E. Tina Cheplick, RNGeriatric Care ManagerE. Tina Cheplick, RNGeriatric Care Manager

Care Solutions for Elderscaresolutionsforelders.com

Carolyn Rosenblatt, RN Attorney at Law

Help With Elders, San Rafael, CA www.HelpWithElders.com

Financial Planners Partnering with Geriatric Care Managers and

Attorneys

Financial Planners Partnering with Geriatric Care Managers and

Attorneys

To give your client resources in making the best decisions for long term care planning

To help in understanding the elder client

To provide choices to the elder client for planning long term care.

Why consider Other Professionals to assist with clients?

What is a Geriatric Care Manager?

What is a Geriatric Care Manager?

Are health and human service specialists

Trained in fields relating to Long Term Care( including but not limited to Nursing, SW, Gerontology)

Act as guides and advocates Identify problems offering

solutions

Professional Geriatric Care Managers Impact

Quality of life

Professional Geriatric Care Managers Impact

Quality of life We provide objective evaluations and plans Coordination and supervision of in home care and

companion services On going management and oversight of care A single point of access to the range of eldercare

options Liaison service to families at a distance Consumer education, advocacy and promotion of

independence Costs savings Counseling and support

Healthcare needs undermine the client’s ability to manage money and make decisions.

Input to you from a GCM and an attorney can help you protect and prioritize your client’s assets.

Planning for your client’s diminished physical and mental health can save your client money and save you from unnecessary aggravation later

On Going Re-Assessment can help you know what your client doesn’t know

OUR PROFESSIONAL PROCESSES

THE CURRENT SITUATIONTHE CURRENT SITUATION

America is graying fast This year over 9 million Americans over

the age of 65 will need Long term care services.

By 2020 over 12 million will need them 60% of individuals over age 65 will

require at least one type of LTC service over their lifetime

Who decides when elders will need services?

Age-risk increases as we age

Singles are more likely to need assistance

Women live longer Life style risk factors Genetics as a risk factor

HEALTH TRENDS

HOW MUCH CARE WILL ONE NEED

HOW MUCH CARE WILL ONE NEED

On average someone 65 today will need LTC for three years

Women need care lasting 3-7 years Men need care lasting 2.2 years 20% will need care for more than 9

years such as care in the home, care in the community, care in Skilled nursing facility

COSTSCOSTS

Based on national surveys in 2007 the national average costs for a semi-private room was $66,000

One year at home with periodic care 16,000/year

$2,714 a week for assisted lvg facility

IMPORTANCE OF PLANNING

IMPORTANCE OF PLANNING

Anticipating that one will need to spend assets on care or placement is essential to good financial planning

Its likely one will need some type of care service

Understanding the costs associated with LTC should be part of what you help your clients plan for

Planning reduces stress Preserving independence requires that you

help your client plan for possible incapacity

“ we both have strong feelings about what type of treatments we

would want, but we’d never bothered to put those wishes in

writing. Now that we have all of the necessary legal documents, our

children and our doctors won’t have to guess about what we want and

don’t’t want in case we can’t speak for ourselves”

“ we both have strong feelings about what type of treatments we

would want, but we’d never bothered to put those wishes in

writing. Now that we have all of the necessary legal documents, our

children and our doctors won’t have to guess about what we want and

don’t’t want in case we can’t speak for ourselves”

ESTABLISH CLEAR LEGAL DIRECTIONS

ESTABLISH CLEAR LEGAL DIRECTIONS

ADVANCE DIRECTIVES DURABLE POWER OF ATTORNEY

for FINANCES TRUSTS, WILLS, REVERSE

MORTGAGES, AND OTHER PLANNING ARE MUSTS

CONSERVATORSHIPS ARE A LAST RESORT, BUT A PLAN SHOULD BE IN PLACE IN CASE THIS IS EVER NEEDED.

ResourcesResources

www.medicare.govMedicare Rights Center( for clients)

NAPGCMWestern and National chapters

Area Agency on AgingEldercare Locator 1800-677-1116

State Medical Assistance Office

How Can A Lawyer Help You Help Your Client?

How Can A Lawyer Help You Help Your Client?

Once the estate plan is done, the lawyer can provide ongoing advice, assessment and support to your aging clients.

.

TEAM APPROACH

The Team ApproachThe Team Approach

FP, Geriatric Care Manager, Lawyer: can this work for you and your client?

When is it time to back off? When is it time to step up? Get advice from other professionals

when you are not sure. The security and safety of our elders is at stake.

Case Study: “Mary”, the son, and loss of mental

capacity

Case Study: “Mary”, the son, and loss of mental

capacity “Mary”, an 87 year old with dementia,

was trustee of her estate, consisting of a home in Marin County and cash assets, invested by her financial planner. She began to decline in physical health. Her memory was so-so. Her son contacted attorney Carolyn Rosenblatt because he was concerned that the bills were not getting paid by the CPA, Mary’s successor trustee.

Documents we all need to understand

Trusts: who is the trustee, successor trusteeIssue: if the elder is the trustee, when is ittime for the successor trustee to take over?The lawyer can help you here!

Durable power of attorney (DPOA) for finances

Power of attorney for health care (also called a “healthcare directive”, “living will”, etc.).

Limitations: trust may not address care, where to live,who will decide where the incapacitated elder should live. We like the DPOA which addresses these things.

Case Study, cont’dCase Study, cont’d

The successor trustee was a CPA who had known Mary for years. He had her best interests at heart, but he had no knowledge of her true mental status, which was rapidly worsening. Her son was an alcoholic, and was incapable of handling her money. Mary lived in a board and care home. She wanted to return to her house to live. What to do?

Case Study cont’dCase Study cont’d

Mary needed a manager or power of attorney who could visit her, check her progress and also protect her assets. She was supporting her son, who lived in her home. He had many unrealistic ideas about what was best for her. He wanted access to her checkbook. The CPA had taken away access. He had also prevented Mary from having control of her funds. The CPA visited Mary once.

Case Study cont’dCase Study cont’d

Son, Mary, and Mary’s friend met with attorney Rosenblatt

Interventions Interview Mary, friend, son together and apart Psychological assessment obtained Draft Durable Power of Attorney Communicate with CPA Refer to GCM for health assessment Appoint fiduciary who could visit Mary

Encourage fiduciary to hire GCM Cheplick

Case Study cont’dCase Study cont’d

Result of interventions CPA resigned and fiduciary was hired. Mary’s son had limited access to funds Attorney coordinated GCM, fiduciary,

son Mary received the care she needed as a

result of the GCM’s regular visits Mary finally passed away, safe and at

peace.

Knowing Your Limitations Knowing Your Limitations

Don’t expect that you can do everything. Use other professionals to handle the areas in which they have expertise.

Make referrals to the right help Do expand your role as money manager to

compassionate professional who is willing to “be involved” in the elder client’s safety issues.

Start with your intake information. • Do you know the client’s estate planning attorney• Do you have a record of whom to contact if your

client’s mental status declines?

E. Tina Cheplick, RNGeriatric Care ManagerE. Tina Cheplick, RNGeriatric Care Manager

Care Solutions for Elderscaresolutionsforelders.com

Carolyn Rosenblatt, RN Attorney at Law

Help With Elders, San Rafael, CA www.HelpWithElders.com