For many seniors, driving is a critical link to their independence. As such, they are often reluctant to give it up – even if it would be in their best interest – and may even avoid any discussions that suggest they do so. If there’s a senior in your life, it’s important that you take a phased approach to this sensitive topic. Here are 5 tips for preparing for the conversation and ensuring your loved one’s safety.

1. Start the assessment early. Impaired driving skills generally happen gradually and affect different people at different ages. Many people drive safely well into their 70s. Others, due to failing eye sight or other health issues, may have driving difficulties much earlier. Observe your older driver over time. Listen for any concerns they express about driving (such as how awful traffic has gotten or how rude other drivers are), and use that as an opportunity to open the conversation.
2. Watch for warning signs. Do they have difficulty turning their head to see when backing up? Are they easily distracted or riding the brake? Have you noticed new dents or scrapes on the car or mailbox or garage? Are they disoriented, or have they gotten lost driving to places where they have driven many times before? The Hartford has a complete list of warning signs at www.safedrivingforalifetime.com. Use this as your guide.
3. Seek a professional opinion. If it’s a health issue, your loved one’s doctor may be able to provide information and guidance that will help convince your loved one that it’s time to stop driving. Or they may refer you to a driving specialist for a comprehensive driving evaluation.
4. Research alternative means of transportation. Many areas have government subsidized senior transportation options available for trips to the doctor, grocery store, etc. Providing information about these alternatives can go a long way in easing the transition and helping seniors retain their independence. Use The Hartford’s “Getting There” Worksheet to assess alternatives: http://hartfordauto.thehartford.com/UI/Downloads/Getting_There.pdf
5. Have the conversation. The conversation should happen long before there’s a serious issue. A potential opener would be a general discussion around health and safety and their connection to driving. Or talking about the increased hazards and traffic on the roads today. Ask questions to find out any concerns your senior has about driving. The important thing is to be sensitive to their need for independence while letting them know that you care about their safety.

For more tips on having this conversation, check out AARP’s online seminar: Talking with Older Drivers, www.aarp.org/weneedtotalk.

Family gatherings around the holidays are a great time to celebrate, catch up, and renew familial bonds.  They are also the perfect time to do some planning for the future. Adult children of aging parents should use this opportunity to discuss with their parents where important documents are kept and what their wishes are in the event of failing health or needing long term care.

Children who live far away may notice changes in their parents’ mobility and mental capacity more so than those who see them on a regular basis. This is an opportunity to compare notes and assess:

• Home safety
• Parents’ driving capability
• Bill payments/late notices
• Medication use/supply

AARP offers tips to help families who are “home for the holidays” determine whether their elderly loved ones can safely live in their own homes, drive and manage their finances.

Once the assessment is made, the next step is having a family discussion to resolve any issues identified, and create a plan for the future.  This can be an area of contention, even for the closest of families. How much longer can the parent drive? Where will they live when the time comes? Collaboratively developing a plan before eldercare becomes imminent can prevent these conflicts.

The National Care Planning Council’s book, The 4 Steps of Long Term Care Planning provides guidelines and checklists for family planning meetings. Here are some basic steps:

1. Get all interested persons together in one place at one time.
2. If the parent is still in good health (which is the ideal time to develop the plan) he/she should conduct the meeting.
3. After a thorough discussion of the issues and solutions, there should be a consensus of all present to support the plan.
4. A written care plan should be developed with each family member signing it to confirm their commitment.

The U.S. Department of Health and Human Services states:

“No one wants to think about a time when they might need long-term care. So planning ahead for this possibility often gets put off. Most people first learn about long-term care when they or a loved one needs care. Then their options are often limited by lack of information, the immediate need for services, and insufficient resources to pay for preferred services. Planning ahead allows you to have more control over your future.”

On November 11 we celebrate the men and women who have served and sacrificed for our country. It seems only fitting that my topic this month be about the benefits available for Veterans and their dependents.

In 1789 U. S. Congress passed as law that pensions were to be provided to disabled veterans and their dependents, and in 1811 the first domiciliary and medical facility for veterans was completed. Since that time the Department of Veterans Affairs has opened a multitude of care facilities nationwide.

For a full list of the benefits provided for veterans by the Department of Veterans Affairs, go to: http://www.vba.va.gov/VBA/.

One of the little-known and underused veteran benefits is “aid and attendance,” which is a pension that provides disability income.  It’s called “aid and attendance” because many veterans or their single surviving spouses can become eligible if they have a regular need for the aid and attendance of a caregiver, or if they are housebound. Evidence of this need for care must be certified by the VA.

Pension can pay qualified veteran recipients as much as $1,949 a month in disability income.  To receive Pension, a veteran must have served on active duty, at least 90 days, with at least one of those days during a period of war. There must be a discharge under conditions other than dishonorable. Single surviving spouses of such veterans are also eligible. If younger than 65, the veteran must be totally disabled. If age 65 or older, there is no requirement for disability. There is no age or disability requirement for a single surviving spouse.

There are income requirements, but a special provision allows household income to be reduced by 12 months worth of future, recurring medical expenses.

Thomas Day, Director, National Care Planning Council, has written two books to help veterans obtain this long term care benefit. The first, “How to Apply for the Aid & Attendance Pension Benefit” explains what the benefit is and how to get it. All forms necessary for filing a claim are included in the book. Tom recommends if you have excessive assets and income or are not sure how to apply medical deductions, use the services of a qualified veterans benefits consultant.

The second book, “Aid & Attendance Handbook for Professionals & Consultants,” is for the professional consultant. The secret for receiving a successful award for aid and attendance or housebound ratings is not in filling out the form, but in knowing what documents and evidence must be submitted with the application.

According to surveys conducted among the elderly, their top three concerns about aging are:

1. Remaining independent in their home without intervention from others
2. Maintaining good health and receiving adequate health care
3. Having enough money for everyday needs and not outliving assets and income

Addressing these concerns requires some pre-planning. Yet few people do it.

In fact, it’s been said that most people spend more time planning for a two-week vacation than they do planning for their “sunset years.” Lack of planning for that time of life can be devastating to an elderly person’s lifestyle, finances and security. It can drastically alter or completely eliminate the three main lifestyle wishes listed above. It can also have an adverse effect on the older person’s family, requiring sacrifices in their time, money and family lifestyle.

Clearly, planning ahead is essential.

Let’s look at some facts.

As people grow older they tend to need more help from others, and many elderly people rely entirely on family or other “trusted” individuals for this help. Unfortunately, this dependence on others often makes an older person more vulnerable to abuse, and less likely to talk about that abuse if it occurs.

An older woman relying on her children to provide meals, transportation and help with financial decisions may find it difficult to complain if one of her children takes advantage of her. If, for example, the child takes her money, hits her, or neglects her care, the parent may be threatened with loss of that support from the child if she complains. The child may also use threats of violence to keep the parent in line.

It is estimated that 5% to 10% of elderly Americans are victims of abuse. According to the National Committee for the Prevention of Elder Abuse: “Spiraling rates of elder mistreatment are reported by both practitioners and researchers. In a recent national study of Adult Protective Services (APS) – typically the agency of first report concerning elder abuse – there were 253,421 reports of abuse of adults age 60+, or 832.6 reports for every 100,000 people over the age of 60 (Teaster, Dugar, Otto, Mendiondo, Abner & Cecil, 2006).”

A National Elder Abuse Incidence Study (National Center on Elder Abuse, 1998) found that “more than 500,000 persons aged 60+ were victims of domestic abuse, and an estimated 84% of incidents were not reported to authorities, denying the victims the protection and support they need.”

Although much attention has been focused on abuse in nursing homes, most of the elder abuse in this country is at the hands of family members or other caregivers in the home.

In 2004, Utah Adult Protective Services workers investigated approximately 2,400 allegations of abuse, neglect or exploitation of vulnerable adults. In Utah, a vulnerable adult is defined as, “an elder adult (65 years or older) or an adult, 18 years or older, who has a mental or physical impairment that substantially affects their ability to protect or provide for themselves.” The majority of the victims were females between the ages of 60-89, and 60% of the perpetrators were immediate family members or other relatives.

There are a number of reasons why incidents of abuse, neglect, or exploitation are not reported to Adult Protective Services or other authorities. One of the most common reasons is the victim’s fear that if the family member or other caretaker is incarcerated, or stops providing support, the victim will be left alone and expected to take care of him/herself, or be forced to live in a nursing home.

Many states have implemented mandatory reporting laws to assist in the prevention of abuse, neglect or exploitation of vulnerable adults. Utah is one of the many states to have a mandatory reporting law. This law states that any person who has reason to believe that a vulnerable adult has been the subject of abuse, neglect or exploitation should immediately notify Adult Protective Services or the nearest law enforcement agency. Anyone who makes a report in good faith is immune from civil liability in connection with the report; however, any person who willfully fails to report is guilty of a class B misdemeanor.

The following is a list of indicators of abuse, neglect or exploitation. It is important to note that the following lists are merely indicators and may not always be violations.

Signs of abuse:

• Unexplained bruises, welts, fractures, abrasions or lacerations
• Multiple bruises in various stages of healing
• Multiple/repeat injuries
• Low self-esteem or loss of self-determination
• Withdrawn or passive
• Fearful
• Depressed, hopeless
• Soiled linen or clothing
• Social isolation

Signs of neglect/self-neglect:

• Dehydration
• Malnourishment
• Inappropriate or soiled clothing
• Odorous
• Over/under medicated
• Deserted, abandoned or unattended
• Lack of medical necessities or assistive devices
• Unclean environment
• Social isolation

Signs of exploitation:

• Missing/”disappearing” property
• Inadequate living environment
• Frequent/recent property title changes or will changes
• Excessive home repair bills
• Forced to sign over control of finances
• No/limited money for food, clothes and other necessities

Prevention can only occur if there is awareness, the statutes are adhered to, and any suspicions of abuse, neglect or exploitation of vulnerable adults are immediately reported to Adult Protective Services and/or law enforcement.

All states have agencies that receive complaints of abuse. In some states, failure to report abuse of the elderly is a crime. To contact an abuse complaint department, call your local area agency on aging. To find an agency on aging in your area go to: http://www.longtermcarelink.net/eldercare/ref_state_aging_services.htm

According to a report from USATODAY/ABCNews/Gallup Poll, 41% of Baby Boomers are caring for their elderly parents, either personally or financially or both.

Many of these caretakers find themselves in a situation where their parents did little or no planning for their physical or financial long term care. This puts the burden squarely on the shoulders of the adult children. Discussions around where the parents will live – at home, with an adult child, in assisted living – how their living expenses will be paid for, how medical decisions and final arrangements will be made can often lead to stress and contention among family members.

If you find yourself in this situation, learn from your parents’ example and don’t let the same thing happen to you and your family. Here are some things you can do right now to start planning for your future to prevent your children from going through the same experience.

It is best for parents and all family members to be involved in planning for future financial needs. The financial resources being used today could change drastically with the occurrence of a stroke, illness or onset of dementia. To plan financially for long term care, you need to know what the costs are now and what they may be in the future.

MetLife does an annual survey of long term care costs. Their 2010 survey shows that the average daily rate for a private nursing home is $229, which is up from $219 in 2009. Assisted living monthly base rate cost rose to $3,293 in 2010 from $3131 in 2009. Home health aides average $21 an hour.

Although it’s difficult to plan exactly how much or how long you will need care, you can determine what will be needed in certain living situations. Staying in your home for care will require Professional Home Care assistance, travel accommodations to doctor appointments, help with shopping, meals, medical supplies and medication and possibly a 24-hour attendant. Even if a family member is doing most of the care, eventually professional care will be required or a move to a nursing home facility will be necessary.

When evaluating your present income and assets consider how they would work for future needs.

• What are my care options?
• What type of long-term care can I afford?
• Do I have long term care insurance?
• Are there assets I can sell?
• If I stay at home how will I pay for care?
• Do I have to sell the house to pay for other living arrangements?
• Do I have life Insurance or the means to pay for a funeral and burial?
• Will my spouse be cared for financially?
• Should I do Medicaid planning?

Long term care insurance is one option for paying for care. Long term care insurance helps pay for the care you need when you can no longer care for yourself. It can protect your family’s financial future and your own investments. There are qualifications that need to be met with health and age. This type of insurance is more expensive the older the person and almost impossible to get if age related illness has already occurred.

Senior Financial Planners, Elder Law Attorneys and Veteran Benefits Consultants can assist you in evaluating your needs and future planning.

Senior Financial Planners are expert in working with seniors and their families to set up long term care plans. They usually work with an Elder law Attorney and Care Manager (Professional) to give you all options and resources for care. Elder Law Attorneys help with Medicaid Planning and Asset protection as well as legal documents needed for final requests.

If you want to stay in your home, a Reverse Mortgage may provide the funds to pay for home care.

Another option for veterans who served during a time of war is the Aid & Attendance Benefit. This benefit provides extra income up to $1,949 to help pay for home care, assisted living and medical costs. It will also pay for widows or widowers of the Veteran. To learn more about qualifications for these benefits contact a Veteran Benefit Consultant in your area.

Knowing your needs and financial resources is essential before making any long term care decisions.

Accreditation

Federal law dictates that no one may help a veteran in the preparation, presentation and prosecution of an initial claim for Veterans Administration (VA) benefits unless that person is accredited. The only exception to this law is that any one person can help any veteran — one-time only — with a claim. To help any veteran a second time requires accreditation.

VA recognizes 3 types of individuals for purposes of accreditation.

1. Accredited attorneys
2. Accredited agents and
3. Accredited representatives of service organizations. (Veterans Service Officers)

An individual desiring VA accreditation must:

1. Submit a formal application
2. Meet certain character requirements and work history requirements, and
3. Pass a comprehensive test relating to veterans claims and benefits. (Attorneys are exempt from this requirement)

There are also requirements for ongoing continuing education.

What Does It Mean to Help a Veteran with a Claim?

The VA interprets its prohibition on preparing, presenting and prosecuting a claim to mean that talking to a veteran or a veteran’s qualifying spouse or dependent after that person has indicated an intent to file a specific claim for benefits requires accreditation. Anyone can talk about veterans’ benefits in general with any veteran and need not be accredited. However, when the discussion turns to specific information about the veteran’s service record, medical conditions, financial situation and other issues relating to a claim, this triggers the accreditation requirement. According to the VA, discussing the specifics of the claim means that the veteran has expressed an intent to file an application for veterans benefits, and at this point, the consultant helping the veteran must be accredited.

Stated again: An individual cannot advise a veteran or other eligible beneficiary about that person’s specific claim for VA benefits unless that individual is accredited.

For a better understanding of how the VA General Counsel interprets the need for accreditation please go to the VA Office of General Counsel Website — Frequently Asked Questions about Accreditation at http://www4.va.gov/ogc/accred_faqs.asp.

Working under the Umbrella of an Accredited Attorney or Accredited Claims Agent

Many individuals or organizations who are not accredited and who are promoting and helping veterans obtain their benefits are often attempting to work under someone who is accredited. Most of these individuals are doing it wrong and not complying with the law.

The only way that a non-accredited individual can operate legally to assist someone who is accredited is to immediately refer a veteran or dependent to an accredited person when first understanding an intent to file a claim. No additional help or advice may be given after the intent to file has been recognized.

Many accredited attorneys also are not operating legally. Only an accredited attorney — one-on-one with the client — may be involved with a claim. Anyone else, inside or outside of the office, cannot assist with the claim except under certain limiting conditions. Specifically, in order to work under an attorney, a non-accredited assistant must either be another attorney in the office, a certified paralegal in the attorney’s office or an office law student or intern. The client must also sign a consent letter allowing this arrangement. This consent must be filed with the original application. No other arrangement is allowed. Please see 38 CFR § 14.629 for an explanation of this requirement.

Charging a Fee for Help with Filing a Claim

Generally, no individual or organization may charge a fee for help with filing an initial application for benefits. There is only one exception to this rule and that is under the third-party exemption in 38 CFR § 14.636 (d). The requirements under this exception are very specific. In our opinion, no one that we know of, who is charging a fee, thinking he or she is operating under this exception, is doing it legally. Here are the ways these people are violating this law. (In most cases those who are operating illegally are engaging in all 4 of these unlawful activities.)

1. The person paying the fee is not a disinterested third party as required by law.
2. The person filing the claim is not submitting the fee agreement to the VA General Counsel as required.
3. The person filing the claim is not submitting the disclaimer to the VA General Counsel as required.
4. The fee is contingent upon a percentage of the amount of the approved benefit.

We are seeing various financial arrangements for filing claims that are disguised fees in one way or another. As a general rule, anyone who would directly benefit financially from helping a veteran file a claim – whether or not a direct fee is charged — is in essence charging a fee. We know from numerous discussions with representatives, this is the way the VA General Counsel treats these arrangements.

If you are working with someone who is not operating legally as outlined above, you should stop using that person’s services. If you yourself are operating in a manner that is not in accord with the conditions outlined above, you must stop doing that. You’re not legal. Not only could unauthorized individuals get a notice to cease and desist, but in some cases there could be fines or legal action involved as well. It’s not worth it. For help with accreditation issues you can contact the National Care Planning Council at info@longtermcarelink.net.

I’m pleased to share with you a recent feature article that ran in the Career and Jobs section of the San Jose Mercury News and other affiliates in the Bay Area.

Minda Cutcher, Financial Advocate for Seniors

By Charlotte Cusack

What’s your background?

I spent over 30 years in the private sector managing multi-million dollar budgets and leading large teams in the telecommunications industry. As a woman engineer in the 70s, I was part of a program that helped expose women with management potential to almost every kind of position and function possible, which included designing additions for telephone buildings, property management, construction project management, human resources and field operations. At another company, I was a finance manager responsible for both billing and collections activities for over $500 million in annual revenue.

I earned a bachelor’s degree in Civil Engineering from Cornell University and a Master of Business Administration (MBA) with a concentration in Finance from Northeastern University.

Tell me about your journey to becoming an advocate.

I’m an only child, and my parents were older when they had me. They started to decline earlier than my peers’ parents, so I’ve had to face the issues involved with parenting one’s parents before my friends did.

My mother passed away over 10 years ago. Eventually, my father’s health significantly declined; he was 93 years old and living 3,000 miles away when I became more involved in his care. I was laid off from my finance manager position three years ago, and I turned my focus to caring for my dad. I learned that his cleaning lady was helping him pay the bills, and I discovered he wasn’t taking advantage of benefits, such as veteran’s benefits for which he was entitled. A week after my father passed away, I also realized that there was so much business around death. Getting death certificates, calling social security, stopping pension payments – a lot of stuff nobody tells you about, all on top of planning his funeral and trying to dispose of his property.

Finding work was difficult because the economy had just tanked, so I decided to start my own business helping seniors and their adult children navigate through what I call the ‘financial challenges of aging.’

What are your duties?

The business initially began as a way to help seniors balance their checkbook, pay bills and organize a budget. But, after helping a few clients, other issues came up, such as overdue charges on credit cards. So, the advocacy element entered, and I was able to call the credit card company on their behalf and get the fees waived. Today, I offer a variety of services: Household management, downsizing and move management, health care cost reduction and geriatric care management. I also have a trusted professional network of other individuals and businesses to assist seniors who I can direct my clients to.

I don’t make decisions for the members of a family, but I provide all the necessary data in order for them to make an informed choice. About half my clients are adult children who are making decisions on behalf of a parent who cannot handle their own affairs anymore. The others are self-sufficient seniors who just need a little more help around the home.

Why do you love your job?

It’s very heartwarming work, and I consider it an honor because I am privy to intimate details of my clients’ lives. My primary responsibility is to the senior and protecting their assets and their wishes. I call myself a ‘dutiful daughter’ because, in some cases, I act like a stand-in for an adult child as I help a client through difficult transitions.

What’s your advice to someone interested in this profession?

I believe you need business experience, and you definitely need life experience. I think it’s a fabulous career for those who are looking for a second career or people who have gone through this. Strong communication skills, empathy and a high level of ethics are all important. Trust is very important, especially because you’re dealing with family finances and the realities of family dynamics. There will always be a need for the younger generation to care for the older generation, and it’s an honor and privilege to help families put the necessary support in place.

Most of us are familiar with the saying, “A fool and his money are soon parted.” And yet, I’d venture a guess that many of us have made a bad investment decision at some point in our lives – either in money, time or trust in another person. When we’re young, these are learning experiences. You assess the damage, pick up the pieces and vow not to be duped again. For the elderly, however, who may not have the time to recoup their loss, these bad investments can be devastating.

Elder financial abuse is one of the fastest growing crimes in the country. According to a recent study, the annual loss by victims of elder financial abuse is about $2.6 billion. Tragically, the perpetrators of this abuse are often family members and others who have gained the trust of the senior. Identity theft in particular is most commonly committed by family members because of their easy access to information and the unlikelihood of the crime being reported. In a previous blog I discussed the reasons why seniors are vulnerable to scams and fraud. Now I’d like to talk about what to do if you – or someone close to you – has been the victim of fraud, a scam or identity theft.

• Report it immediately. By contacting the authorities you may help protect someone else from similar abuse. Provide names, dates and as many details as you can remember. Give them copies of any relevant documentation. If not reported, abuse can escalate. There are several agencies, such as your state Department of Consumer Affairs, whose job it is to protect the public from unscrupulous vendors. State or local social services agencies, such as Adult Protective Services and the local police department should also be contacted. The Older Americans Act of 2006 defines senior exploitation and enables law enforcement agencies to prosecute those who perpetrate elder abuse.
• Share the lesson. There is no value in shame. Talking about what happened to you may help protect someone else’s dignity, assets or even their life. Unscrupulous contractors are famous for blanketing neighborhoods, and touting their work with “your neighbor down the street.” If you’ve been the victim of abuse – or if someone has tried to take advantage of you, even if they failed – share this with your neighbors, friends and the local police so they can be on their guard.
• Protect yourself and your loved ones. Work together to develop strategies to avoid financial abuse. See my previous blog on 5 easy ways to protect your parents’ cash.