Red Flags (Signals) of Possible Elder Fraud

An blog was recently published in the Wall Street Journal detailing warning signs of possible fraud.

Unfortunately, this crime is on the rise.

click here to read the article.

Resource from the American Academy of Neurology

Neurology Now is a magazine, published six times per year, by the American Academy of Neurology. It contains extremely helpful information on a wide variety of neurological conditions.

For more information on the publication, click here.

January is National Glaucoma Awarness Month

January is National Glaucoma Awareness Month.  More than 2.2 million Americans age 40 and older have open angle glaucoma, the most common form of glaucoma, and at least half don’t even know they have it.

 click here to learn more about glaucoma

Frontotemporal Disorders: Information for Patients, Families, and Caregivers

This 30-page guide offers consumer-friendly information about these rare conditions and their causes, symptoms, diagnosis, and treatment, with helpful advice for caregivers.

click here to obtain the guide.

Brain Injury Association of Illinois

The association recently published their January newsletter.

Please click here to learn more about the association and receive their monthly publication, which contains a great deal of helpful information for individuals who have a brain injury and the people who care about/for them.

Parkinson’s Disease Foundation – Helpful Resource!

The Foundation has published their Winter 2012 newsletter.

Please click here to read it and sign-up to electronically receive this helpful publication.

January Newsletter from Dutton & Casey

Please take a few minutes to our January newsletter as it contains helpful information for older adults, people who have a disability, and the people who care for / about them.

click here to read the January issue.

Macular Degeneration Partnership

The partnership offers resources, education, and support for people who have macular degeneration and the people who care for/about them.

click here to learn more.

Illinois Mental Health and Aging Coaltion

On Tuesday, January 17 at 10:00am,  a program discussing “ECT: New Developments and Treamtent Considerations” will be presented by Donald Fagerson, M.D., Medical Director for ECT at Alexian Brothers Behavioral Health Hospital.

click here to read a flyer regarding the program

Chicago Snow Corp

Chicago Snow Corps is a new program that connects volunteers with residents in need of snow removal, such as seniors and people with disabilities.  Chicago Snow Corps aims to help minimize potential heavy-snow emergencies by matching volunteers with blocks where the neediest citizens have requested help.

 How do I request a volunteer?

Call 311. We will try out best to make volunteers available to you, but the services available depend on the number of volunteers in your area. Volunteer matching takes place Monday through Friday from 9 a.m. to 5 p.m. Volunteers will not clear alleys, personal parking spaces, back porches, or any alternate entrances. Do not let the volunteer into your home. Do not offer payment for the shoveling services.

 Who should call 311?

Recipients of assistance must be age 60 or older and/or have a physical disability. They must also live within Chicago City limits and lack access to the available resources (financial resources or local family/friends) to assist with snow removal.

 When do I call 311?

Call 311 if you are unable to get out of your home after a snowfall. Only call 311 if the snow is significant and you do not have friends or family who can help you.

 

Elder Abuse: What do you do if you suspect it?

It’s difficult when you suspect that an elder you care about is the victim of elder abuse.  While the majority of reported elder abuse concerns financial exploitation, abuse may be physical, emotional, or sexual in nature, or may take the form of neglect.  In addition, some elders simply do not have the capacity or ability to properly care for themselves and may fall victim to self-neglect.

Elder abuse does not discriminate between sex, ethnicity or social status.  Between July 1, 2005 and June 30, 2006, the Illinois Department on Aging received 9,191 reports of elder abuse and, sadly, the majority of abusers were family members of the victim.

What do you do when you suspect that someone you love or care about is the victim of elder abuse or neglect?  If you suspect that someone you know is in immediate or life-threatening danger, first call 9-1-1.  Otherwise, to report suspected abuse, exploitation or neglect of an older person you may make a report to your local police department.

You may also call the Illinois state-wide 24-hour Elder Abuse Hotline at 1-866-800-1409, 1-888-206-1327 (TTY).  Under the authority of the Elder Abuse and Neglect Act (320 ILCS 20/1 et seq.), the Illinois Department on Aging administers the statewide Elder Abuse and Neglect program.  Reports of elder abuse are investigated by elder abuse caseworkers at one of 44 provider agencies around the state.  These case workers are trained and certified by the Department on Aging.  You may also call your local elder abuse provider agency directly.

Anonymous reports are accepted and the identity of the reporter may only be disclosed with written permission of the reporter or by court order.  Under the Illinois Elder Abuse and Neglect Act reporters who act in good faith are immune from civil or criminal liability or professional disciplinary action as a result of the report.

For more information on Elder Abuse or to schedule an appointment to meet with an attorney visit our website or contact us at 312-899-0950.

Am I old enough for an Elder Law attorney?

We often get asked this question by potential new clients when calling to make an appointment for a consultation.   The National Academy of Elder Law Attorneys, Inc., (NAELA) states its goal is to establish “NAELA members as the premier providers of legal advocacy, guidance and services to enhance the lives of people with special needs and people as they age.”

Many attorneys who practice in the broad field of elder law are dedicated to planning for the needs of older adults; however, Elder Law is not simply limited to issues affecting those in their later years of life.  In addition to advising as to wills, trusts and simple estate planning, so much of elder law is concerned with disability law and planning for special needs.  Medicaid planning, guardianship, powers of attorney, living wills, and special needs planning are all essential issues to consider when developing an effective estate plan.

For example, a younger client who has a child with special needs may seek advice about the provision of a special needs trust to ensure that child’s needs are met upon the parent’s death.  Older couples who contemplate the need for nursing home care may consult an elder law attorney for Medicaid planning and asset protection.  An adult child may seek an elder law attorney to represent them in petitioning for the appointment of a guardian for a parent or family member who requires assistance with finances or health care decisions and has not designated an agent under power of attorney.

If you would like to meet with an attorney to discuss your particular needs and concerns visit our website or call 312-899-0950 to make an appointment.

When the Trustee is not Trustworthy: Remedies for the Trust Beneficiary

Before my mother passed away, she established a living trust and named my sister as Trustee.  My sister, my two brothers and I are the beneficiaries of this trust.  I recently found out that my sister used my mother’s trust to pay for a cruise for herself and her daughter, and also remodeled her home with my mother’s trust monies.  What can I do?

Naming a Trustee of your Trust is perhaps the most important estate planning decision you make.  Unfortunately, this mother made the wrong decision in naming her daughter as Trustee after her death.  A Trustee has the fiduciary duty to act in good faith, in accordance with the Trust terms and purposes, and to act for the sole interest of the beneficiaries.  Even though the Trustee may herself be a beneficiary of the trust, she is breaching her duties as Trustee by using the trust assets for her personal benefit.

This beneficiary needs to act quickly to prevent the Trustee from continuing to spend the trust assets. If the Trustee/sister spends more trust assets than she is to receive as a beneficiary, it will be difficult to actually recover those trust assets from her.  The beneficiary should engage an attorney to file an emergency action to freeze the trust assets so the Trustee can’t continue to spend them; to remove the Trustee; to force her to account for her actions as trustee; and, ultimately, to pay back the misappropriated funds.  Because the Trustee acted intentionally in using trust assets for her own benefit, the beneficiary may be able to obtain punitive damages – a monetary penalty for breaching her duties to the trust – against the Trustee.

The Trustee will not be allowed to use trust assets to defend herself.  However, because the beneficiary is acting to protect the trust, it is possible that the beneficiary’s attorney’s fees will be paid from the trust assets.

To set up a consulatation to discuss your particular needs, contact the experienced elder law attorneys at Janna Dutton & Associates.

Planning for Your Disabled Child

Few questions can cause as much worry and anxiety for our clients as “who will take care of my disabled adult child or grandchild when I am gone” and “how will she be provided for?”  In particular, our clients are gravely concerned about who will manage their child’s inheritance.  Who will make sure the money is spent appropriately for their child’s benefit?  Will the inheritance affect their child’s supplemental security check, medicaid coverage and eligibility for an adult day program or residential placement?  What if the inheritance disqualifies their child from medicaid?

These are the questions that keep the parents and grandparents of disabled adult children up at night.  Fortunately, through a special needs trust our clients can make sure that their adult disabled child or grandchild will receive an inheritance that is managed by a trustworthy individual in a way that will not disqualify that child from supplemental security income, medicaid, adult day programs or residential placement.

For those who qualify, a special needs trust can substantially improve a disabled person’s quality of life.  Through a special needs trust, a parent can make sure their disabled child is not disqualified from public benefits like medicaid and supplemental security income.  A parent can also make sure the inheritance they leave their child will be managed properly and in a way that enhances their child’s life.

Special needs trusts have enhanced the quality of life of so many disabled adult children and grandchildren.  And they have also given peace of mind to concerned parents and grandparents.

For more information on the benefits of special needs trust or planning for disabled children please visit our website, or call our office to schedule a consultation.  This post is adapted from Kathryn Casey’s article published in the July 2008 issue of Chicago Hospital News.

Talking to Your Aging Parents About Financial and Legal Planning

Good Morning America had a great segment this morning discussing tips for talking with your parents about planning for their financial and legal future.  Financial contributor, Mellody Hobson, had some suggestions for talking points for that important conversation.  The full video is available here:  Talking to Aging Parents About Finances – ABC New.

The highlights were:

• Broach the topic by discussing your own plans for the future;
• Organize their legal and financial documents;
• Suggest direct deposit and bill pay for your parents;
• Research meal, transportation and in-home medical services;
• Discuss long term care planning; and,
• Encourage estate planning and the necessity of drafting a Will.

For more information about any of topics discussed in the video please contact our office to schedule a consultation.

Medical Students Experience Nursing Home Life

The New York Times posted a very interesting article about medical residents who spent a short time living in a nursing home to find out what it’s like to be a nursing home  resident.  One of the goals of the program is to generate interest in geriatric medicine, which continues to be one of the most underrepresented fields in medicine.  Additionally, participants found that their experience offered invaluable insight into how to be better physicians.

Click here to read the full article

For legal assistance, contact the experienced elder law attorneys at Janna Dutton & Associates.

Misuse of Anti-psychotic Drugs on Nursing Home Patients

The Chicago Tribune recently published a series of articles on the use of psychotropic (or antipsychotic) drugs on elderly patients in nursing facilities.  The Tribune reviewed more than 40,000 state and federal inspection reports and found that many patients had been prescribed these powerful drugs despite the fact that they had no history of mental illness, no diagnosis of psychosis, and no display of any psychotic symptoms.

This trend is alarming for a variety of reasons, both for patients and their families.  The most commonly-used psychotropics carry the FDA’s highest advisory.  Some of the side effects include: severe lethargy, permanent involuntary muscle movements, restlessness, seizures and sudden death.  Non-psychotic patients who have been prescribed psychotropics are often described by family and nursing staff as “catatonic,” no longer able to talk or attend physical therapy and many have become so lethargic they must be hospitalized.  Similarly, as a result of this lethargy there have been a number of cases where nursing home residents suffered serious falls in which psychotropics possibly played a role; some of which led to serious injuries or even death.

Read the links below for some theories on why this is happening, information on your rights and where to direct any complaints. 

Five Things to Know About Psychotropics

Compromised Care: Psychotropic drugs given to nursing home patients without cause

Nursing home doctors untouched even as facilities are cited
 

Illinois Citizens For Better Care

For legal assistance from experienced and compassionate attorneys, contact Janna Dutton & Associates.

12/14 Update: A new article states that “Nearly 30% of the total nursing-home population is receiving antipsychotic drugs”

12/21 Update: Yesterday, The Chicago Tribune published another article in their “Compromised Care” series, this one discussing what rules are being sought in order to control the usage of  anti-psychotic drugs and the doctors who prescriev them.  “Medical care should help you get better, not get worse,” said Wendy Meltzer of Illinois Citizens for Better Care (see our blog post on ICBC’s important work).  To provide quality care health advocates are calling for tough new rules, including having Illinois: refuse to pay for certain medications, require nursing homes to use standardized consent forms, centralize information regarding nursing home doctors, so that any issues regarding those doctors can be looked at in their entirety (not just piecemeal) and require drugmakers to publicly disclose payments to doctors so that their patients can be aware of a possible conflict of interest.  See the full article here.

Consider Dementia’s Physical Effects When Making Treatment Decisions

When thinking about the effects of dementia, most people view it as a disease that solely affects the mind– a debilitating illness that strips an individual of his/her memories, but appears to leave the rest of the body untouched.  However, a recent article in the New York Times reminds us that the body undergoes a physical attack as well as a mental attack.  The illness is progressive and as it weakens the brain it also shuts down the body.  Doctors advise that these often-overlooked physical tolls must be understood and taken into consideration when considering the future care of your loved ones. 

 The article explains that the lack of understanding about the physical effects of dementia means that many patients near the end of life are subjected to aggressive treatments, many of which cannot possibly help them, or can even increase symptoms such as confusion and anxiety.  Researchers in a recent Harvard study found there were stark differences in treatment decisions depending on what family members knew about dementia.  Dr. Susan L. Mitchell, the study’s lead author, explained, “When family members understood the clinical course of dementia and the poor prognosis, the patients were far less likely to undergo these distressing interventions.”  She concluded that, “Dementia is a terminal illness and needs to be recognized as such so these patients receive better palliative care.” 

For the full article, click here.

For more information on long-term care planning for yourself or a loved one, contact the attorneys at Janna Dutton & Associates.

Geriatric Care Managers: Experts in Developing Personalized Care Plans

Caring for an elderly parent or loved one can be a full-time job. Even when a family can agree on a care plan, which is not always the case, the plethora of decisions that need to be made and the never-ending pile of documents that need to be filled out is overwhelming. In addition to that, you have your own life to live and yourself to take care of.

It’s tempting to want to handle everything yourself, but sometimes outside help can actually allow you to provide the best possible care for your loved one, not to mention allow you to take better care of yourself. In September, the New York Times published an article on geriatric care managers, or what they also refer to as the equivalent of a case worker. Aptly named, these care managers do just that–manage the care of your family member. They have both the time and the expertise that family members often do not, which can greatly improve your elder’s quality of life. (See complete article for costs)

A good care manager will thoroughly assess the individual and use that assessment to determine a care plan that will meet the individual’s needs. Amongst a variety of other changes, this could mean that home care is recommended, or that sleeping and eating times must be adjusted. Plus, using someone outside of the immediate family can help in a few ways. One family member explained that he couldn’t get his mom to listen to him, but she would always listen to the care manager. It also provides the family with the option to be the “good cop” while the care manager is the “bad cop.” Persuading an older person not to drive anymore is a good example of when the good cop/bad cop routine might come in handy (and be more effective).

Click here to see the article in full. It provides some examples of how geriatric care managers have assisted families in finding and maintaining the right kind of care, costs involved and ways to find the right care manager for your family.

Here is an interview from ChoiceElderCare.org with a registered nurse and care manager on the benefits of care management. 

For legal advice on long-term care planning for yourself or a loved one, contact the attorneys at Janna Dutton & Associates.

November is National Family Caregivers Month

On October 30, 2009, President Obama proclaimed November 2009 to be National Family Caregivers Month.  Organizations across the country are encouraging caregivers to remember their own health and care this month and to consider senior care options.

Click here to read the President’s full proclamation.

Have a caregiver in your life that you’d like to celebrate this November, but not sure how?  Check out: Top 10 Ways to Celebrate National Family Caregivers Month.

Other related article: Caregiver’s stress: How to Care for Yourself While Caring for Others

For caregivers, another important aspect of caring for someone is making sure their affairs are in order.   For assistance with long-term care planning for yourself or a loved one, contact the experienced and compassionate elder law attorneys at Janna Dutton & Associates.

Open Enrollment for Medicare Part D: 11/15/09- 12/31/09

Open enrollment for those with an existing Medicare Part D Drug Plan has begun.  From now until Dec. 31^st, 2009 people already enrolled in a Medicare drug plan can now switch to a different plan, and with the holidays quickly approaching, this window of opportunity will be gone before you know it.  Consumer Reports.org noted that more seniors than ever are expected to revise their drug plans for 2010,  and they suggest doing your homework this year, as sticking with a plan that isn’t right for you can be costly.

If you’re new to Medicare Part D, check out: www.medicare.gov or call 800-MEDICARE (633-4227) for enrollment information.

Already familiar with Medicare Part D?  Head right to “Formulary Finder -2010 Plan Data” and take a look at the plan comparisons.  While the comparisons are helpful, they can also be tedious so plan to spend some time there.

Learn more about financing your long-term care by contacting the experienced elder law attorneys at Janna Dutton & Associates.

The Patient Protection and Affordable Care Act

Late into the day on Wednesday, November 18^th, Senate Majority Leader Harry Reid ( Dem.- NV) unveiled the proposed health care reform bill senate leaders plan to bring to a floor debate at the end of November. The bill, named the Patient Protection and Affordable Care Act, is a combination of the health bill approved by the HELP (Health, Education, Labor and Pensions) Committee and the Senate Finance Committee bill.

Key elder issues:

• Nursing Home Transparency and Improvement
• The Elder Justice Act
• Criminal Background Checks on Long-Term Care Workers
• The CLASS (Community Living Assistance Services and Supports) Act 

According to the NCCNHR, there’s no word yet on whether Senator Reid has enough votes to pass the bill, but he is expected to call for a procedural vote by this weekend.

Keeping up with all the recent health care reforms and bills can be quite a task. Luckily, Senate leaders prepared an overview and section-by-section analysis of the Patient Protection and Affordable Care Act.  Click here to view it.

For more information on how these proposals will affect-term care planning for yourself or a loved one, contact the attorneys at Janna Dutton & Associates.

11/23 UPDATE: On November 21st, the U.S. Senate Democrats got a “fililbuster proof 60 votes that will allow them to bring their version of health care reform to the Senate floor for debate.”  While the vote is considered historic, the passage of this bill is in no way a sure thing.  Read here for complete details from the Examiner.com.

Ways to bring up sensitive, but important matters with your senior parents

Have a concern you’d like to bring up to your elderly parent or loved one, but just aren’t sure how?  Here is a great link featuring some “conversation starters” for those difficult, but important discussions.  Leave a comment about these or any other ways you’ve discovered that helped to approach a sensitive topic with your senior parent. 

 

Click here for: Conversation Starters for Sensitive Subjects

 

Topics covered:

When Health Changes Lifestyles

Did Dad Hit a Light Pole?

You’re Going to Wear That?

When the House Is a Mess

A Senior Moment or Something More?

The Medication Quagmire

Sibling Communication

Mom’s Not Safe at Home

The Money Talk

When Dad Starts to Date

For more information on long-term care planning for yourself or a loved one, contact the attorneys at Janna Dutton & Associates.

Update: I just found a link to a free ebook you can download from your computer about this very subject.  SeniorCare Organizational Systems (SOS) published a book called “Having the Talk” which aims to help you navigate the sometimes scary road of caring for your elder.  Click here to link to SOS to download this helpful resource.

Use Your Holiday Visit to Assess Your Senior’s Needs

Hard to believe it’s already that time of year, but the holidays are here.  For some, this may be the only time that you’re able to visit with the seniors in your life.  It can be difficult to provide care from a distance, but if you do, use your visit to spend some quality time with your family and use that time as an opportunity to get a status on their current care needs.  You may find that an updated care plan may be necessary, that their medication needs to be monitored more closely or something as simple as furniture adjustments might make the home a safer place.   

 Eldercare ABC (About Being Connected) Blog published an article on what to look for during your visit and what assessments should be made.  Click here for the full article.  Having a lengthy period of time to visit will help you keep an eye on:

•  medical conditions
• medical doctors
• medications
• home safety
• driving
• retirement care plan
• guardians
• resources
• costs

 It may also a good time to bring up other important issues, such as whether your parents have a power of attorney or a will in place.  These are not easy topics to discuss, but they are conversations worth having.  For some ideas on how to begin these kinds of discussions, see the 11/25/09 post on some “conversation starters.” 

Aging can be difficult, but you can make the process smoother for your loved one and yourself by planning ahead.  The article added that this, ”will also allow you to prevent emergency senior care planning later and eliminate the added stress last minute planning can cause.”

For more information on long-term care planning for yourself or a loved one, contact the experienced elder law attorneys at Janna Dutton & Associates.

Hospice Care is 35 Years Old and More Commonly-Used Than Ever

Seattle PI published an interesting article on the history of hospice care and its evolution over the past 3 1/2 decades.  As someone who has seen the benefits of hospice care first-hand, it was surprising to hear that hospice care was initially seen as a medical fad.  As some background, the first hospice was started just outside of London and didn’t make it’s way to the United States until about a decade later.  Today, more families than ever point to hospice as a means of guidance and support as they grapple with the physical and emotional tolls of loss.   One caretaker noted that the loss of her parents and husband was made ”bearable” with the assistance of hospice care.

So, how did hospice shift from being a “fad” to an accepted practice?

• 1982 decision by Congress to add hospice to optional Medicare services
• hospice now covered by public and private health insurance
• the medical community recently helped further legitimize the industry by offering certifications in hospice care for doctors, nurses and nursing assistants

Along with it’s shift into the mainstream, this acceptance of hospice care also acted as a catalyst for Americans to rethink their previous notions of death as a taboo subject.  Don Schumacher, president and CEO of the National Hospice and Palliative Care Organization, explained that, “The conversation about death and dying and grief and loss is much more part of the mainstream.”

 Click here for the full article.

Leave a comment to share your thoughts or experiences with hospice care.

For more information on long-term care planning for yourself or a loved one, contact the attorneys at Janna Dutton & Associates.

Confusion Ensues After an Unexpected Trip to the Hospital

I’ve seen this so many times before- a senior makes an unexpected trip to the hospital then returns home without knowing what comes next, or in some cases without even knowing the extent of what happened at the hospital.  Those emergency room trips can be overwhelming for a number of reasons.  They’re unexpected, you’re worried about what this means for your loved one, how long will it take for someone to see us…the list goes on and on.  Regardless of how chaotic the situation may be, it’s important to remember to stay focused on the task at hand, which is helping the sick or injured person get better.

The Alzheimer’s Reading Room recently published an article titled, “After a Visit to the Emergency Room Most Patients are Clueless.”  As the article reminds us, going to the emergency room isn’t always enough.  Often, healing properly means physical therapy, medication or visiting a specialist among other things.  It is essential to know what your treatment plan entails once you leave the hospital.

In addition to the article, here are some tips on following through with your hospital visit:

• Ask questions, even if you think they sound simple (i.e. What does that mean? Can you explain everything to me once more? Where can I reach you if I have more questions?)
• Take notes!  This is always a helpful tool when you need to remember something, but doubly important if the thing you need to remember involves your health or the health of a loved one.  Don’t assume you’ll remember everything.  Trips to the emergency room can be harrowing and you may not recall everything the doctor or nurse told you or you may remember a different version.  Don’t risk it.   

12/9 Update:  On December 8th, The Washington Post  published a story titled, “Groups try simple steps to avoid hospital rebound,” which discusses the shift around the country to better prepare patients leaving the hospital in an  effort to prevent rehospitalization.  The article notes that, “one in five Medicare patients winds up back in the hospital within a month – even worse, one in four patients with heart failure.”  It goes on to add that a “major push is under way around the country to cut rehospitalizations, in part by arming patients with simple steps to keep their recovery on track – like getting past harried receptionists for quicker follow-up doctor visits, and reducing medication confusion.”

See this link for the full Washington Post article. 

For more information on long-term care planning for yourself or a loved one, contact the attorneys at Janna Dutton & Associates.

NPR audio clip: 30% of Americans are Caregivers

This morning I found a brief audio clip from NPR’s “All Things Considered.”  The story focuses on a recent study released by the AARP and the National Alliance for Caregiving, which announced a staggering statistic- 30% of Americans are caregivers for an elderly parent or spouse or disabled child.  NPR’s Joseph Shapiro discussed how the time (an estimated 19 hours a week) and energy expended by caregivers is similar to that of a part-time job.  Nineteen hours a week is a great deal of time and for caregivers who also work and take care of their own families- how do they handle this kind of time and energy commitment?  Eleanor Ginzler of the AARP noted that as most caregivers are also employed, this creates some serious interference with regular work.  As a result, Ginzler said that “making accommodations in the work place has increased in several ways. In most cases, two-thirds of them means they either go in late, leave early or take time off.”  The study also shows that “at least 12 percent of caregivers say they’ve turned down a promotion, reduced their hours, taken a less demanding job, or they’ve given up work entirely to devote themselves to caring for a loved one.” 

Based on the feedback the article received, there are some who say that this is an unfair burden to place on the American workplace and that taking an increasing amount of personal time off is a drain on our resources.  However, for people like Kathleen Bowleg who has acted as a caregiver for both her parents, she explains that taking care of her parents is the thing she is most proud of in her life. 

Click here for the audio clip and/or transcript of the story.

For caregivers, another integral piece of the care puzzle is long-term care planning, both for yourself and your loved ones.  Contact the experienced elder law attorneys at Janna Dutton & Associates for assistance.

Caring Together, Living Better: New Program to Help Caregivers in South Suburbs

Caregivers in the Chicago’s south suburbs may be eligible to get a helping hand with their caregiving responsibilities from a program called Caring Together, Living Better.  The Chicago Tribune recently published an article on the program, which will begin in January of 2010 and will offer services to caregivers to help alleviate the demands of providing care for their loved ones.

Caring Together, Living Better began as a grant from the Harry and Jeanette Weinberg Foundation which was then awarded to AgeOptions, an agency that connects older adults with services in suburban Cook County.  AgeOptions sought out small communities with needy populations that had a genuine interest in helping their senior populations, preferably those who already had existing programs for seniors and/or caregivers. 

Several social service agencies and seven churches in Harvey, Riverdale, Midlothian, Markham and South Holland are part of the program, which will offer services for caregivers such as “respite care, transportation to doctor’s offices, leaf raking, snow shoveling and keeping elderly charges company. Church volunteers will offer the services to low- to moderate-income caregivers of relatives or friends age 60 and older.”

Click here for the full article.

For more information on long-term care planning for yourself or a loved one, contact the attorneys at Janna Dutton & Associates.

Times Especially Tough for Rural Seniors

The New York Times recently published an article on the increasing hardships many rural seniors face as they age.  The article showcased stories of fortitude in the face of hardship that were fascinating, but that you would be equally terrified to read if they were your own parents.  Take Norma Clark, an 80-year-old farm wife who fell and broke her hip in four places, then dragged herself for three hours through snow and mud to get back to her house, only to then call her daughter to have her come feed the farm’s horses before calling for help.  It is both astounding and heartbreaking to hear, but situations like this and plenty of others are happening across the country as rural seniors battle to age at home. 

As the article so appropriately notes, growing old is hard enough as it is.  This is compounded when there is virtually no public transportation, limited access to medical care, and unreliable cell phone and internet service, not to mention a wave of devastating state and local budget cuts to programs catering to the elderly.  Even churches have consolidated or closed, further limiting social opportunities for already isolated seniors.                   

Yet, despite it all, these seniors remain firmly where they are, surrounded by familiarity and their lives’ memories.  Some rural America scholars believe that the current and future state of the economy could make remaining at home too difficult, while others argue that these elders are rooted to the land and won’t leave it regardless of the obstacles they may face by doing so.  

Whether this applies to your family or not, I encourage you to check this article out.  Click here for the full story.

For more information on long-term care planning for yourself or a loved one, contact the attorneys at Janna Dutton & Associates.

HHS Announces Availability of $27 Million to Help Older Individuals with Chronic Conditions

On Wednesday, the U.S. Department of Health and Human Services (HHS) announced the availability of $27 million dollars nationwide to older individuals with chronic conditions. The money, made available through the American Recovery and Reinvestment Act, will work to help these individuals improve their health and reduce their use of costly medical care. Thus far, the Recovery Act has provided up to $650 million dollars to HHS for the Communities Putting Prevention to Work initiative launched earlier this fall to promote evidence-based prevention strategies in communities and states across the country.

The HHS press release notes that, “Research has shown that prevention programs can improve the quality of life for older individuals, including frail seniors with multiple chronic conditions, and also reduce health care costs. The Recovery Act funds will put the results of HHS’ research investments into practice at more than 1,200 community-based sites across the country — reaching tens of thousands of older Americans and their families.”

“Too many seniors do not receive the recommended preventive and primary care they need,” said Assistant Secretary for Health, Dr. Howard K. Koh. “This program will strengthen the health care that our seniors need and deserve by coordinating and integrating care in the community.”

Click here to read the complete press release and for information on funding availability.

For more information on long-term care planning for yourself or a loved one, contact the attorneys at Janna Dutton & Associates.

Amendments to the Elder Abuse and Neglect Act

Janna Dutton & Associates attorney Melissa Howitt authored an article discussing the original and amended provisions to the Elder Abuse and Neglect Act.  These amendments will be in effect beginning January 1, 2010 (which is closer than you think!).  The article highlights: the development of a program to target self-neglect, the amended provisions governing access to elder abuse records, and legal remedies under the Act.

Click here for Melissa’s article.

Visit www.duttonelderlaw.com for other helpful resources or to contact an elder law attorney.

Spotlight On: Illinois Citizens for Better Care (ICBC)

Janna Dutton & Associates recently published an article on the incredible work of the ICBC.  Their mission is to achieve and maintain quality, dignified and compassionate care for nursing home and other long-term care facility residents.  The organization works directly with families to help choose the right nursing home, shorten or avoid nursing home placement by finding alternative care, improve poor or abusive nursing home care and navigate the waters of Medicare and Medicaid.  Their database aides this work by providing information on services various nursing homes provide, their violation histories and the experiences members have had with those homes.

ICBC also works as an advocate for nursing home residents with Congress, the Illinois legislature and various government agencies.

On top of all of this- they do not charge for their services and do not receive any government grants. 

Read the whole article by Janna Dutton & Associates, another advocate for seniors and their families.

Impact on Seniors No Longer Able to Drive

There is a freedom and independence many of us to take for granted that comes with being able to grab your car keys, jump in your car and drive to wherever you want or need to be.  Unfortunately, the older we get the more difficult it becomes to stay behind the wheel for a variety of reasons, but largely due to declining eyesight, hearing and reaction times. 

How does this loss of independence effect the senior population?

A recent article featured in The Boston Globe titled, “Off the road,” discussed both the physical and emotional effects that result when an elder is no longer able to drive.  Sadly, the article explains that “there is an increased risk of depression, isolation, and even, studies suggest, of ending up in assisted living.”  Some studies, most notably by geriatrician Richard Marottoli, an associate professor of medicine at Yale University Medical School, have found an increase in depression and a drop in out-of-home activity levels among older adults after they surrender their license.

This begs the question.……what next?  Considering what these studies have shown, what alternatives are available for these seniors?

As Boomers face the driving dilemma with their parents and as they get closer to dealing with this issue themselves, there is a growing need to develop more comprehensive transportation alternatives that will allow seniors to retain some of their independence and allow them to remain engaged outside of the home. 

Elinor Ginzler, the AARP’s senior vice president of the livable communities initiative, says that despite the impeding number of aging drivers (roughly one in four will be 65 or older by 2025), “many local, regional, and state agencies are failing to include alternatives to automobiles in their planning.” 

A ray of hope: the article featured a fantastic service called Independent Transportation network, a 24-hour driving service run by volunteers which allows seniors who surrender their car to the network to receive the equivalent of the vehicle’s value in free rides.  Or you can simply join without the trade in and pay by-the-ride (which is about half the cost of a cab fare for the same route).  In the 14 years since it started, the group has organized 280,000 rides nationally.  Founded in Maine, the program has now spread to communities in 10 other states.

For more information on long-term care planning for yourself or a loved one, contact the attorneys at Janna Dutton & Associates.

12/30 update: Click here for another recent article by Choice Elder Care discussing this growing problem and the funding cuts many states have faced for their senior transportation programs.

Retirement Communities Affected by Current Economy

The recent Newsweek article, “Bankruptcies Hit Retirement Communities,” highlights the impact that the country’s current economic woes are having on the senior population, specifically those in retirement or continuing-care communities as well as those looking to enter one.  The companies managing these communities explain the difficulty of surviving, let alone succeeding, in the current economic landscape.  As a result of obstacles such as high care costs, restrictive Medicaid budgets and tight credit markets, many companies are posting huge losses, raising their prices, modifying their means of operation, selling themselves to bigger chains or simply leaving the market entirely.  

The question then is: how do these changes affect current or prospective residents?  The answer isn’t a comforting one.  Fortunately, no one can be “kicked out” of their residence… at least not immediately.  However, when struggling senior communities raise their prices many residents are no longer able to afford their care, and are forced to leave.  In other cases, the initial deposits made to get an apartment (can get up to $150,000 or more) are disappearing.  For 170 people in a Pennsylvania senior community, this is exactly what happened when their facility was sold and the new owners did not take on that liability, which had been established by the previous owner. 

With rising costs of care and deposits lost, it is easy for seniors to run though their personal savings, money they thought would have taken care of them for the rest of their lives. 

“You’ve got to keep your eyes open,” says Eric Carlson, director of the long-term-care project for the National Senior Citizens Law Center. “If you look at the agreements, sometimes what you’re being promised is not that much. The provider may be reserving the right to force you to leave for various reasons.” Often there’s a generic “can’t meet your needs” clause in the contract.

He recommends that refundable deposits be set aside in escrow accounts, and that anyone signing a long-term-care contract run it by an elder law attorney first.

If you have questions about financial planning for long-term care or want to schedule an appointment to review your nursing home contract, contact the attorneys at Janna Dutton & Associates.

Click here to read the full Newsweek article.

Pass on Your Passwords

You can do almost anything on the internet today- check your bank statement, pay your bills, purchase clothes, order your groceries, rent movies …the list goes on and on.  For many seniors, the appeal of the internet is clear- all of these tasks can be done from the comfort of your own home, at your own pace.  Yet, with each of these accounts comes the responsibility of yet another username and password.  They are designed to keep identity thieves out, but what happens if someone else needs to get in? 

Many of us use similar passwords and usernames for different accounts, and (give or take some occasional trial and error) we can remember all this information without writing it down.  However, if something were to happen to you and a family member or agent needed to access that information, would they be able to?

This was the subject of an article I read earlier today entitled, “Don’t Forget to Pass on Passwords.”  As someone with a variety of online accounts, this article reminded me about the importance of maintaining a list of those accounts including both the usernames and passwords and providing it to an agent or trusted family member.  Not doing so could cost time (searching for physical documents, making phone calls to companies in an attempt to access your account, guessing at possible passwords) and money (i.e. recurring payments for a cell phone that is no longer in use, or overdue charges for a credit card that a family member was unable to access and pay off). 

For more information or assistance with other long-term planning issues such as wills, trusts, and powers of attorney, contact the experienced elder law attorneys at Janna Dutton & Associates.

Janna Dutton Speaks on Legal Issues Facing Those with Parkinson’s Disease

The Parkinson’s Disease Foundation recently hosted a webinar entitled, “Legal Issues: Planning ahead when you are living with Parkinson’s.”   Attorney Janna Dutton led the presentation, which offered tips on navigating the legal issues that face people living with Parkinson’s disease as well as issues such as care plans, advanced directives and wills. 

 

You can view and listen to the full presentation by clicking here.

If you or a loved one need help understanding your planning options, contact Janna Dutton & Associates.  

Recent GAO reports on “extraordinary” price increases for some prescription meds

On January 11, the Government Accountability Office (GAO) issued a report finding that prices on an increasing number of prescriptions have skyrocketed in recent years.  Apparently, the ballooning prices are due to consolidation in the drug industry, which leaves fewer companies manufacturing niche medications as well as third-party providers who repackage drugs for patients.

The GAO conducted the study to understand the growing cost of brand-name prescription drugs, as they drugs affect “patients, payers, and providers of health care—particularly when price increases are large and occur suddenly.” 

The Associated Press (AP) reported on the GAO study and noted that, “Congressional investigators say the number of extraordinary price hikes on drugs doubled between 2000 and 2008. The drugs affected are mostly specialty medications but also include some popular products like Bayer’s antibiotic Cipro and the Eli Lilly schizophrenia treatment Zyprexa.” The AP goes on to say that the GAO’s findings could put new pressure on drugmakers to contribute billions more to the health-care reform effort being finalized by Congressional Democrats.

Click here to read the Elder Law Prof blog’s summary.

If you would like to speak to an attorney about estate planning for long term care, including the costs of long term care, contact Janna Dutton & Associates.

Effects of Estate Tax Expiration

According to a recent New York Times article, most tax advisers anticipated that Congress would extend the estate tax before it expired at the end of 2009. However, the Senate did not act on this and the tax is currently gone for one year and unless Congress takes action, the tax will return at a higher rate and lower exemption in 2011.

Along with the estate tax also went the IRS provision for date-of-death valuations, meaning heirs may now be responsible for capital gains on any appreciated property when they sell it.

Most expect that Congress will revive the estate tax and make it retroactive from the date of expiration, but most also didn’t think it would expire in the first place. The article notes that this situation has “thrown a wrench in the core tenet of estate planning: set up everything as if you would die tomorrow. What happens if the law changes by then?”

Before, “lawyers often wrote provisions into wills that put the maximum amount into trusts that could be transferred tax-free. What was left usually passed to the surviving spouse.  Now, those exemption limits are gone.” The NYT’s advice?  Review your will.

For assistance reviewing your will or to discuss how the expiration of the estate tax may affect you or a loved one, contact the experienced attorneys at Janna Dutton & Associates.

Click here to read the full New York Times article, “A Bizarre Year for the Estate Tax Will Require Extra Planning.”

 

Medicare Database Can be Downloaded for Free

Last Friday, as part of President Obama’s promise for government transparency, the Obama administration posted a huge amount of government data on the Internet (http://www.data.gov). The posting follows a Dec. 8 White House directive that each Cabinet-level department must post online at least three collections of “high-value” data that have never previously been disclosed.

Before Friday, the Medicare database was available on CD ROM for a fee of $100. Now, the database can be downloaded for free and provides detailed breakdowns of payments for Medicare services and is sortable by the type of medical service provided.

 In a Washington Post article on the subject, Ellen Miller, executive director at Sunlight Foundation, a nonprofit group focusing on the use of technology for greater government transparency, said the effort represents “a sea change in the government’s attitude,” with newfound support of the idea that government data belongs in the hands of citizens instead of locked away in the basement of a federal agency.

The Post included a list of departments required to release the three new data sets, which include the departments of  ”State, Treasury, Defense, Justice, Interior, Agriculture, Commerce, Labor, Health and Human Services, Housing and Urban Development, Transportation, Energy, Education, Veterans Affairs, Homeland Security and the Environmental Protection Agency, the offices of the U.S. Trade Representative and the U.S. ambassador to the United Nations and the Council of Economic Advisers.”

For the full Washington Post article: “Government posting wealth of data to Internet“

For experienced elder law attorneys, contact Janna Dutton & Associates.

Suddenly, You’re a Caregiver

For some, becoming a caregiver is a decision that has been talked about amongst family, planned for, and decided upon before a time of real necessity.  For others, the role of caregiver is unexpected.   In an instant, this responsiblity is thrust upon them when a seemingly healthly and independent older parent takes a fall or is taken to the hospital. 

Today, I stumbled upon an article written for those who suddenly find themselves in the role of caregiver, appropriately titled, “Senior Life: Suddenly, you’re a caregiver.”  The article provides some insightful tips on navigating your first steps as a caregiver, such as what questions to keep in mind when speaking with your loved one’s health care professionals, what documents to have available, a reminder to keep the patient/family member involved in the process and keeping a journal of medications, insurance information and other important information. 

The article also touched on an aspect of caregiving which can often go undiscussed, which is the importance of caregivers caring for themselves.  As the article notes, ”Take regular breaks from caregiving to give yourself a fresh start to your responsibilities. Caregivers often take on the additional worries and burdens, which can, in the long run, have a stressed effect on their own mental and physical health.”

Preparation is often not an option when it comes to caregiving, so remind yourself that much of the knowledge you will gain as a caregiver is “on-the-job.”  When it comes to handling the responsibility of providing care for a loved one, a solid supoprt system and some personal leniency can go a long way.

Click here to read the whole article.

Another important component to a complete care plan, is ensuring that your loved one’s affairs are in order.  For legal assistance with estates, trusts or other elder law issues, contact the experienced attorneys at Janna Dutton & Associates.

2/1 Update: A reader replied to this posting, urging that family members can and should prepare for the tasks involved in caregiving.  As she noted, “Caregiver training is available in classes in many communities; online caregiver training is also available though the Institute for Professional Care Education, www.IPCed.com… (t)he 40 hour comprehensive online Personal Care Aide Certification course is designed to help the home caregiver provide care longer, with less stress, than on-the-job learning yields.  Details:  www.IPCed.com.”  Thank you for your comment!

Study: Higher Medicare Co-Pays Means Older Patients Cut Back on Doctor Visits

On January 28^th, the New England Journal of Medicine published a study examining the relationship between the usage of inpatient and outpatient care among those with Medicare plans that have nearly doubled their co-payments compared to those with similar plans whose co-payments have remained steady.  

Not surprisingly, the study found that while outpatient visits increased over time among all enrollees, those with raised co-payments had slower increases (about 19.8 fewer outpatient visits per 100 enrollees).  If the increase in co-payments was designed to keep people from going to the doctor as frequently, then in a way, the higher prices were a success, right?  Perhaps in the short term the raises are cost effective, but the study also found that in the long term, (expensive) hospital admissions for those with higher co-payments increased per year.  As a New York Times article on the topic explains, “When Medicare plans raise co-payments for outpatient care, older people cut back on doctors’ visits, then wind up needing more expensive hospital care.”

After all is said and done, is raising the price of co-pays actually effective?  Dr. Amal N. Trivedi, the study’s lead author and an assistant professor of community health at Brown University, noted, “This is an ill-advised containment strategy.”  He went on to explain that, “The increase in outpatient co-pays appears to produce both greater health care spending and worse health.”

For help with planning for your own long term care needs, contact the experienced elder law attorneys at Janna Dutton & Associates.

$25 Billion in Medicaid Funding

An additional $25 billion in Medicaid funding was included in President Obama’s fiscal 2011 budget. As discussed in the Washington Street Journal article, “Medicaid Could Get Billions,” this inclusion speaks to the government’s adaptation to the sloth-like progress of health legislation in Congress. The article notes that some states “were so confident Congress would pass a health bill that they included the extra Medicaid funds in their state budgets.”

However, the election of Republican Scott Brown over Democrat Martha Oakley in the Massachusetts race for the U.S. Senate seat formerly occupied by the late Ted Kennedy could throw a serious wrench into the President’s health care plan, and it sent governors “scrambling to plug the hole.”

During a conference call on Friday, January 29, Health and Human Services Secretary Kathleen Sebelius assured governors that President Obama’s fiscal 2011 budget would include a six-month extension (which requires congressional approval) of the Medicaid funding increase that was part of last year’s stimulus package. Without an extension, the extra money would expire at the end of the year.

“The move would help ease a strain on state budgets as the recession is sending more Americans into Medicaid, the health-insurance program for the poor that is jointly funded by the federal government and state governments. To cover the shortfall, governors had considered cutting education funding, reducing payments to doctors and hospitals through Medicaid, and taxing soda, candy and chewing gum.”

Click here for the complete article.

Janna Dutton & Associates, P.C. has extensive experience in understanding both federal and state Medicaid regulations, and devising the best approach for each of our clients so that a Medicaid application has the best chance of succeeding in each situation.  For comprehensive legal assistance with your Medicaid concerns, contact the elder law attorneys at Janna Dutton & Associates.

If Health Care Bill Succeeds, Who Will Care for New Insureds?

For months now, there has been an incredible amount of talk, criticism and skepticism as the health care plan has pin-balled around Congress. For a moment, let us imagine that President Obama’s health care dream becomes a reality and millions of previously uninsured people will now have coverage. The question now becomes, who will treat all of these people?

An article published in Choice Eldercare (www.choiceeldercare.org) describes the concern shared by many, including Obama administration officials, about the availability of doctors to treat the growing population of people needing care. The article explains that administration officials are “looking for ways to increase the supply of physicians to meet the needs of an aging population and millions of uninsured people who would gain coverage under legislation championed by the president.”

In particular, the shortage of primary care providers seems to cause the most concern. Dr. Atul Grover, chief lobbyist for the Association of American Medical Colleges, sums the issue up simply: “If we expand coverage, we need to make sure we have physicians to take care of a population that is growing and becoming older. Let’s say we insure everyone. What next? We won’t be able to take care of all those people overnight.”

In response to the growing shortages, federal officials are considering several proposals, including:

• increase Medicare payments to general practitioners (at the expense of high-paid specialists)
• increase enrollment in medical schools and medical residency training programs
• encourage greater use of nurse practitioners and physician assistants
• expand the National Health Service Corps, which deploys doctors and nurses in rural areas and poor neighborhoods

The article notes, “Some of the proposed solutions, while advancing one of President Obama’s goals, could frustrate others. Increasing the supply of doctors, for example, would increase access to care but could make it more difficult to rein in costs.”

Click here for the full article.

For assistance with planning for your own long term care needs, contact the experienced elder law attorneys at Janna Dutton & Associates.

New Online Resource for Researching Senior Rights and Benefits

If you have an interest in doing any research regarding the legal rights and benefits of older Americans, a new project may be just what you’re looking for.   A new web site called The National Legal Resource Center (NLRC) has been created as an online resource for consumers, attorneys and advocates.  The project was spearheaded by The Administration on Aging, in collaboration with the following organizations:

• The American Bar Association Commission on Law and Aging
• The Center for Elder Rights Advocacy
• The Center for Social Gerontology
• The National Consumer Law Center
• The National Senior Citizens Law Center

National Legal Resource Center: http://www.nlrc.aoa.gov/NLRC/index.aspx

If your questions or concerns require more comprehensive legal assistance, contact the elder law attorneys at Janna Dutton & Associates.

New Illinois Law Allows Convenience Accounts

Janna Dutton & Associates attorney Kathryn Casey recently authored an article on a new Illinois law allowing convenience accounts.  Effective January 1, 2010, the new convenience accounts provide bank account holders with another option for those who want to name another person on their account.  Previously,  the only way to name another person on your account was as joint tenants with rights of survivorship.  In other words, the joint tenant is entitled to inherit the account upon your death AND the joint tenant cannot not be removed from the account without his/her consent (even if they were taking money without your permission!).  If someone was removing money from this account for their own personal gain, you can imagine how quickly they would agree to this!

Fortunately, the new law addresses these dillemas.  Now, you are able to name a person on your account without entitling that person to inherit the account upon your death.  The law also allows you to remove the person from your account without his/her permission.  This is a good option when you want to give a trusted individual the right to manage an account without giving him the right to take the funds for himself and without giving him the right to inherit the money within that account if something should happen to you. 

It’s important to note that your current account will not automatically convert to a convenience account now that the law has passed.  You still have the option to keep your account as a joint account, but for those interested in a convenience account, you’ll need to visit your bank to open one.

Be sure to check out Kathryn’s complete article here. 

For additional information on this new law or assistance with including a convenience bank account in your will or trust, contact Janna Dutton & Associates, P.C. at www.duttonelderlaw.com.

Quinn’s Nursing Home Task Force Releases Report

For some time now, the Chicago Tribune has been publishing a series of articles targeting the state of nursing homes and nursing home care in Illinois (see our blog on the use of psychotropics in IL nursing homes).  One of the most alarming trends these articles have indentified is the violence occurring within nursing homes among frail, elderly residents and younger, mentally ill ones.  Those articles led to the assembly of Governor Pat Quinn’s Nursing Home Safety Task Force, which recently released its final report, including 37 recommendations for the state.  (The U.S. Department had recently acknowledged its support of the task force’s preliminary recommendations, which were released in January.)

The report’s conclusion?  A “sweeping overhaul of the state’s long-term care system is needed to address [the] violence,” according to a Chicago Sun-Times article, “Task force calls for overhaul of state’s nursing homes.”  The report also describes the combination of vulnerable and potentially aggressive residents in close quarters as “toxic.”  The recommendations range from increased staffing levels to higher fines, fees and taxes on facilities to pay for more government oversight– requirements that (shocker!) the nursing home industry opposes.

So what happens now that the report has been released and these recommendations have been made public?  Quinn’s next step is to evaluate the report and devise a way to, as he notes, “make these reforms a reality.”  In a written statement, Quinn also explained that the recommendations “point the way to a system of long-term care that respects the needs and rights of all residents.” 

Click here for the complete Chicago Sun-Times article on the subject.

For compassionate and committed legal care, contact the elder law attorneys at Janna Dutton & Associates.

Help for Veterans: Home Improvement Assistance Program

Aging With Grace, a service dedicated to offering solutions and resources to caregivers, recently posted a blog on the Home Improvement and Structural Alterations (HISA) Program.  Under this program, veterans may receive assistance for home improvements made to accomodate disability in the home.  As the article explains, these grants are typically provided to veterans who are receiving VA health care and who are service-connected disabled, although there are some benefits available for nonservice-connected veterans (see below). 

* Home improvement benefits up to $4,100 may be provided to service-connected veterans.
* Home improvement benefits up to $1,200 may be provided to nonservice-connected veterans.

A clause in the eligibility statutes opens the door for veterans who are on Medicaid or receiving pension with aid and attendance or housebound ratings (commonly referred to as the VA Benefit for Aid & Attendance) to also receive these grants. Also very low income — means tested veterans — may also receive the grant.  Although they are reluctant to provide these grants to veterans who are not in the health-care system, the medical center HISA committee will do so if adequate documentation is provided to justify the grant.
Below are some examples of what the HISA will and will not pay for, but for more information, visit http://www.va.gov.

Examples of what HISA WILL pay for:
* Allowing entrance or exit from veteran’s home
* Improving access for use of essential lavatory and sanitary facilities
* Improving access to kitchen and bathroom counters
* Handrails
* Lowered Electrical outlets and switches
* Improving paths or driveways
*Improving plumbing/electrical work for dialysis patients

Examples of what HISA WILL NOT pay for:
* Walkways to exterior buildings
* Widening of driveways (in excess of a 7ft x 6ft area)
* Spa, hot tub or Jacuzzi
* Exterior decking (in excess of 8ft x 8ft)

Aging With Grace frequently posts new blogs on senior-related topics, click here to visit their blog.

For help with planning your own long term care, contact the elder law attorneys at Janna Dutton & Associates.

Finding the Right Care for the Elderly

An article appeared in the New York Times today titled, “Finding the Right Care for the Elderly.”  It discusses a question I imagine many people with older loved ones often find themselves asking: what is the best care option for my parent/relative, etc.?  And if that question isn’t a big enough beast to tackle, the next question is: is this something our family can afford?  The NYT article notes the surprise that some family members felt when researching what options were available to them once they decided that it was no longer safe for their father to live alone.  This quote about sums it up:

“If you’re in this predicament, you know already there is no simple answer. Older people each have unique medical and emotional needs. And finances often dictate how far you can go in creating the ideal situation for them.”

Not having a simple answer can be overwhelming.  It would be so easy to have directions when it comes to caring for an elderly loved one, and there would be no second-guessing.  When it comes to senior care there is no “one size fits all,” so if you want to look at it from a positive angle, not having a “standard” creates a situation where whatever plan you come up with will be tailored to the specific needs of the person you are caring for, and essentially providing the best quality of care for them.

The article offers “guidelines and considerations that can help you make an informed — if not always easy — decision about what type of housing will support your parent’s needs, without bankrupting the family in the process.”

Click here for the whole article. 

To discuss these and other long term care planning concerns with an experienced elder law attorney, contact the attorneys at Janna Dutton & Associates.

Janna Dutton Adds Care Advocate to Staff

At Janna Dutton & Associates, we know that, just as your family circumstances evolve over time, so do your elder law needs.  To meet these needs, our practice is also evolving, which is why we are thrilled to announce the addition of Erin Vogt, our new Care Advocate, as part of our firm’s new Life Care Planning program.  Erin’s arrival will provide another important component in our efforts to holistically service the comprehensive needs of our clients and their families.  Her knowledge, hands-on experience, and sincerity make her well-equipped to help our clients achieve the best quality of care for themselves or their loved ones. 

Who Erin is:

“I became a geriatric social worker because of my amazing relationship with my grandparents.  Because of them, I have always seen older adults as wonderful people.  Even as a kid, I wanted to own a Laundromat and a nursing home.  Working with older adults and the people who love them allows me to be me, and, in some small way, honor my grandparents.” 
Erin C. Vogt, MA, LCSW, ACSW  holds a Master’s Degree in Social Work from Aurora University, as well as a Master’s Degree in Organizational Leadership from Lewis University.  Her passion for the older adult population led to a specialty certification in geriatric social work from the National Association of Social Workers.  Most recently, Erin served as the Manager of the Alexian Brothers Hospital Network’s Resource Center for Seniors and coordinated the satellite program of Chicago Lighthouse for the Blind and People Who Have Low Vision.

 Erin is also a Certified Care Manager and is an Adjunct Assistant Professor at Lewis University in the Department of  Justice, Law, and Public Safety Studies and at Aurora University in the School of Social Work. Erin and her husband, Peter, have two children, five year old Johnathan and three year old Hailey.

What she does:

So what exactly is a Care Advocate?  The Care Advocate’s role is to provide information and answer questions needed for the client and family to understand and make decisions about the client’s particular health care needs.  Care planning is made up of a lot of moving parts.  The goal of Care Advocacy is to work with you and for you to help fit all these pieces together.  This means helping clients by (but certainly not limited to):

• Working to achieve holistic care, including the physical, emotional, mental and spiritual well-being of the client
• Guiding the client and client’s family to anticipate and plan for inevitable changes, as well as react to sudden ones
• Assisting in understanding public benefits that may help pay for needed care

If you are interested in Life Care Planning, email Erin at evogt@duttonelderlaw.com, call her at (312)371-0954, or contact our office to set up an appointment.

Click here to view our recent newsletter featuring Erin and our new Life Care Planning service.

The New Scoop on Reverse Mortgages

A recent NYT article from April 16^th entitled, “Reverse Mortgages Still Costly, but Less So” revisits the topic of reverse mortgages- confirming some of the old news and announcing some of the new.  As some background, reverse mortgages allow homeowners to pull cash out of their homes without making payments.  It is a loan against your home that you don’t pay back as long as you live in that home.

Recently, consumers were “becoming increasingly reluctant to sign up for reverse mortgages – after all, homeowners could not pull out as much equity as they once could because of the drop in home values.”  Then the F.H.A. reduced the amount that people could borrow, and reverse mortgages had even fewer takers.  

 The old news is that reverse mortgages had a reputation for being expensive.  While that is still true, the good news (for those interested), is that several lenders have cut prices in recent weeks.  Lenders are able to do this because they are making a profit by packaging these loans as securities and selling them to Wall Street investors.  According to the article, the demand for these securities is high because the underlying mortgages are backed by the government and they also tend to be more predictable with slightly longer lives than traditional mortgages.

 However, these mortgages are not for everyone.  The article clearly emphasizes the importance of exercising caution when considering a reverse mortgage, just as you should with any other complex financial product.  As Barbara Stucki, vice president of home equity initiatives for the National Council on Aging, noted, “Is this a good thing?  Yes, but with some caveats.”  In order to determine if a reverse mortgage is right for you and/or your family, it’s important to do your homework on the basics of the product, the costs and the caveats.  First, the article advises to read everything you can on the topic, then consult a housing professional.

 To address this prospect more comprehensively, consult with the elder law attorneys at Janna Dutton & Associates.  In doing so, the conversation to aid you in making a decision on the benefits of a reverse mortgage is supplemented by our attorneys’ understanding of the other moving parts often involved in life planning.

Click here for the full New York Times article.

Resources on Changes in Intimacy and Sexuality for Those With Alzheimer’s

In addition to the Alzheimer’s Association, the National Institute on Aging has wonderful resources for family and caregivers. There is a new list of resources focusing on changes in intimacy and sexuality, an often overlooked challenge for spouses, partners, and professional caregivers of people with Alzheimer’s and other dementias.

For more information on holistic care  for your loved ones, contact Erin Vogt, Care Advocate at Janna Dutton & Associates at evgot@duttonelderlaw.com or (312)371-0954.

Aiding Those With Hearing Loss

In order to provide quality services for, and on behalf of, our older adults, we need to understand how age affects our ability to hear.  This post provides helpful information on a topic that is important, for both professionals and clients, to understand.

In addition to hearing aids, there are many wonderful products to aid a person who has hearing loss. One such program comes from the Illinois Access Telecommunications Commission (IATC), which provides free amplified phones.  This program, funded by a charge on all local phone lines in Illinois, is run by the IATC and has been issuing equipment since 1988. 

In order to qualify for this program, you must:

• be a legal resident of the State of Illinois,
• have working land line phone service at the address shown on the application,

and

• be certified as Deaf, Hard-of-Hearing, Speech-Disabled or Deaf-Blind by:
  • Licensed Physician,
  • Speech-Language Pathologist,
  • Audiologist,
  • or designated DHS/DRS Counselor.

 (There are no age or income restrictions to qualify for the programs.) 

Click here to fill out an application, or for more information, contact the Illinois Telecommunications Access Corporation at the information below:

phone: 217-698-4170 or 1-800-8411-6167 (V / TTY)
website: http://www.itactty.org

For more information on holistical care  for your loved ones, contact Erin Vogt, Care Advocate at Janna Dutton & Associates at evgot@duttonelderlaw.com or (312)371-0954.

Janna Dutton & Associates Becomes Dutton & Casey, P.C.

After four years as an associate with Janna Dutton & Associates, we are thrilled to announce that attorney Kathryn C. Casey has been named a partner in the firm. In light of this exciting news, and to reflect Ms. Casey’s role as a firm principal, Janna Dutton & Associates has changed its name to Dutton & Casey, P.C.  Janna Dutton, the firm’s founder, describes Ms. Casey as an “excellent lawyer with a genuine commitment to elder law. She is highly regarded by the elder law bar and has been a great addition to the firm.  I am excited at the prospect of bringing a member of the younger generation of elder law attorneys into the leadership and perspective of this firm. With Kathryn as a partner, I look forward to a renewed firm energy and fresh ideas.”

Ms. Casey adds, “I am pleased to join Janna Dutton, a nationally recognized leader in elder law, as a partner in Dutton & Casey, P.C.  Together our goal is to tailor elder law to meet the ever evolving needs of our clients and craft the most comprehensive services available to elders, people with disabilities and their families.”

On behalf of the attorneys at Dutton & Casey, P.C., we look forward to providing the same comprehensive, informed and compassionate legal assistance to our clients, just as we have for decades. Our name has changed, but you can expect our continued commitment to offer tailored care for elder law matters of all shapes and sizes.

Visit Dutton & Casey’s brand new website at www.duttonelderlaw.com to learn more about our practice areas, view our attorney biographies, check out our resources, and see how to schedule a consultation.

Dutton & Casey, P.C. Launches Brand New Website

We are thrilled to announce that along with our new firm name, we are also launching a brand new, and very improved (if we may say so), Dutton & Casey website. With the changing of the firm’s name from Janna Dutton & Associates to Dutton & Casey, P.C., and the addition of a new component to our practice, we decided to take this opportunity to really analyze our website and come up with some ways that it can better meet our clients’ and our community’s needs.  To that end, we have created a brand new design in which we’ve updated and reorganized information on our services, our attorneys and the firm as a whole.

So what’s different about this website?  We’re glad you asked.

Our Areas of Expertise have been revised to provide thoughtful, concise descriptions of the elder issues we confront and the ways in which we handle them

Our News section was created to keep you up-to-date on recent developments, such as the firm’s speaking engagements, articles, and awards our attorneys have received

Our About Us page introduces the firm’s mission statement, which touches on our desire to use our experience as attorneys and our humanity as people to best meet your elder law needs in a respectful and compassionate manner

Updated Attorney and Staff bios

A revised Contact Us page, complete with descriptions of how you can schedule an appointment, what to expect during your consultation and the next steps once your consultation is over

A full section on Life Care Planning, the new service component in or efforts to holistically address your elder law needs

A link letting you directly sign up for our monthly eNewsletter (no need to send an email to us, just add your email address and you’ll be included on our monthly distribution)

A font enlarger option in the top right corner of the screen to make smaller text more easy to read

Visit Dutton & Casey’s new website today and let us know how our attorneys can help with your elder law needs.

Haven’t Completed Your Census Form? It’s Not Too Late!

Have you been counted? Complete and return your census form… it seems like such a simple item, but as estimated 48 million households have not sent their’s back this year.  Why do it?  Well, the information the census collects helps to determine how more than $400 billion dollars of federal funding each year is spent on infrastructure and services like:

• Hospitals
• Job training centers
• Schools
• Senior centers
• Bridges, tunnels and other-public works projects
• Emergency services
• and many other programs

If you haven’t recieved a census form, received one and can’t find it, or thought your information didn’t count and threw the form away, please call 1-866-872-6868 or go to 2010.census.gov to complete the census today.  It only takes about 5-10 minutes, but could help your community get the funding it needs.

Dutton & Casey, P.C. publishes “A Guide to Hiring In-Home Help”

If you have decided, or are still in the process of deciding, that in-home care is an option for your loved one, then be sure to read Dutton & Casey, P.C.’s “A Guide to Hiring In-Home Help.”  The guide, written by our attorneys and Care Advocate, can help you confidently navigate the often difficult waters of hiring in-home help.  You may have asked yourself questions like:

• what in-home care options are out there?
• where can I find an in-home caregiver?
• how do I determine exactly what care needs to be provided?
• what questions should I ask that will help me determine if this person is a good fit for my loved one?
• what are some issues to discuss with the care provider before the work begins?

Our guide provides a comprehensive look at a variety of components that are involved in selecting a care provider,  and establishing the foundation for an honest, respectful and solid relationship with that care provider.  The guide even offers checklists on:

• assessing daily living activities of your loved one
• questions to ask when calling a home health care agency
• interview questions for candidates
• issues to discuss on the first day of in-home care
• emergency procedures

View the printable article here and don’t hesitate to pass this on to others who could benefit from this comprehensive resource.

In addition to providing comprehensive legal care, Dutton & Casey, P.C. attorneys pride themselves on serving as a helpful and relevant resource for older adults and their loved ones, who are looking to provide the best quality care possible.  For more articles, information on our attorneys, or to schedule a consultation, visit our website at www.duttonelderlaw.com or call (312)899-0950.

Encouraging Comfort Care: A Guide for Families of People with Dementia Living in Care Facilities

The Alzheimer’s Association-Greater Illinois Chapter is pleased offer a free online resource, Encouraging Comfort Care: A Guide for Families of People with Dementia Living in Care Facilities. This 21-page booklet provides useful information to families and staff of long-term care facilities about Alzheimer’s disease and related dementias, particularly care issues related to the late and final stages.

For families, this guide will enable them to make informed choices about a variety of medical decisions they may face on behalf of loved ones with dementia living in nursing homes, assisted living facilities, and other types of care facilities. It will also equip families to ask good questions aimed at obtaining the best care for their loved ones, including a handy checklist of comfort care measures to be discussed with staff members of care facilities.

 To view and download the free guide, click here: http://www.alzheimers-illinois.org/pti/comfort_care_guide.asp

For more resources or to read about the elder law firm of Dutton & Casey P.C.’s  areas of concentration, visit www.duttonelderlaw.com or call (312)899-0950.

Six Questions to Protect Elderly Patients

A trip to the hospital can leave family members and caregivers feeling more reactive than proactive.  For some of us, the medical jargon can be so over our heads and the stress and worry levels so high, that it seems best to stay on the sidelines when it comes to caring for a patient.  For instance, have you ever found yourself thinking- “this doctor/nurse deals with these situations all the time, so they know how to handle it much better than I do…”  Or how about when a sibling asks why your mom received a certain kind of medication or what the side effects are and you say, “I’m not sure, the doctor told me we should do it.”  There are incredibly caring and knowledgeable health care professionals in the world that are experts at what they do, but as a family member you are an expert in that particular patient, and that counts for something, too!  No matter how great the health care professionals involved with your family may be, advocacy for your patient in the fast-paced health care environment is critical.

But how do you know what to do or what to ask?  This is a start.  Here is a recent blog from the New York Times that poses “Six Questions to Protect Elderly Patients.”  Her blog noted that “About a third of patients over age 70 experience hospital delirium, and the consequences can be serious, delaying a patient’s recovery and even leading to placement in a nursing home.”  So, to play a more proactive role in the care of your family member or loved one, Pam Belluck of the NYT, suggests asking the following 6 questions when it comes to older patients:

1. Do the nurses and doctors routinely screen for delirium or identify high-risk patients?

2. How does the hospital deal with agitation or delirium in patients if it develops?

3. What does the hospital do to keep patients from becoming disoriented?

4. What policies are in place to make sure patients get adequate sleep?

5. If my family member needs a urinary catheter or other bedside interventions, how does the hospital decide when to remove them?

6. Will the physicians and pharmacy staff review my family member’s medications to identify medications that increase delirium risk?

Read the complete blog here. 

To speak to Dutton & Casey’s Care Advocate, Erin Vogt, and learn about other ways to help provide the best possible care for your loved one, contact Erin at evogt@duttonelderlaw.com or (312)371-0954.

Heat and the Elderly

If you live in the Chicagoland area, I don’t need to tell you what summer is like.  Most of the year we complain about how cold the city is, then once summer rolls around, we can’t stand the intense, sticky, humid heat.  Young or old, the heat is certainly an equal opportunity exhauster, but during the summer months, it is vital to remember that hot weather can affect older adults differently that younger people.  I wanted to post an article by the Center for Disease Control titled, “Heat Stress in the Elderly.”  The article discusses varying degrees of heat exposure, such as heat stroke and heat exhaustion, as well as ways to protect yourself, your loved ones, and your neighbors from experiencing any of these.  Should heat stress occur, the article instructs you to:

• Get the person to a shady area.
•  Cool the person rapidly, using whatever methods you can. For example, immerse the person in a tub of cool water; place the person in a cool shower; spray the person with cool water from a garden hose; sponge the person with cool water; or if the humidity is low, wrap the person in a cool, wet sheet and fan him or her vigorously.
•  Monitor body temperature and continue cooling efforts until the body temperature drops to 101°–102°F
•  If emergency medical personnel are delayed, call the hospital emergency room for further instructions.
• Do not give the person alcohol to drink.
• Get medical assistance as soon as possible.

So beat the heat this summer and check out the CDC’s article- it may prevent heat exhaustion in yourself or someone you love.

For more resources on caring forself or the older adults in your life, check out the resources section of Dutton & Casey’s website, an elder law firm designed to work with our clients to understand, and then help meet their needs.

Detection of Alzheimer’s: Promising New Development

This article is a bit older, but important and fascinating enough that we felt it would be worth it to post on.  An article published at the end of June in the New York Times, entitled, “Promise Seen for Detection of Alzheimer’s,” discussed a remarkable new development in the quest for a way to diagnose Alzheimer’s in living patients.  Up to now, the only way to truly diagnose someone with Alzheimer’s was based on the presence of plaque on the brain (in the form of black freckles), only found posthumously during the person’s autopsy. 

Dr. Daniel Swarovsky and his team at Avid Radiopharmaceuticals, develoepd a radioactive dye that they believed would stick to the plaque in the brain. They labeled the dye with a commonly used radioactive tracer and used a PET scanner to directly see plaque in a living person’s brain.  The findings must still be confirmed and approved by the FDA, but if the results hold up, this will mean:

•  for the first time doctors would have a reliable way to diagnose the presence of Alzheimer’s in patients with memory problems (whether you have it or are getting it)
• researchers would have a way to figure out whether drugs are slowing or halting the disease
• patients with memory loss who had previously been misdiagnosed and treated for Alzheimer’s may be able to be properly treated for their real conditions (i.e. depression, low levels of thyroid hormone or drug side effects and interactions)

Click here for the complete article.

Since it’s identification in 1906, Alzheimer’s has posed many more questions than it has answered.  For doctors who have been studying this and families who have been living with it, this is truly remarkable news.

If you or your family is dealing with dementia, Alzheimer’s or memory loss and you need to plan for future care, contact the elder law attorneys at Dutton & Casey.  We specialize in developing care plans based on your family’s specific needs and that address the challenges that come with long life, including how to provide and finance long-term care.  Visit www.duttonelderlaw.com today or call (312)899-0950 to set up a consultation.

HHS Launches New Consumer Focused Health Care Website

There are a lot of pieces to the health care puzzle, and you are not alone in wishing that information regarding affordable health care coverage was located in a centralized location.  In fact, enough people seemed to be interested in the same thing, because at the beginning of July, the U.S. Department of Health and Human Services unveilied an innovative new on-line tool that will help consumers take control of their health care by connecting them to new information and resources that will help them access quality, affordable health care coverage.  Called for by the Affordable Care Act, HealthCare.gov is the first website to provide consumers with both public and private health coverage options tailored specifically for their needs in a single, easy-to-use tool. 

“HealthCare.gov  helps consumers take control of their health care and make the choices that are right for them, by putting the power of information at their fingertips,” said HHS Secretary Kathleen Sebelius.  “For too long, the insurance market has been confusing and hard to navigate.  HealthCare.gov makes it easy for consumers and small businesses to compare health insurance plans in both the public and the private sector and find other important health care information.”

HealthCare.gov is the first central database of health coverage options, combining information about public programs, from Medicare to the new Pre-Existing Conditions Insurance Plan, with information from more than 1,000 private insurance plans.  Consumers can receive information about options specific to their life situation and local community.

In addition, the website will be a one-stop-shop for information about the implementation of the Affordable Care Act as well as other health care resources.  The website will connect consumers to quality rankings for local health care providers as well as preventive services.

“This website is unlike any government website you have ever seen or used before,” said HHS Chief Technology Officer Todd Park.  “It was developed with significant consumer input and is remarkably easy to navigate.  This is despite the sheer volume of content it offers consumers: billions of health care choices through the insurance finder and more than 500 pages of new content, all of which is designed to grow with ongoing consumer feedback and as our health care system improves.”

As the health care market transforms, so will HealthCare.gov.  In October, 2010, price estimates for health insurance plans will be available online. In the weeks and months ahead, new information on preventing disease and illness and improving the quality of health care for all Americans will also be posted.  The website also includes a series of opportunities where users can indicate whether pages were helpful to them and we will continue to seek user feedback to grow and strengthen the site. 

“People need to see what choices are offered, what options cost, and how coverage works in practice,” said Karen Pollitz, Deputy Director for Consumer Support, Office of Consumer Information and Insurance Oversight. “Today HealthCare.gov takes an important first step in that direction.  In the coming months and years, we will add pricing and plan performance information so that consumers can see and understand and make meaningful choices about their health coverage.”

For information on how you can plan ahead to finance long-term care for yourself or your loved one, contact the experienced elder law attorneys at Dutton & Casey, P.C. at www.duttonelderlaw.com or (312)899-0950.

July is Elder Abuse Month

It’s hard to believe it, but July is almost over.  Even though the month is quickly coming to an end, we wanted to take a moment to acknowledge that July is elder abuse month in Illinois.  The Chicago Sun Times posted an article on this annual opportunity to raise awareness entitled, “Preventing Abuse of the Elderly.”   It is a sad but true fact that elder abuse exists.  It can take many forms, from physical abuse to mental and emotional abuse, or financial abuse, and the perpetrators of this abuse can take many forms, too.   Joyce Gallagher, executive director of the Chicago Department of Family and Support Services/Senior Services Area Agency on Aging (DFSS), noted that “a lot of seniors are held hostage by caregivers, sometimes it’s emotional hostage,” and that “very often, the abuse comes from family members.” 

Another sad fact: according to the article, “The U.S. Administration on Aging estimates that 700,000 to 3.5 million seniors are abused in the country each year and only one in five instances of abuse are reported.”

In light of that statistic, how can we recognize Elder Abuse Month and do our part to make sure that instances of elder abuse are reported?  Gallagher explains, ” ‘We want neighbors to look out for the seniors in their buildings and on their blocks.  If neglect is suspected, people don’t need to get involved if they don’t want to.  They just need to give us an address and we will do the rest,” Gallagher said. The DFSS also is looking for more nursing home volunteers.

To report abuse or volunteer, call the DFSS at (312) 744-4016 or the Illinois Department on Aging Senior Help Line at (800) 252-8966.

Also, here are some tips on elder abuse from the Illinois Department on Aging (www.state.il.us/ag ing) and the National Center on Elder Abuse (www.ncea.aoa.gov):

Types of abuse: Physical, sexual and emotional abuse. Also, confinement, passive neglect, willful deprivation and financial exploitation.

Warning signs: Bruises, pressure marks, broken bones, abrasions and burns may be an indication of physical abuse, neglect, or mistreatment. Indicators of emotional abuse include: withdrawal from normal activities; a sudden change in alertness, and unusual depression. Strained or tense relationships and frequent arguments between the caregiver and elderly person are also signs of emotional abuse.

Bruises around the breasts or genital area can occur from sexual abuse. Sudden changes in financial situations may be the result of financial exploitation. Bedsores, unattended medical needs, poor hygiene and unusual weight loss are indicators of possible neglect.

Vulnerability: Social isolation and mental impairment (such as dementia or Alzheimer’s disease) are two factors that may make an older person more vulnerable to abuse. But, in some situations, studies show that living with someone else (a caregiver or a friend) may increase the chances for abuse to occur.

Abuser profile: Adult children, male or female, are more often the abusers than any other group.

Prevention

Talk with your older friends, neighbors and relatives. Maintaining communication will help decrease isolation, a risk factor for mistreatment. It also will give them a chance to talk about any problems they may be experiencing. Look around and take note of what may be happening. Do they seem lately to be withdrawn, nervous, fearful, sad, or anxious, especially around certain people, when they have not seemed so in the past?

Illinois has a statute called the “Elder Abuse and Neglect Act,” which gives specific legal remedies to elder abuse provider agencies to combat elder abuse.  If your situation calls for legal assistance, contact the elder law firm of Dutton & Casey, P.C. at www.duttonelderlaw.com or (312)899-0950 to learn more about what your options are.  Click here for specific information on elder abuse, neglect and financial exploitation.

Why It’s Wise to Use a Health Advocate

In an article posted on the U.S. Department of Health and Human Services’ website, Dr. Carolyn M. Clancy, the Director for the Agency for Healthcare Research and Quality, discussed some reasons why involving a “health advocate” as you navigate the health care system could help you get the best care possible.  In her article, “Why It’s Wise to Use a Health Advocate,” Dr. Clancy touched on what a health advocate can do for you, how they are involved in your health care situation, and how their involvement can give you the peace of mind you need to focus your energy on recovery.

What is a health advocate (or, at our firm, a Care Advocate)?

“A health advocate is a family member, friend, trusted coworker, or a hired professional who can ask questions, write down information, and speak up for you so you can better understand your illness and get the care and resources you need.”

Why hire someone to attend a helath care-related appointment I’ll already be at?

“Research shows that quality health care means taking an active role in decisions about your care. If you’re facing a difficult medical decision, it’s a good idea to bring someone with you who can help you take an active role in your care when you’re not fully up to it.

As a doctor and a patient, I’ve seen how valuable it is to have “another set of ears and eyes” in the exam room. Having an advocate at medical appointments or during a hospital stay can ensure that you get the information you need to manage your health.”

Some of the benefits of patient advocacy that Dr. Clancy listed in her article:

Asking questions or voice concerns to your doctor for you.

Compiling or update your medicine list.

Remembering your medication regimen and help you follow treatment instructions, including asking questions about your followup care.

Helping arrange transportation.

Researching treatment options, procedures, doctors, and hospitals.

Filing paperwork or assist with insurance matters.

Asking the “what’s next” questions, such as, “If this test is negative what does it mean? If it’s positive, will more tests be needed?”

Click here to read the full article.

As an elder law firm, and one that deals with a variety of complex aging issues (often involving health concerns) we also realize the importance of patient advocacy.  Dutton & Casey, P.C. is one of the few elder law firms to offer this kind of advocacy.  Our Care Advocate, Erin Vogt,  is a licensed clinical social worker who concentrates on the care of and advocacy for elder adults.  She will meet with her clients wherever they reside, assess their care needs and then work with them and their families to develop a plan that specifically addresses those needs.  This can include all kinds of advocacy, including the health care advocacy that Dr. Clancy has written about.  If you or a loved on may benefit from having a knowledgeable outside party help you navigate the challenges that come with the aging process, then contact Erin today. 

To speak with Dutton & Casey’s Care Advocate, Erin Vogt, and learn about other ways to help provide the best possible care for your loved one, contact Erin at evogt@duttonelderlaw.com or call her cell phone at (312)371-0954.

Kindness…Something to Think About

This story is a reminder about the power of kindness.  Something to think about in all the business of our daily lives.

The Cab Ride I’ll Never Forget
by: Kent Nerburn

Twenty years ago, I drove a cab for a living. One time I arrived in the middle of the night for a pick up at a building that was dark except for a single light in a ground floor window.

Under these circumstances, many drivers would just honk once or twice, wait a minute, then drive away. But I had seen too many impoverished people who depended on taxis as their only means of transportation. Unless a situation smelled of danger, I always went to the door. This passenger might be someone who needs my assistance, I reasoned to myself. So I walked to the door and knocked.

“Just a minute,” answered a frail, elderly voice.

I could hear something being dragged across the floor. After a long pause, the door opened. A small woman in her 80′s stood before me. She was wearing a print dress and a pillbox hat with a veil pinned on it, like somebody out of a 1940s movie. By her side was a small nylon suitcase.

The apartment looked as if no one had lived in it for years. All the furniture was covered with sheets. There were no clocks on the walls, no knickknacks or utensils on the counters. In the corner was a cardboard box filled with photos and glassware.

“Would you carry my bag out to the car?” she said. I took the suitcase to the cab, then returned to assist the woman. She took my arm and we walked slowly toward the curb. She kept thanking me for my kindness.

“It’s nothing,” I told her. “I just try to treat my passengers the way I would want my mother treated.”

“Oh, you’re such a good boy,” she said. When we got in the cab, she gave me an address, then asked, “Could you drive through downtown?”

“It’s not the shortest way,” I answered quickly.

“Oh, I don’t mind,” she said. “I’m in no hurry. I’m on my way to a hospice.”

I looked in the rear view mirror. Her eyes were glistening.

“I don’t have any family left,” she continued. “The doctor says I don’t have very long.”

I quietly reached over and shut off the meter. “What route would you like me to take?” I asked.

For the next two hours, we drove through the city. She showed me the building where she had once worked as an elevator operator. We drove through the neighborhood where she and her husband had lived when they were newlyweds. She had me pull up in front of a furniture warehouse that had once been a ballroom where she had gone dancing as a girl.

Sometimes she’d ask me to slow in front of a particular building or corner and would sit staring into the darkness, saying nothing.

As the first hint of sun was creasing the horizon, she suddenly said, “I’m tired. Let’s go now.”

We drove in silence to the address she had given me.

It was a low building, like a small convalescent home, with a driveway that passed under a portico. Two orderlies came out to the cab as soon as we pulled up. They were solicitous and intent, watching her every move. They must have been expecting her. I opened the trunk and took the small suitcase to the door. The woman was already seated in a wheelchair.

“How much do I owe you?” she asked, reaching into her purse.

“Nothing,” I said.

“You have to make a living,” she answered.

“There are other passengers.”

Almost without thinking, I bent and gave her a hug. She held onto me tightly.

“You gave an old woman a little moment of joy,” she said. “Thank you.”

I squeezed her hand, then walked into the dim morning light. Behind me, a door shut. It was the sound of the closing of a life.

I didn’t pick up any more passengers that shift. I drove aimlessly, lost in thought. For the rest of that day, I could hardly talk. What if that woman had gotten an angry driver, or one who was impatient to end his shift? What if I had refused to take the run, or had honked once, then driven away?

On a quick review, I don’t think that I have done anything more important in my life. We’re conditioned to think that our lives revolve around great moments. But great moments often catch us unaware—beautifully wrapped in what others may consider a small one.

Culture Change in Chicago nursing home(s)

When used in the context of nursing homes and long-term care facilities, “culture change” is a pretty lofty phrase.  As published in the Chicago Tribune story “Chicago nursing home joins flexibility revolution,” on July 16, some area facilities are adopting new, deceivingly big, methods for revising how they oeprate.  This particular article discussed the decision made two years ago by folks at the Bethesda Home and Retirement Center to “allow” residents to sleep in.  It may not seem like a revolution, but it certainly posed a lot of obstacles for the facility’s administrators, and furthermore, it represents a surprisingly large step in the work towards “culture change” in nursing homes across the country.   

So what is this movement all about?  The article explains:

‘The “culture change” movement seeks to get these facilities to alter their physical layout and their caregiving practices to create homelike environments where residents are seen not as passive recipients of care but as individuals with control over their lives.

Nursing homes that embrace the new philosophy are letting residents decide when to bathe, eat and sleep; allowing them to organize their own activities; and redesigning nursing units into small “households.”

Advocates say residents in such homes are happier and healthier; the employees have more job satisfaction; and giving care this way even costs less.”

Despite what the advoactes are saying, in the traditional world of nursing homes, there is certainly reluctance.  No matter how small the changes may be, embracing them can pose some serious challenges for facilites who decide to rethink the way they work.  Not surprisingly, there are financial considerations that need to be made, especially during a time when nursing home operators are under a great deal of pressure to cut costs.  While advocates are showing that flexible care can actually cost less, facilities worry that enacting the changes will be costly.  Plus, there isn’t much of a push from consumers to make these changes, because most of us don’t realize that these changes are possible.

Bethesda dealt with a whole slew of issues: dealing with nursing home regulations, changing meal and housekeeping  times, and most importantly, medication shcedules.  They also had to give the nurses time to adjust- and lost some of them because not everyone was able or willing to.  Was it worth it?  Bethesda says “yes.”

For proponents of culture change- what does the future look like for reform?

The Health Reform Act passed in March calls for conducting demonstration projects at nursing homes to establish the best ways to effect culture change. So many organizations and government agencies are now working toward culture change that “everything is in place for widespread dissemination,” said Bonnie Kantor, executive director of the Pioneer Network.

Click here to read the full article.

For more resources on caring forself or the older adults in your life, check out the resources section of Dutton & Casey’s website, an elder law firm designed to work with our clients to understand, and then help meet their needs.

IMPORTANT: Proposed Changes to Medicaid Eligibility

Dutton & Casey, P.C. attorney Janna Dutton reviewed the Illinois Department of Health and Family Serivces’ (IDFHS) proposed regulations regarding the future (and past) of Medicaid eligibility.  Reading the proposed regulations could probably take days if you went through them in their entirety, so below Janna has summarized what these proposed changes could mean to you.  I highly recommend taking a look at the summary to see how you or your loved ones could be affected, because the ramifications could be significant, or as my mom put it, “we’re screwed.”

The Illinois Department of Health and Family Services has released a series of proposed regulations which it will be publishing in the Illinois Register on August 13, 2010.  These regulations, in part, implement the federal Deficit Reduction Act provisions passed in February of 2006.  For those in the Chicagoland area that are interested, there will be a 45-day public comment period as well as public hearings scheduled for September 13, 2010 at 9:00 a.m. at the Michael A. Bilandic Building, 160 North LaSalle Street, Chicago, Room 500.

            The proposed regulations contain numerous and significant changes to eligibility for Medicaid coverage of long term care services.  To say they are lengthy would be quite an understatement, so below are some of the most notable changes:

1.  Five Year Look-Back

As of the date of implementation of the proposed regulations, applicants for Medicaid coverage of long term care (skilled nursing, supportive living, and the community care and in-home services programs) will be required to account for and document all financial transactions occurring during the five years prior to the date of application, or February 6, 2006, whichever is later.

 2.  Retroactive Application of More Punitive Transfer Penalty Rules

The Department is proposing to apply new punitive penalty rules to transfers of assets which have occurred since February 8, 2006.  As of the date of the implementation of the new rules, transfers of assets for less than fair market value, meaning gifts, will result in the applicant being ineligible for Medicaid coverage for a certain time period.  This time period does not begin until the month the person is eligible for Medicaid, meaning in need of long term care services and having an approved Medicaid application (but for the imposed penalty period).  The penalty period is calculated by dividing the total uncompensated value of assets transferred by the average monthly cost of long term care services at the private rate in the community in which the person’s nursing home is located at the time of application.  The result is the transfer penalty period of ineligibility in number of months, days, and portion of a day.  For example, if a person makes gifts to grandchildren of a total of $65,000 in June of 2006, and then applies for Medicaid on or before May of 2011, assuming an average private rate of $4000, they will be deemed to be ineligible for Medicaid for a period of approximately 16 months and 7.5 days beginning with the month that their Medicaid application for nursing home care is approved.

 In addition, the Department will no longer allow a penalty period to be reduced by a partial return of the funds gifted.  In order to reduce a penalty period, the entire amount transferred during the five year look-back period will need to be returned.

 3.  Spouses Must Disclose Separate Assets

 Historically, the State has allowed spouses of nursing home residents applying for Medicaid to refuse to disclose their separate assets without affecting the Medicaid eligibility of nursing home residents.  The proposed regulations will no longer allow spouses to refuse to disclose their separate assets. If they do, the only way the nursing home Medicaid applicant (or community spouse) will be allowed to receive Medicaid benefits is if they assign their support rights to the State of Illinois to allow the State to take legal action against the non-disclosing spouse, or, if they can prove that it is an undue hardship. 

 4.  Exempt Homestead Property Limited to $500,000 of Equity

 Under the proposed rules, a person is not eligible for long term care coverage of the person’s equity in homestead property exceeds $500,000.  The federal law allows equity of up to $750,000.

 5.  Strict Limitations on Annuities

 At application and upon redetermination, a Medicaid applicant/recipient and community spouse must disclose any interest either or both may have in any annuity or similar financial instrument.  The disclosure must include a statement that the State of Illinois becomes the remainder beneficiary to the extent of Medicaid paid out.  Failure to make this disclosure may result in denial or termination of Medicaid coverage.

The purchase of an annuity which does not name the State as a remainder beneficiary will be considered a penalized transfer of assets.

  Click here for a printable version of the article.

 In addition to these proposed changes, there are many other changes which will have a significant impact on disabled persons seeking Medicaid coverage of long term care. Persons and groups wishing to submit written comments or testify at the September 13, 2010 public hearings are urged to contact Dutton & Casey P.C. at (312)899-0950.  Public response may result in positive changes to the proposed regulations

Center for Medicare Advocacy to host webinar on health care reform, Medicare, and people in the community

If you are wondering how health care reform is going to affect Medicare for people living in the community, you may want to check out an upcoming webinar hosted by the Center for Medicare Advocacy and presented by the center’s Senior Policy Attorney, Vicki Gottlich.

This session will focus on changes to Medicare that affect all Medicare beneficiaries, including:

• Changes to premium and cost-sharing structures
• Changes to Medicare Advantage plans, including reforms to improve benefit structures
• Changes to the Part D program, including closing the Donut Hole
• Improvements to preventive benefits
• Improvements to care for people with chronic conditions

The Seminar is September 2, 2010 at 3:00 pm EST, and will last one hour and the cost is $80.00, per site. 

You can register at https://salsa.democracyinaction.org/o/777/p/salsa/event/common/public/?event_KEY=61856

For legal assistance with issues relating to asset protection, contact the elder law attorneys at Dutton & Casey, P.C.   You can read more about our areas of concentration, how to schedule a consulation at our website www.duttonelderlaw.com.  By phone, we can be reached at (312)899-0950.  We look forward to helping our clients manage elder law matters of any shape or size.

Northwestern’s “Buddy Program” Pairs Early-Stage Alzheimer’s Patients with Med Students

For thirteen years now the Northwestern University Feinberg School of Medicine’s “Buddy Program” has been matching up first-year medical students with patients from the university’s Cognitive Neurology and Alzheimer’s Disease Center (CNADC).  The purpose of the program is two-fold: older patients in the early stages of Alzheimer’s or other related cognitive disorders have the ability to share their life experiences with younger people, contribute to the education of a future doctor and enhanced self-esteem and quality of life through friendship and independence.  At the same time, med students get an opportunity to improve their understanding of, and attitudes about, aging and dementia.  Darby Morhardt, MSW, LCSW, director of the Alzheimer Buddy Program, noted that, “I like to call the senior buddies my ‘faculty’ because they are contributing in a way that can be transformative to students.”

Click here to read the full article that features more information on how students and patients are matched, profiles of buddies and the activities they do together, and what students are learning from these unique relationships.

To contact the director of the program:

Darby Morhardt, MSW, LCSW

Research Associate Professor

Director of Education

Cognitive Neurology and Alzheimer’s Disease Center Northwestern University Feinberg School of Medicine 320 E. Superior, #11-453B, Chicago, IL  60611

Tel 312-908-9432, Fax 312-908-8789

www.brain.northwestern.edu

If you or a loved one has been diagnosed with early-stage dementia and would like to consult with an elder law attorney about ways to plan for your future, contact the attorneys at Dutton & Casey, P.C. through our website at www.duttonelderlaw.com or call us at (312)899-0950.

Honor Flight Chicago

An incredible organization called Honor Flight Chicago (HFC) was founded by four local women in February of 2008, with the mission to recognize, honor and celebrate the nation’s World War II veterans by flying them to Washington, D.C. for an extraordinary day of remembrance, at no cost to them.   With a total of ZERO employees and a whopping 700+ volunteers and guardians, not to mention the estimated $50,00 price tag for a single flight,  Honor Flights Chicago was somehow able to fund and coordinate 5 flights in its first year of operation, then 9 in 2009 and is projecting 11 flights in 2010.   Thus far, 1294 veterans have been able to visit their memorial in D.C. through Honor Flights Chicago, but an estimated 1300+ are still on the waiting list.  Sadly, the HFC website notes that given the average age of of veterans on the waiting list (which is 87), many of these men and women may not be with us long enough to get their turn.  

If this is a program that interests you and you’d like to read more about how to donate your time/money or to write a thank you letter to a veteran, click here.

Veteran Applications available here.

To read more about flight dates, the day’s agenda, and read testimonials from vets who have visited thanks to HFC, visit their website at http://honorflightchicago.org/index.html.

Next flight date: August 24th!!!

For other ways to assist the seniors in your life, visit the elder law attorneys of Dutton & Casey, P.C.  at www.duttonelderlaw.com.  We are compassionate advocates for seniors, persons with disabilities and their families, and our attorneys can help you and your family navigate the often difficult waters that come with aging.

Judith Johnson on Talking About Death and Dying

I just read an article by Judith Johnson, a life coach, that was published in The Huffington Post this week.  Her article, “Why We Need To Talk About Death and Dying” was summarized on another blog as a call for end-of-life planning.  As an elder law firm we, of course, acutely understand the importance of planning for the end of life, so I read it.  But the article was not about the importance of estate planning or asset protection, it was more about spiritual and emotional planning.  Maybe it seemed touchy-feely to me because I needed another cup of coffee, or maybe it’s because I was expecting something more…technical about getting your affairs in order, but there were some thought-provoking pieces of this article that made we wonder about the connection between the emotional parts of aging and the technical ones and how that may be an important relationship to think about.   

Johnson argues that American culture, unlike others, is not one that embraces or encourages discussion of grief or dying and that our failure to acknowledge this is leaving us unprepared when we come face-to-face with death.  She also noted that, “Eighty percent of Americans do not put their personal affairs in order before they die.”  So what do these two points have in common?  Why do you think it is that so many people do not handle the legal and financial components that accompany aging and the end of life?  I guess the obvious answer is that we don’t want to acknowledge what that means and the reality of it.  Our avoidance of the emotional aspects of dying prevents us from tackling the more techincal components- like issues involving money, property and advance directives.  To us, it seems cold and depressing to even mention those, let alone plan for them.

For me, the bottom line isn’t whether this “denial” is societal or not, it’s about the importance of emotional preparation.  Talking about your wishes and how you feel about dying, while difficult to say the least, may better enable you to get your affairs in order, which can bring peace of mind not just to you, but to your family, too.

To read the full article, which includes some questions that Johnson invites you to ask yourself, click here.

For compassionate and committed elder law assistance, contact the attorneys at Dutton & Casey.  Our clients are facing tough issues and making difficult choices under stressful circumstances, and our attorneys enjoy escorting them from problem to solution, helping them plan for a future, and giving them peace of mind.

Driving Evaluations

Driving evaluations are an instrumental way to help determine if someone is safe to continue driving, whether it be for physical, visual, or cognitive reasons.  The evaluation lasts for three hours and is split up into three different sections.  The first hour is in the clinic with an occupational therapist.  The therapist evaluates range of motion, strength, reaction time, vision, memory, attention, sensation, street signs, and situational driving questions.  The next hour and a half is out on the road, where the driving instructor evaluates handling of the car and ability to safely drive.  The evaluation concludes with a sit down meeting to go over the results and recommendations that will be made to the doctor.  Individuals may pass, fail, or require further training sessions to practice their skills or with equipment if needed.   For more information please call Alexian Rehabilitation Hospital at 847-640-3119.  To see a list of area locations that administer the evaluation, click here.

What do you need to participate?: a current driver’s license and doctor’s order

How long does the evaluation last?: 3 hours

For more information on how to take care of yourself or your loved ones as they age, visit the website of elder law firm Dutton & Casey, P.C. to check out our resources or read about how our attorneys can help give you the peace of mind that comes with planning for your future.

Changes in Medicaid: Special Needs Pooled Trusts Still Available for Seniors

Since we published last month’s Proposed Chages in Medicaid article, outlining a few ways in which Illinois is attempting to change its rules on Medicaid eligibility, you may wonder what hasn’t changed about qualifying for Medicaid benefits in Illinois.  One method of Medicaid eligibility that Illinois has contemplated eliminating entirely, but still currently allows, is the special needs pooled trust for disabled people over the age of 65.

Ordinarily and generally speaking, to qualify for Medicaid, a person cannot own more than $2,000.00 in assets, a home, a car and a prepaid funeral.  Medicaid is intended to provide healthcare coverage for the indigent blind, disabled and aged.  However, one shortfall of this policy is that the indigent disabled usually have special needs and those needs are not met through Medicaid coverage.  To correct for this shortfall in policy, the federal government allows disabled people to qualify for Medicaid even though they have more than $2,000.00 in assets as long as they place those excess assets into a special needs trust.  That special needs trust can then be used to pay for the disabled person’s special needs which are not covered by Medicaid.  Special needs can include special medical and dental equipment, therapies, treatments, pharmaceuticals, custodial and companion care, clothing, personal products and transportation.  For a disabled person living in either the community or a long term care facility, a special needs pooled trust can increase quality of life enormously.  

While the federal government allows disabled people to hold their excess assets in a special needs trust and to use those assets to pay for their special needs, the government does impose some limitations.  For instance, the funds in the special needs trust can only be used for the benefit of the disabled person and any funds remaining in the trust at the end of the disabled person’s lifetime must be used to pay back the bill Medicaid has incurred providing benefits for the disabled person.  Those limitations are minor considering the benefit a disabled person receives from being able to preserve and use their own funds during their lifetime while still qualifying for Medicaid coverage.  The special needs trust is an exceptional tool to prevent the complete impoverishment of the disabled and it is very fortunate that Illinois has not yet attempted to eliminate this important option for disabled people over the age of 65.

For more information on how to prepare a special needs pooled trust, or for other questions you may have in the face of the proposed changes to Medicaid eligibility, contact the experienced elder law attorneys at Dutton & Casey, P.C. at www.duttoncaseylaw.com or (312)899-0950.

World Alzheimer’s Day: Advances in Science and Care

Description:

On September 21st, World Alzheimer’s Day, educational programs are being held in dozens of countries to raise awareness about the growing challenge of this disease for individuals, families, and society. This year, the Alzheimer’s Association-Greater Illinois Chapter, is pleased to bring together professional and family caregivers for a morning of learning about recent advances in science and care.

 Dr. Concetta Forchetti, both a researcher and clinician, will provide an update on current trends in biomedical research including diagnosis, treatment, and popu­lation studies examining risk reduction. Dr. Jeannine Forrest, who manages a research project involving palliative care for people with advanced dementia, will describe best practices and the findings of her current study. Finally, Mary Ellen Geist, author of an acclaimed memoir about caring for her father with Alzheimer’s disease, will talk about her personal journey of caregiving and the power of music and song to connect with those with Alzheimer’s disease.

 Presenters:

• Concetta Forchetti, MD, PhD, is the Director of the Memory Disorders Center at the Alexian Brothers Neuroscience Institute
• Jeannine Forrest, PhD, RN, is the manager of the Palliative Care for Advanced Dementia project at the Alzheimer’s Association-Greater Illinois Chapter
• Mary Ellen Geist, an award winning journalist and news anchor, is the author of Measure of the Heart: Caring for Parent with Alzheimer’s

 Date, Time & Location: September 21, 2010 Check-in: 8:00 a.m. Elk Grove Village Park District, Garden Terrace Room

Program: 8:30 a.m. – 12:00 p.m. 1000 Wellington Avenue  Elk Grove Village, IL

 Fee: $25 for Family Members; three or more persons from the same family discounted at $15 per person

$45 for Professionals, three or more persons from the same organization discounted at $25 per person

Register at: Click here to register or call Cheryl Dawson at (847) 933-2413

Continuing Education credit hours available at no extra charge for professionals.

Oakton Community College Alliance for Lifelong Learning/Continuing Education for Health Professionals has been approved as a sponsor of continuing education by the State of Illinois, Department of Financial and Professional Regulation. For this program, LSW, LCSW, LPC, LCPC, LMFT, LNHA, and SLP will earn 3.25 clock hours of continuing education credit. Occupational therapists and physical therapists will earn 3.9 contact hours. Activity professionals and other professional groups will earn 3.25 universal training hours.

Dutton & Casey, P.C. Opens New Satellite Office in Arlington Heights

Partners Janna Dutton and Kathryn C. Casey are pleased to announce the opening of a new satellite office in Arlington Heights, where we will begin scheduling appointments with clients in October. In addition to our main office in downtown Chicago and our satellite office in Skokie, we are thrilled to expand our service area to also include the Northwest suburbs.

We strive to make our appointments as convenient as possible, and our hope is that this new office will allow even more access to our legal services. 

Our new Arlington Heights address:

1655 N. Arlington Heights Road

 Suite 306 West

Arlington Heights, IL 60004

Appointments in our Arlington Heights office will be available beginning in October.  Those spots are already filling up quickly, so if you are interested in scheduling one, call our office today at (312)899-0950.

Visit us at www.duttoncaseylaw.com.

Don’t Ignore Long Term Care Planning

Last week, The New York Times  published “Ignore Long-Term Care Planning at Your Peril,” an article discussing some surprising (and upsetting) statistics regarding long term care insurance. 

Essentially, the article explained that 2009 was not a banner year for long term care insurance companies, as there were “fewer new individual buyers of the insurance than in any year since Limra, a market research firm, began tracking the data in 1988. It was also the first year that the number of existing policies did not increase.”  At the same time, long-term care costs, per individual, could reach SEVEN figures in the next 20-30 years… as in $1,000,000.

So what is wrong with this picture?  If the cost of taking care of ourselves is going to skyrocket, why are so many Americans ignoring long term care insurance?  For starters, the article cites recent announcements by insurance big dogs like John Hancock and Metlife that they intend to raise premiums on these policies by 40%, if state regulators allow it. 

With the economy the way it has been, and premiums about to explode, it isn’t shocking to see why people are reticent about forking over the extra dollars.  But, Ron Lieber, the article’s author, offers up 9 other consumer motives (some imagined, some real) to explain the lack of coverage.

I recommend reading the full article, and, as Lieber suggests “consider this a test of whether you’re ultimately delusional about your risks and the cost of being wrong,” but here is a summary of the 9 reasons why Americans aren’t purchasing long-term care insurance:

• MEDICARE COVERAGE- According to a 2009 Prudential survey, 37 percent of people think that Medicare will cover their long-term care costs
• THE ODDS OF NEEDING CARE- Why invest in insurance if there’s a chance you’ll never need it? 
• SELF-FUNDING COST -How much might it cost to pay for care yourself? Last week, MetLife, a big seller of long-term care insurance, released new survey data suggesting that the average rate for a private room in a nursing home was now $229 a night, or $83,585 a year, on average, though it can range widely by geography. Average costs for home health aides are $21 an hour.  Another researcher took a 55-year-old couple and assumed one of them would need four years of care starting at age 75. The current cost of care was $200 a day and would rise by 5 percent annually.  The total, including the opportunity cost of lost investment gains (6 percent after taxes) from money that ended up being spent on care instead, would be about $1.5 million.
• COUNTING ON MEDICAID -Medicaid will pay for nursing home costs, and depending on your state, some other types of long-term care, too. But first, you have to qualify, and that usually means spending most of the money you have.
• THE CHILDREN AS NURSES – the assumption that your children will act as caregivers
• THE CHILDREN AS FINANCIERS - the assumption that your children will pay for your care if the parents run out of money. Or one sibling assumes, without ever discussing it with the others, that the children will split any costs for care equally.
• THE GOVERNMENT’S PLAN -One part of the landmark health care bill earlier this year is something called the Class Act. In effect, it sets the government up in the long-term care insurance business.  No one will be able to enroll until 2012 at the earliest, and the plan may not pay much more than $75 or $100 a day for claims (and only after a five-year period of paying premiums first), though that will be indexed for inflation.
• THE COST TODAY - With the economy the way it is, why pay today for something you won’t reap the benefits of until tomorrow?  And for those just struggling to pay for health insurance, the here and now is probably a higher priority.
• FUTURE COSTS Long-term care insurance premiums aren’t like those for, say, term life insurance. They can go up. The fact that they didn’t rise very often until recently led many agents to lead customers to believe (or buyers to fool themselves into believing) that they would never go up.

Good news: rising premiums means the actual long-term care is, presumably, good

Bad news: price increases of this magnitude suggests that some companies had no idea how to set prices on many of their policies (and may still not, meaning your premiums may get hiked so much that they are no longer affordable later in life when you are living on a fixed income)

The bottom line, in Lieber’s words: “you had better have a plan, and a backup plan, too, for when your forecasts inevitably go awry.”

As an elder law firm dealing with a variety of asset planning and protection, our goal is to assist you in creating a plan…and a backup plan if the need arises.  Contact the experienced attorneys at Dutton & Casey, P.C. to talk about your long term care plans today.

www.duttonelderlaw.com

(312)899-0950

Northwestern asks court to revoke daughter’s POA over her refusal to let mom be discharged

Yesterday, The Chicago Tribune published a thought-provoking article on Northwestern Medical Hospital’s decision to ask the court to revoke a daughter’s power of attorney over her hospitalized mother and instead appoint a public guardian for her immediate and long-term care needs.  The story goes that Dolores Bedin, a patient at Northwestern with inoperable pancreatic cancer, has been medically ready for release since September 18 of this year.  However, her daughter, Janet Bedin, has refused to allow the hospital to discharge her mom, arguing that her mother has not been strong enough to return home.  The hospital filed the petition to revoke Janet’s POA so that they can release Dolores to a lower level of care and they claim that Janet is not acting in her mother’s best interests by refusing her discharge.  Plus, because the Bedin hospitalization is not deemed medically necessary, Medicare has rejected claims to reimburse the hospital.  And to further complicate matters, the elder Bedin has been the primary caregiver for a mentally and physically disabled son.

So here you have a daughter, who (without meeting her) wants to make sure her mother receives the care she needs, and worries that she might not be able to provide that because of the current demands of her family and job responsibilites.  It isn’t tough to imagine resisting this discharge if your parent was ill, you knew they needed care and you didn’t know where else they would go if they weren’t in the hospital.

But, on the other hand and without sounding too heartless, that isn’t exactly the hospital’s problem.  If the hospitalization isn’t medically necessary, Medicare is refusing to reimburse them, and other patients do classify as being in need of acute care, and Mrs. Bedin no longer needs that level of care, then it seems appropriate that she would be moved to a different setting.

I suppose the bottom line here is that this is a sad, scary situation to find yourself in, and one that the daughter, her mother, nor the hospital is presumably happy to be in.   The case, while extreme, “highlights a growing problem faced by aging baby boomers: how best to care for elderly parents who are not acutely ill but are unable to take care of themselves on their own. Many elderly people who are not acutely ill nevertheless need help with basic activities of daily living, such as dressing, bathing, eating, walking and using the toilet.”  This care, of course, costs money and many seniors, including Dolores Bedin, lack long term care insurance or adequate savings to pay for it (click here to read Monday’s post on long term care planning).  The best way to prevent finding yourself in a similar situation is to plan ahead.  Talking through how to protect your assets and plan for long term care could save you a lot of time, energy and money later on.      

UPDATE: Later posts on the Tribune website show that attorneys for both parties reached an agreement that Mrs. Bedin will be released from the hospital on Friday and will be moved to her daughter’s Rockford home, although how Janet Bedin will coordinate her mother’s care will still need to be finalized.

To set up a consultation with one of the experienced elder law attorneys at Dutton & Casey and discuss how you can plan for your future, or the future of a loved one, contact our firm today.  Visit our website at www.duttonelderlaw.com or call us at (312)899-0950.

Read more on the topic at Dutton & Casey’s Asset Protection page.

Janna Dutton Authors Article on Possible Risks for Veterans Who are Thinking About Purchasing Annuities

Duton & Casey partner Janna Dutton has authored an article on the surprising facts that veterans should know before they think about purchasing an annuity.  Here is an excerpt from the article:

It is becoming commonplace for assisted living facilities to refer veterans and their families to financial advisors for help with applying for Veteran’s Aid and Attendance Benefits.  In most instances, the financial advisors are insurance brokers who sell insurance products, most notably annuities, which just so happen to pay out high sales commissions for these “advisors.” The financial advisor does not charge for help with the application, however, the advisor recommends that the veteran purchase an immediate annuity (paying out monthly income) to qualify him or her for VA benefits. While this may be an appropriate technique for qualifying for Veteran’s Benefits in some instances, it may not be necessary and may actually pose a huge stumbling block to qualifying for Medicaid if the veteran requires nursing home care in the future.

Click here to read the full article.

To discuss asset protection planning with an experienced elder law attorney, contact the law firm of Dutton & Casey, P.C. at (312)899-0950 or check us out at our website www.duttonelderlaw.com.  We are compassionate advocates for elders, persons with disabilities, and their families.

Happy National Family Caregiver Month!

In 1994, the National Family Caregivers Association (NFCA) launched the first ever celebration of family caregiving, declaring National Family Caregivers Week.  It was recognized by President Clinton when he signed the first proclamation in 1997, and has been proclaimed by an American President annually ever since. Many states, and dozens of local municipalities have proclaimed November as NFC Month.

Did you know that there are more than 65 million family caregivers in the country?  That’s a lot of people, and many of them are also working in addition to providing care to a family member.  That is a tall order for anyone and it certainly deserves some attention.

THe NFCA’s website notes that: No one else is in a better position to ensure continuity of care. Family caregivers are the most familiar with their care recipients’ medicine regimen; they are the most knowledgeable about the treatment regimen; and they understand best the dietary and exercise regimen.  Not to mention they know their recipient’s personality, likes and dislikes, and their history (medically, but as a person, too). 

So what is the purpose of  National Family Caregivers Month?  The  NFCA coordinates this month as a time to thank, support, educate and empower family caregivers. Celebrating Family Caregivers during NFC month enables all of us to:

• Raise awareness of family caregiver issues
• Celebrate the efforts of family caregivers
• Educate family caregivers about self-identification
• Increase support for family caregivers

As a sidenote, I think people are starting to get into that “thankful” zone, now that the holidays are upon us and  Thanksgiving is (shockingly, I might add) just a few days away.   With that in mind, and while I proudly celebrate this proclamation, my wish is that family caregiver thankfulness and awareness not be limited to a season or a month, but may it be spread throughout the year, just as their care is.  When the holidays are over and the new year has begun, think of a thoughtful gesture or a kind word that will let the family caregiver in your life know how appreciated he/she is all year round. 

“The true strength of the American family finds its roots in an unwavering commitment to care for one another.”

President Barack Obama, 2009′s NFC Proclamation

At the elder law firm of Dutton & Casey, P.C., we understand that just as your family circumstances evolve over time, so do your elder law needs. To meet these needs, our firm has added another important component in our efforts to holistically service the comprehensive needs of our clients and their families. Life Care Planning is a new way to respond to the challenges that develop as you go through the later stages of your life, such as long-term illness or disability. A Life Care Plan spells out how our elder law attorneys and elder care professionals will work together with you to establish quality care, help with decisions regarding long term care needs, and find sources to finance quality long term care.  Our Care Advocate can also work with family caregivers to provide them with assistance to make the difficult decisions they may often be making alone or without any support.  To contact our office regarding your situation, please call (312)899-0950 or to read more about our services, check out our website at www.duttonelderlaw.com.

New and Improved Social Security Webpage

Raise your hand if you love government websites!!! 

…

No one?  Well, read on, because last week Michael J. Astrue, Commissioner of Social Security,  unveiled the agency’s newly redesigned home page at www.socialsecurity.gov that will help visitors “more quickly and easily find the information and services they need.” 

Key new features:

• One of the key features of the redesigned home page is a service channeling guide, which appears in the left hand column of the page.  The guide links users directly to the most popular pages on Social Security’s web site — the services visitors are most likely to want to use.
• a rotating “showcase” that provides high visibility for significant agency initiatives that benefit the American public
• Redesigned subpages for the major Social Security benefit programs — Retirement, Disability, Survivors, SSI, and Medicare — are easily accessed by clicking on the row of horizontal blue buttons at the top of the home page.
• An additional button — Business Services — links to a portal with information and services Social Security offers to businesses. 
• A news section keeps readers up-to-date on important Social Security announcements, and a large question mark on the right side of the page takes visitors to frequently asked questions.

Bonus:  While the look of the website may have changed, the bookmarked links to users’ favorite pages have not. 

“We set out to make Social Security’s new home page even easier for visitors to find the services and information they need,” Commissioner Astrue said, “and our new look reflects the useful feedback we received from the public during testing.  Almost everyone either needs the information on our site or can use it to help a relative or neighbor.  See for yourself at www.socialsecurity.gov.”

According to the American Customer Satisfaction Index, Social Security has the three highest rated online services in all of government – the Retirement Estimator, online benefit application, and the Help with Medicare Prescription Drug Plan Costs application. The customer satisfaction scores for these online services exceed the top-rated commercial site, Netflix.

To visit Social Security’s redesigned home page go to www.socialsecurity.gov.

For more helpful resources, visit the elder law attorneys of Dutton & Casey P.C. at www.duttonelderlaw.com.

Confusion About Money and Credit May be Sign of Impending Dementia, Research Suggests

At the end of October, the New York Times published a complex piece entitled, “Money Woes Can Be Early Clue to Alzheimer’s.”  The article is based on some new research that suggests that one of the first signs of impending dementia is an inability to understand money and credit, contracts and agreements.  Imagine if the person in your household that was in charge of finances and paying the bills just stopped doing it one day.  How long would it take you to find out?  This article tells the story of several such  families, all of whom were faced with this exact situation and were blindsighted with their own financial ruin because of it. 

 A call from the homeowner’s association was the catalyst for Renee Packel, who soon realized her husband had not been paying their fees and had stopped writing checks to their creditors.  Her husband was developing Alzheimer’s disease and had forgotten how to handle money.  When she tried to pay their bills, most of their money couldn’t be found, even with the help of a forensic accountant.  To pay off lawyers and creditors Mrs. Packel had to sell her husband’s business and their home and move into a one-bedroom apartment.  Now, in her mid-seventies, she works as a receptionist to support herself and her husband.  Incredibly, the article notes that stories like this are not all that uncommon.

In addition to the heartbreaking problems that families are facing, another population is reeling from the implications of adults who are losing their ability to be competent decision-makers.  Financial advisors and lawyers are encountering some very sticky situations when it comes to determining their client’s capacity and, if necessary, acting on it.

As the article explains, “Last year, Fidelity Investments surveyed 350 investment advisers. The advisers were asked if they suspected that any of their clients had Alzheimer’s or were developing it, and what they did about it. The advisers also were asked if they had mentioned the problem to their clients.

Most — 84 percent — said they thought they had had clients with Alzheimer’s or symptoms indicating that they were developing it. And 96 percent said they did not feel prepared to deal with those clients. Half said they were not comfortable even raising the subject of dementia. They worried that they might be wrong about a client’s mental capacity, and even if they were right, they did not know what they were supposed to do about it or where to refer the client for assessment and help.”

Lawyers are feeling conflicted because their duty is to their client, but what may be in the client’s best interest isn’t necessarily what the client wants.  The attorney is prohibited from discussing anything with the family without the client’s permission, and often the client may not want you to discuss their decision-making capacity with family, whether it is out of denial, forgetfulness, etc.

Here is a scenario from Robert Grant, an attorney in Palo Alto: “[A] lawyer has to make an independent determination that the client is competent. If the lawyer determines the client is incompetent but the client insists on executing a document, the rules say the lawyer should withdraw representation. However, Mr. Grant said, ‘one can question whether withdrawal from representation of an incompetent client is actually in the client’s best interest.’”

The article ends without a real bottom line, or a prevention plan, maybe because there isn’t one and because everyone (familes, advisors, lawyers, even doctors) is doing the best they can as they go.  Memory screening, asset protection and life care planning may at least give you some time, and help provide some peace of mind in trying times like these.

Click here to read the full article.

For more resources on Alzheimer’s disease or to read about Dutton & Casey’s asset protection and life care planning services, visit www.duttonelderlaw.com or call (312)899-0950.

Holocaust Community Services in Chicagoland

While growing older poses new challenges and opportunities for all individuals, Holocaust survivors suffer additional complications during the aging process including experiencing feelings of loss of control and reliving painful memories. Since 2000, Holocaust Community Services, a collaborative effort of JCFS, CJE SeniorLife and the Jewish Federation of Metropolitan Chicago, in partnership with HIAS Chicago, has provided supportive services to the Chicago Holocaust survivor community and their families.

To ensure that survivors continue to live at home independently and with dignity, JCFS case managers facilitate in-home support including housekeeping and laundry services, kosher food home delivery, meal preparation, medication management, transportation services, and bathing and grooming assistance. Holocaust Community Services also offers counseling and support and referral services to survivors and their heirs in the process of applying for various reparations and compensation programs. 

A great ongoing program they offer: Coffee and Conversation, weekly on-going drop-in groups for survivors, are provided three times per week. Survivors meet in a welcoming atmosphere for informal discussions, remembrance and celebration of life. These groups are offered free of charge and are conveniently located in the northern suburbs and in West Rogers Park.
Click here to read their brochure.

For more information, please contact:

Goldie Bachmann

Luftig Building

5150 Golf Rd

Skokie, IL 60077

T: 847 568 5151 F

F: 847 568 5125

Visit: www.jcfs.org

In addition to practicing law, our elder law firm strives to serve as a resource for older adults who are searching for helpful and useful information.   Check out the resources page on Dutton & Casey’s website for more links and articles covering specific issues facing the elder population.

National Resource Center on LGBT Aging

I recently posted on another subgroup of the older adult population, Holocaust survivors, and it got me thinking about what groups of seniors may need additional resources that are specific to their needs and the unique obstacles they are facing as they age.  Getting older is hard enough as it is, but members of the LGBT community often face additional complications because of the lack of relevant, informative resources that are available to them.  Creating communities, whether in-person or online, can help shine some light on these issues, relieve the feelings of isolation and frustration that can occur when resources are lacking, and point LGBT seniors, LGBT organizations, and aging providers in the right direction when it comes to exploring new and emerging topics that are impacting the lives of LGBT elders.

The National Resource Center on LGBT Aging

The National Resource Center on Lesbian, Gay, Bisexual and Transgender (LGBT) Aging is the country’s first and only technical assistance resource center aimed at improving the quality of services and LGBT older adults. Established in 2010 through a federal grant from the U.S. Department of Health and Human Services, the National Resource Center on LGBT Aging provides training, technical assistance and educational resources to aging providers, LGBT organizations and LGBT older adults.  For more information, please see http://www.lgbtagingcenter.org

Their plan for the next year is to construct a web site that will house a variety of resources for aging providers, LGBT organizations and LGBT older adults, including:

• Searchable, up-to-date publications across the many issues affecting lesbian, gay, bisexual and transgender (LGBT) older adults nationwide—from housing to caregiving, from HIV/AIDS to racial and economic inequities, and much, much more
• An interactive state-by-state map that connects LGBT older adults with vital resources in their states and local communities
• Online training and technical assistance for service providers, the aging network and LGBT organizations about the best ways to support LGBT older adults
• Detailed best practices from professionals in different parts of the country that describe how they successfully crafted programs for LGBT older adults
• Our Stories, Our Lives—an evolving story booth that portrays the personal conditions facing LGBT older individuals in all parts of the country
• A directory of organizations and programs that explicitly serve LGBT older adults and can guide other groups interested in forming similar programs
• A growing, interactive library of multi-media resources for adults with different learning styles, including videos, slideshows, audio and other media formats
• Q&A commentaries with leading experts in the field, exploring new and emerging topics that are impacting the lives of LGBT elders
• Opportunities to share, rate and contribute the content that’s placed on this web site, making it a resource that’s created by the communities it serves

For more information and additional resources for older adults and their families, visit the website of elder law firm Dutton & Casey, P.C. at www.duttonelderlaw.com.

Sadly, there are a high number of reported falls among older patients in hospitals and long term care facilities each year.  The cause(s) of these types of falls has created a great deal of debate over the last few years, although the danger of them is inherent.  According to a study published in the November 3 issue of the Journal of American the Medical Association (JAMA), the use of a fall prevention tool kit (FPTK), which included a fall risk assessment, patient-specific prevention plan, an educational handout and a poster for over the patient’s hospital bed, reduced the number of older patients with falls in hospitals. 

Patricia C. Dykes, R.N., D.N.Sc., of Partners HealthCare System, Brigham and Women’s Hospital and Harvard Medical School, Boston, presented the findings of the study at a JAMA media briefing at the National Press Club.  While taking a fall is scary for anyone, the JAMA article explained that:

“Falls are a public health problem worldwide. Hospitalization increases fall risk because of the unfamiliar environment, illnesses, and treatments. Patient falls and fall-related injuries are devastating to patients, clinicians, and the health care system. A single fall may result in a fear of falling and begin a downward spiral of reduced mobility, leading to loss of function and greater risk of falls. Older adults are more likely to be injured from a fall. Injurious falls increase hospital costs and lengths of stay,” the authors write.  

The authors calculated that just for the 8 urban hospital units involved in the study, the FPTK could potentially prevent 1 fall every 4 days, 7.5 falls each month, and about 90 falls each year.

More research is needed to determine if a similar program would be able to reduce repeat falls over a longer period of time, however, this could be promising news for senior patients staying in the hospital or long term care facilities.

To read the full article, click here.

For more information and additional resources for older adults and their families, visit the website of elder law firm Dutton & Casey, P.C. at www.duttonelderlaw.com.

Caring, During the Holidays, For Loved One Who Has Dementia

As the social worker, with the law firm of Dutton & Casey, P.C., I have the oppotunity to assist, and support, many wonderful families. 

I know that the Holiday Season can be very stressful for many. I found a handout, created by the National Institute of Aging,  that provides tips to help make the Holiday Season the best it can be for an individual who has dementia and the people who care about them.

Here is the link:

www.nia.nih.gov/alzheimers/publications/holidaytips.htm

Please share this information with anyone who you feel would benefit!

Center for Medicare Advocacy Says: You Can Leave the Nursing Home

December is a time of holidays, celebrations and school vacations. Nursing home residents often want to join in family festivities and visit with children and grandchildren but may be under the impression that they will lose Medicare coverage if they leave the facility to do so. According to the Center for Medicare Advocacy, Inc. (CMA) this is not true.

The Medicare Benefit Policy Manual recognizes that although most beneficiaries are unable to leave their facility, “an outside pass or short leave of absence for the purpose of attending a special religious service, holiday meal, family occasion, going on a car ride, or for a trial visit home, is not, by itself evidence that the individual no longer needs to be in a SNF for the receipt of required skilled care.

for more information, go to www.medicareadvocacy.org/infobytopic/skillednursingfacility/snf_youcanleavethe snf.htm

New Years Resolutions for Family Caregivers

At the New Year, many people make resolutions and establish new goals. For family caregivers, many of whom put their needs last, making, and sticking with, some changes, can be very helpful. 

The article, located at, http://www.agis.com/newyearsresolutions/default.aspx
provides some wonderful suggestions for changes.
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Item 8 mentions getting important papers organized…for you and the people who are cared for and about.

At Dutton & Casey, we can assist with this task and many, many more! Please visit our website at www.duttonelderlaw.com. While you are there, please sign-up for our electronic newsletter. This monthly publication contains information on programs/services/resources that can be valuable tools for older adults, people who have a disability, and the people who care about them, including family members and professionals.

Your Elder Law Connection, from Dutton and Casey, P.C.

The January 2011 issue of “Your Elder Law Connection” has been published.

This monthly publication contains useful information for older adults, adults who have a disability, and their loved ones.

Please click on the link to be directed to the newsletter:

http://archive.constantcontact.com/fs010/1102793168627/archive/1104185870572.html

Emergency Preparedness

With the current weather conditions, I felt it was important to provide a few resources on emergency planning for older adults and people who have a disability.

With emergency planning, people tend to think of ‘man made events’ but, as was evident in Chicagoland today, a large amount of snow and cold temps, can have a huge impact on daily life.

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http://nod.org/disability_resources/emergency_preparedness_for_persons_with_disabilities

http://www.cdc.gov/aging/emergency/index.htm

http://www.disability.gov/emergency_preparedness/preparedness_tools_%26_resources

Do You Need a Living Trust?

In our ongoing effort to be a community resource, Attorney Lara A. Duda recently wrote an article explaining living trusts.

Here is the link for the entire article.

and….
to discuss estate planning, including Living Trusts, for you or someone you care about, please call the office of Dutton Casey, P.C., to schedule a consultation with one of the firm’s attorneys. Our office numbers are 312-899-0950 (Chicago), 847-906-3584 (Arlington Heights), and 847-261-4708 (Skokie).

March 2011 Newsletter

The March 2011  issue of YOUR Elder Law Connection by Dutton & Casey was released today.
This newsletter contains helpful information for older adults, adults who have a disability, and the people who care about them, including professionals.

Click here to read the issue.

10 Common Estate Planning Questions

 Attorney Melissa Howitt recently wrote an article answering the 10 questions most often asked about estate planning.  Please click here to read this informative, and easy to understand, article.

….

To discuss estate planning for you or someone you care about, please contact the office of Dutton Casey, PC, to schedule a consultation with a firm attorney. 312-899-0950 (Chicago), 847-906-3584 (Arlington Heights), 847-261-4708 (Skokie), or send an email contact@duttonelderlaw.com.

YOUR Elder Law Connection… From Dutton & Casey

The April, 2011 issue of the newsletter from the Law Firm of Dutton & Casey was published today.

Please take a few minutes to read the newsletter… it contains many helpful articles and resources focusing on older adults, adults who have a disability, and the people who care about them, including family members and professionals.

Should there be any questions on the newsletter, to learn more about the many resources that the attorneys and staff can provide, or/and to schedule an appointment with a firm attorney, please go to http://www.duttonelderlaw.com/

New Diagnostic Guidelines for Alzheimers Disease

In April, 2011,   new diagnostic guidelines for the diagnosis of Alzheimer’s Disease were released.  This information  is to important to only be shared once. Please review the guidelines, again, and share this information. We can all be part of the process to assist people receive the care they deserve!

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For assistance with the legal planning that is needed with a diagnosis of a cognitive disorder, please contact the law office of Dutton & Casey. We are compassionate advocates for older adults, people who have a disability, and the people who care about them. Please go to our website  at  www.duttonelderlaw.com  or email us at contact@duttonelderlaw.com. We will be honored to assist.

Family Caregiver Training in Arlington Heights Illinois

Training Tips for the Caregiving Marathon, Speaker: Daniel Kuhn, LCSW

May 18, 2011     7:00-8:30 p.m.

Arlington Heights Senior Center, 1801 Central Road, Arlington Heights, IL

 Please call Kathy Peck at (847) 253-5500 ext. 375 to reserve your seat

…………..

For assistance with the legal planning that is involved with being a family caregiver, please contact the law office of Dutton & Casey. Kathryn Casey is an experienced elder law attorney who sees clients in our Arlington Heights office. For more information or to schedule an appointment, please go to www.duttonelderlaw.comor email us at contact@duttonelderlaw.com

 

Warning about a Scam

Warning about “Living Well” Grant Funds Scam

The U.S. Administration on Aging has alerted the Senior Medicare Patrol (SMP programs) to a phone scam in which the caller tells the call recipients that they are eligible for a “Living Well” grant. The caller then instructs the recipient to complete a grant “application,” provide a cell phone number, and wire money through Western Union. The recipient is told that s/he will be contacted on their cell phone when it is time to pick up their “grant” funds at Western Union. 

This is definitely a scam. The Administration on Aging provides “Living Well” grants to several states, but those grants do not have anything to do with calling individuals or requesting money. If people receive calls like this, they should report the incident to the Illinois Attorney General’s Office consumer fraud hotline at one of the numbers below:

 (800) 386-5438 (Chicago)
(800) 243-0618 (Springfield)
(800) 243-0607 (Carbondale)

 Consumers are also encouraged to report calls like this to the Federal Trade Commission: https://www.ftccomplaintassistant.gov/

 The Federal Trade Commission has information available on their website about fake government grants scams like this one: http://www.ftc.gov/bcp/edu/microsites/phonefraud/government.shtml

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The Law Firm of Dutton & Casey, PC., is dedicated to serving older adults, persons with disabilities, and the people who care for them. Please go to www.duttonelderlaw.com for more information on our services and for additional resources.

Alzheimer’s: Early Planning Critical to Financial Health

In a recent article in Reuters Magazine, Alzheimer’s: Early Planning Critical to Financial Health, working with a certified elder law attorney is an important step in planning for the future.

Janna Dutton, founder of Dutton & Casey, is one of only 8 certified elder law attorneys in Illinois.

Click here to read the article.

For additional information on how Dutton & Casey can assist you, or someone who you care about, please go our website.

Getting Ahead While Playing by the Rules. 08/31 by Rob Pritts | Blog Talk Radio

Attorney Kathryn C. Casey was a guest on ”Disabled Radio” on Wednesday, August 31, 2011.

Getting Ahead While Playing by the Rules. 08/31 by Rob Pritts | Blog Talk Radio.

Medicaid Spousal Impoverishment Protections for Same – Sex Civil Union Partners

When one partner in a long-term relationship needs expensive long term care, often the only way for the couple to pay for it is to look to Medicaid. Historically, there have been no spousal impoverishment protections afforded to partners in same-sex relationships when one partner needs long term care and applies for Medicaid. However, the combination of the new Illinois Civil Union Act and a policy change recently announced by the U.S. Department of Health and Human Services ensure that Medicaid spousal impoverishment protections are afforded to Illinois same-sex civil union partners.
On April 1, 2011, U.S. Department of Health and Human Services Secretary Kathleen Sebelius announced that, effective immediately “[t]he Centers for Medicare & Medicaid Services will notify states of their ability to provide same-sex domestic partners of long-term care Medicaid beneficiaries the same treatment as opposite-sex spouses in the contexts of estate recovery, imposition of liens, and transfer of assets. This includes not seizing or imposing a lien on the home of a deceased beneficiary if the same-sex domestic partner still resides in the home. It also includes allowing Medicaid beneficiaries needing long-term care to transfer the title of a home to a same-sex domestic partner, allowing the partner to remain in the home.” In additional to these protections, the partner in the community is allowed to receive assets, in addition to the home, from the nursing home partner in an amount sufficient to bring the community partner’s assets to the Community Spouse Asset Allowance standard – presently $109,560. The community partner may also be eligible to receive income from the nursing home partner when Medicaid is paying for that partner’s long term care.
The new Civil Union law which became effective on June 1, 2011 provides that a “party to a civil union” is to be included in any definition used in state law where the term “spouse,” “family,” “immediate family,” “dependent,” “next of kin” and other terms that denote “spousal relationship” are stated. The Civil Union Act stops short of granting same-sex couples the right to “marry”; however, it does guarantee “[a] party to a civil union … the same legal obligations, responsibilities, protections, and benefits as are afforded or recognized by the law of Illinois to spouses.
The Civil Union Act in Illinois mandates that the Illinois State Medicaid agency, the Department of Healthcare and Family Services, treat partners in civil unions the same as married partners. The federal Medicaid agency, the Department of Health and Human Services, is allowing states to treat same-sex partners as opposite sex spouses for purposes of Medicaid. Therefore, same-sex partners in Illinois Civil Unions should be afforded Medicaid spousal impoverishment protections if Medicaid coverage of long term care becomes necessary for one of the partners. Dutton & Casey, P.C. is available to represent civil union partners needing long term care in accessing Medicaid and Medicaid spousal impoverishment protections. Please note, federal Medicaid spousal impoverishment protections apply to the Medicaid programs covering nursing homes and assisted living (supportive living) facilities, as well as to the home based services program, the Community Care Program, administered by the Illinois Department on Aging.

Two Tax Court Decisions Clarify When Long-Term Care Expenses Are Deductible

Long-term care can be very expensive, but many expenses can be deducted from your taxes. Two important recent decisions by the U.S. Tax Court provide guidance on when caregiving services are deductible.

 Click here to read the article.

Event: Taking Pride in Wellness

The Services and Advocacy for GLBT Elders at Center on Halsted provides enriching social, cultural and educational programs for the diverse lesbian, bisexual, and transgender older adult population of Chicago. This goal of this Wellness Fair is to educate older adults, caregivers and loved ones of ways to stay healthy in a holistic way. There will be workshops, participatory activities and a vendor fair with topics that touch on upon parts of wellness including intellectual, social, and spiritual health.

Date: Friday, September 16, 2011

Time: 10:00 am-3:00 pm

Location: Center on Halsted, 3656 N. Halsted, Chicago, IL 60613

For the flyer on the program, click here.

Event: Navigating Legal Planning for Family Caregivers

Attorney Janna Dutton will share vital information, related to legal planning, for family caregivers of a person who has dementia.

Date: Monday, October 10, 2011

Location: Rush University Medical Center

Registration: There is no charge to attend. Please contact Kate Krajci 312-563-2703 or kate_a_krajci@rush.edu for more information on the group and registration.

Event: Elder Law and Ethics, 2011

This program will provide an overview of Elder Law topics within an ethical framework. Discussion will This program will provide an overview of Elder Law topics within an ethical framework.  Discussion will include topics of importance to all individuals working with older adults.  These will topics will be presented via interactive lecture and case studies. The following topics will be presented:

• Determination of decisional capacity
• Factors that contribute to a person’s risk for neglect, abuse and exploitation
• Solutions for helping those at risk
• Updated on the changes to Medicaid (DRA) and what impacts they may have

 

Date: Wednesday, September 14 , 2011

Time: 9:00 a.m. – 12:00 p.m.

Firm Speaker: Janna Dutton, JD

Location: The Abington, 3901 Glenview Rd, Glenview, IL 60025-2467

Click here for a flyer.

To Register: No charge to attend. Pre Registration is required by calling Vicki in marketing department at The Abington. Phone: 847-729-0000  or sending an email to: vickibmktg@theabington.com

Event: Elder Law Update

In this session, Attorney Janna Dutton will update you on two important subjects…New Power of Attorney Act and DRA. Bring your questions!

Date: September 15, 2011 – 830-10am

Location: Terrace Gardens Assisted Living, 8415 North Waukegan Road, Morton Grove, Illinois   60053

Registration: There is no cost to attend this program. However, advanced registration is required. Call 847-470-4550 or email tbischoff@bethanymethodist.org by September 12, 2011. Seating is limited.

Continuing Education: 1.5 hours of credit will be awarded to LPC, LCPC, LSW, LCSW, and RN. Credits provided by Silver Connections.

Schedule a Meeting with One of Our Attorneys

To schedule a meeting with one of the firm’s attorney, please call

• 312-899-0950 for the Chicago office
• 847-906-3584 for the Arlington Heights office
• 847-261-4708 for the Skokie office
• 847-886-9456 for the Vernon Hills office

 Email: contact@duttonelderlaw.com

When calling to set up an appointment, you will speak with Joshua Roma, our paralegal and intake specialist. This call is an opportunity for you to discuss your situation and for us to listen. If our services match your needs, Joshua will work with you to find an available date for you to come to meet with one of our attorneys.

Two things will happen prior to your meeting. The first is that you will receive a questionnaire from our office, either in electronic form or through the mail, depending on your preference. Different circumstances call for different information, so the questionnaire you receive will be specific to your situation. The purpose of the questionnaire is to gather as much background information before the meeting so that the information is readily available for the attorney when you meet. This will maximize your time with the attorney, as more of your time can be spent discussing possible solutions and next steps. It also provides the attorney with a more solid understanding of your situation, which will in turn assist her in providing specific advice that will benefit you most.

Secondly, prior to your appointment, you will receive a phone call from our office reminding you of the date and time of your appointment.

What happens during your meeting?  After?

The first meeting lasts one hour and fifteen minutes long.  During this time, you will meet with one of our attorneys and discuss your circumstances with her.  The information included in your questionnaire will help to guide that conversation.  After you discuss your situation and the details surrounding it, the attorney will talk about some strategies for how your situation may be remedied and what steps would need to be taken in order to achieve that solution.  She will also discuss the approximate costs involved in assisting with your elder law matter so that you are aware of the financial commitment ahead of you and can make an informed decision on how to proceed.

The charge for the first meetng is $350 and it is important to know why.  “Free” is good, but some things are free for a reason.  Our attorneys have over 50 combined years assisting their clients with elder law matters of all shapes and sizes.  At Dutton & Casey, the first meeting is designed as an opportunity to sort through your situation and come up with a plan on how to deal with that situation, whatever it may be.  It is not a sales meeting.  Each of our clients is unique, and as a result, we do not believe in a “one size fits all” approach.  We will provide only those solutions that fit your needs, not a generic package that ignores your real concerns while addressing some that do not even apply to you.  The meeting may even provide you with the information you need to understand that you may not need to retain an attorney after all.  By investing in a productive consultation, you are investing in knowledgeable, attentive and tailored legal assistance.

After the meeting, you will have the option to retain Dutton & Casey to represent and assist you in your matter.  If you choose to do so, we ask that you sign and return our retainer letter (which we will provide once you notify us that would like us to assist with your matter) along with the agreed upon retainer amount.  Once we receive the signed document along with the retainer amount, the work begins immediately.

If you would like to schedule an appointment with Dutton & Casey, P.C., please fill out the form and Joshua will contact you.

Name(required)

Email(required)

Phone

Comment(required)

September Is National Preparedness Month – Include Everyone in Planning for Emergencies

In his proclamation designating September as National Preparedness Month, President Barack Obama stated, “In April of this year, a devastating series of tornadoes challenged our resilience and tested our resolve. In the weeks that followed, people from all walks of life throughout the Midwest and the South joined together to help affected towns recover and rebuild…Disability community leaders worked side-by-side with emergency managers to ensure that survivors with disabilities were fully included in relief and recovery efforts. These stories…underscore that in America, no problem is too hard and no challenge is too great.”

Disability.gov’s Emergency Preparedness section has quite a few tools and resources that can help people with disabilities and others prepare for, and recover from, emergency situations and disasters.

 

Here are a few examples of the resources you’ll find on Disability.gov

•    Tips for people who have pets or service animals
•    Information about emergency kits and supplies
•    Preparing for emergencies at work and school
•    Accessible shelters and emergency housing
•    Help recovering from a disaster

You can also find help in your state by visiting Disability.gov’s Information by State section and going to the Emergency Preparedness section for your state. This blog also has postings about the importance of including everyone in emergency management planning, preparing for emergencies in the workplace and taking into account service animals when planning for emergencies.

FEMA has a great website for kids, READY Kids. This site also has a lot of good information for parents and teachers.  

Stay safe, be prepared, and check out these other resources for more information

•    Ready.gov (Listo América)
•    Are You Prepared? Video Contest
•    FEMA’s Office of Disability Integration and Coordination
•    DisabilityPreparedness.gov
•    National Preparedness Month Coalition
•    DisasterAssistance.gov
•    Emergency Preparedness and You
•    Citizen Corps
•    American Red Cross

Free Alzheimers Resource

The Alzheimer’s Association-Greater Illinois Chapter is pleased offer a free online resource, Encouraging Comfort Care: A Guide for Families of People with Dementia Living in Care Facilities. This 21-page booklet provides useful information to families and staff of long-term care facilities about Alzheimer’s disease and related dementias, particularly care issues related to the late and final stages.

For families, this guide will enable them to make informed choices about a variety of medical decisions they may face on behalf of loved ones with dementia living in nursing homes, assisted living facilities, and other types of care facilities. It will also equip families to ask good questions aimed at obtaining the best care for their loved ones, including a handy checklist of comfort care measures to be discussed with staff members of care facilities.

For staff members of long-term care facilities, the guide will serve as an important tool for those who wish to educate families and assist them in care planning. Individuals and organizations are encouraged to disseminate this booklet in electronic and print formats.

Encouraging Comfort Care was made possible through a generous grant from the Retirement Research Foundation to the Alzheimer’s Association-Greater Illinois Chapter.

To view and download the free guide, click here: http://www.alzheimers-illinois.org/pti/comfort_care_guide.asp

Resource: Facts About Age-Related Macular Degeneration

This free resource from the National Eye Institute includes medical, emotional, and practical (vision rehab therapy etc.) information related to Age-Related Macular Degeneration.

Get your digital online copy here or you can order a print copy here.

Event: Resource Fair for Adults with Disabilities and Their Families

Tuesday, November 1, 2011 9 a.m. – Noon
Bernard Horwich JCC Building, Heller Auditorium
3003 West Touhy Avenue, Chicago

The 2011 Linkages Resource Fair features two guest speakers, as well as opportunities for private consultations and personalized assistance from area service providers and attorneys specializing in disability-related issues.

9:30 – 10:15 a.m.
Robin Jones, Project Director, Disability and Business Technical Assistance Center, Great Lakes ADA Center
Robin Jones will focus on the Americans with Disability Act (ADA) and other disability rights laws that impact housing, employment, travel, education, telecommunications, voting and other areas of importance.

10:45 – 11:30 a.m.
Attorney Laura Miller, Equip for Equality
Attorney Laura Miller will discuss recent legislative challenges related to deinstitutionalization of people with developmental disabilities, mental illness and physical disabilities.
Some of the service providers represented will include:
CJE SeniorLife / Jewish Child and Family Services / Life’s Plan / Clearbrook / Jewish Vocational Service /The Center for Enriched Living / Center for Independent Futures / Arts of Life / Access Living / Family to Family / The Arc of Illinois / Illinois Life Span / Thresholds / PACT, Inc. /UIC Rehabilitation Research and Training Center on Aging with Developmental Disabilities

Some of the attorneys represented will include:
Dutton & Casey Associates / Equip for Equality / Attorney Julie Fox / Jeffrey A. Rabin & Associates

To register for this event or to request special accommodations, click here.

Event: Elder Law & Ethics 2011

Please join us for an interactive presentation and case studies of elder law & ethics on topics such as:

• Determination of decisional capacity
• Risk factors for neglect, abuse and exploitation
• Solutions for helping those at risk
• Proposed changes to Medicaid (DRA) and potential impacts Amended Power of Attorney Act

Presented by: Attorney Kathryn C. Casey, JD
Partner, Dutton & Casey, P.C.

Date: Wednesday, September 28, 2011
Registration: 8:30 a.m.
Presentation: 9:00 a.m.– Noon
Location: Lake Barrington Woods
22320 Classic Court
Lake Barrington, IL 60010
Registration: There is no cost to attend. Registration is required prior to September 23, 2011.
847-842-8900. Seating is limited.

This program will award 3.0 clock hours to Illinois Social Workers,
Professional Counselors and Registered Nurses. This program satisfies the Illinois Social Worker 3-hour ethics requirement.
Credits provided by Silver Connections/Paxem.

The President’s Plan for Economic Growth and Deficit Reduction: A First Look at the Impact on Medicare

The President’s Plan for Economic Growth and Deficit Reduction: A First Look at the Impact on Medicare.

Article: Protecting your parents: Keep the sharks at bay

Click here for an excellent article on Elder Financial Abuse.

Lake County Office Opens

In our ongoing effort to be accessible to the community, we have opened a satellite office in Vernon Hills. Please contact us at 847-886-9456 or email for more information or to schedule an appointment to meet with one of our attorneys.

Office Location: 175 E. Hawthorn Parkway, Suite 345, Vernon Hills, IL 60061

Article: End-of-life discussions do not affect survival rates, study shows

End-of-life discussions do not affect survival rates, study shows.

Update: Illinois Medicaid

On September 13, 2011, the Joint Commission on Administrative Rules (JCAR) again considered the comprehensive new Medicaid regulations proposed by the Department of Healthcare and Family Services (DHS) which in part implement the requirements of the federal Deficit Reduction Act provisions affecting Medicaid eligibility.  DHS released revisions of its proposed rules to the public on Friday, September 9, 2011, giving advocates little time to consider the revisions.  JCAR had the option of lifting its prohibition or continuing it.  Due to the remaining concerns of the elder law bar and others, JCAR announced that it was continuing the prohibition and directed DHS to sit down and negotiate with the interested parties.  On September 28, 2011 JCAR staff, Julie Hamos, Director of DHS and her staff members met with various members of the elder law bar to negotiate some of the controversial provisions.  As of now, it is not certain whether DHS will adopt all or some of the proposed revisions suggested by the elder law bar.  If JCAR does not lift its prohibition in its October meeting on October 11,   2011, the proposed regulations will expire and DHS will need to start over in the future.  Director Hamos has suggested that if this occurs, that she will take the matter (implementation of the Deficit Reduction Act) to the Illinois General Assembly for passage in the form of a statute.  Stayed tuned next month – Illinois may or may not have new Medicaid regulations in place.

Medicare Part D Open Enrollment

2012 plan data is now available on the Medicare Plan Finder. You may enroll in 2012 plans from October 15, 2011 to December 07, 2011.

Click here to find a plan that best suits you.

Resource: Chart of Benefits by Income Level – October 2011

New, updated Chart of Benefits. Here’s a breakdown of the updates:

• Income levels for LIHEAP increased September 1, 2011. Clients have 2 options- Percentage of Income Payment Program (PIPP) or Direct Vendor Payment (DVP)
• Income levels for the Weatherization program increased effective September 1, 2011
• Income levels for SNAP will increase effective October 1, 2011
• Income levels for Illinois Cares Rx decreased effective September 1, 2011
• Illinois Cares Rx-Basic is for those who are under 65 and do not have Medicare or for those who are 65 years of age or older and are not a U.S. citizen or qualified non-citizen
• Illinois Cares Rx- Plus is for those with Medicare or those without Medicare who are 65 years of age or older and  a U.S. citizen or qualified non-citizen
• Seniors who want the Free Ride program must qualify by income effective September 1, 2011

 

To download the Chart of Benefits, please click on the path below to access the document on AgeOption’s website:

http://www.ageoptions.org/newsandviews/documents/ChartofBenefits-October2011.pdf

News: Video Conferencing

We now offer video conferencing.  At times, clients are homebound or they have family members who live outside the Chicagoland area.  With this new technology, we are able to serve all of these clients and still offer the opportunity to see each other face to face.

CMS Issues Guidance on Same-Sex Partners as Patient Representatives – RegBlog

CMS Issues Guidance on Same-Sex Partners as Patient Representatives – RegBlog.

Event: Legal and Ethical Issues for Family Caregivers: What Professionals Need to Know

Attorney Janna Dutton will present information on legal topics vital for professionals to know in order to serve their clients.

October 13, 2011

For more information, including registration and program location, please call Lincolnwood Place at 847-372-8607

Event: Legal Planning For Living with a Chronic Medical Condition

Attorney Kathryn C. Casey will be presenting at a support group for people who have Parkinsons Disease and their Loved Ones.

Date: Tuesday, October 18, 2011

Time: 7:00pm

Location: Alexian Brothers Neuroscience Institute, Alexian Brothers Medical Center, 800 Biesterfield Road, Eberle Medical Building, Suite 610, Elk Grove Village

Registration or More Information: Please contact Paula Wiener at 847-516-2768 or pmwiener@sbcglobal.net

Event: Navigating Legal Issues for Family Caregivers

Presented by Attorney Kathryn C. Casey, this session will answer fundamental legal questions common to all family caregivers responsible for taking care of individuals who are unable to care for themselves. Learn to navigate the legal issues involved in caring for an another adult. What are the duties and authorities under a Power of Attorney for Property, Power of Attorney for Healthcare, Living Trust or Living Will? How does the law allow for a person to manage another person’s finances and healthcare? How can loved ones make financial, personal and medical decisions under the law? Is it possible to avoid legal pitfalls as a caregiver? What legal options are still available in planning and paying for long term care? How can caregivers utilize Medicare, Medicaid, long-term care insurance and personal care contracts to maximize a loved one’s quality of life.

Date: Tuesday, November 8, 2011

Time: 7:00 pm

Location: Lake Barrington Woods, 22320 Classic Court, Lake Barrington, IL 60010

To Register: No charge to attend. Pre Registration is required by calling Lake Barrington Woods at

847-842-8900 by November 7, 2011. Seating is limited.

Event: Navigating Legal Issues for Family Caregivers

Presented by Attorney Janna Dutton, this session will answer fundamental legal questions common to all family caregivers responsible for taking care of individuals who are unable to care for themselves. Learn to navigate the legal issues involved in caring for an another adult. What are the duties and authorities under a Power of Attorney for Property, Power of Attorney for Healthcare, Living Trust or Living Will? How does the law allow for a person to manage another person’s finances and healthcare? How can loved ones make financial, personal and medical decisions under the law? Is it possible for your clients to avoid legal pitfalls as a caregiver? What legal options are still available in planning and paying for long term care? How can caregivers utilize Medicare, Medicaid, long-term care insurance and personal care contracts to maximize a loved one’s quality of life.

Date:  Wednesday, November 30, 2011

Time: 7:00 p.m.

Location: North Grove Manor, 5520 Lincoln Ave.,. Morton Grove, IL 60053

Registration: There is no cost to attend this program. However, advanced registration is required by calling 224-534-0584. Seating is Limited.

Advance Directives Might Curb Cost of End-of-Life Care

Advance Directives Might Curb Cost of End-of-Life Care

YOUR Elder Law Connection for 2011

Our e-newsletter contains resource information that is helpful for older adults, people who have a disability, and the people who care about them, including family members and professionals.

Please click here to read the October 2011 issue.

Confused about Medicare?

Medicare is the primary health insurance for people are 65 and older and younger people who have a disability.

However, Medicare can be very confusing. To learn more about Medicare, what is covers, deductibles, co-pays, etc., look at  

www.medicare.gov;  

www.medicareinteractive.org;

www.insurance.illinois.gov/ship

In addition, go to www.medicare.gov/publications for a resource booklets on the various aspects of Medicare.

Resource: Where to Take Your Credit Complaint

The Consumer Financial Protection Bureau has opened a one-stop complaint center for all credit-card-related issues.

44 Questions to Ask a Nursing Home

Choosing a nursing home for a family member can be one of the most difficult decisions anyone ever has to make. The fact that the family member needs to move to a nursing home means that he or she is in a vulnerable state and will be dependent on the care provided in the facility. Here are 44 questions (we counted them so you don’t have to!) that should help a family choose the best facility in an unfortunate situation.

Driving and Dementia

Driving demands quick reaction time and fast decision making — because of this, a person with Alzheimer’s will eventually become unable to drive. Making decisions about when it’s time to stop driving can be difficult, but dealing with the issue early on can help ease the transition. Learn more at our online Dementia and Driving Resource Center, where you can watch how four families deal with different issues related to dementia and driving.

Click here to read the entire article, from the Alzheimers Association.

Medicare D – Open Enrollment

Medicare D Open Enrollment Starts October 15.

Click here for information from the National Council on Aging

Medicare’s Open Enrollment

For questions regarding Medicare’s Open Enrollment, which began on October 15, go to http://www.medicare.gov/open-enrollment.

2011 Northeast Young Onset Parkinson Conference

Donate Now

Register Now for the Free Webcast on Oct. 22, Live from the 2011 Northeast Young Onset Parkinson Conference! Can’t make it to Rhode Island? Watch the live webcast of the key speakers from the comfort of your home. Register now for the free, live webcast and learn about the following topics: Impulse Control Disorders and Other Brain-Related Behaviors Joseph Friedman, MD, Brown University Recent Developments in the Genetics of Parkinson’s Disease Richard H. Myers, PhD, Boston University School of Medicine Social Security Disability Insurance (SSDI): Understanding the Process Tai Venuti, MPH, Allsup, Inc. DBS: What to Expect from Surgery and After Julie G. Pilitsis, MD, PhD, Albany Medical College Beyond the Mask of Parkinson’s: Strategies for Overcoming Communication Challenges Linda Tickle-Degnen, PhD, OTR/L, Tufts University This event is brought to you by the National Parkinson Foundation and the  American Parkinson Disease Association. Thank you to our generous sponsors: Teva Neuroscience, Ipsen and Medtronic. For more information, please call NPF’s Helpline at 1-800-4PD-INFO (473-4636).

Social Security Benefits to Rise 3.6 Percent

Social Security Benefits to Rise 3.6 Percent – ElderLawAnswers Articles.

“Like” us on Facebook

2012 Benefit Limits for Retirement Plans and Social Security

Williams Mullen: Benefit Limits and Contributions for 2012.

Resource Fair for People who have a Disability and their Families

Erin Vogt, the client care coordinator with Dutton & Casey, is participating in the resource fair on November 1.

Please click here to learn more about the event.

 

Governor’s Conference on Aging in December.

Partners, Janna Dutton and Kathryn C. Casey, will be presenting at this year’s Governor’s Conference on Aging.

Click here for information on the conference.

Foundation for Health and Aging Newsletter……

The patient information division of the American Geriatrics Society published their Fall, 2011 newsletter.

Click here to read the newsletter as it contains many informative articles.

Medicare 2012

Medicare has published the 2012 guide.

Click here to obtain the booklet.

Follow us on twitter! @duttoncaseylaw

http://twitter.com/#!/duttoncaseylaw/

National Family Caregivers Month

November is National Family Caregivers Month.

 

In addition to providing emotional and physical support, family caregivers often give much more to those in their care. Nearly 40 percent of family caregivers reduce their work hours or quit their jobs, plus spend an average of more than $5,500 of their own money annually to help provide the care they give. Yet amazingly, unpaid family caregivers provide 90 percent of the long-term care provided in the U.S. So this November, be sure to remember and recognize the family caregivers you know. For more details, visit

 

 

www.thefamilycaregiver.org.

 

 

-We, at Dutton & Casey, thank the family caregivers, who we are privileged to assist, for your efforts to support your family members.

 

The Chicago Commission on Human Relations

The Commission on Human Relations receives, investigates, and rules on discrimination complaints filed under the Chicago Human Rights Ordinance and the Chicago Fair Housing Ordinance.

For more information, please click here.

American Parkinson Disease Association; Young Onset Center

The Young Onset Program, and the Association in general, is a very helpful resource for people who have Parkinson Disease and the people who care about them.

To read the current issue on their newsletter, please click here.

American Brain Tumor Assocation

The Association has a program, The American Brain Tumor Association Connections Support Community, the  connects patients, families, friends and caregivers for support and inspiration.

Please click here to read more.

Medicare Premimums and Deductibles for 2012

The Centers for Medicare and Medicaid released the rates for 2012.

For more information, please click here.

Medicare Part B Premimum Increase Is Lower Than Expected

For more information on the rates, please click here.

Nationwide Emergency Alert System

A nationwide emergency alert system test will occur on Wednesday, November 9, 2011 at 2:00pm Eastern Time (1:00pm Central Standard Time) and will last for about three and a half minutes. The public will hear a message indicating “This is a test”. The audio message will be the same for radio, television and cable.  

The National-level Emergency Alert System is a public alert and warning system that enables the President of the United States to address the American public during extreme emergencies.

Please click on the following links for the press release, fact sheet and frequently asked questions sheet about this endeavor.

http://www.ageoptions.org/newsandviews/documents/NationwideEASPressrelease.pdf

http://www.ageoptions.org/newsandviews/documents/NationwideEASFactsheet.pdf

http://www.ageoptions.org/newsandviews/documents/NationwideEASfrequentlyaskedquestions.pdf

American Medical Association Publishes Booklet on How to Prepare for Disasters

Click here to obtain the booklet.

Family Caregiver Resources from the Alzheimer’s Association

Click here to learn more about the resources, including a phone helpline and resources regarding driving.

National Council on Aging

National Council on Aging has updated its website to be more user-friendly and helpful.

Click here to read more about the National Council on Aging and its efforts. While you are on the site, make sure to look at benefits check up to learn about federal, state, and local programs for yourself, or someone who you care about.

National Institute on Aging

Did you know that the NIA publishes easy-to-read booklets on numerous aging-related health topics?

Click here to learn more about the resources available from NIA.

Replacing a Medicare Card

Medicare is the primary insurance for people age 65+ and people who have a disability.

The red, white, and blue cards can be torn, lost, or damaged.

Click here for information on how to replace a Medicare card.

Medicare and Other Health Insurance Benefits

At times, people have private insurance and Medicare. This can cause a great deal of confusion for consumers trying to understand their health insurance benefits. 

A resource called, Medicare and Other Health Benefits: Your Guide to Who Pays First, may help clarify the situation.

Click here to download the booklet.

Remembered: The Alzheimer’s Photography Project

Gregg Segal created a video documentary, based on the lives of a few people who have Alzheimer’s Disease.

This documentary helps to remind all of us that everyone has a past…even if the person can no longer remember it.

Click here to learn more about the project.

Increase in Prevention of Spousal Impovershment Standards for 2012

The amounts for 2012 of monthly income, and total assets, that a person can keep when their spouse enters a long-term care nursing hom, supportive living,e or needs the services of the Illinois Community Care Program (CCP) and federal financial assistance is used to help pay for these services have been released.

Click here to read more.

Medicaid Protection for Same-Sex Couples

When one partner in a long-term relationship needs expensive long term care, often the only way for the couple to pay for it is to look to Medicaid.  Historically, there have been no spousal impoverishment protections afforded to partners in same-sex relationships when one partner needs long term care and applies for Medicaid.  However, the combination of the new Illinois Civil Union Act and a policy change recently announced by the U.S. Department of Health and Human Services ensure that Medicaid spousal impoverishment protections are afforded to Illinois same-sex civil union partners.

 Click here to read the entire article.

Program for Family Caregivers of Somone Who Has Parkinson’s Disease

For information on the online program, from the Parkinson’s Disease Foundation, please click here.

Department of Health and Human Services Website on Health Insurance

The Department of Health & Human Services has expanded its website on health insurance companies to include a filter allowing small business owners to locate plans allowing for same-sex partner coverage.

The website, healthcare.gov, was established as a result of the health care reform law that President Obama signed into law in 2009. The website provides details about the Affordable Care Act and offers a searchable database enabling individuals and businesses to find health insurance plans.

In addition to providing a filter enabling small businesses to find plans covering same-sex partners, the expansion of the website — activated on Friday — lets businesses find product choices for a given zip code, sort them by out-of-pocket limits, and find plans with mental health and maternity coverage.

Secretary of Health & Human Services Kathleen Sebelius said the change fosters a more transparent and competitive marketplace in addition to allowing businesses to find plans in an unbiased manner.

“This new information will help business owners navigate what has traditionally been a complicated and confusing decision,” Sebelius said. “Both owners and their employees can feel more confident that the plans offered will be the best to suit everyone’s needs.”

An informed source said the change is just a first step and a later iteration of the website will enable individuals — not just employers — to find health insurance plans that allow for same-sex partner coverage.

Related Stories

According to HHS, the website is the first to bring together information and links to health insurance plans in one venue. The Centers for Medicare & Medicaid Services collected the benefits information from insurers. More than 530 insurers provided information for more than 2,700 coverage plans. Fred Sainz, vice president of communications for the Human Rights Campaign, welcomed the change.

“This is good news and another sign of progress,” Sainz said. “Anything that makes it easier for companies to ensure that all their employees, including those with same-sex partners, have access to health insurance is a good thing.

November Newsletter

Our newsletter contains helpful information for older adults, people who have a disability, and the people who care about them.

Please click here to read the November issue.

Identifying Family Caregivers

Suzanne Mintz

There are more than 65 million family caregivers in America. Some are just beginning the caregiving journey while others have been providing care for five, 10, 15, even 20 years or more. It’s hard for those who are just beginning to help Mom and Dad with a few activities each week to relate to those of us who are providing more than 40 hours of care a week to a spouse/ partner, child, or parent who is severely ill and/or disabled, who lives with us, and who needs help with virtually all the ordinary activities of daily living such as dressing, toileting, eating, etc.

Those at the beginning of the journey don’t interact with the healthcare system as much as “high-burden” family caregivers — those of us who are putting in more than 40 hours a week helping a loved one. I fit into the latter group and I suspect that most of you reading this article do too. When there is talk about family caregivers needing help, about the nation’s most vulnerable citizens — and those who require the most resources — we and our loved ones are the people being discussed.

Within the caregiving community, advocates, scholars, researchers and others have all lamented the fact that as a rule, family caregivers don’t self-identify and that is the reason it is so hard to reach us with information and support. People at the beginning of the family caregiving journey are less likely to self-identify as family caregivers and that may be OK, but it is very important that high-burden family caregivers self-identify, or are identified as such by others.

The other day I had one of those “I should have had a V8” moments. I realized that it is less important for family caregivers to self-identify than it is for healthcare providers and the healthcare system to identify who are family caregivers. How can our healthcare system provide patient- and family-centered care, as we are told it should, if it doesn’t identify half of the equation? It doesn’t make sense really, and it certainly isn’t respectful. I have an idea about how family caregivers can be identified through their interaction with the healthcare system, an idea that is easy to implement and will cost virtually no money at all.

We’ve all filled out countless medical intake forms that become part of the medical record. They ask about our health history and even that of our parents, but they never ask, “Do you provide care for a family member or friend who is chronically ill and/or disabled?” or, “If you have a chronic illness or disability, is there a family member or friend who provides care to you or helps you manage your illness or disability?”

How can doctors, nurses and others pay attention to us, find out what care we provide at home, and keep an eye on our own health if they don’t know who we are? It’s important that they know exactly what type of care we provide our loved ones.

Do you do any of the following: take a loved one to the doctor regularly, manage his/her medications, or help him/her get in and out of bed and to the toilet, or eat or dress? How long have you been providing care? Do you have chronic back pain or feelings of depression? Knowing this type of information can impact the plan of care that healthcare professionals recommend and it can alert them to any problems you might have as well. While in some cases it’s obvious that there is a family caregiver, if it isn’t in the record, it isn’t official; consequently, we are truly invisible to the healthcare establishment, the government, and private insurers, despite the rhetoric to the contrary.

Given all the talk about patient- and family-centered care, not identifying family caregivers is at best an oversight and at worst hypocritical; either way, we need to correct this glaring omission. It’s important to inform healthcare professionals, key healthcare decision makers, the government, and private insurance companies that “family caregiver” is not just a term to pay tribute to, but, rather, that we are real people who provide long-term care for millions of Americans.

What you can do to ensure that family caregivers are identified in medical records:

1. Attach a piece of paper to every intake form you fill out for yourself or your loved one. Put your name and your loved one’s name at the top and then write: “I am John Smith’s wife and his primary caregiver,” or, “My daughter, Nancy Dale, is my primary caregiver,” or a similar phrase. List the top five to 10 tasks you do and note the impact on your health and well-being (chronic back pain, depression) and your life (having to cut hours at work). Save this information on your computer and print it out each time you take Mom to the doctor or visit your own.
2. Talk about the idea with your pharmacists, nurses, or others you come in contact with who have some connection to the healthcare system. They have probably never thought about the idea of identifying family caregivers on medical records.
3. Write to your insurance company. Tell them that knowing who among their beneficiaries are family caregivers, and/or who have family caregivers, will provide them with an opportunity to find new ways to improve care and cut costs.
4. Use social media to spread the idea. Talk to family, friends, and even clergy.

The goal is to create a buzz so that family caregivers and everyday people, as well as providers and decision makers, realize that something is missing on medical records: information about whether someone is or has a family caregiver. November is National Family Caregivers (NFC) Month. Let’s make NFC Month 2011 the time we began the movement to identify family caregivers in medical records.

 Click here for more information on the National Family Caregivers Association.

Family Caregivers: How to Avoid Holiday Traps

Caregivers can rewrite the holiday rulebook to reduce stress, increase joy

From Vicki Rackner, MD, 

Holidays, meant to be a celebration of shared joy and connection with family and community, can quickly become a time of burden and a reminder of alienation and loss.For caregivers, holidays can bring an extra measure of activities and caregiver stress¹. “I wish the calendar would flip directly from November to January,” said Fern, 67. “We just got settled into a routine now that Mom moved in with us, and all I see are a longer to-do list and disrupted schedules.”Holiday celebrations can destabilize any family, and family caregivers know this better than most because people who attend to the needs of aging parents, a sick spouse or family friend already live on the edge of a delicate equilibrium. As Gary, 59, so colorfully said, “Since Dad had his stroke, my life is held together with rubber bands and bubble gum. I’m concerned that Christmas will herald its collapse.”

For self-preservation, many caregivers let go of rules about how holidays should be celebrated. “Being a caregiver for my sick wife offers many gifts,” said John, 73. “Maybe the most important is the invitation to look at our life in a new way. Almost out of necessity, I stripped down our holiday celebrations.”

5 Holiday Traps for Caregivers
There are several common holiday traps that family caregivers fall into, but they can be avoided. Just follow a simple concept: Free yourself from ideas about what shouldhappen, and give yourself permission to celebrate holidays in a way that works for you and your family.

• Trap #1: Planning for the worst. Many caregivers think, “This could be Dad’s last Christmas, so I want to make it really special.” Wouldn’t it be great if we came into the world with an owner’s manual that included the expiration date! We do not. I have seen patients defy all medical odds and laugh about the doctor who gave them six months to live—20 years ago. Then there are the tragic untimely deaths. We should all celebrate as if this is our last holiday season!

• Trap #2: Creating Norman Rockwell scenes. The idea of a picture-perfect holiday has an emotional tug that’s particularly seductive to family caregivers who may long to return to earlier, carefree days of health and vitality.While there is no perfect holiday celebration, you can create holiday rituals that are perfect for your family. Say at a family meeting, “Our lives are different this year, so we need to think about how our holiday celebration will be different. What are the two or three things that make the holiday special for you?” For most people, it’s the little things that make a big difference, like the Russian Tea Cakes, the special hand-embroidered tablecloth, or playing board games. Create a montage of your family’s perfect holiday.

• Trap #3: Buying your way out of guilt. For people in the sandwich generation², caring for both children and parents, the guilt that someone is getting shortchanged looms large. Who doesn’t wish for more hours in the day so that children and friends, even the person in the mirror, would get more time and attention? The life of a caregiver leaves big gaps. If you try to fill the gaps with gifts, you will undoubtedly find that it does not work very well.All family members, including children, need to know they are loved and treasured. Gifts are one way to say this, but what most kids of all ages really want is more of you. Consider a different kind of holiday gift, like a coupon for 10 minutes of undivided attention each day, a trip to the ice cream store, or a visit to the zoo.During a holiday dinner, how about shining a “spotlight” on each person at the table, with each guest offering a story that demonstrates why this person is special? You could write the comments on 3×5 cards and give them wrapped in ribbon or mounted in a collage.

  Consider inviting your kids to give rather than receive by touching the lives of those less fortunate. Serve a meal at a shelter. Invite a lonely neighbor to your house. Look for a chance to give a stranger a $20 bill, or whatever you can afford.

• Trap #4: “Smile!” This instruction, given before every photo, captures the tone for holidays. Over and over, we’re told there’s a right way to feel during a holiday, and that’s happy. Family caregivers have a spectrum of feelings that rise to the surface during holidays, like sadness or anger or disappointment. It is sad that it’s not safe for Dad to live alone any more, so set aside some time to acknowledge those dark feelings. Suppressing the feeling does not make it any less real, and adds to your holiday burden. [Note: For help with handling feelings of grief and loss, see 5 Steps to Help You Through the Grieving Process³]

• Trap #5: Party On!If you are an extrovert—someone who gets recharged from being in the presence of others—you are in your element during holidays. Party on!For introverts who get recharged by spending time alone, or those who have limited pep because of illness, holidays can be emotionally depleting. There is still hope for a joyous holiday celebration, it just requires some advanced planning.Plan a social calendar that’s reasonable for you as a caregiver and for your loved one. Be realistic about your energy limits before you make endless commitments, and ask family members to do the same. If either you or your loved one is an introvert, it’s perfectly reasonable to respond to some invitations with, “Thanks for the lovely offer. Unfortunately, we have other plans. I’m sure you’ll have a terrific time, and I’m sorry to miss it.” The host does not need to know that your other plans are a nap.

Your life became different when you became a family caregiver, and it’s time to do things differently. Free yourself from the idea that there’s a right way to celebrate a holiday. Look at your family and decide how to make holidays work for you, and then adjust the family expectations. That’s the recipe for celebrating the blessings in your life, and the joy and love you share with others.

Vicki Rackner, MD, FACS, is a surgeon who left the operating room to help patients and family caregivers enjoy better health. A noted expert on the doctor-patient relationship, Dr. Vicki serves employers through Medical Bridges⁴, and welcomes everyone to join her Caregiver Club⁵.

How to Tell When Your Parents Need Help…

How Do I Know When My Parents Need Help?

As your parents age, you may begin to wonder or worry: “Are they safe at home? How can I tell if they need help?” Your parents are independent, private people who are not going to share with you incidents that make you think they are not okay. They do not want to go to a nursing home and lose their independence. They love their home and enjoy being in it. So they are not going to tell you the things that happen that may send them to a nursing home. As a matter of fact, they will hide these issues from you. They are afraid of going to a nursing home, and this is a rational fear. They have seen their friends and neighbors placed into facilities when their health begins to decline. All of their possession are sold or given away, the home they have spent years in is sold, they can no longer sleep in if they feel like it or eat whatever and whenever they want; their losses are great. You need to acknowledge that this is a rational fear, something that may happen to them that can be unpleasant.

The following is a list of indicators for change. Observing any of these things happening does not mean your parent cannot live at home. What it does mean is the situation needs to be assessed. Professional or informal and volunteer services can be put into place to allow your parent to stay in their home safely.

• Unexplained weight loss
• Falls, accidents or bruises
• Forgetting food on stove (look for burned or scorched pans)
• Unpaid bills or utilities being shut off
• Housekeeping decline: dirty walls, floors, windows or bathtub
• Unable to maintain home; broken items not being repaired over long time
• Refrigerator and cabinets empty; not enough food
• Unable to recognize or react to danger
• Getting lost or locked out of the house
• No longer able to transfer independently from bed to wheelchair
• Incontinence
• Lack of social support
• Decreased interest in fun or social activities
• Medication errors
• Increased emergency room visits
• Wearing dirty clothes
• Needs to reminded to bathe; has dirty hair or personal odor

For more infomation, please click here

Family Caregiving and Ambiguous Loss

Caregiving and Ambiguous Loss

Introduction Caregiving for a loved one can cause stress in many ways. To manage the stress—which we know can be dangerous to a caregiver’s health—we must first know what the problem is. Surprisingly, many caregivers of individuals with memory disorders or dementia report that the main problem is not the illness itself, but the ambiguity and uncertainty it causes. It’s a difficult challenge to care for someone who is here, but not here—here physically, but gone mentally and psychologically. You feel alone, and in some ways, you are. For many caregivers, it’s as if there’s a stranger in the house. Adding to the stress, disorders such as Alzheimer’s disease or traumatic brain injury cause unpredictable memory loss that comes and goes—one moment here, the next moment gone. This roller coaster of absence and presence is a very stressful kind of loss—what author Pauline Boss calls ambiguous loss. Unlike death, there is no closure, no official validation, and sometimes little community or religious support. You feel you are left to cope on your own; even the strongest caregivers feel anxious and depressed. The challenge is to learn strategies to cope with this ambiguity that is so much a part of memory loss.  Symptoms of Overwhelming Stress Caring for someone with a cognitive impairment—and the ambiguous feelings that arise—can create a constancy of sorrow that can immobilize caregivers. For example, decisions are put on hold, tasks pile up, chores delayed. Doubt, confusion, helplessness and hopelessness set in, and caregivers can feel anxious and depressed. Friendships are in limbo as caregiving takes more and more of your time. Conflict increases with spouse, children/stepchildren, siblings. Family gatherings and rituals that were the glue of enjoyable family life are cancelled or changed. When a caregiver feels increasingly isolated, the possibility of depression, anxiety, abuse, guilt, shame, lack of self-care, illness or substance abuse increases.  Tips for Coping with the  Ambiguity of Memory Loss To manage the stress of caregiving, try to connect with other people: if possible, join a support group either in person or on the Internet, attend a book club, social event, or faith-based group. Here are some ideas, questions and tips to help: 1. Name your problem. Know that one real culprit causing your stress is the ambiguity from a loved one being here, but not here. Call it “ambiguous loss.” It is neither your fault nor the patient’s. It is caused by an illness. 2. Practice both/and thinking. It helps to think “both/and” rather than in the extremes of “either/or.” Instead of thinking the care recipient has to be either here or gone, think of him or her as both here and gone. This means balancing two different ideas at the same time—present, and also absent. Both/and thinking is less stressful than continuing to search for an absolutely perfect solution. Here are some examples: “I am both a caregiver—and a person with my own needs.” “I take care of both him—and myself.” “I both wish it was over—and that my loved one could keep on living.”  “I am both sad at my loved one’s illness—and joyful with my new grandchild.” “I am both sad about my lost hopes and dreams—and happy about some new plans and goals.” Now add your own examples. “Both/and” thinking may come faster if you practice with another person. 3. Know your “family” and community information and support systems. You need predictability (not ambiguity) about whom you can talk to and count on for help. Have some other people become “like family” to you? Does your community offer help and social support? Spiritual support? Recreation and respite? Information support? Talk with your Caregiver Resource Center about what help is available to you. Check the web—a quick online search for “caregiver” offers a wealth of information and online communities. If your biological family offers no help, perhaps you can create a “psychological family” that will be there for you when you need help. Talk about how to divide up the work among a “care team.” Make a written plan to know who will do what and when. Who will come once a week so that you can take some time off to do as you wish? Who will come for a week twice a year so that you can take a vacation from caregiving? Several websites can help you establish your caregiving community (see Resource list below). 4. Continue—but revise—family holidays, celebrations and rituals. Do not cancel, but rather, simplify the gatherings with the people you care about to celebrate birthdays, holidays, and religious events and rituals. Families, friends, and communities connect to celebrate life’s transitions. Human connection can help lower your stress in times of sadness. It can help you and a person with dementia feel the spirit of life around you. This is essential to staying strong when the person you care for is not able to connect fully with you. Think and talk about this: what family rituals did you celebrate as a couple or family before the memory loss? Now? How can you simplify your family rituals and celebrations to fit the circumstances now? Young people can be especially helpful in answering these questions, because of their strong imaginations and new perspectives. 5. Revise family roles. To manage the stress of caring for someone with severe memory loss, alterations are needed in what you and other family members previously did. There are changes in family roles as a result of the memory loss. What tasks are you now responsible for? What tasks have you lost? How do you manage these changes? What would help? Is there agreement in the family about who should do the caregiving? Are you resilient enough to change or do you feel you have to do  it all as before? Talk about who plays what roles in  the family. Finally, based on roles, think about how you see yourself now. You might ask: Is it right for me to take time off to go out with friends when my spouse is suffering from Alzheimer’s disease? Do I still feel like a son or daughter or more like a parent to my parent? If my spouse has memory loss, do I still feel married? How should I act? 6. Be aware of family rules.  Who is allowed to do what in your family? Is there a team approach or are you expected to do all the work alone? Become aware of your family’s rules and question them. They can change. Do your family’s rules about race, religion, class, age, or gender get talked about? For example, is there an unspoken rule in your family that only females can be caregivers? Are certain people excused from helping? Why are they excused? There may need to be a new family rule about “teamwork” so that caregiving does not fall to one person alone. Include children and teenagers in the circle of information about the illness, its effects, its unclear prognosis, and your need for help and teamwork. 7. Understand that anger and guilt are normal, but avoid harmful actions. While mixed emotions are an understandable outcome of memory loss, the negative feelings can come out as anger or, worse yet, abuse—and that is not acceptable. Talk with someone—a professional or another caregiver—about your negative feelings to prevent acting out your anger. Remember, feeling angry about the ambiguity in memory loss is normal, but acting out that anger against the patient or yourself is not. 8. It seems contradictory, but imagine something new to hope for. To stay healthy, everyone needs hope. When your loved one is ill, and you are tied to caregiving, you must discover new hope. It helps to talk about this with other people—and again, with young people. They might help you imagine new dreams for your future—new connections, new hobbies, new travel plans, new skills, new relationships. Given the stress from caregiving and the ambiguity of memory loss, what can you plan for the future that is clear and certain? How about an outing, a firm date for dinner with a friend, a hobby that has clear outcomes, a TV program that you clearly enjoy? New hopes and dreams will emerge when you can balance the ambiguity with some activities that have clear outcomes, no matter how small. 9. Check on your own health. Seek professional help if you: Feel depressed, physically sick or hopeless. Feel like hurting yourself or hurting or yelling at the person you care for. Depend too heavily on alcohol or recreational drugs. Fight with your spouse, children, stepchildren, or other family members and friends. No longer take care of yourself. When you are a caregiver for someone with memory loss, the stress of ambiguity adds to the usual pressures of caregiving. You have a duty and a right to take care of yourself.  Summary This Fact Sheet is a caregiver’s guide to managing the extra stress from ambiguous loss. To sum it up, think of managing the ambiguity as learning to walk in the fog. Keep moving forward, despite the stress of not knowing what lies ahead. But at the same time, reach out for support and human connections to stay resilient and strong.  Credits About Ambiguous Loss. See www.ambiguousloss.com/about_ambiguous_loss.phpBoss, P. (2000, paperback). Ambiguous loss. Cambridge, MA: Harvard University Press. Boss, P. (2006). Loss, trauma, and resilience: Therapeutic work with ambiguous loss. New York: Norton.  Recommended Readings Bayley, J. (1999). Elegy for Iris. New York: St. Martin’s Press. McKeithen, M. (2006). Blue peninsula: Essential words for a life of loss and change. New York: Farrar, Straus, and Giroux. Schulz, R., & Beach, S. (1999). Caregiving as a risk factor for mortality: The caregiver health effects study. Journal of the American Medical Association, 282(23), 2215-2219. Sparks, N. (1996). The Notebook. New York:  Warner Books. Film adaptation: Cassavetes, N. (Director), Harris, L. (Producer), & Johnson, M. (Producer). (2004). The Notebook [Motion picture]. New York: New Line Cinema. TeleCaregivingsm Workshop Audio Archive Here but Not Here—Finding Hope When Your Loved One Has Memory Loss (Podcast) http://caregiver.org/caregiver/jsp/content_node.jsp?nodeid=2061 Caregiving and Depression http://caregiver.org/caregiver/jsp/content_node.jsp?nodeid=393 Caregiver Health http://caregiver.org/caregiver/jsp/content_node.jsp?nodeid=1822 Caring for Adults with Cognitive and Memory   Impairments http://www.caregiver.org/caregiver/jsp/content_node.jsp?nodeid=392 Dementia http://caregiver.org/caregiver/jsp/content_node.jsp?nodeid=569 Grief and Loss http://caregiver.org/caregiver/jsp/content_node.jsp?nodeid=404 Taking Care of YOU: Self-Care for Family  Caregivers http://caregiver.org/caregiver/jsp/content_node.jsp?nodeid=847  Resources Family Caregiver Alliance 180 Montgomery St., Ste. 900 San Francisco, CA 94104 (415) 434-3388 (800) 445-8106 Web Site: www.caregiver.org E-mail: info@caregiver.org Family Caregiver Alliance (FCA) seeks to improve the quality of life for caregivers through education, services, research and advocacy.

Internet Scams

The Family Caregiver Toolbox

Don’t Become the Victim of a Scammer

If you have a telephone or an e-mail address, you have no doubt been the target of a scammer. No one is immune from these criminals, who are using more sophisticated techniques every day. Some e-mail scammers have even learned how to make their correspondence appear as if it’s coming from a trusted government source, such as the IRS. The victims of Internet crime alone lose millions of dollars each year.

You can protect yourself and your loved ones. A variety of reputable agencies and organizations have compiled resources and tips that are a must-read for anyone who uses a telephone or computer.

A new toolkit from the National Council on Aging (NCOA), produced in partnership with the Women’s Institute for a Secure Retirement (WISER), and the Bank of America Charitable Foundation — “Savvy Saving Seniors: Steps to Avoiding Scams” — is helping to educate older adults and their caregivers about how to protect themselves from financial abuse and scams. The toolkit includes a list of signs for caregivers to look for when concerned about their loved ones. Go to www.ncoa.org/assets/files/pdf/Steps-to-Avoiding-Scam-Handbook-10-12-11.pdf.

The Internet Crime Complaint Center, a partnership between the Federal Bureau of Investigation (FBI) and the National White Collar Crime Center, provides helpful “Internet Crime Prevention Tips.” Go to www.ic3.gov/preventiontips.aspx#item-16. View more tips at www.fbi.gov/scams-safety/fraud/internet_fraud.

for more information on resources for family caregivers, go to thefamilycaregiver.org

Aging Parents; Helping When Health Fails

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When a parent, or other loved one, needs assistance, it can be a confusing, sad, and frustrating time. This article provides some information on what to do and where to start…. helping.

Click here to read a helpful article on the subject.

Who Are We?

Dutton & Casey, PC (Elder and Disability Law)

Advocates for Elders, Persons with Disabilities, and their Loved Ones.

The law firm of Dutton & Casey, P.C., is committed to serving our clients with the comprehensive and personally tailored service they need and deserve. With 50 years of combined legal experience, we have acquired the depth and breadth of knowledge necessary to address the full scope of elder law and disability issues. 

Our Areas of Concentration:

• Medicaid Eligibility
• Elder Abuse, Neglect, and Financial Exploitation Litigation
• Estate and Disability Planning
• Guardianship
• Litigation
• Mental Health Law
• Probate Administration
• Public Benefits
• Special Needs Planning
• Trust Administration

* Full Time Social Worker/Certified Care Manager On Staff

Office Locations:

Arlington Heights, Chicago, Skokie, and Vernon Hills, Illinois.

Phone / Video Conferencing  Appointments are also Available.

Contact Information:

Telephone:      312-899-0950 or 847-261-3584

Website:          www.duttonelderlaw.com 

 

-please click here for a flyer on the law firm.

American Parkinsons Disease Young Onset Center

The December newsletter contains many informative articles!

Click here to read the December newsletter.

Medicare D

Just a reminder, Medicare beneficiaries have until December 7 to enroll in, or change, Medicare D coverage.

For Resources on Medicare D, please go to www.medicare.gov; www.medicareinteractive.org; www.insurance.illinois.gov/ship

Stroke Survivors Empowering Each Other

This is a wonderful organization dedicated to advocacy, support, education, and resources to stroke survivors and their families.

To read the December newsletter, please click here.

AARP’s Five Step-Toolkit for Job Seekers

AARP’s Five-Step Toolkit for Job Seekers An online employment guide that covers the entire job search process from start to finish. Helps you to set work goals, organize your job search activities, conduct a career exploration to find out which jobs are best for you and learn how to increase your success in finding a job. click here to learn more.

Four Drugs Cause Most Hospitalizations in Older Adults

Blood thinners and diabetes drugs cause most emergency hospital visits for drug reactions among people over 65 in the United States, a new study shows.

Just four medications or medication groups — used alone or together — were responsible for two-thirds of emergency hospitalizations among older Americans, according to the report. At the top of the list was warfarin, also known as Coumadin, a blood thinner. It accounted for 33 percent of emergency hospital visits. Insulin injections were next on the list, accounting for 14 percent of emergency visits.

Aspirin, clopidogrel and other antiplatelet drugs that help prevent blood clotting were involved in 13 percent of emergency visits. And just behind them were diabetes drugs taken by mouth, called oral hypoglycemic agents, which were implicated in 11 percent of hospitalizations.

All these drugs are commonly prescribed to older adults, and they can be hard to use correctly. One problem they share is a narrow therapeutic index, meaning the line between an effective dose and a hazardous one is thin. The sheer extent to which they are involved in hospitalizations among older people, though, was not expected, said Dr. Dan Budnitz, an author of the study and director of the Medication Safety Program at the Centers for Disease Control and Prevention.

“We weren’t so surprised at the particular drugs that were involved,” Dr. Budnitz said. “But we were surprised how many of the emergency hospitalizations were due to such a relatively small number of these drugs.”

Every year, about 100,000 people in the United States over age 65 are taken to hospitals for adverse reactions to medications. About two-thirds end up there because of accidental overdoses, or because the amount of medication prescribed for them had a more powerful effect than intended.

As Americans live longer and take more medications — 40 percent of people over 65 take five to nine medications — hospitalizations for accidental overdoses and adverse side effects are likely to increase, experts say.

In the latest study, published in The New England Journal of Medicine, Dr. Budnitz and his colleagues combed through data collected from 2007 to 2009 at 58 hospitals around the country. The hospitals were all participating in a surveillance project run by the C.D.C. that looks at adverse drug events.

A common denominator among the drugs topping the list is that they can be difficult to use. Some require blood testing to adjust their doses, and a small dose can have a powerful effect. Blood sugar can be notoriously hard to control in people with diabetes, for example, and taking a slightly larger dose of insulin than needed can send a person into shock. Warfarin, meanwhile, is the classic example of a drug with a narrow margin between therapeutic and toxic doses, requiring regular blood monitoring, and it can interact with many other drugs and foods.

“These are medicines that are critical,” Dr. Budnitz said, “but because they cause so many of these harms, it’s important that they’re managed appropriately.”

One thing that stood out in the data, the researchers noted, was that none of the four drugs identified as frequent culprits are typically among the types of drugs labeled “high risk” for older adults by major health care groups. The medications that are usually designated high risk or “potentially inappropriate” are commonly used over-the-counter drugs like Benadryl, as well as Demerol and other powerful narcotic painkillers. And yet those drugs accounted for only about 8 percent of emergency hospitalizations among the elderly.

Dr. Budnitz said that the new findings should provide an opportunity to reduce the number of emergency hospitalizations in older adults by focusing on improving the safety of this small group of blood thinners and diabetes medications, rather than by trying to stop the use of drugs typically thought of as risky for this group.

“I think the bottom line for patients is that they should tell all their doctors that they’re on these medications,” he said, “and they should work with their physicians and pharmacies to make sure they get appropriate testing and are taking the appropriate doses.”

link to original posting in the New York Times.

 

Muscular Dystrophy (PPMD) Outreach Program

Click here for more information on the outreach program for people who have muscular dystrophy and their loved ones.

Medicare Supplement Resource Guide

The Illinois Department of Insurance published a helpful medicare supplement comparison guide.

Click here to learn more.

December 5-9th 2011 is Older Driver Safety Awareness Week

The American Automobile Association (AAA)emphasizes the importance of communication to help keep senior drivers safe and mobile:

http://www.marketwatch.com/story/aaa-urges-families-to-prepare-for-the-silver-tsunami-of-aging-drivers-2011-12-05

Health Literacy and Older Adults

Health Literacy and Older Adults

CDC Releases Practical Advice on Developing Materials to Match the Health Literacy Skills of Older Adults. CDC’s health literacy web site (www.cdc.gov/healthliteracy) has a new section to help health and other professionals develop materials that will communicate more effectively with older adults and their caregivers. The web site includes self-assessments, background information on health literacy, steps to improve materials and links to resources about older adults and caregivers. The new content builds on CDC’s expert panel report on older adults and health literacy issues. 

www.cdc.gov/healthliteracy/DevelopMaterials/Audiences/index.html

 

Lewey Body Dementia Association Survey

The Lewey Body Dementia Association (LBDA) is conducting a survey to assess if there are differences in how grief is experienced by caregivers for individuals with Lewy bodies, Alzheimer’s disease, Parkinson’s disease with and without dementia, and frontotemporal degeneration.  The survey will also assess the well-being and quality of life for caregivers of individuals diagnosed with the neurodegenerative diseases. Internet access is required to participate in the study, and LBDA needs 500 caregivers who are currently providing care for each different disease that is being studied. 

http://www.lbda.org/go/caregiversurvey

Educational Video about the Medicare Program in ASL

The Centers for Medicare & Medicaid Services has a new educational video about the Medicare program in ASL for people who are deaf or hard of hearing. The video gives an overview of the Medicare program, including what Medicare is, who qualifies, the four parts (A, B, C and D), new preventive services under the Affordable Care Act, and help paying Medicare costs.

click here to learn more.

National Caregiver Support Line for Veterans

The Veterans Adminstration has established a National Caregiver Support Line for Caregivers of
Veterans — spouses, children, other family members and friends of Veterans as well as Veteran themselves.  

for more information on the program, please go to http://duttoncaseylaw.com/resources/articles.html

Tools to Help Choose a Good Nursing Home

By Carolyn M. Clancy, M.D.

December 6, 2011

Finding a high-quality nursing home for a family member is a daunting task.

Many people have not had to make this decision before. And it’s often made under stress, when asking good questions and thinking carefully about your options are harder than usual.

Fortunately, more information is available that can help you learn about nursing home quality and prepare you to make a well-informed decision.

Start this process with an online tool from the Federal Government called Nursing Home Compare. This lets you look up nursing homes in your area by name, city, county, State, or ZIP Code. First unveiled in 2009, Nursing Home Compare has detailed information on every nursing home certified by Medicare or Medicaid.

Nursing homes are rated using a 1- to 5-star scale, with those earning 5 stars being rated the highest. Ratings are based on how many and what type of staff members they have, how well they perform on health inspections, and how they rank on quality measures. Ratings for each measure are given individually and are also combined into an overall rating.

Starting in 2012, Nursing Home Compare will include a new measure that includes input from the nursing home residents. This new information will take the place of the quality measures that currently appear on Nursing Home Compare. Findings will be part of the ratings starting in April 2012.

Staffing and health inspection data add important information and will continue to be a factor in each nursing home’s overall rating. The staffing measure tells you the average staffing levels—such as the number of registered nurses, licensed practical nurses, and certified nursing assistants—for each resident each day. This is a good benchmark, but it has limits. It does not show the number of nursing staff present at any given time or describe the amount of care give to any one resident. The health inspection measure looks at many major aspects of care in a nursing home. This includes how medicines are managed, whether food is prepared safely, and whether residents are protected from inadequate care. Inspections take place about once a year, but they may be done more often if the nursing home has several problems to correct.

Even with so much good information, the Nursing Home Compare tool and rating system won’t answer all of your questions. For example, the ratings won’t tell you if the nursing home has improved, or gotten worse, in certain areas since it was rated. That’s why it’s important to visit any facility you are considering. Be sure to ask questions of the staff, especially people who provide care to residents. It’s also a good idea to visit a nursing home a second time on a different day of the week and another time of day. You may get a better idea of changes in staff, activities, and other factors that could make a difference in your choice.

An excellent list of questions to ask during such visits is available from a nursing home checklist (PDF File; PDF Help) by the Centers for Medicare and Medicaid Services (CMS). And a new handbook (PDF File; PDF Help) from CMS explains how to pay for nursing home care, describes residents’ rights, and gives alternatives to nursing home care. Another good resource is your State ombudsman; select to find yours.

click here to read more.

Health Care Scams are on the Rise

Click here to watch a video, from the FDA, and learn how to protect yourself or someone you care about.

Brain Injury Association of Illinois

The association’s website has many helpful resources focused on brain and spinal cord injuries.

Click here for their newsletter.

American Parkinsons Disease Association

In the current issue of their newsletter, dealing with Social Security and nutrition for someone who has Parkinson’s Disease are discussed.

Click here to read their current newsletter.

Medicare.Gov – Resource for Family Caregivers

Did you know that the website for Medicare has a section devoted to assisting family caregivers?

Click here to learn more.

Medicare.Gov – Resource for Family Caregivers

Did you know that Medicare.gov has a section for family caregivers?

Click here to learn more.

New Consumer Guide to LGBT Caregiving

New Consumer Guide to LGBT Caregiving 

Next Steps in Care, in collaboration with SAGE and SAGECAP, recently released a fact sheet that provides practical advice for LGBT caregivers.  In addition to a checklist on important legal documents, the guide also explains how hospital discharges happen, and recommends “Do not wait for the social worker on the unit to find you.  Instead, find the social worker as soon as you can.”  If a caregiver and their loved one lives near a state border or spend a lot of time in two states, the guide also recommends obtaining documents for both states since civil union or domestic partner laws may not carry across state lines. 

http://www.nextstepincare.org/Caregiver_Home/LGBT/?tr=y&auid=10020036%20

New toolkit helps baby boomers transition to Medicare coverage

New toolkit helps baby boomers transition to Medicare coverage

“The Medicare Rights Center and AgeOptions announce the release of “How Medicare Works With Employer-Based Insurance: A Guide for Employers, Professionals and Consumers-”

(By Targeted News Service, December 20, 2011)

http://insurancenewsnet.com/article.aspx?id=317345

 

Making Sense of Memory Loss – 5 Part Educational Class

 Some memory loss is normal as we age, but some older people experience more than occasional forgetfulness. What should family members know and what can they do to help someone who is beginning to experience memory loss or other difficulties with thinking?

A five-part educational program has been developed to help family members of someone in the early stages of memory loss or with early stage diagnosis of Alzheimer’s or Dementia. This special program is taught by Michaela Hoffman, MSW of Catholic Charities Northwest Senior Services and Bonnie Scherkenbach,MS, LPC of The Barrington Area Council on Aging.

The class includes the following topics:

ü Overview of Memory Loss & Related Symptoms

ü Communication Strategies

ü Making Decisions

ü Planning for the Future (Attorney Kathryn Casey will be presenting)

ü Effective Ways of Coping and Caring

 

WHEN: February 14 through March 13^th, 2012

                   Every Tuesday from 1:00 to 3:30 P.M.

 

WHERE: The Community Church of Barrington

                    301 East Lincoln Avenue, Barrington IL

 

FEE:  $15 includes five, two and one half hour weekly sessions and the book “Alzheimer’s Early Stages” by Daniel Kuhn, MSW

 

To register or for more information please contact

Michaela Hoffman, MSW at 847-253-5500 ex. 333 or

Bonnie Scherkenbach, MS, LPC at 847-852-3890

 

12 Financial Resolutions for 2012

 2012 resolutions

It’s time again for New Year’s resolutions. According to Forbes, there are 12 resolutions we should all make – and “plan your estate” is number two:

1.            Set goals;

2.            Plan your estate;

3.            Check your credit;

4.            See where your money is going;

5.            See where you can cut back;

6.            Make sure you have the right amount of insurance;

7.            Build an emergency fund;

8.            See if you can refinance your debt;

9.            Pay down bad debt;

10.          Get on track for retirement;

11.          Consider saving for education;

12.          Make sure your investment portfolio is properly diversified.

As to plan your estate, the author recognizes that we never know when we might need estate planning documents, and that these are “notoriously easy to procrastinate so it’s good to get them out of the way.”

The full article, 12 Financial Resolutions for 2012, is available online at Forbes.

………….

One of the areas that the law firm of Dutton & Casey concentrates in is estate planning. Please click here for information on how we can assist, or someone who you care about.

A Caregivers Guide to Huntington’s Disease

Huntington’s disease (HD) is an inherited disease that causes certain nerve cells in the brain to waste away.

Click here to obtain a caregivers guide, published by the Huntington’s Disease Society of America.

Caring for a Person with Alzheimer’s Disease; A Guide from the National Institute on Aging

The National Institute on Aging offers many publications, and other resources, focusing on Alzheimer’s Disease.

Click here to obtain the guide.

Chicago Lawyer Magazine Article

Partners Janna Dutton and Kathryn C. Casey were recently featured in an article discussing the increasing need for competent, and compassionate, attorneys to assist older adults and their families.

Click here to read the article.

American Parkinson Disease Association

In the current issue of their newsletter, dealing with Social Security and nutrition for someone who has Parkinson’s Disease are discussed.

How Social Security Evaluates Parkinson’s Disease

If you are considering applying for Social Security Disability Insurance (SSDI), are currently going through the application process, or have previously applied and were not approved, this article will help you to understand how Social Security evaluates each case.

Nutrition for Parkinson’s Disease

Good nutrition is important for everyone, but especially for someone with Parkinson’s disease.  A healthy diet can help people with PD achieve or maintain normal body weight, increase energy level, boost their immune system, decrease risk factors for certain conditions or illnesses, and reduce constipation

To view these articles in their entirety or to subscribe their e-newsletter, please contact the APDA Young Onset Center at (877) 223-3801 or visit www.youngparkinsons.org.  

National Council on Aging’s Resource to Help Protect Against Fraud

Top 8 ways to protect yourself from scams

Millions of older adults fall prey to financial scams every year. Use our tips—developed with the help of the Women’s Institute for a Secure Retirement—to protect yourself or an older adult you know. We’ve also included next steps to take if you think you’ve been the victim of a fraud.
Get 8 tips | See 10 senior scams |
Download our scams toolkit

click here to read NCOA’s newsletter and sign up to obtain future issues.