What’s the Middle Class to Do about Rising Nursing Home Costs?

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The Problem

According to the U.S. Department of Health and Human Services, someone turning 65 today will have a 70 percent chance of requiring some long-term care service and support during his or her life. A woman’s average nursing home stay is 3.7 years. For men, it is about 2.2 years. Of the 70 percent that will need long-term care, 20 percent of those will require it for more than five years.

Unfortunately, Medicare will only pay for nursing homes in specific circumstances. For example, it will only cover a

skilled nursing facility for the first 20 days. For days 21 through 100, it only pays a portion. After 100 days, Medicare will not pay anything. Most cannot afford long-term care insurance.

With the average nursing home cost in Louisiana exceeding $5400 per month, most Americans don’t have enough savings to handle it.  Costs can run hundreds of thousands of dollars over a few short years.  Most retirement will be depleted very quickly with nothing to pass on to the next generation.  So, what is the middle class to do?

There is another way – Medicaid LTC.

Because Medicaid LTC is a needs-based program, many mistakenly believe that one has to get rid of (“spend down”) everything they own to qualify. Although the general rule is that one is not allowed to keep more than $2,000 in assets, there are many exceptions.  Often an elder law attorney can preserve more than half of a single person’s assets. Moreover, there are even more exemptions available for married couples, allowing the elder law attorney preserve a much higher percentage – in some circumstances all — of a couple’s assets.

However, it is very important that you tread carefully. There are many traps for those without a thorough understanding of the nuances of the rules. One misstep, such as getting a lawyer to draw up a document to put property in a child’s name, having a CPA utilize the “federal gift tax exemption,” or letting a financial advisor tie your assets up in the wrong kind of annuity or insurance product, can cost you tens of thousands of dollars in care costs. The regulations have too many “exceptions to the exceptions” to rely solely on those types of professionals. An elder law attorney experienced in Medicaid long-term

care planning can preserve a surprisingly large portion of the wealth that a person has worked so hard to accumulate and can work with your other advisors if they’re needed.

Chances are you will need long-term care during your lifetime. It is important that you understand what legal options are available. So, choose your guide wisely.

To learn more about how you or a loved one may be able to qualify to have some or all of your or a loved one’s nursing home costs deferred, please contact Ruston elder law attorney Add Goff by clicking the links on this page. 

Playing the Blame Game with Nursing Homes and COVID-19 Deaths

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According to a report in the Minnesota Star Tribune, they account for more than 40 percent or approximately 45,500 of the US 115,000 COVID-19 deaths, even though nursing home residents are less than one percent of the total US population. Seema Verma, the administrator for the Centers for Medicare and Medicaid Services (CMS), asserts that nursing homes following federal infection control guidelines were largely able to contain the coronavirus.

Harvard researcher David Grabowski, a member of a nonpartisan commission, advising Congress about Medicare, states that “The federal government needs to own this issue,” about the need for federal efforts to routinely test nursing home staff and residents for COVID-19 and make more protective gear available. Grabowski agrees with other advocates for the elderly that the federal government has not provided consistent virus testing and sufficient protective equipment to nursing homes, its staff, and residents.

High Risk for Elderly Care During This Election Year

In this Presidential election year, the stakes could not be higher to garner support from older voters. Partisan overtones affect the discussion and subsequent policies to guide safer nursing home outcomes from the ravages of COVID-19. The blame game is on between political parties fighting for votes and states legally protecting health care workers and facilities from coronavirus lawsuits by residents or their families.

The Trump administration deflects accountability by criticizing nursing home facilities with low federal ratings for infection control and a handful of Democratic governors, New York in particular, who mandated that nursing homes accept recovering coronavirus patients. The number two House Republican, Steve Scalise of Louisiana, states that this NY policy, and other states with similar policies, “ended up being a death sentence.” Verma echoes the nursing homes with low federal rating criticism, saying CMS has data equating low safety ratings with outbreaks of COVID-19. Several academic researchers dispute this data citing their research has found no such link. Amid the finger-pointing, shamefully, more vulnerable senior nursing home residents are dying because of the coronavirus.

Nursing Home Concerns During Coronavirus

In agreement with other academic researchers, Harvard’s David Grabowski opined that neither state policies nor proverbial bad apples among nursing homes were responsible for driving the coronavirus outbreaks. The reason is simply because of the virus’s nature, which can spread via individuals displaying no symptoms and do not feel unwell. The illness’s very nature indicates it is already spread throughout communities. Without routine testing, nursing home staff can unknowingly bring COVID-19 into a facility where it then spreads easily among frail residents living in tight quarters. Ricardo Alonso-Zaldivar of the Associated Press quotes Grabowski, “The secret weapon behind COVID is that is spreads in the absence of any symptoms,” Grabowski told lawmakers at a recent briefing. “If COVID is in a community where staff lives, it is soon to be in the facility where they work.”

Advocacy group Justice in Aging’s long-term care expert Eric Carlson cites the lack of federal coordination as impeding the ability to identify people who are infected by and require care for the coronavirus. Other advocates agree that the White House directive for the testing of all residents and staff has had an uneven response, accounting for why some facilities suffer higher rates of infection than others. The Associated Press report from the end of May 2020 concurs with these opinions reporting “White House goal on testing nursing homes unmet.”

Meanwhile, at CMS, administrator Verma believes her agency has provided necessary safety guidelines, COVID-19 reporting requirements, and Medicare payment for testing residents since the outset of the virus. She continues that states have the money required from the federal government to support the nursing home staff’s testing. Let’s hope that is the case, as the nursing home industry reports one-time testing for every resident and staffer would cost 440 million dollars.

The coronavirus pandemic is not going to go away. New spikes of cases across the country are being reported and not even considered the “second wave” of infection that many experts anticipate. Third-ranking House Democrat Representative and chairman of a special panel on the coronavirus pandemic James Clyburn of South Carolina seems to match wisdom with temperance about the finger-pointing saying that the crisis in nursing homes should not be a partisan issue. Instead, stating, “Nursing home residents have died from the coronavirus in states governed by Republicans and Democrats, in big cities and in small towns, in rural and urban communities.” Capitol Hill law and policymakers seem to be very adept at identifying problems but slow in resolving them. In the meantime, our vulnerable senior nursing home population and their families are paying the price.

We help families with loved ones in a nursing home deal with a variety of issues. If you have a loved one in a nursing home, please don’t hesitate to reach out to see how we can help. Contact our office by calling us at (318) 255-1760 and schedule an appointment today.

Problems, Policies, and Proposals for Long-Term Care

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The long-term care (LTC) crisis is on the rise for aging Americans. Industry driven, massively underpriced policies are playing fiscal catch up with hefty premium rate increases. This price increase is forcing some aging Americans to abandon their policy while others struggle to reduce their amount of LTC coverage to keep their rates affordable or reduce their future lifestyle by dipping into their retirement savings. Abandoning LTC policies turns out to be the last resort for many policyholders as they understand how valuable they are and that a policy lapse would cause them to lose all of their monies paid to the insurer.

Throughout the insurance industry, the metrics applied to the long-term care business model underestimated how long policyholders would live and the number of claims they would submit. Policyholders are living years longer than the actuaries had projected. Compounding the crisis of this flawed business model is years of very low-interest rates. On an inflation-adjusted basis, return on investment has fallen vastly short of needs for all long term investors, including pension funds, life insurers, and the average American saving for retirement. The financial fallout is that fewer people are seeking long-term care insurance policies and those that are, typically pay more and receive less coverage.

Further compounding long-term care problems is the escalation of Alzheimer’s diagnoses and other dementia diseases, which invariably increases an individual’s need for long-term care. Medicare does not make provisions for coverage in long-term care facilities. Even if you position yourself financially to qualify for Medicaid, which does provide for LTC, there is often a long waiting list and reportedly not a high standard of care when you become a resident.

Senator Patrick Toomey (R-PA) is preparing legislation that includes a clause to allow people to pay for long term care insurance via a tax-free withdrawal from their 401(k) retirement plan. The withdrawal, up to 2000 dollars a year, would not be subject to income tax, and the limit would be indexed for inflation over the years.

The Internal Revenue Service is also trying to offset tax liabilities for Americans that cover long term care insurance premiums in 2020. There is a range of tax-deferred dollar amounts depending on your age, and this information is posted on the American Association for Long-Term Care Insurance website.

Nakedcapitalism.com

Relying on the federal government to fix the long term care crisis is a cautionary tale. McKnight’s Senior Living reports that the LTC sector typically gets very little play in Washington, DC. Hospitals, doctors, insurance companies, and drug companies with big lobby monies are far more likely to receive legislative attention, often to the demise of long-term care operators and the vulnerable American population they support. Beyond the untenable high costs of LTC premiums, excessive administrative costs burden the US health care system. Washington DC, notorious for its complex, plodding policy progress, will not likely address the situation beyond creating tax-deferred access to retirement accounts and other tax incentives. Instead, the government is okay to allow the paying public to absorb the high costs of long-term care as the industry sector tries to salvage itself.

One of the worst outcomes of these scenarios is that long-term care has become such an expensive problem that Americans are shying away from proactive planning to address the very likely need they will require long-term care insurance in their future. The US Department of Health and Human Services has a website that addresses long-term care basics and provides resources, tools, and links to guide your LTC planning.

Other solutions can provide the essentials for long-term care packaged in different insurance programs. Short-term care insurance, or convalescent insurance, provides a long-term care type of coverage for 180 to 360 days. Because there is no long- term commitment to the insurance companies, premiums usually are less than traditional LTC. Critical-care or critical-illness insurance are two similar types of insurance coverage offering lump-sum cash payments to those who are diagnosed with a stroke, heart attack, and other serious illnesses. The benefits range can be six months up to two years, depending on the company and policy chosen. The drawback to these insurance policies is they do not cover pre-existing conditions. Deferred annuities for after retirement and annuities with long-term care riders can also be alternative solutions to traditional LTC insurance.

The time to get proactive and creative about long-term care insurance is now. Current statistics may give a false sense of security regarding the likelihood you will need long-term care. Projections are indicating between 65 to 75 percent of Americans will require some level of long-term care after retirement. The unspoken truth that many within the LTC industry and government do not address publically is that if the problem is not resolved, it will still ultimately go away because the person who receives sub-standard or no care will die. The idea that aging Americans would be allowed to languish without proper care when they are at their most vulnerable is unthinkable from a human standpoint. Pro-active planning to find a long term care solution is essential to your future health and financial well-being.

We can help you put a plan in place that includes accessing and paying for appropriate long term care. We can review potential programs to help offset some of the costs while creating a legal plan to protect your assets from the high costs of care. Contact our office by calling us at (318) 255-1760 and schedule an appointment to discuss how we can help you with your long-term plan needs.

The Benefits of Having an Elder Law Attorney on Your Side

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Elder law encompasses a wide range of legal matters affecting an older or disabled person. An elder law attorney or certified elder law attorney (CELA) specializes as a legal advocate for aging adults and their loved ones.  Issues related to guardianship, retirement, health care including advance directives, long term care planning, Social Security, Medicare and Medicaid, and other relevant matters to aging all fall under the umbrella of elder law.

Elder Law Benefits Senior Citizens

An older family member who legally prepares for their aging process helps their family members by addressing day to day issues that affect their actual care through proper legal documentation should the senior become incapacitated. Seniors often falsely assume that a close family member, including a spouse, will automatically be able to make decisions on their behalf if something goes wrong with their finances or health. Postponing legal document preparation through an elder attorney generally winds up being more problematic and expensive to a senior’s estate and wellness.

Many seniors find making legal preparations uncomfortable at first, as the task forces them to confront and assess their mortality. Further into the process, many aging adults experience relief, having removed the fear of the unknown of aging to the best of their ability. Legal preparation can keep a senior from health or financial ruin if they become incapable of making informed decisions regarding these matters. In the absence of legal documents, their family is left with the expensive and time-consuming process of petitioning the courts for legal authority to act on their loved one’s behalf – referred to as establishing a guardianship. By planning early and making sure the correct legal documents are prepared stress on the senior and the senior’s loved ones is greatly reduced.

Elder Law Benefits Family Members

Personal choices regarding end of life care and the disposition of assets and property outlined in legal documentation guarantees that your wishes will be respected by law. This documentation is especially important for seniors when a family member might seek control over the process, whether moral or self-serving, to follow their whims when handling your wellbeing when you are most vulnerable. Besides adhering to your expressed wishes, having your choices documented relieves family members from guessing what you want.

When preparing for your aging process, seek out a well-regarded attorney who specializes in elder law. While many general practice attorneys may have some experience with elder law topics, regulations are ever-changing and complex. It is best to find an attorney who specializes in elder law so that you get the best and most up-to-date advice.

Proactively address your aging process with a qualified elder attorney to make sure your wishes are carried out now, and in the future, regardless of what happens with your health. Both you and your loved ones will garner invaluable peace of mind knowing that your wishes are known and legally documented.  Please contact our office by calling us at (318) 255-1760 and schedule an appointment. We would be happy to help you with your planning and we look forward to hearing from you.

Telehealth Services Added to Medicare

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The Centers for Medicare & Medicaid Services (CMS) recently announced that it has increased access to Medicare telehealth services in response to the COVID-19 pandemic. This means that Medicare beneficiaries can receive more benefits from their doctors without having to travel to a healthcare facility.

The terms “telehealth” and “telemedicine” refer to the ability to exchange medical information from one site to another through electronic communication to improve a patient’s health.  With the rapid rise of COVID-19 cases, there is the urgency to expand the use of technology to help people who need routine care. Telehealth will keep vulnerable beneficiaries and those with mild symptoms in their home, but with access to the care they need by phone and video rather than requiring an office visit.

Prior to this change, Medicare would only pay for telehealth on a limited basis, and only for persons in a designated rural area. Now Medicare beneficiaries will be able to receive the following services through telehealth: common office visits, mental health counseling, and preventive health screenings. This will help keep more of the at-risk population (Medicare beneficiaries) able to visit with a doctor from home, rather than traveling to a doctor’s office or hospital which puts the beneficiary and others at risk. Telehealth visits will be treated the same as regular, in-person visits and will be paid by Medicare at the same rates.

These changes go into effect for services starting March 6, 2020, and will continue for the duration of the COVID-19 Public Health Emergency. For more information, view the fact sheet prepared by CMS.

Better access to telehealth is a big step in getting Medicare beneficiaries appropriate care in the least restrictive way. Contact our office by calling us at (318) 255-1760 and schedule an appointment to discuss how we can help you with any questions on your planning.

The Top Trends for Senior Living

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As the silver tsunami of baby boomers continues to enter the senior living and care organizations markets, the general response has been uncertainty as to how to meet changing and varied senior needs while maintaining profitability.  Health Dimensions Group (HDG ) has released its list for 2020 entitled “Top Trends in Aging Services: Preparing for Historic Changes.” Owners and operators of senior living facilities must become responsive and make changes that are swift and diverse.

New Senior Housing Projects

Actuaries used to define senior housing construction projections and schedules are based on population data that are five or more years out. These metrics attempt to address occupancy and growth challenges as senior living occupancy rates fluctuated between the 86 – 88 percent mark for 2019 according to new data from the National Investment Center for Seniors Housing & Care (NIC). The third quarter of 2019 set a record for the highest demand of net new senior housing units while the construction data indicates a slowdown is near. The population projections of 2015 are not in accord with the latest senior housing demand. More cost-effective construction options and the repurposing of existing real estate is becoming a necessity to offset occupancy pressures and saturated markets.

Alternative Living Care Options

For lower-income seniors, alternative living care models, including the Program of All-Inclusive Care for the Elderly (PACE), integrate Medicare and Medicaid financing; provide a comprehensive service delivery system. This coordination of care is an effort to defer or avoid seniors moving into a long-term care fee-for-service facility. Implementing this program and other, less costly models of care can help to address lower-income senior housing issues. These models will continue to leverage technology to drive innovation and efficiencies, as well as address workforce shortages.

Middle-Income Seniors

The most challenging market segment for senior living is that of middle-income seniors. Those seniors without sufficient resources for long-term care but who are also not in a position to qualify for Medicaid seem to face some of the most significant issues as it relates to housing and healthcare costs. According to McKnight’s Senior Living, investors and operators focus on the upper end of income distribution as their preferred targeted residents while leaving state and local programs to provide for low-income seniors. This scenario leaves a large portion of middle-income seniors whose living needs are not adequately being addressed.

Technology for Seniors

Applied digital technologies are changing the senior living sector, and the race to seize substantial market share in the active adult and under-addressed middle-class needs has not gone unnoticed by tech behemoths like Apple and Amazon. Alexis Ohanian, the co-founder of Reddit, who runs a venture capital firm, is predicting that a significant change is imminent for senior living. New startups, heavy on innovation and technology, will bring major disruption to existing senior living models and facilities very soon.

Investments in Senior Living Facilities

Existing operators and investors of aging senior living facilities are increasing investment in a wide range of offerings and services to remain operationally sound and competitive. One service strategy is to partner with home health agencies that provide therapy under Medicare Part B while a senior resident ages in place. Another is to create more public spaces within facilities. The creation of roof-top restaurants and park spaces on the property can increase senior socialization alleviating depression, which is a contributing factor to downward health spirals for seniors. Smartwatch technology that acts as a smart key for residents as well as a movement and health monitor reduces the number of daily interactions with staff and provides a way for loved ones to monitor their spouse or parent remotely. Creating more job flexibility for staff and dramatically increasing wages for hourly positions is a necessity to recruit and retain competent staff in a tight labor force.

While many of the baby boomers are still below the average age of residents that live in traditional senior communities, demographics point to the fact that the senior living industry will soon be under more pressure than ever to provide for a diverse and increasingly particular population. Market sector opportunities in middle-income senior living will drive innovation as competition increases, and companies vie for market share. These opportunities to realize new solutions will positively affect the entire senior income spectrum for housing.

We help seniors come up with comprehensive plans to address the aging process and the challenges that come with it. We welcome the opportunity to talk with you about your particular needs.

Contact our office by calling us at (318) 255-1760 and schedule an appointment to discuss how we can help you.

Should You Remove Your Loved One from Their Nursing Home?

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Uncertainty can breed fear, particularly when it comes to caring options for a loved one currently in a nursing home during the COVID-19 pandemic. Facing the questions like how long this health crisis will last and will there be secondary, or even more waves of infection, give pause to those with loved ones in these vulnerable nursing home environments. Whether it is your mother, father, or spouse, you are considering moving; there is no right or wrong answer, only choices because all decisions come from a place of love. It is never wrong to try to help those you love to be better protected. Here are some things to consider about changing your loved one’s residence during this pandemic.

The truth is that bringing a cherished family member home is a complicated decision because it is both emotional and fraught with unknown consequences that have real-life ramifications about life and death. If you were to move your spouse or parent home, are you and is your home environment suited to caring for them? If they are on Medicaid, will they allow your loved one to be released and then reinstated in the future? Will there be room in the facility at the time when they need to return? Does your community provide services that can help you provide care? Does the job that you would do at home meet the same level of care as professionals in a nursing home? Will there be a lapse in medications or other necessities during the transition phase?

Before making plans to remove your spouse or parent from a nursing home during the COVID-19 pandemic, the American Association for Retired Persons (AARP) suggests you ask yourself these questions to help you make a sound decision based on your loved one’s wellbeing.

  • What are the benefits versus the risks of moving your loved one out of the facility?
  • What does your spouse or parent want?
  • Can you meet the caregiving needs of your loved one in your home environment? (this includes any specialized medical care, medication management, meals, bathroom and hygiene assistance, and time to engage your loved one in activities)
  • In bringing them to your home, are they still at risk of COVID-19 exposure?
  • How will you prioritize care if someone in your home becomes infected?
  • Can you currently do window or virtual visits with your loved one in the nursing home to decrease the problems associated with social isolation?
  • Will the facility readmit your spouse or parent if you change your mind?
  • Are there still valid reasons for having your loved one in a long-term care facility?
  • Does their current living facility have adequate staff and procedures to handle the issues associated with this pandemic?
  • Will your caregiving in the home match that of the professionals in a nursing home?
  • Do you have the time to dedicate to your loved one’s proper care?

Answering these questions should reveal whether you are leading with your heart or your head while considering moving your loved one out of their current care facility.

AARP’s position on moving your loved one into your home during the COVID-19 pandemic is in agreement with the experts at the Centers for Disease Control and Prevention (CDC). The CDC reports there is no one size fits all solution to this question, and each family must pursue their decisions based on recommendations from their health care providers and their unique circumstances.

Before discussing the option of moving your parent or spouse out of a nursing home, it is advisable to pose these questions with in-home family members as well as your loved one’s health care providers. In times of uncertainty, it is best to logically think through at home living scenarios both short and long term, as well as review the variety of steps the CDC has put in place for long term care facilities with regards to protecting residents and staff during the COVID-19 pandemic. The caregiving your loved one needs will be the best for them if you take the time to make an informed decision.

If you have questions or would like to discuss your particular situation, don’t hesitate to reach out. Please contact our office by calling us at (318) 255-1760.

The Elderly Are Re-Entering the Workforce

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Many of the 50-year-old and older workers are raising children and helping aging parents, and it is putting a strain on budgets. There are over 3 million seniors or near-seniors looking for full-time employment and millions more looking for part-time work. Seniors are finding that to make ends meet and have a financially secure retirement they need additional income especially now that people are living longer than ever before. The good news is jobs are available, companies are hiring “seasoned” workers, and there are programs to help those aged 50 and older find the type of work that is right for them.

If you are age 50 or more, the American Association for Retired Persons (AARP) runs a program called BACK TO WORK 50+ that targets workers who previously worked at moderate income level jobs but who may lack the education level and computer skill sets that presents a barrier to employment in situations that lead to better economic security. There is also SCSEP, the Senior Community Service Employment Program, which is the only federal program targeted to help older workers. AARP works in conjunction with SCSEP and provides employers with qualified candidates who are pre-screened for placement. These programs support the employer in finding a skilled worker at a low cost and allow the senior to bypass the interview process. Both of these programs will train seniors to give them the skills and confidence they need to find a job so that they can provide for themselves financially. According to AARP, senior employment is becoming so prevalent that by the year 2022, workers aged 50 or more will comprise thirty-five percent of the workforce.

If you are a senior with a college degree and solid computer skills, AARP can also help place you in a meaningful work environment. More than 500 companies nationwide have signed the AARP Employer Pledge “We believe in equal opportunity for all workers, regardless of age, and that 50+ workers should have a level playing field in their ability to compete for and obtain jobs. Recognizing the value of experienced workers, we pledge to recruit across diverse age groups and to consider all applicants on an equal basis as we hire for positions within our organization.” This pledge affirms the value of an experienced senior worker and many companies are on board. The belief is that a workforce that leverages talent from all age groups is a stronger workforce. Jobs AARP and other employer resources connect 50+ job seekers with employers who recognize the value of experience that comes with a more senior and seasoned worker. These companies who have signed the pledge are on the AARP job boards, in the job search tools, and even participate in online recruiting fairs.

As more seniors are becoming computer savvy, remote work opportunities are becoming more popular and mainstream. Companies do not have to provide a physical workspace and employees have no commute and no need to spend money on proper work attire; overhead is lower for the employer and the employee. Seniors can use the AARP tools to find legitimate online job prospects. If a senior prefers to work with people for socialization purposes as well as earned income, the senior living industry has excellent opportunities and needs workers. Senior living facilities management acknowledges the expertise, dependability, and worth ethic that is common in the mature workforce. Currently, there are high rates of staff turnover in senior living environments, and a senior employee can make a positive difference in the rate of employee retention.

There is an undeniable benefit to remaining active as you age and work is a significant component of that activity. Old notions of ageism are changing at precisely the right moment to help you create a better retirement living situation for yourself through additionally earned income. If you are 50+ and looking for work, take advantage of these national programs to identify the right job for you.  There is no better time than now to look forward to your own retirement needs and have the peace of mind that additional income brings.

It is essential to meet with an ElderCounsel attorney to ensure that you are increasing income without reducing benefits available to you. You don’t want to cross a threshold that would deny you a government benefit unless it would be financially beneficial.  Many components need to be considered to plan a successful retirement. Contact our office by calling us at (318) 255-1760 and schedule an appointment to discuss how we can help you with your planning.

The Challenges of Aging Alone

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For some seniors in the baby boomer generation aging brings with it new challenges in the form of solo aging. Solo aging is a senior who has no children and no younger (or healthier) family members to assist them as they age. As in generations before, baby boomers are living longer and healthier lives but for some there is no escaping the eventualities of disease like heart disease, arthritis, diabetes or dementia.  Others may require extensive care following a fall that results in a broken hip or other serious injury.

In prior generations when an aging senior needed assistance with activities of daily living they would typically enter a residential facility or be treated at home, often times with a younger family member to supplement their needs. In the case of the baby boomers however, healthy family members who can provide care are in shorter supply. Solo aging requires a modified approach to the requisite standard planning around the larger family system of previous generations.

The Pew Research Center found the rate of childlessness in baby boomers to be about 20% -double the number of previous generations. This childless statistic translates to one in five baby boomers having no adult children to help them when independent living becomes difficult or impossible. This solo aging segment of the baby boomer population is typically white, highly educated, reasonably affluent, and has a desire to remain living in the United States. Any of their immediate family that could provide care is often small in number and likely to live far away. These solo agers are fiercely independent and are accustomed to making their own decisions and will not let go of their self-determination easily.

Like most seniors, the solo ager prefers to remain in their private home. Living at home in the earlier years of retirement is often a suitable arrangement but over time the downward slope of mortal decline can lead to a number of dangerous difficulties. Incorrect management of medication, poor nutrition, isolation and loneliness, alcoholism and depression, dementia, and susceptibility to scam artists are just some of the problems that can become prevalent. Without the benefit of a younger family member who can “well check” them the solo ager is at an increased risk of becoming a victim of fraud, abuse, or more serious health decline. Moreover, when the time does come for care giving and/or relocation to a more suitable and safer living environment the solo ager will not be able to rely on an adult child to help them find qualified caregivers and appropriate living arrangements as well as orchestrate the physical downsizing and relocation to a new home.

What to do? Prepare and prepare early. Even if a solo ager is healthy it is impossible to predict the future. The unexpected fall or illness happens and more often than most people think. The solo ager needs to empower a third party, through proper legal documents, to act in a fiduciary capacity in the event the senior becomes incapable of making decisions. This includes a trusted friend, extended relative or even a professional fiduciary or private guardian.

There must also be legal protection in the form of a healthcare directive and estate plan or trust in place. Without the benefits that a traditional family support system brings the solo ager must pay strict attention to the details of their life planning and seek professional counsel to make proper arrangements. The reliance must shift from immediate family to legal professional counsel to ensure the solo ager is cared for in the manner they want should the need arise. While it may seem an uncomfortable discussion at first, the solo ager should be reminded they are maintaining life control by having legal documents created to reflect their own wishes. The solo ager can garner a sense of inner peace in their retirement years knowing their plans are properly in place and that the course of their life will reflect their desires.

If you or someone you know is a solo ager, we can help. Please contact our office by calling us at (318) 255-1760our office today and schedule an appointment to learn more.

Do You Understand an Advance Directive?

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Kevin stands at the door of Winnie’s nursing home room, tears streaming down his face. The medical staff just finished inserted a feeding tube into Winnie – an act Kevin knew she didn’t want. Unfortunately, Winnie couldn’t express her wishes due to advanced dementia, and she had no legal documents that expressed her wishes not to be fed by artificial means.  Kevin had no choice but to sit back and watch his wife go through a procedure she didn’t want.

The situation with Kevin and Winnie could have been avoided through the use of proper advance directive. An advance directive is actually a collection of documents. What that includes differs depending on your needs and wishes, along with what the law allows. However, it usually means at least a Living Will, and a Power of Attorney for Healthcare.

The purpose of this set of documents is to allow you to control what happens to your health care in case you cannot speak for yourself. If certain criteria are met, your doctors must consult with your advanced directive before making decisions about your care.

Usually, what this means is that two doctors agree that an individual is terminally ill, permanently unconscious, or at the “end-stage” of a condition. Once that happens, and the individual cannot express their preferences, doctors turn to the advance directive to figure out what the individual wants.

A Living Will determines what happens to an individual making it, unlike a Last Will and Testament, which determines what happens to their money and possessions. A Living Will describes what healthcare providers can and cannot do to prolong your life and/or ease your pain when you cannot express those preferences yourself. For example, do you want to be placed on a ventilator if you cannot breathe on your own? Do you want a feeding tube and IVs set up, and if so, for how long? Do you want to be an organ or tissue donor?

A Durable Power of Attorney for Healthcare lets you choose someone to make healthcare decisions for you when you cannot. They still must follow your Living Will, but they will be able to make decisions not explicitly considered by your Living Will, in accordance with the facts of the situation. In most states, there are “default surrogate consent laws” which allow family members to make treatment decisions on your behalf, but who is chosen to make these decisions and what they choose to do may not be in accordance with your wishes, as it hopefully would be with a Durable Power of Attorney.

Other documents may be part of an advance directive by law, or they may be worth including on your own volition. These include Do Not Resuscitate orders and Physician Orders for Life-Sustaining Treatment, among others. You might also consider an advance directive in case of a mental health crisis.

This is a difficult subject to consider, and it always seems like it won’t be necessary. But nearly 70 percent of Americans don’t have plans in place for a worst-case scenario, which means for some of them, decisions may be made for them with which they would not agree, if they had the capacity to choose. For that reason, it is worth thinking about implementing an advance directive even if it seems unnecessary now.

If you or a loved one would like more information about advance directives, please don’t hesitate to reach out contact our office by calling us at (318) 255-1760.