seenon

Blog

Home » Blog

What It Means To Be A Veteran!!!

in Articles by Greg Leave a comment

Very honored to be allowed to speak and introduce the Veterans this morning at the Rutherford County, NC, Senior Center. PROUD to be an American on this day!!!

#theelderlawguy
#LawyerGreg
@lawyergreg

Senior Dental Care with Dentist: Kendalyn Lutz-Craver

in Articles by Greg Leave a comment

Seniors have special dental needs, are often on fixed incomes and rarely have proper dental insurance. However, dental care is so important for quality of life, self confidence and even longevity to the individual. Dr. Lutz-Craver sets her practice apart in how she deals with senior patients and their issues.

#theelderlawguy

GET YOUR STUFF TOGETHER!

in Articles by Greg Leave a comment

Debbie Vaughn teaches how and why you need to take inventory. Keep all your valuable information in one place. Even go as far as how you like your coffee?

#theelderlawguy

Great Episode! What’s the Difference in Home Care and Home Health Care? Do you know?

in Articles by Greg Leave a comment

Edit this episode
Delete this EpisodeTHIS CANNOT BE UNDONE.
Think twice before you click once.Back to all episodes
Elder Law Report 046: What’s the Difference in Home Care and Home Health Care? Do you know?

Expert and director of Helping Hands, Ruth Huffstetler, clears up the differences between Home Care and Home Health Care. Do you know the difference? You should! It could directly affect you and your loved ones.

#theelderlawguy

Hospice – A History and Guide

in Articles by Greg McIntyre Leave a comment

I had the honor of sitting down and talking with Patti McMurry, who has been with Hospice Cleveland County for 25 years. We’re going to talk about what it is, any misconceptions, what Hospice does, and the other amazing services to the community. 

 

Tell us a little bit about Hospice Cleveland County. 

One thing about our community that we’ve found is that everywhere we go, no matter if they are conferences, seminars, or anywhere, Cleveland County is very unique because our agencies tend not to compete with each other, but to help each other out. It’s a great place to live and raise a family, and then grow old. We took in our first patient 30 years ago, so we’re celebrating that. The Shelby Star will have a 12-page insert all about Hospice Cleveland County: how we were formed and where we are today. As of today, we have taken care of over 10,000 people who have died in Cleveland County. We were one of the first Hospices in North Carolina. 

 

How did you get involved with Hospice?

The way I came to Hospice was that my two grandmothers died in the same year. One grandmother died at the hospital with lots of tubes, every two hours two family members could go in to see her. When it looked like she wasn’t going to live much longer, the nurse came out and said, “Two family members can go and be with her while she dies.” My mother had 7 children in the family, she happened to be the second oldest so she got to be with her mom and everyone else was in the waiting room. Shortly after that, my other grandmother got sick with colon cancer. That happened to be the year that Hospice Cleveland County started and she was one of their first patients. Everybody was at the house; she died in her own bed, all of us were there, all the grandchildren were there and it was two totally different kinds of experiences. That’s how Hospice Cleveland County got started because there were people in our area who had heard about Hospices. 

 

 

How did Hospice start? 

“Hospice” the word actually comes from the Middle Ages. A hospice was originally a resting place for weary travelers. They didn’t have hotels, so if people would allow weary travelers to rest in their home, then they would put a lighted candle in their window and that signaled that travelers could stay. When we built our hospice house and our office where we are now, they were going to let us change the name of the road and we thought really hard about what we wanted to name that road. The name is Windover Heights Drive, and wind needs to go from this place to the next, which is what Hospice does: it helps travelers go from this life to the next life with quality. 

It’s a pretty new concept; the first Hospice in America was in 1974, so it’s very new. Now just about every county in every state in the country has a Hospice. And every country, really, has Hospices. It was similar to the birth experience. Women used to be put to sleep when they had babies: they’d wake up and they’d have a baby. Then, natural childbirth started and things got back to nature, so the concept of death also got that way. 

95% of the people who are asked, “How would you like to die?” response “At home”. Much less than half of the people die at home, and everybody wants to yet there are so many things that prohibit that. There’s so much fear in that and in modern medicine. We’ve had people call to set up an admission time, but they’re afraid. They’re thinking, “If Hospice comes in, Mom’s going to die.” But think about this: Mom is going to die, we all are. But we want to get in there and make that experience as good as possible. The scary part about Hospice is really only the first 30 minutes of that first visit, and I promise – I tell people this – if we come in for 5 minutes to explain to you what we can do, we will leave in 5 minutes if you want us to. But it’s never happened that we’ve had to leave. People are complimentary and relieved, actually. On the first visit, we give them our 24-hour telephone number that they can call for a nurse to come and visit. Even just having that number, whether they call or not, is so much security to them. You don’t have to take somebody to the hospital, you don’t have to wonder about anything. We are so involved in patient symptom control, as well. 

I explained once to a doctor: when people come to the doctor and they’re in pain, they get a prescription for pain medication. But when that person leaves with that prescription, it doesn’t mean they have the money to buy that prescription, it doesn’t mean that they’re aware the pain medication is going to cause constipation. There are other things that go along with this illness in just that one pain prescription that our nurses can really address and have people as comfortable as possible, teach families how to take care of their loved ones. They have that number to call 24/7, grief counselors, chaplains, social workers, and more. Our Director of Nursing has said many times, “The easy part of Hospice work is what the nurse goes out and does: get the symptoms, the pain, and those things managed. But then the hard part of the dying process starts.” It’s those fears and thoughts and dark nights as well as emotional, spiritual, and mental things that people are dealing with. 

One thing that modern medicine has taken away is a human element, because the medical model is about the medications and treatments, etc. 1991 was when the living will and healthcare power of attorney conversation started, and that was because of Cruzan and those different cases where you could keep somebody alive for years, for decades actually. And then the conversation came up, “Do you want to leave that in the medical community’s hands as to preserving life at any cost? Or do people want to include that human element in their end of life situation?” 

 

A large part of the process is not only the death of the patient, but the grief the family members have to endure. How do you include everyone? 

A lot of our focus is the family, Hospice is special in that the patient and the family are the unit of care. So the focus is just as much on the individuals of the family as it is on the patient. Oftentimes we’ll go in and the patients are doing fine; they know what’s coming, they’ve accepted it, maybe they’ve struggled and had a lot of treatments, maybe they’ve suffered a lot and they’re really fine. But for the family members, it’s hard to let somebody go. We’ve had children, we’ve had young people, and we have very elderly people. So our counselors, chaplains, and social workers really help those families come to terms with those things. Sometimes when we come in, patients are relieved that they can finally say, “I don’t want to go to dialysis anymore, I don’t want to have another treatment, and I don’t want to go back to the hospital.” They can say that because they have that support, they know that those team members are going to be there to help the family. 

 

Can anyone get involved with your services? 

You don’t have to be a Hospice patient to attend our support programs. You can receive help from the grief programs and counseling, or any of the social work, the drafting of living wills, healthcare power of attorneys and things like that. But Medicare requires us to talk to our patients and families about living wills and healthcare power of attorneys. I will tell you that things go a lot smoother when those things have been done early, rather than when somebody is in a crisis or they’re sick, during which time you have to make quick decisions. What we try to do is talk to the public all the time about doing healthcare power of attorneys and living wills. Really, the healthcare power of attorney is the most important document. It doesn’t go into effect until a patient can’t make their own decisions. We leave those documents in the home on the first visit and explain that our social workers are notaries who can come out and help. Oftentimes, it’s easy to get a patient to do a healthcare power of attorney and living will when the whole family does them, so we’ll just have the whole family complete their documents at that time. 

Working at Hospice, we know that those documents are important. We’ve seen bank accounts being closed because until a will is probated and those kinds of things, you have to have those things in place. And where’s the life insurance policy? Where’s the burial policy? People don’t start looking for those until they need them. We want to get people to think about things on the front side, meaning before the crisis happens when you have to think about them. People also don’t realize things that happen after the death: you have to change where the money is going to, everything on the bank accounts and who the beneficiaries are. There’s a lot of work to be done, and if you do that on the front side, it’s not scary. 

 

How is Hospice funded? How does one pay for Hospice care? 

This is something I think the public does not realize: when you are a Hospice patient, Medicare has a benefit called a Hospice benefit for in home care. That benefit pays for everything that Hospice does. It pays for the staff, it pays for the equipment that has to be rented, it pays for oxygen, it pays for any supplies. It’s the benefit that kicks in before the supplement, which also covers 100% of all the medications that the patient is taking. So sometimes we can get in there and save patients and families thousands of dollars a month, because anything pertaining to that illness – heart disease, which is our primary diagnosis, or anything else you may have that you need medication for – is paid for 100%, even if it’s over the counter. A lot of people don’t know that. The only criteria to be a Hospice patient is the doctor feels like if the illness follows its normal course, that the patient will live 6 months or less. Now, we’ve had patients for a lot longer than that, but our median length of stay is 11 days. That means 50% of our patients die within 11 days after we admit them. So they’re not able to access that Medicare benefit and get all those things paid for. That is the one thing about Hospice care that keeps me awake at night, is knowing that there’s so many people who could benefit from having that support of the staff that they can call, but also financially. Being sick is very expensive.  

While at the facility, some of our beds are residential that have a daily room and board fee. It’s about $140 a day. But everything else is paid for. If you’re in the GIP, which is like an in-patient or crisis – similar to a hospital – it’s paid 100%. So that Medicare benefit is so incredibly important. We work with a Hospice pharmacy, so all the medications are ordered by the nurse and they’re delivered right to the patient’s door. We’ve got a lot of elderly people in Cleveland County who are our patients; they can’t get in the car to get a prescription or go to the drug store and wait on their medications. So we try to make everything as comfortable and in the highest quality possible. The nurse orders the medicine, Hospice Medicare pays for it, it’s delivered right to the door so that people can spend their time doing the things that they enjoy. 

One last comment: anybody can make a referral to Hospice. If you know anybody that is suffering or seems to not be getting better, anybody can call our office anonymously, give us a name, and we’ll talk to the doctor to see if their eligible, and if they’re not we just file that away. If they are, it can be the greatest gift that you can give to somebody. 

We’re very proud of the work we do and the relationships we’ve forged with the patients. We’ve named the rooms in honor of the people who we’ve cared for, so it’s a compliment to our staff and the patients that have worked together. 

If you want to contact the office, our number is 704-487-4677.

Call me if you have any questions:

Greg McIntyreGreg_Full
Elder Law Attorney
McIntyre Elder Law
123 W. Marion Street, Shelby
704-259-7040

Client Communication and Education – The Importance of Technology

in Articles by Greg McIntyre Leave a comment

Hunt at night

My son Jordan and I recently took a small trip to Campbell Law School in Raleigh, North Carolina and North Carolina State University. While there, we visited the Hunt Library on NC State’s Campus, which is an absolutely amazing facility that really shows the benefit of being at the forefront of technology. This library had what’s known as a book robot – this is a small robot that has you plug in the book you want and will then go and get it in the warehouse to bring it to you. Wow! We were also in a group room that had whiteboards for walls, and my son was fortunately able to do some of his Calculus on them.

Being in that library inspired me to touch on a subject that some people tend to shy away from. I want to talk about the place of technology in Elder Law. I know there are some individuals and companies who would be hesitant in bringing technology into that field. It scares people, I know that. But in my experience, the seniors I count as my clients are extremely up on technology: they’re on Facebook, they navigate email, they do it all. You’ve heard me talk about our eDocs Access Program, which we’re very proud of. This system allows any of our clients to have access to their important healthcare documents 24 hours a day. Stored on the eDocs system are exact copies of the documents, and clients enjoy bank-level security through the system. When they log in, they have a wallet card which lists their login information. They can also access the program from a mobile device, tablet, or other computer to get to all the documents that they need. Now, this comes in handy if you are going on vacation or have a healthcare incident while away from home, heaven forbid. 

Transmission of information is also key for keeping the lines of communication open with the seniors and other clients that I welcome to my office. As you browse the website, you’ll notice that there are a plethora of different options that you can peruse in addition to the blog posts. These include videos and interviews, different social media links, and other forms of relevant content. To ensure that communication is consistent, I have even established a newsletter sign-up right on the front page of the site. Clients and non-clients alike can enter their information and receive the latest news and information that my company generates about Elder Law and the advances that are being made in that field.

Communication and technology are thus key when it comes to Elder Law in keeping the seniors and other clients involved. My goal in this process is not just to be your attorney that drafts wills and powers of attorney; my goal is to be an attorney who develops a culture which sparks excitement, interest, and facilitates communication. 

These are some of the many ways that incorporation of technology can help seniors protect their hard-earned assets and legacies. Constant involvement and distribution of information is therefore essential to this process.

Call me if you have any questions:

Greg McIntyreGreg_Full
Elder Law Attorney
McIntyre Elder Law
123 W. Marion Street, Shelby
704-259-7040

Pre-Needs Funeral Planning – With Expert Cecil M. Burton

in Articles by Greg Leave a comment

Great show with Hayden and funeral and planning expert, Cecil M. Burton. Funeral planning is a crucial part of Medicaid planning and using your money the way you choose!

Pre-Need Funeral Planning

in Articles by Greg McIntyre Leave a comment

The planning tool that I want to highlight this week is known as Pre-Need Funeral Planning. This is a great benefits planning tool for long-term care Medicaid planning. In essence, those who choose to participate in this pre-planning opportunity can place $10,000 to $15,000 in a trust or insurance account with a reputable funeral home and that money is exempt from the Medicaid spend down. The unused portion is then generally distributed directly to the heirs/children of the deceased. In order to gain more insight into this process, I interviewed Cecil Burton, a long-time friend of mine and owner of Cecil M. Burton Funeral Home and Crematory. Cecil’s been in this area of practice for years now, and from him you can learn about the importance of pre-need funeral planning and why it’s a vital part of planning as you age.

How long have you been in the funeral business?
Close to 40 years. I’m third generation in this. I grew up in it.

How did you get into this industry?
I attended Gupton-Jones College of Mortuary Science in Atlanta, but then got my funeral and embalming license, so I’m an embalming and funeral veteran. Then after that I got my crematory license and opened my own crematory about six years ago, so I’m a certified crematory operator.

Why is it important to choose the right person to do your funeral planning and to do pre-needs funeral planning?
Well, it’s essential that you pick the right funeral home because we’re just like any profession, we have our good people and our bad people. 90% of them are good and do a good job, but you need to go and inspect the facilities and make sure that the people have their licenses and are certified to do pre-planning because in the state of North Carolina you have to have a license to do pre-planned funerals.

Full Video of interview on Pre-Needs Planning Here:

In order to be a licensed funeral rep, you have to have two licenses to be able to do a pre-planned funeral. We have a lot of people who are pre-planning their funeral now just for Medicaid reasons, the spend down. We put the money into an insurance trust where it gets interest on your money but it’s tax-free interest. We also do business with people who just want to pick out their stuff and lock in the price. We do that, too. You can pick your stuff, lock in the price, and it doesn’t matter how long it takes, it’s taken care of.

You’ve handled funerals for my family and many families in this area, in Cleveland County. Just to dispel the myths of a funeral home and things like that, it can really be – in my mind – it’s almost a ministry. You’re meeting and greeting families and helping them through an extremely important time in their lives, wouldn’t you say?

Our goal is to help them. It is a ministry, that’s what we say about our occupation. And what we want to do is help the family, guide them through the process, but also celebrate the life and honor the person who passed away, and help the family to honor the life that lived. That’s what we try to do and help them go through all the steps.

If somebody comes to you and says, “McIntyre at McIntyre Elder Law told me to come over here and I need to do a pre-needs funeral plan,” go through the steps; what would you do for that person?
Well, we’d find out what their needs are. Sometimes they have brothers or sisters who want to be in the process of picking out a casket or the vault for the cremation, and they can’t be here physically, so we’d help them. Then sometimes people want to just put money aside. We put that into a trust, and we trust 100% of the money and that way the money will get tax-free interest until the person passes away. For Medicaid, it has to be an irrevocable trust. This means they divorce themselves totally from that money; they can’t get that money out until that person dies. The money will sit in interest and then if something does happen, they have the principle plus interest to pick out the casket, the vault for cremation services when the brothers and sisters can be in on it.

Now, we have some people where the brothers and sisters are local and they want to go ahead, come in, and pick out the casket and vault for the cremation services to go ahead and pay for it, lock in the price. We do it that way also. That’s called inflation proof, which means you’re locking in the price. If you just put money in, it’s called a standard contract, which is the second type. Both of them for Medicaid have to be irrevocable. If you’re not doing Medicaid, you can always make it revocable meaning you can get the money out anytime you want, interest plus principle.

But it’s still your money, it’s still a countable asset under the Medicaid long-term care payment rules, and you’d have to deal with that aspect of it.
Right. One thing about a revocable contract, you can always make it irrevocable down the road. You can roll it over into irrevocable trust, but if it’s irrevocable you cannot roll it back. You’d have to get a judge.

How can people contact you if they want to know more information?
They can call my office at 704-480-8383.

Call me if you have any questions:

Greg McIntyreGreg_Full
Elder Law Attorney
McIntyre Elder Law
123 W. Marion Street, Shelby
704-259-7040

Hospice Explained with Patti McMurry

in Articles by Greg Leave a comment

Long time Hospice team member Patti McMurry talks about the many needed services provided by Hospice care. How to pay for it. The history… Check it out.

#theelderlawguy

Health and Rehabilitation at Peak Resources

in Articles by Greg McIntyre Leave a comment

In my never-ending quest to discover all available options to seniors, I had the privilege of sitting down with Kris Thompson, the Executive Director at Peak Resources. We spoke briefly about the services that Peak Resources offers, what families and seniors should look for when choosing a nursing home, and the many benefits awarded to individuals who become a part of this incredible system.

See the full video interview here:

 

What are your responsibilities as Executive Director at Peak Resources?
I’m pretty much responsible for everything that goes on at the facility. The financial part, the business part, making sure we meet at the rules and regulations, which in healthcare and with nursing homes, there is an awful lot. I’m also involved in the healthcare part of it. There is a director of nursing in the department of nursing that oversees her staff and makes sure that the healthcare aspects of the nursing home are met.
What should a senior look for when choosing a nursing facility? What should the family of the senior look for?

Location. Everyone talks about real estate, which is very important. It’s crucial that you’re going to feel comfortable visiting, so you want to be close. If you have to drive across town and deal with a lot of traffic, that’s probably going to be burden and a factor that keeps you from visiting. Individuals who enter nursing homes shouldn’t lose contact with their family members. I would also recommend that you go through the facility and tour, just do a walk-through. Most facilities would be glad to do that and have a representative walk through with you to answer questions and point out things that the facility offers. As you’re walking around, look for common sense things such as this:

 

  • Are there any pervasive odors that you notice throughout the facility?
  • Are the residents of the facility happy? Are they socializing and doing different activities? 
  • Are the staff members happy? If they are happy with their job, that is going to be reflected in their performance and how they interact with residents. 

Positive communication is one of the most crucial components that a nursing home resident can have. Is it a warm and welcoming environment? That’s always a good thing. 

 

All facilities are also required to have their 25/67, which is their annual survey where the state comes in with nurses, pharmacists, and dietitians. It is state required to make sure that the employees are doing their job. You won’t see a federal survey every year, but you’re guaranteed that each year the state one will be conducted. They come in and look at all of those rules and regulations, they are making sure that the residents are getting the treatment that they need. They ensure that they are not being taken advantage of and that they can have access to their money right there. 

Most facilities have the shopping aspect. On Fridays, we take everyone to the Wal-Mart to go out shopping, and if the resident doesn’t feel like going out, he/she can give the list to an employee who is managing the funds to go pick up personal items that the resident needs. 
Not all nursing homes are health and rehab facilities, is that correct? 


Right, and that’s usually part of the Medicare benefits. Most people have Medicaid Part A or Part B. That’s going to cover if they’re coming in from the hospital. For most people right now, unless it’s coming through a bundle payment part of Medicare, you’re required to have a three-day hospital stay. You want to make sure that if you are in the hospital, that it is a stay and not an observation because then you are qualified to use your Medicaid Part A benefits. If you meet that criteria – of which therapy or wound care is a part – you can use your Medicaid Part A benefits. 

So if you’re going to be there at the facility 100 days, that first 20 is covered at 100%. The next 80 days is paid 80%, so there is a 20% co-pay. The supplement would pay that 80% if you have the supplement. Now, if you have long-term care insurance, it would pick up for that deficit and pay. 
Does the supplement stop paying if the prognosis of the patient worsens?

 

Yes. When it comes to the Medicare criteria, the therapist will set up goals, such as, “I want him to be able to walk 10 feet in 5 days”. So if the patient is not increasing and making progress – and there’s a little bit of leeway there. Some people might have other stuff going on. They say you can refuse three times, but after that the therapy is going to be required, which is going to drop the Medicare Aid benefits and the supplement, as well. 
Say if it’s a 10-bed facility, maybe 50% to 80% of the beds are certified, and that can also be with Part A, too. You can have them duly certified with Medicaid and Medicare, or one of each. Of course, if you have Medicare and you’re not in the certified bed, Medicare is not going to pay, so the home would advise you of that. 

 

You meet with families from time to time, and you have folks at the facility who are trained to meet with the families to ensure that they have their affairs in order and can find a way to pay for the services and qualify them for the process. Is that right? 


Yes, one of the federal regulations is that you have to have  a social worker, and with that they do set up systems. You have to have a business manager that takes care of the billing. The social worker will deal with community resources, and there are options there as far as to help pay or help get them set up in the system. For some families, this is the first time that they are going through the process. Their parents have aged and they have reached that threshold where they need to enter the system. For many, it is a new and unfamiliar process. It can be very complicated, and considering those rules and regulations, they need to know when they meet the qualifications and how to determine eligibility. 

Do you find that most families have planned ahead for this type of situation? 


No, and I think people tend to put it off and not think that this is going to happen to them. If you look at statistics, you have a one in three chance of being in a skilled nursing facility. A lot has changed now because we do have 20-22% of our residents that are short-term that may come for that Medicare Part A, they get the rehabilitation, and then they’re able to go back home to live with their family. Others that return home with receive some type of home health care and sitter. There are a lot of good supports out there. 

However, if someone at the facility feels that there is going to be what is known as an unsafe discharge, meaning the individual is well enough to go back home, but perhaps will not be taken care of the way he/she should in the home, then we are required to notify Adult Protective Services (APS). They would come in and do a home assessment to make sure that it is a safe environment for the senior citizen. Someone has to be home to take care of the senior, administer medication, etc. APS checks all of that out, and if they do not like what they see in the assessment, they’ll step in. That’s not meant to be a big brother system; this is meant to protect the seniors and get their needs met. 

 

If you would like to know more about Peak Resources or speak to one of their employees, you can contact them by phone at 704-482-5396. They are located at 1101 N. Morgan Street in Shelby.

Call me if you have any questions:

Greg McIntyreGreg_Full
Elder Law Attorney
McIntyre Elder Law
123 W. Marion Street, Shelby
704-259-7040

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Page 60 of 73
1 58 59 60 61 62 73
Page 60 of 73« First...102030...5859606162...70...Last »

Schedule Your Free Consult!

Start
WordPress Image Lightbox