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.   

hiring-a-live-in-caretaker-pros-and-cons

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

  1. Live-in caregivers can provide companionship and socialization to an elderly person that may be more recluse.
  2. 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
  3. 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.  
  4. Seniors are a lot more comfortable in their own home especially if they have dementia or Altzeimer. 

Cons of Live-in Care

  1. 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. 
  2. Independent caregivers can create tax complications and arduous paperwork unless the caregiver services are covered by Home Care Aid medicaid.  
  3. 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.
  4. 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:

  1. Assisted living can provide a healthy lifestyle and social activities fostering engagement.
  2. It is a more economical choice compared to a nursing home.
  3. Family members may feel less stressed or worried knowing that their loved one is in a safe environment that will provide excellent care.
  4. 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:

  1. Depending on the facility, medical care may not be provided at all一especially for certain medical conditions.
  2. Seniors may find it challenging to adapt to a new place, a group setting, and new policies.
  3. Facilities could limit the senior’s privacy.
  4. 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.

Potential Challenges When Naming a POA

A Power of Attorney (POA) is the most important document needed for estate planning. A POA grants an individual, known as a principal or grantor, the right to make health and/or financial decisions for someone else. Seniors usually appoint an adult child as their grantor as their mental and/or physical health deteriorates. While the legal process of obtaining a POA may be quick, the emotional burden is a heavy one. Family members often argue over who can be trusted and will treat their duties with the utmost responsibility. In order to decide who qualifies under this position, it is important to understand what a POA is and what actions the grantor has control of. 

Family Members Feud Over POA

Common Factors in Deciding Who To Name as POA

In many cases, a senior acknowledges their eldest child or child that lives closest to serve as a POA. However, in other cases individuals choose to take other factors into consideration before making a serious decision. Seniors will make their decision on preconceived notions of their child’s history maintaining their personal finances. If the elder knows that their son/daughter is thousands of dollars in debt and spends their money carelessly, then they will be less likely to trust them as their POA. In contrast, if a child is in a related profession, then the elder will be more likely to trust them with control of financial or medical decisions. Professions such as nurses, doctors, bankers, and accountants fall under this category. 

Potential Problems Naming Joint or Co–Agents as POA

At the same time that seniors may have a difficult time determining who to acknowledge as their POA, their children may also not want to take on the role. When the senior finally chooses who to name their POA, other children may exhibit emotions of disappointment and/or anger. Picking one child over another implies that the latter is unfit to take on the responsibility. To prevent a feud from occurring, there are ways in which responsibilities can be divided between siblings. 

POA obligations are divided into two categories: medical and financial. Of course, one individual may take on both obligations, but it is also possible to split them between two people. By granting separate responsibilities to each child, they will feel that their perspectives are equally viable in determining their parent’s elder care. It also allows them to work together as a team when the two obligations cross paths. 

An alternative option is to name consecutive agents when drafting a POA. In this scenario, if a designated grantor is unable or refuses to uphold their obligations as POA, then a secondary agent will take over their position. While this may not improve present sibling tensions, it highly guarantees that a responsible individual will preside over the elder’s decisions. In this case, even if a child refuses to serve as POA, there will always be someone to take on the role in consecutive order as listed by the elder. It is always a good idea to have a backup plan to ensure the elder is taken care of at all times. 

A more likely solution to a sibling feud is to name them as co–agents in the POA document. Co–agents have an equal say on all decisions made for their parents easing tensions between the two. However, it is important to note that not all states allow for a co–agent option and also vary in the ways in which these two can act on decisions together when drafting POA. To find out whether co–agents are a feasible option in your state, it is best to consult with an experienced and knowledgeable licensed attorney. On the downside, co–agents are granted joint powers of attorney, meaning they cannot make independent decisions on any matters. Therefore, when naming co–agents, it is crucial that the two individuals have established a positive and productive relationship. Once again, this legal binding only exists in some states. To find out whether co–agents may act independently in your state, you should always consult with an attorney. 

The POA Decision and Potential Family Aftermath

Some families do not face any obstacles when appointing POA. However, the hardships commence when the agent begins to administer their duties. Oftentimes, siblings disagree over whether the agent carries out their duties in an efficient and responsible manner. 

Questioning the Validity of the POA Document and Actions of the Agent

Sibling rivalry oftens unleashes conflict over POA. Siblings who aim to sabotage the named POA will accuse them of taking advantage of their mentally disabled parents. In some cases, they may accuse them of forcing their parents to sign a POA even if it was signed under legitimate circumstances. Unfortunately, even if the agent has abided by all legalities, these accusations may lead to a long and stressful investigation. 

Unwilling to Follow the Principal’s Wishes

A designated agent must uphold a legal responsibility to ensure that all decisions are made in the best interests of the individual they represent. Even if personal opinion conflicts with best financial or medical interests, the agent must put their opinion aside. For example, a Do Not Resuscitate (DNR) order often classifies as a conflict of interest. If an agent does not follow the principal’s wishes, they can be sued at any time. 

When the POA is not the Hands-On Caregiver

Issues tend to arise when the appointed POA is not the same individual that provides full time care to the principal. This creates animosity between the caregiver and POA. For instance, it is frustrating if one sibling lives with and cares for their mother, while another sibling has full control over medical and financial decisions. This situation may cause miscommunication and/or lack of agreement on what is best for the principal. 

For all of your elder law needs, please contact the Law Office of Inna Fershteyn at (718) 333-2395.

When POA Isn’t Enough: Authorizations Needed to Act on A Loved One’s Behalf

Family caregivers are often given the responsibility to access private documents/information regarding their loved ones due to the large amount of paperwork that might arise pertaining to their personal care. Caregivers often feel bombarded with signing, filing, mailing, or faxing such documents, which is where Power of Attorney documents (POAs) come at hand, saving time and stress. In some cases, a few organizations require their own documentation to approve contributions in one's affairs. An individual should never take on this lengthy process by themself. To minimize the risk of making a mistake that may cause dire consequences down the road, the best approach is to hire an elder care attorney.

POA May Not Be Enough

Hiring a Power of Attorney is Crucial for Seniors and their Caregivers 

Elder law attorneys specialize in legal concerns that affect older individuals, their spouses, and their children—specifically the medical and financial aspects of them. A Power of Attorney document allows certain individuals who are identified as “the agent” to legally make decisions on behalf of another person who is identified as “the principal.” The individual is then granted power upon the principal’s personal matters. It is evident that such preparations cannot be legally processed without such documents being authorized. 

However, POAs are not always apodictic. The actions an agent can or cannot take on behalf of a principal, as well as when their powers commence and stop, might differ depending on how these papers are written. Caregivers may run into issues when attempting to utilize POA forms for healthcare and money to oversee the care of seniors if they are not correctly prepared or interpreted. Long before incapacitation becomes a concern, families should prepare these legal documents. When a loved one is unexpectedly disabled due to an accident or sickness, POA paperwork can allow agents to step in and help handle the situation—provided those documents are prepared appropriately.

Some Entities Do Not Accept Power of Attorney 

As useful as POA’s are, third parties such as banks are reluctant to approve such financial documents due to the possibility of fraud, in which case they may be held responsible for any harm that results. 

Such banks take an extended period of time to verify the legitimacy of a financial Power of Attorney and may even want to speak with the attorney who finalized it. In addition, they might also require that the agent and/or future POA sign a written statement declaring that they are operating legally, therefore absolving the other party of all liability. Nonetheless, there should be no issues arising besides the time-consuming process of being approved as a POA. 

Authorizations Needed to Manage a Senior’s Care

A SSA Authorized Representative

Helping a loved one or assigned senior with Social Security applications is possible with the correct documentations, one can apply to be their authorized representative by completing the SSA-1696 Appointment of Representative Form. 

SSA Representative Payee

You must apply to become a representative payee if you want to actively help a Social Security recipient manage their retirement payments and/or Supplemental Security Income (SSI). All beneficiaries who are unable to manage their own payments must have a representative payee according to the Social Security Administration.

While this may be the authority you're searching for, it's important to note that it comes with a lot of responsibility. This work necessitates a thorough recording of all a beneficiary's benefits and how they are utilized, requiring attentive and responsible individuals. If there is no family member or acquaintance available to hold the “rep payee” title, the SSA will designate another qualified beneficiary to hold such recipient benefits. 

VA Fiduciary Designation

Administering veteran benefits also requires its own process. Obtaining POA authority is not a satisfactory requirement for the U.S Department of Veterans Affairs (VA). The VA will request the appointment of a fiduciary if a physician or a court of law determines that a veteran (or surviving spouse) is incapable of handling his or her money. A close friend or relative is readily available to fulfill such a position as long as the VA successfully and thoroughly conducts a close investigation of such individuals’ competence. If there is no family member or acquaintance available to hold responsibility for the veteran, the VA will designate another qualified beneficiary to hold such recipient benefits. 

Medicare Authorization 

It is important to note that Medicare will not provide disclosed health information to an assigned caregiver regardless of relationship to the agent. There must be a written authorization already submitted and approved by the Centers for Medicare and Medicaid Services; verbal permission is also an accepted option. Medicare enrollees may be able to speak and answer simple questions over the phone, giving their caregivers permission to disclose coverage data. If you and your loved one are unable to speak on the phone together, consider attempting to “include them” using your cellphone or other three-way calling device to keep all parties on the same page.

The "1-800-MEDICARE Authorization" Form can be filled out and mailed in or done over the phone with the help of a customer service professional. Please note that certain private insurance companies frequently have their own processes for these documents, so make sure to ask about their unique permission needs.

Be Proactive About Caregiver Documentation

Keep in mind that many problems may be addressed with a combination of goodwill, clear explanations, and reasonable inquiries asked of the appropriate individuals when advocating for your loved one or assigned “agent.” If you're unsure, ask to talk with a supervisor. If no one is available, or if no amount of logical conversation appears to be working, you have the right to consult with legal counsel. 

If you are in need of highly qualified and experienced help regarding a Power of Attorney issue, please contact the Law Office of Inna Fershteyn at (718) 333-2395 to have all of your authorization questions answered.