers, attorneys, mediators, and arbitrators providing services for family law issues such as divorce, child custody and visitation, support, and Military family law.

They offer Elderlaw Mediation for disputes and intergenerational issues as well as probate court resolution. They also do Superior Court Mediation and Arbitration as well as Pension Mediation. Mediation and Arbitration is also offered by the firm for divorce mediation, separation, and all family law issues pre and post divorce.

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

The A B Cs of Joint Bank Accounts

2011-06-30T12:08:00.003-04:00

One might think that the general topic of “bank account ownership” is easy to understand and that forms of bank account ownership are understood by the general public and by bankers. But mistakes are made all the time. To begin with, some accounts were set up by bankers and customers decades ago. The accounts were written out by hand. Some of them listed two names only, some of them listed two names as “Joint Tenants” and others listed two names as “Joint Tenants with right of survivorship.” The above designations can cause problems when an owner dies or loses capacity.

It bears repeating that if you have a will, the will should address joint accounts. The usual clauses are a “true joint account clause” or an “account of convenience clause.” The former makes clear that your joint accounts were intended to go to the surviving joint tenant. The latter states that your joint accounts were intended as a convenience with the intention that the funds be added to your estate.

A person’s wishes can be thwarted during or after death. In a recent case the bank account was designated as “Joint”. The bank record did not say “with right of survivorship.” The daughter wanted to retain the funds. Her siblings challenged her. The Supreme Court agreed with her siblings. The decedent may have intended that her daughter receive the funds but she did not write “with right of survivorship.”

The moral of the story is: Check every account and be sure that your intention regarding ownership has been properly designated. This problem comes up regularly and it causes family feuds more often than you would think. In a facetiously written 1998 Rhode Island case it was noted that there are two ways to start a civil action. To paraphrase: The first is to follow the statutory procedure for starting a case and the second was “by opening a joint bank account with right of survivorship. “

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The Law Offices of Jeremy W. Howe, LTD. are ElderLaw attorneys in RI for wills and trusts, estate planning, guardianship, probate, and Veterans Aid and Attendance Benefits. They practice Pension and Retirement law as well with a focus on Qualified Domestic Relations Orders (QDRO), Military Pension Orders, Civil Service Orders, as well as Consultation on Pension issues. They also are Newport RI Divorce lawyers, attorneys, mediators, and arbitrators providing services for family law issues such as divorce, child custody and visitation, support, and Military family law.

They offer Elderlaw Mediation for disputes and intergenerational issues as well as probate court resolution. They also do Superior Court Mediation and Arbitration as well as Pension Mediation. Mediation and Arbitration is also offered by the firm for divorce mediation, separation, and all family law issues pre and post divorce.

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

KLR Article: Seven Reasons to Review Your Will

2011-06-22T11:39:00.004-04:00

Our office recevied this article from the montly e-newsletter supplied by Kahl, Litwin Renza & Co, Ltd. (KLR). Their office can be reached at 888-KLR-8557 or their webiste at www.KahnLitwin.com. We thought our clients would be interested in this "short list" of reasons to review your will.

Seven Reasons to Update Your Will

Wills Must Keep Up With Life Changes

A will is an essential part of planning for the future. But don't think creating a will is a one-time proposition. Even if you have a valid document, it may need to be updated for a variety of reasons. For example:

1. Deaths - If individuals named (as heirs or executors) have died or they become incapacitated, a will should be changed.

2. Assets - Revisions may be needed if the value of assets has increased or decreased significantly, or they are no longer owned. For example, if you specifically leave your home to one of your children, and later sell it, you may want to change the distribution of your other assets.

3. Marriage - Wedding bells usually signal the need to review a will. Which assets should pass to your spouse? Are step-children involved? If this is not spelled out in a will, the state will decide. In a community property state, a spouse automatically inherits half of all community property. In most other states, a spouse may receive one/third to one/half of the estate, absent any other directions.

Also, keep in mind that an unmarried couple living together may want to leave assets to each other but in order to make an inheritance happen, it must generally be spelled out in a will.

4. Divorce - In many states, a divorce automatically revokes a will or those provisions concerning an ex-spouse. As a result, if you get divorced, it's best to have a new will drafted. For instance, you might have your former spouse removed as a primary beneficiary. In addition, you may want to change the beneficiary of your life insurance, pension or any existing IRAs. Consider the use of a trust if children from a previous marriage are involved.

You may also want to change your will if one of your children gets divorced.

5. Births - Once parents have children, their wills should be amended immediately to include the names of guardians to care for the children in the event the parents die prematurely. Also, parents or grandparents might wish to restructure their wills concerning distribution of assets after children are born. Again, the use of a trust may be recommended.

6. Retirement - This event may also trigger the need to make changes to an existing will. For example, many retirees sell their homes and move to other states. But state laws can vary widely. Furthermore, individuals may consider a power of attorney that enables someone else to act on their behalf in the event of certain illnesses.

7. Tax law revisions - The Internal Revenue Code is regularly changed. In fact, many aspects of estate tax planning are in flux right now. A will should be designed to take advantage of maximum tax benefits that exist today so it may have to be updated as tax laws change.

Where is It?

Before it's too late, people should let someone know where their original will is stored. If one can't be found after a person dies, a court may decide it was destroyed. Have your attorney and/or your accountant retain the original will. Ask them what will happen to the document if they die, move, or quit practicing.
Store the will at home. Of course, it could be lost, inadvertently destroyed or discovered by an interested party who could deliberately destroy, conceal, or alter it.

You don't have to tackle this problem on your own. If you need to update a will, rely on your estate planning advisers to guide you.

We are here to help you. Call us at the Law Offices of Jeremy Howe, Ltd. 401-841-5700 or go to our website for more information about us at www.CounselFirst.com.

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The Law Offices of Jeremy W. Howe, LTD. are ElderLaw attorneys in RI for wills and trusts, estate planning, guardianship, probate, and Veterans Aid and Attendance Benefits. They practice Pension and Retirement law as well with a focus on Qualified Domestic Relations Orders (QDRO), Military Pension Orders, Civil Service Orders, as well as Consultation on Pension issues. They also are Newport RI Divorce lawyers, attorneys, mediators, and arbitrators providing services for family law issues such as divorce, child custody and visitation, support, and Military family law.

They offer Elderlaw Mediation for disputes and intergenerational issues as well as probate court resolution. They also do Superior Court Mediation and Arbitration as well as Pension Mediation. Mediation and Arbitration is also offered by the firm for divorce mediation, separation, and all family law issues pre and post divorce.

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

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

2011-05-16T08:35:00.002-04:00

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 RI for wills and trusts, estate planning, guardianship, probate, and Veterans Aid and Attendance Benefits. They practice Pension and Retirement law as well with a focus on Qualified Domestic Relations Orders (QDRO), Military Pension Orders, Civil Service Orders, as well as Consultation on Pension issues. They also are Newport RI Divorce lawyers, attorneys, mediators, and arbitrators providing services for family law issues such as divorce, child custody and visitation, support, and Military family law.

They offer Elderlaw Mediation for disputes and intergenerational issues as well as probate court resolution. They also do Superior Court Mediation and Arbitration as well as Pension Mediation. Mediation and Arbitration is also offered by the firm for divorce mediation, separation, and all family law issues pre and post divorce.

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