Design Strategies for Memory Care Centers to Meet the Needs of Dementia Patients – Annapolis and Towson Estate Planning

If your loved one has Alzheimer’s disease or another form of dementia, you should try to find a quality memory care facility that incorporates the best elements of design tailored to people with dementia.

When a long-term care facility designates part of an existing center to memory care, they often try to retrofit the space for people with dementia care. Unless the memory care center employs design concepts that address common aspects of dementia, the facility itself can actually increase the residents’ anxiety, sleep disturbances, wandering, falls, injuries and need for medications.

A well-designed memory care facility can make residents less anxious by its mindful design, reducing the amount of prescription drugs the residents need. Here are some design strategies for memory care centers to meet the needs of dementia patients.

Ground Floor Is Problematic

Every winter, there are tragic news stories of dementia patients who wander outside and succumb to the elements. Despite this fact, many facilities have their memory care rooms on the first floor. A better plan is to have the Alzheimer’s portion of the center on the third floor, with multiple security points, locked doors and keypads between the memory care residents and the great outdoors.

Speaking of the Great Outdoors

Having ready access to safe, peaceful spaces outside can reduce anxiety for people with dementia. One facility uses the roof of an adjacent building for the memory care garden. The space has lovely plants, seating for individuals and small groups and discreet fencing to keep the residents safe. There is even a non-functional classic Cadillac for residents to sit in and reminisce. You would not realize that venue is a rooftop garden.

Circular Walking Paths Indoors and Out

When an older person moves away from her home, she might get confused and feel lost. She might walk around, trying to find her home. She might simply feel restless and have a need to walk. An accessible circular walking path in the garden can satisfy her need.

The interior layout of the facility should not have long hallways that end with doors. When an exit door is the destination of the hall, it is logical the resident will try to open the door. Instead, the layout should have a social room, kitchen, restroom, or other room at the end of a hallway.

Design Principles for Memory Care Facilities

Savvy design will camouflage exit doors, place them to the left or right of hallways and use keypad locks that do not look as if they guard Fort Knox. By nature, human beings do not thrive in an institutional setting. The more the memory care facility looks like a home and less like an institution, the happier and healthier the residents will be.

Since memory loss is central to memory care centers, the residents should not have to remember their room numbers. Well-placed personal objects next to the door should readily identify the room for the resident.

Another tailored design feature is to do away with nursing stations and staff uniforms. Having the staff dress in regular clothing and eliminating the nursing stations makes the facility feel more residential. When people feel at home, their anxiety levels go down and they need fewer medications.

References: A Place for Mom. “Alzheimer’s Care Facilities Design.” (accessed August 21, 2019) https://www.aplaceformom.com/planning-and-advice/articles/alzheimers-care-facilities

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What You Need to Know About Continuing Care Retirement Communities – Annapolis and Towson Estate Planning

With all the different types of residential options for seniors today, it is easy to get confused by the terminology. If you are trying to decide which choice is right for you or your loved one, you need to evaluate several kinds of arrangements. Here is what you need to know about continuing care retirement communities.

A continuing care retirement community offers a continuum of care, from independent living for people who need no assistance, to assisted living that offers some services, to nursing home care that provides skilled nursing care. A person or couple usually move into the level they need with the option to move to either more independence or more services as their needs change.

The benefit of a continuing care retirement community (CCRC) is you do not have to move to a different facility when you need more medical attention or if your health improves. You would have to move to a different part of the community that is usually in a separate building. However, all levels of care are at one campus or physical location.

The drawbacks of CCRC include:

  • These facilities tend to be more expensive than stand-alone centers. There is usually a sizeable entrance fee, ranging from $10,000 to $500,000.
  • The monthly expenses of living in a CCRC make these facilities out of range for low-income and most middle-income seniors. On top of the rent, there is a monthly maintenance fee that can range from $200 to more than $2,000.
  • There might not be a vacancy in the section to which you want to move, so you might have to go on a waiting list or move out of the CCRC to get the level of care you need. If you move out, you can lose the entrance fee you paid.
  • Usually, you do not own the place where you live, even though you might pay more than the market value of the building.

On the other hand, CCRCs have advantages, like:

  • A broader range of activities and services than stand-alone facilities.
  • Getting to stay close to the friends you have at the CCRC when your needs change.
  • More options for independent living, like apartments, houses, duplexes and townhomes.
  • The CCRC arrangement creates a social network and helps residents get through grief when a spouse passes. Residents of CCRCs tend to have less social isolation and higher activity levels as widows or widowers than people who live in single-family homes that are not part of a CCRC.
  • Because CCRCs have so many ongoing activities and the facilities include a range of opportunities for physical exercise, like swimming, yoga, tennis, golf, walking and dance, seniors in these communities tend to stay healthy and socially engaged.
  • Many CCRCs have barbers, hairdressers, grocery stores, coffee shops and retail shops onsite for the convenience of residents.
  • You can tailor your services to your desires. One resident might only want lawn care and snow removal. Another person might want housekeeping, meal preparation and transportation.

Make sure that you get detailed written information about all the costs for each service the CCRC offers and for all levels of care. Get the facility to tell you in writing what happens to your entrance fee, if you move from the facility. Compare at least three CCRC developments if you decide that a CCRC is the option you prefer and can afford.

Reference: A Place for Mom. “Continuing Care Retirement Communities.” (accessed August 21, 2019) https://www.aplaceformom.com/planning-and-advice/articles/continuing-care-retirement-communities

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Does Your Family Include A Hoarder? – Annapolis and Towson Estate Planning

We all know someone who can’t bear to throw anything out, no matter how small or valueless the item is. When they pass, loved ones have the dreadful task of cleaning away the mess while grieving. It’s not easy, says Next Avenue in the article “6 Tips for Dealing with the Aftermath of a Family Hoarder.”

For one woman whose grandmother lived in a one-bedroom apartment only ten miles away from her, the idea of cleaning out her grandmother’s apartment didn’t seem like it would be so bad.

It was worse.

Her spending and hoarding had led to a foreclosure on the woman’s home six years after her husband had passed away. Her possessions overflowed from every closet, drawer and surface. She had 30 large bins filled with craft supplies in the small living room. There were notes and pictures shoved into boxes with fast-food napkins and outdated receipts.

The apartment was rented, so everything had to be cleared out in thirty days, unless the family wanted to pay another month’s rent.

Three weeks and three garage sales later, the apartment was cleaned out. Five large bags of clothing were donated to local charity. A junk removal service was paid $250 to remove a mattress, couch and TV. Most of it went to the trash.

Here are six tips for anyone confronted with this difficult task:

  1. If you can, don’t do it yourself. Ask friends or family members to help. If you can afford it, consider a clean-out service.
  2. Find out if there are any instructions in the will. If there are specific directions about possessions, follow them. If not, let close family members make requests before the clean out starts.
  3. Limit what you keep. You don’t need a full dining room set or a box of costume jewelry to remember a loved one.
  4. Look for easy items to discard. Get rid of any trash, old food in the pantry, junk mail, etc., first.
  5. Don’t pinch pennies in a garage sale. Yes, some stuff may be worth top dollar, but your goal is to sell as much stuff as possible. Accept any reasonable offers.
  6. Make “let it go” your personal anthem. Remember that just because you are getting rid of stuff, does not mean you are getting rid of the person or your memories. Handle items fast, get the task done, and move on. It’s like yanking off a bandage–the faster you do it, the better.

Reference: Next Avenue (August 12, 2019) “6 Tips for Dealing with the Aftermath of a Family Hoarder”

Sims & Campbell, LLC – Annapolis and Towson Estate Planning Attorneys

Preparing for Alzheimer’s – Annapolis and Towson Estate Planning

Once there has been a diagnosis of dementia, there are a number of issues that families need to address, including legal issues. The best way to approach this task, says being patient in the article “Alzheimer’s and the Law” is to meet with an estate planning attorney who can guide the family in planning for the future and creating the needed documents.

The conversation will start with who should be named to two different kinds of power of attorney. One is for the durable power of attorney, which will give the named person the ability to manage any business decisions, sign contracts and deal with insurance companies. This document will need to be inclusive so the agent can act for the person who is going to be incapacitated.

Next, there will need to be a healthcare power of attorney. It should be complemented by a living will, which states what kind of lifesaving measures you would want if you were to be declared terminally ill. The healthcare power of attorney also allows a person to be named to make medical decisions if the person with dementia can no longer make good decisions on their own behalf.

As long as the doctor has not yet declared the person incapacitated, they can sign the power of attorney for financial and health care. If the person has been declared incapacitated, then the family will need to go to court for a guardianship proceeding so the court can declare who will be in charge of the person with dementia.

Some families prefer to have one person in charge of the loved one’s financial affairs and a second person to be their healthcare power of attorney. If there is a family member who is good with money and business, that person will do a better job than someone whose heart is in the right place but doesn’t manage money well. A nervous or easily excitable family member may also not be the best choice for healthcare power of attorney, especially if important decisions need to be made in a crisis situation.

Make sure that the people who are being considered for these tasks live near enough so they can be available when needed. A child who lives on the other side of the country may want to be the decision maker, but if they are too far away, it will create more problems than it solves.

Before naming anyone to the power of attorney roles, speak with them about the situation and be clear about what they will be expected to do. Clarify the difference between the two roles and that of the executor. The executor is the person who is in charge of the person’s estate after they pass. They do not have an active role while the person is living.

People generally don’t like to think about times when they may not enjoy good health, but this is a situation where waiting to address the issue can become extremely costly. A skilled estate planning attorney who works with families with dementia will understand the situation. They can be a valuable resource of information about other related services that will become needed over time.

Reference: being patient (August 22, 2019) “Alzheimer’s and the Law”

Sims & Campbell, LLC – Annapolis and Towson Estate Planning Attorneys

Nothing is Certain but Death and Taxes – Annapolis and Towson Estate Planning

No one actually enjoys paying taxes, and few of us really want to think about our own death, but both require advance planning and careful consideration, advises Ohio’s Country Journal in the article “Death and Taxes.”

Think about how quickly the year has gone. Doesn’t it feel like only yesterday you were making New Year’s resolutions? Then it was tax season, which for more people is worse than going to the dentist. While we all know we should see our dentist on a regular basis, we also like to forget that we need to tackle our estate plan.

Preparing for taxes and death: neither one is associated with warm, fuzzy feelings, but we still need to plan for it. This is to avoid burdening our families and loved ones. It’s hard enough to grapple with loss and grieving, but to be completely unprepared, makes matters worse for those who are left behind. Here are some suggestions to prepare for these certainties of life.

Have a last will and testament prepared. Work with an estate attorney who is licensed to practice in your state. It doesn’t matter if you have a simple life or a complicated one. You need a will.

Designate a power of attorney. Choose someone you trust to be able to sign important documents and take care of business if you are unable. It does not have to be a family member. Sometimes a trusted advisor is the best candidate for a POA.

Have a living will prepared and designate a medical power of attorney. Again, choose someone you trust who will make the decisions you want. Talk with them about what you want and put your wishes in the document.

Create a master file and tell someone where important papers can be found. The documents include insurance policies, mortgages, wills, trusts, POA, healthcare POA, information about bank accounts, investment accounts, retirement plans. Don’t leave out contact information for your estate planning attorney, CPA, financial advisor or healthcare providers.

Plan your funeral service. Describe what you would like to happen in as much detail as you can manage. This will help your family immeasurably so they won’t be left wondering what you’d want or wouldn’t want. If you plan on being buried, purchase a plot. If you want to be buried with your spouse, purchase two adjoining plots.

Don’t forget digital assets. Make a list of all your digital accounts, usernames and passwords. If possible, name a person to handle your online accounts. Some digital platforms allow you to designate a person to manage your accounts, access your data and close your accounts. Others do not. If you have valuable data online, from business records to family photos, make sure you’ve planned for these assets.

All these items can be updated as needed. In fact, every three or four years, you should update your estate plan so that it is current with changing laws and doesn’t miss any opportunities. The same goes for large events in life, including births, deaths, marriage and divorce. Speak with an experienced estate planning attorney to make sure you are ready for the sure thing.

Reference: Ohio’s Country Journal (August 26, 2019) “Death and Taxes”

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Where Should I Keep My Estate Plan? – Annapolis and Towson Estate Planning

Many people ask their attorney to hold the original documents of their estate plan. This prevents the plan from being misplaced at home and keeps it away from prying family members.

Forbes’ recent article, “Keeping Your Estate Planning Documents Safe,” explains that because of the expense of storage and the move to paperless offices, some estate planning attorneys are now having their clients hold the original documents.

This saves money for the attorney, but it leaves the client with the problem of where to put the originals.

If you need a safe and secure place for them, here are some options.

No safe deposit boxes. Avoid placing the original documents in a safe deposit box, because the authority to get into the box is inside the box! If you pass away or are incapacitated—and nobody has access to the safe deposit box—they’ll need a court order to get access. For them to get the court order, they need the documents inside the box. It’s like the chicken and the egg.

Get a fireproof safe. A fireproof safe is a great place to keep these important documents.

Make copies. Get a set of hard copies in another location that is easily accessible. You can now use the safe deposit box to hold a set of copies of your documents. Your attorney should also have a set of hard copies.

E-records. Your estate planning attorney should also have an electronic copy of your estate plan and should send you an electronic version of the documents to keep with your e-records.

Don’t lose it, if the originals are misplaced or destroyed. If the original documents somehow vanish, your family may still be able to use a set of copies. For instance, a photocopy of a will can be probated, once the executor has attested that she has made a diligent search to find the original which hasn’t turned up.

Remember that this isn’t a “one and done” task. You should review your documents every few years to make certain the people you’ve named in them are still alive and your intentions haven’t changed.

Reference: Forbes (August 16, 2019) “Keeping Your Estate Planning Documents Safe”

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How Do I Get an Executor to Sell My Mom’s Home? – Annapolis and Towson Estate Planning

It’s not uncommon for a parent to leave his or her home to their children in equal shares.

Let’s assume that two sisters are both equal beneficiaries of their mother’s estate in New Jersey. Each adult child has retained an attorney. The executor, who’s a family friend, is moving slowly with the probate process, and it’s been more than a year of waiting. The executor of estate is the individual who is specifically designated in the deceased’s will to manage the estate.

In this case, the glacier-like progress of the executor is causing a strain on the sisters’ relationship. This results in the sisters fighting over the estate. One sister is in no hurry to sell the house, and the other feels frustrated and may have to just give her everything and walk away to save her sanity.

nj.com’s recent article on this topic asks “My mom’s executor won’t sell the house. What can I do about it?” The article says that these sisters probably tried to negotiate a resolution. However, there’s no reason to think the only way to resolve this is for you to “give her everything and walk away.”

The executor should sell the home and distribute the proceeds to the sisters.

If one of the children, her attorney, or the executor object to the sale of the home, a judge may need to intervene.

If there’s no issue, and the executor won’t act, a beneficiary can apply to the court to remove the executor. The judge may then name the two sisters as co-executors, so they can sell the home.

Although there would be legal fees and costs to go to court to get some action, if the executor won’t move, there may not be any other choice.

In addition, the sisters could ask the judge to decrease any executor commission that would be owed to the original slow-moving executor to cover the legal fees, if the judge agrees that the executor was acting improperly.

Reference: nj.com (August 10, 2019) “My mom’s executor won’t sell the house. What can I do about it?”

Sims & Campbell, LLC – Annapolis and Towson Estate Planning Attorneys

How Do I Discuss My Parents’ Long-Term Financial Goals With Them? – Annapolis and Towson Estate Planning

A recent study by Ameriprise Financial found that more than one-third of adult children say they haven’t had a conversation about their parents’ long-term financial goals. Even though discussing this delicate topic may seem uncomfortable, addressing it now can help avoid challenges and uncertainty in the future.

To that end, the Ameriprise Family Wealth Checkup study found that those who talk about money matters, feel more confident about their financial future.

The Enterprise’s recent article, “Four financial questions to ask your parents,” provides some questions that can help you start the dialogue.

“What do you want to achieve in the next five or 10 years?” Understand your parents’ aspirations for the next few years. This includes their personal and financial goals and when they plan to retire (if they haven’t already). Do they want to move closer to their grandchildren or to warmer weather? Getting an idea of how they want to spend their time, will help you know what to expect in the years ahead.

“Where is your financial information located in case of an emergency?” An incident can happen at any time, so it’s essential that you know how to access key personal, financial and estate planning documents. You should have the contact info for their financial adviser, tax professional and estate planning attorney, and be sure your parents have the right permissions set, so you can step in when the need arises. You should also ask your parents to share the passwords for their primary accounts or let you know where you can find a password list.

“How do you see your legacy?” Talk to your parents about how they want to be remembered and their plans for making that happen. These components can be essential to the discussion:

  • Ask them if they have an updated will or trust, and if there’s anything they’d like to disclose about how the assets will be distributed.
  • Health care choices and expenses are often a big source of stress for retirees. Talk to your parents about their current health priorities and the future and have them formalize their wishes in a health-care directive, which lets them name a loved one to make medical decisions, if they’re unable to do so.

“How can I help?” Proactively offering to help, may get rid of some of the frustrations or relieve stress for even the most independent and well-prepared parents. The assistance may be non-financial, like doing house projects or giving them more time with their grandchildren. You should also look into including an attorney in the discussion, if your parents have estate planning questions.

Retirement and legacy planning can be complex. However, taking the time to have frequent conversations with your parents, can help you all prepare for the future.

Reference: The Enterprise (August 19, 2019) “Four financial questions to ask your parents”

Sims & Campbell, LLC – Annapolis and Towson Estate Planning Attorneys

Here’s What You May Not Know About Roth IRAs – Annapolis and Towson Estate Planning

There is a lot that most people don’t know about Roth IRAs, as detailed in the article “9 Surprising Facts About Roth IRAs” from the balance. Some of them may surprise you.

Roth IRA contributions can be used for emergencies. In a perfect world, no one would ever need to use retirement money for anything but retirement, but because Roth contributions are not deductible, they can be withdrawn at any time, for any reason, without taxes or penalties. A Roth IRA can serve as an emergency fund. However, it needs to be noted that the funds you can withdraw do not include amounts that were converted to a Roth IRA or investment gains. Therefore, if you put $5,000 into a Roth IRA that grew to $6,000, you may only withdraw the $5,000 without taxes and penalties.

You might be able to use a non-deductible IRA to fund a Roth. If you make over a certain limit, you can’t contribute to a Roth IRA—or can you? Some people who keep other retirement money inside qualified retirement accounts are permitted to make a non-deductible IRA contribution every year and then convert that into a Roth. This is sometimes called the “backdoor Roth.” However, you’ll need to be careful, and you may need help. In some cases, you can even roll a self-directed IRA back into a company plan, so in future years you could use the backdoor Roth strategy without having to pay taxes on the converted amount. Get a professional to help you with this: mistakes can be expensive!

You may roll after-tax 401(k) contributions into a Roth IRA. Many employer plans let you make after-tax contributions and then, at retirement, these after-tax contributions can be rolled into a Roth IRA. Any investment gain on the after-tax contributions can’t go into the Roth, but the contributions can.

Roth IRAs have no RMDs (Required Minimum Distributions). There aren’t any age requirements for when you take money out, so there are no delayed tax bombs lurking. However, non-spouse heirs will have to take required distributions from an inherited Roth. The nice thing: they will be tax free.

You can contribute to both a SIMPLE IRA and a Roth IRA. As long as your income is within the Roth IRA limits, then you can contribute to both the SIMPLE and the Roth. The contributions to the SIMPLE IRA will be deductible, the Roth contributions will not be. This dual funding strategy lets you reduce taxable income now and have funds in the Roth accumulate for tax-free benefits in retirement. For the self-employed person, who is diligent about saving for retirement, this is a good plan.

Your employer plan may allow Roth contributions. Many 401(k) plans let you make Roth contributions. They are called “designated Roth accounts.” Check with your HR department to see if their plan let you choose which type of contribution to make. Some may be all or nothing, while others let you do some of each.

Age is not the key factor in determining whether or not to use a Roth IRA. The primary deciding factor here is your income bracket, your tax rate now and your expected tax rate during retirement. If your expected tax rate during retirement will be lower, the deductible contributions may be better. If your tax rate during retirement is going to be the same or higher in retirement, which is often the case for people with large IRAs or 401(k)s, then a Roth IRA may make a lot of sense, regardless of your age.

You might be able to make a spousal Roth contribution. Even if your spouse has no earned income, as long as you have an earned income, you can make an IRA contribution on their behalf. Many couples can double their tax favored retirement account savings by doing this.

Be careful about Roth conversions. As stated previously, mistakes here can become expensive, so don’t rely on online Roth calculators to manage conversions. Talk with an experienced professional who can help make sure that your numbers and your strategy fits with your personal retirement scenario. Every person and every situation is different, so planning needs to be specific to your needs.

Reference: the balance (August 13, 2019) “9 Surprising Facts About Roth IRAs”

Sims & Campbell, LLC – Annapolis and Towson Estate Planning Attorneys

Understanding Why a Will is Important – Annapolis and Towson Estate Planning

These questions presented by The Westerly Sun in the article “Making a will is an important legal step,” may seem very basic, but many people don’t really understand how wills work and why they are such an important part of estate planning. Let’s go through these fundamentals about wills.

A will is a legal document that must be prepared under very strict standards to explain your wishes about how you want your estate–that is, your property, money, tangible possessions, and real estate—distributed after you die.

A will also does more than that.

A will, which is sometimes referred to as a “Last Will and Testament,” also makes clear who you want to be in charge of your minor children, if both parents should die. It also is how you name a person to be in charge of your affairs after death, by naming them as executor of your estate.

A complete estate plan includes a will, and several other documents, including a power of attorney, trusts and a health care proxy. The goal of all of these documents is to make it easier for your surviving spouse or loved ones to take care of you and your possessions, if you become too ill to speak on your own behalf, or when you die.

Your will provides instructions about what happens to your estate. Who should receive your money and property? These instructions must be followed by the person you choose as your executor. The local probate court must give its approval, and then the estate can be distributed.

If you have a valid will, it is admitted to probate (a court process) upon your death, and then your wishes are followed. If you don’t have a will, you are said to have died “intestate.” The laws of the state, and not you, and not your loved ones, will decide what will happen to everything you own that is subject to probate. Usually this means that assets are distributed to family members, based on their degree of kinship with you.

This may not be what you wanted. If you have children, and especially if you have children with special needs, the court will appoint a guardian for those children. You may not want Aunt Jennifer raising your daughters, but that may end up happening.

Properly prepared by an experienced estate planning attorney, a will is a binding legal document that carries great significance. No one likes to think about dying, or becoming incapacitated, but by planning ahead, you can determine what you want to happen, and protect those you love.

Reference: The Westerly Sun (August 18, 2019) “Making a will is an important legal step”

Sims & Campbell, LLC – Annapolis and Towson Estate Planning Attorneys