Archive for the ‘Learning Center’ Category
What is Guardianship?
Guardianship refers to the authority granted to a person by the Court to take care of a disabled person’s person and / or property. If a family member or someone in need is unable to manage his or her affairs due to frailty, long-term illness, disability or mental incompetency, you can petition the court for guardianship.
A person is deemed to be competent unless a court has determined otherwise. Before making a decision, the court appoints an attorney to represent the interests of the alleged disabled person, and that attorney provides the court with a written report. The alleged disabled person’s assets and income needs to be reported to the court, and there are strict rules governing the management and accounting of the assets of the guardianship estate.
The court may, but is not required to appoint the petitioner as guardian. There is no specific test to be met for a guardianship award. The court takes into account all the facts and circumstances and uses its discretion to make an equitable determination. An experienced attorney can assist you by explaining how a court may view the particular case and what should be done to satisfy the court to increase your chances of being appointed.
A guardianship order can be obtained in a day or two in an emergency situation, otherwise the process can take a month or several months. The cost, delay and administrative inconvenience of a guardianship can be avoided by having a durable general power-of-attorney signed before one becomes incompetent.
Planning and timing is important. Everyone, and senior citizens especially, should meet with an attorney with experience in these matters to review their basis estate planning needs and plan for disability. Having a power-of-attorney in place will make it easier for your representative to act quickly on your behalf and avoid the stress, delay, inconvenience and expense of a guardianship proceeding.
Contact us now to inquire about our elder law services.
My focus, as an elder care lawyer, is guardianships for seniors, particularly those in need of guidance from an elderly care lawyer. Decline in mental capacity, dementia, Alzheimer, inability to make rational decisions or perform activities of daily living, neglect, financial and or emotional abuse of an elderly person, unsanitary living conditions, are all key factors in considering whether guardianship for care of an elderly or other person is appropriate. Although there is no legal requirement that one be represented by legal counsel, it is prudent to do so. The process can be involved for someone who does not deal with these matters on a regular basis. Moreover, there often are important legal and strategic planning considerations that ought to be considered before one proceeds with a guardianship, particularly when eldercare legal and practical issues are concerned. If nothing else, investing in a comprehensive consultation with an experienced guardianship lawyer can help save you considerable time, stress and avoid costly mistakes. Bear in mind that you are usually dealing with the intimate subject of taking over control and responsibility for another human being who, even if suffering from moderate to advanced mental incapacity, still has feelings and fluctuating moments of understanding. Moreover, there are other areas of law that often have to be dealt with, such as estate planning, tax planning, marital property rights, and very importantly, Medicaid law. Mismanagement of the disable person’s planning for disability, in particular with regard to eligibility for public benefits, can very serious and possibly subject the guardian to personal legal liability and could even result in criminal prosecution. Long story short, don’t short-change yourself or the disabled person by cutting corners. You need to find out what you need to know and do things right!
Contact us now to inquire about setting up guardianship.
LONG-TERM CARE “CONVERSATION CHECKLIST” FOR FAMILIES AND SENIORS
Having a conversation about long-term care with an aging loved one can be difficult. Initiating a conversation can be awkward or uncomfortable for family members or care-givers. Although it is impossible to know what the future will bring, ROB GOLDMAN LEGAL SOLUTIONS, your local Elder Law Firm, offers the following hints and checklist that may help to begin a conversation about housing options and elder care law with your loved one. We are also a resource for relationship counseling to reduce family tension relating to this decision. Our participation early in the process could avoid significant problems.
1. Determine if it’s time to think about long term care facilities.
Reasons to seek long-term care vary from person to person. In addition to potentially offering a more comfortable and safer environment for the aging loved one, long-term care may be necessary for the mental and physical health of the caregiver.
To ensure your loved one is able to contribute to his/her future, introduce alternate housing options as early as possible, even before it becomes necessary. Ask your loved one questions about lifestyle or health-related challenges.
2. Understand this usually this is an evolutionary process.
To minimize resistance and facilitate recognition of the need for increased care, continue the conversation over time by sharing your observations and concerns, including any of the following physical and mental symptoms:
- Are they able to move around easily given the physical layout of the home? For example, are stairs, carpet, bath/shower or door handles obstacles for mobility? Is the heating and lighting adequate for any sensory impairments including hearing, sight and circulation problems?
- Are they experiencing balance issues, especially when changing positions? Are you concerned about them falling.
- If they fell, are you confident he or she would be able to call for help? Is there a reliable source to respond to a call at all times?
- Is your loved one repeatedly complaining of physical aches and pains?
- Are they experiencing frequent incontinence? Can they attend to the problem when this happens or is help needed?
- Do they have difficulty dressing, bathing or with personal hygiene such as hair and foot care?
- Is your loved one experiencing frequent, significant sleep disturbances?
- Are they capable of cooking or preparing healthy meals?
- Have operating gadgets or appliances such as the can opener, stove or telephone become difficult?
- Have household chores become a burden? Is vacuuming, sweeping, taking out the garbage, cleaning the dishes or bathroom being done in timely ways?
- Are finances such as bill payment, deposits, and investments being handled in a timely manner?
- Is your loved one still driving? If so, are you concerned about his/her and others wellbeing? Is public transportation a safe and viable option?
- Are prescribed medications obtained and taken as indicated consistently?
Is your loved one demonstrating personality changes, including but not limited to:
- Frequent irritability?
- Insensitivity to others?
- Disoriented to place and time?
- Aggressive behaviors?
- Repetitive behaviors?
- Communicating with inappropriate language?
- Is your loved one socially withdrawn and not able or not wanting to get together with friends or family? Are there signs of depression?
- Do they express negative comments about him or herself?
- Are they demonstrating an inability to make decisions or making poor decisions?
- Is your loved one able to understand communication or instructions from others?
3. Schedule a family meeting
A family meeting can move the topic of long-term care to a more focused discussion that can lead to a plan. Here is a checklist for planning your family meeting:
- Determine the family members that should be involved directly or indirectly in decision making. This may include extended family members, close friends or paid caregivers. Always include the person if he/she is capable of taking part in any decision making.
- Consider including an independent third party to play the role of mediator. This could be a minister or other member of the clergy, a social worker or case manager.
- If necessary, find a neutral place to hold the meeting.
- Prepare an agenda to help you stay focused. It may include:
- A medical update
- Sharing of feelings about the illness and caregiving
- Daily caregiving needs
- Financial concerns
- Who will make decisions
- What support role each person will play
- What support the primary caregiver needs
- Next steps moving forward
4. Continue to involve family.
The move to a long-term care facility is an immense transition for any family, so it’s important to involve everyone relevant to the person:
- Reach out to siblings to secure their input and support. For example, share online information about long-term care facilities to secure greater involvement and participation.
- Is there is an unequal financial or time burden to one family member? If so, acknowledge the distribution of resources and discuss a strategy for achieving a balance that appeals to everyone.
Good communication reduces the risk of family friction, suspicion and mistrust.
5. Continue to engage your parent or loved one.
- Have ongoing conversations at times when your loved one is feeling best and there are few distractions.
- Introduce the idea of an overnight visit to a long-term care facility or an extended afternoon visit to get a feel for the various available options.
6. Begin researching long-term care options in your area.
- Go to SnapForSeniors.com to access a nationwide senior housing database.
- Enter your city, state, zip, county or address and begin researching options by category of housing.
- View the listing details or contact the facility to ask questions and schedule a site visit.
- Read comments from consumers on the listing if available.
- Ask the facility you visit for a copy of their last annual licensing survey report.
- Contact your local senior ombudsman to get perspective from a local trusted resource.
- Check references from existing or prior residents or families.
7. Consult with an Elder Law Attorney.
Elder law attorneys are estate planning attorneys with a concentration in addressing the estate planning needs of seniors. Services typically involve more than simply preparing documents. An elder law attorney can provide valuable guidance with regard to quality of life planning to enable the senior to continue to live at home for as long as possible, review important considerations regarding planning for financial protection and disability, attaining and preserving eligibility for Medicaid long term care benefits, and many more related issues. Given the complexity of the Medicaid laws, the high cost of assisted living and nursing home care, and the stress one has to cope with as care services become increasingly difficult, it makes sense to get the elder law attorney involved as early as possible in this process. That will help you to make informed decisions and avoid potentially catastrophic financial consequences.
Contact us now to schedule an appointment to discuss your long term care needs.
Do any of the following situations apply to you?
- When I reach age 65 I will automatically be eligible to receive Medicaid benefits.
- I don’t need a Power-of-Attorney because I put my daughter’s name on my accounts?
- I don’t need a Will because I don’t have much.
- I can gift up to $14,000 a year to each of my children and thereby protect this money from the nursing home and qualify for Medicaid when my funds run out.
- I can protect my money by adding my son’s name to my accounts.
- I’ll just transfer everything I have into my children’s names. I know they will take care of me and then my money will be safe from the nursing home.
- I know many people who have added their children to their deed to protect their home against the nursing home and that will work for me!
- I don’t need legal documents now because I am in good health.
- I will never have to go into a nursing home because I have good kids who will take care of me and make sure I never have to go into a nursing home.
- I really don’t need legal documents now because my kids’ names are on all our accounts and our home.
- I have a disabled son who has lived with me his entire life. I recently put his name and my daughter’s name on all my accounts and on my house in case something happens to me. My daughter said she will make sure my son is taken care of and I know I depend on her.
- Mom has Alzheimer’s, and I want to put mom’s accounts and house in my name to protect them from the nursing home.
- Most of the money belongs to me and is only in my name, so my money is protected if my wife has to go into a nursing home.
- I have left my house and all my savings to my sister and my children equally in my Will. If I put my sister on all my accounts and name her as the Personal Representative in my Will that will avoid any conflict among my children, who don’t get along.
- I don’t need to plan for nursing home expenses because I have good health insurance and a good income.
- I’m in a second marriage. All my money belonged to me before I remarried and I keep all my money in separate accounts.
- If I need a legal guardian, my children will ask the Court to appoint my oldest child as guardian.
- The nursing home said they can help me apply for Medicaid and I don’t need to see a lawyer.
- I can apply for Medicaid myself and if the paperwork isn’t complete, the Dept. of Social Services will tell me what I need to do to address any issues.
- My kids all work full-time and have a busy life, but they promised they would never put me in a nursing home so all I really need right now is a simple Will.
- I want to treat all my children equally, but one has a drug problem and another is in a bad marriage and I don’t want their shares to go down the drain, so I’m leaving everything to my son who said he will take care of his sisters.
- I have three siblings but only I take care of my dad. My brothers state they are too busy. They hardly ever visit or call to find out how dad is doing. Dad told them he was going to take them off his Will. Now they accuse me of manipulating our dad and are threatening to take me to court if they are not treated equally.
- My friend’s daughter is a paralegal and she says I can save a lot of money by going onto the internet and doing things myself.
- If I give someone power of attorney, they will be in charge of me and my property and I won’t be able to make any more decisions myself.
- My mother has moderate Alzheimer’s and can be stubborn, even aggressive, at times. But she made me power-of-attorney a few years ago and so if she gets too difficult I can just place her in a nursing home.
Each statement, decision and belief above is erroneous. Not knowing what you don’t know can be scary. Not doing something about it can lead to catastrophic consequences.
How do you make your decisions? Friends can provide helpful pointers and referrals, but just because they are well-intentioned does not mean they are knowledgeable about the law. Effective planning depends on you making the right decision for you. How can you do that if you don’t understand the impact of the various laws that affect estate planning?
It takes considerable legal training and experience to be able to recognize all the issues and potential pitfalls on a case-by-case basis, explain them clearly so that you can make an informed decision, develop a plan that works for you, and help you every step of the way through implementation. – That’s what brings you ‘Peace of Mind!’ At Rob Goldman Legal Solutions, we do this stuff every day! The real question is: Can you afford not to do things right?
Are you a procrastinator? Do you have any idea how often a seemingly healthy person suddenly becomes disabled or dies from a heart attack, stroke, or aneurism, not to mention a car or other accident? Do you think it is sensible, or fair, for those who care about you, to have to take off even more time and run to lawyers and the court and get even more stressed out because you do not have the necessary documents in place to authorize someone to manage your affairs, get access to your information, and make decisions on your behalf? You can always change your documents later, but why not take care of getting your affairs in order now? Don’t wait until it is too late. You may miss out on valuable estate planning and asset protection possibilities.
If you need elder law services in Baltimore, Dundalk, Essex, Rosedale, Middle River, White Marsh, Parkville, Abingdon, Bel Air, Aberdeen, Havre de Grace, Owings Mills, Reisterstown, Pikesville, Maryland, ROB GOLDMAN LEGAL SOLUTIONS is the law firm Marylanders turn to for calm, sensible advice and Peace of Mind.
Contact us now to inquire about our elder law services.
Do not listen to what the nursing home office tells you! In many cases, the family home is or can be protected. Experience has shown that nursing home business office managers and Medicaid assistants do not understand key aspects of the Medicaid laws. You could end up paying a whole lot of money to the nursing home that you didn’t need to!
Whether the issue is keeping your home or your savings, the Medicaid laws a re complicated and different rules apply depending on the facts and circumstances.
The most important first step is to consult with an elder law attorney, who can evaluate your case and explain your rights and options.
Retain an experienced Elder Law Lawyer to represent your interests. The nursing home only cares about what is good for the nursing home.
When you have the information you need to understand your Rights & Options, you will be able to make sound decisions. See the next question regarding asset protection planning.
Contact us now to inquire about our elder law services.
You should always review a proposed Nursing Home Contract with an Elder Law Lawyer before signing or providing significant financial information to the nursing home.
While most people prefer not to enter or place a loved one in a nursing home, there are times when, despite one’s best intentions, one has no alternative. Because nursing home care is so expensive, typically round $9,000 (in 2016), it is essential to consider the potential impact of nursing home care on one’s finances and to take advantage of whatever planning opportunities may exist. By doing so, you will maximize your options to protect the family assets and ensure that the community spouse is not left destitute.
Nursing homes have tremendous expenses, and their contracts are designed to protect the nursing home as much as possible. Although there are laws that protect nursing home residents and their families from over-bearing contracts and abuse, it is up to you to seek professional guidance and review of the contract before you sign it. You also want to be sure not to assume personal liability for the resident’s nursing home expenses. By obtaining professional legal advice before you sign anything, you will allow your attorney to show you how to avail yourself of income and asset protection planning opportunities that may no longer be available after the contract has been signed.
Some nursing home office managers will tell you they can help you apply for Medicaid and that you don’t need a lawyer. Beware! Experience has shown the nursing home assistants who do this often do not understand key aspects of the Medicaid laws and do not tell you what you can keep or advise you how to protect your assets. And if the Medicaid application is delayed or denied, the nursing home will say they were only helpying you with the application and will hold you responsible. Can you imagine being suued by the nursing home for $18,000, $27,000 or more? Invest in a professional Elder Law Consultation with an Elder Law Attorney so that you can understand your Rights and Options and make an informed decision.
The decision over whether to place an elderly parent in a nursing home often leads to family tension among children and siblings. Our experience includes relationship counseling and pragmatic problem solving. Having a neutral professional consider the various points of view and motivations can go a long way to easing family tension and finding a solution all or most can accept.
The quality of care your loved one receives at a nursing home depends a great deal on how much time you spend visiting and talking with the care-givers. The less interest you show, the greater the likelihood of neglect.
Contact us now to inquire about our elder law services.
The purpose of the spousal elective share law is to provide some protection to a spouse against being disinherited by granting the surviving spouse a right to elect to receive a percentage of the decedent’s estate instead of what, if anything, is provided in the Will. See Estate & Trusts Article 3-208. The statute also provides how the elective share may be waived (3-205).
Spousal election used to apply only to assets in the probate estate. Non-probate assets were exempt. Many states, including Maryland, now provides that spousal election extends to the augmented estate, i.e. which includes non-probate assets. The rationale for augmenting the scope of the assets that can be reached is to protect a spouse against estate planning designed to move assets out of the probate estate to reduce or eliminate a spouse’ elective share. There are exceptions, and in some instances matters are not always clear-cut. For instance, a pre-nuptial agreement or a marital separation agreement may negate the spousal election. The distinction here, is that these are consensual agreements.
In the context of Medicaid paying for long term nursing home care, if the Medicaid recipient’s spouse predeceases, the Medicaid recipient is still entitled to his or her elective share. His representative must claim the elective share timely and report this claim to the Dept. of Social Services managing the case. Failure to do so will result in the non-claimed assets being treated as a gratuitous transfer, which will trigger a penalty period and make the Medicaid recipient ineligible for continued Medicaid benefits. The Medicaid recipient’s representative may also become personally liable. In the context of Medicaid eligibility, the State’s Medicaid Recovery Lien does not extend to the augmented estate.
One must following the procedure and file the election timely or the right to elect against the Will will lapse. These are matters that should be discussed with an attorney exeprienced in Elder Law and probate matters as soon as possible.
The key purpose of a pre-nuptial agreement is financial protection of assets owned by each spouse prior to the marriage, including income protection and liability for alimony, and can include assets acquired during the marriage. Should your new spouse become entitled to half of everything you own immediately upon your becoming married simply by virtue of being married to you? Doesn’t it make sense to give the relationship time to prove whether and to what extent you have a true partnership in a future together? If you were mistaken or misled and either party wants out of the marriage, are you really okay with giving up half your stuff?
A second key purpose of going through the pre-nuptial agreement process is that the process itself is an incredibly effective learning and bonding experience. Your learn a lot about how each other thinks, what they want and how they respond to and resolve differences. This process can give you a terrific sense of validation in your choice of a partner and the confidence you need to move forward with peace of mind!
Marriage is more than milk and honey; marriage is an economic partnership that can have substantial financial impacts over time. The point is that if you want to provide for your spouse, be generous and so forth, you can provide for this in a sensible, graduated manner that protects you against unexpected revelations about your spouse and against people referred to as ‘gold-diggers.” The latter type of people look for and prey on well off, often lonely, people, who they subtly manipulate, and when they feel the time is right, provoke a failure of the marriage and claim half, or more, of the assets.
Insisting on a pre-nuptial agreement does not imply that you don’t trust the person you love. It means you are intelligent enough to recognize that being in love doesn’t mean you should impulsively give away the farm without first allowing the relationship to stand the test of time. You want to be sure the person you are marrying is marrying you for the right reasons, that you are marrying that person for the right reasons, and that your goals and approach to reaching those goals are compatible. Do you really want to be with someone who is reluctant, or refuses, to consider and validate your concerns?
Over 60% of marriages end in divorce! A relationship should be satisfying, with good communication, exchanges of ideas, learning how to compromise, a healthy sex life, fun times and working together. You should feel you are a team. Of course, there are some exceptions where people have disabilities and other life-changing issues. If this isn’t true of your relationship, have you really thought through what you want for the long haul? Diving into a lottery pool where the odds are not in your favor is, simply put, not smart. Make sure you know what you are looking for in a spouse and whether the person you have chosen meets those criteria. Although managing a relationship can be challenging at times, and takes some effort and consideration to make smart choices, a good, healthy, sustainable relationship should not be hard work. Do not ignore red flags! – This is the time to get some help to figure out how to handle the problem, how to re-evaluate and decide what is best for you.
The reality is that sometimes people are not who you think they are. For some people, marriage is a passport and the culmination of an effective courtship. The sense of “mission accomplished” can mean there is no reason to try any longer and one can revert to one’s true self. Surprise, surprise! And people change. Goals change. Looks and outlooks change. Trust and loyalty can turn into mistrust and betrayal. You can be doing everything right and it’s just not good enough. In some cases, nothing is ever good enough. The reasons unexpected or unforeseen changes occur are infinite. The reality is that change happens, often when you least expect it. Protect yourself! Protecting yourself does not mean you need to do so at the other’s expense. There is no place for a sense of entitlement.
If you are a young couple wanting to start a family, neither owns much, and you wish to build a life together, in most cases, a pre-nuptial agreement is not necessary. However, making sure you have good reasons to believe your are right for each other to make this journey together is still very important. Consulting together with an estate planning attorney/counsellor to review your thoughts as to careers, investments, retirement planning, decision-making, basic legal planning, and so forth, – before you get married may be very helpful in learning more about how each other thinks and how well you can discuss and resolve issues. This process may incease your sense of confidence or it may raise red flags that will give you reason for pause.
When one party is substantially wealthier, or if one has been married before, one person is considerably older, or there are other important considerations and interests that warrant protection against marital property claims if the marriage doesn’t work out, it makes sense to explore, with a professional, whether a pre-nuptial agreement is appropriate for you. If you find yourself hesitating to invest the time or money to do so, ask yourself whether securing your financial security and happiness is important to you. If you care so little about protecting your own interests, do you really expect others to care about your wishes and needs? Sensible planning is a smart investment in your financial security and peace of mind!
Again, … why should someone become entitled to a windfall solely by reason of having married someone of substance? Why should “half” or more be fair just because one got married? There is a huge difference in sharing equally the fruits of what a couple contributed during their marital partnership, and being forced to share with a taker and user. – There are many different ways to contribute to a marriage partnership and talking through that early on is important too.
Don’t you want to have a better understanding of the challenges, the risks, the pitfalls and the techniques to better equip you going forward? The right adviser can be a cross between a mentor, a coach, a guidance counselor, a strategic planner, a marriage counselor, an investment counselor, an insurance counselor, and more! If your intended spouse is not right for you, wouldn’t you rather find out now than after you’re married, have children, buy a house together and who knows what else you have committed yourself to? For all these reasons, you owe it to yourself to invest in a thorough marriage partnership consultation?
A pre-nuptial agreement can provide for greater sharing as the marriage partnership proves its stability over time and ensure that the value of other spouse’s contribution to the marriage (in all ways), is fairly addressed. However, it makes no sense that a marriage partner who brings little into the marriage should be able to benefit at the expense of the other spouse or have an economic incentive to have the marriage fail. Bear in mind that a pre-nuptial agreement can be highly customized and creative to provide solutions for a variety of needs and concerns. The bottom line is that it doesn’t hurt to get some good professional guidance early and enable yourself to decide how best to move forward with confidence, … and it may hurt you very badly if you don’t!– You are the master of you own destiny!
Basic real estate succession planning typically is planning to ensure that your children (or whomever you want), will inherit your home when you die. For most folk, real estate means their personal residence and is their most valuable asset. For the purpose of this article, real estate includes virtually all kinds of real estate. Concerned about the potential claims of creditors and other family members, the IRS, and for various other reasons, many go about trying to protect their property the wrong way, sometimes with catastrophic consequences. In most cases, the right way to achieve this goal is to keep your real property out of probate. Simply adding a family member to your deed usually is a bad idea!
While ignorance may be bliss, there many important considerations to be considered in determining whether and how to protect one’s property. Decisions made without the right information can have unintended consequences and cause great hardship to those you love and were trying to help. So, yes, legal services involve far more than “just” preparing a “simple” document. The real value, that you should gladly pay for, is the knowledge and experience that underlies the questions the lawyer asks to get to understand your needs, concerns and true objectives, consider which laws and potential issues need to be taken into account in order to determine the best approach for you and explain this in a way that enables you to make an informed decision with confidence and Peace of Mind.
Perhaps the most effective and commonly used approach to keep a home or other real estate out of probate is the life estate deed. There are different types of life estate deeds and the choices may seem similar on one level, but can have substantially different consequences in certain circumstances, such as bankruptcy protection, divorce, maintaining control of the property and access to equity, Medicaid eligibility and asset protection planning, among others.
The key benefit of making a life estate deed is that the property becomes a non-probate asset and, since it is not part of one’s probate estate, it cannot become subject to the claims of one’s ordinary creditors. On your death, the property will bypass probate and go directly to the persons named in the deed. Another major benefit is that acquistion of a property by life estate deed is treated as inherited property. The advantage of inheriting real estate rather than receiving it as a gift, is that the recipient receives a stepped up tax basis to the fair market value as of the date of death of the decedent rather than receiving the carry over basis of the decedent, thereby avoiding capital gains tax liability.
In addition, one can save money through using the deed to make multi-generational transfers without the concern that someone may overlook or neglect to plan effectively for the next generation. Once again, there are other considerations that come into play, so one should be careful to avoid having the tail wag the dog. Sound legal advice is invaluable in all deed planning decision-making.
After the death of the decedent, if none of the above planning was implemented, the real estate will be included in the probate estate. Assuming there are sufficient liquid assets to pay all the administration expenses, estate debts and distributive shares without having to sell the real estate, there exists an opportunity to do some smart estate planning, save money and eliminate the risk of a failure to plan in the future.
An experienced estate planning lawyer may be able to identify intelligent estate planning opportunities for you, save you money in the long run, and reduce risk. Instead of having the Personal Representative (also known as the Executor) simply transfer the property from the estate to the beneficiary, depending on the planning objective, one may be able to create several levels of planning in one deed. A trust may also be worthy of consideration. This is another advantage to having the mindset that consulting with a professional is a smart investment, rather than trying to save money by making decisions solely based on price.
Hospice care refers to the type of care services provided to individuals who have a terminal prognosis and their family. Hospice care essentially means “comfort care” and is intended for patients diagnosed with a life expectancy measured in months rather than years. There is no limitation on the age of a person who may receive hospice care. The goal is to make a patient with a serious, life-limiting illness, who can no longer benefit from curative treatment, as comfortable as possible in a warm, supportive environment. Medication, medical supplies and equipment, psychological and spitiual counseling are provided to provide the needed comforst and support and to enable the patient to maintain as much control and dignity as possible.
Palliative care is an approach to care services that focuses on the symptoms that cause physical and emotional pain and suffering and provides medication and support to the patient to enhance the quality of the person’s life. Palliative care services also provides support to the individual’s family, including for a period after the patient’s death. Palliative care is provided to hospice patients, and to individuals of any age at any time after one’s illness is diagnosed and, unlike hospice care, is not limited to individuals who have a limited life expectancy.
Hospice care may be provided in one’s own home, or in a dedicated hospice facility, or in a long-term care facility. Some counties provide free non-medical hospice care services, typically provided by trained volunteers. Perhaps the largest source of hospice care coverage is provided by the Medicare Hospice Benefit, which is available to individuals over 65 years of age. Since this benefit covers virtually everything relating to hospice care, one does not have to be concerned about out-of-pocket costs.
How does one get the Medicare Hospice Benefit? There are four key requirements: 1) the patient must be eligible for Medicare Part A; 2)the patient must have a terminal illness of six months or less; 3) the patient must choose hospice care instead of routine Medicare benefits and sign a form certifying that they are making this choice; and 4) the patient must be in a Medicare-approved hospice program.
Medicaid, private insurance or pre-paid health plans typically cover hospice most services. One should check their eligibility requirements and scope of coverage. To be eligible for such coverage, one must have a prognosis of six months or less.