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keep elderly safe

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”

keep assets

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”

elder law attorney

How Do I Find a Great Elder Law Attorney?

Elder law attorneys specialize in legal affairs that uniquely concern seniors and their adult children, says Explosion’s recent article entitled “The Complete Guide on How to Find an Elder Law Attorney.”

Finding the right elder law attorney can be a big task. However, with the right tips, you can find an experienced elder law attorney who is knowledgeable, has the right connections and fits your budget.

While, technically, a general practice attorney will be able to handle your retirement, Medicaid and even your estate planning, an elder law lawyer is deeply entrenched in elder law. This means he or she will have extensive knowledge and experience to handle any case within the scope of elder law, like the following:

  • Retirement planning
  • Long-term care planning and insurance
  • Medicaid
  • Estate planning
  • Social Security
  • Veterans’ benefits; and
  • Other related areas of law.

While a general practice lawyer may be able to help you with one or two of these areas, a competent elder law lawyer knows that there’s no single formula in elder law that applies across the board. That’s why you’ll need a lawyer with a high level of specialization and understanding to handle your specific circumstances. An elder law attorney is best suited for your specific needs.

A referral from someone you trust is a great place to start. When conducting your elder law lawyer search, stay away from attorneys who charge for their services by the hour. For example, if you need an elder law attorney to work on a Medicaid issue, they should be able to give you an estimate of the charges after reviewing your case. That one-time flat fee will cover everything, including any legal costs, phone calls, meetings and court fees.

When it comes to elder law attorneys, nothing says more than experience. An experienced elder law lawyer has handled many cases similar to yours and understands how to proceed. Reviewing the lawyer’s credentials at the state bar website is a great place to start to make sure the lawyer in question is licensed. The website also has information on any previous ethical violations.

In your search for an elder law attorney, look for a good fit and a high level of comfort. Elder law is a complex area of law that requires knowledge and experience.

Reference: Explosion (Aug. 19, 2020) “The Complete Guide on How to Find an Elder Law Attorney”

medicare

Will Medicare Cover Everything?

Actually, far from covering all your healthcare needs, Medicare may leave you with thousands of dollars in expenses for which you’ll be responsible.

The recent article in The Mooresville Tribune entitled “3 Reasons Medicare Coverage Isn’t as Comprehensive as You Think” provides three reasons why:

  1. Medicare has expensive deductibles and coinsurance. There are different parts to Medicare. Part A covers hospital care. Part B pays for outpatient care. Each one has deductibles and some coinsurance expenses. Let’s look at these examples:
  • Medicare Part A has a $1,408 deductible per benefit period this year. If you are in the hospital more than 60 days during a benefit period, you’ll owe coinsurance costs starting at $352 per day, based on how long you remain in care.
  • Part B has a $198 deductible in 2020, and you’ll pay coinsurance costs of 20% of the Medicare-approved amount for medical services after you meet the deductible. You’ll also owe monthly premiums.
  • Part C (Medicare Advantage) takes the place of traditional Medicare (Parts A and B) with private insurance. Coinsurance, copay and premium costs vary by plan.
  • Part D (prescription drug coverage) has several plans with varying premiums and coverage rules.

As a result, with only Parts A and B, you could wind up paying thousands of dollars out of pocket. That’s especially true, if you’re hospitalized for a long time during the year or if you need extensive outpatient care.

  1. Coverage exclusions. In addition, there are some items of care that Medicare doesn’t cover at all. For example, Medicare doesn’t cover routine dental care, eye exams, contacts, hearing aids or glasses.
  2. Medicare doesn’t cover long-term care in most circumstances. A major Medicare exclusion is long-term care insurance. Medicare covers care in a skilled nursing facility under a few circumstances, such as after a long hospital stay when you need assistance from a medical professional to recover. However, the program doesn’t pay for “custodial care,” either at home or in a nursing home. Thus, if you require someone to help you with routine aspects of daily living, like getting dressed, eating, or using the bathroom, you’ll have out-of-pocket costs.

It’s important to know that long-term care can be very costly. The median monthly costs of home health aides are roughly $4,300, and a semi-private room in a nursing home costs about $7,500 in 2019, according to Genworth. Since Medicare won’t pay for any of this in most circumstances, you’ll need another way to pay for it.

Don’t assume that Medicare will cover all your needs as a retiree. So, prior to retirement, examine what Medicare will actually cover. That will help you determine the amount you’ll need to save for healthcare costs. You can also consider Medigap or Medicare Advantage Plans or look into long-term care insurance.

Reference: Mooresville Tribune (Aug. 10, 2020) “3 Reasons Medicare Coverage Isn’t as Comprehensive as You Think”

visiting grandparent during pandemic

Visiting Grandma at the Nursing Home

In spots where visits have resumed, they’re much changed from those before the pandemic. Nursing homes must take steps to minimize the chance of further transmission of COVID-19. The virus has been found in about 11,600 long-term care facilities, causing more than 56,000 deaths, according to data from the Kaiser Family Foundation.

AARP’s recent article entitled “When Can Visitors Return to Nursing Homes?” explains that the federal Centers for Medicare and Medicaid Services (CMS) has provided benchmarks for state and local officials to use, in deciding when visitors can return and how to safeguard against new outbreaks of COVID-19 when they do. The CMS guidelines are broad and nonbinding, and there will be differences, from state to state and nursing home to nursing home, regarding when visits resume and how they are handled. Here are some details about the next steps toward reuniting with family members in long-term care.

When will visits resume? As of mid-July, 30 states permitted nursing homes to proceed with outdoor visits with strict rules for distancing, monitoring and hygiene. The CMS guidelines suggest that nursing homes continue prohibiting any visitation, until they have gone at least 28 days without a new COVID-19 case originating on-site (as opposed to a facility admitting a coronavirus patient from a hospital). CMS says that these facilities should also meet several additional benchmarks, which include:

  • a decline in cases in the surrounding community
  • the ability to provide all residents with a baseline COVID-19 test and weekly tests for staff
  • enough supplies of personal protective equipment (PPE) and cleaning and disinfecting products; and
  • no staff shortages.

Where visits are permitted, it should be only by appointment and in specified hours. In some states, only one or two people can visit a particular resident at a time. Even those states allowing indoor visits are suggesting that families meet loved ones outdoors. Research has shown that the virus spreads less in open air.

Health checks on visitors. The federal guidelines call for everyone entering a facility to undergo 100% screening. However, the CMS recommendations don’t address testing visitors for COVID-19.

Masks. The federal guidelines say visitors should be required to “wear a cloth face covering or face mask for the duration of their visit,” and states that allow visitation are doing so. The guidelines also ask nursing homes to make certain that visitors practice hand hygiene. However, it doesn’t say whether facilities should provide masks or sanitizer.

Social distancing. The CMS guidelines call on nursing homes that allow visitors to ensure social distancing, but they don’t provide details. States that have permitted visits, state that facilities enforce the 6-foot rule.

Virtual visits. Another option is to make some visits virtual. Videoconferencing and chat platforms have become lifelines for residents and families during the pandemic. Continued use after the lockdowns can minimize opportunities for illness to spread.

Reference: AARP (July 22, 2020) “When Can Visitors Return to Nursing Homes?”

combat social isolation

How Can I Combat the Social Isolation of Coronavirus?

Local and state governments are asking that we socially distance ourselves to prevent the spread of the coronavirus.

The CDC recommends that anyone who’s age 60 and older avoid crowds, and that those in a community with an outbreak remain at home as much as possible.

AARP’s recent article entitled “How to Fight the Social Isolation of Coronavirus” gives us some ideas to keep in mind to decrease the threat of social isolation and loneliness as the pandemic continues:

  1. Social isolation and loneliness are significant health issues. These related conditions impact a great number of adults in the U.S. It is thought of as being the equivalent of smoking 15 cigarettes a day! According to research from the National Academies of Sciences, Engineering and Medicine, 43% of adults over 60 in the U.S. reported feeling lonely.
  2. Prepare and stay in contact. It’s crucial that we talk to family and friends to develop a plan to safely stay in regular touch, as we socially distance ourselves—or if required to self-quarantine for a possible exposure or are in isolation for a COVID-19 infection. This should confirm whom you can contact, if you need help getting food, medicine and other supplies.
  3. Find helpful organizations. Create a list of charitable and other local organizations that you or the people in your plan can contact, if access is needed to information, health care services, support and resources.
  4. Don’t forget about pets. Pets are a great source of love and companionship, and they can help combat loneliness. In fact, some pets have been linked with owners’ longevity. Just as you need to be sure you have enough supplies for you and family, be stocked with food and other supplies for your furry friends.
  5. Keep in mind those who are at the greatest risk for social isolation and loneliness. People with the highest risk of serious illness from COVID-19 and who should be the most aware of social distancing, will also be the most at risk of increased social isolation and loneliness. While planning is important, know that many individuals will likely experience increased social isolation and loneliness.

Reaching out to friends, family, and neighbors can help protect all of us from COVID-19, as well as social isolation and loneliness.

Reference: AARP (March 16, 2020) “How to Fight the Social Isolation of Coronavirus”

caregiver for family member

Can I Get Paid to Be a Caregiver for a Family Member Who’s a Vet?

AARP’s recent article entitled “Can I Get Paid to Be a Caregiver for a Family Member?” says that you may be able to get paid to be a family caregiver, if you’re caring for a veteran. Veterans have four plans for which they may qualify.

Veteran Directed Care. Similar to Medicaid’s self-directed care program, this plan lets qualified former service members manage their own long-term services and supports. Veteran Directed Care is available in 37 states, DC, and Puerto Rico for veterans of all ages, who are enrolled in the Veterans Health Administration health care system and require the level of care a nursing facility provides but want to live at home or the home of a loved one. A flexible budget (about $2,200 a month) lets vets choose the goods and services they find most useful, including a caregiver to assist with activities of daily living. The vet chooses the caregiver and may select any physically and mentally capable family member, including a child, grandchild, sibling, or spouse.

Aid and Attendance (A&A) Benefits. This program supplements a military pension to help with the expense of a caregiver, and this can be a family member. A&A benefits are available to veterans who qualify for VA pensions and meet at least one of the following criteria. The veteran:

  • Requires help from another to perform everyday personal functions, such as bathing, dressing, and eating
  • Is confined to bed because of disability
  • Is in a nursing home because of physical or mental incapacity; or
  • Has very limited eyesight, less than 5/200 acuity in both eyes, even with corrective lenses or a significantly contracted visual field.

Surviving spouses of qualifying veterans may also be eligible for this benefit.

Housebound Benefits. Veterans who get a military pension and are substantially confined to their immediate premises because of permanent disability are able to apply for a monthly pension supplement. It’s the same application process as for A&A benefits, but you can’t get both housebound and A&A benefits simultaneously.

Program of Comprehensive Assistance for Family Caregivers. This program gives a monthly stipend to family members, who serve as caregivers for vets who require help with everyday activities because of a traumatic injury sustained in the line of duty on or after Sept. 11, 2001. The vet must be enrolled in VA health services and require either personal care related to everyday activities or supervision or protection, because of conditions sustained after 9/11. The caretaker must be an adult child, parent, spouse, stepfamily member, extended family member or full-time housemate of the veteran.

Reference: AARP (May 15, 2020) “Can I Get Paid to Be a Caregiver for a Family Member?”

long-term care covid infections

Does Long-Term Care Impact COVID-19 Infection Rates?

The National Investment Center for Seniors Housing and Care (NIC) say that research supports the finding that keeping older Americans in apartments of their own may be saving many of them from COVID-19. That’s a summary of results from a survey of more than 100 senior housing and care operators.

Think Advisor’s recent article entitled “LTC Type Has Big Effect on COVID-19 Infection Rates: Provider Survey” explains that some participants provide more than one type of long-term care (LTC) services.

The sample includes 56 assisted living facility managers and 29 nursing home managers, as well as providers of some other types of services.

The assisted living facility managers said that they’d tested 22% of the residents as of May 31, and only 1.5% had confirmed positive, or suspected positive, COVID-19 tests.

The nursing home managers tested 34% of their residents.

Roughly 6.7% of the residents tested had confirmed or suspected positive coronavirus tests.

Analysts at the Foundation for Research on Equal Opportunity believe that, as of June 19, approximately 43% of the people who’ve died from COVID-19 in the U.S. have been in nursing homes and assisted living facilities.

Many seniors with private long-term care insurance (LTCi) policies, short-term care insurance policies, or life insurance policies, or annuities that provide LTC benefits attempt to use the policy benefits to stay at home as long as possible, or to live in the least restrictive possible LTC setting.

The NIC survey results support the finding that access to private LTCi and LTC benefits may have protected some insureds from the COVID-19 outbreak.

Reference: Think Advisor (June 29, 2020) “LTC Type Has Big Effect on COVID-19 Infection Rates: Provider Survey”

nursing home pandemic planning

Should Nursing Homes Plan for Future Pandemics?

Roughly 6,000 nursing home residents have died during the pandemic in New York State.

The coronavirus pandemic has exposed vulnerabilities for one of the country’s most high-risk populations: our senior citizens.

Spectrum News reports in the article “Nursing Homes Could Be Required to Have Pandemic Plan” reports that a proposed bill in that state would require nursing homes to have plans for future pandemics, make those plans readily available on websites, provide regular updates on the status of patients and establish protection plans for staff and residents.

In addition, communication via videoconferencing must be made available for residents.

The bill would also mandate that a pandemic plan preserve a resident’s place in a nursing home after hospitalization is through. It would also include provisions for the facilities to have a minimum two-month supply of personal protective equipment (PPE).

The New York State Department of Health will be required to audit facilities annually for compliance.

“The nature of COVID19 exposed a tragic vulnerability among one of our most high-risk populations: our elderly,” said Assemblyman Joe Lentol, a Brooklyn Democrat. “The rapid spread of the virus in nursing homes exposed a fatal flaw in pandemic planning and it is clear that more has to be done to protect nursing home residents and its healthcare workers.”

New York’s response to nursing homes during the crisis has come under some scrutiny. Part of that has been a March 25 order that required the facilities to take in COVID-positive patients.

New York Governor Andrew Cuomo has partially reversed that directive, by banning hospitals from discharging people to nursing homes who are still positive for the virus.

Cuomo has also placed some of the blame on the CDC guidelines for permitting nursing homes to take COVID residents. However, he didn’t raise the issue in a recent meeting with President Trump.

Twice weekly testing of nursing home and adult care facility staff is now underway. The testing capacity and supply has increased in New York over the past month.

The bill must still be considered by Governor Cuomo for approval.

Reference: Spectrum News (May 28, 2020) “Nursing Homes Could Be Required to Have Pandemic Plan”

Suggested Key Terms: Elder Law Attorney, Elder Care, Caregiving, Legislation

crimes against elderly

Will the Sunshine State Crack Down on Crimes against the Elderly?

Florida Governor Ron DeSantis signed a bill recently approving the creation of elder abuse fatality review teams.

These teams are authorized by Senate Bill 400, which permits, but doesn’t require the creation of elder death review teams in each of Florida’s 20 judicial circuits. The teams would review cases in their judicial circuit where abuse or neglect has been found to be linked to or the cause of an individual’s death.

The Naples Daily News’ recent article entitled “Deaths of Florida’s elderly who were abused or neglected to get increased scrutiny under new law” reports that for many years, the state has authorized teams to examine child deaths and domestic-violence deaths where abuse is involved. However, the state hasn’t had a comparable review when an elderly adult dies, even under suspicious circumstances.

State Senator Audrey Gibson, D-Jacksonville, has sponsored the bill for the last four years and remarked that it’s “incumbent upon us as a state” to review cases of elder abuse and to look for gaps in service and possible policy changes to better protect the elderly.

“It can help to reduce elder abuse, if somebody knows that it’s going to be up for review if something happens to that senior,” said Gibson, the Senate minority leader. “The other thing is to prevent what happened in the cases they’re reviewing, to keep that from happening to another senior.”

Elder advocates believe that the new elder death review teams could help decrease the number of cases of nursing home neglect and mistreatment, like those identified in a recent USA TODAY Network – Florida. The investigation looked at 54 nursing home deaths from 2013 through 2017 where state inspectors cited neglect and mistreatment as factors.

The investigation found that Florida’s Agency for Health Care Administration seldom investigated the deaths.

The new law states that these elder abuse fatality review teams can be established by state attorneys and would be part of the Department of Elder Affairs. They would be composed of volunteers and open to people from a variety of disciplines, such as law enforcement officers, elder law attorneys, prosecutors, judges, nurses and other elder care advocates.

The teams are restricted to looking at files that have been closed by the State Attorney’s Office, whether or not it resulted in criminal prosecution. Remarkably, state attorneys didn’t prosecute any of the 54 nursing home deaths reviewed in the network’s investigation.

Reference: Naples Daily News (June 11, 2020) “Deaths of Florida’s elderly who were abused or neglected to get increased scrutiny under new law”