The following is from our friends at Dutton & Casey Law Firm...
What is it? A trust is a legal document that provides for the control and distribution of assets. The assets in a trust may be money, stocks, bonds, real estate, business interests, or other possessions. A trust may provide how assets are to be distributed during a person’s life, and also how they are to be distributed after a person’s death. A Special Needs Trust is a type of trust that helps to protect the assets of a person with disabilities. A trust may be set up by one person for another with a disability, to contain an inheritance or gift. A self-funded Special Needs Trust is a trust that contains the assets that had belonged to the person with the disability, who is the beneficiary of the trust. It is designed to have the funds be used to supplement, but not replace, governmental benefits. The Special Needs Trust may be managed by a trustee (someone other than the beneficiary).
The Need
Individuals with disabilities often receive governmental assistance and would benefit from having funds in a trust used to maintain their quality of life. When an individual who receives government benefits also receives money, the government benefits may be jeopardized. This situation may arise when the individual receives a Social Security back payment, a personal injury settlement or an inheritance. Regardless of the source of the funds, once the individual has money in their own name, the government benefits may be at risk. To protect the government benefits, the excess funds can be placed in a Special Needs Trust. A Special Needs Trust is used to supplement, not replace, public benefits such as Supplemental Security Income (SSI) or Medicaid. The trust assets should be used to purchase things that government benefits do not provide, and the Trustee should be aware of the impact of any distribution on government benefits.
What You Need to Know
Even if a trust is properly established and funded, if the Trustee improperly spends the income or principal of the trust, the public benefits of the beneficiary could be reduced or eliminated. The Trustee also should be aware of the tax ramifications of distributions made from the trust. A Trustee should be familiar with investment standards and the expectations for maintaining trust records. The Trustee should be aware of the tax ramifications of distributions made from the trust. A Trustee should be familiar with the types of public benefits available, the actual benefits received by the trust beneficiary and the requirements of the public benefits, such as SSI, SSDI, and Medicaid. The Trustee also should be familiar with other types of assistance for which the beneficiary qualifies, so that the Trustee does not waste trust assets on items that would otherwise be payable by public benefits. The trust assets should be used only to purchase something that cannot be purchased with public benefits and which, if purchased, will not jeopardize the benefits of the beneficiary.
Thursday, August 18, 2011
Tuesday, August 16, 2011
Senior Boom Creates A Demand For Home Health Workers
At her home health care agency here, Venus Ray quizzes 65 job applicants assembled before her: Can they cook? Do they know the right way to wash their hands? Can they safely transfer patients into wheelchairs? If they give wrong answers, speak English poorly or — God forbid — forget to turn off their cell phones, she asks them to leave.
Francess Sillah helps to transfer Tanya Pittman out of an imaginary wheel chair while role playing during a group interview at Health Management Inc. Venus Ray, the agency's executive director, looks on and assesses their skills to be a home health aide. (Photo by Jessica Marcy)
By the end of the session, Ray has dismissed 42 of the applicants, almost two-thirds, even though she's in dire need of employees.
Ray is executive director of Health Management Inc., which employs about 410 people, including 395 home health aides. With business booming, she is constantly looking to hire more, and she holds group interviews once or twice a month.
"There's a huge demand, and it's only going to get larger as the years go by," Ray said. With the nation's aging population, she added, many people "will tell you that they are more comfortable in their home."
The demand for workers by Ray's company mirrors national trends and is fueled in part by stepped-up efforts to keep seniors and the disabled out of nursing homes. The growth is likely to pick up in coming years as the 2010 federal health law tries to reduce hospital readmissions and expands programs such as Money Follows the Person, which encourages Medicaid recipients to receive care at home.
But experts warn that a shortage of qualified labor is looming. Workers often lack the training and support needed to properly care for patients, and poor working conditions lead to high turnover, experts say. In addition, salaries are low: In 2009, the median national hourly wage for direct-care workers — a term that includes home health aides — was $10.58, substantially below the $15.95 median for all U.S. workers.
Read full article...
Francess Sillah helps to transfer Tanya Pittman out of an imaginary wheel chair while role playing during a group interview at Health Management Inc. Venus Ray, the agency's executive director, looks on and assesses their skills to be a home health aide. (Photo by Jessica Marcy)
By the end of the session, Ray has dismissed 42 of the applicants, almost two-thirds, even though she's in dire need of employees.
Ray is executive director of Health Management Inc., which employs about 410 people, including 395 home health aides. With business booming, she is constantly looking to hire more, and she holds group interviews once or twice a month.
"There's a huge demand, and it's only going to get larger as the years go by," Ray said. With the nation's aging population, she added, many people "will tell you that they are more comfortable in their home."
The demand for workers by Ray's company mirrors national trends and is fueled in part by stepped-up efforts to keep seniors and the disabled out of nursing homes. The growth is likely to pick up in coming years as the 2010 federal health law tries to reduce hospital readmissions and expands programs such as Money Follows the Person, which encourages Medicaid recipients to receive care at home.
But experts warn that a shortage of qualified labor is looming. Workers often lack the training and support needed to properly care for patients, and poor working conditions lead to high turnover, experts say. In addition, salaries are low: In 2009, the median national hourly wage for direct-care workers — a term that includes home health aides — was $10.58, substantially below the $15.95 median for all U.S. workers.
Read full article...
Detroit jumping on board the senior citizen express
Independence and the ability to age at home are the top two concerns for many in the rapidly expanding senior citizen demographic, and mobility is an important aspect of seniors maintaining their freedom. In response to the aging population, Ford Motor Company has developed a number of innovations for its vehicles to make them more “senior friendly.”
“As you get older, the possible loss of that driving capability is equated with the removal of freedom, so what we can do to try to help older people continue to drive is important to them, because it really equates to a loss of freedom if they can’t do that,” says Gary Strumulo, Manager of Vehicle Design and Infotronics at Ford.
The innovations Ford has incorporated into some of its vehicles include specially contoured seats that prevent blood buildup when seated, user-friendly designs to help those who have joint stiffness or lack a full range of motion get in and out of cars easier, and easy fuel filters that let some push the gas nozzle directly into the device, making it easier on people with arthritic fingers.
In addition to this, Strumulo says Ford is also looking to address chronic illnesses that passengers may have, like diabetes, asthma, or allergies, by incorporating technology into their vehicles with a three pronged approach. This includes using Ford’s in-car connectivity system SYNC to connect to mobile health services that are on the web, and connect to devices brought into the vehicle (like a continuous glucose monitor) which communicates through bluetooth, and also to leverage the number of Smart Apps on smart phones.
Ford wants to adjust the purpose of SYNC to include health and wellness in addition to infotainment, says Strumulo, and the car company is looking beyond basic car safety features to reflect the aging population.
Another plan to make vehicles more “senior friendly” is to make font sizes on vehicle controls and interfaces bolder and wider. Ford cars arriving in dealerships next year will feature font sizes that have been increased 40%, starting with the Ford Edge and Explorer before spreading to other models.
By the year 2030, U.S. Census data shows about 20% of the American population will belong to the elderly demographic, and the number of American 50-year-olds will outnumber those under 20.
A recent Transportation for America study showed a huge “senior mobility crisis” threatening the Baby Boomer generation, as transportation options for many senior citizens are limited to driving. With an estimated 56% of the 65 and older crowd living in suburban areas where driving is the main method of transportation, it’s important to cater to this population by providing vehicle features that will help them to remain mobile longer, and therefore maintain their independence.
Thursday, August 11, 2011
New study confirms elderly women with sleep apnea at high risk for dementia
Elderly women with sleep apnea had an 85% higher risk of developing mild cognitive impairment or dementia than elderly women without sleep apnea, a new study found.
Researchers from Brigham and Women's Hospital in Boston studied a group of 298 women, roughly a third of whom had been diagnosed with sleep-disordered breathing. The average age of women in the group was 82.
Sleep-disordered breathing, which causes the brain to be deprived of oxygen, was defined as 15 sleep apnea events per hour of sleep. At the beginning of the study, none of the participants had been diagnosed with dementia. All of the participants underwent overnight sleep studies between 2002 and 2004.
Five years after the study, investigators conducted cognitive function tests designed to detect brain health and cognitive impairment. They found that 45% of study participants with sleep apnea developed cognitive impairments, compared with 31% of women without sleep apnea. Investigators said up to 60% of elderly people suffer from sleep-disordered breathing, which means addressing apnea may boost cognitive health.
“This is one of those rare, positive and hopeful articles. If the abnormalities in getting oxygen are what's causing the damage to the brain, it's a potentially reversible or preventable problem," said Gary Kennedy, M.D., a geriatric psychiatrist who was not involved in the study.
The study was published Aug. 10 in the Journal of the American Medical Association.
Researchers from Brigham and Women's Hospital in Boston studied a group of 298 women, roughly a third of whom had been diagnosed with sleep-disordered breathing. The average age of women in the group was 82.
Sleep-disordered breathing, which causes the brain to be deprived of oxygen, was defined as 15 sleep apnea events per hour of sleep. At the beginning of the study, none of the participants had been diagnosed with dementia. All of the participants underwent overnight sleep studies between 2002 and 2004.
Five years after the study, investigators conducted cognitive function tests designed to detect brain health and cognitive impairment. They found that 45% of study participants with sleep apnea developed cognitive impairments, compared with 31% of women without sleep apnea. Investigators said up to 60% of elderly people suffer from sleep-disordered breathing, which means addressing apnea may boost cognitive health.
“This is one of those rare, positive and hopeful articles. If the abnormalities in getting oxygen are what's causing the damage to the brain, it's a potentially reversible or preventable problem," said Gary Kennedy, M.D., a geriatric psychiatrist who was not involved in the study.
The study was published Aug. 10 in the Journal of the American Medical Association.
Monday, August 08, 2011
More evidence that vascular disease contributes to cognitive decline in later years
Those who smoke, are overweight, or have high blood pressure are more likely to have cognitive challenges later in life, a new study suggests.
Researchers from the University of California at Davis studied MRI scans of approximately 1,352 people for the purpose of identifying vascular risk factors.The subjects were part of the Framingham Offspring Cohort Study and had multiple scans over the past decade.
Among the results: researchers found that people with diabetes in mid-life lost brain volume faster in the hippocampus. Participants who smoked in mid-life lost their overall brain volume faster than non-smokers. Obese participants and those with hypertension were more likely to do badly on tests involving executive functioning or planning.
The good news is that the damage can be limited if recognized early enough, study author Charles DeCarli, M.D., said. “Our findings provide evidence that identifying these risk factors early in people of middle age could be useful in screening people for at-risk dementia and encouraging people to make changes to their lifestyle before it's too late,” he said. The study was published in the Aug. 2 issue of Neurology.
Researchers from the University of California at Davis studied MRI scans of approximately 1,352 people for the purpose of identifying vascular risk factors.The subjects were part of the Framingham Offspring Cohort Study and had multiple scans over the past decade.
Among the results: researchers found that people with diabetes in mid-life lost brain volume faster in the hippocampus. Participants who smoked in mid-life lost their overall brain volume faster than non-smokers. Obese participants and those with hypertension were more likely to do badly on tests involving executive functioning or planning.
The good news is that the damage can be limited if recognized early enough, study author Charles DeCarli, M.D., said. “Our findings provide evidence that identifying these risk factors early in people of middle age could be useful in screening people for at-risk dementia and encouraging people to make changes to their lifestyle before it's too late,” he said. The study was published in the Aug. 2 issue of Neurology.
Thursday, August 04, 2011
New anti-depressants linked to falls and fractures in the elderly
The following is an interesting article that appeared in McKnight's Daily Update on August 4.
Elderly patients being treated for depression may have better luck and fewer side effects with older tricyclic antidepressants rather than newer, more popular antidepressants such as Effexor and Prozac, a new study reports.
Researchers say that while newer selective serotonin reuptake inhibitors (SSRIs) are generally considered safe and effective, there have been fewer studies testing their safety and efficacy in senior citizens. SSRIs, which include Celexa, Paxil and Zoloft, recently have been linked to an increase in falls in the elderly. However, British researchers say tricyclics could be safer in people over 65, especially those at risk for falls.
The University of Nottingham analyzed prescription data of more than 60,000 patients between the ages 65 and 100 who had recently been diagnosed with depression. They found that seniors taking SSRIs have a higher risk of dying, having a stroke, falling, breaking a bone or having seizure than seniors not on antidepressants.
Additionally, within one year, 10.6% of this group of seniors taking SSRIs died. Eight percent of seniors taking tricyclics died, versus 7% of seniors taking no antidepressants.
"When you find the right medication, it can be a lifesaver. But it's so complicated, seniors need to have an ongoing conversation with their doctors," researcher Angie Hochhalter, Ph.D., told HealthDay News.
The study was published in Aug. 2 issue of BMJ (British Medical Journal).
Elderly patients being treated for depression may have better luck and fewer side effects with older tricyclic antidepressants rather than newer, more popular antidepressants such as Effexor and Prozac, a new study reports.
Researchers say that while newer selective serotonin reuptake inhibitors (SSRIs) are generally considered safe and effective, there have been fewer studies testing their safety and efficacy in senior citizens. SSRIs, which include Celexa, Paxil and Zoloft, recently have been linked to an increase in falls in the elderly. However, British researchers say tricyclics could be safer in people over 65, especially those at risk for falls.
The University of Nottingham analyzed prescription data of more than 60,000 patients between the ages 65 and 100 who had recently been diagnosed with depression. They found that seniors taking SSRIs have a higher risk of dying, having a stroke, falling, breaking a bone or having seizure than seniors not on antidepressants.
Additionally, within one year, 10.6% of this group of seniors taking SSRIs died. Eight percent of seniors taking tricyclics died, versus 7% of seniors taking no antidepressants.
"When you find the right medication, it can be a lifesaver. But it's so complicated, seniors need to have an ongoing conversation with their doctors," researcher Angie Hochhalter, Ph.D., told HealthDay News.
The study was published in Aug. 2 issue of BMJ (British Medical Journal).
Wednesday, August 03, 2011
Stretching prescription medication can prove deadly.
Whether you're treating a chronic condition or trying to stock your medicine cabinet with the basics, medications can be pricey.
To cut costs, you may be considering splitting pills or taking a medication after it has expired (though staring down a bottle of Tylenol purchased during the Clinton administration can make even staunch stomachs uneasy). You may well be wondering if cutting pills or ignoring use-by dates is really safe.
As if often the case in medicine, that's a simple question with a long answer.
Pill Splitting
It's basic math: Cutting pills in half can make a bottle of medication last twice as long. And if you only need half a pill to get the job done, splitting seems to make sense.
Some medications lend themselves to being halved, but certain others should never be split, says Dr. Norman Tomaka, a clinical consultant pharmacist in Melbourne, Fla. Splitting extended-release capsules, for instance, would cause a dose that's intended to be administered over several hours to be ingested all at once. In some cases, that might result in nothing more than a stomachache. But with drugs such as anti-seizure medications that need to be constantly active in the body, a sudden dose that then tapers off quickly could pose serious health risks.
Read full article
To cut costs, you may be considering splitting pills or taking a medication after it has expired (though staring down a bottle of Tylenol purchased during the Clinton administration can make even staunch stomachs uneasy). You may well be wondering if cutting pills or ignoring use-by dates is really safe.
As if often the case in medicine, that's a simple question with a long answer.
Pill Splitting
It's basic math: Cutting pills in half can make a bottle of medication last twice as long. And if you only need half a pill to get the job done, splitting seems to make sense.
Some medications lend themselves to being halved, but certain others should never be split, says Dr. Norman Tomaka, a clinical consultant pharmacist in Melbourne, Fla. Splitting extended-release capsules, for instance, would cause a dose that's intended to be administered over several hours to be ingested all at once. In some cases, that might result in nothing more than a stomachache. But with drugs such as anti-seizure medications that need to be constantly active in the body, a sudden dose that then tapers off quickly could pose serious health risks.
Read full article
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