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Elderly during COVID-19

New Survey Conducted on Keeping the Elderly Safe in the Pandemic

New Survey Conducted on Keeping the Elderly Safe in the Pandemic

Those in our oldest generations, who were recently surveyed, were found to be more distrustful of senior living and care operators than younger generations.

Nearly half (49.5%) of baby boomers said they don’t trust senior living and care providers to keep residents safe, while 43.9% of the Silent Generation reported the same distrust.

Younger people are more trusting: 42.3% of Generation X reported distrust, 31.8% of millennials and 38.2% of Generation Z.

McKnight Senior Living’s recent article entitled “41% don’t trust assisted living, nursing homes to keep residents safe during pandemic: survey” notes that 43.1% of baby boomers responded that they trust facilities “somewhat,” as did 51.4% of the Silent Generation respondents.

Some of this mistrust may come from the extensive media coverage of coronavirus deaths in nursing homes because senior residents are especially vulnerable to the illness.

Some say that it goes further than that: the quarantine and social distancing has added to families’ stress and anxiety over the safety and mental well-being of the seniors who live in these facilities because they aren’t able to visit as often as they want.

An online survey from ValuePenguin.com and LendingTree of more than 1,100 Americans recently found that COVID-19 has generated a rush of loneliness and worry among older adults.

According to the results, 36% of older adults feel lonelier than ever. In addition, more than 70% of seniors said that they have worries about the virus’ effects on their younger relatives. Those concerns were equally expressed by younger generations for their older relatives. Almost 50% of both age groups are worried that their relatives will catch the virus.

However, the pandemic looks to have a silver lining for family communications. An overriding sense of concern for the mental and physical health of elderly loved ones has led to more contact since the pandemic began.

Nearly 44% of the younger survey-takers stated they’ve spoken to their older relatives more frequently during the pandemic, about 25% of young people reported visiting their older relatives in person more frequently.

The top request from respondents aged 75 and older to their loved ones, is to call more frequently.

Reference: McKnight Senior Living (Sep. 11, 2020) “41% don’t trust assisted living, nursing homes to keep residents safe during pandemic: survey”

Read more related Articles at:

Coronavirus and COVID-19: Caregiving for the Elderly

AARP Coronavirus Poll: How Older Americans Feel About Their Health, Families, Finances

Also read one of our previous Blogs at:

C19 UPDATE: Keeping Ourselves and Our Elderly Loved Ones Safer

Click here to check out our Master Class!

Pre Election

Pre-Election Estate Planning Includes a Vast Variety of Trusts

You might remember a flurry of activity in advance of the 2016 presidential election, when concerns about changes to the estate tax propelled many people to review their estate plans. In 2020, COVID-19 concerns have added to pre-presidential election worries. A recent article from Kiplinger, “Pre-Election Estate Planning Moves for High Net-Worth Families,” describes an extensive selection of trusts that can are used to protect wealth, and despite the title, not all of these trusts are just for the wealthy.

The time to make these changes is now, since there have been many instances where tax changes are made retroactively—something to keep in mind. The biggest opportunity is the ability to gift up to $11.58 million to another person free of transfer tax. However, there are many more.

Spousal Lifetime Access Trust (SLAT) The SLAT is an irrevocable trust created to benefit a spouse funded by a gift of assets, while the grantor-spouse is still living. The goal is to move assets out of the grantor spouse’s name into a trust to provide financial assistance to the spouse, while sheltering property from the spouse’s future creditors and taxable estate.

Beneficiary Defective Inheritor’s Trust (BDIT) The BDIT is an irrevocable trust structured so the beneficiary can manage and use assets but the assets are not included in their taxable estate.

Grantor Retained Annuity Trust (GRAT) The GRAT is also an irrevocable trust. The GRAT lets the grantor freeze the value of appreciating assets and transfer the growth at a discount for federal gift tax purposes. The grantor contributes assets in the trust and retains the right to receive an annuity from the trust, while earning a rate of return as specified by the IRS. GRATs are best in a low interest-rate environment because the appreciation of assets over the rate goes to the beneficiaries and at the end of the term of the trust, any leftover assets pass to the designated beneficiaries with little or no tax impact.

Gift or Sale of Interest in Family Partnerships. Family Limited Partnerships are used to transfer assets through partnership interests from one generation to the next. Retaining control of the property is part of the appeal. The partnerships may also be transferred at a discount to net asset value, which can reduce gift and estate tax liability.

Charitable Lead Trust (CLT). The CLT lets a grantor make a gift to a charitable organization while they are alive, while creating tax benefits for the grantor or their heirs. An annuity is paid to a charity for a set term, and when the term expires, the balance of the trust is available for the trust beneficiary.

Charitable Remainder Trust (CRT) The CRT is kind of like a reverse CLT. In a CRT, the grantor receives an income stream from the trust for a certain number of years. At the end of the trust term, the charitable organization receives the remaining assets. The grantor gets an immediate income tax charitable deduction when the CRT is funded, based on the present value of the estimated assets remaining after the end of the term.

These are a sampling of the types of trusts used to protect family’s assets. Your estate planning attorney will be able to determine if a trust is right for you and your family, and which one will be most advantageous for your situation.

Reference: Kiplinger (Aug. 16, 2020) “Pre-Election Estate Planning Moves for High Net-Worth Families”

Read more related articles at:

Pre-Election Estate Planning Moves for High-Net-Worth Families

Estate Planning in the 2020 Election Year

Also, read one of our previous blogs at:

Different Trusts for Different Estate Planning Purposes

Click here to check out our Master Class!

LTC Insurance

What’s the Latest Trend in Long-Term Care Insurance?

What’s the Latest Trend in Long-Term Care Insurance?

Approximately half of Americans turning age 65 today will require some type of long-term care (LTC) in their lives. The older a person, the more likely he or she will need LTC at some point. What’s the Latest Trend in Long -Term Care Insurance?

The Treasury Department also reminds us about the general aging of the national population because much of the baby boom generation already is above that age, and the rest will be within 10 years.

FedWeek’s recent article entitled “Report Sees Mismatch between Long-Term Care Insurance Needs, Purchases” also notes that private insurers began offering long-term care insurance in the 1970s in response to demand for financial protection against the risk of having to enter a nursing home. The sales of new policies hit a high in the early 2000s but have since dropped because many insurance companies left the market due to the poor financial performance of these products.

The sales of these policies peaked in 2002, when the government started its own program for federal employees, the Federal Long Term Care Insurance Program.

About 750,000 people bought policies, but the numbers have fallen steadily since. It was down to just 57,000 in 2018, despite the fact the share of the population in the age group most likely to purchase private LTCI were up from 9.5% in 2010 to 11.4% that year.

The Treasury Department report also emphasized that the government doesn’t recommend purchasing or not purchasing insurance. However, it said that currently much of the burden of providing this care falls on the Medicaid program. It paid $159 billion for these expenses in 2018, while Long Term Care insurance covered only about $10 billion, and individuals paid another $55 billion out of pocket. It is also hard to know the amount of unpaid care provided by family members.

The report said that for the private LTC insurance market to meet the coming demand, there will have to be more innovation in the way this type of insurance is designed and delivered.

This may be having LTC coverage as a rider to other types of insurance, instead of a stand-alone product, along with policies with a more limited scope. This limited scope could be to cover only nursing home care and only for up to a year, which would mean lower premiums.

The Treasury Department also said there should be better coordination when it comes to how such insurance is regulated, education and awareness programs regarding possible need for coverage and tax incentives to buy LTC insurance.

So those are some answers to what the latest tends in Long Term Care Insurance are.

Reference: FedWeek (Sep. 10, 2020) “Report Sees Mismatch between Long-Term Care Insurance Needs, Purchases”

Read more related articles at:

Long-Term Care and LTC Insurance – New Trends

10 Best Long Term Care Insurance of 2020

Also, Read one of our previous Blogs at:

Do I Need Long-Term Care and Why?

 

How to Keep Track of Mom’s Healthcare Information if She Gets Sick or Injured

How to Keep Track of Mom’s Healthcare Information if She Gets Sick or Injured

It’s common for seniors to have several chronic medical conditions that must be closely monitored and for which they take any number of prescription medications. Family caregivers usually are given a crash course in nursing and managing medical care, when they start helping an aging loved one. The greatest lesson is that organization is key, which is especially true when a senior requires urgent medical care. Here is How to Keep Track of Mom’s Healthcare Information if She Gets Sick or Injured

Physicians encounter countless patients and families who struggle to convey important medical details to health care staff, according to The (Battle Ground, WA ) Reflector’s recent article titled “The emergency medical file every caregiver should create.”

A great solution is to create a packet that contains information that caregivers should have. Here’s what should be in this emergency file:

Medications. Make a list of all your senior’s prescription and over-the-counter medications, with dosages and how frequently they’re taken.

Allergies. Note if your loved one is allergic to any medications, additives, preservatives, or materials, like latex or adhesives. You should also note the severity of their reaction to each of these.

Physicians. Put down the name and contact info for the patient’s primary care physician, as well as any regularly seen specialists, like a cardiologist or a neurologist.

Medical Conditions. Provide the basics about your senior’s serious physical and mental conditions, along with their medical history. This can include diabetes, a pacemaker, dementia, falls and any heart attacks or strokes. You should also list pertinent dates.

Do Not Resuscitate (DNR) Order. If a senior doesn’t want to receive CPR or intubation if they go into cardiac or respiratory arrest, include a copy of their state-sponsored and physician-signed DNR order or Physician Orders for Life-Sustaining Treatment (POLST) form.

Medical Power of Attorney. Keep a copy of a medical power of attorney (POA) in the packet. This is important for communicating with medical staff and making health care decisions. You should also check that the contact information is included on or with the form.

Recent Lab Results. Include copies of your senior’s most recent lab tests, which can be very helpful for physicians who are trying to make a diagnosis and decide on a course of treatment without a complete medical history. This can include the most recent EKGs, complete blood counts and kidney function and liver function tests.

Insurance Info. Provide copies of both sides of all current insurance cards. Include the Medicare Supplement Insurance (Medigap) and Medicare Prescription Drug Plan (Part D) cards (if applicable). This will help ensure that the billing is done correctly.

Photo ID. Emergency rooms must treat patients, even if they don’t have identification or insurance information However, many urgent care centers require a picture ID to see patients. You should also include a copy of their driver’s license in the folder.

Once you have all the records, assemble the folder and put it in an easily accessible location. Give the packet to paramedics responding to 911 calls. It should also be brought to any visits at an urgent care clinic.

Reference: The (Battle Ground, WA ) Reflector (Sep. 14, 2020) “The emergency medical file every caregiver should create”

Read more related articles at:

Can I access someone else’s medical records (health records)?

10 Things to Know About HIPAA & Access to a Relative’s Health Information

Also, read one of our previous Blogs at:

Do I Really Need a Health Care Proxy?

Click here to check out our Master Class!

Protecting Assets from nursing home costs

How Do I Keep My Assets from the Nursing Home?

How Do I Keep My Assets from the Nursing Home?

If you don’t have a plan for your assets when it comes time for nursing home care, they can be at risk. Begin planning now for the expenses of senior living. The first step is to consider the role of Medicaid in paying for nursing home services.

WRCB’s recent article entitled “How to Protect Your Assets from Nursing Homes” describes the way in which Medicaid helps pay for nursing homes and what you can do to shield your assets.

One issue is confusing nursing homes and skilled nursing facilities. Medicare does cover a stay in a skilled nursing facility for convalescence. However, it doesn’t pay for full-time residence in a nursing home. For people who can’t afford to pay and don’t have long-term care insurance, they can apply for Medicaid. That’s a government program that can pay nursing home costs for those with a low income. People who don’t have the savings to pay for nursing home care and then require that level of care, may be able to use Medicaid.

For those who don’t qualify for Medicaid when they need nursing home care, they may become eligible when their savings are depleted. With less money in the bank and minimal income, Medicaid can pay for nursing home care. It is also important to remember that when a Medicaid recipient dies, the government may recoup the benefits provided for nursing home care from the estate. Family members may discover that this will impact their inheritance. To avoid this, look at these ways to protect assets from nursing home expenses.

Give Away Assets. Giving loved ones your assets as gifts can help keep them from being taken by the government when you die. However, there may be tax consequences and could render you Medicaid ineligible.

Create an Irrevocable Trust. When assets are placed in an irrevocable trust, they can no longer belong to you because you name an independent trustee. The only exception is that Medicaid can take assets that were yours five years before you died. Therefore, you need to do this as soon as you know you’re going into a nursing home.

Contact an experienced estate planning, elder law, or Medicaid planning attorney to help you protect your assets. The more you delay, the less likely you’ll be able to protect them.

Reference: WRCB (Dayton) (Sep. 4, 2020) “How to Protect Your Assets from Nursing Homes”

Read more related articles at:

Medicaid Trust: Qualify for Government Aid for Nursing Home Cost

6 Steps To Protecting Your Assets From Nursing Home Care Costs

Also read one of our Previous Blogs at:

New Medicare Rule Makes It Harder to Receive Home Care

Click here to check out our Master Class!

Social Security-colas

Will We See a Bump in the COLA for Social Security Next Year?

Will We See a Bump in the COLA for Social Security Next Year?

Experts anticipate roughly a 1% increase beginning in January 2021, and possibly less. The actual amount of the COLA depends on the economy, which has picked up in the past month.

AARP’s recent article entitled “Social Security COLA Forecast for 2021” reports that other experts’ projections are in the same area.

It’s small, as far as a COLA. Based on the average Social Security retirement benefit of $1,514.13 a month, a 0.5% increase would be $7.57 a month, and a 1% increase would amount to $15.14.

Social Security COLAs have been pretty rare in the past 10 years. The average COLA over the decade has been a 1.52% increase. The biggest was a 2.8% bump that went into effect in January 2019. There were no COLA increases starting in January 2011 or January 2016.

A reason for a possible small COLA for next year is that inflation has been low. The COLA is determined by the change in the Consumer Price Index for Urban Wage Earners and Clerical Workers, or CPI-W, from the third quarter of 2019 to the third quarter of 2020. The COLA calculation looks at the average CPI-W index numbers for July, August and September of 2019 and compares them with the same third-quarter numbers for 2020. The percentage change between the two quarterly averages is the COLA for the next year. If there’s no change, or if there’s a decline in the CPI-W, there’s no bump in Social Security.

The Social Security Administration typically announces the amount of the COLA in October.

The impact of the COVID-19 pandemic, which has depressed the economy, has made inflation forecasting extremely hard.

For example, some grocery items, such as meat and chicken, have gone up in price. However, the price of a gallon of regular gas has dropped from $2.608 twelve months ago to $2.188 today.

If the increase in Social Security is small enough, some retirees may get a small discount on their Medicare Part B premiums.

The law says that if the COLA for Social Security is less than the increase in Medicare Part B premiums, the premiums would be decreased to prevent a drop in Social Security retirement benefits.

As a result, it could prevent as many as 43 million beneficiaries (about 70%) from having increases in Medicare Part B premiums larger than their Social Security COLA.

Those who have monthly benefits of about $900 or lower would also be protected.

Reference: AARP (Aug. 25, 2020) “Social Security COLA Forecast for 2021”

Read more related articles at:

Cost-Of-Living Adjustment (COLA)

Why the increase in your Social Security check could be among the smallest ever next year

Also read one of our previous blogs at:

Will the Pandemic Affect My Social Security?

Click here to check out our Master Class!

Trump Healthcare Reform

Why Did Trump Consider Reforming Long-Term Care Insurance?

Why Did Trump Consider Reforming Long-Term Care Insurance?

A Trump administration task force recently released its report on a review of the nation’s long-term care (LTC) insurance system. However, the group was unwilling to commit to any real changes to a badly broken system.

Forbes’ recent article entitled “The Trump Administration Thought About Reforming Long-Term Care Insurance. But Decided Not To” says the report only contained a few minor suggestions, and none will dramatically improve the ability of people to pay for the growing costs of the services and supports required by the elderly with disabilities.

The task force was comprised of senior officials from the departments of Treasury, Health and Human Services and Labor; and the Office of Management & Budget (OMB). The group’s starting point was a set of proposals by the National Association of Insurance Commissioners (NAIC)—which is an extremely cautious consensus document. Nonetheless, the Trump Administration wasn’t prepared to go as far as the NAIC in many areas. They were also reluctant to endorse reforms that might dramatically increase the number of Americans with some form of long-term care insurance.

The task force refused to endorse an opt-out model for employer-based LTC insurance, similar to the design many employers use to encourage workers to participate in 401(k)-like retirement plans. However, they did propose that the federal government do a better job of educating consumers about long-term care and the need to finance it. They also recommended that Congress should grant the Treasury the authority to lower the level of required inflation protection included in private LTC policies. Policies now must offer to increase benefits by 5% annually to qualify for special tax benefits (although consumers can choose less inflation protection). This move would lower premiums.

The task force also would like to see private insurers offer so-called incidental benefits to policyholders, before they become eligible for full benefits. This would allow insurers to help support the costs of home modifications, caregiver training, or information services early in a policyholder’s long-term care need. This could keep people healthier and safer, and lower costs in the long-term.

However, the task force didn’t endorse the plan. Rather, they said the idea should be further assessed and suggested Congress “could consider” changes to allow such a benefit. Aside from this, the group offered only general support for state efforts to make policies more attractive to consumers. The administration also didn’t endorse major new tax subsidies for buyers of long-term care insurance.

The task force’s biggest contribution may have been its finding that no public policy changes alone will fix private LTC insurance. There’s also more evidence pointing to a public social insurance benefit, the solution adopted by every major developed country in the world, except for the US and England. The group said combined with such a public program, private insurance might also have a future.

Reference: Forbes (Aug. 12, 2020) “The Trump Administration Thought About Reforming Long-Term Care Insurance. But Decided Not To.”

Read more related articles at:

How The Trump Administration Is Reforming Medicare

Donald Trump on Health Care

Also read one of our previous Blogs at:

Do I Need Long-Term Care and Why?

Click here to check out our Master Class!

Incapacity Planning

How to Plan for Incapacity

Planning for incapacity is just as important as planning for death. One is certain, the other is extremely likely. Therefore, it makes sense to prepare in advance, advises the article “Planning ahead for incapacity helps you and family” from The Press-Enterprise.

Let’s start by defining capacity. Each state has its own language but for the most part, incapacity means that a person is incapable of making decisions or performing certain acts. A concerned adult child is usually the one trying to have a senior parent declared incapacitated.

A person who has a mental or physical disorder may still be capable of entering into a contract, getting married, making medical decisions, executing wills or trusts, or performing other actions. However, before a person is declared incapacitated by medical professionals or a court, having a plan in place makes a world of difference for the family or trusted person who will be caring for them. Certain legal documents are needed.

Power of Attorney. This is the primary document needed in case of incapacity. There are several kinds, and an estate planning attorney will know which one will be best for your situation. A “springing” power of attorney becomes effective, only when a person is deemed incapacitated and continues throughout their incapacity. A POA can be general, broadly authorizing a named person to act on different matters, like finances, determining where you will live, entering into contracts, caring for pets, etc. A POA can also be drafted with limited and specific powers, like to sell a car within a certain timeframe.

The POA can be activated before you become incapacitated. Let’s say that you are diagnosed with early-stage dementia. You may still have legal capacity but might wish a trusted family member to help handle matters. For elderly people who feel more comfortable having someone else handle their finances or the sale of their home, a POA can be created to allow a trusted individual to act on their behalf for these specific tasks.

A POA is a powerful document. A POA gives another person control of your life. Yes, your named agent has a fiduciary duty to put your interests first and could be sued for mismanagement or abuse. However, the goal of a POA is to protect your interests, not put them at risk. Choosing a person to be your POA must be done with care. You should also be sure to name an alternate POA. A POA expires on your death, so the person will not be involved in any decisions regarding your estate, burial or funeral arrangements. That is the role of the executor, named in your will.

Advance health care directive, or living will, provides your instructions about medical care. This document is one that most people would rather not think about. However, it is very important if your wishes are to be followed. It explains what kind of medical care you do or do not want, in the event of dementia, a stroke, coma or brain injury. It gets into the details: do you want resuscitation, mechanical ventilation or feeding tubes to keep you alive? It can also be used for post-death wishes concerning autopsies, organ donation, cremation or burial.

The dramatic events of 2020 have taught us all that we don’t know what is coming in the near future. Planning in advance is a kindness to yourself and your family.

Reference: The Press-Enterprise (July 19, 2020) “Planning ahead for incapacity helps you and family”

Read more related articles at:

Legal Planning for Incapacity

5 Legal Facts You Need to Know About Incapacity Planning

Also, read one of our previous Blogs at:

What Can I Do to Plan for Incapacity?

Click here to check out our Master Class!

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