Estate Planning Blog Articles

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How Do I Care for a Loved One with Arthritis?

Those with arthritis know how stiffness and pain can restrict the ability to move and function properly.

VeryWell Health’s recent article entitled, “Caring for Someone With Arthritis,” says there are some things that you can do (or keep in mind) when caring for someone with arthritis. These may include the following:

  • Understand their condition. Have a clear understanding of your loved one’s arthritis condition. This can help you see where they may need help. For example, suppose an individual has rheumatoid arthritis that affects their hand and upper extremity movement. In that case, they may need assistance opening bottles and jars or managing fine motor tasks, like handling medication.
  • Keep lines of communication open. Talking with your loved one about arthritis is a great way to understand how it impacts them. You should also share your feelings about caring for them with someone, since providing care and helping someone consistently may take an emotional toll on you.
  • Know when to help and when to stand back. Most people with arthritis want to remain as independent as possible. Therefore, be sure your loved one has the opportunity to be as functionally independent as possible and know that they will ask for assistance when needed.
  • Help manage medication. Sometimes managing arthritis means managing various medicines. If your parent has difficulty keeping drugs and dosages straight—or if they physically have difficulty handling medicine—be ready to assist.
  • Help with managing assistive devices. Some people with arthritis need assistive devices, like canes or walkers, to get around. Sometimes using these can be hard to use. You may help by learning how their assistive device should be used and how to operate it properly.
  • Encourage and help with exercise. Exercise has proven to be beneficial for many with arthritis. Movement helps keep joints lubricated and muscles strong, and exercise can help maintain or improve functional mobility.

Know that your family member may have times when your care and assistance are welcomed and when they want to do it alone. Stay flexible in your care and provide help when necessary and when it is welcomed.

Reference: VeryWell Health (May 29, 2022) “Caring for Someone With Arthritis”

How Can I Prevent a Fall?

Less than 60% have considered the home modifications necessary to age in place safely, says Yahoo Finance’s recent article entitled, “Prevent 300,000 Fall-Related Hospitalizations with Simple Aging in Place Home Modifications According to Lisa M. Cini.”

America’s leading aging expert compiled a list of simple home modifications to prevent falling and maintain balance while they stay home. Consider these simple home modifications to prevent falls:

  • Keep Item Within Reach. This includes your telephone and anything on a high shelf, or on another floor you may need. That way, you won’t have to stretch or balance on step ladders to reach things you need daily, since it can lead to falls.
  • Use Smart Flooring to prevent falls. For example, invest in anti-slip tiles for bathrooms and kitchens to avoid sliding on water or polished surfaces, and ensure that all rugs have anti-slip mats underneath to prevent slipping across the floor.
  • Consider Motion Activated Lighting. Install lighting with sensors to turn on when movement is detected, especially on stairs and in bathrooms.
  • Make the Garden Safe. Clear moss and old leaves from the paths to minimize the risk of slippery spaces. Avoid too many pots and ornaments as they are easy to trip over. Install lighting, so you can see your way along paths in the dark.
  • Get Rid of Clutter. Clearing clutter from steps and floors helps you to avoid slips and trips. Don’t leave things on the floor where they can cause a hazard.
  • Try Posture Exercises. Pilates and yoga will help you avoid falling by maintaining good balance, core strength and posture techniques. Some exercises are chair-based. However, most are gentle and set at a pace that the group can follow.
  • Install Handrails to Keep You Steady. Get handrails in all high-risk places, such as the shower or stairs, to prevent falls.
  • Make Your Bathroom Safe and Functional: Falls often occur in the bathroom. Today’s bathroom can include the Assisto bathtub, which features an easily accessible and ergonomic design that reduces the risk of injury and falls.
  • Voice-Controlled Assistance Devices: Play music, make calls, set music alarms and timers, ask questions and control smart home devices.

Reference: Yahoo Finance (May 8, 2023) “Prevent 300,000 Fall-Related Hospitalizations with Simple Aging in Place Home Modifications According to Lisa M. Cini”

Court Victory for Adults Caring for Parents at Home

A New Jersey Appellate Division recently reaffirmed the state’s regulation that allows older adults to transfer their homes to adult caregiver children without Medicaid penalty, reports an article titled “Major Victory for Adults Who Provide Home Care for Parents” from The National Law Review. The regulation permits the home to be transferred with no Medicaid penalty, when the adult child has provided care to the parent for a period of two years. This allows the parents to remain at home under the care of their children, delaying the need to enter a long-term care facility.

New Jersey Medicaid has tried to narrow this rule for many years, claiming that the regulation only applies to caregivers who did not work outside of the home. This decision, along with other cases, recognizes that caregivers qualify if they meet the requirements of the regulation, regardless of whether they work outside of the home.

The court held that the language of the regulations requires only that:

  • The adult child must live with the parent for two years, prior to the parent moving into a nursing facility.
  • The child provided special care that allowed the parent to live at home when the parent would otherwise need to move out of their own home and into a nursing care facility.
  • The care provided by the adult child was more than personal support activities and was essential for the health and safety of the parent.

In the past, qualifying to transfer a home to an adult caregiver child was met by a huge obstacle: the caregiver was required to either provide all care to the parents or pay for any care from their own pockets. This argument has now been firmly rejected in the decision A.M. v. Monmouth County Board of Social Services.

The court held that there was nothing in the regulation requiring the child to be the only provider of care, and the question of who paid for additional care was completely irrelevant legally.

It is now clear that as long as the child personally provides essential care without which the parent would need to live in a nursing facility, then the fact that additional caregivers may be needed does not preclude the ability to transfer the home to the adult child.

The decision is a huge shift, and one that elder law estate planning attorneys have fought over for years, as there have been increasingly stricter interpretation of the rule by New Jersey Medicaid.

While Medicaid is a federal program, each state has the legal right to set its own eligibility requirements. This New Jersey Appellate Court decision is expected to have an influence over other states’ decisions in similar circumstances. Since every state is different, adult children should speak with an elder law estate planning attorney about how the law of their parent’s state of residence would apply if they were facing this situation.

Reference: The National Law Review (March 22, 2021) “Major Victory for Adults Who Provide Home Care for Parents”

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