Elder Abuse, a growing crisis without leadership–Part 3 of 3

 

So who is responsible?  The Administration on Aging & Health and Human Services are supposed to be providing the leadership services to put this problem in the spotlight where it can get the resources it needs to support our seniors.  The Elder Justice Act of 2009 makes grants available to states for Adult Protective Services Programs.  The Act also puts forward the means of creating, and implementing national priorities.  The Act, however, does not speak to national Elder Abuse Studies.

The report recommends that no less than The Secretary of Health and Human Services should determine the importance of providing Adult Protective Services with dedicated resources, and work with the Attorney General to create and deploy a national Adult Protective Services database so that the true measure of this problem is understood.

It is our firm’s hope that once properly understood, and the real depth of elder abuse comes to light, and thereby appropriate resources will be finally granted to the states to stop this horrible crime.

The report does seem to point to a need for better information, better cooperation, and better standards.  However what the elder community needs is real support.

With big government’s seeming paralysis to act on almost 50 years of “good intent” the need for legal representation, specializing in Elder Law is very obviously paramount.  While the firm of Cohen & Oalican deplores the need for protection for the elderly, the rising tide of abuse, in share numbers and sophistication makes it obvious that qualified legal counsel needs to be retained to help protect our more vulnerable population. 

Please, if you are a victim of abuse, don’t hide it, seek out help from law enforcement, and with an attorney.   If you haven’t been a victim of elder abuse, engage the services of an elder law firm to help you in decisions where you might be vulnerable.

 

Abuse and neglect should be important to all of us. Contact the elder law offices of Cohen & Oalican to talk to us. A loved one in your life may be the victim of nursing home abuse and neglect. An attorney can help you understand the law and what to do next

Alternatives to Nursing Homes as Nursing Home Populations Swell With Younger Patients – Conclusion

Our current health care reform has several provisions to incentivize states to expand at home care, but there is still a strong “institutional bias” that requires states to fund nursing homes, but makes the payment of nurses for at home care optional.   Despite the savings, participation in  a new Federal pilot program that promotes at home health care is optional for states.

Another trend that has been found is that the population in nursing homes is changing to those who are either sicker, or more economically disadvantaged.   Those with the ability to pay, are moving to assisted living facilities.  Those who do not have as great a medical need (i.e. Healthier, but still in need of assistance) are also better served in more independent living facilities.  This new movement creates a nursing home population that is more disadvantaged both from a medical and a financial perspective.

NPR reports that “By federal law, people who face going into a nursing home must be told about alternatives. But in Miller's study in one state, nearly 30 percent of younger people in nursing homes said they weren't told about options. Often doctors and other health care providers just don't know what's available — and recommend a nursing home instead.”

Many times, when younger people chose to not to into a nursing home, it is at the expense of family members.  These family members provide care at no cost to the state.  While the state gets a free pass, the care giver family members can bear a huge burden in terms of  health, time and stress.

There are alternatives for many younger people to nursing home care.  With an experienced legal advocate by your side, you can also consider independent living facilities.  Many severely disabled people still live full and rich lives, not even in a facility, but with at home care.  It will frequently take an experienced attorney to protect your rights, and to help you determine what care is most appropriate for your situation.

 

We welcome hearing from you if you or a family member has special needs, and is looking for alternatives to nursing homes, or looking for ways to protect your family financially from the costs of long term care.

Call one of elder law attorneys at Cohen & Oalican, LLP Boston, Andover and Raynham.

MEDCottage or Granny Pod–Part 2

The actual name for the “granny pod” is MEDCottage and it is a type of mobile residential unit that can be rented on a monthly basis. It can be parked in your backyard, you can connect your water and electricity to the unit and it transforms into an independent room for your elderly relatives. This innovative concept is becoming quite popular all over the country, especially in the state of Virginia where the zoning restrictions have been relaxed for these hi-tech homes by the government, which are expected to be available next year.

The MEDCottage has vinyl siding on the exterior and French doors with a white trim around them, while the interiors are fully equipped with a comfortable suite of rooms, with a kitchen and toilet. In short, the MEDCottage is a complete home in itself with all amenities needed to live a safe, comfortable life and ideal for the elderly.

What makes the MEDCottage even more suitable for the elderly is that inside the unit there is state-of-the-art health monitoring equipment and a lift to take an incapacitated person from the bedroom to the bathroom. There is also a camera installed just a foot above the floor that is adequate to view the person’s feet, so if he/she fell down it would immediately be seen. It has been estimated that falls in the home are one of the primary reasons elderly people have to be taken to hospitals and nursing homes, so having this “Feet Sweep” camera would be a big help in the timely assistance in case of such accidents. In addition to these useful conveniences, the MEDCottage has lighting along the floors that would help the elderly in easy movement around the unit. There are monitoring systems that offer regular updates on the medical status of the occupant, like heart rate and temperature and also provide information about medicine intake and other details.

The thought of relegating your older relative in a separate unit in the backyard may not sit easy with most people, but Rev. Dupin says that it is in line with the independent nature of most Americans. The space of the MEDCottage with the family and yet apart is symbolic of American self-reliance and independence. It is not that we can declare loudly that we do not want our older family members in our home, but neither would they wish to live with us. The MEDCottage is an acceptable alternative where the elderly are near their family but are not stepping on anyone’s feet in the process. It is a wonderful way for the older generation to remain part of the family, enjoy the company of their grandchildren and feel safe and content, without being any sort of a burden on others.

Rev. Dupin does not think that his parents would be living in a “granny pod” but certainly visualizes a future where he might be living in the backyard of one of his children.

 

Call one of elderlaw attorneys at Cohen & Oalican, LLP Boston, Andover and Raynham to see if this fits into your  long term care plan.

Superior Court Upholds MassHealth Applicant's Sale of Property to Daughter: A Summary of Clark v. Dehner

Overview

The implementation of the Deficit Reduction Act (DRA) has made it increasingly complicated for families to protect their assets from the high costs of long-term nursing home care. Many planning options were curtailed by the DRA, and state Medicaid agencies are implementing the revised rules at a disadvantage to families seeking government benefits. However, a 2009 Massachusetts Superior Court decision has validated a planning option involving the fair market value sale of assets to family members.



Background

In May of 2005, George and Susan Clark established the George E. & Susan Clark
Irrevocable Trust. They were named as grantors and trustees of the trust. George and Susan transferred title to their home located in Marshfield into the trust on the date the trust was executed. The home's value at that time was approximately $412,000. The trustees of the trust were to hold the property for the benefit of George and Susan's children, Michelle Dionne and Kerri Poole. This transfer disqualified George from MassHealth benefits for a period of fifty-two months beginning on the date of the transfer.



In August of 2006, George entered the Walden Nursing Home, a long-term care facility. He suffers from a degenerative condition called Pick's Disease. As George's date of admission was during the aforementioned fifty-two month ineligibility period, an alternative planning strategy was implemented. This strategy involved curing the original transfer through the sale of a partial interest in the home using a promissory note and mortgage executed between Susan and Michelle.



Promissory Note

The MassHealth regulations allow applicants for long-term care to sell assets through the use of a promissory note and mortgage if the following conditions are met: 1) the repayment of the note is actuarially sound, 2) the promissory note provides for equal payments during the life of the loan, 3) the promissory note prohibits cancellation of the balance on the death of the lender. See 130 C.M.R. 520.007(G)(3). The regulations do not specifically prohibit such transactions from occurring between family members, as long as the sales are for fair market value and meet the above requirements. However, in recent years, MassHealth has taken the position that such transactions between family members are not reasonably enforceable, and therefore should be treated as disqualifying transfers.


George submitted an application for Medicaid benefits on October 31, 2007. Although the promissory note executed between Susan and Michelle satisfied all of MassHealth's regulatory conditions, as described above, George's application for benefits was denied. The hearing officer determined that Michelle's purchase of the property interest was a disqualifying transfer of assets, due in large part to the fact that it occurred between family members.

Tomorrow we will share the supreme court decision.

Cohen & Oalican, LLP provide a full spectrum of services for the elderly, for disabled adults, and for the families.