1 mile west of the Chicago Premium Outlet Mall (800) 810 3100
I, (Rick Law) teach a continuing education class for health care professionals entitled “In the Shadow of Schiavo: Life, Death, and Care Instructions.”  Most  attendees come to the class assuming they are going to hear some lawyer drone on about boring legal documents.  But when life and death are on the line, health care advance directives are part of the human drama. 

 

Very few doctors, nurses, or other health care personnel understand the interplay between the Illinois statutory advanced directives such as the Living Will, Power of Attorney for Health Care, and Do Not Resuscitate Order.  When a person lacks effective advance directives, then a physician can trigger the Illinois Health Care Surrogate Act to create a decision-maker.

 

Unfortunately, many lawyers consider the health care power of attorney as a “throw-in” document in an estate plan.  In reality, it’s important to consider the hidden definitions for terms used in the statutory advance directives and the Health Care Surrogate Act.

 

For example, a principal should be very careful when naming both primary agent and successor agents.  Many clients seem to be willing to vest life-and-death authority in persons whom he/she knows are inappropriate.  Individuals will put fear of causing offense within the family above their own welfare. We attorneys must point out that even a successor agent may come to hold your life in their hands if your best agent is “unavailable.”  Even if an individual is a third or a fourth successor agent, if the higher-priority agents are unavailable, then whichever agent is available will make the final decision.  An agent is considered “unavailable” if “the person’s existence is not known; the person has not been able to be contacted by telephone or mail.”

 

I recommend that attorneys add full contact information of agents into the Power of Attorney. This simple act makes it easier for health care providers to communicate with the highest priority agent during a time of crisis. 

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After a long hiatus, we’re back to posting regularly on our blog!  We’ve been very busy over the past  year and can’t wait to share what we’ve been doing with our readers; but first, we want to share some important information about an issue that affects many of the clients who come into our office, and something we’d like to help prevent: When dementia hits the pocketbook.  We hope you find this information helpful, and please come back next week to read about the exciting things we’ve been doing in our firm and in the community! The first signs of Alzheimer’s or dementia are not always easy to see.  Families may go months or more before they realize that a loved one is forgetting a few too many things or confused about more than just the new DVD player.  One of the first signs of Alzheimer’s or dementia is also one of the most dangerous—a growing inability to understand and handle financial matters.  Elder care lawyers often hear stories that reveal that one of the first signs of dementia is an inability to understand money, personal finances, and contracts.  Client families need to take steps to protect the family finances when a loved one grows vulnerable to financial manipulation.  There is no legal standard for ‘vulnerability,’ but vulnerable individuals are easy prey for scam artists and just plain poor financial decision-making.  One novel idea used by a family to stop the loss of thousands of dollars being spent by a loved one to obtain supposed lottery “winnings” was to limit the affected person’s checking account balance.  In addition, family members actively created a lottery game to distract and amuse their loved one.  It worked! If family members live far away, some of the first people likely to notice these telltale signs of dementia are the senior’s own advisors—doctor, lawyer, or financial planner.  Unfortunately, these advisors often don’t always have the ability to take action.  Both doctors and lawyers, for example, are bound by patient or client privilege; even if they want to inform the family of their suspicions, they may not be able to.  Recent changes to Illinois State Bar Association Code of Ethics do allow an attorney to take action to protect a client when there is a reasonable belief that the client has become incapacitated and is in danger.  The American Medical Association also is not insensible to this issue, and has guidelines for dealing with patients who show signs of incapacity.  Unfortunately, doctors are under pressure to spend minimal amounts of time with patients.  Many people are able to ‘fake it’ during a short interview by doctors, lawyers, and financial advisors.  It is extremely important that the healthy spouse and/or responsible adult child get actively involved in pointing out to professionals any abnormal acts of vulnerability.  This may mean doing something that feels very uncomfortable, but is absolutely critical to get the protection needed.  No one will ever know what the family is seeing and experiencing at home unless you tell the story to your trusted advisors and friends.  It is dangerous to keep your fears a secret.  Almost everyone has a loved one who has been or will be affected by the progressive loss of decision-making capacity. What can families do to recognize the signs of dementia and prevent the financial fallout that often results?  First of all, it should be a topic of family conversation early and often, long before Mom or Dad is at risk.  Talk about the possibility and how it should be handled.  Geriatric care managers and elder care lawyers welcome input from the entire family of their clients.  Familiarity with the entire family gives more options if signs of dementia do start to appear, and an atmosphere of open communication can go a long way toward preventing suspicion and family fights later on.  Attorneys need to know who among the family the client believes are their ‘honest and reliable adult children’ who may be able to safeguard family finances and provide ongoing care and attention to the situation.  Care managers will recommend how best to combine family resources with professional services.  Experienced elder care attorneys and care managers can help the family to plan for future financial and health care needs.  Most families underestimate both the financial impact, emotional burden, and care needs that will be required due to the dementia of a beloved member of the family. Once a family has discussed options for the future and who might be the best person to take control of Mom or Dad’s finances in the event that they are unable, then an elder care attorney can assist them with the development of appropriate legal documents and Power of Attorney for financial decision-making.  These documents give a nominated agent the power to make financial decisions for the affected loved one.  The time to work on these plans is while the forgetful one still has sufficient capacity to make a Will, Trust, Power of Attorney for Health Care, Power of Attorney for Property, and any other estate protection plans.  Lawyers trained in this area of planning work to make sure that the healthy spouse is not excessively impoverished by long term care expenses. The onset of Alzheimer’s or dementia affects the entire family, and should be discussed as an entire family.
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Last Will and Testament Recently, at two different MCLE (continuing legal education) presentations, I spoke on the “Elder Law Essentials.”  The goal of the presentation was to distinguish the solutions of elder law vs. the solutions underlying traditional estate planning. I was originally trained as a tax attorney, and my principal estate planning solutions were motivated by the client’s desires to:
  • Minimize or avoid estate & gift tax costs; and
  • Minimize or avoid probate expenses; and
  • Minimize problems at the time of ultimate distribution to heirs/beneficiaries.
As an elder law attorney, however, the usual client motivation is the diagnosis of a long term illness.  This is illustrated by the life-changing call I received at my office almost ten years ago.  A family friend called me and she asked, “Rick, what are we going to do?  Bob has been diagnosed with Alzheimer’s disease.  Am I going to lose my home?  Are we going to lose EVERYTHING?”  There was panic in her voice. In those days, I was not prepared to give appropriate answers.  I was a traditional estate planner—and she was not asking for a traditional solution.  She was asking me for answers to these questions:
  • How are we going to maintain sufficient income?
  • How are we going to pay for Bob’s health care needs?
  • Will I ( the healthy spouse) be forced  move out of my home by health care expenses?
When someone asks these type of questions, elder law has the answers.  Our goal is to work with our clients to try to assist them to protect their income, obtain quality health care, and protect the marital residence for the healthy spouse. If a traditional estate plan is not the right fit, please call us to discuss how we may be able to help you. Rick Law
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Illinois senior citizens may soon be punished by the State of  Illinois when they announce new Medicaid eligibility rules for nursing home (NH) and Supportive Living Facility (SLF) benefits. The goal is to save the state big money by creating new ways to deny fragile senior citizens assistive living or nursing home help. The state wants to impose harsh penalty periods of ineligibility for NH and SLF services for any Illinois senior has given away money or assets during the five years (60 months) prior to a Medicaid application.  Can you imagine being punished for helping your children and grandchildren? Due to recent unemployment in the younger generations, Illinois seniors have paid loved ones’ medical bills, mortgage payments, tuition, and grocery bills.  Illinois Healthcare and Family Services (HFS) is about to implement rules which will punish seniors whose only “crime” is helping those they love. The current Illinois Medicaid eligibility rules are fair and include a  “forgiveness factor.”  Seniors who give away money or other assets create an immediate Medicaid penalty period of eligibility. When  a senior is still healthy and/or wealthy enough to cover their own healthcare expenses the ‘penalty’ quickly goes away.  For example, if a senior gives away $10,000 to a loved one, within about three months the senior is “forgiven” for that gift.    BUT— The new rules have no forgiveness factor. They will impose penalty periods of  ineligibility that will hang over a senior’s head for five years.  If you apply for Medicaid within five years after a gift, you will be punished with non-payment of Medicaid nursing home costs. This will happen even when the senior is ill and impoverished.  Both the senior and the long term care industry will be denied payments.  Can you predict what your health will be in five years? Illinois must provide law-abiding seniors with fairness and a Medicaid forgiveness factor! Illinois elder law attorneys have organized a DRA Task Force for Senior Fairness.  Ask Governor Pat Quinn and HFS Director Julie Hamos to be fair to Illinois’ frail senior citizens and long term care providers.  Contact Jessica Bannister at jessica@lawelderlaw.com to become involved!
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I had just checked into the Crawford Country Store and Motel—a combination convenience store and motel in Crawford, Colorado.  I had chosen to live at this clean and basic lodging during a five-day horse training clinic on the western slope of the Rockies.  After I found and entered my room, I dropped my bags and headed for the bathroom.  I walked in, turned to my right, and flipped the light switch—nothing happened.  “The light bulb must be burned out,” I thought.  I tried again—and nothing.  Well, I hustled back downstairs to the country store area and told the folks behind the counter that my bathroom light did not work.  A young man looked at me, chuckled, and said, “You need to flip the switch behind the towel.”  My jaw dropped and I asked, “There’s a switch behind the towel?”  He assured me that there was, as he had just used it that morning when he cleaned the room.  Shaking my head and wondering about whomever had decided to install a towel rack over a light switch, I went back upstairs to see if this was really true.  I put my hand behind the towel and felt a switch.  Bingo, the light turned on! I thought about this for a moment…  I had a low opinion of the decision to place a light switch “behind the towel”—but then it reminded me of how often in life the real answer to something is hidden from us.  The obvious answer is often not the right answer—this is why we need to find those professional counselors, health care providers, and lawyers who know where to find the light switch we need. Imagine for a moment that you suddenly have a diagnosis of some grave physical ailment.  You would most likely consider immediately hustling off to see experts places such as the Mayo Clinic or the Cleveland Clinic.  Another example: even though we are lawyers ourselves, we often hire other lawyers to give us advice in specific legal problem areas.  When we need to hire a lawyer, we seek out an experienced practitioner with a proven record.  You see, when I need an attorney, I want the best!  We don’t just hire the first person who says, “I’m sure I can take care of you, but I’m going to have to do some research in the area first.”  We hire legal counselors and refer our clients only to attorneys who can readily say, “Oh yes, we handle situations like yours every day.”  Those legal advocates know where the hidden light switches have been placed. When it comes to dealing with the issues of the frail, elderly, and disabled, Law Elder Law knows where those hidden light switches are.  Our areas of concentration are elder law estate planning, disability, Medicaid, and V.A. long term care benefits.  Our outstanding Law Elder Law team turns on the lights for our clients every day! towel-blog-towel-and-switch-pic-for-end-of-blog
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remaly-blog-remaly-family-photo-john-melinda-rick-alyssa-at-top How do you think you would feel if you could not remember a time that your father or mother did not have memory issues?  John Remaly was only nine years old when his dad was diagnosed with Young Onset Alzheimers.   He and his sister Alyssa have grown up adjusting to the gradual loss of their dad’s memory and ability to care for himself. I spoke to John and his mom, Melinda, and asked them to share with me some of the trials and victories that they have experienced during the last few years.  John told me that in his family, they have worked together to provide a united front to withstand Alzheimers’ attack on their family happiness.  “Most people, when dealing with something like this, start to fight and blame each other.  We have decided to use our gift of humor to find creative ways to work with my dad.”  He went on to share with me that his father, Rick Remaly, has always been a guy who loves the quick one-liner jokes and over-the-top comedy.  He says that the family enjoys shows like Will and Grace, Everybody Loves Raymond, and Family Guy.  John and his sister Alyssa love theater and acting, and they have memorized sketches from the different shows, complete with script, dialogue, jokes, and timing.  This helps keep their father engaged and laughing.  John quickly added, “Dad can still catch ‘quick humor’ and he is very easily amused.  In fact, one evening when he was feeling low, I decided that he and I should have a little fun and put calcium tablets in our mouths.  Do you know what happens when you put calcium tablets in your mouth?  It doesn’t hurt you, but you foam like a rabid dog!  Dad and I could not stop laughing.” Melinda added that life at home is not always humorous and that John has had to take on the role of being an adult and a caregiver for his father.  She admires the way John works with his father.  Rick seems to take direction better from John than anyone else.  “When you’re dealing with Alzheimers, you need to work together as a family and be open to sharing with loved ones and co-workers.  You need to be truthful in keeping people informed about the real situation at home.”  She went on to say that it’s very important to be able to go out with friends and to have support systems.  In fact, one of the key principles in helping the Remalys stay emotionally healthy is recognizing that from time to time, you have to get away from the caregiving at home. The Remaly family is about to embark on a new phase of life.  John Remaly has applied to, and been accepted at, Bradley University in Peoria, Illinois.  His dad and mom will be losing one of the pillars that support being able to provide for Rick at home.  John wrote a college admissions essay in October 2009 which detailed his experiences in growing up with Alzheimers.  The entire text is available by clicking on this link: John Remaly’s College Admissions Essay In both October 2008 and October 2009, Melinda Remaly organized a group to participate in the Alzheimers walk in Libertyville, Illinois called “On the Move for Alzheimers.”  Each year the family, friends, and John’s friends from school walked together to raise funds for Alzheimers research.  All the friends and family members wore t-shirts that said. “Walk for Rick.”  On the back of Mr. Remaly’s  t-shirt it said, “I am Rick.” We here at Law Elder Law are grateful that the Remaly family has chosen us to be their legal advocates. remaly-blog-walk-for-rick-rick-john-at-bottom
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Our Law Elder Law motto is “Serving Seniors and Those Who Love Them.”  Jo Buscemi, niece of Raffaella Calabrese (more affectionately known as “Auntie Florence”), shared these words with me and asked me to share them with you: Dear Mr. Law, Around October 2008 my mother and I had our first meeting with Mr. Jonathan Johnson in regards to my Aunt Raffaella Calabrese (“Auntie Florence”).  My aunt had suffered for years with dementia and had various (six in all) live-in caregivers.  I was told by many to keep my aunt in familiar surroundings for as long as possible and I being her power of attorney, I did exactly that. I came to your Aurora office one day and had our initial meeting with Jonathan.  I was very apprehensive.  Norridge HealthCare Facility recommended that I talk with you folks.  Well, after our second meeting with Jonathan and many phone calls and questions, we returned in about November of 2008 and contracted with your firm for assistance.  I put off as long as I possibly could placing Auntie in a nursing home, and then only because our sixth caregiver was returning to Poland and Auntie had exhausted all her life’s savings in addition to what I paid for from my savings.  I have MS (Multiple Sclerosis) and it was difficult to care for my aunt and mom, so I had to quit my job two years ago.  But this letter is not about me—it is about my Auntie Florence. Auntie went to live at Norridge HealthCare Facility on June 18, 2009 and sadly, she passed away on February 9, 2010.  We were very satisfied with this facility and its staff.  During this time I was assigned to Gina Salamone as our attorney at Law Elder Law.  I know I drove Gina and Sean (and everyone who answered the phone) nuts with all my calls and my frantic questions and nervousness.  I do believe Gina and I have a bond, though, and I trusted her with my precious family member and for that I am very grateful to her. I have recommended people to your firm and I have even gone as far as handing out Jonathan’s and Gina’s phone numbers—and advised these people to get all their ducks in a row now rather than wait. I have attached a picture of Auntie Florence and I wish you to express my family’s sincere appreciation for all the thousand times I called, ranted, cried, and went nuts—but your staff never gave up, not once.  Gina even went to the DHS regional manager on our behalf. Mr. Law, I really appreciate everything your entire staff did for Auntie, and I promise you I will always recommend people who need this type of help to your firm.  God bless everyone at Law Elder Law in Aurora, Illinois.  Thank you all again on behalf of Auntie Florence and the Buscemi family—we truly thank you.   Please enjoy the catered lunch on Thursday that my family is having delivered to your office. Jo Buscemi
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Here at Law Elder Law, I like to refer to our team as the ‘Teddy Bear Lawyers.”  On the other hand, my dear friend Kerry Peck is a man who I happily refer to as the “Grizzly Bear Lawyer.” He is at Cook County Courthouse every day that it is open.  Kerry is much more than a great courtroom attorney—he is a wonderful human being!  Recently, my daughter, Attorney Diana Law, wrote the following letter about Mr. Peck: “Kerry R. Peck is not only an extraordinary attorney, but he is an extraordinary human being.  He and his law firm are known for passionate advocacy, leadership in the legal and civic community, and holistic representation.  The firm Peck Bloom strives to fulfill their motto of “Winning Solutions In and Out of the Courtroom.” Mr. Peck represents clients who are emotionally drained and vulnerable. They may have just lost a loved one; or received a devastating medical diagnosis; or they are trying to protect the rights of their child with disabilities; or they are embroiled in tumultuous familial conflicts while administering a contested trust or estate.  Despite this, he provides his clients with dignity, unequalled representation, and superb service.  He meets his clients where they are, and he appreciates their need for compassion and empathy. Mr. Peck is not afraid of hard work, both physically and mentally.  He has a unique ability to take what he has learned from law books and his experience and merge them into a vigorous representation of his clients. Mr. Peck is a man of impeccable character who inspires me and others to be committed to professionalism and integrity.  As a young elder law attorney who is fortunate enough to call Kerry my mentor, I have turned to him with many questions concerning the interplay between ethics and my clients’ particular needs and circumstances.  He is an amazing sounding board and teacher.  He not only teaches me the correct technical answers, but also how these answers will affect the lives of the people we serve. He constantly opens my eyes to a much bigger picture then I would have seen before.  If we all navigated by his moral compass, we would never lose our way. Mr. Peck has dedicated his life to serving others and championing the rights of the elderly and persons with disabilities.  He is sought after by our local and state governments to advise judges and legislators on the laws affecting the elderly, including writing the State of Illinois “Elder Abuse and Neglect Act.” Despite the myriad hours Mr. Peck has clocked to serve his clients and the profession, he makes time to serve the community through civic, charitable, and religious organizations.  The commitment and dedication Mr. Peck demonstrates to bar associations and community organizations is the same commitment and dedication he shows to his family and clients.  I must also mention Mr. Peck’s unparalleled generosity.  He is a man who freely gives of his time, talents, and finances to those who are in need. Lastly, I have seen Mr. Peck in both personal and professional settings, and I admire the way he speaks to everyone with respect and good humor—whether it is a CEO or a waiter at the restaurant table.” We highly recommend Kerry Peck, Esq. and the fine legal team of Peck Bloom, when and if you are seeking excellent legal counsel for probate, guardianship, estate planning, or disability planning in Cook County.
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Law Elder Law is very proud to announce that our very own Diana Law has just become the youngest member of the Leading Lawyers Network here in Illinois!  The Leading Lawyers Network is a prestigious group to be a part of because the only way to become a member is to be nominated by your peers.  Even once you are nominated you aren’t actually accepted until you have been reviewed by a number of your peers.
“Leading Lawyers Network surveys lawyers, asking them which of their peers, indeed their competitors, they would recommend to a family member or friend if they could not take a case within their area of law or geographic region.”  (from the Leading Lawyers Website)
In fact, the Leading Lawyers Network takes only 5% or less of all the attorneys in Illinois.  We are proud to have TWO of our Law Elder Law attorneys be a part of this group, as Diana’s dad Rick Law is also a member of the Leading Lawyers Network. Of course, it’s no surprise to us that Diana was nominated.  In addition to being involved in the Kane County Bar Association and giving her time in many other service organizations, Diana is known for her focused and caring service to her clients. As for Diana, she’s pleased with the membership in part because she hopes it will be beneficial in dealing with the practical aspects of her job, which is namely ensuring that the elderly of our community receive the advice and protection they need.  Many clients come in feeling overwhelmed and scared, not even having known they needed an elder law attorney until the last minute.  Diana hopes she will be able to reach more seniors and their families this way. When asked what Diana likes most about elder law, she answered “I enjoy providing more than just legal services. In fact some days I feel more like a social worker. We get and give lots of hugs! I like that I can develop close relationships with my clients during a crisis time of life; I’m helping them when I know they need it most.” Congratulations Diana! To read the full article from Leading Lawyers Network click here: Leading Lawyers Article
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Value billing is based on the idea that one should charge a fee that is appropriate and ethically reasonable for the value provided to the client. It is my viewpoint that both clients and lawyers can enjoy better relationships if lawyers charge value-based fees. Read on to see how we might make value-billing work…

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