John Boden

Incapacity Can Happen

We are the captain of our affairs and know how to operate them and keep our ship on course. If you expect everything to continue working when you no longer can, you better have someone trained and qualified in the intricacies of your affairs, ready and able to step in. This does not mean someone with their name on a piece of paper in a bank vault who has no idea about how your ship floats.

One of the most effective tools to accomplish this is a Revocable Living Trust, an estate planning tool in use for many, many years. A lot of us are not aware of it as it is usually used for larger, more valuable estates. A very simple illustration is that it is like setting-up a corporation, of which you have full control that will own your assets. Since it is also very effective before you die if you become incapacitated, it is a shame it is not used more often as it can greatly simplify the process of having someone take over.

There is a lot of information in circulation about Revocable Living Trusts being great estate and financial planning tools. Some of the information is accurate, some is unreliable, and some is just plain wrong. So I would like to start with saying that the advice and counsel of a well qualified attorney is required to assure your desires are met, that no harm is caused, and that all other needed documents, such Living Wills and Power of Attorneys, and Pour-Over Wills are also provided.

After you have all of the proper documents you must also take all required steps to make it operational in the real world, which is referred to as "funding the trust". A bad document or a good one improperly put into effect or no legal plan at all can turn into a nightmare. One version of that nightmare is guardianship or appointment of a conservator, with the court making the decisions about you and your affairs.

From the point of view of a caregiver, I see the greatest value of a trust as providing the tools to operate the affairs of an incapacitated person in a way that is both effective and requires only a reasonable amount of effort. If someone needs to start their duties as trustee or as attorney-in-fact from scratch in the midst of the often accompanying health and emotional crisis, they may very well become overwhelmed and ineffective. For your well being and to minimize the intrusion you will cause if you should become incapacitated, you should involve your trustee in your affairs now even though there may be no present need. Including them in the process of making a trust operational is an excellent place to begin. Show them where things are kept, introduce them to the medical, financial and legal professionals you work with, and help them to comply with all the administrative requirements that banks, brokerages, insurance companies, etc. will demand.

In short, get those who will be taking over from you onto the bridge of your ship and show them how to navigate. For more general information on trusts see here.

BenefitsCheckup.org helps older Americans locate benefit programs

The National Council on Aging (NCOA) provides a web site called BenefitsCheckup.org that can help older Americans determine if they are missing out on benefits. The site helps older Americans find out about federal, state and local assistance programs for the aged.

Caring for an elder relative is not only a lot of effort, emotionally and physically, but it can also have a major financial impact on the elder, and their family, as well.

Money is an important ingredient when looking for caregiving choices and more of it is better than less. Options for help with caregiving may be free or may cost many thousands of dollars per month. Free sounds like the way to go and services such as meals-on-wheels, transportation, visiting nurse, homemakers, to name some, may have programs in your area. However it is often the case that so many people need the service that the waiting list will be so long that it is effectively not available. This is why agencies that charge abound. Without them I do not know how millions of our elders would cope.

There are a myriad of programs and agencies that have assistance available. Medicaid and SSI are two huge and well-known Federal programs. But many of us who have worked hard and saved for decades will not meet their strict income and asset limitations. So what are we to do? It is impossible be an expert about what help is available because there are so many programs, and so much variance from area to area, that being effective when searching on our own is very difficult, if not impossible.

The National Council on Aging has realized the magnitude of the problem and has come up with a very easy-to-use tool that can effectively guide us in the search. The BenefitsCheckup.org web site can help you to become a benefits expert for your loved one. The site will not ask you to identify yourself or your loved one but it will ask for a lot of information, and I mean a lot. But please do not let this deter you. The BenefitsCheckup system will digest all of the information you input, and then compare it to federal, state, local, and private resources for which your elder may be eligible.

As professional care mangers, we, on many occasions, found assistance that added up to more than $2,000 a month in value. Of course this is not typical, but it is often typical to find some assistance that will be a help.

Go to www.benefitscheckup.org to learn more about how to find out what assistance may be available to help you.

Medicare Part D

Many people think the D in Medicare Part D is for Disorder, Distress, Disarray, and Discouragement.

You have read about it and seen it on the news, so you know there are issues with the plan. However it will not really strike home for you until an elder in your life asks for your help and advice We are often lulled into believing it’s harder for older people to grasp new things; and we have been able to help them in the past to use the new phone, the remote control, and microwave oven. Medicare Part D looks just like any other obstacle, so we will be able to help with this too, no problem. You will be surprised at the challenge you will meet.

This new program will bring to your knees, make you pull out your hair, and bring you to tears. To illustrate what I mean, read this excerpt from Medicare explaining how Part D works, and see if you can make heads or tails of it.

After you pay the $250 deductible, here's how the costs work;

• You will pay a monthly premium (varies depending on the plan you choose) then the first $250 per year for your prescriptions. This is called your "deductible."
• You pay 25% of your yearly drug costs from $250 to $2,250, and your plan pays the other 75% of these costs, then
• You pay 100% of your $2,850 in drug costs, then
• You pay 5% of your drug costs (or a small co-payment) for the rest of the calendar year after you have spent $3,600 out-of-pocket. Your plan pays the rest.

Sure! Who couldn’t easily understand something written as clearly and simply as that. I however must admit that I have given up on trying to understand how it works or to answer the many questions I get.

But that said; this is a real benefit and hope is available. There is a way to pick a program that will benefit your loved one even if you don’t understand all the ins and outs of the program

In December, Medicare placed a tool, on-line, to help you choose a plan that will best suit an individual’s situation. It will guide you step by step and allow you to enroll directly into the plan that is best. Use the link above and be connected now. And while you are at it, show the list to the doctor and ask if all the medications are needed and safe to be taken together. You can also try using the drug checker in the links provided. Good Luck

Learn more about Medicare part D

Enroll in Medicare part D

Asking for Advice

It seems obvious to most that if they have a medical problem they should see a doctor; a legal problem, a lawyer; and if your car won't start, a mechanic. If you are having caregiving problems there are also experts available to help.

Learning by experience works, but not as well as learning from the experience and expertise of others. Very often, we don't even know the questions we should be asking, what help is available to us, or even the actual needs of our parent. The first step is to admit that we are not expected to know all the answers and that asking for advice is the wise thing to do. Now that we have set the right mental attitude we can seek out the advisors we need.

Okay, I admit it. I need advice. So what do I do now? Start my making a list of your concerns. When you are able to figure out, and write down the first question, you will find that many more will come to you, and the list will soon grow. With your questions in hand, you can begin the search for advice.

The best and most comprehensive advice can be found by using the services of a Geriatric Care Manager (GCM). A nationally certified GCM will be thoroughly familiar with all aspects of caregiving. They will begin by doing a comprehensive assessment of your parent's status and their needs. A GCM will know, what resources are available in your community and will help you build a care plan that will be best suited to your particular situation. They will be able to refer you to other professionals, whose services may be needed such as elder-law attorneys, doctors, or home healthcare.

GCMs normally charge between $95and $125 per hour for their services. If you are able to make an investment of a few hundred dollars, you will enjoy ongoing savings and better care, now, and well into the future.

You can locate a GCM in your area by going to the National Association of Professional Geriatric Care Managers locator at www.caremanager.org. You can also call the Eldercare Locator at 800-677-1116. In many areas, you can contact your local Eldercare Locator directly by dialing 211. The phone advisers will be helpful in identifying resources for services and information Try looking in the Yellow Pages. A good starting point is Senior Citizen Services.

Medical Explanation Confusionitis

I used to suffer from this dreaded affliction almost every time I spoke with a doctor. I would become dizzy and confused. My brain would skip a synapse or two. By the way, synapse, used to be a word that brought on a serious case of confusionitis until I applied my home remedy.

I continued to suffer from insidious bouts of confusionitis for a number of years, until I developed my sure fired cure. The cure is very easy to apply. Just say WHAT?

I now always stop and ask what is meant whenever a doctor or nurse uses a word I do not understand. But I also do one more thing that has repeatedly helped me avoid being reinfected. I ask them to spell the confusing word, diagnosis, medication, etc. while I write it down. Then when I have a moment to digest what I have heard, I ask the smartest friend I know, my computer, to help me to learn and to understand what I have been told. The only demand a computer makes of me is a correct, or almost correct, spelling of the question I ask of it, thus the reason I need to write down those long and confusing words.

I have found another great benefit from my cure. If I use the complicated word when speaking with someone, and they know what I am talking about, it is great indication that what they have to say may be of actual value

To apply the home remedy you will need a pen a paper and a few sessions alone saying Excuse me, what does this, that or the other mean? Repeating this phrase 4 or 5 times will usually be sufficient training.

I give you one caution about which you should not be overly concerned, and that is, the doctor having to check for the correct spelling themselves. Just because they know how to say it, what it means, and what to do about, does not necessarily insure they will know how to spell it correctly.

For more tips on how to communicate with your health care providers check out the article on Better Health Care Visits in the ElderIssues.com online library.