Apps to Make Dementia Care Easier.

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Smartphones and tablets have become integral parts of everyday life. There seems to be an app for everything. Not surprising, there are many smartphone and tablet apps to help dementia sufferers and their care givers address the many dementia-related challenges faced on a daily basis. Loretta Woodward Veney, a motivational speaker and author, whose mother has dementia, shares some of her favorite care giving and dementia apps available today and how they may help, at www.healthcentral.com.  There are apps to help schedule and organize appointments and care, apps to help share events, coordinate activities, and communicate with members of a care giving team, even activity apps to engage dementia sufferers.

You may follow the link here to read the article.

New Tax Law Boosts Michigan ABLE Accounts for the Disabled.

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A MiABLE account allows a disabled Michigan resident to save money in an account in their own name and not jeopardize eligibility for needs-based government benefits such as Supplemental Security Income (SSI) and Medicaid. Money can be withdrawn from the account to pay for “qualified disability expenses” and such expenditures will not be counted as income to the disabled individual to determine eligibility for SSI or Medicaid. Further, there is no income taxation of the gain in value of a MiABLE account.

The recently enacted Tax Cuts and Jobs Act includes two provisions that enhance the benefits of MiABLE accounts for disabled Michigan residents:

One provision of the new tax law allows families to roll over funds that they may have saved in a 529 college savings account to a MiABLE account, provided that the beneficiary is the same individual on both accounts. The money can be transferred from a 529 account into a MiABLE account and the individual may still enjoy the benefits of the account funds without jeopardizing their eligibility for government benefits. This can be an important benefit if a disability occurs after birth or is not readily apparent at birth, and it is not likely that the disabled person will not be able to attend college. For example, grandparents set up and contribute to a 529 account for their newborn grandchild. The grandchild is later diagnosed with autism at age 11. The money the grandparents have deposited into the 529 account can be transferred to a MiABLE account for the grandchild without penalty.

The second provision allows a working disabled individual to contribute more than the current annual contribution limit of $15,000 to a MiABLE account without jeopardizing their eligibility for government benefits. Many disabled individuals want to work and are able to, but are discouraged from doing so because they may lose their SSI or Medicaid benefits if they earn too much money from a job.

When The Elderly Refuse to Stop Driving: How One Family Took Action.

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What do you do when the time comes for an elderly parent to stop driving, but they won’t?

When Stephen Petrow came face to face with dilemma, he and his siblings did something drastic – they anonymously reported their mother’s dangerously poor driving to the State of New York DMV. Although she passed the written exam, her license was revoked after she failed a mandatory driving test.  The examiner’s comments on her road test included:  “Extremely dangerous!! Turns wide into wrong side of road! Poor late braking. . . Completely unaware of surroundings.”

While Stephen Petrow knew this was the right thing to do, he wonders if he will have the courage to willingly give up his car keys (and autonomy) voluntarily if he becomes a danger to others.

This is a good article relating one family’s struggle with what is, unfortunately, a growing problem.

Read Stephen Petrow, When our elderly mother refused to stop driving, we took drastic action.

What “Cause” is “Good Cause” to Remove a Conservator?

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A “conservator” is a person appointed by a probate court to manage the assets or affairs of another (the “protected individual”) who, by reason of physical or mental disability, is incapable of controlling or managing their assets or affairs on their own. The conservator acts as a “fiduciary,” meaning that the conservator must manage the assets and affairs of the protected individual always and solely for the benefit of the protected individual.  Decisions the conservator may make regarding the protected individual’s assets or affairs must be made solely in the best interest of the protected individual; the conservator must subordinate their own wishes or preferences in their decision making.

In Michigan, a conservator may be removed for “good cause.” The Michigan statute addressing the removal of a conservator does not define the term “good cause.”  A recent case decided by the Michigan Court of Appeals addresses the issue of what is “good cause” to remove a conservator .

In 2013, Marian was appointed conservator for her mother, Mary, who was 86 years old and had begun to exhibit symptoms of dementia. Mary had eight children at the time the conservatorship was established. In 2015, one of Marian’s siblings, Rita, filed a petition to remove Marian as Mary’s conservator based upon Marian’s conduct managing Mary’s assets and affairs.

After a lengthy hearing, the local probate court found that Mary continued to require a conservator, but despite their good intentions, neither Marian, nor any of her siblings was suitable to act as Mary’s conservator. The probate court found that based upon the deep emotional connection between Mary and Marian, Marian was not capable of acting in Mary’s best interest and separating Marian’s wants from Mary’s needs. In addition, based upon the ongoing conflict among Mary’s children, the best interest of Mary required the appointment of a public administrator as Mary’s conservator.

On appeal, Marian argued that the probate court should not have removed her as conservator because she had not mismanaged Mary’s assets or affairs, or failed to perform any duty required of her as Mary’s conservator. The Michigan Court of Appeals upheld the probate court’s decision, saying that the statutory “good cause” standard for removal does not require any particular misconduct. “‘Good cause simply means a satisfactory, sound or valid reason’” for removal. The court stated that, due to Marian’s inability to remove her emotions and personal wishes form decisions pertaining to Mary’s assets and affair, she was incapable of making decisions solely in Mary’s best interest and was reason enough to warrant her removal.

Every conservatorship is different, but the duty of every conservator is the same: To act in the best interest of the protected individual. The typical person appointed as conservator for another is usually a close family member — a spouse, child, or grandchild. In such cases it is often extremely difficult to separate one’s emotions from the decision-making process. In addition, siblings or other close family members may have their own ideas what should be done with respect to the protected individual’s assets and affairs. Family in-fighting is a common occurrence and can justify a probate court to look outside the family for a suitable person to act as conservator.

As we saw with Marian, her conduct was not malicious, nor had she mismanaged Mary’s assets or affairs. She broke no laws. But when a conservator’s decisions, like Marian’s, are colored by emotion or personal desire, or may be affected by family in-fighting, those decisions may not be in the protected individual’s best interest, warranting their removal.

The case is In re Conservatorship of Mary Louise Montgomery. You can read the entire opinion here.

Are you struggling with managing the assets or affairs of another as their conservator? Give me a call, I can help.

Contact me

18 Questions You Should Be Asking A Nursing Home

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How do you know whether a nursing home is right for a loved one?  The Pioneer Network, a non-profit organization, offers 18 questions to ask when evaluating a nursing home for a loved one (and a separate list of 16 questions to ask when evaluating an assisted living facility).  The Pioneer Network is made up of professionals working in long-term care, long-term care facility residents and family members who advocate for them.

The Pioneer Network, active in 36 states, is part of a growing broad-based movement in long-term care that is sometimes called “culture change.” Culture change is a movement away from generic, system-based care and toward more individual, person-centered/directed care. Under culture change, residents have a meaningful voice in the care they get and have as many of the freedoms they had in their earlier homes as possible.

You can find out if a nursing home is part of the culture change movement by asking specific questions (and the answers you should get) when you visit for a tour, including:

  • Is your nursing home involved in culture change?
  • Will my loved one be able to choose when they are awakened in the morning?
  • What is your policy regarding food choices and alternatives?
  • What types of activities are offered to residents?
  • What is the turnover rate for the direct care staff here?

Please go to this page at the Pioneer Network’s website to read the entire list of questions (with answers to listen for) to ask when assessing a nursing home or an assisted living facility for a loved one. The lists are available for download, too.

Michigan Launches the MiABLE Account Program.

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Michigan’s ABLE account program (“MiABLE”) has gone into effect. The program launched November 1, 2016.

MiABLE program accounts are modeled after 529 college savings accounts, and are meant to help persons with disabilities save money in their own names and allow tax advantaged distributions for certain expenses including housing, transportation, health and wellness, education and more, while maintaining eligibility for federal and state aid. Like 529 college savings accounts, if funds distributed from a MiABLE account are not used for qualifying expenses, any investment growth will be taxed at ordinary income tax rates, plus a 10% penalty. MiABLE account funds can be rolled over tax-free from one MiABLE account to another and the designated beneficiary can be changed from one disabled person in a family to another in the same family.

Some details for Michigan MiABLE accounts:

  • Six investment portfolio options are available, from conservative to aggressive portfolios.
  • Debit cards will become available to account holders in early 2017. This will make it easier for an account holder to access funds in their account.
  • A major benefit to a MiABLE account holder is the ability to post their account online, like GoFundMe accounts, to make it easier for third parties (parents, grandparents, siblings, etc.) to donate directly to the account.
  • MiABLE accounts will be charged an annual fee of $45.

More MiABLE account information, as well as online enrollment is available at www.miable.org.

Short Term Care Insurance Becoming More Popular

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According to an article at Financial Advisor online, more seniors are purchasing short-term care insurance policies to help with the costs of care. As the name implies, a short term care policy generally provides coverage for a maximum of 360 days, and can pay for assisted living, home care assistance and skilled nursing home care costs. Short-term care insurance helps seniors cover gaps in Medicare and can be an alternative to long-term care insurance when age, cost, or other factors are issues. The cost is substantially less than that of long-term care insurance. Over 90 percent of the purchasers of short-term care insurance are over the age of 60.

If you or a loved one are considering alternatives to paying for costs associated with care assistance or nursing home care, short-term care insurance may be an attractive option.  As with any insurance purchase decision, don’t invest unless you know how the policy works and fully understand its terms, including its exceptions and exclusions.

Please read the entire article here.

Social Security Introduces Digital “My Social Security Account”

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With the advent of new digital technology, you may now manage your Social Security account online using your own personal “my Social Security account.” Setting up a “my Social Security account” is quick, secure, and easy. Over 18 million Americans have already done so. A new account is opened approximately every 6 seconds.  A “my Social Security account” will give you the tools to manage the complex issues surrounding social security.

With a personalized “my Social Security account,” you can:

  • Get an instant, personalized estimate of your future Social Security benefits;
  • Verify the accuracy of your earnings record;
  • Apply for retirement, disability, spousal, and Medicare benefits;
  • Check the status of your benefit application;
  • Utilize one of Social Security’s benefits planners to help you better understand your options as you plan for retirement;

And much more.

The site is optimized to function on home computers, tablets, and smartphones so you can access your personalized account from anywhere.

You can sign up today at www.socialsecurity.gov/myaccount.

Estate Planning For The Here and Now

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Estate planning clients tend to focus on the “when I die” issues when tending to their estate planning. However, if all you have done is sign a will and trust to order your affairs and distribute your property after you die, your estate plan is seriously deficient. Death is a certainty, but incapacity at some point during your lifetime is highly probable. And failing to plan to maintain continuity and management of your medical care and financial affairs during a period of incapacity can have disastrous consequences.

You must include tools in your estate plan to allow others to handle your personal and financial affairs during times when you cannot do so yourself. If you don’t, a court will be required to appoint a guardian to handle decisions concerning your person, and a conservator to manage your assets. This can be a time-consuming, expensive, and burdensome proposition.

So, what should you include in your estate plan to protect you during a period of incapacity? At a minimum, a durable power of attorney, a medical power of attorney, and a HIPAA medical authorization. Let’s look at each:

Durable power of attorney. Under a durable power of attorney, you appoint an agent to handle your financial affairs if you become incapacitated. Everything from banking and bill paying to preparing and filing tax returns on your behalf can be handled by your agent. Your agent will be able to access bank accounts, make sure your bills are paid, and keep your affairs in order until you regain the ability to do so. A durable power of attorney can be designed to take effect the moment you sign it, or at some point in the future if and when you become incapacitated.

Medical Durable Power of Attorney. Commonly referred to as a “patient advocate designation,” Michigan law allows you to appoint someone (your “patient advocate”) to make medical treatment decisions for you in the event you cannot make them for yourself. Your patient advocate can access medical records, talk to your doctors and make treatment decisions for you as long as you can’t make them for yourself. It may contain expressions of your desires concerning medical treatment at the point where your condition is such that there is no longer any prospect of a recovery, such as at the end-stage of a terminal illness. These instructions will ensure that you live your last days in dignity and peace.

HIPAA medical authorization. With a HIPAA authorization, you designate a person with whom medical providers can share your medical information and discuss your medical care. Even with a valid health care power of attorney, a medical provider may refuse to release your medical information to another person. They may refer to privacy restrictions contained in the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Doctors, hospitals, and other medical facilities fear the legal repercussions of unauthorized disclosures of one’s medical information. So without written authorization from you, they may not speak with family members, even a spouse or a child, or release medical information to them.

Don’t neglect the here and now in your estate plan. Adding a durable power of attorney, medical power of attorney, and a HIPAA authorization to your existing estate plan will give you protection during your lifetime when you are most vulnerable.