Senior Living Week is a FREE opportunity to gather information and resources to help you and your loved ones make decisions for better living as you age. This year, there will be 13 workshops – 3 at the Senior Living Week Expo on Friday, May 2nd and 10 throughout Senior Living Week. This is your chance to hear from and speak with experts in health, memory loss, downsizing and moving, financial issues, legal issues, inter-generational communications, and more. Click on the dates below to learn more about the workshop topics and where they will be held.
Registration is encouraged as some locations have limited seating. Please contact De Bora McIntosh at (734) 998-9338 for more information.
One of the most common questions I am asked is when should care begin, closely followed by what kind of care and where. The answers are not as clear as the milestones or benchmarks when raising our children. Those tend to be age related and as our parents are demonstrating – age really is just a number and not necessarily reflective of wants or needs! Our parents’ uniqueness as individuals has had a lifetime to grow, develop, and sometimes even become rigid or cast in stone. There are no age-related growth and development charts for easy reference. You can, however, visualize a pie chart with three equal pieces labeled Limitations and Medical Concerns, Quality of Life and Social Needs, and Financial Considerations. Begin filling theses pieces in, knowing there will be a time when the current arrangements will no longer work.
Functional limitations and medical concerns may include activities related to daily living such as nutrition, hygiene, dressing, activity (addressing literally how one gets around), medication, and chronic disease management. Instrumental activities of daily living include how one interacts with their environment, such as preparing meals, doing laundry and housework, using the telephone, shopping, and driving. Medical concerns like anti-coagulant therapy, memory impairment, visual or hearing limitations have a direct impact on daily living functions and need to be included here. Try not to wait until the existing arrangement is not working!
Quality of life and social needs are not as easily measured. These are the things that make us unique as individuals and one could argue – the most important consideration. My father is a North Dakota native; farming is in his DNA. His connection to nature and the land is amazing and unfailing. Those are his guideposts for living. He has made this piece of the pie very clear for us; he will not be leaving his beloved land and people. For us, the where has been answered. The when and what kind of care remains episodic, rather like a moving target, affording us plenty of practice in hope of getting it right.
Financial considerations are the black and white reality, though there is room for some creativity. What kind of care and where balanced with quality of life requires ongoing learning and evaluation of the pie chart. For many families this piece may not be clear. Those of us raised in the 50s and 60s learned early on what our business was and what was not and we learned it well! Having a clear financial reading provides clarity and opens discussion if there is going to be any creativity. Assets, debt, and fixed incomes can all be successfully managed (no matter the level) once you have a clear picture.
Learning when care is needed, what kind of care and where, is as individual and unique as your parents are. There is no one size fits all solution. Continued evaluation and understanding of the pie chart will increase your chances of hitting the moving target! Making informed decisions with or for your loved one requires due diligence and heart.
Senior Living Week, presented by UM Housing Bureau for Seniors, is an opportunity to begin or continue understanding when care is needed, what kind of care, and of course where. Start filling in the pie chart at Senior Living Week 2014! Beginning Friday, May 2nd and continuing through Saturday May 10th, there are workshops, open houses, free health screenings, and an Expo at the Ann Arbor Marriott Ypsilanti at Eagle Crest, with something for everyone. There is free parking and free admission, so mark your calendar!
Learn more about how Certified Geriatric Care Managers can perform an assessment to help determine the needs of an elder loved one and find the right resources. Certified Managers may also conduct a review of financial, legal and medical issues and refer your family to appropriate specialists. Learn more about counseling, coping with illness, grief and loss, and planning for the future. Learn what Medicare, Medicaid and private insurance will and will not cover. Also, gather firsthand information from local resources to help you make informed decisions. Just as important, learn why Ann Arbor is one of the leading retirement cities, our weather notwithstanding! Please join this collaborative effort to share resources and information and start planning today!
Contributed by Rawlin Myers
Legacy Law Center is proud to participate in Senior Living Week once again this spring. Each year, our law firm hosts a booth at the Expo, and we enjoy getting to meet a wide variety of attendees and other professionals. Terrence A. Bertram, our firm’s senior attorney, will be speaking on some estate planning basics that everyone should know.
Legacy Law Center is a firm in Ann Arbor that particularly specializes in elder law and estate planning. The specific areas of law we practice include wills and trusts; powers of attorney to cover both health care decisions and financial and legal decisions; decedent’s estates; Medicaid and Veteran’s benefits counseling and qualification; and guardianship and conservatorship law. Additionally, we serve as probate mediators, or neutral parties trained in facilitating peaceful resolutions among family members about issues that arise in caring for an aging loved one.
Terry’s presentation will cover the types of documents that should comprise a complete estate plan, and how to go about making the decisions and elections required in your plan. Many interesting things are currently happening in the estate planning arena, so Terry will also have his pick of an array of special topics to cover in his presentation. I will address just two of them here.
One topic that is of perennial interest and importance is the need to have a valid health care power of attorney so that someone you trust always has the authority to make medical decisions for you in the event that you cannot. Health care powers of attorney are a vital piece of your estate planning tool kit, yet statistics show that far too many people are still putting off executing this simple document that can save so much pain and uncertainty for your loved ones.
Second, since last October, we’ve been kept particularly busy by changes in the laws that govern powers of attorney in Michigan. One of the main changes is a new requirement that your durable power of attorney have a signed acceptance page. In effect, the person you nominate to act on your behalf, if you become unable to do so, now has to sign an agreement stating that they will act in your best interest. Powers of attorney that were executed prior to October 2012 are still effective, but because banks and financial institutions are not required to accept them, we have recommended to our clients that they consider an update.
We are eager to participate in Senior Living Week 2013 and we hope to see you there.
On Thursday, September 13th the Housing Bureau for Seniors held our annual meeting where Dr. Aaron David Cooke gave a presentation on this topic. Here is a synopsis of his presentation.
Dr. Cooke is an Assistant Professor of Internal Medicine at the University of Michigan Health System. His presentation does not necessarily represent the views or opinions of the University of Michigan Health System.
What is in the Bill:
Expanded patient protections
- Eliminates pre-existing conditions clauses after 2014
- No lifetime limits on care
- New appeals process
- Patient’s Bill of Rights
- Limit insurance overhead spending to no more than 15%
- Insurance plans must justify 10%+ premium increases
- Reduce Medicaid/Medicare fraud
- Change payment model – quality, rather than quantity
- Promote preventive care
- Eligibility expanded to cover those at or below 133% of poverty (monthly income for 1 individual up from $931 to $1238, for 2 persons from $1261/month to $1677/month)
- Annual health maintenance visit
- Preventive services covered (and no co-pays, co-insurance or deductibles on these services) including colon cancer screening, mammograms, osteoporosis screening, cholesterol testing, blood pressure screening, more immunizations, dietary counseling for high-risk patients and smoking cessation
- Closure of the “Donut Hole”
- o By 2020, once patients have spent over $2830 on medications, they will have a 50% brand-name discount and a 25% co-pay. Once patients reach the catastrophic range of over $6440, they will have a 5% copay
- o Over the next 8 years, there will be increasing coverage for generic drugs
What is NOT in the Bill:
- Death panels
- Setting maximum, lifetime limits on care
- Health care rationing (limit health care procedures based on age)
- Outlawing private insurance
- Jail time for refusing to buy health insurance
- Free health care for illegal immigrants
During this political season there’s been a lot of talk about the “Ryan Plan” and how it differs from the Affordable Care Act. Here’s a side-by-side comparison of the major provisions:
Affordable Care Act (ACA)
|Insurance Exchanges and Premium Support||Implements||Eliminates|
|Medicare Eligibility Age||Remains 65||Age begins to rise in 2022 until reaches 67 years old in 2033. In 2022 closes Medicare enrollment for persons turning 65, who will then receive $8,000/yr towards private health insurance|
|Medicare Prescription Drug Plan Donut Hole||Eliminates by 2020||Revert to pre-ACA, individuals pay 100% of annual medication costs between $2830-6440|
|Services Covered||Retains current structure, adding preventive care benefits||Minimum coverage standards; otherwise determined by individual insurance plans|
|Spending Growth Caps||Limits spending increases to GDP growth + 5%If spending exceeds cap, payment advisory board recommends cuts, but not in benefits or coverage||Limits spending increases to GDP growth + 5%Premium support payments are subject to a hard cap|
|Cost Control Mechanisms||Reduce payments to providers, limit insurance overhead, pay-for-performance, best research practices, independent advisory board||Assumes that free market competition will reduce costs|
|Medicaid Changes||States encouraged to increase eligibility to 133% of povertyMaintains current federally-determined payment/benefit structureMaintains asset protection for community-residing spouse||Eliminates expansion to 133% of povertyConvert Medicaid to fixed block grants, indexed for inflation but do not keep pace with costs. States set eligibility and benefits.Assets of both spouses considered for Medicaid coverage of nursing home payments; some seniors may lose nursing home care coverage|
Want to know more? Check out these Web sites!
- www.healthcare.gov explains changes and provisions of health care reform bill
- www.kaiserEDU.org public policy site with extensive analyses of bill
- www.factcheck.org addresses truthfulness of claims made for/against bill
- www.AARP.org guide for seniors on health care reform (www.healthlawguide.aarp.org)