Plan Smarter, Not Harder: Holistic Strategies for Elder Care and Dementia Support

"Planning isn't just about the paperwork"

In this episode of 'Advice From Your Advocates', Attorney Bob Mannor and co-host / executive producer Savannah Meksto discuss the complexities of elder law, focusing on long-term care planning, the importance of holistic approaches, and the necessity of having essential legal documents like powers of attorney. They emphasize the need for families to start planning early, the significance of building a support team for dementia care, and debunk common legal myths surrounding estate planning. The episode also highlights community resources and support groups available for families dealing with elder care issues.

Takeaways

• Planning for life is more important than planning for death.
• Holistic planning includes financial, emotional, and legal aspects.
• Powers of attorney are crucial for decision-making.
• It's essential to start planning for long-term care early.
• Dementia care requires a comprehensive support team.
• Medicaid options can help protect assets.
• It's never too late to seek legal advice.
• Community resources are vital for families in need.
• Legal documents are tools that need to be used correctly.
• Families should care about financial planning for their loved ones.

Listen to more episodes of Advice From Your Advocates wherever you get your podcasts. Learn more about Mannor Law Group: www.mannorlawgroup.com

Host: Attorney Bob Mannor, CELA with Savannah Meksto, CDP

Chapters

• 0:04 Elder Care and Estate Planning
• 11:56 Care Team & Asset Protection
• 24:28 Legal Documents for Adults

Transcript

Savannah Meksto: 0:04

You're listening to Advice from your Advocates, a show where we provide elder law advice to professionals who work with the elderly and their families.

Attorney Bob Mannor: 0:11

Welcome to Advice from your Advocates. I'm Bob Mannor. I'm an elder law attorney, so we're going to focus on a lot of legal issues, but we're really going to talk about anything that's affecting older folks as they age and particularly making sure that we have the best care that we can for the rest of our lives. We might have a special focus on folks that have family members with dementia. It's an important issue for me and something that we really work with our families.

Savannah Meksto: 0:40

And I'm Savannah Meksto. I'm a certified dementia practitioner and your co-host. Today, we're here to break down the complex issues around elder care and elder planning, so that you can protect your loved ones and your peace of mind.

Attorney Bob Mannor: 0:54

Today's show and all the future shows are going to be filled with valuable insights, real stories and practical advice.

Attorney Bob Mannor: 1:00

Whether you're driving to work or just drinking your morning coffee, stay tuned and you won't want to miss this show. Okay, folks, we're going to dive right into a topic that is really important to a lot of families, and that's going to be long-term care. So we don't really think about this. For most of us, we plan for most stages of our life and then just imagine that we're going to fade off into the sunset and die with our boots on. But the reality is most of us are going to face some period of time before we die that we're going to need some help from other people, and most families aren't prepared for that. So it's something that I think we should discuss. We have what we call a holistic practice, because we're not just going to focus on dollars or legal documents. We're going to focus on the big picture of making sure that we get quality of life and quality care, making sure we have resources to pay for that care, including government benefits that might help out with that.

Savannah Meksto: 1:55

That's right, bob. Planning isn't just about the paperwork and that's something that we talk a lot about in our firm often and it's really just about ensuring that your loved ones are cared for in the best way possible, whether that's financially or emotionally. We want to help you and guide you in that journey, and today we're going to walk you through how to approach estate planning from this holistic perspective.

Attorney Bob Mannor: 2:20

So let's start off with that, and one of the things I like to focus on is something I call planning for life. What do I mean by that? Well, the thing is, a lot of folks do go when they get a will or they get a trust, they get some legal documents, but most people, when they go, their thought is I'm planning for my death, right, I'm planning for what happens when I die, and that, of course, is important, and that's stuff we do at Manor Law Group also. I think the more important question is what happens if you live, and what I mean by that is, you know, in previous generations we'd get old, we'd get sick and we'd die.

Attorney Bob Mannor: 3:00

Now, most of us are going to get old and get sick and we live, and how do we make that time better? How do we make sure that we're going to our family's, going to know what to do and we're not going to be a burden and we have resources to pay for care and that we just have a better quality of life? This gets particularly difficult when we have a loved one with dementia. So this is very important, and one of the things that we always have to focus on is making sure that we don't go broke, that we don't deplete our assets in paying for care, especially for a married couple. We don't want to have one person use all the money and then the surviving spouse ends up in poverty. So those are things that can be avoided.

Savannah Meksto: 3:40

That's such a crucial point, bob. Dementia, for example. It's something that can change everything. Suddenly. You're not just dealing with financial issues, but now you also have medical issues, emotional issues and even legal challenges. A holistic plan looks at all of these aspects together and how to protect your assets yeah, of course, but also how to ensure that your loved one's dignity and quality life are preserved.

Attorney Bob Mannor: 4:06

Yeah, savannah, that's one of the things that I really like. What you said there about a holistic plan, this is something that a lot of people don't think about. Even lawyers A lot of lawyers they are just kind of you know a lot of great lawyers. They're doing great legal work, but they're really focused on legal documents, and I think it's really important to be holistic and think about, okay, how are we going to use these documents? How is that going to be relevant? So let's start at the beginning.

Attorney Bob Mannor: 4:31

Let's start at what really is one of the most important things that we start with, and then one of the most important documents to work with a lawyer on is not actually your will. Most people assume that's what they're going to talk to their lawyer about is to get a will. I think the most important document is your powers of attorney, one for financial and one for medical, because if I'm focusing on what happens, you know, how do we plan for life as opposed to planning for death. Those are more important. We need to have good, detailed rules in place, documents in place to allow the people you love and trust to be able to help you if and when you need help, and otherwise we end up having to go through different processes, like a court process with guardianship or conservatorship, but it's really important that most important first document that I think that we really have to focus on is your powers of attorney, financial and medical.

Savannah Meksto: 5:31

And that's where working with someone who understands the nuances comes into place. For instance, in dementia care, it's not just about who makes the decisions, but what those decisions look like. Do they understand the progression of the disease? Can they advocate for the type of care that maintains dignity and safety? These are the tough questions that a holistic estate plan will answer.

Attorney Bob Mannor: 5:53

So now I'm going to get into something a little bit more complicated. So you know, you've probably heard of a power of attorney before and again, I really want to focus on how important that is and that you pick the right people and it's not just a fill-in-the-blank form either. It should be that we're really focusing on what authority, what powers do we want to give somebody and they're not all the same. A lot of people think, oh, it's a power of attorney, you just put your name on it, sign it and get it notarized. The powers of attorney we use are very different depending on the circumstances and what the needs are, but one of the reasons that we have it is one of the reasons we need that is when we get to the point of how are we going to pay for care? Now, I don't know about you, Savannah, but I'm not a millionaire.

Savannah Meksto: 6:39

I wish I was, but no.

Attorney Bob Mannor: 6:41

Most of us are. Most of the listeners probably are. And you know, if we had unlimited money, we wouldn't have to worry about this stuff. Right, we just wouldn't have to worry about it. And that's not true for most of us. We do worry about it and sometimes people say, oh well, you know, we're fine, they figure out the math and they say, well, I think, if you know, if we look at mom's savings and if we had to sell mom's house or whatever, we might be able to pay for care for two or three years. Okay, well, what happens if mom lives 10 years?

Attorney Bob Mannor: 7:12

This is a very serious thing and a lot of people think. First of all, a lot of people have never thought about this. Right, it's just not something that most people are going to give much attention to, until and unless it affects your family, until it's your mom or your spouse. And now we really do have to think about this. And the good news there's actually really good news on this that there are benefits that you've paid into your entire life that can help pay for things like home care or assisted living or a nursing home.

Attorney Bob Mannor: 7:43

There's different programs that we're going to be talking about through the series of this show. It is very important that we look at ways to make sure that you're not going to go broke if and when it comes to be that your loved one needs care and some people think, oh well, I've got Blue Cross right, I've got Humana, whatever it is. Unfortunately, Blue Cross and Humana and Medicare do not pay for continuing care. So they might pay for the hospital visit, they might pay for the doctor's visit, you can have coverage for prescriptions, but if you need somebody to come over every day and help you get dressed or help you shower or just make sure that you're staying safe, then we're going to have to look to other government benefits.

Savannah Meksto: 8:32

Bob, that is so right and so important and something that we say a lot in the firm that really sticks with me is that it's never too late and it's never too early to start planning. Of course, the earlier that you start planning, the more options that you're going to have, which is, of course, important, and this is why we encourage families to start these conversations sooner rather than later. But, again, it's never too late and it's never too early to start planning.

Attorney Bob Mannor: 8:58

That's great, savannah. That's so true. You know, of course it's better to plan ahead and I know not everybody does that right. I prefer you to, obviously, but we can help in a crisis too. I'm going to be honest with you. Probably over 50% of the folks that I help with dementia or long-term care issues, they come to me in a crisis. They come to me after they think that it might be too late. Well, honestly, like Savannah said, it's never too late. We can help in a crisis. If you're not in a crisis now, though, you might want to think about planning ahead, because it's going to be easier on the family, it's going to be less expensive, it's going to give you more options. So we can help in a crisis. It's never too late. If there's a, you know, there's a stroke, there's a fall, there's. You know, we found that dad was wandering away from the house or, you know, was driving and got, you know, got pulled over because the police saw that he was confused, or something like that. Those are crises and we can help with that, but it's better to get in front of it so that we're not. You know that that's not the problem.

Attorney Bob Mannor: 10:10

At Mannor Law Group, we help families. We help families with life and death and illness. It is something that has been our passion and we will help you with basic things like wills and trusts. We can help you with things like if there is a diagnosis, a serious diagnosis or a dementia diagnosis, parkinson's, anything like that. It is very difficult for the family to address that and there are legal and financial considerations that we can help with and make sure that you're getting good care. We provide care, navigation and help with finding resources to pay for care, including accessing federal and local benefits. So you can reach our office in Grand Blanc at 810-694-9000.

Savannah Meksto: 11:05

So these questions that we're about to go through have come in from clients of the past. We're not going to use real names for today's questions, but we thought that these were really important and we get these a lot, not just from the clients that we've had, from just people that we meet in the community. So I'm really excited to share some of these with you. The first question by Betty my mom was just diagnosed with early stage Alzheimer's and we're starting to think about long-term care. What should we be doing now?

Attorney Bob Mannor: 11:35

So this is a great question and you know I mentioned earlier that we have this podcast with the same name, advice from your Advocates, and on the podcast I recently interviewed a guest that was talking about all the services that are available for families that have a loved one with dementia or Alzheimer's. And the thing is what he was saying was a lot of families tend to sort of cocoon. They just kind of hide in their house and they don't want, you know, they're just afraid, and so that they just make sure that mom doesn't go out anymore or dad, you know, is kind of confined, and that's probably not the best answer. In fact, what he was saying was it probably makes it worse. Not only does it make it worse for their health, but it makes it worse quality of life for the family and for the person suffering from dementia or Alzheimer's. And so it's really important, when we look at this, that you want to start developing a team, a team of resources that's going to be able to help with this. So many families think they have to deal with this on their own. I can't tell you how many people are dealing with similar issues and trying to figure this out on your own. I just can't imagine that you're going to come up with the best answers on your own. This is not something you can Google and say you know what to expect when your loved one has dementia, so it is something that you really need.

Attorney Bob Mannor: 13:02

Some people that have been working in this for a long time know the details of the community. Even every community is going to be a little bit different as far as what resources are going to be available for somebody with Alzheimer's or dementia. You know I'm going to obviously tell you that you need an elder law attorney, somebody that's experienced in Medicaid, experienced in veterans benefits, experienced with the community, and our biggest strength at Manor Law Group is our relationships with the long-term care community. We know the folks that are involved in it. We know the nuances of it, the folks that are involved in it. We know the nuances of it. We know what we can demand as far as quality of care and what places frankly provide better care, and so part of that team is going to be an experienced elder law attorney.

Attorney Bob Mannor: 13:50

But I also think you need to start thinking about your medical experts. So maybe a gerontologist, maybe a neurologist, but I actually think the gerontologist has a more holistic view. Sometimes they're not just looking at the brain, and then we really need to be thinking about making sure if you have a financial person, if you have a financial advisor, they should be communicating with the lawyer. They should be communicating and we should start thinking about a plan. If we need to access resources, which accounts should we be taking that from?

Attorney Bob Mannor: 14:22

There's an answer to that question. This is not a rhetorical question. Sometimes it's better to take it out of a savings account, sometimes it's better to take it out of an IRA, and so those are real questions and you're probably not going to find that great advice unless you have a team that's working together the lawyer, the financial advisor, the doctor and then what are the community resources? You know, are there some daycare options? What are the options that we'd look at for home care? What are the options we'd look at for care outside of the home? So that's my advice when you have somebody that's early stage Alzheimer's, our advice is start building a team of those people you're going to rely on.

Savannah Meksto: 15:02

That is so important, Bob. I really love that answer. And this next question comes in from a client that we are going to call Bill, and Bill says I'm concerned about my dad running out of money if he needs long-term care. How can we protect his assets?

Attorney Bob Mannor: 15:18

dad running out of money if he needs long-term care, how can we protect his assets? This is a good question and this is a question that a lot of kids are timid to ask, and I don't think you should be. I wrote an article years ago for the View newspaper that you know we see everywhere, and the article said why you should care about your parents' money. And it was a provocative title intentionally, because a lot of times we have families that come in and say well, you know, we don't care about the money, we don't care about mom and dad's money, we just want to make sure that they're taken care of. We should care about the money. It's important to think this through. We don't want to be in a crisis. We don't want to be in a situation where we have worse services or have to go to the lesser places or don't have options. You know, the bottom line is we should care about the money and there's going to be a time especially if your parent or spouse is experiencing some dementia there's going to be a time where they're not fully capable of making. You know all of the financial decisions that they used to make. You know all of the financial decisions that they used to make. This is a difficult place for a child to be in because they're used to, you know, mom and dad being the ones that tell them what to do, and not us telling mom and dad what to do, and especially when it comes to money, because it almost sounds like you're greedy and it's not. It's not about being greedy, it's about being smart and making sure that we're making, we're leveraging things and making the best use of our resources. And it can go a long way. You know you don't have to be a multimillionaire to be able to get good quality care. It's just if you're, we have to leverage it.

Attorney Bob Mannor: 16:49

We have to look for things like Medicaid options the PACE program, which is called the Program for All-Inclusive Care for the Elderly, the my Choice Waiver program, which is called the Program for All-Inclusive Care for the Elderly, the my Choice Waiver program, which provides for some home care, or, you know, medicaid, nursing home Medicaid. There's a bunch of veterans benefits that we can we'll get into eventually and talk about in future programs. But the bottom line is the if it's a veteran or spouse of a veteran, widow of a veteran, there's a bunch of programs through the VA. Sometimes it's actually just providing you money to pay for care. Sometimes it's just providing that care.

Attorney Bob Mannor: 17:23

So the key on this is you really should be asking this question and there are ways to protect your assets and qualify. A few times I've mentioned the word Medicaid. Sometimes, when people hear that, they think, oh, that's only for poor people. There's a bunch of Medicaid programs, including some Medicaid programs that allow us to protect assets. We're just following their rules and you do not have to spend down to nothing before you qualify for these Medicaid programs. They can pay for things like in-home care or nursing home care.

Savannah Meksto: 17:55

And remember, it's not just about the money. Protecting assets is also about ensuring that your dad or your mom or your grandparent has access to the best care possible, which is why we look at the whole picture.

Attorney Bob Mannor: 18:10

You've been listening to Advice from your Advocates and we'll be back with our legal myth busters.

Savannah Meksto: 18:21

All right, welcome back to Advice From your Advocates. It is time for our legal myth busting segment. Bob, here's a common myth I have a will, so I don't need anything else. What do you think?

Attorney Bob Mannor: 18:34

That is a good one and something I frequently hear, or I even hear just as often. I have a trust and therefore I don't need anything else. You know a lot of people think trust is just sort of this magical document that's going to solve all our problems, or a will is sufficient and it's going to take care of things. Frankly, that's not the final answer. The document itself is just a tool, like a tool in a toolbox, and you know I joke with the folks at the office at Manor Law Group sometimes that I have a lot of tools at home. I have a really big toolbox. I don't know how to use very many of them and I'm just not that great as far as a construction person or a handyman, but I have the tools and so that's one of the key things is having a will or having a trust.

Attorney Bob Mannor: 19:23

Unless we're using that tool right and actually you need more tools than that that's just not going to be sufficient and really we need to know how and when to use those things. So a will. For example, when does a will take effect? Savannah?

Savannah Meksto: 19:37

When you die Wrong? Oh darn it.

Attorney Bob Mannor: 19:41

That's a trick question she knew it was a trick question. So it's when you die and then when a judge puts it into effect, right, a judge has to issue a letter of authority before the will has any legal effect, so the will doesn't work without going to court. So then there's a thing called a trust, which is basically just a contract between you and your family. Now, a trust is going to be a lot more flexible than a will, but it's still not going to solve all your problems. That's where what we talked about earlier is things like a really strong power of attorney, a really strong patient advocate in case you can't make medical decisions for yourselfacy waivers. There's just a lot of different things. You know HIPAA waivers, things like that, where you really need to have it be more thorough and holistic.

Savannah Meksto: 20:21

Yeah, exactly, planning is about much more than just dividing up your money when you die. It's about making sure that you're protected during your lifetime, no matter what happens. Lifetime, no matter what happens. So, before we wrap up today, I think that we should talk about some fantastic local resources that we have for families and professionals that are dealing with elder care.

Attorney Bob Mannor: 20:48

For 10 years now and this is actually something that Savannah's been running for several years. We have something we call Elder Care Boot Camp or Elder Law Boot Camp, and it's kind of what we're known for with Mannor Law Group and in this area, and then Flint and Grand Blanc area, Lapeer, Shiawassee, and so we have been training folks in the long-term care industry. So we've trained social workers and care administrators and in the past we've done some nursing continuing education credits. We've, like you said, the case managers and the certified senior advisors.

Savannah Meksto: 21:24

Even financial advisors.

Attorney Bob Mannor: 21:25

Financial advisors, exactly, and other attorneys. One of the things I've been able to do it's been kind of an honor to I teach other attorneys through the Institute of Continuing Legal Education, and this is such an area of law that a lot of attorneys never got trained in this in law school. This is a unique area of law that most lawyers at least when I was in law school, they didn't even offer this as an option. It wasn't even an optional class, an optional class. So it is something that we've enjoyed being able to help others and educate folks and learn from other folks.

Attorney Bob Mannor: 22:02

It'll be in May this year, may next year, 2025. One of the things is we learn so much and we talk about it as the circle of care that we're all working together to get the best care we can for our folks that need help. And so the circle of care is very important to us because we're learning from you, you're learning from us. We're all trying to work together to get the best results for folks.

Savannah Meksto: 22:21

And being a listener today, you're a part of our circle of care too.

Attorney Bob Mannor: 22:24

Yeah, very nice. I want to highlight something that Savannah is going to give us a little bit more information about, but we just started an Alzheimer's support group at our office in Grand Blanc. We were looking to do it at a senior center, but we found that a lot of folks were looking for a one that was not during business hours. They wanted it after hours, and so the senior centers weren't open at that time, and so we are hosting it at our office with our fantastic social worker, nikki Inches.

Attorney Bob Mannor: 22:56

And so Savannah can give a little bit more information about that.

Savannah Meksto: 22:59

Yeah, absolutely so. If you are a caregiver of someone with dementia, we invite you to come to this session that we have the third Tuesday of every month at our Grand Blanc Manor Law Group office. We're just located in Grand Blanc on Saginaw Street, right next to Chase Bank, if you're familiar with the area. If not, call us we'll tell you, but the meeting is from 530 to 630. Again, it's the third Tuesday of the month and we would love to see you there. We even have cookies. That's a good time.

Attorney Bob Mannor: 23:27

Nikki has been one of the social workers that works with our office, and we make a good use of social workers in our office. We call them care navigators. So in one of the future programs we're going to talk about care navigation, because it's really important. When a family is dealing with long-term care they're dealing with a aging loved one they're worried about making sure that they're safe and they're getting good care. It's really hard to maneuver and really figure everything out, and so our office, in addition to providing the legal services and getting access to benefits that can help pay for care, we provide care navigators that can really walk us through that system. So you've been listening to advice from your advocates. It is an exciting adventure for Savannah and I.

Savannah Meksto: 24:12

Yeah, absolutely. And if you want more in-depth discussions, just like this, you can find us wherever you listen to podcasts. And if you like video if you'd rather watch us than listen you can find us on YouTube.

Attorney Bob Mannor: 24:24

We're also on a few of the social media things. It's kind of funny that we've actually gone viral a few times on TikTok If you ever look at the TikTok.

Savannah Meksto: 24:34

Yeah, the TikTok. Yes, you can tell how old I am when I call it the TikTok.

Attorney Bob Mannor: 24:40

So, yeah, we have fun with it and we actually were just recently. The thing we went viral on is we were promoting that anybody that's 18 years or older should start with some basic legal documents like a power of attorney. So that is something that we were promoting on TikTok and I think we got like 1.5 million views.

Savannah Meksto: 24:57

Yeah, we did. Yep, it was amazing. Thanks for tuning in to Advice from your Advocates and remember you're not alone in this journey. We're here to help you every step of the way. Thanks for listening. To learn more, visit MannorLawGroup. com.