216 Higgins Road Park Ridge, IL, 60068 (847) 221-0154
Have you ever had a “senior moment” or know someone who has? Do you have trouble remembering facts about your own life – either from years past or from the past five minutes? These are common and usually not a cause to worry. But sometimes these are our first steps on a long journey of care needs. If so, then these may be the first steps of a journey that can lead to increasing confusion, loss of memory and other cognitive impairment. Dementia and Alzheimer’s affect many Americans and is characterized by progressive changes in a person’s behavior and personality. Because dementia can be a progressive disease that can go on for many years, long-term care in an intermediate care or skilled care nursing home (including memory care facilities) will often become a necessity. First, talk to your Chicago area doctor or your loved one’s doctor if you are noticing any signs or symptoms of memory loss, personality changes, or impaired thinking or judgment. Also, you should take steps now to consult a Chicagoland elder law attorney to prepare legally and financially for the coming years of long-term care, even if the journey has already begun and you or a loved one are already in the early stages of Alzheimer’s or other forms of dementia. For example, start thinking about “senior estate planning” with legal documents such as advance directives,  powers of attorney for property, powers of attorney for healthcare, wills and trusts that are designed specifically for seniors, rather than non-seniors, and a host of related planning tools that are designed to preserve your assets, legally and ethically. Similarly, position yourself properly take advantage of governmental benefit programs that you have paid into during your lifetime as a U.S. Citizen-Taxpayer. Select the right options and elections in Social Security. Do you understand your options in the four main Medicare plans: Parts A, B, C and D? Have you planned your affairs with a view toward your eligibilityfor long-term care through the Medicaid program in order to avoid total impoverishment and have some asset protection should you require long-term care for many years. Don’t wait….take action now. Make certain that you are “getting your ducks are in a row”. ABFerraro
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The Senate passed a compromise bill, called the American Taxpayer Relief Act of 2012 (ATRA), to avert the fiscal cliff at about 2 AM on January 1, 2013 by an overwhelming 89 to 8 vote. ATRA is generally classified as tax legislation, but has built into it numerous provisions affecting public benefits, elder care, Elder Law and our seniors and boomers in general. What does this mean for seniors and boomers? Consider the following: 1. Tax rate changes – The bill permanently extended current tax rates for individuals earning less than $400,000 and couples earning less than $450,000. Wealthy taxpayers (those making more than $400,000) will revert back to a 39.6% (up from 35%) tax rate. Taxpayers in this wealthy category will also see an increase in their capital gains tax rate and dividend tax rate from 15% to 20%. Also, married couples that earn more than $300,000 and individuals that earn more than $250,000 will face a phaseout of the personal tax 2. Estate Tax Changes – The estate tax is alive and well. The federal estate tax exemption for 2013 will be $5.25 million per person and be indexed for inflation in future years. Effective January 1, 2013, the top federal estate tax rate will increase from 35% to 40%. Portability of the unused exemption will remain in place for spouses. And the gift tax exemption will remain at $5 million. The Illinois estate tax exemption will increase to $4 million per person for 2013. 3. Payroll tax – Since 2011, the payroll tax rate, which funds Social Security, was kept at 4.2%. Starting January 1, 2013, the payroll tax rate will now revert back to 6.2% for those earning wages. 4. Good news for doctors (and all of us) – For another year, doctors will not suffer the previously scheduled 27% reimbursement cuts to Medicare patients’ fees. 5. Older Americans Act funding – There is additional increased funding for important aging programs. For fiscal year 2013, Area Agencies on Aging will receive an additional $7.5 million in additional funds. The Aging and Disability Resource Centers received an additional $5 million. The National Center for Benefits and Outreach Enrollment will also see an increase of $5 million in funding. Also, Medicare State Health Insurance Programs (SHIP) will receive an additional $7.5 million in additional funding for 2013. 6. Sequestration- The scheduled automatic spending cuts are delayed by a few months. Half of the cuts would come from defense spending and the other half would come from non-defense spending. 7. Class Act is repealed – This was to be an attempt at a national long-term care insurance program. It was scrapped in exchange for the establishment of the Commission on Long-Term Care. 8. Commission on Long-Term Care- This commission will develop a plan for the establishment, implementation and financing of a comprehensive system that ensures availability of long-term services and support. The commission will look into the coordination of Medicare, Medicaid and private long-term care insurance. The commission will have 15 members, including the President. The various members will represent the interests of consumers, older adults, family caregivers, healthcare workers, private long-term care insurance, state insurance departments, and state Medicaid agencies. Let’s hope they come up with an affordable long-term care model for our boomers and seniors. Remember, the most painful financial crisis affecting seniors and boomers today is the devastating cost of long-term care ($6,000 to $10,000 per month, per person in the Chicagoland area!). . Other items – The bill extended Medicare programs for older Americans including the payment for outpatient therapy services and specialized Medicare advantage plans for special needs individuals. The bill also extended the qualifying individual program (QI program). 10. Note: This is complicated stuff. But don’t let it stop you. Keep reading in the months ahead to understand more of the changes and how they might impact you. Also note that this bill still doesn’t solve the problems regarding sequester and the debt limit debate. That heavy lifting is still coming. Things will certainly heat up in trying to resolve those issues. We will be writing about the impact of “sequestration” soon. The Takeaway: Stay tuned in. Start your ” Senior Estate Planning” now. Anthony B. Ferraro Attorney- MsTax- CPA          
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This will depend heavily on how much care your mother requires. A private agency or home health provider can help determine what skill levels are needed and find you a suitable worker. You might need somebody just for housekeeping-type chores, such as cooking and cleaning. If your mother has not moved past the beginning stages of Alzheimer’s and remains fairly independent, you might want to hire a sitter so she isn’t left alone. If this is the case, make sure you specify you want a sitter with experience with dementia patients. If your mother requires more help with things such as bathing, toileting or dressing, you will need a certified nurse aid, or the equivalent. A nurse would become involved only when your mother would require skilled services. These become needs typically after a hospital stay. A home care agency can provide the aid and advice you require. An agency will do the background checks, actual hiring, training and payment of the worker — and dismissal if/when it’s needed. Many people think it’s worth it to pay for this bit of extra support. If you hire an assistant on your own, you can count on spending a lot more time on the particulars, though the monetary cost will likely be lower. Again, depending upon your mother’s abilities, adult daycare is another option. Your mother could attend all day and get any or all of the services mentioned above taken care of. She would receive supervision, meals, activities, socialization and assistance as needed. For you, as a family caregiver/hostess, it will give a needed break. Your mother probably also will like the change of scenery and socialization, among other things. And she should get good care. This is a scenario many people face. Remember to go with your gut feeling when you are dealing with anyone caring for a loved one. If you are not entirely — as in 100% fully — comfortable with a person charged with taking care of a loved one, you should reconsider and make changes as necessary.  For more information, an excellent resource is “The Indispensable Alzheimer’s Resource Kit.” It can be downloaded at no cost by clicking here.
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This is a good question for Alzheimer’s patient caregivers since it’s not an uncommon scenario. At some point, you dad may decide he’s ready for death. This could be verbal, but if he can’t talk, you still might be able to sense it. By this point, no doubt, the disease will have been a tough battle. He could be very tired. As hard as it might be for you or other family members, you have to let go and allow your father his wish, and the peace he is seeking. Death is, after all, a part of life. For him, death is a good thing. For those left behind, it can be difficult. It is never easy, no matter how long the disease has been around or how much you’ve prepared for a final good-bye. By this time, you will already have lost a lot of your father along the way, yet it is tough to come to grips with because it is so final. Let yourself grieve. Talk with others around you — friends, family, professional counselors, clergy, etc. Continue to speak with your father. Reminisce together. Sharing your feelings and thoughts can be a healing process. Of course, contact your father’s physician if you sense he is ready to die. The doctor might order hospice care. It is a wonderful service that will not only help your father but also you and the rest of the family. Hospice workers’ goal is to make your father comfortable, peaceful and pain-free. They also want to support you in your time of grief and lighten your load. They will allow you to rest and recoup energy. Hospice is there to help the entire family in the grieving process.  An excellent resource is “The Indispensable Alzheimer’s Resource Kit.” It can be downloaded at no cost by clicking here.
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You are going through a grieving process when you are in a situation like this. A normal, regular stage of grief is anger. The key is to not let it overtake you or cause declines in your own physical or mental health. Grieving has several stages. Just like individuals experience Alzheimer’s in different ways, at different speeds, the same is true with grief. Some stages might be quicker than others, and some might not materialize at all. Be patient with the grieving process. Allow yourself to feel, allow grieving to run its course. When Alzheimer’s is involved, the 10 normal stages of grief are as follows: (REMEMBER: You might or might not experience all of these, and even then, to varying degrees.) Shock: Disbelief that Alzheimer’s has been diagnosed. Denial: It’s not really Alzheimer’s. It’s just a stage that will pass. Depression: Feelings of loneliness and isolation take over. Physical symptoms of distress: Sickness and tiredness consume you or your thoughts. Anxiety: What will the future hold? What might happen to me? And other worries. Anger: Everyone’s fair game: Anger at the disease, the doctor, your loved one, even at God for “allowing” this to happen. Guilt: Blaming ourselves — often for things we have/had no control over, or for doing things we think we shouldn’t have done, such as yelling. Hesitancy to keep up normal activities: Worries about how others will view or treat you and/or your loved one. Healing of memories: Realize that painful memories are actually part of the healing process. Acceptance: Coming to grips with the fact that your loved one has Alzheimer’s, it is here to stay and you simply have to make the best of it. Alzheimer’s is tough on the psyche. Because your loved one can go through several stages of the disease, you might experience stages of grief (as described above) with each one. Realize that this is normal. Allow grieving to take place. Let yourself be angry. Keep a journal with your feelings and thoughts. This is often a healthy way to express yourself. It allows you to vent, without hurting your loved one or anyone else around you. If you can deal with your feelings in this manner, you will be in better shape to help your loved one — and conduct your life as you need to. If you become dispirited and internalize your distress, it can damage you not only mentally or emotionally, but physically as well. That is not going to help you be there for your loved one’s needs. Here is something that will help you deal with your feelings: “The Indispensable Alzheimer’s Resource Kit.” These FREE books will help you deal with your feelings, as well as with dozens of other subtopics.
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The jury is still out on this one. Scientists now tell us that if you have a blood relative who has Alzheimer’s, your chances of getting it are much greater than someone who doesn’t. This does not mean, however, that if you have more than one relative with Alzheimer’s, your family has one of the forms of the disease that apparently could be strongly inherited. A good place to look for more information on this topic is the website of the Alzheimer Society of Canada. (http://www.alzheimer.ca) There is a lot of detailed information about genetic research and Alzheimer’s here. If you have a loved one with Alzheimer’s, it’s best to deal with the situation in a constructive way. As difficult as it might be, you should not worry about something that might or might not happen, ruining your quality of life in the process. People have become debilitated by the fear of possibly inheriting Alzheimer’s. Don’t fall into this trap. Put your thoughts into a journal. Obtain professional counseling if your normal routines start to fall apart. Whatever you do, don’t try to deal with this alone. Your best support group will probably be friends and family, so keep them near. Join a formal support group (and start one if there’s not one available for you). Even if it you just wind up going for coffee with a friend or relative, that’s a start that can be built upon. You need to talk about Alzheimer’s after it has entered your life (in whatever manner it does). Talking with others in a similar situation can be especially helpful since they will understand what you are going through and vice versa. There are many beneficial resources available in the Indispensible Alzheimer’s Resource Kit including resources to assist you in journaling.
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Caring for a beloved family member with Alzheimer’s isn’t easy. In fact it is one of the toughest tasks anyone can undertake. As an Elder Law attorney, I witness the burden families bear taking care of their loved ones with Alzheimer’s. What’s more, I see too many families who haven’t taken the right steps to protect themselves… and it’s sometimes too late to help them. They’ve unknowingly made little mistakes that render their loved one ineligible for important benefits, costing them $5,000 to $7,000 a month or more in long term care fees. That’s why I’m making an incredible resource available to everyone in the Alzheimer’s community – and it’s completely free and you can access all or any part of it online. The Indispensable Alzheimer’s Resource Kit has the information that’s vital to caregivers. I feel so strongly that caregivers should understand the steps they need to take right now that I am making it available to anyone who wants it. You will find:
  • How you may be able to get help paying for nursing homes, assisted living, or in-home care for your loved one.
  • How to avoid caregiver burnout, which can result in serious health problems.
  • Answers to the 101 most frequently asked questions about Alzheimer’s.
  • How to know when it is the right time to take away the car keys.
  • Helpful tips to find the right nursing home when it is appropriate.
  • Three one-hour recordings discussing Alzheimer’s Caregiving tips and techniques, featuring caregiving expert Jo Huey.
Many families find out too late that there are simple steps that could have protected them from being out of money and out of options. Don’t let that happen to you.   To get access to your FREE Alzheimer’s Kit go to www.RosemontMemoryLawyer.com or call the office at 847-292-1220 and we will sign you up to receive this valuable information!
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DIRECTIONS TO OUR OFFICE (Street map is available below) Columbia Center I 5600 N. River Road, Suite 764 Rosemont, IL 60018 (NW Corner of River Road & Bryn Mawr) 847-292-1220 ****Important Information**** Our building security requests that you write down your vehicle license plate number when you enter the building. Please jot this information on a piece of paper so that it is readily accessible. From the North: Take 294 South and get off at the 190 West exit (to O’Hare). After paying toll, look for the exit ramp which says Mannheim South. Take Mannheim South and then take the entrance ramp to I-190 East. Proceed for approximately ½ mile until you see the River road exit. Exit at River Road. At the bottom of the ramp, make a right turn. Our building is the first building on the right. Turn right on Bryn Mawr and turn right into the parking lot. From the West: Take the Northwest Tollway, and look for the exit titled 190 West (O’Hare). Proceed on 190 West and after paying the toll, look for the exit ramp called Mannheim South. Take Mannheim South and then take the entrance ramp to I-190 East. Proceed for approximately ½ mile until you see the River road exit. Exit at River Road. At the bottom of the ramp, make a right turn. Our building is the first building on the right. Turn right on Bryn Mawr and turn right into the parking lot. From the South: Take 294 North to the O’Hare River exit. Exit at River Road. At the bottom of the ramp, make a right turn. Our building is the first building on the right. Turn right on Bryn Mawr and turn right into the parking lot. From Downtown: Take the Kennedy to O’Hare-River Road-Mannheim extetnsion. Stay to your right and look for the River Road exit (about ½ mile) and exit at River Road. At the bottom of the ramp make a right turn and proceed south on River Road. Our building is the first building on the right. Turn right on Bryn Mawr and turn right into the parking lot. To Return to 294 North: From our building, take River Road North approximately ¼ mile to the on ramp for 190 West. Get on the 190 West on-ramp and look for the exit ramp called Mannheim South, approximately ½ mile. Take Mannheim South, then immediately look for the entrance ramp called 190 East. Get on the 190 East ramp and proceed on 190 East until you see the Northbound entrance to 294. Enter the on ramp and you will be on 294 North. [mappress]
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  A NEW MINEFIELD FOR SENIORS Illinois’ Proposed New Medicaid Rules for Long Term Care             On August 3rd, we were informed that Illinois Department of Human Services Director Julia Hamos had signed proposed rule changes for Medicaid eligibility in the State of Illinois.              The rules were published in the Illinois Register on August 13th.             The proposed rules will have a tremendous impact on senior citizens and disabled persons seeking Medicaid coverage for long term care.             If any individuals or organizations wish to submit written comments or testify at the September 13th public hearings described below, they should contact our offices at 847-292-1220.  Any effort to inform state officials about the public’s opinion of these new rules will possibly result in the rules being finalized in a way that is fair for our citizens.             Public hearing requests must be received by the Illinois Department of Human Services within 14 days of publication.  There will be a 45 day public comment period and public hearings are scheduled to commence on September 13, 2010 at 9:00am at the Michael Bilandic Building, 160 N. Clark St., Chicago, Illinois, Room 500.             As I have explained in prior newsletters, we have expected the proposed rules to be forthcoming for a substantial period of time.  On February 8, 2006, President Bush signed the federal Deficit Reduction Act (DRA).  The proposed Illinois rules that were published on August 13th are being proposed by Illinois to implement, in part, the Federal DRA.             In summary, here is a timeline for upcoming DRA matters in Illinois:
  • August 2, 2010              Signing Date
  • August 13, 2010            Publication Date
  • August 27, 2010            Deadline for public hearing requests for groups of 100, or 25 individuals
  • September 13, 2010      Public Hearing
  • September 27, 2010      Deadline for written comments
            The rule changes are numerous and complex.  Below are just a few of the changes.  I hope this will help you understand the impact of these changes: 1)     Medicaid applicants will be subject to a five year lookback period.  Previously, the look back was three years (36 months).  Under the proposed rules, all applicants for Medicaid coverage for long term care under either the community care and the in-home service programs, the supportive living program, or a skilled nursing program, will be required to produce accounting and documentation for all financial transactions during the five years prior to the date of the application.  This is, in effect, an onerous 5 year audit. 2)     Start date of penalized transfers made harsher.  Up until now in Illinois, the penalty period began at the time the transfer was made. Under the new rule the penalty period for non-allowable transfers will commence only when the applicant is eligible for Medicaid benefits (but for the penalty period in question).   This means commencing the penalty period only when the person is institutionalized and has applied for Medicaid.  This will have a disastrous consequence and negatively impact senior citizens in nursing facilities or SLF’s and those waiting to be admitted if they have made any transfers of assets during the past 5 years.  For example, a senior with dementia who makes withdrawals totaling $50,000 from her savings account 14 months prior to the Medicaid application will be ineligible for Medicaid long term care benefits for 10 or more months following the month in which she applies for Medicaid.  Where will that money come from to cover her through that ten month penalty at such a late date in her life? 3)     Partial returns of prior unallowable transfers are not permitted.  This means that if a senior citizen grandmother gave away $50,000 to a grandchild so that the grandchild could go to college, such gift could result in a ten month penalty.  If the child was able to give back $49,000, the penalty period would not be reduced because the proposed law requires that the entire $50,000 be returned.  What if only $49,000 can be returned? What happens to the generous and helpful grandmother if there is no commensurate penalty reduction? 4)     $500,000 limit on home equity that is exempt.  Prior to the proposed rules, there was no limit on the equity of property used as a principal residence.  Thus, a Medicaid applicant’s principal residence was an exempt resource regardless of value.  The proposed rules impose a $500,000 limit on the exempt value of a principal residence when the owner is institutionalized or residing in a nursing home.  States are given an option of increasing the level of exemption to $750,000 under federal law. Final note: There are other changes, such as changes to annuities, spousal refusal to disclose assets, accumulation of gift penalties etc. that will be onerous for many of our senior and disabled citizens. In our forthcoming Elder Law Updates, we will provide you with more information about the rules and what can be done to deal with these new rules. If additional information is desired, please don’t hesitate to contact our offices at 847-292-1220. Elder Law & Long Term Care Planning Attorneys The “3 Phase” Lawyers Legal Counsel Assisting You in the 3 Phases of Your Life: –           Maturing Years – Will, Trust, Taxes, and Asset Protection  –           Senior Years – Long Term Care: Pre-Planning and Crisis Planning –           Post Death Years – Estate, Probate, and Trust Administration Educate to Motivate This communication is advertising material.  This is not intended to be, and cannot be, used as legal advice. Anthony B. Ferraro Attorney-CPA The Law Offices of Anthony B. Ferraro, LLC The Estate & Trust, Elder and Asset Protection Law Firm Columbia Centre I 5600 N. River Road, Suite 764 Rosemont, IL 60018 PH (847) 292-1220 FAX (847) 292-1221 Website:  abferrarolaw.com  Email:  abferraro@abferrarolaw.com NOTE: The information contained in this message is confidential and may be protected by the attorney-client privilege and/or the work product doctrine.  If you have received this electronic message in error, please reply to the sender and destroy this message. Pursuant to federal regulations imposed on practitioners who render tax advice (“Circular 230”), we are required to advise you that any tax advice contained herein is not intended or written to be used for the purpose of avoiding tax penalties that may be imposed by the Internal Revenue Service. The Illinois rules of Professional Conduct require attorneys to identify unsolicited communications to prospective clients as Advertising Material.  If the context requires, please consider this letter and the enclosed literature to be Advertising Materials. To unsubscribe, please reply to this email.  In the subject line, please write your name and the word “unsubscribe.”  If you are responding on someone else’s behalf, please also include the email address that our message was sent to.  Thank you. This document is for discussion purposes only and is not intended to be, nor should it be, considered as legal advice.  You should never attempt Medicaid planning, Estate Planning, Probate, or Estate and Trust Administration without the advice of competent legal counsel.
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A New Illinois Bill To Protect Seniors From Financial Elder Abuse Please note that Governor Quinn signed a bill that was designed to protect seniors from financial elder abuse.  The bill will be handled with the involvement of the Illinois Department of Aging and Illinois Department of Financial Professional Regulation which will establish standards and trainings for employees at financial institutions to keep on the lookout for financial exploitation of the elderly.  The new law is requiring financial institutions across the state to become more vigilant and on the lookout for matters pertaining to financial elder abuse of our senior citizens.  The bill requires reporting when abuse is suspected.  This is a step in the right direction.  Let’s hope that the implementation will allow this to be a useful tool in protecting the elderly.  Continuing Care Retirement Communities (CCRC) The Senate recently held hearings on matters pertaining to Continuing Care Retirement Communities (CCRCs).  The investigation dealt with matters pertaining to the current market conditions and some of the financial risk associated with residents in CCRCs.  Recently there have been some failures in CCRCs.  This places the financial investment and also the continuity of care for the resident seniors at risk.  The CCRCs are a good concept, but be sure you review the contract for your care thoroughly and do your due diligence early on. NEW FREE E-COURSES We invite you to sign up for one of our three FREE e-courses: Estate Plan Essentials Guide, Veteran’s Benefit Report, and Medicaid Nursing Home Guide.  After signing up for an e-course, a series of letters will be emailed to you which discuss our areas of practices and services we provide clients.  http://www.estateplanessentialsguide.com/ http://www.veteransbenefitreport.com/ http://www.medicaidnursinghomeguide.com/ Long Term Care Planning Attorneys The “3 Phase” Lawyers Legal Counsel Assisting You in the 3 Phases of Your Life: –           Maturing Years – Will, Trust, Taxes, and Asset Protection  –           Senior Years – Long Term Care: Pre-Planning and Crisis Planning –           Post Death Years – Estate, Probate, and Trust Administration Educate to Motivate This communication is advertising material.  This is not intended to be, and cannot be, used as legal advice. Anthony B. Ferraro Attorney-CPA The Law Offices of Anthony B. Ferraro, LLC The Estate & Trust, Elder and Asset Protection Law Firm Columbia Centre I 5600 N. River Road, Suite 764 Rosemont, IL 60018 PH (847) 292-1220 FAX (847) 292-1221 Website:  abferrarolaw.com  Email:  abferraro@abferrarolaw.com.   NOTE: The information contained in this message is confidential and may be protected by the attorney-client privilege and/or the work product doctrine.  If you have received this electronic message in error, please reply to the sender and destroy this message. Pursuant to federal regulations imposed on practitioners who render tax advice (“Circular 230”), we are required to advise you that any tax advice contained herein is not intended or written to be used for the purpose of avoiding tax penalties that may be imposed by the Internal Revenue Service. The Illinois rules of Professional Conduct require attorneys to identify unsolicited communications to prospective clients as Advertising Material.  If the context requires, please consider this letter and the enclosed literature to be Advertising Materials. To unsubscribe, please reply to this email.  In the subject line, please write your name and the word “unsubscribe.”  If you are responding on someone else’s behalf, please also include the email address that our message was sent to.  Thank you. This document is for discussion purposes only and is not intended to be, nor should it be, considered as legal advice.  You should never attempt Medicaid planning, Estate Planning, Probate, or Estate and Trust Administration without the advice of competent legal counsel.
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