By Rick Law, Senior Estate Planning Attorney and Elder Law Attorney in Aurora, IL. Mary and her husband, Larry, enjoyed health, happiness, and modest success for many decades. After reaching retirement age, Larry began to notice that Mary’s memory was slipping. Within a few years, Larry had changed from being Mary’s husband and best friend to being her full-time caregiver. Larry vowed that Mary would never go to a nursing home. It would be wonderful if such sentiments could always be fulfilled. Unfortunately, the realities of life and long-term care often thwart such commitments. And so it was to be for Larry and Mary. Then one day, Larry, who had been a lifelong smoker, was diagnosed with inoperable cancer. He was told to go home and get his affairs in order. Larry remained stoic about his own condition, but he was distraught about what was going to happen to Mary. He worried about how to provide the best care for her after he was gone. A friend whom he had come to know through an Alzheimer’s support group encouraged him to see an elder-law estate planner. This attorney understood estate planning, long-term care options, and nursing home and Medicaid law. Under the direction of the lawyer, Larry modified his estate plan to create a new will, which included a special kind of trust for the sole benefit of Mary during the balance of her life. Having money available for hearing aids, mobility devices, specialized therapies, trips, personal attendance, room enhancements, special events, and more is a marvelous way to increase the dignity of a person’s life while still qualifying them for nursing home Medicaid benefits. Too many families needlessly lose everything they have. Don’t let that be you. If you need help paying the overwhelming cost of long term care, give our office a call at 800-310-3100. Your first consultation is absolutely free. We’ll let you know what steps you need to take, right now, to protect yourself and your family. Call now, because when you’re out of money, you’re out of options! Sincerely, Rick L. Law, Attorney, Estate Planner for Retirees. Rick was named the #1 Illinois elder law estate planning attorney by Leading Lawyer Magazine. He has been quoted in the Wall Street Journal, AARP Magazine, TheStreet.com, and numerous newspapers and articles. Rick is the lead attorney for Law Elder Law, LLP, focusing in Estate Planning, Guardianship, and Nursing Home Solutions. His goal is to give retirees an informed edge when it comes to dealing with an uncertain future. Get flexible retirement strategies that work during good times and bad, plus information on how you can save your home and assets from being used to pay for long term care. Call 800-310-3100 for your free consultation now!

Protect Your Loved One With Alzheimer’s Disease

By Rick Law on

April 18, 2015

- Alzheimer's and Dementia, Elder Law, estate planning

By Rick Law, Elder Law and Estate Planning Attorney. Senior Advocates at the Estate Planning Center at Law Elder Law in Aurora, IL. Often, when there is a diagnosis of Alzheimer’s disease, there is a healthy spouse. The concern of dealing with a person with Alzheimer’s is being able to provide long-term health care, even when the healthy spouse pre-deceases the person with the diagnosis. The circumstances that cause an event such as a healthy spouse predeceasing a person diagnosed with Alzheimer’s is statistically significant. And when doing planning for a husband and wife when one of the two of them has been diagnosed with a long-term illness, it is extremely important to not make the assumption that the person with the long-term disease trajectory is going to die before the healthy spouse. Without proper planning, you could have one of two results: the client didn’t do the proper estate planning and now the spouse has inherited all of the assets, or the client bypassed the spouse with the hopes that the children would simply “do the right thing” and take care of the spouse, and they didn’t. The savior can be the testamentary Special Needs Trust. This tool will not interrupt public benefits, but will provide for the special needs until the beneficiary’s death. One of the best ways to protect the individual with Alzheimer’s disease is to set up a special-needs trust or, in some states, to transfer monies to what has been referred to as a “pooled trust.” The type of special needs trust or other trust to be selected depends upon the goals and circumstances of both the donor, who is often referred to as the grantor, and the person with the diagnosis or beneficiary. There is much more to this decision making than merely deciding to put money and property into a trust. There are two synonymous ways to refer to a special-needs trust—simply a “special-needs trust” or a “supplemental needs trust.” In both, the language of the trust must specifically state that the assets in the trust are not available to be used for anything that would be covered by governmental benefits but, instead, are used to complement—to supplement but not supplant—whatever care would be provided for by governmental benefits. That’s a key concept, and that’s what makes this type of a trust—what is referred to as a “dignity for client trust,” —because what is being provided is more care than what would be available through the overburdened governmental Medicaid system. If your loved one has memory problems and you’re afraid of the consequences that may bring, give our office a call today at 800-310-3100. Your first consultation is absolutely free. We’ll let you know what steps you need to take, right now, to protect yourself and your family. Call now. Sincerely, Rick L. Law, Attorney, Estate Planner for Retirees. Rick was named the #1 Illinois elder law estate planning attorney by Leading Lawyer Magazine. He has been quoted in the Wall Street Journal, AARP Magazine, TheStreet.com, and numerous newspapers and articles. Rick is the lead attorney for Law Elder Law, LLP, focusing in Estate Planning, Guardianship, and Nursing Home Solutions. His goal is to give retirees an informed edge when it comes to dealing with an uncertain future. Get flexible retirement strategies that work during good times and bad, plus information on how you can save your home and assets from being used to pay for long term care. Call 800-310-3100 for your free consultation now!

Shirley’s Tale: A Widow with Dementia

By Rick Law on

April 15, 2015

- Adult Illness, Alzheimer's and Dementia, estate planning, Financial Planning

By Rick Law, Senior Advocate at the Estate Planning Center at Law Elder Law – Across from the Aurora Premium Outlet Mall, right near the Farnsworth exit off the I-88 tollway in Aurora, IL. Shirley was an aged widow who eventually developed dementia. She was in her 80’s at the time of receiving a diagnosis of Alzheimer’s-type dementia. A women of moderate middle-class means, she was like the majority of seniors. In other words, she essentially had middle-class income and corresponding net worth. She didn’t have sufficient income or assets to provide private-pay, luxury nursing home care for the full period of time that they had dementia. Most seniors in the United States do not have sufficient resources to pay for even one full year of private pay at either an assisted-living facility or a skilled-care nursing home. Since dementia is a progressively debilitating condition, many of those affected will need multiple years of ever-more-expensive care. Once one’s personal resources have been exhausted, each state has a nursing home Medicaid benefit program, which may become the sole resource to pay for skilled nursing home care for those affected by Alzheimer’s disease. Although nursing home Medicaid benefit eligibility varies from state to state, an institutionalized person occupying a Medicaid-funded bed is essentially asset-less and income-less. Let’s explore the impact upon dignity and quality-of-care life differences that can be achieved when an appropriate special-needs trust is used to supplement the very limited nursing home Medicaid resources available to a person with Alzheimer’s. At one time, Shirley and her husband, Curly, had enjoyed a life of health and prosperity. Like most men, Curly’s health began to deteriorate several years before Shirley had any significant aging-related health issues. And as is quite common, Shirley provided most of the care for her husband for many years. During the time of his decline in health they spent a substantial amount of their marital assets on Curly’s ever-increasing health-care needs. Eventually, Curly had to be moved out of the home and had to be institutionalized in a skilled nursing home setting. By the time he died, Shirley was substantially impoverished—so she was unable to continue to afford their marital home or to remain in the neighborhood that they had enjoyed for many years. She was forced to move to a small apartment where she lived frugally on one Social Security check of $1,200 per month. Her assets were $120,000 in total, which represented the proceeds from the sale of their home. A few years later, Shirley developed dementia of the Alzheimer’s type. After she became unsafe in a normal environment, she needed to live in a skilled nursing care setting. In her state of residence, one does not qualify for nursing home Medicaid until all assets above $2,000 have been “spent down” on health care. In addition, once a person has qualified for nursing home Medicaid benefits, all of the income is assigned to the care facility in which they reside. The only exception is that the institutionalized person may keep $1 per day, which is referred to as the “personal needs allowance.” Near the end of Shirley’s life, she was out of money and out of options. With only $30 per month for her personal-needs allowance and less than $2,000 in assets, she was bereft of any resources beyond the state nursing home Medicaid benefits. If she needed dental care, new dentures, hearing aids, modified mobility devices, specialized therapies, foot care, or other such services, the likelihood of the state meeting her needs was remote. Shirley powerlessly lived out her final days warehoused in a nursing home Medicaid bed. Too many families needlessly lose everything they have. Don’t let that be you. If you need help paying the overwhelming cost of long term care, give our office a call at 800-310-3100. Your first consultation is absolutely free. We’ll let you know what steps you need to take, right now, to protect yourself and your family. Call now, because when you’re out of money, you’re out of options! Sincerely, Rick L. Law, Attorney, Estate Planner for Retirees. Rick was named the #1 Illinois elder law estate planning attorney by Leading Lawyer Magazine. He has been quoted in the Wall Street Journal, AARP Magazine, TheStreet.com, and numerous newspapers and articles. Rick is the lead attorney for Law Elder Law, LLP, focusing in Estate Planning, Guardianship, and Nursing Home Solutions. His goal is to give retirees an informed edge when it comes to dealing with an uncertain future. Get flexible retirement strategies that work during good times and bad, plus information on how you can save your home and assets from being used to pay for long term care. Call 800-310-3100 for your free consultation now!

The Four Different Levels of Care

By Rick Law on

April 11, 2015

- Alzheimer's and Dementia, Health Care, Long Term Care

By Elder Law Attorney Rick Law. Senior Advocate and Managing Partner at the Estate Planning Center at Law Elder Law in West Suburban Aurora, Illinois. The very basic level of care is called “routine level of care”, which is the absolute minimum that Medicare expects a hospice to do. That’s the very basic level of care where a patient can be seen anywhere from daily to every 14 days by the nurse, a certified nursing assistant, the chaplain, or a social worker. The next level is called “respite care.” Normally, seniors don’t qualify for skilled nursing care unless they’ve been in an acute-care hospital for at least 72 hours. The exception to that is hospice, for a patient living at home when the person caring for them becomes injured or sick or perhaps when there’s a fire in the house. The hospice will pay for that patient to be transferred to a nursing home and the hospice will pay for five nights at that facility while they sort out the situation. Or, let’s say they’re living at home with a daughter or son who needs a break. The hospice can bring the ill person to a nursing home, and that’s one of the rare times that Medicare will pay for nursing home care without that initial acute-care hospitalization stay. The third level of care is “continuous care” or “comfort care.” This is the most financially risky area of care for the hospice agency because it enables putting a nurse at the bedside to manage pain symptoms and end-of-life care. There are very specific criteria— certain combinations of nursing home hours versus CNA [certified nurse assistant] hours. There are only so many hours per every 24-hour period that a patient receives care in order for the agency to be reimbursed. If they are off by even 15 minutes, the hospice may not get paid. But some hospices provide that level of care because it enables their patients to die at home. There are few agencies that do that. The highest level of care is called “general inpatient care.” That is done in a facility where there’s a registered nurse on the premises at all times—a Medicare-accredited hospital setting or skilled nursing facility. It’s the only time that Medicare allows the hospice to pay room and board in a skilled area. There are very specific criteria to qualify. An example would be somebody at home who is not doing well, but they would like to be around when their grandson comes home from college for a final goodbye. The decision might be made to take them to a hospital or nursing home to start an IV to get some hydration going and help make that wish come true. Those are the four levels of care. All hospices do the routine level of care. Most will do respite care because there’s no financial risk involved. There are very few hospital-based hospices that do all four levels. It is very important to interview different hospice options to ask them what levels of care they will provide. Too many families needlessly lose everything they have. Don’t let that be you. If you need help paying the overwhelming cost of long term care, give our office a call at 800-310-3100. Your first consultation is absolutely free. We’ll let you know what steps you need to take, right now, to protect yourself and your family. Call now, because when you’re out of money, you’re out of options! Sincerely, Rick L. Law, Attorney, Estate Planner for Retirees. Rick was named the #1 Illinois elder law estate planning attorney by Leading Lawyer Magazine. He has been quoted in the Wall Street Journal, AARP Magazine, TheStreet.com, and numerous newspapers and articles. Rick is the lead attorney for Law Elder Law, LLP, focusing in Estate Planning, Guardianship, and Nursing Home Solutions. His goal is to give retirees an informed edge when it comes to dealing with an uncertain future. Get flexible retirement strategies that work during good times and bad, plus information on how you can save your home and assets from being used to pay for long term care. Call 800-310-3100 for your free consultation now!

More Caregiver Tips with Master Alzheimer’s Caregiver Jo Huey

By Rick Law on

April 8, 2015

- Alzheimer's and Dementia

By Estate Planning Attorney Rick Law. Senior Advocate at Law Elder Law in Western Chicago, IL. Q: How common is it for an older person suffering from Dementia or Alzheimer’s to falsely accuse a younger person of theft or manipulation? A: I’ve seen some attorneys conduct family meetings in their office, and I believe that is the right strategy. You get everyone together and spend time just getting acquainted and then you can pick up on what’s really happening by watching the body language of everyone in the room. Body language can be much more informative than just listening to their words. After the family meeting, have the people separate and then talk to each one about the same things. When interviewing the client, ask questions like, “Tell me what you need your money for. What are you going to do with it? What are your plans? Who do you want to have your money and things after you’re gone? Why?” This type of interview will help the attorney sort out whether or not their client still has the ability to appreciate what they have and what is really happening around them. I think the attorney needs to be very calm during these meetings. An attorney can provide great value to the client and family, because most families seldom get around to having those types of discussions. If you look at the model of a geriatric care manager, one of the first things they do is go to the home and interview the individual who needs care as well as the family. They do this before they work on the care plan. If the attorney would consider the model of the geriatric care manager, they would get the family together and do an assessment before the attorney decides on the right course of action. Too often, I’ve seen situations where the attorney “charges the enemy” before really knowing who is hostile and who is a friend. Q: Is it very common for people to go through the full Alzheimer’s disease trajectory and then actually die of Alzheimer’s? A: Although Alzheimer’s disease is an illness that ends in death, most often people die from other causes first, such as stroke or heart attack. The most common death for people with Alzheimer’s or a related disorder is infections, especially pneumonia and sepsis (an infection that goes into the bloodstream). The most common forms of sepsis for people with Alzheimer’s tend to be from things the ordinary person wouldn’t even think of, mainly urinary tract infection, also called UTI, or a bowel backup. The tough reality is that it’s very difficult for a person with Alzheimer’s to tell you what’s going on internally and it tends to get overlooked by the care staff because the behaviors of somebody with a urinary tract infection often are not seen as an infection. They get very ill very quickly and it happens so fast. Q: Will you share with me some principles to improve communication with someone affected by Alzheimer’s disease. What do we need to know? A: The name of my book is “Alzheimer’s Disease, Help and Hope: Ten Simple Solutions for Caregivers”. The 10 Absolutes are communication tools to allow caregivers (and perhaps lawyers) to know what to say and what not to say when working with people affected by Alzheimer’s. My goal is to help people motivate those with Alzheimer’s to do the right things, such as taking a bath. I also want to help people to avoid the non-stop battles and enjoy what time they have together. There are still lots of things that a person with Alzheimer’s may be able to do, and they still need to have some meaning and purpose in their lives. Too often, everything is taken away from them and they feel like there is nothing left worth living for. The Ten Absolutes are:

Never argue; instead, agree.
Never reason; instead, divert.
Never embarrass; instead, distract.
Never lecture; instead, reassure.
Never say, “Remember”; instead, reminisce.
Never say, “I told you”; instead, repeat/regroup.
Never say, “You can’t”; instead, do what they can.
Never command/demand; instead, ask/model.
Never condescend; instead, encourage/praise.
Never force; instead, reinforce.

If your loved one has memory problems and you’re afraid of the consequences that may bring, give our office a call today at 800-310-3100. Your first consultation is absolutely free. We’ll let you know what steps you need to take, right now, to protect yourself and your family. Call now. Sincerely, Rick L. Law, Attorney, Estate Planner for Retirees. Rick was named the #1 Illinois elder law estate planning attorney by Leading Lawyer Magazine. He has been quoted in the Wall Street Journal, AARP Magazine, TheStreet.com, and numerous newspapers and articles. Rick is the lead attorney for Law Elder Law, LLP, focusing in Estate Planning, Guardianship, and Nursing Home Solutions. His goal is to give retirees an informed edge when it comes to dealing with an uncertain future. Get flexible retirement strategies that work during good times and bad, plus information on how you can save your home and assets from being used to pay for long term care. Call 800-310-3100 for your free consultation now!

Surprising Truths Within Hospice Care

By Rick Law on

April 5, 2015

- Adult Illness, Health Care, Long Term Care

By Attorney Rick Law, Managing Partner at the Estate Planning Center of Law Elder Law in the Western Chicago suburb of Aurora, IL. Carolyn Peterson is an RN who has worked as a nurse for 43 years. Seventeen years ago, she began to focus exclusively in the area of hospice care. She works for an organization that provides care for the dying and incurably ill. I recently talked with Carolyn about hospice care and found out some surprising truths that most people don’t know. Q: RNs have the capability of working in almost any area of medical care. What attracts you and keeps you working with hospice? A: I think it’s the humanity of the work. RNs enter a person’s life at a time when the rest of the medical community seems to have abandoned them. When people get to the point in their illness where it can’t be fixed, a lot of the medical community kind of give up on them. Many times when nurses first meet a patient or family, they might be the first one to have explained what’s going on in terms of their disease and that, truthfully, there is no more treatment available except hospice. It takes quite a bit of finesse and compassion, and when a nurse has these conversations there are no do-overs. Q: Would you explain about the composition of a hospice team? A: Medicare dictates who must be a part of the interdisciplinary hospice team. The top person is the medical director, who is an employee of the hospice and must be a doctor who is board certified in hospice and palliative care (relieving and preventing suffering). There must be a nurse case manager, a non-denominational chaplain, and a social worker. Q: In a typical month, how many different patients or clients are cared for by a team? A: Many hospice teams service 12 to 13 new families per month. Q: What are the typical services that one could expect to find provided by a hospice on a per-day basis, and who pays for it? A: Medicare Part A pays for hospice care at 100 percent. It does not require any supplemental insurance, because the Medicare hospice benefit covers it. Medicare provides for four different levels of hospice care. Some companies provide all four levels of care even though two of the levels can be financially risky (not profitable). Medicare reimbursement is fixed at a maximum dollar amount, regardless of the level of care provided by a hospice. If you’re ready to start getting your estate in order and secure your assets for the “worst-case” scenario, please give our office a call at 800-310-3100. Your first consultation is absolutely free. We’ll let you know what steps you need to take, right now, to protect yourself and your family. Call now. Sincerely, Rick L. Law, Attorney, Estate Planner for Retirees. Rick was named the #1 Illinois elder law estate planning attorney by Leading Lawyer Magazine. He has been quoted in the Wall Street Journal, AARP Magazine, TheStreet.com, and numerous newspapers and articles. Rick is the lead attorney for Law Elder Law, LLP, focusing in Estate Planning, Guardianship, and Nursing Home Solutions. His goal is to give retirees an informed edge when it comes to dealing with an uncertain future. Get flexible retirement strategies that work during good times and bad, plus information on how you can save your home and assets from being used to pay for long term care. Call 800-310-3100 for your free consultation now!

When the Daughter Can’t “Pull the Plug”

By Rick Law on

April 3, 2015

- estate planning, Health Care

By Estate Planning Attorney Rick Law, Senior Advocate and Elder Law Attorney at the Estate Planning Center at Law Elder Law. Wanda came into our office to discuss her estate plan… We spent close to two hours going over all of her wishes relative to her finances, her legacy, and, finally, her views regarding life-prolonging treatments that were incorporated into her health-care power of attorney. She had been accompanied to this meeting by her daughter whom she had chosen to be her executor, her trustee, and her agent under her power of attorney for property and health care. All seemed to be going well until reviewing Wanda’s wishes relative to life-prolonging treatments and end-life decision making. At that point the daughter (Wendy) suddenly stated, “No Mom, I could never direct a physician to withhold or remove life support.” Wendy was expressing her very strong religious beliefs regarding the sanctity of life and her church’s definition of ordinary health care. Wanda was outright stunned that her daughter would not fulfill her wishes regarding end-life decisions. She realized that certain adjustments needed to be made in her health-care decision-making process and eventually she chose a different person to make the final life-prolonging decision. It is important for anyone involved in the planning process to understand not only how their chosen agent may respond to their view on end-life treatment but also the position of the health-care provider. There are many charitable, religious hospitals and nursing homes that will not fulfill patients’ desires relative to end-life decision making. In the event that a health-care provider is unwilling to comply with the legitimate end-life decision making elected by a patient and/or agent under the health-care power of attorney, they should request that the client be moved to a different facility that is willing to fulfill the client’s wishes relative to end-life decisions. Give our office a call at 800-310-3100. Your first consultation is absolutely free. We’ll let you know what steps you need to take, right now, to protect yourself and your family. Sincerely, Rick L. Law, Attorney, Estate Planner for Retirees. Rick was named the #1 Illinois elder law estate planning attorney by Leading Lawyer Magazine. He has been quoted in the Wall Street Journal, AARP Magazine, TheStreet.com, and numerous newspapers and articles. Rick is the lead attorney for Law Elder Law, LLP, focusing in Estate Planning, Guardianship, and Nursing Home Solutions. His goal is to give retirees an informed edge when it comes to dealing with an uncertain future. Get flexible retirement strategies that work during good times and bad, plus information on how you can save your home and assets from being used to pay for long term care. Call 800-310-3100 for your free consultation now!

Something About Mary: A Widow’s Journey

Protect Your Loved One With Alzheimer’s Disease

Shirley’s Tale: A Widow with Dementia

The Four Different Levels of Care

More Caregiver Tips with Master Alzheimer’s Caregiver Jo Huey

Surprising Truths Within Hospice Care

When the Daughter Can’t “Pull the Plug”

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