Florida Elder Law Blog - ElderLawAssociates.com

There is a popular tune played this time of year called “Grandma Got Run Over by A Reindeer” which relates that Grandma -- after drinking too much eggnog -- went out into the winter cold to get her medication and was run over by a reindeer. The question is, “Who was supposed to be watching Grandma?”

Though this little tune is just for fun, it may very well raise alarms to many caregivers of the elderly. Caregivers know that even at a holiday party they cannot let down their diligent watch over their elderly loved one. As far-fetched as it may sound, with all the people and noise, an elderly family member with dementia or Alzheimer’s may be enjoying the family gathering and then suddenly become confused and walk to the door and leave. (One should alway make plans well before-hand with the wise counsel of a qualified Florida Elder Law Attorney.)

For family caregivers the added stress of the holidays with decorating, shopping, parties and keeping up with all the family traditions is an overwhelming quest. Feelings of isolation, depression and sadness come with this added stress. There are millions of Americans who are caring for elderly frail loved ones and most of these caregivers will go through some of these emotions, especially this time of year.

There are some things you can do as a caregiver to help you and those you care for enjoy the holiday season.

First take care of yourself. Try to eat right, get plenty of sleep and exercise. This will help reduce stress and strengthen your ability to cope with caregiving responsibilities.

Prioritize your holiday traditions. Perhaps instead of cooking a large family dinner, have everyone bring his or her favorite dish. Use paper plates. Forfeit the traditional outside light decorating for a lighted wreath on the front door. Choose one or two parties or concerts to attend instead of trying to do it all.

Arrange for help. Call on other family members to help with the caregiving while you do your shopping or go out for the evening. If family is not available, ask your church group or a neighbor if they would donate a few hours.

Use community services. Many senior centers provide meals for the elderly and supervised activities, onsite, at no charge or a minimal charge. For locating senior services in your state, call your state Area Agency on Aging or check the national locator website at http://www.n4a.org/

Use adult day care services. Some assisted living facilities provide day activities and meals for seniors on a day by day basis. Other organizations called "adult day service providers" specialize exclusively in this sort of care support at a reasonable cost. These support services provide respite for caregivers from their caregiving responsibilities as well as social interaction for their elderly family members. There is a cost for adult day services, but the benefit for all is worth it.

For example:

Jean had brought her mother into her home to care for her when mom's Alzheimer’s made it impossible for her to be alone. When the Christmas season approached, Jean realized she had to make some choices. She did not want to give up the traditions she had set with her daughters in shopping and lunches, but it wouldn’t be possible with her caregiving responsibilities. In searching for a solution, Jean visited an adult day services facility near her home. She found she could schedule the days she needed off for her mother to come in. The adult day services company also provided transportation and would pick up mom and bring her home in the evening.

Although Jean's mother was not sure she would like to go at first, she found she enjoyed the programs, meals and conversation with new friends and the activities provided.

The time it gave Jean to have for herself was worth the extra cost for the day care.

Technology to the rescue. Here is a solution that would have kept “Grandma” from going out in the winter cold and getting run over by a reindeer. Companies that have created monitoring systems, security alarms and other safety equipment are “tweaking” them to adapt to the needs of seniors and their care givers.

Here are a few examples:

• Ankle or wrist bands that monitor location and alert the provider when a person has gone beyond the designated perimeter, such as out the front door of the house.
• Motion detectors. Set throughout the home, motion detectors allow someone outside the home to follow a senior as he or she moves through the house.
• Smart medication dispensers. Live monitoring and dispensing of pills.
• Emergency response alert. At a touch of a button on a desktop monitor, bracelet or necklace, emergency help is summoned.

Whether providing care in your home or helping senior family members in their own homes, your use of monitoring and “tech” help aids can provide extra safety for your loved ones, and peace of mind for you.

You are not alone. Join a caregiving help group. Your local senior center may have one or go on the internet to find one. Hearing about other caregivers' problems and solutions and being able to share your own and ask questions is a great way to relieve stress and gain a new perspective. Check out websites like the National Family Caregivers Association at http://www.nfcacares.org/

Work with a Senior Care Professional. Recognize that you are doing the very best you know how. You are not a geriatric health care practitioner, geriatric care manager, home care nurse or aide, hospice provider or family mediation counselor, nor do you have the years of training and experience these professionals have, but you can definitely use their experience. In fact, using a senior care specialist will make caregiving easier for you and more beneficial for your elderly family member.

As an example:

Mark stopped by his father Dan’s home every night after work to help with any errands or things he needed around the house. He began to notice that Dan was not showering, dressing or even fixing meals some days. Another concern was his father's growing confusion and disorientation. A trip to the family doctor only brought more concern to Mark, since the doctor claimed it was just the aging process that caused the confusion.

Wanting a second professional opinion on what was best for his father, Mark hired Shelly -- a Professional Geriatric Care Manger -- to do an assessment. Shelly arranged for Mark and Dan to see a geriatrician, who advised that proper meals and an increase in some vitamins, would help clear up the confusion and disorientation. Shelly arranged for a home care company to come in daily to help with personal needs and prepare meals.

Soon Dan was back to his old self and able to function on his own.

One more thing to remember. As a family caregiver, the greatest gift you are giving this holiday season is “Love.”

Labels: Florida Elder Care, florida elder law, Florida Elder Law Attorney

Caring for a child or loved one with special needs carries
certain challenges that many cannot understand, and yet
too many of us are confronted by these challenges on a
daily basis. A Special Needs Planning Attorney can assist
you with Medicaid Planning, planning for your loved
one with special needs trusts and comprehensive estate
planning. A Special Needs Planning Attorney recognizes
that caregivers typically do not add up the cost of support
and caring for an individual with a disability. Caregivers
provide many services “naturally” and willingly to loved
ones to help enhance their quality of life. These services
might include any one or more of the following:

• Advocate
• Social service coordinator
• Companion
• Guardianship
• Job coach
• Chauffeur
• Personal care attendant
• Money manager
• Recreation director

If you become unable to provide these services or die
without planning for the continuation of these services,
your loved one’s quality of life may suffer.

An experienced Special Needs Planning Attorney will:

• Establish comprehensive care plans organized so that monies for your loved one with special needs will not be at risk from estate taxes or the long-term care costs of caregivers
• Assist with applying for SSI benefits for a person with disabilities
• Apply and qualify for Medicaid for a person with disabilities
• Provide for a person with special needs in your Will
• Apply for Guardianship
• Set up a Special Needs Trust
• Set up a Supplemental Needs Trust
• Assist in the creation of a Letter of Intent
• Inform you of the estate planning options available to you
• Assist families with long term care planning for loved ones with special needs

What is a Special Needs Trust?

A special needs trust (usually funded with the assets
of the disabled individual) or a supplemental needs
trust (usually funded with the assets of a third party,
such as the parents of a disabled individual) makes it
possible to appoint a trustee to hold property for the
benefi t of your disabled child after you’re gone. A special
needs trust provides for the needs of a disabled person
without disqualifying him/her from government benefi ts
programs such as Social Security and Medicaid.
Why Can’t I Leave My Assets to Other Family Members?
While it might seem like a good idea simply to leave a
certain amount of money to your disabled child’s sibling
or other close relative, with the understanding that the
money will be spent on the disabled child, this approach
is not the best strategy and often produces negative
consequences. For example, any one or more of the
following can occur by leaving your assets to another
family member:

• The money can become subject to judgments, divorce settlements or bankruptcy decrees against the relative
• The disabled person has no legal right to force the relative to use the money to benefit the disabled person
• The relative to whom the money is left may be taxed at a higher income tax rate than the disabled child or a trust
• Should the relative die before the disabled child, the money would go to the relative’s heirs and not the disabled child

A special needs trust avoids these potential problems
without putting an emotional strain on family relations.

Monthly SSI benefi ts can be spent on food and shelter.
The special needs trust money can be used to pay for
additional items that will enhance the quality of life of
your disabled child. Such things might include:

• Summer camp
• Lessons
• Educational expenses
• Airline tickets for travel
• Electronic video games
• Vitamins and grooming supplies
• Funeral and burial expenses

Preparing a Letter of Intent

One way to set forth what your intentions are for your
disabled child’s future is to sign a “Letter of Intent.” This
letter can be given to the trustee of the special needs trust
at the time of your death. This document gives family
members and others the benefi t of your knowledge
about your child’s capabilities, needs and interests. Once
completed, you can update the letter as necessary should
the child’s needs change or should your goals for your
child change.

A typical letter of intent will include:

• Biographical information
• Financial details
• Medical history and needs
• Social contacts
• Any negative infl uences you would like to guard against
• Personality traits
• Skills, hobbies and physical abilities
• Goals your child is working toward

While the challenges facing your disabled loved one are
daunting, they can be even more so if you are not around
to attend to his or her needs. However, with a little
forethought and planning, you can make your disabled
child’s future potentially much brighter.

Howard S. Krooks, JD, CELA, CAP is a partner of Elder Law
Associates PA, which has offi ces in Boca Raton, Aventura,
Weston and West Palm Beach. He is admitted to practice
law in Florida and New York, where he serves as Of Counsel
to Amoruso & Amoruso LLP in Westchester County. His
professional practice is devoted to elder law and trust and
estate matters, including representing seniors and persons
with special needs and their families in connection with asset
preservation planning, supplemental needs trusts, Medicaid,
planning for disability, guardianship, wills and trusts.

Mr. Krooks is certified as an Elder Law Attorney by the
National Elder Law Foundation and is a member of the
Council for Advanced Practitioners of the National Academy
of Elder Law Attorneys (NAELA).

He is an active member of the Special Needs Planning and
Elder Law community on the local, state and national level.
Mr. Krooks currently serves on the NAELA Board of Directors
and is an offi cer of NAELA (Secretary). As a member of the
Joint Public Policy Task Force of The Florida Bar Elder Law
Section and the Academy of Florida Elder Law Attorneys,
Mr. Krooks works to protect the rights of the state’s most
vulnerable citizens. He recently was invited to join a special
sub-task force to review policies of The Florida Department of
Children and Families (DCF) that may not be in compliance
with federal law. The special task force will also determine
whether DCF policies have followed proper rule-making
procedures.

Labels: Florida Estate Planning, Florida Guardianship, Florida Special Needs Trust