and good evening.

>> Thank you so much for watching LIFE Ahead here on PBS Fort Wayne, I'm your host Mark Evans.

This is a weekly viewer interactive program with some very vital information for adults of all ages.

>> So we welcome you.

We also want to encourage you to make phone calls or give us a text in the next half an hour for a very special guest.

Now the phone numbers will be on your screen.

In fact, you can see them right now to call its two six zero (969) 27 two zero or to text it's a little bit different to six zero (969) 27 three zero when you give us a call or text, give us your first name at least and the city from where you're calling or texting.

We appreciate that because we're going to give you a nice shot at and we appreciate your support and your viewership here at PBS .

>> Fort Wayne tonight talking about long term care which is going to include the state planning planning for long term care wills, power of attorney court ordered guardianship among other important topics.

Got it with our very special guest Brian Nugent.

>> Thank you.

You're a regular on this program but once a month.

Yeah.

What's monthly come?

>> Well, we truly appreciate you.

Thank you.

It's my pleasure to be here.

And I have to be honest when it comes to the estate planning and long term care even though at my age I'm a little inept if you will.

>> So I always learn so much good when we do this.

I appreciate that.

Absolutely.

>> So we'd like to start out with I wanted to mention too that you are an elder attorney at law and an estate planner.

>> Is that correct?

So there's estate planning and elder law.

>> Okay, so I practice and other attorneys practice in the elder law.

So when we think of estate planning we think of when you pass where your assets are going to go, who's going to be in charge of handling all that and elder law does all of that plus typically protecting assets as we age to make sure that you have money to last your lifetime, pay for your care if you need care to be paid for as you age also deals with guardianships, deals with special needs trusts.

So elder law suggests that only seniors would need elder law but actually with the estate planning component elder law starts at birth and it's just it's an area that's much more robust than just estate planning.

So yeah, I personally am an elder law attorney so of course we do estate planning as part of that elder law issues with that and there are other elder law attorneys in our community as well.

>> Well and how do you differ from a regular attorney?

Can a regular attorney do what you do?

Well, so yes, actually they can but it would be like someone hiring me to do criminal defense.

Oh so I'm licensed to do criminal defense.

I'm licensed to do bankruptcies.

But you would not want to hire me for criminal defense or bankruptcies.

It just isn't an area in which I practice.

>> Okay, so it's a good point that you're bringing up the mark which is if you are speaking with someone about a particular are the law elder law is my area but you want to make sure that the person that you're working with actually practices in that area doesn't dabble in that area if you are concerned about protecting assets or caring benefits, those types of things, you would want to make sure that you're working with an elder law attorney versus someone that's just doing estate planning, just focusing on where your money goes when you pass.

>> OK, I'm so glad to discuss that here.

Thank you.

Now let's go have lunch into our long term care.

You know, according to the stats in fact the last time you were on we talked about this 70 percent according to the stats of people over 65 are expected to need some form of long term care in their life .

>> That's right.

That's kind of staggering to me.

That's seven out of ten of us.

>> Yeah, well, I think that umbrella also includes when folks go through some type of a rehab.

So as we age if we have a fall and have a hip replacement or some type of hospital stay in after the hospital stay, we go into rehabilitation.

So I think that would be under that umbrella as well.

Not always does it mean that if someone's going through rehabilitation that they would have a long stay at a nursing home.

That's possible.

It's also possible that someone goes into long term care nursing home stay memory care unit stay other than just after a hospital stay.

They may go because cognitively they're declining.

They can't live on their own.

It could be that physically they're failing at home and they need a little bit of extra assistance so that they may have that long term stay.

So 70 percent it is true but that that's the figure but it doesn't necessarily mean that you'll have a long a lifetime stay or a several year stay at a facility.

>> It's more likely you may have some rehab that may convert into a longer term stay.

But we think of as a nursing home or a memory care unit.

>> Well, you know but let's talk about nursing homes.

Sure.

What are some of the ways that you can plan you ahead financially well to plan ahead financially for a nursing home stay and to make sure that you in essence don't run out of money and you're able to pay for your care for a lifetime and have some reserves typically people are looking at several buckets of money.

It could be that someone is a veteran and as a result of being a veteran the VA has contracts with certain nursing home certain facilities that will pay for your day if you're going there.

>> It could be that if you're at a facility for a rehabilitation stay your Medicare typically will pay for some or all of that depending upon how many days you're in rehab.

Folks may also be out.

Folks may also have purchased something called long term care insurance.

>> Long term care insurance pays for your stay when you're at a nursing home memory care unit.

I don't see as many long term care policies as I used to their expensive frankly.

And so the beginning of my career I saw a lot of people with long term care insurance policies.

Now I don't see as many.

In fact, I've spoken with directors at nursing homes and they're seeing single digit residents.

>> The percentage of residents they have single digits are their own long term care policies.

>> And then finally folks often will pay for their stay using Medicaid and Medicaid.

People arrive at Medicaid paying for their care for one of two reasons.

One, they maybe they've used their resources, their assets and paid for their stay.

Now they're out of resources and they need to apply for Medicaid also it could be that folks are wanting to plan ahead and say how is it that I can protect money and still receive those Medicaid benefits so they may speak to an elder law attorney and use unique trusts that are set up to protect assets and that's commonly used folks would insulate their assets inside of a trust and then after a period of time five years frankly those trusts to work after a period of time is past five years.

If they did have a nursing home stay, had a memory care unit stay or needed care in the home that that trust would be used to protect their assets.

>> So those are some of the ways that folks are going to pay for their own stay.

And I'm sure most everyone at the age of 65 and over know about Medicaid and Medicare.

>> I'll tell you I don't know that that's true.

>> You don't I hear oftentimes people confusing Medicare and Medicaid aren't that out for us.

>> Sure.

So we all get Medicare so at a certain age we all can apply for Medicare or if you have some other issues you may be able to apply for Medicare a little bit earlier than that.

But so Medicare would pay for that rehab stay that I was talking about.

I like to think of Medicare as like your insurance.

It's your health insurance and it could pay for drugs, could pay for your doctor's visits and could pay for a period of rehabilitation after you have a hospital stay.

So advantage plan can have up to 20 days of that stay and you could appeal for it to go longer not so likely to extend much, much beyond twenty days if you have traditional Medicare it could pay for that rehabilitation rehabilitation and stay for up to one hundred days.

So sometimes what happens is that people get confused gosh mom is that the nursing home and Medicare paid for all of her stay when she came back home.

But people get confused about is that it was actually Medicare paying for rehab stay at inside a nursing home rehab taking place inside a nursing home.

So beyond that rehabilitation Medicare does not pay for your stay at a nursing home.

>> You would need to use one of those resources that I was referencing earlier.

OK, very good.

>> Well, we have a look like a call but the person I think his name is Eric and it just went away.

>> Oh, don't get nervous, OK?

Yeah well we'll get that call back in there in just a second but Eric wanted to be offline off the air and that's just fine and we'll transcribe this question and get back to it in just a second .

>> So you're talking about Medicaid and Medicare now what are some of the most common myths about Medicaid?

>> I think the most common myth is that if I'm receiving I'm a Medicaid recipient and Medicaid is paying for my care in my home state, Medicaid is paying for my stay in a nursing home.

Remember care unit I'm somehow going to get substandard care.

My care won't be as good because Medicaid is paying for it and I'm not privately paying for it.

It is not true.

I defy anyone to walk down the halls of a facility where folks are staying there and some are privately paying for their stay.

Some stay is being paid for by Medicaid.

I defy you to determine what entity is paying for what care or if it's private being privately paid.

That's not the case.

Same dietician, same nurse, same mattress, same care.

It just doesn't change based upon payer source.

That is not that's not true.

OK, all right.

>> Very good.

Let's talk about the legal documents every senior should actually have in place so everybody needs first of all you need a durable power of attorney.

Everyone needs to have a durable power of attorney and if we're speaking about Medicaid and qualifying somebody for Medicaid, we need some language in that way that allows the individual that you have appointed to make decisions for you that's your attorney in fact is their name.

So we need language in there that indicates they can speak with entities like Medicaid, speak with entities like Social Security on your behalf.

So we want some very unique language in those powers of attorney.

But everybody needs that's to make sure that we can avoid having guardianship.

We have we avoid having a guardianship.

The courts really want us to try and make those decisions ourselves without needing to go to court without having to have a guardianship in place.

So play essential a next document that everyone needs to have is something called a health care representative designation.

We're indicating who it is that can make health care decisions on your behalf if you can't sometimes people will think gosh, might my son's off at college if something happens with my son or my daughter I can make decisions for them.

I'm their parent not if they're eighteen or above.

They need to appoint somebody to make decisions for them but us about seniors.

So yes, as a senior you should definitely have a health care representative designation in place so that if you're unable to tell the doctor what it is that you want or don't want, you've appointed somebody else that can make those decisions for you.

And in Indiana now inside those health care representative designations we can include living wills language and that indicates that if the efforts to sustain your life is futile, you're actively passing.

You're saying don't take any heroic measures.

I don't need artificial hydration and nutrition.

You don't need put me on a ventilator.

Just allow me to go if the effort to sustain my life is futile.

So if that isn't your health care representative designation that that living will language we want to stand alone living will to make sure that's in place OK and then I would indicate that everybody also needs to pay attention to who it is it's receiving our assets, who it is, who is it that's going to be receiving their wealth at the time of their passing when I use the term wealth I don't mean that you have to have lots of zeros behind your in your checking account.

Huge balance or a huge balance in a brokerage account an IRA?

No, not at all.

It's whatever you have that is your wealth.

So we want to organize where's that money going at the time of your passing if you don't decide in writing in advance of your passing where it goes then the state of Indiana decides where it goes.

It's not a really scary thing.

It's called intestate succession has a very specific statute that indicates where the money goes but you may or may not want the money to go to your siblings or somebody else in your family.

People think that if they're married their spouse will automatically receive all their assets when they pass.

That's not the case.

Your spouse doesn't automatically receive everything your spouse gets a percentage or children get a percentage.

Now it is true if you are married and you had no children and then your spouse would receive one hundred percent of the estate but without that no it goes elsewhere.

Wow wow.

Yeah we have a text coming in.

It looks like it's from James and we'll take a look at his question what are the usual first assets to go when trying to afford a nursing home or a hospice that's from James in Fort Wayne .

>> What are the first assets to go when I'm assuming that when James is asking that the first assets to go what he's asking is what assets are used to pay for one's care?

Typically liquid assets so money that's readily available that we can get to very quickly.

So it could be money in a checking account money savings account if you have a brokerage account we would look at liquidate that if there's an IRA we would want to spend that money down and pay for your care once we get past liquid assets typically real estate is sold and so once the real estate is sold then we spend that down and provide payment for your care over time.

So there isn't necessarily an order in which you should sell assets.

What I'm typically saying James though is that assets that are immediately available are used to pay for one's care in the facility.

So the trick is is there I shouldn't say trick but sometimes the objective that folks have is have is that I can protect those assets and maybe keep some of those for loved ones or for charitable entities like PBS .

Let's say you're wanting to remember PBS and your estate planning.

How is it that I set that money aside to make sure I can remember PBS or my my spouse or my children as age?

>> How can I do that?

OK, very good.

Let's talk about wills.

A simple simple will can you explain that and are there any drawbacks or things to look for sure so I that phrase always kills me when somebody says a simple simple will now in my mind there isn't a simple well wills can be very complex.

I like to see language in wills that indicate gosh, if somebody is under a particular age we don't necessarily want someone to receive money at eighteen or perhaps we don't want an in-law or an ex in-law to be managing money for our grandchild great grandchildren.

We want somebody else to manage that money for us in those wills.

I'd like to have language that indicates perhaps they don't get the money until they're twenty one or twenty five and we do multiple bites at the apple.

I really like giving money out over time as opposed at once and maybe it being wasted just because a young person doesn't appreciate money as much as they might as they age within her will.

>> I also like to include language that indicates if somebody at the time they're inheriting is something a special needs person or special supplemental needs person that we're protecting assets and something called a supplemental needs or special needs trust.

We're protecting assets for them so that if they need that care that I was referencing earlier, that nest egg that mom, dad , grandpa, grandma gave to them is protected can be used for them during their lifetime but wouldn't necessarily be depleted really quickly like James our last caller was asking or mentioning hopefully not going through that really quickly to pay for one's care.

So yes, a will needs to be in place.

Everybody needs a will I I the phrase a simple will I'm not sure what that means because they are complex documents but it's a great question that you're asking me.

I get those questions a lot with clients when they're saying you know, I just need a simple well what does that entail?

And really it's difficult when you're speaking with your elder law attorney or estate planning attorney, you should be really open and talk to them about what it is that you want.

What do you want to get accomplished and then let them guide you.

Gosh, maybe maybe this language in a will is appropriate.

Maybe you need something more than a will.

Maybe you need a trust but go in with an open mind about what may be appropriate for you based upon those goals you have for yourself, your your beneficiaries, the charities of your choice etc.

OK, we have another text.

>> Yes.

Let's take a look at that question please.

And this is from Dory from Fort Wayne .

I currently pay some of my family members to help me pardon me around the house and take me to appointments with us affect my ability to get Medicaid.

>> Well, great question, Dory.

I appreciate your your asking.

So you are able to pay family members to take care of you so and it won't impact your ability to get Medicaid so long as you have a written agreement between yourself and your family member that agreement is notarized.

It's pacifically defines what worked at that family member is going to be doing for you indicates how much you're going to be paid.

So if you're paying a family member to care for you and you're paying them under the table right.

Paying them in cash they're not getting they're not having that recognized by the Indiana Department of Revenue or the IRS that's going to get you in trouble with Medicaid if you're paying them and keeping with a written agreement that's notarized where you're there recognizing receipt of that money and at the end of the year you give them a W-2 or a ten ninety nine and they declare it that won't cause a problem for you getting Medicaid if you don't take those steps.

Daury the issue is that the Medicaid if you were to apply for Medicaid at some point within five years of paying that family member Medicaid's going to say you gave that to them, that was a gift.

So if you've made a gift to a family member even if they did work for you but they didn't pay taxes on it, you didn't have that written agreement.

Medicaid is going to look at that as if you were trying to get rid of money and in order to apply for benefits for Medicaid to pay for your care.

So generally for around every eight thousand it's not quite eight thousand but around every eight thousand dollars you give away.

Medicaid says I won't pay for one month of your stay.

So if that one month of your stay costs ten, eleven, twelve thousand dollars then we somebody has to come up with that ten, eleven twelve thousand dollars to pay for that month as a result of your having paid a family care family caregiver under the table eight thousand dollars.

So great question Jerry.

I appreciate that you have to be very careful with paying folks and they're not paying tax on that or giving money the way it creates a big problem when you if you need to apply for Medicaid at some point it sounds like it.

>> Let's change gears a little bit and talk about it states does a person necessarily need to be wealthy to benefit from an estate plan?

>> So to answer that initially I don't know what it means to be wealthy.

I don't I really don't understand what that is.

It's different in everybody's mind what wealthy is.

>> So no, I as I said earlier, the number of zeros you have in your checking account in your bank account, in a brokerage account if you don't have a brokerage account, that alone doesn't indicate whether or not you should have estate planning in place.

It really is making things transfer more easily at the time of your passing.

It really is about making sure that's very efficient and clean and is is economical is possible at the time of your passing that the money goes where you want it to go.

So amount of wealth that that to me is very curious.

I do think that if you're speaking with an estate planning attorney or an elder law attorney they're probably going to be speaking with you, talking with you about the assets that you have.

Do you have a checking account ?

You have these different various various forms of accounts you own real estate.

It would be appropriate for them to ask you those questions not because they're not going to be doing work with you if you don't have enough assets or anything like that.

It's so that they know how best to help you.

So learning about those assets, giving you options of things that you can do with those assets in your estate planning is a reason for asking that.

But no, I will say because you feel that you aren't wealthy that you don't have enough money that is not a reason not to move forward with some estate planning.

I would actually say that sometimes those a smaller account can create issues for folks so that that organization during your lifetime to assist at the time of your passing very important.

>> OK, because I was going to ask you what are some of the risk of not having an estate plan?

Well, I think the risk the main risk is what we talked about a little bit earlier, which is the money doesn't go where you want it to go.

>> Right.

So if you have a strange sibling and you're not married no kids and having a strange sibling, maybe my sibling will get a percentage of my estate.

People are often surprised to learn that if we have a second spouse, third spouse, the second spouse, if we don't have children with them they without an estate plan they inherit a nominal amount of your estate.

So it's very important to have those things in place.

You make the assumption that I'm married to someone as a result they're going to be inheriting my estate.

That is not the case, especially if you're second or third spouse and if you have no children with that individual they receive even less money.

>> All right.

That's that's a big deal.

Very important.

We have another text that looks like it's from Joan of New Haven.

My father lives in his home and I'm providing care for him in his home.

He gives me a weekly stipend for this care.

Is that OK?

And I'm also considering moving in with him to provide additional care.

>> Bless your heart.

And is that a good idea?

She's asking so first of all, Joan, like Marc was saying good for you.

>> That's not an easy thing to do.

I think it's very difficult to care for a loved one.

It really changes the dynamics between you and that loved one when you're providing direct care.

So my hat's off to you for doing that.

>> So if you're going to be providing care for your father, I it's important that as I was mentioning before that you have an agreement with your father that it spells out exactly the work that you're going to be performing for him, that you have that agreement reduced to writing and notarized and that then your father pays you in keeping with terms of that agreement.

So my hat is off to you for being able to take care of your father both now and then in the future moving in with him.

Yes, you have every right to be paid for that.

We just want you to be paid in the most appropriate way so it doesn't cause an issue for your father if at some point he needs to apply for Medicaid.

>> So there's something called a penalty period which is remember I was saying before earlier in tonight's show that every eight thousand dollars that's given away if you give away that money Medicaid is going to say over the past six months or the past five years how much have you given away?

We're going to divide that by a number around eight thousand dollars.

It changes every year, goes up a little bit every year but for purposes of this discussion we'll say eight thousand.

So if you've given away eighty thousand to a family member in a way that was not in keeping with a written caregiver agreement, that's ten months of care that your father, you or somebody else is going to have to come up with the money to pay for it.

You've given that money away.

It creates a penalty period.

So be very cautious when your heart you're doing the right thing caring for dad both now and you may move into his home you're doing the right thing but be very cautious about not digging a hole for dad if he needs to apply for Medicaid benefits in the future.

I would also say that if your dad does qualify for Medicaid there are programs whereby as a family member you can be paid to provide care for him in his home.

Of course he has to qualify for those but there are many different things to look at when you're addressing care for a loved one.

So it's a good idea to reach out and seek some advice before you make some mistakes with the money and how it's being transferred and how it's being utilized.

>> So great question and good for you.

Yes, great job Jim.

As we are coming to the close of the show really I'm very curious about this.

What are some of the most common mistakes you see pardon me seniors making and planning for their future?

>> I think the most common thing that I see that is a big mistake is actually just not planning thinking that gosh, things are going to fall like I anticipate them.

I've told my kids where I want things to go.

I put a sticker on the bottom of this or sticker on the bottom of that.

I've expressed my concerns.

I live in Indiana.

You know, people you know I'm never going to leave my home, take me around the back of the barn.

Don't don't don't ever let that happen to me that I so I think the biggest mistake is not planning ahead not having an honest discussion with your children, letting your children know that gosh, my circumstances may change over time.

I recognize that and so please take care of me as you deem appropriate.

I'm going to point you as my attorney in fact using that play my health care surrogate using the health care represented designation get my will and possibly a trust in place as well.

>> Okay, one final question this time we have but when should someone start looking at a long term care planning boy?

>> Long term care planning typically I see folks doing it in their early seventies is when I see folks start to think about it but it's no shame in doing it.

>> Maybe even in your sixties.

>> No shame at all in your not at all.

Brian Nugent, thank you so much.

Thank you, Mark.

We have to have you back again.

All my life I had my pleasure.

Remember you can see this and other episodes of of LIFE Ahead on YouTube and also on our website and we thank you so much for watching and we certainly hope that you'll enjoy and embrace your LIFE Ahead.

Thanks for watching