What Should I Know About Advocating for a Loved One with Parkinson’s Disease?

Unfortunately, recent studies have shown that three out of every four hospitalized Parkinson’s Disease patients didn’t get their regular home medications on time or had doses entirely skipped.

Proper medication management is the most critical part of a successful hospitalization for someone with Parkinson’s Disease.

Antiparkinsonian medications (levodopa or amantadine, for example) must be given correctly, at the right time and in the correct dose.

If regular home medications aren’t provided in the hospital, Parkinson’s Disease patients can develop mental disturbances, increased muscle rigidity, tremors and difficulty communicating. As a caretaker, you have a vital role in helping the transition from home to the hospital run smoothly.

Next Avenue’s recent article, “How to Advocate for Your Hospitalized Loved One with Parkinson’s Disease,” has some ways you can do this.

Make sure you have an up-to-date list of medications your loved one takes. The list should include the name, dose, when it was last taken and what pharmacy is used for prescriptions. Be prepared to give this to the hospital staff when requested.

You should also list drug or food allergies, including reactions. For example, did a particular drug cause severe irritability or a rash in the past?

It is important to remain with your loved one when they arrive at the hospital until the first dose of their regular medication is administered. Note that a first dose can usually be delayed by several hours if the nurse needs to input the medication list into the chart immediately or if the hospital pharmacy is delayed in verifying the orders. However, after the first dose, future quantities will likely be on schedule.

Cooperate with nursing staff to make sure that your loved one is comfortable. Be direct, yet kind, in asking when the patient might need personal hygiene supplies, a quieter environment, or on-time medication.

As a caretaker, your education and experience regarding Parkinson’s Disease are powerful tools.

Some things might fall through the cracks in a busy hospital– and you know the patient best. So don’t be afraid to speak up and express your needs as you advocate for your loved one.

Reference: Next Avenue (December 22, 2023) “How to Advocate for Your Hospitalized Loved One with Parkinson’s Disease”

How Do I Transfer Vehicle Ownership of a Deceased Relative?

The way to transfer a vehicle after death can depend on several factors. These include whether the automobile was owned by one person or several individuals and whether any provision was made in a will for its transfer.

If the title to the vehicle has more than one name on it, then the surviving owner may inherit the vehicle by operation of law.

That person can change the title to put in their name only, without further intervention from the executor.

When the vehicle is titled in joint tenancy, and the owners are living, the signatures of all owners are necessary to transfer ownership. Joint tenancy is when the names of two or more owners listed on the title are joined with the word “OR,” “AND” or “AND/OR.” These words note the right of survivorship.

Yahoo Finance’s recent article, “What Happens If the Executor of My Will Dies?” explains that when the title is in the name of the deceased owner only, the title will have to be changed to whoever will assume ownership.

Suppose the motor vehicle is included in probate because there is no surviving joint owner or it hasn’t been transferred to a trust. In that case, a title change likely won’t be able to be completed until probate ends and ownership of the car is assigned to one of the decedent’s heirs.

There are three documents that you will typically need to transfer a vehicle title after death:

A copy of the owner’s death certificate
The original title; and
Probate court documents allowing the transfer.

Transferring vehicle ownership after someone passes away can vary from state to state. It’s a good idea to review the probate laws and contact the local Department of Motor Vehicles (DMV) to see what’s required to complete the transfer.

Reference: Yahoo Finance (May 15, 2023) “What Happens If the Executor of My Will Dies?”

Ever Wonder How the Very, Very Rich Pass Wealth to Their Children?

When making plans to pass assets on to family members, it’s important to consider how estate planning can help manage the taxes associated with inheritances, says a recent article, “Here’s How the Ultra Rich Pass Wealth Tax Free to Their Heirs” from yahoo! finance. The very rich have used many strategies to pass on wealth with limited or no taxes owed, and some of these strategies can be used by regular people too.

The annual gift tax exclusion. Transferring wealth during your lifetime, rather than after your death, allows you to gift any number of people up to $17,000 each in a single year without incurring a taxable gift and having no impact on your estate and gift tax exemption. Married couples may give up to $34,000. People often use this annual exclusion for cash gifts and deposits into 529 education savings plans. These plans permit “frontloading” of up to five years’ worth of gifts into one year, which results in longer and more significant compounded growth.

Paying directly for medical care or tuition. If you wish to help a loved one pay for healthcare needs or education costs, the way to do this is to pay the institution directly. You may make unlimited payments to medical providers or educational institutions on behalf of others for qualified expenses without incurring a taxable gift or impacting your $17,000 individual gift exclusion. In addition, qualified medical expenses would be considered deductible for income tax purposes. Educational expenses are tuition, not living expenses or dorm fees. However, educational expenses aren’t limited to college and could be for a private school at the primary or high school level. Even certain daycare and afterschool activities might qualify.

Using the lifetime gift and estate tax exemption. One of the best estate planning tax strategies is to gift assets you expect to have significant appreciation in the future. For example, you have a $100,000 investment in a tech start-up you believe will appreciate ten times over the next five years. Of course, gifting the $100,000 investment today makes you eat slightly into your gift and estate tax exemption. All the future appreciation of the investment is still out of your taxable estate and into the hands of your heirs—estate and gift-tax free.

Converting IRAs to Roth IRAs. The SECURE Act’s 10-year rule eliminated the ability to ‘stretch’ inherited IRAs over most beneficiary’s lifetimes. A way to preclude the tax burden on your heirs from an inherited IRA is to convert it to a Roth IRA. You’ll pay the taxes at the time of conversion, but they won’t have to pay taxes upon inheriting the IRA or any future appreciation in the account.

Implementing discount strategies. This is a complex strategy used for transferring family businesses or real estate. Discount strategies reduce the value of an interest before its transfer to its value for gift tax purposes is reduced. You maintain some control or benefit from the asset after the transfer. Examples are FLPs (Family Limited Partnerships), Limited Liability Companies (LLPs) and Qualified Personal Residence Trusts (QPRTs).

Reference: yahoo! Finance (May 25, 2023) “Here’s How the Ultra Rich Pass Wealth Tax Free to Their Heirs”

Estate Planning Lessons from Elvis’ Mistakes

So far, part of the Presley legacy appears to be the failure to create effective estate plans, says a recent article from Kiplinger, “Five Estate Planning Lessons We Can Learn From Elvis’ Mistakes.” An effective estate plan transfers assets and legacy to the right people at the right time, while keeping the wrong people out.

In this case, the right people would be the people whom Elvis and Lisa Marie wanted to benefit, and a good estate plan would have ensured that their desired beneficiaries or heirs received their inheritance. The right time would be to give control of assets to loved ones when they are mature enough to benefit for a lifetime. Keeping the wrong people out would mean minimizing tax and administrative costs and protecting heirs from lawsuits, divorce, creditors and a second level of estate taxes upon their own death.

Most recently, Priscilla Presley challenged a 2016 amendment to Lisa Marie’s trust which would have removed Pricilla as co-trustee from serving alongside Lisa Marie’s former business manager, Barry Siegel. This may have been her intent. However, the amendment didn’t include basic legal formalities. A confidential settlement was recently reached on this issue.

Priscilla had grown Elvis’ estate after his death. Despite his fame, he left an illiquid estate worth $5 million in 1977—adjusted for inflation, roughly $20 million in today’s dollars. The IRS successfully asserted that the estate was worth far more and asserted $10 million in estate taxes.

The estate didn’t include as much royalty income as expected because Elvis’ business manager, Colonel Tom Parker, sold the music catalog to RCA for $5.4 million, of which only $1.35 million went to the estate. Priscilla then assumed control of the estate. From her wise use of Graceland profits, merchandising and royalties for music recorded after the RCA deal, Priscilla grew the estate to $100 million.

In 1993, Lisa Marie turned 25 and was eligible to receive and control her inheritance. She established a revocable trust to hold her inheritance, then appointed a businessman as her co-trustee with primary control over her assets. In two years, he sold 85% of her interests in Elvis Presley Enterprises, an entity The Elvis Presley Trust created to conduct business, including Graceland and worldwide licensing of Elvis Presley Products.

The deal was worth $100 million but brought the estate only $40 million after taxes, plus $25 million in stock in a future holding company of American Idol, later made worthless due to bankruptcy by its parent company.

Careful planning could have avoided substantial income tax on the sale and provided the family a much better financial return. Siegal was removed as trustee in 2015 when lawsuits between Siegel and Lisa Marie began, which were pending when she died unexpectedly in 2023.

The lessons from the Elvis estate:

Use a trust, not a will. The trust removes delays, and higher costs and keeps private details private.

Make sure that your estate plan addresses estate tax issues. The goal is to reduce the value of the taxable estate and increase the value of your legacy to family and loved ones. The estate tax must be paid in cash within nine months from the date of death. This often requires a sale of estate or trust assets to pay the tax and can lead to heirs getting less than the full value of assets because of the need to come up with the cash. A simple testamentary charitable lead annuity trust (TCLAT) could have prevented the estate tax assessed after Elvis’ death and provided substantial benefits to Lisa Marie.

Plan for a lifetime legacy. Lisa Marie gained complete control over her inheritance at age 25. First, however, she needed to prepare for the complexity of the business and other assets she inherited and learn how to maintain a lifetime of living within her means.

Plan for estate taxes on the sale of the family business. Careful planning can almost always reduce the tax triggered by the sale of appreciated property. Unfortunately, no tax mitigation planning was taken before the $100 million sale of Elvis Presley Enterprises. As a result, the maximum capital gains tax, federal and estate combined, can be more than 40%.

Carefully choose the successor trustee or executor and provide at least two alternatives. Elvis appointed his father Vernon as the executor. Elvis died tragically in 1977 when Vernon was elderly and not well. Appointing a business manager as a trustee creates an inherent conflict of interest due to the business manager’s ability to profit from decisions made. A professional trustee would have been a better choice due to the complexity of the estate and Lisa Marie’s age.

Reference: Kiplinger (May 18, 2023) “Five Estate Planning Lessons We Can Learn From Elvis’ Mistakes”

How Can I Quickly Downsize?

Optimally, it’s best to spend months or years carefully purging excess belongings. However, life may get in the way, says The Independent’s recent article, “3 Steps to Downsize in a Hurry.” So let’s look at what we can do now:

Collect paperwork. This includes photos, prescriptions, and perishables. You may want to box unsorted documents and photos for temporary storage in a climate-controlled area and sort through them later. Next, deal with the stuff that can’t be sold or donated, such as unneeded medications and perishable food that won’t be eaten in time. Nonperishable, unopened food items typically can be donated to a local food bank.
Identify the ‘keepers’. These are possessions with a definite home. iIf someone’s moving, this includes things that will be going with them. However, if you’re clearing out after a death, keepers may consist of items destined for heirs. An executor officially charged with settling someone’s estate may be required to hire appraisers to value possessions before anything is distributed. If you have potentially valuable items, like antiques, jewelry, art, or collections, ask a personal property appraiser to help you determine what may be worth the extra effort of selling. However, hiring an appraiser can cost hundreds or thousands of dollars, which may not always be practical.
Decide what to do with the rest of it. If you have several rooms of furniture and household items remaining, think about an estate sale to help you dramatically downsize. Estate sales are often organized by professionals who advertise the sale, price the items, handle transactions and provide security. Estate sales agents may agree to donate or dispose of whatever doesn’t sell. They typically get 30% or more of the sale proceeds. Giving stuff away is another option. However, charities are often selective about what they’ll accept. Check their websites or call first to avoid an unnecessary trip. Some charities will send a truck to pick up approved donations.

Reference: The Independent (May 18, 2023) “3 Steps to Downsize in a Hurry”

How is Congress Trying to Protect Seniors from AI Scams?

Senator Mike Braun, R-Ind., the ranking Republican on the Senate Special Committee on Aging, led a bipartisan effort to draft a letter to the Federal Trade Commission (FTC) that asks for an update on what the agency knows about AI-driven scams against the elderly and what it is doing to protect people. The letter, signed by every member of the Senate committee from both parties, asks about AI-powered technology that can be used to replicate people’s voices.

Fox News’ recent article entitled, “AI ‘voice clone’ scams increasingly hitting elderly Americans, senators warn,” reports that the letter to FTC Chairwoman Lina Khan cautioned that voice clones and chatbots are allowing scammers to trick the elderly into making them believe they are talking to a relative or close friend, which leaves them vulnerable to theft.

“In one case, a scammer used this approach to convince an older couple that the scammer was their grandson in desperate need of money to make bail, and the couple almost lost $9,400 before a bank official alerted them to the potential fraud,” the Senate letter said. “Similarly, in Arizona, a scammer posing as a kidnapper used voice-cloning technology to duplicate the sounds of a mother’s crying daughter and demand ransom.”

Senator Braun said “imposter” scams lead to about $2.6 billion in losses every year and that the elderly are especially at risk now that scammers have access to voice-clone technology.

“We’re getting calls into our constituent services line back in Indiana already where this is coming in and happening to some extent,” Braun said. He added that imposter scams can be done without using an artificial voice but warned that “AI makes it even easier because it’s like talking to your grandkid.”

Braun recalled a Senate hearing this week in which Senator Richard Blumenthal, D-Conn., opened the hearing on AI with an AI-generated voice that sounded like him, reading off an AI-generated script and said scammers have access to these same tools.

“When you can replicate a voice to the extent I couldn’t tell if that was Sen. Blumenthal or a replication – it sounded exactly like him – just imagine,” Braun said. “That is a tool that the scammers never had.”

The FTC has said it will use its authority to protect consumers from AI to the extent it can, as Washington policymakers look to expand their regulatory oversight of this new technology. The Senate letter to the agency suggested that the FTC update its “educational and awareness” materials to help seniors understand that scammers may be looking to fleece them out of their money using AI-generated voices.

“I’ve never seen any new technology, new business, where the people that created it have been more worried about how you use it,” he said. “They’re worried that if they’re going to get any monetary value out of it, they are going to have to make sure it’s well-regulated.”

“I just think there’s no way that AI can go unchecked, and I’m glad to see the people … on the forefront are thinking the same way,” he said.

Reference: Fox News (May 18, 2023) “AI ‘voice clone’ scams increasingly hitting elderly Americans, senators warn”

What Should I Know About Wills?

A valid last will lets you do the following:

Leave assets to people that would be excluded by the laws controlling property distribution after you die;
Change how your assets would be distributed to family members;
Establish caretakers for your children; and
Create requirements for inheriting.

Forbes’ recent article entitled, “Last Will And Testament: Everything You Need To Know,” explains that a will is a legal document created in anticipation of your death. The best known function of a last will is to determine who gets property. However, a last will can also control other things about your property and responsibilities. It’s an important tool in estate planning and one that almost everyone should create.

There are different kinds of last wills that you can create to take control of your legacy. Let’s look at some of the most common types.

Simple Will. With this last will, assets are left directly to beneficiaries. Simple wills are easy to write in most cases, and you can amend them as needed over time. They are a sound choice for those who don’t have children from a prior marriage, who do not have a lot of assets and who do not have concerns about anyone challenging their last will and testament.

Complex Will. This will is used if you have more specialized needs, such as creating a testamentary trust, which is created within your last will. You create the testamentary trust to transfer ownership of assets into a trust instead of directly to beneficiaries. A complex last will can also be used to create a special needs trust (to leave assets to a person with disabilities who relies on means-tested government benefits) or to create a protective trust for your child.

Holographic Will. A holographic will is handwritten by the creator of the last will (known as the testator). This type of last will isn’t recognized in all states. A holographic last will must also often meet specific requirements, such as the last will being signed by witnesses present when the testator signed the document.

Living Will. This is much different from the other kinds of wills. A living will does not specify who inherits assets, but rather is aimed at making advanced decisions about medical care. When you create a living will, you specify what kinds of medical care you do and do not want if decisions must be made while incapacitated.

Reference: Forbes (May 18, 2023) “Last Will And Testament: Everything You Need To Know”

What Does “Power of Attorney” Mean?

A power of attorney is a legal document giving one person—the “agent”—the legal power to make legal, financial, or medical decisions for another person. According to a recent article from Nerd Wallet, “What is a Power of Attorney (POA)? Types, How, When to Use,” the POA lets someone act on your behalf if you are traveling, too sick to act on your own behalf or can’t be present to sign legal documents.

You may name any adult, including your spouse, adult child, sibling, or a trusted friend, to act as your agent under power of attorney. It can be granted to anyone who is a legal adult and of sound mind. Ordinary power of attorney designations dissolve if you become incapacitated. However, durable power of attorney designations remain intact, even upon incapacity.

You can give one person power of attorney or divide the responsibilities among multiple people.

Most people don’t know that power of authority authorizations can be very specific or general, depending on your needs. When having an experienced estate planning attorney draft a power of attorney, review the desired scope of your agent’s authority, when it should take effect and the desired duration.

If you don’t have a power of attorney and become incapacitated, a court can appoint someone to act on your behalf. However, court intervention turns a private matter into a public proceeding, and you cannot know if the appointed conservator will follow your wishes.

There are several types of power of attorney. The durable power of attorney remains intact, even when you are incapacitated. The ordinary power of attorney becomes moot once you are incapacitated. A dual power of attorney gives power to two people and requires both individuals to sign off on any decisions.

A dual power of attorney may be useful if you have two children, for instance, and you’d like them to make joint decisions for you. Regardless of how many powers of attorney you appoint, you should always name successor agents for each power of attorney, in case the primary person is unable or unwilling to serve when needed.

A medical power of attorney, also called a health care proxy, is a type of advance directive giving another person to make all health care decisions for you in accordance with your wishes when you are unable to do so. Health care proxy decisions generally cover any type of medical treatment or procedure to diagnose and treat your health. Make sure the person you grant medical power of attorney to is familiar with your wishes and knows what decisions you would want in treatment or for life—supporting measures.

Reference: Nerd Wallet (May 10, 2023) “What is a Power of Attorney (POA)? Types, How, When to Use”

Is Coffee Good for My Blood Pressure?

A new study has found that drinking three or more cups of coffee is associated with lower blood pressure.

According to the study’s lead author, Dr. Arrigo F.G. Cicero, associate professor in the Department of Medical and Surgical Sciences at the University of Bologna, peripheral and central blood pressure are markers of arterial stiffening and aging.

Healthline’s recent article entitled, “Hypertension: 3 Cups of Coffee a Day May Lower Blood Pressure,” noted that in seniors with high blood pressure, the large arteries tend to be stiffer, leading to higher systolic blood pressure (the top number of the blood pressure reading) and wider pulse pressure (the difference between the top and bottom numbers).

The authors note in their report that the effects of coffee on blood pressure are still questioned, since the caffeine content of coffee can raise blood pressure in the short term. However, these effects may be offset by coffee’s antioxidants, which can help blood vessels dilate and protect cells against free radicals.

Cicero and his team examined a sample of 720 men and 783 women in the Brisighella Heart Study. This ongoing study began in 1972 and included a randomized sample representative of a rural Northern Italy town called Brisighella. They looked at the participants’ blood pressure and coffee-drinking habits and a selection of other data relevant to cardiovascular health.

The researchers found that coffee consumption was associated with lower blood pressure.

“The trend seems to be positive from two [cups of] coffee per day,” said Cicero. “So, coffee drinking should not be a priori forbidden in current coffee drinkers, if the fear is that coffee could increase BP levels.”

Dr. Jim Liu, a cardiologist at The Ohio State University, said that while this study is small and focuses on a specific population, its findings are consistent with prior knowledge about how coffee affects blood pressure.

“Coffee can increase blood pressure acutely after consumption, but there really has not been any consistent evidence to show that moderate amounts of coffee consumption lead to long-term issues with high blood pressure or heart disease in general,” he noted.

The American Heart Association says that people are advised to avoid drinking “too much” coffee because of its ability to raise blood pressure. It can also cause problems sleeping, heart palpitations and anxiety.

Reference: Healthline (February 12, 2023) “Hypertension: 3 Cups of Coffee a Day May Lower Blood Pressure”

What Changes Will Allow Military Families to Put More Food on the Table?

Defense officials plan to modify the eligibility rules for the Basic Needs Allowance, increasing the income eligibility cap to 150% of federal poverty guidelines, Secretary of Defense Lloyd Austin said during a Senate Armed Services Committee hearing.

Military Times’ recent article, “More troops will soon be eligible for Basic Needs Allowance,” says that’s six months before the DoD is required by law to make the change. The higher income cap “will allow us to help more families,” Austin said.

Mandated in the 2022 National Defense Authorization Act, the allowance is a safety net for military families to help combat food insecurity. The law went into effect in January and currently applies to troops whose total family income is less than 130% of federal poverty guidelines. In addition to total family income, this is based on household size and location.

In the 2023 National Defense Authorization Act, Congress added a provision raising the income eligibility cap for the allowance to 150% of federal poverty guidelines. This lets more families qualify. The DoD is required to implement the new provision by 2024. However, the law allows them to do it earlier.

Based on Defense Department estimates, the higher income cap would increase the number of active duty families eligible for the allowance to about 2,400. However, a sticking point is that the Basic Allowance for Housing is counted as income by DoD when calculating eligibility. Senator Kirsten Gillibrand of New York asked Austin whether he would consider removing BAH from the calculation for the Basic Needs Allowance.

“We will do whatever’s feasible or what we’re allowed to do by law,” Austin replied.

“DoD’s own surveys show that 24% of our service members experience food insecurity,” Gillibrand said. “Last year, I met with military families on Staten Island who spoke about the challenges they face in basically putting food on the table to feed their kids.

“However, very few service members are considered eligible for Basic Needs Allowance … since [the housing allowance] is included in family income calculations.”

In addition, two congressmen have proposed legislation that would make the Basic Needs Allowance tax-exempt.

“Taxing support meant to help the most vulnerable undermines the purpose,” said Rep. Steve Womack, R-Arkansas, who introduced the proposal on March 22 with Rep. Dan Kildee, D-Michigan. “BNA should be treated like other military benefits outside of earned income, which is exactly what this bill prescribes.”

Military members “deserve to receive the full value of their military benefits,” said Kildee. “The Basic Needs Allowance, which helps support thousands of service members and their families, is not income and should not be subject to income taxes.”

Reference: Military Times (April 3, 2023) “More troops will soon be eligible for Basic Needs Allowance”

Estate Planning Blog Articles

Estate & Business Planning Law Firm Serving the Providence & Cranston, RI Areas

What Should I Know About Advocating for a Loved One with Parkinson’s Disease?

How Do I Transfer Vehicle Ownership of a Deceased Relative?

Ever Wonder How the Very, Very Rich Pass Wealth to Their Children?