After suffering ten years of domestic abuse at the hands of her husband, Jennifer finally filed for divorce and moved herself and her daughter in with her parents, Gerry and Donna Daly. Although the relocation was supposed to be temporary, Jennifer has exhausted her bank accounts, refuses to obtain employment, and has sunk into a deep depression. Gerry and Donna are proud, retired grandparents who want to ensure that their grandchild is raised with love, discipline, and opportunity. They have been expensing the household’s grocery bills and clothing for the child, as well as toting her from play-dates to extracurricular activities. The Dalys’ other children have begun to voice concern over their parents’ spending, noting that their income is supposed to sufficiently cover a two-person household and not be stretched to support a four person family. While Gerry and Donna understand their concern, they don’t believe in asking Jennifer and her daughter to leave and have the utmost confidence that Jennifer will get back on her feet. What are their legal and financial options?

Many times, the child-rearing duties that grandparents assume will cause a real strain on seniors’ budgets. Child care costs can grow exponentially dependent on the length of time a grandparent will be asked to assist in raising his or her grandchild. Given this responsibility, these seniors might consider obtaining legal authority to make decisions for that child – on important issues such as healthcare and schooling – and financial assistance from the State.

In Massachusetts alone, 67,781 children reside in grandparent-headed households. Although the Daly’s granddaughter is physically living in their home and they are raising her, Gerry and Donna do not have any legal rights or authority to make decisions on behalf of the children. Jennifer could sign a form giving her parents ‘caregiver authorization.’  This is a caretaking option provided by the Massachusetts Uniform Probate code and allows parents to authorize a designated caregiver to exercise “concurrent parental rights” on healthcare and schooling matters. Provided that the caregiver lives with the child, the authorization is valid for two years and does not require court approval. Caregiver authorization is an alternative to filing for Guardianship of a Minor, a court decree effectively suspending the rights of the parents and transferring them to a guardian entrusted with caretaking responsibility. Depending on Jennifer’s state, this may be necessary for the Dalys.

If you are on a fixed income and unable to get help from a child’s parents, the child may be eligible for payments from Massachusetts’ Transitional Aid to Families with Dependent Children and medical coverage through MassHealth. For further information on assistance through these and similar programs, consider reviewing the Massachusetts “Resource Guide for Grandparents Raising their Children.”

While it may be your desire to become legally and financially responsible for your grandchildren, you are not required to as a matter of law. It is ultimately up to the Commonwealth to assign custody to a suitable individual. However, if circumstances have placed your grandchildren in your home, it is helpful and oftentimes necessary to review your present legal options and to adapt an existing estate plan to ensure that the unique challenges of caring for grandchildren are addressed. Contact Vickstrom Law to your situation and get informed on your options.

After attempting to cope with his mother’s diagnosis of dementia for several months, Joe has finally decided to research local nursing homes for his mother. However, he is concerned about the cost while protecting his mother’s multiple properties, which have been in the family for generations. During a vist, Lindsay, a social worker from the facility, reached out to Joe, offering to complete a MassHealth application for his mother at no-cost. While Joe likes the concept of this free service, he can’t help but wonder if there is a catch involved.

Employed by the nursing home, social workers and other nursing home advocates focus on the rights of the nursing home and not the resident. The nursing home has a vested interest in keeping someone on “private-pay” for as long as possible because their private pay-rates are much higher than the amount received in MassHealth/Medicaid reimbursement. This means more out-of-pocket costs for residents than may be necessary.

Further, even if nursing home advocates do have the best of intentions, the MassHealth/Medicaid process is riddled with complex rules and regulations that are difficult to navigate for those not educated in the eligibility requirements and advantageous planning opportunities available under MassHealth/Medicaid. For instance, an individual encouraged to apply too soon might be ineligible for an extended time period and have to pay privately for a longer duration. Alternatively, the “advocate” may not inform the family that they can pre-pay for funeral expenses as part of a spend down, thereby reducing the burden on family members when the applicant passes.

Individuals that enlist family members to fill out their MassHealth applications or file themselves may face similar problems. Unfamiliar with eligibility requirements and liable to miss prime planning opportunities, these individuals are likely to encounter harsh penalties or confusion when faced with the application process, as well as income and asset verifications. Once they receive their denial notice in the mail, it will be much more expensive to get an Elder Law attorney involved at that point. Additionally there are strict time periods that must be adhered to in order to have any change at being sucessful in a MassHealth/Medicaid appeal.

Nursing home advocates and family members, although the cheapest solution up front, do not have the requisite knowledge, skills, or ability to compose trusts, devise appropriate estate plans, and represent you in an appeal setting if the need should arise. Rectifying the mistakes of an advocate or self-handled application may be more costly than a properly executed plan formulated a skilled elder law attorney. By hiring an elder law attorney to guide the MassHealth application process, you will ensure that your savings, your spousal support, and your family’s inheritance will not be jeopardized by lost opportunities in a last minute planning strategy.

Hiring a lawyer to handle your MassHealth application is a necessary investment. Elder law attorneys can save clients and their family members an amount greater than the cost of their legal services. If you are interested in learning more about the MassHealth application process or long-term care planning, contact Vickstrom Law today!

Mary lived alone on a large estate for fifteen years following her wealthy second husband’s death. Her only living relative was her sister, Louise. The two have been close since childhood, but in recent times the frailty of both women has led to fewer and fewer visits. Mary passed away in January after a three-year battle with endometrial cancer. Although weakened by age and sickness, often delusional and dependent on prescription medication, Mary executed a second version of her will in 2010 (unbeknownst to Louise) with the assistance of her live-in caregiver, Kate. When the terms of Mary’s will are administered, Louise discovers that she is to receive just $1,000 while Kate is the primary benefactor of Mary’s $450,000 estate.

Many times, the relative of one who has recently passed believes that they were unjustly left out of a will. Perhaps due to the mental state of the deceased, the relative might believe that the deceased was delusional in granting a non-relative a financial windfall. In the above example, Louise would like to know whether she has any legal recourse to challenge Kate’s award. She feels that Kate knew about Mary’s delusional capabilities and possibly took advantage of Mary in receiving the majority of Mary’s estate, and finds it hard to believe that her sister would not have left her more. However, it is also reasonable to see that Mary might have felt indebted to Kate and wanted to provide her with a genuine token of appreciation for her services.

In order to create a valid will in Massachusetts a person must possess “testamentary capacity”. In most states, this means that the person creating the will understands the nature of the document, the worth of her assets, and her relationship with whomever she is transferring them to. Testamentary capacity requires freedom from delusion which is the effect of disease or weakness and which might influence the disposition of her property. The person executing the will needs only to be aware of her actions during the period of time she is making the will. The fact that he or she doesn’t remember it the day after does not invalidate a will.

Although wills contests arise frequently, proving that a person is without testamentary capacity is difficult because signing a will does not require a great deal of coherence nor consistency. Louise would have be allowed to contest Mary’s will in the probate court, but it likely would lead to a lot of costly litigation. Most often the disagreeing parties will negotiate a settlement to mitigate the litigation.

If a relative finds themselves in a similar position, they should contact an attorney experienced in Estate Administration to discuss the possibility of a legal claim. If you considering disinheriting an heir who might attempt to challenge a will’s provisions, speak to an experienced Estate Planning attorney about avoiding the probate process altogether through the use revocable or irrevocable trust planning.

Contesting a will is a procedural and difficult process. Yet, if you feel that a loved one lacked the mental capacity to transfer his or her estate, contact our office to discuss your options.

Most everyone would say that they want to be independent and remain in their own homes as long as possible. This sense of autonomy can be kept in place longer than ever before due to medical advances, assistive devices, and in-home care provided by family members and private caretakers. However, what happens when an elder can no longer remain safely in their home and an adult child is trying to get them the help they need?

Esther is 89 years old. She has lived alone since the death of her husband 23 years ago. She gave up driving two years ago, but is regularly visited by her children and grandchildren, who take care of errands or drive her to handle things herself. Lately, she has been rather unsteady on her feet. Additionally, she has been very forgetful and once left the stove on all night. She is also having trouble remembering to take her medications. There were so many her daughter, Susan, sorts them every week into a pill box. Esther still forgets to take them and sometimes actually doubles up on doses. Susan can see its time for more help but Esther is adamant about not having strangers in the house and doesn’t want to end up in “one of those places…”

Many times, elders resent their adult children trying to help them.  In the elderly parents mind, they are still independent and completely able to handle their own affairs.  In the above example, Esther does not appreciate her daughter’s suggestion that they bring in some private home care, or that her mother visit an assisted living facility or rest home. She feels her children are being too pushy, and trying to take control.

But on the other side, Susan feels that Esther isn’t thinking clearly anymore. She is extremely hurt by her mother’s attitude and reaction. After all, Susan is just trying to help. 

The parent/child roles have been reversed, except unlike with young children, the adult child does not have the automatic right to make decisions for the elderly parent. Unless the child seeks to declare the parent incapacitated through a court ordered Guardianship or Conservatorship, or has the parent’s Health Care Proxy and/or Durable Power of Attorney activated, the child has to realize that in the eyes of the law, the parent may make their own decisions. And, unfortunately, people are allowed to make bad decisions.  However, it is important that the adult child watch the situation carefully and not get frustrated and leave the parent to their own devices.  Assisting does not mean taking over against their parent’s will. 

Too many children have simply given up when their “help” is not accepted. If one finds themselves in that situation, they can contact our office for assistance and suggestions for getting through to the parent, discussing the possible need for Guardianship, ensuring that the elder’s estate planning documents are in order, scheduling a medical evaluation, and/or perhaps referral to a geriatric care manager where appropriate.

The elderly years can be as challenging as the terrible twos, terrible terrible teens, and even the terrible twenties.  Elderly parents must be respected by the adult child who is trying to help, even if the parent/child roles have truly been reversed.

Here’s a common  scenario

Florence, an 86-year-old widower, decided to have her eldest daughter, Marie, listed on all her bank accounts after her husband’s passing. She needed some help getting to the bank and figured it was easier to have Marie do it for her. Sometimes, Florence needed Marie to help her write out the monthly bills because she was also starting to have memory issues.

Marie took this responsibility very seriously and made weekly trips to the bank for her mother. A few times Marie helped herself to $200 here and there, just to get her through to her next paycheck. She always put it back… except for the last three times. She just can’t seem to get caught up. Maybe Marie would be able to take on more hours at work but she is very stressed about her 16-year-old son who just severely injured someone in a car accident. She’s thinking about filing for bankruptcy to ease the financial situation.

Be sure to properly assess potential risks

For Florence, adding Marie, or another other loved one, as co-owner on bank and brokerage accounts seemed to be an easy and convenient way of managing her assets and making sure her bills are paid on time.  However, many seniors do not take into account the risks and potential consequences of joint ownership, and the alternatives that can mitigate those risks.

First,  a joint owner has complete access to your accounts and make unlimited withdrawals without your approval. Marie has been helping herself to a little bit here and little bit there for a while now. Florence never knew about it and when she did find out she didn’t ask for it back because she felt bad for Marie. Unfortunately, these were considered disqualifying transfers or “gifts” when Florence applied for MassHealth. She was denied coverage for her nursing home stay because to qualify for MassHealth (Medicaid) you can’t give gifts (or other disqualifying transfers) for five years.

Your co-signer’s liabilities could now be your responsibility

Second, a joint owner is considered owning 100% of the assets, just as you are, regardless of who contributed them in the first place. This leaves your assets vulnerable to their debts and liabilities. If Marie is sued because of her minor son’s  accident, Florence’s bank accounts are at risk. Florence’s bank accounts could also be at risk if Marie files for bankruptcy. If your co-owner goes through a divorce, has a business failure, or gets sued for any other reason, your money could also be exposed to those claims.

Your estate plan could be undermined

Third, when you die, the assets in a jointly-owned account will automatically become the property of the surviving owner.  Florence’s Will directed her estate to be split equally amongst her three children when she died. When she died she only had a few personal effects and a few bank accounts with roughly $10,000. Since Marie was listed as joint owner on all accounts, the funds became legally hers when her mother passed. She knows she has a moral obligation to follow what the Will says, but nobody can make her do it. After all, her brother hasn’t bothered to see her mother in two years and her sister is pretty well-off; she needs the money more than they do anyways. 

Protect your assets

One simple alternative is to have a Durable Power of Attorney prepared by an Elder Law Attorney. Your agent under your Power of Attorney would be able to manage your finances on your behalf, including making withdrawals and writing checks without your permission, but the assets would be owned by you alone. 

Your agent would have a legal duty to manage your finances on your behalf and in your best interest; your assets would not be subject to your agent’s liabilities; and your assets would not automatically pass to your agent upon your death.

It’s important that you speak to an Elder Law attorney about planning for a time when you may be incapable of managing your own affairs.

On June 2, 2009, a 93-year-old driver hurt a mother and toddler in a stroller when he drove his car into a Danvers Wal-Mart. He stepped on the gas pedal because he thought he was stepping on the brake.  The next day, a 73-year-old Middleboro driver accidentally drove her minivan into a crowd of people attending a Vietnam War Memorial in Plymouth. As a result, eight people went to the hospital. Read this blog for more information.  In an effort to reduce the number of accidents involving elderly drivers, Massachusetts legislators passed the new Safe Driving Law.

The new Safe Driving Bill is eight pages long but can be reduced to a few major points affecting elderly drivers:

• Drivers can no longer compose, send or read text messages while driving.
• If you’re 75 years old or older, you must renew your drivers license in person at the Registry of Motor Vehicles.
• If you’re 75 years old or older, you have to take a vision test every five years when you renew your license.
• A health care provider or police officer who feels an individual cannot mentally or physically operate a motor vehicle safely can request an evaluation of the person’s ability to possess a license.  Such a request, however, cannot be made solely based on a person’s age.

The law is also designed to remove problem drivers from the road and encourage people to drive more carefully by reducing the number of “surchargeable incidents” (anything that causes insurance premiums to rise, including at-fault accidents, speeding tickets, etc.).  A driver involved in three such incidents in a two year time span faces license suspension.

Certain ideas with respect to estate planning are widely accepted, yet unfortunately, inaccurate. This article will reveal and explain the most commonly stated estate planning myths. 

Myth No. 1: ‘If I have a valid will, my estate does not have to go through probate.’

Many people believe that having a will means that their estate will not have to be probated when they pass away. A will is a document that, in part, gives instructions as to the distribution of the assets in the decedent’s probate estate. The assets in the probate estate are those assets that are held in the decedent’s name alone that do not have a designated beneficiary. Thus, whether or not probate is needed is not based upon whether or not the decedent had a will; rather, it is based upon how the assets are owned by the decedent.

If the decedent left probate assets, then in order for their will to ‘speak,’ a probate estate must be opened. If all the assets held in the decedent’s name are jointly owned with a right of survivorship or have named beneficiaries, then there is no need for probate.

Myth No. 2: ‘I can give away $10,000 to as many people as I want each year, but if I give more, then I have to pay gift tax.’

This myth emanates from the gift-tax system. In 2010, the rule with respect to gift tax is that you may give up to $13,000 to as many people as you want without having to file a gift-tax return. Note that the amount that can be gifted is stated incorrectly in the myth because most people remain unaware of the ongoing increases to the allowable gift amount.

Also under the current rules, even if a gift-tax return must be filed because more than $13,000 is given to one person, the giver of the gift will not pay any gift tax until he or she has gifted more than $1 million during their lifetime. Thus, if a person has $100,000 and gives all of it away in one year to one person, they will need to file a gift tax return, but they will not owe any gift tax because the gift does not exceed the lifetime threshold.

The estate tax system is NOT to be confused with MassHealth/Medicaid planning. If nursing home care is eminent and you intend on having MassHealth/Medicaid pay for your care, gifts of any size are not allowed and can lead to MassHealth/Medicaid disqualification.

Myth No. 3: ‘I can give away assets when I enter a nursing home and still obtain Medicaid benefits.’

When faced with a nursing home bill of approximately $8,000 per month, many people wish to obtain Medicaid benefits to pay for this care. In order to obtain Medicaid benefits, an asset limit must be met; therefore, assets valued above this amount must be reduced to the asset limit before benefits will be granted. In their efforts to reduce the excess assets, many people believe that they can gift the excess assets due to the gift-tax exclusion explained in Myth No. 2. While a person can make a gift of up to $13,000 per person in 2010 without filing a gift tax return, the Medicaid program is not governed by the gift tax rules.

The Medicaid program imposes a penalty when any assets are given away within five years of the application for benefits, except in very specific circumstances. This penalty results in being unable to obtain Medicaid benefits for at least five years after such a gift is made. Thus, a gift of any amount will typically result in a penalty being imposed even if the gift does not have to be reported on a gift-tax return.

Myth No. 4 – ‘If I need nursing home care, Medicare will pay for my care.’

In part, this myth is perpetuated due to the fact that “Medicare” sounds very much like “Medicaid,” which does pay benefits for nursing home care for approved applicants. Medicare Part A will pay for medically necessary inpatient care in a skilled nursing facility, but only following a three-day hospital stay. Medicare will pay for up to 100 days of skilled nursing care or rehabilitation services. The actual length of benefits could be much shorter than 100 days if those services are no longer required.

When Medicare benefits are paid, Medicare pays 100% of the cost for the first 20 days, but only 80% of the cost of the next 80 days. Most Medicare recipients also have Medigap insurance, which will pay the balance not paid by Medicare. When Medicare benefits are exhausted, an alternative payment source is needed to pay for ongoing nursing home care.

Questions? Wondering if something you’ve heard is a ‘myth?’

 This article was originally published in Business West.

To answer these questions, ElderLawAnswers asked two experienced Estate Planning and Elder Law attorneys to evaluate three leading online will preparation and estate planning programs: Nolo’s Online Will, BuildaWill, and LegalZoom. Their findings and ElderLawAnswers’ conclusions are presented in a five-page whitepaper that is available for free on ElderLawAnswers website.

The conclusion: “We conclude that while online estate planning could possibly work for people who have little or no property, small savings or investments, and a traditional family tree, the significant remainder of the population should not rest easy using one of these programs and should instead consult with a qualified Estate Planning attorney. In other words, in all but the most commonplace Estate Planning situations (and only an attorney can determine what is “commonplace”), do-it-yourself estate planning programs can be a risky, and often quite costly, substitute for in-person planning with an experienced estate planning attorney.”

I encourage you to read the whitepaper and see for yourself. Common issues with these type of estate plans include oversimplification. For example they do not explain the complexities of naming too many decision makers to serve at the same time, nor do they explain why a minor child or an elder parent may not be a good choice to name as an agent. They often overlook tax laws. Its important to remember that each State’s probate laws and tax laws vary. Further, mixed marriage situations are never a good fit for these programs. Additionally, users may miss powerful opportunities to sheild a child’s inheritance or plan for a special needs child. Finally, there is the issue of liability. Who do you hold accountable if a mistake was made?

In my office alone, I have several consultations per month where I assist clients in backing out of poorly drafted, do-it-yourself estate plans, and into something that makes sense for them and their families. Its very important to remember that there are no one-size-fits-all when it comes to planning one’s estate but that the utmost care should be placed in choosing the right person (Estate Planning or Elder Law Attorney) to help you, and not the right computer program.

In April 2008, the Massachusetts Health Care Quality and Cost Council (MHCQCC) issued its annual report recommending that Massachusetts establish a pilot program to improve communication between patients and clinicians, and other interested parties, regarding end of life treatments. The MHCQCC found that many patients nearing the end of life were unaware of the treatment options available to them, or, if patients had been aware of such treatment options and had discussed them with their doctors previously, nothing was in place to ensure that their preferences were honored. Therefore, the Massachusetts legislature enacted legislation in August 2008 establishing a demonstrative program for the MOLST process in one community in Massachusetts: Worcester. (Yay, Worcester!)

The MOLST form is fairly simple and easy to read; the most difficult part is actually making the decisions and putting them down on paper. The form is only two pages long, and only two sections must be completed in order for the form to be honored. These two sections are Section D (patient information – specifically who is signing the document on behalf of the patient) and Section E (physician information). In   Section D, it is possible for the patient, the patient’s health care proxy, or the patient’s guardian to sign on his or her behalf. If a guardian is signing for the patient, the guardian must ensure that s/he has the legal authority under the guardian appointment to do so. This may require consultation with the patient or guardian’s Elder Law attorney.

If any other section of the form is not filled out, the health care agent is not limited in his or her decisions for life-sustaining treatment for the patient. Sections A, B, C, and F ask the difficult questions regarding resuscitation, intubation and ventilation, hospitalization, respiratory support, dialysis support, and artificial nutrition and hydration. It is critical that you speak with a physician before making these decisions so that you fully understand the meanings of the terms used and the potential consequences. Once these sections are filled out, they must be honored by all health care professions in Massachusetts, where clinically appropriate. The MOLST form is different from a Living Will or another document expressing your “final wishes” because it carries more authority and is more likely to be honored. A Living Will or final wishes document is only used by health care professionals to keep your wishes in mind when making decisions about treatment. While the MOLST form is not currently legally binding, health care professionals are strongly encouraged by the state to honor it.

Finally, Section G simply asks for the contact information of the health care agent. There is also room on the form for other treatment preferences, in which you can more clearly articulate your wishes. There is an expectation that the form will be reviewed throughout the patient’s life so that if his or her preferences change, those preferences will still be honored.

View a sample MOLST form here.

MOLST in Massachusetts from Commonwealth Medicine on Vimeo.

Support for Family Caregivers:
It is estimated that 38 million Americans provide unpaid care for an aging relative. Many of these caregivers have other jobs and small children to care for as well. The $102.5 million Caregiver Initiative would add $52 million to the Department of Health and Human Service’s budget for caregiver support programs and $50 million to programs that provide transportation help, adult day care, and in-home services for the elderly. Providing more government support for these programs will hopefully help lower costs so that caregivers of aging relatives can get the help they need and focus more on their jobs and immediate families. The Caregiver Initiative will also allow more seniors to stay in their homes with safe, reliable care, without placing an undue burden on their loved ones.

Retirement Security:
It is estimated that 78 million working Americans lack employer-based retirement plans. This means that about one half of all working Americans are either not saving for retirement or are being forced into doing so through private mechanisms that do not afford them certain key benefits. The task force is recommending that the Obama Administration establish a system of automatic IRA direct deposits where employers will be required to enroll their employees in an IRA program unless the employees opt out. Under the recommendation, eligible families will receive funds matching their contributions through the Savers Tax Credit. For families making under $65,000, the Savers Tax Credit will match 50% of the first $1,000 contributions, and a partial credit will be allowed for families making up to $85,000. This credit will also be a refundable credit, meaning that even if the taxpayers do not owe any taxes, they will be able to reap the full benefit of the credit.

Finally, the task force developed other recommendations to improve the transparency of 401(k) plans. This heightened level of transparency is meant to ensure that workers and plan sponsors have information they need to ensure that they are receiving investment, record-keeping, and other services at a fair price. Obviously, the first question here is: what information will be provided? Will workers receive invoices that show where all their fees are being spent? Or, will these documents show where their fees are being spent AND what other plans charge for the same services? How much will these recommendations actually improve transparency? All of the recommendations must go through Congress before anything will happen, so only time will tell.

Other recommendations concerning 401(k) plans include: encouraging plan sponsors to give unbiased investment advice to workers, making annuities and other forms of guaranteed lifetime income more available, and requiring clear disclosure on target-date funds. These recommendations are not ironed out clearly yet, and Congress is likely to spend a great amount of time working through them.

The full fact sheet on the recommendations presented by the task force includes recommendations on expanding the Child and Dependent Care Tax Credit and making college more affordable.