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“The art of medicine consists of amusing the patient while nature cures the disease.” Voltaire

“Once a patient goes brain dead and relatives sign his organ donation consent form, he will get the best medical treatment of his life. A hospital code blue may be a call for doctors to rush to the bedside of a beating heart cadaver who needs his or her heart defibrillated.” Dick Teresi, The Undead: Organ Harvesting, the Ice-Water Test, Beating Heart Cadavers–How Medicine Is Blurring the Line Between Life and Death.

As an agent appointed by a Health Care Proxy, you will have the right to make the following types of decisions: Choices about medical care, including medical tests, medicine, or surgery. …
These are difficult questions to think about. However, they are very important, as every estate planning attorney knows. Should you ever become unable to speak for yourself, reports the Enid News & Eagle in the article “Veteran Connection: What you should know about advance directives,” there is a way to make a plan, so your wishes are known to another person or persons and by legally conveying them in advance, making sure you have a say, even when you don’t have a voice.

The advance directive helps family members and your doctors understand your wishes about medical care. The wishes you express through these two documents described below, require reflection on values, beliefs, views on medical treatments, quality of life during intense medical care and may even touch on spiritual beliefs. The goal is to prepare so your wishes are followed, when you are no longer able to express them. This can include situations like end-of-life care, the use of a respirator to breathe for you, or who you want to be in the room with you, when you are near death.

It should be noted that an advance directive also includes a mental health component, that extends to making decisions on your behalf when there are mental health issues, not just physical issues.

What is an Advance Directive and Do I Need One? There are three types of documents: a durable power of attorney for health care, a health care proxy and a living will.

The durable power of attorney for health care lets you name a person you trust to make health care decisions when you cannot make them for yourself. This person is called your health care agent and will have the legal right to make these decisions. If you don’t have this in place, your doctor will decide who should speak for you. They may rely on order of relationships: a legal guardian, spouse, adult child, parent, sibling, grandparent, grandchild or a close friend.

A living will is the document that communicates what kind of health care you want, if you become ill and cannot make decisions for yourself. This helps your named person and your doctor make decisions about your care that align with your own wishes. Another very important part of this issue: the conversation with the people who you want to be on hand when these decisions have to be made. Are they willing to serve in this capacity? Can they make the hard decisions, especially if it’s what you wanted and not what they would want? Do you want a spouse to make these decisions on your behalf? Many people do that, but you may have a trusted family member or friend you would prefer, if you feel that your spouse will be too overwhelmed to follow your wishes.

Reference: Enid News & Eagle (March 13, 2019) “Veteran Connection: What you should know about advance directives”

RELATED ARTICLES

• The Undead: Organ Harvesting, the Ice-Water Test, Beating Heart Cadavers–How Medicine Is Blurring the Line Between Life and Death
• Veteran Connection: What you should know about advance directives
• How to Decide Who Your Healthcare Proxy Should Be

“Anyone may arrange his affairs so that his taxes shall be as low as possible; he is not bound to choose that pattern which best pays the treasury. There is not even a patriotic duty to increase one’s taxes. Over and over again the Courts have said that there is nothing sinister in so arranging affairs as to keep taxes as low as possible. Everyone does it, rich and poor alike and all do right, for nobody owes any public duty to pay more than the law demands.” Learned Hand

“In America, there are two tax systems: one for the informed and one for the uninformed. Both are legal.” Learned hand

If you went to a doctor’s office and did not tell the doctor what your symptoms were, it would be hard to get a good diagnosis and treatment. The same goes for a visit to the elder law estate planning attorney. Without all the necessary facts, advises the Times Herald-Record in the article “What you need to tell the elder law estate planning attorney,” the estate plan may need to be revised or created all over again, the inheritance may be given to people other than those you intended and there could be family conflicts.

Elder law is all about the issues that affect the elderly client. The planning for disability and incapacity, to include identifying the people who would make decisions for you, if you become incapacitated and protecting your hard-earned assets from the cost of nursing home care.

Estate planning is focused on transferring assets to the desired people, the way you want, when you want, with minimal court costs, taxes, or unnecessary legal fees and avoiding disputes over an inheritance. Here are some of the things your attorney will need to know, with full disclosure from you:

Family dynamics. Do you have a child out of wedlock? Are you part of a blended family or do you have a child you haven’t seen in years, you need to discuss the child. They may have a legal claim to your estate, and that must be planned for. Perhaps you want to include the child in the estate, perhaps you don’t. If you disinherit a child in a will and you die without a plan, that child becomes a necessary party to probate proceedings and has the right to contest your will.

Health issues are important to disclose. If you don’t have long-term care insurance, you need five years to protect assets in a Medicaid Asset Protection Trust (MAPT). Therefore, now may be the time to start a plan. If you have a child who is disabled and receives government benefits, you can leave them money in a Special Needs Trust (SNT).

Full disclosure of all your assets, income, how assets are titled, who the beneficiaries are on your IRAs, 401(k)s and life insurance policies, are all the kinds of information needed to create a comprehensive estate plan. Keeping secrets during this process could lead to a wide variety of problems for your family. Your entire estate could be consumed by taxes, or the cost of nursing home care.

There’s no doubt of the seriousness of these issues. You or your spouse may experience some strong emotions, while discussing them with your attorney. However, creating a proper estate plan, preparing for incapacity and loved ones with special challenges will provide you with peace of mind.

One last point: an estate plan is like your home, requiring maintenance and updates. Once it is done, make a note in your schedule to review it every time there is a major life event or every three or four years. Laws change, and life changes. Your estate plan may also need to change.

Reference: Times Herald-Record (May 25, 2019) “What you need to tell the elder law estate planning attorney”

The conversation that you have with an estate planning attorney, for Estate Planning Documents and Medicaid Planning when you are in your thirties with a new house, young children, and many years ahead of you is different than the one you’ll have when you are much older, maybe just before you retire. The estate planning attorney will know that you are about to enter a time in your life, when the legal documents you prepare are more likely to be used, says the article “Learn about legal documents and Medicaid” from the Houston Chronicle.

It should be noted that everyone needs an estate plan at any time of life, so they may state their wishes for how assets are distributed and name a person who will speak in their behalf, in the event of incapacity because of an illness or injury.

The necessary Estate Planning Documents and Medicaid Planning documents must be part of estate plan also includes a power of attorney, so someone you chose can serve as your agent to transact business and handle your financial matters. There should also be a declaration of guardian, in the event of later incapacity and a HIPAA medical authorization document. In some instances, a designation of remains is prepared in order to name an individual who will be the appointed agent to care for the body at the time of death.

However, there’s another reason why you’ll need to meet with an attorney at this time. As we get older, the need to address long term care becomes more important. Making the right decisions now, could have a big impact on the quality of your retirement and your later in life medical care.

If you have not updated your will or your powers of attorney, specifically a durable power of attorney for property, it would be wise to do so now. You will need a document to clearly authorize your agent to deal with assets. Any documents that are out of date, or in which named agents have predeceased you, won’t be effective, leading to problems for you and your heirs.
The document may also need to include a broad gifting power for your named agent, so assets can be transferred out of the estate. If this detail is overlooked, the agent may not be able to protect your assets.

This is the time when you may want to take steps to protect your children upon your death or upon the death of the second parent. If your goal is to eliminate assets to be eligible for Medicaid coverage, Estate Planning Documents and Medicaid Planning needs to be done well in advance. In numerous states, there are state administered programs that pursue recovery of assets when a person has received Medicaid benefits.

Your attorney will be able to work with you and your family to address your specific situation. It may be that your estate plan will include trusts, or that certain assets need to be retitled. Meet with an estate planning attorney who is familiar with your state’s laws. And don’t procrastinate.

Reference: The Houston Chronicle (April 19, 2019) “Learn about legal documents and Medicaid”

If you notice your aging parent is struggling financially, you probably want to pitch in and help. Of course, doing so will mean that less money is available to pay your bills and save for your retirement. Your loved one’s money troubles could create economic stress for you and your children. It would be wonderful if you could find a pot of gold in the backyard, but we live in the real world. Here are some tips on how to help your aging parents get financial benefits.

The National Council on Aging: How to Help Your Aging Parents Get Financial Benefits

This National Council on Aging created a tool that will search through more than 2,000 federal, state, and private benefits programs across the United States. The search tool can connect your older loved one with assistance that can help pay for housing, medication, food, medical services, utilities, transportation and other necessities.

You can call 888-268-6706 to find a Benefits Enrollment Center in your area. An agency employee can help you at no charge to locate the benefits for which your parent is eligible. After you fill out a questionnaire, you will receive a detailed report listing all those programs and telling you how to apply. You can get application forms and assistance at the Benefits Enrollment Center.

If you prefer, you can do the search yourself online at BenefitsCheckUp.org. This search tool is free and confidential. Once you create the list of programs for which your parent qualifies, you can apply for benefits. Many of the forms are available at the enrollment centers or available online. Some programs require you to contact that entity directly to apply.

How the Benefits Locator Works: How to Help Your Aging Parents Get Financial Benefits

The online questionnaire will ask for information like your parent’s:

• Date of Birth
• Income
• Assets
• Expenses
• ZIP Code
• Prescription Drugs
• Veteran Status

Your parent must be age 55 or older to use the locator tool. Allow about 15 minutes to complete the online intake form.

Types of Programs for Seniors: How to Help Your Aging Parents Get Financial Benefits

There are many government benefits for older Americans, but do not overlook private groups that assist people in need. Some people do not apply for Social Security retirement benefits, because they did not work for enough years to qualify for full retirement benefits.

Your loved one might qualify through a spouse’s work record or be eligible for partial benefits, based on his own limited work history. A few hundred dollars more a month can make enough of a difference that your parent does not need financial help from you.

Depending on several factors like income, age and geographic area, your older parent might qualify for:

• Housing through HUD
• Home repairs or weatherization
• Transportation
• Reduced real estate taxes
• Financial management and budget counseling
• Groceries through the Supplemental Nutrition Assistance Program (SNAP), the Emergency Food Assistance Program, the Senior Farmers’ Market Nutrition Program, the Commodity Supplemental Food Program and many regional and local food pantries, meal delivery programs for low-income or elderly people.
• Prescription drugs through Part D Medicare coverage, Medicaid, the federal Low-Income Subsidy (also called Extra Help), drug manufacturers, and charitable groups.
• Utility bill help, including discounts on heating and cooling bills
• Monthly cash benefits through the Supplemental Security Income (SSI) for very low-income seniors with few assets.

These are just some examples of the multitude of benefits programs available for seniors.

Every state makes its own regulations, so your state might vary from the general law of this article. Be sure to talk to the Law Office of Frank Bruno, Jr. an elder law attorney in New York.

References
HuffPost. “How to Find Financial Assistance for Elderly Parents.” (accessed October 9, 2019)

RELATED ARTICLE

• How to Find Financial Assistance for Elderly Parents

It’s definitely an uncomfortable thing to do. However, making funeral arrangements for yourself eliminates a lot of stress and anxiety for the family members, who are left to guess what you may have wanted. This, says the Leesville Daily Leader in the article “Planning for the end of your life” lets you make the decisions.

When considering end-of-life care for loved ones here are some of the things to consider:

• Do you want to be buried or cremated?
• Do you want a funeral or a memorial service?
• What music do you want to be played?
• Do you want flowers, or would you prefer donations to a charity?
• Do you want people to speak or prefer that only a religious leader speak?
• What clothing do you want to be buried in?
• Have you purchased a plot? A gravestone?
• Who should be notified about your death?
• Do you want an obituary published in the newspaper?

There are also estate matters that need to be attended to before you pass. Do you have a will, power of attorney, healthcare power of attorney, or a living will? Make sure that your family members or your executor know where these documents can be found.

If you do not have an estate plan in place, now is the time to meet with an estate planning attorney and have a plan created.

Your family will also need to be able to access information about your accounts: investment accounts, credit cards, utility bills, Social Security, pension, retirement funds and other assets and property. A list of the professionals, including your estate planning attorney, CPA and financial advisor, along with the names of your healthcare providers, will be needed.

If you are a veteran, you’ll need to have a copy of your DD-214 in your documents or let family members know where this is located. They will need it, or the funeral home will need it, when applying for burial benefits from the Department of Veterans Affairs and the National Cemetery Administration.

If you wish to be buried in a national cemetery, you’ll need VA Form 40-10007, Application for Pre-Need Determination of Eligibility for Burial in a VA National Cemetery. This must be completed and sent to the National Cemetery Scheduling Office. Include a copy of the DD-214 with the application.

End-of-life care for loved ones grieving in your family may find discussing these details difficult, but when the time comes, they will appreciate the care that you took, one last time, to take care of them.

Reference:

• Leesville Daily Leader (May 1, 2019) “Planning for the end of your life”
• What the Elder Law Estate Planning Attorney Needs to Know

“Some are sad.
And some are glad.
And some are very, very bad.
Why are they Sad and glad and bad?
I do not know.
Go ask your dad.”

― Dr. Seuss, One Fish, Two Fish, Red Fish, Blue Fish

“A will can save one’s family from being put into a quagmired pit of legal conundrum, in case of death (which may even be untimely).” ― Henrietta Newton Martin. Did you know that more than half of American adults—and 78% of millennials—don’t have any basic estate planning documents like a will or living trust? It may not be that much of a shock, since younger adults tend to put off thoughts of estate planning. However, even if you don’t have children or many assets yet, you can benefit from creating an estate plan now. Forbes’s recent article, “6 Reasons Why You Should Have An Estate Plan,” provided six reasons why you should have an estate plan at any point in life:

Why Do I Need an Estate Plan?

Plan for yourself.

A big step in the estate planning process, is deciding who will make decisions on your behalf, if you’re unable to do so yourself. If you become incapacitated, a revocable trust will hold assets for your benefit, while you’re alive and name the individuals you want to receive your property when you pass. Designating an agent under a durable power of attorney to act on your behalf when it comes to financial and legal matters, if you become physically or mentally disabled, can help make certain that any decisions made, are in your best interest. If you can’t make medical decisions for yourself, you should have a healthcare proxy, agent or power of attorney, HIPAA release, and living will.

Decide How to Dispose of Your Wealth.

A will names an executor or personal representative who’s responsible for the administration of your estate after you die. He or she distributes property, as you determine in your will. If you have minor children, you can also designate a guardian to care for them in your will. Any life insurance, retirement accounts, or annuities require you to name beneficiaries, so they don’t need to be included in a will.

Lessen Transfer Taxes.

One goal of estate planning is to maximize the wealth you transfer to your beneficiaries, along with minimizing transfer taxes. The Tax Cuts and Jobs Act of 2017 expanded the amount individuals may give away at death—or during life—without any transfer taxes. The new law offers an increased exemption amount and portability. That means spouses can share one another’s exemption. You can make annual tax-free gifts up to $15,000 in 2019 (twice this amount for married couples). You can also pay medical and educational expenses for someone else without any gift tax.

Include Charitable Giving.

If you have philanthropic goals, an estate plan can help make certain that your objectives are satisfied. You can select a charity that’s important to you, choose the assets you want to donate, and decide—along with your attorney—the best way to make your gift.

Protect Family Wealth.

There can also be wealth protection benefits in estate planning through asset ownership arrangements, insurance, limited liability entities, irrevocable trusts and asset protection trusts. These are designed to protect your assets from creditors. An experienced estate planning attorney can help you decide, if one of these options is appropriate for your situation.

Ready your Family to Receive Wealth.

You can also prepare the next generation to receive wealth, which can also be helpful in preserving family wealth in the long run. Your estate plan can set out wealth planning goals, facilitate conversations about what wealth means to your family and educate your adult children about financial ideas and the ways in which they can get involved in creating and sustaining the family legacy.

Why Do I Need an Estate Plan? Estate planning can be a formidable task, especially if you’re starting from ground zero. However, you can always engage an estate planning attorney to help you develop the documents you need to give you peace of mind about your financial affairs.

Reference: Forbes (February 22, 2019) “6 Reasons Why You Should Have An Estate Plan”