Challenging Health Care Bills

We owe immense gratitude to those who are caring for the sick, and to those who support those workers. At the same time, we should be skeptical of bills we may be presented for that care.

The struggle to contain health-care costs in this country is now a fixture in the national policy debate. Our health-care expense does not lead to good results. The United States spends more on health care as a share of the economy – nearly twice as other developed nations – yet has the lowest life expectancy and the highest rates for suicide, chronic disease, and obesity. See:

https://www.commonwealthfund.org/publications/issue-briefs/2020/jan/us-health-care-global-perspective-2019

If that expense has landed in the middle of your household budget, here are some home truths that may help you monitor what you’re being charged. In many cases, the bills are fair. But they may not be.

For example, in the case of coronavirus testing, many providers charge between zero and $200 – yet one Texas lab charged insurance companies as much as $2,315.

Or, a hospital may have charged you exorbitant fees for medication you could have obtained over the counter. A patient was billed $238 for eyedrops obtainable in a retail pharmacy for between $15 and $50. Sometimes the worst excesses are due to “surprise medical bills.” You can be treated in a hospital that is in your insurer’s network, but if the particular physician has rejected the insurer’s rates as too low, the physician will be treated as out-of-network, the costs can go through the roof, and your insurance company will refuse to pay. 

If you are willing to put in the time and effort, it may be that you can negotiate to have your bills reduced. If the charges are big enough, it may be worthwhile to embark on an effort to get them reconsidered.

Health care reporter Sarah Kliff, formerly of Vox and now with the New York Times, has written a primer on how to proceed. 

The steps she outlines are:

*     Obtain an itemized bill. The first bill you receive may give you no idea of what the charges are for.

*     It is common practice for emergency rooms to bill for simply walking in the door. Hospitals often use a point system depending on their assessment of the emergency, with higher fees for more complicated conditions. You may be able to challenge the assessment down to a lower grade.

*     You may be able to obtain a discount for paying promptly. Sarah Kliff advises persistence until you connect with a person who has authority to permit this.

For especially big bills, please call us at 1.800.660.7564 or email us at info@covertlaw.com. We can assist in advocating for you.

Family Caregiving During the Coronavirus

There are new challenges to meet for family systems with loved ones who are most vulnerable to the coronavirus yet still require caregiving. Family caregivers that use to aid their family directly, now find themselves learning how to be long-distance providers during this pandemic. US News reports that before the coronavirus, thirteen percent of Americans provided long-distance care. The new reality is that all family caregivers must employ protocols that maintain social distancing to protect their loved ones.

The best way to stay close from far away with ease is to employ technology in your parent’s home, making wellness checks, or using camera monitoring if they are particularly frail. Many homes are already fully alarmed with cameras and motion detectors inside and out. Sharing access codes will allow a family caregiver to visually check-in and ensure all is well. As access codes can be changed, a parent can know if the future permits, they can reassert their independence by simply changing their code. Camera systems are an incredibly valuable tool in the event you cannot reach your parent by phone.  

In the absence of cameras previously installed in the care recipient’s home, solutions such as Briocare or LifePod remotely address a senior’s quality of life. Both of these solutions meet the needs of self-care, independence, and safety while allowing access to you, the remote caregiver. Briocare employs Amazon’s virtual assistant technology (smart speaker) by overlaying their mobile application (app) with customized care subgroups like dementia care, diabetes care, hypertension care, and general wellness. 

Daily routines can be set, including medication reminders, family calls, emergency calls and alerts, medical device integration, and entertainment activities. Similarly, LifePod uses the capabilities of smart speakers for family caregivers to configure reminders and remotely check in with their loved ones. Telemedicine interactions with their physicians are also possible using a smart speaker. A remote appointment can provide much-needed assurance, prescription dosage changes, or determination that, despite the pandemic, medical intervention is required. Smart speaker voice-activated technology that is appropriately configured to meet your parent’s specific needs is a lifeline between remote family caregivers and their loved ones. 

Beyond organizing daily activities, medical needs, and monitoring the safety of your at-home senior, there are other essential needs to address like food and finances. Restaurant food delivery services are readily available in all but the most rural of locations to provide prepared meals to your senior’s doorstep. Restaurants must meet strict guidelines for food preparation and handling to ensure safety during the coronavirus. Meanwhile, at the grocery store, personal shopping assistants can gather all the food and pharmacy needs on your list for delivery to your parent’s home. 

Check with the local stores your parent prefers for instructions on how to get home delivery or check out Instacart, an online food shopping service provider, that in some areas can deliver groceries in as little as an hour. Fully one-third of family caregivers are now millennials who have a comfort level leveraging technology to simplify caregiving to their family. If you are a baby boomer and are unsure about using these online food services, enlist the help of your children or a trusted friend who is comfortable with technology. 

An Amazon Prime account can send packaged food goods and even connect a user to Whole Foods Market for fresh meat, fish, and produce shopping. Tips on how to save money and expeditiously choose and use food products are outlined on these sites. Read through the information provided on the website as a little planning goes a long way to purchasing efficiency and proper nutrition for your care recipient.

To ensure your parent’s finances are in good order, again turn to technology. During this pandemic, many older people are rightly experiencing a lot of fear as they are primary targets of the new scams associated with the coronavirus. Even if you have never checked on your parent’s finances before, now is an excellent time to have a look. Check for unusual activity in credit card balances or credit score data. Seniors tend to accumulate many and varied account types such as investment accounts, credit and debit card accounts, business entities, real estate, and more. If you feel out of your depth in overseeing their finances, implement some online financial services.

Individualized shared platforms like EverSafe and Onist monitor all types of financial accounts and provide simple tools that let you organize, analyze, and track your loved one’s finances all in one place. Each program is customizable to grant access to family members and even financial professionals if managing monies is not your expertise. Artificial intelligence tools are designed for oversite, identifying account anomalies like unusual withdrawals, missing deposits, changes in spending habits, and will provide suspicious activity alerts to your email, text, or phone. Look for platforms with highly secure 2048-bit encryption to ensure online security.

There are many practical considerations to address when caregiving remotely for your family loved one, but using technology can solve most of them quite easily. While nothing can replace human contact, the basics of care for your parent are within reach because of the digital age. 

We help families who are caring for aging parents. If you have questions or would like to discuss your family situation, please don’t hesitate to reach out by calling us at 1.800.660.7564 or by emailing us at info@covertlaw.com.  Stay safe.

Isolation Due to COVID-19 May Increase the Risk of Elder Abuse

As some of the most vulnerable Americans to the COVID-19 pandemic, older adults are staying at home to lower their risk of infection as the coronavirus spreads throughout communities. The American Bar Association (ABA) reports that an unfortunate outgrowth from this isolation is an increase in risk factors for elder abuse, exploitation, and neglect. Senior adults facing self-imposed or long-term care facility lockdown need to follow health and safety guidelines that the Centers for Disease Control and Prevention (CDC) outline to protect themselves. Also, if you have a senior family member, you need to understand the guidelines set forth for the protection of your loved one. 

Socially isolated seniors can become increasingly lonely, despondent, and feel abandoned, which is a medical problem in its own right as it leads to depression, weight loss, and sometimes self-harm or disruptive behavior. Remote monitoring and online social interaction during the coronavirus pandemic are the few ways to stay actively “in touch.” Yet, it provides limited visibility to the full scope of the problems your senior may be facing. 

Essential services like Adult Protective Services (APS) will continue receiving and investigating reports of neglect, abuse, and exploitation. APS is a distributed system approach, typically handled via local or state health, aging, and regulatory departments. Abuse occurs in such variation, and as such, there is no generic template to employ as a solution, thus the multidisciplinary approach to providing aid and support to older adults. Information as to where to report problems in each state is online at the National Adult Protective Services Association (NAPSA).

Be aware that because of social distancing protocols, some APS programs are temporarily modifying how the work. In situations when it is reasonable to do so, the first contact will be made by phone rather than in person. Some programs may extend the time frame for the first contact to meet staffing challenges unless the report indicates there is an imminent threat to safety or health. If this is your circumstance, be specific in reporting that your situation is dire.

It is a sad fact that often adults who are vulnerable to abuse are isolating with their abusers. Wellness phone calls and video check-ins should occur frequently and at varying times to identify if your loved one is experiencing neglect, exploitation, or abuse. Tips on specific questions to ask that raise red flags, or signs of abuse are online at the American Bar Association (ABA) website. Recognize that not all abuse is emotional or physical. Financial exploitation is a rampant problem among the elderly, so extra diligence is required in reviewing your loved one’s finances. Remind your senior that while it is natural to want to help family and friends experiencing financial problems, they must first take care of themselves. 

Caregivers are human beings too, and many experience fears of contracting COVID-19 while caring for the vulnerable elderly population. Some have found the financial rewards of unemployment more beneficial than work as it allows them to remain at home in isolation with their own family. Caregivers are supposed to call for backup if they are unable to meet the needs of their care recipient. Community resources are stretched thin during COVID-19, so if you have a loved one who requires caregiving, be sure to have a reliable worker or have multiple backup plans.

It is reasonable to assume that all local services for seniors are overwhelmed trying to meet their needs and that self-neglect may stem from a senior who cannot get the services provided that they require and give up trying. These services include the basics of life, like needed medical supplies and groceries. Check if your loved one is receiving the medications and meals they require to keep them healthy. 

Scams are an unfortunate yet inevitable byproduct of the coronavirus pandemic. Remind your senior never to provide information on health insurance, Medicare, Medicaid, or financial information to anyone with whom they did not generate contact. Remind them that the IRS’s first point of contact with Americans is always via postal mail. Contact the United States Department of Justice at their website if you suspect a scammer is targeting you or your loved one.

Asymptomatically, or purposefully exposing a vulnerable older adult to the coronavirus can result in serious illness or death. Make sure you keep your senior’s circle of contact extremely limited and be aware of the individuals who provide their care and talk to them often about the protocols they follow to ensure your loved one’s health. Vigilance about the health of your senior and their caregiver is essential to lower the risk of contracting the coronavirus. 

The COVID-19 pandemic is changing the way Americans interact, and it puts extra stress on our most vulnerable population, the elderly. Protocols of isolation are useful to limit the spread of the coronavirus but also increase the risk of elderly abuse, exploitation, and neglect. Be an advocate and protective force for your loved one by raising your awareness of how this pandemic increases their risks. 

If you have questions or would like to talk about planning opportunities to protect you or a loved one from financial abuse, please don’t hesitate to reach out by calling us at 1.800.660.7564 or by emailing us at info@covertlaw.com.

Should You Remove Your Loved One From a Nursing Home During the COVID-19 Pandemic?

Uncertainty can breed fear, particularly when it comes to caring options for a loved one currently in a nursing home during the COVID-19 pandemic. Facing the questions like how long this health crisis will last and will there be secondary, or even more waves of infection, give pause to those with loved ones in these vulnerable nursing home environments. Whether it is your mother, father, or spouse, you are considering moving; there is no right or wrong answer, only choices because all decisions come from a place of love. It is never wrong to try to help those you love to be better protected. Here are some things to consider about changing your loved one’s residence during this pandemic.

The truth is that bringing a cherished family member home is a complicated decision because it is both emotional and fraught with unknown consequences that have real-life ramifications about life and death. If you were to move your spouse or parent home, are you and is your home environment suited to caring for them? If they are on Medicaid, will they allow your loved one to be released and then reinstated in the future? Will there be room in the facility at the time when they need to return? Does your community provide services that can help you provide care? Does the job that you would do at home meet the same level of care as professionals in a nursing home? Will there be a lapse in medications or other necessities during the transition phase?

Before making plans to remove your spouse or parent from a nursing home during the COVID-19 pandemic, the American Association for Retired Persons (AARP) suggests you ask yourself these questions to help you make a sound decision based on your loved one’s wellbeing. 

• What are the benefits versus the risks of moving your loved one out of the facility?
• What does your spouse or parent want?
• Can you meet the caregiving needs of your loved one in your home environment? (this includes any specialized medical care, medication management, meals, bathroom and hygiene assistance, and time to engage your loved one in activities)
• In bringing them to your home, are they still at risk of COVID-19 exposure?
• How will you prioritize care if someone in your home becomes infected?
• Can you currently do window or virtual visits with your loved one in the nursing home to decrease the problems associated with social isolation?
• Will the facility readmit your spouse or parent if you change your mind?
• Are there still valid reasons for having your loved one in a long-term care facility?
• Does their current living facility have adequate staff and procedures to handle the issues associated with this pandemic?
• Will your caregiving in the home match that of the professionals in a nursing home?
• Do you have the time to dedicate to your loved one’s proper care?

Answering these questions should reveal whether you are leading with your heart or your head while considering moving your loved one out of their current care facility.

AARP’s position on moving your loved one into your home during the COVID-19 pandemic is in agreement with the experts at the Centers for Disease Control and Prevention (CDC). The CDC reports there is no one size fits all solution to this question, and each family must pursue their decisions based on recommendations from their health care providers and their unique circumstances. 

Before discussing the option of moving your parent or spouse out of a nursing home, it is advisable to pose these questions with in-home family members as well as your loved one’s health care providers. In times of uncertainty, it is best to logically think through at home living scenarios both short and long term, as well as review the variety of steps the CDC has put in place for long term care facilities with regards to protecting residents and staff during the COVID-19 pandemic. The caregiving your loved one needs will be the best for them if you take the time to make an informed decision.

If you have questions or would like to discuss your particular situation, please don’t hesitate to reach out by calling us at 1.800.660.7564 or by emailing us at info@covertlaw.com.

Who Should Make Financial Decisions for You?

Who should you trust to manage your financial well being when you are no longer able to do so? A power of attorney (POA), otherwise known as an agent to your principal, has the legal authority to represent and make decisions on your behalf. What characteristics should you look for when designating a power of attorney? No matter what type of power of attorney you seek to arrange, your potential agent must be a person you deem to be trustworthy and honorable to conduct your affairs in your best interest. 

Often the principal who designates the POA may prefer to choose a family member such as a spouse or adult child. If a family member is unable or unwilling to act when needed you can name a trusted friend or retain professional representation to ensure your interests are well looked after.  Some people choose to have co-agents or name a secondary agent in the event another might pre-decease you. 

Stipulations regarding the selection of a POA are minimal. Your chosen power of attorney must meet two legal thresholds; be an adult and not be incapacitated.  There are no special qualifications regarding financial acumen or legal knowledge, and in fact, integrity is considered the most important attribute when selecting your agent. 

Some questions to consider beyond your basic level of trust with this person(s) include:

• How does this person manage their own legal and financial responsibilities? Are they financially responsible? Do they lead a steady life? Are they good at making decisions under pressure?
• Will the person you select charge you a fee for their service? Generally, family members will not but, if you choose professional representation such as a financial planner or an attorney, there is usually a fee associated with their expertise and service.
• Is the person you want to represent you willing to do so? Becoming an agent is a big responsibility to accept, and for many reasons, the person you want may not agree to serve as your agent.
• Your power of attorney agent can have broad or limited legal authority to make decisions and transactions on your behalf about your property, finances, and medical care. The agent’s power is derived through your permissions, and if you are dissatisfied with your agent, you can terminate the POA/agent relationship and create a new one. Your power of attorney must comply with state law. When you work with us, we will make sure yours complies with all applicable laws. 

There are a few misconceptions about the power of attorney. The first is you can create a POA on your behalf after you are incapacitated. You cannot as it is too late. For your power of attorney to be valid, your agent must be appointed before you become incapacitated through illness or disability. If you do not have your POA agent legally in place and are unable to manage your affairs, it may become necessary for a court to appoint someone to act on your behalf. People appointed to represent your interests in this manner are referred to as guardians, conservators, or committees, depending on your local state law. To avoid someone making decisions for you who you may not have chosen, it is imperative to have the proper power of attorney legally in place before you become incapacitated. 

Another misconception is that your POA agent can make whatever financial decision they want to about your estate and that all power of attorney documents are the same. Your selected agent, by law, has an overriding obligation known as a fiduciary obligation to make decisions in your best interests. This responsibility is why it is imperative to choose a trustworthy agent as it can help avoid challenges to and litigation of your estate. You must have full confidence in the actions your agent will take on your behalf. You can appoint different agents for different POA document functions. We can help you figure out which powers should be given to particular agents. For example, you may want a different agent to handle real estate transactions on your behalf. 

Selecting an agent and preparing a financial power of attorney is an important part of your overall plan. We would be happy to help you and welcome your call at 1.800.660.7564 or you can simply email us at info@covertlaw.com.

The Hardest Question: Who Draws the Line?

In this Covid-19 epidemic, a wrenching question especially demands an answer: if you or someone you love is taken down into life-threatening illness, how far would you want extreme life-prolonging measures to be tried?

For us who are particularly vulnerable – seniors, those with compromised immune systems, those already struggling with medical conditions – this question is particularly stark. Many people are familiar with DNR orders, “do not resuscitate.” These are intended for cardiac arrest. The threats posed by the current virus, though, more often implicate breathing problems. The longer time spent on a ventilator, the greater the chances of permanent damage, disability or death .

Many are dying alone, without their loved ones present. The New York Times recently reported on a particularly heartbreaking case. 

Most people over sixty with a serious illness say they would prefer to be kept in comfort at the end, even if that care shortens life. But where to draw the line? How much time alive would you be willing to sacrifice, to decline aggressive treatment and possibly die sooner? The need to provide at least some answers is important not just for you. Clinicians and caregivers need guidance, too. 

A 2017 study showed that approximately two-thirds of Americans had neglected to provide prior guidance by creating advance health-care directives like health care powers of attorney and living wills. Back then, most of us could not have imagined being in an epidemic like the one now.

Even if you or your loved ones have already done the responsible thing and created advance directives, now is the time to review those documents to make sure they reflect what you want under current conditions. 

Health-care providers are ethically obligated to do everything feasible to keep us alive. If we have no advance directives in place, the system will take over – and families can end up in long-lasting anguish for having had to be the ones to make the final call. Don’t let that happen. Think through the question for yourself and talk with a person whom you trust to make that decision for you if need be. Call us for your advance health-care directives – and may you and yours not need them for a good long while.  Simply give us a call at 1.800.660.7564 or email us at info@covertlaw.com. if you have any questions.

Your Digital Footprint is Growing – Have You Planned Accordingly?

There are very few individuals without a digital footprint anymore. From social networks like Facebook, Linkedin, Instagram, Twitch.tv and Twitter, blogs and licensed domain names, email, music, photos, seller accounts on eBay, Amazon, or Itsy, gaming accounts, even your financial, utility, and medical accounts are all part of your digital footprint. When most of us created these accounts, we blithely accepted the End User License Agreement (EULA) without much thought to when we would no longer be around to manage their content and activity. However, a EULA designates in detail the rights and restrictions that apply when using the software known as terms of service (TOS). Most EULA’s are a standard form of contract, a contract of adhesion, which is known to exploit unequal power relationships. A user has no option to negotiate the terms of a EULA if they want to use the software.

When you create your will and its associated documents like a durable power of attorney (in the event you become incapacitated) it is prudent to include digital assets and a designation for someone to access your online accounts and manage their activity. Without specific instructions, most of your online accounts will not pass through the typical estate planning devices like trusts and wills because they are not your property. Still, they are very representative of your being. Since most TOS are non-transferable, you will likely be unable to transfer the “ownership” of your online accounts legally. However, you can still plan for how they should be handled when you die.

In terms of Facebook and other social network platforms, each company has its policy regarding the account of the deceased. Facebook, for example, will permit your account to be placed in a “memorial” status so that it can be viewed, and loved ones can leave memorial messages. Other social networking sites will delete or deactivate your account. If the social network is not appraised of your death, the company won’t know for a while, allowing someone to make changes to your account after your death, perhaps even posting a final status or update of your choosing. Though this is in opposition to most social networking platform policies, it is difficult for online companies to know about and monitor user activity in the event of death.

Your executor should inform readers of a blog or other licensed domain names you maintained while alive. A licensed domain name should be transferred or ended as continued licensing payment makes no sense. The content of these sites should be removed or archived. If you belong to online communities such as a book group or community list serve, you may also choose to leave a final message or have your executor notify the group of your passing.

If you store movies, music, photos, eBooks, or other digital online files, your executor should have access to the files and carry out your wishes as to what to do with them. If you do not leave access to your online accounts, they will eventually become disabled due to inactivity, and no one will have access to the files. In the event you own the data, i.e., personal photos, you can use your will or living trust to leave them to a loved one or a friend. You will have to leave detailed descriptions (My trip to Paris) for photos. As far as purchased online music or eBooks it is not the same as owning a physical CD or book. Software or digital content does not permit acquisition of ownership rights. This means the money you paid for the online content was more of a subscription service solely for your use and not transferable upon your death. Your virtual music and film library will die with you.

If you are an online seller on eBay, Amazon, Itsy, or the like, leave specific instructions about what to do with your online store. You may leave all profits that continue to come in and the stock items you sell through your will or living trust. When the company knows of your death, your executor will have no power over the account itself, but you can make provisions for the profit and stock items to be bequeathed. If you want someone to take over your online store after you die, you will need to reference the TOS of the company. Most do not allow accounts to transfer; however, the new “owner” can open a new account and reimagine your storefront.

Financial, utility, and medical accounts should all be addressed very clearly in your digital will. Leave instructions as to what website, username, and password are for each account. Also, leave written instructions about what to do with each of them. Regarding your financial accounts, their contents will be addressed in your will or trust, but your executor will have to access these accounts to wrap up your estate. These accounts include checking and savings accounts, mortgage, life insurance, and retirement accounts, as well as phone, cable, gas, and electric bills, tax preparation services, medical accounts, and more.

Your online presence requires digital legacy planning. Take a good look at all of your online accounts and be sure to leave reliable access to them and instructions for your executor. We can help you with this process, and with drafting appropriate planning documents to deal with these assets.  We also have a Client Portal for all of our clients, and this Client Portal permits our clients to encrypt and store logins, passwords, etc. for ease of access for their children and their other estate planning “helpers” they may have.  If you are interested in learning more about your digital footprint or our Client Portal, please contact us at 1.800.660.7564 or email us at info@covertlaw.com. 

Staying Mentally Sound During the Coronavirus Pandemic

Many of us are facing unprecedented challenges during this coronavirus crisis in America, and it has increased anxiety and fear levels in all of us. The reactive part of your brain called the amygdala, a human physiological response when faced with fear, takes control of your actions, and you enter what is known as the fight-flight-freeze response. This stress response induces your body to produce a steroid called cortisol to handle the feelings of fear. Unfortunately, cortisol has another effect on your physiology; it weakens your immune system. This effect makes you more vulnerable at a time when you need strength. 

No matter what your challenges are during this pandemic, there is one thing you can bring to the crisis from which all other problems can be better solved, overcome your fear with mental toughness. Being afraid can quite literally make you more susceptible to becoming sick. As such, the proper precautions like getting adequate rest, staying hydrated, and social distancing should have an additional component, help your brain to feel safe to maximize your physical health.

Some of the techniques you can employ include shifting your focus to those things you are grateful for, like a roof over your head, food in your refrigerator, your health. Consider all of the things you have that others may not; the things we all may typically take for granted. If you can’t find gratitude about your circumstances, think of those people working on the front lines in this continuing pandemic and be grateful it is not you. Finding something to be grateful for will immediately get you out of the fight-flight response.

Begin to practice empathy. Look at the time you spend with your loved ones at home as a gift and not a jail sentence. Embrace being with them, laugh, tell them you appreciate them because when you spread joy to others, it will boost their immune system as well. It turns out that being positive is healthy and contagious.  We all have a rare opportunity to forge better, more loving relationships with our immediate family, or if you live alone, take the time to recharge and re-center yourself. Take full advantage of this moment and choose positive behaviors. Extend your empathy to those who are feeling ill if possible, through video chat, phone calls, texts, or prayer. This moment is so much bigger than just ourselves.

Turn off the news and turn on personal growth and connection. News reports are full of data, some of which are not accurate. Being addicted to the 24/7 news cycle breeds uncertainty and fear as it touts mostly negative statistics and woeful stories of the moment. The basics about this pandemic are well documented at this point. Practice proper hygiene, particularly with your hands, avoid touching your face, avoid large gatherings, and implement social distance but do not do this out of fear, do it as an act of service. Flip how your brain associates your daily choices by knowing that your actions are preventing the potential deaths of others.

Find something in media or on television that brings a smile to your face or makes you laugh. Break out the board games, cards, art projects, or walk outside (distant from others!) and get some sun. Sun provides vitamin D for your system, which also boosts your immune system. Whatever you choose, staying active and busy in a positive way will lessen any concern or fears that you are experiencing about the pandemic.

These points of view may all may read as cliché, but in 2009 Dr. Alvaro Pascual-Leone conducted a study consisting of two groups of people learning to play a simple piano melody. For five days, one group practiced the melody for two hours a day while the other group, over the same time, sat in front of the keyboard, imagining they were playing the melody. Dr. Pascual-Leone mapped the brain activity of the study participants before, during, and after the experiment, and the results were surprising. Both groups experienced the same brain changes. What this means is the brain does not differentiate between imagination and reality. What this also means is you have a choice, a choice to be riddled with anxiety, worry, and uncertainty or the opportunity to be courageous, bold, and confident by simply imagining those feelings. How you feel is a choice. 

In simple terms, when you have a thought, your brain sends a pulse of electrical activity at the same moment. This electrical activity stimulates a release of neuropeptides that communicate with your body to produce a feeling. So truly, your thoughts create feelings. Activate your brain’s natural superpowers and boost your immune system by redirecting your brain’s thought patterns. Remind yourself daily to think positive thoughts, be grateful, and practice empathy which will give you the mental toughness to endure what still lies ahead.

We are open for business and would be happy to discuss any concerns you have. The pandemic we are living through has opened everyone’s eyes to the importance of having healthcare documents, as well as other planning documents like a will or trust. If you’d like to discuss your particular needs, please contact us – we’d be happy to help.  Just call us at 1.800.660.7564 or email us at info@covertlaw.com.  Stay safe.  Stay healthy.  

Helping Seniors Avoid Loneliness While Maintaining Social Distance

The medically recommended protocols for social distancing and government mandates that restrict large gatherings of Americans to slow the spread of the coronavirus are minimizing our abilities to interact with each other. This isolation holds especially true for those seniors who live alone or in long term health care facilities. Human beings are, by nature, designed for close contact and social interaction. Maintaining human connection, whether it be family or casual acquaintances, can help boost immunity, combat anxiety and stress, and can even lower health risks that are exacerbated by stress like heart attacks and hypertension.  

The Association of Health Care Journalists reports that it is critical for older adults’ wellbeing to maintain social ties. Those seniors who experience loneliness and social isolation are more likely to develop dementia, more likely to fall, have an increase in hospital readmissions, and an increase in mortality. Because of the COVID-19 pandemic, health care facilities and hospitals across the country have put a pause on in-person visitation. This separation will protect the most vulnerable populations, such as older adults and those individuals with chronic health conditions.

To help your loved ones in a facility or living on their own during this challenging time of COVID-19 Right at Home, a leader in the in-home senior care industry, has some ideas to stay connected to those you love who are isolated during this outbreak. 

• Set up phone dates. Scheduling a regular call at a prescribed time and date brings you closer through conversation and also gives a senior something to look forward to experiencing. Do not over-promise. It is better to have two calls a week that you always attend rather than to miss a promised chat session because you overscheduled your time. 
• Write letters to each other. Getting postal mail is fun for all ages, especially when it is a letter, filled with memories of shared times. Include self-addressed stamped envelopes back and forth to encourage continuing the exchange. Lonely seniors will usually re-read these notes and treasure them.
• Set up chatty technology. Whether it’s a tablet, home device, or smartphone, you can use your digital device to use apps like Facebook Messenger, Alexa, FaceTime, Skype, and more to videoconference with your senior. If your senior needs some technical help, most health care workers will be able to help get them started as you will not be permitted to be onsite.
• Virtually watch movies together. If you and your senior have a desktop computer or laptop that uses the Chrome browser, Netflix Party will synchronize video playback and add group chat capability to your chosen show or movie. It’s like having a long-distance movie night or tv watching party.
• Attend online events and activities. Participating online is a big deal when faced with isolation. There are thousands of people online who have similar interests as you. Meetup.com is a free membership group that has 24 separate categories, like dance, language, and culture, photography, family, tech, health and wellness, music, and more. All of these categories host multiple online events in which your senior can participate.
• Attend virtual religious services. Faith is so important right now, especially for some seniors. If your loved one has a worship service they used to attend, see if they are now providing their services online. Many houses of worship have Facebook pages where a service is a click away. It will lift your senior’s spirits immensely to see and listen to their familiar pastor, rabbi, or priest.
• Make use of the public library online. More than ever, libraries are offering their services for things like movies, e-books, and audiobooks.
• Stay physically active. Log into a virtual exercise class online. Most of the classes are free, and they are found everywhere on YouTube. Just be sure to search for an exercise class that is appropriate for your age and physical abilities. As with any new exercise regime, always consult your doctor first.
• Get outdoors, even for 5 minutes. If at all possible to do safely, step outside on the porch, patio, or balcony and encourage your loved one to do the same. Take in some sunshine and fresh air, take a deep breath and see the bigger picture of life.

Prolonged loneliness can bring about depression and even dementia. However, social distancing does not have to bring about social disconnection. Employ some of these ideas in the world of your senior to protect them from isolation during this pandemic. It is crucial to your loved one’s wellbeing to have direction and routine, hope, and human connection. 

We are also using video technology for our meetings so we can continue to help with planning needs of our community. If you have questions about what you read or would like to discuss planning for you or a loved one, please don’t hesitate to reach out by calling us at 1.800.660.7564 or by emailing us at info@covertlaw.com. We would be honored to help.

Telehealth Replaces Many In-Person Medical Appointments

Through the use of videoconferencing over wireless devices and remote health tech monitoring, telehealth can connect patients to vital health care services. According to the American Hospital Association (AHA)fully 76 percent of US hospitals are using some form of telehealth for their patient groups. 

During this COVID-19 pandemic, the federal government has freed up some regulations that previously stifled telehealth practices by increasing Medicare coverage allowances as well as permitting doctors to practice over state lines, further increasing telehealth demand. This unprecedented surge in patients is stressing major telehealth providers’ technical infrastructure as well as the availability of physicians, physician assistants, and registered nurses who can deliver accredited virtual care. Huge backlogs are becoming the norm as telehealth ready hospitals and other facilities scramble to meet the demand.

Addressing the incoming demand is not that easy as major health systems like the Cleveland Clinic are experiencing a fifteen-fold increase in telehealth visits per week, and that number is likely to increase.  For those lacking standard internet connectivity, doctors are expanding phone consultations and recording videos as telehealth services increase asynchronous connection capability to address rural patients lacking reliable broadband capability for health services during this pandemic. The Cleveland Clinic also has a health bot (an automated online interactive chat window) COVID-19 risk assessment available on its home page where you can follow the prompts to determine your risk level for coronavirus based on your given answers. The University of Pennsylvania (Penn Medicine) is receiving virtual health care requests faster than clinicians can respond to them even though the hospital’s daily consultations have gone from 6 to 60 online appointments. Hospitals across the country are experiencing a similar explosion in the number of telehealth requests.

Many Americans do not seem to be fully satisfied with gathering their information about COVID-19 on websites such as the Centers for Disease Control and Prevention and the World Health Organization. Instead, they are opting for more personalized contact via a telehealth provider, which may be decreasing fear levels more than providing additional insights as medical personnel uses the guidelines established by these reliable health organizations.

The telehealth service sector is hoping that the coronavirus pandemic demonstrates the value of remote health services resulting in an enduring shift to its delivery mechanism in the future. Even when stretched beyond full capacity, telehealth allows the pooling of health care resources and delivery of them to where they are most needed. Though not currently operating to its full potential, telehealth during the time of the coronavirus pandemic remains one of the safest ways to receive medical attention and advice. 

We encourage you to reach out to your medical provider to determine whether telehealth is an option should you need medical attention. It is a much safer way to talk to a health care specialist and determine what type of treatment you may need.

We are also available for online meetings during the COVID-19 pandemic. If you would like to set up a meeting, simply visit our website for information on how we can connect, or call us at 1.800.660.7564 and email us at info@covertlaw.com.

Americans of All Ages are Creating Their Wills During COVID 19 Pandemic

There has been an explosion in the numbers of Americans rushing to make their will online. Understandably, the coronavirus pandemic has created the scramble to set up wills and end-of-life-directives. However, online do it yourself (DIY) wills are often deemed invalid as they do not comply with all of the legal requirements of your state. According to Caring.com, the prevalence of will and estate planning has been on the decline since 2017 but this trend is quickly reversing itself with the advent of the coronavirus pandemic.  

So, who needs a will? Ask yourself if you care who gets your property or money if you die? If you have minor children, do you care who will act as their legal guardian? The answer is anyone married, anyone with children or anyone with assets needs a properly executed will. Wills are governed by state law. Your will should reflect your wishes in the language and format required by the state in which you live for it to be valid. 

Many law offices are turning to teleconference with their clients to address social distancing protocols while still providing legal services such as writing a will. Businesses like Zoom are experiencing a quadrupling of daily users. Part of this significant increase includes hosting secure attorney/client meetings for will preparations. The importance of an attorney guiding you through the process of creating a will cannot be understated as they understand the nuances of how things need to be written. Once your will is complete, it must be correctly notarized as mistakes made in the will-signing process can potentially invalidate your will. Your attorney will guide you through the signing process, and could involve signing during a video conference. 

Beyond the creation of a will, many Americans are increasingly concerned about their powers of attorneys, health care surrogates, living wills, and end of life directives. These “life documents,” as they are active while you are alive, are equally as important as your will. Named executors, successors, beneficiaries, power of attorneys should have several back-up representatives as the mortality rate due to the coronavirus remains unknown.

According to research in a recent New York Times report, health care workers are more likely to contract COVID 19 than the average person. During this pandemic, many doctors and other medical professionals are rushing to have their wills drawn up. In addition to doctors, anyone on the front lines in the fight against COVID 19, from hospital custodians to nurses to EMS responders, should either make a will or review and possibly update their existing one. However, the truth is no matter what your profession or likelihood of contracting this virus, you should have a properly executed will during this time of considerable uncertainty.

There are few things you can act on during the COVID 19 pandemic that can bring you assurance and a sense of relief. The legal creation of your will or living trust and life-directives (Designation of Health Care Surrogate, Living Will, HIPAA Authorization, Medical Emergency Card for your wallet) are actions you can take that protects you and your family. We can help. Call us at 1.800.660.7564 or email us at info@covertlaw.com to schedule a phone or video conference and we’ll get this importance process started for you.

Questions to Ask Before Hiring In-Home Health Care Services

There is a wide range of home health care services available from daily household tasks to medical care. Before identifying a health care service for information, get a clear idea of what you are in the market for, be it recovery from surgery or long-term care for a chronic illness. The first step is to determine what you need help with and how often you need that help. Then assess your budget to provide home health care services. Get the specific information together about the types of insurance you will be relying on for payment. Determine what your loved one’s comfort level is with the process. A non-compliant recipient of care is going to make for misery all around. Have open and non-threatening discussions with your loved one and listen to their concerns. They may give you refined information about what type of individual to look for in a home health aide such as a non-smoker, early riser, card player, fastidiously neat person, an aide with experience with a specific chronic disease, or a multi-lingual aide.

Once you have identified your needs, though they may change or need to be scaled back, the search for a provider begins. The Mayo Clinic recommends finding a qualified home care service agency. Only deal with properly licensed agencies. Most states require agencies to be licensed and regularly reviewed, so check with your state health department. Be sure the agency is Medicare-certified for federal health and safety requirements. If it is not, inquire as to why. Ask about employee screening and if the agency is willing to provide references and follow up on them. Request a list of the doctors, hospital discharge planners, and other medical and administrative workers who have experience with the agency.

The individual home health aide should have proper credentials. Check to see that they are appropriately licensed by directly checking with the licensing body itself. Does the aide have a track record, and can they provide references from at least two employers? Follow up on any references given. Also, check with your loved one’s medical team to see if they have specific individuals who would be qualified and a good fit as your home health aide. Check for the quality characteristics of the agency. How do they monitor and train caregivers? Are caregivers licensed, accredited, and insured through the agency and proper licensing bodies? Is continuing education provided to health aides? Does the overall attitude of your potential home health aide have a positive attitude and display patience? Can scheduled hours be consistent with the patient’s needs? Will the same aide reliably and routinely show up?

Once you have a few qualified home health care options available, it is time to identify which agencies are affordable to your budget in the area of your loved one. It makes no sense to learn about specific services that you cannot afford, so pricing is one of the first considerations beyond qualifications. Ask the agency how it handles billing and expenses and get literature that explains services and fees. What levels of care do they provide? It is important to get detailed, written information as to all of the costs associated with home care services. If it is not in writing, be wary and walk away.  

Does the agency allow for fees to be covered by health insurance or Medicare? Talk with the agency’s billing personnel to ensure that your health insurance is accepted and be sure to understand the criteria that Medicare requires. Do not forget to ask about financial assistance or payment plans and again request that all the information is in writing. Once you understand the payment set-up, reconfirm what services are included in those fees. Often the sales pitch in the front office does not map out to the details of fee-for-service in the accounting department.

How much will the aide charge for providing home health services, and what services are included? Does this information mirror the data provided by the agency? Inquire about sick days and check for any scheduled vacations that might impact continuing service to your loved one. Who is responsible for payroll, social security, and other taxes associated with the aide? Does your aide receive standard holidays off as defined by federal guidelines; are they paid holidays, and who pays?

Before an aide enters into your loved one’s home, there should be a written care plan that includes details about medical equipment, specific care needs, and the responsibilities of the aide and the agency. This plan is usually in the form of a 3-ring binder where an aide denotes hours of care provided and can reference doctor input, which should be frequently updated. Also in the book should be a list of responsibilities and rights for everyone involved, which is often referred to as the patient’s bill of rights. This document varies widely, but Medicare.gov provides a detailed example of what they include. 

Inquire if the agency will continue to work directly with you and other family members after the aide is identified and hired for service. What is the process for elevating concerns and complaints? If there are problems, what is the protocol to resolve them? What are the emergency plans in the event of power failure or a natural disaster that can create safety hazards, particularly with medical equipment? What are the response times during a medical emergency? Is your aide instructed to dial 911 first? Check for a back-up plan in the event the home health aide has an emergency come up or has car trouble, or inclement weather precludes them from showing up.

According to Homecare.com, the average agency health care worker has between 1 to 2 years of experience, so implement the 3 R’s and get resumes, references, and reviews. Ensure the credentialing process through your identified agency includes home health aide social security number and trace verification. Be sure it checks federal and state criminal records, sex offender registry, and valid driver’s license check through the licensing department in your state. The aide’s license and credential verification need to be vetted. Finally, there should be contact with the Fraud and Abuse Control Information Systems (FACIS), which checks for wrong actions by individuals and agencies in the health care field.

To hire the best home health care services possible for your loved one do your research thoroughly before moving forward. Once you are engaging agencies and individual aides ask questions, get literature, take notes and then follow up on references, license verifications and credentialing. The research and care you put into the process upfront can stave off unwanted complaints or problems with your home health aide selection. You will create the best outcome for the patient by identifying the most qualified and affordable candidate for your situation.

We help families create comprehensive estate plans for anyone who may need long term care. We discuss care needs, how care will be paid for, who will make decisions, and much more. Give us a call at 1.800.660.7564 or email us at info@covertlaw.com – we’d be happy to help your family plan for the future.