Elder Care Dilemma – One Family’s Solution

Kris Maser Attorney at Law

In my 30 years as an elder law attorney I have had the opportunity to counsel many families in the journey through the elder care maze. Families struggle with the want to help their elders, the high cost of care outside and even inside the home, the time commitment for care, jobs outside the house, layoffs because of the current economic condition, and caring for the family and children. I have seen some creative solutions and some disasters.

Let me share with you one family’s solution to their elder care dilemma. Mother – age 73 and father – age 84. Mother is healthy and has been caring for her husband who was diagnosed with Alzheimer’s disease 4 years ago. Mother admits she is tired and feels isolated. There are 4 children in the family. All children have children. Three of the 4 children live in Minneapolis, the 4th lives in San Francisco. Two of the children have been laid off from their jobs and have been looking for work for the past 8 months. One child, a daughter, is a registered nurse and is working. She is single with 3 small children.

All children get along. After much discussion with Mom and Dad alone in my office and later with the children, with the consent of the parents, a plan was devised to help mom care for dad, help single daughter with daycare issues, find employment for the 2 laid off children and keep the child in San Francisco involved.

In a nutshell this is what the plan looks like. The parents will pay to build an addition to RN daughter’s house to add a mother-in-law suite. (This daughter has the space on her property to do so.) The value of this addition to the house will be noted and used for further discussion about the division of the parents’ estate upon both parents’ death. A contract will be developed to determine who is responsible for what costs in the maintenance of the family compound.

RN daughter will continue to work but will monitor and oversee medications and be involved with medical issues for Dad. Mother will continue to provide care. The two children who are currently unemployed will be hired by Mother and Dad to augment care for Dad and for Mother, if Mother begins to need help. Social security will be withheld, along with FICA, FUTA and workers compensation insurance. The three children will allocate hours for care, develop cleaning schedule and meal preparation schedules, and be on sight to assist Mother with care for father and to care for father when Mother needs time away.

The children of RN daughter are school age, but need oversight after school. They will now be able to return home after school. RN daughter will discontinue the after school programs that the family used to provide daycare for her children while she is working.

AND the child in San Francisco? This child agreed to handle the investments, income taxes, set up the accounts, pay the parents bills and pay the salaries of siblings. This child will also make periodic trips to Minnesota to visit the parents and spell the other three children. (The parents don’t see this child enough and would like to pay for the child’s return to Minneapolis more often.)

We have a lot of things to determine here. How long can the parents stay independent? What happens if any of the children want out of the arrangement or if the parents want out? How do we determine salaries for the children? What other work is to be done around the house while the children are caring for the parents? Is any of this work going to benefit the RN daughter and if so should she pay the other children? Should RN daughter be paying siblings and parents for the child care? Who is responsible for meal preparation? Who will pay for groceries? Do the siblings have to bring their own lunches? And how will the parents allocate the funds that remain, if any, after their deaths?

Interesting, isn’t it. When care was being provided to parents during the depression often times there was no money to pay for expenses. Everyone just pitched in. The benefit now is that in this family they are choosing to provide care at home and pulling the entire family together to do it. Thankfully there are sufficient funds to carry this program on for some time.

How to Choose an Elder Law Attorney

Kris Maser Attorney at Law

There 4 law schools in the Twin Cities area. This means there are approximately 1,200 new lawyers graduating each year. With the economy as it is today these new lawyers as well as more seasoned lawyers are finding jobs hard to find. Choosing a good Elder Law attorney in these times is no easy task. The area of Elder Law encompasses a number of different areas of the law and some non-legal decisions, some of which are interdependent upon each other. Issues arise with real estate, estate planning and estate taxes, disability planning, income and capital gains taxes, caregiver issues, trusts, long-term care insurance issues, age discrimination, short and long-term disability, hospice care, contracts with caregivers, assisted living facilities, family members, housing options, medical insurance issues, Social Security, Medicare, Medicaid and Veteran’s benefits, both State and Federal, and a myriad of other related health care issues, including how to organize the family to maintain and oversee good care for the elder.

Since the area of Elder Law is complex, choosing an Elder Law attorney who practices and has substantial experience in the Elder Law arena will help you address all the concerns that can impact an elder’s quality of life. Here are some suggestions to help you choose the right law firm and attorney for your needs.

• Make sure that the attorney practices Elder Law. An estate planning attorney traditionally deals with how to distribute your wealth after you have passed away. An Elder Law attorney works in the area from retirement or disability to the end of life and beyond. Minnesota does not have a specific specialty for the Practice of Elder Law. Consequently it is important that you research the background of the attorney. The National Elder Law Foundation certifies Elder Law specialists in the United States. This certification doesn’t guarantee that one lawyer will serve you better than another, but it may be a good place to start. Be mindful of the certification though. This certification is national. Elder Law can and is very State specific. The national certification cannot deal with all the nuances of the laws in each individual state.

• Friends and other professionals are a very good source of information. Tap into these resources and find out who they recommend. If the attorney’s name comes up from different sources chances are the attorney knows what he/she is doing.

• Go to the law firm’s website and read the information about the attorney. There you may find additional information about how long the attorney has practiced in the Elder Law area, what roles the attorney has had in the elder bar and if the attorney participates in other organizations that work in this area. Perhaps you will find out if the attorney has had personal experience in his/her family with caring for a family member. How does the attorney give back to the community? And finally, find out how much of the attorney’s time is devoted to the Elder Law practice. Is it the focus of the firm or is Elder Law just a minor piece of the firm’s areas of practice?

Finding a good Elder Law attorney before a problem becomes a crisis is good advanced planning.

How Does the State of Minnesota Define a Vulnerable Adult?

By Kris L. Maser

Under Minn. Stat. section 626.5572 sebd.21 a vulnerable adult is defined as:
a person 18 years or older who:

• Receives certain services from a qualified provider
OR
• Regardless of services received, possesses physical, mental, or emotional infirmity or dysfunction

What is the purpose of this definition?
• To trigger a mandated report
• To guide responders
• To guide law enforcement

Here are some factors to consider in determining if someone is a Vulnerable Adult:
• Current medical condition
• Current financial condition
• Living arrangements
• Involvement of family members/friends/neighbors
• Recent life events (death of a spouse, inheritance, change in medical condition)

Red Flags – financial exploitation:
• Opening new bank account or unusual bank activity
• Checks being signed by someone other than the vulnerable adult
• Accumulation of bills or debts even though a power of attorney document exists
• Recent signature of power of attorney, joint checking account, mortgage documents
• Use of the vulnerable adults’ debit/credit card for purchases uncharacteristic to the vulnerable adult
• Large even sums withdrawn from the vulnerable adult’s accounts
• Removing all forms of communication between the vulnerable adult and others
• Firing of caregivers
• Change in doctors
• Significant financial changes with no advice from the attorney or financial advisor

Red Flags – personal/emotional abuse:
• Poor personal hygiene
• Withdrawal
• Loneliness
• Depression
• Paranoia
• Confusion or disorientation
• Loss of weight/dehydration
• Recent company by unfamiliar family or friend, wandering
• Memory loss of recent events/family

Who are mandated reporters under the statute?

A mandated reporter is a professional or professional’s delegate while engaged in:
1. Social services
2. Law enforcement
3. Education
4. The care of vulnerable adults
5. Any of the health related occupations referred to in Minn. Stat. section 214.01, subd. 2 including:
     • Board of examiners of nursing home administrators
     • Office of Unlicensed complementary and alternative health care practice
     • Board of medical practice
     • Board of nursing
     • Board of chiropractic examiners
     • Board of optometry
     • Board of physical therapy
     • Board of psychology
     • Board of social work
     • Board of marriage and family therapy
     • Office of mental health practice
     • Board of behavioral health and therapy
     • A person that performs the duties of the medical examiner or coroner
     • Board of dietetics and nutrition practice
     • Board of dentistry
     • Board of pharmacy
     • Board of podiatric medicine
     • Veterinary medicine
6. Any employee of a rehabilitation facility certified by the commissioner of jobs and training for vocational rehabilitation
7. Any employee or person providing services in a facility as defined in subdivision 6
8. A person that performs the duties of the medical examiner or coroner

Anyone can be a voluntary reporter. Note that attorneys, financial planners and Certified Public Accountants are not mandated reporters.

If you need to make a report the common entry point number for:
• Hennepin County is 612-348-8526
• Ramsey county is 651 266-4012

For the common entry points for other counties go to the Minnesota Board on Aging or call the Senior Linkage Line at 1-800-333-2433.

Social Security (Part 6 of 6)

By Kris L. Maser

Divorced Spouse Benefits:?
• The ex-spouse must have applied for benefits.?
• The spouse must be at least 62 for reduced benefits or 66 for full benefits.?
• The marriage lasted for 10 years or more.
• The person receiving the divorced-spouse benefit is currently not married.
• Also note that more than one ex-spouse can receive benefits on the same worker’s record.
• Benefits paid to one ex-spouse do not affect those paid to the worker, the current spouse or other ex-spouses.
• The worker will NOT be notified that the ex-spouse has applied for benefits.
• The divorced-spouse benefits stop upon remarriage.?

Social Security (Part 5 of 6)

By Kris L. Maser

Here is how to estimate your Social Security benefits. If you are 60 or older you will receive an annual statement in the mail. This statement should help you estimate the benefit. Or you can go to www.SocialSecurity.gov and click on Estimate your retirement benefits or use one of the calculators on the social security website.

Please pay careful attention to the information that Social Security gathers for your benefits. The highest 35 years of earnings are averaged and used to calculate the benefit. If this information is recorded incorrectly (we have seen this with our clients), or not recorded at all, this could substantially alter your benefits. It is important to check the website or statement at least annually to ensure its correctness.

Before you think about retiring and begin to collect your Social Security benefits we strongly urge you to talk to a financial planner who is well versed in the arena of social security benefits and who is familiar with your income, assets, lifestyle and health issues. Some decisions are irrevocable.

Social Security (Part 4 of 6)

By Kris L. Maser

What if you apply for early for Social Security benefits?

If you were born between 1943 and 1954:
• At age 62 your benefit will receive 75% of your total benefit plus the 2.8% annual cost of living adjustment.
• At age 63 your benefit will be 80% of your total benefit plus the 2.8% annual cost of living adjustment.
• At age 64 your benefit will be 86.7% of your total benefit plus the 2.8% annual cost of living adjustment.
• At age 65 you will receive 93.3% of the total benefit plus the 2.8% annual cost of living adjustment.

However if you wait to take benefits until later (and you were born between 1943 and 1954), look at what happens:
• At age 66 your benefit will be 100%.
• At age 67 the benefit increases to 108%.
• At age 68 the increase goes to 116%.
• At age 69 the benefit increases to 124%.
• And at age 70 the benefit goes to 132%.

Where else in the current market will you get 8% return on your money? Additionally, don’t forget to calculate another 2.8% annual cost of living adjustments. If you can afford to wait (and that takes some thinking and planning), this can be quite an investment.

Power of Attorney

Kris L. Maser

Recently, I talked about the need for high school graduates to complete their Health Care Directives upon turning age 18 to enable parents to make medical and health care decisions on their behalf. (This presumes your child will appoint you as his/her parent and not his/her BFF.) It is important to have these new adults think about adding a Power of Attorney for financial matters to their disability planning arsenal.

The Minnesota Statutory Power Of Attorney is a document that your child can sign which will enable you to access his/her financial information and manage assets. While both my sons were in college out of state, they maintained accounts in Minneapolis. Organization was not a strong suit with my kids at the time they left for college. I think they were more interested in what the world was going to be like without their helicopter mom.

At the time they met with the attorney for the Health Care Directive, we asked that they also discuss the Power of Attorney for Finances. Once completed, the Power of Attorney for finances allowed us, as parents, to transfer assets from the kid’s accounts to pay for schooling, to help them with bill payment, to access their accounts to ensure that the accounts were not overdrawn and to oversee their spending habits.

We also contacted the colleges to verify that the college would accept the Power of Attorney and if not, what documents were necessary to allow us access to their financial information from the college.

Although we, as parents, thought we had educated our kids about money management, it was a different story once they were on their own. What was taught in principal didn’t carry over into practice right away. Having access to their financial information helped us minimize their financial issues so that they could focus on their studies (and on the other issues impacting college life).

In a nutshell, disability planning is not limited to the elderly. Not one of us knows what is around the next bend in our lives and each of us should be prepared with the documents necessary to help our loved ones help us in a time of need.

The Health Care Directive and the Power of Attorney for Finances are two documents that we all hope we never have to use. BUT in the event a crisis happens they are great tools to keep the court system out of family matters.

Welcome to the Maser Amundson, P.A. Blog!

We are excited to announce our new blog, where we’ll be posting timely updates, news and events.  Be sure to check back often to stay in tune with the latest on Elder Law!

Geriatric Chat Series Session 3: Transitions of Care Across Settings & Over Time

When: Tue Sep 18, 2012 10:30am to 12pm  CDT

Where: 10:30 am-12:00 pm Normandale Lutheran Church (Choir Rehearsal Room) – 6100 Normandale Road, Edina, MN
Event Status: confirmed

Geriatric Chat Series Session 4: Advanced Care Planning

When: Tue Nov 27, 2012 10:30am to 12pm  CST

Where: 10:30 am-12:00 pm Normandale Lutheran Church (Choir Rehearsal Room) – 6100 Normandale Road, Edina, MN
Event Status: confirmed

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