Granny Pods: An Alternative To A Nursing Home?

 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”

Medicare Payment: Improvement No Longer The Standard

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


National Honor Society Students Offer “Handyman” Services to Winchester Seniors

For four weekends in March, the National Honor Society of Winchester High School will be offering their time, talent, and “elbow grease” to provide help with any jobs that are needed throughout Winchester. The students will be in teams of two, four or six depending on the size of the job, they will be providing assistance to those who cannot get to all the jobs on their to-do list. Students are available for such tasks as painting, raking, shoveling, cleaning, shopping, moving, etc. Community members may schedule the students for just one task or a number of activities for which they might need more manpower.

Students are available to work:

March 3-4;

March 10-11;

March 24-25;

March 31 – April 1

Please contact the National Honor Society Advisor directly to set up as appointments are not made through the Jenks Center.  Please email [email protected]  or call Nancy Smith at 781-721-7020 to schedule and to add your name and task to the list, along with what weekend day works best.  Arrangements will be made to coordinate the effort.

Finally – Social Security Increase Scheduled for 2012

The Social Security Administration announced that starting on December 30, 2011, social security recipients will receive a 3.6 percent increase in benefits. Increases in social security benefits are based on a cost of living adjustment (COLA). For the first time since the automatic COLA adjustment was put in place (1975), there were no increases in benefits for 2010 and 2011.

The average monthly social security check is $1,082.00. With the 2012 adjustment, that will mean an additional $39.00 per month. The largest increase was in 1981 when benefit checks increased 11.2 percent.

More Information:
Social Security Administration: How COLA is Calculated

Social Security Administration: Chart of COLA Increases from 1975-2012

Financial Abuse of the Elderly: How to Spot It and Stop It

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.

What Can Be Done to Protect Seniors?

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.

Knowledge Before a Crisis

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.

Practical Steps

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

Estate Planning and Elder Law Newsletter: Elder Law

Every month I send an E-Newsletter that has articles on estate planning and elder law topics. If you would like to subscribe to this E-Newsletter please feel free to sign up.

This months topic is “Elder Law Elements.” Elder Law, unlike many other areas of law, is centered on the needs of the client – not a specific area of the law. Elder law attorneys help clients with estate planning, protecting assets from the overwhelming cost of a nursing home, helping spouses when one may have to go to a nursing home, housing issues – even bankruptcy, which may be the result of a catastrophic illness.

Attorneys practicing in this area of law help guide clients and their families through some of life’s most difficult challenges.

If you would like to learn more about Elder Law services, please feel free to visit my website: Elder Law
Elder Law FAQs
Medicare and Medicaid Basics.

May is “Elder Law Education Month” in Massachusetts

Every year the Massachusetts Bar Association and the Massachusetts Chapter of the National Academy of Elder Law Attorneys co-sponsor an event for elder law education. This year, the topic is “Taking Control of Your Future – A Legal Checkup.”

Many of the area Councils on Aging request an attorney to come in and give a presentation. This year I will be at The Arlington Council of Aging on May 26, 2011, starting at 1:30.

The topics to be covered will include: Medicaid and protecting assets, Reverse Mortgages, Long-Term Care Insurance, and real estate tax exemptions and deferrals. I will also be happy to answer any questions about what documents you should have in place, the probate process, the difference between Wills and Trusts – whatever topics may be of interest. I hope to see you there.

National Health Care Decision Day

I do not know how I missed this, but Saturday, April 16, 2011 was National Health Care Decision Day (NHDD). The idea behind this day is to “encourage patients to express their wishes regarding healthcare and for providers and facilities to respect those wishes, whatever they may be.” NHDD has a lot of wonderful resources on their web page.

I have also been asked to participate in a “Final Affairs Fair” in Burlington, Massachusetts, on May 1, 2011. I will be bringing the health care form “5 Wishes,” from Aging With Dignity, and will be giving them away to anyone who wants one. Please feel free to stop by to pick up the form and ask any questions you may have.

New Massachusetts Homestead Law – Update

The new Massachusetts Homestead Law goes into effect today, March 16, 2011. Secretary of State William Galvin provides a brief summary of the new law on his website.

In addition, the new Homestead forms are now available for download. There are two available forms:

1. Homestead for Individual Owners, including those over 62 years.
If both spouses are over 62 years old, each should file their own Declaration of Homestead. This will protect the property if one spouse passes away. Another change for the better is that when the second spouse files, the filing date will go back to the date of the first filing. Before today, any new filing would automatically have voided the earlier filing, possibly subjecting the property to any claims for the dates between the two filings.

2. Homestead for Property in a Trust.
This is completely new form because, for the first time, Massachusetts allows trustees to sign and record the Declaration of Homestead.
In December I wrote about some of the changes that come with the new Homestead Law. Among them are:

  • Automatic protection of $125,000.00 even if no Declaration of Homestead is filed;
  • $500,000 worth of protection if a Declaration of Homestead is filed at the Registry of Deeds; and
  • Trustee(s) are now allowed to sign and file a Declaration of Homestead.

Some parts of the Homestead Law remain the same:

  • The filing fee is still $35.00;
  • The Declaration of Homestead must still be filed in the Registry of Deeds in which the property is located;
  • Filing a Declaration of Homestead will not protect against claims from Medicaid when the recipient dies; a mortgage secured by the property; or a judgment for spousal or child support.

Secretary Galvin also has a booklet available: Questions and Answers: The Homestead Act.

Estate Planning and Elder Law Newsletter: Estate Planning Tips for Singles

Every month I send an E-Newsletter that has articles on estate planning and elder law topics. If you would like to subscribe to this E-Newsletter please feel free to sign up.

This month’s topic is “Estate Planning for Singles.” Whether divorced, widowed, or never married, nearly half the population is single. Read why estate planning is just as – and maybe even more important important – for single people as married couples.