I’m sure you will agree, most people want to stay home!    Our concern……. the home is safe.

Safety checklist for seniors at home

FLOORS:  Look at the floor in each room.

STAIRS AND STEPS:    Look at the stairs you use both inside and outside your home.

KITCHEN:  Look at your kitchen and eating area.

BATHROOMS:  Look at all your bathrooms.

BEDROOMS: Look at all your bedrooms.

From the Centers for Disease Control and Prevention National Center for Injury Prevention and Control (NCIPC).

There can be costs associated with living home, specifically if there is need of Care Givers assisting with Activities of Daily Living (ADL’s).

Did you know that Veteran’s or their Surviving Spouse may be eligible for a VA program called the Improved Pension, Aid and Attendance.  The spouse may receive approximately $1,000.00 tax free per month, while a Veteran and Spouse both needing help would be just over $2,000.00.

We would be happy to speak with you and find out if you are eligible for the wonderful Veterans benefit.

Both Bill Alexander and Tovah McDonald Mitchell are VA Accredited Attorneys.

919-256-7000  or write rick.messemer@wgalaw.com

If you are moving to the Raleigh area or you are just arrived, don’t forget to get your legal matters in order!

We suggest at every life event………… a move, birth of grandchildren, retirement or the passing of a loved one, have your core legal documents reviewed.  Let us look over your wills, power of attorneys, advanced directives and your HIPAA release forms to make sure they are up to date and state specific.

Here is a breakdown of the metros where the percent of seniors grew the most:

(2000 to 2010)

Answer: It depends on what the power of attorney document allows.

At W.G. Alexander & Associates, we know that the power of attorney is the most important document that a client can have. In terms of doing estate planning, asset protection planning, and looking into Medicaid and VA benefits (Aid and Attendance) options available to a client, the power of attorney can either help or hinder a family from seeking help for their loved one

A power of attorney is a written document in which one person (the principal) appoints another person to act as an agent (power of attorney) on his or her behalf, thus conferring authority on the agent to perform certain acts or functions on behalf of the principal. The powers conferred upon the agent are limited to what the document specifically authorizes.

For example, a lot of people have something called a short form power of attorney. In this document, the principal either initials or decides not to initial certain powers thereby granting or not granting powers to her or his agent. In just the same way that a principal can decide not to confer powers to her or his agent by not initialing a power, if a document does not specifically state than an agent has a certain power the principal does not confer said power to the agent.

Do you know what your power of attorney authorizes????

If you have any questions on this or any long-term planning/asset protection questions, please  write one of our VA Accredited Attorneys, Bill Alexander (WGA@wgalaw.com) or Tovah McDonald Mitchell  (tovah.mcdonald@wgalaw.com) or give us a call at 919-256-7000.

As of April 1, 2010, there were 40.3 million 65+.

This number is up 15% from 2000. Currently woman outlive men: just 90.5 males for every 100 females 65 and older.

Real estate values are down, investment portfolios are down, increases in the cost of long-term care…….the question is how do you protect your home and assets if long-term care (in-home, assisted living or skilled nursing) is needed?

There are just a few things that you can do right away that will be very beneficial:

• Make sure you have a well written, up to date Power of Attorney (not the one page, “check here” variety)
• Do you have an updated Health Care Power’s of Attorney and HIPAA (medical information) release forms
• When was the last time you checked your beneficiary designations:  how many times do we see life insurance policies from first jobs or first wives that have not been corrected.

If you have any questions on this or any long-term planning/asset protection questions, please do not hesitate to write: rick.messemer@wgalaw.com or one of our VA Accredited Attorneys, Tovah McDonald Mitchell  or tovah.mcdonald@wgalaw.com

• The national average daily rate for a private room in a nursing home rose 4.4% from $229 in 2010 to $239 in 2011.
• The national average monthly base rate in an assisted living community rose 5.6% from $3,293 in 2010 to $3,477 in 2011.
• The national average daily rate for adult day services rose 4.5% from $67 in 2010 to $70 in 2011.
• The national average hourly rates for home health aides ($21) and homemakers ($19) were unchanged from 2010.

Nursing homes cost an average (national average) of over $7000.00 per month.

It is extremely important that you plan for Long Term Care expenses as well as protecting your assets.

If you have any questions on Asset Protection, Medicaid (North Carolina) or VA Aid and Attendance Benefits, please write rick.messemer@wgalaw.com

on the Topic of Charitable Giving on February 29, 2012.

The outline of the discussion is below.

If you have any questions regarding Charitable giving, the setting up of a

Charitable Trust, or to review something you have in place now, please contact

 Bill’s office at 919-256-7000 or email rick.messemer@wgalaw.com

Legal Issues in Dealing with Aging Donors

Speaker: William G. Alexander, Attorney W. G. Alexander & Associates, PLLC – Raleigh, North Carolina

Bill will discuss issues of capacity in dealing with donors making outright or deferred gifts.

Why is it important that you are aware of issues with aging donors?

What is the law in NC regarding Diminished Capacity and making contracts?

Incapacity versus Diminished Capacity      Minimal or Sufficient Capacity      Impact on current gifts and testamentary gifts      What is Undue Influence?

What are the signs to look for?      Factors in determining diminished capacity

What actions should be taken to protect the intended gift.

Understanding the donor’s family situation, communication, and positioning a desire to make a gift versus capacity issues

Thoughts and ideas around establishing and documenting donor intent as early in the gift planning process as possible

How do Powers of Attorney play into gift planning?

How to work with a legal counsel to achieve your donor’s wishes

Leave me home!!!   You better not put me in any nursing home!

Most people we speak to want to stay home.  Our concern is not just home, but home in a safe “senior friendly” environment.

You can make your home safer with a few simple steps; better lighting, trip hazards like worn or torn rugs, securing hand rails or banisters, etc.   Here are a few things you can do:

Quick fixes for creating a safer environment A good approach to begin creating a safer environment for seniors is to ask them what they have trouble with around the house, or watch them move within their home to determine what is causing them difficulty. The rooms in the home where the senior spends the most time, such as the family room, bathroom, kitchen, and bedroom, can be a good starting point. This room-by-room safety guide helps the senior, adult child, or caregiver focus on easy changes for a safer and more comfortable senior living space.

Overall Improvements:

• Cleanup clutter around the home to greatly lessen the chances of tripping. Look for any low-lying items that are on the floor, such as stacks of magazines or plants, which may be close to a walking path. Move electrical cords from lamps or in-home medical devices so that they are out-of-the-way.
• Inspect the condition of the floor in each room. Carpet shouldn’t be too shaggy or be wrinkling; feet catch easily on both. Tile or vinyl can be slippery, especially when wet. Secure throw rugs with anti-slip pads, tape them down, or remove them altogether. Stairs are particularly dangerous, so keep them clutter-free and install handrails on both sides.
• Ensure there is enough lighting outside leading into the home and inside the home, in all walkways, and in rooms that the senior uses the most. Keep flashlights in easy-to-see and reach locations.
• Replace doorknobs with easy, lever-style handles.

The Bathroom:

• Install grab bars around the tub, shower, and toilet.
• Elevate toilet seats.
• Consider a walk-in shower or bathtub with built-in seating, or put a shower seat in the bathing area.
• Use non-skid mats in front of the sink and toilet and outside the tub if you don’t put down low-pile carpeting.
• Cover the bottom of the tub with a suctioned safety mat or a permanent rough coating.
• Replace faucet knobs with lever handles to make it easy to turn water on and off.

The Kitchen:

• Make sure everything in the kitchen is within easy reach, so that a stepstool is not necessary.
• Post all important phone numbers,emergency contacts, and the senior’s doctors on the refrigerator.
• Post a list of all medications the senior is taking, any allergies, and any health conditions.
• Ensure lighting is sufficient.

The Bedroom:

• Use a bed only as high as necessary. An elevated bed can be a problem to get in and out of.
• Make sure the path to the bathroom is clear.
• Install night lights where necessary for middle-of-the-night bathroom trips.

SPECIAL QUESTION:  Are you, or do you know of a Wartime Veteran or their surviving spouse?  The Veterans Administration  has a program called  “Improved Pension, Aid and Attendance” that helps pay for helping the Veteran or surviving spouse with their activities of daily living while they remain in their home.   If you would like to know more, visit our web-site – www.wgalaw.com or email rick.messemer@wgalaw.com

Excerpt from “Senior Spirit” newletter from Raleigh Geriatric Care Management

Every new caregiver needs to be introduced to the Client by their manager. The “Caregiver Orientation” is

when the caregiver is introduced to the home environment (care plan, danger spots, Client preferences, daily

routine, the location of the supplies required to do their job). It is also when they are introduced to the Client.

Most companies do not do this “Caregiver Orientation.”

#7. THE CAREGIVER IS NOT SUPERVISED / FAMILY IS NOT INVOLVED

Regular supervision in the home and at the office by a qualified staff member (both announced and

unannounced) is required to maintain a safe and productive environment. Regular and frequent interaction

with the senior and their family will uncover issues before they have a chance to develop into problems.

#8. THERE IS NO CONTINUING EDUCATION OR UPDATING OF CAREGIVER SKILLS

Technologies, methods and procedures constantly change. Continuously updating caregiving skills through

teaching and testing, administered by an RN is important to keeping caregivers in top shape. For most

companies this is non-existent or “hit-or-miss”.

#9. THERE ARE NO DAILY PROGRESS NOTES/DOCUMENTATION OF ACTIVITY

Daily care activity and unusual occurrences need to be documented for everyone to review. Many companies do not require daily written documentation of activity in the home (Daily Progress Notes).

#10. THERE IS NO WRITTEN CARE PLAN

A written care plan needs to always be available in the home. The Care Plan should document the needs of the Client and the requirements of the caregiver and must be approved and signed by a medical professional.

Enjoy the peace of mind knowing you or your loved one is cared for properly by taking some basic precautions in the early stages of investigation.

REMEMBER:  If you are homebound, need the “aid and attendance” of another person to assist with your activities of daily living  and a veteran or surviving spouse of a veteran there may be financial assistance for your caregiver costs available.

Let me know your particular situation and see if there is help available.

rick.messemer@wgalaw.com

The baby boomer group is turning 65, on average,  at the rate of 10,000 individuals per day.  In many of the southeastern states like North Carolina, we have become a “destination” state for retirees, increasing the potential number of seniors looking for in-home care.

Kevin Corrigan of Caring Senior Service shared the top 10 things to look for when interviewing an in-home agency.  Here are the first five, look for the last five in a few days!

#1. YOU MIGHT GET AN INEXPERIENCED CAREGIVER

It is very dangerous to leave a senior with an inexperienced caregiver. Most companies do not require enough experience from their caregivers – usually only one year (because that is NC State law). Companies should

require at least 5 years of verifiable eldercare experience. Inexperienced Caregivers are dangerous.

#2. GETTING A LAZY OR INCOMPETENT CAREGIVER

It would be regrettable to leave a poor worker in the home. Most companies only require 3 work references

from an applicant. But it is important to interview both employers and friends. Checking too few references

will not let you get a good picture. Home Care companies should require 6 references (3 personal and 3 work).

#3. PUTTING A CRIMINAL IN THE HOME

It would be disastrous putting a criminal in the home. Most eldercare companies do not do thorough enough

criminal background checks – only checking on a local/statewide basis. And they only do that once at hiring

time. All criminal background checks need to be nationwide. And they need to be repeated frequently.

#4. CAREGIVERS ARE NOT PROPERLY INTERVIEWED AND ASSESSED

A Caregiver can look good on a resume and get by a casual hiring manager. Caregiver applicants need a

thorough face-to-face interview and skills assessment performed by a qualified professional.

#5. GETTING A DRUG USER FOR A CAREGIVER

Illegal drugs are widespread in our country and prescription medications are prevalent where seniors are

present. Initial urine drug testing at the time of hiring and then random follow-up drug testing is critical.

It is so important to choose the right care options, but don’t let your legal documents go uncheck either.  Make sure as you begin the care process with these updated documents:  your Health Care Power of Attorney, Advanced Directive, HIPAA Release form are in order.  Added to this, Wills should be updated, General Durable Powers of Attorney (GDPOA) and make sure all your insurance, retirement and annuity beneficiary designations are correct.

Please feel free to contact us if you have any questions regarding our post:             rick.messemer@wgalaw.com

We would all like to extend to you a warm Christmas greeting

Bill Alexander, Tovah McDonald, Rick, Tracy, Deb, Ann, Katherine, Elizabeth and Shelia

W. G. Alexander & Associates, Elder Law Attorneys, Raleigh, NC