Pennsylvania - Pittsburgh

I was at a family reunion recently, and I overheard a lady say that one of the challenges of getting old is seeing your parents aging. This lady is probably in her late 50s and she is the caregiver for her mom, who is in her 80s, with very serious health problems. Speaking with the owner of a relatively large business recently, he said that many of his employees are needing to take time off from work. This is because they are caregivers for their parents. This is a sign of the times, and there are an increasing number of people dealing with these issues.This One Is For The CaregiversMost of our presentations and educational content are focused on our clients, whether its retirees in their 60s or seniors in their 70s and 80s. We do estate planning across the generations, but given the increasing number of caregivers taking care of their parents, I wanted to reach out to the caregivers. The title of this blog What to think about when the unthinkable happens, refers to what we should think about and do as caregivers, if a parent becomes sick or passes away.Estate planning is really about the management of control and access. The control aspect refers to who is making the decisions, and access refers to what is allowed with regard to the finances. If my client has a stroke, or gets dementia, they may have mental faculty issues. As a result, they may not be able to manage their own affairs as they used to. If you notice your parents health is declining, as caregivers you need to consider the following:Power Of Attorney DocumentThe first thing you need is a document called a financial power of attorney, which shifts control when someone needs assistance. There are essentially two types of Power of Attorney documents:A springing power of attorney is based on the idea that you sign the document while you have the capacity, so that should anything happen, your child can take over. The problem is that nobody ever admits that they are losing capacity, especially if they have dementia. It then becomes a battle if the child needs to use the power of attorney, to act on behalf of a parent.The other type is a durable power of attorney, which you sign while you have your mental faculties. However, the document is effective immediately even if your child may not use it immediately. This type of Power of Attorney is preferred in most situations. Since dementia is progressive in nature, there will likely be a gradual decline in a seniors mental capacity. Over time, the child caregiver will need to take more responsibility to help their parent. Eventually the time will come when the parent cannot manage on their own. This is the time when the durable power of attorney will work, and is the primary way to plan for someones incapacity.Asset Protection Is ImportantAnother suggestion is to consider doing some asset protection, using an asset protection trust. I recommend these trusts for middle class and upper middle class families who are concerned about long term care expenses. We can work with you to create these trusts. The system in this country often results in seniors going broke if they need long term care. Nursing homes in Pennsylvania cost $180,000 a year and most people cant afford to pay that. Only when you are broke, can you get Medicaid benefits to pay the nursing home. Medicaid is the only payment source for long term care, and its important to understand the rules of Medicaid. One of the rules is that if you have transferred assets to an asset protection trust ahead of time, those assets are protected from long term care costs.We Can Help You To Find Long Term Care FacilitiesIf you have a parent who is starting to slip, they may need long term care at a later stage. Please take the time to understand the different types of facilities available to provide care for your loved one. We help our clients with this aspect, and we have a social worker on our team who is familiar with the different facilities. We help people find good care, which I believe is part of doing good estate planning.Take Care Of YourselfWhile you are taking care of a loved one, if you are a caregiver, you must get the resources to help you to take care of yourself. Here is link to a website with information on caregiver resources: https://www.hospiceandpalliativecareofkodiak.org/caregiver-resources. Jennifer who started this company did so after being a caregiver. She realized the many challenges that caregivers face from an emotional standpoint. You are not in this alone and you also need the support.Losing A Loved OneWhen we talk about the unthinkable happening, we are talking about losing a loved one. Perhaps youre the executor and you are wondering what you should do first if your loved one passes away. Let me reassure you that there is no legal or financial emergency that needs addressing in the first 48 hours. If you have just lost someone dear to you, allow yourself time to grieve. When it comes to the estate administration process, it is a marathon and not a sprint. This is especially pertinent when it comes to probate cases. Please contact the Sechler Law Firm or your estate planning attorney, to get help with the estate administration process. 

According to the American Heart Association, high blood pressure contributes to many significant health conditions, including heart attack, heart failure, stroke, and kidney failure. In the United States, 121.5 million adults suffer from high blood pressure, also known as hypertension. While half of these individuals have improved their conditions, others have uncontrolled blood pressure, which can harm their health. Self-monitoring ones blood pressure can help control this condition. Depending on your state, Medicaid may cover part of the cost.What Is Self-Measured Blood Pressure (SMBP)? Medical care is an important part of blood pressure management. Yet, you can also help your doctor treat you by monitoring and recording your symptoms at home. This is called self-measured blood pressure (SMBP). When combined with a doctors support, SMBP might improve your health. You can use a manual blood pressure cuff or an automated blood pressure device to monitor your BP. With at-home measurements, you can record your blood pressure levels over time. Your doctor can use this information to help treat you. The Benefits of Monitoring Blood Pressure at HomeSome evidence suggests that SMBP with clinical support may be more effective than medical care alone. When you measure your blood pressure at home, you can assess your condition regularly. You don't have to wait for a medical professional to evaluate your BP. If your blood pressure becomes dangerously high, you can inform your doctor and seek emergency treatment. By keeping track of the fluctuations in your blood pressure at home, you can give your doctor detailed information to help with your treatment. For instance, your doctor can use the information to decide what kind of medication and dosage to prescribe. Sometimes, blood pressure levels change depending on the situation. SMBP can identify forms of hypertension that present differently. At-home measurements can reveal white-coat hypertension (when a patients BP is high at the doctors office, but at a healthy level at home) and masked hypertension (when BP readings appear normal in a doctors office but are high in other settings, such as at home or work). Why Might Medicaid Beneficiaries Need Coverage for SMPB?Per Medicaid.gov, one-third of all Medicaid beneficiaries have high blood pressure. With uncontrolled hypertension disproportionally affecting low-income, non pregnant adults, SMBP coverage and reimbursement through Medicaid can be beneficial for many.Does Medicaid Cover Home Blood Pressure Monitoring?Medicaid covers SMBP in certain states. Yet not all states have coverage. Continue reading for more information.What Does SMBP Medicaid Coverage Include? Depending on your state, Medicaids coverage for self-measured blood pressure could include the following: Provider reimbursement for medical supportBP measurement devices for you to use at home (manual blood pressure cuffs or automated blood pressure devices)In most states with SMBP coverage, Medicaid takes care of medical care as well as devices. Other states cover just one or the other. The American Medical Association outlines what Medicaid provides in each state.Which States Cover Medical Support and BP Measurement Devices?The following states provide coverage to some extent for both medical support and devices: ArizonaColoradoDelawareHawaiiIdahoIndianaMichiganNebraskaNew JerseyNew MexicoNorth CarolinaNorth DakotaOhioOregonTexasVirginiaWisconsinWyomingThese states only cover durable medical equipment (manual blood pressure cuffs or automated blood pressure devices):AlaskaArkansasCaliforniaConnecticutD.C.IllinoisIowaKansas (only covers manual blood pressure cuff)LouisianaMaineMarylandMassachusettsMinnesotaMississippiMissouriNevadaNew HampshireNew YorkUtahVermontWashingtonThe following states reimburse providers for supporting patients with SMBP. However, Medicaid doesn't pay for at-home devices. GeorgiaKentuckyMontanaRhode IslandSpeak With an Attorney If you have high blood pressure, self-measurement might help. Consult with an attorney to learn more about whether you could be eligible for Medicaid coverage in your state.

An estate plan often focuses on tangible property such as jewelry, artwork, money, and vehicles. However, in this age of technology, it is important to remember to include your digital assets. Digital assets consist of everything we own online. Because we spend more time on computers and smartphones than we ever did before, you may not realize how much digital stuff you own, from photos and videos to online accounts, cryptocurrency, and nonfungible tokens (NFTs).Why Is It Important to Plan for Digital Assets?Planning for digital assets is important for several reasons. First, without a plan, digital assets may get lost in the Internet ether and not pass to your loved ones after your death due to the simple fact that their existence is unknown. Second, planning now means your family will not have to worry about hunting for these items upon your death while also grieving a beloved family member. Third, like most adults (roughly 70 percent of them), you want certain aspects of your digital life to remain private. If you do not create a plan, your loved ones may learn things that you wish to keep secret. Finally, planning now can minimize the risk of identity theft, which happens to 2.4 million deceased Americans each year. Keep reading to learn more about why it is important to include digital assets in your estate plan and how to account for them.Digital Assets: What Are They?Instead of existing in photo albums and on videotapes and DVDs, most of our family photos and videos are now digital. Even if they lack commercial value, they certainly have sentimental value that you want to preserve for your family and friends. Social media accounts containing your photos and videos can also have value to your loved ones when you are gone. For example, a Facebook account can serve as a memorial after you pass away. When you consider all of the other accounts that you log into (more than 130 on average), the list becomes quite lengthy. Digital assets that you may own include the following:Social media accounts (e.g., Facebook, Twitter, LinkedIn)Financial accounts at brick-and-mortar and online institutionsBusiness documents and other files stored in the cloudCryptocurrencyNFTsDatabasesDevice backupsInternet domain names and uniform resource locators (URLs)Streaming service accounts (e.g., Netflix, Peacock, Hulu)Merchant accounts (e.g., Amazon, Etsy, eBay)Gaming tokensVirtual avatarsPoints-based loyalty programs (e.g., for groceries, gas stations, airlines, and hotels)Rights to intellectual property, artwork, and literatureOnline betting accountsMonetized video contentIncluding Digital Assets in Your Estate PlanTaking inventory of your digital assets may take some time, but it is worthwhile. If something were to happen to you, your estate planning attorney or another trusted person should have complete access to your online footprint. This includes usernames and passwords for all accounts. Tools such as Dashlane or the password manager integrated in your browser can be used to simplify the storage of usernames and passwords. In addition, you should continuously back up all digital assets, including photos and important documents, to the cloud, and ensure that your attorney and trusted person can easily access them when the time comes. Because they are not controlled by governments or banks, cybercurrency and NFTs must be handled carefully. You do not have the option of calling customer service to reset your password if you forget or lose it. NFT and cryptocurrency passwords should be stored online in a hot wallet, or in an offline device known as a cold wallet. Either way, someone needs to know how to access your passwords when you cannot. Other estate planning considerations for digital assets include the following:Your estate plan can provide that your digital possessions be handled by one or more cyber successors who can distribute your digital assets like tangible property.One cyber successor can control your Instagram account, for example, while another can take possession of your Bitcoin. Keep in mind that passwords should not be memorialized in your will, especially regarding cryptocurrency, as they could be made public if the will is submitted to probate court. Consider how technologically savvy a person is before appointing that person as your cyber successor.Next Steps for Your Digital AssetsTalk to your estate planning attorney about your digital assets and cyber successors. Have a conversation with potential cyber successors about how they would handle your assets, and make sure that they would carry out your wishes before appointing them. Digital assets can be placed into a trust or distributed through your will, or you could grant access to them through a power of attorney. With the help of an experienced estate planning attorney, you can feel relieved that your digital assets will be easily located, managed, and passed to your loved ones.

First-Time Caregiver?  You're Not Alone and Hospice Can HelpTaking care of someone who is seriously ill or facing a life-limiting illness can be intimidating, tiring and sometimes frustrating. But your role as a first-time caregiver can also be rewarding if you:Lean on your hospice team for support, education and hospice-specific careFollow the advice and suggestions of experienced caregiversNearly 40 percent of Americans are providing long-term care to an older family member or friend, according to the Associated Press-NORC Centers Long-Term Caregiving Poll.1 Caregivers include 59 percent women, 41 percent men, with older caregivers likely to be caring for a parent or spouse, and those under 40 likely to be caring for a grandparent or friend.Hospice supports patients and their first-time caregiversIf your loved one has a life-limiting illness that qualifies for hospice care, start by calling VITAS to explore the home-based services and benefits that are available to first-time caregivers. Resources range from weekly visits from members of a VITAS hospice medical team (physician, nurse, aide) to home delivery of equipment, supplies and medications related to your loved ones diagnosis. Most hospice care is provided at home, wherever your loved one calls home.Explore Medicare benefits for hospice careThe costs of hospice care are fully covered for hospice-eligible patients by Medicare, Medicaid and most private insurance plans. Talk to your love ones doctor about the requirements for a hospice referral, knowing that primary-care physicians can remain involved in your loved ones care even after they are receiving hospice services.The goal of hospice care is to relieve the burden on your terminally ill loved one by addressing pain, managing symptoms and supporting quality of life at the end of life. Hospice also supports caregivers by providing access to a hospice chaplain, social worker, volunteer and bereavement support up to 13 months after a loved ones death.The national caregiving poll found that prayer and meditation were common sources of comfort and coping for caregivers, and other strategies and tips from experienced caregivers can help first-time caregivers avoid caregiver burnout.Just remember that if youre a first-time caregiver, youre not alone.1Associated Press-NORC Center for Public Affairs Research. June-July 2018 poll of 1,024 U.S. adults. https://www.longtermcarepoll.org/long-term-caregiving-the-true-costs-of-caring-for-aging-adults/