As the baby boomer generation begins to retire the concern about the need for long-term care increases. Long-term care is expensive. In Arkansas, the average costs are as follows:*

• Avg. Daily Nursing Home Rate : Private $150
• Avg. Daily Nursing Home Rate : Semi-Private $128
• Avg. Monthly Cost in Assisted Living Facility: $2,194
• Home Health Aide Average Hourly Rate: $15
• Homemaker Services Average Hourly Rate: $15
• Adult Day Services Daily Rate: $77

The rates for care in Little Rock are higher than the state averages. The costs for long-term care in Arkansas are lower than the national average.

Medicare only pays the full cost of nursing home care for the first 20 days; after that, Medicare will pay for a portion of the cost up to the 100^th day of care. Payment for nursing home care by Medicare after the 100^th day stops. In addition, Medicare will not pay for care in an assisted living facility, continuing care retirement community or adult daycare. Medicaid funding for these services depends on the state.

This means that most of the cost for long-term care will be out of pocket, unless you purchased long-term care insurance.

Long-term care insurance is probably the best option to cover costs of long-term care. However, it is impossible to buy when you need it. Many employers are offering long-term care insurance as part of a benefit package. If you have young adults just entering the work force advise them to take advantage of this insurance while they can get it for less expense. You could also consider asking your employer to provide it as part of your benefit package in lieu of a raise; it could save you both money.

*Source: National Clearinghouse for Long-Term Care Information

Deborah Sexton Law Office, PA is a member of the American Academy of Estate Planning Attorneys.

A guardian is a person who is appointed by a court to control and take care of interests of a person who cannot handle their own affairs. There are two types of guardians

• Guardian of the person – the guardian controls and takes care of the ward’s personal interests. They can make decisions about where there person lives, medical care, and schooling
• Guardian of the property – has control of the ward’s finances.

It is possible for one person to have both roles, as guardian of the person and the property but it is not required.

Courts appoint guardians of incapacitated adults and minor children. Parents who have small children can appoint someone the guardian of their children who would act in the child’s best interest if they die prematurely. Appointing a guardian of young children is an essential component of any good estate planning.

Courts appoint guardians of incapacitated adults when a petition is filed by a person of interest (usually a family member) that the ward is in danger because they are physically incapacitated or mentally incapacitated and in danger of being taken advantage of by unscrupulous persons. This situation often happens in the case of elderly persons who have developed Alzheimer’s or some other debilitating disease.

A person who is appointed guardian of a ward is under the continued supervision of the court. The guardian of the person must make at least annual reports of how the ward’s money is being managed and maintained. The guardian must seek permission from the court to make major expenditures on behalf of the ward. The guardian is also compensated for their services. Any expenses they incur on behalf of the ward should be deducted from the assets being held for the ward.

Deborah Sexton Law Office, PA is a member of the American Academy of Estate Planning Attorneys.

One of the most important things to consider when you are planning for retirement is where you want to spend your later years. Do you want to move into an assisted living facility, live with family members or remain in your own home?

If you want to stay at home, you are not alone; most people choose this option if it is available to them. You’ll want to come to this decision as early as possible so that you can modify your home now to accommodate your needs later. For example, if you do not have a restroom on the first floor of your home, you will definitely need to add one.

Most of today’s homes were not built for the elderly, but for young families. It is common for people to ignore the limitations of their homes until something happens that requires them to sit up and pay attention, like a fall or permanent disability. It is not a good idea to wait until you absolutely have to make changes due to lack of mobility, poor eyesight or another ailment. Making all of these modifications at once can drain you financially, and you will be living in an environment that might be dangerous for you until you have useful additions completed.

When you are ready to modify your home, contact someone that specializes in modifications for the elderly. Some of those changes include replacing traditional doorknobs with lever doorknobs, enlarging the bathroom and adding a walk-in shower, adding ramps, and lowering cupboards. These modifications don’t necessarily make your home look all that different; they are meant to create an accessible living environment for you, even when you are no longer functioning at the same level. These modifications also make your living environment safer as you age.

Deborah Sexton Law Office, PA is a member of the American Academy of Estate Planning Attorneys.

When you look at the demographics as they apply to segmented population growth the statistics are very surprising to many people. Senior citizens are the most rapidly growing group in the United States, and when you drill down another level the oldest among them, the segment of seniors who are 85 years old and above are growing at an even faster rate than senior citizens as a whole. This has some very practical consequences within the realm of estate planning, and when you consider the implications these statistics underscore the need for incapacity planning.

It is important to recognize the fact that one can become either physically or mentally incapacitated, so you can be able to get around well but be mentally unable to make sound personal and/or financial decisions. If you have not stated your wishes and executed the legal documents necessary to name the people that you would like to empower to make these types of decisions in your behalf, the court can be petitioned to appoint a guardian to make your personal decisions for you, and a conservator you make financial decisions on behalf of your estate.

If you would prefer to make your own choices concerning the people who will make decisions for you should you become incapacitated, you can do so with the proper planning. To handle the medical choices you can execute a health care proxy and name someone to make medical decisions in your behalf. Your financial matters can be placed in the hands of a person or entity of your choosing through the assignment of a durable financial power of attorney.

When you have these two documents in place you won’t have to wonder about who will be taking care of things in the event of your incapacitation. You can discuss your wishes with these potential representatives so the decisions that are eventually made in your behalf will be informed by your own personal perspective.

Deborah Sexton Law Office, PA is a member of the American Academy of Estate Planning Attorneys.

When you are engaged in long term planning during these technologically advanced times the exercise extends beyond the financial matters that are typically associated with estate planning. People are living longer than ever, and many are very surprised to hear that the fasted growing segment of the population is people 85 years of age and over. For this reason it is important to prepare for the inevitable realities of aging, not just from a financial standpoint but from a health care perspective as well.

The reality is that most of us do not pass away on a Tuesday after feeling alive, alert, and well on Monday. The end of your life may very well include a period of disability or incapacitation, and you may not be in a position to make your own medical decisions at some point in time. For this reason advance directives have become a recommended component to every holistic estate plan, and one very useful and comprehensive directive is known as Five Wishes.

With Five Wishes you simply address five end of life issues that involve personal choices. Your answers to these questions would make your wishes known:

• Who would you choose to make medical decisions for you if you couldn’t do it for yourself?
• Which medical treatments or life support measures would you accept and which would you reject?
• What are you personal and comfort care preferences?
• How would you like others to treat you?
• What final thoughts would you like to pass along?

The Five Wishes document provides a way to make sure that your family knows how you would like to proceed as your life winds down, taking the burden of difficult decision making off their shoulders. At the same time, by stating your preferences you gain the peace of mind that comes with knowing that you have left nothing undone as the end of life nears.

Deborah Sexton Law Office, PA is a member of the American Academy of Estate Planning Attorneys.

As of 2007, 41% of Americans had a Living Will. Are you among that number? If not, you should be. A Living Will is an important part of your incapacity plan.

The main purpose of a Living Will is to dictate your medical preferences. If you become incapacitated either due to a mental disability or a terminal illness, your Living Will can declare your medical wishes for you.

Most Living Wills focus on treatments or care used when a terminal diagnosis has been issued. When you make a Living Will, you can state your wishes regarding life-prolonging treatments such as blood transfusions, CPR, and respirators. If you do not wish to endure some or all life-prolonging treatments, you may use your Living Will to say so.

Living Wills may also cover palliative treatment. This is pain relief care used to provide comfort to those who may have chosen to avoid life-prolonging treatments.

Whatever your preferences are for life-prolonging and palliative care, it is ideal to state those preferences in a legal document such as a Living Will. If you do not have a Living Will or have not stated your medical choices in another disability planning document, your health care agent may not know your wishes regarding terminal illness treatments and life support systems. He or she will have to make decisions based upon what is considered best for you. The treatment chosen may not be one you wished to have.

A Living Will is just one cornerstone of your disability plan. You can also create a Medical Power of Attorney to name a health care agent and a Durable Financial Power of Attorney to name a financial agent. We also recommend a HIPAA Authorization. When deciding what path is best for your disability plan, speak with your attorney. The important thing is simply having a way to state your medical choices when you are no longer able to.

Deborah Sexton Law Office, PA is a member of the American Academy of Estate Planning Attorneys.

You may be among the lucky ones who never have to experience a life-changing disability, but since you won’t know until it does or doesn’t happen, you should always be prepared. You can prepare for a possible disability with the help of your attorney and a solid Disability Plan.

Avoid Guardianship

If you become mentally or physically disabled to the extreme of not being able to make your own choices, you need someone to assist with your medical decisions. With a Disability Plan you can sign an Advance Medical Directive, also called an Advance Health Care Directive or a Medical Power of Attorney. Your medical directive will allow you to name a loved one to act as your health care advocate. This person will have access to information a doctor would normally provide to you only. Your agent will use the information supplied to making any necessary health care decisions on your behalf.

If you do not have a legal plan that names a health care agent, then a court of law will choose an advocate for you through a conservatorship or guardianship. A court-imposed guardianship can cause many problems within your family if some of your loved ones do not agree with the selected guardian. Also, your guardian may not be the person you feel would be best at making decisions for you. When you name a health care advocate in advance, you have time to speak with your advocate to make sure he or she understand your wishes and can seamlessly take over your health care when it is time.

State your Medical Preferences

You should also have a Disability Plan in order to state your medical preferences. You can do so with the help of a Living Will. If you do not advise of your medical wishes in advance, your chosen advocate or your court-ordered guardian will have to guess at the type of medical treatment you would have chosen.

Deborah Sexton Law Office, PA is a member of the American Academy of Estate Planning Attorneys.