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Long-Term Care Planning: Never Too Soon

The senior citizen population of the U.S. is expected to reach some 71.5 million by 2030. Fortunately, the "graying" U.S. population is demonstrating a newly heightened awareness of long-term care planning. Long-term care has long been one of the ignored areas of estate planning. People tend to dislike thinking about getting older and needing a plan in place if they become infirm. So they don't. Then, the burden of their care — financial, emotional and physical — lands on their children and grandchildren. Too often, their families place them in a care facility which they might not have selected, had they been able to choose.

Long-term care planning is also important for older adults with disabilities; their numbers will also increase to roughly 21 million by 2040. By 2050, it is estimated that there will be at least 25 million people in the U.S. who are using long-term care, either at home or in an assisted living or skilled nursing facility. How will those 25 million people pay for their care?

Many of them hope to rely on Medicare or Medi-Cal, but Medicare only pays for up to 100 days of care in a skilled nursing facility after three days in a hospital, and only if that skilled care has been deemed necessary. After the first 20 days, Medicare also has a co-pay which must be met.

Simply stated, Medicare is not a meaningful source of assistance when long-term care services are needed.

The average cost of a nursing home stay in California is $250 per day. Assisted living facilities in California cost an average of $2,900 per month. Adult day services typically run at least $80 a day. Hourly home care costs run between $15 and $30 for a home health aide, who assists with activities of daily living (bathing, dressing, etc.), but is not a registered medical professional and cannot meet more than basic health care needs.

If a more skilled home care provider is needed, the cost is typically between $20 and $40 per hour.

Medicaid, known as Medi-Cal in California, can pay the cost of skilled nursing care, but only after careful planning steps are taken and eligibility is achieved.

Good long-term care sidesteps complete reliance on federal support. A person's plans may include long-term care insurance, which covers care typically not covered by "regular" health insurance, Medicaid or Medi-Cal. Long-term care insurance helps cover care for someone who cannot perform at least some of the activities of daily living — bathing, dressing, restroom use, eating and moving from chair to bed and back again.

If you are considering a long-term care policy, know that not all insurance agents are aware that you will need a policy that covers both in-home and assisted living care for at least three years (and longer, if possible).

There are multiple long-term care policy options, including policies that provide life insurance benefits if long-term care coverage is never needed. Consult with your estate planning attorney to determine what policy best fits your estate needs for the future.

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Health Care Decisions Day April 16, 2014

A Message from Myra Gerson Gilfix

We at Gilfix & La Poll Associates believe that estate planning includes planning with regard to what will happen to us – not just to our property and other assets – when we're at the end of our lives. We make it part of our service to you to enter into a discussion about what you want and don't want to happen when the end of life is near. This is only the first conversation; we encourage you to share your feelings, values and wishes with your loved ones and medical practitioners. We practice what we preach. If we don't engage in this planning, we’re vulnerable to what can transpire by default – spending our last few days in an ICU, even if that’s at odds with our needs and preferences.

“Dying well” is quite personal. Your conversation(s) with the people you’re closest to lets them know how you want to die and how they, surviving friends and family members, can help carry out your wishes without uncertainty and guilt. People who’d prefer to die at home can do so, and benefit from pain management and comfort over costly and "heroic" measures. Having this conversation before a crisis – or being open to such conversations – gives everyone time to digest, reflect and integrate the information.

We want you to be clear about end of life treatment so that family members and medical providers have the guidance they need to respect your preferences. Loved ones need to talk to one another when circumstances aren’t so charged. Better that these conversations occur around a dining table than around a hospital bed.

Most of you have already signed an Advance Health Care Directive. That is a huge benefit to you and to your loved ones. But be sure to keep the conversations going. The person you appointed to make decisions on your behalf when you are unable to speak for yourself needs to feel comfortable with your wishes and to understand your values. Having the rest of your family "on board" is also important.

Wednesday, April 16, is Health Care Decisions Day. Let this be a reminder to communicate with those you care about so that your life can reflect your values and wishes – even at its end. Then go out and celebrate life!

Myra Gerson Gilfix was the founding Chair of Healthcare Decision-making Special Interest Group (SIG) for the National Academy of Elder Law Attorneys. This SIG dealt with multiple issues regarding health care, including health care advance directives, durable powers of attorney, DNR orders, biomedical ethics, issues relating to pain relief, dying at home, palliative care, and informed consent.



Wall Street Journal Features Gilfix & La Poll

When the Wall Street Journal recently reported on problems faced by older investors, Michael Gilfix of Gilfix & La Poll Associates was prominently featured.

The article examined issues that we all must be aware of as we age: some retirees, even when dementia is not an issue, have trouble identifying riskier investments or warning signs, and financial scammers often take advantage of this.

The Wall Street Journal piece told the story of a client we helped with just this type of situation.

The article is an important reminder that older investors and their families need to be on guard. Even highly intelligent and sophisticated investors can fall prey to scams and bad investments.

As Michael Gilfix states in the article, it is also important for adult children of retirees to monitor their parents' financial health just as they would their physical and mental condition.

No one should have to tackle these complex issues without assistance. At Gilfix & La Poll, we have decades of experience in the field of elder law, and we take pride in providing our clients with the highest level of service and advice.

As the feature in the Wall Street Journal illustrates, Gilfix & La Poll is a nationally recognized authority in the field of elder law and estate planning. We know you have worked hard to earn what you have, and you want to secure a comfortable retirement. We know how important it is to ensure that your assets are preserved for your loved ones and that your wishes are honored after your passing. To accomplish those goals, you should have the experience and knowledge of Gilfix & La Poll at your disposal.

To see other national publications that have featured Gilfix & La Poll, please see our In The News section.