Should Your Elderly Mom Or Dad Drive a Car?

Should Your Elderly Mom Or Dad Drive a Car?

We all know the pain of being stuck behind a dangerous driver. My vehicle was recently hit by a young lady who had only been driving a year. Young drivers certainly lack the experience of road warriors like ourselves, yet there will come a time for all of us, when we will come full circle. The following article explicates the challenges of that difficult transition from the driver's seat, to riding shotgun.

How to Talk to Parents about Giving up the Keys

By Carolyn Rosenblatt

from: www.agingcare.com

In the 29 years I handled personal injury cases, most of them were car accidents. I represented injured people hundreds of times. When the victim was hit by an elder or older driver who should never have been driving, I always wondered why no one had taken the car keys away. Where were the adult children as elderly aging parents began to lose the ability to safely operate a car?

If we're talking about your Mom or Dad, and you've notice that he or she just isn't safe behind the wheel anymore, this is to encourage you to get involved. Most older drivers who are losing their ability to drive safely don't recognize it or are in denial and can't face the terrible thought of giving up their independence and control. Sometimes, loss of the ability to drive a car is a life changing event, as the elder can no longer maintain himself at home without transportation. Denial is a very common reaction to the early warning signs of becoming a dangerous older driver. Denial can occur both among the elderly, who really, really don't want to have this privilege taken from them, and in their adult children, who then have to deal with the consequences of Mom or Dad becoming a burden around transportation.
If this is happening in your aging parents, try these tips to handle this emotionally charged and difficult issue.

Tips for Dealing with a Dangerous Elderly Driver:

1. Approach the subject respectfully and at the best time of day for your parent. Ask if it's ok to talk about this now.

2. Bring up the issue of driving while you express caring and concern for how difficult it must be to even talk about it, but gently insist if your parent resists the subject.

3. Encourage your elderly parent to see a doctor to find out what physical problems could be going on. Some people need a change in medication or other health care treatment to correct alertness, vision, or ability to attend to detail in driving. Go with him or her to the doctor if you can.

4. If the doctor concurs that your aging parent should give up the keys, use the doctor as the reason for bringing up the subject and the reason for suggesting limiting or giving up driving.

5. Research alternative kinds of transportation where your parent lives. If you are in a rural area, there may be none, but family, neighbors, or church or synagogue members may be willing to help. Public transportation may be a good alternative in urban areas, even if your elderly parent has not used it before.
The subject of driving is always a "charged" one.
________________________________________
Carolyn Rosenblatt is a registered nurse and attorney who has 40 years of experience. She is the author of "The Boomer's Guide to Aging Parents."

Is a Beneficiary Deed a Good Option in Missouri?

The short answer is "Maybe." The following is an excerpt from Reg Turnbull, a well-known elder law attorney in Missouri.

"Those of us who do estate planning counsel our clients that beneficiary
deeds are not panaceas. Often the following issues arise:

1. The grantor-decedent's Creditors still must be paid. Under section
461.300, RSMO, creditors can go after transfer on death (including
beneficiary deed) transferees (beneficiaries) to get bills paid. Creditors must
force open a probate within one year of the date of death to get paid and
bring in the transferees to the extent of the bill. Thus, such transfers do
not avoid estate recovery.

2. No one is in charge. An involuntary partnership arises if the
transfer is to more than one transferee. In probate, someone takes charge to
make sure that the maintenance of the real estate continues, e.g., the
utilities get paid so the "pipes don't freeze," that the real estate is
maintained, and that the RE taxes are paid. Also if some want the property to be liquidated, then it takes all of the transferees to sell it. If
disagreement, then may have to partition.

3. Any grantor-decedent's special intent is legally disregarded.
Intents for one or some but not all of the transferee-beneficiaries to farm
the farm or to live in the dwelling requires agreement (or at least
acquiescence) of the other family members. This can result in resentment from those who want the real estate liquidated for fair market value so that each can
get his or her fair share. If disagreement, then those wanting the money
must be bought out.

4. Any issues with real estate before the TOD are not resolved and
usually get passed on to the beneficiaries.
In Missouri, many people use Beneficiary Deeds because they are obsessing
about how to avoid probate. Some people should have used trusts to avoid
probate and still have central administration of their assets with clear
responsibility to carry out intent rather than just kicking the real estate
with problems down to the beneficiaries to deal with.

In the zeal to avoid probate, many issues are not worked out in a planned
manner with the TOD-beneficiary deeds when more is needed as they arguably
would be with more directions/instructions in a will (through probate) or
trust (without probate).

When our clients ask what we think about beneficiary deeds, we tell them
that we see beneficiary deeds as options that may or may not be appropriate
depending upon the situation."

Federal budget negotiations propose radical changes in Medicare and Medicaid

This article posted by Naela summarizes the proposed changes to Medicare and Medicaid in the current budget debate. It is a great resource for understanding how the proposals could impact the way older and disabled Americans have access to affordable health care.

Federal budget negotiations propose radical changes in Medicare and Medicaid

Briefly, Medicare and Medicaid have provided health insurance coverage to older people, the disabled, women, and families with children for more than 45 years. These programs ensure that vulnerable populations who could not get health care coverage from private health insurance have access to basic health coverage.

The futures of Medicare and Medicaid are uncertain as a result of proposed reform and deficit reduction proposals under discussion in Congress.

One such proposal which promotes radial change is that of Congressman Paul Ryan (R-WI) who chairs the House of Representatives Budget Committee. Ryan’s proposal, “The Path to Prosperity: Restoring America’s Promise” would reduce the deficit primarily by cutting government spending by $6.2 trillion over a ten year period.

As part of this reduction in government spending, the Ryan proposal would end the Medicare and Medicaid system as they currently operate. Instead, Medicare benefits would shift to a premium support or voucher model and federal funding for Medicaid would be converted to a block grant system.

What Happens to Current Nursing Home Residents if the House Budget Resolution Becomes Law?

I want to let you know about an informative alert from the Center for
Medicare Advocacy.

You can read the alert here:
"What Happens to Current Nursing Home Residents if
the House Budget Resolution Becomes Law?"

National Healthcare Decisions Day 2011 - Locations around KC

For a complete listing of events in the Kansas City area, please go to www.nhdd.org or www.practicalbioethics.org.

On Friday, April 15th, local elder law attorneys will volunteer at locations throughout the Kansas City area with free information about advance care planning and advance directive forms. The following locations will be welcoming the public throughout the day:

Gamber Center 4 SE Independence Avenue Lee's Summit, Missouri 64063 Friday, April 15th, 11:00 a.m.- 1:00 p.m.

Liberty Silver Center 1600 S. Withers Road Liberty, Missouri 64068 Friday, April 15th, 9:00 a.m. - Noon

Irene B. French Community Center 5701 Merriam Drive Shawnee Mission, Kansas 66203 Friday, April 15th, 10:00 a.m.- 1:00 p.m.

Kansas City North Community Center 3930 NE Antioch Road Kansas City, Missouri 64117 Friday, April 15th, 10:00 a.m.- 2:00 p.m.

Participating attorneys: Kara Burgess, Northland Elder Law Linda Hart Tabory, Hardwick Law Firm Lisa R. Joyce, Shepherd Elder Law Group Samantha L. Shepherd, Shepherd Elder Law Group Timothy Murphy, Murphy & Tobin Law Offices

National Healthcare Decisions Day 2011

Rallying to Encourage and Empower Us All to Make Our Healthcare Decisions Now for the Unknown Later…

College education. Career path. Relationships. Starting a family. Buying or selling a house. Vacations. Retirement. From the age that we’re old enough to understand, most of us are taught and accept that these are the markers in life that we plan for. However, there’s one key marker that’s all-too-often missing from this list: healthcare decision-making. Like planning for these other life events, planning for the time (or times) that we are unable to express our healthcare wishes is of the utmost importance. It is something that should be well thought out, documented and revisited at different points in life to reflect any change in our desires or family situation or the person we wish to advocate for us. Unfortunately, it is a planning point that that majority of us have missed. As a consequence patients’ families suffer the added burden of having to guess when a health crisis happens. That’s why Nathan Kottkamp founded National Healthcare Decisions Day (NHDD) back in 2008 and why this nationwide advance care planning awareness initiative is as important as ever. So this year, I’ve joined my fellow bloggers throughout the country to spread the word about the importance of advance care planning with this special NHDD edition blog.

NHDD, which happens every April 16, is a collaborative effort of national, state and community organizations as well as dedicated individual advocates committed to ensuring that adult Americans – like you and me —have the information and opportunity to communicate and document their healthcare decisions.

April 16 is rapidly approaching, so it’s time to kick the engagement effort into high gear. Here are some things you can do for yourself and your loved ones to prepare for NHDD 2011:
· Lead by example. Schedule time with your loved ones (on or before April 16) to “Have the Talk” and complete your own advance directive. There are many tools, including free forms, you can use to walk you through the process and make your wishes known; access them through the NHDD Public Resources page.
· Encourage your loved ones and friends to learn more about advance directives and to complete their advance directives. You can forward this link: http://www.nhdd.org/p/resources.html to them. Or, encourage them to find a nearby participant and attend a local NHDD event.
· Share your advance directive with your healthcare providers and make sure it is on file in the event it is needed.

Already had the conversation with your loved ones, but want to do more? Here a few suggestions to rally support for NHDD and encourage even more action:
· Like the NHDD Facebook fan page and share it with your Facebook friends
· On Twitter? Follow @NHDD and share the information with your followers, i.e. ‘Just 5 days to #NHDD, when will you #havethetalk? @NHDD can help: http://bit.ly/glff1V’
· Send an email to your friends, staff, colleagues, lodge/social club members, and/or house of worship, telling them that you are participating in NHDD and encouraging them to do the same. Share the information above with them and/or use this template email:

April 16 is National Healthcare Decisions Day, and I hope that you will join me in taking this time to discuss and document your healthcare wishes. We all need to be prepared in the event of a health crisis, and having the talk is easier than most people think, but many of us need a little inspiration or a reminder to do it. I hope that this message and National Healthcare Decisions Day are all you need for inspiration. Please mark your calendar for April 16 to have the talk with your loved ones. There are all sorts of free resources, including free advance directive forms for each of the 50 states, on the NHDD website: http://www.nhdd.org/. Additionally, please help me spread the word with Twitter, Facebook, and LinkedIn. Advance care planning is something we ALL should do and encourage others to do, regardless of age or current health. Discussing your wishes can be one of the most important gifts you ever give your loved ones.

Take the “pledge” to complete or update your advance directive on the NHDD website
. Please use and share the resources available through the NHDD website and encourage and empower us all to make our healthcare decisions now for the unknown later.

Advocates for the aging fear waiting list for services is on the way

Advocates for the aging fear waiting list for services is on the way:
But administration officials say they are working on a plan to avert that
By Dave Ranney
Monday, March 14, 2011
TOPEKA — A spokeswoman for the Kansas Department on Aging said the agency is doing all it can to avoid putting frail seniors on a waiting list for in-home services.
“We know that in the past when people have gone on the waiting list, one-third of them end up in nursing homes, which increases the nursing-home portion of our budget," said Sara Arif of KDoA. "We're trying not to let that happen."
But advocates for the elderly said a waiting list is almost inevitable.
“Judging from the (legislative) committee discussions that have taken place so far, I’d have to say it’s almost guaranteed some time in fiscal 2012,” said Craig Kaberline, executive director at the Kansas Area Agencies on Aging.
The state’s next fiscal year begins July 1.The agency initially requested an operating budget of about $579 million. The governor instead proposed about $561 million. His plan was to avoiding a waiting list, in part, by cutting KDoA salaries and positions by $3 million from all funds; $1.2 million from the state general fund, and using that money to pay for senior services.
KDoA, Arif said, will formally announce its intent to lay off 20 full-time employees later this week. But agency officials have said that to avoid a waiting list, the department needs an additional $4.6 million for the services shifted from other agency spending.
An additional 787 frail seniors are expected to seek in-home services in the coming year.
KDoA Secretary Shawn Sullivan has said he thinks he can free up the needed extra money from elsewhere in the state-funded portion of the department’s budget but has not said how.
Last week, the House Appropriations Committee told Sullivan to cut the state-funded portion of his budget an additional $800,000.
“We don’t see how the secretary going to be able to do that,” Kaberline said.
Arif said she expects the department to outline its cost-cutting plan later this week.
“We’re within $1.3 million of where we need to be,” she said. “We’re at the point now where we’re trying to work with CMS (Centers for Medicare and Medicaid Services) on allowing us some flexibility in certain areas. It’s difficult to know at this point how that’s going to go.”
Rep. Jerry Henry, D-Cummings, said he’s was skeptical the agency would be able to avoid a waiting list.
“This whole thing doesn’t make sense to me,” he said. “We’ve got more and more people with more and more needs coming into a system that’s already stretched pretty thin and we’re being told we can do it with fewer staff and for less money. If you ask me, the Brownback administration is rolling the dice on this one."
Henry is the ranking minority on the House Social Services Budget Committee.
“I think we’re either going to have a waiting list or there’s going to be a lot of corner-cutting going on,” he said. “I don’t know that the secretary is going to propose. I suspect we may not like it.”
The committee’s chairman, Rep. David Crum, R-Augusta, defended Brownback’s proposal.
“I think people tend to overlook the fact that the governor funded Medicaid, he fully funded people who are on the frail elderly waiver now and he put an additional $1.2 million in the waiver,” Crum said. “That’s a substantial amount of money.”
Crum said he hoped the department would be able to avoid a waiting list.
“But, still, it’s a possibility that some seniors may have to wait for services,” he said. “Time will tell.”
Brownback also has proposed and budget committees in both the House and Sentate have upheld a 10 percent cut in the state-funded portion of the department’s home-delivered and congregate meals programs and a 20 percent cut in Senior Care Act-funded grants.
Across the state, area agencies on aging use Senior Care Act dollars Meeting the Needs of Older Kansans

(Article from the Kansas Area Agencies on Aging Association)