Featured Article
What is the End of Life Option Act? 

Soon we will be able to chose when we die if we are unfortunate enough to have a terminal illness. The act is called the End of Life Option Act and it was signed into law on Oct. 5, 2015, which permits an adult with a terminal disease and the mental capacity to make health care decisions to request and be prescribed an aid-in-dying drug if specified conditions are met:
  • at least 18 years old
  • a California resident
  • mentally capable of making and communicating health care decisions, and
  • diagnosed with a terminal disease that will result in death within six months.

A patient who meets the requirements above will be prescribed aid-in-dying medication only if:

  1. The patient makes two verbal requests to their doctor, at least 15 days apart.
  2. The patient gives a written request to the doctor, signed in front of two qualified, adult witnesses. (The law sets out the specific form that the patient must use.)
  3. The prescribing doctor and one other doctor confirm the patient's diagnosis and prognosis.
  4. The prescribing doctor and one other doctor determine that the patient is capable of making medical decisions.
  5. The patient has a psychological examination, if either doctor feels the patient's judgment is impaired.
  6. The prescribing doctor confirms that the patient is not being coerced or unduly influenced by others when making the request.
  7. The prescribing doctor informs the patient of any feasible alternatives to the medication, including care to relieve pain and keep the patient comfortable.
  8. The prescribing doctor asks the patient to notify their next of kin of the prescription request. (The doctor cannot require the patient to notify anyone, however.)
  9. The prescribing doctor offers the patient the opportunity to withdraw the request for aid-in-dying medication before granting the prescription.
  10. To use the medication, the patient must be able to ingest it on their own. A doctor or other person who administers the lethal medication may face criminal charges because that would be considered euthanasia which is not legal.
Hospice care will not be discontinued. In fact, it is possible that good hospice care will make it unnecessary to end your life yourself. Brittany Maynard who left California to go to Oregon chose not to have hospice because her symptoms were causing her suffering which could not be relieved. If you have ever been involved with hospice or have been with someone who is dying in the hospital, you probably have already experienced that the patients are often heavily sedated by doctors before their deaths in a form of slow euthanasia. Many administer infusions of drugs to keep patients unconscious for hours or days at a time as they consider it a valuable way of easing the pain and anxiety of patients who are dying with conditions such as cancer. In real terms, this is seen an alternative to legalized euthanasia.

Click Here for a great link to a Lancet Journal Article on the existential aspects of being clear of mind while dying.

Proponents of death with dignity argue that the term "suicide" doesn't apply to terminally ill people who would prefer to live but, facing certain death within months, choose a more gentle way of dying. Opponents cite the possibility of a cost benefit analysis that determines who should live and who should die if insurance companies refuse to supply life sustaining drugs or make them too expensive for the average citizen, poor or disabled to purchase. Of course, there is always the argument that frail older adults will be unduly influenced to leave this planet prematurely by scheming greedy relatives.

Unlike the right to make decisions about life sustaining treatment- defined as any treatment that serves to prolong life without reversing the underlying medical condition such as mechanical ventilation, renal dialysis, chemotherapy, antibiotics, and artificial nutrition and hydration, no other person -- such as a health care agent, attorney-in-fact, or conservator -- may make a request for aid-in-dying medication on behalf of the patient.
You can read the full text of the bill by clicking here
The Money Desk
A surcharge on my Medicare Insurance?  Really?  
Am I being punished again for working hard and making money?
How many of you know about the income-based premium surcharges that can increase higher-income clients' health insurance costs by more than 200% percent during retirement? Yep. Those with modified adjusted gross income(MAGI) , going back two years, that exceeds $85,000 (for individuals) or $170,000 (for married clients filing jointly) will see a Part B and Part C surcharge imposed based on a sliding scale.  The biggest surcharge is imposed upon single clients with MAGI exceeding $214,400 and couples whose MAGI exceeds $428,000.
MAGI includes most types of traditional income such as wages, Social Security, IRA and 401(k) distributions, dividends, earned interest, and capital gains. You should talk to your financial advisor because other investments do not qualify for MAGI such as Roth IRAs, non-qualified annuities, income drawn from a health savings account, which also allows tax-free savings to accumulate over the years and loans taken from a whole life insurance product 
Fortunately, there are ways to alter a client's investment mix to generate income that is excluded from Medicare's income calculation, but because Medicare looks to income earned prior to retirement in determining whether the surcharge applies, the time to plan is now.

Talk to your parents about hearing loss Provided by CapTel Captioned Telephone

People with hearing loss are often not willing to face the fact that they may not be able to hear as well as they used to. Hearing loss often occurs gradually over time, and many people may not even realize that it has become an issue until someone they care about brings it to their attention. If you have a parent who is experiencing hearing loss, there are some helpful tips that can make the conversation easier for everyone involved. 

Click Here to read the rest of this article

Dementia
Alzheimer's Update

I heard this story on NPR (National Public Radio) and thought it was worth sharing because so many of my clients are dealing with the high cost of care and Alzheimer's. 
First, Alzheimer's takes a person's memory. 
Then it takes their family's money.
The Hornbacks
That's the central finding of a report published Wednesday by the Alzheimer's Association on the financial burden friends and families bear when they care for someone with dementia.
"What we found was really startling," says Beth Kallmyer, vice president of constituent services for the organization. "The cost of paying for care was putting people in a situation where they had to make really difficult choices around basic necessities - things like food, medical care, transportation."
The report, based on a survey of more than 3,500 Americans contributing to the care of someone with dementia, also found that:
  • Friends and family spent, on average, more than $5,000 a year of their own money on the expenses of their loved one with dementia, ranging from food to adult diapers.
  • More than one-third of these contributors to care who had jobs had to reduce their hours or quit.
  • To make ends meet, about 13 percent had to raise money by selling personal belongings, such as a car.
  • Nearly half of the care contributors surveyed had to dip into their savings or retirement funds.
The Alzheimer's Association decided to conduct the survey, Kallmyer says, after hearing lots of stories of financial hardship from friends and family members of people with Alzheimer's. One of those stories came from Paul and Sarah Hornback, who live in central Kentucky.
Paul Hornback was a senior engineer and analyst for the U.S. Army when was diagnosed with Alzheimer's six years ago. He was just 55.
"I was kind of at the height of my career and then this dreadful diagnosis came and it just wiped out every plan I had for my career," he says.
Hornback and his wife, Sarah, had to re-imagine their future. Then they began to consider the financial implications.
The Hornbacks had borrowed a lot of money to put three children through college. Now Paul was being forced to retire early and they wouldn't have his salary to pay off the debt.
"We had to sell basically everything but my wife's car and an old truck that I kept to drive around here on the farm," he says.
At first, Sarah Hornback kept working as a school administrator. But about 18 months ago, she also had to retire early - to care for her husband.
"It got to the point where it just wasn't safe for him to stay alone just because of memory and decision making," she says. "He might leave the stove on or he might decide that there was a tree branch bothering him and he should get out the chain saw."
The Hornbacks are getting by on their early retirement income. But Sarah Hornback says the real financial problems will start when she can no longer care for her husband on her own.
"When he has to go into full-time care, I'm going to be at the poverty level, basically," she says.
The financial burden is greatest for people like the Hornbacks, who have to pay more while working less, Kallmyer says.
"It's really a double whammy," she says. "People are sometimes not able to work as much or not able to work at all in order to provide care, and then they're paying money out of pocket on top of that."
The survey also found that about two-thirds of Americans believe Medicare will help cover nursing home costs, or aren't sure whether it will. It won't.
"What that tells us is that families are ultimately unprepared for that really, really significant cost of long-term care," Kallmyer says.
Clinics that specialize in Alzheimer's often try to help family members navigate the financial aspects of care.
"It's a challenge for almost every family that we see," says Dr. Pierre Tariot, a geriatric psychiatrist and director of the Banner Alzheimer's Institute in Phoenix. "We do see folks who are lucky and have considerable resources. But even for those families it's a major financial obligation."
And it's not realistic to expect every family to absorb the cost, Tariot says.
"Ultimately," he says, "society will need to think of other ways of funding care for our elders as they become vulnerable."
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My Watch Dog
Watchdog
Alerting you to the latest SCAMS, Elder Abuse,
and things that are just plain WRONG!

Report Claims Financial Elder Abuse Is Top Advisor Concern

Financial Advisor IQ March 31, 2016
Retirement income advisors are especially worried about protecting their elderly clients from financial abuse, according to a new study.
The survey, by the nonprofit private educational institution the American College of Financial Services, found protecting aging clients is the top ethical concern for advisors.
Out of the 244 individuals who took part in the Ethical Issues in Retirement Income Planning Survey, 82% indicate concern about financial abuse of the elderly.
Yet some of those surveyed don't think financial elder abuse is widespread, and only 28% believe that it's a common occurrence.
But many advisors surveyed are concerned that clients and FAs alike are ignorant about elder abuse.
The study also finds 68% of those polled are troubled that advisors aren't keeping up with legal changes impacting clients' retirement income, such as refinements to ERISA and new requirements for receiving Social Security and Medicare systems.
Additionally, the report claims 64% of retirement income advisors are worried they're "unable to perform their jobs because of inadequate training." Some 88% fear clients can't properly comprehend their retirement income plans, and 85% are fretful that clients don't understand the products and services they are offered.
For Jamie Hopkins, co-head of the retirement income program at the American College of Financial Services, the survey shows advisors have a lot of balls in the air. And though they're "well aware of the challenges" to developing comprehensive retirement plans, they worry "the industry as a whole lacks the proper training and education required to effectively serve aging clients," Hopkins says in a press release.
Yesterday, the North American Securities Administrators Association announced it's offering a training program for state regulators to help broker-dealers and advisors identify financial abuse. The training program will be available to NASAA members in April.
SOCIALIZATION FOR THE 60+ GROUP
There is finally an online local social resource for boomers, seniors, and caregivers.  Things to do, places to go, and people to meet in the greater San Fernando Valley area for those looking to find out what's going on in their backyards.   To join their mailing list go to  www.suddenly65.com  
JUST FOR FUN...CHECK OUT THIS LINK OF ELDERLY RUNNERS. ONE OF THEM IS 98 YEARS OLD!
Do you need my help? 
  • Medi-Cal Planning and Asset Protection
  • Living Trust
  • Nursing home abuse litigation
  • Probate
  • Post Death Estate Administration
  • Conservatorships 

You can call me at 1 (888) 422-6070. I have offices throughout LA, OC and Ventura. I also do lots of telephone consultations. info@susanbgeffen.com      www.susanbgeffenlaw.com
Susan B. Geffen | Gerontologist, Attorney, Author | 1(888) 422-6070
Take that nursing home and shove it!





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