Often I have listened to a client’s moving story about his or her service as primary caregiver to their sick spouse.  Each speaks with both passion and pain, describing their caregiving as “the loneliest time of my life.”  For this reason, each wants to speak out and be an encouragement to others who might be on the same road.

Managing spouses whose husband and/or wife have been diagnosed with Huntington’s Disease, a long-term illness that strikes at an average age of 39 is hard.  To paraphrase their words, “My husband/wife had the diagnosis, but the disease took them away from me.  I no longer had a lover, a soul mate, someone who could really share with me.  Our days as a couple were at an end.”  During this time of increasing illness, their spouse’s were not able to hold them, kiss them, or care for them for many years of the disease.
Each shared that during this illness, they had to sacrifice their own feelings for the benefit of their spouse.  An area of greatest hurt was the abandonment of their spouse by their own extended family.  Their burden could have been lighter if family and friends had stayed more involved.  Each related that when they called their husband’s or wife’s brothers or sisters and reminded them of how important it was to them to be able to see them from time to time; many responded with, “I just can’t stand to see him/her that way.”
“I was a widow with a living spouse,” each stated with sadness.

It seems to me that we could all do a much better job in helping others carry the load of long term illness.  We need to be more aware of what family members are going through during what may well be the loneliest and most difficult time of their lives.  We need to come alongside them and provide sympathy and support.

On a more positive note, I learned of another man who has been diagnosed with Huntington’s disease and whose male buddies have rallied around him.  They have intentionally gone out of their way to work together to take this man out of the house and to sporting events with them.  They have specifically set up time to talk with his wife to make sure they understand his care needs.  They work together to make it possible for him to go on their annual fishing trip.  These men are an extraordinary example of what it means to truly be a friend.

I hope that each one of us would choose to follow this model of true friendship if someone we know and love develops a long term illness.

For further information and advice in any elder care matter, do not hesitate to contact me toll-free at 888-800-7442, or e-mail me at fniemann@hnlawfirm.com.

As the New Jersey economy worsens, examples of elder financial abuse are on the increase. The aging are vulnerable to scams and financial exploitation by family members in need of money.

Up to one million elderly Americans may be targeted yearly. Family members and caregivers are the perpetrators in 60% of cases, although financial losses are higher with investment fraud scams.

While no one can guarantee that a loved one is not the victim of financial abuse, there are some definite steps you can take to minimize the chances. One suggestion is to have more than one family member involved in caring for the loved one. Using a direct deposit is also helpful.  And of course you should always screen caregivers and verify references.

Financial abuse and exploitation can be very hard to detect.  Here are some signs that Fredrick P. Niemann has found to exist in elder abuse cases he has handled:

• The disappearance of valuable objects, especially valuable objects
• Large amounts of money are taken out, checks are made payable to cash, or consistent low bank balances even after regular  deposits
• A new “best friend” and isolation from other friends and family
• Large and unusual credit card transactions
• Signatures on persons checks look different or are inconsistent
• A name is added to a bank account or a joint bank account is created
• Indications of fear of caregivers

If you suspect someone of being financially abused, there are several actions you can take:

• Make a report by calling your County Adult Protective Services and/or the NJ Office of the Ombudsman for the Elderly.  File a police report if you believe the facts support a crime.
• Explore legal options with a qualified financial abuse of the elderly attorney.  In New Jersey, the Chancery Court is  available to address alleged legal abuse. The court can intervene if someone in the family is misusing a power of attorney or  their role as guardian or conservator.
• Contact advocacy organizations. The National Center on Elder Abuse offers guidance on how to investigate and seek justice  for elder abuse. New Jersey law has remedies available to deal with the situation and you may be able to get restitution for  breach of fiduciary duties.
• Try to get a temporary restraining order from a court while building your case.  Again, speak to a qualified elder law  attorney.

If you have any questions regarding an elder law and financial abuse, contact Fredrick P. Niemann, Esq. toll free at 888-800-7442, or e mail him at fniemann@hnlawfirm.com.  He is very experienced in these types of matters.  For further information, please go to http://www.youtube.com/user/NJElderLawCenter#p/search/0/J2tM8-rqg8I to learn more.

The death of a family member can be one of the most stressful times of anyone’s life. Adding to this stress can be drawn-out proceedings under New Jersey probate, the process in which the court oversees the division of the decedent’s estate. Many times, dividing the estate of a loved one is the last thing you want to think about at such an emotional time. Luckily, there are ways to minimize the stress and sometimes avoid the probate process.

During the probate proceedings, the Court will not only oversee the division of the decedent’s assets, but will also resolve claims of creditors and debts and hear any claims of interest that heirs to the estate may have. Pertaining to the assets of the deceased, the Court will follow the division that the decedent set forth in their will, if the deceased has one. If they do not have a will, the Court will divide the assets according to law, increasing the likelihood that your assets will not go to the people you specifically intended them to.

The Court will appoint someone, called an executor, to become the overseer of the entire estate. Their job is to then write checks, sign over deeds, and handle any other affairs the estate may have. It is the executor’s responsibility to settle all debts and claims against the deceased. Often the executor will hire an experienced probate attorney experienced in New Jersey Estate Administration to assist with most matters, particularly in larger estates with a multitude of complex issues.

As you can imagine, the probate process can be long and drawn-out. Most families desire to avoid such a process. Creating a living trust allows you to ensure that your family will not have to suffer through the probate process during such an emotional time. When you create a living trust, you place your assets that are going to be distributed in trust and name a trustee to distribute them upon your death. The Court will not be involved in the distribution, nor will a court-appointed executor. The trustee acts as the administrator of your estate upon your death. Not only is the trustee someone trustworthy that you choose, but they are obligated by law to follow your wishes indicated in the trust. The living trust thus effectively ensures that your estate will be administrated to your heirs as you wish, while avoiding the stressful death probate process for your family. 

The probate process can take quite a while, depending on how complex your estate is. It is often desirable to avoid this process, especially since it is during a difficult, emotional time for any family. Creating a living trust allows your family to avoid the process, while assuring you that your estate will be distributed as you desire.  If you have questions about New Jersey probate or the benefits of creating a living trust, please call Fredrick P. Niemann, Esq., an experienced New Jersey Trust & Estate attorney today.  He can be reached toll-free at 888-800-7442 or by email at fniemann@hnlawfirm.com. He would happy to meet with you on any estate planning matter you may have.  For further information, go to http://www.youtube.com/user/NJElderLawCenter#p/search/3/I5rmD8r1Qjg to learn more.

Until this year, taxpayers could only convert funds to a Roth IRA if their adjusted gross income was under $100,000.00.  Starting in 2010 conversion is open to anyone regardless of annual income.

Why could converting to a Roth IRA be beneficial?  A traditional IRA allows tax deductions for contributions and grows, tax-deferred.  A Roth IRA does not provide up-front deductions, but earnings and withdrawals are tax-free.  And unlike a traditional IRA which requires minimum distributions starting at age 70 1/2, a Roth IRA does not require minimum distributions during your lifetime.  A Roth IRA could provide a number of advantages depending on your age, the growth rate of your funds, and your total retirement needs.  Say you have a $1 million IRA balance and $300,000 in other funds.  If you convert to a Roth you could use the $300,000 to pay taxes.  Then the $1 million Roth IRA and all future earnings on it will not be taxed at withdrawal.  Further, as the law stands, in 2011 anything over $1 million in your estate would be taxed at a rate of at least 41% at your death.  In this case, converting could save estate taxes of $124,000.

Should you make the switch?  If you convert, you can undo the conversion or “recharacterize”, until October 15, 2011, the extended due date for 2010 tax returns.  If a stock increases dramatically in value you may choose to stay in the Roth IRA since withdrawals are tax-free; if the stock falls, you could un-do the conversion.
Converting to a Roth IRA could reduce the value of your estate for tax purposes, let you take distributions tax-free, and avoid minimum distribution requirements.

Do you have a question(s) not addressed here?  If so, contact Fredrick P. Niemann, Esq. toll-free at (888) 800-7442 or e-mail him at fniemann@hnlawfirm.com to schedule a consultation about your particular needs.  He welcomes your calls and inquiries and you’ll find him very approachable and easy to talk to.

What steps can you take to protect a deceased loved one’s personal information and assets?
• Immediately notify banks and creditors of the death by providing copies of the death certificate for verification.
• Close individual accounts, The surviving spouse may be asked to close any joint accounts, which also helps reduce the  chances of identity theft.
• Contact the three main credit bureaus (TransUnion- www.transunion.com, Equifax – www.equifax.com, and Experian –  www.experian.com) and ask that credit reports be flagged as “Deceased: Do Not Issue Credit”.  Also request a copy of each  credit report so that you can be sure you did not overlook any accounts.
• Notify the Social Security Administration directly.  While funeral homes do not report deaths to the Social Security  Administration, don’t assume they will do so in a timely fashion.
• Notify the Department of Motor Vehicles.

If you suspect fraud, file a police report and contact the company in question.  Provide a copy of the death certificate to make the process go more smoothly.

Do you have a question(s) not addressed here?  If so, contact Fredrick P. Niemann, Esq. toll free at (888) 800-7442 or e-mail him at fniemann@hnlawfirm.com to schedule a consultation about your particular needs.  He welcomes your calls and inquiries and you’ll find him very approachable and easy to talk to.

Communication between parent and child before a crisis is so important and can provide peace of mind and reduce stress for both.  The following are some of the questions that families should discuss, which will often begin a dialogue about the type of preplanning parents can do before a crisis occurs.

1. Children should know roughly how much and where their parents’ assets are.  Do they have enough to sustain the healthy spouse should one spouse become ill and need extended hospitalization and/or nursing home care?

2. What does the income picture look like?  If one spouse dies, how much income will the surviving spouse be left with?  Will there be a significant drop in income?  Often time’s steps can be taken before that spouse passes to help boost the surviving spouse’s income.

3. Is financial support anticipated?  People are living longer than ever.  Many people are at risk of outliving their money.   Answering this question means not simply looking at current expenses vs. income but looking at the next step in the elder care journey and the next step after that and asking “Do I have enough to pay for long term care and if so, for how long?  And if not, what is my plan then?

4. What types of insurance are there (ie., health, long term care, life)?  Is coverage adequate? If not, can coverage be increased?  You certainly want to do that before you become uninsurable.

5. Are there a power of attorney and a health care directive and where are they?  Are they up to date or stale?  If these documents are not in place then the only alternative is a costly and time-consuming process called guardianship.  The court will be involved in your family’s affairs and you may not get the result you want.

6. Is there an up to date will?  A clear, thought out estate plan can avoid family squabbles after the parent passes away. Even people with small estates should have a will.  Also, make sure the original will can be located. Probating a copy is difficult and expensive.

For further information and advice in any elder law or estate planning matter, do not hesitate to contact me at 888-800-7442, or email him at fniemann@hnlawfirm.com.

As I have written previously, in speaking with families, overwhelmingly the desire is for elderly family members to remain in their own home as they age and face declining physical and mental health.   But, is that always the best thing?  For many people, the answer is yes.  But, perhaps not for everyone.

I was reading a recent post on the New York Times New Old Age blog (www.newoldage.blogs.nytimes.com) which highlighted two cases in which elderly parents were living at home in declining health.  One was a 95 year old woman living in her own home with a team of aides and other assistance, all coordinated by her overwhelmed daughter.  The other was an elderly man suffering from Alzheimer’s Disease, living in the basement of his son’s home.  The woman had visitors and activity in her home every day.  The man did not, spending most of the day alone watching television.

The two cases raise some interesting questions.  Would the elderly man be better served in an assisted living facility or at least, adult day care?  He is not getting any mental stimulation through most of the day, which, if received, could slow down the progression of his disease.  There is the safety issue as well.  He remains at home in the basement for long hours unsupervised.  What if there is an emergency?   Will help arrive in time?

The elderly woman would seem to be better cared for.  She has visitors in and out of her home throughout the day.  But, her daughter is coordinating all this care.  It sure sounds like a full time job.  And then we learn that the daughter, herself, is 74 years old.  How is this affecting her health and what happens if she needs care?  Finally, I wonder what Mom’s finances are?  All this assistance can approach and exceed the cost of care in a facility.  Will she run out of money and if so, what happens then?

As 77 million baby boomers begin turning 65 in 18 months, long term care will continue to be a major issue families will have to wrestle with.  And, I am not saying that remaining at home shouldn’t be the goal for many.  However, as with most complex problems a one size solution does not fit all.  Assisted living facilities and nursing homes will always have a place in the continuum of care and may just be the right fit for some.  Food for thought and a different perspective to consider.

For further information and advice in any estate matter, do not hesitate to contact me at 888-800-7442, or info@fnlawyerinnj.com.

Just about everyone who gets Social Security, Social Security Disability Insurance (SSDI), Supplemental Security Income (SSI), or a Railroad Retirement or Veterans Administration disability pension, will receive a one-time payment from the U.S. government of $250 as part of the American Recovery and Reinvestment Act of 2009 (a/k/a the stimulus bill). The extra payment is scheduled to arrive by the end of May the same way you receive your usual benefit.

Among those receiving the one-time stimulus payment will be long-term care facility residents on Medicaid who draw Social Security benefits. (But note that SSI beneficiaries who live in a nursing home and get a monthly SSI benefit of $30 are not eligible for the payment.)

Medicaid-eligible long-term care facility residents and their families should know that the stimulus payment is not considered income and will not be counted as a resource for 10 months (including the month of receipt) in calculating benefits under Medicaid (or any other federal program or state program with some federal financing). The $250 will also not count as gross income for tax purposes. Recipients can save the payment if they want to, but they should make sure that it will not put their savings over the asset limit for any program benefits they may receive as of February 2010.

Because the $250 payment will not be counted as income, it will not put a Medicaid-eligible resident over the state’s income limit. In addition, a Medicaid nursing facility resident should not see an increase in his or her patient pay for the month the payment is received.

“This money is yours. Your home or facility is not allowed to take it to pay your bill, even if you get help from your state paying for your care,” says the National Council on Aging (NCOA) in an informational handout directed at residents of nursing homes, assisted living facilities and board and care homes.

If you have any questions, contact Fredrick P. Niemann, Esq. at 888-800-7442, or info@fnlawyerinnj.com.  He is happy to answer your inquiries.

WHAT IF 33% OF ALL SENIORS IN THIS COUNTRY could receive up to $1,949 a month in additional income from the government to help cover their elder care costs? THEY CAN!

Under the right circumstances, a little-known federal program will pay additional income to cover long term care costs for at least 1/3 of all US senior households — that’s how many war veterans or their surviving spouses there are in this country. But the provisions of this program are such a well-kept secret that only 4.7% of US seniors are actually receiving the benefit. The great news about this program is the Department of Veterans Affairs will pay you to hire your family, friends or just about anyone to take care of you (Caregiving spouses can’t be paid under this program). The program is called “Veterans Pension.”

Most people who have heard about Pension know that it will cover the costs of assisted living and, in some cases, cover nursing home costs as well. But the majority of those receiving long term care in this country are in their homes. Estimates are that approximately 70% to 80% of all long term care is being provided in the home. All of the information available about Pension overlooks the fact that this benefit can also be used to pay for home care.

It also comes as a surprise to most people that the Department of Veterans Affairs will allow veterans’ households to include the annual cost of paying any person such as family members, friends or hired help for care when calculating the Pension benefit. This annual cost is deducted from household income and used to calculate a lower “countable income” which in turn enables families to receive this disability income from VA. Even though VA claims the benefit is for low income families, because of the special provision in the regulations — allowing for deduction for care costs — households earning between $3,000 to $6,000 a month or more can still qualify for Pension under the right conditions.

This extra income can be a welcome benefit for families struggling to provide eldercare for loved ones at home. Under the right circumstances, this annualized medical expense for the cost of family members, friends or any other person providing care, could create an additional household income of up to $1,056 a month for a single surviving spouse of a veteran, up to $1,644 a month for a single veteran or up to $1,949 a month for a couple.

If the disabled care recipient has been rated “housebound” or in need of “aid and attendance” by VA, all fees paid to an in-home attendant will be allowed as long as the attendant provides some medical or nursing services for the disabled person. The attendant does not have to be a licensed health professional. There is also no need to distinguish between medical and non-medical services — all are deductible.

For a disabled person who has been rated “in need of aid and attendance” or “housebound”, a family member will be considered an in-home attendant, but that family member has to be paid for services duly rendered. There is potential for fraud here where a family member may move into the home and ostensibly receive payment as a caregiver but not actually provide the level of care paid for. Documentation for this care must be provided to VA, and it is reasonable for VA to question whether the services being purchased from a family member living in the household are legitimate. Such arrangements should be extensively documented and completely arm’s-length.

The care arrangements and payment for home care must be made prior to application and there must be evidence that this care is needed on an ongoing and regular basis. We recommend a formal care contract and weekly/monthly invoice billing for services. Money must exchange hands and federal law requires employment taxes must be withheld and there must be evidence of this. All of this documentation must be provided as proof to VA when making application for the pension benefit. Costs for these services must be un-reimbursed; meaning these costs are not paid by insurance, by contributions from the family or from other sources. VA will allow, however, family caregivers being paid by their loved ones, to turn around and pay the household bills for their loved ones to help defray the cost of the care.

Due to the need for a rating, documentation for annualizing care costs and the extensive proof needed to show the caregiver is indeed an employee of the care recipient, most people should not try this on their own. An attorney in this area should be sought to help with the application in order to avoid lengthy delays in awarding a benefit or a possible denial of benefits.

For further information and advice in any elder law matter, do not hesitate to contact me at 888-800-7442, or info@fnlawyerinnj.com.  Fredrick P. Niemann and Lauren Bercik have been accredited by the U.S. Veterans Administration to counsel veterans and their families in aid and attendance and pension benefits.

One of the most pressing needs for disabled beneficiaries is medical care.

Medical Insurance
It is crucial that the disabled beneficiary obtain some form of medical insurance. Options include the following:

• Private Medical Insurance. Typically, the only source of private medical insurance at regular rates is through the parent’s coverage with the parent’s employer. Parents of such child must make every effort not to lose their jobs.
• COBRA. The Consolidated Omnibus Budget Reconciliation Act of 1996 (COBRA) allows former employees and their dependents to continue the employer’s coverage for a limited period of time, commonly 18 months. However, if the employee became disabled within two months of the qualifying event causing him to lose medical insurance coverage, COBRA coverage may be extended for 29 months. If the former employee died, divorced, or became entitled to Medicare, then the employee’s dependents are eligible for 36 months of coverage.
• State-Mandated High-Risk Pools. Many states have high-risk pools to cover persons who are uninsurable in the private market. This coverage often tends to be very expensive.
• Medicare. Medicare is only available to persons under 65 if they are disabled and have 20 quarters of coverage. If they receive SSD, then two years after the determination of disability they are entitled to Medicare. Persons receiving Medicare should obtain a Medicare supplement policy. There is usually a very limited open enrollment period to obtain this coverage after which it becomes impossible to obtain because of pre-existing conditions.
• Medicaid. Persons receiving SSI also receive Medicaid. In non-SSI states having a Medically Needy program, persons qualify for Medicaid by spending down their income if income is above a certain amount. Some states have income caps. Other ways of obtaining Medicaid are through state Medicaid waiver programs, including various Kid Care programs available in many states. Eligibility rules vary. A Katie Beckett waiver program is very desirable, because the income and assets of the parent are not deemed to the children. Some states do not call their programs Katie Beckett, which is a specific categorically eligible group of Medicaid recipients, but the effect is the same because those state identify groups of children with disabilities and provide for Medicaid eligibility so the waiver services are available. Slots tend to be extremely limited.

Non-Covered Medical Expenses
Typically, Medicaid pays for 100 percent of covered expenses. However, very often, psychological services, certain types of testing and some special therapies are not covered. It is appropriate for a trustee to pay for these non-covered services. It is also appropriate for a trustee to pay for dental care, prescriptions, and podiatrist care.

Provider Non-Acceptance
Some providers do not accept Medicaid, because of the low reimbursement rate. It is difficult to find a dentist participating in the program. Some persons with disabilities choose physicians who do not accept Medicaid. It is appropriate for a special needs trust to pay for services from those physicians.

Out-of-Pocket
If the person with a disability receives Medicare, rather than Medicaid, there may be co-payments, deductibles and payments for services that Medicare does not cover. It is appropriate to pay for those costs from a special needs trust.

If you have any questions concerning Medicaid or a trust for a disabled or handicapped child, contact Fredrick P. Niemann, Esq. at 888-800-7442, or info@fnlawyerinnj.com.  He is happy to answer your inquiries.