Documents needed for Advance Care Planning

February 8, 2023

Starting discussions earlier helps ensure that a person with dementia stays involved and understands the planning process. In the same fashion, regular reviews of plans over time are beneficial for ensuring that their wishes are carried out. There are a few essential documents needed for advance care planning that you need to have included.

Health News’ recent article entitled “Can Someone With Dementia Sign Legal Documents?” cautions that, when family members don’t know the preferences of their loved one, they have difficulties and stress in making decisions. Family members may also have feelings of guilt, self-doubt and stress while making advanced care decisions.

Laws in each state may differ. Working with an experienced elder law attorney can help seniors interpret state laws, plan how wishes should be carried out and understand financial options.

Geriatric care managers, trained social workers, or nurses can also offer support to those living with dementia, as well as their families.

While advance care planning, families and their loved ones with dementia should create a plan for long-term care and plan for funeral arrangements in advance.

Advance care planning documents commonly include the following:

A durable power of attorney for healthcare names someone to function as a proxy for the person with dementia, when he or she may be unable to make healthcare decisions for themselves.
A living will includes an individual’s wishes for end-of-life treatment. This can concern specific procedures such as dialysis, tubal feeding, or blood transfusion. If the person becomes permanently unconscious (coma), families can make treatment decisions based on wishes expressed in a living will.
A do-not-resuscitate order (DNR) is put with a patient’s chart when the patient doesn’t want to receive cardiopulmonary resuscitation (CPR) if their heart stops or breathing ceases. A doctor needs to sign these DNR orders before they can be placed in the patient’s charts.

Advance care planning can be a sensitive topic for families and those with dementia.

Getting medical and legal advice early is helpful in planning advance care. Involving the person with dementia in the planning process also helps families ensure that the wishes of the patient are respected. Work with your estate planning attorney to ensure these needed documents for advance care planning are included in your overall planning. If you would like to learn more about advance care planning, please visit our previous posts.

Reference: Health News (Jan. 11, 2023) “Can Someone With Dementia Sign Legal Documents?”

How the Guardianship Process Works

January 17, 2023

For family members of the estimated 6.5 million dementia patients in the U.S., it is crucial to understand whether guardianship may be an option for their loved one. A recent article from Next Avenue titled “Thinking of Becoming a Guardian?” explains how the guardianship process works and what factors go into the decision-making process.

Guardianship is the position of being responsible for someone else. State courts usually appoint a guardian to make decisions for a person, if the court finds that person to be incapacitated or unable to make safe and reasonable decisions for themselves. People who are placed under guardianship, known as “wards,” often lose their independence in making financial, legal and health care decisions.

If full guardianship is awarded, the person cannot make decisions about whether they may vote, marry, where they live, or make their own end-of-life decisions.

Two tasks that are evaluated when considering guardianship are a person’s ability to manage personal finances and to take medications as prescribed.

The court may call on a geriatrician or psychiatrist to evaluate the person’s functional behavior, cognitive function, disabling conditions and ability to meet their essential needs.

There are benefits to guardianship for someone who is not able to care for themselves. It ideally creates a safety net for a person who cannot make informed decisions for themselves.

this, of course, assumes that the guardian is honest and accountable, which is not always the case. The inconsistencies plaguing the guardianship system include minimum standards for guardians, lack of regular independent reviews of the need for guardianship and lack of educational requirements for guardians.

Once guardianship is assigned, there is a tendency for the person to become lost when no follow-up is done. The very same person who lacks capacity to care for themselves is not going to be able to advocate for themselves, contact an attorney or access funds for court proceedings.

There is also a tendency to assign full guardianship for a person, rather than less restrictive alternatives.

There are alternatives, but they require planning and discussion. More than 40% of Americans have not discussed their wishes for end-of-life care with their loved ones, according to an article in the Journal of the American Geriatrics Society. Families should have a conversation at the first sign of memory loss or when preparing for retirement regarding wishes for end-of-life care and write them down as part of an Advanced Directive—also known as a Living Will and Health Care Power of Attorney—when preparing their estate plan.

Another important document, although not legally binding, is a “Value History,” where you share your values and beliefs as they may impact care choices.

Designate a Power of Attorney and list two or even three back-up candidates. This person will be responsible for financial, legal and personal matters, avoiding the need for guardianship.

Appointing a family member or friend as a guardian is the ideal solution. However, there are instances when the best person to be a guardian is not a family member, but a court-appointed outsider. This relieves the family of being the ones who need to inform a person suffering from dementia with the news of having to move into a nursing home facility or sifting through financial records to learn that the family home is in foreclosure. The family can focus on being supportive and loving, while the guardian deals with the sometimes harsh realities of the person’s life.

Speak with your estate planning attorney to learn about how the guardianship process works, and whether it may be the right move for your family. If you would like to learn more about guardianships, please visit our previous posts.

Reference: Next Avenue (Dec. 23, 2022) “Thinking of Becoming a Guardian?”

Guardianship is a Valuable tool to Protect Loved Ones

December 5, 2022

Guardianship is a valuable tool to protect loved ones. It is usually an act of last resort, embarked upon when there is no lesser restrictive means of protecting a person. There are steps to be taken to avoid being placed under guardianship, including signing a durable financial power of attorney and a medical power of attorney to allow someone of your choosing to make important decisions for you.

If you have these documents and later become incapacitated, there won’t be a need for guardianship because you’ll have an agent or agents in place to act on your behalf.

It is when there has been no advance planning and you develop a significant cognitive impairment when guardianship becomes necessary, according to a recent article, “Guardianship gone good: Protections afforded by guardianship may be necessary,” from The Dallas Morning News.

What if the powers of attorney you had so diligently prepared became invalid? It is possible but can be easily avoided if you take the right preventive steps.

First, make sure to review these documents every now and then. If someone you named to serve in one of these roles has moved far away, they may not be able to serve. Do you have a second person named for financial or medical POA? The same could occur if the person named became incapacitated, died, or declined to serve.

Second, you could have an agent who does not act in your best interest, often referred to as a “rogue” agent. This could be worse than having no agent.

Third, if you are acting against your own best interest, there’s not much a power of attorney can do to protect you from yourself. If your incapacity leads you to making bad decisions which jeopardize your own welfare, a court may create a guardianship to protect you from yourself.

This is why guardianships are nuanced, with every situation requiring a different solution.

For example, levels of incapacity vary. If the cognitive impairment is mild, you may not need someone to act for you. If your impairment is severe and leads to self-harm, violent outbursts or harm to others, a guardianship may become necessary.

Another concern for families whose loved ones have become incapacitated is their vulnerability to scammers.

While guardianship receives a lot of negative coverage in the media, it is, in many instances, a useful and valuable tool used to protect loved ones. If you would like to learn more about guardianships, please visit our previous posts.

Reference: The Dallas Morning News (Nov. 13, 2022) “Guardianship gone good: Protections afforded by guardianship may be necessary”

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How to Manage Aging Parents Finances

October 5, 2022

A day will come when age begins to catch up with your parents and they will need help with their finances. This begs the question of how to manage your aging parents finances. Even if your parents don’t want to feel dependent, when you think they need your assistance, you can approach the issue with sensitivity and extend your support for the management of their finances, says Real Daily’s recent article entitled “5 Tips to Manage an Aging Parent’s Finances.” Here are some tips:

Start the conversation early. Your parents may not need your help with the handling of their financial matters right away. However, it is smart to begin the conversation early. Approach the issue of who will manage the financial responsibilities when they’re no longer able to do it. Parents should select a trusted family member by providing their advance written consent. This will let you to talk about your parents’ financial issues with financial advisors, doctors and Medicare representatives and carry out timely financial planning.
Create a list of all pertinent legal and financial documents. Prepare a list of your parents’ important contacts, bank account details and locations of any stored documents, like wills, property deeds, insurance policies and birth certificates. Make certain all information and documentation is accurate and up to date. If information needs to be modified because of a change of circumstances, this is time to apprise them of it and help them do what’s needed.
Consider executing a power of attorney. A competent adult can sign a power of attorney to authorize another person to make decisions on their behalf. A power of attorney for a specific purpose may cover medical, financial, or other decisions, and it may be designed to give limited or more sweeping powers. When your parents sign a power of attorney with you named as their attorney in fact, it will legally empower you to make key decisions when they can’t. An elder law attorney can help you draft an appropriate power of attorney according to your situation.
Document your actions and keep others in the know. Transparent communication will help you avoid misunderstandings or controversy within your family. Keep your parents, siblings and any other loved ones involved with your family informed about your actions. No matter how noble your intentions may be, if others are kept in the dark, it can raise questions about your motives. Managing the finances of aging parents is a lot of work, and you can ask for the support of family members or at least keep the lines of communication open.
Don’ comingle your finances with your parents’ plans. While it may look to be a convenient or cost-effective thing to do, it’s never a good idea to combine your parents’ finances with your own. Keep them separate. Using your parents’ money for your purposes or your own money to help them out is usually a slippery slope that should be avoided. Don’t forget about your own financial goals and retirement savings while you focus on helping your parents.

Take the time to sit down with your parents and their estate planning attorney to have an understanding of their existing planning and how to manage your aging parents finances. If you are interested in learning more about managing the finances or care of your elderly parents, please visit our previous posts.

Reference: Real Daily (Sep. 9, 2022) “5 Tips to Manage an Aging Parent’s Finances”

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Geriatric Care Managers can make Life Easier

August 3, 2022

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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Planning for Special Needs Requires Care

May 3, 2022

Planning for loved ones with special needs requires great care. When a family includes a disabled individual, sometimes referred to as a “person with special needs,” estate planning needs to address the complexities, as described in a recent article titled “Customize estate plan to account for disabled beneficiaries” from The News-Enterprise. Failing to do so can have life-long repercussions for the individual.

This often occurs because the testator, the person creating the estate plan, does not know the implications of failing to take the disabled person’s situation into consideration, or when there is no will.

The most common error is leaving the disabled beneficiary receiving an outright inheritance. With a simple will, or no will, the beneficiary receives the inheritance and becomes ineligible for public benefits they may be receiving. The disruption can impact their medical care, housing, work and social programs. It may also lead to the loss of their inheritance.

If the disabled beneficiary does not currently receive benefits, it does not mean they will never need them. After the death of a parent, for instance, they may become completely reliant on public benefits. An inheritance will put them in jeopardy.

A second common error is naming the caregiver as the beneficiary, rather than the disabled individual. This causes numerous problems. The caregiver has the right to do whatever they want with the assets. If they no longer wish to care for the beneficiary, they are under no legal obligation to do so.

If the caregiver has any liabilities of their own, or when the caregiver becomes incapacitated or dies, the assets intended for the disabled individual will be subject to any estate taxes or creditors of the caregiver. If the caregiver has any children of their own, they will inherit the assets and not the disabled person.

The caregiver does not enjoy any kind of estate tax protection, so the estate may end up paying taxes on assets intended for the beneficiary.

The third major planning mistake is using a will instead of a trust as the primary planning method. A Special Needs Trust is designed to benefit a disabled individual to protect the assets and protect the individual’s public benefits. The trust assets can be used for continuity of care, while maintaining privacy for the individual and the family.

Planning for individuals with special needs requires great care, specifically for the testator and their beneficiaries. Families who appear to be similar on the outside may have very different needs, making a personalized estate plan vital to ensure that beneficiaries have the protection they deserve and need. If you would like to learn more about special needs issues, please visit our previous posts.

Reference: The News-Enterprise (March 15, 2022) “Customize estate plan to account for disabled beneficiaries”

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What Do You Need to Age in Place?

April 27, 2022

Many Americans prefer the idea of living out their gold years at home and “age in place”, rather than relying on family or assisted living. So what do you need to age in place? Home modification is the official term (from the Americans with Disabilities Act) for renovations and remodels aimed for use by the elderly or the impaired. It means physically changing your home, removing potential hazards and making it more accessible, so you can continue living in it independently.

Bankrate’s recent article entitled “The best home modifications for aging in place” reports that home modifications can be pricey—typically ranging from $3,000 to $15,000, with the average national spend being $9,500. However, it can be a worthwhile investment. You can save money by doing the right home modifications. That is because the longer you can safely live in your home, the less you will need to pay for assisted living care.

The best aging-in-place home modifications align with “universal design,” an architectural term for features that are easy for all to use and adaptable, as needs dictate. This includes additions and changes to the exterior and interior of a home. Some of the simplest home modifications include DIY jobs:

Adding easy-grip knobs and pulls, swapping knobs for levers
Installing adjustable handheld shower heads
Rearranging furniture for better movement
Removing trip hazards; and
Installing mats and non-slip floor coverings.

Next, are some more complex home modifications. These probably would need a professional contractor, especially if you want them up to code standards:

Installing handrails
Adding automatic outdoor lighting
Installing automatic push-button doors
Leveling flooring; and
Installing doorway ramps

There are also home modifications that can be done by room:

In the bathroom, installing grab bars and railing, a roll- or walk-in shower/tub, or a shower bench
In the kitchen: adding higher countertops, lever or touchless faucets and cabinet pull-out shelves
For the bedroom, use a less-high bed, non-slip floor, walk-in closets and motion-activated lights
Outside, you can add ramps, a porch or stair lifts, and automatic push button doors.

Finally, throughout the house, keep things well-lit and widen hallways and doorways; add a first-level master suite, elevators or chair lifts, “smart” window shades/thermostats/lighting and simpler windows.

Note that some home modifications may qualify as medical expenses. As a result, they are eligible for an itemized deduction on your income tax return. A home modification may be tax-deductible as a medical expense, if it has made to accommodate the disabilities (preferably documented by a physician or other health care provider) of someone who lives in the home, according to the IRS. Home modifications may not be the only thing you need to age in place. Speak with an experienced elder law attorney who will be familiar with many of the types of assistance available to keep you in your home. If you would like to learn more about elder care, please visit our previous posts.

Reference: Bankrate (March 30, 2022) “The best home modifications for aging in place”

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Avoid the Economic Dangers of Caregiving

April 13, 2022

AARP’s recent article entitled “5 Steps to Avoid Economic Pitfalls of Caregiving” reports that 20% of family caregivers have to take unpaid time off from work due to their caregiving responsibilities. There are ways to avoid the economic danger of caregiving.

The average lifetime cost to caregivers in lost wages and reduced pension and Social Security benefits is $304,000 — that is $388,000 in today’s dollars. This does not count the more than $7,200 that most caregivers spend out of pocket each year, on average, on housing, health care and other needs for loved ones in their care, according to the AARP report.

Step 1: Calculate the gap. The average cost of a full-time home health aide is nearly $62,000 a year, and a semiprivate room in a nursing home runs about $95,000. Ask your parents about the size of their nest egg, how fast they are spending it, whether they have long-term care insurance and how much equity they have in their home. Compare your parents’ assets against their projected expenses to determine your gap.

Step 2: Fill the gap without going broke. Try to find free resources: Use the National Council on Aging’s Benefits Check Up tool to find federal, state and private benefit programs that apply to your situation. Then create a budget to determine what you can contribute, physically and in dollars, to closing the gap. In addition, ask your siblings if they can pitch in.

Step 3: If a gap remains, consider Medicaid. This program can cover long-term care. However, your parent or parents may need to spend down assets to qualify. Note that if just only one parent is in a nursing home, the other can generally keep half of the assets, up to a total of $137,400 (not including their house). However, the rules differ by state. As a result, this can get complicated. Speak with an elder-law attorney for help.

Step 4: No matter what the gap, try to get paid. If your parents have enough resources, you may discuss having them pay you for caregiving. However, you should speak with an attorney first about drawing up a contract. This should include issues like the number of hours a day you will spend on providing care and whether doing so will require you to quit your job. The caregiving agreement is written carefully, so that it does not violate Medicaid regulations about spending down assets.

Step 5: Protect your own earning ability. If you are mid-career, it is very difficult to leave a job for family responsibilities like caregiving and then go back into the workforce at the same salary. The Society for Human Resource Management says that it costs six to nine months’ salary to replace an employee, so many employers now see it is less expensive to make an accommodation.

It can be difficult to avoid the economic dangers of caregiving. Work closely with an elder law attorney to ensure you have everything in order to protect yourself and your loved one. We can help! If you would like to learn more about caregiving, please read our previous posts.

Reference: AARP (Feb. 24, 2022) “5 Steps to Avoid Economic Pitfalls of Caregiving”

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The Estate of The Union Season 2|Episode 6 -

The Estate of The Union Episode 14: Needle in a Haystack – Finding the right Caregiver is out now!

February 22, 2022

The Estate of The Union Episode 14: Needle in a Haystack – Finding the right Caregiver is out now!

Getting squeezed between being a parent and caring for an adult parent? Looking for a caregiver for an aging relative? In this episode of The Estate of the Union, Brad Wiewel interviews Lina Supnet-Zapata with Mir Senior Care Consultants. Mir is a care management resource for finding great elder care and personalizing it to fit the family. Not everyone is cut out for assisting older people because the job requires a unique skillset and, more importantly, empathy. There are things you need to know before hiring someone as a caregiver for the elderly. Brad and Lina have a lively discussion that covers all the bases in senior care management. Finding the right caregiver can be difficult. It ain’t over easy, but it’s achievable!

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!

To learn more about Lina Supnet-Zapata and Mir Senior Care Consultants, please visit their website:

The Estate of The Union Episode 14: Needle in a Haystack – Finding the right Caregiver 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. You can also view this podcast on our YouTube page. The Estate of The Union Episode 14 is out now. We hope you enjoy it.

Texas Trust Law/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.

Family Caregivers eligible for Tax Credits

February 21, 2022

Family caregivers who support loved ones are eligible for several tax credits and deductions. It’s not just for taking care of parents; other relatives may be covered as well, notes a recent article “If you are a caregiver of elderly parent, you may be eligible for tax breaks” from The Oklahoman. The IRS has different options and certain requirements must be met.

When a dependent mother lives with an adult child who pays for more than half of her living expenses—food, housing, utilities, health care, repairs, clothing, travel, and similar necessities—and if the mother’s gross income is under $4,300—the child can claim the mother as a dependent. The tax credit, which is nonrefundable, can be as much as $500.

When siblings are cooperative and everyone contributes to mom’s expenses, only one can claim the mother as a dependent. It has to be the adult child who pays for at least 10% of support costs. The IRS calls this a “multiple support agreement.” There’s information on the IRS website to help you figure out if you qualify for a “Credit for Other Dependents.”

Medical deductions are another credit. If an adult child claims a parent as a dependent and also pays medical, dental, and/or long-term expenses that are not reimbursed by insurance, the expenses in excess of more than 7.5% of the adult child’s Adjusted Gross Income (AGI) can be deducted.

For example, if the adult child’s AGI is $80,000, anything after the first $6,000 of the parent’s medical bills—7.5% of the AGI—could be deductible. If the parent’s medical bills were $8,000, $2,000 would be deductible. When calculating the total, include medical expenses for you and your spouse.

AGI thresholds vary by state, so if your state has a lower AGI, you might get a break on state income taxes, even if you do not qualify on federal income taxes.

What about in-home care or adult day care costs? They might also be covered, under the Dependent Care Tax Credit, and could be worth as much as $4,000. To qualify, the dependent parent must have been physically or mentally incapable of taking care of themselves and have lived with you for more than six months.

There is also the possibility of using funds from a Health Savings Account (HSA) or a Flexible Savings Account (FSA) from your employer to pay for a loved one’s medical expenses, as long as she is a qualified dependent. One caveat: if you use the funds from an HSA or FSA to pay for a dependent’s medical costs, you cannot take a tax deduction on the expenses. There are options available for family caregivers that may be eligible for tax credits. If you would like to learn more about caregiving, please visit our previous posts.

Reference: The Oklahoman (Jan. 25, 2022) “If you are a caregiver of elderly parent, you may be eligible for tax breaks”

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Category: Caregivers

Documents needed for Advance Care Planning

How the Guardianship Process Works

Guardianship is a Valuable tool to Protect Loved Ones

How to Manage Aging Parents Finances

Geriatric Care Managers can make Life Easier

Planning for Special Needs Requires Care

What Do You Need to Age in Place?

Avoid the Economic Dangers of Caregiving

The Estate of The Union Episode 14: Needle in a Haystack – Finding the right Caregiver is out now!

Family Caregivers eligible for Tax Credits

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