Clients often come to us to set forth advanced healthcare directives should they experience a serious illness or accident in the future. Subsisting on expensive life-support, long past when that treatment might improve life, is not an inviting prospect. For that reason, it’s now common practice that we attorneys write living wills for our clients to decline drastic treatment that would only prolong life.

But what about patients who have been diagnosed with a terminal illness and, until the inevitable end comes, suffer greatly? Drugs are available to usher in death relatively gently, to put an end to the misery that can only lead to a fatal outcome.

However, there is a difference between allowing
death to happen by declining treatment, as opposed to making
it happen with an affirmative act. Acting to end life, before its natural course has run, poses grave moral issues. For that reason, the traditional rule has been to make assisted suicide a crime. For example, in Arkansas, physician-assisted suicide is a felony punishable by three to ten years imprisonment and a fine of up to $10,000.00.

Despite that prevalent rule, New Jersey has joined eight other states in an emerging trend permitting medical aid in dying (“MAID”). Patients seeking MAID must be adults who have received a prognosis of six months or less to live, who can demonstrate that they know what they are doing, and are able to take the lethal medication themselves. Physicians act as gatekeepers, to make sure patients are qualified and to inform them of the risks and alternatives. The physician then writes the prescription and the patient takes the final act that causes death.

Opponents fear that elderly, poor, and disabled patients could be subjected to pressure, from family members or unscrupulous doctors, into premature death. Others object based on their belief that life is a sacred gift and that humans do not have sovereignty over when it ends. New Jersey Gov. Phil Murphy, a Catholic, subscribes to the latter view. He nevertheless signed the New Jersey bill into law, stating:

“I am torn between . . . my faith and my compassion for those who suffer . . . unnecessary, and often intolerable, pain at the end of their lives. . . . As things now stand, it is the law, rather than one’s own moral and personal beliefs, that governs such decisions. That is not as it should be. . . . [W]hile my faith may lead me to a particular decision for myself, as a public official I cannot deny this alternative to those who may reach a different conclusion.”

There are many who do, in fact, reach a different conclusion. Juries tend to acquit doctors who are prosecuted for MAID. The city council in Bisbee, Arizona – a state that criminalizes MAID – passed a resolution in 2015 requesting that the county prosecutor de-prioritize MAID cases. In 2017, nearly half the states were considering MAID bills and there is increasing support from healthcare professionals and medical associations.

On the other hand, opponents protest that the premature ending of life forecloses on relational and spiritual healing that can emerge at the time of approaching death. Those who hold fast to the belief in the sanctity of life argue that the power of choice wrongly prioritizes personal preferences overvalue that exists even when the person living that life no longer wants it. British journalist Brendan O’Neill notes: “Saying to people, ‘Well, maybe your life isn’t worth living and maybe you should give up,’ is ‘moral defeatism.’”

Doctors themselves have expressed the wish that MAID is sought only as a last resort. They have observed that people often request MAID because they fear they will be abandoned to die in pain. If such people can be reassured that easing pain is doable and that their comfort will be attended to and taken care of, the doctors hope that the need to resort to MAID would be lessened.

There is no doubt that euthanasia – the deliberate, direct causing of death by a physician  – remains beyond the pale for most people in this country, especially, of course, if done without the patient’s informed consent. But where the decision to end one’s life is based on a voluntary, thoroughly considered request in the presence of terminal illness and impending death, more and more states are declining to require that life should be prolonged at all costs, especially not if the patient feels the suffering involved is not worth the cost.

The New Jersey statute, the “Medical Aid in Dying for the Terminally Ill Act,” becomes effective on August 1, 2019.

If you have questions about what you have read or would like to discuss your situation, please don’t hesitate to contact us. If you’d like to discuss ways we can help, please  contact  our office at 973-226-0050.

The post New Jersey’s Medical Aid-in-Dying Explained appeared first on Faloni Law Group.

Elder law and estate planning are similar in concern, but they have significant differences.

The Concerns are Similar

No matter what age we’re in, life can deliver some hard knocks. Hope for the best, but plan for the worst. We can get into accidents, especially when we’re young and under the impression that we’ll live forever. Who would we like to be there for us if we can’t speak for ourselves? If we can’t pay the bills? Decide about our health care?

Both estate planning and elder law attorneys help you choose people you trust to stand in your shoes when you can’t speak for yourself.

As adults, we start families and assemble worldly goods. If we’re thinking realistically, we want to make sure our families are taken care of and who gets our property if the worst happens to us.

Both estate planning and elder law attorneys help you with those questions. Both kinds of attorneys also know how to protect your estate from tax burdens and to avoid the expense and delay of court proceedings.

The Differences Make All the Difference

Elder law expertise becomes crucial when we get older. We’re living longer, healthier lives – but nobody knows when we, or those whom we love, will get too sick to make decisions or to live independently.

It’s understandable, but not wise, to postpone thinking about these things. Delay or denial can mean that entire savings get wiped out paying for nursing homes. Misconceptions about government benefits can forfeit eligibility for them. If you want to retire from your own business, do you have a plan for a smooth and profitable transition? What quality of life can you protect? What housing arrangements can be made? What is the wisest allocation of financial resources to protect against as many foreseeable contingencies as possible?

This is where we elder law attorneys come into our own. We can help you face these difficult questions with your and your families’ best interests at heart. What we know can go far to spare you the distress and anxiety if you were caught unprepared. We know how Medicaid, Medicare, and Social Security work. We can help you manage retirement income benefits. We can steer you to the financial arrangements necessary if you or yours need long-term nursing care.

These are difficult, complicated questions that require particular knowledge to answer. We elder law attorneys have studied long and hard for that knowledge. We have learned how to help you plan to enjoy the life you have, plan for when life becomes harder with age, and have something left over for your legacy.

Estate planning is only the beginning. If you’d like to discuss ways we can help, please  contact  our office at 973-226-0050. The post Is Elder Law and Estate Planning the Same Thing? appeared first on Faloni Law Group.

Famous for starring in shows like Animal Adventures, Voices for Wildlife, and Into the Wild, Jack Hanna, suffering from dementia has decided to retire. Known as “Jungle” Jack, he left the Columbus Zoo and Aquarium, where he served as director, then director emeritus, for 42 years in December 2020.

His family most recently posted on his verified Twitter account explaining his condition to his many fans. “Doctors have diagnosed our dad, Jack Hanna, with dementia, now believed to be Alzheimer’s disease,” further stating, “His condition has progressed much faster in the last few months than any of us could have anticipated.”

Jack Hanna lives a healthy, active lifestyle and is currently age 74. Let that sink in.

Worldwide the statistics are not good, and they are not in favor of the average aging American. The Alzheimer’s Association website states that one in three seniors currently dies with Alzheimer’s or some other dementia. In the absence of a medical breakthrough to prevent, slow, or cure Alzheimer’s disease, the predictive numbers will only increase.

By 2050 more than 15 percent, or 12.7 million Americans age 65 or more, will be diagnosed with dementia. There will be still more elderly Americans living with the disease undiagnosed by a medical professional, often due to poverty associated with lack of proper medical care. Living with dementia is not only a challenge to an individual’s daily life, but it is also expensive. When it comes to footing the costly care bill, where does that leave our country, our health care system, our caregivers, our families, and you?

Alzheimer’s and other dementias problems are overwhelming in the larger sense, so control what you can. As an individual, create a plan responsive to the changing needs of Alzheimer’s care should you receive the diagnosis. Women, more than men and certain ethnic groups, tend to be hit hardest with the disease. If you fall into these categories, pay special attention to the onset of early symptoms because, as in all diseases, early diagnosis is key to more successful intervention. All individuals should speak with their doctors honestly about any cognitive challenges they experience as they age. The Alzheimer’s Association has a checklist of symptoms that you can use as a starting point.

The early, middle, and late stages of Alzheimer’s disease all require different degrees of caregiving as behaviors change in each stage. The one truism is that your caregiving situation will require a team providing support on many levels. Look for community and online community resources. The Alzheimer’s Association also has a Cognitive Impairment Care Planning Toolkit to help define and deliver person-centered care planning.

One of the earliest challenges you will face after a dementia diagnosis is developing or adapting your existing estate plan and advance directives that speak to financial and medical issues. You may have to move to be nearer family members, which can upend your will and other legal documents as they are executed by state authority. Adapting your legal plans early on can protect any challenges by heirs regarding your mental fitness and any estate plan changes. In truth, funding care for a dementia diagnosis can drain your assets to the point where generational wealth no longer exists for your inheritors. You cannot afford to have family challenges to your estate, particularly when you are no longer capable of understanding the scope of the issues due to your dementia.

There is a lot to take in, and much to get done should you receive an Alzheimer’s disease diagnosis. Even if you do not fall into a high-risk category for dementia, you ignore the possibility of the disease at your peril. Even the seemingly healthiest and most advantaged persons like Jack Hanna can experience the diagnosis and have the disease attack swiftly.

We help families create plans that address long-term care concerns, financial issues such as how to pay for care, and tax issues. Many clients of ours have a dementia diagnosis and we understand the challenges that come with such a diagnosis. We welcome the opportunity to discuss your concerns and your wishes so that they can be properly documented for you and your loved ones. If you’d like to discuss ways we can help, please  contact  our office at 973-226-0050.

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Currently, there are 58 million special needs Americans five years of age or older, which is the single greatest minority in the nation. The majority of federal and state benefits available to help persons with disabilities are needs-based, meaning income and assets are strictly limited and can often be misinterpreted, resulting in costly mistakes.

One of the most common mistakes a parent or loved one makes is disinheriting their family member with special needs. The reason is often that the family believes other siblings will step in and take care of the disabled family member. However, this can lead to numerous problems, especially if the non-disabled sibling gets sued, divorced, or otherwise loses the money left to them.

Another common mistake is failing to create a properly drafted trust to qualify the disabled family member for government benefits that can help pay for costly medical and/or living expenses. Qualifications for government benefits like Supplemental Security Income (SSI) or Medicaid dictate that the disabled individual has no more than $2,000 in assets. If your disabled loved one has assets above this threshold, they will have to be “spent down” to qualify for government assistance or otherwise protected in a properly drafted trust.

Well-meaning friends and extended family may not understand the complexity of disability benefits and give a disabled loved one money or assets that would disqualify them for state and federal benefits. It is especially difficult if the disabled person already has benefits and becomes disqualified because the “needs-based” review discovered additional funding putting them over the $2,000 asset limit. It is best to avoid this situation as it is a big hassle to re-qualify your dependent for government assistance.

Be wary of crowdfunding sites like GoFundMe to benefit your loved one with special needs. In the absence of qualified legal planning, these donations can disqualify SSI, Medicaid, food stamps, and section 8 housing. A well-meaning fund campaign could cut the benefits of a disabled person and make their living circumstances worse than before.

What to do? Plan ahead! There are several ways to provide for your special needs dependent and stay within government guidelines for additional benefits. One of the best ways is to establish a special needs trust that has the specific purpose of supplementing federal and state assistance programs. By doing so, a disabled loved one can benefit from government programs and have additional money to supplement what those programs provide.

There are strict rules when it comes to creating special needs trusts for a disabled family member. There are also restrictions on what the money can be used for. We can help you determine what type of trust is best based on you and your loved one’s particular circumstances. Give us a call at your convenience to set up a time to discuss your situation further, please  contact  our office at 973-226-0050.

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The Covid-19 pandemic has brought an important question to the forefront; how far would you want extreme life-prolonging measures to be tried? For us who are particularly vulnerable – seniors, those with compromised immune systems, those already struggling with medical conditions – this question is particularly stark. Many people are familiar with DNR orders, “do not resuscitate.” These are intended for cardiac arrest. The threats posed by the current virus, though, more often implicate breathing problems. The longer time spent on a ventilator, the greater the chances of permanent damage, disability, or death.

Many are dying alone, without their loved ones present. The New York Times recently reported on a particularly heartbreaking case.

Most people over sixty with a serious illness say they would prefer to be kept in comfort at the end, even if that care shortens life. But where to draw the line? How much time alive would you be willing to sacrifice, to decline aggressive treatment, and possibly die sooner? The need to provide at least some answers is important not just for you. Clinicians and caregivers need guidance , too.

A 2017 study showed that approximately two-thirds of Americans had neglected to provide prior guidance by creating advanced healthcare directives like health care powers of attorney and living wills. Back then, most of us could not have imagined being in an epidemic like the one now.

Even if you or your loved ones have already done the responsible thing and created advance directives, now is the time to review those documents to make sure they reflect what you want under current conditions.

Health-care providers are ethically obligated to do everything feasible to keep us alive. If we have no advance directives in place, the system will take over – and families can end up in long-lasting anguish for having had to be the ones to make the final call. Don’t let that happen. Think through the question for yourself and talk with a person whom you trust to make that decision for you if need be. Call us for your advance health-care directives – and may you and yours not need them for a good long while. If you’d like to discuss ways we can help, please  contact  our office at 973-226-0050.

The post Don’t Leave It up to Someone Else to Draw the Line appeared first on Faloni Law Group.

Since the 1960’s, lawmakers have continued to tackle age discrimination in the workplace. According to study.com , age discrimination is defined as “the practice of letting a person’s age unfairly become a factor when deciding who receives a new job, promotion, or other job benefits. Decisions about terminating employees also cannot be solely based on their age.” Age discrimination is illegal and there are laws to protect people from it.

The Law

The Age Discrimination in Employment Act (ADEA) is the federal law that protects job applicants and workers over the age of 40 from age discrimination. There are a few exceptions of groups that are not included in the ADEA. These include elected officials, military personnel, and independent contractors. The law applies to employers with at least 20 employees or labor organizations with at least 25 members. It also applies to employment agencies, the federal government, and state and local government. Along with the ADEA, all states have laws that protect workers against age discrimination, and in most cases, these laws are more stringent than federal law.

ADEA Protection

Under the ADEA, employers are prohibited from using age considerations in hiring, firing, layoffs, demotions, or promotions. In addition, there are several things employers cannot do. Employers may not mention specific age requirements or preferences when placing ads for jobs or recruiting employees. Employees may not be forced to retire at a certain age except in certain limited cases. Age limits cannot be set or specified for training programs and employers may not retaliate against employees that file age discrimination charges.

In addition, employers who provide benefits must provide those opportunities for all employees, regardless of age. However, with benefits that increase in cost with age, employers may provide the same amount of cost assistance for all employees regardless of cost or age.

Identifying Age Discrimination

Age discrimination can take many forms. Age-related comments or speaking to older employees in a demeaning manner can become harassment due to age. Harassment based on age is a tactic employers may use in an effort to get older employees to quit rather than firing them when they are deemed too old. When a company has a track record of hiring only younger people, this may be a sign of age discrimination. Getting turned down for a promotion that is then given to a younger, less qualified person or being overlooked for challenging work assignments can be signs of age discrimination. If an employer encourages or forces an employee into retirement, this is age discrimination. Oftentimes age discrimination may come in the form of being left out or isolated. Unfair disciplinary action can also be a tactic used to discriminate against older employees. If an employee suspects that he or she is being discriminated against because of age, these indicators may help in deciding if a claim needs to be filed.

Filing a Claim

Any employee has the right to file a claim if they feel they are being discriminated against because of age. If an employee wishes to pursue a claim, they must first file an administrative claim with the federal Equal Employment Opportunity Commission (EEOC). The EEOC will then contact the employer and investigate the claim. If the EEOC deems the claim to have merit, they will issue a right-to-sue notice.  Then, the employee is allowed to file suit against the employer. Claims must be filed within 90 days of the EEOC’s notice.  With the various rules and requirements of this process, it is important to have competent and timely legal advice.

If you have any questions about something you have read or would like additional information, please feel free to  contact  our office at 973-226-0050.

The post A Serious Problem: Age Discrimination appeared first on Faloni Law Group.

A doctor’s visit for most people is an important event. Often, you must explain your ailment quickly and succinctly, trust that your doctor has your best interests at heart and will keep your confidentiality; and make yourself vulnerable and talk about health issues that may be uncomfortable. Having a good relationship with your doctor can alleviate all these issues and can even increase the quality of your healthcare. So, you have a good relationship with a doctor you like, and you find out he is no longer in your health insurance network. Now what?

First, let’s examine why doctors leave health insurance networks. Usually, doctors leave health insurance networks for normal reasons such as retirement or if they move geographic locations. They are professionals, after all, and just as you probably have had to move to a new job, they do the same. Sometimes, there are other more technical reasons, such as if the doctor is unhappy with how the health insurance network conducts business. You’ll most likely be warned ahead of time if your doctor is leaving your network so you have time to plan, however, your doctor and your health insurance provider are not legally obligated to inform you if he is no longer covered. Unfortunately, huge surprise medical bills are all too common and these can leave you financially crippled for years. This is why it is so important when you reach your open enrollment dates each year that you call your doctor’s office and ensure your doctor is still covered under your plan.

So, what do you do if your doctor leaves your network? You may have continuity of care protection, which enables you to retain the same level of care from your doctor, for the same copays and fees, temporarily. If you are a senior who participates in a Medicare Advantage plan, you have the option to leave your health care network if your doctor does and if the network change is “considered significant based on the [effect] or potential to affect current plan enrollees” according to the Centers for Medicare and Medicaid Services guidebook. If you are currently covered under a private plan and are considering switching, it is prudent to call your doctor’s office and ensure they are covered under the new plan you are considering.

What if you can’t switch plans? Often, doctors will allow you to pay cash for your visits. You may be able to negotiate a reasonable cash price with your doctor because they won’t have to bill your insurance, which would save them time and administrative costs. If your doctor’s cash price is relatively expensive, it may still be worth it to you to maintain continuity of care.

If the previous options are out of the question for you, the next best thing to do is just to ask your doctor if they have any referrals. After all, your doctor will know your situation best and how to provide the best care and may know someone else who will be a good fit for you.

Having a doctor you like and trust can be such a relief and it’s always an unfortunate circumstance when your health insurance network no longer covers that doctor. Fortunately, there are ways you can plan for this and methods to make a smooth transition to a new doctor. If you need assistance in this process, please  contact  our office at 973-226-0050.

The post What Happens When Your Doctor Leaves Your Health Plan? appeared first on Faloni Law Group.

In-home care is the preferred living arrangement for many aging seniors. However, many medical conditions and personal care needs as adults age can cause this to become more difficult due to cost. The cost of in-home care varies from place to place, but generally follows the cost of living. Places where the cost of living is lower usually have lower costs for in-home care and the opposite is also true. In areas with a higher cost of living, in-home care is generally more expensive. Another challenge of paying for in-home care is the strict limitations on using Medicare and Medicaid to pay for in-home care. However, it is possible to pay for in-home care. Let’s look at some of the options.

Medicare and Medicaid

Although these two options are more limited in the in-home care covered, there are occasions where they can be used to pay for in-home care. Medicare generally pays for in-home care services for a period of time and most often occurs for a time after a patient is discharged from a hospital or rehabilitation facility. Treatment generally would not be covered for a chronic condition. Medicaid rules vary from state to state but are often similar to Medicare. All programs cover short-term in-home care when the patient has an acute condition. Medicaid offers long-term coverage in some areas, but this is often limited to patients who are ill enough to qualify for nursing home coverage. This care must be provided by a Medicaid-certified care agency. With Medicaid, each state runs its program differently and coverage will vary from state to state.

Reverse Mortgage

A reverse mortgage is an option for paying for in-home care. If the senior, age 62 or older, owns a home outright or owes little on the home, they can apply for a reverse mortgage. A reverse mortgage gives seniors the option of using the value of the equity in their home to get cash. The bank enforces strict rules about taxes, maintenance, homeowner’s insurance, and mortgage insurance. Therefore, it is important to do research on reverse mortgages and find a reputable bank, to lower the risk of defaulting on the reverse mortgage. Another important consideration is the length of time that care may be needed, as compared to the value of the equity. If a senior decides the reverse mortgage is a good choice for them, the cash can be used to cover the cost of in-home care.

Veteran’s Aid and Attendance Benefits

Aid and Attendance is an often-overlooked benefit available to veterans who are paying out of pocket for care. Veterans who served on active duty for 90 days, with one day during wartime, and who were honorably discharged, may be eligible for aid and attendance benefits. However, the qualification process is not easy and many veterans become frustrated when trying to do so.  As a result, the majority of veterans who may be eligible for the benefits never receive them.

Once qualified, a veteran can receive a monthly cash benefit, tax-free, to use for care. For veterans and their spouses, these benefits can be a major help in paying for in-home care. Surviving spouses of wartime veterans can also qualify for a monthly cash payment through the aid and attendance benefit.

Life Insurance

Life insurance is another possible way to pay for in-home care. If the life insurance policy is no longer needed to care for someone after death, it can be an option for paying for in-home care. A life insurance policy can be sold back to the company for a percentage of the value – usually 50 – 75%. This money can then be used to pay for in-home care. Many policies have flexibility, but some require the senior adult to be terminally ill. A policy with an Accelerated Death Benefit rider allows the policyholder to take a cash advance on the policy that is subtracted from the amount beneficiaries would receive. In this instance, the premiums are still paid and the policy still belongs to the policyholder.

Although in-home care is costly, the good news is that there are options available to help seniors pay for this care. The above are just a few options that may help seniors who wish to continue to live at home even when extra assistance is needed.

We help seniors and their loved ones find and pay for good long-term care using many of the options discussed above. We also create legal plans to protect the home and savings to make sure our clients never run out of money or options for good care. If you would like to learn more, please feel free to contact us.  If you’d like to discuss ways we can help, please contact  our office at 973-226-0050.

The post Ways to Finance In-Home Care appeared first on Faloni Law Group.

The need for estate planning becomes more and more critical as we age. Many people avoid estate planning because they do not want to think about the end of life, failing health, or disability. Others believe that an estate plan is only for rich people. However, an estate plan is helpful for the senior adult and their families regardless of overall wealth.

The estate is all the property owned both individually and jointly, including bank accounts, real estate, jewelry, etc., and what is owed. Without an estate plan, it is very difficult to carry out a person’s wishes and can bring on a long, drawn-out probate that can be very expensive for the family. If an estate plan is in place, it can provide peace of mind for the senior adult and their family, as well as protection for the wishes of the senior.

Below are some basic guidelines for what should be included in an estate plan.

Having an estate plan is necessary if you or your senior loved one wishes to have a say in what happens at the end of life and with assets after death. Consulting and planning with an elder law attorney will help to ensure that all options are explored and the best possible solution is utilized. The elder law attorney can walk you through all of the necessary parts of the estate plan, provide an explanation, and prepare the paperwork. Elder law attorneys will help take the guesswork out of estate planning.

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.

The post Your Estate Plan Must Include These 5 Items appeared first on Faloni Law Group.