Helping Seniors Beat the Heat

The entire east coast is undergoing a severe heat wave, with record setting temperatures and code red air quality for days on end. It is important that every person, and especially seniors, take steps to ensure that they are not overcome by a heat related illness.

The following tips from Dr. Robert Luchi, a Professor of Medicine-Geriatrics, and from About.com can help seniors beat the heat:

* If you don’t have air conditioning head to to the shopping mall, senior center, library, movie theater, or place of worship, and plan to spend some time there in the cool air.

* Cool baths or showers can provide relief. Ice bags and wet towels are also helpful.

* Beware of dehydration. Drink water before outdoor activities and drink water at regular intervals during the day, even if you are not thirsty. Avoid beverages with caffeine or alcoholic beverages because such drinks can lead to dehydration.

* Curtail physical activity during extremely hot weather. Activity adds to heart strain. If you must do something outside, take frequent rest breaks, preferably in the shade. Try to schedule outdoor activities for cooler times of the day–before 10 a.m. and after 6 p.m.

* Avoid heavy meals. Limit salt use.

* Wearing loose fitting, lightweight clothing will allow for good air circulation around your body.

* Use a hat or umbrella to protect your head and neck from sun exposure and be sure to use sunscreen with an SPF of 15 or greater anytime you go outside.

* Take the heat seriously. Dizziness, rapid heartbeat, diarrhea, nausea, headache, chest pain, mental changes or breathing problems are warning signs that you should seek immediate medical attention.

* If you have a chronic medical problem, talk with your doctor about additional precautions you should take to prevent heat related illness. Some conditions and medications may place you at higher risk.

* If you show any signs of heat related illness try to get to a cooler place as soon as possible, sip some cool fluids and sponge yourself off with with lukewarm tap water.

The Gatesman Law Office wishes you a safe and healthy summertime.

Is It OK to Pay My Way?

Mother has a stroke and moves in with you to live in the in-law suite in your home.  Mother pays you each month to cover her share of the utilities and to pay for the separate phone line installed in her room,  which line is included on your own personal telephone account.

Some time later, Mother needs long term care in a nursing home.  Unfortunately, she has only $1,000 in the bank and has been subsisting month to month on her income.  So you help your mother to apply for  Medicaid benefits to cover her nursing home costs.

The Medicaid caseworker accepts your application and does nothing for several months.  The nursing home, knowing that you have applied for Medicaid, requires that your mother only pay her income to the nursing home per month, which she must do in order to get Medicaid.  However, such payment is substantially less than the $8,500 per month the nursing would cost without Medicaid.

Five months after filing the Medicaid application, which is a typical application processing period, the caseworker informs you that mother’s contributions to the household expenses and the telephone bill will be treated as gifts to you, causing your mother to be ineligible for Medicaid.  In response, the nursing home sends you a bill for $40,000 for five months of care and will start billing $8,500 per month for future months.

“That’s outrageous,”  you exclaim, “my mother simply paid for the cost of heating and cooling her living space and for her private telephone line!  Those were not gifts to me!”

Outrageous as that may seem, it is true that the Medicaid rules penalize that type of cost sharing unless it is supported by a contract between you and your mother.

For this reason, any time a senior family member is contemplating entering into a financial transaction or co-living arrangement with another family member, it is wise to seek competent legal counsel.   Indeed, seemingly commonsense actions could have far reaching adverse consequences if nursing home care ever becomes a necessity.

The Gatesman Law Office stands ready to assist your family in doing appropriate planning to ensure that such surprises do not occur in your life or the lives of your parents.

More Than One Way to Skin a Cat

You’ve heard the old saw: “There is more than one way to skin a cat.” Such folk wisdom can inspire estate planners to dream up creative solutions to thorny legal problems.

Recently, the Gatesman Law Office had been assisting a family in revising the distribution pattern under their estate plan. Husband and wife each had a revocable trust, which trusts held property in further trust for one of their children after both husband and wife died. The share for their other child was to be given to him outright, free of trust.

However, as time passed, the conditions that prompted the desire to hold property in trust for the couple’s now adult child no longer existed and they were in the process of revising their revocable trusts to eliminate the trust for such adult child.

Then, suddenly and unexpectedly, husband died. As a consequence, husband could no longer amend his revocable trust. While wife, who survived her husband, was now the trustee and beneficiary of husband’s trust, she did not have the power to amend the trust to change how trust assets would be distributed after her death.

Read the rest…

Estate Plan Checkup

For our younger readers, this time of year is heralded by the hustle-bustle of back to school activities.  It is the time for parents of young children to double check that the kids have shoes that fit for gym class, warm clothes for the winter months, and pens, pencils, and rulers to stock the kids’ backpacks for the first day of school.

For all adults, now is a good time to review your estate plan to make sure that your plan is in order to meet your changing needs.  Have you executed a Power of Attorney to ensure that a trusted agent can manage your financial affairs should you become incapacitated?  Do you have an advance health care directive to ensure that appropriate medical choices are made even if you cannot communicate those choices to your health care providers?

Are the individuals you have chosen to serve as your agents in those documents still the best choices, or have your or their circumstances changed significantly so that choosing other agents is appropriate?

Do you have a Will?  Does your will impose limits because your children were minors when you wrote it, limits that are no longer appropriate?

By asking yourself these and other questions, you will discover whether it is time to review your estate plan with your legal counsel.  This type of periodic review of your estate plan will ensure that your plan continues to meet your needs even as your needs change over the years.

Happy autumn from the Gatesman Law Office.

Medicaid Transfer Penalty

In Maryland, one is ineligible to receive Medical Assistance, or Medicaid, for long term care in a nursing home if one gives property away, or transfers property for less than full value.  Since 2006, this period of ineligibility does not begin to run until the gift giver resides in a nursing home and is out of money.

The period of ineligibility is determined by dividing the amount of the gift (or the aggregate amount of all gifts) by the penalty divisor.  The penalty divisor has been $4,300 for many years.  For Medicaid applications filed on or after June 1, 2009, the penalty divisor will be $6,800.  Using the new divisor, a gift of $68,000 will cause a Medicaid ineligibility period of 10 months, six months less than the penalty that would have been imposed using the old divisor.

Please contact the Gatesman Law Office to learn more about how this change may affect you.

Last Chance to Change Medicare Coverage

The open enrollment period to make changes to your Medicare coverage, or to add coverage such as the so-called Medicare Part D drug coverage ends December 31, 2008. Now is the time to act if you desire to make changes to your coverage.

To learn more, you may log onto the online Medicare Open Enrollment Center by clicking -Here-

Medicaid Planning in a Turbulent Economy

In the current turbulent economic climate people are finding that the values of their assets from their homes to their investment portfolios to their retirement accounts are declining substantially. Such decline of value has implications for those who are seeking to engage in Medicaid asset preservation planning.

Read the rest…

Estate Plan Check Up

Many people are in the habit of visiting their doctors for an annual physical or other regular check-up.  Still more visit their accountants each year to assist them with their income taxes.  And most people regularly visit their auto mechanics to change the oil in their cars every three months or so.

The practice with lawyers is different, however, and people may put themselves in peril if they do not periodically review their affairs with their attorney.

Read the rest…

Medicaid Largesse

When people think about using Medicaid to pay for nursing home care, they generally think that the program will pay only after most of their assets are gone. However, there are little known rules that allow people to keep certain substantial assets and still get Medicaid for nursing home care. Some of these rules apply only if there is a spouse living at home, and others apply even if a single person is seeking Medicaid benefits.

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Tying the Hands of Your Health Care Agent

This office has recommended, and most estate planners will agree, that one should consider appointing a trusted individual to make health care decisions for you in the event you are unable to do so. I wrote a comprehensive article on that topic on October 7, 2007.

Maryland law not only allows one to appoint a Health Care Agent, the statute provides forms one may use to do so. While I have always recommended that one seek experienced legal counsel when appointing a Health Care Agent – one of the statutory forms curiously omits a significant provision – such advice is even more compelling in light of a new ruling by Maryland’s Attorney General.

Read the rest…

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