By Martha Jo Patterson
After watching the PBS Frontline Special "Life and Death in Assisted Living" I wanted to provide advice on some things you need to know about moving your parent into a care or retirement living facility. I have more detailed information in my indispensable Alzheimer's Resource Kit at www.AlzheimersAnswersNow.com
A. When you Tour the Facility they want your parent to move in because they have a room to fill.
The person giving the tour is a marketing person. For facilities the most important thing is having rooms filed, I once overheard the marketing director of a facility tell the new person who was going to work at this facility that each new resident had a value to the company of $250,000!!! As a consumer we must always beware.
Look around try to see in the places they don't want you to see, use your nose and your ears. You may smell or hear something that concerns you. When you tour a facility it is like touring a model home, they want you to see everything as perfect.
B. Ask What Can the Facility Legally Do?
There are three levels of facilities and each can do different things:
C. Someone needs to check on your loved one, no matter where they are living.
If you have placed a loved one in a facility, each time you visit you need to make sure they are not showing any signs of bedsores, or other injury. If your loved one has dementia they cannot accurately report what is happening to them so you need to listen for anything that seems off. I had a client whose mother was being mistreated by a caregiver, my client noticed her mom always looking for someone, her mother started talking about an incident in her childhood where she was bullied like it was happening daily. I was able to help my client put together what was happening, and we were able to have her mom moved.
D. Plan Ahead!
The other day a widow and her children all who knew my dad came into my office in Orange, California. They were impressed that I was Certified as an Elder Law Attorney by the National Elder Law Foundation. They knew me well, yet had checked me out, so they knew very few people specialize in Elder Law. They were worried about their mom, their dad had just passed away, and they were afraid that mom would need care in a facility soon as her health was failing and she was having trouble walking.
I talked about the Elder Care Journey and how it is very important that everyone plan for two things avoiding probate and taxes, and for what happens if you don't die but need help with daily care and paying your bills. I told them that in my office I do things differently than other attorneys. Most Estate Planning Attorneys put together great plans for someone who goes from healthy and vigorous to falling asleep and never waking up. I wish that for everyone who comes in my office, but I have learned through both my personal experience and that of others that you must plan for a journey that involves Long Term Care.
I help many families like this one with an Estate Plan which will protect Assets, the widow will be able to qualify for the Aid and Attendance Benefits since her husband was a World War II veteran, when she needs assistance with two activities of daily living and is paying most of her income for her care. If the widow needs Skilled Care I have made sure her home and the Vacation/Rental Home in Big Bear are protected and that she will qualify for Medi-Cal. My hope is that the plan I have prepared is like putting a jacket in your suitcase when you travel in August, you don't plan to use it (no one wants to leave their home), but if you do you have plan that will protect you just as your jacket would keep you warm and dry if a sudden rain storm hit.
As I asked her if she had a Will or old Trust she had a very old will, at that point her son asked "should we (pointing to the others) get a Trust too? I wish this was the first time someone in their sixties asked that question. Boomers think there is no sense of urgency in providing for their demise. They make the biggest mistake people make they PUT OFF PLANNING. The answer to these "children" all who had children and some had grandchildren was yes you need a Trust too, the youngest has been struggling with a business that has barely survived the economy, and said "I don't have enough to worry about". I told him that was not true, if he did not plan he would leave a mess for his kids (he was divorced).
My tips for today: Don't put off planning, and plan for both avoiding probate and taxes and the big What If: What if you don't die but live with Disability, Disease of Dementia. (I have a book by that name). So Don't WAIT ANY LONGER, call me today to "get your affairs in order"
By Peter Michelson
At Renewal Design-Build we typically discuss many of the common aging in place home design criteria, such as extra wide hallways and the minimum requirement of at least one step-free entrance to the home.
Eventually, we address aging in place design strategies for the bathroom.
Individuals who have experienced a progressive illness, an injury, or a disabling health problem may encounter significant accessibility challenges in the bathroom. Very few of today's bathrooms are handicap accessible. Additionally, accessibility upgrades required in the bathroom may be much more extensive than simply adding grab bars in strategic locations.
What are the particular accessibility challenges encountered in most bathrooms? Today's bathroom typically includes a standard height toilet, a vanity with cabinets below, tight spaces, traditional bathtubs, and shower stalls with a raised shower pan sill. Each of these items may present an obstacle to a wheelchair-bound individual.
The following are a few of the aging in place bathroom design tips we share with our prospective clients:
No-threshold Showers: No-threshold showers enable wheelchair-bound individuals to simply roll in to the shower. They also allow a mobile individual with a disability or infirmity to easily walk in. Many no-threshold showers are equipped with grab bars and wall mounted seats for increased comfort and security, in addition to other safety features such as anti-scald shower faucets.
The no-threshold shower presents a particular design challenge, since the shower drain must be set at a lower elevation than the bathroom floor, as the sill must be removed for accessibility. A home renovation company experienced in aging in place design, such as Renewal Design-build, will have a variety of viable options for the homeowner to consider, such as an open shower area with a sloping floor, or a shower pan that is set slightly below the finished floor height.
Walk-in Tubs: The walk in tub is another popular accessibility feature in the bathroom designed with aging in place in mind. Walk-in tub models offer in-line water heaters, a swinging door that seals in the water, hydrotherapy jets; and other features that offer a relaxing and safe bathing experience.
Aging in Place Bathroom Design Features: The aging in place bathroom will be spaciously designed to include a 60 inch wheelchair turning radius, grab bars, a roll under vanity, accessible storage and other features that provide ease-of-access and safety for the homeowner.
By Scott Cohen
THE PROS OF REVERSE MORTGAGE
As with any type of loan made to the senior demographic, assessing the health, wealth and legal structure of the estate is crucial. A reverse mortgage is structurally similar to a typical conventional mortgage with many nuances designed to help seniors. There is no required payment, yet one can be made at any given time. You can make interest payments or decide to pay on your principal. The lender does not own the property and does not have the power of sale, unless the homeowner violated covenants listed in the closing loan documents.
Additional advantages include:
Paying for long-term care costs
For many seniors, estate planning may not include a long-term care policy. Yet, there's good news for homeowners with considerable home equity. It's possible to obtain a reverse mortgage to pay for that care and the cash-out proceeds are tax-free (always consult a professional tax advisor).
Avoid Medicaid lien attachments
Reverse Mortgages record two liens on one's property. Both are lien's, but the 2nd is not a loan, it's a HUD lien for an equal amount of the first, or much higher, depending upon the property value. When Medicaid services are deployed, they will try to attach a lien to a property and will see there's no equity and will not go into 3rd position, until the property is sold during their lifetime or upon the estate settlement.
Improves one's ability to age in place
Aging in place is a goal most Americans strive to attain. By eliminating a required mortgage payment, a reverse mortgage can increase monthly cash flow and help preserve liquid and non-appreciated assets that would be included in the estate. A reverse mortgage along with other estate planning strategies helps with this preservation.
Outliving the loan and loss of all equity "advantage"
Reverse mortgages are considered "open ended loans," but what happens at the end of a fixed- rate 30 year-term? Do you have to move out? No, on the contrary, if a homeowner is still living in the home, they can keep living there with no payment required!
When selling the home, what if it's "upside down "in value –in other words, you owe more on the loan than what the home is worth. Reverse Mortgages are "non-recourse" loans which means you do not have to make up the loan difference or deficiency if you decide to relinquish your home. Also, the borrower and lender are protected from any losses through monthly mortgage insurance premiums.
Qualification are much easier
For many homeowners on fixed incomes, the likelihood of qualifying for a conventional mortgage with increased payments is challenging. With a reverse mortgage, the qualifying emphasis is on paying your property taxes, homeowners insurance, and property upkeep with less emphasis on your credit history (this depends on your personal credit history).
Estate picks up the unpaid interest when liquidated (heirs could get benefit)
With a traditional mortgage, homeowners deduct mortgage interest paid at the end of the year. With a reverse mortgage and sizable estates, whatever mortgage interest accrues throughout the life of the loan, the estate recognizes it when the estate is liquidated. This means any interest you owe is deferred and taxes are offset with no capital gains until the property is sold.
Cure deferred maintenance on property thru escrow
A reverse mortgage can fund and close prior to the curing of the deferred maintenance (deferred maintenance is the practice of postponing necessary repairs or improvements to the property). This feature is not readily available on most conventional loans and must be monitored closely, as properties must be appraised in average "as is" condition and cannot have excessive deferred maintenance. The result from curing deferred maintenance increases the chance of obtaining "top dollar" for the property when it's eventually sold.
Choice of payment options
Homeowners have the ability to adjust their current and future cash flows with various payment options. When obtaining a fixed-rate product, a "lump sum" is the only option. When an adjustable-rate mortgage is utilized homeowners may select a combination of: lump sum; line of credit and monthly stipend payments over a specified term. Close attention must be paid to the overall structure of a seniors' estate and cash flow analysis, in order to avoid constant restructuring and lowering all potential costs involved.
New options with reduced closing costs
With the advent of a "HECM SAVER" program, loan costs are dramatically lower and in some instances, upfront mortgage insurance may be waived. This saves borrowers a considerable amount of money, making it more attractive to consider a reverse mortgage. Be sure to ask your loan representative for details.
Unlimited flexibility to change your payment structure
The borrower may change the payment plan at any time. There is no limit on the number of times a borrower may request a change. The servicer will charge the borrower a fee of $20.00 for each change occurrence and this fee may be financed and added to the loan balance.
Ability to make loans to a LIVING TRUST
Excluding the state of Texas, a reverse mortgage may be made to a *revocable trust. This is not common in the "forward mortgage" world, as residential loans are typically made to natural persons. On a case-by-case basis, a reverse mortgage may be made to an irrevocable trust, but if the irrevocable trust does not allow for principal distribution, an additional review by the lender's counsel is required. A homeowner must supply the complete trust, but if not available, a **Certification of Trust or an Abstract of Trust may be utilized, on an exception basis.
THE CONS OF REVERSE MORTGAGE
Loss of future equity / value of estate
If there's any home equity left when an estate settles, this reduced amount will adversely affect the net distributions to desired beneficiaries. Please note that utilizing a reverse mortgage and getting cash out reduces the value of one's estate anyway!
Loss of annualized interest deductions if payments are not made
Conventional mortgages have the benefit of an annual mortgage interest deduction. A reverse mortgage doesn't require payments and therefore cannot benefit from deductions. If deductions are needed today or in the future, a reverse mortgage is not the answer.
Can't put on a subordinated lien
Reverse mortgages will appear on title as two liens. The first is in the lender's name and the second will be in the name of HUD, for the same amount as the first. This is done to make sure there aren't any subordinated liens being placed on the property. However, this means that you will be ineligible to secure another loan on your property.
Homeowner must occupy the property as primary residence
Although a reverse mortgage is beneficial in so many ways, second homes and rental properties are not eligible for seniors age 62 and above. Annual inspections are performed in order to maintain compliance. If your Reverse Mortgage expert, in conjunction with your financial planner, have strategized that your property will eventually be used as rental income, then a Reverse Mortgage is not for you!
By Lewis Myers
Recently, we were honored to include Lewis Myers, a top rated Home Caregiving Expert in Maryland to our circle of experts, and we sat down and asked him key questions about how families are dealing with the care of parents in their homes. Welcome Lewis! We are thrilled to have you on our expert team!
The way we provide caregiving as an industry is changing", says Lewis Myers of Rockville, Maryland. In 2012, after extensively researching national caregiving franchises, Myers saw that the elder care industry was flooded with organizations employing under-educated and under-trained caregivers to meet the specific needs of their clients, with little or no quality control in place. "There was so much demand that providers saw the market solely as an opportunity to make money; completely ignoring operating procedures like hiring and training standards for caregivers. There was little follow-up in customer care," Myers states. Seeing the opportunity to provide leadership in Maryland, Myers began his relationship with Right At Home by recruiting outstanding caregivers and training them to serve Montgomery, Anne Arundel and Prince George's county clients. With their success and reputation growing, Right at Home Maryland is expanding their reach to include new offices throughout their region.
Engaging caregivers through the Right At Home national model empowers families because adult children may not necessarily live in the same location as their aging parents," Myers points out. "Almost half of our initial inquiries come from adult children outside our state, looking for a reputable organization that can coordinate their parent's care. Since they live away from their loved one, they are not able to vet an organization in person. But that doesn't change the fact that they want assurance that their parent is well cared for," Myers reiterates. "We stand out from other agencies by matching caregivers to elders based on need, logistics and most importantly, personality." Personality is often overlooked when determining a caregiver match, but it is a critical component to achieving satisfaction when hiring an organization to provide a caregiver for your loved one. Though caregiving encompasses many services, the most impactful care relationships are built on trust, dignity and rapport. Demonstrating empathy and genuine interest in an elder's care elevates an average caregiver to a trusted family advocate. "We take the time to make not just any match, but the right match", Myers says. "We want our customers to understand that we care about their family and value their business." Their customized matching process and ability to coordinate scheduling, streamline payment procedures and provide backup care mean that family members can have peace of mind with their loved ones living Right At Home in their Maryland communities.
For more information on Lewis Myers and his Maryland caregivers, please visit them at on their website (highlight website and link to:http://www.rightathomemd.net)
Like Right at Home Maryland on Facebook (highlight "Facebook" and link to:https://www.facebook.com/rightathomemd) and follow Right at Home on Twitter (highlight "Twitter" and link to @lewismyersRAH)
Courtesy of FirstLight Home Care
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