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IL Estate Planning Blog

Monday, April 6, 2015

Illinois Nursing Homes Watch List

MemberoftheFamily.net provides information on nearly 16,000 U.S. nursing homes, including easy-to-understand Nursing Home Reports based on recent government surveys. 

This website provides easy-to-read reports to help families choose the right nursing home for their loved ones. State survey results for health, fire-safety, and other violations and complaints will help you choose a qualified home for your loved one.

Visit http://www.memberofthefamily.net/watch-list/IL/ for a complete listing.


Monday, March 23, 2015

Navigating Medicaid and long-term care by Terry Savage

 Navigating Medicaid and long-term care - Chicago Tribune March 8, 2015

Copyright Terry Savage Productions, Ltd.; Distributed by Tribune Content Agency

 
The oldest baby boomers are now turning 70. Suddenly, the possibility of needing long-term care looms, despite the medical advances in joint replacement, heart surgery and pharmaceuticals. Boomers now must face the increasing possibility of needing care with activities of daily living - things like dressing, bathing and toileting.
 
Medicare does not cover these basic services, beyond a limited number of days of "skilled" nursing care required, for example, after a surgery. The U.S. Department of Veterans Affairs does cover some care, primarily restricted to VA nursing homes. Long-term care insurance is the obvious solution - yet less than 10 percent of seniors have such a policy.
 
Consequently, many seniors who need daily custodial care are forced to turn to state Medicaid programs.  Here's what you should know if you're counting on Medicaid as a last resort for custodial care:
 
1. Medicaid care takes away choice.
The majority of custodial care provided by Medicaid is given in an institutional setting. That structural bias takes away the chance to remain at home and have limited care for several hours a day. It also takes away your choice of nursing homes. Given increasing demand and low Medicaid reimbursement rates, most facilities have a limited number of Medicaid beds, instead opting to serve those who pay through private savings or long-term care insurance.
 
2. Medical and financial qualification is necessary.
Each state sets its own criteria to qualify for Medicaid custodial care. For example, Illinois provides long term care services for 55,000 eligible residents in 738 nursing facilities. Those facilities take all but $30 a month from your Social Security or other income to pay for your nursing home care.
 
3. There are exemptions for spouses remaining "in community" outside the nursing home.
Each state sets its own limitations for how much of your income will be retained by your spouse. For example, in Illinois in 2015, the non-Medicaid spouse could keep up to $2,980.50 of income per month from the Medicaid spouse. The federal maximum for property retained by the community spouse is $119,220, in addition to the family home (up to a value of $552,000, or higher in some states), car and household furnishings. But your state exemptions might be lower than the federal limits, which are adjusted yearly.
 
4. Avoid Medicaid planning and transfers.
It obviously is tempting to transfer assets to children in order to qualify for your state's Medicaid long-term care program. In fact, an entire industry has sprung up to plan for this eventuality. But states are getting tougher - creating a "look back" period, typically five years, to examine such asset transfers. 
 
5. Consider long-term care insurance.
Although it's estimated that 70 percent of seniors will need at least some assistance with basic activities of daily living during their lifetimes, the average stay in a long-term care facility - the dreaded nursing home - is only 2.43 years.
 
So you may be better off purchasing a short-term long-term care insurance policy - one that allows the flexibility of choosing benefits for home health care, assisted living or a nursing home, as needed. 
Growing older is better than the alternative. And realistically planning for the possibilities of needing care in your later years gives peace of mind for you - and your family. That's the Savage Truth.
  

 

(Terry Savage is a Registered Investment Advisor, blogger and the author of four best-selling books, including "The Savage Truth on Money." Terry responds to question on her blog at TerrySavage.com.)


Monday, March 16, 2015

Guest Post

Guest Post by Heather McCarthy and Kate Ryan

 

A special thank you to Mr. Stephen Sutera, Attorney at Law, for allowing us to be guest bloggers this month.  Please allow us to introduce ourselves.  We are Heather McCarthy and Kate Ryan, both middle school English teachers at Oak Lawn Hometown Middle School.  We are also both mothers and writers.  Kate grew up in Mt. Greenwood, attended Mother McAuley High School, and Eastern Illinois University for her undergraduate degree.  She is the mother of Mae who is currently three years old.  Heather grew up in Justice, attended Argo Community High School and Elmhurst College for her undergraduate degree.  She is the mother of Maya (5 years old) and Christian (almost 2 years old).

 

We recently met with Mr. Sutera to talk about our new business adventure of writing personalized picture books for children with special needs.  We are a startup company that will create personalized picture books for children with disabilities, conditions, and syndromes ranging from Cerebral Palsy to Epilepsy, Autism to Downs Syndrome, and even food allergies.  Our company Someone Special Uniquely Personalized Books, LLC will run a Kickstarter Campaign in April and hopefully be fully functional to take orders by May this year.  If you would like more information about our company please visit our Facebook page or send us an email at someonespecialbooks.com.

 

While we write books for small children ages birth to eight years old, we would like to share a recent article we read for parents of children with special needs.  The January 29, 2015 post from Brain Child Magazine, written by Hilary Levey Friedman, discussed the top ten books for parenting children with disabilities.  Please enjoy our summary below or visit Top Ten Books for Parenting Children with Disabilities to read the full article.

 

All the books mentioned in the post make two similar points: 1) Your child is more than a syndrome or symptoms or disability, and 2) Navigating the bureaucracy associated with having a child with a disability is challenging. In their own ways, these memoirs and advice books provide advice and comfort not just to parents whose children share a similar issue, but to all. Lessons about self-reliance and acceptance are important for all kids.

 

These books were published in this century, which makes sense given that we know so much more about how young brains and bodies develop than we ever have before. All of them also talk about similar acronyms like IDEA, IEE, and 504. While some of the books focus on just one special need (like autism or learning disabilities or genetic conditions or Down’s syndrome), together they look to the future in some way, helping children to develop into adulthood—when they will become adults with disabilities, a specific population two books on the list focus upon.

 

Parenting Children with Health Issues and Special Needs by Foster Cline and Lisa Greene

This condensed version of 2007’s Parenting Children with Health Issues is a useful volume that focuses on the emotional development of ill children. The 2009 version includes advice for those with autism, learning disabilities, and other similar conditions. It has advice for all parents—like nurturing self-concept and being a consultant parent rather than a drill sergeant or helicopter. The main take-away is that children need to learn to take responsibility for their own bodies and adhere to medical advice.

 

A Good and Perfect Gift: Faith, Expectation, and a Little Girl Named Penny by Amy Julia Becker

A Good and Perfect Gift chronicles how Amy Julia and her husband, along with their families, friends, and students, come to understand Penny (born with Down’s Syndrome) and what she adds to their communities. Published by a Christian Press there is quite a lot of religiously-motivated discussion, but for those unfamiliar with this point of view it won’t distract from the larger messages of the book. Becker finds that Penny having Down’s Syndrome was hardest to deal with in the abstract, but once they were in a room together she became nothing more than their wonderful daughter who happens to have an extra chromosome. The lessons about pity versus compassion will help all of us who know someone with a special needs child.

 

The Boy in the Moon: A Father’s Journey to Understand His Extraordinary Son by Ian Brown

The Boy in the Moon is Canadian journalist Ian Brown’s lyrical memoir about his son, Walker. Walker suffers from a rare orphan genetic syndrome (meaning it comes out of nowhere), labelled Cardiofaciocutaneous (CFC). Given the small numbers who have it not much research is devoted to studying CFC, and as Brown soon learns he often knows more about it than the pediatricians he sees (as do the other parents with CFC children he meets and stays connected with via the Internet). Brown’s story reminds us that we all need to be advocates for our children to help them develop the best inner and outer lives possible.

 

Will My Kid Grow Out Of It? A Child Psychologist’s Guide to Understanding Worrisome Behavior by Bonny J. Forrest

Dr. Forrest’s practical guide will appeal to parents who are worried their children may be depressed, autistic, ADHD, schizophrenic, or have an eating or learning disorder. While she is clear that Will My Kid Grow Out Of It? is not meant to be a substitute for professional advice, her advice is plentiful. She believes there is no downside to screening a child because a parent will either get reassurance or get early access to the resources a child needs. This book offers a useful bibliography divided into sections like scientific journal articles, books, and websites.

 

Thinking Differently: An Inspiring Guide for Parents of Children with Learning Disabilities by David Flink

Like Dr. Forrest, Flink pushes testing and assessment for children because it helps families and schools build profiles that can lead to useful interventions. Flink focuses on “learning disabilities,” which are, “Generally understood to be an umbrella term for neurological difficulties in the brain’s ability to receive, process, store, express, and respond to information.” Flink himself has been diagnosed with a learning disability, dyslexia, and ADHD, and he is an expert in navigating how to use the educational system to get help. His Chapter 3, “Take Action,” is especially helpful in explaining to parents the laws and evaluations that can help children access help (his discussion about whether to hire an independent evaluator or use the one the school provides is important).

 

Essential First Steps for Parents of Children with Autism: Helping the Littlest Learners by Lara Delmoline and Sandra L. Harris

This short book by two professors who run the Douglass Developmental Disabilities Center at Rutgers University is packed full of useful information. Each chapter starts with the story of a specific family who has a child with an autism spectrum disorder and ends with a list of further reading and resources related to that chapter whether it be on self-help skills or play. A focus on your individual child and data on him or her is vital to seeing changes in child’s performance and behavior—so parents, start taking notes!

 

The Out-of-Sync Child: Recognizing and Coping with Sensory Processing Disorder by Carol Stock Kranowitz

Sensory processing disorder is seen as a new definition of an old problem. Until recently it was often overlooked, except by occupational therapists who are most effective in helping children with a range of sensory processing issues. Like other authors on this list, Kranowitz is a strong advocate for early intervention—even recognizing that insurance doesn’t always cover the cost of therapy, mainly because the disorder still isn’t included in the latest DSM. Kranowitz presents many checklists and questionnaires throughout the comprehensive book, but her images are also useful, like saying we should think of sensory processing disorder like indigestion of the brain and just like an antacid soothes, kids need occupational therapy to smooth their neural pathways.

 

The Complete Guide to Creating a Special Needs Life Plan: A Comprehensive Approach Integrating Life, Resource, Financial, and Legal Planning to Ensure a Brighter Future for a Person with a Disability by Hal Wright

Eventually many children with special needs develop into adults with special needs. Hal Wright is a Certified Financial Planner who has a daughter with Down’s syndrome. This book deals with various forms of planning, but the sections on financial and legal planning are especially useful. Wright talks about siblings and how parents need to be fair to help all children financially, while also knowing siblings often take on other burdens related to special needs siblings. It is up to parents to plan ahead and deal with the practical intricacies as children become adults and this book acts as a useful guide.

 

Parenting an Adult with Disabilities or Special Needs: Everything You Need to Know to Plan for and Protect Your Child’s Future by Peggy Lou Morgan

If Wright’s book focuses on the practicalities of having an adult child with special needs, Morgan’s book focuses on the actual caring issues. She writes, “All parents deal with the sometimes-paralyzing question of what happens to adult children when we can no longer be there for them. While legal documents are very important, they may not prepare caregivers, nominated representatives, or others to understand someone who may not be able to communicate his needs directly. The sample caregiver’s manual in the appendices is important for anyone working on this daunting task.

 

Touchpoints Birth to Three: You Child’s Emotional and Behavioral Development by T. Berry Brazelton and Joshua Sparrow

You might be surprised to find a book on this list that focuses on “typical” developmental milestones. But many parents of special needs kids express, as Becker does in A Good and Perfect Gift, that it can be helpful in a way to see in what ways a child is attaining milestones at around the right time (could be verbal if physical is a problem, or vice versa). Touchpoints recognizes not only development forward, but also regression at certain times. So some special needs parents may learn a bit, but they will also benefit from discussion of other issues like divorce, television, etc. In the end, a book like this reminds us that each child is an individual and not just a symptom, disorder, or disease.

 

Hilary Levey Friedman is the Book Review Editor at Brain,Child and the author of Playing to Win: Raising Children in a Competitive Culture

 


Sunday, March 1, 2015

Community Care Program -- Helping Older Adults Stay Home

Taken from PLOWS Council on Aging Newsletter January-February 2015

 The Community Care Program (CCP) is designed to help persons, age 60 and over, live independently, in their own homes for as long as possible. Services available under this program include In-Home services, Adult Day Care and Emergency Home Response.  The Community Care Program is a State of Illinois program and there is no cost to eligible participants.

  

In order to begin the process for services, PLOWS sends a Care Coordinator to your home to determine your eligibility for the program.

 

If you qualify for CCP services, your Care Coordinator will work with you to determine your needs, set up services that are appropriate for you, and keep in touch with you to make sure the services continue to meet your needs.

 

Qualifications established by the Illinois Department on Aging for the Community Care Program open the program to individuals who:

  • are 60 or older
  • are U.S. citizens or legal aliens
  • have assets of $17,500* or less for a single person, not including home, car, or personal furnishings
  • are determined physically in need of service, meaning you are at least moderately impaired

Help is a phone call away.  If you would like to know more about this service, please call 708-361-0219.

*determining asset guidelines for couples is more complex and will vary depending on certain factors.  This can be explained during the care coordinator's home visit.


Thursday, January 22, 2015

Alzheimer's Association: Know the 10 Signs (Early Detection Matters)

Taken from the Alzheimer's Association Publication:

 Know the 10 Signs of Alzheimer's Disease:

1.  Memory loss that disrupts daily life.  One of the most common signs of Alzheimer's, especially in the early stages, is forgetting recently learned information.  Others include forgetting important dates or events; asking for the same information over and over; relying on memory aides (e.g., reminder notes or electronic devices) or family members for things they used to handle on their own.  What's typical?  Sometimes forgetting names or appointments, but remembering them later.

 

2.  Challenges in planning or solving problems.  Some people may experience changes in their ability to develop and follow a plan or work with numbers.  They may have trouble following a familiar recipe or keeping track of monthly bills.  They may have difficulty concentrating and take much longer to do things than they did before.  What's typical?  Making occasional errors when balancing a checkbook.

 

3.  Difficulty completing familiar tasks at home, at work or at leisure.  People with Alzheimer's often find it hard to complete daily tasks.  Sometimes, people may have trouble driving to a familiar location, managing a budget at work or remembering the rules of a favorite game.  What's typical?  Occasionally needing help to use the settings on a microwave or to record a television show.

 

4.  Confusion with time or place.  People with Alzheimer's can lose track of dates, seasons and the passage of time.  They may have trouble understanding something if it is not happening immediately.  Sometimes they may forget where they are or how they got there.  What's typical?  Getting confused about the day of the week but figuring it out later.

 

5.  Trouble understanding visual images and spatial relationships.  For some people, having vision problems is a sign of Alzheimer's.  They may have difficulty reading, judging distance and determining color or contrast.  In terms of perception, they may pass a mirror and think someone else is in the room.  They may not recognize their own reflection.  What's typical?  Vision changes related to cataracts.

 

6.  New problems with words in speaking or writing.  People with Alzheimer's may have trouble following or joining a conversation.  They may stop in the middle of a conversation and have no idea how to continue or they may repeat themselves.  They may struggle with vocabulary, have problems finding the right word or call things by the wrong name (e.g., calling a watch a "hand clock").  What's typical?  Sometimes having trouble finding the right word.

 

7.  Misplacing things and losing the ability to retrace steps.  A person with Alzheimer's disease may put things in unusual places.  They may lose things and be unable to go back over their steps to find them again.  Sometimes, they may accuse others of stealing.  This may occur more frequently over time.  What's typical?  Misplacing things from time to time, such as a pair of glasses or the remote control.

 

8.  Decreased or poor judgment.  People with Alzheimer's may experience changes in judgment or decision making.  For example, they may use poor judgment when dealing with money, giving large amounts to telemarketers.  They may pay less attention to grooming or keeping themselves clean.  What's typical?  Making a bad decision once in a while.

 

9.  Withdrawal from work or social activities.  A person with Alzheimer's may start to remove themselves from hobbies, social activities, work projects or sports.  They may have trouble keeping up with a favorite sports team or remembering how to complete a favorite hobby.  They may also avoid being social because of the changes they have experienced.  What's typical?  Sometimes feeling weary of work, family and social obligations.

 

10.  Changes in mood and personality.  The mood and personalities of people with Alzheimer's can change.  They can become confused, suspicious, depressed, fearful or anxious.  They may be easily upset at home, at work, with friends or in places where they are out of their comfort zone.  What's typical?  Developing very specific ways of doing things and becoming irritable when a routine is disrupted.

 

If you have questions about any of these warning signs, the Alzheimer's Association recommends consulting a physician.  Early diagnosis provides the best opportunities for treatment, support and future planning.

 

For more information, go to:

http://alz.org/alzheimers_disease_10_signs_of_alzheimers.asp

 

 

 

 

 

 


Monday, December 15, 2014

Permission to Grieve

Taken from "A Bereavement Publication from Heartland Hospice", Winter 2014 

As we begin to celebrate this Holiday Season, there are many among us who have lost someone during this past year.  For them, I would like to share this "Holiday Bill of Rights":

  • You have the right to take care of yourself:  to eat right, exercise regularly, and get enough rest.
  • You have the right to have mixed emotions: happy, sad, frustrated, angry, guilty, afraid, and thankful.
  • You have the right to cry when you are sad, smile when you are happy and not feel guilty about it.
  • You have the right to say no to any holiday activities - to pace yourself differently.  You have the right to change your mind about a previously agreed to commitment.
  • You have the right to share your feelings or not.
  • You have the right to have solitude:  for planning, thinking, reflection, introspection, prayer, and relaxation.
  • You have the right to remember your loved one in a meaningful way.
  • You have the right to ask for help and support from friends; family; your church, synagogue, or mosque; and/or community service agencies.
  • You have the right to give gifts that are within your holiday budget.
  • You have the right to follow old traditions or make up new ways of celebrating holidays.

The Law Offices of Stephen Sutera wish everyone a season filled with peace!


Monday, November 10, 2014

Estate Plans For Collectibles.....Without proper planning your treasured possessions could wind up being dumped in a yard sale.

Excerpts taken from November 1-2, 2014 Wall Street Journal

Estate Plans for Collectibles

Alex Cilento has assembled a 3,700-piece casino-chip collection - but can't find any family member who wants to take it.

The New York resident, who is 65 years old and childless, has been collecting the Las Vegas chips - which he estimates are worth as much as $500,000 - for more than two decades.  No one in his family has expressed any interest in his passion for Las Vegas history or chip collecting, he says.  He also is afraid they would unwittingly sell them for far less than they are worth.

Collectors can spend a lifetime amassing things like baseball cards, comic books or even casino chips, as well as art.  But they often pay too little attention to what will happen to their prized possessions after they die.

Collectors may hope their children will suddenly find a passion for all the stuff that cluttered their house when they were growing up.  They may figure another collector will pay their heirs big bucks for it, or dream of donating it to a museum that will display it for posterity.

Without proper planning, though, their treasured possessions could wind up being dumped in a yard sale.

They also could miss out on tax savings, says managing director of wealth planning at Wells Fargo Private Bank in San Francisco.

Here are some steps collectors can take whether they decide to pass along, sell or donate their collections:

  • Passing it on.  Collectors should make sure there is someone in their family who might be interested in their collections - and they also need to make sure that person can afford the upkeep, including insurance and storage, says Carol Kroch, managing director of wealth and philanthropic planning at Wilmington Trust in Wilmington, Del..  There are other considerations as well.  If some family members, but not others, are interested, how does the collector compensate those who aren't receiving the collection?  If everyone is interested in the collection, do you split it up?  If so, does that affect its value?  Finally, if no one can afford the costs of keeping the collection, can the collector afford to leave an endowment to maintain the collection?  To answer these questions, the collector would first need to have the collection appraised both as a single collection and as several smaller collections, to see what the impact on its value would be, Ms. Koch says.  The collector also would need to look into long-term storage and insurance costs, to decide how much of an endowment would be needed to cover those costs.   Often, trusts are used to hold the collection, either during the collector's lifetime or transferred to a trust at death.  
  • Selling it.  Some people simply choose to sell their collections.  They first need to determine the collection's fair value, using an independent appraiser.  Note that collectibles are taxed at the higher capital-gains rate of 28%, and the sale also may be subject to other costs, such as commissions and shipping.
  • Donating it.  It isn't always so easy for donors to find charities willing to take their collections.  Even if you find one, it might require an endowment fund to maintain the collection.  If collectors want to make gifts during their lifetimes that would be deductible for income-tax purposes, they need to consider the value of the collection in light of their adjusted gross income, or AGI.  In addition, the charity must use the donated property for a related purpose or the donor won't be permitted a full fair-market-value deduction.  

 

 


Wednesday, October 29, 2014

Pope Francis' 10 Tips for a Happier Life

1.  "Live and let live."  Everyone should be guided by this principle, he said, which has a similar expression in Rome with the saying, "Move forward and let others do the same."

2.  "Be giving of yourself to others."  People need to be open and generous toward others, he said, because "if you withdraw into yourself, you run the risk of becoming egocentric.  And stagnant water becomes putrid."

3.  "Proceed calmly" in life.  The pope, who used to teach high school literature, used an image from an Argentine novel by Ricardo Guiraldes, in which the protagonist -- gaucho Don Segundo Sombra -- looks back on how he lived his life.

4.  A healthy sense of leisure.  The Pope said "consumerism has brought us anxiety", and told parents to set aside time to play with their children and turn off the TV when they sit down to eat.

5.  Sundays should be holidays.  Workers should have Sundays off because "Sunday is for family," he said.

6.  Find innovative ways to create dignified jobs for young people.  "We need to be creative with young people.  If they have no opportunities they will get into drugs" and be more vulnerable to suicide, he said.

7.  Respect and take care of nature.  Environmental degradation "is one of the biggest challenges we have," he said.  "I think a question that we're not asking ourselves is: 'Isn't humanity committing suicide with this indiscriminate and tyrannical use of nature?"'

8.  Stop being negative.  "Needing to talk badly about others indicates low self-esteem.  That means, 'I feel so low that instead of picking myself up I have to cut others down,"' the Pope said.  "Letting go of negative things quickly is healthy."

9.  Don't proselytise; respect others' beliefs.  "We can inspire others through witness so that one grows together in communicating.  But the worst thing of all is religious proselytism, which paralyses: 'I am talking with you in order to persuade you,' No.  Each person dialogues, starting with his and her own identity.  The church grows by attraction, not proselytising," the Pope said.

10.  Work for peace.  "We are living in a time of many wars," he said, and "the call for peace must be shouted.  Peace sometimes gives the impression of being quiet, but it is never quiet, peace is always proactive" and dynamic.


Thursday, October 2, 2014

Protect Your Data

Protect Your Data (Excerpts taken from AARP The Magazine)

 

As the data hacking continues at retailers such as Target, Home Depot and others, how do you protect yourself from these breaches?  By adopting new habits in how you do business, monitoring your financial life and safeguarding your electronic devices.  Checking off all the items on the following list doesn't guarantee you won't be a victim.  It does increase the likelihood that if your accounts are hacked, you'll notice this - and be able to shut it down - quickly.  And that's half the battle.  Here's what to do.

Monitor your financial life
Keep an eye on your bank and credit card account activity, as well as your credit report.  Check your bank accounts online almost daily.  Check your credit card statements several times before the end of each billing statement. Using AnnualCreditReport.com you should request one free credit report every four months from the three major reporting bureaus.

Layer up

In addition to checking your report, you can put a freeze on it in most states even if you haven't been an ID theft victim.  That prevents thieves from applying for credit in your name.  It typically costs $3 to $10 to freeze - and unfreeze - per credit-reporting bureau.  You can also get credit monitoring for free from several sites online.  This is what is called "layered security".

Ditch the snail mail

Neal O'Farrell, executive director of the Identity Theft Council, calls the U.S. postal system "an absolute gift" for identity thieves, who can reach into your mailbox and grab whatever's there.  Subvert them by doing as much banking and bill paying online as possible.  Doing this makes you less vulnerable, not more.

Protect your technology

As you are busier online, you need your devices to be as secure as possible.  Make sure they have the latest antivirus software and the most recent secure browser.  If you insist on doing transactions via Wi-Fi, be certain you've got a secure (i.e., encrypted) connection, which freebies generally don't offer.

Fix poor passwords

Weak passwords are a crook's best friend.  Make yours long and complex, and change them often - not just on your bank account but on your email and social media, too.


Tuesday, May 27, 2014

More Stress Caring for Spouse than Parent

Taken from May 21, 2014 Southtown Star:

More Americans may wind up helping Mom as she gets older, but a new poll shows the most stressful kind of caregiving is for a frail spouse.

The population is rapidly aging, but people aren't doing much to get ready even though government figures show nearly 7 in 10 Americans will need long-term care at some point after they reach age 65.

In fact, people 40 and over are more likely to discuss their funeral plans than their preferences for assistance with day-to-day living as they get older, according to the poll by the AP-NORC Center for Public Affairs Research.  Five findings from the poll:

Effect on Families:  Half of people 40 and older already have been caregivers to relatives or friends.  Six in 10 have provided care to a parent, mostly a mother, while 14 percent have cared for a spouse or partner.

Overwhelmingly, caregivers called it a positive experience.  But it's also incredibly difficult, especially for spouses.  While 7 in 10 who cared for a spouse said their relationship grew stronger as a result, nearly two-thirds said it caused stress in their family compared with about half among those who cared for a parent.

It's not just an emotional challenge but a physical one:  The average age of spouse caregivers was 67, compared to 58 for people who've cared for a parent. 

Virginia Brumley, 79, said caring for her husband Jim for nearly five years as he suffered from dementia strengthened their bond.  But eventually he needed a nursing home because "he was too big for me.  He was as helpless as a baby," she said.

Long-term Planning: A third of Americans in this age group are deeply concerned they won't plan enough for the care they'll need in their senior years, and that they'll burden their families.

Yet two-thirds say they've done little or no planning.  About 32 percent say they've set aside money to pay for ongoing living assistance; 28 percent have modified their home to make it easier to live in when they're older.

In contrast, two-thirds have disclosed their funeral plans.

Becoming a Caregiver: Three in 10 Americans 40 and older think it's very likely that an older relative or friend will need care within the next five years.  

Just 30 percent who expect to provide that care feel very prepared for the job, while half say they're somewhat prepared.  But only 40 percent have discussed their loved one's preferences for that assistance or where they want to live.  Women are more likely than men to have had those tough conversations.

What Does it Cost?: Some 53 percent of people underestimate the monthly cost of a nursing home, about $6,900.  Another third underestimate the cost of assisted living, about $3,400.  One in 5 wrongly thought a home health aide costs less than $1,000 a month.

Contrary to popular belief, Medicare doesn't pay for the most common long-term care.  But nearly 6 in 10 Americans 40 and older support some type of government-administered long-term care insurance program, a 7 point increase from last year's AP survey.

What Else Might Help?: More than three-fourths of this age group favor tax breaks to encourage saving for long-term care or for purchasing long-term care insurance.  Only a third favor a requirement to purchase such coverage.  Some 8 in 10 want more access to community services that help the elderly live independently.

More that 70 percent support respite care programs for family caregivers and letting people take time off work or adjust their schedules to accommodate caregiving. 

The AP-NORC Center survey was conducted by telephone March 13 to April 23 among a random national sample of 1,419 adults age 40 or older, with funding from the SCAN Foundation.  Results have a margin of sampling error of plus or minus 3.6 percentage points.

 

 

 

 


Tuesday, April 29, 2014

What are the differences between a Living Will, Health Care Power of Attorney (HCPOA), Physician Orders for Life Sustaining Treatment (POLST) and a DNR?

What are the differences between a Living Will, Health Care Power of Attorney (HCPOA), Physician Orders for Life Sustaining Treatment (POLST) and DNR?

A Living Will informs others of your preferred medical treatment should you become permanently unconscious, terminally ill, or otherwise unable to make or communicate decisions regarding treatment. In conjunction with other estate planning tools, it can bring peace of mind and security while avoiding unnecessary expense and delay in the event of future incapacity. 

The law allows you to appoint someone you trust to decide about medical treatment options if you lose the ability to decide for yourself. You can do this by using a Health Care Power of Attorney or Health Care Proxy where you designate the person or persons to make such decisions on your behalf. You can allow your health care agent to decide about all health care or only about certain treatments. You may also give your agent instructions that he or she has to follow. Your agent can then ensure that health care professionals follow your wishes. Hospitals, doctors and other health care providers must follow your agent's decisions as if they were your own.  The health care power functions appropriately as long as you have named the correct agent.

 

As per the Chicago end of life coalition (http://www.cecc.info/resource-links/physicians-order-for-life-sustaining-treatment-polst/):

POLST stands for “Physician Orders for Life-Sustaining Treatment”.  A POLST form is a signed medical order that travels with a person to assure that an individual’s treatment preferences at end-of-life are honored across all settings of care (hospital, nursing home, assisted living facility etc.).

POLST is designed for people who are seriously ill or have life-limiting illnesses. It is also appropriate for someone that will lose the ability to make health decisions for themselves, such as someone with dementia.

The POLST form:

  • Allows patients to create medical orders reflecting their treatment wishes at end-of-life.
  • Helps health care professionals know and honor the treatment wishes of their patients.
  • Allows emergency medical personnel to facilitate these wishes.

The POLST form is an advance directive in accordance with Illinois law. It is NOT intended to replace a Health Care Power of Attorney (HCPOA) form, but to be used in addition to this form. Therefore, this form is actually signed by your doctor and the patient.

 

As per the Illinois Department of Health, the Illinois Department of Public Health (IDPH) created a new Uniform Do-Not-Resuscitate (DNR) Advance Directive form that offers Illinoisans more health care options. The DNR form is also designed for people who are seriously ill or have life-limiting illnesses.  An advance directive is a written statement you and your doctor prepare, about how you want your medical decisions to be made in the future if you are no longer able to make them for yourself. The new IDPH form adds a greater level of specificity when it comes to decisions about cardiopulmonary resuscitation (CPR) and life support measures including being intubated, placed on a ventilator and fed through a tube. The new IDPH advance directive form also meets requirements to nationally be considered a physician orders for life-sustaining treatment (POLST) form. Therefore, this form is actually signed by your doctor and the patient. It is NOT intended to replace a Health Care Power of Attorney (HCPOA) form, but to be used in addition to this form.

 

Hence, these documents should only be signed in limited circumstances; whereas, Health Care Power of Attorney Forms should always be considered for individuals desiring to control medical decisions when they are not able to make these decisions themselves.


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With two offices in Oak Lawn and Oak Brook, Stephen M. Sutera assists clients throughout Cook County, DuPage County and Will County IL including Chicago, Hometown, Barrington, Burbank, Burr Ridge, Chicago Ridge, Darien, Downers Grove, Evergreen Park, Geneva, Worth, Bridgeview, Palos Park, Palos Hills, Palos Heights, Hickory Hills, Midlothian, Willow Springs, Oak Forest, Orland Park, La Grange, Brookfield, Berwyn, Tinley Park, Hinsdale, Villa Park, Clarendon Hills, Westchester, Westmont, Lombard, Elmhurst, Western Springs, Berkeley, Downers Grove, Fox Valley, Glen Ellyn, Willowbrook, Aurora, Addison, Lisle, Forest Park, Bensenville, Wheaton, River Forest, Itasca, Shorewood, Frankfort, Mokena, Naperville, Crest Hill, Homer Glen, New Lenox, Bollingbrook, Schaumburg, Channahon and Woodridge.



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