If you execute a new power of attorney, it should state that old powers of attorney are revoked.  However, you may also put the revocation in writing. The revocation should include your name, a statement that you are of sound mind, and your wish to revoke the power of attorney.  You should also specify the date the original power of attorney was executed and the person selected as your agent. It should be signed by you according to the same requirements needed to execute a power of attorney in your state.  Send this revocation to the agent under your old power of attorney, as well as your new agent, and any banks or financial institutions that you are working with.  Attach your new power of attorney to the revocation.

You will need to get the old power of attorney back from your agent. If you can’t get it back, send the agent a certified letter, stating that the power of attorney has been revoked to put them on notice that they are no longer allowed to act on your behalf.

Finally, because a durable power of attorney is the most important estate planning instrument available, if you revoke a power of attorney, it is important to have a new one put into place immediately.  An elder law attorney can assist you in revoking an old power of attorney and drafting a new one. 

For more information on powers of attorney, click here www.manzlawfirm.com

A health care proxy form, also known as an advance medical directive, allows you to appoint someone else to act as your agent to make medical decisions for you when you are unable to make them yourself.  It should also include a Living Will that states what your wishes are for end of life care.

An advance medical directive takes effect only when you require medical treatment and a physician determines that you are unable to communicate your wishes concerning what that treatment should be.  Appointing someone to serve as your agent helps ensure that your wishes will be carried out when a crisis occurs.

While an advance medical directive serves to appoint an agent to speak for you, you can also use it to give the agent guidance about your medical wishes.  The following are some issues that can be addressed in an advance medical directive:

• The name of the person authorized to act for you. It is good to appoint an alternate as well in case your primary agent is unable to assist you.
• If you are terminally ill, in a coma, or have brain damage with no hope of recovery, you can explain the kind of treatment you do not want. For example, do you want to be kept alive by machines if you are in a persistent vegetative state?
• Under what circumstances you want pain medication to be administered.
• Whether you want to donate your organs.
• Whether you want to be cremated or buried and where and how your remains should be disposed of.

Whatever choices you make, you should take time to consider your health care wishes before drafting an advance medical directive. For this reason, signing a generic hospital form is not a good idea, as such a form will not take your individual wishes into account. Instead, you should work with an estate planning attorney to have a proper advance medial directive prepared that reflects your personal wishes. In addition, if you already have an advance medical directive as a part of your estate plan, the generic form will revoke your more personal advance medical directive

The Law Office of Angela N. Manz can help you create a document that specifically addresses your unique situation and feelings on medical decisions and end of life care. Email us for more information by clicking here.

By RICHARD LARDNER

Associated Press Writer

WASHINGTON (AP) — Medical researchers say there may be a link between exposure to the defoliant Agent Orange and other herbicides used during the Vietnam War and an increased chance of developing serious heart problems and Parkinson’s disease.

A study from the Institute of Medicine released Friday contains several caveats, but suggests there is a stronger connection than previously thought about the health risks to Vietnam veterans.

The research was sponsored by the Veterans Affairs Department, which will decide what to do with the findings. A VA spokeswoman said the department is reviewing the study to determine the full extent of the toxic effects of Agent Orange so exposed Vietnam veterans get the disability benefits they are entitled to.

American forces sprayed millions of gallons of Agent Orange and other defoliants over parts of Vietnam from 1962 to 1970. Military authorities used the defoliants in an attempt to massively prune away the dense jungle cover used by North Vietnamese forces to hide.

American troops and others exposed to the chemicals later complained of numerous health problems, however, and researchers are still trying to determine the scope of the damage.

The Institute of Medicine, a division of the National Academy of Sciences, is mandated by Congress to review every two years evidence about the effects of Agent Orange exposure.

To determine whether Vietnam veterans faced an increased chance of ischemic heart disease – a condition involving reduced blood supply to the heart – researchers reviewed several studies that showed links between higher exposure levels and greater incidence of the disease.

Other factors such as smoking, age, and weight can also play a role, they noted. Still, they said veterans exposed to the chemicals may be at greater risk.

The conclusion on Parkinson’s was based on a review of 16 studies that looked at herbicide exposures among people with the disease or Parkinson’s-like symptoms. But the study cautions the review was hindered by the lack of studies specifically investigating Parkinson’s rates among Vietnam veterans.

© Copyright 2009 Associated Press. All rights reserved.

The process of estate planning means that you have a plan prepared for the management of your affairs during your life and for the disposition of your property upon your death or disability.  No one likes to dwell on the prospect of his or her own death or disability. The failure to plan may cause you or your family to incur unnecessary expenses, taxes, delays, and stress when you die or be become disabled. You run the risk that your loved ones may not receive what you would want them to receive after your death due to conflicts and disagreements, taxes, or administrative costs after death. Failure to plan may also cause you to run out of money during your lifetime if you are to need long-term care. This means that there may be no inheritance left for your spouse or children. This can all be avoided by proper estate planning.    A complete estate plan should consider the needs of your spouse, children, and other beneficiaries.

A comprehensive estate plan will address the following questions:

Whom do I want to make financial or health care decisions for me if I am incapacitated?

Whom do I want to manage my estate after my death?

Where do I want my property to go after my death?

What if my I want to leave property to a beneficiary who is disabled, has a substance abuse problem, or may become divorced?

What happens if my spouse or I become disabled?

How can I minimize or avoid probate taxes and fees after my death?

How can I leave an inheritance for my children?

All estate plans should include the two important estate planning instruments: a durable power of attorney and an advance medical directive.  The first is for managing your property during your life, in case you are ever unable to do so yourself.  The second is for the management of your health care decisions in case you are unable to do so yourself.  Also, an estate plan should include a will and possibly a revocable trust.  Many Americans are using revocable (or “living”) trusts to avoid probate and to manage their estates both during their lives and after they’re gone, but that doesn’t mean it’s the best option for your family.

A complete estate plan will address your needs, as well as the needs of your spouse, children and other family members or business partners.  A good estate planning attorney will discuss your specific family situation with you to determine the best estate plan for your family, whether you need a will and/or a trust and to ensure that you are take care of in the event of a disability.

Don’t delay in getting a proper estate plan put into place. Not having the proper estate plan could have disastrous results for your family. Prior planning makes all the difference.

Just as overwhelming for a caregiver is the never-ending to-do  list.  Most caregivers face a landscape of too little support at too high a cost. 

Caregivers who don’t get the help they need can wind up doing more than they are able to (emotionally, financially or physically) and end up with caregiver burnout. Caregivers who are “burned out” may experience fatigue, stress, anxiety, and depression. Many caregivers also feel guilty if they spend time on themselves rather than on their ill or elderly loved ones.

The symptom of caregiver burnout include:

Feeling blue, irritable, hopeless, and helpless

Changes in appetite, weight, or both

Changes in sleep patterns

Withdrawal from friends, family, and other loved ones

Loss of interest in activities previously enjoyed

Getting sick more often

Feelings of wanting to hurt yourself or the person for whom you are caring

Emotional and physical exhaustion

Irritability

How can I prevent burnout?

Here are some steps you can take to help prevent caregiver burnout:

Find someone you trust — such as a friend, co-worker, or neighbor — to talk to about your feelings and frustrations.

Take advantage of respite care services. Respite care provides a temporary break for caregivers. This can range from a few hours of in-home care to a short stay in a nursing home or assisted living facility.

Be realistic about your loved one’s disease, especially if it is a progressive disease such as Parkinson’s or Alzheimer’s. Acknowledge that there may come a time when the patient requires nursing services or assisted living outside the family home.

Don’t forget about yourself because you’re too busy caring for someone else.

Talk to a professional elder law attorney to ensure that your loved one is getting any benefits they may be entitled to and that they have a long-term care plan in place.

Stay healthy by eating right and getting plenty of exercise and sleep.

Accept your feelings. Having negative feelings — such as frustration or anger — about your responsibilities or the person for whom you are caring is normal. It does not mean you are a bad person or a bad caregiver.

Join a caregiver support group. Sharing your feelings and experiences with others in the same situation can help you manage stress, locate helpful resources, and reduce feelings of frustration and isolation.

Where can I turn for help for caregiver burnout?

If you are already suffering from stress and depression, seek medical attention. Stress and depression are treatable disorders. If you want to prevent burnout, consider turning to the following resources for help with your caregiving:

Geriatric Care Managers – Geriatric Care Managers assist families with creating and putting into place a long-term care plan.  They can help the family with all aspects of that plan, including finding home health care or nursing home placement. 

Home health services — These agencies provide home health aids and nurses for short-term care, if your loved one is acutely ill. Some agencies provide short-term respite care.

Adult day care — These programs offer a place for seniors to socialize, engage in a variety of activities, and receive needed medical care and other services.

Nursing homes or assisted living facilities — These institutions sometimes offer short-term respite stays to provide caregivers a break from their caregiving responsibilities.

Caregiver support services — These include support groups and other programs that can help caregivers recharge their batteries, meet others coping with similar issues, find more information, and locate additional resources.

Some content from: The Cleveland Clinic Foundation.

Seminar dates:  July 28th, August 25th, September 29th

2:30 pm - Virginia Beach Central Library

To register, call Angela at 757-271-6275.  Don’t miss this great opportunity to have all your questions answered!

This benefit pays the veteran or spouse a monthly tax-free  pension amount.  A veteran is eligible for up to $1949 per month and a widowed spouse is eligible for up to $1056 per month in tax-free income. 

In order to qualify, the veteran or widowed spouse must have recurring medical expenses or require personal assistance.  Medical expenses can include in-home care (including a child who is taking care of a parent either part-time or full-time), assisted living community costs, nursing home costs, prescription drugs, medical equipment, adult day care, insurance premiums, etc. 

There are asset and income qualifications as well.  An experienced elder law attorney can assist the veteran or his widowed spouse in creating a plan for veteran’s benefits and determining the best method for preparing the application.  The elder law attorney will also discuss with the family how any application for VA benefits might affect future eligibility for Medicaid or other government benefits. It is imperative that steps be taken to adequately preserve the senior’s assets and to preserve eligibility for any other benefits the senior may require in the future.

Finally, the process of applying to the VA for this benefit can be very lengthy and difficult.  It is best to work with someone knowledgeable who can assist you in preparing your claim so that it is approved as quickly as possible. 

The VA also requires that anyone giving advice to veterans about this benefit be accredited through the VA.  Before choosing a professional to assist you, make sure to ask if they are accredited and if they will help your family prepare a Medicaid or other long-term care plan at the time they are preparing the plan for VA benefits. 

Angela N. Manz is an elder law attorney licensed in the Commonwealth of Virginia.  She is accredited through Department of Veterans Affairs to assist veterans and their families in the preparation of claims for veterans benefits.

This blog post is not intended to provide legal counsel or to be a substitute for legal counsel. We assume no responsibility for any errors, omissions or any damage resulting from the use of this information.

http://www.alsa.org/files/cms/News/Archive/2008/VA%20Release.pdf

Medicaid is frequently used for people who require full-time or skilled nursing care. In Virginia, Medicaid will provide benefits for a nursing home or for some limited in-home care service

The eligibility requirements for Medicaid are very strict and there can be significant penalties imposed for not following the rules. In Virginia, a single person can have no more than $2,000 in countable assets. For a married couple, the spouse applying for Medicaid may have no more than $2,000 and the spouse still living in the community may keep up to $109,560 in countable assets. This doesn’t mean that every community spouse may keep $109,560. It means that this is the maximum in countable resources that the community spouse is allowed. The rules on how to calculate the amount that a community spouse may keep depend on what assets the couple has when the institutionalized spouse enters the hospital or nursing home. Also, not every asset is countable for Medicaid purposes. For instance, an individual applying for Medicaid is allowed to have one personal vehicle as an exempt asset.

The biggest question I get is whether Medicaid will take your home. I frequently find that there is a lot of misinformation on this subject as well, so we will clear that up here today. In Virginia, Medicaid does not “take” anything from anyone. What happens is that the assets of the couple (or individual, if not married) are looked at as of the date that the ill spouse (or single individual) first entered the hospital or nursing home for a period of thirty days or longer. This is called the “snapshot date”. If the couple (or single individual) has too much in countable resources, they will be required to spend those excess resources before becoming eligible for Medicaid. This is called “spending down”.  Once those extra assets are spent down, they can then apply for Medicaid. The good news is that, for a married couple, as long as the community spouse remains in the home, it is NOT a countable resource and is not counted for Medicaid purposes. For a single person, the home is exempt for the first six months, but after that a “good faith effort to sell” must be made. This does not mean that the person must actually sell their home before getting Medicaid.  This is where people can get themselves into trouble, so it would wise to seek counsel from an elder law attorney before attempting this on your own.

Each week I hear stories from my clients about advice and ideas that they get from others. Most of the time the information is either incorrect or is not correct for that person’s situation. It is imperative that you discuss your individual situation with an elder law attorney. You need someone who can look at all pieces of the puzzle and give you accurate advice to create a long-term care plan that works for your family. Don’t rely on third-hand information. Going straight to a professional will save you time, money and heartache in the future.

This blog post is not intended to provide legal counsel or to be a substitute for legal counsel. We assume no responsibility for any errors, omissions or any damage resulting from the use of this information.