Cleveland, Ohio Elder Law Attorney Paul Stano

Preparing for the Inevitable

Paul Stano — Fri, 11 May 2012 13:49:16 +0000

Let’s face it, not many people think about how they will pay for care for a confused, elderly mother or father. In general, people avoid thinking about death at all costs, and when they are hit with the actual costs required to care for their aging parents they are surprised and unprepared. Aging is inevitable, and it is extremely important to give thoughts to these types of situations before they happen.

The Aflac WorkForces Report from 2011 surveyed 4,000 US workers on the subject. Of the 4,000, only 13% thought that the need for long-term care would affect their families at some point in the future. This is surprising, when In reality nearly 10 million adult children are caring for their aging parents, and this figure only counts the number of adult children that are physically caring for their aging parents. Many more are contributing to the financial responsibility to provide care for their parents in nursing homes or assisted-living centers, which average $3,500 per month in costs.

It’s an eye-opener, but a problem that can be much easier to deal with by planning in advance. The first step in planning doesn’t necessarily need to be discussions about money, but rather power of attorney. This legal document grants the authority of decision-making to a loved one in the event the elderly parent cannot make decisions on their own due to illness or memory loss. The downfall to avoiding the necessary planning is that you can end up in guardianship court, which involves significant legal fees, doctors, judges, time and money.

It’s never easy to think of your parents reaching an age where they cannot care for themselves, but lack of planning can leave Mom or Dad feeling like a burden when care must be arranged and costs covered. Taking the first steps and talking with your aging parents can be difficult, but it’s the only way to avoid major complications, and unnecessary expenses, when the time comes for Mom or Dad to need more involved medical care.

Are Nursing Homes Prepared to Care for Patients in a Natural Disaster?

Paul Stano — Sun, 06 May 2012 15:17:15 +0000

Nearly seven years after the devastation of Hurricane Katrina, the inspector general’s office of the Health and Human Services Department identifies major gaps in emergency preparedness and response of nursing homes across the country. Natural disasters, be it tornados, hurricanes or floods, leave the nearly 3 million elderly and medically frail living in nursing homes across the United States particularly vulnerable.

“We identified many of the same gaps in nursing home preparedness and response,” the inspector general’s office wrote in a recent report. “Nursing homes faced challenges with unreliable transportation contracts, lack of collaboration with local emergency management, and residents who developed health problems.”

Recommendations have been made that Medicare and Medicaid add training plans and emergency planning to the federally required disaster plan. Investigators took a closer look at 210 facilities that were affected by floods, hurricanes and wildfires. On paper, the facilities appeared to be in good shape, but the truth came out when the inspectors showed up at 24 nursing homes in California, Louisiana, Minnesota, North Carolina, North Dakota Tennessee and Texas, and began interviewing staff and looking at files. Some surprising findings included:

Of the 24 plans, 23 had no details on how to handle a resident’s illness or death during evacuations.
None of the 24 had the recommended 7 day supply of fresh water in the facility
22 of the 24 plans had no backup plan in place to replace staff members unable to report for work due to the disaster
At one facility, the disaster plan was in several boxes. In another, it was on a legal pad
17 of the 24 had no plan for working with government or emergency coordinators to determine whether to evacuate or shelter in place
7 facilities had no plan in place to identify patients, such as name tags or arm bands.
15 of the 24 had no medication list in place, meaning patients would likely go without their medications in the event of an evacuation
Employees of nursing homes shared information regarding transportation contracts not honored during evacuation
One facility’s employees that chose not to evacuate temporarily lost patients during the emergency.

Dementia Care Units

Paul Stano — Sun, 29 Apr 2012 19:30:46 +0000

Specialized care, such as that offered through dementia care units, can improve the general well being of your loved one with dementia by reducing the overall agitation he or she feels on a regular basis. Dementia care units typically different from other care facilities in that the staff have been trained to deal with individuals with this specific condition. Furthermore, the environment and living space for individuals at these facilities has less distracting stimuli than other facilities. For instance, instead of consisting of an often overwhelmingly large facility with high traffic, constant noises, and blaring lights, these facilities offer a quieter environment with less traffic and even locked doors for those individuals who tend to wander. Much of the idea here is to simply provide a safe space for residents to engage in symptomatic behaviors instead of trying to prevent those behaviors.

Should you consider placing your loved one in a dementia care unit, you should take your time making your decision, as a poor decision could result in unneeded distress for both you and your love one. If you have multiple care units in your area, then plan to visit at least three. Spend time interviewing the staff and take note of how they interact with residents. Also, take note of the overall cleanliness of the facility. Finally, with regard to conditions such as Alzheimer’s disease, you’ll want to make sure the facility has an activities director.

If for any reason you’re facing a situation wherein your loved one has been requested to move to another facility, then you may want to reach out to an Ohio elder law attorney. Because moving your loved one is stressful, time-consuming, and expensive, it is perhaps one of the last options you should consider. A qualified elder law attorney has the resources and experiences to help assess your loved your loved one’s specific situation, and present you with options you may not have considered.

Smaller Homes

Paul Stano — Sat, 28 Apr 2012 19:30:15 +0000

Depending on your specific situation, you may consider a small home, or a boarding-care home for your loved one with Alzheimer’s disease or dementia. These homes differ from other nursing homes and assisted living facilities in that they usually consist of five to six individuals. Furthermore, the residents at theses homes often play a role in the day-to-day activities. For instance, depending on their level of functioning, some residents may fold towels or laundry while others set the table, sweep, or water plants. These types of activities often yield the benefit of making your loved one feel as though he or she is an important part of the home. Finally, another benefit to these types of homes is that they typically offer an ideal staff-to-resident ratio, which ensures your loved one receives the attention he or she needs.

While these homes may seem ideal in many respects, they are certainly not for everyone. There’s actually a very good chance your loved one may instead benefit from the type of care only a nursing home or assisted living facility offers. Indeed, you’ll want to ensure you’ve done your research before placing your loved one in one of these homes. Not only will you want to make sure that the home has specialists for your loved one’s specific condition (e.g., Alzheimer’s Disease, bedridden), you will also want to make sure your loved one feels safe and comfortable with both the staff and other residents. After all, with any move, you’ll need to ask yourself, “Is this a place where my loved one could potentially live out the rest of his or her life?”

You may come across other concerns questions when making decision about your loved one’s living situation, and some of these questions may require the assistance of an elder law attorney. For instance, would you know whether or not one of these smaller homes would accept Medicaid in the event your loved depleted his or her funds? Furthermore, how would licensure factor into the equation? Might you be able to use Medicaid benefits to cover the cost of care should the home not have proper licensing? These questions and more certainly fall into the domain of an Ohio elder law attorney, and as such, should you have questions concerning your loved one’s future, then you should reach out to one as soon as possible.

Communication with Your Loved One

Paul Stano — Fri, 27 Apr 2012 19:29:27 +0000

Misunderstandings are common enough in everyday life. Whether we’re asking a stranger at a convenience store for directions or simply telling a story to our spouse, family members, or friends, the messages we intend to convey don’t always come across clearly. This is especially true when speaking with individuals living with Alzheimer’s disease or dementia. Those with the condition often have a difficult time remembering faces—let alone words—so it’s little wonder that our loved ones often misconstrue our meanings or that our words seem to occasionally fall on deaf ears.

Consequently, you may find that both you and your loved one grow tired, frustrated, or angry after many unsuccessful attempts to communicate a want or a need that—once upon a time—came as naturally as breathing. What’s extremely important to remember here is that you slow down and exercise patience with your loved one, and try your best to acknowledge that he or she is trying. Also important when communicating is to remember that you’re trying to communicate with an individual who has a disease—and not a diseased individual.

That said, you may want to consider some of the following tips when communicating with your loved one. Tips including avoiding speaking about your loved one as though he or she were not in the room. Also, avoid attempts to communicate in environments full of distracting noises. For instance, instead of trying to tell your father something important while you’re both sitting in front of the television, just take a moment to go outside or in another room where there are fewer distracting noises or images.

Taking time to put yourself in your loved one’s shoes as well as taking time to consider your surroundings are both useful ways to avoid putting your loved one in a situation where he or she is bound to grow frustrated or upset. That said, though, despite your best efforts, your loved one could still erupt in an emotional outburst or reaction puts his own safety at risk. Should you find yourself in this type of situation frequently, then you may want to consider reaching out to a professional, such as your loved one’s physician or even an elder law attorney, who can address any concerns you may have regarding your loved one’s safety.

In-Home Care Options

Paul Stano — Thu, 26 Apr 2012 19:28:08 +0000

At one point or another, you may find that there are just not enough hours in the day to balance work, life, and the time needed to properly care for you loved one. Should you find yourself in this position, try not to allow guilt get the best of you, and instead just realize that you may need some help—and there’s nothing wrong with that. After all, you’ve got to remember that if you aren’t doing what you need to take care of yourself, you’ll likely have a difficult time adequately tending to the needs of those people whom you love.

That said, you may consider how to find in-home care for your loved one. Since many people require in-home care services, you should know that you have a couple of options. Depending on the type of services you need, you can find are through an Area Agency on Aging, the Department on Aging, Social and Rehabilitation Services or the Alzheimer’s Association. Should your loved one require the services of a nurse, a home care agency can definitely assist you. In such cases, doctors are usually involved in this process, so you’ll need to make sure you’ve spoken with him or her about these types of in-home care services.

Finally, for in-home care services, you can also consider hiring someone on your own. Should you select this option, you’ll want to make sure you spend plenty of time during the interview process. You’ll also want to make sure you’ve collected all the appropriate paperwork, as you’ll want to avoid any potential compliance issues. Should you have questions on how to do this, you may want to set-up an appointment with a qualified Ohio elder law attorney. By taking the time to consult with an elder law attorney, you ensure you avoid potentially issues down the road, such as Medicaid eligibility issues that sometimes crop-up when individuals pay for in-home care.

When Your Loved One Feels Ready

Paul Stano — Wed, 25 Apr 2012 19:27:30 +0000

While caregivers have every right to feel that providing day-to-day care for a loved one with Alzheimer’s disease or dementia is exhausting, they should try their best to keep in mind that those who’ve actually suffered from the disease every day for years on end feel especially weary. That said, they should try their best to understand when their loved ones feel ready to let go. Simply put, the years of battling the disease and the years of feeling like a burden to others takes it toll—to the point where these individuals desire a release from the ever-demanding struggle. As such, it is common that individuals with Alzheimer’s diseases or dementia reach a point where they feel they are ready to die.

While some individuals may communicate this wish verbally, others may indirectly indicate it through their body language, or—as others have suggested—you may just get a “sense” of it. However he or she conveys communicates this desire to you, you should respect his or her decision, as the road has been long and difficult one, and your loved one will need all the support she can get to make it through this final stretch. Very likely—despite all your best efforts to prepare for this time—you and your loved one will still find this period very difficult.

At this point, if you haven’t already, you should reach out to professionals for advice and counsel on how to best handle the road ahead. Be sure to contact your loved one’s physician and communicate your loved one’s desires. Also, you’ll want to schedule an appointment with your elder law attorney to ensure you’re the realization of your loved one’s final wishes and desires. By contacting a qualified elder law attorney and taking care of any loose ends, you make sure that you can spend what the limited time you have tending to you and your family’s emotional needs.

Confusing Television Personalities for Real Ones

Paul Stano — Tue, 24 Apr 2012 19:26:46 +0000

Caretakers sometimes express concern that activities such as watching television or listening to the radio have a negative impact on their loved one’s general well being. This is easily understandable, as television and radio personalities have been known to confuse individuals suffering from Alzheimer’s disease or dementia to the point that they cannot tell the difference among real people and the characters portrayed on TV. In other words, due to the effects of the disease, these individuals believe that the personalities they see on a daily basis are real people with whom they’ve had previous interactions and even know personally.

While such beliefs typically don’t cause these individuals any distress, anxiety, or put them in harm’s way, some individuals can grow so agitated by the lack of appearance of a television or radio personality that the absence prompts a negative change in behavior. For instance, a family member or caretaker might have reason for concern if his or her loved one refused to play bingo or eat until he or she had the chance to ask a game show host if he wanted to play or eat dinner too. In this case, the television might be interfering with the loved one’s ability to have real and fulfilling social interaction or receive adequate nutrition, which could lead to depression or other health issues.

That said, though, you should not immediately jump to the conclusion that the confusion is negatively impacting your loved one’s life. Your loved one may getting his or her social or nutritional needs fulfilled another way—say, through family visits, or regular snacks. In which case, he or she is not showing any signs of distress. Just keep in mind that you’ll have to consider the situation yourself; however, the general rule of thumb is whether or not the behavior is causing your loved one any distress. If not, then you may not want to make the behavior an issue, as you could inadvertently cause your loved one another form of distress by taking away an enjoyable activity.

Protect Your Family! We’ve Cracked the Code on Long-Term Care Planning

Paul Stano — Mon, 23 Apr 2012 19:25:47 +0000

A complaint shared among many individuals who seek legal advice—especially those with questions about long-term care planning—is that the advice they receive often seems erudite to the point that they require a translator. As you might imagine, for those trying to grasp the ins and outs of financial planning as it relates to Medicaid, Medicare, and reverse-mortgages, the last thing these folks want to encounter is more confusing terminology, jargon, and rules. The goods news for people in this situation is that they now have an easily understandable and comprehensive guide to navigating the road of their financial future for both themselves and their loved ones.

In his second publication, Protect Your Family! We’ve Cracked the Code on Long-Term Care Planning, Paul J. Stano and ten leading elder law attorneys provide readers with essential tools for long-term care planning. Stano, in particular, leaves his mark in this book by authoring the section on reverse mortgages wherein he describes what they are, and what type of role they play in long-term planning. For two decades, Paul Stano has been involved in the design of Estate and Long-Term Care Plans for Americans, their loved ones, and their families, and before him, his father Jerome P. Stano served as state senator and Chairman of the Nursing Home Commission.

The contents of this book provide those individuals, who have concerns for their elderly loved ones, with essential resources for long-term planning. However, given that you’ll want to make sure you’ve addressed all the nuances of your specific situation, you should be sure to schedule an appointment with an Ohio elder law attorney.

World Elder Abuse Awareness Day

Paul Stano — Sun, 22 Apr 2012 19:24:17 +0000

This June 15^th, in Prague will mark the 7^th annual World Elder Abuse Awareness Day, and the International Network for the Prevention of Elder Abuse is excited to report that this year, the United Nations has officially recognized the day as an International Day. Each year the INPEA contributes to World Elder Abuse Awareness Day by providing resource “tool kits” as well as other useful information for those individuals interested raising awareness of abuse. As this is an international day that requires the coordination of many groups, other organizations also play a role in spreading awareness. For instance, the National Center on Elder Abuse provides resources for those individuals interested in this type of activism by including information on how to encourage action to fight elder abuse through existing organizations.

While elder abuse has been recognized as an issue that affects individuals and families internationally, you should know that the prevalence of the issue does not necessarily make it an easy one to address. To explain, because individual states often have varying definitions of what constitutes elder abuse, you’re likely best served by contacting an elder law attorney who’s familiar with your particular state’s definition. Furthermore, each person’s story or experience of elder abuse will vary slightly, so you’ll want to make sure you’re placing your concerns in trusted hands and not simply the hands of a general practitioner or the most affordable guy in town. By contacting a qualified Ohio elder law attorney, you can rest assured you’ve reached out to the right person—someone who’ll take the time needed to carefully review the details of your case as well as address any specific concerns you have regarding the well-being of your loved one.