All You Need to Know About Advance Directives

Kevin stands at the door of Winnie’s nursing home room, tears streaming down his face. The medical staff just finished inserted a feeding tube into Winnie – an act Kevin knew she didn’t want. Unfortunately, Winnie couldn’t express her wishes due to advanced dementia, and she had no legal documents that expressed her wishes not to be fed by artificial means.  Kevin had no choice but to sit back and watch his wife go through a procedure she didn’t want.

The situation with Kevin and Winnie could have been avoided through the use of proper advance directive. An advance directive is actually a collection of documents. What that includes differs depending on your needs and wishes, along with what the law allows. However, it usually means at least a Living Will, and a Power of Attorney for Healthcare.

The purpose of this set of documents is to allow you to control what happens to your health care in case you cannot speak for yourself. If certain criteria are met, your doctors must consult with your advanced directive before making decisions about your care.

Usually, what this means is that two doctors agree that an individual is terminally ill, permanently unconscious, or at the “end-stage” of a condition. Once that happens, and the individual cannot express their preferences, doctors turn to the advance directive to figure out what the individual wants.

A Living Will determines what happens to an individual making it, unlike a Last Will and Testament, which determines what happens to their money and possessions. A Living Will describes what healthcare providers can and cannot do to prolong your life and/or ease your pain when you cannot express those preferences yourself. For example, do you want to be placed on a ventilator if you cannot breathe on your own? Do you want a feeding tube and IVs set up, and if so, for how long? Do you want to be an organ or tissue donor?

A Durable Power of Attorney for Healthcare lets you choose someone to make healthcare decisions for you when you cannot. They still must follow your Living Will, but they will be able to make decisions not explicitly considered by your Living Will, in accordance with the facts of the situation. In most states, there are “default surrogate consent laws” which allow family members to make treatment decisions on your behalf, but who is chosen to make these decisions and what they choose to do may not be in accordance with your wishes, as it hopefully would be with a Durable Power of Attorney.

Other documents may be part of an advance directive by law, or they may be worth including on your own volition. These include Do Not Resuscitate orders and Physician Orders for Life-Sustaining Treatment, among others. You might also consider an advance directive in case of a mental health crisis.

This is a difficult subject to consider, and it always seems like it won’t be necessary. But nearly 70 percent of Americans don’t have plans in place for a worst-case scenario, which means for some of them, decisions may be made for them with which they would not agree, if they had the capacity to choose. For that reason, it is worth thinking about implementing an advance directive even if it seems unnecessary now.

If you have questions or need guidance in your planning or planning for a loved one, please do not hesitate to contact our Norman office by calling us at (405) 241-5994.

Seniors Are Facing an Affordable Housing Shortage

There is a growing need for affordable senior housing that is only starting to be addressed by businesses that build for this market. If you have a lot of money you typically have a lot of options. At the other end of the spectrum if you have nothing you can qualify for government assistance though these programs, but most often include wait times, years of wait times, due to lack of available housing. The truth is many seniors, nearly 40%, have less than $50,000 in savings, not including the value of their homes, according to a study by the Joint Center for Housing Studies and Harvard University. That doesn’t make them poor, but it doesn’t make them rich either. Middle income seniors are stuck in the middle and the statistics are indicative of a looming senior housing crisis. By 2035 one in three households will be headed by someone aged sixty-five or more years and the population aged eighty or more years will have doubled to 24 million.

The truth is that thoughtfully designed housing for senior adults is not being created on a scale that reflects the growing need and the need is palpable. Many aging adults don’t even want to project that one day they will no longer be able to live in their current home. When asked about their forward living plans it usually consists of some variant of “the plan is to die in my home.” Sadly, it is impossible to script your passing and while you might hope it happens gently in your home it is more likely that an adverse event, such as a fall, will change everything and you will require some level of care. The Social Security Administration estimates that if you turn 65 today, you will live to 84.3 if you are a man, and to 86.6 for women. Added SSA: “And those are just averaging. About one out of every four 65-year-olds today will live past age 90, and one out of ten will live past age 95.” (https://www.thestreet.com/story/13640644/1/inside-the-nation-s-looming-senior-housing-crisis.html) Those numbers of longevity represent staggering costs when you consider the likelihood that those oldest years will require the most significant care.

That “significant care” costs serious money. According to “A Place for Mom,” the average national cost for a private assisted living facility is almost $4,000 per month. If you want private nursing home care that cost increases to more than $6,000 per month, depending on where you live. If you compare these costs with the fact that nearly 50% of adults aged sixty-five or older have just enough income to afford basic expenses, you can intuit it is a recipe for disaster. The only thing left is to spend assets pay for care. That is not a good option for several reasons. First, you will likely run out of assets quickly due to the current costs of care. Second, you would be unable to leave a legacy to children or continue to provide for a spouse after you are gone.

That is why the understanding of aging is facing a paradigm shift – many companies that design and build for retirement communities want the word “senior” dropped altogether. Innovative technology companies and non-profits are sounding the alarm and changing the discussion from challenge to opportunity, from health care to health, wellness, and lifestyle, and bringing entrepreneurial ideas to create a positive change. It is a step in the right direction, but it does not change the current reality – there is a shortage of affordable senior housing and there is a continuing increase in need for senior residency.

What is your housing reality and future? Do you have a plan in place to handle the changes that most likely will affect you and your living environment? It is important to have this discussion with your family, and with a professional elder law attorney. Proactive planning is in your best interest.

If you have questions or need guidance in your planning or planning for a loved one, please do not hesitate to contact our Norman office by calling us at (405) 241-5994.

Understanding the Impact of Coronavirus on Seniors

We are living in confusing and scary times. The senior population has been identified as the most at-risk demographic for COVID-19. Information coming out about COVID-19 is very fluid, which can also contribute to overall stress. Thankfully there are ways to try and manage stress and stay as healthy as possible during this time thanks to advice from several federal agencies monitoring the situation and the impact of COVID-19 on the senior population. This article highlights some of the advice provided from those agencies monitoring this situation closely.

For those living in a nursing home or long-term care living facility, new protocols have been established by the federal government to curb the spread of Coronavirus. A new preparedness checklist is available on the Centers for Disease Control and Prevention (CDC). It includes staff education and training for the rapid identification and management of ill residents, as well as an increase in supplies and resources. There are also restrictions on all visitation, excepting some circumstances like an end of life situation.  Other restrictions have been placed on volunteers and non-essential health care personnel, and the cancellation of all group activities and communal dining.

Before the identification and dissemination of information about Coronavirus, the CDC had identified the 2019-2020 flu season as being particularly challenging. Now many seniors wonder whether they have a different type of flu, allergies, or are experiencing the Coronavirus. Not knowing is particularly frightening since seniors have been identified as the demographic with the highest mortality rate. The CDC has a straightforward checklist of symptoms of respiratory infection, including COVID-19:

  • Fever
  • Cough
  • Shortness of breath

Because other types of flu have similar symptoms and there is no Coronavirus vaccine, and its test is in very short supply, many older adults will only be able to treat their symptoms without full knowledge as to the contagion.

One their website under “How to Prepare” the CDC provides information on protecting yourself, your family, your home, and managing anxiety and stress. According to the CDC, there are some things that seniors can do whether or not they are in a facility or living at home that can help reduce their risk of catching the Coronavirus or any other virus for that matter in this bad flu season. The first line of defense sounds counterintuitive to a global pandemic, but it is crucial, stay calm and try to relax.

Getting quality sleep during this outbreak will allow your body the time it needs to restore immunity responses to contagions. Stay well hydrated by drinking plenty of water. Staying calm, getting restful sleep, and remaining hydrated will allow your body’s natural defense mechanisms to protect itself.

Have someone near you help you stock up on supplies. Stay in your home as much as possible. If the weather permits, open a window for fresh air. If you have a home with a porch or patio, take in some sun for vitamin D. You want your immune system to be as robust as possible. Take everyday precautions to keep space between yourself and others. If it is not necessary, don’t go out in public, avoid crowds, stay away from anyone who is sick, and wash your hands often. Cancel any cruise or non-essential air travel and do not use public transportation.

The Environmental Protection Agency (EPA) has posted a list of disinfectants for use against the Coronavirus. Proper disinfecting of often-used surfaces is critical as this particular Coronavirus can live for long periods, up to 72 hours on some surfaces. As of now, the EPA reports no detection of COVID-19 in drinking water supplies and believes the risk to the water supply is low based on current evidence.

The CDC is reporting that seniors with chronic medical conditions like heart disease, lung disease, and diabetes are at higher risk of contracting COVID-19 and should take extra precautions about self-isolating. Those seniors with these conditions in a nursing home or long-term care facility will be triaged according to CDC guidelines for best practices with the elderly who are the highest risk.

If you feel worried and panic is taking over your rational responses, seek a loved one or trusted friend to guide you through the steps you can take. There is a great deal that is unknown about the Coronavirus, but there is a great deal known about what you can do as an individual senior to combat the threat and remain healthy.

We would be happy to discuss any questions or concerns you have as we continue to understand the impact of COVID-19 on our country. If you have questions or need guidance in your planning or planning for a loved one, please do not hesitate to contact our Norman, Oklahoma office by calling us at (405) 241-5994.

Important Steps to Protect Your Special Beneficiaries

All children are a blessing. From the day they are born, you begin making plans to ensure that your child or grandchild has a bright future. What will their interests be? What job will they have? Who will they marry? While these are common concerns for most families, for those with a special needs child or grandchild, taking steps to ensure they have a safe, happy, and healthy future is even more important due to the additional hurdles they may face. To help provide a prosperous future for your special needs child or grandchild, we suggest the following steps:

Have a Special/Supplemental Needs Trust Prepared

One of the first things you can do in your estate planning is establish a special or supplemental needs trust (SNT) for the benefit of your child or grandchild. An SNT is a special type of trust designed to set aside money and property for the benefit of a beneficiary who may qualify for public assistance for medical and other care expenses as a result of his or her disabilities. This type of trust can be added to an existing trust, or it can be drafted as a standalone trust.

Because most government programs providing aid to disabled individuals have strict requirements about how much money and property a person can own and how much money they can receive on a regular basis, it is important to make sure that any inheritance your special needs child or grandchild receives is structured in a way that will not disqualify them from receiving the government benefits. Even if your child or grandchild is not currently receiving government benefits, this does not mean that they will never receive them. When planning for their future, we want to make sure that we are maximizing all opportunities available to them, not limiting those opportunities. To accomplish this, it is crucial that the trust be carefully drafted by an attorney who is familiar with the eligibility requirements for government benefits.

In addition to providing for your child’s or grandchild’s financial future, an SNT allows you to appoint a care manager or an advisory committee. As opposed to a trustee, whose job is to manage the money and property in the trust and make distributions, the care manager acts as your child’s or grandchild’s advocate. Depending upon the level of care your child or grandchild needs, the care manager may only need to check on them periodically or may be responsible for their day-to-day care. For those needing more assistance, the care manager may also serve as part of an advisory committee made up of multiple friends, family, and/or professionals. As an advocate, the care manager or advisory committee can advise the trustee about the beneficiary’s needs and the best ways to use the funds.

Within the SNT, a statement of intent can be included to instruct the trustee, and if necessary, the court, as to why the trust was established and how the money and property should be used. Although your intentions may seem obvious, including this section in the SNT can act as a safety net should there be a change in the law causing the special needs beneficiary to become ineligible for government benefits. If you include a statement of intent, it can be easier to change the trust to ensure that your original objective is carried out after you have passed away in the event of unforeseen changes.

Write Down Your Instructions

In addition to creating an SNT, writing a letter or memorandum of intent can provide excellent instructions to the trustee you choose about what is to happen after you have passed. Although this document is not legally binding, it can give your trustee insight into your true intentions. You can include instructions regarding the types of things you want the money to be used for (so long as they are allowable under the various government rules), milestones you would like to see the beneficiary achieve, and the standard of living you would like the beneficiary to have.

Consider Life Insurance to Provide the Necessary Funds

Supporting a special needs child or grandchild can be expensive. While you are working or have a stream of income, you can allocate money as you see fit. However, not everyone has enough of a nest egg to continue covering these expenses for their special needs child or grandchild once they have passed away. By purchasing life insurance and naming the SNT as the beneficiary, you can guarantee that there will be sufficient money at the trustee’s disposal to care for your child or grandchild. Life insurance can be an attractive option because it is paid out as a lump sum and does not have the same income tax liabilities as retirement accounts.

Review Your Retirement Accounts

With the passage of the SECURE Act, most beneficiaries lost the ability to stretch distributions from an inherited IRA over their life expectancies. However, Congress created a new class of beneficiaries called “eligible designated beneficiaries,” which includes disabled beneficiaries. These beneficiaries retain the ability to receive distributions over their life expectancies, reducing the amount of income tax due when those distributions are made. Congress also passed additional rules allowing the disabled beneficiary’s life expectancy to be used for certain types of trusts. If you have a large retirement account, it is very important that we meet to discuss ways this money can be distributed after your death to maximize its benefits to all of your beneficiaries.

Give Us a Call

Ensuring that your special needs child or grandchild is cared for after you are gone is likely a top priority for you. Our priority is to assist you in crafting a plan that will ensure continued support and prosperity for your loved ones. Call us today to schedule your appointment.

Why Do Americans Retire Poor?

Well managed money brings with it a freedom of lifestyle in retirement. Sadly, reports say that less than 5 percent of Americans will be financially free by the age of 65. Changes in the U.S. economy coupled with increased health care costs and lack of personal savings have put millions of American workers at financial risk as they approach their retirement years. According to a study published online at cnbc.com, nearly 40% of America’s middle-class will experience poverty in retirement. Why?

One reason is that few Americans clearly define what financial freedom means to them. The definition is a wide array of personal opinion, but there is an economic equation that can easily encompass the most basic standard set for financial freedom; P.I ≥ L.E. Translated it means passive income = lifestyle expenses. An individual’s passive incomes from assets need to be equal to or higher than the income you require to afford your chosen lifestyle. Many people retire poor because they did apply this fundamental equation to their financial future. Some individuals are too disinterested to engage in financial planning or too lazy to be proactive and productive. The adage, “failing to plan is planning to fail” sadly applies to many Americans’ retirement strategies. Hoping things will work out is not a strategy any more than planning on winning the lottery is. Individuals must establish their goals and ruthlessly and relentlessly pursue them.

Every American has a different financial reality, and much of it is derived from the mindset they choose to adopt regarding finances. Consciously, as well as subconsciously, rich people think like rich people and poor people think like poor people. What you manifest is what you see and in turn, what you become. This mindset is why so often lottery winners go bankrupt after “hitting it big” and why wealthy people who go bankrupt often go on to develop a new fortune. Keep your mindset focus positive and reinforce your short- and long-term financial goals daily. Your attitude can determine your altitude.

Many Americans who retire poor chose the “let’s just wing it” path or did not attain sound and conservative financial management help. Do not be influenced by other poor people. Surround yourself with successful friends and family and learn from them. You can model their behavior in your own life. Retain a trusted accountant, banker, or financial advisor who can tailor your individual financial needs into an easy to follow set of steps and apply them. It does not have to be overly complicated and sometimes, the more straightforward the approach, the better. If you learn from successful people and sound financial consultants, you stand a better chance of becoming financially free.

Some Americans stick their heads in the sand and never confront the facts of their financial reality. These are the people with stacks of unopened bank statements in their homes. While it can be painful to address a bleak economic reality, it is worse to have an inherent aversion to tackling the task at hand. You cannot abdicate your financial situation to anyone. You can receive trusted advice and help but do not avoid facing the truth of your finances. Oversight avoidance is how some famous athletes and performers have made vast fortunes but managed to squander every last cent. No one should care more about your financial freedom than you do.

Many people who retire poor did not save any money, and those who inherited wealth squander instead of saving in the name of immediate gratification of a new car, or large home. Extravagant expenditures feel great at the moment, but the goal is to live beneath your means. Make saving money your number one habit. People who are successful at saving sometimes make a game of it like shopping online for the best deals or using coupons. Small savings during purchasing not only add up over time, but they also reinforce the habit of saving money. When you save money, you can apply the power of compound growth. Many people who retire poor do not understand how valuable the concept of compound growth is. It can take modest savings and in time, create wealth. Sadly, many Americans understand the concept of compound growth from the wrong side of the equation. Generally speaking, Americans are debt slaves. They rack up credit card debt and pay services charges, which are the bank lending industry’s compound growth money maker. People retire in poverty because they are on the wrong side of the compound growth equation.

Without the saving habit, compound growth equation, living beneath your means, and acquiring as little debt as possible you wind up working for money instead of money working for you. It is essential to assess the three following ways income can manifest itself in your life. There is earned income, which generally is in the form of a paycheck or salary for services or products provided. Then there is portfolio income which represents stocks, investments, and pensions. Finally, there is passive income, which comes in the form of royalties, patents, online services, or rental revenues, to name a few. These multiple streams of income can make retirement far more comfortable than relying on a modest pension and ever declining social security benefits check. People who retire rich have multiple streams of income, giving them a real path to financial freedom. People who retire in poverty continue working for money without the benefit of alternative sources of revenue.

There is little excuse to lack the knowledge and skillsets to become financially solvent in the digital age. Americans who struggle financially in retirement did not take the time to become financially educated. Being ignorant about finances is a sure way to retire poor. Online and for free, you can find many websites that generate articles about financial education. It comes as no surprise that people who retire with financial problems have the worst reading habits. If you don’t enjoy reading, try financial literacy games for adults or learn through online seminars to boost your financial understanding. Even with financial knowledge if you lack a plan and the will power to follow it, you will retire without economic freedom. The practical application of your plan is crucial. Most Americans do not make a plan for their retirement, and many that do begin too late to affect a substantial change because compound growth and accrual of wealth take time. However, it is better to start your retirement plan late than not at all.

Ultimately the choice rests with the individual. Most Americans would rather retire with adequate incomes for a comfortable retirement lifestyle. Remember that you are not a product of your circumstances; you are a product of your decisions. Make the right decision today for your financial freedom in retirement.

If you have questions or need guidance in your planning or planning for a loved one, please do not hesitate to contact our Norman, Oklahoma office by calling us at (405) 241-5994.

COVID-19 Update

On March 13, 2020, President Trump declared a national emergency regarding the coronavirus, which causes the disease COVID-19. The coming weeks will be a trying time for our country. Nevertheless, The Law Office of Tyler R. Barrett, P.L.L.C. remains committed to its mission of protecting and preserving your hard-earned assets. Here are a few steps we are taking to make certain that we keep providing superior service in the areas of estate planning, probate and elder law while at the same time safeguarding the health and well-being our valued clients:

Office Hours

The office will remain open during our normal business hours, which are Monday through Thursday from 8:30 a.m. to 5:00 p.m. and Fridays from 8:30 a.m. to 1:00 p.m. As always, we are available by appointment only at other times.

Virtual Meetings

We are conducting meetings in-office as scheduled. However, if clients prefer, we have the ability to hold virtual meetings via Zoom or Skype. While the Estate Plan Signing Ceremony could warrant other considerations, the design and development phase of the estate planning process can take place on an exclusively virtual basis.

Expedited Plans

A core value of the Law Office of Tyler R. Barrett, P.L.L.C. is “people over profits”. We believe that of all the things in life one can rush, an Estate Plan is not among them.  That’s why we spend hours, sometimes over the course of several meetings, exhaustively covering every detail with our clients so they can rest assured that their legacy is secure.

We prefer not to deviate from our normal process. But in the current environment, we are also aware that circumstances can change rapidly. So, if the health of you or a loved one suddenly deteriorates, we are ready to work overtime to ensure that your Estate Plan is in place.

Conclusion

Like everyone, our hearts are with those affected by this terrible disease. And we are hopeful that – as President Abraham Lincoln once famously said – “this too shall pass”. In the meantime, you can count on the Law Office of Tyler R. Barrett, P.L.L.C. to meet your legal needs with the same passion as always.

Passing Down Your Family’s Values

Successfully addressing and legally formalizing inheritance of family values and assets can be challenging, especially if parents wait too long to begin instilling family values. Undoubtedly the best time to teach and empower your children as eventual inheritors of your family legacy is during childhood, then continuing throughout adulthood. Waiting until your later stages in life to discuss family values as a guide to handling inherited worth is often ill-received as grown adult children prefer not to feel parented anymore, particularly when they are raising children of their own.

There is value in the spiritual, intellectual, and human capital of rising generations, and it is incumbent upon older generations to embrace this notion and work with their heirs rather than dictating to them their ideas about how to facilitate better outcomes. While the directions taken by newer generations will likely differ and can sometimes be downright frightening than that of their elders, there can still be a deep sense of service and responsibility to family values and stewardship of inherited wealth. Allow your children to exert their influence over the family enterprise early on in life and make adjustments that create synergy, connection, and like-mindedness.

If this description of a somewhat ideal family system does not resemble yours, take heart. Most families do not conform to perfect standards of interaction. The more affluent a family is, the higher the failure rate to disperse assets without severe fallout. The Williams Group conducted a 20-year study and determined there is a 70 percent failure rate that includes rapid asset depletion and disintegration of family relationships during and after inheritance. Establishing inheritable trusts can provide real benefits. Benefits include avoiding probate, reducing time to handle estate matters, privacy protection, the elimination or reduction of the estate tax, and can be effective pre-nuptial planning. A parent who wants to control outcomes should focus on these benefits of the trust instead of trying to legislate their future adult children’s behavior.

It is imperative not to allow your values and legacy to become weaponized within the family system. A sure-fire way to inspire conflict is via “dead hand control,” meaning trying to control lives from the grave. Most often, if you put excessive trust restraints on adult children, they will act accordingly to your perception that they are not adult enough to handle wealth. Instead, consider enrolling them in a few classes about managing wealth. Spark an interest in them to learn how you have created wealth, the mechanisms you used, and what their future endeavors may look like long after you are gone. Formally educate your children about finances, the earlier the better, and instead of talking about who gets what the conversation can shift to the mechanics of managing wealth. This tactic resets the context of the issue and aligns purpose and intended long term outcomes.

Estate planners try to encourage trust choices that lead to flexibility. If a beneficiary is genuinely incapable of making the right decisions, a trustee can be appointed to make distributions in the beneficiary’s best interest. This trustee discretionary power of money management can help a well-funded trust survive for generations.

You can also write a letter of wishes or provide a statement of intent to your children. Though these are not legally binding, it gives you a platform to remind them of family values and your desire for these values to be maintained for future family generations. This type of letter is an opportunity for you to convey your vision for how your wealth can bring growth and chance for fulfillment to beneficiaries.

Prosperity should positively shape lives. Family trust beneficiaries hopefully already have a self-driven life that includes purpose, responsible behavior, and a basic understanding of personal finance. If you worry your children may squander inheritable assets, create the opportunity for them to succeed through classes that teach them about managing legacy family values and wealth. Address your concerns legally and directly through a detailed trust that can help but not overly constrain them to achieve what you envision they can become. Start an honest conversation early on, but remember it is never too late to make good choices and create positive family value influences for the coming generations. A well-known Ann Landers quote sums it up neatly, “In the final analysis it is not what you do for your children but what you have taught them to do for themselves that will make them successful human beings” – a worthy goal of any family value system.

If you are interested in establishing a trust to pass wealth on to your children, we can help. We can also guide families on how to pass on family values in a meaningful way.

If you have questions or need guidance in your planning or planning for a loved one, please do not hesitate to contact our Norman, Oklahoma office by calling us at (405) 241-5994.

Dementia Care Evolving in Facilities

The National Institute of Health (NIH) Library of Medicine reports the most common form of dementia is Alzheimer’s disease, accounting for approximately two-thirds of all diagnosed cases of dementia. Alzheimer’s is also one of the most expensive diseases to treat and often results in financial strain on families trying to find and pay for the best care. In the past, care in facilities often resulted in Alzheimer’s patients being separated from others. However, as you’ll read below, facilities are now exploring better ways to treat Alzheimer’s patients while living in a facility.

Medical breakthroughs that increase our understanding of how to best treat and introduce disease modification therapies for people living with Alzheimer’s and other neurodegenerative diseases provides future hope. However, according to the Alzheimer’s Association, there are already more than 5.8 million Americans living with Alzheimer’s disease. These individuals may not live long enough to benefit from new therapy discoveries since new treatments must undergo rigorous testing and clinical trial phases. Current projections indicate that unless some of these medical breakthroughs have practical applications very soon, more than 14 million Americans will be clinically diagnosed to be living with Alzheimer’s by 2050, with many more struggling in the long-preclinical phase of the disease.

As senior living facilities become more saturated with dementia patients in all stages of progression, there is a shift underway towards non-segregated memory care living. Alzheimer’s patient reintegration into general senior living residence status is shifting dementia care into a human-centric model. It provides insights and lessons into eldercare facility living, its providers and staff, family members of residents, and all of the patients, not just memory care patients. This human-based approach is a kinder, more medically practical and appropriate, and in the long term, a more cost-effective method for facility residents who have dementia.

Before there were outcome-based clinical research findings to support the segregating of dementia patients care facilities began creating stand-alone memory care units, floors, and facilities.  Families knew their loved ones were safely locked away in a highly monitored unit, and staff could focus their training and efforts in a more specified range of care. Because this isolation model became overwhelmingly profitable for business operators, it became the de facto standard of memory care operation. Profits were trumping the human condition. At the outset, it seemed rational enough to put like-patients together, yet because everyone’s memory disease progression is unique, the concept was flawed. Living circumstances for humans is an emotional experience, and the sad outcome for assembled memory care patients was faster disease progression in their isolated, shrinking worlds. This accelerated mental decline was partially due to the lack of broader social and emotional connection with non-dementia residents. It seems integrating patients of all types and generations enriches and expands what residents can do, creating a diverse human model focusing on the positive aspects of life and personal interaction.

Some of the conditions all aging adults share, not just those living with dementia, include difficulty hearing and seeing, finding mental focus more demanding, becoming more concerned about being in large crowds, and noises that increase their stress levels. For a community of residents, no matter what the patient illness, facilities can create an atmosphere that addresses these common concerns. These shared needs include not only medical care but activities that are available in a 24-hour cycle and the encouragement of socialization in smaller, quieter circles. Interactions among residents in this calming style of environment tend to create friendships organically and provide enriching connections among patients irrespective of their illness type. The overall common conditions of aging require sameness in approach, no matter how varied the residents’ medical conditions are.

Technology that allows for digital wrist monitoring of patient location and vital signs permits ease of monitoring residents, particularly as they wander their living space.  Even the proper lighting, carpeting, and circular hallway architecture reassure residents’ feelings of safety, comfort, and familiarity, which appeals to all, regardless of diagnosis. When an entire senior living facility is dementia friendly, and all staff is trained in memory illness and care, every employee can add value to a resident’s enjoyment of life from the medical professionals to the social workers to the landscapers.

A diagnosis of Alzheimer’s can strike fear and worry in America’s aging population because of the emotional, physical, and financial upheaval associated with it. An older person might recognize the onset of some memory problems and become terrified, thinking about Alzheimer’s and the possibility of being relocated from their home and community to a dementia unit. There is a sense of dread that you may never feel seen, heard, and loved again by other people. Interpersonal relationships and connectedness are a hallmark of the aging communities in America. AARP reports large percentages of technology use in older Americans is related to interpersonal connections like email, viewing photos of family and friends, and using social media and the internet. Even in digital spaces and experiences, elderly community residents are looking to create personal networks, connecting to the world at large. The human spirit inclines to be expansive.

Appropriate social and physical environments play a significant role in healthy aging. Compartmentalizing memory care patients into homogeneous units will increase their memory decline, isolate their human connection, and spiral the patient into an ever-shrinking world of interaction, often making them non-verbal. Alzheimer’s patients who experience higher levels of social integration respond conversely, expanding their horizons as they experience and feel the extension of human love and support. There is no one set of symptoms for Alzheimer’s patients, and all patients are on their own trajectory of the disease. Mistakenly putting them together in a one size fits all approach of care has been a disservice to their health and well being and to the future care of others who will become afflicted with Alzheimer’s. The memory care model is shifting for the better and not a moment too soon.

If you have questions or need guidance in your planning or planning for a loved one, please do not hesitate to contact our Norman, Oklahoma office by calling us at (405) 241-5994.

The Various Ways to Hold Title to Property

For many people, real property, including their home, is a big part of their overall net worth.  How the home and other pieces of real property is titled deserves careful consideration. Real estate constitutes the land and any structure, including vegetation, livestock, crops, and other natural resources that sit on the land under the state’s law. Real estate can be commercial or residentially owned. Ultimately how you hold a property title has far-reaching consequences for liability, and when it comes time for sale or the bequeathing of it as an inheritable asset.

The title is a reference to the document that lists the legal owner(s) of a piece of property and can depict ownership of both personal and real property. Real estate titles are regarded as real property as it is a tangible asset. The title for real property, by law, must be transferred if the asset is sold or inherited and must be clear for the title transfer to take place. A clear title is free of liens or any other encumbrance posing a threat to proper ownership. The most common types of real estate titles are joint tenancy, tenancy in common, tenants by the entirety, sole ownership, and community property. Less common property ownership titles are corporate, partnership, and trust ownership.

Individual name or sole ownership allows for a single person to hold title, even if you are married. If the person becomes mentally or physically incapacitated due to injury or illness, a spouse or family member typically will need to conduct business with regards to your property. Your family member will not be able to do business transactions like refinancing or changing lines of credit, and they will be unable to act until a court appoints someone to act on your behalf. Many people assume if they have a will it will address the problem, yet a will does not go into effect until after you die and is not in effect if you become incapacitated.

Joint tenants (some may have rights of survivorship) occur when two or more people hold the title to real estate jointly. This type of title is widespread among but not exclusive to married couples. Unmarried couples may also hold joint tenant title as can parents and their adult children. It is a fair, uncomplicated, and free way to hold the title. In the case of a couple, the death of one automatically transfers full ownership to the surviving owner without probate. However, probate is more than likely just to be postponed. In the event the surviving owner dies without adding another owner, or if both owners die at the same time, probate is almost certain to occur before the property can go to the heirs.

Being a co-owner means that to sell, refinance, or take any action to the property, both owners must agree to the business action. If there is disagreement or in the event your co-owner becomes incapacitated, the court will become involved to resolve the disagreement or to protect the interest of the one who has become incapacitated. Court involvement will occur even in the event the incapacitated owner is your spouse. Joint tenants also expose the property to both of the co-owners obligations and debts. If a creditor successfully sues your co-owner, you could lose your home. In the case a co-owner is not a spouse, there can be income tax or gift tax problems. A will does not control any jointly owned assets, and you may mistakenly disinherit your family when your co-owner inherits your share, particularly in the case of second marriages with children from a previous union.

Tenants in common (TIC) allows for two or more people to hold title to real estate with equal rights during their lifetime to enjoy the property. A tenant in common title creates shares of ownership, and those shares will be distributed as directed in a will upon an owner’s death. In the absence of a will, the property goes to the heirs of the owner. As a tenant in common individually holds title for a respective part of the property, they are at liberty to dispose of said owned property or encumber it at will. Owners of their respective shares are permitted to use their portion of the property as collateral or in financial transactions. They may also be sued or have creditors place liens on only their portion of the property.

Tenants by entirety (TBE) are only permissible if the owners are legally married. This title, for purposes of ownership, treats the couple as one person for legal action and interpretation. Upon the death of one person, the TBE title is transferred in its entirety to the other spouse. This is advantageous as no legal action is necessary upon the death of one’s spouse. It does not require a will and probate is unnecessary.

Community property is only in effect in nine states (AZ, CA, ID, LA, NV, NM, TX, WA, and WI) and is a form of joint ownership between spouses commonly referred to as community property. When you die, your share of the community property is automatically transferred to your surviving spouse unless your will provides otherwise. Both tenants, by the entirety and community property titles, can find the remaining owner with several new co-owners, who, upon their death, can have their heirs inherit the property. Also, issues of incapacity and lawsuits are magnified if several property owners are trying to reach a consensus about the sale of the property or other business actions.

Corporate ownership allows a legal entity, a company owned by shareholders, to hold title to property. Partnership Owners can own real estate as a partnership. This title constitutes two or more people who transact business for profit as co-owners. There are also limited partnerships where an investor has limited liability because they do not make management decisions regarding business transactions of the property. In the case of limited liability, a singular general partner will typically be responsible for making business decisions on behalf of the identified limited partners.

Trust ownership, most often in the format of a revocable living trust, is a legal entity that owns the real property, which is managed by a founding or designated trustee on behalf of all trust beneficiaries. In the event you become incapacitated, your named successor trustee can seamlessly take control of your trust without court interference. A successor trustee is legally obligated to follow the instructions put forth in your trust. If you recover from incapacitation, you resume control of your trust. If you were to die, the property would be distributed according to your trust instructions and without probate. Holding real estate in trust ownership has challenges regarding benefits that surround financial and legal liability, managerial influence, and tax considerations. A real estate trust document can provide significant advantages to property owners but only if created by competent legal staff who take into account the complexities surrounding the trust and its interaction with the liabilities listed.

Methods of holding and owning title to real estate property are determined by state law and, as such, must be considered when researching and determining the best method to acquire and hold title to real property where you live. Depending on the complexity of your situation, assessing the best way to title your real estate may require professional real estate, legal and tax guidance.  We help clients determine the best way to hold title to property, and whether a trust would be beneficial.

If you have questions or need guidance in your planning or planning for a loved one, please do not hesitate to contact our Norman, Oklahoma office by calling us at (405) 241-5994.

The Future of Social Security and Medicare

According to the American Association for Retired Persons (AARP), every single day 10,000 baby boomers are turning 65 years old. The deluge of aging Americans and the increase in longevity in the already 65 plus population are the main reasons why the Social Security and Medicare programs are expected to have financial insolvency issues in the coming decades. Unsurprisingly, the vast majority of baby boomers agree that it is critical to preserve Social Security benefits even if it requires an increase in taxes paid into the system by working Americans. Payroll taxes by far account for the majority of monies available to pay for social security benefits.

The boomer generation is keen to preserve social security benefits as many of them are not well prepared for retirement. The financial retirement picture for nearly half of the younger boomers (ages 55 – 64) is bleak with reportedly no retirement savings at all. The US government is also unprepared to sustain full benefit payments. By the Social Security Administration’s admission in 2034, the program will run out of reserves at which time benefits would have to be reduced by 25% unless the government can fix the program’s long-term funding shortfall.

This same group of unprepared boomers also appears to have uncertainty as to how much of their income health care costs are projected to absorb. Health View Services states “HealthView Services’ Retirement Healthcare Cost Index, which calculates the percentage of Social Security benefits required to address total lifetime retirement healthcare expenses, reveals the impact of expected healthcare costs on retirement budgets. The index shows a healthy 66-year-old couple retiring today will need 48% of their lifetime Social Security benefits to address total lifetime healthcare expenses.” Additionally, about half of baby boomers believe Medicare will cover the cost of long-term care, but that is not the case.

How federal government institutions face the challenge of covering the costs of social insurances like Social Security benefits and Medicare costs to a burgeoning boomer population will determine whether many citizens will be able to age successfully.  Beyond the more significant problem of funding these social programs, the government is looking to technology to cut costs for senior care. Virtual assisted living that can help families care for older adults and smart devices appear to be some of the technological saviors for the American baby boomer population.

Joseph Coughlin, Ph.D., director of the MIT AgeLab in Cambridge, MA, and others testify before the Senate Special Committee on Aging as debate about policy and program funding for American seniors can no longer be put off. Coughlin recommends that virtual reality (VR) become a standard device among senior living communities, assisted living and nursing homes. Not only did residents engaging with VR have fun, but there is also less depression and more engagement in active conversations with other residents as a by-product of the technology.

Other technologies on display include smartphone apps with health functions, smart glasses that can help prevent accidental falls for seniors with limited eyesight, and a pen that can help people with reduced vision identify items. Using these and other tech devices can create a better aging experience and reduce the need for hospitalization for many seniors. Technology provides a net benefit for programs like Medicare that routinely pay for hospitalization costs that include injuries due to falling, reactions from incorrect prescription dosages, and other emergent care needs that can be avoided with practical technology applications.

While no one can discount the importance of funding social programs that benefit aging Americans, applications of specific technologies for seniors can reduce overall costs associated with the baby boomer generation. As the federal government begins to tackle the issues at hand for seniors, there is a lesson to be learned. Putting off planning for or relying on some other entity to solve retirement and health care issues is a dangerous proposition.

If you have questions or need guidance in your planning or planning for a loved one, please do not hesitate to contact our Norman, Oklahoma office by calling us at (405) 241-5994.

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