Filing out an out-of-hospital “Do Not Resuscitate” form for your loved one is part of bringing in hospice to provide  extra care.  When hospice comes in curative care stops and comfort care begins.  This is not an easy task to undertake for a loved one.

Many hold off signing an out of hospital do not resuscitate form because as someone goes down a path with no off-ramps, there could be times when resuscitation makes sense. Then there comes that day when you just need to accept those times are past; that if we have not reached the end, we can see it from here.

Advanced directives are designed to provide both guidance and comfort for those around someone who is nearing death, not to mention fulfilling the wishes of the one dying.  Without having real conversations about this issue, you might not have that comfort.  When you make a decision that basically accepts death as opposed to hope for life, it is hard, no matter how prepared for it you think you are.  You come to realize this in conversations with others, particularly where maybe not all family members are accepting of the finality.

Most of us have an extended family and most of them are not “on the ground” with us the last few months are days we live.  It is important that when the decision about the end of life is made, all of the close family is on board.  Some extended family may not be, but , it is none of their business. Respect and courtesy says you inform them, but when it comes down the decision time, it’s up to the person legally designated to make that decision. Talk to whomever you want, but in the end, it will be who you choose to share information that matters.  That is why it is important to really talk about the end of life when everyone is healthy and sound of mind. Such a conversation will provide a lasting memory and hopefully comfort.

I can not tell you how many unbilled hours this sweet lady spent with families, holding their hands and guiding them.  These memories came back to me reading her husband’s letter on this challenging time of life.

During these conversations you must be very clear with each other about what you want.  For instance, I have had many clients recount when a loved one had a feeding tube installed and that person had no hope of recovery. Often followed by the statement “if you stick one of those down my throat, I will come back and haunt you.”

When one is suffering from something like frontal temporal dementia, which can impact swallowing at some point, just remembering those conversations gives comfort as you are making that particular decision.

When you have these conversations, sitting at the kitchen table or on the patio, you are not thinking about the time you will have to make decisions about life or death. Most believe they will live long lives then fall over dead without a lot of complications.  However, life does not turn out that way.

This one hit close to home because my co-worker was such a sweet lady.  It reminded me of my father’s journey at the end.  Help your loved ones by communicating and making the decisions for them and then consult with an attorney to help you.  These documents are very important and you cannot afford to leave an I un-dotted or a T un-crossed.

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In this week’s Column, I will provide 3 tips for caring for a loved one with Alzheimer’s.

Create a Safe Environment for your loved one with Alzheimer’s

During the early stages of Alzheimer’s disease, your loved one may be able to continue living on their own. Even then, it’s important to keep a very close watch on them and be aware of when that begins to change.

As Alzheimer’s progresses, you should take precautions around the home to keep your loved one safe from falls. You may need to remove obstacles around the home and install ramps to make it easier for the elderly person to get around.

You may also want to install locks on substances like alcohol and things like guns that can be dangerous to your loved one. Think about fire safety as well.

Hot water is another potential danger. As Alzheimer’s progresses, you may need to lower the thermostat so that the water cannot get as hot and potentially burn the senior.

Keep Frustration to a Minimum

When your loved one is diagnosed with Alzheimer’s disease, this is often coupled with a lot of frustration. A person with Alzheimer’s disease can experience frustration with forgetting to do things they were once able to do. They experience frustration because they struggle to follow and understand tasks and communication.

Frustration can also come from loss of independence. It is important to recognize these frustrations and take steps to reduce the frustration.

Provide your loved one with choices whenever possible. Allow your loved one to help with tasks they are capable of, even if it takes them longer that it may take you, or longer than they were able to do it before their diagnosis. Make directions and requests simple.

When your loved one needs to focus, eliminate distractions. Create a calm environment. Be patient with your loved one and take time to allow them to do tasks.

Work at Communication with your loved one with Alzheimer’s

Communication often becomes difficult when an elderly loved one has Alzheimer’s disease. This is an area that takes patience. When communicating with your loved one, they may get discouraged if they can’t understand you or you can’t understand them. Always maintain eye contact with your loved one when communicating. Keep communication simple and to the point, but positive.

When your loved one is attempting to communicate with you, be sure to allow them to talk. Be careful not to interrupt or try to complete their sentences. This can add more frustration. Keep conversations going with your loved one as long as possible by encouraging them and truly listening to concerns.

Use physical touch, such as holding a hand or touching a shoulder, to communicate with your loved one. Don’t take outbursts personally. The illness causes you loved one to do and say things they may not normally do or say. Always be aware of your tone and keep it kind.

Alzheimer’s is a disease with many varying characteristics.  It can wreak havoc on the person our loved one once was.  Caring for a loved one with Alzheimer’s can be frustrating and difficult.  However, patience is the overarching quality that a caregiver must possess to deal with an elderly person with Alzheimer’s disease in a loving and positive manner.

Consulting with professionals who understand the Elder Law and diseases like Alzheimer’s and Dementia will provide peace of mind, knowing that are developing the best plan possible to provide for your loved one’s care.

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I have seen situations where a family member suggest they be paid for caring for their elderly parent(s).  This reflects the views of many adult children who have elderly parents to care for.

Creating a caretaking agreement between relatives is something that benefits both the caretaker and the elderly relative.

However, a financial arrangement between a caretaker and an elderly relative can actually be a way to protect the older person.  There may come a time when they have to go into a nursing home and wish to qualify for Medicaid.  While I believe Medicaid should be an avenue of last resort, the caretaker agreement could help them qualify.

The financial arrangement must be an official one.  Any money given to a caretaker outside of the legal caretaker agreement could be construed as simply a gift.  This may cause a disqualification or delay in receiving benefits.

Although you may feel that you would gladly care for your mother or father for free, consider the benefits of a caregiver agreement.  Talk to your attorney about whether a contract of this kind could be useful to your family.  All situations are not equal, but if they are close to qualifying a caregiver agreement may be the ticket.

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The information in this column is not intended as legal advice but to provide a general understanding of the law.  Any readers with a legal problem, including those whose questions are addressed here, should consult an attorney for advice on their particular circumstances.

Life is unpredictable and certain events can have a significant impact on your estate plan. It’s a misconception that once you’ve created your estate plan, you can just forget about it. It’s important to consider how common life changes can affect your existing estate plan.

Birth of a Child or Grandchild

Many parents create their estate plan after their first child is born. But if their plan only includes their first child, the second child might not get their fair share without going to court. That’s why it’s important for parents to update their estate plan after each subsequent child is born.

Similarly, if a grandchild is not included in the grandparents’ estate plan, they may not be able to receive any of the benefits or opportunities that the grandparents wanted them to have. This could happen because of the family’s structure or how the estate plan was written.

Death of a Family Member

When creating a will or trust, different people play different roles: the person making the document (Testator for a will or Settlor for a trust), the people who will receive something from it (beneficiaries), and the people responsible for making sure the instructions are followed (executor in a will, trustee in a trust).

If any of these people pass away, it can impact the estate plan. For example, if a beneficiary dies, their share may go to someone else or their own descendants. It’s important to review your estate plan to ensure your wishes are still carried out.

It is also important to have backup people in place in case the person you named as the personal representative, executor, or successor trustee is unable to carry out their duties (even if it’s due to passing away before you). If you didn’t name any backups, then your loved ones may have to choose someone to take over, or a judge may have to decide who should be appointed. This could be especially difficult for families who tend to have conflicts.

Purchasing a New Home

If you have a trust-based estate plan, it’s important to make sure that all of your property and accounts are owned by the trust or named as a beneficiary. When you buy a new home, you need to remember to transfer it into the trust to avoid probate.

When you buy real estate, the title company may assume that you are buying it as an individual or as a married couple, so you need to tell them that you want to buy it in the trust’s name. If you forget to do this, you will need to contact your estate planning attorney to transfer the property into the trust after a successful transaction.

If you don’t put your property into your trust, then after you pass away, it will either go to the person who co-owns it with you (if you co-own it in a certain way), or it will have to go through a court process called probate if you owned it individually or as a tenant-in-common. It’s another Risk of Neglecting Your Estate Plan.

Marriage or Divorce

Getting married is an exciting time, but it can also be complicated, especially when it comes to money and property. You and your spouse may own separate property, as well as property that you accumulate together during your marriage. To avoid confusion and ensure that your wishes are carried out, it’s important to have an estate plan that outlines what property is separate and what is joint, what you want to leave to your spouse, and who should make decisions for you if you are unable to do so. If you don’t update your estate plan after getting married, a court may have to get involved to determine how your property should be distributed and who should make decisions for you.

If you get divorced, though, your wishes may change. To avoid any confusion, it’s important to update your estate planning documents after your divorce is finalized. This will ensure that your former spouse is not involved in your estate plan, even if they were previously named as a decision maker or beneficiary. It’s best to work with an estate planning attorney to update your documents and choose new decision makers and beneficiaries.

Don’t Risk of Neglecting Your Estate Plan

An estate planning attorney can review any estate planning documents you have, whether from years ago or a prior marriage, including Wills, trusts, powers of attorney and beneficiary designations, and then help you create new documents for your current situation.

Sam A. Moak is an attorney with the Huntsville law firm of Moak & Moak, P.C.  He is licensed to practice in all fields of law by the Supreme Court of Texas, is a Member of the State Bar College, and is a member of the Real Estate, Probate and Trust Law Section of the State Bar of Texas.

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Hospice care is a type of health care that patients with terminally ill conditions rely on at the end of their lives. This type of care focuses on pain management and emotional, spiritual, and familial support for patients nearing the end of their lives.

There are several options for receiving hospice care, including being cared for at home.  The type of intimate care a patient receives while in hospice is more conducive to being received at the patient’s home.  This becomes a team effort, and it helps to have a peaceful environment when receiving care.

Patients with serious illnesses like cancer, heart disease, dementia, kidney failure, or other fatal conditions benefit from hospice care.  This type of care can help the patient live a more comfortable life while decreasing the emotional burden of grief for families by preparing them for the loss of their loved one.

When Is Hospice Recommended?

Hospice care should not only be considered by those who have loved ones nearing the end of their lives.  While most of these services are generally reserved for people with six months or less to live, early hospice care can be beneficial for patients and their families as well.

You may wish to consider such services in the following cases:

– The patient has a serious decline in their physical well-being

– After a diagnosis of Alzheimer’s disease or dementia

– You have decided to forgo any treatment to improve your physical treatment or care for your illness

Who Makes Up a Hospice Care Team?

Your hospice team can consist of many different types of people.  Various professionals and volunteers may be involved in end-of-life care. Some of those you may see on your care team can include:

– Doctors

– Nurses

– Social workers

– Spiritual advisors

– Trained volunteers

Who Pays for Hospice Home Care?

Like any other health care option, these services can quickly become very expensive.  Fortunately, there are several ways to cover the cost, including:

Government Programs

Private Insurance

Charitable Organizations

Having a well written power of attorney that includes health care is an important part of a comprehensive estate plan.  I suggest that it may even be more important than setting up a Last Will and Testament, because an power of attorney for health care will help you and your agent manage your health care while you are still alive and possibly under hospice care.  It’s worthwhile to give your health care  some thought in advance.

Sam A. Moak is an attorney with the Huntsville law firm of Moak & Moak, P.C.  He is licensed to practice in all fields of law by the Supreme Court of Texas, is a Member of the State Bar College, and is a member of the Real Estate, Probate and Trust Law Section of the State Bar of Texas.  www.moakandmoak.com

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The information in this column is not intended as legal advice but to provide a general understanding of the law.  Any readers with a legal problem, including those whose questions are addressed here, should consult an attorney for advice on their particular circumstances.

What are DECEDENTS?

Often we in the legal world forget there are terms we use that are not used in everyday conversations.  “Decedent” is one of those terms.  Decedent a legal term that refers to a person who has died with unsatisfied legal obligations.

At the end of their life, a decedent has some legal duties that must be fulfilled through a representative.  For example, decedents remain obligated to satisfy certain debts incurred during their life and file their last income tax return.

The word “decedent” is mostly used for estate planning purposes.  For example, you may see this term in a last will and testament, or in estate closure documents related to closing a deceased person’s bank account and filing their final income taxes.

In addition to finalizing an estate, if a person was a party in an active civil lawsuit before they died, the word “decedent” will be added to the party’s name in court documents to signify that a representative is continuing with the case.  I have had to assist families with loved ones that were a party to a lawsuit for personal injury and asbestos lawsuits.  In those cases, someone has to been assigned the legal authority to continue the matter when the “decedent” dies.

Obligations of DECEDENTS

Decedents have legal obligations after their death. Since they cannot perform these duties, the person they appointed before their death must meet any obligations.  These legal responsibilities must be handled according to state law if the deceased person did not name a representative before they died.

Duties of the Representative

Duties that someone has after they die that must be completed by their representative include the following:

– Notify banks, credit card companies, and other creditors about the death of the individual. Also, government agencies must be notified, including Medicaid, Medicare, and the Social Security Administration.

– File the decedent’s last will and testament with the probate court. The representative will also be responsible for representing the decedent’s estate in court.

– Pay any of their outstanding and payable debt.

– File income taxes.

– Open a bank account for the estate. The representative will pay bills, debts, and taxes from the new account.

– Distribute the estate’s assets to the heirs named in the decedent’s last will and testament, or ensure that the heirs at law receive the appropriate property if assets are passed down via intestate succession.

If you would like guidance on estate planning for yourself or for administering an estate following the death of a loved one, you should seek the advice of an attorney who focuses on estate planning and probate process to assist you with these matters.

Sam A. Moak is an attorney with the Huntsville law firm of Moak & Moak, P.C.  He is licensed to practice in all fields of law by the Supreme Court of Texas, is a Member of the State Bar College, and is a member of the Real Estate, Probate and Trust Law Section of the State Bar of Texas.

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Medicaid                     52%

Private Pay                  35%

Medicare                       9%

V.A. & other Public    2%

Private Health Insurance 2%

However, these figures do not include long-term care provided in private residences and personal care homes.  When all is considered, the bulk of long-term care is provided by families and friends.  When planning for retirement, it would be wise to plan for long-term care as well.

Many individuals postpone planning of this nature until it is too late.  By the time they try to qualify for Medicaid they realize just what a tremendous task that can be.  To be eligible for Medicaid you cannot have a monthly income exceeding an amount tied to the current poverty guidelines.  Additionally the total value of savings, cash, investments, and other non-excludable resources are capped.  Burial plans, automobiles and life insurance also have similar maximum values.  This is complicated by the fact that the person applying must have been at this level for up to 60 months before the need for nursing home or home health care arose.

Gifting your property in order to reach this level is tricky for several reasons.  There is a limit of $16,000 per gift annually without tax consequences.  Additionally, gifting property now may result in the grantee having to pay substantial capital gains taxes.

Perhaps worse is that since 2005 the government can place a lien against your estate to recover monies you have received while on Medicaid.

Long-term care planning for most individuals should be planning for Medicaid avoidance, not Medicaid eligibility.  In order to qualify for Medicaid an applicant must prove a “medical necessity for nursing home care” and establish financial eligibility.  Impoverishing a person so as to make them financially eligible for Medicaid may serve only to strip them of their assets when they need them most.

94% of Texas nursing home facilities are Medicaid certified.  The 6% that are not certified include some of the very best in the State.  If you can afford to live in one of the better facilities you may prefer to do so rather than try to preserve assets for other family members.

“Medicaid beds” pay less than “private pay beds.”  Therefore, many facilities have only limited numbers of “Medicaid beds.”  You may have to go on a waiting list before a bed is available.  One result of this is that to have a good choice of nursing homes, it may be necessary to go in as a “private pay” resident and have enough funds to pay privately until a “Medicaid bed” becomes available.  However, recent case law may change this.

Another problem is that Medicaid does not pay for holding a bed if you go to a hospital temporarily.  If when you are discharged from a temporary hospital stay, the nursing home does not have available “Medicaid beds,” then you may have to move to another facility.

Many people see Medicaid as a form of “welfare” and are resistant to applying for it, even if they would be eligible.  Some nursing homes encourage these sentiments by having separate wings for their “Medicaid beds,” sometimes with lower quality floor coverings and other amenities.  If you share these sentiments, then Medicaid may not be right for you.

An alternative to using your personal savings or Medicaid is planning with long-term care insurance. How do you know if long-term care insurance will work for you?  A good approach is to plan for a worst case scenario and determine from that if you will be able to afford the cost of your care.  However, what your worst case is will vary depending on whether you are married or single and the size of your financial portfolio.  For a married couple the worst case scenario usually is for one spouse to need nursing home care, while the other spouse is able to continue living at home.  This is financially the worst case, because the expenses of maintaining a residence and the lifestyle of a more or less active person continue, with the long-term care costs stacked on top.  The amount of care you or your spouse may require will affect your scenario as well.

Factors to consider include the cost of nursing home care and your life expectancy.  The Texas Department of Human Services has determined that the average cost for nursing home care is over $5,000 per month; but as with life expectancy, that is only an average.  When planning, it is best to include scenarios that are worse than average.

Why should you consider buying long-term care insurance?  The most common reason is to insure against impoverishment.  However, you may just want to ensure that you do not have to use any of your life savings or assets to pay for your living expenses.   Finally, you may want to leave an inheritance to your children or grandchildren.  Another common belief is you can’t take it with you so you might as well spend it all before you go.  Your choice to purchase long-term care insurance can only be determined by your personal values and goals.

In parting, I will add that if you are interested in long-term care insurance, then the younger you are when you purchase this type of insurance, the better, because the cost of the policy increases dramatically with age.

I hope the information provided here is helpful.  If you have any questions regarding this, please consult with an attorney.

Sam A. Moak is and attorney with the Huntsville law firm of Moak & Moak, P.C.  He is licensed to practice in all fields of law by the Supreme Court of Texas, is a Member of the State Bar College, and is a member of the Real Estate, Probate and Trust Law Section of the State Bar of Texas.  www.moakandmoak.com

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The most well-known form of caregiver is a family member or close friend who takes on the care of a loved one when they are no longer able to complete important tasks on their own. However, caregivers could also be someone whom the older adult may not know.  They may be employed through an agency and come into the home, or work in the facility where the elder person may live. These are professionals who provide services that can range from companionship to full medical care.

As someone ages, it is crucial to have people around who can support them. More than ever before, seniors are wanting to stay in their homes and are able to, if they utilize caregivers.  Because of this development, and because many seniors are living in a long-term care facility that employs caregivers rather than move to a nursing facility, there has been a rise in the demand for caregivers.

Currently, there is a nationwide shortage of caregivers in all types of settings, and it is impacting communities at all levels. Shortages of familial caregivers, volunteer caregivers, and professional caregivers have caused many older adults to do without these services for long periods of time.  The waiting period for caregiving services has risen, even if someone has been approved to start receiving care.  Once services are started, there may also be times when the extent of services an elder may need exceeds the number of caregivers or hours of care they are granted.

Facilities and agencies are also experiencing shortages. Not only are people not able to find caregivers to come directly to the home, but people are also not able to find caregivers within facility settings.

For this reason, it is wise to start sooner rather than later to form a relationship with an agency and/or caregiver(s).  It is wonderful when an agency or caregiver is first hired, and it goes smoothly for all parties. However, it may take trying several caregivers or agencies before you find one that is a good fit for the care receiver. Word of mouth can be an effective way to contact someone interested in being a caregiver.  Let the people in your social circles know you have a need and see if anyone answers the call.

When the caregiver is found, then you must be familiar with what the law requires.  Each state has regulations on health care.  The Texas Professional Association of Caregivers recommends an 8-hour certification course.  This ensures that the person who is taking care of your loved one is properly trained and thus equipped to provide care.  It is also recommended that a background check be performed, an agreement in writing be entered and insurance provided.

Caregivers are one of the most important and impactful resources for an elder to maintain quality of life.  If you or someone you know needs services, or may need them in the near future, start the process now.  As part of that process, you should consult with an attorney familiar with Elder Law to assist you with questions in this area.

Sam A. Moak is an attorney with the Huntsville law firm of Moak & Moak, P.C.  He is licensed to practice in all fields of law by the Supreme Court of Texas, is a Member of the State Bar College, and is a member of the Real Estate, Probate and Trust Law Section of the State Bar of Texas.  www.moakandmoak.com

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One of the greatest concerns for my clients is that they may end up in a nursing home. This not only means a great loss of personal autonomy, but also a tremendous financial price. Many seniors are watching their retirement funds or “nest eggs” shrink as the financial crisis affecting our country deepens. As a result, many are seeking counsel on how to shelter their assets from nursing home care costs.

A relatively new industry has arisen as a result of these fears. These “asset protection” firms encourage their clients to shelter their assets so that they can bequeath their home to the heirs and leave taxpayers to foot the nursing home bill. In my opinion, this is further evidence of the decaying moral fiber in our country that has led to the sad situation in many areas. It is a society’s moral obligation to take care of their elders. Not the taxpayer, but the families. A better plan would be to seek the advice of a financial planner to help the couple save money for their elder care, perhaps by utilizing long term care insurance to provide their care rather than other taxpayers footing the bill.

Medicaid is a joint federal-state program that provides health insurance coverage to low income children, seniors and people with disabilities. In addition, it covers care in a nursing home for those who qualify. However, Medicaid will probably not provide a level or quality of care you would hope for. For example, Medicaid will not pay for a private room.

In order to be eligible for Medicaid benefits a nursing home resident may have no more than $2,382.00/month income and $2,000.00 in “countable” assets for a single individual 2021. There are protections if one spouse has to enter a nursing home. The spouse of a nursing home resident, called the “community spouse,” is limited to one half of the couple’s joint assets up to $130,380.00 (in Texas for 2021) in “countable” assets. This figure changes each year to reflect inflation. In addition, the community spouse may keep the first $26,076.00 (again in 2021 for Texas), even if that is more than half of the couple’s assets. The maximum allowance in Texas is up to $130,380.00.

All assets are counted against these limits unless the assets fall within a short list of “noncountable” assets. Noncountable assets are limited to the following:

– Personal possessions, such as clothing, furniture and jewelry;

– One motor vehicle, valued up to $4,500.00 for unmarried recipients and of any value for the healthy community spouse;

– The applicant’s principal residence up to $603,000.00 (in 2021 for Texas);

– Prepaid funeral plans and a small amount of life insurance (face value less than $1,500.00);

– Assets that are considered “inaccessible” for one reason or another.

The second major rule of Medicaid eligibility is the penalty for transferring assets. Medicaid does not want you to move into a nursing home on Monday, transfer your assets on Tuesday and apply for Medicaid on Wednesday. Congress has imposed penalties on the transfer of assets without receiving fair value in return. The Deficit Reduction Act of 2005 (DRA) has made these restrictions very severe.

A common hurdle in qualifying for Medicaid is gifting of one’s assets in order to qualify. The rules regarding gifting are quite complex. Gifts made during the 60 calendar months prior to the Medicaid application month may result in a loss of eligibility for a calculated period of time.

The penalty period is calculated by dividing the total amount gifted within the prior 60 calendar months by $21.371 (considered the average daily cost of nursing home care in Texas in 2020). For example, if an applicant had given away $10,000.00, the period of disqualification would be calculated as follows: $10,000.00 divided by $213.71 = 46 days or about 1 /1/2 months of disqualification.

The period of disqualification begins running on the first day of the month that your loved one entered a medical facility and met the medical need, income and resource criteria for eligibility. Be very cautious making gifts. When gifting, the gift giver can’t expect to get the money back from the gift recipient. It is a gift with no strings attached. Also, the recipient may intend to keep the gift for the giver but the recipient’s creditors or spouse or the recipient’s death may cause the funds to be diverted elsewhere. There is no way I could alert you to every possible disadvantage. One must always take into consideration “unforseen circumstances.”

There are transfers which are exceptions to the transfer penalty. They are limited to the following transfers:

– To the applicant’s spouse;

– To a child who is under 21 years of age or who is blind or disabled;

– Into a trust for the sole benefit of a disabled individual under 65 years of age;

– To a sibling who has lived in the home during the year preceding the applicant’s institutionalization and who already holds an equity interest in the home; and,

– To a “caretaker child,” who is defined as a child of the applicant who lived in the house for at least two years prior to the applicant’s institutionalization and who during that period provided care that allowed the applicant to avoid a nursing home stay.

For a brief period it was against the law to help someone transfer assets improperly. This is no longer the case, although it may be again in the future. If you decide to embark on a plan to make your loved one eligible for Medicaid, it is important to avoid a claim of exploitation. Texas law defines “exploitation of an elderly person” to be the appropriation of their assets without the elderly person’s informed consent. So long as there is no one to complain about proper Medicaid planning (i.e., ALL family members agree on a course of action), then the issue will probably not arise. However, if someone perceives that you or someone else is taking advantage of your loved one, Adult Protective Services may become involved. Civil and criminal penalties can result from finding of exploitation.

Another factor to be aware of with Medicaid is that on March 1, 2005, Texas implemented the Medicaid Estate Recovery Program in compliance with federal Medicaid laws. The program is managed by the Texas Department of Aging and Disability Services.

Under this program, the state may file a claim against the estate of a deceased Medicaid recipient, age 55 and older, who applied for certain long-term care services on or after March 1, 2005. Claims include the cost of services, hospital care, and prescription drugs supported by Medicaid.

Remember, nothing from the government comes for free. There are always strings attached and before you blindly apply for Medicaid, know all the facts so that you can make an informed decision. There are a lot of myths and untruths out there about Medicaid, seek legal advice from somewhere other than the coffee bar.

If you find yourself in the age group of 50 to 70 you should start researching long-term care insurance. The younger you are when you apply the better. Why should you consider buying long-term care insurance? The most common reason is to insure against impoverishment. However, you may just want to ensure that you do not have to use any of your life savings or assets to pay for your living expenses. Finally, you may want to leave an inheritance to your children or grandchildren. Another common belief is you can’t take it with you, so you might as well spend it all before you go. Your choice to purchase long-term care insurance can only be determined by your personal values and goals.

I hope the information provided here is helpful. If you have any questions regarding this, please consult with an attorney skilled in estate planning and elder law.

Sam A. Moak is an attorney with the Huntsville law firm of Moak & Moak, P.C. He is licensed to practice in all fields of law by the Supreme Court of Texas, is a Member of the State Bar College, and is a member of the Real Estate, Probate and Trust Law Section of the State Bar of Texas. www.moakandmoak.com

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In previous columns, I explained the importance of having a Durable Power of Attorney, Medical Power of Attorney and a Directive to Physicians, Family and Surrogates (commonly referred to as a Living Will). While I often advise clients on the benefits of these instruments, I want to stress the importance of these documents if you have been diagnosed with Alzheimer Dementia. Having personally lived with the effects of dementia with my father, I can tell you this is a very difficult disease. Planning should be done as soon as possible if you have been diagnosed or if you have been told you have early symptoms of Alzheimer Dementia because you must be of sound mind when you execute these documents. This will require a note or letter from your doctor verifying your ability to sign documents of this nature.

Alzheimer is a crippling disease that can progress very quickly. It requires specialized care, and in some instances, around the clock supervision. If you do not take time to have the proper legal documents put into place, then you could cause your spouse or children to bear a great emotional and financial burden. As I have pointed out in my earlier columns, you never know what could happen to you or when it might happen. So it is prudent to plan ahead by executing a Durable Power of Attorney, Power of Attorney for Healthcare and Directive to Physicians, Family and Surrogates. This allows you to choose who you would want to handle your affairs and deal with your doctor and healthcare provider, and even give advice to your chosen representative as to the type of care you desire. Having these documents in place ahead of time can save valuable time in the case of an emergency.

Anyone is susceptible to being diagnosed with Alzheimer Dementia, suffer a stroke, or be the victim of an accident. While age has a great deal to do with Alzheimer Dementia, it has no bearing on the latter. These cases are good examples of why planning ahead and having a Durable Power of Attorney, Medical Power of Attorney and Directive to Physicians, Family and Surrogates is important.

While there are a myriad of sources for these instruments, all powers of attorney are not created equal. I have reviewed everything from a one or two page power of attorney to an eight or nine page document. Remember, what works in one part of the country will not work in all parts. Additionally, merely having a power of attorney does not mean it will be accepted by all entities your agent may be dealing with unless it explicitly states their authority. After you become incapable of handling your affairs without assistance is not the time to find out your documents do not work.

If you would like to plan ahead and have one or all of the instruments discussed in this column prepared, be aware that Texas law places certain requirements as to the form of the documents discussed and as recently as September 2017, updated the recommended requirements. Therefore, you should consult an attorney who is focused on this area of law and has experience with regard to what is required to insure your agent can use these documents when the time comes. If you had any of these documents prepared for you in the past or while you resided in a different state you should have a Texas attorney review the documents to make sure they comply with current Texas law.

Sam A. Moak is an attorney with the Huntsville law firm of Moak & Moak, P.C. He is licensed to practice in all fields of law by the Supreme Court of Texas, is a Member of the State Bar College, and is a member of the Real Estate, Probate and Trust Law Section of the State Bar of Texas.www.moakandmoak.com

The post ALZHEIMER DEMENTIA PLANNING appeared first on Moak & Moak, P.C. -Attorneys At Law.