Elder Care - Trust and Estate Planning Law Office

Exploring the Benefits of Home Attendants Over Nursing Homes

When it comes to the care of our loved ones, we want nothing but the best. The decision whether to choose a nursing home or opt for a home attendant is a crucial one, as the result can dictate your loved ones comfort and care for the upcoming years. Although nursing homes typically serve as the traditional route when debating on long term care, there is nothing comparable to the comfort your loved one will receive in their home as well as the one on one care that is tailored to their needs. In this article, we will analyze the many reasons why home attendants provide a transformative experience which prioritizes individual’s needs in the comfort of their own home.

Personalized Care and Individual Attention

Home attendants offer a level of personalized care that sets them apart from nursing homes. When individuals receive care at home, they benefit from one on one care with a caregiver that can focus exclusively on their needs. Unlike a nursing home where the staff to patient ratio is higher, home attendants have the opportunity to build strong connections to their patients and allow them to understand their unique routines and preferences of treatment. Home attendants can also offer constant assistance with tasks including bathing, dressing and meal preparations. The individualized attention given by home attendants allows for meaningful relationships, companionship and emotional support which establishes trust between the patient and caregiver while providing a sense of comfort to the patient as well.

Nursing Homes Are Extremely Expensive

In New York State, the average cost of a private room in a nursing home totals to $158,797 annually (American Council on Aging) in comparison to the average annual home attendant cost of $52,620 (SeniorCare). Nursing homes provide elderly care within a facility, which includes expenses related to maintaining and operating a residential establishment. With the expenses of utilities, staffing, and maintenance, the cost increases drastically. Nursing homes are also equipped to handle emergency medical situations which require round-the-clock medical personnel. Additionally, the cost of the living space such as rooms and bathrooms as well as meal plans, is included in the overall price. Home attendants on the other hand, provide medical care in the patients residence, therefore eliminating the additional facility expenses. Home attendants can be more flexible in terms of scheduling allowing for cost effective options based on an individual’s needs.

Familiar Surroundings

Home attendants offer a unique advantage by allowing patients to age in the comfort of their own home. This becomes particularly important for patients with dementia or Alzheimer's disease. These two conditions can cause memory loss and disorientation which makes it incredibly difficult for those individuals to adapt to new environments. Being in a familiar setting such as their home helps minimize the stress and anxiety of changing locations. Remaining in a recognizable space also helps to maintain daily routines which can be comforting for patients with memory loss. Allowing patients to age in their own home can enhance their quality of life and promotes familiarity during challenging times.

Increased flexibility and Family Involvement

Home attendants allow for much more family involvement and flexibility when it comes to treatment plans. By receiving care at home, families have more control over schedules and care provided. Home attendants are able accommodate specific preferences and routines and adapt to a patient's needs. Home attendants encourage family involvement as well by allowing families to actively participate in decision making and will also keep them informed about their loved one’s condition.

Comfort to the family

Home attendants can provide the family of a patient a higher level of comfort in comparison to nursing homes. Families can often take comfort in knowing that their loved one is in the hands of a trusted individual of their choosing. Knowing that they are receiving individual attention in the comfort of their own home can put their minds at ease. Additionally, with patients who are immunocompromised, it can be comforting knowing they are only exposed to one individual instead of living with a significant number of people.

Home attendants offer countless advantages that make them superior to nursing homes. The personalized care, individual attention, and comfort they provide to patients contribute to a higher quality of life and overall well-being to seniors. While seeking assistance with elder care needs, Attorney Inna Fershteyn can be a valuable resource to assist you in making the best choices suited for your family’s needs. With her expertise and knowledge in elder law and estate planning, Attorney Inna Fershteyn can guide your family through the legalities of elder care, ensuring that your loved ones receive the best possible treatment. Her dedication to serving the needs of seniors makes her an invaluable asset in navigating the challenges of eldercare. Ensure your loved ones are comfortable and provided for by calling the Trust and Estate Planning Office at (718) 333–2395.

How Can I Increase My Home Attendant Hours?

The process of applying for a home attendant requires many documents and a lot of patience when waiting for a response. Medicare typically provides home attendant assistance for a maximum of 28 hours per week, and in some cases, up to 35 hours per week. However, for many elderly individuals who are incapable of walking, cooking, and showering by themselves, around the clock attention is crucial. Oftentimes, the process of increasing home attendant hours is even more gruesome. Medicare will justify any reason against extending current hours and make the vulnerable individual’s life easier. In this article, the Trust and Estate planning office will explore ways to maximize the amount of home attendant hours so that you or a loved one can receive the care that suits your needs.

Understanding The Current Home Attendant System

To receive at-home medical care, the applicant needs to fit multiple criteria. Primarily, you will receive a physical assessment to determine whether or not you are eligible for the program as well as assess the amount of hours you will receive each week with a home attendant. A physician's recommendation is often required to support the need for a home attendant. In many cases, patients may receive less hours than they feel is necessary. In these cases, there are various ways to obtain additional home attendant hours. It is important to assess each option to determine which one works best for you.

What You Can do to Receive Additional Home Attendant Hours

Medicare advantage plans- A Medicare advantage plan, or Medicare part C, is an alternative way to obtain additional home attendant hours. These plans are offered by private insurance companies that are approved by Medicare. Depending on the plan that you chose, they will provide the benefits of Medicare as well as additional services and coverage. For example, if Medicare provided you with a limited number of home attendant hours, a Medicare advantage plan can cover the costs of additional hours if needed.
Medicaid waiver programs- Some states have implemented Medicaid waiver programs in which Medicaid and Medicare can work together to fulfill the needs of those who require additional support. This program will allow you to receive additional home attendant hours if eligible and allows individuals who require constant care to reside at home rather than a nursing facility. However, these programs have many eligibility requirements, including proof that you need an equivalent amount of care that you would receive in a nursing home. If you believe that you qualify for additional care, consulting with a knowledgeable and experienced attorney will assist you in applying to these programs.
Appeal the decision- If you disagree with the amount of home attendant hours Medicare has provided, it is in your best interest to file an appeal as soon as possible. Attorney Inna Fershteyn is an experienced and proficient attorney who will help you appeal a Medicare decision pertaining to your home attendant hours and provide you with additional care if you feel it is necessary. Consulting with an attorney regarding your appeal can relieve stress and increase your chances of approval. Additionally, if your home attendant hours were reduced by Medicare, appealing the decision can help restore your initial amount of hours.

In 2020, Attorney Inna Fershteyn was introduced to a case in which a client’s home

attendant hours were reduced substantially although the client required round-the-clock care. Attorney Inna Fershteyn helped this client win a fair hearing and ensured that their amount of care would be restored to the original amount of hours.

CDPAP- The Consumer Directed Personal Assistance Program is a Medicaid program which allows an individual to designate a family member to be a home attendant and get paid hourly in the process. Although Medicaid pays for up to sixty hours of care based on eligibility, home attendants may apply to get paid overtime which will compensate for additional services.
Request a physical reassessment- Before receiving a home attendant, a patient must undergo a physical examination to establish their eligibility and the extent of care necessary. A physical reassessment can reevaluate your necessity for additional care and can grant you extra home attendant hours.

How can I benefit from an attorney in this process?

If you or a relative feel that you need to increase your home attendant hours for any amount, but your claim has been unfairly denied, a Medicaid attorney will help. In fact, consulting with a knowledgeable attorney is the best approach to take in preparation for a fair hearing or challenging Medicare’s response. Inna Fershteyn has over 20 years of experience helping clients extend their home attendant hours. She will assist you by preparing a strong application for CDPAP, Medicaid waiver programs, or Medicare advantage plans. Most importantly, she will attend to your emotional needs through this long winded process. If you believe that you require additional home attendant hours and fit all of the requirements, yet your request has been unjustly denied, please contact the Trust and Estate Planning Office at (718) 333–2395.

4 Reasons Why A 24-Hour Home Care Aid is Better Than An Assisted Living Facility

4 Reasons Why A 24-Hour Home Care Aid is Better Than An Assisted Living Facility

Elder care is often difficult and extensive and is different for every individual. One thing is clear - no one can or should do it alone. As our loved ones age and their needs change and very often escalate to around the clock care, we face the difficult decision - should we hire a live-in home care aid or should we resort to putting our loved ones into an assisted living facility and sometimes even a nursing home? But how do these options compare? Based on the vast experience of an elder law attorney in NY and based on visiting many different retirement facilities in NY, Medicaid funded nursing homes in NY, and assisted living facilities in NY, we compiled these top four reasons why a home care aid or a live-in caregiver is better than a nursing home or an assisted living facility.

Live-In Caregiver or Home Care Aid in NY:

Live-in care is a service provided by either a professional caregiving company, a private hire, and the role of a live-in caretaker requires them to live in the home of the care recipient. It is implied that room and board will be provided to the caregiver. Live-in caregivers are allowed to rest and sleep, and therefore should have a 5-8 hour sleeping time allotted in the care plan. It would be beneficial to align the caretaker and care recipient’s sleep schedules.

If you would like for there to be an active caregiver while the care recipient is asleep, overnight care and 24-hour care is also available. Overnight or 24-hour caretakers agree to and are paid to stay awake. 24-hour care is usually arranged by an agency so that the 24-hour period is split between multiple caregivers to ensure that the care recipient is never left unattended.

Whether it’s live-in care or 24-hour care, around-the-clock care provides safety and care to elderly in the comfort of their own home.

Assisted Living NY or Nursing Home NY facilities:

Assisted living is another option that may be more suitable for those who need more supervision. Assisted living facilities give the elderly personalized care in a residential setting and transfer the care recipient out of their home. Residents are typically assessed when they first move in, which allows the facility to make an individualized and specific service plan. Facilities often provide services like managing medication, assisting with bathroom use, and helping with dressing and grooming. Most facilities also provide meals, housekeeping, laundry, transportation, and social activities.

In contrast, NY nursing homes have trained medical staff that provide more medical help than help with everyday activities. Medicare and Medicaid accredit these facilities where they can provide both short-term rehabilitation and long-term medical care. NY Medicaid would cover the cost of such nursing homes, but if the person has assets, a 5 year look back provision exists. These facilities are recommended to those who need more intensive or specialized medical care.

4 Reasons a 24 Hour Home Care Aid or Live-In Home Attendant Is Better than a Nursing Home

Live-in caregivers can provide companionship and socialization to an elderly person that may be more recluse.
Families of the care recipient often find comfort knowing that a caregiver is in the home with their loved one at all times and has much less exposure to people who may be sick of Covid-1.9
It's much cheaper to have a live-in caregiver rather than paying for the Assisted living facility or a nursing home where cost can range up to $15,000 a month.
Seniors are a lot more comfortable in their own home especially if they have dementia or Altzeimer.

Cons of Live-in Care

Typically, live-in caregivers are privately hired so vetting people can be a long and arduous process. It depends on the caregiver’s background and qualifications as well as the needs of the care recipient.
Independent caregivers can create tax complications and arduous paperwork unless the caregiver services are covered by Home Care Aid medicaid.
It can be quite costly to maintain the home itself with property taxes, home repairs, and upkeep so an independent person is needed to take care of financial issues.
Hiring a live-in caregiver is largely dependent on trust which will take time to build. The responsibilities and demands of a live-in caregiver are intense and could potentially cause relationships to sour.

4 Benefits of Assisted Living Facility:

Assisted living can provide a healthy lifestyle and social activities fostering engagement.
It is a more economical choice compared to a nursing home.
Family members may feel less stressed or worried knowing that their loved one is in a safe environment that will provide excellent care.
Seniors can retain independence while getting back or exploring new hobbies. Without the responsibility of maintaining their home, they have more free time.

4 Detriments of NY Assisted living Facilites:

Depending on the facility, medical care may not be provided at all一especially for certain medical conditions.
Seniors may find it challenging to adapt to a new place, a group setting, and new policies.
Facilities could limit the senior’s privacy.
Assisted living facilities in NY are very expensive. The average cost of the facility is around $10,000 a month.

If you need Elder Care planning in NY and would like to speak to NY best Elder Law attorney and NY Asset Protection lawyer please contact our Trust and Estate Planning law office at 718-333-2395 for all of your elder planning needs.

What Are Some Alternatives to Guardianship?

Guardianship is a court arrangement where a judge appoints someone to assist in managing an individual’s healthcare and financial affairs when the individual is no longer able to do so on their own. Guardianship is divided into two categories that deal with different aspects of the individual's needs. The first category allows the guardian to oversee the ward’s daily care, Guardianship of the Person. The second category grants the guardian power to oversee the ward’s personal and home property, Guardianship of the Property. Usually, people who require guardians are individuals who may have neglected to engage in advance estate and care planning.

The guardian could be a family member or the court could appoint an independent person. The court then supervises the guardian after they have been appointed. Guardianship appointments can be time-consuming and costly with prolonged legal fees. However, the good news is that guardianship is preventable. There are a few alternatives to guardianship that you can explore with early and proper planning. The following are potential alternatives to guardianship that should be widely considered.

Obtaining a Representative Payee as Alternative to Guardianship of the Property

If someone receives government benefits like Social Security, but they cannot manage the money on their own, the Social Security Administration can grant an individual to be appointed to receive the funds on behalf of the incapacitated individual. Social Security designates this person as a representative payee. The payee is required to use the funds to pay for the individual’s expenses and report the expenses to the agency. The payee must give an account to Social Security for how the money was spent. If you believe this is necessary for you and your family or loved one, you can do this by contacting Social Security and completing an interview. After completing the interview, you may be approved and be appointed a representative payee. Becoming a representative payee may avoid the need for a Guardian of the Property.

Obtaining Durable Powers of Attorney as An Alternative to Guardianship of the Property

A Power of Attorney (POA) is a legal document used to plan ahead of time. A POA allows one person (called the principal) to appoint one or more other people (called agents) the right to make health and/or financial decisions for them. Elders usually appoint an adult child as their agent as their mental and/or physical health deteriorates. In order to appoint an agent, the principal must have the capacity, at the time they choose who they want to act as their agent and when they sign the document. A POA is significantly less expensive and less time-consuming than a guardianship hearing. Having a Power of Attorney in place could prevent the need for a Guardian of the Property to be appointed.

Acquiring a Health Care Proxy as An Alternative to Guardianship of the Person

Similar to a Power of Attorney, a Health Care Proxy (HCP) is a document used to plan early. An HCP allows for an individual, with capacity, to appoint another person that they trust to make healthcare decisions for them. The principal will choose one person who can serve as their agent. An HCP, along with any other medical directives, will allow the principal to state their health care wishes early on. Although the HCP can be signed at any time, the HCP is only effective after two doctors decide that the principal is not able to make decisions on their own. Having a health care proxy in place could obviate the need for a Guardian of the Person.

Trusts And Estate Planning as An Alternative to Guardianship of the Property

A third alternative to guardianship is to execute a trust. A trust is a legal contract between three parties – the grantor, the trustee, and the beneficiary. A trust can serve as a means for property management. Having a trust can sometimes avoid having a Guardian of the Property because the trustee can effectively manage your property, instead of a guardian.

For disabled individuals or individuals planning for disability, you can create a First Party Supplemental Needs Trust or a Third Party Supplemental Needs Trust. These types of Trusts allow you to protect your assets while still being eligible for certain government benefits. Certain supplemental needs trust may need the court’s approval before being established. Each of these trusts has nuances that should be discussed with an estate planning or elder law attorney.

Joint Checking Accounts as An Alternative to Guardianship of the Property

A fourth alternative to guardianship and property management is by setting up and maintaining a joint account with another person. You can also add a person to the account for convenience sake only. By adding another person to the account, it will allow the other person to pay the bills and be an alternative to a guardian of the property.

Assistance with Care Management As Alternatives to Guardianship

If someone requires limited assistance, they may be able to use a case management tool instead of a guardian. They would create a plan that would allow others to assist and support the individual with the specific needs they may have while also allowing the individual to function independently in the areas they are able to. For instance, Adult Protective Services (APS) can provide case management without the need for a guardian. APS would appoint a case manager who can provide assistance with different needs like obtaining and recertifying for Medicaid, assuring proper living arrangements, monitoring safety, managing financials like social security benefits, and providing heavy-duty cleaning services.

How can an elder law or guardianship attorney help?

Guardianship is an expensive and, at times, cumbersome and complicated process. It is very possible to avoid guardianship by using any of the above ideas or resources. We can help you avoid guardianship. If unavoidable, we can also help you petition for guardianship. To learn more about the legal process of seeking guardianship it’s best to consult a lawyer.

For further elder care information, please contact the Law Office of Inna Fershteyn at (718) 333-2395 to receive the most highly qualified legal advice.

How To Get Guardianship of An Elderly Parent?

When an older adult is not able to think clearly, their capability to make informed and meaningful decisions will be affected. The onset of Alzheimer’s disease or other related dementias, stroke, brain injury, mental illness, or other serious issues can be the cause. If the person you are caring for is not able to make rational, sound-minded decisions about their health care, finances, or other aspects of life, seeking legal guardianship might be necessary for their safety and quality of life.

What Is Guardianship for Elderly Individuals?

Guardianship is a legal option in the event that an adult has not appointed a healthcare proxy or power of attorney (POA) and they are not capable of doing so anymore because of advancing age, illness, or disability. Even if they named a POA, guardianship might still be necessary especially if their POA is not durable, meaning it ends when they are incapacitated. The most common scenario is when family caregivers seek guardianship for adults with dementia and they have not made legal preparations for the future.

The definition for the term, guardianship, varies between states. In some states, guardianship gives the appointed person control over where the incapacitated individual lives, what health care they can receive, and how their daily needs are met. On the other hand, conservatorship allows the appointed person to handle the incapacitated individual’s financial decisions, such as paying bills, managing investments, and budgeting. These terms are often used interchangeably.

In order to act as someone’s legal guardian or conservator, the person petitioning for guardianship must go to court and have the incapacitated individual declared as incompetent based on an expert’s findings. If the incapacitated individual is legally ruled as incompetent and the petitioner is a fit candidate to serve as a guardian, then the court transfers the responsibility for managing finances, living arrangements, medical decisions, or any combination of these to the petitioner.

The entire process often takes a decent amount of time and money. Family members can disagree about if guardianship is necessary or who should be assigned as a guardian. It can be painful, prolonged, and costly.

What Is a Court-Appointed Guardian?

A court-appointed guardian (or conservator) has court-ordered authority to handle an incapacitated individual’s affairs. They have a fiduciary duty to act in the best interests of the individual they are appointed to serve. Unfortunately, it strips the incapacitated individual of many rights. However, it may be the only way to obtain the legal authority to make important decisions on their behalf.

Who Can Be a Legal Guardian?

The court will hold a hearing to decide if the person seeking guardianship is fit for the role. Their relationship, criminal background, credit history, and any potential conflicts of interest are factors that go into the court’s decision.

In the case where more than one person is petitioning for responsibility for the incapacitated individual’s needs, the court will determine who is best qualified. Sometimes one person is appointed to handle the medical decisions (aka guardianship of the person) while another is appointed to manage financial matters (aka guardianship of the property). The incapacitated individual’s preferences and previously prepared legal documents (ex: Non-durable POA, a will, or advance directive) are factors for this decision.

Most states can give preference to the incapacitated individual’s spouse, adult children, or other family members because they are most familiar with the individual’s unique needs and abilities. If a loved one is not willing or not qualified to serve as a guardian then a professional guardian or public guardian might be appointed.

When Is a Guardian Appointed?

A guardian or conservator can only be assigned if a court hears evidence that an incapacitated individual lacks mental capacity in some or all areas of their life. The court also determines that the individual can no longer make informed decisions for themselves. Allegedly incapacitated individuals (not deemed incapacitated) have the right to an attorney and the right to object to the appointment of their guardian or conservator.

In rare cases, if an elder’s health and/or finances are in jeopardy, emergency guardianship may be granted right away. Be warned, guardianship is a very serious intervention and should only be considered as a last resort.

A Guardian’s Role:

Whenever possible, the guardian or conservator must find the opinion of the incapacitated individual and can only act in areas authorized by the court. After a thorough investigation, the court can rule if guardians can be given limited or broad authority. Sometimes the court delegates responsibilities to several parties. In general, the court needs to see reports and financial accounting at regular intervals or whenever important decisions are made. For some large decisions, prior court approval can be required.

Do Guardians Receive Compensation?

All court-appointed guardians are entitled to reasonable compensation for their services. When a family guardian (a spouse, family member, or friend) is appointed, they usually do not charge the incapacitated individual for their services. If a private guardian is appointed, they are paid directly from the incapacitated individual’s estate if they can afford to. If compensation is provided, the compensation amount must be approved by the court, and the guardian must carefully account for all their services, the time their tasks require, and any associated out-of-pocket costs. Public guardians are appointed to incapacitated individuals who do not have family or friends to be their guardians or the resources to hire a professional guardian. They are funded by public money, like government funds and charitable contributions.

Hire an Elder Care Attorney.

To learn more about the legal process of seeking guardianship or conservatorship in your state, it’s best to consult a lawyer.

For further elder care information, please contact the Law Office of Inna Fershteyn at (718) 333-2395 to receive the most highly qualified legal advice.

10 Warning Signs of Alzheimer’s Disease and Dementia

As our loved ones age, how do you know if they are showing normal aging changes or if they are showing early signs of dementia or Alzheimer’s? The most common type of dementia is Alzheimer’s. In 2020, according to the Alzheimer’s Association, roughly 5.8 million people were living with Alzheimer’s disease. Warning signs for Dementia vary, but changes to behavior, increasing confusion, and loss of memory are common signs. Noticing these signs early may help you and your loved one prepare for the possibility of dementia.

Every dementia patient experiences different symptoms with various severities, but there are some early warning signs you can find. These are 10 signs to look out for in order to determine if a loved one should seek a comprehensive medical workup and cognitive testing for dementia.

10 Warning Signs and Symptoms of Dementia

1.) Forgetfulness and Short-Term Memory Loss

Memory loss is the most common symptom of most types of dementia. Alzheimer’s affects short-term memory first which means a person can forget information they recently learned. However, just because someone can’t remember where they put their keys or switch up names it does not mean they have Alzheimer’s. We all forget parts of a conversation from time to time, but an early symptom of dementia can result in someone forgetting entire conversations that just happened. Dementia patients may also forget important dates and events and frequently ask for the same information repeatedly. Caregivers may have to give reminders more frequently whether it's leaving notes or calling to remind them of daily tasks.

2.) Lack of Concentration and Increased Confusion

Another common symptom of dementia is getting confused about times and places and difficulty concentrating. Both can make daily activities take much longer than they used to. Dementia patients can forget where they are, how they got somewhere, and can easily get lost navigating familiar places. As dementia progresses, patients may have trouble differentiating between past, present, future events. They can lose track of seasons and general passage of time which causes them to either show up to appointments or events at the wrong time or not show up at all.

3.) Losing things

Dementia patients could start to put things in more and more unusual places. We all can misplace our car keys or house keys from time to time but finding “lost” keys in the refrigerator could be a sign of dementia. Patients could lose things and then not be able to retrace their steps to find their missing things. However harmless this may seem; this can escalate into theft accusations when they can’t find their personal belongings that they have unknowingly misplaced. Patients can become paranoid and subsequently put their things in even more unusual spots to ward off the suspected thief. Suspicion and delusions may occur in middle-to-late stage Alzheimer’s.

4.) Difficulty Doing Familiar Tasks

Dementia can also affect one’s capability to do normal daily tasks. Patients could have difficulty with coordination and remembering how to complete multi-step processes like driving, cooking, or playing a familiar game. They may start to rely more on their loved ones to do things for them. Caregivers should maximize the patient’s independence and allow them to try and figure it out but should remain cautious. Dementia can also affect depth perception, distance perception, and color perception. Caregivers may notice increased clumsiness, accidents, falls, and uncharacteristic mishaps.

5.) Language and Speech Problems

Alzheimer patients will typically have trouble recalling the right words while speaking or while writing. Some patients can use stand-in words like “thingy,” “thingamajig,” “doodad,” or “what-cha-ma-call-it” and can make up their words or terms for actions. For example, someone with dementia might call a fridge a “cold space.” Because of these confusions or impaired speech abilities, they may also stop talking or writing abruptly.

6.) Problem with Simple Math

Math may not come easy to everyone, but people in early stage dementia may have difficulty completing basic math problems. They can find it difficult to work with numbers in everyday life such as budgeting, calculating tips, or even adding and subtracting. Caregivers should remain patient when helping dementia patients with this. Patients may feel embarrassed so it’s also critical caregivers remain non judgemental, offering help or corrections as suggestions.

7.) Poor Judgement

Depending on the patient, changes in decision-making, through process, and judgement could be a sign of dementia. If a person has made risky decisions all through their life, dementia may not be the cause of their changes in decision-making. However, if a logical person who usually carefully weighs all the options and makes informed decisions suddenly begins showing poor or reckless judgement, dementia could be the cause of that. For example, if they start recklessly spending, inappropriately dressing for the weather, or falling for obvious scams (Nigerian prince) those could be a sign of dementia.

8.) Personality Changes and Mood Swings

Personality changes and mood swings could be a symptom of dementia. Patients can become fearful, suspicious, paranoid, depressed, or anxious. Someone who is usually confident may become more closed off and shy. Patients could easily become more upset when they’re frustrated especially when they are put outside of their comfort zone. Caregivers can reduce the effects by creating a calm environment and avoiding or limiting environmental triggers such as light glare or background noises.

9.) Changes in Grooming and Personal Hygiene

Changes in grooming and personal hygiene such as not changing clothes, skipping showers, and not brushing their teeth are common signs of dementia. In addition, neglecting basic upkeep of their home such as allowing clutter to accumulate and not cleaning at all are common signs of dementia. Caregivers may have to help patients with grooming, maintaining personal hygiene, and cleaning. However in cases where patients may refuse help, it is best to remain patient and explain to patients how you can help.

10.) Withdrawing from Friends and Family

Increased withdrawal from social events that one normally enjoys attending could be a sign of dementia. Patients may avoid social activities to prevent drawing attention to their other symptoms such as memory lapses or difficulty communicating. Patients who are aware of their signs or symptoms of dementia may be less confident in themselves which leads them to avoid interacting with their loved ones. If loved ones or caregivers notice this, reassurance and making patients feel comfortable in an environment could help.

What to do if you notice these signs?

If you recognize any of these signs and think any of your loved ones may have a form of dementia such as Alzhmeir’s, you should make a doctor’s appointment promptly. An early diagnosis is crucial as it can check for curable conditions that can mimic symptoms of dementia, devise care and treatment strategies, and make legal and financial plans for the future. Should you notice any of these signs, elder law planning may be something you need.

If you and your loved one need estate planning, please contact the Law Office of Inna Fershteyn at (718) 333-2395 for legal assistance and enquiries.

5 Frequently Asked Questions About Senior Guardianship

When an individual begins to age, it may be time to consider taking action to obtain guardianship of the senior. With age, it may become difficult to make logical decisions that would reflect one’s best interest due to the onset of Alzheimers, Dementia, etc. If an individual becomes incapacitated or unable to make decisions on their own, it is a good time to consider filing the necessary paperwork for guardianship. This will allow you to guarantee that your loved one is in good hands, as you will be responsible for making medical and financial decisions on their behalf. Since obtaining guardianship of a senior is a lengthy and challenging process, here are five commonly asked questions regarding Senior Guardianship.

What is guardianship? Guardianship refers to individuals who have not yet had the opportunity to appoint a power of attorney for healthcare necessities or financial decisions. Typically, the individual in need of guardianship has become incapacitated and in need of a responsible person to make decisions according to the senior’s best interests. Guardianship allows the person to have a say in where the incapacitated individual lives, the type of healthcare they receive, and activities in their daily lives. On the contrary, a conservatorship grants a person the right to manage an individual’s financial assets and decisions. Oftentimes, it may be difficult to come to a consensus regarding the best time to file for guardianship and select which person should be the legal guardian.
What does court-appointed guardian mean? This person has a court-appointed order and right to handle the incapacitated individual’s affairs. It is their responsibility to act in the individual’s best interest to benefit the incompacitated individual. Some duties a court-appointed guardian may have pertains to selling property, managing finances, making healthcare decisions, nursing home admission decisions, etc. During the hearing, the court will make a decision regarding whether the person seeking to become a guardian is the right fit for the position. In the case that more than one individual seeks to become the guardian, then one will be selected for the purpose of medical and health related decisions, while the other will be selected for financial decisions. Typically, the court would give preferance to the incapacitated individual’s family members, such as the spouse or children because these individuals are most familiar with the needs and preferences of the incapacitated senior.
When is the proper time for a guardian to be appointed? A guardian will be appointed when the court finds it evident that the incapacitated individual is unable to make decisions for themselves. The individual is unable to make logical choices regarding their physical and mental health, as well as their financial assets. The incapacitated individual has the right to appoint an attorney in the case they feel that they do not need a guardian and can make decisions for themselves. If an individual’s health and financial assets are suffering immensely, then an emergency guardian may be selected.
What tasks is the guardian responsible for accomplishing? In regards to making decisions on behalf of the incapacitated individual, the guardian is responsible for paying bills, managing real estate and other financial prospects, as well as deciding how finances are handled. The guardian must determine where the individual will live and must monitor their residence. Additionally, the guardian must provide consent for medical treatments and monitor non-medical services. The guardian should attempt to maximize the incapacitated individual’s freedom to the greatest extent possible in order to give them some independence. Lastly, a guardian must report to the court at least annually regarding how the incapacitated individual is doing and how the financial, as well as medical decisions are being managed.
As a guardian, will I receive compensation for my role? Court-appointed guardians are actually subject to compensation for their work in addressing the incapacitated individual’s financial and medical needs. If the guardian is a family member, such as a spouse or a child, then the services will be free. They will most likely not charge their incapacitated loved one in regards to obtaining compensation for their work. If a private or public guardian is appointed, then they are paid directly from the incapacitated individual’s estate if they can afford the costs. The compensation amount is typically approved by the court.

For further Guardianship information please contact the Law Office of Inna Fershteyn at 718-333-2395 to effectively file for guardianship when your loved one becomes a senior.

What are assets you can have and still qualify for Medicaid in NY?

Applying for Medicaid is quite a complex process, as the questions being asked within the application have great depth and implications for your future. The foundation system responsible for asking the questions that define your eligibility for Medicaid purposely selects specific diction and word choice which may make it challenging for elderly individuals to effectively answer the questions. Considering that these questions are the main defining factor when it comes to obtaining Medicaid coverage, family members should seek guidance from an experienced Elder Law Attorney to guide them through this imperative process. Additionally, it may be difficult to understand the limit on your assets in order to still qualify for Medicaid in New York. The attorney is quite familiar with your state’s rules when it comes to long-term care planning and receiving government benefits when it comes to ensuring that you qualify for Medicaid. The Elder Care Attorney will use her experience in the field to devise the most effective plan in assisting the family by selecting strategies that align with the family’s personal and financial circumstances.

Is it possible to have assets and qualify for Medicaid?

Seniors often believe that they are not allowed to have any assets if they hope to qualify for Medicaid. However, this is quite a common misconception because there is a grand variety of assets seniors can own and still be eligible for Medicaid coverage. Many are curious to know if they can own a car, or a home, or a life insurance policy while still being eligible for Medicaid. All of these inquiries will be answered below in the 2021 Medicaid Asset Limits section. The important note to keep in mind is that all Medicaid applicants may keep up to $2,000 in countable assets while still qualifying and remaining eligible for coverage. All assets below this sum are considered non-countable assets in the eyes of the government, thus having such assets would not have a negative impact on your potential medicaid eligibility. However, any quantity of money that goes over this set limit of $2,000 becomes known as countable assets, which would have an impact on your eligibility and make it difficult for you to qualify for Medicaid in New York.

2021 Medicaid Asset Limits:

Countable Liquid Assets- as mentioned previously, Medicaid applicants who have over $2,000 in assets will no longer be able to qualify for medicaid coverage in New York according to the state’s rules.

A single applicant who is 65 years old or over may have up to a maximum of $2,000 in cash, bonds, stocks, certificates of deposits, and other assets in order to still qualify.
A single applicant in the state of New York is allowed to retain $15,750 in liquid assets.
The asset limits for married couples varies because it depends on state guidelines and whether only one spouse or both spouses are applying to qualify for Medicaid coverage.

An Elder Care Attorney can assist you in understanding where you stand in terms of qualifying for Medicaid and what actions you may participate in to increase your chances of qualifying for coverage.

Primary Residence Value- there is a way to ensure that the primary residence is exempt from consideration in regards to Medicaid qualifications, as long as it abides by the specified requirements.

Most importantly, the home must be in the same state that the applicant is applying for Medicaid in.
The equity value in the home, otherwise known as the fair market value minus debts if owned singly must have a value equivalent to $595,000 or less in order to still qualify for Medicaid.
The applicant must continue to reside in their residence or have a strong intent to return home in the case that they are currently living in a nursing home due to their physical health conditions. An important note to consider is that if an individual must inhabit a nursing home, the home may still be exempt if the individual’s spouse or children are still living in it at this point in time.

Funeral and Burial Funds- Medicaid will consider the value of any non-refundable, pre-paid funeral plan as exempt because you cannot obtain that money back and therefore it does not impact your potential qualification for coverage. This also pertains to irrevocable funeral trusts, however these funds are typically limited to a maximum of $15,000 or less per spouse.

Car- one car will be considered as a non-countable asset regardless of its brand, or price. This automobile, however, must be used for transportation of the applicant or any other members of the household in order for the car to be exempt from your assets when qualifying for Medicaid.

Life Insurance Policies- Medicaid will ignore all term life insurance policies. This is because only the cash value of a life insurance policy owned by the applicant will be counted. However, in order to remain exempt and qualify for Medicaid coverage, the combined cash value of any insurance policy cannot go over the limit of $1,500.

Property for Self Support- only the Medicaid applicant’s equity interest in any property that is considered essential to their self-support will be taken into account regarding qualifying for coverage.

Any real estate properties that generate income, such as farms, rental properties, real estate investments, etc will be considered.
A maximum of $6,000 of an applicant’s equity interest in the property may be exempt from their allowable assets. However, this only applies if the property is able to produce a net annual income of at least six percent of the equity value annually.
All values that exceed the $6,00 maximum will be taken into account as assets, which could harm your ability to qualify for Medicaid coverage.

An medicaid planning attorney can help you better understand these asset limits and can assist you in potentially qualifying for Medicaid even if you exceed some of these limits. Note that a senior may still be eligible for Medicaid even if their assets exceed the general limits stated above. An esteemed attorney is well aware of the rules and guidelines regarding qualifying for Medicaid coverage, thus you will attain all of the aid and guidance you need in answering all of your inquiries.

For further Elder Care inquiries and information please contact the Law Office of Inna Fershteyn at 718-333-2395 to qualify for Medicaid coverage given the 2021 Asset limitations.

What you need to know about the stimulus relief bill

The Covid-19 pandemic has been a very stressful time for all Americans. Many individuals have been forced to file unemployment because they have been unable to work and high risk residents have faced challenges in obtaining a stable income during these unstable times. Much of the population has struggled financially on top of the emotional and physical strain the pandemic has caused. With such a discrepancy from normalcy, the people of this nation are reaching out for a helping hand and a sense of comfort during these challenging times. With Joe Biden as our new President, he has made some changes towards the Covid-19 relief stimulus checks in the effort to alleviate some of the financial hardships Americans are facing during these times.These changes greatly vary from the previous two stimulus checks you have received under President Trump based on the new qualifications and groups of individuals eligible to receive aid money. President Biden’s new $1.9 trillion bill allocates a greater magnitude of money towards relief for utility, rental, and mortgage costs, as well as more funding for schools and insurance premiums.

Who will receive the third stimulus check?

Unlike the maximum limit of $100,000 in annual income needed to qualify for President Trump’s stimulus checks, the stimulus checks will only apply to individuals making less than $80,000 annually. However, those who do qualify will be receiving $1,400 direct payments into their bank accounts as soon as this weekend. Couples who file taxes jointly have a new income cap of $150,000 of conjoined income to receive the stimulus check. On the contrary, couples who have made a joint annual income of $160,000 or more will not be receiving a third stimulus check. The income cap for couples during the first two stimulus checks was $200,000 so be sure to note the massive change in income limit for couples when inquiring if you are qualified to receive the third stimulus check. Head of household filers, such as single parents have an income cap of $150,000. A married couple with two children is subject to receive up to $5,600 in aid. On the contrary, a single parent with two kids would receive up to $4,200 in aid. Additionally, you will receive $1,400 for each of your young dependents.The federal government will utilize your 2020 adjusted gross income based on your tax returns when determining how much aid money you are subject to in relation to your income.

Will adult dependents receive this stimulus check?

It has been decided that adult dependents will in actuality receive this stimulus check to help them cover expenses brought forth by the Covid-19 pandemic. These adult dependents potentially include college students who will be receiving $1,400. This is also a great sign in regards to including adult dependents with disabilities by granting them a stimulus check to help fund the costs they may not be able to afford because of the financial strain brought upon the population by the pandemic and its consequences on the economic state of this nation. This stimulus check will apply to four different populations that the previous two checks did not include under President Trump. President Biden’s new stimulus package will include High school students 17 or older claimed by someone else, college students claimed by someone else, elderly adults claimed by someone else, and disabled adults claimed by someone else.

How will President Biden’s new stimulus package impact the child tax credit?

The child tax credit was initially created 24 years ago with the purpose of aiding parents in helping to pay for their children due to financial difficulties. However, with the Covid-19 pandemic, these financial circumstances have only increased in severity, therefore creating a directly correlated response in regards to the child tax credit. The child tax credit will be expanded to $3,600 per child under the age of 6 and $3,000 for each child under the age of 17. Based on current changes, the government will now be conducting monthly payouts instead of you having to claim the credit when you file your tax returns. Providing these monthly payments would provide regular income, rather than a large sum of money granted upon the completion of taxes. This tax credit will be a lifesaver and massive reliever for parents who have lost their jobs in the face of the Covid-19 pandemic and are struggling to provide their children with everything they need to thrive.

What impact does President Biden’s new stimulus plan have on unemployment payments?

President Biden’s new stimulus package provides a bonus of $300 per week in regards to unemployment funding. This pandemic aid will be extended until September 6 in order to help people get back on their feet after suffering job loss during these challenging times. Additionally, a new tax waiver on the first $10,200 of unemployment benefits will become available. This will extend the CARES Act Programs until early September. The Pandemic Unemployment Assistance benefits will increase to a minimum of 79 weeks, or 86 weeks in high-unemployment states. This will expand Public Emergency Employment Compensation up to a maximum of 53 weeks. The unemployment payments aim to reduce the massive poverty population within the nation and reduce the financial burden the pandemic has brought forth upon the American people.

Does President Biden’s new stimulus package include information on food assistance programs?

Yes, President Biden will extend the Supplemental Nutrition Program (SNAP) program benefits till September to provide the populations in need of food assistance. The program, however, will not extend the Pandemic-EBT program which would have been beneficial in the face of future emergencies and crises. By providing specific grocery benefits for the meals that children miss at school due to the in-person school shutdowns, parents were able to feed their children despite the financial hardship they were facing from potentially losing their jobs during the pandemic. During the mid-January census, 24 million parents in the U.S. stated that they did not have enough food to feed their families, while prior to the pandemic only 8.5 million adults stated that they did not have enough food. Thus, President Biden’s new proposal would extend 15% maximum SNAP Benefit increase so that all the parents in need could feed their children.This would include approximately $27 more per person per month in SNAP Benefits. This would total approximately an additional $100 per month for a family of four.

How will President Biden’s third stimulus check eligibility rules affect older adults?

If you have a pension or investments that are taxable, that would have an impact on your adjusted gross income, which would influence your eligibility for receiving the third stimulus check. If you're over age 65 and a recipient of Supplemental Security Income or Social Security Disability Insurance, you were eligible for the first and second stimulus check under President Trump, and will be eligible for a third under President Biden. Your gross income does not include any Social Security Benefits unless half your Social Security benefits plus your other gross income and any tax-exempt interest is more than $25,000 filing single or $32,000 if married, filing jointly. Qualifying relatives may be considered adult dependents and filed as such on tax paperwork. An adult who has a gross income of less than $4,200 annually and lives with the family all year can be declared an adult dependent on the tax paperwork. If you're 65 years-old or older, you should file taxes only under the following circumstances: You are a single filer with at least $13,850 in gross income or you are a head of household with at least $20,000 in gross income. Other qualifications of filing taxes after 65 years old are if you are married filing jointly (if one spouse is 65 or older, $25,700 in gross income; if both spouses are 65 or older, $27,000 in gross income), if you are married filing separately, or if you are a qualifying widow(er) age 65 or older with at least $25,700 in gross income.

For further Elder Care information please contact the Law Office of Inna Fershteyn at 718-333-2395 to be informed of your stimulus check qualifications.

How to Care for Aging Parents When you Can’t be There?

All of your life your parents have always been there to support you and guide you through your development. As a child, your parents taught you how to feed yourself, dress yourself, and helped you do all your homework. Then, when you got older, your parents were there to give you advice on which college to go to and which career would be a perfect match for your passions. They were there to support you during your marriage and took care of your children when you went to work. Your parents dedicated their lives to caring for you and now the roles have reversed. Now, it is your turn to take care of them. This can be an extremely stressful task, as it is hard to allocate time to caring for your parents, caring for your children, and working full time. At the same time, it can be even more stressful leaving your parents in the care of strangers because you can't be there to care for them. The best decision in this case is to refer to an Elder Care Attorney for guidance in making the best decision for your family.

An Elder Care Attorney can assist you in drafting a power of attorney and healthcare proxy.

Power of Attorney:

A power of attorney gives an individual the right to act on your behalf. There are four types of power of attorney documents that are mostly commonly utilized. These include General Power of Attorney, which means the document comes to a close when the principal becomes incapacitated, revokes the agent for the power of attorney, or passes away.The power of attorney has the power to make medical decisions on behalf of the senior in need of care. A Durable Power of Attorney enables the agent to maintain power even once the person becomes incapacitated. This implies that they can make decisions for the senior even once the senior is not in a clear and present state of mind. A Special Power of Attorney gives the agent specific limited powers within a specific area. Lastly, a Springing Durable Power of Attorney comes into place when a specific event causes the principal to become incapacitated. This document must be prepared while the individual is still competent to ensure that the agent has the power to make all of these imperative decisions when the time comes. A Power of Attorney allows the principal to appoint a specific agent who will act on their behalf in the case that they become incapacitated. Therefore, this individual must prioritize the needs and preferences of the principal by making imperative decisions. These decisions pertain to finances, healthcare, recommending a guardian, etc. This ensures that your loved one’s wishes are met through the guarantee of financial security and effective healthcare. Now you may ease your concerns about the financial and healthcare aspects of your parent’s care. The power of attorney guarantees that you will be able to act on their behalf if you are the selected agent. Therefore, you will be able to care for your parents even if you are not physically beside them every step of the way.

Health Care Proxy:

A Health Care Proxy is a document in which the patient selects an agent who will be responsible for making their medical decisions for them. When the patient is unable to make their own decisions concerning their health and overall well-being, the healthcare proxy will be the one responsible for making the imperative medical decisions. If you are the agent declared on the healthcare proxy documentation, then you are the one responsible for making all of the decisions concerning your parents health and well-being. This guarantees thay you do not have to worry about other individuals making decisions on behalf of your parents without any input from you. This is a way for you to oversee your parents health even if you are not constantly taking care of them. You should not have to choose between working full time to prove for your family, moving from a different state of residence, not being able to care for your children after school, in order to become your parent’s caregiver. There are a variety of different ways in the modern world to care for your elderly parents without having to quit your job and other responsibilities.

COVID-19 Concerns:

With the pandemic in full force, you are most likely even more concerned about the care of your elderly parents. The constant worrying if your parents have food in their fridge, if they are taking their medications, if they are safe can all be reduced and even avoided by taking the first step in hiring an Elder Care Attorney today. You deserve to know that your parents are in good hands without having to feel guilty for not being the one to physically care for them. You should not quit your job and risk being unable to pay rent and purchase necessities just so that you can can care for your aging parents, especially during the pandemic that has caused great instability within the current economic state of the United States. The final decision is yours. With the proper documents completed, you will be the one in charge of making all of the most important decisions concerning your parent’s well being. Make the decision today to hire an esteemed Elder Care Attorney who will guarantee that you will be able to care for your aging parents even if you can't be there in person.

For further Estate Planning information please contact the Law Office of Inna Fershteyn at 718-333-2395 to best prepare for your future through will drafting, power of attorney, health care proxy, and living will documentation.