As a loved one continues to age, it can be difficult to discuss the inevitable long term care needs.  Both you and your loved one will likely feel anxieties and denial about her needs.  It’s important to communicate effectively so that you’re able to get her the help she needs.

Take a look at the information below to learn ways to better communicate about long term care.  If you have any questions, or if you’d like to discuss long term care options, meet with an estate planning – elder law attorney.

Encourage your loved one to ask for help. It’s important that your loved one feels comfortable asking for help and discussing her needs.  This will open the door for discussions such as long term care topics.  If you and your loved one have a comfortable relationship, she will likely feel comfortable discussing difficult topics such as long term care.

Slowly ask questions and bring up conversations. It may take your loved one some time to feel comfortable talking about her needs.  Don’t try to pressure your loved one into discussing her needs in one conversation.  It’s a good idea to spread out the discussions. You will be able to accomplish more over a more lengthy time period than in one afternoon.

Communicate with your loved one about the many options. Most seniors have fears of long term care because they assume there is only one way to get care:  the nursing home.  There are many ways to get the care that is needed such as home care and assisted living facilities.  It’s a good idea to communicate all of your loved one’s options so that she has a better understanding of her choices.

Take the time to carefully discuss this difficult topic with your loved one.  If you have any questions, or if you’d like help choosing a long term care option, consult with a qualified estate planning – elder law attorney.

Legacy APC, A Trusts & Estates Law Firm is a member of the American Academy of Estate Planning Attorneys.

If you have an elderly loved one, ensure that he is able to live comfortably and that all estate planning affairs are handled.  In other words, take the time to review your loved one’s needs to ensure that everything is being handled appropriately.  If you need help, meet with an elder law – estate planning attorney.

• Make sure that your loved one has a full estate plan in place. If your loved one has never planned, now is the time to do so.  If there is planning in place, but it’s more than 3 years old, encourage your loved one to update.

An emergency may occur when your loved one is least expecting it and you want to make sure that he is fully protected.  If your loved one loses capacity to execute estate planning documents, you will have to go to court for a conservatorship proceeding.

Talk with your loved one about his estate planning to ensure that all matters have been handled.  This can also serve to bring a greater sense of peace to your loved one as well as to you and your family members.

• Make sure that your loved one’s healthcare needs are met. Is your loved one receiving proper medical attention?  Does he or she need more medical help as life unfolds?  Discuss your loved one’s health along with your loved one and his doctor to better understand current and probable future needs.
• Understand your loved one’s long term care insurance. If your loved one has long term care insurance, it’s important to make sure that you understand all of the terms.  Now is the time to carefully review all information.
• Consider funeral planning. Taking the time to plan ahead for funerals or memorial services can eliminate much stress in the future and can ensure that your loved one’s wishes are fully respected.  It’s important to discuss this option with your loved one.

Carefully review your loved one’s needs as well as the current plans in place.  It is in both your best interests and those of your loved one to make sure that your loved one has proper planning so that he continues to be protected.  If you have any questions about your elderly loved one’s estate planning needs, consult with a qualified elder law – estate planning attorney.

Legacy APC, A Trusts & Estates Law Firm is a member of the American Academy of Estate Planning Attorneys.

We know that it’s stressful to choose a nursing home.  It’s a difficult task which can feel overwhelming.  To make things easier for you, we’ve created this punch lists of factors to consider when choosing a nursing home.

We hope you find this list helpful, but if you still have questions, consult with a qualified elder law attorney.

• Location.  Is the facility near family, friends, church, and the like?
• Finances.  Is the facility affordable?  Do they accept your loved one’s insurances?
• Certified.  Is the facility state certified?  Is the administrator certified?
• Medical.  Does the facility provide medical services to meet your loved ones needs?  What if your loved one later needs more support?  Can you loved one stay at the facility or would she have to move? 
• Facility.  Is the facility safe, well lit, attractive, clean?  Are the personal rooms comfortable?  Can your loved one control the temperature, air flow, and television in her room?
• Food.  Is there a separate dining room or are meals taken in personal rooms?  How is the quality of the food?  Is the kitchen clean?  Can a resident offer snacks and drinks to guests?
• Staffing. What is the staff to patient ratio?  How long does a resident have to wait to get help?  Will staff be readily available to take your loved one to the bathroom if assistance is needed? 
• Organization.  Are the nurses stations clean and well organized?  Are there ongoing activities and entertainment?  Is there a schedule for eating and sleeping?
• Other Services or Policies.  Are beauty shoppe services available?  Who cuts residents’ nails?  Are there other services available such as massage or reflexology?  Are restraints used?
• Contract.  What terms are in the facility contract?

If you have additional concerns about choosing a nursing home, consult with a qualified elder law attorney.

Legacy APC, A Trusts & Estates Law Firm is a member of the American Academy of Estate Planning Attorneys.

If you have elderly parents, there are likely three generations in your family that all need estate planning: you, your parents, and your adult children. For those with elderly parents, there are important estate planning considerations:

• Your elderly parents may fear losing control of their finances and their lives. Proceed with caution and great respect.

• Your elderly parents may fear the onslaught of dementia. Gently support them in getting medical treatment and having open and honest discussions with the doctor.

• Sometimes, elderly parents attempt to hide symptoms of dementia because they are afraid and/or ashamed. Never shame. Always support.

• Elderly parents often deal with depression especially if they have failing health, the loss of a spouse, the loss of friends and siblings, and the loss of independence. Depression can be treated with medication. There is no reason anyone should suffer.

• Many elderly parents should not be driving, but they are hesitant to give up their driver’s license because it is the last line of defense in losing their independence. If your parents have a HIPAA release and your are authorized to do so, speak with your parents’ doctors about the driving issue.

• Talk to your elderly parents about estate planning. Gently ask what planning is already in place. If comprehensive and up to date planning is not in place, suggest that they meet with an estate planning attorney and offer to make the arrangements and drive them.

• Gently explain that if your parents don’t have powers of attorney for health care, you can’t help them with medical decisions and a court might have to intervene.

• Gently explain that if your parents don’t have powers of attorney for finances, you can’t help them with paying bills and taking care of day to day business. If they become too ill to take care of these matters themselves, the court will have to intervene.

• Court intervention is expensive, time consuming, an invasion of privacy, and public.

If you have questions about elderly parent estate planning considerations, consult with an estate planning attorney.

Legacy APC, A Trusts & Estates Law Firm is a member of the American Academy of Estate Planning Attorneys.

We have highlighted the rising costs associated with long term care recently and they are indeed considerable. To briefly recap, the average annual charge for a yearlong residence in an assisted living facility in the United States was just a tick under $40,000 in 2010. This represented a very significant 5.2% increase over the previous year, and nursing home costs rose by nearly as much.

The national average for a year in a private room in a nursing home in 2009 was $79,935, which is certainly no small chunk of change. But in 2010 that number rose to $83,585, which is a 4.6% increase. In California this average was higher, coming in at over $100,000 a year.

Statistics indicate that the average stay in a nursing home is about two and a half years, so this is a cost that is significant and needs to be budgeted for appropriately. And remember, we are seeing annual increases, so if you are planning for long term care that may become necessary 20 years down the road the costs may well be 50% higher, and perhaps even more. If you are married your projections should be double the anticipated costs for an individual.

Stating that “one must plan ahead” for these costs is easy, but doing so effectively is challenging. Unless you are fortunate enough to be able to say with confidence that money is no object, you need to understand the options that are available to you and act accordingly.

Medicare is not going to cover these costs; Medicaid might unless you are showing too many assets. Long term care insurance in an option, but funding the premium payments can take some planning.

Your decisions with regard to long term care have a lot to do with your estate plan, because your legacy can be severely eroded if you and your spouse should incur hundreds of thousands of dollars of expenses toward the end of your lives. The wise course of action is to discuss long term care with your estate planning lawyer and address this contingency pragmatically early on so that your needs are met and the lion’s share of your legacy remains intact.

Legacy APC, A Trusts & Estates Law Firm is a member of the American Academy of Estate Planning Attorneys.

The majority of the time seniors will either use long-term care insurance to pay the cost of nursing home care, or they will try and qualify for Medicaid to help them cover these costs. In some situations it may be a good idea to use long term care insurance in order to help you qualify for Medicaid later.

One reason why someone might want to combine long term care insurance with Medicaid planning is if they can afford coverage for a certain amount of time, but may not be able to pay the premiums over the long term.

In this situation you can purchase insurance for a specific amount of time, probably about 5 years and then transfer assets during this time, either to family or through a trust created to hold these funds for family members. This will ensure that you will qualify for Medicaid when you can no longer afford your insurance premiums. With this tactic you will want to ensure that you keep enough of your assets to cover your premiums for at least five years, as well as any other expenses that you might have.

Another situation where you might considering combining Medicaid planning with long term insurance would be if you want to transfer assets from your name, but if something were happen would be unable to pay for the five year look back period that Medicaid requires. If you have long term care insurance, you will be covered until the penalty period is over and you would qualify for Medicaid.

Using a strategy of combining Medicaid planning with long term care insurance is a good solution if you have assets that you would like to protect if you should need Medicaid in the future. If you would like to using long term care insurance to supplement the five year look back period required by Medicaid, it is a good idea to talk with an attorney experienced in Elder Law and Estate Planning. An attorney can help you with your plan to ensure that it does what you intend to it do.

Legacy APC, A Trusts & Estates Law Firm is a member of the American Academy of Estate Planning Attorneys.

Talking with your parents about issues like their will, funeral arrangements, or long term care can be difficult at best. Unfortunately many people will put off having this talk with their parents simply because they don’t know how to broach the subject. This can be a big mistake for your entire family.

Here are some tips that may help you talk with your parents about long term care planning.

When should you have the talk – Although the sooner your parent has a plan for long term care the better, it is not always easy to bring up the issue. If you don’t feel comfortable doing it now, you will certainly have to do it if there is an illness or some type of emergency. Waiting for an illness or emergency will make it easier, but could make planning more difficult.

How to bring up the subject – In nearly all cases it is better to bring up the subject in a way that you are not directly referring to your parent’s future disability or death. Instead bring up the conversation by talking about your own estate planning. You can also voice your concerns about taking care of your parents when that time comes. Parents don’t usually concern themselves with their own welfare as they do their children’s so many people will take action in order to protect their children from problems in the future.

You don’t need an attorney before you have the talk – Although an attorney can advise you of your options, what you really need to do is convince your parent that they should seek out the services of an attorney to begin an estate plan.

Have patience – If you broach the subject of long term planning and your parent refuses to talk about it, try again at a later time. They may just need some time to contemplate the future and what will happen to them eventually.

Legacy APC, A Trusts & Estates Law Firm is a member of the American Academy of Estate Planning Attorneys.

As we have pointed out in this space previously the costs associated with long term care are going through the roof, and this is a major source of concern in the elder law community. The national average charge for a year in an assisted living facility in 2010 went up more than 5% to $39,516. A private room in a nursing home cost an average of $83,585 in the United States in 2010, and this was a 4.6% increase over the previous year. Industry pundits expect these costs to continue to rise, so if you are planning for perhaps twenty or thirty years from now you can expect nursing home costs to be exorbitant.

One way that you can prepare yourself for the possibility of long term care expenses would be to purchase long term care insurance. The premiums are significant, but the younger you are when you obtain the coverage the lower the cost will be.

To determine whether or not you should purchase long term care insurance you need to examine all of the relevant facts. As mentioned above, the cost of a year in a private room in a nursing home is over $83,000 a year and rising. The average stay is two to three years.

Statistics indicate that about 60% of senior citizens will need long term care of some sort, but not all of these folks will be in nursing homes incurring these enormous annual costs. Limited in-home care is much less expensive. So you may not be able to afford to pay for three years in a nursing home out-of-pocket thirty years from now, but you may not have to.

Long term care insurance is an option, and it is something to explore. If you are interested it would be a good idea to obtain some current quotes, determine the cumulative cost, evaluate the risk/reward equation and make an informed decision.

Legacy APC, A Trusts & Estates Law Firm is a member of the American Academy of Estate Planning Attorneys.

Depending on your means, planning for your twilight years can be very challenging because to put it bluntly, none of us has a crystal ball and you simply don’t know how long you are going to live. The statistics tell us that people are living longer; the “oldest old,” those who are 85 years of age and older are the most rapidly expanding portion of the American population. This is as it stands now, and medical science is making strides on a continual basis, so there is no reason to think that the numbers of people living into their late eighties and nineties won’t continue to grow.

This increased longevity makes it all the more likely that you may spend some time in a nursing home or assisted living facility at some point in time, and the financial ramifications of this are profound. MetLife does a study on the subject each year, and the numbers are trending upward with no end to the increases in sight. In 2010 the average annual cost for a private room in a nursing home was $83,585, which is an increase of 4.6% over the 2009 average annual rate of $79,935.

The cost of residing in an assisted living community actually rose even more. In 2009 the average annual rate was $3,131 per month, which is $37,572 a year. In 2010 the average national cost rose to $3,293 a month or $39,516 annually.

In the state of California as a whole the cost of nursing home care is higher than the national average at nearly $105,000 annually for a private room; in San Diego it is about $97,500. The average cost for a year in an assisted living facility in San Diego is just below $37,000, which is right around the national average.

These are some eye popping numbers and the experts say that they will continue to grow, so it is useful to keep this in mind when you are planning your legacy.

Legacy APC, A Trusts & Estates Law Firm is a member of the American Academy of Estate Planning Attorneys.

Continuing Care Retirement Communities (CCRCs) are three-level care communities for senior citizens built on the premise that you can move from independent living to assisted living to nursing care facilities (based on the state of your health), in one place. You remain close to friends you have made over the years and have many of the same staff members performing your care.

In each of the areas of this community “rent” is charged for the apartment or room you reside in. CCRCs may offer many of the same amenities as any private apartment complex, such as pools, spas and fitness centers. Newer CCRCs even offer formal fine dining facilities and coffee shops. Many CCRCs would have trouble distinguishing themselves from being a nursing home or single family home with amenities such as granite countertops, multiple bathrooms and bedrooms, whirlpool tubs and crown moldings.

A typical resident of a CCRC wants to maintain their independence, but likes the peace of mind of having medical professionals close by, if needed. Dwellings in the independent and assisted living areas of the CCRCs have emergency calls lights that can send an alert to the nursing care facility that the resident needs help.

The more amenities a community has, the higher the fees. Entrance fees into a CCRC can range from thousands of dollars to over $1 million, depending on the community’s amenities and services. Rent for an independent living area can range from a few hundred dollars a month to a few thousand. There seems to be a growing trend, however, for a facility to offer a high percentage refund of all entrance fees once a person passes away and the space is re-rented. Tax-wise, the good news is that some of the entrance fees and 25-30 percent of the monthly fees are tax deductible under pre-paid medical expenses.

Before you commit to a CCRC, shop around for the best “fit.” CCRCs each have a unique culture and can revolve around religion or even your college alma mater.

Legacy APC, A Trusts & Estates Law Firm is a member of the American Academy of Estate Planning Attorneys.