Dirk is asking whether expenses incurred solely on account of the patient's disability can still be set against tax liability even if the patient is living at and care for at home. I imagine he is thinking in terms of specialist equipment, continence care supplies, HCA fees, nursing care and so on. I don't know the answer to Dirk's question but I'm sure somebody else will?
This is all very valuable information. I sure wish I'd thought to cancel mom's credit cards. After giving away over $20k, she ran up $11k in donations. I don't know what to do.
The article is helpful, but I have a question. If a doctor diagnoses dementia and the the person is bedridden and taken care of at home, to what extent can the patients income be specified as being necessary to support the patient?
Quick ad comment on tracking meds - does MedEx transfer the information if you ever change pharmacies, or insurers? Sounds like a helpful service, especially if they have a way to transfer information when resources change.
I used to think that MDs kept track of the meds for each patient, but when my Vet, using a medical model, was treating my elder cat in his last year of life, I would get so annoyed when I'd bring the cat for a check up on a condition he had described to me, and I assumed then that we were now following - and the first question the vet would ask me on each visit was: What meds is he taking?
I was annoyed and confused - for he was the only doctor involved, and he had originated the plan and the list, with long explanations to me each time about the needs and the reasons and tracking procedures.
I kept saying, don't you have a system for each patient, that lists all their meds? He and his staff would say they asked because they wanted to check and see if I would report giving the right doses as updated - but I believe that was actually a cover up, for the lack of an office procedure, to track all meds going into one patient.
My brother's insurance reports for prescriptions, sends me lists of meds purchased during the last month, so that is up to date, but I would have to pull them all out and study the history, to note any changes.
Thank you, John. That was very helpful. Amazing actually. One thing I would like to add about the medication is we use MedEx, a pharmacy that organises medications, compares for the lowest price, they contact the doctors for the scripts, provide a list of updated meds, fax them to your doctors so they have the latest information for your loved ones appointments and all doctors are aware of what the others are prescribing. MedEx helps with advice on medications and then packages them according to time of day they are given and mails them to your house (they also do vitamin supplements etc.). I then take these packets and put them in the automatic pill dispenser that gives off loud beeps until I dispense the meds. It is great for aides that come in and are unfamiliar with the medication routine. If your loved one still lives at home and you are managing the meds, it is a Godsend.
This is enormously helpful and clear, with the plans for ongoing tracking in mind.
When I had responsibility for my disabled brother, I learned about record-keeping piecemeal, from the demands of different organizations, but because those change over time, I found record-keeping frightening, and would delay it until forced to sit down and create tallies. When a new organization, or even other family member became involved, I did new tallies from their perspectives.
The meds I did not track as much, my brother only takes 5, but I can see how maintaining a chart, could have helped.
Because he has never been able to gain an income, or manage his own affairs, I became his Representative Payee early in his life, when he left home, and later I became Healthcare POA. I followed and helped with his care all along, and doing that well was my focus, and as noted, the needs change over time, as do programs. I found that if the care arrangement is set up to really meet his needs, it is more economical. He gets services under low income guidelines, and the nursing home he needs by now, manages that tracking. But while I was managing his living situation and daily care needs, tracking the finances seemed to be just one major added challenge, on top of helping him, finding the right care, and advocating for pieces of help.
I did track finances, but I like the 3 essentially targeted systems you have come up with, to update regularly.
The original poster gave a very rosy picture of The Perfect Way Things should be Done. Unfortunately, most families are.not operating this way and have not, for several decades. In my family the picture - perfect accounting (3 tidy schedules, and correctly done taxes) were not done by the former POA. I took over mid-stream and began to get things organized but mom died before too long...and now, wouldn't you know it!!! the siblings are stamping their little feet wanting all the details.
although I like to have respite from my husband's son a day or two a year, he allows my husband to drink two or three beers and than drive by himself. he arrives home not able to walk a straight line. I have stopped the private visitation because of fear of what could happen when my husband is alone behind the wheel. I am however now taking him on vacation with us so he can see his dad. talking does not help. I feel like I have two patients at once. this seems so straightforward but it is not, due to the fact that his son refuses to visit my husband's doctors and is in denial of his father's 14 year struggle with vascular dementia now with Alzheimer's. any suggestions?
Yes, an Elder Law attorney can be an invaluable asset if you are planning for long term care. They can help you with basic estate planning including living wills, power of attorney designations and your last will and testament. They can help you with Medicaid and VA applications.
They can also assist you with more complex planning with assets and resources for those who may have an opportunity to preserve and protect some level of assets. Medicaid, VA and the IRS all have different rules and an experienced Elder Law Attorney understands how to plan to address all of these.
Most estate planning attorneys can establish a basic estate plan for their clients. The complexity occurs when the client is of a certain age and/or are facing health challenges. This is the trigger that indicates that your current concerns and goals may be different from what they were years ago. Often times the new goals revolve around the question "how do I access and pay for care?"
Access to care isn't usually the challenge. The bigger question is how to pay for care. An Elder Law Attorney should specialize in Medicaid and Veterans' benefits. If VA benefits are a consideration they should be VA accredited.
In recent years Life Care Planning has been a component of some Elder Law that firms across the country. While each firm may have their own management style they all prescribe to the same philosophy regarding the importance of having an advocate on staff to help their elder clients navigate the long term care system.
They can assist you with selecting a long term care community, home care or hospice provider. They can also assist with care conferences and advocate on your behalf during hospital discharges and nursing home discharges. Their role is quite broad and if you are looking for personal attention with regards to navigating the long term care system then working with a Life Care Planning attorney should be a consideration.
What can you do if the parents refuse to cooperate with you, and the rest of the siblings want the money but don't want the work? When the bank says Mr. Smith you need to designate a POA or have someone on your account so that bills can be paid and "Mr. Smith" responds negatively-what then?
John L. Roberts, Expert, Certified Elder Law Attorney, has been very helpful in providing all the information in respect to questions Care Givers may have in taking care of an elder and a loved one. I highly appreciate all the kind advice, assistance and instructions that Mr. Roberts has provided. You have just helped me in so may ways in taking care of my mother who has dementia and who is going through the last years of her journey through life. Thank you.
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4 Elder Law Organization Techniques That Helped Us Care for Dad
I used to think that MDs kept track of the meds for each patient, but when my Vet, using a medical model, was treating my elder cat in his last year of life, I would get so annoyed when I'd bring the cat for a check up on a condition he had described to me, and I assumed then that we were now following - and the first question the vet would ask me on each visit was: What meds is he taking?
I was annoyed and confused - for he was the only doctor involved, and he had originated the plan and the list, with long explanations to me each time about the needs and the reasons and tracking procedures.
I kept saying, don't you have a system for each patient, that lists all their meds? He and his staff would say they asked because they wanted to check and see if I would report giving the right doses as updated - but I believe that was actually a cover up, for the lack of an office procedure, to track all meds going into one patient.
My brother's insurance reports for prescriptions, sends me lists of meds purchased during the last month, so that is up to date, but I would have to pull them all out and study the history, to note any changes.
When I had responsibility for my disabled brother, I learned about record-keeping piecemeal, from the demands of different organizations, but because those change over time, I found record-keeping frightening, and would delay it until forced to sit down and create tallies. When a new organization, or even other family member became involved, I did new tallies from their perspectives.
The meds I did not track as much, my brother only takes 5, but I can see how maintaining a chart, could have helped.
Because he has never been able to gain an income, or manage his own affairs, I became his Representative Payee early in his life, when he left home, and later I became Healthcare POA. I followed and helped with his care all along, and doing that well was my focus, and as noted, the needs change over time, as do programs. I found that if the care arrangement is set up to really meet his needs, it is more economical. He gets services under low income guidelines, and the nursing home he needs by now, manages that tracking. But while I was managing his living situation and daily care needs, tracking the finances seemed to be just one major added challenge, on top of helping him, finding the right care, and advocating for pieces of help.
I did track finances, but I like the 3 essentially targeted systems you have come up with, to update regularly.
for long term care. They can help you with basic estate planning
including living wills, power of attorney designations and your last will
and testament. They can help you with Medicaid and VA applications.
They can also assist you with more complex planning with assets and resources for those who may have an opportunity to preserve and protect some level of assets. Medicaid, VA and the IRS all have different rules and an experienced Elder Law Attorney understands how to plan to address all of these.
Most estate planning attorneys can establish a basic estate plan for
their clients. The complexity occurs when the client is of a certain
age and/or are facing health challenges. This is the trigger that
indicates that your current concerns and goals may be different from
what they were years ago. Often times the new goals revolve around
the question "how do I access and pay for care?"
Access to care isn't usually the challenge. The bigger question is
how to pay for care. An Elder Law Attorney should specialize in Medicaid and
Veterans' benefits. If VA benefits are a consideration they should be VA accredited.
In recent years Life Care Planning has been a component of some
Elder Law that firms across the country. While each firm may have
their own management style they all prescribe to the same
philosophy regarding the importance of having an advocate on staff to
help their elder clients navigate the long term care system.
They can assist you with selecting a long term care community, home care or
hospice provider. They can also assist with care conferences and
advocate on your behalf during hospital discharges and nursing home
discharges. Their role is quite broad and if you are looking for
personal attention with regards to navigating the long term care
system then working with a Life Care Planning attorney should be a
consideration.
A couple of helpful links:
To check if an attorney is VA Accredited
http://www.va.gov/ogc/apps/accreditation/index.asp
To find an Elder Law Attorney who offers Life Care Planning
https://lcplfa.org/