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Jim & Dawn R.
after MassHealth approval for Dawn’s Mom
Client and Professional Colleague
Emergency Guardianship Client
Business Owner, Creditors’ Rights Client
SOME ELDER LAW SUCCESS STORIES TO ILLUSTRATE WHAT WE DO
The answer to the question of “What is Elder Law?” often ends up being long and convoluted because the practice is defined by the needs of the client rather than any single substantive area of the law. Although many of our clients share similar concerns, every client and family is unique and solutions must be found that address their special circumstances. Collectively their stories help to illustrate what exactly it is that we do.
Single elder client with three adult children. We did estate planning over a period of years. Early work included the creation and funding of an Irrevocable Trust to protect her $250,000 house in the event she needed nursing home care in the future, and a Revocable Trust for the rest of her assets. Five years passed, and the transfer was no longer subject to any transfer penalty rules: the entire now appreciated value of the house was completely protected. House then sold. At closing, the check was made payable to the “Revocable Trust” rather than the “Irrevocable Trust.” Because we had accompanied her to the closing, we were able to preserve her planning by refusing the check and requiring that it be rewritten to the “Irrevocable Trust.” Had she accepted the check as written and deposited the funds into her Revocable Trust account, she might have undone five years of work and again exposed the $250,000 to the costs of her care. With the fix, the funds remained fully protected. Her non-protected funds were spent down over the next few years for her home care and assisted living. She ultimately needed nursing home care, and we were able to immediately get her MassHealth benefits, with the funds remaining in the Irrevocable Trust not counting towards her $2000 asset limit. On her death, the $200,000+ funds remaining in her Irrevocable Trust were distributed to her children as she had wished.
Elder couple. Very limited resources. Husband suffering from progressive illness. Wife killing herself taking care of him. In addition to helping with referrals to geriatric care manager, home modification contractor, home health services, and community benefits, we helped to facilitate reverse mortgage to help them get an infusion of cash to cover bills and help to keep him at home. And, when they began to hire outside help which increased their out-of-pocket expenses, we helped them to pursue Veteran’s Aid & Attendance benefits to help cover the unreimbursed medical expenses.
65 year old single Daughter who had lived her whole life living with and taking care of Mom. Mom’s health declined, and first project was getting Mom qualified for MassHealth benefits to pay for the nursing home. We were able to get “Home Maintenance Allowance” from Mom’s income so that Daughter had funds available to continue to cover house expenses. On Mom’s death, Daughter inherited the house. Second project involved planning for Daughter’s own future care needs which included taking steps to protect what was now her house. Daughter’s ultimate goal is to be able to pass her estate on to her nieces and their families.
Elder couple owned two houses with a total value of approximately $600,000. We created an estate plan which included Wills with “testamentary supplemental needs trusts” designed to protect assets for whichever of them lived longer. Because at the time plan was created we had no idea who might pass away first, assets were titled so that even if no additional work was ever done, on the death of the first, at least $300,000 would be preserved. Husband (“H”) suffered a sudden stroke, and was in a coma for five days. In the hours before he died, Wife (“W”) signed new Deeds transferring over to H the $300,000 of real estate remaining in her name, giving H 100% ownership of all of the real estate. Through H’s estate, the full $600,000 was protected for the benefit of W, and will be completely not-countable in the event that W ever needs nursing home care.
Elder couple gave their children over $65K of cash gifts over previous couple of years before Husband ended up in a nursing home. Ordinarily, those transfers should have resulted in a long period during which H would have been disqualified from receiving MassHealth benefits. We had no doubt that if the family had done the application themselves, or had been talked into letting the “free” agency used by the nursing home to submit the application for them, H’s benefits would have been denied because of the gifting. We presented the application in such a way so as to explain the gifts, resulting in no disqualification penalty.
Elder client already in a nursing home, paying privately, but hoping to transition to MassHealth coverage. Client’s son purchased a large single premium immediate (and irrevocable!) annuity for Dad in reliance on what turned out to be inaccurate representations by the insurance agent. Unfortunately, the contract was disqualifying under Medicaid rules, and this purchase would have resulted in Dad being ineligible for benefits for many months. Working with the Son, and ultimately threatening to sue the insurance company for unfair and deceptive practices, we were able to un-do the purchase, get the funds back into the dad’s name, preserve them through a pooled trust deposit, explain it all on the application, and get Dad approved without any penalty.
85 year old single client came for an initial consultation. Towards the end of the meeting, she suffered a stroke! We called 911, were able to share with the EMTs the limited amount of medical knowledge she had shared with us, and she was rushed to the hospital. She never returned home and remained in a nursing home until her death over a year later. There is no doubt that had she been alone at home when this medical emergency occurred, she would have died! (This qualifies as the most terrifying thing ever to occur in Deborah’s now 30 years of practice.) We were able to help the hospital identify distant relatives, and ultimately to help the family assume responsibility for client’s finances and healthcare, and to access MassHealth to pay for client’s care.
Young couple, already accumulated assets well in excess of $1 million. Two very young children. Created estate plan that will protect them in event of disability, will minimize or avoid estate tax exposure, appoints guardian for their children in the event that both parents died prematurely, established plan that will ensure the kids are fully provided for and protected through at least age 25, and beyond.
Elderly couple in assisted living facility (“ALF”). Owned over $400K in cash assets. H declined and moved to a nursing home. We were able to get H on MassHealth right away, and through appeal process, W was able to keep all of the cash assets (even though they were far above the standard asset limit) so that she could continue to live in ALF. W is now 94 years old and still going strong, able to live out her days there without having to worry about running out of money
Elder couple. Existing trust plan, done by an estate planning attorney who did not specialize in elder law. Documents were well-written, but did not accomplish any asset preservation for long term care planning purposes. However, clients believed that their trust protected their house from exposure to costs of care. On review of existing plan, we had to break the news that their understanding was wrong, and house was still exposed. Because they were still relatively healthy, and had enough other assets to carry them through in the event of a medical crisis, we were able to create a new Trust that will indeed protect the value of the house as they wished.
Single elder client. No children. Substantial assets. Very strong feelings about her family members, important to her that they NOT inherit from her. Worked with her to create a Revocable Trust and then to retitle her assets into the Trust so that on her death there will be no need for probate (which would involve notice to her family) and her assets will pass quickly to a variety of charities and causes important to this client.
Elder client living in home she and her six siblings had inherited from their parents in the 1950s. She could no longer live there alone, and wanted to sell. But title was all messed up due to deaths along the way of several of the siblings, each of whom had lived in a different state. She was basically a prisoner in her house, because she had no resources to move without the sale proceeds. It took many months, and many thousands of dollars of legal fees and court costs to clean up the mess, but ultimately through a variety of probate proceedings we were able to completely clear title, sell the house, and share her joy when she moved to her new apartment. (The moral of this story: a few hours of legal time to identify and address issues, invested before or right after someone dies, can save months/years and lots of money and angst down the line.)
Elder gentleman. In senior housing. Very limited funds and not in good health. Just needed disability planning documents so that his son would be able to help him when he was no longer able to do things for himself. During our meeting, client expressed concern about credit card debt that was hanging over him and causing considerable stress. We were able to write letters for him that ended collection efforts, and gave him peace of mind for his remaining days.
Elder couple, living at home. Wife suffering from advanced Alzheimer’s. Husband, who had been caring for his ill wife, was himself dying of cancer. Immediately before he died, we were able to get niece appointed as guardian/conservator for Mrs. A. and got court authority to transfer the couple’s home to the husband. Mrs. A. was unable to live alone, and within a few weeks moved to a nursing home where she spent the rest of her life. But through Mr. A’s death bed estate planning we were able to preserve the couple’s limited assets to supplement Mrs. A’s care and greatly improve the quality of her remaining years.
Widowed, youngish client with diagnosis of early Alzheimer’s. Approximately $800,000 of assets, including retirement accounts and real estate. Two younger children, one in college and one still living at home. Anticipating future care needs and a $2000 asset limit for government assistance, plan included creation of an Irrevocable Trust funded by house to begin process of asset preservation. Facilitated care management consultation to help family identify and access care that will help her remain independent at home as long as possible, and facilitated hiring a professional trustee who will be able to provide guidance to the financially inexperienced (albeit legally adult) children as their mom’s condition progresses.
Two young adult children of older estate planning clients, each about to embark on exciting work opportunities out of the country. Anticipating the possibility that financial matters might need to be handled here at home while they were away, or that one (or both) could become seriously ill abroad, we made sure that each now has disability planning documents in place that empower their parents to help them in a crisis, or just for convenience.
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