The Difference Between Home Health and Home Care
The Difference Between Home Health and Home Care

The Difference Between Home Health and Home Care

Many people use the terms “home care” and “home health” interchangeably, which can cause confusion when you try to find funding for these services. This article will try to help you understand the difference between home care and home health.

What is Home Care?

Home care goes by a variety of names, including “aging in place,” “caregiving,” “in-home assistance,” “personal care” and “companion care.” The services do not include medical treatments. The people who provide these services are home care aides or caregivers. Because the services are non-medical, the worker category is “non-clinical” or “unskilled.”

Home care can include such things as preparing meals, assisting the older adult when eating, reminding him to take his medication and helping him to bathe, groom and dress. Depending on the needs of the person receiving the care, the tasks can include house cleaning, transportation and help with paying bills. The services usually get tailored to the individual client.

The total package of home care can involve multiple parties. For example, the older adult might have a home care aide who comes to the house for two or three hours every morning. The aide might help the client get ready for the day, with taking a bath, getting dressed and performing the morning grooming tasks. The aide might get the client’s breakfast ready, remind him to take his pills and make a sandwich for his lunch. Another person might come in once a week to clean the house, do laundry and batch cook some meals.

The client might use a grocery or meal delivery service. He could have a money manager make sure that his bills get paid.

Medicaid can pay for some of these services, if the senior qualifies for Medicaid. Some long-term care insurance policies can help with some of the cost. The remainder of the expenses is private pay.

Home Health Care

Skilled medical professionals provide home health care. These services usually take place after the doctor discharges the patient from the hospital, but she still needs some medical treatment, like physical therapy or care for a surgical incision. Depending on the treatment plan the doctor prescribes, the client might also receive health status monitoring, medical tests and the administration of drugs, including injections.

The medical professionals who provide home health care services include physical therapists, registered nurses, occupational therapists and other skilled healthcare workers. Sometimes the services last for a matter of weeks, until the doctor releases the patient. However, for some individuals with chronic conditions, the patient might need ongoing in-home medical treatments. The services might include teaching the patient skills to regain and maintain better health and function independently.

When a doctor prescribes home health care, Medicare will sometimes pay the expense of the services. If the client meets the low-income and other qualifications, Medicaid can bear the cost.

Overlap of Home Care and Home Health

When an older adult needs medical treatment in the home, he often also needs help with personal services. If a family member is unavailable to assist him, he might need to obtain the care from an agency. The fact many people need both types of services, home care and home health, contributes to the confusion.

References:

A Place for Mom. (accessed August 7, 2019) https://www.aplaceformom.com/planning-and-advice/articles/home-health-vs-home-care

 

Can Liz Hurley’s Son Inherit Grandfather’s Fortune?
Can Liz Hurley’s Son Inherit Grandfather’s Fortune?

Can Liz Hurley’s Son Inherit Grandfather’s Fortune?

Can Liz Hurley’s Son Inherit Grandfather’s Fortune? Multi-millionaire Dr. Peter Bing recently tried to stop Liz Hurley’s 17-year-old son Damian from getting access to his fortune—because he was born out of wedlock and claimed therefore that he was not a “grandchild.”

However, Wealth Advisor’s recent article, “Liz Hurley’s son Damian wins legal battle against grandfather over inheritance,” says that a Los Angeles judge ruled recently that Damian–fathered by Dr. Bing’s son, Steve–is a rightful beneficiary of the family trust.

Dr. Bing argued that his son, American businessman Steve Bing, has “never met” Damian and he doesn’t want the child to inherit any of his fortune.

In addition, Dr. Bing insisted that after creating the family trust in 1980, he stipulated that any grandchild must be “raised by my children as part of their families” to benefit from it.

The elder Bing noted in recent court papers that the trust “would not benefit any person born out of wedlock, unless that person had lived for a substantial period of time as a regular member of the household”.

Dr. Bing claimed that the definition of the term “grandchild” in the trust was unclear.

However, in court papers, Judge Daniel Juarez wrote: “There is no ambiguity in the trust’s use of the term ‘grandchild’”.

“The trustee’s [Dr Bing] interpretation of the trusts is unreasonable, and the trustee’s construction of ‘grandchild’ is simply unfounded.”

Damian was born to The Royals actress Elizabeth Hurley in 2002.

Steve Bing is worth roughly $555 million. He initially denied that he was Damian’s father, saying the couple was not in an exclusive relationship at the time. However, a paternity test proved he was the father of the child.

Can Liz Hurley’s Son Inherit Grandfather’s Fortune? The Court determined that Damian was legally a grandchild entitled to a portion of Steve Bing’s multi-million dollar fortune.

Reference: Wealth Advisor (July 23, 2019) “Liz Hurley’s son Damian wins legal battle against grandfather over inheritance”

 

Second Time Down the Aisle? Make Sure Estate Plan Is Ready
Second Time Down the Aisle? Make Sure Estate Plan Is Ready

Second Time Down the Aisle? Make Sure Estate Plan Is Ready

Second Time Down the Aisle? Make Sure Estate Plan Is Ready. It’s always a good idea to review your estate plan, especially when a major life event, like a second marriage, is taking place. The use of a pre-nuptial agreements gives prospective spouses the opportunity to discuss one another’s rights of inheritance, and clarify a great many issues, says nwi.com in the article “Estate Planning: Planning for second marriages.”

There’s a second opportunity to sign an agreement detailing inheritance rights after the wedding takes place, called a “post-nuptial agreement.” The problem is that once the wedding has occurred and you are both legally married, you might get stuck with some surprises and, well, you’re married. For most people, it’s better to set things out before the wedding, rather than after.

There also may have been dissolution decrees in one or both of the couple’s prior divorces that have requirements which must be satisfied. A spouse may be required to maintain life insurance with the ex-spouse as a beneficiary. This can have an impact on the couple’s estate plan. It is recommended that you have everything discussed up front in the pre-nup.

Second Time Down the Aisle? Make Sure Estate Plan Is Ready. The rest of the steps are those that should be followed for any estate review.

Make sure that the last will and testament reflects your new spouse. If there are any mentions of the prior spouse, you probably want to remove them.

Verify how all of the assets are owned. Will they continue to be owned by just one spouse, or converted to jointly owned? Does your estate plan have a trust, and if so, are assets owned by the trust? Does there need to be a change made to your trustees?

Many people don’t remember how their bank accounts are titled. Fewer still can tell you who their beneficiaries are on their retirement accounts, life insurance policies and bank accounts. Remember: the beneficiary designations are going to determine who receives these assets, regardless of any language in your last will and testament. Once you die, there is no way to contest that distribution. Review your accounts and make sure that the beneficiaries are up to date.

Part of your pre-nup and estate plan review will be to discuss inheritance rights for any children in the blended family. Do you want to leave assets only for your children, or do you want to leave assets for all the children? It’s not an easy conversation to have, especially at the start of the blending process.

Second Time Down the Aisle? Make Sure Estate Plan Is Ready. Remember also that blended family dynamics can change over the years. When you review your estate plan next—in three to four years—you’ll have the opportunity to make changes that hopefully will reflect deepening bonds between all of the family members. Your estate planning attorney will help create and revise estate plans, as your life circumstances evolve.

Reference: nwi.com (May 5, 2019) “Estate Planning: Planning for second marriages”

 

Is it Worth it to Contest a Will?
Is it Worth it to Contest a Will?

Is it Worth it to Contest a Will?

Is it Worth it to Contest a Will? If it helps, and it might not, this happens more frequently than you’d think. The response is sometimes shock, other times, it’s anger. However, according to this recent article from Forbes, “5 Things You Should Know About Contesting A Will,” before you start making revenge plans or hiring the most tenacious attorney in town, take a deep breath. You need to consider some cold hard facts:

Is it Worth it to Contest a Will?

  1. Litigation is expensive. Many people will ask if an attorney will take the case on a contingency fee basis—typically a third of what you receive, and he or she only gets paid if you do. Most probate attorney won’t take a will contest on a contingency fee, because there’s a risk they won’t get paid. If they do, be certain that you have an experienced estate planning attorney with experience in estate battles.
  2. Have lots of Rolaids on hand. You’re gonna need them. It’s a rough journey, one that can be full of lies, misrepresentations and accusations. There may also be a counter lawsuit against you. You’ll probably be deposed in a deposition, where the opposing lawyer will ask you questions about the case. You may be portrayed as greedy, and you might have to testify in court.
  3. Snap decisions are required. Once you hire your attorney, he or she will work with you to develop a strategy for the case. Your attorney may recommend that you file suit immediately and be the first one into the courthouse. On the other hand, your counsel may think it best to send a letter to the attorney representing the person you’re suing with a request for information. Depending the response, you may decide to file suit. In most cases, you’ll have a limited time to contest the will. If you don’t do so within that time period, you can’t bring a lawsuit. Talk to an experienced attorney shortly after the death.
  4. You’ll probably reach a settlement. Once the litigation has begun, and the attorneys have had time to exchange information and do some fact finding (in what is known as the discovery process), your attorney will talk to you about the strengths and weaknesses of your case. It may be appropriate at that juncture for one side to present the other with a settlement offer. This would end the litigation without the time and expense of trial. This may be a wise option, if you’re tired of fighting and willing to consider a settlement instead of going to trial. Your attorney may also point out weaknesses in your case and advise you to be happy with getting a settlement. That way you can move on with your life. You should approach the settlement like a business decision, and try to keep emotion out of it.
  5. Expect emotional pain. While you may get some satisfaction if you win, you will may lose any connection with the people you bring to court. If you lose, well, that’s a lose-lose proposition. No matter how big the win, any underlying emotional issues will still be with you. Be prepared to be very businesslike about any estate battle.

Reference: Forbes (May 21, 2018) “5 Things You Should Know About Contesting A Will”  

Is it Worth it to Contest a Will? To finish like a lawyer-it depends.

 

Why an Attorney Should Help with a Medicaid Application
 Why an Attorney Should Help with a Medicaid Application.

Why an Attorney Should Help with a Medicaid Application

Why an Attorney Should Help with a Medicaid Application.

Elder law attorneys can be very helpful when planning for Medicaid coverage, and they can save money in the long run, ensuring that you (or a loved one) get the best care. Instead of waiting to see how wrong the process can get, says The Middletown Press, it’s best to “Use a lawyer for Medicaid planning” right from the start. Here’s why.

Conflict of interests. When a nursing home refers a family to people for preparing the Medicaid application, very often the person has dual loyalties: to the nursing home who refers them the work, and to the family who will pay them a fee for help with applying for benefits. Whose interests comes first?

Everyone wants the Medicaid application to be successful, but let’s be realistic. It’s in the nursing home’s best interest that the resident pays privately for as long as possible, before going on Medicaid. It’s in the resident or family member’s best interest to protect the family’s assets for care for the resident’s spouse or family.

Why an Attorney Should Help with a Medicaid Application. An attorney has a duty of loyalty only to her client. She also has an ethical and professional responsibility to put her client’s needs ahead of her own.

Saving money is possible. Nursing homes in some areas cost as much as $15,000 a month. While every market and every law practice is different, it would be unusual for legal fees to cost more than a month in the facility. With an experienced attorney’s help, you might save more than her fee in long-term care and probate cost. Most attorneys will consult with new clients at little or no cost to determine what they need and what they want to achieve before paying a larger fee.

The benefit of experience. It’s all well and good to read through pages of online information, but nothing beats the years of experience that an attorney who practices in this area can bring to the table. Any professional in any field develops knowledge of the ins and outs of an area and applying for Medicaid is no different. Without experience, it’s hard to know how it all works.

Peace of mind from a reliable, reputable source. Today we hear a lot about “FOMO,” or fear of missing out. Consulting with an experienced attorney about a Medicaid application will help you avoid years of wondering, if there was more you could have done to help yourself or your loved one.

There are multiple opportunities for nursing home residents to preserve assets for themselves and spouses, children and grandchildren, particularly when a family member has special needs. However, here’s a key fact: if you wait for the last minute, there will be far less options than if you begin planning long before there’s a need to apply for Medicaid.

Reference: The Middletown Press (July 29, 2019) “Use a lawyer for Medicaid planning”

Why an Attorney Should Help with a Medicaid Application.

Dissolving the Mystery of Probate
Dissolving the Mystery of Probate

Dissolving the Mystery of Probate

Dissolving the Mystery of Probate. Probate can be avoided with proper estate planning, or certain assets can be placed outside of the probate process.

The Street’s recent article on this subject asks “What Is Probate and How Can You Avoid It?” The article looks at the probate process and tries to put it in real-life terms.

Probate is an estate planning process that works within a probate court with the Surrogates’ Court judge presiding over the proceedings. Usually, surviving families and other interested parties initiate a probate process, to address issues relating to the deceased individual’s estate settlement. These include:

  • The handling of the deceased’s valid will;
  • Properly citing and categorizing the deceased’s assets;
  • Appraising the deceased’s estate and property;
  • Paying off any of the deceased’s existing debts; and
  • Distributing the deceased’s property to those directed by the will (or, if there’s no will, the probate court will direct the distribution of estate assets, according to the laws of intestacy).

The executor handling the deceased’s estate will typically start the process. Dissolving the Mystery of Probate…here are the basic steps:

File a Petition. The estate’s executor will file a request for probate where the deceased resided.  The court will then assign a date to confirm the executor and, once that is done, the probate judge will officially open the probate case.

Notice. The executor must send a notice that the deceased’s estate is officially in probate to all applicable beneficiaries, heirs, debtors and creditors.

Inventory Assets. The executor will then collect, list and present a value for all of the deceased’s assets and supply this to the probate court.

Pay the Bills. The executor will need to pay all outstanding debts owed by the estate.

Complete Any Tax Returns. The estate may also have existing tax returns that need to be filed. An accountant can be hired by the estate to work on this, or the executor may choose to file the taxes on his or her own.

Pay the Heirs. The executor can now distribute the remainder of the estate to any heirs, according to the will’s instructions.

Close the Estate. Finally, the executor will file paperwork with the court and file to close the estate.

An experienced estate planning attorney licensed to practice in your state will be able to explain what strategies are used to avoid probate, how to remove certain assets from the process, or whether it needs to be avoided at all. In some regions, probate is swift, while in others it is long and tiresome. A local estate planning attorney is your best resource.

Reference: The Street (July 29, 2019) Dissolving the Mystery of Probate “What Is Probate and How Can You Avoid It?”

 

Your Estate Plan Decides or the State Decides
Your Estate Plan Decides or the State Decides

Your Estate Plan Decides or the State Decides

Your Estate Plan Decides or the State Decides.

It’s something that everyone needs, but often gets overlooked. Estate planning makes some people downright uncomfortable. There’s no law that says you must have an estate plan—just laws that will impact how your property is distributed and who will raise your children, if you don’t have a will. Planning is important, says WMUR 9 in a recent article “Money Matters: Estate planning,” if you want to be the one making those decisions.

An estate plan can be simple, if you only own a few assets, or complicated if you have significant assets, more than one home and multiple investments. Some strategies are easier to implement, like a last will and testament. Others can be simple or complex, like trusts. Whatever your needs, an estate planning attorney will be able to give you the guidance that your unique situation requires. Your estate planning attorney may work with your financial advisor and accountant to be sure that your financial and legal plans work together to benefit you and your family.

There are circumstances that require special estate planning and Your Estate Plan Decides or the State Decides

  • If your estate is valued at more than the federal gift and/or estate tax exclusion, which is $11.4 million per person in 2019
  • You have minor children
  • There are family members with special needs who rely on your support
  • You own a business
  • You own property in more than one state
  • You want to leave a charitable legacy
  • Your property includes artwork or other valuable collectables
  • You have opinions about end-of-life healthcare
  • You want privacy for your family

The first step for any estate plan is a thorough review of the family finances, dynamics and assets. Who are your family members? How do you want to help them? What do they need? What is your tax picture like? How old are you, and how good is your health? These are just a few of the things an estate planning attorney will discuss with you. Once you are clear on your situation, you’ll discuss overall goals and objectives. The attorney will be able to outline your options, whether you are concerned with passing wealth to the next generation, avoiding family disputes, preparing for a disability or transferring ownership of a business.

A last will and testament will provide clear, legal direction as to how your assets should be distributed and who will care for any minor children.

A trust is used to address more complex planning concerns and to provide instructions if incapacitated. A trust is a legal entity that holds assets to be used for the benefit of one or more individuals. It is overseen by a trustee or trustees, who can be individuals you name or professionals.

If you create trusts, it is important that assets be retitled so the trust owns the assets and not you personally. If the assets are not retitled, the trust will not achieve your goals.

Some property typically has its own beneficiary designations, like IRAs, retirement accounts and life insurance. These assets pass directly to heirs according to the designation, but only if you make the designations on the appropriate forms.

Once you’re done with your estate plan, make a note on your calendar. Estate plans and beneficiary designations need to be reviewed every three or four years. Lives change, laws change and your estate plan needs to keep pace.

Reference: WMUR 9 (Aug. 1, 2019) “Money Matters: Estate planning”

 

What’s the Difference Between a Life Estate and an Irrevocable Trust?
What's the Difference Between a Life Estate and an Irrevocable Trust?

What’s the Difference Between a Life Estate and an Irrevocable Trust?

What’s the Difference Between a Life Estate and an Irrevocable Trust? Investopedia’s recent article asks “Life Estate vs. Irrevocable Trust: What’s the Difference?” The article explains that a life estate and an irrevocable trust are two different ways to make certain that assets are transferred to the right party. Each of these has advantages and disadvantages.

A life estate that’s used to gift property will divide the ownership between the giver and receiver. Some parents create a life estate to reduce their assets to qualify for Medicaid. While the parent still has some interest in the property, Medicaid doesn’t count it as an asset. A life estate lasts for the lifetime of its creator and it prohibits the selling of the asset, without the permission of its beneficiaries. Therefore, a parent can’t sell a home without the permission of his children, if they are beneficiaries of the life estate.

If you’re attempting to be eligible for Medicaid and are concerned that your home will disqualify you, ask your estate planning or Medicaid planning attorney about an irrevocable trust. With this trust, if a husband and wife both own a home, the husband can transfer his portion to his wife, and his Medicaid eligibility won’t include the home.

There must be a five-year gap between the creation of the trust and the application for Medicaid. If there isn’t, those funds will be counted as part of existing assets when determining Medicaid eligibility. Therefore, you can’t start an irrevocable trust right before you apply for Medicaid, if you want to receive those benefits.

One negative of an irrevocable trust is that the founder of the trust relinquishes any rights he has to the home. However, the beneficiary of the trust can’t sell the home, unless he or she is also named as a trustee. Once an irrevocable trust has been created, the trustee can’t take back control of the trust.

Remember that a life estate and an irrevocable trust aren’t always mutually exclusive. It’s possible to place an asset (like a home) in an irrevocable trust and keep a life estate. In that case, you’re irrevocably transferring ownership of your house to the trust. However, you still keep control. In this case, you are permitted to sell the home, remodel, or rent out a room, but the house itself—or the sales proceeds from it—would remain in the irrevocable trust.

In this situation, a parent would also not risk giving their children part of the tax liability that is associated with owning a home. The parent would keep more personal control over the house and wouldn’t need their child’s permission to sell the home. This may be the best option because it would still allow the parents to apply for Medicaid and not have the property count in their assets, but he or she would remain the sole decision-maker for the house.

What’s the Difference Between a Life Estate and an Irrevocable Trust? Both have their pros and cons, but a combination of the two can often be the best answer. Make no moves either way, without the advice of an experienced elder law attorney.

Reference: Investopedia (June 16, 2019) “Life Estate vs. Irrevocable Trust: What’s the Difference?”

 

Use This Checklist When Visiting Assisted Living Facilities
Use This Checklist When Visiting Assisted Living Facilities

Use This Checklist When Visiting Assisted Living Facilities

Use This Checklist When Visiting Assisted Living Facilities. When you are trying to find an assisted living community for yourself or a loved one, you need to do your homework to find at least three candidates that meet all the needs of the future resident. After you have narrowed your search down to those facilities, you should visit each one with the person who will be living there. Know what you want to look for before you visit the first center, so you will get all the information you need from every facility.

It is easy to get overwhelmed in the process of finding the right assisted living community. To help you in this quest, use this checklist when visiting assisted living facilities.

  1. First impressions count. Pay close attention to your initial thoughts and feelings about the center as you approach and enter. Your instincts often pick up on “micro-symptoms” that can indicate a problem, even before you notice the issue itself.
  2. Try to see down the road. Visualize yourself or your loved one actually living at the assisted living community. Ask yourself if you would be happy there. Pay attention to whether you feel comfortable or anxious. Evaluate whether the staff and other residents are friendly and inviting.
  3. Use Smell-a-vision. When you walk through the building, pay attention to the smells. You should not be able to detect any unpleasant odors. Strong “cover-up” scents are also a warning that the place likely has cleanliness issues.
  4. Look for dirt, dust, and grime in the obvious locations and places, like the baseboards and windows. You might be surprised at how many expensive assisted living centers cut corners on cleaning costs.
  5. The staff in action. Watch the staff in action, when they are interacting with the residents. Pay attention to their facial expressions and tone of voice to see if they love their jobs or are merely going through the motions. You should also observe the body language of the residents when they receive care from the staff. Look for any signs of fear, hostility, or resentment. Keep looking until you find a place where both the residents and the staff are happy, warm and friendly.
  6. The proof is in the pudding. Good food is one of the highlights for many people who reside in assisted living. Visit during mealtime and arrange to eat a meal there. Find out if the meals are both nutritious and tasty. Get a copy of the monthly menus to check for variety. Find out the center’s policy, when a resident cannot come to the dining room.
  7. Explore the both outdoor areas and the indoor facilities. Make sure that your loved one would be safe when enjoying some fresh air outside. Look to see if there are adequate sitting areas and tables.
  8. The current residents. You can find out valuable information from the people who already live at the center. Without making them feel uncomfortable, notice whether the residents are well-groomed and wearing clean clothes. Sit and visit with some residents. Let them know you are considering this community for yourself or a loved one. Ask for their advice. Find out if they have to wait a long time for personal care or other services. If so, the facility is likely under-staffed.

Use This Checklist When Visiting Assisted Living Facilities.

A Place for Mom. “Tips for Touring Assisted Living Communities.” (accessed August 7, 2019) https://www.aplaceformom.com/planning-and-advice/articles/tips-for-touring-assisted-living

 

What Should I Know About a Special Needs Trust?
What Should I Know About a Special Needs Trust?

What Should I Know About a Special Needs Trust?

What Should I Know About a Special Needs Trust?

Your disabled family member may be eligible for a number of government programs. However, Pauls Valley (OK) Democrat’s recent article asks “Can your family benefit from a special needs trust?” The article reminds us that these programs don’t cover everything. You may need to close the gaps.

A few government programs have eligibility restrictions, based on the level of financial assets that are available to the recipient. This means the financial help you’re wanting to provide may do more harm than good, unless you establish a special needs trust.

As the donor, you supply the funds. A trustee holds and administers them, according to your instructions. The beneficiary typically can’t use the trust for basic support or to receive benefits that can be provided by the government. The special needs trust can be used to provide specialized therapy, special equipment, recreational outings and other expenses.

When considering a special needs trust, What Should I Know About a Special Needs Trust? You’ll need to look at several issues with your attorney. However, there are two that are critical. The first is designating a trustee. You could name a family member or close friend as a trustee. While this works well for many, it has the potential to cause family conflicts. You could also name a trust company. This company can provide professional management, expertise and continuity of administration. A third option is to name an individual and a trust company as trustees.

The second critical issue with a special needs trust is funding the trust. You can fund the trust during your lifetime or have it activated when you die.

Note that you don’t have to be the sole donor. A special needs trust can be created so other family members can also contribute to it. The trust can be funded with securities (stocks and bonds), IRA proceeds, insurance death benefits and other assets.

You’ll need to understand the requirements of various federal, state and local benefit programs for people with disabilities, so that your loved one’s benefits are not at risk.

What Should I Know About a Special Needs Trust? Speak with an experienced elder law or estate planning attorney about how you can to make life better for a disabled child or family member with a special needs trust.

Reference: Pauls Valley (OK) Democrat (August 1, 2019) “Can your family benefit from a special needs trust?”