22 APR 2024 · 7 Rules of Thumb in Choosing your Agent in a Power of Attorney   A Power of Attorney is a legal document you sign to name someone to be your agent to act on your behalf. That means that you must decide who to name as your agent. You can pick anyone you want. Married clients usually name each other and, if they have children, one or more of them as alternates. Unmarried clients or married clients whose spouses have dementia usually name children, if they have them. But, what are the considerations? Here are a few rules of thumb to help you make your decisions:   -   Only consider people you can trust to act in your best interest honestly, deliberately and transparently. -    Only consider people who have the time and emotional capacity to do the job. -   Pick someone who is decisive and well organized. They don’t need to be an accountant, a lawyer or a financial planner – they can hire those skills. -   Proximity is important, but not conclusive. It will be easier for someone who lives in your community to travel to banks to be added to your accounts, to collect your mail and pay bills, to deal directly with vendors. That said, a lot can be set up while visiting you and handled electronically afterwards.  -    Avoid using co-agents. You don’t want two “cooks in the kitchen.” However, you do want a “back-up” agent named in the Power of Attorney. If you are compelled to name co- agents, only name two people as the POA and give each authority to act independently of the other. -   Don’t worry too much about the feelings of anyone you don’t name. It’s more important that you have an agent or agents you can have confidence in. -   Consider the age and health of your agent.                                                                                                                                                                                                                                                                                                                                                                                     If you follow these rules of thumb, you should be able to choose the right person or people to name in your Power of Attorney. If the result is that you do not have any family member or close friend that you feel comfortable with, you can name a professional, such as an attorney, accountant or bank. This is not common and will cost more in fees than naming a family member. But if it means that you’ll be protected and you’ll avoid family fights, it may well be worth the cost.

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29 AUG 2023 · End-of-life decisions are never easy. One of the toughest decisions you may have to make is whether you need nursing home care or hospice care. It helps to know the difference. Nursing Home Care Nursing homes residents receive treatment to extend their lives. This care includes custodial and skilled care. Custodial care means assistance with dressing, bathing, cooking, laundry, and other types of personal care. The provider does not need a medical license to provide this type of caie. Skilled nurslng care is provided by licensed medical practitioners. Skilled care is medical treatment that includes wound care, physical therapy, injections, and other care that ensures their physical well-being. Skilled care residents usually also receive custodial care. Medicaie generally does not cover custodial care. Medicare Part A covers certain medical conditions but is limited to short-tern care in a skilled nursing facility (rather than a nursing home). What is Hospice Care? Hospice care is an option for patients who do not wish to receive treatment or extend their life, but want comfort care as they reach the end of their lives. Hospice care teams include doctors, nurses, social workers, spiritual advisors, and volunteers. A hospice care team is also trained in treating end-of-life pain. Hospice care can be administered in a patlent's home or in an institutional setting. Hospice may also provide support to family members and caretakers, including respite care. In an institutional setting, Hospice patients generally receive custodial care as well. A Note on Concurrent Care Complicating matters is the fact that Medlcare will not cover custodial care at all and generally will not cover Skilled care and hospice care (known as concurrent care) at the same time. Currently, individuals on Medicare must give up Medicare payment for care related to their terminal condition if they want to receive Medicare's hospice benefit. As a result, many individuals facing a terminal illness may not opt for hospice support services. Policymakers have been pushing for a benefit within Medicare that would allow patients to receive hospice care services and curative treatment simultaneously. The Centers of Medicare and Medicaid Services has spent the past several years testing various models, including one known as the Medicare Care Choices Model (MCCM). MCCM has been shown to iirpiove the quality of patients' end- of-life while also resulting in Medicare savings. However, this option has not yet been made permanent. End-of-Life Dilemma: Which Should I Choose? While considering the next steps to take in your health care plan, speak candidly with your family and health care team about your needs and how you see your future. If you have questions about coverage options that may be available to you in a nursing home or with hospice care, speak to your elder law attorney.

4 AUG 2023 · Most older adults want to remain in their homes and communities as they age rather than move into assisted living facilities or nursing homes. To accomplish that, those folks must take steps to protect their physical, mental, and financial welfare. What Does it Mean to Age in Place? The Centers for Disease Control and Prevention defines aging in place as a senior's "ability to live in one's own home and community safely, independently, and comfortably, regardless of age, income, or ability level." According to AARP, more than three-quarters of older adults prefer to age in place. To do that, consider these issues: Resources to Manage Chronic Diseases Seniors with a chronic disease should focus on: • Accessibility in the home; • Proper nutrition; and • Dental health. Research has found that proper oral care can help prevent the progression of many chronic diseases. Eating Well While Aging at Home Proper nutrition is a vital part of caring for yourself at home. If you need meals, Meals on Wheels is a great resource here in Cincinnati. We have several non-profits that offer meals on wheels. I toured Meals on Wheels S.W. Ohio some years ago up in Price Hill. Top notch operation. They make the meals onsite and deliver them to your door. Neighborhood senior centers, places of worship, and charities may also provide a hot meal while you make new friends. If you cannot leave your home, Door Dash will deliver food at your door for little or no cost. But, restaurant food may not be so "balanced". Support for Mobility Aging in place is a much more realistic goal if you can walk for exercise, access transportation to medical appointments and errands, and maintain a safe environment at home, free from increased fall risks. Consider simple changes you can make to your home to promote your safety. Examples of helpful modifications around the house include handrails, temporary ramps, no-slip bath rugs, and assistive seating. Mental Health, Substance Abuse, and Memory Care Services There is an increased need among older adults for mental health, substance abuse, and memory care services. An estimated 20 percent of older adults have a mental health disorder, and the total number of seniors with a mental health or memory care diagnosis is likely to increase over time. Suggestions for addressing mental health concerns among older people include: • Focusing on preventative care. Identify warnmg signs of depression, anxiety, and memory care problems. • Look for common signs of a substance abuse. This is an often overlooked area of older adult mental health care. Some common signs to watch for include reduced hygiene, unexplained bruises, erratic behavior, and the smell of alcohol on their breath. The Need for Social Connection Among Aging Adults Older adults benefit tremendously from social connections and interaction. Consider: • Joining an organization or social club • Volunteering • Learning a new hobby • Attending a religious institution • Adopting a pet • Using technology to stay in touch with friends and family Wearables and Smart Monitoring Devices Technology can help monitor our health and that of our aging loved ones. Examples of wearable health and smart-home monitoring devices include: • Smartwatches and smartphones. • Medical alert bracelets and necklaces. • Sensors and smart locks can alert caregivers when their loved one living at home leaves a window, garage, or door open, or has forgotten to lock them. • Small plugs, which can automatically turn on and off lights, space heaters, thermostats, security cameras, and more.

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