Restoring Quality Time with Mom

As caregivers we can become so task-oriented that we lose sight of what’s really important at the end of the day- spending quality time with our loved ones. I saw this happen very quickly as my mother and I worked together to care for my grandmother who has dementia.

It starts out very innocently- mom needs a bath, to get dressed, to eat breakfast and then take a glass of water to her chair in front of the TV. Every hour, she needs to get up and do some exercises so that she can maintain her strength. Oh shoot, did she take her pills this morning? When is that next doctor’s appointment? How am I going to get her there? Did I put the kids on the bus this morning? Did I get groceries for her house last night? Were the bills paid? And then gradually, we lose sight of mom. We become so overwhelmed with making sure that everything is done properly and on time that we forget to sit down, hold mom’s hand and have a real conversation with her.

By now you are saying that it is impossible to sit down, I know. But what if it were possible? What if there were some way to make sure that all of these tasks were done and we still had time to sit with mom and chat or hold her hand at the end of the day? I am writing to tell you that it is possible and that I can make it happen.

As a Certified Geriatric Care Manager, my background is gerontology. I understand the aging processes, changes associated with aging, health-related concerns and illnesses that affect the older population and I happen to very much enjoy helping people cope with these things. But most importantly I am familiar with services, programs, resources and professionals that exist to serve this population and improve their quality of life.

My job is to identify the needs of my older client and put together a plan that meets those needs and which will improve their quality of life, create a safer living environment and restore quality time for the family with their loved one. My goal is to take the burden off of the family and give them the freedom to enjoy those special moments with mom and continue to make memories that they want to have.

Care Management Services is a non-legal service that Marshall, Parker and Weber offers for families who need assistance coordinating services in the community to help their loved one age in place or even find a new place to call home. The service involves identifying needs and then matching the need with a service provider.

Once I coordinate these services, I monitor them to make sure that they are successful and the needs of the client are being met. I communicate with the family, update them on any changes and provide ongoing education. I visit my client in his home- whether that is the home they’ve been in for fifty years, an apartment, an independent living center, a personal care home or a skilled nursing facility. I ensure that the care and assistance they are receiving is good and that it is enough to keep them safe.

I can take some of the burden off of you as a caregiver. I can make appointments at doctor’s offices; schedule transportation; arrange for a caregiver to provide assistance with bathing, dressing, medication reminders, cooking, cleaning and laundry; arrange meal delivery for when you can’t be there; schedule respite care; equally distribute care giving responsibilities between family members that are local and long distance; make home modification and home safety recommendations; schedule social activities for mom or dad during the day; assign a friend to take her to church; reroute the mail or reassign financial management duties; assist the family in understanding behaviors related to dementia; perform facility visits to ensure that mom or dad is getting the best care and determine if and when there will be a discharge and what level of care is most appropritate; communicate with doctors, attorneys, health care professionals, financial professionals and other professionals in the community who exist to serve mom and dad’s needs.

Call me. I can help.

It’s a Good Time to Review your Power of Attorney

If you are an older adult, your power of attorney (POA) may be your most important legal document. It is crucial that the right people are named as your agent and that their powers and duties are tailored to your particular circumstances and goals.

A well drafted POA can be the key to protecting financial security for you and your family. A poorly drafted document can be a license to steal.

A financial POA allows you to name someone you trust to act on your behalf in the event you ever need help managing your income and assets. In your POA document you can control the powers and duties your agent will have.

For example, would you like your agent to be able to transfer some of your assets to your spouse or children to protect them from health and long term care costs? Then you must specifically give your agent that power in your document.

Pennsylvania Changes Law on Financial Powers of Attorney

Last summer Pennsylvania made important changes to the laws that govern POAs. The most noticeable of these changes take effect on January 1st. This means that December and January are the perfect time for you to review your POA and make sure that your document (1) has the right provisions for your situation and (2) is updated, as needed, to conform to the new law.

The law has some new forms that must be used in documents signed in 2015 and thereafter. So, if you review your POA in December you may want to wait until January to sign your new document.

“Hot Powers” and Duties

The new law (Act 95) tries to walk a fine line between allowing you to give your agent the powers you want and protecting you from potential financial abuse. It says that you can give your agent broad powers to transfer your assets and make other changes to your estate plan, but only if you specifically authorize these “hot powers” in your POA.

Older adults should carefully consider whether to give any hot powers to their agent. Some people may want their spouse or a trusted child to have virtually unlimited authority. Others, depending on their own particular situation, may want to ensure that their agent has no hot powers.

It is also important to review the standards of accountability to which you want your agent to be held. Act 95 places strict duties and limitations on your agent unless you designate otherwise. For example, the law mandates that your agent keep your funds separate from those of the agent. You may determine that this is inappropriate in your situation because you want to allow for joint accounts. If so, you can release your agent from that duty in your POA.

One Size does NOT fit all

Hot powers and the agent’s duties are some of the important issues that you will want to discuss with a lawyer who is an expert in POAs and understands the complexities of Pennsylvania’s new law. Your POA should not be “one size fits all.”  It’s hard to overemphasize the importance of getting truly expert legal assistance to make sure your document is right for you. Don’t take chances with the preparation of your most important legal document.

Further Information

[The new law (Act 95) applies mainly to POAs used in financial and property matters. Health care and mental health POAs are pretty much unaffected.]

Pennsylvania Revises Law on Powers of Attorney

Don’t Use New Power of Attorney Forms before January 1, 2015

Power of Attorney: Things You Need to Know

Powers of Attorney and Other Tools for Financial Management

Pennsylvania Act 95 of 2014 (House Bill 1429)

Traditional Medicare vs Medicare Advantage: Quality and Access

It’s the Medicare open enrollment continues until December 7th and many Medicare beneficiaries are considering their options and trying to choose between traditional Medicare and a Medicare Advantage plan.  

I’ve given my two cents in a prior posting regarding why I chose to stick with traditional Medicare. See: Choosing Between Original Medicare and Medicare Advantage. But I realize that each beneficiary’s circumstances are different, and the factors that were important to me might not be quite so important to others.

If you are currently struggling with this choice, the Kaiser Family Foundation (KFF) has just released a helpful review of the literature comparing the quality and access provided under traditional Medicare and Medicare Advantage plans. Here is a link to the Kaiser review: http://tinyurl.com/ovhmw8k

Here is an overview from the Executive Summary:

On the one hand, the evidence indicates that Medicare HMOs tend to perform better than traditional Medicare in providing preventive services and using resources more conservatively, at least through 2009. These are metrics where HMOs have historically been strong. On the other hand, beneficiaries continue to rate traditional Medicare more favorably than Medicare Advantage plans in terms of quality and access, such as overall care and plan rating, though one study suggests that the difference may be narrowing between traditional Medicare and Medicare Advantage for the average beneficiary. Among beneficiaries who are sick, the differential between traditional Medicare and Medicare Advantage is particularly large (relative to those who are healthy), favoring traditional Medicare. Very few studies include evidence based on all types of Medicare Advantage plans, including analysis of performance for newer models, such as local and regional PPOs whose enrollment is growing.

KFF notes that “studies comparing overall quality and access to care between Medicare Advantage plans and traditional Medicare tend to be based on relatively old data, and a limited set of measures.” Better evidence is needed. “At a time when enrollment in Medicare Advantage is growing, it is disappointing that better information is not available to inform policymaking.

Medicare’s blog recently noted that convenience can be an important factor in making a choice. See, Medicare Open Enrollment: the value of convenience.

Further Information

Beware of Shifting Options Within Medicare Plans, NY Times, October 3, 2014.

Choosing Between Original Medicare and Medicare Advantage, Marshall Elder and Estate Planning Blog, April 8, 2013.

Medicare Open Enrollment: the value of convenience.

Apprise: A free health insurance counseling program that helps older Pennsylvanians with Medicare. Phone 1-800-783-7067.

PA Home Energy Assistance Program Now Open

Written By Case Manager, Jody Lose

The Home Energy Assistance Program for low-income customers, known as LIHEAP, opened on November 3, 2014.  This program helps low-income eligible customers with their heating bills or heating crisis throughout the fall, winter, and early spring seasons.

The Pennsylvania Department of Public Welfare administers this federally funded program.  To qualify you must meet certain income guidelines.  LIHEAP benefits are based on income, household size, the fuel type, and heating region where you live.  To receive help you do not have to be on public assistance, you do not have to have an unpaid heating bill, and you can either rent or own your own home.

Eligibility income requirements –

Household Size

Income Limit

1

2

3

4

5

6

7

8

9

10

Each Additional Person Add

$17,505

$23,595

$29,685

$35,775

$41,865

$47,955

$54,045

$60,135

$66,225

$72,315

$6,090

You can apply three different ways –

1.  Through the COMPASS website, www.compass.state.pa.us .

2.  Download a hard copy application from the LIHEAP website and turn it in to your local county assistance office.  Click here to access a fill-in application, http://www.dpw.state.pa.us/cs/groups/webcontent/documents/document/c_115648.pdf .  Request an application be mailed to you by calling the Statewide LIHEAP Hotline at 1-866-857-7095, or TDD for the hearing impaired at 1-800-451-5886.

3.  By filing an application in person at your local county assistance office.  A listing of county assistance offices can be found at http://www.dpw.state.pa.us/findfacilsandlocs/countyassistanceofficecontactinformation/index.htm.

Once you apply you will be sent a written notice that will tell you if you qualify and the amount of your grant.  The grant payment for heating assistance is sent directly to your utility company or fuel provider and is credited towards your bill.  In some cases the payment is mailed directly to you.

If you know of anyone that may benefit from this program, pass this information along.  Let’s keep everyone warm this winter.  The program closes on April 3, 2015.

 

 

 

Don’t Use New Power of Attorney Forms before January 1, 2015

Pennsylvania has passed a new law that makes extensive changes to the rules governing powers of attorney (POAs). A POA is a vital legal document that allows someone else to manage financial and property matters for you in the event you are unavailable or become incapacitated.

In its many pages Act 95 of 2014 makes numerous changes to the law governing POAs. The most obvious changes are to the notice and acknowledgment forms that must be signed by the principal (the person creating the POA) and the agent.

The principal signs a notice form that contains state mandated information about the significance of the POA. Act 95 revises the language that is to be used in this notice.

The agent signs an acknowledgment form accepting the duties that go with acting as an agent, and agreeing to act in conformity with the principal’s expectations, in good faith and only within the scope of the authority granted in the document. The form must be in substantial conformity with the new language set out in the Act. An agent has no authority to act until he or she has signed this acknowledgment form and it is affixed to the POA document.   

Act 95 was signed into law on July 2, 2014. Since then I’ve noticed that some lawyers have already begun using the new notice and acknowledgment forms. This is a mistake.  

Act 95 delays the effective date for use of new forms in order to give everyone time to prepare for the change. The law says that its provisions regarding the use of the new forms are not effective until January 1, 2015. That means that the use of the old notice and acknowledgment forms remains mandatory until January 1, 2015.

The bottom line: Act 95’s provisions regarding the new language in notice and acknowledgment forms do not take effect until January 1, 2015. POAs signed before that date should continue to use the language and forms from the prior law.  

Further Reading

Pennsylvania Revises Law on Powers of Attorney