I have to decide between my two children, who should be my power of attorney when I need help communicating with doctors and handling my financial matters. Can’t I just name them both?

You can, but please don’t. You risk creating conflict or chaos if you name more than one child to serve simultaneously. Instead, pick one child at a time.

Think about which child is better suited to the responsibilities. For health care decision-making, your agent should ideally be calm in stressful situations and be able to advocate courteously but firmly with doctors and nurses for the treatment you want. For financial management, your agent should be organized, careful, and good with numbers.

Your health care agent should live nearby, but if the child who lives locally is terrified of things like needles and blood, the other, sturdier child might be a better choice. On the other hand, who can manage finances from afar, but if that child didn’t cope with a checkbook, the other would be better. So if one child is good in one area and the other child is good in the other, the dilemma is solved. You can name the number-proficient daughter for the financial side and your son for the health care. Or, if just one child is altogether more capable than the other, name that one child for both health care and financial powers.

But you do not want to create a situation where children who share the job start arguing about what health care you would want. Busy physicians have little time or patience to mediate fights like that. Likewise, you do not want your children quarreling about how you would want your money to be spent.

That’s why it’s best to give one child decision-making authority at a time. You can name the other as a backup in case the first child becomes unavailable, but naming both to serve simultaneously is generally not a good idea. Please contact us at 973-226-0050 and schedule a free consultation to discuss your legal matters.

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When caring for an aging family member, a family caregiving meeting can be a great way to coordinate communications and activities. These meetings are beneficial for helping to keep all family members abreast of decisions that need to be made, changes in diagnosis or prognosis, and help to ensure that all family members feel that they have a voice. Family meetings can also help to keep caregiving responsibilities from falling solely on the shoulders of one family member. In addition, family caregiving meetings can foster cooperation among family members and lessen the stress associated with caring for an aging loved one.

Who should attend a family caregiving meeting?

There are a number of people who should be included in a family caregiving meeting. First and foremost, it is important to include the aging loved one in the meeting whenever possible. This helps the aging loved one to feel that they are being heard and that their opinions and thoughts are being considered. If a spouse is living, the spouse should be included, as well as any children and possibly siblings of the aging person. Some families may choose to include other family members, but this really varies from one family to another. Anyone else involved in care for the person should also be there. This could include paid caregivers, family friends, or neighbors. Depending on family dynamics, a facilitator can be helpful in running the meeting.

When should a family have a caregiving meeting?

First, it is important to note that family caregiving meetings are not a one-and-done event. They must occur on a regular basis. The first family meeting can occur before an aging loved one actually needs care. This can give the person who may eventually need care more say in their future care, but oftentimes this does not occur. Most families find that the initial meeting needs to occur when an aging loved when begins to show signs of needing care or when a diagnosis is given that determines care will soon be needed. In addition, meetings should be scheduled regularly to discuss changes in diagnosis, prognosis, or general needs of the loved one or the caregivers.

How can a family hold a successful caregiving meeting?

The key to having a successful caregiving meeting is cooperation. This doesn’t mean that family members will agree on everything, but it is important that all family members are respectfully heard and considered. Families must be willing to compromise and seek the best plan for their aging loved one. Additionally, a smoothly run meeting should have an agenda and families should try to stay focused on the items included on the agenda. When holding a meeting, always put things in writing and be sure that all those involved get a copy of the important information and everyone’s responsibilities.

What challenges do families face in caregiving meetings?

One of the biggest challenges to family caregiving meetings is the family’s history. All families have their own dynamics that can cause problems in a caregiving meeting. There may be members of the family who are at odds with one another, creating an obstacle to having a successful caregiving meeting. The role that each family member plays can be a challenge. Some members may be overbearing and demand control, while others are peacemakers and do not feel free to share their thoughts. Another challenge is that some family members may be in denial of the severity of an aging loved one’s needs which could make it difficult to get a consensus for care.

Family caregiving meetings are beneficial and necessary when an aging loved one can no longer care for themselves. These meetings can help to divide the responsibilities of caregiving and reduce the stress placed on the family members. It is important that families remember that the meetings are for the care of their loved one and cooperate with one another to help the process to run more smoothly and successfully.

If you have any questions about something you have read or would like additional information, please feel free to contact us at 973-226-0050 and schedule a free consultation to discuss your legal matters.

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You would hope your living will is properly prepared and your resuscitation instructions or DNR (do not resuscitate) are in order. While your wishes in a living will may be appropriately documented, that does not guarantee the instructions will be carried out as you stated. The frightening truth is that mistakes about your end-of-life instructions are made while you are at your most vulnerable. Dr. Monica Williams-Murphy , medical director of advance-care planning and end-of-life education for Huntsville Hospital Health System in Alabama has said, “Unfortunately, misunderstandings involving documents meant to guide end-of-life decision-making are surprisingly common.”

The underlying problem is that doctors and nurses have little if any training at all in understanding and interpreting living wills, DNR orders, and Physician Orders for Life-Sustaining Treatment (POLST) forms. Couple the medical professionals’ lack of training with communication breakdowns in high-stress environments like a hospital emergency ward where life and death decisions are often made within minutes, and you have scenarios that can lead to disastrous consequences.

In some instances, mix-ups in end-of-life document interpretation have seen doctors resuscitate patients that do not wish to be. In other cases, medical personnel may not revive a patient when there is the instruction to do so resulting in their death. Still other cases of “near misses” occur where problems were identified and corrected before there was a chance to cause permanent harm.

There are some frightening worst-case scenarios, yet you are still better off with legal end-of-life documents than without them. It is imperative to understand the differences between them and at what point in your life you may change your choices based on your age or overall health. To understand all of the options available it’s important to meet with trusted counsel for document preparation and to review your documented decisions often as you age. In particular, have discussions with your physician and your appointed medical decision-maker about your end-of-life documents and reiterate what your expectations are. These discussions bring about an understanding of your choices before you may have an unforeseen adverse health event, and provide you with the best advocates while you are unable to speak for yourself.

There are several documents that may be appropriate as part of your overall plan. Each of those is discussed below, and we are available to answer any questions you may have about them.

A living will
is a document that allows you to express your wishes about your end-of-life care. For example, you can document whether you want to be given food and hydration to be kept comfortable, or whether you want to be kept alive by artificial means.

A living will is not a binding medical order and thus will allow medical staff to interpret the document based on the situation at hand. Input from your family and your designated living will appointee are also taken into account in your best decision-making strategy while you are incapacitated. A living will become activated when a person is terminally ill and unconscious or in a permanent vegetative state. Terminal illness is defined as an illness from which a person is not expected to recover even though they are receiving treatment. If your illness can be treated this would be regarded as a critical but not terminal illness and would not activate the terms of your living will.

Do not resuscitate orders ( DNRs
) are binding medical orders that are signed by a physician. This order has a specific application to cardiopulmonary resuscitation (CPR) and directs medical professionals to either administer chest compression techniques or not in the event you stop breathing or your heart stops beating. While your living will may express a preference regarding CPR it is not the same thing as a DNR order. A DNR order is specifically for a person who has gone into cardiac arrest and has no application to other medical assistance such as mechanical ventilation, defibrillation, intubation, medical testing, intravenous antibiotic, or other medical treatments. Unfortunately, many DNR orders are wrongly interpreted by medical professionals to mean not to treat at all.

Physician orders for life-sustaining treatment forms ( POLST forms
) are specific sets of medical orders for a seriously ill or frail patient who may not survive a year. This form must be signed by a physician, physician assistant, or nurse practitioner to be legally binding. The form will vary from state to state and of the three instructive documents the POLST is the most detailed about a patient’s prognosis, goals, and values, as well as the potential benefits and risks various treatment options may bring about.

A power of attorney for a health care decision, sometimes referred to as a health care directive, allows you to name an agent to make decisions for you if you are unable to. Unlike a living will which only covers end-of-life decisions, a power of attorney for health care decisions allows the agent to act at any time that you cannot make decisions for yourself.

We can help you determine which documents best suit your current needs, and help you clearly state your wishes in those documents. Please contact us at 973-226-0050 and schedule a free consultation to discuss your legal matters. We look forward to hearing from you and helping you with these important planning steps.

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When you embark on a second marriage, you should be aware of how this will affect you and your new spouses’ Medicaid benefits. Current costs for long-term care facilities can run between $70,000 – $150,000 annually. Studies show that 70% of Americans will need that kind of care, perhaps for three years or longer.

If one spouse in a marriage becomes ill, the assets of both spouses are, by and large, required to be spent on the ill spouse’s care before Medicaid benefits become available. This could be a big problem, especially if the money that the well spouse had saved for her children’s inheritances goes to pay for the ill new spouse’s care instead.

With careful planning, this need not happen. Financial arrangements can be made to protect the estate of the well spouse and to ensure that the spouse who needs care will be responsible to pay his or her own way.

The benefits rules do provide that the spouse who does not need care yet may keep an allowance of a certain sum for that spouse’s benefit. This is known as the “Community Spouse Resource Allowance” (CSRA). But many find that the CSRA is too small to permit the well spouse to maintain her standard of living, pay for her retirement, and still leave enough for her children to inherit.

Any planning or shifting of assets must be done very carefully and only after consulting with experienced professionals like us. The Medicaid rules heavily penalize transfers of assets made without receiving value in return. Gifts, in other words.

Assets can be protected, though, by a number of strategies that are permitted by the Medicaid rules. Some or all of the well spouse’s assets could buy a Medicaid-compliant annuity. This would provide an income stream for the well spouse, without the assets being otherwise deemed available to pay for the ill spouse’s care.

In turn, the assets of the spouse needing care could be transferred to people whom that person especially trusts: a trustee, or an agent for financial affairs, or a family member or beneficiary. That kind of transfer would be subject to penalty, but planned-for, using the strategies permitted under the Medicaid rules. Some relief from penalties can be achieved using existing Medicaid rules.

There are also insurance products available to provide for long-term care coverage, which any newly married couple – or everybody, really – ought to consider. Find advice on the various insurance options here.

The best strategy of all, though, is to consult an experienced elder law attorney as soon as possible. The sooner the consult, the more options are available and the more money can be saved.

When we embark on the adventure of marriage, nobody can tell what the future has in store. But with thoughtful planning, assisted by qualified elder law attorneys like us, you can relax and let the nuptial celebrations begin. If you’d like to discuss ways we can help, please  contact  our office at 973-226-0050.

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A healthy lifestyle can increase your longevity significantly. Your lifespan can be increased by as much as 14 years for a woman and 12.2 years for a man according to the American Heart Association’s journal Circulation study. The United States is one of the wealthiest countries in the world, but according to the World Health Organization, it ranks about 53rd in life expectancy from birth compared to other developed nations, according to 2015 data.

What are these five lifestyle habits? The first is leading a non-smoking life and the second is not subjecting yourself to other people’s second-hand smoke. If you have ever been a smoker, find a way to quit. Try hypnotherapy, patches, gum – whatever it takes – but figure out a way to stop smoking. Breath is life, and without a healthy respiratory system, you are shortening your lifespan. If you do not smoke now or never have, that is great! Stay on that path and do not subject yourself to other people’s smoking.

Exercising for 30 minutes each day is imperative for longevity and coincides with the third thing you can do to extend your lifespan.  Maintain a healthy body mass index (BMI). The best and easiest daily exercise is to walk. If you are currently out of shape and 30 minutes a day seems unachievable, then begin with 10 minutes. Make a plan and increase your time to 20 minutes as you become more physically able to do so. By the time you are ready for 30 minutes of daily exercising, be sure that your pace is moderate to vigorous. Walk every day in the morning at a set time and make it your routine. Walking will help you lose weight, gain muscle, and reduce your body mass index.

The fourth and fifth things to do are eat a healthy diet and consume only moderate amounts of alcohol. Healthier foods are generally found on the outskirts of your supermarket and include fresh fruits and vegetables, dairy and eggs, as well as lean meats. The inside aisles of a supermarket are packed with food products, not real food. Much of this food is so over-processed and chemical-laden that it is not healthy to eat. Consuming moderate levels of alcohol is defined as one drink a day for women and two for men. Adopting a new healthier lifestyle can include days where you choose not to have an alcoholic beverage. If you have fallen into excessive drinking patterns, make changes today. The liver is a restorative organ and can heal itself if excessive damage has not been done.

If these five healthy life choices are something you already do or are willing to implement in your lifestyle and you do add 12 or 14 years to your life expectancy, what if you don’t have the money to survive those additional years? The Social Security Administration says that about one in four Americans 65 or older today will live past age 90 and one out of ten will live past 95. Where will the money come from if you live another decade or longer? Health care costs are skyrocketing and assisted living facilities are expensive. Unless you are already financially independent, 60 is the new 50 and retirement may not come as soon to you. You can make adjustments to your life today that will help you to become more financially fit just as you can make changes to become more physically fit and extend your lifespan.

Saving money aggressively and developing the habit of spending less is possibly the single best way to stretch your retirement assets. Learn to live below your means. Beyond being thrifty, change your trajectory regarding your investment strategy. Talk to a trusted financial advisor to see if you need to shift any investment strategies.

While longevity can only be estimated and everyone will have their own life expectancy experience, increased awareness of healthy lifestyle choices is changing the way seniors are approaching aging. Your longer lifespan will require adequate funding which can be achieved by frugal spending habits, possibly delaying your retirement, and thinking differently about conventional investment strategies in senior years. Getting sound and trusted advice about longevity and your financial aging strategy can bring you peace of mind as well as financial security. If you’d like to discuss ways we can help, please  contact  our office at 973-226-0050.

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In estate planning, it is common that parents divide the inheritance equally among the children. But sometimes, parents intentionally choose to not leave anything to a child, and the reasons for doing so may vary. One reason could be that a child who is more financially successful than the others and the parent doesn’t feel it’s necessary to leave anything. Another reason may be a desire to prevent a child with special needs from losing government benefits. Or a parent may not want to leave an inheritance to an irresponsible or drug-dependent child for fear the inheritance will be wasted.

Regardless of the reason, disinheriting a child can negatively affect that child’s relationship with his or her siblings. The courts are full of siblings who sue each other over inheritances but even if they don’t sue, it is highly unlikely they will be a close family unit. Money aside, there is symbolic meaning to receiving something from a parent’s estate.

Disinheriting a child for what may seem to be a valid reason may actually be completely unnecessary. For example:

How we choose to include our children in our estate plans has lasting effects, both positive and negative. Choosing not to disinherit a child who has caused grief and heartache sends a message of love and forgiveness while disinheriting a child, even for what seems to be a good cause, can convey a lack of love, anger, and resentment.

If you have previously disinherited a child and you have since reconciled, update your plan immediately. If you wish to disinherit a child, it may be wise to tell that child and explain the reasons why. Doing so may help deter the child from blaming siblings later and may prevent a costly court battle.

Regardless of your desires about how you want to leave an inheritance to your children, grandchildren, or other loved ones, we can help. Give us a call to schedule time for a private conversation about your wishes, and we will make sure your wishes are properly documented. If you’d like to discuss ways we can help, please  contact  our office at 973-226-0050.

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Imagine this scenario, an unwed middle-aged lady, Sandy, being the sole caretaker for her 85-year-old mother. Sandy still worked full time and would help her mom in the evenings and weekends. Unfortunately, Sandy was in a serious car accident and would be out of work for at least 8 weeks. She now faced the challenge of paying her bills while out of work and finding someone to help her mom until Sandy could get back on her feet.

There are only so many ways you can plan for the unexpected.  Short-term disability insurance is one.  Yet many people may not know exactly what short-term disability is or how it can benefit someone who has experienced an unexpected illness or injury that may prevent them from being able to work for an extended period of time.  There are also the planned events, such as surgery to correct a chronic health issue for which you will need some income to help cover the procedure and other expenses incurred during your time away from your job.  It is estimated that on a yearly basis, an average of 5.6 percent of workers in America will have a need for short-term disability.  Here is an overview of what short-term disability insurance is and what it can and cannot do for you during the unplanned and most likely unwanted downtime you hope you never have.

The short-term disability is used for non-work-related illnesses or injuries, as opposed to a worker’s compensation policy, paid for by the employer, that provides income replacement for a work-related injury.  As the name suggests, the short-term disability is active for a limited period of time, is often offered as part of a benefits package, and may be purchased on your own through a private insurance agent if your employer is not mandated to offer it.  Currently, there are only five states where it is mandatory for employers to offer this type of coverage to their employees.  These states are California, New York, New Jersey, Hawaii, and Rhode Island.  Of note, the income replacement from a short-term disability insurance policy will seldom cover 100% of your income but typically will cover anywhere from 40% to 70% of your income depending on the policy terms.

The time covered by short-term disability can range from 30 days to sometimes up to a year depending on the policy, but it is important to know that your job is not guaranteed should you need to use short-term disability.  It may be possible to transition to a long-term disability plan once short-term benefits are used up and you are not ready to return to work.  Another important thing to know is what the elimination period is for the policy.  Employers do not want to start paying for an illness or injury that could possibly be covered by an employee’s “sick days” fund, therefore there is an elimination period associated with the policy, which means that the policy may dictate how many days you would have to be off work with the disability before a claim could be filed.

Fortunately, there are many conditions that qualify for a short-term disability that even include many mental health issues.  As mentioned earlier, if there is a need to be off work for a planned procedure that will render you unable to return to work for a while, you will want to be sure your policy covers that issue and time needed to recover when planning for your care needs.  There may be limits to what one employer covers versus another, and conditions that are covered should also be part of your consideration when choosing a plan should you decide to purchase your own policy.  Unfortunately, pre-existing conditions are not covered by short-term disability, nor can benefits be used to take time off from work to care for other family members who are sick or injured.   In general, the short-term disability plan, when you are informed and knowledgeable of how it works, can be a benefit that may provide some peace of mind should an unexpected health crisis happen.

We help people of all ages plan for the unexpected so that their wishes will be carried out. Through the use of legal documents like a living trust, power of attorney, and health care directives, we make sure your home, your savings, and your family are taken care of if the unexpected happens. If you’d like to discuss ways we can help, please  contact  our office at 973-226-0050.

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Hospice care is meant to provide comfort by reducing suffering and focusing on the quality of life for the patient and the family. And yet a lack of regulation, oversight, and available information means that isn’t always the case.

The HSS Inspector General has found that, between 2012 and 2016, health inspectors cited 87% of hospices for deficiencies. In 20% of hospices, these deficiencies were serious – serious enough to endanger patients. For-profit hospice agencies are more likely than to have non-profits, likely because decreasing staff increases profit margins.

There aren’t many options for the Centers for Medicare and Medicaid Services (CMS) to discipline hospices. They can drop hospices from the Medicare program, but they can’t assess fines or install temporary management. Many complaints can’t be substantiated, and even when they are, that information doesn’t become readily available to consumers. CMS could put citations for deficiencies and complaints on their website for consumers, Hospice Compare, but they don’t.

The CMS Inspector General has recommended that legislators strengthen hospice standards, increase inspections, streamline the complaint and investigation process, and improve accountability and availability of information. Whether we will see improvements in the near future remains to be seen.

Choosing long-term care for a loved one can be challenging. We help families find good long-term care and work with them on how to pay for the care. If you’d like to discuss ways we can help, please  contact  our office at 973-226-0050.

Read more at:

https://www.npr.org/sections/health-shots/2019/07/09/739471717/hospice-oig-reports

https://www.latimes.com/local/california/la-me-lopez-hospice-complaint-20190216-story.html

https://www.latimes.com/california/story/2019-08-09/hospice-mother-california-complaint

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Most young adults don’t consider estate planning a priority. Young adults in their twenties and thirties often think they don’t own enough to constitute an estate. However, an estate is the total of all you own – money, investments, real estate, vehicles, business interests, digital assets (including cryptocurrency), and other personal belongings. No matter how much or minor, you own your possessions need to go somewhere after you die. You may not think you will die young, but if the coronavirus pandemic has taught us anything, it is that life is uncertain. It is a myth that estate planning is just for the rich and the old.

Some documents may vary depending on your wealth or financial structure; however, everyone should have a will
. At the time of your death, everything you own becomes your estate. Your estate will go through a probate process where the court will determine what happens to you everything you own that doesn’t have a co-owner or beneficiary. Because the probate court will inventory your assets and notify and pay creditors, your will is a public record. If you have a will, the probate court will use it as a guide. In the absence of a will (dying intestate), the court will use state intestacy laws to determine who inherits your assets.

A will designates two critical things. The first is the naming of your executor. An executor is responsible for carrying out the instructions in your will, making payments on any outstanding debts, distributing assets to named heirs, and filing your final taxes. Second, if you have dependents, your will names the guardian and backup guardian to provide care for them. The naming of an executor and guardian for a dependent can only happen in a will.

All young adults should have an advance healthcare directive
, also known as a medical directive or living will, which includes a durable healthcare power of attorney. These legal documents specify your healthcare wishes if you are permanently incapacitated or for end-of-life healthcare and designate who will make those decisions on your behalf according to your instructions. In addition, it is imperative to include a HIPAA privacy authorization form for your durable healthcare power of attorney or trustee. The form permits medical and healthcare professionals to disclose pertinent health information and medical records to your healthcare proxy.

While it may be uncomfortable to contemplate being unable to make decisions for yourself as a young adult, accidental injuries, heart disease, cancer, and strokes, to name a few, are becoming all too prevalent in young American adults. Making plans while you are competent and able is a prudent course of action and can bring you a sense of calm, knowing you have confronted the possibility and have a plan in place.

Some young adults will have enough assets, real estate, or business interests to make a revocable living trust
worthwhile. This trust type avoids the probate process, ensuring privacy. There is no limit to the number of times you can amend a living trust. You may change asset distribution or add assets as you acquire more throughout your life. An estate planning attorney can help you determine if your financial situation and age warrant the setting up of this type of trust.

You probably have more assets than you realize. To assess your situation, inventory all of your belongings which typically includes but is not limited to:

Once you realize the scope of your belongings and assets, you can begin formulating your estate plan. First, consider who you want to receive your possessions and think about secondary beneficiaries, especially over time, as early estate planning requires frequent reviews and updates in the event of deaths, marriage, divorce, or the birth of a child.

Once you have an inventory and have begun thinking about who should handle things upon your passing and who you want as beneficiaries, it’s time to sit down with an estate planning attorney. Working with an estate planning attorney is easier than ever now, as COVID-19 increases the use of video and smartphone conferencing that streamlines legal planning. Estate planning attorneys like us can create a plan that best suits your situation, even if you aren’t sure what to do. Proper legal documents can save your loved ones from an expensive probate trial should someone contest your will. Even as a young adult, it is best to start planning now, even if it is just with some primary documents.

We would be happy to discuss your needs in a confidential setting that you are comfortable with – by video, over the phone, or in person. If you’d like to discuss ways we can help, please  contact  our office at 973-226-0050.

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