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Pause Before You Sign That Nursing-Home Contract

Pause Before You Sign that Nursing Home Contract

 

Suppose your mother can no longer make decisions for herself and she now needs nursing-home care. You are stressed and anxious. The nursing home puts a twenty-page, single-spaced contract in front of you. You wish you could flip straight to the last page and sign then and there, just to get it over with.

Do not do this. You could be agreeing to pay, out of your own pocket, many thousands of dollars for your mother’s care.

Try to get your mother admitted and then, before you sign the contract, bring it to us for our review and guidance. Once your mother has moved in, she can’t be evicted just because you want to negotiate the contract.

But if that is not feasible, then sit down and take a few deep breaths. Read the contract carefully. Make a list of questions and ask a facility representative to explain. Ideally, that person would sit with you as you go through the document. Don’t sign until you understand.

Here is what to watch out for.

You should not use your own money to pay

* Do not sign the contract if it requires you to obligate yourself to pay with your own money. Carefully scrutinize any language referring to you as the “responsible party” or “resident representative” or “agent.”  

The suspect buzz-words are “co-signor,” “guarantor,” “personally guarantee,” “personally liable,” “private-pay guarantor,” “surety,” “individual capacity,” or any such language. Words like these obligate you, personally, to pay if your mother doesn’t have the money. Don’t sign even if there are no buzz-words, but the language looks something like this: “If the resident does not or cannot pay, I will pay the amount owed for residency charges, services, equipment, supplies, medication, and other charges.”

Please understand that it is legal for the facility to require you, if you hold financial power of attorney or are guardian, to pay nursing-home bills from your mother’s money and assets. It is legal to require you to spend her money on her care and not for any other purpose. It is not legal to condition your mother’s admission on your agreeing to pay her bills with your own money, which is what the above buzz-words mean in plain English. The nursing home can ask you to agree – and if they ask, refuse – but you cannot be forced to agree to pay with your own money.

If your mother lacks the money, the next step is to apply for Medicaid assistance, not to go digging into your pocket.

Sometimes the contract is confusing. For instance, one nursing-home agreement says that the representative “personally guarantees continuity of payment.” This alarming language is properly followed by an italicized statement that the representative is “not required to pay for Resident’s care from his/her own personal funds.” The agreement proceeds, though, to use the phrase “personally guarantee” in other contexts. Ambiguity like this is why we recommend that you first bring the agreement to us. We can ensure, on your behalf, that the facility clarifies such language and does not misapply it.

Everyone in need has the right to apply for Medicaid

*           The nursing-home contract must not require your mother to waive – give up – her right to seek government assistance like Medicare or Medicaid, nor can it ask her or you to sign any statement that she is ineligible for those benefits.

*           If your mother has no money to pay for care, a Medicaid application will be required. The contract may seek your permission to apply for Medicaid for you. You have the right to decline that option and, instead, seek legal counsel to help you apply. We have seen some facilities mishandle Medicaid applications, which wound up being denied when they should not have been.

In any case, though, whoever files for Medicaid, you must cooperate by immediately providing all records necessary for that application.

If your mother is eligible for Medicaid, Medicaid pays

*          If your mother does get Medicaid, the nursing home must not require an additional payment over and above that designated by the Medicaid scheme in your State. 

*           The nursing home must not demand that your mother receive additional services not covered by Medicaid and then, if your mother declines those services, evict her. It should ask, in advance, whether those services are desired at specified additional cost.

*           The nursing home must not require additional donations to a charity as a condition of admittance.

Do not agree to arbitration

*           The contract may seek your consent to arbitration. If you agree, you will be giving up your right to a jury trial if a dispute arises. The rules are in flux at the moment, but, generally, you should decline such a provision.

The nursing home must protect property reasonably

*           The nursing-home contract may try to fudge its responsibility to take care of your mother’s property, but the bottom line is that it is obligated to care for your mother’s property during her stay. You should, however, use good judgment to safeguard her valuable property like fine jewelry by keeping it elsewhere.

Protect yourself. Cross out, and sign the right way

*           Cross out provisions in the contract that you decline, and put your initials by the strike-outs. 

*           Be sure to sign the contract only as your mother’s agent. Your signature should read: “[Mother’s name], by [your name], her agent.” 

To be fair to nursing homes, they are entitled to be paid and they often have difficulty collecting on legitimate debts. Facilities are forbidden from suing to take a resident’s Social Security or pension income. They must comply with strict federal consumer-protection restrictions. Despite these payment hurdles, they must still protect frail and vulnerable people from all manner of harm. They also suffer public hostility, thanks to the misconduct of some bad actors. We always urge cooperation with nursing-home personnel if feasible, because their job is a difficult one.

On the other hand, you and your family have the right to be protected from the excesses of bad actors – or from the imperfections, for example, of the facility mentioned above that misuses the “personally liable” language. Thus, no matter how reputable the facility, it is good judgment to consult an attorney before you sign an admission contract. If that’s not possible, then take care and time to study the contract, get facility staff to explain it to you, and strike out the objectionable provisions as advised above.

A few moments of care, even despite the stressful circumstances you are surely in at the time, can save you a lot of difficulties later. Please feel free to reach out if you have questions or need assistance by calling us at 1.800.660.7564 or by emailing us at info@covertlaw.com.

Holding a Family Caregiver Meeting

Holding a Family Caregiving Meeting

A family caregiving meeting is an essential tool when dealing with the care of an aging loved one. These meetings are beneficial for helping to keep all family members abreast of decisions that need to be made, changes in diagnosis or prognosis, and helps to ensure that all family members feel that they have a voice. Family meetings can also help to keep caregiving responsibilities from falling solely on the shoulders of one family member. In addition, family caregiving meetings can foster cooperation among family members and lessen the stress associated with caring for an aging loved one.

Who should attend a family caregiving meeting?

There are a number of people who should be included in a family caregiving meeting. First and foremost, it is important to include the aging loved one in the meeting whenever possible. This helps the aging loved one to feel that they are being heard and that their opinions and thoughts are being considered. If a spouse is living, the spouse should be included, as well as any children and possibly siblings of the aging person. Some families may choose to include other family members, but this really varies from one family to another. Anyone else involved in care for the person should also be there. This could include paid caregivers, family friends, or neighbors. Depending on family dynamics, a facilitator can be helpful in running the meeting.

When should a family have a caregiving meeting?

First it is important to note that family caregiving meetings are not a one and done event. They must occur on a regular basis. The first family meeting can occur before an aging loved one actually needs care. This can give the person who may eventually need care more say in their future care, but often times this does not occur. Most families find that the initial meeting needs to occur when an aging loved when begins to show signs of needing care or when a diagnosis is given that determines care will soon be needed. In addition, meetings should be scheduled regular to discuss changes in diagnosis, prognosis, or general needs of the loved one or the caregivers.

How can a family hold a successful caregiving meeting?

The key to having a successful caregiving meeting is cooperation. This doesn’t mean that family members will agree on everything, but it is important that all family members are respectfully heard and considered. Families must be willing to compromise and seek the best plan for their aging loved one. Additionally, a smoothly run meeting should have an agenda and families should try to stay focused on the items included on the agenda. When holding a meeting, always put things in writing and be sure that all those involved get a copy of the important information and everyone’s responsibilities.

What challenges do families face in caregiving meetings?

One of the biggest challenges to family caregiving meetings is the family’s history. All families have their own dynamics that can cause problems in a caregiving meeting. There may be members of the family who are at odds with one another. This can become an obstacle to having a successful caregiving meeting. The role that each family member plays can be a challenge. Some members may be overbearing and demand control, while others are peacemakers and do not feel free to share their thoughts. Another challenge is that some family members may be in denial of the severity of an aging loved one’s needs. This may make it difficult to get a consensus for care.

Family caregiving meetings are beneficial and necessary when an aging loved one can no longer care for themselves. These meetings can help to divide the responsibilities of caregiving and reduce stress placed on the family members. It is important that families remember that the meetings are for the care of their loved one and cooperate with one another to help the process to run more smoothly and successfully.

If you have any questions about something you have read or would like additional information, please feel free to contact us at 1.800.660.7564 or by emailing us at info@covertlaw.com.

Balancing Caregiving and Your Career

Balancing Caregiving and Your Career

Providing care for a senior family member, particularly long-term care, can bring about lost wages and missed opportunities for the caregiver. A report by Genworth entitled Beyond Dollars 2018 shows that although statistically having to miss work to provide care is down 7% from 2015, overall 70% of caregivers still report missing work because of caregiving responsibilities. While the percentage remains high, employers are better able and more likely to meet the needs of an employee who also routinely provides family caregiving services. The corporate shift to create flexibility and policy that addresses caregiver needs in the workplace will continue to increase as the baby boomer population ages. The change is welcome as, on average, caregivers spend 21 hours every week providing care. 

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Genworth:  Beyond Dollars Report

 

Flexible work hour policies are having a positive effect as caregiver employees can transport their loved one to a daytime doctor appointment or other scheduled event. Some of the employee’s workload is being shifted to online work remotely from their home while other employers will allow a coworker to donate vacation or sick time to a caregiving employee.Julie Westermann of Genworth toldMcKnight’s Senior Living“Access to caregiver support or employee resource groups is another benefit. Also, counseling, coaching or wellness programs specific to supporting caregivers themselves and the financial and legal implications.” There are additional policies and benefits available for family caregiver support that include subsidized in-home back up care and emergency care, and other low-cost or free resources and services.

It is widely projected that 70% of all seniors will need long-term care during their lifetime. Increasingly that care is being provided in the home by family, and the ages of both parties involved are becoming younger. Genworth found that the average age of a care recipient in 2018 is 66. Comparatively in 2010 62% were older than 75. The age of caregivers has shifted from an average age of 53 in 2010 to an average age of 47 in 2018. Fully 58% of family caregivers are now in the 25 – 54 year age bracket.

As the need for senior caregiving increases, employers will have to continue increasing accommodations to employees who are also family caregivers. For career planning purposes a family caregiver should take full advantage of coaching and support programs that outline future financial and legal implications of caregiving as it relates to their employment. Mitigating negative circumstances before they present themselves is the goal. The sooner a realistic assessment of needs for the senior is handled the sooner a caregiver can put a plan in place to protect their livelihood and future retirement.

Employers understand the negative impact that absences, reduced hours and chronic tardiness have on productivity and the bottom line. A caregiver must strategize how best to cover the responsibilities that could put their career in jeopardy. Corporate policy changes and additional resources regarding employees who are also caregivers are helping make this situation mutually agreeable. The percentage of caregivers reporting negative impacts on their career due to caregiving is dropping. While this is a positive sign, there is a lot of groundwork to do to ensure caregivers have the opportunity to retain their job without undue financial loss or penalty.

Remember that most seniors or near seniors are in denial about their potential need for care and most caregivers sort of fall into their role after an adverse health event of a family loved one. A caregiver’s savings and retirements funds are put at risk when no planning is in place. Planning can help to reduce stress and negative impacts on future caregiver status as well as career success.

If we can help answer questions about planning options available to your or a loved on, please don’t hesitate to reach out by calling us at 1.800.660.7564.

Holding a Family Caregiving Meeting

Holding a Family Caregiving Meeting

A family caregiving meeting is an essential tool when dealing with the care of an aging loved one. These meetings are beneficial for helping to keep all family members abreast of decisions that need to be made, changes in diagnosis or prognosis, and help to ensure that all family members feel that they have a voice. Family meetings can also help to keep caregiving responsibilities from falling solely on the shoulders of one family member. In addition, family caregiving meetings can foster cooperation among family members and lessen the stress associated with caring for an aging loved one.

Who should attend a family caregiving meeting?

There are a number of people who should be included in a family caregiving meeting. First and foremost, it is important to include the aging loved one in the meeting whenever possible. This helps the aging loved one to feel that they are being heard and that their opinions and thoughts are being considered. If a spouse is living, the spouse should be included, as well as any children and possibly siblings of the aging person. Some families may choose to include other family members, but this really varies from one family to another. Anyone else involved in care for the person should also be there. This could include paid caregivers, family friends, or neighbors. Depending on family dynamics, a facilitator can be helpful in running the meeting.

When should a family have a caregiving meeting?

First it is important to note that family caregiving meetings are not a one and done event. They must occur on a regular basis. The first family meeting can occur before an aging loved one actually needs care. This can give the person who may eventually need care more say in their future care, but often times this does not occur. Most families find that the initial meeting needs to occur when an aging loved when begins to show signs of needing care or when a diagnosis is given that determines care will soon be needed. In addition, meetings should be scheduled regular to discuss changes in diagnosis, prognosis, or general needs of the loved one or the caregivers.

How can a family hold a successful caregiving meeting?

The key to having a successful caregiving meeting is cooperation. This doesn’t mean that family members will agree on everything, but it is important that all family members are respectfully heard and considered. Families must be willing to compromise and seek the best plan for their aging loved one. Additionally, a smoothly run meeting should have an agenda and families should try to stay focused on the items included on the agenda. When holding a meeting, always put things in writing and be sure that all those involved get a copy of the important information and everyone’s responsibilities.

What challenges do families face in caregiving meetings?

One of the biggest challenges to family caregiving meetings is the family’s history. All families have their own dynamics that can cause problems in a caregiving meeting. There may be members of the family who are at odds with one another, creating an obstacle to having a successful caregiving meeting. The role that each family member plays can be a challenge. Some members may be overbearing and demand control, while others are peacemakers and do not feel free to share their thoughts. Another challenge is that some family members may be in denial of the severity of an aging loved one’s needs which could make it difficult to get a consensus for care.

Family caregiving meetings are beneficial and necessary when an aging loved one can no longer care for themselves. These meetings can help to divide the responsibilities of caregiving and reduce stress placed on the family members. It is important that families remember that the meetings are for the care of their loved one and cooperate with one another to help the process to run more smoothly and successfully.  If you have any questions about something you have read here about holding a family caregiving meeting, or about anything else, please feel free to contact us at 1.800.660.7564 or email us at info@covertlaw.com.

The Stress of Caregiving on the Sandwich Generation

The Stress of Caregiving on the Sandwich Generation

Dorothy Miller, a social worker, first created the term “sandwich generation” in 1981. A Journalist, Carol Abaya, continued to study and add to what the term means. In 2006, Miriam Webster included the term, sandwich generation, in the dictionary for the first time. The sandwich generation is defined as a generation of people who care for their aging parents while supporting their own children. It is believed that this is occurring because of the increase in life span for adults and also because of delayed parenting. This means that medicine and technology are allowing people to live longer and couples are waiting to start families at a later age. Therefore, leaving people sandwiched between caring for aging loved ones and young children. This can lead to some potential problems for the sandwich generation.

Issues for the Sandwich Generation

One major issue for the sandwich generation is financial burdens. Because many in the sandwich generation may not have anticipated have to provide for the needs of their aging parents, they may be stretched thin financially. Another issue for this group that is often compounded by financial struggle is stress. When pulling double duty of caring for children and aging parents, stress is an understandable and expected side effect. Whatever the living situation of the aging parent, the responsibilities of caring for the aging parent often adds to the already busy schedule related to parenting their own children. The sandwich generation then fills pulled in too many directions. This can often leave them feeling as though they do not have enough of themselves to give to everyone they need which in turn leads to guilt and burnout.

If these issues continue to mount, then depression can become another issue for the sandwich generation. Depression can set in when the sandwich generation has little time for hobbies or social interactions, leaving them feeling isolated. The stress and financial burdens can contribute to feelings of depression. The bottom line is that the sandwich generation must recognize these potential problems and find ways to deal with them. Otherwise they will be ineffective in their care for aging parents and their own children and the pressure will continue to mount.

Dealing with Issues for the Sandwich Generation

In order to be a good caregiver, the sandwich generation must find ways to take care of themselves and to ask for and accept help when necessary. One way for the sandwich generation to find times for themselves is respite care. Respite care provides short-term relief from caregiving responsibilities. Respite car provides a way for caregivers to can find time for themselves and take care of family responsibilities.

Caregivers can plan ahead for tasks and finances to help tackle stress and financial burdens. Having a family meeting to delegate responsibilities to other family members can be very beneficial. This means giving up some things to the spouse and children. Extended family can also help to share the responsibility of caregiving, so meeting with siblings or other involved family members to share the task of caring for the aging parent can help to lessen the burden on one person. Having a close friend to talk to about the struggles can also be a very therapeutic way to deal with the stress experienced by the sandwich generation.

Being a member of the sandwich generation has many challenges. The demands on a person caring for aging parents while also raising their own family can be overwhelming. Self-care is essential to avoiding the pitfalls associated with caregiving. In addition, it is important to remember that it is perfectly acceptable to seek or ask for help in order to maintain mental health and provide good care for everyone.

If you have any questions about something you have read or would like additional information, please feel free to contact us at 1.800.660.7564 or email us at info@covertlaw.com.

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Covert | Law

Your Plan. Your Family. Their Future.

- - We Take Care of Families: Today - Tomorrow - Forever - -

NEIL R. COVERT, Attorney at Law

Clearwater - Sarasota - Fort Myers - Naples

1.800.660.7564

email: info@covertlaw.com

© 2019 Neil R. Covert, P.A. - - All Rights Reserved.

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