Walnut Creek Elder Law Blog

When my elderly father would come to visit me, I would ask, “Where’s your cane Dad?” He would say that he didn’t need it, and that he was trying to build up his strength. He needed to use his cane though, because he would hang onto me or my brother, or hang onto whatever was close to him, like a lampost, etc.  One evening on a weeknight at about 3:00 a.m., my father called me to tell me that he had fallen. It was bad, in that he cut his head, and we had to take him to the emergency room.  He was badly shaken, and it took a long time for him to recuperate.

Injuries from falls from older people is a real concern. Statistics show that once an older person has fallen, they are likely to fall again, unless precautions are taken. Injuries are the fifth leading cause of death among older people, and 80% of those injuries are the result of falling. For older women, falls can more often cause bone fractures because of osteoporosis.  My older clients remind me of my parents, and I encourage them to use their canes or walkers.

We often receive calls from the loved ones of older persons who have fallen.  Many times it is a wake up call to get things in order, such as wills, trusts and other estate planning documents. The concern for planning for long term care for the older client becomes more critical.

Written Michael J. Young, lawyoung1@gmail.com, elder law attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc.

Most (perhaps 99%) of all revocable living trusts and financial durable powers of attorney are defective for asset protection and government benefits planning, when incapacity occurs.
 
For the older client, we become focused on how we will pay for in-home care,  board-and-care, assisted living facilities and skilled nursing home costs. We are concerned about how to make our assets last longer for our own care. We want to protect assets, and we would like to hopefully leave something to our loved ones.
 
We become concerned with how to qualify for and utilize Medi-Cal  and VA benefits for our care. 
 
The standard language in the revocable living trust and financial durable powers of attorney do not allow for asset protection, protection of the home from a Medi-Cal lien, transfers of assets between spouses (including the home), transfers to children or to other trusts for government benefits planning, if incapacity occurs.
 
Updating the revocable living trust and financial powers of attorney  before incapacity occurs is good planning. 

Written Michael J. Young, lawyoung1@gmail.com, elder law attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc.

Most estate planning documents are prepared for what happens when we die. They are not prepared for what happens if we don’t die. With regard to the trust, if one spouse dies, for instance, everything goes to the other spouse. When the second spouse dies, everything goes to the children. During the lives of the spouses, all assets stay in the trust. If any gifting is allowed, it is not to exceed $13,000 per year per child. If there is no trust, the financial durable power of attorney will usually not provide for any gifting or asset protection.

But what if we want to do Medi-Cal or VA Aid & Attendance Benefit planning, and the makers of the trust or the makers of the financial durable powers of attorney have lost their mental capacities. For this planning, we at times will transfer assets, including the home,  from the ill spouse to the well spouse. We might also make transfers of various assets from parents to the children or to other loved ones.  The language to do this type of planning, 99% of the time, is not included in the typical estate planning documents. If the makers of the documents have lost their mental capacities, we cannot do this planning, and may have to go to court to reform the documents. As a result, long term care planning should include updating the estate planning documents to include government planning and asset protection language.

This blog is for informational purposes only and is not legal advice. You should consult an elder law attorney for your particular case, and before you proceed with any planning.

Written Michael J. Young, lawyoung1@gmail.com, elder law attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc.

The surviving spouse of a wartime Veteran may be eligible for the VA Aid and Attendance Pension Benefit. This benefit can help pay the costs of in home care, board and care and assisted living facilities for the surviving spouse. We must be able to show that the surviving spouse had been married to the Veteran for at least one year, or had children by the Veteran if married less than one year.

The surviving spouse is not eligible if he/she has remarried. Also, the surviving spouse must have been living with the Veteran at the time of the Veteran’s death, unless they were separated because of  medical or military reasons. The Veteran must have a discharge from the military that is other than dishonorable.  The pension rate for the surviving spouse may be as much as $1,056 per month, or $12,681 per year. 

Each VA claim is different and unique, and there are never any guarantees that any claim will be granted by the VA. When we plan for the VA Aid and Attendance Pension benefit, we also plan for Medi-Cal at the same time. Both benefits have different qualification rules, which must be coordinated.

This blog is general in nature, is for informational purposes only and is not legal advice. You should consult an elder law attorney for your particular case, and before you proceed with any planning.

Written Michael J. Young, lawyoung1@gmail.com, elder law attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young, who also advises on Medi-Cal qualification, asset protection, nursing homes and the VA Aid & Attendance qualification, serves Contra Costa and Alameda Counties in CA, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc.

When we plan for the VA Aid and Attendance Pension benefit, we plan for Medi-Cal at the same time. Medi-Cal and the VA benefit are both asset and income based programs. Medi-Cal pays for the costs of skilled nursing facilities, minus the share of cost paid by the recipient. The VA benefit can help pay for the costs of assisted living facilities, board and care facilities, and in home care costs. Under both programs, if the applicant is “over assets”, they can spend down, gift some of their assets away, or use other legitimate asset protection techniques to obtain qualification. 

The VA Aid and Attendance Pension Benefit program does not have a “look back” penalty period. The applicant could give away $50,000 for instance, today, and theoretically be eligible for the VA benefit tomorrow. If the same applicant then went to apply for Medi-Cal, after having gifted the $50,000, there would be an eight month penalty period. Divide $50,000 by $5,698 (penalty divisor) and you have 8.775 or, rounded down, eight months of ineligibility. As a result, the applicant would not be eligible for Medi-Cal for eight months.

There are legitimate gifting and planning techniques which your elder law attorney can show you to  create fewer months of ineligibiity for Medi-Cal. Remember that Medi-Cal pays for skilled nursing, which is much more expensive than assisted living facilities. Planning for Medi-Cal and the VA Aid and Attendance Pension benefit at the same time, is good planning. Your Medi-Cal, elder law attorney can help you with this.

 Written Michael J. Young, elder law and asset protection attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa County and Alameda County, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc. Medi-Cal Attorney Contra Costa.

VA BENEFITS MAY COVER THE COST OF AN ASSITED LIVING FACILITY OR IN HOME CARE

www.WalnutCreekElderLaw.com. As we discussed in previous Elder Law Today newsletters, the Veteran’s Administration provides a wonderful pension benefit for those individuals who served at least one day during a period of wartime and are now disabled due to non-service connected reasons (aging related issues,  Alzheimer’s, Parkinson’s, multiple sclerosis, and/or other physical disabilities).  This pension, referred to as “Aid and Attendance Allowance”, may pay  the long term care provided in an assisted living facility, or in-home care.  

The “Aid and Attendance” (A and A) benefit is available to a veteran who is disabled and requires the aid of another person to perform the personal functions required in everyday living.  A veteran can show they are eligible if they have a substantial need for assistance with the activities of daily living.  Such activities include bathing, dressing, meal preparation, etc.  A veteran would also qualify for this pension if they can show they need the attendance of another person in order to avoid the hazards of his or her daily environment.  The need for assistance does not have to be permanent.

 Under this program, a veteran can receive up to  $1,644.00 per month or $19,736 per year in benefits, and a widowed spouse can receive up to $1,056.00 per month of $12,681 per year in benefits.  The applicant must be “permanently and totally disabled” under the VA rules.

The vet does not need to be helpless under the rules. He only needs to show that he is in need of aid and attendance on a regular basis. Someone who is housebound or in an assisted living facility and over the age of 65 is presumed by the Veterans Administration to be in need of Aid and Attendance.

Eligibility for the program is based on the income and assets of the veteran. In determining income, deductions are allowed for unreimbursed medical expenses (UMEs). In home care workers are an allowable deduction, provided that some medical or nursing services are provided. Also, the cost of an assisted living facility, or a portion thereof, can be an allowable medical deduction against gross income. 

 In addition, a family member can provide in-home care for a veteran who is applying for aid and attendance.  In order to meet the disability criteria, the care services provided by an unlicensed relative must be prescribed by a health care professional (ex. doctor, RN, LPN or licensed physical therapist) and the professional must consult with the unlicensed relative caregiver at least once a month (in person or by telephone) to monitor the regimen.  In addition, there must be a valid care contract in place and the caregiver must be receiving no more than fair market value for services he or she is providing.

If you or someone you know is a Veteran receiving care in an assisted living facility, or at home, please encourage them to file a claim for this benefit. It would be prudent to seek the guidance of an experiended elder law attorney who is accredited by the VA.

 CAVEAT: When planning for this VA benefit, you should also plan for Medi-Cal benefits and coordinate all of this with your elder law estate plan at the same time. An elder law estate planning attorney, who is also accredited by the VA, is best equipped to help you with this planning. When seeking help for this VA benefit, always ask if the person helping you is accredited by the VA.  

 The following are some additional requirements for eligibility:

 a. Be a veteran who served at least 90 days of active duty.

b. At least one day of active duty had to be during wartime: WWII – 12/7/41 to 7/25/47 – Korea – 6/27/50 to 12/31/55 – Vietnam – 8/5/64 to 5/7/75;

c. Does not need to have been in combat;

d. Discharged other than dishonorably;

e. Income less than $1,644 per month, once out-of-pocket medical expenses are considered.

f. Net worth less than approximately $50,000 for singles or $80,000 for couples.

g. Gifting of assets is allowed with no look-back period, but must be coordinated with Medi-Cal planning and gifting, which does have a look-back period.

 If you or someone you know is a Veteran receiving care in an assisted living facility, or at home, please encourage them to file a claim for this benefit. It would be prudent to seek the guidance of an experiended elder law attorney who is accredited by the VA.

Elder Law Today is written by Michael J. Young, Attorney at Law, 1931 San Miguel Dr., Ste. 220,  Walnut Creek, CA 94596. This information is for general informational purposes only, and does not constitute legal advice. For specific questions, you should consult a qualified attorney. MIKE@WALNUTCREEKELDERLAW.COM

For additional information, such as upcoming seminars, past newsletters, and to listen to an interview with attorney Michael J. Young, visit  www.WalnutCreekElderLaw.com.

Office: (925)-256-0298

UPCOMING SEMINARS BY ELDER LAW ATTORNEY MICHAEL J. YOUNG:

Dates: Fridays, January 8 and 22, from 2:00 to 3:30 p.m. at the Law Offices of Michael J. Young, in the Channell Room. For reservations call 925-256-0298.

Parkinson’s disease is a brain disorder, wherein certain nerve cells in the brain become impaired or die. These nerve cells, called “neurons” normally produce a chemical known as dopamine. This chemical allows for smooth, coordinated functions of the body’s muscles and movements.

When a high percentage of the brain cells which produce dopamine are impaired, symptoms of Parkinson’s disease may appear. Symptoms may include tremors, changes in facial expression, imbalance, small handwriting and slowness of movement. In time, the symptoms may become worse. Mild tremors can become more severe. Body movements may also become slower, and mobility problems may become worse. The use of eating utensils, dressing, and performing various activities of daily living may become more difficult.

Parkinson’s disease, which is difficult to diagnose officially, affects both sexes in equal numbers, and does not discriminate on the basis of ethnicity, social status or where you live. There are different rates of progression for the disease. We encourage our clients who have Parkinson’s disease and their familiy members to seek the help of support groups, to pursue ongoing medical care, and to learn adaptive techniques from medical professionals.

 Parkinson’s disease is the most common brain disorder, after Alzheimer’s disease, that we see with our clients. When symptoms of Parkinson’s disease appear, as with symptoms of Alzheimer’s disease, we receive inquiries from individuals who may have the disease, or from their loved ones. They want know what should be done now regarding the establishment of a long term care plan for the person with the disease.

We help clients review and update their existing estate planning documents, to be sure the documents contain the requisite asset protection language. We then help the family plan for long term in-home care, which is the preference of most of our clients. We help the family plan for the VA Aid and Attendance benefit, which can help pay for in home care, for veterans. We also help with planning for Medi-Cal benefits, which can pay for nursing home care.   

 If you or a loved one has symptoms of Parkinson’s disease, please feel free to call elder law attorney Michael J. Young, with offices in Walnut Creek, CA, at 925-256-0298. Mr. Young serves clients principally in Contra Costa and Alameda Counties. You can visit our web site at www.WalnutCreekElderLaw.com

Experts suggest that Hispanics may be more suseptible to Alzheimer’s Disease than the general population, according to a New York Times article entitled “Are Hispanics at a Greater Risk for Alzheimer’s Disease.” “>” http://www.nytimes.com/2008/10/21/us/21alzheimers.html The article suggests that Hispanics may have more risk factors for developing dementia than other groups, and that a signigficant number appear to be getting Alzheimers’ earlier. In addition, the article suggests that language barriers may discourage family members from helping their older loved one who may have signs of dementia. I have prepared a publication entitled “The Alzheimer’s Legal Survival Kit” where I address Alzheimer’s disease and how the family can help cope with the disease. This publication and other information can be found on my web site at www.WalnutCreekElderLaw.com