New Medicaid laws coming: Joshua Becker quoted in State-Journal Register today

On the front page of the Springfield State-Journal Register this morning, there is an article about the new Medicaid law changes and how they will impact families.  Joshua was quoted several times in the article and a big illustration summary of the law, states at the bottom “Source:  Joshua Becker of Edwards Group LLC”.  The reporter, Dean Olsen, came out to our office earlier this week to talk to him about the new law.

Click here to read the SJ-R article quoting Joshua Becker.

Families Face Aging Parents – Trends and Struggles

Aging Trends and Obstacles of Legacy and Control

There are some things going on in our society now that makes aging, and the way families deal with it, different than it used to be. The issues below are things I see my clients facing as we discuss planning for aging and disability.

1. Better healthcare and longer life expectancy. That’s a good thing, right? Yes, but it leads to some challenges. If you live longer, your health issues may cause you to run out of money, your declining health may dramatically reduce your quality of life, or there’s even a chance your children may face declining health or even pass away before you do.

2. Earlier retirement. People are living longer, but retiring earlier. In 1910, the average retirement age was 74 years, meaning people often worked until they passed away or had to quit for health reasons. In 2002, the average retirement age was 62. Isn’t it nice to retire early? Yes, but it also leads to more planning pitfalls, i.e. more years to potentially get bored, lonely, or run out of money.

3. Families are more scattered. I know some people who have several households within the same family living on the same street. This is rare. More common is that parents have children scattered around different cities, different states, or even different ends of the country. When the family is so spread out, what does that mean for the parents as they age and need assistance? The magazine Christianity Today recently had a column (“Honor Thy Father” for Grownups) about honoring your parents by taking care of them in their old age. How does a family do that when there are 1000’s of miles in between? Often it means delegating the day to day assistance to professional care givers or medical personnel.

4. Communication between generations. David Solie’s book “How to Say it to Seniors: Closing the Communication Gap with our Elders” discusses the two main tasks facing older adults: how to maintain control and how to leave a legacy. Those issues can lead to both conflict as well as rewarding and meaningful conversations.

Let’s think about control

As a person ages, they are faced with losing control. Loss of health, friends, social status, ability to work, driving, choosing where they live, and control of money. All these evaporate as the years tick by. As they are already facing these things slipping away, along comes one of their kids. And what is he telling them? Stop driving, move to assisted living, go to the doctor, eat better, etc.

Is it any wonder that the older generation balks at the advice sometimes? Even if the advice is logical and right on target, it is still another threat to their independence and control. The control is already slipping away naturally and then comes a child wanting to (seemingly) speed up that loss. When a child pushes their elderly parent to make the “right” decision about some life circumstance, it can lead to frustration on both sides, with both feeling unappreciated.

Some people learn from experience that trying to convince our elders with logical arguments will get no where when the elder sees it as a threat to their independence and control. The author, David Solie, says we should stop fighting for control and instead be there to assist. When an older person is allowed the room to make a decision they will often come to a conclusion much more quickly than if they were pushed.

Those in the younger generation are constantly pushing forward to the next new thing. Older adults are sometimes faced with hanging on tight to avoid losing what they already have. Remembering each generation’s different perspective will hopefully reduce the frustration and conflict in those already difficult conversations.

Leaving a legacy

Unfortunately, some seniors spend so much energy and effort trying to maintain control that they never get to the second task of aging – reviewing their legacy. Leaving a legacy involves reflecting on life and how we will be (or want to be) remembered. Reflection means slowing down and focusing on past details. True reflection means a lack of urgency about current tasks.

This lack of urgency is another obstacle to a child pushing a parent to make decisions about a new living arrangement or some other decision that “must be made right now.”

For all us overly busy people, measuring our worth on errands done, emails sent, and whether we are caught up on our facebook status, it may be hard to relax and drop our task orientation.

However, when you hear an older person repeating a story or going into exhaustive detail, listen! You might see how the values in the story reflect the legacy that the storyteller wants to leave and how they would like to be remembered.

Getting Old Ain’t for Sissies: 10 Things to Consider As You Get Older

Here are some things to consider for yourself as you look at getting older. They are in no particular order, just my random thoughts from years of working with families facing these situations.

1. Are you having discussions about how you want to be cared for as you get older? Talk about it. Better yet, put your wishes down in legal documents so people are clear what you want.

2. Is your family prepared to handle things without your help, whether financially or otherwise? If not, you better make doubly sure things are set up right, so they get the assistance they need.

3. Have you lined up the financial resources needed if you became disabled? Such as disability insurance (at work or individual), long term care insurance, emergency fund savings. Do you have too much debt? Do you really want to be retired or facing a disability with credit card debt or a mortgage that’s not paid off?

4. Who is going to help you with healthcare decisions? Who will encourage you to go to the doctor? Who will go to the appointments with you to make sure you stay as healthy as you can for as long as you can?

5. Are you spending too much? How does your income, savings, and spending line up if you look out a few years? Have you calculated how your savings will grow or shrink based on your current spending level? or do you need to have a professional help you do that?

6. Are you spending too little? You have worked hard and saved your money. It’s OK to spend some and enjoy yourself by traveling or other things you enjoy. Or, if you truly have more income than you need and can spend, consider using those funds to increase what you leave at death. For instance, if you have IRA distributions you have to take (after age 70.5), use those distributions to pay life insurance premiums. Then leave the life insurance to your loved ones or a charity you believe in. When we run statistical projections for clients considering life insurance, they almost always show that a person leaves more money at death by purchasing life insurance. If you really don’t need the money, parlay it into a bigger chunk with life insurance.

7. Never say never. Transitions and change are difficult. Are you laying down a gauntlet by saying “I never will…”? Instead, make a plan so you can enjoy the most freedom and as full a life as possible for as long as possible.

8. Are you willing to make a transition sooner than necessary so you can avoid losing control? By getting “greedy” and holding on too long, sometimes people can end up losing their independence more quickly. For example, a grandmother leaves the family home earlier than anyone thinks she needs to, and enters a retirement community, where she has less stress of home upkeep, and more social opportunity that keeps her young. Another grandmother waits too long, goes downhill at home by herself, gets hurt by falling, declines by not eating right. Then when she is later forced to move to another living arrangement, she can’t enjoy the people or activities there because of declining health. Remember, there are endless variations to the type of retirement community or assistance a person can choose. Make choices while you still have choices, instead of having those choices made for you in a crisis.

9. Make gifts while you are around to see someone enjoy them. Gifts to your church or charity. Gifts to family (especially of heirlooms where you can share the story behind them). If you can, give some money and things away while you are still healthy so you can see how they bring joy and benefit to those who received it. To learn more about charitable giving, click HERE.

10. The ultimate question. I personally can never think about getting older without thinking about the ultimate question – what is there beyond this life?  I believe that faith in Jesus Christ leads to eternal life.

You can pick your friends, but you can’t pick when you need your healthcare directives

Peace of Mind: Can you access your important documents 24/7?

I am writing this from Nashville, Tennessee, where I am on a family vacation. Every year, we spend a week with my parents, brother, sister in law, and nephew.

Being out of town reminded me of an important part of planning for emergency health or disability issues. Suppose you work with me to plan for those issues, and we prepare healthcare powers of attorney and a living will. Then you are on a trip, maybe to Nashville or somewhere else out of state. If something happens and you end up in the hospital or emergency room, will you have access to your important legal documents? If the doctors ask for proof that your spouse or loved one has authority to make decisions on your behalf, will you be able to provide it? Will the doctors even talk to your loved one without written permission because of the privacy laws?

Do you travel with copies of your powers of attorney and living will? If not, then if something happens you may not have access to the documents when you need them. When we are talking about legal decisions regarding healthcare or end of life issues, lack of access to the documents at the right time means the documents are worthless at that moment.

If you don’t have immediate access to the documents you need, what are your options?

  • Deal with it without using the legal documents. This means that your decisions and the helpers you have designated to carry out those decisions may not be followed, or at least won’t be followed as easily, quickly, or accurately.
  • Try to get a copy of the documents from your attorney. Not a bad plan, but most law offices aren’t open 24/7. What if you are injured in the middle of the night during a holiday weekend? Or maybe you are in Hawaii with a big time difference and the law office is closed when you contact them? Our office is always glad to provide copies of documents, but we can’t guarantee we can get them to you around the clock.
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    Neither of these options is adequate. So, how do we make sure that you have quick access to the documents when you need them? For our clients who are members of our Dynasty Program, we provide a membership to DocuBank.

    What is DocuBank? It’s a business that was created to help people have immediate access to their legal healthcare documents when they need them. They have solved the exact problem we are talking about. For an annual fee, DocuBank will get copies of your documents to you, anytime, day or night, no matter where you are.

    How does DocuBank work? As part of the planning process, our clients sign a DocuBank application that provides emergency contact info and important medical information. We then send that application to DocuBank, along with copies of the client’s healthcare power of attorney and living will. The client will later get in the mail a wallet card they can carry at all times that explains how to access those documents. By calling an 800 number or logging in to a web site and putting in a PIN # (that is listed on the wallet card), DocuBank will provide the legal documents within minutes, either via the web or fax. Check out more info at www.docubank.com.

    Do you know someone who would appreciate the kind of peace of mind that a DocuBank membership provides? Have them give us a call today at (217) 726-9200.

    Aging – There’s Only One Alternative

    Getting older. We are all faced with it. As my dad has said, if you don’t want to grow old, there is only one other option. (You know, die young…)

    As I work with clients, I am constantly confronted with aging and death. How the circle of life comes around and all of us, eventually, will face declines in our health, mental ability, independence, etc. Depressing, isn’t it? Well, it can be, I guess, but also involves not just death but how we live our lives now and the legacy we leave behind. And it makes us confront our ultimate spiritual reality and what we think happens after we leave this earth.

    I am an avid newspaper reader. I often read most of the paper. I always make sure I look at 3 things: Dilbert, Dear Abby, and the box score from last night’s Cardinal baseball game or Illini basketball game (depending on the season).  Here was a letter I saw in Dear Abby.

    Dear Abby: I am a single woman in my 60s who lives alone. One of my greatest fears is developing dementia. Because there is no one living with me, there would be on one around to notice changes in my behavior. I am still able to balance my checkbook, do my grocery shopping, drive myself to the dentist’s office, etc. If I ever need assisted living, how would I recognize the fact so I could make other arrangements before requiring someone else to make them for me? –GROWING OLDER IN SAN DIEGO

    Abby had an answer for her: ask your doctor to check you over during each annual physical exam. That’s an OK answer, but I have better one.

    Dynasty Program Membership

    By planning with me and becoming a member of our Dynasty membership program, a person would have the best disability planning options available. We help clients name a “disability panel” that consists of both loved ones and at least one doctor, who will decide when the person needs help managing their affairs. Because our office has contact with each client at least once a year and most often several times a year, we are also able to watch for signs that a person needs assistance. In fact, we probably know our clients better than their doctors as to the daily living issues. We have spent hours and hours with them over the years.

    Once assistance is needed, our clients have already set out instructions in legal documents that outline how they want to be cared for toward the end of life.

    Powers of Attorney?

    Maybe you are thinking “isn’t a power of attorney enough to plan for disability?”  Well, a power of attorney is important, but pull them out and see what instructions are included in there. There are a lot of powers given in those documents, but very few instructions. Where in the power of attorney does it talk about whether you have a preference to be cared for at home rather than a nursing home? Do you have an opinion about that issue? If so, does it make sense to have it written down somewhere in your estate plan?

    Living Trust: valuable tool for Disability Planning

    It’s my job to use whatever tools will best get the job done for the client. What will work best to build the plan the client wants?

    Although it’s not the client’s job to understand all the tools that we use in the plan, most clients end up with a basic understanding of how a living trust works by the time we are done designing the plan.

    Living Trust – not just to avoid probate

    In most plans, a living trust is the most useful tool to accomplish a lot of important goals. The living trust does help a client avoid probate, if used properly. This has been a big focus over the years by both attorneys and clients. But that’s only the beginning.

    Disability Planning: Don’t settle for a “blank check” power of attorney

    The living trust is also the best vehicle to help do detailed disability planning. Powers of Attorney typically give a power as a “blank check” with no guidance, but a living trust is different. A living trust allows you to do disability planning that gives a lot of details about how you want to be cared for, who will manage the funds while you are disabled, who can they spend money on during your disability, and who decides whether you are disabled in the first place. The power of attorney simply grants raw power without much guidance about how to use it. A living trust grants similar power but then can give lots of guidance, procedures, preferences, and instructions to be used by those managing your money when you are too sick to do it.

    The goal of disability planning within a living trust is to have you and your family cared for during your disability in the same way you would have done it yourself, if you had been able.

    The Nursing Home – 5 Ways to Pay For It

    How will you (or your parents or grandparents) pay for a nursing home? People work hard their whole lives saving money, living frugally, hoping to pass something on to their kids and grandkids. Then reality sets in as age and health issues force that money to be used for healthcare instead.

    Maybe you have wondered, “What are the options for my family to pay for nursing and long term care costs?”

    There are 5 basic ways to handle it.

    1. Stay at home without outside help. As long as one spouse is healthy, this works fine. But too often I see the caregiver spouse start having health issues, possibly brought on by the stress of 24-hour care for their loved one.

    2. Move in with family and avoid the expense altogether. Just tell them to get your room ready, you’re on your way! This option works great for some families, but not so great for others. And it’s not just the younger generation that has the concerns. Often, my older clients say they don’t want to be a burden to their kids or put stress on them. Plus, there are some health concerns that are just beyond what a family can handle at home on their own.

    3. Spend your life savings, either on nursing help at home or in a facility.

    4. Let the government pay for it. Too many times, I have heard people say, “I’ll give all my stuff to my kids and let the government pay for my nursing home.” Unfortunately, there are some kinks in this plan.

    If you give your money away, you really have to give it AWAY. This means your kids can waste it all, the money can be exposed if your child gets divorced, or can be at risk if they have financial problems such as getting sued, having a downturn in business or getting laid off.

    You can’t just give all your money away and then apply for Medicaid to get the government to pay for your nursing care. If you give assets away, it may impact your application if you apply within 5 years after the gift (5 years according to federal law – Illinois is still at 3 year “look back” because they are late in complying with the federal requirement).

    Even if you get on Medicaid, you have limited options. The government won’t pay for home care and only pays for the bare minimum of care in a nursing home that may not have been your first choice. I’m sure it’s no surprise that the nicest nursing homes don’t take government aid, they only take private payments.

    5. Buy long term care insurance. If you need long term care, whose money would you rather spend? The insurance company’s or yours (which was intended to be your kid’s inheritance)? Plus, certain long term care policies allow you to use the funds to hire help at home, so you can avoid a nursing home altogether. In addition, many people are exploring hybrid long term care benefits, where they purchase an annuity or life insurance policy that can be accessed for nursing costs if necessary.

    We can help you sort out these options.  The earlier you start planning the better. If you would like to start planning now for nursing home costs, our popular Long-Term Care Essentials Workshop is a great place to start. This free workshop will talk about planning for care, protecting your assets and myths about Medicaid qualification. Find out more about the workshop HERE.

    However, it’s never too late to plan.  Even if you have a loved one in a nursing home using their savings to pay for it, call us at (217) 726-9200. There are legal and financial strategies that may be able to protect some of the funds for the family.

    For more information about general planning, check out our article “Getting Old Ain’t For Sissies: 10 Things to Consider As You Get Older” HERE.