hospice

5 Misconceptions About Hospice

Many people are afraid of hospice. This fear comes from a misunderstanding of the services hospice can provide. Last week we talked about the basics of hospice and why it is one the most positive ways to approach the end of life. This week we tackle some of the big misconceptions about hospice.

5 Misconceptions About Hospice

1) Doesn’t saying “yes” to hospice mean you’re “giving up”? No, hospice does not require that you give up hope. Yet, many people see it that way. Hospice is a way to deal with the transition of death on your own terms, generally in your own home. Most people arrive at hospice too late, making the process harder, not easier, on their family.
2) Won’t my doctor know when it’s time and recommend hospice? Not necessarily. Doctors are trained to heal. They don’t want to “give up” either. Because of that, it’s important to understand what hospice is, and how it can help, if you or a loved one has a terminal illness or advanced disease. Again, most people get hospice care too late, which robs them and their family of quality time together in their last days/months.
3) Will hospice provide 24/7 continuous care? No, you need to have a dedicated caregiver. In the beginning, you will receive more visits from hospice staff, then it will drop off a bit. Towards the end, the visits will pick up again, but hospice is not around-the-clock nursing care. If you or your loved one needs that, and your family cannot arrange for a dedicated caregiver, then you need to consider other options.
4) Do I have to use my hospital’s hospice program? No, you have a choice about what hospice to use.​ You do not have to use the hospital’s service. Again, it’s important to plan ahead if at all possible. Some hospices are better than others. This is not a decision you should make without doing some research.
5) Aren’t all hospices non-profit organizations derived from a religious affiliation?75% of hospices in the US are now for-profit organizations, according to a Washington Post article from 2014This is not necessarily a bad thing, but it does mean consumers have to be careful when choosing which agency to use. The hospice industry has much less oversight than nursing homes or other healthcare providers, which places the burden of oversight on families who are already in a very stressful situation.

All in All, Hospice Is a Very Good Thing

Most people, if given the choice, would rather die peacefully at home instead of experiencing a series of acute hospital stays or ER visits for the last few months of their life. Yet that’s what many people inadvertently do because they don’t understand hospice.

Hospice gives patients and families great comfort in a time of great stress. It shouldn’t be done at the last minute when it is too late to provide meaningful moments between the patient and family. Good hospice care can help facilitate the tension of such a big transition while making more meaningful moments possible. Because of the spiritual care and social workers, hospice is an amazing support system for those dealing with the hardest, and ultimate, transition in life.

As always, if you have any questions or concerns about estate planning, elder law, Medicaid planning, long-term care planning, Veterans benefits or end-of-life documents, please give us a call at 217-726-9200. We are more than happy to speak with you!

 

What You Need to Know About Hospice

At Edwards Group we believe that education is foundational to navigating the issues of aging with as little stress as possible. And with all the misinformation out there about hospice, we thought it would be good to do an article on the topic.

Elisa Cottrell, a former hospital chaplain who handles our marketing and communications, sat down with Kathleen Sgro, founder of Alterna-Care Home Health (and former oncology nurse), and Joseph Sgro, Chief Development Officer for Alterna-Care, to talk about hospice. What is it? Who needs it? And why is it such a powerfully positive experience when done well?

What is hospice?

Hospice is a type of comprehensive and compassionate care for someone facing an advanced or terminal illness. Hospice care addresses the physical, emotional, social and spiritual needs of the patient, while also helping the family with their emotional and spiritual needs. Hospices employ nurses, social workers and chaplains to meet these needs. Primarily, hospice is a home health benefit. This means that patients get to stay in the comfort and familiarity of their own home while they receive hospice services. The nurses, chaplains and social workers come to you and your family.

Who needs hospice?

In addition, if your disease is causing great pain, hospice nurses are experts in managing pain. They also have a much better outcome than nurses who have not been trained in hospice care.

Generally, if you have been given a prognosis of 6 months to live, then you will qualify for hospice. This DOES NOT mean that you are giving up or that you will get “kicked out” after 6 months. You can receive hospice services for as long as you are declining. It is a coordinated effort between all of your medical team to determine if you still need hospice. Sometimes people get better and get discharged. While you receive hospice though, you may not go to the ER. Hospice is about quality of life and making life as good as it can be while you have an advanced disease.

Why should you use hospice?

In addition to effective pain management, there are other very good reasons why hospice needs to be viewed as a good thing and not something negative.

Going in and out of the hospital trying to get acute care, which is only going to cause more stress and pain in the short run, is not a good way to spend the end of life. Most people, if given the choice, would rather die peacefully at home instead of experiencing a series of acute hospital stays or ER visits for the last few months of their life. Yet, that’s what many people inadvertently do because they don’t understand hospice.

Hospice gives patients and families great comfort in a time of great stress. It shouldn’t be done at the last minute when it is too late to provide meaningful moments between the patient and family. During our conversation, Joe Sgro said he “routinely argues that oftentimes hospice is more for the family than the patient.” It gives everybody the time and space to do what needs to be done relationally at the end of life, and that is so very powerful. Frequently, the patient will be ready to stop “fighting” via active treatments of their disease, but the family isn’t ready for that. Hospice can help facilitate that tension and make more meaningful moments possible. Because of the spiritual care and the social workers, hospice is an amazing support system for those dealing with the hardest, and ultimate, transition in life.

Should I wait until my doctor recommends hospice?

Doctors are trained to save lives, and because of that they have a hard time telling patients that it’s time for hospice. According to Joe Sgro, “Doctors are trained to heal. They don’t want to ‘give up’ either,” which is why it is so important to fight the misconception that hospice is “giving up.” Hospice gives people a sense of dignity, and it gives families meaningful time with their loved ones – time that can make the end of the life transition easier and less traumatic.

“Even as someone who has training in end-of-life spiritual care and knows how deeply effective and positive hospice can be, I had trouble getting a real conversation started with doctors and family when my father-in-law was diagnosed with Stage IV cancer,” says Elisa Cottrell. “I knew the important work we all had to do in saying goodbye. In making sure all those things you want to say to your loved ones get said, but it was a hard sell. In the end, we thought we had a few months left with my father-in-law, but we only had five weeks. He never made it to hospice. I still feel very strongly that my father-in-law’s oncologist robbed us from having meaningful time that could have made the transition easier. There are many long-term complications of grieving that will linger with the family because they didn’t have the chance to properly face the situation. Nobody was able to be at peace with what was happening. They were all fighting it. It made for a lot of extra stress then and now.”

And that’s one of the most important things hospice can do. In addition to walking families through the stages of grief and helping them to understand the process better, Kathy Sgro feels that the most important thing Alterna-Care can do is to get the family and patient to the peace stage. This is the truly revolutionary part of hospice that most can’t understand unless they’ve been through it before.

For more on end of life issues, read our article, Approaching End of Life Issues With Forethought here. And check back next week for our upcoming post, 5 Misconceptions About Hospice.

2 Types of Help You May Need

Last week we gave you a secret test you could give a named helper (or potential helper) to see if they might be up to the task. But what sorts of things might you need help with? There are generally two categories…

Help With Finances

A recent National Institutes of Health study showed a decrease in decision-making skills between the ages of 56-85. We also know, statistically, that if you reach the age of 65 you will, on average, live 19.2 more years. Therefore, many of us will need help with complicated financial decisions that occur in the last few decades of life.

A Power of Attorney for finances will allow someone to help you pay bills, manage your investments and make financial decisions. This may sound very scary, but we help our clients make good choices about financial POAs on a daily basis. That’s why you see the word “Counselor” in our name.

Help With Healthcare Decisions

As you age, you may want input from others about your healthcare. We all know how complicated the medical care world is to navigate these days.

A Power of Attorney for healthcare will allow someone to help you make decisions about a variety of medical issues:

• Medical treatments – like chemo and radiation if you’re diagnosed with cancer. Sadly, doctors and nurses can’t always be relied upon to recommend the best course of action. It can be extremely helpful to have someone else listening to the options, the pros and cons, and then helping you make sense of the process.

• Surgery – whether it’s really needed or not.

End of life decisions – do you want to be hooked up to machines? Do you want to spend your last days at home if at all possible?

• Where to  live – should I downsize, stay put (age in place) or is there another alternative?

• How to get the best care – marketers are very savvy and they know that seniors are an easy target. It would be very helpful to have someone who can help you weed through all the “flash” of advertisements and get down to the real useful information so you can make informed choices.

• When to sign a “Do Not Resuscitate” order.

Learn more about what exactly helpers do in our post, “12 Duties of a Helper.”

How Edwards Group Can Help

We help families choose good helpers everyday. This is a difficult decision and one of the most important you’ll ever make. You don’t have to do it alone. We can guide you through the process of deciding who is best. While you’ll only do this once in your lifetime (maybe twice), we’ve helped hundreds of families since 2008. In that time, our firm has been solely dedicated to estate planning and elder law. We’ve seen A LOT and gained a lot of wisdom from the families we help on a daily basis. We can help you know what to do and what NOT to do.

Give us a call at 217-726-9200 and plan to attend an upcoming workshop today. If you attend one of our workshops, you’ll receive $200 off your initial meeting fee (if you schedule your appointment within 30 days of the workshop). We do this so you’ll know, before spending your hard earned money, if we’re the right firm for you. Attending a workshop makes the planning process easier and more effective.

The greatest threat to an effective estate plan is not taking any action at all, so take your first step today and call us at 217-726-9200.

The Top 2 Concerns of Planning

When a loved one is facing long-term care the first concern people have when they come to us for planning is how to get the best care possible. The second concern is how to pay for it.

Getting Good Care

People come to us worried about an aging family member or friend all the time. Their primary concerns are making sure their loved one is provided for, making sure they’re safe and getting the medical care that they need, while helping them have quality of life as much as possible. And these are the primary goals for our firm as well. We want to help decrease stress, increase quality of life and preserve family relationships during the last decades of life.

Paying for Care

This is the issue that usually adds the most stress for families because they don’t know where to turn or where to get good advice about the options that are out there. The scary truth is that a lot of people are given wrong information and think there’s nothing that can be done if you can’t afford care on your own.

In reality, there are many planning tools that we can use to protect assets and gain benefits, even if someone is already in a nursing home. Our firm finds ways to maximize benefits available to pay for care, and protect some of the assets that mom hoped she would leave her family someday. Even if somebody’s been in a nursing home for months or years, it’s oftentimes not too late to get benefits to pay for care.

As long as somebody is writing personal checks to the nursing home every month, it is not too late to plan and save some of those assets.

The key is working with an experienced elder law attorney. Most “estate planning” attorneys just do what we call “death planning” (last will and testament, etc.), but elder law attorneys (like Edwards Group) have specialized training and expertise, and that means we deal with Medicaid and VA benefits every single day. We help you use the legal tools to their full advantage. And that means, in most cases, we can qualify someone for benefits faster than they ever expected, get more benefits than they ever expected, and in the end, protect much more of their life savings than they thought possible!

aging alone

Aging and Alone: 7 Steps to Protect Yourself

In a previous post, we talked about a growing segment of people who are aging alone without the help of their adult children (either because they don’t have children or their children live very far away). These seniors face unique challenges in their 70’s and 80’s. To read about those four challenges, click here. With proper planning, guided by an experienced elder law attorney who has faced these issues many times before, you can achieve peace of mind and have a plan in place if you do not have close family nearby.

7 Steps Every Senior Should Take if Aging Alone

1. Make a plan while you are still sharp (physically and mentally).

A study by the National Institutes of Health found decreased cognition and decision-making impairment begin around the age of 60. Research has also shown that the ability to make sound investment decisions sharply declines at 70. Because of this, it’s important to plan ahead.

2. Make sure your plan is a comprehensive plan and not just a will.

An effective Life Care Plan should include documents like Powers of Attorney (for health and finances), advanced directives for end of life medical issues, etc. It should also address questions such as how will you pay for long-term care, how do you want care decisions to be made, and do you want to stay at home if at all possible?

3. Set up structures to protect yourself.

With the help of an experienced elder law attorney, you should anticipate future issues and how you want them handled. (For instance, if you don’t have kids, consider a professional helper such as an attorney, CPA or bank to handle your finances.)

4. Be open to changing your living arrangements.

If you’re willing to alter your living arrangements earlier on, then you’ll be able to make changes on your own terms, deciding what’s most important to you. If you wait until crisis strikes, others may have to dictate where you go, or your medical issues may dictate where you have to live.

If you start to become isolated in your house, having difficulty taking medicine or eating properly, there needs to be a fail-safe in place so that you don’t suffer and linger too long in the house on your own.

5. Create a plan with ongoing maintenance.

In the last few decades of life things can change rapidly. That’s why a plan with ongoing maintenance is especially helpful. Crafting a flexible plan, through an attorney you trust, insures that adjustments can be made as circumstances change.

6. Gather a list of contacts who can help you.

Identify what tasks you need help with (cooking, cleaning, yard work, etc.) and then match the tasks with people (friends, neighbors, nieces, nephews, church members) who might be able to help you with those specific jobs.

7. Find local resources to help.

There are several good resources that can help seniors, or their distant children, get the help they need.

Illinois Department on Aging     1-800-252-8966

Area Agency on Aging     1-800-252-8966    (Here’s a more detailed listing for Sangamon County)

Senior Services of Central Illinois     217-528-4035

Aging is not something any of us wants to think about, but by thinking and planning ahead, you can save yourself a lot of grief, stress, dignity and money.

If you are facing the prospect of aging alone and are concerned that you don’t have an adequate plan in place, don’t hesitate to give us a call at 217-726-9200. We are always happy to help in anyway that we can!

4 Challenges of Aging Alone

There’s a growing segment of people who are aging without the help of their adult children (either because they don’t have children or because their children live far away). Read on to learn more about the challenges this group faces.

People are living longer than ever before in history. People are having less children. And those children often live out of town or in other states. Because of all these factors, 1 in 4 Americans over the age of 65 are at risk of becoming “elder orphans.”

Many don’t like this term. “I’ve lived just fine on my own nearly all my life!” However, it is a quick and clear way to describe a growing number of people who are getting older without the immediate support of close family. And it is a HUGE challenge – one our firm is seeing more and more often.

4 Challenges of Aging Alone

It used to be that a will was an adequate estate plan for most people, but a will only works after a person’s death. A will cannot help with the challenges that present themselves when a person is in their 70’s and 80’s. And if that person does not have children, or has children halfway across the country, then the challenges of the last two decades of life can make things even harder.

So what are 4 important things to consider if you find yourself in this situation?

1. Who’s gonna be in charge?

Of course, you would like the answer to be yourself, but what happens if you have a stroke, start to experience the signs of dementia or develop cancer? When the time comes (and it will come for the vast majority of people), who will pay your bills for you? Who will help get you to doctor visits or treatments? Who will help you get groceries or cook? Read about choosing good helpers here.

2. Who will even know if you need help?

Oftentimes, we don’t recognize the need for help in our own lives. More often than not, at our firm, it is the adult children who notice that their parents need help. It is nearly impossible to notice a slow decline in your own life without someone else’s perspective.

3. What if you get help from all the wrong places?

Sadly, there are more ways to scam seniors than ever before. Dishonest caregivers have always been able to steal money, change the will, etc. but now there are mail order scams, and tech scams on iPads or via email. It is really hard to know who to trust (read about 7 Types of Helpers to Watch Out For here), which brings us to the next challenge…

4. What if you reject good advice because you don’t know who to trust?

While it is really hard to know who to trust, there are still some really good, honest people out there who are passionate about helping seniors. We work with these types of advisors everyday. They are out there, but if you’re on your own, how will you know if you can trust them?

Aging is not something any of us wants to think about, but by thinking and planning ahead, you can save yourself a lot of grief, stress, dignity and money.

If you are facing the prospect of aging alone and are concerned that you don’t have an adequate plan in place, don’t hesitate to give us a call at 217-726-9200. We are always happy to help in anyway that we can!

checkbook

The Checkbook Test: Can your executor or trustee pass it?

Good “helpers” are essential to an effective plan. Could the people you’ve chosen as executor, trustee, power of attorney or guardian pass this simple test?

Every Estate Plan Needs a Good Helper

We talk about good “helpers” a lot, and that’s because they are vitally important to an effective estate plan. Helpers are the people who will carry out your plan when the time comes. They can be known by different names depending on which document names them as a helper. Some helpers are trustees for trusts, some are executors for wills, some are power of attorney for health or finances, and some helpers are guardians for minor children. No matter the title, their job is essentially the same – to make good choices and to act for you when you cannot do it for yourself. (Read more about choosing good helpers here.)

The Checkbook Test

There is a very simple way to gauge whether you have chosen the right person to be one of your “helpers.”

Imagine the person you have chosen (or are considering choosing) as your executor or trustee. Now, imagine giving them your checkbook and letting them pay your bills for a couple months. How does that make you feel? Do you feel nervous? Anxious? If so, you may want to reconsider who you’ve chosen as a helper. 

Read about 7 Types of Helpers to Watch Out For here.

So, how can Edwards Group help?

If you’ve been around Edwards Group for any amount of time, we hope that you’ve seen how we approach estate planning differently. One of the things we do differently is by counseling our clients as they make the hard decisions that have to be made when creating an estate plan. We have experience that most people don’t. We do estate planning all day every day, and we’ve done it for nearly a decade now. We can help guide our clients through these hard choices.

If you need help choosing “helpers” for your plan, call us at 217-726-9200 and ask for a copy of our paper newsletter on choosing helpers. We’ll be more than happy to mail you a copy. You can get immediate access to this great resource here.

Download our resource on choosing good helpers HERE.

Widows at Risk for Being Taken Advantage Of

It may be hard to believe, but when a husband (or wife) dies, there are plenty of people there to take advantage of the situation. A recent article in a national newspaper column highlighted this risk with a local Springfield woman.

Trustworthy helpers are vitally important to widows/widowers…

Recently, there was a very concerning article in the paper about people preying on a widow after her husband’s death. It would have been an eye-opening article regardless, but the writer of the letter to the paper’s columnist was writing from Springfield, Illinois, so it created quite a stir around here. Several people forwarded the article to us. Some wondered what they could do to avoid such a terrible situation. Some wondered how Edwards Group could help prevent such a thing.

First things first, read the article here.

SJ-R Widows article April 2015 web copy

In the letter, the writer from Springfield details how the funeral home, real estate agents, car dealerships, home repair companies, charities, and even the widow’s own pastor, tried to take advantage of her and pressure her to make unwise financial purchases, decisions or donations. The number of requests shocked this family friend, who had been asked by the late husband to watch out for his wife after he was gone. People were literally coming out of the woodwork… including 2 estranged children who hadn’t been in the picture for 13 years. (Much of this is because obituaries and wills are very public, and opportunists watch them carefully.)

So, what did the columnist recommend? Click here.

First, he told the writer how lucky the woman was to have a friend such as himself. Secondly, he recommended finding a professional “helper” (such as a trust company) in Springfield who could help pay bills and provide other assistance and guidance related to the house, medical care, or other things she might need. He also recommended a good Certified Public Accountant to help make sure that her finances are properly taken care of.

So, how could Edwards Group have helped Alice?

We thought this would be a great opportunity to show you what it would be like if Alice (the widow in the article) were a client of Edwards Group:

1) When Alice’s husband died, she would have had a plan in place and known who to call right away. The plan would clearly outline what would happen, and Edwards Group would have been with her every step of the way, possibly preventing a funeral home from taking advantage of her and the situation. (Click here for a checklist of what to do when a loved one dies.)

2) Alice and her husband would have already carefully chosen helpers for their plan, in case they were needed. They would have done this with the help and advice of our attorneys who are very experienced in making these sorts of important decisions and thinking through every detail.

3) When decisions came up or needed to be made, Alice would have someone (she already knows and trusts) to call for assistance. That might be one of the attorneys, or perhaps Laura Peffley, who has walked with many clients through terminal illnesses and the loss of loved ones. (Often making house calls, when needed.)

4) Liis, our Trust/Estate Administrator, would be available to help with bill paying or other financial management issues that may come up.

5) If Alice had been a part of our Dynasty membership program, she would have an up to date asset list and we could help advise her on how new potential investments fit into her (and her late husband’s) planning goals.

6) We would help Alice know what questions to ask of other professionals in her life, such as her financial advisor, CPA or banker. We would help her coordinate between them and help her make wise choices after her husband’s death. We would also help watch out for those trying to take advantage of her.

7) And when it comes to Alice’s estranged children, who now want to be in the picture, we could serve as a buffer or mediator. Edwards Group has worked with estranged children and challenging family dynamics before, always trying to bring peace if possible, or if not, to protect the client from family pressures.

At Edwards Group, we take care of our clients as if they were our own family. (See testimonials from clients here.) Integrity is of great importance, and we take the trust that our clients place in us very seriously. If you, or someone you know, could use help with estate planning, long-term care planning, estate administration, probate, finding a good nursing home for your loved one, or even finding a good attorney in another field, we strive to be a trustworthy resource for the Springfield community and beyond. Call us at 217-726-9200, and we’d be happy to speak with you.

Is Your Estate Plan Old and Clunky?

David Edwards loves what he does, and it’s obvious because he can connect just about anything to estate planning! In this post, Dave and his dad explore how estate planning is like… old tennis rackets. 

Estate Planning is Like… Old Tennis Rackets

When my parents were first married (around 1967 or so), my mom’s parents gave them each a tennis racket. They were nice sturdy wooden rackets with the frames that you could screw down to keep them from warping.

My parents used them a little, but not too much before they ended up in storage in the attic above the garage. When I was in the 10th grade, I signed up for tennis at the YMCA one summer. Since I needed a racket, my dad proudly offered, “We have a couple of nice ones up in the attic. Barely been used.”

I came home after that first lesson and said, “Dad, the coach said that I need a new racket.” As we shopped for the new racket, my dad later told me he realized just how much things had changed in the past 20 years or so. That wooden racket was really heavy and clunky compared to the new, lightweight metal ones.

Dave and the Taylorville Boys Tennis Team

David Edwards and the Taylorville Boys Tennis Team around 1989

David Edwards and the Taylorville Boys Tennis Team around 1989

Dave’s Dad Tells Us How Old Rackets are Like Estate Planning (And No, Estate Planning is Not a Racket!)

Recently my dad reminded me of this story and thought it would be a good topic for a newsletter or a post. And he was right!

Old tennis rackets are like estate planning… if we’re not careful, our estate plans can become “clunky old wooden rackets” and be really out of date. They just won’t get the job done.

But there’s another great lesson in here, too, concerning our children —

Don’t send them out into the world with “clunky old wooden rackets.” Be sure to give them the training and the tools they need to face what lies ahead.

Our firm is pretty unique in that we work with the whole family to draft an estate plan that is effective. That means that when the time comes to put your plan into action, your kids will already have met us, know who to call, and we will help guide them through the process during one of the most stressful times of their life. What better tool to get the job done?

If you’re new to Edwards Group and wondering if we’re the right estate planning firm for you, please check out our FREE workshop, Intro to Edwards Group: Wills and Trusts Orientation. We hold them every month and they are great for:

  • Those who know they should plan but are intimidated by the process.
  • Those who already have an estate plan, but are unhappy with it.
  • Those considering Edwards Group for estate planning.

Call 217-726-9200 to save your spot at an upcoming workshop or to request more information. Just for attending, you’ll receive $200 off your initial meeting fee if you decide to work with us.

3 Myths About Choosing a Helper for Your Plan

We’ve talked previously about what a “helper” is and why it’s so important to not only choose one, but choose a good one. Whether it’s as a trustee, executor, power of attorney or guardian, it’s very important that you choose someone who is up to the task.

Here are 3 myths about choosing a helper that you should avoid:

1. “I need to name my oldest child.”

While it is historically conventional to name your oldest child as a “helper” in estate planning, we challenge that convention when it’s not the best choice. If your oldest child is not your most responsible child, or if your oldest child has extenuating circumstances in their life (like a special needs child) that would prevent them from carrying out the duties of a helper, then it is perfectly acceptable to choose a child other than your firstborn.

2. “I should name all of my kids as co-executors.”

In an effort to be “fair,” many people think that naming their kids as co-executors is a good idea. David generally does not recommend this option. Read here to find out why.

3. “My kids will figure things out without me.”

This may seem like the easiest option, but it is generally the worst option for your children. The stress and aftermath of a parent’s death is easily one of the hardest times in life. By leaving all of the hard decisions to your kids, you’re heaping an unbelievable amount of extra stress and pressure on them. Good families are destroyed by bad estate planning. We see it everyday.

So what factors should you consider when choosing a helper? Read this article, Every Estate Plan Needs a Good Helper to find out. Also, check out “12 Duties of a Helper” to learn more about what exactly executors, trustees, guardians and powers of attorney do. And if you need help making this decision, that’s part of our unique approach to planning – we walk our clients through the process, helping them think of every detail. Give us a call today at 217-726-9200 or attend one of our upcoming workshops.