This Made Me Laugh

May 12, 2010

Filed under: Uncategorized — Tags: — Alexis @ 4:40 PM

Talking to a client this afternoon, and he mentions that he is attending an annual get-together tonight with some friends.  The way he describes it: “A bunch of old men getting together and telling lies.”  I love it!!

Today We Moved to an Assisted Living

February 3, 2010

Filed under: Ruthie — Tags: , — Alexis @ 7:34 PM

Today I helped move my grandmother to assisted living. She’s been living at home for years, going to a day program 6 days per week. The van would pick her up and bring her home. She has a fantastic home health aide Myrlene who would come in the morning to help get her ready and return in the evenings to take care of dinner and to make sure my grandmother got to bed. For five years, we weren’t worried about the overnights alone, since my grandmother has never wandered or mixed up her days and nights. She has some dementia, but for the most part it’s short-term memory loss.

But her hips have awful arthritis and she’s been having more and more trouble getting herself up and down and walking around. We finally got to the point where we’ve become worried about her trying to get to the bathroom in the middle of the night. At the same time, we’ve become less enamored with her day program. And it’s just too difficult for her to navigate the stairs getting in and out of her apartment building every day. So we all – the whole family, including my grandmother – decided it was time for assisted living.

And what a place we found! She is in the memory program assisted living at Newbridge on the Charles. All I can say is WOW. The staff is incredible, so thoughtful and kind, and watching their residents so closely. I am beyond impressed. And the building! Well, it’s beautiful. And the food! Fresh and delicious.

Here is a hot tip – they had us arrive for move-in at 11:30, so the very first thing that happened was we were escorted to the dining room for lunch. Well, my grandmother could not have been happier! To sit in a lovely dining room, being waited on, eating scrumptious food – she kept looking at us, saying “I get to live here?!” And from there they swept her up into the day’s activities and Myrlene and I went to set up her room.

Her first day could not have been better! She didn’t ask for Myrlene and me at all that whole afternoon. We were worried about her going to bed alone and being confused by the new room, and maybe waking up in the morning and not knowing where she was, so Myrlene slept over with her. The report is that they kept her busy with activities until 8 pm and then she slept all night!

I am headed back over on Friday morning to visit with my two-and-a-half year old. I’ll be chronicling how my grandmother is doing and how the rest of us are adjusting to the change.  So far, things are looking great!

South Shore Senior Population Set to Boom

January 18, 2010

Filed under: Uncategorized — Tags: , — Alexis @ 2:56 PM

Yesterday’s South Section of the Boston Globe had a two-page story on the coming boom in the senior population.  It’s reassuring to read that senior centers are reexamining their goals and programming in light of the change in clientele. The biggest issues I see facing my clients are (1) bringing in the support system required to remain at home for as long as possible and (2) transportation.

So far the societal responses to these needs have been minimal. Take transportation – the Ride is, well, a long ride. The senior centers have vans, but you need to set up your appointment in advance, and their funding allows them to transport seniors only for certain types of activities. Poor transportation options as an elder or disabled person have been the flip-side to the choice of living the quiet life in the suburbs.

As for remaining at home for as long as possible, there is more help available here, and I help my clients access the resources available to them as best as possible. There is veteran’s funding, MassHealth money, and then good old fashioned creativity – like setting up a contract with a child that allows her to leave her job in order to care for her parents, yet be paid so that she can still meet her own obligations at home. Or, another example would be two or three elderly neighbors sharing the services of a personal shopper or a personal chef so that the grocery shopping and cooking is taken care of.

As a society, we expect to be taken care of in our old age, yet we encourage our children to cross the county in search of their dreams, so we don’t have a built-in support system. And we don’t like to pay taxes. So who will care for the Boomers? I think the coming decades will see a blossoming of the American “creative spirit” – neighbors banding together to develop shared living arrangements, new businesses developing to serve seniors at home at prices they can afford. And in the mean time, each aging Boomer should be saving up funds for what they hope will be a long retirement. Meeting with a trusted financial advisor would be a very good first step.

Howard Gleckman’s New Book: Caring for Our Parents

August 25, 2009

Filed under: Estate Planning — Tags: , , , , — Alexis @ 5:27 PM

Driving to work on Friday, I had the treat of listening to NPR’s Robin Young interview Howard Gleckman on his new book, Caring for Our Parents: Inspiring Stories of Families Seeking New Solutions to America’s Most Urgent Health Crisis. I only caught the end of the interview, but it was so reassuring to hear him close with this message: we should all have our health care proxies and end of life wishes in order.

This is what I talk about when I give presentations and when I meet with clients. I’ve blogged about it – read about health care proxies here and about end of life wishes here.  This is such an important message to get across to people. A health care proxy lets someone else make health care decisions for you when you cannot make or communicate them yourself – anesthetic fog? dementia? shock from an accident? Without a health care proxy in place, your family could very well be forced to go to court and waste a lot of money, time, and emotion.

And making your end of life wishes clear will save your family a tremendous amount of anxiety, guilt, grief, and arguments. Give your family the gift of peace by taking the burden off of their collective shoulders – tell them ahead of time what you would want in a difficult situation.

It gives me hope to hear Mr. Gleckman advising a national audience to get their health care proxies and end of life statements in order. So many families would have such an easier time caring for their loved ones with these documents in place.

End of Life Wishes & Living Wills

Clients are always asking about living wills. Massachusetts law does not recognize a living will, and it’s also impossible to write a thorough, well balanced statement of your end of life wishes in just a few paragraphs.

I provide clients with a solution to their goal, but in a much better form. I give my clients a workbook called Your Way. It is published by a nonprofit in California, H.E.L.P.: Helping People Meet Aging-Related Legal & Care Challenges.

This workbook is twelve pages long and very thoughtfully walks the reader through various scenarios you could confront in an end of life situation and what kind of comfort and care you would like to receive. For example, what matters to you the most – being with friends and family? Listening to music? Being able to help dress yourself? Under various scenarios, would you want curative care or to be kept comfortable? Who do you want with you as you are dying? Where would you want to be? A twelve-page work book written by heath care professionals does a much better job elucidating your wishes than an attorney can do in a one-page living will.

If you are not a client of this office, then log onto the Your Way website and order a workbook. If you are my client, then you already have a copy. Complete the exercises and give your family the gift of knowing exactly what you would want them to do in a crisis situation.

Why Should My Elder Law Attorney Draft My Health Care Proxy? I Have the Form from the Hospital.

May 10, 2009

Filed under: Estate Planning — Tags: , , , , — Alexis @ 4:58 PM

Massachusetts hospitals hand patients a two-page Health Care Proxy form that was developed in 1999 and does not accommodate for changes in the law since then or for issues pertinent to elders. 

You probably have signed a “HIPAA” form by now at your doctor’s office.  This form allows the doctor’s office to share your confidential information with anyone in particular you name, such as your spouse or children – while you are competent.  (The Health Care Proxy kicks in when you cannot make or communicate your own decisions.)  Without this form in place, your medical team is well within its rights to refuse to discuss your case with your family.  Many elders like to know that the doctor will speak with their child later in the day to review the results of the appointment.  A well drafted Health Care Proxy with your Elder Law Attorney will enable this.  The state form does not.

The hospital form can also lead to expensive guardianship proceedings, because it lacks several important items.  It does not allow the person you have named to authorize anti-psychotic medications, which can be critical to an elder with dementia, depression, or anxiety, or a combination of all three.   It does not allow the agent to sign for a nursing home admission, nor to permit extraordinary measures (ex. feeding tube).  If you have only the state form and you need any of these actions later, your family will have to commence a lengthy and time-consuming guardianship process.

Contact your elder law attorney today and ask to draft a new Health Care Proxy form and save your family considerable expense and headache later.

MassHealth (Medicaid) Programs for Kids

February 4, 2009

Some children don’t have private health insurance coverage through their parents, as a matter of fact, lots of kids – one in four Massachusetts children is on MassHealth (Medicaid). 

Applying for MassHealth is very confusing – there are several programs, they each have different enrollment criteria, and they provide different levels of coverage.  Check out this guide, produced by Children’s Hospital and the Boston Bar Association – chapter 3.  Scroll down to page 10 for a good overview of several different MassHealth programs.  The guide is written for parents of kids with mental health issues, but the insurance chapter applies to all kids.