Florida Elder Law Blog - ElderLawAssociates.com

A new state-by-state scorecard evaluates the effectiveness of long-term care services across the country and concludes that there is a lot of room for improvement. The State Long-Term Services and Supports Scorecard examines the performance of state long-term care services for older people and adults with physical disabilities. The purpose of the report is to provide information on how to improve long-term care systems so that everyone can have affordable, high-quality, well-coordinated services, and family caregivers have the support they need. The scorecard, a collaboration between the AARP, The Commonwealth Fund, and The SCAN Foundation, looked at the range of services and supports available for people who need long-term care, whether in their home, nursing home, assisted living facility, or other setting. The report ranked the performance of long-term care systems in states in four main categories: affordability and access, choice of setting and provider, quality of life and quality of care, and support for family caregivers. According to the report, Minnesota, Washington, and Oregon provided the best long-term services and Mississippi, Alabama, and West Virginia provided the worst. The findings indicate that there is a lot of area for improvement even in the top-performing states, and the report presents several actions that states can take to improve performance. One recommendation is that states expand Medicaid eligibility to increase access and choice as well as move the balance of services away from institutional care and toward home or community-based options. Other recommendations include providing greater flexibility to consumers to direct their own services, helping to move nursing home residents who want to return to the community back to their homes, and making sure nursing homes are properly and frequently monitored. All the information from the scorecard has been put into an interactive Web site (http://www.longtermscorecard.org/) to allow policymakers to identify areas where improvement is needed and uncover gaps within the system. For more on long term care and how to plan for it, consult a qualified South Florida Elder Law Attorney.

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Being a trustee is a big responsibility and if you don't perform your duties properly, you could be personally liable. That's why it's important to hire the right people to guide you in this important role. A trust is a legal arrangement through which one person (or an institution, such as a bank or law firm), called a "trustee," holds legal title to property for another person, called a "beneficiary." If you have been appointed the trustee of a trust, this is a strong vote of confidence in your judgment. A trustee's duties include locating and protecting trust assets, investing assets prudently, distributing assets to beneficiaries, keeping track of income and expenditures, and filing taxes. As a trustee, you have a fiduciary duty to the beneficiaries of the trust, meaning that you have an obligation to act in the best interest of the beneficiaries at all times. It also means you will be held to a higher standard than if you were just dealing with your own finances. A trustee is usually entitled to hire an attorney (and other professionals like an accountant) to assist in trust administration. The attorney's fees will be paid from the trust funds. While hiring an attorney will cost money, not having an attorney at all could cost a trustee much more if errors are made. A trust can be administered without court involvement, but that doesn't mean that the administration is simple. There are many areas where problems can arise -- for example, if assets aren't invested properly, taxes are late, or if proper records aren't kept. If something goes wrong during the administration of the trust, the trustee can be removed and held personally liable for any costs incurred or losses suffered. Even if a spouse is the trustee, he or she should still consult with an attorney. Many couples have so-called "AB" trusts to take advantage of the maximum estate tax exemption; these trusts require special knowledge to determine whether the trusts are properly funded and the taxes filed. As always, before making any final decisions, consult an experienced South Florida Elder Law Attorney.

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It's a problem that many of us face - an elderly loved one lives alone or far from us. I came across this article which offers some solutions to how to bridge that gap. Click here to read the full article by the Chicago Tribune.

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Once a family member has moved to a nursing home, it is important to visit as often as time allows. Residents of nursing facilities need to be reassured on a regular basis that they are still an important member of the family. The following list of ideas may help you to provide care and support to your loved one during your visits to see them.

• When you visit, be supportive and affectionate. Personal contact with others is extremely important and many times the only touch older adults living in a facility experience is when they are dressed or bathed. Residents in nursing homes need to know they are loved and not forgotten. If they are receptive, hold their hand, give them hugs when you arrive and leave, and give them eye contact when they are talking to you. It is important to try to ignore any distracting smells or noises so as not to upset your loved one.
• Ask permission to visit and then plan your visits in advance. First, it is important to enable your family member to retain as much control in his or her life as possible. By asking their permission to visit, you are enabling your loved one to have control over at least one aspect of their schedule. Because there are two parts to a visit (looking forward to the visit, and the visit itself), plan your visits ahead of time rather than just dropping by. Planning ahead allows a resident the enjoyment of anticipating your visit.
• Listen attentively to your loved one. Do not dominate the conversation or talk "at" them. Even if you have heard the story before, being a good listener allows them to enjoy their memories or current thoughts by sharing them with you.
• Speak to all residents as adults, not as children. The use of the term "we" instead of "you," for example, robs a person of his or her identity. "How are we this morning?," is patronizing to many listeners. Treating older adults like children, even if they are frail or cognitively impaired, only contributes to low self-esteem and increased dependence.
• When you visit, share news about your life and your family and don't forget the photo album! Do not spend the entire visit asking them questions about how they feel or if they have eaten. Instead, share funny stories or talk about a big decision you have made. Make sure to tell your loved one about trivial events, too. Even little details can be important and make elders feel included.
• Bring your children to visit your loved one to encourage a relationship between them. These visits can also be "teachable moments" parents use to explain the aging process and how older persons also need love and affection. Parents will be providing an example of the importance of caring for our elders by making visits a priority. In addition, bring a few of the children's art projects as gifts to brighten your loved one's room.
• While you are visiting, make a point to say "hello" to other residents who may not receive many visitors. Becoming familiar with others who live in the facility not only brightens their day, but also enables you to observe the care of other residents.
• If their health and mobility permits, and with the approval of the medical staff, take your family member out of the nursing home for a day. Take him or her to lunch or for ice cream, to watch a parade, to get her hair done or to get him a shave, for a drive in the country, or include them in a family get together. The activity and the sights and sounds of other people may lift their spirits and provide them with a new and wonderful memory.
• Become acquainted with nursing home staff. Your active involvement and consistent visits illustrate your interest in your loved one as well as an appreciation of the care they provide. Do not hesitate to thank the staff or compliment something they have done well.
• If you are unable to visit your loved one in person, due to distance or your own health limitations, be sure to keep in touch by telephone or by sending notes and cards. Receiving pictures of you, your garden, or your pet could brighten your family members' day and provide them with something to enjoy for days afterward.

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