Massachusetts Estate Planning and Elder Law

Speaking Engagement - Divorce and Estate Planning

Just a reminder that I will be speaking at the Suddenly Single Retreat in Boston on June 29, 2008 on the topic of Estate Planning and Divorce.  Click on "events."  Note that the site has music playing, so you may want to mute your computer before clicking. 

The 2 day event is for divorced (or soon to be divorced) women who are 40 or older, and is being put on by Nancy Michaels.  There will be great work shops on everything from helping your kids (and yourself) cope with the divorce, to the financial and legal things you need to know and do to protect yourself going forward.  There is also yoga in the morning and an ambush make-over! 

Download the agenda by clicking here:    Download SuddenlySingleAgenda.pdf

Hope to see you there!

Joanne Koenig Coste Podcast - Sustaining Hope Amidst Alzheimer's

The Patriot Ledger has an article about the Hingham Alzheimer's Event which contains a podcast by Joanne Koenig Coste about staying positive and in the moment while living with and loving someone with Alzheimer's Disease.  She stresses the importance of accepting where the person is now, and what they can do, rather than dwelling on who they used to be, and what they can't do.  Click here to listen.

Thanks to Sue Sheibel at the Patriot Ledger Blog, A Good Age, for posting about this. 

Driving and Aging

Jessica Foley, an attorney in Quincy, has a recent post about driving when your mobility is impaired.  While there are sometimes when physical issues that make driving unsafe, there are many times when you can still drive even though you have difficulty getting around.  Jessica lists the criteria for obtaining a handicap placard, which can make your errands easier by giving you a parking space closer to your destination.  You must be a resident of Massachusetts and must have your doctor, chiropractor or nurse practitioner certify that you meet one of the following conditions:

• Cannot walk 200 feet without stopping to rest.
• Cannot walk without the assistance of another person, prosthetic, cane or crutches.
• Have a lung disease such that your respiratory expiratory volume is less than 1 liter.
• Use portable oxygen.
• Have a Class III cardiac condition.
• Have a  Class IV cardiac condition (if you have this the registry requires you to surrender your license, in this instance you will be issued a placard for the motor vehicles you are riding in).
• Have Class III functional arthritis.
• Have Class IV functional arthritis.
• Have Stage II anatomic arthritis.
• Have Stage IV anatomic arthritis.
• Are legally blind (again a situation where you would surrender your license and would be issued a placard for the vehicles in which you are a passenger).
• Have lost one or more limbs.
• Have permanently lost use of one or more limbs.

For more information on obtaining a disability plate or placard, visit the RMV Website. 

Teleseminar - How To Be Your Own Generational Coach

AgeWise Living is offering an 8 week tele-seminar on becoming your own generational coach.

This tele-seminar is for you if you are caring for a loved one and are having some of the following issues:

	Are you a member of the "sandwich generation" -- squeezed between raising children and caregiving responsibilities for your parents, in-laws, or other aging loved ones?
	Stressed and struggling with your eldercare issues?
	Do you lie awake nights worrying about them?
	Are they consuming your time and draining you financially and emotionally?
	Are eldercare issues creating problems at work and at home?
	Are conflicts with siblings or other family members sabotaging your efforts and undermining your relationships?
	Are you spending hours searching for solutions to your critical eldercare issues only to have your aging loved ones refuse to cooperate or even discuss them with you?
	Do you feel like your life is out of control?

Even if you can't attend the live phone calls, they will be recorded so that you can listen to them at your convenience. You also get a private coaching session with Barbara every week, her book on How To Be Your Own Generational Coach, and lots of other resources.    This is another great way to care for yourself as you are caring for others. 

How Clear Are Your Last Wishes?

This is the title to a recent New York Times health blog post. (You need to register to read it, but it is free.)

The author recounts her experience with her family trying to deal with her grandfather's illness and their attempts to interpret his wishes about the end of his life.  She writes:

...the experience made me realize that having a living will isn’t enough — we need to be sure that we have been clear and specific, and that we have considered a variety of scenarios as we try to instruct our loved ones to make decisions for us in a medical crisis. Phrases like “terminal illness” are vague at a time when new treatments and drugs can keep patients with a terminal disease alive for months or years.

Many people prepare a "Living Will" or "Life Support Statement" as part of their estate plan.  As the author indicates, these documents are sometimes filled with vague statements about death being a natural part of life, and "heroic measures", which can make it difficult for your family to interpret in their time of grief.

I explain to my clients that even if they sign a Living Will, it is very important that they also have conversations with their loved ones about the different types of situations that can arise and what they might want done in those cases.  These conversations do not need to be a big, formal, one-time thing. They can occur if something is in the news about end of life care, or if a friend or relative is going through something similar.  It can be easier for your family to remember this way - "Oh, I remember when Aunt Peg was in the final stages of breast cancer, mom said she wouldn't want another surgery if that happened to her." 

The Mayo Clinic also has a great guide for discussing your last wishes.  It outlines the different treatments that you'll want to address: resuscitation, mechanical ventilation, nutrition and hydration assistance, dialysis and treatments at the end of life.  It also reminds you to revisit your wishes from time to time to see if they change - for instance during pregnancy or if you are diagnosed with a terminal illness. 

The Importance of Naming an Alternate Beneficiary in Your Will

I have posted before about the importance of naming an alternate beneficiary on your life insurance policies, so that the proceeds can be distributed to someone else in the event that the primary beneficiary predeceases you.  However, it is likewise important to name alternate beneficiaries in your Will. 

For example, if you have one child, and you leave everything to that one child, what if he or she predeceases you? Where do you want the funds to go then?  Did you mean for them to go to your grandchildren?  Or you have multiple children and one predeceases you.  Did you want their share to go to their siblings or their children?   Or, perhaps you wanted the funds to to go to your daughter-in-law who took such good care of you.  Without specifying so, the money would not go to her, but rather to your next closest relative who may be someone you have never met, or do not even like. Or maybe you would like your college, or a certain charity to be the contingent beneficiary.  Maybe the person who would inherit the funds by operation of law is a spendthrift, or addict, or has special needs and the money would be better protected in a Trust.

Unfortunately, you will not be around to explain what you wanted, and the statutes which dictate how the funds will pass without your direction will not necessarily match your wishes.  When thinking about your Will, you must always think "What if this person passed away before me, where would I want their share to go?"  Then talk about it with your attorney, who will help you make sure that all contingencies are covered. 

Setting Up A Burial Account In Massachusetts

Under Medicaid, or MassHealth, regulations, the applicant is allowed to have $1500.00 in a "Burial Account."  However, if you go down to your bank and ask to open a "Burial Account", they may look at your strangely and not know what you mean.  When this happens to my clients, I tell them to go back to the bank and request to open a Savings Account.  Many times a bank will allow you to name the account, if they do simply have the account named "Burial Account."  If you cannot name the account, that is ok.  You will report it to Medicaid as a Burial Account, and they will send you back a piece of paper to sign indicating that you understand that you cannot spend the money in the account on anything except your burial. 

This is one of the easier aspects of applying for Medicaid.  If you find you have more complex issues, or just want someone else to handle everything, feel free to call me about setting up a consultation. 

Misconceptions about Medicaid

The Patriot Ledger has a blog written by Sue Scheible called A Good Age. Sue writes about various issues affecting the elderly, including caring for her aging father. She recently had a post about some misconceptions about Medicaid/MassHealth.  I commented on the post, and then we spoke by phone.  The result of that conversation is this post, which tried to address some of the misconceptions about Medicaid and the people who receive it. 

Want to Give, But Not Sure Which Charity to Choose?

If you are wanting to make a charitable donation, but aren't sure about which charity to choose, or you want to check on a charity to see what they spend on administrative costs and overhead - try a website like Charity Navigator. 

In addition to rating charities, it also contains information about What to Do When A Charity Calls (be wary, get something in writing, do your research, and don't give out private or credit card information to inbound callers), Protecting Yourself From Online Scams (again, be wary, don't give out information based on unsolicited emails, delete unknown emails with attachments), and How to Stop Solicitations by Mail (request that your name not be shared with other charities, call the charity directly to stop the mail, and avoid giving lots of small donations to many charities.)

When making a gift of charity, you want to be sure your money will be used properly by an organization you trust. So always do your homework, and ask lots of questions, before you give.

New Massachusetts Medical Certificate for Guardianships

The Massachusetts Probate Courts have come out with a new, much more comprehensive, medical certificate to be used when petitioning for a guardianship of a person.  The old form was 2 pages, and consisted mostly of blank lines, which left it up to the doctor filling the form to come with what information he or she thought was needed.  The new form is 8 pages, and requires much more detailed information from the doctor.  It also requires the doctor to specify whether a limited guardianship or a full guardianship is needed.

Click here to access the new Medical Certificate. Download medcertgdn31408.pdf
For comparison, here is the old certificate: Download OldMedicalCert.pdf

Quite a difference.

Here's the link to the official announcement on the Probate Court Website.

 

Speaking of Divorce and Estate Planning....

I will be speaking at the Suddenly Single Retreat in Boston on June 29, 2008 on the topic of Estate Planning and Divorce.  Click on "events."  Note that the site has music playing, so you may want to mute your computer before clicking. 

The 2 day event is for divorced (or soon to be divorced) women who are 40 or older, and is being put on by Nancy Michaels.  There will be great work shops on everything from helping your kids (and yourself) cope with the divorce, to the financial and legal things you need to know and do to protect yourself going forward.  There is also yoga in the mornings and an ambush make-over! 

Hope to see you there!

Free AgeWise Living TeleSeminar - Wednesday Night

AgeWise Living offers free monthly teles-eminars on a variety of topics for caregivers and children of aging parents. 

Barbara Friesner is hosting a seminar on Wednesday March 12, 2008 at 7pm eastern time on Helping Your Loved One Get What They Want and What's In Their Best Interest.
Click here for details and the call-in number. 

You can listen to past seminars by clicking here, including a great one on sibling relationships. 

Even though Barbara is in New York, she does all of her generational coaching by phone, so she can help families throughout the country. 

Estate Planning and Divorce - Tips on Trusts for the Family Law Attorney

Many times in a divorce, one or both parties will be required to set up a trust to hold funds for the minor children's college education.  I've been contacted by  divorce attorneys after the divorce to draft such trusts based on the language in the divorce agreement. Which was written by divorce attorneys. Not trust attorneys.  And that is where the problems can begin. 

Many times the terms used in the divorce agreement regarding the trust are not clear - for instance if "minor children" is used in one place and "emancipated children" is used in another, which was meant?  If it refers to a providing for funds for a "secondary education" does this mean only at an accredited school, or would a trade school qualify?  Trying to interpret the answers to these questions after the divorce is final so that the trust can be drafted to comply with the agreement can be time consuming and costly.  In addition, if the other party disagrees with how the trust was drafted based on vague language in the divorce agreement, that can lead to more costs and time with the divorce attorneys hashing out what their clients meant in the agreement, and the estate planning attorney having to redraft the trust. 

Checking in with an estate planning attorney when you are including language about a trust in a divorce agreement can save you and your client a lot of time and hassle, and the estate planning attorney might bring up some issues you hadn't thought of with regard to the trust. 

Estate Planning and Divorce - Part 2: Post Divorce

See first post in the series here.

You are nearing the end of your divorce, the final hearing or settlement is in sight.  The last thing you want to do is hire another attorney, write another check out of your bank account which may have taken quite a hit during the divorce.  But, you must.  You need to see an estate planning attorney, to make sure that those things you fought for in the divorce are protected, and that your wishes are honored.   And, rest assured, visits with an estate planning attorney do not involve any court visits, there are no "opposing parties" and generally estate planning attorneys do not charge by the hour. 

You should meet with your estate planning attorney to form your plan before the final divorce hearing, so that the documents can be signed as soon as possible after the final hearing.  This is because during the 90 days after the final hearing, you are still married, and if you pass away during this time without a new plan in place, your soon0-to-be-former spouse could inherit everything.

After your divorce, in addition to signing your new estate planning documents, you should also make sure that you have changed the beneficiaries on any life insurance policies, 401(k) plans, IRAs, and any other accounts that may have had your former spouse listed.  If you have set up a trust, your estate planning attorney can assist you in making sure that the trust is properly named as the beneficiary of these accounts.

For thoughts on this subject from a Family Law Attorney's perspective, visit the Massachusetts Divorce and Family Law Blog written by Attorney Steven Ballard, who posted about this on Saturday. 

Estate Planning and Divorce - Part 1

If you are separated from your spouse, filing for divorce, or even just contemplating it - you need more than just a divorce attorney.  You need to visit with an estate planning attorney to make some critical changes to your estate plan before and after the divorce.  This post will deal with changes than can be made before the divorce, and the next post will be about changes to make after the divorce. 

1. If you have signed a health care proxy naming your spouse as the person to make medical decisions for you, you should revoke it and sign a new one appointing someone else.   Notify your spouse that you have revoked the HCP naming them.  Make sure that anyone who knows of the old HCP (such as your doctor) is given a new one.  If you have not signed a HCP, sign one, and make sure your doctor has a copy and carry a card in your wallet indicating who your new health care agent is, and where your HCP is located.
   
2. Remove your spouse from any Power of Attorney documents that you've signed appointing them and notify any entities that may have received a copy of the old Power of Attorney so they know it has been changed.  The POA is a powerful document which can give the holder the right to access bank accounts that are in your name alone, get financial and sometimes medical information about you and even sell real estate that is your name.  It is vital that you sign a new one if you do not want your spouse to have this power. 

During this time you should also be thinking about your estate plan after your divorce. If you would not want your former spouse to be in charge of the money that you will leave to your minor children, you will need to set up a trust, with someone else as trustee.  This can be a sibling, parent, friend or even a bank or other financial institution.  Your estate planning attorney can explain what the responsibilities of the trustee are, so that you can make the best choice, and can help you determine when the best time to sign the new documents are.

 

Tune in tomorrow for "Post-Divorce Estate Planning Tips".

For further thoughts see the New York Probate Litigation Blog.

Economic Stimulus Check Resources for Seniors and Those on Medicaid/MassHealth

Thanks to Patti Dudeck, for her post about Social Security recipients needing to file their 2007 Tax Returns before they will be able to receive their economic stimulus check.

The AARP has a page with answers to questions about the stimulus checks, and who is eligible.  They also have information about how to obtain tax filing help for low income seniors. 

And, note that the funds from the payment will not affect eligibility for needs-based benefits programs, as explained on the AARP page:

Will the stimulus payment affect eligibility for needs-based benefits programs? No. Receiving a payment under the stimulus package does not have any effect on eligibility for or amount of needs-based benefits programs (i.e. Food Stamps). Specifically, the payment does not count as income in the month it is received and does not count as a resource (asset) for 60 days after the month in which it was received.

Keep in mind that it will count as an asset after 60 days after the month in which it was received.  If your public benefits depend on your assets being below a certain limit, always keep an eye on your balance.

Information Binder for Parents and Children

I recently had a client who was having surgery, and was leaving her pets in the care of some friends. She left extensive instructions about what her pets eat, what they are allergic to, who their vets are, their medical history and current issues, and any quirks they have such as a favorite toy or special sleeping place.

It made me wonder how many people leave records like this when they leave their small children in the care of another.  Whether you're going out for the evening and leaving your children with a babysitter, or going away for a week and leaving your children with your parents, it's a good idea to keep a binder handy with all of the important information: 

• Each child's full name, date of birth and social security number.
• Any allergies (these should be in large, red lettering) to foods, medicines, soaps, etc.
• Name and phone number of pediatricians and other doctors seen regularly.
• Any recent or chronic illnesses.
• Name, dosage and location of any medications for each child.
• Name of each child's teacher and grade at school.
• Name of people allowed to visit child, and name of anyone you don't want visiting your child.
• Photocopies of the front and back of any health insurance or dental insurance cards.
• Copy of emergency guardianship proxy document.
• Recent pictures of each child. 

While you may know this information like the back of your hand, the people who are watching your children won't, especially in a crisis. 

By using a binder to store this information, you can add and change information as needed.  In addition, a binder, as opposed to a computer program, is easily accessible and can be grabbed as you are running out the door. 

Caring for the Caregiver

Whether you are caring for an aging parent, small children, or just yourself - everyone can use time for themselves to regroup and recharge.  One way that I like to recharge is with a short yoga practice during the workday.  Stacey Shipman of Let It Flow  has a great 10 minute Yoga At Your Desk podcast which will leave you feeling refreshed and ready to face the rest of your day. 

Because of the physical and emotional stress of caregiving, caregivers need to make sure they take care of themselves, too.  As they say on airplanes, you have to put on your own oxygen mask before helping the person next to you.  So think of this practice as putting on your own oxygen mask and breathe!

Driving While Elderly

There has been a lot of talk in the local media about elderly drivers lately, and a push to require more frequent testing and stringent standards.  Whether you are an older driver concerned about your eyesight or coordination, or a caregiver becoming more nervous about a loved one's driving ability - remember that all drivers, of all ages, need to be safe on the road and to keep others safe. 

The Massachusetts Registry of Motor Vehicles website has an entire section devoted to senior drivers, including things for caregivers to watch out for, quizzes and local driving safety courses, warning signs of unsafe driving and how to report an unsafe driver.

Losing the ability to drive can be very traumatic for an older person, as it can lead to isolation and depression.  Remember the feeling of freedom you had when you first got your license? Keep that in mind when you are talking to someone about not driving anymore.  Think of ways they can keep their independence while staying safe - maybe it means using the town senior shuttle, or joining you on your weekly shopping trips, or even taking the money saved on insurance and gas and hiring a companion to act as a driver.  Having a plan in place before taking away the keys can make the transition easier. 

 

See also: Massachusetts Driving Law Blog

 

Making Sure Your Paper Work is Signed

I recently heard a story about a man who had passed away suddenly, leaving behind a young adult daughter.  He had been at a job that had offered him life insurance and certain other benefits when he retired a few years back.  However, as the grieving daughter began to sort through things, she realized that he had never signed any of the paperwork that would have put these benefits into effect.   

Maybe the father thought he'd get around to it soon, maybe there was a miscommunication with the company, but the reality of it is that this man's only heir is now left with a lot less than what her father intended.  And when she should be dealing with the death of her father, the daughter is having to deal with human resource departments, insurance companies and attorneys. 

Take some time over the next week or so to check in with your employer (or yourself if you are your own employer) to make sure that you've signed up for all the benefits that will protect your family in the event of your death or disability.  Make sure the papers have all been properly filled out, and that your beneficiary designations are current.

If it's been a few years since you've reviewed your estate plan, go over that as well to make sure it is still up to date.  If you haven't done your estate plan yet, call me at 781-749-2284 to find out how to get started. 

Appointing More Than One Person As Agent in Your Documents

One of the decisions that my clients often find the hardest to make working on their Wills, Powers of Attorney and other estate documents is deciding whom to appoint as the agents in those documents.  The agent (or Executor in a Will) is the person who act on your behalf in the event you are unable. For instance, in a Power of Attorney, the agent will be able to do your banking for you, file tax returns, hire people to take care of you and even sell your house (if appropriate and if allowed by the document.) 

Clients will sometimes want to appoint two children as joint agents so that things are "equal" and they aren't favoring one child over the other.  If this is the case, I often advise them to think about it some more.  Deciding who to appoint as your agent is not about making people feel good, or avoiding hurt feelings - it's about making sure that your wishes will be carried out in a timely manner when there is a crisis.  And being appointed as a person's agent under a Power of Attorney can be a lot of work and involve taking time off of work or away from family matters to tend to things. 

Things to keep in mind when choosing to appoint joint agents or executors are:

• why do you want to appoint joint agents? Are you trying to make things even? Do you not fully trust one of the people and you want to have a checks and balance system in place?
• have you talked to the individuals involved to see if they want to serve jointly with another person?
• do these two people get along?
• do they tend to think along the same lines so that there will not be a delay in making decisions due to disagreements?
• have you considered what might happen if they are unable to reach an agreement and necessary action must be delayed due to the indecision? 

If you want two of your children each be able to assist you with different matters, and be able to split up the work, you could appoint joint agents who each have the power to act separately (meaning only one of them would need to sign a document for it to be effective.)  Again, you want to be sure that they will not be working against each other, but this can alleviate some of the logistics of obtaining two signatures from people who live in different states and have different schedules. 

Part of the work that I do with my clients is helping them sort through issues like these so that their estate documents (and the agents appointed) will serve them well in a crisis. 

What are you leaving behind? Thoughts on decluttering as part of planning.

I posted recently about the health effects of clutter on the person living with the clutter.  However, the effects of your clutter live on even after your death.  This blog, Confessions of a Hoarder, has a post describing the process of trying to declutter an estate after a person's death. 

The author describes how her mother, a member of the American Association of University Woman, was often called to help clean out someone's estate that had been left to the AAUW.  They had to prepare the house for sale, and in doing so they had to clear out decades-worth of things that had been collected by these people who had generously left their estate to the charity. 

The author's mother offered these tips to aging people, as well as their adult children as they decide what to keep and what to recycle, give away or throw away:

1. Do not save months and years of magazines, with a thought towards donating them. 
   
   

   Collections of magazines, such as Life or Look, usually have no value as libraries have copies in their archives. National Geographic and The New Yorker, for instance, are available on CD-ROM. Professional journals are usually available on-line these days. Newspapers, magazines, and other periodicals collect moisture, become mildewy and/or moldy and attract other unhealthy pathogens.

2. If you have collectibles that you want people to inherit from you, think about giving the item sooner along with the story behind it. 
   
3. Identify all keys with tags or labels.  Safe deposit box keys should have the bank name, branch and box listed on them.
   
4. Photographs of unidentified people are usually thrown out if donated to a charity, and are much more valuable to family if they have the identity, date and relationship listed on them. 
   
   It only takes a few generations for the identity of people in photographs to be lost, so if you are looking through unlabeled pictures with an older family member, take some time to ask them who the person is, what they were doing, where they were, and who they were related to. Which is more meaningful, a label that says "Joe", or one that says "Uncle Joe, Joe Sr.'s son, age 19, 1942 in front of his store front in San Francisco."  This type of project is a good one for younger generations to help out with, and can lead to more stories and memories being shared and passed down. 
   
5. Identify flowers, plants, trees and houseplants if you know what they are.  These can be useful for prospective buyers, who may want to know how to continue to care for them.
   
6. Broken, rusted or otherwise unusable tools have no value. Consider having them repaired or throwing them away.
   
7. Identify circuit breakers.
   
8. Clearly mark where the main water shut-off valve it.  Houses that are left vacant can sometimes have pipe-freezes and knowing where to shut off the water coming into the house is vital to stopping the flood.  The plumber can usually find it, but the water should be shut off ASAP in the event of a pipe freeze. 

Many times my clients who are dealing with the estate of a loved one have commented to me about things their mother, father, aunt or uncle saved, and have wondered aloud what made them hold on to so many things.  They often resolve that they will not subject their children to the same onerous task of clearing out their house when the time comes. 

Are there things you are saving because you think they might be of value? Do you need help decluttering and clearing out your house? Are you trying to figure out how to approach your parents about their clutter?  You might try starting with some books on the topic,  and then gently offering to help. Remember that people are often very attached to their clutter (and their sentimental items) so you can't just start throwing things away that don't belong to you, but you can start a conversation and offer to help get things in order. 

New Medical Students Learning to Care for Aging Patients

The Boston Globe has an article today about medical schools focusing on the care of the elderly.   Some of the course work includes a focus on hip fractures, drug costs, and discussing end of life issues with their patients. 

The new emphasis on aging is part of a wave of change sweeping medical schools nationwide as they focus - many for the first time - on preparing all newly minted doctors to treat the growing population of older Americans. Although students have traditionally trained in hospitals filled with older patients, many graduated with little knowledge of how elderly patients' bodies and minds differ from younger ones.

Now, medical schools are increasingly teaching students in settings that include senior centers and nursing homes. They are incorporating lessons on aging in basic coursework. And many are testing students on their skill in treating older patients before they are allowed to graduate.

"This work is crucial to the well-being of older people and the well-being of healthcare in the United States," said Dr. Richard Besdine, director of the Center for Gerontology and Health Care Research, who is leading a curriculum overhaul at Brown. "Every physician in the United States needs to be educated about care of older people unless they're going to do lifetime pediatrics."

It will be interesting to see if the new emphasis on caring for the aged will lead to a resurgence of doctors who make home visits (and not just to the nursing home or assisted living facility.)  As more people choose to age in place, with supports from family, paid care-givers and companions, the need for doctors who make home visits will increase.  Just as you can't have an elder law practice without making home visits to those clients who need them, a doctor  will have a hard time calling herself a geriatrition if she isn't willing to do the same thing for her patients.    

Do you know where your Will is?

I often meet with clients who have Wills that were drawn up 20, or more, years ago.  Usually the clients have copies of the Will and the originals are with the attorney who drafted the Will.  And many times the clients have moved around since the original drafting, and many more times the attorney has moved offices, or even retired.  Did you think to tell your attorney from 20 years ago when you moved last year?  What if he or she was retiring or passed away and the attorney taking over the files needed to notify you? Would they be able to find you? 

If you do not have your original Will, make sure you check with the attorney who does have it to make sure they have your current contact information to be able to notify you in the event that they move their office, or are retiring.  Even better, have your old Will reviewed to make sure that it is still an accurate reflection of your wishes, that the people you appointed as Executor are still around, and that your planning needs have not changed in the last 20 years, which they probably have.  If you had small children when you first drafted the Will, chances are they won't be needing those guardians that you appointed in the Will, and you may even want one of your children to act as Executor now.  And if you are nearing retirement, facing a long term  illness or have a child with special needs or addictions you need to know what types of protections are available to you and your family. 

So find your Will (the original), dust it off, and have it looked at by an attorney.  You'll be glad you did. 

Stories of Harm - Health Care Quality Videos

My friend and former colleague Nicola Truppin of Health Navigator Partners sent me the link to the Health Care for All blog which has a recent post about people who were harmed while getting medical treatment at prominent Boston hospitals, either through misdiagnoses, medical errors or preventable infections.  There are 3 videos - each 3 minutes long - in which each woman describes what happened to her.  Click here to see the videos and read the post. 

The goal behind these videos and the work being done by Health Care for All's  Consumer Health Quality Council is to bring awareness to the problem and advocate for quality improvement and patient safety in health care. 

Family Caregiver Handbook - Free Online Resource

The MIT Workplace Center has recently published a Family Caregiver Handbook, which is available for free viewing on-line.  The handbook deals with such matters as Financial and Legal Issues, Home Health Care & End of Life Care, Caregiver Support, Housing and Transportation, and How to Get Involved.

The book serves as a gateway to the resources available to families and caregivers.  Rather than providing a lot of substantive information, the handbook gives a summary of the issues (such as a summary of MassHealth programs, or the different types of respite care available for caregivers) and then provides the contact information for local and national groups, associations, and government agencies that can provide the necessary services.

This handbook is a great resource  for  seniors, their caregivers and professionals who work with them. 

Green Burials

More people are going green these days - recycling, buying less, driving cars with better gas mileage, and just being good to the earth.  So it makes sense that these same people would not want to have a burial that causes pollution or involves toxic chemicals.  The Natural Burial Company provides caskets made from recycled paper and biodegradable materials, and their website has a wealth of information about green funerals, natural burials, and related resources.  They even have a link to a local company, Mourning Dove Studio, that makes one-of-a-kind caskets, urns and shrouds.

If you want your conservation efforts to continue even after you are gone, you may want to get in touch with these companies when you are planning for the end of life, and also make sure that your family knows your wishes. 

Charitable Giving - Being Specific with Your Wishes

Many of my clients want to remember certain charities in their Wills or Trusts.  They may say "I want to leave money to my church" or "I'd like to set aside some funds for the Salvation Army" or perhaps another charity that has local and national branches.  One thing to keep in mind when thinking about leaving money to a charity, is that it is important to consider where and how you'd like the funds to be used. 

Your church may have several different locations where the funds can be distributed, and if you want your money to stay in your local parish, you'll need to make sure it isn't left to the state or national branch.  You may even be able to specify that you'd like it to be used for a certain purpose at your local level - such as religious education, upkeep of the facilities or other special uses.   Likewise, the Salvation Army and similar charities have both local and national branches.  If you don't specify where you'd like the funds to go, they very often end up at the national level, even if you wanted them to stay in your community.  If you are leaving funds to a hospital, which are sometimes considered charitable organizations, you can also specify that the funds be used for a particular purpose.   

If you are unsure of your options, you can contact the charity or religious organization yourself to speak to someone in their planned giving department, or you can ask your attorney for assistance.  Many times, the attorney has dealt with bequests to that charity before, and can provide you with some guidance in determining how you'd like the funds to be used.  And, after you've made your decision, your attorney will coordinate with the charity to ensure that the appropriate wording is used in your estate planning documents.

When discussing charitable giving with your family, and ultimately with your attorney, make sure you specify where you'd like the funds to be left, and how you'd like them to be used.  This way, you know your wishes will be carried out and that your funds will be used the way you intended. 

Setting Goals, Not Resolutions

People like to set resolutions for the New Year - lose weight, spend more time with family, get their estate plan in order, put finances in order.  But resolutions always seem to fade by February. Maybe it's because they are too vague, too big, too unwieldy. Why not set goals instead, with mini-goals along they way to get you there?

If your goal is to get your finances in order, start with tracking your spending.  You don't need anything fancy, a notebook or spreadsheet on your computer will be fine.  Next, keep track of all your bills and income. When you have a month or so of expenses tracked, and all of your bills in one place, contact a financial planner to help you make sense of it all, and put a plan in place for moving forward. This might involve investing your money in a certain way, obtaining appropriate insurance policies, even setting up a college fund for your children. 

If your goal is to "get your affairs in order", again, start small.  First, sit down with your spouse or partner and decide what you want to accomplish.  It might be making sure someone is appointed to care for your children if you are unavailable, or having someone be able to make decisions for you and manage your finances if you are unable.  Perhaps you want to protect your assets, or provide for a child with special needs, or maybe you just want to make things simple for your family if you pass away. 

After you've thought about your "big" goals, think about who the people are that you trust and who you'd want to handle things in the event you are unable.  It might be that you and your spouse choose each other as the primary agent named in your documents, but that you each choose different alternates.  That is fine.  In addition, you can choose different people to manage your finances, make health care decisions and become the guardian of any minor children.  The important thing is that you are choosing people you trust, and who will be able to handle the responsibilities. 

Once you've decided who you'd like to appoint and what your vision for the future looks like, or even if you've just narrowed it down a little, you should contact your attorney to meet and talk about your plans. Your attorney can review your current situation and your goals and let you know what you need to do to achieve them.  Before you know it, you'll be on your way to having your estate plan in place and you can move on to working on your other goals like reducing stress and getting in shape. 

Health (and other) Effects of Clutter

The New York Times had a recent article on the health effects of clutter.  The article points out that if you can't find your shoes, you certainly won't be able to go walking, and if you can't find your medications or other instructions from your doctor that could be harmful to your health as well. 

In addition to possibly harming your health, clutter could make it difficult for your loved ones to help you in a time of crisis.  If you are admitted to the hospital urgently, and a copy of your health care proxy is needed so that someone can communicate with the doctor, you don't want your family to have to search through piles of paper or lots of unmarked boxes.  Additionally, in the event of your passing, your family should be able to easily locate your estate documents such as a will or trust, burial plans, any insurance policies you have and information about your bank accounts and real estate. 

Why not set a goal to get your paperwork in order for the New Year?  A simple fireproof box from an office supply store (make sure you either leave it unlocked or tell your family where to find the key), along with some folders and labels will make quick work of the job.  You can then rest assured that in the event of an emergency, your family can concentrate on what matters - you, and not be endlessly searching through your clutter. 

ABA Guide to Wills and Estates

The American Bar Association has book called the Guide to Wills and Estates available for downloading from their website.  The book guides you through the different estate planning tools, and talks about how planning now makes things easier for your family later. 

While advice from a book does not replace a relationship with an attorney, it can certainly help you figure out what you want your plan to look like, and help you understand some of the things you'll be talking about with your attorney.  And, the book is written with general advice that is not specific to any one state, so keep in that some terms or processes described in the book might be slightly different in your state.

If one of your New Year's Resolutions is to get your estate plan in order, this book can be helpful in getting you started, but you still need to be the one to actually call your attorney and make the appointment. 

Information Needed for MassHealth (Medicaid) Application

If you or a loved one find yourselves needing to apply for Medicaid (also called MassHealth) coverage for a nursing home stay, or think you might have to in the future,  you must be prepared for the extensive amount of information required by MassHealth. The following is a list of documentation you will be asked to provide with the MassHealth Application, and you could be asked for more:

1. Copies of birth certificates, driver's license or citizenship papers.  If you were born in a foreign country, these can be difficult to obtain, and obtaining copies of citizenship papers can take time.
2. Copies of all health insurance cards including Medicare.
3. Copies of at least 3 months of bank statements for all bank accounts, including those you share with another person, and accounts which have been closed in the last 3 years.  This means checking, savings, money market, CDs, and passbook accounts.  You will also need to provide an explanation of all withdrawals over $500.00 (and sometimes lower amounts).   You may also be asked for records of where certain deposits came from. 
4. Proof of all income.
5. Copies of the first page of all life-insurance policies, and a letter from the insurance company regarding the cash value of certain policies.
6. Proof of value of stocks, savings bonds, mutual funds.
7. Copies of annuity contracts.
8. Copies of deeds, current tax bills and amounts owed on all real property that you have an interest in - whether it it your principal residence, a vacation home, or a life estate that you hold in certain property. 
9. Copies of the registration for each vehicle, proof of outstanding loans and the current value.
10. Copies of funeral trusts, burial accounts or prepaid funerals.
11. Copies of any trusts of which you are the grantor, trustee or beneficiary, and documents showing financial activity of the trust.
12. Copies of proof of your at-home spouse's living expenses.
13. Documentation and explanation of any transfers you made in the last 36 months of any funds or property.
14. The last two years of tax returns.
15. Clinical information on the applicant, which must be sent in by the facility. 

After the application is filed, there will be a request for more information mailed to you which will often require further explanation of certain things like deposits for withdrawals, proof of certain transactions,  and updated statements for all accounts.  You will have a limited amount of time to get this additional information to MassHealth, and it must be received by MassHealth by the date indicated or it could impact your eligibility.   

It's a good idea to keep your records up to date, and not discard any old passbooks from closed accounts, or bank statements.  Even if you don't need assistance now, you may in the future, and it will save time if you have easy access to your records.  It will also save your family time if they have to take over management of your assets at some point in the future or apply for Medicaid on your behalf.

I provide assistance in preparing and filing MassHealth Applications.  Please call me to set up a consultation if you need assistance with this process, or if you think you or a loved on may need to file a MassHealth Application in the future. 

Understanding What You are Signing

I often hear from people that they have some sort of estate plan in place, but they aren't sure what's in it because they didn't really understand what they were signing, and they haven't looked at it since they left the attorney's office months or years ago.

Signing your estate plan can be overwhelming.  There may be 10 or more documents signed at one time, and some of the documents can be quiet lengthy.  However, your attorney should have explained in detail (and in plain English) what each documents does, when it takes effect, when it is revoked, what power you are giving to the people named in the document and when it should be revised.

If your attorney is explaining something and you don't understand, tell her.  Ask her to phrase it a different way, ask for an example. Ask until you understand.  I always check in with my clients to make sure I have not lost them, because while I understand what I'm talking about - it's very important that they understand, too!

What makes sense to one person, might not to another so even if your spouse understands, you need to also.  There might come a day when your spouse is not around to explain the documents to you, or you need to use them because your spouse has fallen ill. 

And don't be afraid to call your attorney after the meeting if you want something cleared up, or if you have more questions.  The plan is being put in place to work for your specific situation, so make sure you understand what you are signing. 

Should You Discuss Your Plans with Your Children?

Clients often wonder if they should share their estate plans with their children. Now, these are not clients who are setting up elaborate trusts with millions of dollars that will flow down to future generations, these are just regular people who worked hard all of their lives and are now trying to figure out how to best divide up their estate.  My answer to this question is, of course, it depends.

If you are dividing your estate up equally among all of your children, you may think there is no need to discuss your plans with them. However, if you are appointing one of them as the executor/executrix, you should let that person know that you are planning on appointing them, and you should let the others know your choice.  If you can't decide who to appoint, you might want to talk to your children to find out if they have a preference.  One might be better equipped to take over management of your finances when the time comes, while another feels more comfortable making medical decisions. 

It gets trickier if you have a child with financial, drug or alcohol problems who you've either chosen to disinherit or have made special provisions for through a Trust. Often times, in cases like this, inheriting a large sum of money (even $10,000.00 at one time) could be harmful or deadly to someone with drug or alcohol problems.  If you are in contact with this child and you think they would understand the reasons for your decisions, you may want to talk to them.  If you are not in contact with the child or you think that bringing it up would cause problems, it may be best to not address it at this time.  Be aware that your child will in all likelihood find out the way you've distributed your estate after your death, and may become angry at their siblings who have inherited more.  You might consider drafting a letter to be opened by that child after your death, which explains your reasons.

If you do decide to talk to your children, you could follow the lead of one of my clients who threw a pizza party at her house and invited her children to come and talk about her plans for the future, who wanted to be appointed as what, and how they wanted certain items of her personal property distributed among them.  It might have even prompted her children to go home and think about their own plans for the future. 

Changed your mind? Make sure you change your will.

The Boston Globe had an article today about a Rhode Island man who had disinherited his two young children, and their mother's fight in court to obtain some of the estate for their use. 

What struck me about the article were the last few paragraphs:

Family members on both sides of the dispute agree on one thing: Corky Sliwkowski loved his daughters dearly. In the two years before he died, he saw the girls frequently, bought a camper to take them on road trips, and planned to expand his Rhode Island home to accommodate their visits, Joe and Barbara Sliwkowski said.

But Corky Sliwkowski never changed his will to reinstate his children. His brother and ex-wife said they believe the document was written when he was in a dark period caused by the manic-depressive disorder he had been diagnosed with a decade earlier. They said his illness could have caused him to forget what the will said, or postpone revising it.

The dead man's longtime pastor, the Rev. Joseph Creedon, of Kingston, R.I., said he believes Sliwkowski would have changed the will in time.

"You don't expect a will to come into play for years," he said. "So if you want to change it, you feel you have plenty of time."

While no one can ever know what he was thinking, it appears that his family and friends believed that he had changed his mind about disinheriting his daughters in his will. Sadly, he never changed his will to reflect his wishes.  The article points out that he did leave life insurance for the children so the finances may not have been an issue, but what child wouldn't feel hurt at being left out of their father's will?

If you've left someone out of a will and have had a change of heart, don't wait to make the changes to put them back in. You never know what life holds.

Important Coversations to Have with Loved Ones

With the holiday seasons coming up, many people will be traveling home to see parents or aunts and uncles. At this time, you may notice that things have changed since you last saw them.  While it can be difficult to talk about changes, and to see them in yourselves and your loved ones, it's important to realistically assess the situation. 

Some things to talk to aging relative about (or to check-in with yourself about)

• are medications up to date, and in clearly labeled bottles?
• where are important documents like powers of attorney, health care proxies, financial information and computer passwords kept? Have they been updated recently?
• have they (0r you) been to the doctor for a complete physical within the last year?
• check to see if stairs and decks are in good condition, doorways are well lit, that there's nothing that could be tripped over.
• do shower rails or raised toilet seats need to be installed?
• is the food in the refrigerator out of date or spoiled?
• are they (or you) able to get out and do things they still enjoy?

You don't have to have a formal sit down to check in on these things. Just keep your eyes and ears open and don't be a afraid to speak up whether you are the adult child noticing things are changing, or you are the parent who is in need of some assistance.

If you find that you or your relatives are in need of legal assistance, call me at 781-749-2284.  If you are in need of other assistance check out the links to the right under "Resources." 

Probating an Estate in Massachusetts

Probating an estate is the process by which a person's Will is delivered to the Court, allowed by the court, an executor is appointed, and the person's property is distributed according to their Will.  If the person has no Will, the process, called estate administration, is similar and the property is distributed  according to state law. 

People often talk about wanting "to avoid probate." They have an image of estates that remain open for years, with property languishing and heirs in a never ending battle. While this can happen, it is not typical, and can be prevented with proper planning.

Below are some of the general steps involved in probating an estate in Massachusetts:

1. The original will is filed with the probate court, along with a petition, bond and death certificate. A copy of the petition and death certificate are sent to the Office of Medicaid (Medicaid may have a claim against the estate if the person received Medicaid, or MassHealth, while they were alive.
2. Heirs and "interested parties" are notified. Interested parties are those people named in the will, and may be the Attorney General if there are charities named in the Will or if there are no known heirs at law. 
3. The Court will issue a citation, which needs to be published in the newspaper and sent to interested parties. This citation lists the date (called the "return day") by which people can object to the appointment of the executor or administrator.  The citation will contain very specific instructions which must be followed.
4. File a military affidavit with the court if all heirs have not assented.
5. Once the will has been approved and the executor appointed, the executor should begin to gather the assets, review the debts, obtain a tax id number for the estate and open an estate bank account.
6. The executor will need to file an inventory with the court, outlining all of the property that is in the estate.
7. The debts of the estate, such as funeral debts, should be paid, if the estate is solvent. Be aware of Medicaid estate recovery debts.  Creditors have a year to come forward and make claims against the estate. 
8. Determine, perhaps with assistance of an accountant, the best way to start making distributions from the estate. If there is real estate, that may need to be sold and may be subject to Title V (septic tank) regulations, which can be costly if repairs or replacement are needed. 
9. When the estate is closed, an account will need to be filed with the court which lays out what was in the estate when the person died, what came into the estate and what went out of the estate and where it went (usually distributed to heirs or to pay debts.)

There are tax matters that need attention, so you'll want to make sure to have an accountant you can consult with.  And things that can hold up the process are waiting many years to open an estate, heirs who are missing, heirs who object to the appointment of the executor or the provisions of the will or anything else they can think to object to, real estate which has title problems or needs extensive septic work done, abandoned property (especially stocks if the stock certificates have been lost). 

This is not a comprehensive list, but it will give you some idea of what the executor will need to do, and where some of the bottle necks can occur.

If you are responsible for probating someone's estate in Massachusetts and need legal assistance, or you want to talk to someone about structuring your own estate plan to prevent bottlenecks, please call me at 781-749-2284. 

Free Alzheimer's Coaching Services

Part of the difficulty of having a loved one with Alzheimer's is adapting your own actions and expectations to the changing behavior of the person with Alzheimer's.  A coach can help you with that.

Thanks to funding from a Title IIIE Older Americans Act Grant, Alzheimer Coaching Services is able to offer up to three in home coaching visits free of charge.  These visits are available in Braintree, Cohasset, Hingham, Holbrook, Hull, Milton, Norwell, Quincy, Randolph, Weymouth and Scituate.

There are no income or age restrictions for this service, and no referral is required.

Coaching can help you:

• Understand the disease or condition causing the memory loss
• Understand the behaviors cause by the disease/condition.
• Learn how to respond to behaviors in a way that values the person and restores meaning and purpose to life.
• Learn how to maintain and enrich family relationships throughout the disesase.
• Learn about resources to ease care partnering. 

For information and to sign up, contact Beverly Moore at 617-233-1145. 

Planning for the holidays when a loved one has Alzheimer's

The holiday season is coming upon us (or is already upon us if you count the Red Sox being in the World Series a holiday).  If you have a loved one with Alzheimer's or other memory issue, some traditions may need to change in order to make things easier (and safer) on yourself and your loved one. 

If you are caring for a loved one at home, they can often still assist with the cooking and baking, with some adjustments.  Instead of expecting them to remember the recipes or help at the stove, give them a distinct direction such as chopping the carrots, or measuring the nuts, or dropping cookies onto a tray.   People with Alzheimer's often have trouble initiating an action, but can carry it out if prompted.  This allows them to remain involved.

Try to keep the decorations at a minimum.  Flashing lights and lots of clutter can be confusing to people with Alzheimer's.  Also try to keep the gatherings to a small size, and don't have too much background noise like music or TV, which can be disorienting. 

If your loved one is in an assisted living or nursing facility, consider holding a small celebration there instead of bringing your loved one home, if her doctors think a visit home might be too overwhelming.  And rather than having a lot of people show up at once, consider having just a couple of people at a time, and stopping if your loved one seems to be getting too tired or agitated.

And don't forget to take care of yourself. If you are the primary care giver of a relative with memory loss and you usually host Thanksgiving or your family expects you to go all out for New Years but you just don't have the energy - feel free to just say "no."  Ask them to help out before they ask you to play hostess (in addition to your role as nurse, companion, taxi driver, medication dispenser, appointment scheduler, personal care giver, etc.) 

Make sure you are getting enough exercise, enough rest and enough time for yourself and your other priorities.  Take advantage of respite care or day care programs in your area, and think about attending a local care giver support group.

There is a care giver event at Sunrise in Plymouth on Thursday November 1, 2007. The event starts at 5:30 and goes until 8:30.   There will be dinner and entertainment and the feature speaker will talk about  Emotional Freedom Technique, Guided Imagery and there will be reiki demonstrations.  To attend, you should RSVP at 508-584-1561 x272,   

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