Alternatives to Nursing Homes as Nursing Home Populations Swell With Younger Patients - Part 1

We heard the other day on National Public Radio, that one of the fastest growing populations in Nursing Homes is not the elderly, but rather adults   aged 31 TO 64.

These patients that are victims of disease, accident, health failure, or mental health problems.  Many of these new patients could be cared for at home, or assisted living facilities, but are instead finding themselves in the Nursing Home System.  Young people aged 31 to 64 are the single fastest growing population of nursing homes.  This population has grown roughly 40% since 2000.

This report underscores the fundamental need for legal advocacy when considering nursing home care, or alternatives to nursing home care.

You can see the full report here.

http://www.npr.org/2010/12/09/131912529/a-new-nursing-home-population-the-young

 

All too often, people think of nursing homes as a repository for the elderly, and disability attorneys like Cohen and Oalican as being entirely elder law.  There is a huge sense of accomplishment for us, however, when  we can use our skills and help young people, and their families, to live a fulfilling life, perhaps outside of institutional care, and despite their disadvantages.  We have long been involved in special needs trusts to help protect family’s finances when there is a young (or younger) family member with special needs.

 

To be continued….

Sharing of Data Leads to Progress on Alzheimer’s Disease–Part 2

The need was for all researchers and experts to come together to work and evolve a standard data set. But how was this possible? It would entail an incredible collaboration as no one company or researcher could manage to do this alone. The project would involve 800 subjects with varying degrees of memory impairment; some normal, some with a little impairment, some with Alzheimer’s and all had to be tested for the biomarkers and then followed up for several years to judge whether the markers heralded the progression of the degenerative disease. It did seem an impossible project and one that was way beyond anybody’s implementation.

But in the car, Dr. Potter had an intuitive flash when he felt that this project due to its seriousness of objective and aim of ending untold suffering may well propel people to work together in a way that had never been attempted before. The concept was to make the National Institutes of Health the go-between or broker between the world of academia and the pharmaceutical industry. Very soon afterward the director of the National Institute on Aging Dr. Richard J. Hodes talked about this to the former scientific director at the National Institute of Mental Health, Dr. Steven M. Paul and the latter agreed to consult the drug companies to find ways of getting funding for the research. Soon it became clear that all these companies were ready to assist as the development of diagnostic methods was a gigantic task that no one could manage on their own. Collaboration was the need of the hour. Congress established the Foundation for the National Institutes of Health to find ways and means to garner private funds for the institutes. Dr. Steven M. Paul was appointed to the board of the foundation.

Ultimately, $ 41 million was given by the National Institute on Aging, $2.4 million was contributed by some other institutes, 2 non-profit associations and 20 organizations together managed $27 million and this became the initial seed money to get the project started and keep it going for the first 6 years. The National Institute of Aging advanced another $24 million last year and on the basis of further federal and private funding the foundation made plans for the project to continue for another 5 years.

In the beginning, the unique parameters of the project had many scientists worried as they wondered whether giving up ownership and sharing valuable data with all and sundry would result in anything positive at all. There could be misinterpretation, misuse and wrong information being disseminated that could do more harm than good. But despite the misgivings, all realized that there was no alternative to this collaborative endeavor. Even the drug companies, who were usually looked upon with suspicion, were roped in and everyone had to overcome this mental block, according to Dr. John Karlawash an Alzheimer’s researcher at the University of Pennsylvania.

Dr. Karlawash stresses the need to combine resources and work together. The need to find these valid biomarkers for Alzheimer’s was urgent and the entire process demanded such huge funding and massive research that it was impossible for any one company or academic institution to even think of embarking on the project. It had to be a collaborative exercise and now all concerned are making use of the data. The huge data set has been downloaded at least 3200 times and the data sets comprising images of brain scans have been downloaded almost a million times.

The positive outcome of the project has delighted Dr. Buckholtz who says that he is quite “pleasantly surprised” by the way it has turned out. No one was sure how this innovative concept of sharing everything in the public domain in a research project would evolve, but they were confident that ultimately there would be some good coming out of the hard work and combined research. That is how it has turned out to be and it has kindled new hope for the conquest of these diseases.

Could someone you love have Alzheimer’s? Do you have a long term plan to deal with the Medicaid issues surrounding this? Call Cohen & Oalican, LLP to draw up a plan.

Elderlaw and reverse mortgages - Cohen & Oalican., LLP

In our last blog we mentioned a New York Times series focusing on retirement. These articles serve to raise awareness and to inform people of the importance of making financial decisions based on their specific needs and Medicaid Planning. The most recent article in the series dealt with reverse mortgages. As many of you may know, a reverse mortgage is a loan with a bank, where the bank pays the homeowner either monthly or in a lump sum, compared with a typical mortgage where the homeowner makes monthly payments to the bank. For some clients a reverse mortgage can be a terrific estate planning tool to make funds available to keep an elder in their home. However, the New York Times points out that reverse mortgages are not appropriate for everyone.

Reverse mortgages have very high closing costs, sometimes as high as eight percent of the loan. Questions consumers should ask to determine if a reverse mortgage is their best option:
How long do you plan to stay in your home? If you plan to stay home for just a couple of years, other kinds of loans might make more sense.
What do you plan to use the money for? If you are using the money for a vacation or plan to invest the funds, do not proceed with a reverse mortgage.

If you have any questions pertaining to Medicaid, guardianship, conservatorship or other elder law issues, please feel free to contact us Cohen & Oalican, LLP

Facing the Realties of Long-Term Care

Cohen & Oalican, LLP; Medicaid, MassHealth and Elderlaw Attorneys in Boston, Andover, Raynham.

On Thursday, October 23, 2008, the New York Times included a Special Section entitled "Retirement" containing a number of interesting and informative articles. Given the present financial crisis and the resulting uncertainties we face, it is more important than ever to be well informed about financial and legal issues which may impact our families and to do some medicaid planning. We encourage you to read these articles as well as other articles which impact seniors at the New York Times website.
"Young Workers Must Face Realties of Long-Term Care" focuses on the the need for baby boomers, many of whom are caring for elderly parents, to consider their own potential need for long-term care in the future. Faced with the rising costs of nursing home residence and the present economic crisis, this article answers basic questions concerning long-term-care insurance: when to buy coverage, where to buy coverage, how much coverage is needed, etc. The full article can be accessed at the following link: Article.


This series, brought to you by Boston Attorneys Cohen & Oalican, LLP, specializing in Guardianship and Conservatorship Attorneys in Boston. Posted by Elder Law Boston Lawyer

What are the alternatives to guardianship or conservatorship?

There are several less restrictive alternatives to guardianship or conservatorship. These include the durable powers of attorney, representative payees, trusts and health care proxies. Each of these options may avoid or delay the need for a guardian. These documents need to be executed before the individual is incapable of doing so due to mental impairment.

This is a series, brought to you by Boston Attorneys Cohen & Oalican, LLP, specializing in Guardianship and Conservatorship Attorneys in Boston. Posted by Elder Law Boston Lawyer.

What are the responsibilities of the guardian or conservator?

In addition to those concerning authority to consent to medical treatment, the guardian must report back to the court regarding the ward’s care and living situation. The conservator must account carefully for all of the ward's income and any expenditures made on this or her behalf. This is accomplished by the conservator filing an inventory listing the ward's assets with the court as of the date of appointment and by filing annual accounts with the court detailing all the income and expenses the ward has. A final account must be filed when the conservatorship is terminated. The guardian and conservator are liable for their acts until the court allows (approves) the account.

This is a series, brought to you by Boston Attorneys Cohen & Oalican, LLP, specializing in Guardianship and Conservatorship Attorneys in Boston. Posted by Elder Law Boston Lawyer.

What authority does the guardian or conservator have?

Unless limited by the court, the guardian has total control over the personal decisions of the ward and the conservator has authority of all financial decisions. This includes deciding where the ward will live, determining how the ward's funds will be spent and making routine medical decisions for the ward. For medical decisions involving extraordinary medical care, nursing home admission, the administration of anti-psychotic drugs, commitment to a mental health facility or the sale of the ward's real estate, the guardian has to seek the approval of the court in a separate proceeding. The conservator must seek court authority to make any gifts or to implement an estate plan for the ward.

This is a series, brought to you by Boston Attorneys Cohen & Oalican, LLP, specializing in Guardianship and Conservatorship Attorneys in Boston. Posted by Elder Law Boston Lawyer

How long does an appointment as Guardian or Conservator last?

A temporary appointment can last 90 days. A permanent appointment may last until the death of the ward or the guardian, until the ward is able to establish that she is competent, or until the guardian or conservator resigns or is removed by the Probate Court.

This is a series, brought to you by Boston Attorneys Cohen & Oalican, LLP, specializing in Guardianship and Conservatorship Attorneys in Boston. Posted by Elder Law Boston Lawyers