Category: Dementia

Planning for Long Term Care Is Important

Planning for Long Term Care Is Important

Elder law attorneys have far too many stories of people who fail to plan, plan incorrectly or incompletely, or plan to fail by doing nothing at all, as described in the article “Elder Care: People in a pickle” from The Sentinel. Planning for long term care is important. Here’s a sad story.

A woman calls the elder law office because her husband fell at home—a common occurrence among the elderly. He was hospitalized and is now receiving rehabilitation in a nursing home. The treating physician recommends that the husband remain in the nursing home because he has significant limitations and his wife, who has her own medical issues, isn’t physically able to care for him.

The wife agrees. However, she has a host of challenges to overcome that were never addressed. The husband took care of all of the finances, for decades telling his wife not to worry. Now, she has no idea what their resources are. Can they afford to pay for his nursing home care? She doesn’t know. Nor does she have the authority to access their accounts, because there are accounts in her husband’s name only and she does not have access to them.

Her husband’s insistence of being the only one in control of their finances has put her in a terrible predicament. Without the estate planning documents to give her access to everything, including his own accounts, she can’t act. Can he now sign a Power of Attorney? Maybe—but maybe not, if it can be shown he lacks capacity.

If the couple cannot pay the nursing home bill, they have given their children a problem, since they live in Pennsylvania, where the state’s filial support law allows the nursing home to sue one or more of the children for the cost of their parent’s care. (This law varies by state, so check with a local elder lawyer to see if it could impact your family). Even if the wife knew about the family’s finances and could apply for public benefits, in this case his eligibility would be denied, as they had purchased a home for one of their children within five years of his being moved to the nursing home. Medicaid has a five-year look back period, and any large transfers or purchases would make the husband ineligible for five years.

If this sounds like a financial, legal and emotional mess, it’s a fair assessment.

Unexpected events happen, and putting off planning for them, or one spouse insisting “I’ve got this” when truly they don’t, takes a big impact on the future for spouses and family members. All of the decisions we make, or fail to make, can have major impacts on the future for our loved ones.

Other situations familiar to elder lawyers: a parent naming two children as co-agents for power of attorney. When she began showing symptoms of dementia, the two children disagreed on her care and ended up in court.

A father has guardianship for a disabled adult son. He promised the son he’d always be able to live in the family home. The father becomes ill and must move into a nursing home. Neither one is able to manage their own personal finances, and no financial or practical arrangements were made to fulfill the promise to the son.

No one expects to have these problems, but even the most loving families find themselves snarled in legal battles because of poor planning. Careful planning for long term care is important. It may not reduce the messy events of life, but it can reduce the stress and expenses. By choosing to exert some control over who can help you with decisions and what plans are in place for the future, you can leave a legacy of caring. If you would like to learn more about long term care issues, please visit our previous posts. 

Reference: The Sentinel (Aug. 19, 2022) “Elder Care: People in a pickle”

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Important to consider Long-Term Care Insurance

Important to consider Long-Term Care Insurance

It becomes especially important to plan for the future when the world around us seems so volatile and unpredictable. We can’t control future health care costs, but we can plan for them, says a recent article titled “Economic instability and the need to plan for long-term care” from The Indiana Lawyer. Failing to plan could mean lost assets and a lost legacy. It is important to consider long-term care insurance as you get older.

According to Genworth’s Cost of Care survey, from 2004 to 2021, the cost of long-term care has outpaced inflation by a large margin. Many of the increases were driven by supply and demand issues. There aren’t enough people to care for the growing population of people needing services, which will continue to be the case for at least the next decade. A total of 10,000 boomers turn 65 every day and 70% will require care and support services in their lifetimes.

How can assets be protected from long-term costs?

One of the most frequently used tools is an asset protection trust or an irrevocable trust. The irrevocable trust cannot be modified, amended, or terminated without permission of the grantor’s beneficiary or beneficiaries. Once the grantor transfers assets into the trust, the grantor no longer has the rights of ownership. The trust can be designed to minimize taxation, maximize access to long-term benefits and protect assets.

The trust must be drafted properly, so trust income and principal, if needed, can be accessed.

The timing is critical. Asset protection trusts must be created when there is no immediate health care crisis, and the grantor has no need for long-term care. The best trust is created when the person is in good health and of sound mind.

Those who are nearing retirement, passed retirement age or who may have health issues in the distant future and expect to need Medicaid in the future are best candidates for an asset protection trust.

Medicaid’s Five Year Look Back Period

Planning needs to be done at least five years in advance, as Medicaid looks at the applicant’s past five year’s finances to see if any assets were sold or gifted for under market value. Transferring assets to an irrevocable trust is treated as a gift and violates the five-year look back, making the person ineligible for Medicaid coverage. Nursing home care will have to be paid out-of-pocket until the person becomes eligible.

Asset protection strategies are available for those who need immediate protection of assets. However, they have to done quickly and correctly with an estate planning elder law attorney. People who have suffered a fall and have significant injuries or who have received a diagnosis of a difficult disease should speak with an elder law attorney in a timely manner. They’ll need to discuss preparing for a Medicaid application, what assets can be protected and steps they need to take. It is important to consider long-term care insurance before you reach a point when it is needed. The earlier the plan is put into place, the better. If you would like to learn more about long-term care insurance, please visit our previous posts. 

Reference: The Indiana Lawyer (Aug. 3, 2022) “Economic instability and the need to plan for long-term care”

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Spotting early Dementia Symptoms is Critical

Spotting early Dementia Symptoms is Critical

It’s easy to miss the first signs of cognitive decline. Spotting early dementia symptoms is more critical than ever: the Alzheimer’s Association projects that 12.7 million people 65 and older will have some form of dementia by 2050. That’s why a lot of research on behavioral changes associated with dementia could help in the early detection of the neurodegenerative condition. However, this subtle action is often ignored by people with dementia and their families.

Yahoo’s recent article entitled “This Is the No. 1 Dementia Symptom People Ignore, Doctors Say” explains that many people believe that memory loss is the only sign of dementia. However, there’s much more to this debilitating condition than forgetfulness. There are a number of other behavioral and psychological symptoms associated with dementia, the most common of which are apathy, depression, irritability, agitation and anxiety. The rarest symptoms are euphoria, hallucinations and lack of inhibition. Many of these are subtle at first. Therefore, understanding what to look for is critical in early detection. It can significantly affect the course of your disease and delay its progression. This behavior change can be seen many years before a dementia diagnosis.

A 2020 study in JAMA Internal Medicine found, when looking at the medical records and consumer credit reports of more than 80,000 people aged 65 and older who were Medicare beneficiaries, people who developed dementia were significantly more likely to have financial problems and poor credit scores. These financial problems became more prevalent following a dementia diagnosis.

Monica Moreno, Senior Director of Care and Support at the Alzheimer’s Association, tells Best Life, “While there are several signs or symptoms of dementia, challenges with problem-solving or planning can cause a person to mismanage their finances. Other dementia-related symptoms that can adversely affect money management or personal finances include poor judgment and difficulty completing familiar tasks.”

The study concluded that missed bill payments lead to higher penalties and interest fees that are detrimental to your financial well-being. Therefore, financial guidance is essential for dementia patients after diagnosis.

“During the early stages of dementia, a person may be able to do simple tasks like paying bills but struggle with more complicated tasks, like managing investments or making a decision on large purchases,” explains Moreno. “Since dementia is often progressive, these challenges will increase over time. Therefore, family members need to identify these potential signs early and intervene as soon as possible.”

It’s important to spot financial behavior changes for early detection of dementia. Common signs include:

  • The inability to balance checking accounts
  • Consistently making late payments on credit cards; and
  • Overspending.

Moreno adds, “People with dementia are susceptible to fraud, including identity theft, insurance scams and get-rich-quick schemes. Allowing these problems or potential threats to go unaddressed can put individuals living with dementia [and their families] at great financial risk.”

Spotting early dementia symptoms is critical to protecting older adults and their families from the burden of unnecessary financial stress.

The JAMA Internal Medicine study advises, “Families should be counseled about the potential need to help with financial management following [dementia] diagnosis.” If you are interested in learning more about dementia and other cognitive disorders, please visit our previous posts. 

Reference: Yahoo! (Aug. 8, 2022) “This Is the No. 1 Dementia Symptom People Ignore, Doctors Say”

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Grounds for Contesting a Will

Grounds for Contesting a Will

As a beneficiary of a will, if you don’t agree with how the assets are being distributed, you may have grounds for contesting the will. MSN’s recent article entitled “Contesting a Will? You Might Not Need a Lawyer” says to do this you must have a legitimate legal reason to challenge the will, such as one of the most common arguments:

  • Lack of mental capacity. If the person making the will (the “testator”) wasn’t “of sound mind,” he or she may not understand their decisions. The testator must be able to understand what they own, who their natural heirs are and what they are giving and to whom.
  • Fraud, undue influence, or forgery. Some people are tricked into signing a will, are forced to create a will under duress, or have their signature forged.
  • Multiple wills. In this situation, the one that was made most recently is often the one that the courts will decide is valid. However, wills created immediately before death may be contested due to undue influence, lack of mental capacity, or other reasons.
  • The state requirements aren’t met. Every state has specific requirements as to what must be in a will, the way in which it’s signed and the number of witnesses required. If these elements aren’t met, then the will may not be valid.
  • Location. Some states may not recognize wills created in another state.

To contest the will, you must have grounds, or legal standing, which means you must meet one of these requirements:

  • A prior will designates you as a beneficiary;
  • The current will designates you as a beneficiary;
  • You’re the beneficiary of a more recent will made after the one in question; or
  • You would be an heir if there was no will, and the state’s laws of intestacy were applied.

Your attorney will next file a petition in the state probate court where the estate is under probate. This tells the probate court that you are a beneficiary and the estate that you are contesting the will. If your case is not settled, it goes to court where you’ll make your argument as to why the will should be changed. The court will decide the outcome of your case.

A way to keep family members  from fighting over an estate is add a no-contest clause into the will. This disinherits any beneficiary who challenges a will, if their challenge fails. In order words, if you don’t win your challenge, you get nothing from the estate. If you would like to read more about wills and probate, please visit our previous posts.

Reference: MSN (May 30, 2022) “Contesting a Will? You Might Not Need a Lawyer”

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Even Young Adults Need a Will

Even Young Adults Need a Will

Even young adults need a will. Everyone, age 18 and older, needs at least some basic estate planning documents. That’s true even if you own very little. You still need an advance health care directive and a power of attorney. These documents designate agents to make decisions for you, in the event you become incapacitated.

The Los Angeles Daily News’ recent article entitled “Estate planning, often overwhelming, starts with the basics” reminds us that incapacity doesn’t just happen to the elderly. It can happen from an accident, a health crisis, or an injury. To have these documents in place, you just need to state the person you want to make decisions for you and generally what those decisions should be.

An experienced estate planning attorney will help you draft your will by using a questionnaire you complete before your initial meeting. This helps you to organize and list the information required. It also helps the attorney spot issues, such as taxes, blended families and special needs. You will list your assets — real property, business entities, bank accounts, investment accounts, retirement accounts, stocks, bonds, cars, life insurance and anything else you may own. The estimated or actual value of each item should also be included. If you have life insurance or retirement plans, attach a copy of the beneficiary designation form.

An experienced estate planning attorney will discuss your financial and family situation and offer options for a plan that will fit your needs.

The attorney may have many different solutions for the issues that concern you and those you may not have considered. These might include a child with poor money habits, a blended family where you need to balance the needs of a surviving spouse with the expectations of the children from a prior marriage, a pet needing ongoing care, or your thoughts about who to choose as your trustee or power of attorney.

There are many possible solutions, and you aren’t required to know them before you move ahead with your estate planning.

Young adults need a will. If you are an adult, you know generally what you own, your name and address and the names of your spouse and children or any other beneficiaries you’d like to include in your plan. So, you’re ready to move ahead with your estate planning. The key is to do this now and not procrastinate. If you would like to learn more about estate planning for young adults, please visit our previous posts.

Reference: Los Angeles Daily News (July 24, 2022) “Estate planning, often overwhelming, starts with the basics”

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Geriatric Care Managers can make Life Easier

Geriatric Care Managers can make Life Easier

Geriatric care managers (or GCMs) help seniors deal with their burdens in an efficient, organized manner. Geriatric care managers can simply make life easier for both you and your senior, says Seniors Matter’s recent article entitled “What is a geriatric care manager?”

Seniors Matter created a guide to provide seniors with detailed information about geriatric care managers, including what they do and how to locate the most qualified individuals in your area. If you’re not sure about the role of a geriatric care manager, it can be broken down into two parts: First of all, “geriatric care” simply refers to geriatric medicine, which focuses on health care services for elderly individuals. The second part of the phrase is quite straightforward, since a “manager” is simply someone with strong organizational skills who is in charge of making important decisions.

Geriatric care managers are knowledgeable and organized individuals skilled in advocacy and care coordination for seniors. They are specialists in senior care who can guide family caregivers and others in providing the best support for their seniors. In fact, many family caregivers think of senior care managers as unofficial family members.

They’re people you can trust to make the right choices when it comes to eldercare services, and they often develop bonds with the entire family.

Geriatric care managers have strong qualifications. Many of them have professional experience in case management, physical therapy, nursing, social work, or occupational therapy. Some have worked as gerontologists. Note that a GCM doesn’t need to directly provide seniors with all of the medical treatment they need. A significant part of their role involves finding other qualified medical professionals and senior care providers who can offer more specialized assistance.

GCMs are especially helpful in long-distance care situations. They can ensure quick response times in the case of an emergency.

Even if the time commitment of informal caregiving isn’t an issue for you, a geriatric care manager can be a welcome source of advice, guidance, and advocacy.

You can make life easier and feel confident about important decisions when you consult with qualified geriatric care managers.  They can help you with the complex issues associated with proper care coordination. If you would like to learn more about elder care and elder law, please visit our previous posts. 

Reference: Seniors Matter (July 7, 2022) “What is a geriatric care manager?”

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There are Alternatives to Guardianship

There are Alternatives to Guardianship

Guardianships are drastic and very invasive. They strip individuals of their legal autonomy and establish the guardian as the sole decision maker. To become a guardian requires strong evidence of legal incapacity, and approval by a judge, explains an article titled “Guardianships Should Be a Last Resort–Consider These Less Draconian Options First” from Kiplinger. They should not be undertaken unless there is a serious need to do so. Once they’re in place, guardianships are difficult to undo. There are alternatives to guardianship.

If an elderly person with dementia failed to make provisions durable powers of attorney for health care and for financial matters before becoming ill, a guardianship may be the only ways to protect the person and their estate. There are also instances where an aging parent is unable to care for themselves properly but refuses any help from family members.

Another scenario is an aging grandparent who plans to leave funds for minor beneficiaries. Their parents will need to seek guardianships, so they can manage the money until their children reach the age of majority.

Laws vary from state to state, so if you might need to address this situation, you’ll need to speak with an estate planning attorney in the elderly parent or family member’s state of residence. For the most part, each state requires less restrictive alternatives to be attempted before guardianship proceedings are begun.

Alternatives to guardianship include limited guardianship, focused on specific aspect of the person’s life. This can be established to manage the person’s finances only, or to manage only their medical and health care decisions. Limited guardianships need to be approved by a court and require evidence of incapacity.

Powers of attorney can be established for medical or financial decisions. This is far less burdensome to achieve and equally less restrictive. A Healthcare Power of Attorney will allow a family member to be involved with medical care, while the Durable General Power of Attorney is used to manage a person’s personal financial affairs.

Some families take the step of making a family member a joint owner on a bank, home, or an investment account. This sounds like a neat and simple solution, but assets are vulnerable if the family member has any creditor issues or risk exposure. A joint owner also doesn’t have the same fiduciary responsibility as a POA.

An assisted decision-making agreement creates a surrogate decision-maker who can see the incapacitated person’s financial transactions. The bank is notified of the arrangement and alerts the surrogate when it sees a potentially suspicious or unusual transaction. This doesn’t completely replace the primary account holder’s authority. However, it does create a limited means of preventing exploitation or fraud. The bank is put on notice and required to alert a second person before completing potentially fraudulent transactions.

Trusts can also be used to protect an incapacitated person. They can be used to manage assets, with a contingent trustee. For an elderly person, a co-trustee can step in if the grantor loses the capacity to make good decisions.

Planning in advance is the best solution for incapacity. Guardianship is a very significant step, so consider the alternatives first. Talk with an experienced estate planning attorney to protect loved ones from having to take draconian actions to protect your best interests. If you would like to read more about guardianships, please visit our previous posts. 

Reference: Kiplinger (July 7, 2022) “Guardianships Should Be a Last Resort–Consider These Less Draconian Options First”

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Deciding where to Store your Documents is Critical

Deciding where to Store your Documents is Critical

It’s a common series of events: an elderly parent is rushed to the hospital in the middle of the afternoon and once children are notified, the search for the Power of Attorney, Living Will and Health Care Power of Attorney begins. It’s easily avoided with planning and communication, according to an article from The News-Enterprise titled “Give thought to storing your estate papers.” However, just because the solution is simple doesn’t mean most people address it. Deciding where to store your documents is critical.

As a general rule, estate planning documents should be kept together in a fire and waterproof container in a location known to fiduciaries.

Most people think of a bank safe deposit box as a protected place. However, it’s not a good location for several reasons. Individuals may not have access to the contents of the safe deposit box, unless they are named on the account. Even with their names on the account, emergencies don’t follow bankers’ hours. If the Power of Attorney giving the person the ability to access the safe deposit box is inside the safe deposit box, bank officials are not likely to be willing to open the box to an unknown person.

A well-organized binder of documents in a fire and waterproof container at home makes the most sense.

Certain documents should be given in advance to certain agencies or offices. For instance, health care documents, like the Health Care Power of Attorney and Advance Medical Directive (or Living Will) should be given to each healthcare provider to keep in the person’s medical record and be sure they are accessible 24/7 to health care providers. Make sure that there are copies for adult children or whoever has been designated to serve as the Health Care Power of Attorney.

Power of Attorney documents should be given to each financial institution or agency in preparation for use, if and when the time comes.

It may feel like an overwhelming task to contact banks and brokerage houses in advance to make sure they accept a Power of Attorney form in advance. However, imagine the same hours plus the immense stress if this has to be done when a parent is incapacitated or has died. Banks, in particular, require POAs to be reviewed by their own attorneys before the document can be approved, which could take weeks to complete.

Depending upon where you live, Durable General Powers of Attorney may be filed at the county clerk’s office. If a POA is filed but is later revoked and a new document created, or if a fiduciary needs to convey real estate property with the powers conferred by a POA, the document at the county clerk’s office should be updated.

Last will and testaments are treated differently than POA documents. Wills are usually kept at home and not filed anywhere until after death.

Each fiduciary listed in the documents should be given a copy of the documents. This will be helpful when it’s time to show proof they are a decision maker.

Having estate planning documents properly prepared by an experienced estate planning attorney is the first step. Step two is ensuring they are safely and properly stored, so they are ready for use when needed. Deciding where to store your documents is critical to ensuring your planning happens the way you designed. If you would like to learn more about estate planning documents, please visit our previous posts. 

Reference: The Times-Enterprise (June 11, 2022) “Give thought to storing your estate papers”

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Tips to avoid a Contested Will

Tips to avoid a Contested Will

A last will and testament is the document used to direct your executor to distribute assets and property according to your wishes. However, it’s not uncommon for disgruntled or distant family members or others to dispute the validity of the will. There are tips to avoid a contested will. A recent article titled “5 Reasons A Law Will May Be Contested” from Vents Magazine explains the top five factors to keep in mind when preparing your will.

Undue influence is a commonly invoked reason for a challenge. If a potential beneficiary can prove the person making the will (the testator) was influenced by another person to make decisions they would not have otherwise made, a will challenge could be brought to court. Undue influence means the testator’s decision was significantly affected by a person who stood to gain something by the outcome of the will and made a concerted effort to change the testator’s mind.

Even if there was no evidence of fraud, any suspicion of the testator’s being influenced is enough for a court to accept a case. If you think someone unduly influenced a loved one, especially if they suffer from any mental frailties or dementia, you may have cause to bring a case.

Outright fraud or forgery is another reason for the will to be contested. If there have been many erasures or signature styles appear different from one document to another, there may have been fraud. An estate planning attorney should examine documents to evaluate whether there is enough cause for suspicion to challenge the will.

Improper witnesses. The testator is required to sign the will with witnesses present. In some states, only one witness is required. In most states, two witnesses must be present to sign the will in front of the testator. A beneficiary may not be a witness to the signing of the will. Some states have changed laws to allow for remote signings in response to COVID. If the rules have not been followed, the will may be invalid.

Mistaken identity seems farfetched. However, it is a common occurrence, especially when someone has a common name or more than one person in the family has the same name, and the document has not been properly signed or witnessed. This could create confusion and make the document vulnerable to a challenge. An experienced estate planning attorney will know how to prepare documents to withstand any challenges.

Capacity in the law means someone is able to understand the concept of a will and contents of the document they are signing, along with the identities of the people to whom they are leaving their assets. The testator doesn’t need to have perfect mental health, so people with mild cognitive impairments, such as depression or anxiety, may make and sign a will. A medical opinion may be needed, if there might be any doubt as to whether a person had testamentary capacity when the will is signed.

A contested will can be time-consuming and expensive, so keep these tips in mind to avoid it, especially if the family includes some litigious individuals. If you would like to learn more about drafting a will, please visit our previous posts. 

Reference: Vents Magazine (May 6, 2022) “5 Reasons A Law Will May Be Contested”

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The Estate of The Union Season 2, Episode 2 – The Consumer's Guide to Dying is out now!

 

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The Estate of The Union Season 2, Episode 2 – The Consumer's Guide to Dying is out now!

The Estate of The Union Season 2, Episode 2 – The Consumer’s Guide to Dying is out now!

The Estate of The Union Season 2, Episode 2 – The Consumer’s Guide to Dying is out now!

Dealing with a funeral home after the death of a loved one is something no one relishes.

In this episode of the Estate of the Union, we interview Nancy Walker, the Executive Director of the Funeral Consumers Alliance of Central Texas, a non-profit that helps people navigate this unpleasant task. Nancy hits on the perils of the process and even discusses “natural burials.” Learn what the organization is and how they are an important resource for making educated choices and arrangements prior to end of life.

This is fun, innovative and informative. Despite the topic, you will love it!

To learn more about Nancy Walker and the Funeral Consumers Alliance of Central Texas, please visit their website: www.fcactx.org

We’ve got fifteen episodes posted and more to come. We hope you will enjoy them enough to share it with others. These are available on Apple, Spotify and other podcast outlets. Click on our logo to listen on Spotify.

In each episode of The Estate of The Union podcast, host and lawyer Brad Wiewel will give valuable insights into the confusing world of estate planning, making an often daunting subject easier to understand. It is Estate Planning Made Simple! The Estate of The Union Season 2, Episode 2  – The Consumer’s Guide to Dying can be found on Spotify, Apple podcasts, or anywhere you get your podcasts. Please click on the link below to listen to the new installment of The Estate of The Union podcast. We hope you enjoy it.

The Estate of The Union Season 2 premiere - Millennials’ Mysteries Uncovered Part 2

Texas Trust Law focuses its practice exclusively in the area of wills, probate, estate planning, asset protection, and special needs planning. Brad Wiewel is Board Certified in Estate Planning and Probate Law by the Texas Board of Legal Specialization. We provide estate planning services, asset protection planning, business planning, and retirement exit strategies.

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Information in our blogs is very general in nature and should not be acted upon without first consulting with an attorney. Please feel free to contact Texas Trust Law to schedule a complimentary consultation.
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