Archive for January, 2009

According to a recent study, when asked about their most important concerns for the future the elderly are most fearful about:

1) Remaining independent in their homes without intervention from others;

2) Maintaining good health and receiving adequate health care;

3) Having enough money for everyday needs and not outliving assets and income.

While the elderly are certainly concerned about long-term care disability and the resulting catastrophic needs, those items are not ranked at the top of the list. What most seniors don’t realize is that in order to achieve the three top goals listed above one generally needs to plan ahead. Unfortunately, this does not appear to be happening.

Currently, long-term care costs are running, on an average, about $6500 per month (The MetLife Market Survey of Nursing Home & Assisted Living Costs, October, 2007). At that rate, most persons’ savings will be depleted in less than an average stay in a nursing home (2.5 years). Thus, an extended disability that requires long-term care is probably the most catastrophic event that could happen. It can make it impossible for a senior citizen to achieve the three goals mentioned above, destroying any hope for a secure future. For example, with the need for long-term care the older person: a) Loses independence b) Has experienced a loss of good health c) Uses up remaining assets and income. (more…)


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The Centers for Medicare & Medicaid Services (CMS) has recently implemented a rating system for nursing homes to help seniors and their families evaluate a long term care facility. Under the new rating system, facilities are given from one to five stars to rank their performance in the following areas: quality measures, nurse staffing levels and health inspection reports.

While families seeking long term care may be relieved to have an objective method of comparing facilities, it may not be as objective as it appears.  Toby Edelman, senior policy attorney for the Center for Medicare Advocacy has stated that two of the three criteria that are used in evaluating nursing homes are actually self-reported.  This raises questions about the accuracy of the ratings.  In fact, Edelman said, “Relying on nursing homes to describe accurately how well they are doing . . . just doesn’t make sense.”

Consumers should be careful to compare the rating of the nursing home with their own experience when visiting the facility.  The ratings can be viewed on the agency’s Nursing Home Compare website.

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More and more these days we hear about the “sandwich generation.”  This is defined as the generation of people who are involved with the simultaneous demands of caring for their own children as well as their aging parents.  How can these competing demands be met? 

            According to Alex Johnson in his article A Generation Caught Between Two Others (msnbc.com, Feb. 13th, 2007) there are 20 million Americans who are “sandwiched” between the demands of their children and aging parents.  The typical solution is shown by the word “sandwich” – the children end up taking a large share of the responsibility.  In 2006 there were 32 million Americans who were caregivers to their aging parents.  Thus, it is not surprising that caring for aging parents was cited as the number one concern in the minds of Baby Boomer financial services clients (The Financial Life Planning Institute, November, 2007).

            While the children of aging parents end up taking much responsibility it is often unintentional.  Senior citizens generally do not want to be thought of as a burden to their children and often experience guilt and remorse when they believe that they may become so.  (more…)

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The pain and stress of dealing with a loved one with a long-term illness can lead to tension.  This tension also arises after the loved one passes away and the family has to deal with inheritance issues.  Cordial relationships between family members often become strained.  In fact, animosity can result – sometimes causing a break in long-time associations and substituting animosity instead of fraternal camaraderie.

One solution is “elder mediation.”  This is a new tool to help families heal broken relations, solve difficult issues arising from dealing with elderly parents or prevent misunderstandings or problems from happening in the first place.

In the context of dispute resolution mediation has been around for a long time.  However, it only recently has been applied to helping to solve problems with the elderly.  Thus, the term “elder mediation” is not commonly known, but nevertheless, it is still very important.  To illustrate, mediation has become common in recent years in the area of “family mediation.”  Such family mediators typically handle negotiations and disagreements in domestic relations cases involving divorce, child custody and parenting time, juvenile cases or the settlement of estate plans.  The tensions that arise from families caring for aging parents also provide an area where mediators can truly help. (more…)

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Persons faced with the possibility of a nursing home stay in the near future have in the past transferred a certain amount per month out of their name.   That was a legal possibility under the old law.  It is not under the new law.

Under the old law, the state set a monthly “divisor” amount.  This is based upon the average cost of one month in a nursing home and is currently about six thousand dollars ($6000).   Thus, for every $6000 a person transferred out of their name, the state would impose a one month penalty.  During that penalty period the person could not get Medicaid.  In Michigan, all fractions were dropped.  That meant that if anything less than 1 was transferred, there would be no penalty at all.  For example, if a person transferred $5400, that is .9  of the $6000 divisor.  Since the Michigan law said that all fractions should be dropped, there was no penalty.  If the person transferred $11,400, or $6000 x 1.9, the fraction would be rounded off to 1, and there would be only a one month penalty.  (more…)

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