Walnut Creek Elder Law Blog

I can’t help myself talking about our grandkids, at least one more time. My wife and I have two grandchildren, a boy 4 and a girl 2 ½. Both kids “stayed over” a couple of weekends ago. They arrived on Saturday morning with their little suitcases packed, which included their swimsuits. They wanted to swim with us in our community pool, but that plan was thwarted when we found out the pool pump was broken.

We felt horrible, and did not have a little pool for them. What we did have was a large plastic storage container, which held about 20 gallons of water. We also had large and small “Super Soaker” squirt guns, and Grandma had all sizes of plastic measuring cups. The kids put their swim suits on, filled the storage container with water, and climbed inside the container! They played with the hose, the squirt guns and the measuring cups for hours. Every once in awhile they would climb out of the container and lie on their towels in the sun to dry off. When they were dry they would climb back into the container and have more fun! I guess we don’t really need a pool, but I am off to Target to find something for them to use at our house.

There is probably no legal point to all of this, (other than to include your grandchildren in your estate plans) but I just had to share with you how fun it is being grandparents!  

Written Michael J. Young, lawyoung1@gmail.com, elder law attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc.

This information is not to be taken as legal advice, and you are encouraged to see an elder law attorney for professional advice.

When I was younger and people started to talk about their grandchildren, I would practically plug my ears. Now that we have two grandchildren, ages 4 and 2, I am the one who can’t stop talking about them.

So, since I can’t stop myself, I must tell you a story about my granddaughter, Edie. She will be 3 this coming September. Grandma and I were watching both grandchildren a few weekends ago, and Edie was on my lap. I was opening a package that came in the mail, and when I opened the package, bubble wrap came out. My granddaughter said to me, “BaPa, cut a small piece for me.” So I cut a small piece for her and said, “Like this?” She said, “Yes, not pop it! Pop it! Pop It!” I started to pop the little bubbles for her, and she couldn’t stop laughing. It made me laugh that she was laughting, and I was also laughing at how this little girl could give me orders which I would immediately comply with.

I felt like my life was made at that moment. My granddaughter and I were both happy and laughing. I was also astonished that this little girl at age 2  1/2 would know about these things and could tell me what to do like that! I just can’t imagine that other grandchildren are that smart. (ha ha)

I hope you didn’t plug your ears. Thank you, BaPa, Mike Young.

Written Michael J. Young, lawyoung1@gmail.com, elder law attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc.

This information is not to be taken as legal advice, and you are encouraged to see an elder law attorney for professional advice.

Most (perhaps 99%) of all revocable living trusts and financial durable powers of attorney are defective for asset protection and government benefits planning, when incapacity occurs.
 
For the older client, we become focused on how we will pay for in-home care,  board-and-care, assisted living facilities and skilled nursing home costs. We are concerned about how to make our assets last longer for our own care. We want to protect assets, and we would like to hopefully leave something to our loved ones.
 
We become concerned with how to qualify for and utilize Medi-Cal  and VA benefits for our care. 
 
The standard language in the revocable living trust and financial durable powers of attorney do not allow for asset protection, protection of the home from a Medi-Cal lien, transfers of assets between spouses (including the home), transfers to children or to other trusts for government benefits planning, if incapacity occurs.
 
Updating the revocable living trust and financial powers of attorney  before incapacity occurs is good planning. 

Written Michael J. Young, lawyoung1@gmail.com, elder law attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc.

Most estate planning documents are prepared for what happens when we die. They are not prepared for what happens if we don’t die. With regard to the trust, if one spouse dies, for instance, everything goes to the other spouse. When the second spouse dies, everything goes to the children. During the lives of the spouses, all assets stay in the trust. If any gifting is allowed, it is not to exceed $13,000 per year per child. If there is no trust, the financial durable power of attorney will usually not provide for any gifting or asset protection.

But what if we want to do Medi-Cal or VA Aid & Attendance Benefit planning, and the makers of the trust or the makers of the financial durable powers of attorney have lost their mental capacities. For this planning, we at times will transfer assets, including the home,  from the ill spouse to the well spouse. We might also make transfers of various assets from parents to the children or to other loved ones.  The language to do this type of planning, 99% of the time, is not included in the typical estate planning documents. If the makers of the documents have lost their mental capacities, we cannot do this planning, and may have to go to court to reform the documents. As a result, long term care planning should include updating the estate planning documents to include government planning and asset protection language.

This blog is for informational purposes only and is not legal advice. You should consult an elder law attorney for your particular case, and before you proceed with any planning.

Written Michael J. Young, lawyoung1@gmail.com, elder law attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc.

     Medicare is a Federal health insurance program. Social Security funds are used to pay the costs of the program. Individuals who are over the age of 65, and who have made Social Secuirty contributions during their working lives are entitled to benefits. Part A of Medicare pays for hospitalization, hospice and some health care. It also pays for rehabilitation in a nursing home for specific periods of time. Part B is designed to pay for outpatient hospital care and doctors’ visits. Co-payments, deductibles and monthly payments may be required for Part B.  

     If a person is hospitalized for three days under Medicare, and then goes into a skilled nursing facility (SNF), Medicare will pay pay 100% of the bill for up to 20 days in the SNF. After that, for days 21 to 100, Medicare will pay only for 80% of the cost. During this time, the Medicare recipient will be required to make a co-payment, through supplemental insurance or will pay privately.

    After 100 days, there is no Medicare coverage for a SNF. After that time, you must pay privately, pay through your long term insurance policy (if  you have one) , or qualify for Medi-Cal to pay for the SNF. The average stay in a SNF under Medicare is under 24 days. Medicare and Medi-Cal are two different programs, and are not related to each other.

     Planning for Medi-Cal qualification should be made early on, through your elder law attorney. There are qualification requirements with regard to assets, income,  spending down, gifting, and a share of cost which goes to the the nursing home. There are legitimate and legal methods through the Medi-Cal regulations to protect assets and create qualification for Medi-Cal. You may visit our web site at htt://WalnutCreekElderLaw.com, for information on how to plan for and how to qualify for Medi-Cal. The estate planning documents, including the financial durable powers of attorney and revocable living trust are usually updated to include government benefits and asset protection language. If a client loses mental capacity, and this language is not present in the estate planning documents, qualification for government benefits, including Medi-Cal, and asset protection is much more difficult.

 Written Michael J. Young, lawyoung1@gmail.com, elder law attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young, who also advises on Medi-Cal qualification, asset protection, nursing homes and the VA Aid & Attendance qualification, serves Contra Costa and Alameda Counties in CA, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc.

When choosing an assisted living facility for a loved one who suffers from dementia, certain things should be taken into account regarding the facility. More and more assisted living facilities can now accommodate residents with various levels of dementia. Some facilities have separate wings or dementia units. I have visited many assisted living facilities, and have many clients with loved ones in assisted living facilities. In addition, I have made personal observations about the quality of care for persons with dementia in these facilities.

Music: My wife’s mother, who is 89, has advanced Alzheimers disease, and has been in an assisted living facility for a number of years. Although she does not seem to recognize her children, she does respond very positively to music. When music is played for her, or if someone performs or sings for her, her face lights up. She smiles, and tries to sing. I have noticed this for many residents with dementia, when I have played jazz piano for them in various facilities. Also, on researching the subject, it seems that music is processed and understood through a different part of the brain, usually with positive results.   As a result, find out if the facility you are interested in arranges for music to be played or performed for the residents on a regular basis.

Religious Services: Another item to take into account, is whether the facility is consistent with your religious beliefs. If the resident and family are religious, it will be important for them to have the facility provide religious services for their loved one during all phases of dementia. When my father, who was Catholic, was in an assisted living facility,  I know that he cherished receiving communion every week.  

Behavior: Find out whether the facility will be able to accommodate your loved one during all stages of the disease process. Plan for the future, as the disease may progress and become worse. Ask the facility what behaviors would trigger them to say that they can no longer accommodate your loved one. Also, ask how they would handle the behavior of your loved one if he or she becomes aggressive, loud, or acts out. You will find out more if you are very specific.  

 Written Michael J. Young, lawyoung1@gmail.com, elder law attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young, who also advises on Medi-Cal qualification, asset protection, nursing homes and the VA Aid & Attendance qualification, serves Contra Costa and Alameda Counties in CA, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc.

Parkinson’s disease is a brain disorder, wherein certain nerve cells in the brain become impaired or die. These nerve cells, called “neurons” normally produce a chemical known as dopamine. This chemical allows for smooth, coordinated functions of the body’s muscles and movements.

When a high percentage of the brain cells which produce dopamine are impaired, symptoms of Parkinson’s disease may appear. Symptoms may include tremors, changes in facial expression, imbalance, small handwriting and slowness of movement. In time, the symptoms may become worse. Mild tremors can become more severe. Body movements may also become slower, and mobility problems may become worse. The use of eating utensils, dressing, and performing various activities of daily living may become more difficult.

Parkinson’s disease, which is difficult to diagnose officially, affects both sexes in equal numbers, and does not discriminate on the basis of ethnicity, social status or where you live. There are different rates of progression for the disease. We encourage our clients who have Parkinson’s disease and their familiy members to seek the help of support groups, to pursue ongoing medical care, and to learn adaptive techniques from medical professionals.

 Parkinson’s disease is the most common brain disorder, after Alzheimer’s disease, that we see with our clients. When symptoms of Parkinson’s disease appear, as with symptoms of Alzheimer’s disease, we receive inquiries from individuals who may have the disease, or from their loved ones. They want know what should be done now regarding the establishment of a long term care plan for the person with the disease.

We help clients review and update their existing estate planning documents, to be sure the documents contain the requisite asset protection language. We then help the family plan for long term in-home care, which is the preference of most of our clients. We help the family plan for the VA Aid and Attendance benefit, which can help pay for in home care, for veterans. We also help with planning for Medi-Cal benefits, which can pay for nursing home care.   

 If you or a loved one has symptoms of Parkinson’s disease, please feel free to call elder law attorney Michael J. Young, with offices in Walnut Creek, CA, at 925-256-0298. Mr. Young serves clients principally in Contra Costa and Alameda Counties. You can visit our web site at www.WalnutCreekElderLaw.com

The Law Offices of Michael J. Young Present An Elder Law Seminar – “DON’T GO BROKE IN A NURSING HOME” – “How To Get Medi-Cal Coverage For Your Nursing Home Care … Without Selling Your Home or Leaving Your Family Without a Dime”

In the Workshop Learn How to get Medi-Cal coverage for your Nursing Home Care, Without Selling Your Home or Leaving Your Family Without a Dime. One of our biggest fears is having our life savings wiped out if we end up in a nursing home. Whether you or a family member is in a crisis or not, it is important that you understand what to do now to protect your hard-earned assets.

Also, learn about the Veterans Administration Aid & Attendance Benefit, for war time veterans. This V.A. program can help pay for in-home care, board and care costs, and costs for assisted living facilities.

At this workshop, here are some items we will discuss:
How to protect your home against a Medi-Cal lien.
How to avoid having your life savings wiped out by a nursing home spend down.

The asset protection language that most people do not have in their revocable living trusts and financial durable powers of attorney.

The Veterans Administration Aid & Attendance Benefit.
A glimpse at the new Medi-Cal rules under the Deficit Reduction Act, which is coming soon to California

Attendance at this workshop is free, but seating is limited. You can reserve your spot at the workshop by calling (925) 256-0298.

We will also be distributing our Alzheimer’s Legal Survival Guide, and our Nuts and Bolts Guide to Veterans Benefits.

Please check the website for seminar dates.

It is not a requirement that the Veteran purchase an annuity and/or sell his home in order to qualify for the VA “Aid and Attendance” benefit. And, in the majority of cases, neither is necessary. An elder law attorney who deals in this area of planning, will in most instances be accredited by the VA to file claims for their clients. We receive calls from family members who complain bitterly that they sold their parents’ home and bought an annuity at the advice of someone, to obtain qualification for VA benefits. They find out later that the purchase of an annuity and sale of the home were both unnecessary. The Veterans Administration has a non-service connected benefit available as a potential source of funds to help pay for long-term care costs for the disabled veteran who is at home or in an assisted living facility. It is a program called “Aid and Attendance”, and is available for Vets who are disabled due to the issues of old age, such as physical disabilities, Alzheimer’s, Parkinson’s or multiple sclerosis. The Vet needs to show that he is in need of regular aid and attendance on a regular basis. Needing help with various “activiities of dailly living”, is a good measure of the test. A Vet who is housebound or in an assisted living facility and who is over 65 is presumed eligible for the benefit. A Veteran can receive up to $1,801 per month, and a widow or widower can receive up to $976 per month. There are asset and income requirements. When planning for VA benefits, you must also plan for Medi-Cal benefits at the same time. There is no “look back period” for gifting under VA rules, but there is a “look back period” under Medi-Cal rules. A big transfer of assets to create eligibility for the VA benefit could make the older person ineligibile for Medi-Cal benefits. The home is exempt for qualification under both benefits, so there is no need to sell the home. The home can be protected, however, from a Medi-Cal lien after the death of the recipient. The purchase of an annuity to create eligibility for VA benefits, could make the older person ineligible for Medi-Cal benefits. The annuity may not fit within Medi-Cal guidelines, and could be treated by Medi-Cal as a transfer of assets. Moreover, and more importantly, although not all annuities are bad or unnecessary, the purchase of an annuity, may not be necessary at all. When seeking help to obtain the VA benefit, ask if the person helping you has VA accreditation to file claims. A fee cannot be charged for filing a VA claim, and elder law attorneys will pursue the claim on a pro bono basis. Usually, the VA benefit is only part of long term care planning for the elder client, which will also involve asset protection, disability planning and Medi-Cal planning. Before purchasing an annuity, or any product as part of VA planning, and certainly before you sell the home, it is good advice to contact an elder law attorney for a review. You can see more on this subject in several of my Elder Law Today newsletters as follows: A VA Benefit for Long Term Care Pt. 1 – And to be 85 Again”>A VA Benefit for Long Term Care Pt. 1 – And to be 85 Again VA Benefits May Cover the Cost of an Assisted Living Facility or In Home Care A VA Benefit for Long Term Care Pt. 2 – And Back to Work After the War You can see additional information on this and other subject at my website at WalnutCreekElderLaw.com.

An elderly client of mine died recently. When she first came in to see me, she was in her early 80′s. She was quite frail physically, but very with it mentally. She brought her three children with her. Fortunately, she still had good mental capacity, so we were able to amend her revocable living trust and durable power of attorney to add good asset preservation and elder law language. At the first meeting, we discussed what steps we could take now, to preserve assets, in case she were to go into a nursing home and she wanted to apply for Medi-Cal. One of the children said that they should wait. My client then looked at me and said, “Mr. Young, I don’t think I am getting any better. Also, I know I am not getting any younger. So, I think we should start now.” I will never forget that moment. I think she was signaling to her children to pay attention to the fact that action should be taken now. We should take action with our estate plans and elder care planning, preferably when we are younger and better. Take a look at one of my Elder Law Today Newsletters where we discuss this issue at: http://walnutcreekelderlaw.com/Newsletters/EarlyDiagnosisOfDementia.html Also, you can find additional information on this and other subjects in my website at http://walnutcreekelderlaw.com/ . Thank you,
Michael J. Young, Elder Law Attorney.