Posts Categorized: Elder Law

 Officially called a MEDCottage, these are modular units that can be placed in a family members yard and may be an alternative to nursing home placement. The company that manufacturers them, N2Care, says their mission is to “to design, create and deliver products that will enable families the opportunity to directly participate in the extended care of loved ones.”

There are three sizes available ranging from 288 – 605 square feet, although the size and design of each cottage is customizable. Each unit has a kitchen, bedroom, visiting area, and a handicapped accessible bathroom. Electricity and water connections are made to the homeowner’s utilities. The units also have an array of high-tech features to monitor medication, vital signs, and may be equipped with features found in most modern hospital rooms, including safety rails, lighted flooring, built-in cameras and a defibrillator machine.

According to Kenneth Dupin, the founder and CEO of N2Care, sometimes local zoning restrictions limit where the cottages may be placed. The Cottages, which can cost up to  $125,000, have generated a lot of interest as families look for alternatives to nursing home placement for an aging parent.

More Information on MEDCottages:

CBS Morning News Story: “Granny Pods: Inside Housing Alternative for Aging Loved Ones.”

Washington Post: “Pioneering The Granny Pod”

For decades, the decision on whether Medicare would pay for coverage for chronically ill patients has been based on the whether the patient’s condition would improve with additional care. That was a very high bar. Many patients undergoing needed physical and occupational therapy would be notified that Medicare would no longer pay because they had reached a plateau.

The rehab facility would essentially tell the patient – or their family – that they had reached their maximum level, and any further stay would have to be paid for privately. With the high cost of care, this was devastating news.

In October, the Obama administration announced a proposed settlement to a class action lawsuit that would direct Medicare to pay for services if those services are needed to “maintain the patient’s current condition or prevent or slow further deterioration.”

This is a very different standard than the one previously used by Medicare, and should result more Medicare coverage for patients who need the additional care. The proposed settlement would apply to Medicare and private Medicare Advantage programs, and applies to in-home services as well as those provided in a re-hab or nursing home setting.

Additional Information:

New York Times: Settlement Eases Rules for Some Medicare Patients

AARP: Class Action Lawsuit Against the Federal Government Terminates Medicare Improvement Standard

Despite the Elder Justice Act, passed in 2010, financial abuse of the elderly continues to be an enormous problem. In a follow-up study to research done in 2009, MetLife, with researchers from Virginia Tech and the University of Kentucky, released a report in June 2011, that shows financial abuse of the elderly remains rampant.(Download Full Report here)

Some key findings of the report:

-Fraud committed by strangers: 51%

-Fraud committed by family, friends, neighbors: 34%

-Fraud during holiday seasons (Thanksgiving to Christmas) was overall highest category.

-Women were twice as likely to be victims of fraud than men.

-Most victims were between 80-89 years old, lived alone, and needed some assistance with personal care or home maintenance.

-60% of the perpetrators of the fraud were male.

-An annual loss by victims of financial abuse is estimated at $2.9 billion dollars.

In Massachusetts, the Executive Office of Elder Affairs (EOEA) has a hot-line setup specifically for suspected cases of elder abuse. That number is 1-800-922-2275. Reportable abuse includes suspicion of fraud or theft. Additionally, every city and town in Massachusetts has a state agency, created by the EOEA, designated to assist seniors. These agencies, called Aging Service Access Points, are the local representative for seniors and their families needing assistance. Click here to find the ASAP for your community.

Many times, the problem is that families are either unaware of the problem or are the ones actually committing the financial abuse. Another problem is that the senior may not even realize that they are a victim of fraud.

This is the “ounce of prevention” method. Although it may be awkward to talk to an older relative about their finances, it is better to do this before a crisis hits home. ABC News reports that 94% of children have never spoken to their parents about their finances. Having this conversation will build trust and educate family members about the finances of the elder.
ABC News/Moneywatch link about how to talk with your older relatives about their finances.

Depending on each family, it may make sense to have two people involved in this conversation. If there is any possibility that a family member may not always act in the best interest of the parent, they should be excluded from the conversations. Encouraging the family member to record bank and financial information may also help open the door to conversations.

There are some steps that can be put in place to protect the most vulnerable:
-Register the home telephone number with the Do Not Call Registry

-If there is in-home care – health aides, cleaning services, etc. – hire from a reputable company and make sure the company is insured and performs background checks on employees;

-Periodically check the mail coming into the house. If there are a large number of solicitations, it could be a sign that the person has been placed on a list of likely targets. If your relative agrees, maybe consider setting up a post office box to prevent this mail from even coming into the house. You can bring the mail to them and throw away the solicitations.

-Get the person a shredder and set it up for them. If they are unsure what to shred, have them make a pile that you can review and shred with them. Once they start shredding, it usually becomes an enjoyable habit!

-If the person is already a victim, report the fraud to the police, the bank, the Attorney General’s Office for your state, Better Business Bureau, and the person’s doctor.

Financial abuse of the elderly is a terrible problem, perpetrated by terrible people. There is just no single – or simple – answer. Family involvement, openness, and trust, may help protect from outside scammers, but could also contribute to fraud by a family member. However, having several family members involved with an older person, and building their trust, is a good start.

Additional Resources:
AARP Article: Tips for Avoiding Being a Victim of Fraud

AARP Article: Elderly Fraud Victims

Aging Care Article with Tips to Help Parents:

FBI Information on Common Fraud Schemes and What Actions to Take