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Being a Healthcare Advocate: How to Best Engage with Healthcare Professionals

The first time you attend a doctor’s appointment as your parent’s healthcare advocate, you might feel a little awkward. That’s natural. You’re kind of like a third wheel, stepping into what was previously a very private and intimate conversation.

To prepare for this, it’s helpful to establish preferences and expectations with your parent up front. Does your parent want to take the lead and just have you present as an extra set of eyes and ears, or will you be taking a more active role in communicating with the doctor. Talk with your parent in advance so you are both on the same page with your game plan.

It’s a good idea to bring the health journal mentioned previously with you to appointments both for reference and as a place to take notes about any questions and answers discussed with the physician or nurse. (While you might be tempted to record conversations with doctors using your phone or other device, this can sometimes make physicians uncomfortable. If you must, it’s best to ask permission first.)

Try to keep appointments focused on the two or three most pressing issues. Respect the role you agreed to in your pre-visit conversation with your parent, but don’t be afraid to speak up if questions are either overlooked or not answered to your satisfaction. Ask for clarification if you’re unsure of a term or instructions.

If your parent sees multiple doctors, don’t assume that they are all communicating with one another. It’s part of your job as a healthcare advocate to bridge the gap between different parts of your parent’s care and ensure that all parties are up to date on the latest developments and treatments. Diligent record keeping and communication are a major part of any healthcare advocate’s duties. While doctors may lay claim to the medical expertise needed to care for your parent, you are the expert on your parent’s overall health and treatment.

Becoming a healthcare advocate for a parent is a big responsibility both logistically and emotionally, but it doesn’t have to be an overwhelming experience for you or your parent. Making time to have important conversations before you step into your role can go a long way toward preparing you both for the changes ahead. Collecting and reviewing all the relevant information before you dive into attending doctor’s appointments and handling other details will help you feel more confident and capable. And, finally, knowing how to effectively engage healthcare professionals in the doctor’s office and beyond will put you and your parent more at ease during those visits.

And that’s a big part of being a supportive healthcare advocate – making the journey less stressful for everyone involved.

#healthcare #parents #aging #seniors #caregiver
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Being a Healthcare Advocate: 9 Important Tips

As you embark on your journey as a healthcare advocate for a loved one, you’ll want to make sure you’ve got as much information at your fingertips as possible.

Emergency can strike at any time, and you want to be prepared; but even simple routine care can require a high level of organization and knowledge. It’s best if you give yourself time (by starting early) to pull all the information together. Don’t wait until something happens.

Here’s a starter list of preparations for a new healthcare advocate:

Collect all the contact details (names, emails, telephone numbers, office addresses, etc.) for any primary care and specialist physicians. You may also want to get information about hospital and health network affiliations, which insurance they accept, and any outside billing partners they may employ.
Request copies of your parent’s medical records. These documents will include information about general health, diagnoses, medications, visit notes, test results, and other key information about your parent’s medical history.
Compile a list of all the medications your parent takes, including dosage and any other relevant details.

Keep a health journal for your parent — a notebook or computer file in which you record a running list of concerns (your parent’s and your own), health-related events, and so forth. This will be a valuable resource at doctor’s visits.
Make sure that your parent’s medical file is updated with your contact information both as a reference and in case of emergency. You may also want to provide a list of any additional family members who can be permitted access to medical records and/or the physician. Remember, however, that while your parent may grant additional people access, for day-to-day matters, you will want to establish one person as the primary contact.

Provide your parent’s primary physician with signed copies of your parent’s healthcare proxy or durable medical power of attorney (POA) for healthcare. A durable POA provides additional legal leverage, and as of October 2016, updated POA laws in Connecticut provide even greater protections. (In fact, even if your parent currently has a POA in place, you may want to update that document in order to take advantage of the new protections, which only apply to new POAs, not ones that existed prior to October 2016.)
Introduce yourself to the pharmacist who will be filling your parent’s prescriptions. Pharmacists can be a valuable resource for helping you sort out any potential drug interactions and so forth.

Know your hospitals. In case of needing special testing, treatment, or support for a healthcare emergency, the facility can make a big difference in both experience and outcome. While you can’t always choose where your parent goes, it’s smart to know ahead of time about any personal preferences, specialized care options, insurance considerations, and so forth.
Research your parent’s healthcare insurance and Medicare/Medicaid benefits so that you understand exactly what is covered (and what is not), and also so that you’re better equipped to be able to spot anomalies on statements and bills.

By doing the up-front work of organizing and reviewing all the relevant information and documentation, you will feel much more prepared for whatever comes your way. Just taking the time to familiarize yourself with everything can go a long way toward reducing stress and anxiety – for both you and your parent – as you get used to your new role.

Original article appears on our blog at: #healthcare #parents #caregiver #aging
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Estate Tax Changes: What They Mean For You…If Anything

Most people are not affected by changes in laws related to estate taxes – you can see below just how small this population is.

What matters most is for EVERYONE to spend more time on other issues, such as deeply considering and planning how to distribute your assets to your beneficiaries after your pass.

But if changes in the estate tax exemptions do affect you, you should understand the recent changes and that they are not permanent.

As you have likely heard, the federal estate tax exemption is now at $11.2 million per person. This means that a person may give away during their life or have when they die, or some combination of the two, $11.2 million without paying any estate or gift tax. For a married couple the amount doubles to $22.4 million.

And as a result of legislation Connecticut passed in October, the Connecticut estate tax exemption is set to increase to

$2.6 million in 2018
$3.6 million in 2019
$6.1 million in 2020
But let’s get some basic facts out there about the federal estate tax before it was changed.

According to IRS statistics showing estate tax returns filed in 2016, when the estate tax emption was $5.43 million per person, only 5,219 taxable estate tax returns were filed where a tax was due, compared with 7,192 non-taxable returns.

Of these returns, 2,402 were for estates between $5 million and $10 million and 1,293 were for returns between $10 million and $20 million. Only 300 were for returns over $50 million. The number of returns will only go down as the exemption is increased to $11.2 million.

All of this netted revenues for our federal government $18.3 billion (compared to $17.1 billion in 2015). The 300 returns that were for estates over $50 million generated $7.6 billion in estate tax.

For 2017, it is projected that only .2% of all estates will file a federal estate tax return. With the exemption being $11.2 million for 2018, this number will be reduced even further.

So can you pull the covers over your head and go back to sleep and say none of this affects you?

Here is an overlooked fact: The federal estate tax exemption in 2026 and beyond, according to the law that was just passed, will revert to where it is was in 2017.

You get only a temporary reprieve. So, no, you can’t pull the covers over your head and go back to sleep.

And you still need to factor in that Connecticut’s estate tax exemption, although intended to be equal to the federal exemption in 2020 as a result of legislation Connecticut passed this past October, might not actually become so now that the federal exemption is going to be, temporarily at least, so large.

So what does this all mean for you?

You need to see your estate planning attorney to review where you stand amidst these shifting federal and state sands.

You need to shift your focus, perhaps, to income tax issues and income tax basis planning.

With a potentially reduced emphasis, at least for now, on estate taxes, more thoughtful planning can be devoted to how, and to whom, your assets will pass at your death.

So, there is an opportunity to perhaps simplify, refocus on non-tax issues, and shift to income tax planning. But the opportunity starts with calling your estate tax attorney. I look forward to hearing from you.

#estatetax #tax #connecticut #estateplanning

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Estate Planning Steps for New Parents

It may seem odd to ask young parents to think about estate planning, but starting a family is actually the perfect reason to address some really important questions. After all, becoming a parent isn’t just about choosing names and picking out nursery colors. It’s about being wholly responsible for someone else—a child—for life.

While it’s difficult to even contemplate the unthinkable, it’s imperative that new parents plan for every possibility to ensure that their children are protected, cared for, and financially secure.

Since it may be a while since you traveled this road, here is an overview of the estate planning details young parents should address.

Choosing a Guardian for Minor Children
One of the most important decisions young parents need to make is who will care for their children in the event that they are no longer able to do so, whether because of a premature death or because they have become incapacitated by either illness or injury.

This can be a delicate conversation.

As a grandparent, it’s best if you can maintain a certain level of objectivity and also be supportive of your child’s decision about a guardian.

To help guide your child through this process, here are a 7 suggestions you might make as they navigate this choice:

1. First, and this might be hard for you to hear, it’s not usually advisable for young parents to choose grandparents as guardians. As much as you love your grandchild, it’s typically better if the guardian to be someone closer to the parents’ age.

2. The decision needs to be made by both parents after a good deal of discussion and thought.

3. While choosing one guardian may seem difficult enough, the best practice is actually to choose two so that there is a backup option in case the first choice is either unable or unwilling to step in at the time of need.

4. Your child should not, however, designate another couple as guardians. Unfortunately, there is always the possibility of divorce, which could potentially subject your grandchild to an unwanted custody battle.

5. The person selected as guardian should have the physical, emotional, and financial means to care for and raise a child. They also need to be willing to take on the immense responsibility of not just being there for the child, but also for making difficult medical and other decisions as needed.

6. In addition to having the capacity to care for a child, the guardian should also be someone who shares your child’s beliefs and who has similar parenting philosophies.

7. The location of the guardian should also be considered. Does the guardian live close by? Would he or she be willing to relocate for the best interests of your grandchild?

Obviously, this is a very hard decision that will likely bring up a lot of difficult questions that new parents may not feel completely prepared to answer. However, the alternative is having the court appoint a guardian. Better to deal with the issue as a family than leave such an important question to chance.

Preparing a Will and Other Important Documents
There are a number of key legal documents that new parents should have in place in addition to a last will and testament in which they bequeath property and name a guardian for their children. These include:

Health Care Directives: This document names the person who will make medical decisions on a person’s behalf it that person is incapacitated and unable to do so.

Living Will: Also called an “advance directive,” this document defines a person’s wishes related to end-of-life care and covers things like pain medication and whether or not resuscitation should be used.

Power of Attorney: Similar to the health care directive, if a person becomes disabled mentally or physically, this document gives the designated person authority to access and manage assets, with the least expense and without court intervention.

In addition, new parents should name an executor or trustee for their estate. This way, if either parents die or the surviving spouse dies or becomes incapacitated, there will be someone who knows the parents’ wishes to take responsibility for financial and legal matters on behalf of minor children.

As a grandparent, you naturally want to do whatever you can to ensure your grandkids’ safety, comfort, and financial stability. Helping your own child navigate these often overlooked but very important steps in the journey to being a responsible parent may be one of the best gifts you can give your grandchild.

By helping your child get a good start with smart estate planning, you will be not only helping to protect your grandchild’s future, you will also be helping to give your grandkid’s parents much-needed peace of mind.
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LGBT seniors are being pushed back into the closet

No one should ever have to pretend to be someone they’re not.

This is especially true later in life when a person has, by dint of having years’ worth of life experience, earned the right to live authentically, without fear of judgment or discrimination.

Tragically, however, denying their truth and hiding behind lies is exactly what many senior LGBT people must do to receive quality care in elder care facilities. Similarly, they are struggling to navigate legal and financial issues related to medical care, insurance, health proxy designations, and inheritance.

Finally getting media attention

The issue of discrimination against LGBT partnerships and marriages in medical, hospice, and long-term care scenarios is finally getting some mainstream attention.

Last summer The Atlantic Magazine published a piece about how LGBT seniors are being pushed back into the closet. In the article, David R. Wheeler profiles Rabbi Sara Paasche-Orlow and her work to educate long-term care residents and staff members on the specific barriers to and disparities of healthcare that many LGBT seniors face

The article also cites some stats from a survey run by The LGBT Aging Project, a Boston-based nonprofit that advocates for LGBT seniors:

Yet the LGBT Aging Center’s survey found that only 22% of respondents felt they could be open about their sexual identities with health-care staff. Almost 90% predicted that staff members would discriminate based on their sexual orientations or gender identities. And 43%reported instances of mistreatment.

This is clearly not an isolated problem.

On another front, a beautifully produced movie is also helping to educate people about the very real and uniquely heartbreaking situations that many LGBT seniors find themselves in during the most vulnerable years of their lives.

The work of acclaimed documentary film maker, Stu Maddux, Gen Silent tells the stories of six LGBT seniors to whom Maddux posed a difficult question: whether they would hide their true identity (along with their friends and spouses) in order to survive in the long-term care system. The answers captured on film may surprise you as they reveal levels of oppression that most people believed were far behind us.

Trying to bring about change

In addition to media coverage of this emotional topic, there are also several organizations that are working on the ground, side-by-side with LGBT seniors and the people who love them — friends and family — to bring about change on the individual and systemic level.

The National Resource Center on LGBT Aging, founded in 2010, describes itself as a “technical assistance resource center aimed at improving the quality of services and supports offered to lesbian, gay, bisexual and/or transgender older adults.” Their website includes many resources including state-by-state resources lists (here’s the list for Connecticut), a number of helpful reports on topics such as Marriage, Medicare and Medicaid – What Same-sex Couples Need to Know, and other insightful materials such as their poignant and eye-opening Stories from the Field.

Hopefully, increasing awareness of these issues and providing real-world resources to address individual situations will help to mark the beginning of the end of the cruel and unfair discrimination as well as general mistreatment of LGBT seniors. In the meantime, the entire team at CzepigaDalyPope is always here to provide support in any cases where an individual is being discriminated against for any reason.

#LGBT #Connecticut #law #seniors #elderly
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Sharon Pope Disability Planning Attorney in Connecticut

We are thrilled to share with you that attorney Sharon Pope is now Special Counsel to our Special Needs and Disability Planning department.

Sharon's reputation in disability planning is widely known. We are pleased to announce that she will continue to assist you and your clients with special needs trusts, settlement planning, trust administration and public benefit eligibility.

Attorney Sharon PopeIn addition to Sharon's enhanced role, we plan to welcome new staff soon as we continue to expand our scope of services. This expansion, coupled with the recent move of our Hartford location into our Berlin office, gives you more than 20 professionals under one roof who will be serving your needs.

We are happy to share this good news with you. To schedule an appointment or a speaking engagement with Sharon, give us a call at (860) 236-7673 and we'll get you on her calendar.

#connecticut #disability #planning #medicaid #benefits #settlement #attorney #lawyer
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Do I need a Tax ID Number for a Trust?

When it comes to managing a trust, ensuring a smooth process has a lot to do with knowing the rules and paying attention to the details. For instance, if you are the trustee of a trust, did you know that you need to get a separate tax identification number for the trust?

The only scenario in which a new tax ID number is not needed is if you, as trustee, are also the surviving spouse and everything has been left to you outright or in a revocable trust. In such cases, you can use your Social Security number since, in essence, you are the rightful owner of any assets.

In any other scenario, however, you must apply for a separate tax ID number called an EIN, which stands for “employer identification number.” This number operates much like a personal Social Security number for the trust. You’ll need it in order to open a bank or brokerage account for the trust because financial institutions use the EIN to report any interest earned on such accounts until funds are distributed to the beneficiaries.

The danger of not having an EIN

It’s important to note that you should not attempt to avoid the need for an EIN by distributing the trust’s assets immediately.

While it may seem logical that expedited distribution would eliminate any interest earnings and, therefore, also the need for the tax ID number, such a tactic actually puts you at financial risk. It’s imperative that you allow enough time to ensure that all expenses and tax debts associated with the trust have been fully settled.

It’s not uncommon for a trust liability to come to light months into the process, and if the trust’s assets have all been distributed, the trustee is then in the awkward position of having to either pay the debt personally or contact beneficiaries to try and recover some of the distributed money.

How to get an EIN

Luckily, getting an EIN is not a difficult process. The most convenient way to apply is via the IRS website, The most efficient way to do this is to print out a hard copy of the form (it’s called the SS-4 application form) and fill that out first so that you know you have all the information you need before you begin completing the online version of the request.

Of course, if you need any guidance about how to best establish or manage a trust, contact us, we are here to assist you.

#trust #tax #EIN #Connecticut #estateplanning
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Challenging a Will in Connecticut

Contrary to popular belief, a Will or Last Will and Testament, isn’t always written in stone.

Quite frequently, disputes arise over the contents of a Will and the parties who are at odds must seek outside help to resolve the issues. Because there are often conflicts of interest around such disputes, it’s important for each party to retain appropriate legal guidance to ensure that their rights are protected.

There are many reasons a Will might be contested. The most common include cases of

• undue influence
• questionable competence
• improper execution
• fraud

When the deceased has been divorced and or remarried, there are a host of other scenarios that could lead to someone challenging a Will.

For instance, a Will that was drawn up before a divorce and not updated after a second marriage might still include provisions for the ex-spouse, but not the new spouse. In other cases, a Will may fail to make provisions for the children of one of the marriages or even specifically disinherit the present spouse even though that individual is entitled to a widow’s allowances and elective share of the estate.

Clearly, there are many complex and delicate situations that might require someone to challenge a Will.

How to contest a Will

If you believe the Will of a loved one does not accurately reflect his or her true wishes, you may be able to contest it in Probate Court. During the probate process, there are certain steps that can be taken to protect your rights.

The process is not overly complex, but it does need to be done according to certain protocols.

1. You must first file an Objection to the Admission of the Will. This is a written document that should be submitted after you receive the Application for Administration or Probate of Will. The Objection explains why you wish to contest the Will and puts family members and other interested parties on notice as to why you think it shouldn’t be admitted.

2. Next, a hearing on the Will should be scheduled. The court may send notice to all parties informing them of the time and place of the hearing because every interested person listed in the Will has the right to attend the hearing. The primary purpose of a hearing is to provide equal opportunity for family members and other interested parties to ask questions and/or state objections regarding the Admission of the Will.

3. Once an Objection has been filed and a hearing has occurred, the court issues what is known as a “scheduling order” and sets a date for trial. A scheduling order is simply a list of dates by which the parties need to complete certain investigative tasks that must be addressed before trial begins.

What happens at the trial?

At trial, each party has the opportunity to present the court with all the information they learned during their investigation. They may call expert witnesses, family members, and other fact witnesses to testify. At the end, the party contesting the Will asks the court to deny Admission of the Will based on the evidence that it does not reflect what their loved one would have wanted.

If you wish to contest the validity of a Will, your case will benefit greatly from professional representation. At CzepigaDalyPope, we are dedicated to protecting your rights and will work with you and your family in any and all types of Will contests involving personal property, bank accounts, and real estate.

#connecticut #will #estateplanning #elderlaw #law #legal #probate #family #estate
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Second Marriages and Blended Families: 3 Key Steps to Estate Planning

Finding love for the second time is a beautiful thing, but amidst all the fireworks and violins, it’s important to be aware that second marriages typically create the need for some fairly in-depth estate planning.

To ensure wedded bliss and family harmony far beyond the wedding day, it’s critical to proactively address how your nuptials will affect your financial liabilities, existing benefits, and distribution of your assets to loved ones.

1. Communicate Like a Pro

The first step to ensure success in such matters is to have open and comprehensive conversations with your spouse and your family. You must clearly articulate your wishes and your concerns, and you must also provide a forum in which family members can share their thoughts and concerns.

Because these conversations can quickly become tactically or emotionally overwhelming, it’s a good idea to engage a trusted estate planning attorney or a professional family meeting facilitator. This impartial, professional third-party will ensure that your family conversations are collaborative and productive.

2. Ask the Hard Questions

Addressing estate planning details that are important to not only your long-term wedded bliss, but also the well-being of your entire family. Here are just a few of the key questions that come up in the event of a second marriage:

Do you or your spouse have any financial obligations to ex-spouses?
Do either of you have other liabilities that might negatively impact each other’s financial standing?
Is either of you collecting benefits such as Social Security from a deceased spouse, and — if so — do you know how remarriage will affect those benefits?
If either you or your spouse-to-be on Medicare or Medicaid, do you know if getting married will put the other party’s assets at risk?
If either of you have children from a previous marriage, do you know how you want to handle leaving assets to them and any other heirs?
If there are young children in your family, do you know how you plan to handle any guardianship issues and provide financially for those children?
Have you discussed whether you will keep your assets separate, commingle them, or create a hybrid solution that involves keeping some assets separated and commingling others?
Though this is just a sampling of the kinds of questions that can arise, it’s easy to see how one question can lead to another and another and so on. The complete scope of the situation can quickly become quite broad.

This is why it’s so important to create clarity around your wishes and then put those wishes in writing.

3. Document Your Plan

Once you’ve come to terms with all the possible issues and done the up-front work of having those important conversations with your family, the last step to put all this to bed is to get the appropriate estate planning documents drafted – Wills, trusts, powers of attorney, healthcare directives, etc. Click here to learn more about these.

Estate planning decisions for second marriages and blended families can be complicated. Give us a call and we’ll help you get this done. Once your plan is in place, you can rest assured that your intentions will be carried out.

#estateplanning #blended #secondmarriages
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Got an irresponsible adult child?

In our latest newsletter, we discuss how to leave money to said child through inheritance.

Also learn facts about life insurance and nursing home resident rights.

Read all about it here:

#estateplanning #elderlaw #connecticut
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