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By Attorney David Engler

All of our parents and clients and ourselves should have durable health care power of attorneys. It is called an Advanced Directive because it takes your client’s wishes and makes them known in advance of them being incompetent of making such decisions. For many professional conservators or guardians the Health Care POA either existed or there would never be one now.

Each Health Care POA has a part where the client designates who will make such life and death decisions in the future. I thought it might be helpful to give some examples of who not to appoint.
DO NOT APPOINT ANY OF THE FOLLOWING :

1. The wife who keeps your emergency inhaler stored in a covered crock pot on the storage shelf in the basement.
2. The son who has labeled some of your favorite possessions with the word “Mine”.
3. Your husband who removed the “9” and “1” keys from the phone.
4. Your daughter who believes Tylenol is VooDoo medicine.
5. Your younger sister whose first comment after you last came out of recovery was “Your still here huh?”
6. Your neighbor who while driving you to ER with chest pains says “Wait just a sec, I’ve got to pick up just a few things from the store for the weekend.”
7. Or the grandson who tells you why can’t you old people get a buzzer reservation system like they use at Applebee’s to give us a 3 hour notice of your death.
8. The Mother who said you had to stay home on family vacations in case there was a car wreck, at least someone from the family would survive. You were only three at the time.
9. The caretaker sent over from the agency who tells you it’s her hobby to know the name of a person’s first pet; street they grew up on and mother’s maiden name.
10. Your girlfriend who knows a great astrologist in Seattle she consults for all of life’s tough questions. Madame Xanthar is always booked two months in advance so it can’t be a question that needs an answer like RIGHT NOW.

Please contact us at info@eguardianship.com if you want a Durable Health Care POA for your state, or follow our blogs at FamilyFaultLines.com or eGuardianship.com .

I appreciate the work of a caregiver and wanted to give you a moment of laugh.

Attorney David Engler
Phone: 330-729-9777
http://www.DavidEngler.com Attorney Engler’s website
Areas of Practice: Family Law, Elder Law, Domestic Relations, Bankruptcy, Criminal

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By Attorney David Engler

Caregiving

Medicare does not have any program to pay a family caregiver. Medicare has only limited coverage for home care, and when it does cover home care it does so through a Medicare-certified home health care agency. It does not pay independent caregivers, family or otherwise.

But that does not mean you are without a solution because most money spent on nursing and home health care comes from the States who pay for Medicaid in partnership with the federal government.

In many states, Medicaid has a program to directly pay a person needing home care, and that person can turn around and use the money to pay a family member (or anyone else) to provide that care. If the person who needs help in order to stay at home rather than go to a nursing home has too many assets; the senior in need might still qualify for such a direct payment program. That’s because in many states eligibility for these programs is extended to people who have low income and assets though not low enough to qualify for Medicaid.
Caregiver
These payments work through a state program, called Passport, Cash and Counseling or other similar name, often run through the state’s Medicaid program. To learn more about these cash assistance programs, contact the local Medicaid office usually run through the local welfare department. (now often called Jobs and Family Services) If your state has a Cash and Counseling or similar state cash assistance program, you can get information about it at a local Medicaid office. To find a local Medicaid office, contact the Eldercare Locator by phone toll-free at 800-677-1116, or online you can go to any search engine and type in “Medicaid” and the name of the state.

Attorney David Engler
Phone: 330-729-9777
http://www.DavidEngler.com Attorney Engler’s website

Areas of Practice: Family Law, Elder Law, Domestic Relations, Bankruptcy, Criminal Law

By Attorney David Engler

Adult Protective Services (APS) is responsible for investigating reports of suspected abuse, neglect, or exploitation of Ohioans aged 60 and older. Similar agencies exist in every state. APS is part of each Ohio County Department of Job & Family Services (CDJFS). The Ohio Revised Code defines “abuse” as infliction upon an adult by self or others of injury, unreasonable confinement, intimidation or cruel punishment with resulting physical harm, pain, or mental anguish. “Neglect” is defined as the failure of an adult to provide for self the goods or services necessary to avoid physical harm, mental anguish, or mental illness or the failure of a caretaker to provide such goods or services. “Exploitation” means the unlawful or improper act of a caretaker using an adult or an adult’s resources for their monetary or personal benefit, profit or gain.

Lady

APS can petition Probate Court for a temporary restraining order to prevent interference or obstruction of its investigation by any person, including the abused adult. The court must find (a) that there is reasonable cause to believe the adult is being or has been abused, neglected, or exploited, and (b) that access to the adult’s residence has been obstructed. APS can also petition the court to approve a service plan providing involuntary services. The adult must receive a notice describing his or her rights and the consequences of a court order at least five working days before a hearing on the petition. An indigent adult has the right to a court-appointed attorney. Notice of the hearing must also be sent to the adult’s guardian, attorney, caretaker and spouse.
The court must find by clear and convincing evidence that (a) the adult has been abused, neglected, or exploited; (b) the adult is in need of protective services; (c) the adult is incapacitated; and (d) no other person authorized by law is available to give consent. If the court so finds, it must issue an order requiring protective services for up to six months, but can be re-authorized for up to a year.

But like with any governmental organization, APS can be too intrusive. Before they act there needs to be clear authority that an adult can be removed.

Recently, I met a distressed couple who had their Mother literally yanked from their home in the final months of her life. An anonymous tip was given by the Mother’s long time “friend” that she wanted to go back to the care-takers residence. The mother was in full scale dementia and would answer a few questions correctly and if asked would parrot the name of the “friend.” In horror the family of the elderly woman watched as APS took the mother from their home and moved her back to the friend’s house. After the Mother was there the friend arranged for her entire estate to pass to him. An attorney helped in the sham transfer.

In a matter of months the family desperate for help asks the Probate Judge to order an evaluation of the Mother. She had dementia for at least a year and was unable to make any decisions on her own. Be careful when a governmental agency says that it knows best. Hold on to your liberty because they are about to snatch it from you.

Probate Court acted quickly but it was too late. The Mother died a few days after the mental health assessment. Her possessions real and personal would have passed to the children, but for the friend getting everything transferred.

More than the money the family loss the beauty of being with their parent as she lived her final months. All they are left with is bitterness towards a government going too far and a scrapbook of memories.

Attorney David Engler
Phone: 330-729-9777
http://www.DavidEngler.com Attorney Engler’s website

Areas of Practice: Family Law, Elder Law, Domestic Relations, Bankruptcy, Criminal Law

Also published on Attorney David Engler’s Legal Blog on April 3, 2012 http://davidengler.wordpress.com// and Family Fault Lines Blog http://familyfaultlines.com//

By Attorney David Engler

Walking Woman

In my earlier blog I wrote about my Mother finding a new friend in the weeks of her final dawn. “Wanda and Stella” was about the two WWII era nurses that made a pact to go to heaven together.

Mom died on February 3, 2012 and Stella died March 3, 2012. The following piece is from Louis Begley who writes with beauty about friends lost as we age. This was published in the March 18, 2012 New York Times.

“My mother died in 2004, two days short of her 94th birthday, and 40 years and two months to the day after the death of my father. He died at 65; for the preceding four or five years he had been in poor health.

My mother and I lived through the German occupation in Poland; my physician father, having been evacuated with the staff of the local hospital by the retreating Soviet army, spent the remaining war years in Samarkand. Left to fend for ourselves, my mother and I became unimaginably close; our survival depended on that symbiotic relationship. All three of us — I had no brothers or sisters — arrived in the United States in March 1947, and once here I began to keep her at arm’s length. Especially during her long widowhood, I feared that unimpeded she would invade my life, the life she had saved. I remained a dutiful son, watching over her needs, but was at first unwilling and later unable to be tender.

My abhorrence of the ravages and suffering inflicted on the body by age and illness, which predates my mother’s decline in her last years, is no doubt linked to there being no examples of a happy old age in my family. The grandparents, uncles, aunts and cousins who might have furnished them all met violent deaths in World War II.

Unsurprisingly, dread of the games time plays with us has been a drumbeat in my novels. Thus, arms akimbo, majestic and naked, standing before a glass, Charlie Swan, the gay demiurge of “As Max Saw It,” illustrates for the younger narrator on his body the physiology of aging: misrule of hair, puckered brown bags under the eyes, warts like weeds on his chest, belly, back and legs, dry skin that peels leaving a fine white snow of dandruff. Listening to him, the younger man is reminded of his own father in a hospital, permanently catheterized, other tubes conducting liquids to his body hooked up to machines that surround his bed like unknown relatives. He prefers his mother’s “triumphant” exit. A headlong fall down the cellar stairs kills her instantly.

I have followed the progress into old age of Albert Schmidt, like me a retired lawyer, in three novels. Schmidt is 60 when we meet him in 1991; when we part on New Year’s Day 2009, he is 78, therefore a couple of years older than I was then. Life has not been kind to him, but so far, Schmidt enjoys excellent health, marching up and down the Atlantic beach in Bridgehampton and New York City’s avenues, and doing laps in his pool. Although he worries about performance, his libido is intact. Nevertheless, the reflection of his face in the window of a shop is frightening: he sees a red nose and bloodshot eyes, lips pursed up tight over stained and uneven teeth, an expression so lugubrious and so pained it resists his efforts to smile. My appreciation of my own charms is not very different. Like Schmidt, I see that nothing good awaits me at the end of the road, and that passing years will turn my life into a Via Crucis.

And yet my body, like Schmidt’s, continues to be a good sport. Provided my marvelous doctor pumps steroids into my hip or spine when needed, it runs along on the leash like a nondescript mutt and wags its tail. My heart still stirs when I see a pretty girl in the street or in a subway car, but not much else happens. Except that, since by preference I stand leaning against the closed doors, she may offer me her seat. When last heard from, Schmidtie figured he had another 10 years to live. I have a similar estimate of my longevity. Such actions as buying a new suit have become dilemmas. The clothes I have may be fatigued and frayed, but won’t they see me through the remaining seasons? Can the expense of money and waste of time required to make the purchase be justified?

My mother did not remarry after my father died. She lived very comfortably, but alone, in an apartment 15 blocks away from my wife’s and mine. If we were in the city, we went to see her often and then daily as her condition deteriorated in the last two years of her life. Our children and grandchildren tried to see her often, too — and those visits brought her great joy — but they live far away and the happiness was fleeting. During her last decade she was very lonely. Most of the friends she had had in Poland had been killed. Those who had escaped and settled in New York one by one became homebound or bedridden, lost their minds or died. Or she found they bored her. Hearing poorly, tormented by arthritis in hip and knee joints, too proud to accept a wheelchair, she stopped going to museums, concerts and even the movies. She had loved sitting on a Central Park bench and putting her face in the sun. That humble pleasure was also abandoned; she couldn’t get the hang of using a walker.

Having rehearsed the bitter gifts reserved for age, T. S. Eliot wrote in “Little Gidding” that “the end of all our exploring/ Will be to arrive where we started/ And know the place for the first time.” The closer that place — the human condition — is to home, the harder it is to take in. I could speak movingly of Schmidt’s loneliness after the loss of his daughter, calling his existence an arid plane of granite on which she alone had flowered. But it has taken me until now, at age 78, to feel in full measure the bitterness and anguish of my mother’s solitude — and that of other old people who end their lives without a companion.”

Louis Begley is the author of several novels, including “Schmidt Steps Back.”
A version of this op-ed appeared in print on March 18, 2012, on page SR7 of the New York edition with the headline: Age and Its Awful Discontents.

Attorney David Engler
Phone: 330-729-9777
http://www.DavidEngler.com Attorney Engler’s website
Areas of Practice: Family Law, Elder Law, Domestic Relations, Bankruptcy, Criminal

Also published on Family Fault Lines on March 20, 2012 http://familyfaultlines.com/

By Attorney David Engler There have been powerful world convulsing events over the last year where the heroes used Twitter, Facebook and the power of a digital image.
The Arab Spring began when Buoazizi set himself and fruit cart afire in protest over Tunisian dictatorship. In Egypt the end came when Asmaa Fahouf posted her video on YouTube calling for protesters against Mubarak to meet in Cairo's Liberation Square. In my case against a Children Service Board it was the triumph of a wounded grandmother coming forth with video atrocities of her grandchildren that began with what will one day be how this dysfunctional agency is undone and replaced with something more accountable and caring. The public becomes personal and the personal becomes public when pictures, moving or still, text and audio become digitized and loose on the Internet. And so it was with my own grief over losing my Mom at the end of her fight with Parkinson's disease. She was with my sister Amy, a hero, in Maine. She cared for her and eventually spent a part of each day at the Maine's Veteran's Home. With the lost came the relief that prayers were answered for God to take her from her body that had long ago grown tired. But she was stubborn and her will to live never did quite give out. In your grief you question whether you could have been a better son or daughter and reflect upon the relationship to your parent and all the complexities that absolutely existed. So the obituary is posted on Facebook and hundreds of friends and family reach out in small meaningful ways. Each call or text from my friends brought me solace. I am not sure I ever knew what that word meant before, but now I know what it feels like. And for every acknowledgement on Facebook....I thank you. It means more than you could imagine or maybe not since we almost have all felt lost before. So again I thank you and I also thank Facebook and Twitter and Wordpress for showing me in a very personal way how the loss of your parent can be eased with the power of social media. I can see how it worked when it was something so dear to me and I suppose that was a very small fraction of the collective power used by revolutionaries and heroes I mentioned above when their personal pain became public and collective. Attorney David Engler Phone: 330-729-9777 http://www.DavidEngler.com Attorney Engler's website Areas of Practice: Family Law, Elder Law, Domestic Relations, Bankruptcy, Criminal

By Attorney David Engler

Wanda and Stella
Wanda and Stella

Wanda is my Mom. Parkinson’s disease has slowly but assuredly taken her strength and her voice. The stroke on the Royal Wedding Day this spring did not help matters either. But as the New Year approaches she is in the Maine Veterans Home. She does not want to see her 86th year. She has prayed to her husband and my father, Bill who passed 21 years ago, that she wanted nothing more to do with her worn body. They met 59 years ago. She was a nurse at the VA hospital in Cleveland and he was a disabled vet getting a degree at Kent State.

Stella is 93 and cancer is fighting her will and she knows the battle is nearly over. The last great battle she saw was working as an Army nurse in England helping to heal GI’s as they returned from Normandy. Not coincidentally she married a soldier whom she met a few years later and he took her to Maine. Over time she would have two children and help turn a family owned bar and grill into a large seafood wholesaler specializing in selling Lobsters, of course. The great irony Stella explained was that she could never taste what her family sold because she was allergic to shell fish which should not be confused with seafood.

About 15 months ago we moved Mom from her home in Ohio to live on the first floor of my sister’s home in Maine. She was falling and insisted that she could care for herself; the reality was she could not make the one step from the living room to the kitchen.

So off to Maine she went. The state motto is “Life As It Ought To Be”. My sister is busy with an 8 year old adopted Chinese whirlwind named Molly and a professorship at the U of Maine. Three 911 calls in 6 months and it was clear that Mom needed nursing home care. So in May of this last year she gets put in a room with Stella. Stella’s hair is wispy from the many chemo treatments she received to slow down cancer’s assault. Long before the cancer her hearing went. She seems to fill in the words if you can talk loud enough. Mom had one good eye before the stroke and Parkinson’s and now that one went bad. Reading and watching the news was a daily companion, now she can just listen to Ann Curry.

The room looks like any other nursing home. Cards crowd the bulletin boards and the closet door is a backdrop of art work created by grandchildren. What makes the room a home is each other. The nurses and aides see the two holding hands trying to make sense of a death that is unscheduled but waiting. It was Stella who told the staff that she and Wanda have a pact that they would like to hold hands and race into heaven together. The spunky nurse from Portugal attracted to Maine by her country’s fishing heritage, said “It was more like a turtle race to Heaven”, since neither seemed closer to the end despite their bodies having months ago failed.

So it was on Christmas Day this year that I traveled to surprise my Mom. At first she did not recognize me. I have heard how hard that is to hear. But after a few minutes she asked about each of the kids that she raised when they were small and that I feed her a favorite dark chocolate mint from Philadelphia Chocolates. It was my favorite Christmas memory. And what I took home was this picture I snapped with my iPhone that neither old nurse could have imagined. A new friend was made in what will surely be their last year on this Earth. It is the power of a touch of a hand and someone that cares when you least expect it.

Attorney David Engler
Phone: 330-729-9777
http://www.DavidEngler.com Attorney Engler’s website
Areas of Practice: Family Law, Elder Law, Domestic Relations, Bankruptcy, Criminal

By Attorney David Engler

Weston

The Philadelphia Enquirer reported December 9, 2011 on one of the nation’s most horrific example of abusing a ward or in Linda Weston’s case a “payee”. Weston is accused of imprisoning intellectually challenged adults in a Tacony cellar and stealing their federal benefits. Weston was the official recipient of Social Security benefits for 10 men and women from 1995 to 2011, according to a source familiar with the ongoing investigation.

“She had applied to be the “representative payee” for an 11th beneficiary, her biological daughter, the source said.

In an ongoing investigation, the Social Security Administration has found that Weston was getting the checks for four relatives, including children; five individuals who were not related; and one person who had the same last name but whose relationship to Weston has not been firmly established.

As of October, Weston was terminated as the payee for seven of the beneficiaries, the source said.

Of those beneficiaries, three were with Weston at the time of her arrest; two are dead; one no longer needed a representative payee; and one was switched to a more suitable payee.

Payments for the three others were suspended, pending the results of an investigation by the administration’s Office of Inspector General, the source said.

Police continue to probe the 2005 death of Donna Spadea, 59, while in Weston’s care in Philadelphia.

Another person who died under Weston’s care was Maxine Lee, 39, of Philadelphia. In November 2008, she was found dead in a house that Weston was renting in Norfolk, Va. Norfolk police said Lee died of natural causes. A medical examiner attributed Lee’s death to meningitis, with severe malnutrition as a contributing factor.

Weston had served less than four years in prison for a 1984 conviction for starving to death a man, 25, she kept trapped in her Philadelphia apartment. She was arrested in October with her daughter and husband after the landlord of a Tacony apartment house found four intellectually handicapped people locked in the building’s cellar.

A sweep of the apartment where Weston was staying turned up identification records for as many as 50 people, including power-of-attorney paperwork, forms of identification, and Social Security numbers. Police said it suggested a vast fraud operation.

People who are convicted of crimes are banned by law from accepting government checks on behalf of others, but it is a self-reporting system.

The social security administration is very lax on who is appointed as a representative payee and should be encouraging more professional organizations or registered guardians to act as payees. Each year billions are stolen in benefits from the poor by those who are claiming to help.

The answer is not only better background checks but accurate record keeping that can be reviewed by other family members, a court or agency at any time. Our company, eGuardianship.com www.eGuardianship.com has pioneered the nation’s first online real-time reporting system for wards. Such systems ensure proper recordkeeping and help to minimize if not eliminate fraud.

U.S. Sen. Bob Casey (D., Pa.) is proposing a bill that would give the Social Security Administration access to FBI databases in order for caseworkers to conduct criminal background checks. It’s a start.

Attorney David Engler
Phone: 330-729-9777
http://www.DavidEngler.com Attorney Engler’s website
Areas of Practice: Family Law, Elder Law, Domestic Relations, Bankruptcy, Criminal

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