Using an Attorney Effectively in Trust Administration
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The document outlines the framework for life care planning, emphasizing its three levels: estate planning, long-term care planning, and life care planning, which collectively aim to ensure quality of life and asset preservation for individuals in need of long-term care. It details the roles of attorneys, financial planners, and care coordinators in developing personalized care plans and coordinating necessary resources. Key benefits include improved decision-making for care, advocacy for quality of care, and support for families facing complex health and caregiving dynamics.
Using an Attorney Effectively in Trust Administration
- 1. Life Care Planning May 3rd, 2011 750 University Avenue Suite 140 Los Gatos, CA 95032 (408) 354-0200 www.css-lawfirm.com Leslie Yarnes Sugai, Esq.
- 2. Three Levels of Planning • Estate Planning – Planning for death and incapacity • Long-Term Care Planning – Planning your estate and for the preservation of your assets if you need long-term care • Life Care Planning — Planning for the quality of your life and care, Planning your estate, and protecting assets if long- term care is needed 2
- 3. Estate Planning • Trusts- Revocable and Irrevocable • Wills • Durable Power of Attorney • Advanced Health Care Directives 3
- 4. Long-term Care Planning • Pre-Planning For Long-Term Care -Financial & legal concerns -Planning for eligibility for Medi-Cal and VA benefits -Long-term care insurance considerations 4
- 5. Life Care Planning • An innovative, coordinated and holistic approach for addressing long term care needs • Customized to your loved one’s situation • Combines legal and financial planning while addressing personal and healthcare needs • An on-going relationship between the law firm and the client 5
- 6. Why Life Care Planning? How are my parents going to manage when my father can no longer drive? 6
- 7. Prevent Loss Reduce Family Reduce Burden Prevent of Conflict on Duplicated, Autonomy Support System Unnecessary Services Avoid Ensure Life Inappropriate Quality of Life Placement Assure Safety Care in an Overly and Peace of Mind Planning Restrictive Setting Help Slow Asset Getting and Resolve Issues Deterioration of Protection Keeping Public with Health and Planning and Government Care Providers Level of Benefits Functioning A Life Care Plan Puts the Elder First 7
- 8. Goals of Life Care Planning • Quality of Life – Assistance in making decisions regarding long-term care needs and goals • Quality of Care – Advocacy for good care whether at home or in a facility • Preservation of Assets – Assistance in finding and obtaining resources to help pay for long-term care 8
- 9. Who would benefit from Life Care Planning? • Clients with a Current Health Crisis / Complex / Chronic Health Issues – Hospitalization / Injury – Multiple diagnoses with multiple treatments – Frequent medication and/or treatment changes – Medications prescribed by 2 or more providers – Multiple health care providers – Lack of health care advocate 9
- 10. Clients with: • Increased Need for Caregiver Support • Complex Family Dynamics / Poor Family Communication • New medical or care providers needed – Dissatisfied with current provider – New to area – Change in benefits • Lives Alone / Social Isolation – Loss of interest in socializing with family/friends – Loss of interest in outside activities 10
- 11. Role of the Attorney Legal and Financial • Attorney addresses the legal and financial issues involved in long-term care planning for the ill client 11
- 12. Role of the Attorney Legal and Financial • Collaborates with client’s CPA and financial planner to budget private resources • Identify, explain and evaluate client’s asset preservation options and consequences • Review of existing long-term care insurance policies 12
- 13. Role of the Attorney Legal and Financial • Evaluates client’s eligibility and need for – VA benefits – Medi-Cal benefits – Other public benefits & community resources 13
- 14. Role of the Attorney • Examine client’s current estate planning documents and update/replace as needed Will, Living Trust, Durable Powers of Attorney, Advance Health Care Directive • Prepare long-term care planning documents Irrevocable Trusts Personal Care Contracts 14
- 15. Role of the Financial Team • Examine current asset structure with CPA/financial planner • Consider options for financing care utilizing resources available 15
- 16. Role of the Care Coordinator Health and Personal Care • Address personal and health care needs • Coordinate with legal and financial team members to assist clients in maintaining the best possible, health, safety, and well-being 16
- 17. Care Coordination • Comprehensive Assessment – Medical/Health/Physical Assessment • Diagnoses • Medications – Activities of Daily Living/Functional Needs • Housekeeping • Personal Care • Nutrition and food prep • Transportation – Housing / Living Arrangement / Environment • Home safety assessment 17
- 18. Role of Care Coordinator Comprehensive Assessment (cont.) • Psychosocial Assessment • Emotional concerns • Cognitive concerns • Socialization • Support system • Legal and Financial Assessment • In coordination with legal team members 18
- 19. Role of Care Coordinator (cont.) • Personalized Care Plan – Overall care goal – Concerns – Goals – Recommendations – Plan of action – Outcome/progress 19
- 20. Coordinating Environmental Concerns Care Needs Mental Health Safety Falls Cognitive Difficulties Driving Social Support Fire Hazards Emotional Isolation Difficulties Transportation Caregiver Difficulties Meals / Complex Family Nutrition Dynamics Communication Shopping Difficulties Cooking Clean Up Community Legal and Financial Resources Concerns Bill Paying Public Benefits Trusts Personal Care Private Assets Medical Issues Advance Health Care Dressing Directives Hospitalizations Power of Attorney Bathing Toileting Multiple Diagnoses for Finances Grooming Allergies Incontinence Housekeeping Cleaning Multiple Doctors Laundry Multiple Medications Yardwork Garbage Pet Care 20
- 21. Role of Care Coordinator (cont.) • Referrals to Geriatric Specialists and Community Resources • Education Regarding Aspects of Long Term Care – Regulations and rights – Advantages and disadvantages of different long term care options • Advocacy in Long Term Care Facilities – Attendance at care conferences – Coordination with social services and medical staff to ensure proper care 21
- 22. Role of Care Coordinator (cont.) • Caregiver Education and Resources • Family Meeting Facilitation • Short Term Crisis Management – Hospitalization – SNF discharge 22
- 23. Why is the Care Coordinator Crucial to Life Care Planning? •The Care Coordinator works with the family and professionals to ensure follow through of your loved one’s care (i.e. make sure an appointment with a physician is made and kept following a hospital stay or medication instructions are understood •Your loved one may divulge things to Care Coordinator that may be uncomfortable for him or her to tell you (i.e. issues of incontinence or forgetfulness in leaving the stove on) •The Care Coordinator can uncover trouble issues that may have been occurring for a long time and are now getting worse and needing intervention. •The Care Coordinator can help your parents to get past the ‘saving for a rainy day’ mentality and understand this is the middle of a hurricane. •The Care Coordinator understands the language that health and legal professionals speak and will use that knowledge to advocate on loved one’s behalf. 23
- 24. The Life Care Planning Process Meet with attorney and Assessment Financial elder care of needs Planning Estate coordinator Planning Medi-Cal 6 month application follow up Change in Action Financial Transition to Plan situation ALF / SNF Continue follow up Address problems Annual with care assessment 6 month follow up Address VA problems Benefits with care
- 25. Thank you for coming Janis Carney Leslie Yarnes Sugai Sheri Sudweeks 25