When Others Can Be Our Guide For Caring

Caretaking for a suffering spouse and transitioning into a nursing home

When Others Can Be Our Guide For Caring For our Loved Ones

When someone comes into our offices after caring for a loved one with declining health, often they have been a caretaker for a long time. It is not uncommon for these clients to have drained many of their own resources, whether those be personal or financial. They may have been caring for their spouse in their home and realized it was no longer a safe environment, or the daily medical assistance needed to provide a safe home may be too overwhelming to administer. Either way, when the well-spouse begins considering moving their suffering partner into a nursing home, they often start with the resources around them, whether it be close family members or others in the community.

Over the last few months, we have had the pleasure of working with a family who came to us after consulting with one of their closest friends. These two men have lived in the same neighborhood together for several years and had taken counsel with one another through good, bad and challenging times. Both were caring for their wives, while contemplating transitioning them into a nursing home. While being so occupied by caring for their wives, they hadn’t been able to keep in touch like they had just a few years before. So, when one friend told the other he had recently transitioned his wife to a nursing home, the other confided in him that he too, was contemplating making the same difficult decision.

I’m sure many personal stories were shared between these two longtime friends. I’m confident these discussions helped them cope and endure their mutual circumstances. That’s what friends and neighbors are for. One of the stories shared with us about their conversations, was the referral of a book called the Complete Guide to Caring for Aging Loved Ones. Authored by Robert Riekse of Focus on the Family, this book provides advice for caregiving loved ones and for those transitioning another into a nursing home. Here is a summary from Amazon, “Whether you’re preparing for the responsibility or are in the midst of caring for an elderly loved one, this complete guide from Focus on the Family provides the practical information you need―and a spiritual and emotional lifeline. Topics include burnout; physical, emotional, and mental changes in aging; medical, financial, and legal help; elder abuse; choosing a care facility; and end-of-life decisions. Caregivers will also learn what the Bible says about caregiving and the keys to effectively fulfilling that role. True stories throughout the guide share common concerns and a sense of support from those who have been there.”

I understand the challenges of taking care of our loved ones with declining health cannot simply be answered with a book. However, it is important that we are willing to accept help from others and look out for resources in our communities that are there to assist us with our caregiving. I do not receive any financial benefit from recommending this book, and it is just one of dozens of great editorial resources available. However, I can say that it has assisted a least two clients in the last year while they managed caring for their loved ones in the home, and while transitioning them into nursing homes.  This story most importantly highlights the importance of reaching out to others in our lives for advice and help.

If you feel like you have reached the limit of your own resources or are just simply looking for advice on what steps you should take next to care for someone you love, please feel free to contact us at (913) 491-6332, visit our website berger-lawfirm.com or stop by our conveniently located offices at 11233 Nall, Suite 140 Leawood, KS 66211 for more information.​ Berger Estate & Elder Law P.A. has been finding solutions throughout Kansas City for over 30 years providing Trusted Counsel with Proactive Solutions for many. We’ve been helping individuals plan, navigate and overcome the challenges of caretaking and life’s transitions for over 30 years. Give us a call today!


TOD, POD, Beneficiary, What’s that All About?

Transfer on death, Paid on death, account beneficiaries

Transfer on Death, Payable on Death, Account Beneficiaries, Make Sure Your Will or Trust is in Alignment.

Many bank and investments accounts, as well as real estate, have joint owners who take ownership automatically at the death of the primary owner. Other banks and investment companies offer payable on death accounts that permit owners to name the person or people who will receive them when the owners die. Life insurance, of course, permits the owner to name beneficiaries.

All of these types of ownership and beneficiary designations permit these accounts and types of property to avoid probate, meaning that they will not be governed by the terms of a will. When taking advantage of these simplified procedures, owners need to be sure that the decisions they make are consistent with their overall estate planning. It’s not unusual for a will to direct that an estate be equally divided among the decedent’s children, but to find that because of joint accounts or beneficiary designations the estate is distributed totally unequally, or even to non-family members, such as new boyfriends/girlfriends, late-in-life friends or neighbors.

It’s also important to review beneficiary designations every few years to make sure that they are still correct. An out-of-date designation may leave property to an ex-spouse, to ex-girlfriends or ex-boyfriends, and to people who died before the owner. All of these can thoroughly undermine an estate plan and leave a legacy of resentment that most people would prefer to avoid.

These concerns are heightened when dealing with retirement plans, whether IRAs or 401(k) plans, because the choice of beneficiary can have significant tax implications. These types of retirement plans benefit from deferred taxation in that the income deposited into them as well as the earnings on the investments are not taxed until the funds are withdrawn. In addition, owners may withdraw funds based more or less on their life expectancy, so the younger the owner the smaller the annual required distribution.  Further, in most cases, withdrawals do not have to begin until after the owner reaches age 70 1/2. However, this is not always the case for inherited IRAs.

Following are some of the rules and concerns when designating retirement account beneficiaries:

  • Name your spouse, usually. Surviving husbands and wives may roll over retirement plans inherited from their spouses into their own plans. This means that they can defer withdrawals until after they reach age 70 1/2 and take minimum distributions based on their age. Non-spouses of retirement plans must begin taking distributions immediately, but they can base them on their own presumably younger ages.
  • But not always. There are a few reasons you might not want to name your spouse, including the following:
    • He or she is incapacitated and can’t manage the account
    • Doing so would add to his or her taxable estate
    • You are in a second marriage and want the investments to benefit your first family
    • Your children need the money more than your spouse
  • Consider a trust. In a number of the above circumstances, a trust can solve the problem, providing for management in the case of an incapacitated spouse, permitting assets to benefit a surviving spouse while being preserved for the next generation, and providing estate tax planning opportunities. Those in first marriages may want to name their spouse as the primary beneficiary and a trust as the secondary, or contingent, beneficiary. This permits the surviving spouse, or spouse’s agent if the spouse is incapacitated, to refuse some or all of the inheritance through a “disclaimer” so it will pass to the trust.
  • But check the trust. Most trusts are not designed to accept retirement fund assets. If they are missing key provisions, they might not be treated as “designated beneficiaries” for retirement plan purposes. In such cases, rather than being able to stretch out distributions during the beneficiary’s lifetime, the IRA or 401(k) will have to be liquidated within five years of the decedent’s death, resulting in accelerated taxation.
  • Be careful with charities. While there are some tax benefits to naming charities as beneficiaries of retirement plans, if a charity is a partial beneficiary of an account or of a trust, the other beneficiaries may not be able to stretch the distributions during their life expectancies and will have to withdraw the funds and pay the taxes within five years of the owner’s death. One solution is to dedicate some retirement plans exclusively to charities and others to family members.
  • Consider special needs planning. It can be unfortunate if retirement plans pass to individuals with special needs who cannot manage the accounts or who may lose vital public benefits as a result of receiving the funds. This can be resolved by naming a special needs trust as the beneficiary of the funds, although this gets a bit more complicated than most trusts designed to receive retirement funds. Another alternative is not to name the individual with special needs or his trust as beneficiary, but to make up the difference with other assets of the estate or through life insurance.
  • Keep copies of your beneficiary designation forms. Don’t count on your retirement plan administrator to maintain records of your beneficiary designations, especially if the plan is connected with a company you worked for in the past, which may or may not still exist upon your death. Keep copies of all of your forms and provide your estate planning attorney with a copy to keep with your estate plan.
  • But name beneficiaries! The biggest mistake many people make is not to name beneficiaries at all, or they end up in this position by not updating their plan after the originally-named beneficiary passes away. This means that the plan will have to go through probate at some expense and delay and that the funds will have to be withdrawn and taxes paid within five years of the owner’s death.

In short, while wills are important, in large part because they name a personal representative to take charge of your estate and they name guardians for minor children, they are only a small part of the picture. A comprehensive plan needs to include consideration of beneficiary designations, especially those for retirement plans.

If you want to ensure that you make the right decisions for your own family when considering beneficiary designations and titling your most important financial assets, contact us at (913) 491-6332, visit our website berger-lawfirm.com or stop by our conveniently located offices at 11233 Nall, Suite 140 Leawood, KS 66211 for more information.​ Berger Estate & Elder Law P.A. has been getting results for over 30 years, providing our clients with Trusted Counsel and Proactive Solutions.


6-Steps for Transitioning A Loved One into a Nursing Home

6-steps to help transition a loved one to a nursing home, but I will make an extra mention of step-3, which has been a revelation to me over time, and that is to make sure to stay with your loved one on moving day and overnight if all involved think best.

Most of what I remember about my grandfather are his days living with Alzheimer’s. As a physical training instructor in the military during WWII and instrumental in developing training materials during the war at Fort Riley, he would often display his callisthenic programs in front of others, long after his time of service. Besides these memorable moments at family outings, I also remember him disappearing during the day, ironically often being found at Dairy Queen or strolling the side walk between the DQ and his home with an ice-cream cone in one hand and not a care in the world in the other. I’ll always wonder if this was just his guise, because the ice-cream “issues” come to find out are genetic.

As time went on, even with all hands-on-deck, including my mother, two aunts and uncle, eventually they had to make a difficult decision, a decision many of us already have had or will face. Fortunately, for my family, there was only one option for nursing home care at the time in their small town in western Kansas. This saved them from a lot of emotional decision making and tough discussions.

But, while this made the decision of where easier, it didn’t make the transition any less challenging for our family. As an elder law and estate planning firm, our team spends a lot of time discussing the transition process with clients. We discuss the best options for where and how to make this transition. Throughout these discussions, it is easier to unpack the process if where to transition to and how to make the transition are split into two different conversations. Much of the time, I’ve noticed families spend adequate time on discussing the where, while being surprised in the moment how much time (and emotion) it takes to handle the how.

Many steps can assist in successfully accomplishing these processes and here we will discuss 6-steps to help transition a loved one into a nursing home. Carolyn Rosenblatt, of AgingParents.com has also created a list that was published in Forbes magazine and this is also a valuable guide in helping with the transitioning process.

The first step in the transition process is to have a meeting or care conference, as it is often coined by care communities. Many are not aware of this, but almost all nursing home communities include this as part of their standard intake process. Not being aware of this step, many families unwittingly include it later in the process than they should, but conducting one from the start is the best option. Care communities are very knowledgeable about the transitioning process and will assist in many ways you may not be aware of that can alleviate much of the burden. Make sure you don’t miss out on all the contacts and resources others have to offer.

During your care conference, deciding the type or “types” of care is the primary goal. Knowing this will assist in deciding a move-in date, because availability and care will have to be scheduled for your chosen community, and levels of care. Having a move-in date is the final part of the first step, because this isn’t just a date; it is your deadline for all the planning that will go into making the transition. This is your marker for crossing over the line from your loved one living at home and moving him or her into a nursing home. This establishes a clear timeline for accomplishing the many tasks that will have to get done to make the transition complete.

Some of these decisions include: How do we move our loved one? What do we do with years of collected and often precious belongings? Do we sell the house? These decisions and accomplishing them takes time and are all things an elder law or nursing home are experienced with and more than willing to help with.
It is also important to include in these discussions your family doctor, the transitioning staff, and RN on staff at the nursing home. They will be able to establish a summary of what is recommended to further care for your loved one in a nursing home and develop a care plan with a list of all their required medications that need to be taken from day one.

After this, don’t forget to follow-up with all involved, including the front desk, care takers at the community and possibly your current one at home. Talk with the nurse on staff and double-check your medication and care list for overlooked or additional items that may have been forgotten. Add as much detail as possible to your care list and make sure to communicate your loved one’s preferences. Anything you can communicate is helpful, so the community will know your loved one more before moving in the better.

To condense this discussion, I will go on to list a summary of the 6-steps to help transition a loved one to a nursing home, but I will make an extra mention of step-3, which has been a revelation to me over time, and that is to make sure to stay with your loved one on moving day and overnight if all involved think best.

1.       Set up a meeting and get recommendations from your community of choice for the best care options. Meet them in person with all loved ones. They are experts in this field and can often and are very willing to help with more than you may know. Listen to their and your elder law attorney’s recommendations and allow others to assist you in making the best decisions possible for your loved one. Having help with these decisions will allow you to choose the best date to move.

2.       Make a list of recommendations and medications. This list will allow community health care and housing staff to know your loved one before moving in. Medication is often not overlooked, but also, I have found is not emphasized enough. Double, even triple check that the community has the appropriate medications and that your loved one is getting them according to their medication schedule day one.

3.       Be with your loved one on moving day. Transitioning is stressful and confusing for anyone at any age or stage of life, and if someone close to your loved one is there throughout the process it will make the transition easier.  Even consider staying there overnight if thought best.

4.       Follow up with the community. You are your loved ones biggest and most important advocate, and any community knows this. Rely on the community to take care of your concerns. They are not only there for their residents, but they are there for their residents loved one’s. Take advantage of this and their unbound knowledge and willingness to help.

5.       Provide the community with a list of your loved one’s preferences, needs and desires. No-one knows your loved one better than you. Help the community know them as well. They will love having this (or these) conversations. It’s their passion. It’s their profession.

6.       Recognize that nursing homes may be the safest environment for your loved one, but nothing is full proof. Make sure to monitor your loved one’s care, mental and physical health on a regular basis. Communicate, communicate, communicate. If you and the community are all partnering to take care of your loved one, not only will the transition be a success, but their new home will be as well.

Berger Estate & Elder Law P.A. has been finding solutions throughout Kansas City for over 30 years providing Trusted Counsel with Proactive Solutions for many. We’ve been helping individuals plan, navigate and conquer the challenges of caretaking and life’s transitions for over 30 years. Give us a call today at (913) 491-6332, visit our website berger-lawfirm.com or stop by our conveniently located offices at 11233 Nall, Suite 140 Leawood, KS 66211 for more information.

Stretcher Bearers Could Save You From Disaster

Over the years we’ve had our fair share of difficult situations to handle, especially for adult children and well-spouse caretakers. These often have a wide array of challenges, that one can only imagine working in elder law for over 30 years. The most difficult challenge of all is seeing families struggle through difficult times. Our responsibility in these situations is to help guide others through their circumstances and provide them with the best options to remedy their situation.

But as the saying goes, “what has been done can’t be undone,” and this is often the feeling someone has when a another accuses them of neglect and abuse.  Thankfully, we have been able to help clients that have been falsely accused in these situations, but often these issues can be better managed if handled differently early on.

For first time caregivers, and especially those caring for someone they love, it is often easy to take on too much. This can lead to feelings of resentment and regret, and questions of “what if?” can start to settle in. This may damage loving relationships and leave one susceptible to malicious accusations by financial institutions, social workers, caregivers, extended/out-of-town family members and outsiders that aren’t as involved in the care taking responsibilities as the person taking on the majority of these tasks.    

The timeline of the story often goes in stages, but the stages are reoccurring for many spousal and adult-child caretakers. The worst-case scenario is one we see all too often and that is one that includes a caretaker being accused of neglect or abuse. Often, when someone is diagnosed with some form of dementia, a loved one, like a well-spouse or adult-child will step in and try to be the best caretaker they can be. Reasonably, this is thought to be the best option, as they are the closest and most knowledgeable person in the room about the day-to-day ailments of the sufferer. Additionally, they have more invested emotionally and physically than anyone. They are willing to go above and beyond in their care, literally doing whatever it takes to help their suffering spouse or parent.

The pitfalls of caregiving are well documented, but possibly the biggest is when you try to take too much on our own. The exact time, when too much is too much, is hard to recognize and that is why it is helpful to be in constant communication with others. Many delay asking for help for numerous reasons, but the one we see most is guilt. The guilt of asking for help, the guilt of blaming yourself for the situation and the guilt of not being able to handle it all on your own. But, this shouldn’t be the case and this reasoning is usually unjustified and simply not true. Dementia is no one’s fault and calling out other stretcher-bearers to help carry the burden, as soon as possible is often the right thing to do.

Two suggestions we continually make to clients under these circumstances are: (1) bring on more than one stretcher bearer. These could be friends, neighbors, care-givers, your church community, or social workers etc., or (2) consider a nursing facility and don’t feel guilty about it. These recommendations may sound simple, but they are often ignored and unheeded.

Ask for help before it’s too late. Too many times we’ve been contacted by a well-spouse or adult child after a third-party institution or organization has reported them for neglect or abuse. These cases are often concocted stories from third-party sources, that care more about protecting themselves than the individuals involved. Others, often blame the well-spouse or adult child for anything and everything that happens to the individual suffering from dementia, because they may be insecure of their own involvement with the situation. Having multiple stretcher bearers, with different experiences and perspectives offers families more lines of communication and observation. This not only relieves some of the pressure from caretaking, but provides a diverse system of checks and balances. In a way, it is doing your due diligence.

Unfortunately, the legal system has seen its fair share of exaggerated elder abuse and neglect claims, however with the right counsel, protecting yourself from these claims is possible. Not to belittle these cases or portray them all as being unwarranted, as many aren’t, but unfortunately, we live in a society where everyone wants to try to blame somebody else, even when there is no one to blame.  As the saying goes, “no good deed goes unpunished.” 

Berger Estate & Elder Law P.A. has been finding solutions throughout Kansas City for over 30 years providing Trusted Counsel with Proactive Solutions for many. We’ve been helping individuals plan, navigate and conquer the challenges of caretaking for over 30 years. Give us a call today at (913) 491-6332, visit our website berger-lawfirm.com or stop by our conveniently located offices at 11233 Nall, Suite 140 Leawood, KS 66211 for more information.

Un-Funded Trusts

Many of the people we meet with have made the decision to set up a revocable living trust (RLT). This probably isn’t surprising, given we are estate & elder law attorneys, but what is surprising, is the number of times we hear individuals or couples have established a trust and NEVER got around to funding it, they are disappointed and feel misled by their previous representation and are coming to us for help.

One possible reason for this is that it can be a time-consuming process. But, most of the time it is because clients were under the impression that funding was almost complete at the time of signing a trust or that the attorney hired to establish the trust was going to do it afterwards.

RLT’s go by several different names. Over the last few years, it seems every law firm has branded their own term that fits their own clientele. This is good marketing, but often confuses clients into thinking they are getting an entirely different product. Some names I’ve recently come across were Legacy Trust, Wealth Preservation Trust, Estate Trust, and the list goes on. Rest assured, these products all “basically” can do the same things, customized to a specific client’s situation. Some of the benefits of RLT include the ability to continuously control assets during and after your lifetime, provide for children of any age, avoid the costs, publicity and burdensome process of probate proceedings, and limit your federal tax burden. However, with increases in the Federal Estate Tax Exemption, tax planning has become less of a focus.

It’s important to know that none of these benefits will be realized if the trust is never funded. This is especially unfortunate since the concept of funding is fairly simple. Funding includes changing the names on assets such as financial statements or the title to a house or car, to the name of your trust. It also entails changing beneficiaries on financial accounts and other non-title assets to the trust. Title, insurance and financial organizations can be helpful in assisting their clients with these changes, but after someone dies, they often can be difficult to work with, frequently going beyond their own legal requirements to make these changes for their customers. As the saying goes, they love taking your money, but when it comes to giving it back, “good luck.”

Many Estate planning attorneys that write RLTs for their clients do not fund trusts after they are executed and if they do, charge additional fees. This is because the time involved funding trusts is unpredictable, as institutions have different requirements, and these requirements seem to change daily, depending on who you talk to on a given day.

Setting up an unfunded trust is like buying a car, and not putting any gas in it. Before discussing a trust, make sure you check to see if the tank is full. Make sure you’re able to get where you want to go when it counts. Many attorneys will talk about the wonderful features of a trust, but never put anything in it, that will help you do what you thought you had planned for it to do.  

Berger Estate & Elder Law P.A. has been finding solutions throughout Kansas City for over 30 years providing Trusted Counsel with Proactive Solutions for many. We’ve been helping our clients establish trusts tailored for their desires and needs and being upfront about trust funding, doing it for you or helping you every step along the way. Give us a call today at (913) 491-6332, visit our website berger-lawfirm.com or stop by our conveniently located offices at 11233 Nall, Suite 140 Leawood, KS 66211 for more information.

New Medicare Cards are Coming

Medicare Card, Jesse kalin BrownThe federal government is issuing new Medicare cards to all Medicare beneficiaries. To prevent fraud and fight identity theft, new cards will no longer have the beneficiaries’ Social Security numbers on them.

Centers for Medicare and Medicaid Services (CMS) is replacing each beneficiary’s Social Security number with a unique identification number, called a Medicare Beneficiary Identifier (MBI). Each MBI will consist of a combination of 11 randomly generated numbers and upper-case letters. The characters are “non-intelligent,” which means they don’t have any hidden or special meaning. The MBI is confidential like the Social Security number and should be kept similarly private.

The CMS will begin mailing the cards in April 2018 in phases based on the state the beneficiary lives in. The new cards should be completely distributed by April 2019. If your mailing address is not up to date, call 800-772-1213, visit www.ssa.gov, or go to a local Social Security office to update it.

The changeover is attracting scammers who are using the introduction of the new cards as a fresh opportunity to separate Medicare beneficiaries from their money. According to Kaiser Health News, the scams to look out for include phone calls with callers:

  • Claiming to be from Medicare looking for your direct deposit number and using the new cards as an excuse
  • Asking for your Social Security number to verify information
  • Claiming Medicare recipients need to pay money to receive a temporary card
  • Threatening to cancel your insurance if you don’t give out your card number

There is no cost for the new cards. It is important to know that Medicare will never call, email or visit you unless you ask them to, nor will they ask you for money or for your Medicare number. If you receive any calls that seem suspicious, don’t give out any personal information and hang up. You should call 1-800-MEDICARE to report the activity or you can contact your local Senior Medicare Patrol (SMP). To contact your SMP, call 877-808-2468 or visit www.smpresource.org.

 Berger Estate & Elder Law P.A. has been finding solutions throughout Kansas City for over 30 years providing Trusted Counsel with Proactive Solutions for many. Give us a call today at (913) 491-6332, visit our website berger-lawfirm.com or stop by our conveniently located offices at 11233 Nall, Suite 140 Leawood, KS 66211 for more information.

Whatever Happened to Counter Service

counter service, jesse kalin brown

Recently, I had a conversation with a client about his wife being in memory care. “Joe”, who recently went through the Medicaid process with our firm, has meals a few times a week with his wife. They regularly eat at the community where she lives in Olathe, Kansas. During this conversation and while eating the incredible German chocolate cupcakes he brought in, Joe commented that he still enjoys eating out at local restaurants. Being able to qualify for senior discounts for quite some time, Joe and his wife used to make a hobby of searching out weekly specials and discounts. He says that, if you hit the right specials at the right times, you can eat cheaper going out than staying at home. Of course, if you don’t order drinks he says. Now this is a theory I’m interested in trying.
Since living apart from his wife, Joe commented how much he misses going out to eat in the company of his wife. Despite this, he said he still enjoys going out, albeit by himself most days and Joe still makes the weekly rounds hitting some of the best specials in town. Joe says its just not the same without someone else to sit with and talk to, but did comment that having his iPad to read or “act” like he’s reading makes feeling comfortable easier. Funny, I think we’re all guilty of that.
This conversation reminded me of an old hometown favorite restaurant, Tippin’s. For those living in Kansas City for some time, you’d remember that, back then, they not only had a lot of great pies, but a few restaurants too. I remember eating at their Metcalf location on a regular basis with Sue, she would order the French Silk and my favorite Pecan. We always enjoyed the food and old-time courtesies of dining back then.
One thing Tippin’s restaurants had at every location was counter service. One could always count on at least a few single souls, mostly seniors, reading the paper or chatting with others at the counter, with attached swivel chairs. This was a staple of their ambiance, and card games could also be found being played in the back midday. Should we start a bring back Tippin’s restaurants campaign or what?
Other iconic Kansas City restaurants with counter service that are still around are Winstead’s, Town Topic, and Pegah’s (which has a location in what used to be Sterns, if you’re up to speed on all things Old Shawnee and an old IHOP, both of which had large counter service areas). For some time now, Town Topic has been quite the hot spot for millennials and hipsters, making it less desirable for some seniors, but quite an interesting development in the possibilities of counter service making a comeback. Franchises like IHOP, Denny’s, Perkins, Shoney’s and Waffle House were all once known for their counter service, but these restaurants are either losing locations or updating with limited counter service or none at all.
How about you? Do you miss the old counter service style of restaurants? Wish they would bring it back? Or know of any secret gems around KC that Joe or other seniors around town would enjoy? Let us know in the comments below and we’ll be sure to share them with our clients.

Berger Estate & Elder Law P.A. has been finding solutions throughout Kansas City for over 30 years providing Trusted Counsel with Proactive Solutions for many. Give us a call today at (913) 491-6332, visit our website berger-lawfirm.com or stop by our conveniently located offices at 11233 Nall, Suite 140 Leawood, KS 66211 for more information.