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What are the Signs My Doctor Isn’t that Great?

June 11, 2020 No Comments

If you’re in need of a new physician, do some research first, like reviewing a prospective physician’s credentials and looking for board certification. However, your investigation isn’t over at that point: when you arrive for your appointment, continue looking for clues about whether you’re at the right place or should make a quick escape.

Considerable’s recent article entitled “If your doctor shows one of these red flags, it’s time to move on” lists seven red flags to help you.

The receptionist doesn’t know you’re alive. The reception desk handles your questions about appointments, medical records, prescriptions and many other issues. The demeanor of those behind that desk should be professional, helpful and attentive. If you’re not greeted by the receptionist soon after you step through the door, and they fail to inform you that your doctor will be running late, or how long that wait will be, it’s discourteous. Of course, we all have bad days. However, if you see a pattern over time, or find yourself hating to contact that office, it may impact your care. Speak to your doctor about it.

A pharmaceutical company rep got there before you. If you look around the waiting room and see pharmaceutical logos on all kinds of pens and post-its, it’s a good sign that drug company reps have been there. They may have treated the staff to lunch, left new medication samples with the doctor and touted their latest brand drug or device. If you see that your doctor is accepting freebies from pharma companies, and you receive a prescription for a related brand-name drug, mention it to the doctor. If your doctor dismisses you, it may be time to get another opinion.

Your privacy isn’t properly protected. Most offices are exceptionally good about complying with HIPAA, which limits who has access to your health records. However, breaches can happen and impact nearly 5.6 million patient records last year. The standard HIPAA release form that patients sign states how your personal medical information can be used. If you don’t see your doctor’s office following the rules, talk to the office manager or the doctor. They know how critical protecting your privacy is and should be receptive to resolving any issues, if they’ve been lax.

The doctor is trying to sell you something. There’s been an increase in the number of doctors looking to enhance their incomes and selling products, such as vitamins, botanicals, minerals and other dietary supplements for weight loss, enhanced cognition, or improved libido. This behavior makes a doctor a salesperson who can take advantage of a patient’s vulnerabilities. If your doc tries to sell you something, it may be time to get a second opinion—or leave.

The doc’s diplomas seem a little suspect. A doctor’s office gives you a look at the chronology of the his or her education and may tell you whether he or she is board-certified, on the medical staff of a university, has also achieved a sub-specialty, as well as awards or honors. You can also look at your state’s licensing board website and check on the doctor for his or her education and practice information, history of malpractice, or professional misconduct and criminal convictions.

The doctor’s office is almost as bad as your kid’s room used to be. You may be so concerned about your health issues that you don’t see the signs of neglect which can critically impact your treatment. A dirty lab coat or dusty shelves may mean less than optimal attention to cleanliness. Disorganized desks and chart racks are ripe for misplaced notes and records.

They ignore feedback. Your physician should be all right with working with you, when you want to explore new treatments. If not, the doctor might be closed-minded and out of touch with the most recent research.

It’s difficult to find the right doctor but doing the research to find the perfect fit for you will pay off in the long run. It’s a vitally important relationship in your life, so don’t settle if you see these signs.

Reference:Considerable (Nov. 11, 2019) “If your doctor shows one of these red flags, it’s time to move on”

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Medicare vs. Medicaid

Why Do I Need an Advanced Healthcare Directive?

June 8, 2020 No Comments

During the prime of our lives, we typically don’t give much attention to thoughts about becoming seriously ill or about the end of life. Conversations about sickness and your own mortality aren’t easy topics to raise. However, it’s important for us to approach these heavy topics with our families, so we rest easy knowing their needs will be met if or when our health fails.

Rome News-Tribune’s recent article entitled “Things to know before drafting a living will” explains that an advanced healthcare directive, also called a living will, is a legal document in which you can detail the specific types of medical care and comfort treatment that you want, if you are unable to make decisions for yourself because of illness or incapacity. A living will can state whether life support should be used and whether pain medication should be administered.

A living will is separate and distinct from a traditional will. A will is a legal document that states how you would like your assets distributed after you pass away.

A living will is not always required, if you don’t have any strong feelings about the decisions made on your behalf while you are incapacitated. However, if you do want to provide instruction about your treatment and care, a living will is the best way to be certain that your choices will be carried out. Here are some other questions you may want to ask yourself about a living will.

Do I want to eliminate the stress of difficult decisions from my family? A living will can relieve your grieving family of the responsibility of making very tough decisions of invoking lifesaving (“heroic”) measures.
Do I have strong feelings about life-saving methods? A living will allows you to state your exact preferences on feeding tubes, life support when brain function is minimal and many other circumstances.
Do I have a trusted person who is able to carry out wishes? A health care proxy is an individual that you name and give the power to make decisions for you, if you are unable to express your preferences for medical treatment. Along with a living will, the health care proxy or “durable medical power of attorney” can fulfill your wishes accordingly.

Ask your estate planning attorney about this important component of medical and estate planning.

Reference: Rome News-Tribune (March 7, 2020) “Things to know before drafting a living will”

To Probate or Not to Probate?

Are My Beneficiary Designations Trouble for My Heirs?

May 27, 2020 No Comments

There are many account types that are governed by beneficiary designation, such as life insurance, 401(k)s, IRAs and annuities. These are the most common investment accounts people have with contractual provisions to designate who receives the asset upon the death of the owner.

Kiplinger’s recent article entitled “Beneficiary Designations – The Overlooked Minefield of Estate Planning” provides several of the mistakes that people make with beneficiary designations and some ideas to avoid problems for you or family members.

Believing that Your Will is More Power Than It Really Is. Many people mistakenly think that their will takes precedent over any beneficiary designation form. This is not true. Your will controls the disposition of assets in your “probate” estate. However, the accounts with contractual beneficiary designations aren’t governed by your will, because they pass outside of probate. That is why you need to review your beneficiary designations, when you review your will.

Allowing Accounts to Fall Through the Cracks. Inattention is another thing that can lead to unintended outcomes. A prior employer 401(k) account can be what is known as “orphaned,” which means that the account stays with the former employer and isn’t updated to reflect the account holder’s current situation. It’s not unusual to forget about an account you started at your first job and fail to update the primary beneficiary, which is your ex-wife.

Not Having a Contingency Plan. Another thing people don’t think about, is that a beneficiary may predecease them. This can present a problem with the family, if the beneficiary form does not indicate whether it is a per stirpes or per capita election. This is the difference between a deceased beneficiary’s family getting the share or it going to the other living beneficiaries.

It’s smart to retain copies of all communications when updating beneficiary designations in hard copy or electronically. These copies of correspondence, website submissions and received confirmations from account administrators should be kept with your estate planning documents in a safe location.

Remember that you should review your estate plan and beneficiary designations every few years. Sound estate planning goes well beyond a will but requires periodic review. If this is overlooked, something as simple as a beneficiary designation could create major issues in your family after you pass away.

Reference: Kiplinger (March 4, 2020) “Beneficiary Designations – The Overlooked Minefield of Estate Planning”

Resources To Probate or Not to Probate?

What Should I Know about Guardianship?

Some Counterintuitive Retirement Strategies

May 27, 2020 No Comments

There are way too many people who choose to go with their gut, when planning for retirement. Investopedia’s recent article entitled “7 Counterintuitive Retirement Strategies” discusses some big misconceptions people commonly believe when it comes to retirement planning—along with the correct ways of thinking and approaches.

The first myth is that you should constantly be moving in and out of stocks, timing the market and that a buy-and-hold strategy is really a losing one. However, many studies have repeatedly shown that it is often less risky to hold stocks for longer periods. You know, it’s tough to find a 10-year period when the stock market had a negative return. Stocks and real estate are the two big asset classes that have outpaced inflation over time, and—even with a few bearish periods—they’ve slowly gone up in value and will likely continue to do the same. However, that doesn’t mean you can simply fund and forget. Periodically monitor your portfolio and its performance.

Another misconception is that if I don’t sell a losing position, then I don’t have a loss. That is just hogwash. You’re losing money in a declining stock or other security, despite the fact that don’t sell it. You won’t be able to claim a loss on your tax return, if you don’t actually divest. However, the difference between realized and recognized losses is only for taxes. Your actual loss is the same, no matter what is recognized on your tax return.

Myth Number Three is that you can just let your money managers handle it. While professional portfolio management is a good choice in many cases, you still need to be personally engaged in the management of your finances. You can assign market trading and day-to-decisions to a pro, but don’t leave the overall course of your finances totally with your broker or banker.

Next, don’t sell an investment and then buy it back again. Instead, just hold it. No, you can (and probably should) sell a depressed holding and declare a capital loss prior to year’s end to recognize a tax deduction. Why hold on? If the asset does recover, you could plunge in again. Buying an identical stock 30 days before or 30 days after the date of the sale of the original triggers the IRS’s wash sale rules. As a result, your capital loss claim will be void.

Another misconception is that my Social Security benefits will be enough to pay for my retirement years. This is not true. The average monthly Social Security payment for retirees was only $1,471 in June 2019. Benefits vary a lot, but your benefits were never designed to be more than 40% of your pre-retirement wages.

The next myth is that I should put all of my retirement money in totally secure income-oriented investments, especially after I retire. That is not necessarily true. Low-risk vehicles, of course, are more of a priority at this point in your life. However, most retirees should have at least some of their savings in growth and equities in some form, either through individual stocks or mutual funds.

The final misconception is that retirement is a long way away, and so I needn’t worry about it for a while. This is a very dangerous myth, because you’ll be poor and dependent on relatives if you don’t get this straightened out ASAP. It takes time for your investments to grow to what they’ll need to be to keep you through your retirement. Get going!

Reference: Investopedia (Oct. 21, 2019) “7 Counterintuitive Retirement Strategies”

Resources Top 10 Reasons to Get Going on an Estate Plan

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What are the Big Dental Issues for Seniors?

May 21, 2020 No Comments

People with dental anxiety typically are not too eager to visit the dentist. However, ignoring your oral health puts you at risk for dental problems in the future, says Considerable’s March 2020 article entitled “7 top dental problems for people over 50.” Let’s look at these common dental issues for seniors:

Tooth decay. The protective, outer layer of tooth enamel wears down from years of chewing, eating acidic foods and drinking carbonated beverages. We’re more likely to have cavities as we age, and cracks expose the tissue to inflammation and irritation, letting bacteria in and causing decay near the root of the tooth.
Tooth sensitivity. As we age, surfaces of our teeth may become sensitive to hot and cold temperatures, especially when decay has already set in, or if the roots of the teeth are exposed.
Shifting teeth. Teeth shift as we get older, which causes overcrowding, making it more difficult to floss and causing food traps to form. These can become areas for tooth decay to spread.
Dry mouth. The calcium and phosphate in saliva help protect our teeth from decay, but many seniors take prescriptions that may decrease saliva production. Side effects can include dry mouth, bad breath and a metallic taste. Cavities can form as fast as three months after symptoms of dry mouth start.
Gingivitis. If your gums are red, puffy and bleed when you brush or floss, you may have gingivitis. If left unchecked, it can turn into something far worse. Research shows a connection between gum inflammation and other health conditions like respiratory issues, diabetes, stroke and heart disease.
Periodontitis. This is a gum disease that causes infections in the gum, jawbone and the ligaments that support the teeth. When the gum pulls away from the tooth, deep pockets are created which create an open spot for bacteria-laden plaque to collect. If not addressed, there’s a higher risk for receding gums, wobbly teeth, deterioration of the jawbone and tooth loss.
Oral cancer. There is a higher risk of oral cancer in those who are heavy drinkers or smokers. A regular dental examination should include the dentist’s examination of the soft tissue in the mouth, as well as the throat and jaw to detect any signs of oral cancer.

Early detection is the best defense against dental problems, so visit your dentist at least twice a year for regular cleanings and exams (and possibly more frequently as you age). Keep up with preventative measures at home, like regular brushing, flossing and using fluoride, as needed. This will help you keep your beautiful smile for a long time.

Reference: Considerable (March 12, 2020) “7 top dental problems for people over 50”

Resources What to do when you see mobility problems in elderly?

Top 10 Reasons to Get Going on an Estate Plan

May 13, 2020 No Comments

The time to have an estate plan really begins the moment you have assets that need to be distributed, but most people put off this important task. There are more than ten good reasons to talk with an estate planning attorney and get your estate plan in order, says the article “Top ten reasons to create an estate plan today” from OakPark.com, but these ten should be compelling enough to get you started.

10-It’s better to start with a plan than with an emergency. A sudden health crisis, whether a global pandemic or a spouse’s heart attack, should not be the reason for you to get going on your estate plan. Get an estate plan done, before you or a loved one needs it.

9-Don’t hope for the best for your minor children. A will is used to name guardians for minor children and to name a financial guardian who will oversee assets left for them. Without a will, the court will make that decision. The person selected by the judge may not be the person you’d want.

8-Equal is not always fair. If you paid for your oldest child’s college education, and your youngest is still in middle school, how will an equal division of your assets be fair to the child who has yet to go to college? A will and estate plan lets you map out how assets can be distributed equally, taking a variety of factors into consideration.

7-Inheritance begins at age 18, ready or not. With no will, children 18 and over will inherit assets all at once, no questions asked. If you have a son who likes expensive cars, there won’t be anything stopping him from spending his entire inheritance on a Ferrari.

6-Estate planning is an act of love. Couples strengthen their relationship, when they create an estate plan. It’s a love letter to your spouse and your family that demonstrates a tangible desire to protect them.

5-Build personal connections. Asking someone to be there for you and your family when you are the most vulnerable—incapacitated or deceased—is a strong statement of trust. Creating an estate plan cements relationships and sends a clear message that you believe in others to care for your loved ones.

4-Make parenting your college-age children easier. In the eyes of health care privacy laws, your children are strangers to you, once they reach the age of majority in your state (i.e., usually age 18). With young adult health care powers of attorney and HIPAA (Health Insurance Portability and Accountability Act) privacy waivers in place now, you can be informed and involved in case of an emergency later.

3-The state wants you to have an estate plan. One of the results of the coronavirus pandemic is that many states have made it lawful to have estate plans witnessed and notarized by video conference. You don’t have to leave the house to create or update your estate plan. There are no excuses now!

2-Your mortality is basically 100%. People procrastinate having their estate plans done because who wants to think about death and dying? However, whether or not you procrastinate doesn’t matter. We will all die one day, and an estate plan will make it better for those we leave behind.

1-There is a good chance that you have more time on your hands now, than before the coronavirus pandemic. Call an estate planning lawyer, and get it done. There’s no time like the present.

Reference: OakPark.com (April 15, 2020) “Top ten reasons to create an estate plan today”

Should I Create a Trust?

May 11, 2020 No Comments

Just 40% of adults in the United States have any kind of estate planning documents in place. That leaves 60% of adults who don’t have their property and other assets protected in the event of death.

Without planning, their family and loved ones will have trouble trying to determine what to do next.

Frequently, when thinking of estate planning, we think of a will. However, there are other options. Creating a living trust may be a better option for you and your family, advises kake.com’s recent article entitled “What Are the Advantages of Creating a Living Trust for My Family?”

The article provides some of the major benefits of a living trust.

It can save your family money. When a person with a living trust passes, the trustee takes possession and control over the trust property, according to the instructions provided by the trustor. It can be less expensive, because there are no fees that may be incurred in probate. Everything also moves faster.

Protection of your privacy. A living trust is much more private, because it doesn’t have to go through the probate court and won’t become public record. In contrast, a will becomes public record, that anyone can request to view as a court record.

A trust is for more than death. A living trust can be invoked at other times before death. The creator can add specific stipulations and conditions to the living trust to designate when the trustee can take over the management of property and finances.

More difficult to challenge. A will can be contested in court, if a family member thinks that she is entitled to more of your assets than was outlined in the will. A judge can rule that your will isn’t valid, and the contesting family member can possibly get more than you intended. With a living trust, there is much less chance that this will happen.

Creating a living trust takes legal expertise, so work with an experienced estate planning attorney. You can then discuss an entire estate planning strategy.

We are ready to help walk you through these decisions, understand the ramifications of your choices, and memorialize your plans in binding legal documents. We are currently offering no-contact initial conferences remotely if you prefer. Book a call now and let us help you make the right choices for yourself and your loved ones.

http://kornfeldlawfirm.com/contact-us/

Reference: kake.com (April 20, 2020) “What Are the Advantages of Creating a Living Trust for My Family?”

Caring for Alzheimer’s and Dementia Patients

May 7, 2020 No Comments

The Havre Daily News’ recent article entitled “Alzheimer’s Association offers tips for keeping people with dementia engaged during stay-at-home orders” reported that, to help caregivers engage their family members suffering from Alzheimer’s and other dementia, the Alzheimer’s Association has provided some ideas to assist.

Alzheimer’s disease is a progressive disorder that causes brain cells to degenerate and die. This disease is the most common cause of dementia, which is defined as a continuous decline in thinking, as well as behavioral and social skills that disrupts a person’s ability to function independently.

When considering how to help a person with dementia stay engaged during the pandemic, the release from the Alzheimer’s Association said, you can start by asking yourself these questions:

What do they like to do?
What are they able to do?
What are they in the mood for today?

The Alzheimer’s Association says that spending time with a family member or loved one with Alzheimer’s and other dementia can still be a meaningful and fun experience, especially if you take your cue from them. Let’s look at some ideas:

Encourage involvement in daily life activities. These types of basic activities can help the person feel like a valued part of the household. This can be things like setting the table and folding laundry. The tasks can give a dementia patient a sense of success and accomplishment.

Be ready to adjust and modify activities. Some activities that the person enjoys may need to be changed or modified, because of the stay-at-home orders in effect in most states. A few ideas are low-impact at-home workout videos; playing games like checkers, cards, or board games; or looking at photo albums.

Concentrate on individual enjoyment. Someone who’s worked in an office might enjoy activities that involve organizing, such as collating papers, putting coins in a holder, or creating a to-do list. A former farmer or gardener may like being in the fresh air and working in the yard.

Don’t be afraid to request help. Ask family members and friends for help with some non-contact chores. This might include help putting the trash out, collecting the mail, or tending to the yard. You should also look into meal and grocery delivery services.

The Alzheimer’s Association now has free expanded educational programs via telephone and online. These programs provide crucial information about Alzheimer’s and related dementias, effective communication techniques, understanding and responding to dementia-related behaviors and more.

There are also additional resources for caregivers on the association’s website at https://www.alz.org.

References: Havre Daily News (April 14, 2020) “Alzheimer’s Association offers tips for keeping people with dementia engaged during stay-at-home orders”

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“Estate Planning Strategies during this Pandemic”

May 6, 2020 No Comments

With the COVID-19 pandemic, many people are looking to execute estate plans they’ve delayed in finalizing and signing. Others are ready to get going on their estate plans that they should’ve started years ago.

Forbes’ recent article entitled “Eight Estate Planning Strategies In A COVID-19 World” lists some things you should know.

Most estate planning can be done at home. While you may be restricted from physically seeing your attorney, you can still create, update, or finalize your estate plan. Attorneys are working remotely and are available via email, telephone and video conferencing to help you.

Get your estate planning in order. The odds are you now have some time to consider the issues you’ve placed on the back burner for a long time. Leverage this time to address your estate planning.

New options for signing document. Many attorneys are approaching estate plan document signings on a case-by-case basis. You may be able to sign in the attorney’s office or at your home, while practicing social distancing and wearing gloves and masks. Some law firm are even offering drive-up will signings.

Some states now permit online notarization of certain types of documents.

These new laws allow for remote online notarization (RON), a process by which notarization is conducted via video conferencing. In this process, the signing party (the “principal”) must undergo an identity-proofing process that differs by state.

In most states, the principals are required to answer several personal questions. They also must show valid ID, which in many states, must be examined and verified by a third-party security service. Once the principal’s identity is confirmed, she signs the document with a digital signature. The remote online notary witnesses the document, by affixing an electronic seal as they stream the live, audio-visual conference.

Talk to an experienced estate planning attorney about how you should proceed with your estate planning, in light of this new (and hopefully temporary) reality.

At least, you can get all your documents organized and ready to sign when it is safe to venture outside.

Reference: Forbes (March 23, 2020) “Eight Estate Planning Strategies In A COVID-19 World”

ResourcesWhat Estate Planning Documents Do You Need?

http://kornfeldlawfirm.com/contact-us/

What Should I Know about Guardianship?

May 5, 2020 No Comments

In a perfect world, a child would be raised by its parents. However, this isn’t always possible, and legally enforceable decisions must sometimes be made to name the person who is best positioned to look after a child.

Guardianship is generally only needed when a person is incapable—whether legally or practically—of looking after their own affairs, says VENTS Magazine in the article “Legal Guardianship 101: What You Need to Know.”

Courts have the power to appoint guardians for adults and children. This is usually a person who is unable to make decisions for themselves.

It may be a disabled person, and guardians are appointed for children when parents consent to it, when their parental rights are removed by a court, or when both parents are dead or permanently incapacitated.

Guardians have duties as to both the protected person and their estate. The duties to the person include providing necessities, education and appropriate medical treatment, where necessary. As far as the estate of the protected person, the duties are to manage any funds properly and to spend them, pursuant to the protected person’s needs. Guardians must prepare an inventory of assets within 60 days of their appointment to the role.

Custody is only granted for children. When appointed, a custodian is given parental rights over the child. Guardianship does not bestow these rights.

A guardian is appointed to take care of a protected person and to safeguard their estate. Biological parents, if alive, keep their parental rights over the child.

To become a guardian, you must file a petition with the court. There will be a hearing on your application. You must present proof (from a doctor, for example) that guardianship is necessary under the circumstances.

Guardianship litigation can be stressful, but it is frequently necessary, so engage an attorney to help you.

http://kornfeldlawfirm.com/contact-us/

Reference: VENTS Magazine (April 13, 2020) “Legal Guardianship 101: What You Need to Know”

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Our Blog

What are the Signs My Doctor Isn’t that Great?

Why Do I Need an Advanced Healthcare Directive?

Are My Beneficiary Designations Trouble for My Heirs?

Some Counterintuitive Retirement Strategies

What are the Big Dental Issues for Seniors?

Top 10 Reasons to Get Going on an Estate Plan

Should I Create a Trust?

Caring for Alzheimer’s and Dementia Patients

“Estate Planning Strategies during this Pandemic”

What Should I Know about Guardianship?

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