Estate Planning Blog Articles

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Will Vets Get a Cost-of-Living Boost?

The Veterans’ Compensation Cost-of-Living Adjustment Act passed unanimously in the House and without objection in the Senate earlier in the summer. By the time you read this, President Joe Biden is expected to sign it into law.

Military Times’ recent article entitled “Veterans benefits could see a big cost-of-living boost later this year” explains that the legislation links the cost-of-living boost for veterans benefits to the planned increase in Social Security benefits. Although the Social Security increase is automatic every year, lawmakers must approve the veterans benefits increase annually.

The amount of the increase for next year is still not certain. The Social Security Administration is expected to announce the COLA rate for 2022 in October, based on economic trends over the last few months. That increase will go into effect for benefits checks sent out starting this December.

The cost-of-living bump hasn’t been above 3.0% since 2011, and has averaged less than 1.3% over the last six years.

However, officials from the Senior Citizens League predicted that next year’s rise could top 6.2%, based on recent inflation and wage data released by federal economists. If so, it would be the largest increase since 1983 for Social Security and VA benefits recipients.

Lawmakers praised the bill passage as needed support for American veterans.

“The cost-of-living adjustment to veterans’ benefits is so much more than a rate adjustment tied to inflation,” said Rep. Mark Takano, D-Calif., in a statement. “It is a quality-of-life guarantee in the retirement years for veterans suffering with service-connected disabilities and ailments.”

VA officials will announce the plan soon, which includes a review of service records to see if individuals’ eligibility for benefits should be approved.

Committee ranking member Mike Bost, R-Ill., said the increase is critical for veterans and families who rely on disability benefits as a primary source of income.

“Many veterans rely on disability compensation payments to make ends meet; this was especially true during the pandemic,” he said in a statement. “For millions of veterans and their families, this adjustment is more important now than ever before.”

The VA COLA increase applies to payouts for disability compensation, clothing allowance, dependency and indemnity benefits and other VA assistance programs.

Reference: Military Times (Sep. 21, 2021) “Veterans benefits could see a big cost-of-living boost later this year”

Does My Brain Improve as I Age?

Money Talks News’ recent article entitled “2 Ways Your Aging Brain Actually Improves Over Time” explains that our ability to gather new information and to concentrate on the most important things in any given situation may get better with age, according to new research out of Georgetown University Medical Center. The findings were published in the journal Nature Human Behavior.

As part of the study, researchers examined three distinct components of attention and executive function in group of about 700 participants:

  • Alerting — a state of enhanced vigilance and preparedness in order to respond to incoming information;
  • Orienting — the shifting of brain resources to a particular location in space; and
  • Executive inhibition — in which we inhibit distracting or conflicting information, allowing us to focus on what is important.

Study co-author João Veríssimo, an assistant professor at the University of Lisbon, Portugal, explained:

“We use all three processes constantly. For example, when you are driving a car, alerting is your increased preparedness when you approach an intersection. Orienting occurs when you shift your attention to an unexpected movement, such as a pedestrian. And executive function allows you to inhibit distractions, such as birds or billboards, so you can stay focused on driving.”

They looked at individuals from 58 and 98, the ages when cognition tends to change the most during the aging process. The researchers found that while alerting abilities declined with age, the other two abilities improved. Those two abilities help us with several key parts of cognition, such as:

  • Memory
  • Decision-making
  • Self-control
  • Navigation
  • Math
  • Language
  • Reading

The researchers say orienting and inhibition appear to be skills that can get better over a lifetime the more they’re practiced. However, it appears that alerting — a basic state of vigilance and preparedness — can’t improve with practice.

Study co-author Michael T. Ullman, a professor in the Georgetown University Department of Neuroscience and director of Georgetown’s Brain and Language Lab, commented, “People have widely assumed that attention and executive functions decline with age, despite intriguing hints from some smaller-scale studies that raised questions about these assumptions. However, the results from our large study indicate that critical elements of these abilities actually improve during aging, likely because we simply practice these skills throughout our life.”

Reference: Money Talks News (Sep. 6, 2021) “2 Ways Your Aging Brain Actually Improves Over Time”

What Upgrades Can I Make to ‘Age in Place’?

With our aging population, we need more solutions to help seniors live well. That’s where universal design comes in: it’s a concept that tries to make products and structures usable by everyone, regardless of age, ability, or other factors.

Money Talks News’s  article entitled “8 Essential Home Features for Aging in Place” says that aging in place requires homes that accommodate our needs as we age. The article sets out a list of eight design features buyers focused on accessibility are looking for based on survey data from the National Association of Home Builders’ 2021 “What Home Buyers Really Want” report.

  1. Lower countertops. The kitchen is the center of most homes, and it’s an important part of universal design. Countertops that are three inches lower than the standard height of 36 inches lets seniors and those with limited mobility to fully participate in meal prep. You can round all countertop edges and corners because fewer 90-degree angles may reduce bumping and bruising and minimize injury in the event of a fall.
  2. Lower kitchen cabinets. According to Aging in Place, upper kitchen cabinets that are three inches lower than standard height lessens the tendency to overreach and potentially lose balance. Lower cabinets that feature pull-out shelves, “lazy Susan” corner cabinets and easy-pull handles offer additional convenience for seniors and those who rely on a wheelchair or mobility scooter.
  3. Bathroom aids. For seniors, using the bathroom safely can a challenge. Aging-in-place design recommends these features to make bathrooms more practical and convenient:
  • A walk-in tub or a shower with non-slip seating
  • An adjustable or hand-held showerhead
  • A comfort-height toilet
  • Ground-fault interrupter (GFI) outlets that reduce the risk of shock; and
  • Grab bars near the toilet and shower.
  1. A Stepless entrance. To age in place safely, AgingCare recommends that a home’s main entrance not have steps and should have a threshold height of no more than a half an inch. Here are a couple of ways that an entryway without steps can make life better for seniors:
  • It facilitates smooth entrance/exit by wheelchair, scooters, or walker
  • It decreases the risk of falls, particularly in snowy or icy conditions; and
  • It makes it easier to get deliveries and enter the home carrying groceries.
  1. Non slip floors. According to the CDC, more than 35 million older adults fell at least once in 2018, and 32,000 died from fall-related injuries. To help, non-slip surfaces like low-pile carpet, cork and slip-resistant vinyl can minimize the risk.
  2. Wide hallways. Wide hallways (defined as at least four feet wide) let seniors access every space in their home with a walker, wheelchair, or scooter, or with the assistance of a home health aide.
  3. Wide doorways. A standard doorway can be as narrow as 24 inches, which is a tight fit for seniors who rely on wheelchairs, scooters, or walkers. Seniors like wide doorways, defined as at least three feet wide. According to the ADA, doorways should have at least 32 inches of clear width. To help with an easy transition from room to room, thresholds should be as flush to the floor as possible.
  4. Full bath on main level. Not just convenient, it’s a critical safety feature for seniors. Besides eliminating the need to go up and down stairs several times a day, main floor bathrooms also allow the elderly to (i) respond to incontinence issues more quickly; (ii) practice regular self-care; and (iii) access a private space when required.

Reference: Money Talks News (Aug. 5, 2021) “8 Essential Home Features for Aging in Place”

What Is Science Doing About Hearing Loss?

Thanks to advances in technology and medicine like artificial intelligence and gene therapy, hearing research is producing significant innovations. AARP’s recent article entitled “Three Game-Changing Innovations for Those With Hearing Loss” looks at a couple of them, in various stages of development.

  1. Eyeglasses That Turn Speech into Subtitles. With these, you’ll be able to read what people are saying. An app on your smartphone would listen to a conversation and transcribe the speech into sentences in real time. The text would be sent instantaneously to your enhanced eyeglasses, which would create subtitles. Vuzix, a tech company, recently released smart glasses that work with transcription software. Automatic speech-to-text programs have proliferated in recent years, and live computer-generated captions are now available on most videoconferencing platforms. Smartphone apps can also generate real-time transcriptions for in-person conversations. However, the issue is that users have to be in front of a PC or looking at a phone, which detracts from full social engagement. However, companies are making subtitles more natural, by using “smart glasses” technology, which can project text to a user’s field of vision in a comfortable, nonintrusive way. We may see this in a few years.
  2. An App That Lets You Hear Someone in a Crowded Room. This technology can isolate a person’s speech in a noisy environment, which would solve what scientists call the “cocktail party problem.” An app would “listen” to the soundscape surrounding you and separate out different streams of sound, including voices, ambient music and other background noise. It would then isolate the sound you want to hear based on the direction you’re facing — and reduce everything else. The cleaned-up sound would then be delivered straight to your ear through your hearing aid, cochlear implant, or earbuds. Powerful de-noising programs look to be available on hearing technology within five years.
  3. Drug Therapy That Regrows Cells That Help Your Hearing. Your body would repair damage to your inner ear — like when a salamander regrows his tail. A drug delivered into your inner ear would turn on chemical switches to regrow the cells responsible for hearing and most hearing loss. Those born with hearing loss or those who lose hearing later in life would get injections to restore some or all of their hearing. This hair cell regeneration would be ideal for anyone who’s lost hearing because of missing or damaged hair cells. However, this isn’t anticipated to be available very soon. Some hair cell regrowth therapies using different methods are currently in human clinical trials. There are trials being conducted at Novartis, Eli Lilly, Frequency Therapeutics, and Pipeline Therapeutics. However, most of this work is still being tested in the lab.

Reference: AARP (August 2, 2021) “Three Game-Changing Innovations for Those With Hearing Loss”

This Breathing Trick may Make You More Heart-Healthy

An easy technique, called high-resistance inspiratory muscle strength training (IMST) is when a person inhales deeply through a hand-held device that provides resistance. Doctors say that to get an idea of how it works, think of “sucking hard through a tube that sucks back.”

Money Talks News’ recent article entitled “This 5-Minute Trick Could Help Your Heart More Than Exercise” reports that, as part of the study, 36 adults ages 50 to 79 with above-normal systolic blood pressure readings (120 or higher) were divided into two groups. Half of them performed high-resistance IMST for six weeks; and the other half did a placebo protocol, which involved much less resistance. (Systolic blood pressure refers to the first or top number in a blood pressure reading. For example, if your reading is 120/80, your systolic blood pressure is 120.)

After six weeks, the systolic blood pressure of the IMST group went down an average of nine points. That reduction is better than what’s normally achieved by walking 30 minutes a day, five days a week. It is also equal to the effects of some drugs that work to lower blood pressure. Moreover, those in the IMST group saw a 45% improvement in vascular endothelial function. That’s the ability of arteries to expand upon stimulation. Levels of nitric oxide — a molecule that dilates arteries and prevents plaque buildup — also increased. Lastly, markers of inflammation and oxidative stress fell drastically. Higher levels of these markers are linked to increased heart attack risk. These findings were published recently in the Journal of the American Heart Association.

IMST has been used for years to help patients with respiratory disease to strengthen their diaphragm and other breathing muscles. Researchers now say that more widespread use of IMST might help aging adults lower their risk of cardiovascular disease, the No. 1 cause of death in America.

In a press release, Daniel Craighead, lead author of the study and an assistant research professor in UC Boulder’s Department of Integrative Physiology, noted, “There are a lot of lifestyle strategies we know can help people maintain cardiovascular health as they age. But the reality is, they take a lot of time and effort and can be expensive and hard for some people to access. IMST can be done in five minutes in your own home while you watch TV.”

The researchers say that 65% of U.S. adults over age 50 have above-normal blood pressure—this raises their risk of heart attack or stroke.

It’s usually suggested that those performing IMST engage in a 30-minute-per-day regimen at low resistance. However, Craighead and others have found that a reduced regimen of 30 inhalations per day at high resistance, six days per week also offers cardiovascular, cognitive, and sports performance benefits. The researchers noted that the IMST regimen may be of particular benefit to postmenopausal women. Earlier research has found that postmenopausal women who aren’t taking supplemental estrogen don’t see as much benefit to vascular endothelial function from exercise as men do.

But IMST looks to boost vascular endothelial function in women just as much as men. Craighead says, “If aerobic exercise won’t improve this key measure of cardiovascular health for postmenopausal women, they need another lifestyle intervention that will. This could be it.”

The breathing-muscle training device used in the study is called a POWERbreathe K3, manufactured by a company in England. It costs a few hundred dollars. However, the researchers say they’re developing a smartphone app that will enable people to do the same IMST regimen at home with other devices.

Reference: Money Talks News (July 15, 2021) “This 5-Minute Trick Could Help Your Heart More Than Exercise”

Does Air Pollution Cause Alzheimer’s Disease?

The air quality study was released by the Alzheimer’s Association.

Researchers monitored two groups of at-risk adults, one in Europe and the other in the U.S., over a 10-year period.

WTOP’s article entitled “Study: New evidence shows link between air pollution, Alzheimer’s disease” reports that Dr. Heather Snyder, the vice president of Medical and Scientific Relations at the association, commented that those in Europe who were in less-polluted areas saw a drop in risk by 15% for dementia and 17% for Alzheimer’s disease.

More than six million Americans are living with Alzheimer’s. By the year 2050, this number is expected to increase to nearly 13 million.

The Alzheimer’s Association reports that one in three seniors dies with Alzheimer’s or another dementia. It kills more people than breast cancer and prostate cancer combined.

Women in the U.S. who participated in the study saw a 26% decrease in risk of developing dementia.

This included a reduction in certain categories of pollution, including traffic-related pollution.

Long-term exposure to air pollution was linked to a possible biological connection to physical brain changes that result in Alzheimer’s disease.

“When you actually modify or change air pollution, decrease it, there actually also seems to be a benefit on cognition in a population that are aging,” Snyder said. “I think these data demonstrate the importance of policies and action by federal, state and local governments to address reducing air pollution.”

Snyder remarked that it’s important for those with loved ones battling the disease to take advantage of community resources to see better outcomes overall.

According to the Alzheimer’s Association, more than 11 million people in the United States provide unpaid care for people with Alzheimer’s or other dementias.

in 2020, these caregivers provided an estimated 15.3 billion hours of care, valued at approximately $257 billion.

Reference: WTOP (July 26, 2021) “Study: New evidence shows link between air pollution, Alzheimer’s disease”

Can a Retired Police Officer Qualify for Medicaid?

An 84-year-old retired police officer recently took a fall in his home and injured his spinal cord. He retired from the police force more than 20 years ago and received a lump sum.

Currently, he gets more than $2,000 per month from his pension and Social Security.

How does this retired police officer spend down to qualify for Medicaid, since he is now a paraplegic?

State programs provide health care services in the community and in long-term care facilities. The most common, Medicaid, provides health coverage to millions of Americans, including eligible elderly adults and people with disabilities.

Medicaid is administered by states, according to federal requirements. The program is funded jointly by states and the federal government.

Nj.com’s recent article entitled “How can this retired police officer qualify for Medicaid?” advises that long-term services and supports are available to those who are determined to be clinically and financially eligible.

A person is clinically eligible, if he or she needs assistance with three or more activities of daily living, such as dressing, bathing, eating, personal hygiene and walking.

Financial eligibility means that the Medicaid applicant has fewer than $2,000 in countable assets and a gross monthly income of less than $2,382 per month in 2021.

The applicant’s principal place of residence and a vehicle generally do not count as assets in the calculation.

If an applicant’s gross monthly income exceeds $2,382 per month, he or she can create and fund a Qualified Income Trust with the excess income that is over the limit.

The options for spending down assets to qualify for Medicaid are based to a larger extent on the applicant’s current and future living needs and the amount that has to be spent down.

Consult with an elder law attorney or Medicaid planning lawyer to determine the best way to spend down, in light of an applicant’s specific situation.

Reference: nj.com (July 19, 2021) “How can this retired police officer qualify for Medicaid?”

What Does Cleveland Clinic Say about the New Alzheimer’s Drug?

When the drug first debuted, the Cleveland Clinic said it would not administer Aduhelm, the new FDA-approved Alzheimer’s medicine. However, the hospital system was promoting the unproven drug on its social media accounts.

Cleveland Clinic was the first major medical center to say it would not administer Aduhelm, and two hospital systems have followed the clinic’s lead. However, the Cleveland Clinic made a sudden change, as just two weeks ago, the clinic said that the drug offered “hope.”

Axios’ recent article entitled “Cleveland Clinic’s about-face on the new Alzheimer’s drug” reports that the hospital posted the article on Facebook (July) and on Twitter (June 29)— about a month after the FDA approved the drug. Each social media post said the treatment has been “a sign of hope” for the patient.

At the end of the article, a patient says: “There are people who could really benefit from this, so let’s give them the drug. We’d all like to take something that may be able to help us. Hope is hope.”

Babak Tousi, a neuro-geriatrician at the Cleveland Clinic, called the drug “a real turning point in the field of dementia.”

However, a footnote at the bottom of the article discloses that Dr. Tousi is a paid adviser to Biogen.

She has received $16,700 from Biogen and the drug’s co-developer Eisai since 2014, according to federal data.

Dr. Tousi also has received more than $25,000 during that time from Eli Lilly, which makes a competing experimental Alzheimer’s drug.

What they are saying: The Cleveland Clinic did not make anyone available for an interview, and calls to Tousi’s office went unanswered.

A Cleveland Clinic spokesperson said the article was about the trial, and “research is fundamental to our mission. We regularly provide updates on studies we are participating in.”

The Cleveland Clinic spokesperson did not address questions about the article being promoted after the FDA’s approval and that the article said the drug offered “hope,” even though there’s conflicting evidence about whether the drug works.

The spokesperson added, “We support continued research in this area, and when additional data become available, we will re-evaluate this medication for use in our patients.”

Reference: Axios (July 19, 2021) “Cleveland Clinic’s about-face on the new Alzheimer’s drug”

Do I Need Long-Term Care Insurance?

Women face some unique challenges as they get older. The Population Reference Bureau, a Washington based think tank, says women live about seven years longer than men. This living longer means planning for a longer retirement. While that may sound nice, a longer retirement increases the chances of needing long-term care.

Kiplinger’s recent article entitled “A Woman’s Guide to Long-Term Care” explains that living longer also increases the chances of going it alone and outliving your spouse. According to the Joint Center for Housing Studies of Harvard University, in 2018 women made up nearly three-quarters (74%) of solo households age 80 and over. Thus, women should consider how to plan for long-term care.

Ability to pay. Long-term care is costly. For example, the average private room at a long-term care facility is more than $13,000/month in Connecticut and about $11,000/month in Naples, Florida. There are some ways to keep the cost down, such as paying for care at home. Home health care is about $5,000/month in Naples, Florida. Multiply these numbers by 1.44 years, which is the average duration of care for women. These numbers can get big fast.

Medicare and Medicaid. Medicare may cover some long-term care expenses, but only for the first 100 days. Medicare does not pay for custodial care (at home long-term care). Medicaid pays for long-term care, but you have to qualify financially. Spending down an estate to qualify for Medicaid is one way to pay for long-term care but ask an experienced Medicaid Attorney about how to do this.

Make Some Retirement Projections. First, consider an ideal scenario where perhaps both spouses live long happy lives, and no long-term care is needed. Then, ask yourself “what-if” questions, such as What if my husband passes early and how does that affect retirement? What if a single woman needs long-term care for dementia?

Planning for Long-Term Care. If a female client has a modest degree of retirement success, she may want to decrease current expenses to save more for the future. Moreover, she may want to look into long-term care insurance.

Waiting to Take Social Security. Women can also consider waiting to claim Social Security until age 70. If women live longer, the extra benefits accrued by waiting can help with long-term care. Women with a higher-earning husband may want to encourage the higher-earning spouse to delay until age 70, if that makes sense. When the higher-earning spouse dies, the surviving spouse can step into the higher benefit. The average break-even age is generally around age 77-83 for Social Security. If an individual can live longer than 83, the more dollars and sense it makes to delay claiming benefits until age 70.

Estate Planning. Having the right estate documents is a must. Both women and men should have a power of attorney (POA). This legal document gives a trusted person the authority to write checks and send money to pay for long-term care.

Reference: Kiplinger (July 11, 2021) “A Woman’s Guide to Long-Term Care”

Aging Parents and Blended Families Create Estate Planning Challenges

Law school teaches about estate planning and inheritance, but experience teaches about family dynamics, especially when it comes to blended families with aging parents and step siblings. Not recognizing the realities of stepsibling relationships can put an estate plan at risk, advises the article “Could Your Aging Parents’ Estate Plan Create A Nightmare For Step-Siblings?” from Forbes. The estate plan has to be designed with realistic family dynamics in mind.

Trouble often begins when one parent loses the ability to make decisions. That’s when trusts are reviewed for language addressing what should happen, if one of the trustees becomes incapacitated. This also occurs in powers of attorney, health care directives and wills. If the elderly person has been married more than once and there are step siblings, it’s important to have candid discussions. Putting all of the adult children into the mix because the parents want them to have equal involvement could be a recipe for disaster.

Here’s an example: a father develops dementia at age 86 and can no longer care for himself. His younger wife has become abusive and neglectful, so much so that she has to be removed from the home. The father has two children from a prior marriage and the wife has one from a first marriage. The step siblings have only met a few times, and do not know each other. The father’s trust listed all three children as successors, and the same for the healthcare directive. When the wife is removed from the home, the battle begins.

The same thing can occur with a nuclear family but is more likely to occur with blended families. Here are some steps adult children can take to protect the whole family:

While parents are still competent, ask who they would want to take over, if they became disabled and cannot manage their finances. If it’s multiple children and they don’t get along, address the issue and create the necessary documents with an estate planning attorney.

Plan for the possibility that one or both parents may lose the ability to make decisions about money and health in the future.

If possible, review all the legal documents, so you have a complete understanding of what is going to happen in the case of incapacity or death. What are the directions in the trust, and who are the successor trustees? Who will have to take on these tasks, and how will they be accomplished?

If there are any questions, a family meeting with the estate planning attorney is in order. Most experienced estate planning attorneys have seen just about every situation you can imagine and many that you can’t. They should be able to give your family guidance, even connecting you with a social worker who has experience in blended families, if the problems seem unresolvable.

Reference: Forbes (June 28, 2021) “Could Your Aging Parents’ Estate Plan Create A Nightmare For Step-Siblings?”