If you want to be comprehensively prepared for the future you can’t overlook things that you may not be especially anxious to think about. There are those who cross their fingers, stick their heads in the sand, and hope for the best, but these are the people who find themselves totally unprepared for contingencies that arise. Making prudent preparations for things that may or may not happen is wise because these advance plans will be welcome should they be needed, and if they are not all the better.

One of the things to think about when you’re looking forward is the possibility of a stay in a long-term care facility or the need for in-home care. Statistics compiled by the United States Department of Health and Human Services tell us that seven out of every 10 senior citizens will someday need some form of long-term care. So this is something that is relevant to all of us, and using current figures a typical stay in a nursing home may run you in excess of $200,000. This is a lot of money for many people so it is wise to be aware of all of your options.

Some people address long-term care costs by taking out a home equity conversion mortgage. These are federally backed reverse mortgages that make payments to you in return for equity in your home. The loan becomes due after you move from the home or pass away.

You could choose to take out a home equity conversion mortgage and use the money that you receive to pay for in-home care. If you’re able to stay at home throughout your life, when you pass away the loan will become due. At this time your heirs could choose to sell the house, pay off the loan balance, and keep any remainder that may exist. It should be mentioned that they’re not required to sell the home. The loan must simply be satisfied, and this can be done utilizing any source of funding that may be available to the responsible party.

Another option would be to use the funds derived from the HECM to pay for long-term care insurance. If you do need to move into a long-term care facility your coverage will pick up the costs. You could then sell the home, pay off the loan, and pocket the amount that remains.

The Law Offices of Saul Kobrick, P.C. is a member of the American Academy of Estate Planning Attorneys.

When you are planning for your retirement years you are probably envisioning travel and leisure times, and this is as it should be. But if you want to be comprehensively prepared you would do well to consider all of the eventualities of aging. There may come a time that people call the “twilight years” when your life slows down and you may in fact find it difficult or impossible to take care of your personal needs without assistance. Though this is not the most pleasant thought in the world, it is the reality, and you have to plan ahead accordingly if want to minimize the challenges that you may face should you need living assistance eventually.

How likely is it that you will someday spend time in an assisted living community or nursing home? People are living to an advanced age quite routinely these days and the portion of the population aged 85 and up are the fastest growing age group in the United States. Statistics indicate that one-fourth of the oldest old are indeed residing in nursing homes at any given time. In addition, seven out of ten senior citizens will need long-term care at some point in time. So the fact is that it is quite possible that you will be among them.

The suggestion here is to take this possibility seriously and identify a suitable long-term care facility on your own before you ever need such care. There are going to be a lot of options out there and some will be a better fit for you than others. If you do your research and then physically visit the facilities that are on your short list you can inspect the property, ask questions, and compare the prices in an effort to find optimal value for your dollar.

If you wait until you are actually in need of long-term care to start looking you may not be as capable as you will be earlier on. You may never need long-term care, but if you do it is comforting to know that you will be living in a community that you have visited and carefully selected beforehand.

The Law Offices of Saul Kobrick, P.C. is a member of the American Academy of Estate Planning Attorneys.

Some 1.5 million people are living in nursing homes in the United States, and the average cost for a year in a private room has reached over $83,000. Being financially prepared should you or a family member require long term care is an essential element of estate planning. But being prepared financially is only half of the equation. Finding a facility that best suits your needs is a challenging task as well. Fortunately we live in the information age, and the Internet has made it possible to do a great deal of research quickly and efficiently.

The federal Centers for Medicare and Medicaid Services (CMS) has created a Five-Star Quality Rating System to help consumers compare long term care facilities in their states. The five star rating system uses three data sources: (1) Health Inspections; (2) Nurse Staffing; and (3) Quality Measures. The top ten percent of facilities in each state are given five star ratings. The ratings for all long term care facilities in New York can be found at www.medicare.gov (Nursing Home Compare). This information has been further refined at health.usnews.com. The website shows all the facilities in each state that received a top overall rating of 5 stars from the CMS.

Five star rating are great but this is just a place to start. You will need to compile a list of facilities in your area that appear to be suitable, giving preference to those closest to your home. Call and arrange a visit to each of the facilities, and then make an unannounced second visit before making a final decision. Prepare a list of questions in advance or go to the Medicare.gov website and print out the Nursing Home Checklist. The checklist will help you stay on track and cover all the pertinent areas that you may not have considered on your own.

If you take advantage of the resources that are available and do some legwork you should be able to make an informed decision and feel at ease should you or a loved one find it necessary to spend some time in a long term care facility.

The Law Offices of Saul Kobrick, P.C. is a member of the American Academy of Estate Planning Attorneys.

When you have your finger on the pulse of the elder law issues of the day, the thing that really gets your attention in a broad sense is the fact that the country is getting older. The “Baby Boomers” are now becoming seniors, birth rates are on the decline, and of course medical technology is capable of more amazing things every day. Many people are stunned when they hear that the most rapidly growing segment of American society is the senior population, and the portion that is 85 years old and above is growing fastest of all.

This demographic trend has far reaching implications for estate planning professionals. More people living longer is going to result in an increase in the number of people living in nursing homes and assisted living communities. When you look at the costs associated with these facilities the need to plan ahead becomes very clear.

MetLife conducts an annual study that dissects the costs of long-term care, and the results of this year’s probe are telling. The national average cost for a private room in a nursing home in 2010 was $83,585; in 2009 it was $79,935, so that is an increase of 4.6%. For a semi-private room the cost in 2009 was $198 a day, which winds up being $72,270 per year. In 2010 the average cost of a semi-private room in a nursing home in the United States was $74,825, which is an increase of 3.5% over 2009 rates.

As you might expect, nursing home costs in New York are much higher than the national averages. The average rate for a private room in 2010 was $350, and the average cost for a semi-private room was $336. So we are talking about almost $128,000 per year to live in a private room in a nursing home. This is a considerable amount of money, and it is something to pay close attention to when you are making your long term plans.

The Law Offices of Saul Kobrick, P.C. is a member of the American Academy of Estate Planning Attorneys.

When someone enters an assisted living facility or a nursing home they do not give up the rights that they had when they were living on their own and it’s very important that both the resident and the resident’s family are aware of those rights. You should also have a clear plan of action in the event those rights are violated.

In general, your loved one has the right to be treated with dignity and respect. They should be addressed by their proper name, receive nutritious meals at the specified times and should never be forced to participate in activities they don’t choose to engage in.

Your loved one also has the right to feel safe and secure in the facility, and that means they are not subjected to any type of abuse, whether verbal, physical or otherwise.

Residents also have the right assistance with personal needs, such as using the restroom, cleaning the resident, etc and they should not be restrained without cause.

Residents have the right to privacy. When they are being attended to by nursing assistance, they should be in a closed area where visitors and other patients cannot see this person in a compromising situation. The person also has the right to keep personal belongings in their living space, as long as these objects do not interfere with the care of that patient, or others.

If they are capable, residents at nursing facilities still have the right to make decisions about their medical care, including changing their healthcare provider. They can also refuse treatment and food if they choose. They also have a right to look at their financial records.

If any of these rights are violated the resident or their family has the right to take steps to remedy the problem. If the violation is serious you can all the police or social services, otherwise you can bring it to the attention of the director of the home. If the situation is not corrected you can inform social services and remove the person from the home. If there is physical and emotional harm resulting from these abuses you can also file a lawsuit against the facility.

The Law Offices of Saul Kobrick, P.C. is a member of the American Academy of Estate Planning Attorneys.

If you have a loved one that has begun to show signs that they may need more care than what you can provide, you may be thinking about a nursing home. This can be a very traumatic experience for both the person being admitted to the facility, as well as those that have to make this decision.

It is not easy to come to the decision to put a parent in a nursing home, and often people just don’t know how to recognize when it is truly time to do this. Some of the signs to look for to determine if your parent or loved one requires more care than they can get from family members include:

• Inability to live independently
• The need for 24-hour supervision
• They need help with everyday personal care, such as bathing, eating, walking, etc.
• There are excessive demands on your time and finances, which is causing a major strain on your family.

If the above describes your parent or loved one, it is probably a good idea to understand that they are ready to live in a different type of environment, but keep in mind that this doesn’t necessarily have to be a nursing home. A lot depends on the extent and type of care that your loved one needs.

• Home Health Care – This is one alternative to a nursing home. Home health care will keep your loved one at home where they will be happiest, but they will get visits from nursing assistants, nurses, doctors, and even therapists. This will help ease the burden on you, the family.

• Adult Day Care – This is an option that more and more people are choosing; the loved one goes into the facility during the day so that their family can work, and during the evening they return home. This alternative also works well when combined with home health care.

• Retirement Community – There are many assisted living retirement communities that will provide a number of services to their residents; these services include housekeeping, meals, social events, and even personal care. Although these services are available, your loved one will still have their own apartment and the ability to prepare their own meals and care for their own needs, if they are capable.

No one wants to put their loved ones in a nursing facility, especially considering the risk of abuse, but there may come a time when you are no longer able to care for them. Before choosing a facility, consider the alternatives to find the best possible choice for you and your loved one.

The Law Offices of Saul Kobrick, P.C. is a member of the American Academy of Estate Planning Attorneys.

Did you know that over 60% of people over the age of 65 will need some form of long term care services? Long term care becomes necessary when an individual has difficulty, or is unable to perform, what the industry terms ADL’s, or the activities of daily living. These activities include bathing, eating, walking and dressing.

Many assume that their current health insurance plans or Medicare will cover the cost of long term care. This is NOT the case. Long term care (LTC) benefits are typically only offered through specific long term care insurance policies. It’s best to address long term care insurance before you need it, and the earlier you purchase a policy, the lower the rate you can lock in.

We are often asked if everyone needs a long term care insurance policy. For most individuals, our answer is yes. The cost of long term care can easily top $100,000 annually for specialized needs, and not knowing what life changes are in your future, its best to know the cost when planning for retirement, and long term care insurance can help in that respect as well.

There are typically two types of LTC insurance policies:

• An indemnity or “per diem” policy pays up to a fixed amount regardless of the cost. The payments may range from $50 to $300 daily for a facility that offers long term care. This type of policy should offer an adjustment for inflation to account for higher expenses down the road, be sure to check the particulars of the policy for this.
• An expense-incurred policy allows you to choose the benefit amount when you buy the policy and you are reimbursed for actual expenses for services received up to a fixed dollar amount.

How much is long term care insurance? Of course, the cost varies widely, but national rates in 2007 according to the U.S. Department of Health and Human Services are as follows:

To ensure you’re adequately covered, you should include long term care as part of your estate planning process. It is an issue that should be addressed sooner rather than later to properly plan those ‘golden’ years.

The Law Offices of Saul Kobrick, P.C. is a member of the American Academy of Estate Planning Attorneys.

There was a time when senior citizens had only three choices for living arrangements; living alone, living with family or living in a nursing home. Luckily, times have changed and there are a wide range of facilities that senior citizens can consider as their lifestyles and needs change.

Continuing Care Retirement Communities (CCRC’s): CCRC’s are residential campuses that provide several levels of living arrangements for seniors — from independent living to assisted living to skilled nursing care, all in one location.

Lifestyle Communities: 55+ lifestyle communities are age restricted communities that offer resort style amenities and social activities for adults 55 and older. These may be ownership, rental or land lease communities.

Independent Living Communities: Independent Living Communities are designed to allow active seniors to enjoy a lifestyle filled with recreational, educational and social activities with other seniors. The housing options are typically low maintenance such as one-level homes, townhomes or apartments.

Assisted Living: Assisted Living provides a combination of residential housing and personalized support services and care. They are typically designed to offer assistance to senior that need help with their daily activities such as meals, transportation and personal care.

Nursing Care or Skilled Nursing Facilities: The new term for a nursing home, skilled nursing facilities are designed for seniors and individuals who are in need of 24-hour nursing care.

Home Care: Home Care is a general term to describe services delivered at home to recovering, disabled, or terminally ill persons in need of medical, nursing, social, or therapeutic treatment. Home health care allows seniors to stay in their home for longer periods of time.

Adult Day Care: Adult day care offers daily structured programs in a community setting with activities and health-related services to seniors who are physically or emotionally disabled.

Alzheimer’s Care: Alzheimer’s or Memory Care provides specialized care and housing tailored to the special needs of individuals with this disease and provides constant care and oversight to meet their needs.

Respite Care: Respite or short term care provides relief from duties for caregivers, ranging from several hours to days. Respite care may be provided in-home or in a residential care setting such as an assisted living or skilled nursing facility.

Each of these living options should be considered when planning for retirement and building an estate plan, particularly when considering how they will paid for and where they fit in insurance coverage needs.

The Law Offices of Saul Kobrick, P.C. is a member of the American Academy of Estate Planning Attorneys.