Hardly anyone enjoys filling out income tax returns. This time of year, however, all of us must either engage a professional to do it for us or camp out at the dining room table in a dangerous jungle of forms, receipts, statements, and strong coffee. As unpleasant as the task is, people who handle the financial affairs of elderly loved ones are responsible to do all they can to make sure that records are kept accurately and reported on time. A recent case in the U.S. tax court illustrates the danger of letting financial records sit on the back burner for those receiving companion care in Carlsbad or anywhere else.

 During 2007, a New Yorkresident, Lillian Baral, paid $49,580 for the round-the-clock companion care that she needed. Her brother took care of all her financial bookkeeping, since Ms. Baral suffered from dementia. In a wise move, the two had established a power of attorney for Ms. Baral’s brother some time earlier, so that he could legally handle her finances. In most cases, if a person has documentation showing that he or she is chronically ill and needs constant supervision, expenses paid for companion care are tax deductible. Unfortunately, the brother neglected to send the IRS a return for Ms. Baral’s 2007 income taxes, and nearly two years later, the IRS took hold of the situation and notified him that Ms. Baral owed $17,681 in back taxes, according to their estimation.

Complicating the situation was the fact that Ms. Baral had already passed away, so her brother was handling the dispute from her estate. The problems could have been easily avoided, if the brother had correctly filed the return with her companion care expenses clearly stated. Instead, he ended up having to fight to prove that Ms. Baral actually met the qualifications for the tax deduction while she was still living. In addition, in court he can not claim a deduction for any expenses that are not accompanied by receipts proving that they were paid for qualifying medical services and products—a tall order, given the fact that the transactions are several years old.

How can you avoid this nightmare for a loved one receiving companion care in Carlsbad or elsewhere? Keep careful records, don’t throw out any receipts, and make sure that you can document exactly how your loved one’s money is being spent on companion care. Even though it may seem like yet another burden right now, you could save yourself from an exhausting and expensive argument with the government later on.

Original article: http://issues.flemingandcurti.com/tag/estate-of-baral-v-commissioner/

Technology has resulted in a number of convenient, easy to use devices that give elderly individuals a quick way to reach help in the case of an emergency. The most familiar of these is a small, lightweight device with a single button that immediately sends an alarm to a help center when pressed.

While a number of reputable companies produce these lifesaving devices, a recent news story reminds us that families with loved ones receiving senior help in Oceanside should always research elderly care products carefully and only buy from established, reliable sources.

Here is the cautionary tale:  Medical Alert Buyers Alliance Corp is a company based in Maryland that produces an emergency alert device for seniors. Customers purchase a one-year service plan along with the device, allowing them to contact a central response center in the event of an emergency.  As with other similar services, a representative would then notify local emergency personnel and give them the location of the senior in need of help.

After receiving several reports of the devices failing to bring help to seniors who had fallen or who needed emergency help, the Maryland attorney general’s office investigated the situation and charged the company and its owner with defrauding its customers. According to the filed paperwork, Medical Alert Buyers Alliance Corp stopped providing services without warning or notification after incurring debts that made continued business impossible. This breach of contract resulted in some very dangerous situations, as elderly people depending on the alert device were forced to wait hours in an injured condition before emergency personnel arrived on the scene through other means.

Worse yet, it appears that the company continued to bill customers and impose unauthorized credit card charges even after the provision of service ended. If these charges are proven, they represent a clear example of preying on elderly customers for profit.

The company is no longer allowed to sell devices, and it will remain closed for business until the case is brought to court. While justice will hopefully be served in this instance and no further damage will be done, it is critical for family members and providers of senior help in Oceanside to protect the elderly from predatory schemes and unreliable help in the first place. When making a decision about a safety devices, always read plenty of customer reviews, investigate the history and reputation of the company, and never place cost considerations above the safety of your loved ones.

See: Medical alert company accused of taking advantage of elderly

Hospital emergency rooms, the theory goes, get overcrowded because people without health insurance have no place else to go.

But that’s not the view of the doctors who staff those emergency departments.

The real problem, according to a new survey from the American College of Emergency Physicians, isn’t caused by people who don’t have insurance — it’s caused by people who do, but still can’t find a doctor to treat them……Since these insured patients are more — not less — likely to use the emergency department, 89 percent of physicians in the survey said they believe the number of visits to emergency rooms will increase as the new health law is implemented. (The findings also echoed the results of a December survey of more than 600 emergency department administrators by the Schumacher Group.)

“The results are significant,” said ACEP President Sandra Schneider in prepared comments. “They confirm what we are witnessing in Massachusetts — that visits to emergency rooms are going to increase across the country, despite the advent of health care reform, and that health insurance coverage does not guarantee access to medical care.”

See: Emergency Room Doctors Say Health Law Will Make ER Crowding Worse

From our friend Steven Ratner, Elder Law Attorney:

Many people have the misconception that in order to receive Medi-Cal benefits, one must be close to the state poverty limit. This, in fact, is far from the truth. Generally, a married couple can own up to $111,560, a home, a vehicle, and retirement accounts, and still be eligible for Medi-Cal. Moreover, if their combined income is below $2,739 per month, they can own more than $111,560 and still receive Medi-Cal benefits.

For example, if a husband and wife receive $2,500.00 as their combined monthly income, with current interest rates at .5%, they can have $573,600 in the bank and still be eligible for Long Term Care Medi-Cal. Likewise, if the husband and wife receive $2,000.00 of combined monthly income, with current interest rates of return at .5%, they can have up to $1.8 million in the bank.

Of course these numbers are dependent on interest rates at the time of application. Therefore, if interest rates increase, then the couple can have less in the bank. Even with an interest rate of 2%, however, a couple receiving $2,000.00 per month in combined income can still have $443,400 in the bank and receive Medi-Cal.

Accordingly, those who end up spending through their life savings paying for nursing home costs, thinking they are not eligible for Medi-Cal, may just be misinformed.

As we age, sometimes our ability to be sharp at managing our finances diminishes and our vulnerability to unscrupulous outsiders increases.  Here are some ways to avoid losing control of Seniors’ finances:

• Ask your parent to authorize the bank to send your parent’s bank statements to you each month.
• Consider asking the post office to forward all of your parent’s mail to you, so that you can watch for warning signs such as past due bills, credit card statements with outlandish purchases, or ads for fraudulent schemes.
• Offer to pay your parent’s bills for him or her, saving them the time and effort and keeping yourself “in the know” about their finances.
• Set up a weekly pocket money allowance for your parent so that he or she can’t be victimized for large amounts of money.
• Cancel your parent’s credit and debit cards.

Home care caregivers or personal attendants helping your parents can be allies for you in your campaign to protect your parent’s finances.  If you know that the home care workers are honest and dependable you can work with them to be vigilant when answering the phone or answering the door when people come to visit your parents and speak up if it seems like someone is taking advantage of your parent.

There is a useful article about this on AgingCare.com called Warning Signs That Your Parent’s Finances Are Off Track.

If you  are caring for an elderly family member or other loved one, are you getting paid?  If not, should you be?

These provocative questions are explored in a helpful new article on VOA.com.  Although it might seem awkward or inappropriate to ask to be paid, there are sometimes very good reasons for doing so.  Oftentimes one adult child takes care of elderly parent(s) while the other siblings don’t help or are too far away to help.

If you have an appropriate caregiver agreement in place, everyone’s expectations will be clear and the agreement will be upheld if properly drawn up (hint: this is one thing that you really, really should see an elder law attorney about).  Also, when such payments are made pursuant to a proper agreement, it is less likely that Medicaid will make trouble over the payments when the elderly person applies for Medicaid benefits.

For the complete article, see:  Getting Paid to Look After Elderly Relatives

New stories have been coming out frequently for some time now, pointing out that some of the key assumptions behind the government’s healthcare takeover health care reform law are flawed and create a slippery slope to more and more big government interference in our private financial and medical affairs.  In this article we highlight one such issue:  The growth in so-called “concierge practices” provides more evidence that many people have had it with paperwork and bureaucratic barriers to care.   When people can chose how to pay for their care and who to go to for that care, they are willing to do so.  The freedom to do so may threaten the takeover reform plan.

Now, from The Associated Press, this story:

Every year, thousands of people make a deal with their doctor: I’ll pay you a fixed annual fee, whether or not I need your services, and in return you’ll see me the day I call, remember who I am and what ails me, and give me your undivided attention.

But this arrangement potentially poses a big threat to Medicare and to the new world of medical care envisioned under President Barack Obama’s health overhaul.

The spread of “concierge medicine,” where doctors limit their practice to patients who pay a fee of about $1,500 a year, could drive a wedge among the insured. Eventually, people unable to afford the retainer might find themselves stuck on a lower tier, facing less time with doctors and longer waits.

When a primary care doctor switches to concierge practice, it means several hundred Medicare beneficiaries must find another provider.

Does that create an environment in which the government will eventually dictate to doctors that they must take Medicare patients or Medi-Cal (our version of Medicaid) patients, or that consumers may not pay extra for extra services?  Don’t be too quick to dismiss such concerns.  There are already examples of such laws, for example laws requiring pharmacists to dispense drugs that they object to on moral grounds and court decisions saying the doctors cannot decline some patients based upon the doctors’ religious beliefs.

From the consumer’s standpoint, is it too far fetched to think that the government could prohibit us from paying for extra medical services?  After all, the so-called health care reform law takes the position that the government can require us to purchase health insurance.  Is it really a big leap for the government to next tell us what we can’t pay for?  Case in point: In Canada, under their nationalized healthcare system, Canadians are prohibited from paying extra for healthcare in order to obtain services that they want that are not authorized under the national system.

As a wise man once said: The government that is big enough to give you all that you want is big enough to take away all that you have.

For the complete Associated Press story, see:  High-end medical option prompts Medicare worries

This is our editorial opinion.  We welcome responsible comments from others.

A group of local eldercare ombudsmen in California are pushing for the creation of an independent not-for-profit organization that would replace the current statewide long-term care ombudsman office, California Watch reports.

Background

Eldercare ombudsmen investigate abuse allegations involving seniors in long-term care facilities.

Joseph Rodrigues, the state long-term care ombudsman, is a political appointee operating within the state’s Health and Human Services Agency.

Sylvia Taylor-Stein — team leader for the Committee for an Independent State Ombudsman Office — said several local ombudsmen created the committee because they felt that Rodrigues had failed to effectively advocate for funding for long-term care ombudsman programs.

Rodrigues has said his office is well-positioned to speak out on eldercare issues because of his proximity to state leaders and the governor’s office.

Push for Independent Office

Sen. Lois Wolk (D-Davis) has expressed support for the creation of an independent ombudsman office that would have “the complete autonomy needed to speak out effectively on behalf of resident concerns.”

Wolk has introduced a bill (SB 345) to serve as a placeholder for legislation that would create the independent office. Wolk’s office said the bill would be modeled after similar independent ombudsman offices in Colorado and Washington state.

The full legislation is expected to be developed this week (Jewett, California Watch, 3/31).

Source:  California Healthline

Elder abuse victims who suffer severe traumatic injuries are more likely to be female, suffer from a neurological or mental disorder, and to abuse drugs or alcohol, according to research published in the March issue of the Journal of the American Geriatrics Society.

“Past studies have shown that alcohol abuse by the perpetrator plays a substantial role and is strongly associated with physical abuse,” says Lee Friedman, assistant professor of environmental and occupational health sciences at the University of Illinois at Chicago and lead author of the study. “Our findings indicate that alcohol abuse among the victims may be an important contributing factor as well.”

The abuse victims in the study tested positive for alcohol at a rate that was more than twice that of victims in a control group.

The elderly victims of physical abuse in this study suffered more severe injuries than their non-abused counterparts. They also suffered disproportionately from pre-existing medical conditions such as heart disease, dementia and Alzheimer’s disease, mental illness and alcohol abuse.

Eighty-five percent of the perpetrators were family members or intimate partners. In most cases, the abuse was not identified until after the admission process or several days into hospitalization.   The failure of medical staff to properly identify abuse victims and contact adult protective services in the majority of cases shows that clinicians need to better understand elder abuse, Friedman said.

The research was funded by a grant from the Retirement Research Foundation. Co-authors are Susan Avila and Dr. Kimberly Joseph of the John H. Stroger Hospital of Cook County and Kathy Tanouye of Advocate Lutheran General Hospital in Park Ridge, Ill. Friedman’s work on the project predated his joining the full-time faculty at UIC.

Over at GeriatricCareManagement.com, Maria Basso Lipani has written an excellent article that may surprise many people.  Here is the list of those seven pesky un-covered items:

1. 1. Assisted Living Facilities
   2. Homemaker Services
   3. Home Health Aides
   4. Transportation To/From Doctors’ Visits
   5. Routine Eye Exams
   6. Routine Dental Exams
   7. Routine Hearing Exams

See the complete article at Seven Things Medicare Still Doesn’t Pay For