How is the VA Handling Aging Veterans?

The Department of Veterans Affairs and veterans organizations across the country are working to care for a new generation of older veterans who are apt to have greater expectations for longevity and independence than earlier generations, yet also may struggle with more complex medical conditions, reports Military Times’ recent article entitled, “America faces a tidal wave of aging military veterans.”

“We’re kind of compounding multiple variables, in the sense that not only are people living longer, but … many of them survived something that wasn’t survivable,” says Scotte Hartronft, the director of geriatrics and extended care at VA. “A lot of veterans have survived significant injuries over the last couple of conflicts that [they] wouldn’t have survived in previous wars.”

In California, the most populous state and home to the highest number of vets, the State Department of Veterans Affairs, known as CalVet, the state’s veterans department, is working to create a modern facility that centers the needs and dignity of older veterans. Like VA facilities across the country, people charged with caring for veterans must address the same question: How do we best care for those who have served on our behalf as they grow old?

Other states also have issues: between 2021 and 2041, the number of veterans older than 85 is expected to increase by 31%. That’s partially because the overall number of veterans nationwide is actually decreasing. Between 2000 and 2018, the number of veterans in the country declined by a third — the bulk of Americans who have served in the military served decades ago.

Vietnam and Gulf War-era veterans represent a different slice of the population than veterans who fought in World War II and Korea: the number of women veterans over 65 is expected to increase by 237% between 2021 and 2041. Racial diversity is also increasing, and the geographic distribution of veterans is shifting. As a result, veterans’ care must change. Women, for example, have a greater life expectancy than men do. Women veterans will generally need more support to continue to live independently as they age for longer — a fact compounded by the fact that women, who tend to be informal caregivers to friends and family, often have more difficulty than men finding their caregivers when needed.

In addition to higher rates of post-traumatic stress and other conditions affecting mental health, veterans are more likely to be exposed to risk factors, such as traumatic brain injuries or toxic exposure, for Alzheimer’s and other dementias. Vets also have a higher chance of being diagnosed with certain types of cancer, like lung and skin cancer. Roughly 50,000 new cancer cases among veterans are reported annually; that number is expected to rise as veterans age.

Every VA medical center will offer veteran-directed care within the next two years. This popular program provides qualified veterans with a stipend to hire local caregivers to assist them with daily living or even companionship. VA is expanding home-based primary care — which provides health care to veterans at home, many of whom are housebound — to 75 new sites and expanding its Medical Foster Care program. This lets some vets live in a private home with a caregiver rather than in a nursing home. They’re also piloting a program using predictive analytics to help determine which veterans are at the highest risk of nursing home care in the coming years to connect them with preventive services.

Reference: Military Times (June 2, 2023) “America faces a tidal wave of aging military veterans”

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”

Will I Be Able to Afford Nursing Home Care?

About 60% of older adults — or 24 million households — wouldn’t have the resources to pay for in-home long-term care, despite the fact that they would prefer to “age in place,” per a National Council on Aging report.

Fox News’ recent article entitled, “Most seniors in America can’t afford nursing homes or assisted living, study finds,” says that the researchers looked at 2018 data from the Health and Retirement Study, which was a joint effort by the National Institute on Aging and the Social Security Administration that surveyed some 20,000 U.S. adults about their net wealth.

When the researchers started examining the data some years ago, they were initially surprised to see that so many older adults were at severe risk of financial insecurity, Dr. Jane Tavares, a lead researcher at the LTSS Center at UMass Boston, told Fox News Digital.

“There is a common misconception that older adults are asset-rich, but we have found in our research that this is not generally true,” she said.

Dr. Tavares also noted, “We expect that there will probably be some worsening, once we examine data for the period covering the COVID pandemic.”

The national average cost for assisted living is $4,500 per month. However, it can vary significantly depending on the location and level of care needed.

“As the population continues to age and demand for these services grows, it is likely that the cost will continue to rise,” said Dr. Steven Norris, a senior health and care expert who is also the medical director at Transitions Care in Chicago, Illinois.

The widespread shortage of qualified caretakers means facilities must pay more to secure the right people.

“For decades, there has been a lack of awareness of how expensive assisted living really is.” “Additionally, recent increases in minimum wage requirements and changes in overtime payment legislation are increasing assisted living costs,” he said.

The cost could range from $3,000 in rural areas to $7,000 to $9,000 in urban locations.

“For decades, there has been a lack of awareness of how expensive assisted living really is,” Kim told Fox News Digital.

“Some people thought health insurance would cover long-term care costs, while other people optimistically believed that they would live a healthy life forever.”

Assisted living companies had to raise prices to keep up with their costs continually. However, retirees did not see the same growth in savings or investments. Middle-aged and older adults are also now facing a very different financial landscape than the generations before them did. More than the increases in household income and assets have also been needed to keep up with rising living costs, health care and inflation. Even when older adults have assets, they are often tied up in property and need to be more readily available to help them cover costs.

The changing retirement model has also added to gaps in savings. Past generations had private, employer-sponsored pensions that provided predictable payments. Many Americans now rely on 401(K) accounts, leaving individuals responsible for saving enough money to cover their retirement years.

“With all of this combined, few older adults have any significant savings in retirement accounts — and most can’t afford long-term care insurance that would help cover the expensive costs of assisted living or nursing home care,” she explained.

“With private long-term care insurance being unaffordable for most older adults, it is key to begin considering combined public and private initiatives that can put the cost of coverage within reach and make it more appealing to consumers,” she said.

Reference: Fox News (April 26, 2023) “Most seniors in America can’t afford nursing homes or assisted living, study finds”

Use Estate Planning to Prepare for Cognitive Decline

Since 2000, the national median age in the U.S. has increased by 3.4 years, with the largest single year gain of 0.3 years in 2021, when the median age reached 38.8 years. This may seem young compared to the life expectancies of older Americans. However, the median age in 1960 was significantly lower, at 29.5 years, according to the article “Don’t Let Cognitive Decline Derail Well-Laid Financial Plans” from Think Advisor.

An aging population brings many challenges to estate planning attorneys, who are mindful of the challenges of aging, both mental, physical and financial. Experienced estate planning attorneys are in the best position to help clients prepare for these challenges by taking concrete steps to protect themselves.

Individuals with cognitive decline become more vulnerable to potentially negative influences at the same time their network of trusted friends and family members begins to shrink. As people become older, they are often more isolated, making them increasingly susceptible to scams. The current scam-rich environment is yet another reason to use estate planning.

When a person is diagnosed with Alzheimer’s or any other form of dementia, an estate plan must be put into place as soon as possible, as long as the person is still able express their wishes. A diagnosis can lead to profound distress. However, there is no time to delay.

While typically, the person may state they wish their spouse to be entrusted with everything, this has to be properly documented and is only part of the solution. This is especially the case if the couple is close in age. A secondary and even tertiary agent needs to be made part of the plan for incapacity.

The documents needed to protect the individual and the family are a will, financial power of attorney, durable power of attorney and health care documentation. In addition, for families with more sophisticated finances and legacy goals, trusts and other estate and tax planning strategies are needed.

A common challenge occurs when parents cannot entrust their children to be named as their primary or secondary agents. For example, suppose no immediate family members can be trusted to manage their affairs. In that case, it may be necessary to appoint a family friend or the child of a family friend known to be responsible and trustworthy.

The creation of power of attorney documents by an estate planning attorney is critical. This is because if no one is named, the court will need to step in and name a professional guardian. This person won’t know the person or their family dynamics and may not put their ward’s best interests first, even though they are legally bound to do so. There have been many reports of financial and emotional abuse by court-appointed guardians, so this is something to avoid if possible.

Reference: Think Advisor (April 21, 2023) “Don’t Let Cognitive Decline Derail Well-Laid Financial Plans”

Protect Your Elderly Parents from Scammers

Thinking on a very practical level, if you were a thief and had to choose a target, it would likely be someone who has wealth and is vulnerable—the picture of an elderly person, especially one who is likely to be isolated and may have cognitive issues. According to the Federal Trade Commission, consumers aged 60 and older filed 467,340 fraud reports in 2021, reporting total losses of more than $1 billion.

A recent article from cbsnews.com, “How to protect elderly parents from financial scams,” says that consumers age 60 and older are less likely to report losing money to fraud than those aged 18—59. Still, when they do report a loss, it tends to be for more money, especially among those 80 and older. They have the highest median loss of all groups.

Older adults are likelier to lose money on scams involving tech support, prizes, sweepstakes, lotteries and friends and family impersonations. What can you do?

Talk about it. Scams target everyone. Therefore, it is an easy topic to bring up. First, start the conversation with your experiences or a trending news story. Next, explain specific scams, like someone reaching out through social media saying they want to be friends, followed by an urgent request for money or fake text messages from a grandchild who needs bail money. People informed about scams’ specifics are less likely to respond.

Use anti-fraud tools. Spam-blocking apps on cell phones can send unknown numbers to voicemail immediately. A credit freeze can secure credit information and is easily temporarily unlocked for legitimate access. Setting strict privacy tools on social media can also limit the number of scammers who can get through.

Signing up for financial account monitoring or receiving alerts for transactions is easily enough put into place. However, in some instances, it would be wise to allow adult children to monitor these accounts, depending upon the parent’s comfort level with sharing this information.

Put legal tools into place. A durable power of attorney, revocable trust, or, if appropriate, guardianship, can be among the most effective ways to keep an older adult’s assets safe from scammers. If a revocable trust is created, an adult child can quickly step in before too much damage is done, whether it’s a fake charity or a “kidnapped grandchild” scammer.

Know the warning signs. An older adult who is suddenly reluctant to talk about their finances had said they are having trouble paying bills when they never had a problem before or is receiving a high number of text messages or phone calls and insists on being alone when they respond may have become a victim of fraud.

Scammers are especially good at creating a sense of urgency, saying their victims must send money or gift cards immediately, or the IRS or police will arrive at their door. The latest wrinkle is the use of artificial intelligence to mimic a loved one’s voice, and the technology is so good that even experts are fooled.

Avoid shaming loved ones. The embarrassment of being the victim of elder financial abuse worsens a bad situation. Don’t scold an elderly person for being fooled; they certainly will be angry enough at themselves for being taken. Reassuring words are more likely to allow the victim to keep some of their dignity, while encouraging them to call you if, and more likely when, they are confronted with another scammer.

Reference: cbsnews.com (April 10, 2023) “How to protect elderly parents from financial scams”

Older Singles Can Plan to Protect Themselves

The U.S. Census Bureau reports nearly a third of all seniors live alone—about 14 million—some of whom don’t have children or anyone to care for them if they need help. However, according to a recent article from Forbes, “Essentials for the Solo Ager,” everything is fine until there’s a problem. This is especially true when the solo ager’s friends are all about the same age and in the same situation.

One financial adviser asked an estate planning attorney to contact a client who was 88, living alone, still driving and maintaining her own home. She had an inadequate estate plan done for free by a volunteer at her senior center and needed a Power of Attorney and Health Care Power of Attorney. In addition, her only living relative lived outside of the United States, and the person she relied upon was a 90-year-old, legally blind neighbor. All of this had worked fine for years, but at 88, she was highly vulnerable.

Here are some options for solo agers to consider while planning constructively for the future:

Consider naming a fiduciary to handle finances in your estate plan, which an experienced estate planning attorney should prepare.

Healthcare decisions are often a minefield for someone who is cognitively or physically impaired and unable to make decisions. Some professionals can be named as your healthcare agent, preferably someone who knows the healthcare system and can advocate for you if you are incapacitated. In addition, a healthcare power of attorney would be needed.

Make your wishes and preferences clear in your estate planning documents, so someone who does not know you well can follow your specific directions and fulfill your wishes.

Give up the idea of being 100% well until you pass. Most seniors unfortunately experience one or more health challenges and need more assistance than they ever imagined. Be realistic and identify younger adults who will be able to help you and give them the legal tools to do so. If they never need to help you, fantastic, but if they do, you’ll be glad to have their help.

Single people are independent and self-reliant and take pride in these characteristics. This is great. However, there comes a time when none of us can be independent. No one likes to think about losing their independence or becoming disabled. However, planning will keep you safer rather than hoping for the best.

Meet with an experienced estate planning attorney who will help you plan for your future and protect you from the unexpected.

Reference: Forbes (March 26, 2023) “Essentials for the Solo Ager”

Does Government Have Financial Assistance for Alzheimer’s?

Social Security Disability Insurance (SSDI) provides financial support to those who’ve worked and paid into the Social Security system and are now unable to work due to a disability, including dementia. To be eligible for SSDI, a person must have enough work history and their condition must meet the SSA’s definition of a disability.

Help! Dementia recent article entitled, “Financial Costs and Planning for Dementia and Alzheimer’s,” explains that Supplemental Security Income (SSI) provides financial support to those who have a limited income and assets and are aged, blind, or disabled. People with dementia may be eligible for SSI, if they satisfy the income and asset limits set by the Social Security Administration.

The Area Agency on Aging has information and resources on financial assistance for those suffering from dementia. However, financial assistance can vary depending on the location and the services offered by the agency. Some services that the aging agency may provide include:

Information on government benefits, such as Medicaid, may be available to individuals with dementia and their families to help cover the costs of care.
Assistance with long-term care planning, like resources on long-term care options, including assisted living facilities and in-home care. They can help individuals with dementia and their families plan for their future care needs.
Information on financial assistance programs, such as grants and loans, may be available to individuals with dementia and their families to help cover the costs of care.
Life resource planners and elder law lawyers can be helpful to those with dementia and their families who need assistance with financial and legal planning.

Life resource planners are professionals who specialize in helping individuals and families plan for their future, including financial and legal planning. They can provide guidance on government benefits, caregiving and long-term care planning.

Elder law lawyers specialize in legal issues affecting older adults, including government benefits and long-term care planning.

Reference: Help! Dementia (Feb. 12, 2023) “Financial Costs and Planning for Dementia and Alzheimer’s”

Should I Consider Working with an Elder Law Attorney?

Partnering with an elder law expert is the best way to make life transition easier as seniors age. RC Online’s recent article entitled “Why Is It Ideal for Working with An Elder Law Attorney During Life Transitions?” explains that many people have issues in the stage of life when they’re weak and not feeling well. This can result in health or mobility issues for many family members. The challenges faced by the family can cause financial strain, making lifestyle adjustments difficult, the article says.

Elder law attorneys can help family caregivers understand their loved one’s current situation and provide possible future solutions. This includes planning for situations where a debilitating illness requires long-term care.

Elder law attorneys often see various financial and medical circumstances when representing seniors in court, so their assistance can be extremely valuable when addressing issues, such as managing long-term care needs.

Specialized services for elderly care. Elder law attorneys focused on legal matters concerning older individuals. An elderly law attorney will be familiar with the elder laws of your state and will be able to identify potential conflicts or issues easily. As a result, they’ll be able to take appropriate actions to protect their client’s interests and rights.

Long-term care plan development for seniors. An elder care attorney can provide an objective perspective on the kind of care for their elders. This can help create a longevity plan that meets everyone’s needs.

The attorney will focus on families’ issues and problems as parents or spouses age. They provide legal services to individuals facing aging challenges, such as health care decisions and financial planning. An elder law attorney will consider the required level of care and whether a person can remain in their own home or require long-term nursing care.

Help for families in mediation and education. These are critical parts that play an important role during a family’s transitional phase. Mediation helps families maintain communication, and education provides knowledge for handling various issues.

It is important to have legal agreements related to retirement benefits, assets and who will be responsible for caring for an elderly loved one. An elder law attorney can help make these arrangements to prevent family fights and protect assets. They can assist seniors as well as heirs and beneficiaries to prevent losing assets due to financial problems or other circumstances.

Reference: RC Online (Feb. 14, 2023) “Why Is It Ideal for Working with An Elder Law Attorney During Life Transitions?”

What Is Elder Law?

Estate planning concerns distributing assets after one dies, including the use of last wills, trusts and preparing the estate to minimize assets passing through probate. Elder law is more focused on protecting the individual during their lifetime.

Elder law provides people with legal rights and protections, as they become older and become vulnerable. The field of elder law covers a range of issues impacting seniors, including long-term care planning options, end-of-life and estate planning and problems including nursing home abuse or neglect. There are a variety of issues for which seniors benefit from legal assistance, says a recent article titled “Elder Law: A Complete Guide” from Forbes.

Medicare Planning and Social Security. An elder law attorney can help seniors understand their options to maximize Social Security benefits. Claiming benefits before full retirement age results in a reduction in monthly benefits, while a delayed claim leads to a larger monthly income. Signing up for Medicare can be daunting, with so many options and decisions to be made. An elder law attorney can help get it right the first time.

Incapacity Planning. While one can become incapacitated at any time in life, the chances of becoming physically or mentally impaired increase as one ages. Having a living will allows you to specify what kind of medical treatments you want to accept or decline. A durable power of attorney allows you to name an agent to control your assets, and a healthcare power of attorney lets another person make medical decisions on your behalf.

Guardianship. If no incapacity planning has been done and action needs to be taken on your behalf, the court will assign a guardian. This could be a family member, or if none is available or the court does not deem the family member to be a good candidate, a professional guardian might be assigned.

It takes time for a person to be declared legally incapacitated and for a guardian to be appointed. The process can be costly and is stressful for all concerned.

Long-Term Care Planning. Someone turning 65 today has as much as a 70% chance of needing some type of long-term care during their lifetime. Long-term care planning addresses making decisions in advance for having care at home or moving into a nursing home for rehabilitation or as a permanent resident. Long-term care planning includes planning for Medicaid and protecting assets.

Elder Abuse Laws. Unfortunately, seniors are vulnerable to abuse, especially when they must rely on others for care. Elder abuse laws exist to protect you from physical, mental, emotional, sexual, or financial abuse. An elder abuse claim can be pursued to recover compensation for medical bills, loss of assets, emotional distress, or physical pain.

An elder law attorney can help create a plan to address issues and protect those who are lucky enough to enjoy a long life.

Reference: Forbes (Jan. 11, 2023) “Elder Law: A Complete Guide”

Can a Dementia Patient Sign Legal Documents?

Once a diagnosis of dementia has been received, families need to immediately begin advance care planning, as explained in a recent article titled “Can Someone With Dementia Sign Legal Documents” from Health News. Depending on their medical condition, some patients with dementia, particularly in early stages, may be capable of making their own decisions regarding legal decisions. However, discussions must begin early, so the person can be involved and understand the planning process.

When family members don’t know the wishes of their loved ones, they are more likely to experience distress and difficulties in making decisions. Families report feelings of guilt, self-doubt and stress while making advance care decisions with no input from their loved ones.

Laws concerning advance care vary from state to state. An elder law attorney can help older adults interpret state laws, plan how their wishes will be carried out and understand financial options.

Advance care planning focuses on both long-term care and planning for funeral arrangements. These documents typically include a durable power of attorney for healthcare, a living will and Do-Not Resuscitate orders, often called a DNR. Depending on state law, there may also be a MOLST document, short for Medical Orders for Life-Sustaining Treatment.

The durable power of attorney for healthcare names another person who can serve as a proxy for the person with dementia, if and when the person is not able to make informed healthcare decisions for themselves.

A living will states a person’s wishes for end-of-life treatment. This documents their views about specific medical procedures including but not limited to dialysis, tube feeding or blood transfusions. If the person should become unconscious, then families may make treatment decisions based on what their loved one wanted.

A Do-Not-Resuscitate order is placed in a patient’s medical chart if the person does not want to receive CPR (cardiopulmonary resuscitation) if their heart stops or breathing ceases. This must be signed by a doctor before it is placed in the chart.

Planning for a funeral is a difficult task. However, it will alleviate stress and possible guilt in the future. People with dementia can tell their loved ones in advance what they want regarding a funeral or memorial service, burial, or cremation. If any arrangements are already in place, such as the purchase of a burial plot, providing details to family members will make it easier to manage.

Advance care planning can be a sensitive topic but seeking legal advice early on is useful so the family can focus on making sure their loved one has the care they want. Involving the person with dementia in the process is respectful. An elder lawyer attorney will be able to guide the family to ensure planning is done properly.

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

Estate Planning Blog Articles

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

How is the VA Handling Aging Veterans?

How is Congress Trying to Protect Seniors from AI Scams?

Will I Be Able to Afford Nursing Home Care?

Use Estate Planning to Prepare for Cognitive Decline

Protect Your Elderly Parents from Scammers

Older Singles Can Plan to Protect Themselves

Does Government Have Financial Assistance for Alzheimer’s?

Can a Dementia Patient Sign Legal Documents?

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How is the VA Handling Aging Veterans?

How is Congress Trying to Protect Seniors from AI Scams?

Will I Be Able to Afford Nursing Home Care?

Use Estate Planning to Prepare for Cognitive Decline

Protect Your Elderly Parents from Scammers

Older Singles Can Plan to Protect Themselves

Does Government Have Financial Assistance for Alzheimer’s?

Can a Dementia Patient Sign Legal Documents?

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