Nugen Law; specializing in estate planning and elder care law, emphasizing independence and quality of life.

Serving Indiana, Ohio, Michigan, and Florida.

More information at NugenLaw.com.

good evening.

I'm so glad you're watching the Fort Wayne PBS television with us tonight.

I think you're going to learn a lot here this evening.

We're going to be talking with Brian Nugent again who's one of our regular guests here on LIFE Ahead.

So when you see him again here in just a moment, you'll know who I'm talking about.

>> He specializes in elder law and we are going to be talking about elders and a lot of ways tonight we're going to show you some alarming statistics.

>> I found them alarming.

>> We'll see what you think.

Brian, thank you for coming back with us again tonight.

Thank you, Sandy .

I appreciate it.

>> Thanks for having me.

OK, now we do have a lot of things we want to show you on the screen and I also want you to look at the bottom of the screen.

We have a phone number that'll be appearing there periodically throughout the show.

That's the phone number.

You can call and talk directly to Brian here and ask him any questions you would like again in the area of elder law if possible and you are going to be showing us these statistics.s with me.

Yeah, there are a lot of people turning seniors.

>> That's right.

I mean like every day there's an amazing out.

>> So I so I brought some statistics with me if you want to put those up on the screen every day in the United States we have ten thousand people turning age sixty five.

It's the fastest growing population in the United States.

>> Those age 65 and above make up about fifty five point eight illion people in the United States.

It's currently sixteen point eight percent of our population and it's increasing to twenty three percent by the year twenty fifty four.

So we have not slowed down yet.

So life Head and some of the topics that we talk about on this show are very relevant to today.

>> They are and that's the purpose or the mission of PBS is to provide you with a lot of great entertainment of course, but also with information and education and in our case with LIFE Ahead it's just what the title says we try to inform you on topics that might help you make some choices in your LIFE Ahead and I mean the alarming statistics as far as people getting is it the baby boomers?

>> What are the baby boomers right there?

It's as I say, the fastest growing population.

Ten thousand people a day at age sixty five that's not slowing down any time soon and I call it the silver tsunami.

>> Right.

It's that first people that are hitting age sixty five well and that has affected a lot of things.

I mean well we recently have done a couple of shows on Medicare and health insurance and obviously that's affected greatly by the increase in the eldr population right now this is open enrollment season so if folks have Medicare or Medicare this is the time if you want to change plans or have your plan examined, this is the time to do it.

There are ship counselors, ippy counselors that you can get a hold of here in northeastern Indiana.

>> You can find them online and they would review your counsel and ship EZchip.

Yeah, they'll review your Medicare plan with you and make sure that it's most appropriate for your the physician that you're seeing the medications that you're taking the care that you're needing and make sure that you have the most appropriate Medicare plan for you that's going on now.

I know in our office we're doing it and a lot of other offices are doing it as well.

>> So from now until December 7th, right December 7th I think that just right.

OK, OK.

I have a question.

Sure.

And then we'll get to our real topic.

But since we're talking about the insurance issue all over TV ,I mean every other commercial you know is all about Medicare and call this number and you know, get counseling, change your plan if you need to.

>> I'm telling you I'm correct when you call those numbers you're not calling Medicare.

>> You're calling an insurance company.

Someone's selling you a product.

And the reason that you're seeing so much advertising right now is because it is open enrollment season.

>> So people are tuned into it and they are aware that if they need to change it, now's the time.

So yes, there's going to be a huge push of advertising folks that are selling insurance product now when I was referencing a ship counselor though that's done without cost.

There's no charge to you for that.

They're not selling the product .

They're just educating you on your plan and making you aware of other plans that may be appropriate for you.

So there's no product that they're selling.

But if you're calling a number on online, be careful, be careful and be very careful.

This is always the case.

Be very careful about giving your personal information out over the phone.

You don't want to give out your date of birth Social Security number of those types of things and they're good they're good at pulling that information from you.

>> So be very careful about making this right and the next thing you know you've changed companies bought a new insurance policy and that's not what you might not do.

But if you want to stay with the same company, if you do nothing, it will roll over your plans to stay the same.

And if for some reason they don't have the same plan in place, they'll recommend a different one for you and then you would continue with that.

>> OK, so most definitely there are services out there that will review your Medicare with you that aren't selling a product and by all means take advantage of that.

But at Sandy Point I would be cautious about calling generally phone numbers that you see on TV.

>> That's right.

And because the way they do the graphics and the commercial, you know, it's like huge big one eight hundred whatever and they act like you're calling Medicare and you've covered this topic on the show.

>> Yeah, yeah yeah.

So I hope I hope everybody's aware of that but as Brian said it's up till December 7th.

You have to change or make a different decision if you would like.

>> And so we want to keep reminding people about OK, let's talk about baby boomers some more and some statistics.

How about health ?

And since we've been talking about health insurance, it seems like all I hear so much about now is dementia and Alzheimer's is it's like a big umbrella.

>> That's right.

I think you're parodying me.

Yeah.

You've you've taught me that you are dementia's the umbrella.

>> Yeah.

But under that there are many different illnesses.

>> Alzheimer's is is the biggest one.

Alzheimer's is the most widely diagnosed type of dementia.

So I think sometimes I will hear people say oh my father had dementia but he never got Alzheimer's or he had Alzheimer's and never got dementia.

Yeah that's actually yeah.

Dementia is the giant umbrella Alzheimer's being the most widely diagnosed type of dementia.

I have a statistic about dementia as well in Alzheimer's if you'd like to bring that up.

Thank you.

Unfortunately currently seven million Americans are living with Alzheimer's and now most-we of dementia and one in three so a third of seniors die with Alzheimer's or another type of dementia which is staggering to me.

>> It really is without a doubt in the year twenty twenty for dementia across the United States.

Three hundred and sixty billion dollars for their care and that number is going to one trillion dollars by the year 2050.

Again, a staggering figure now is this the amount that like everyone collectively that's that's paying for someone who has dementia?

>> That's right.

That's their care their medical care in home care facility stay if you have a dementia, any of those types of things fall under that umbrella.

So it's that that it's a huge figure.

I will also say that the dementia is currently diagnosed every sixty five seconds it will be increasing to every thirty three seconds by the year 2050 if we don't have some type of a cure or some type of medication or treatment that can the growth of those dementias.

So all those figures that I've just presented were provided by the Alzheimer's Association.

I would encourage anybody that is dealing with the disease is is aware of it has a concern that they may be suffering from that to reach out to the Alzheimer's Association.

They're not selling a product.

They're not that shouldn't be a scary number to reach out to scary folks to reach out to.

It's a very it's a wonderful program and so folks, if you or a loved one are suffering from some type of a dementia and Alzheimer's, you need some assistance with that.

>> I would encourage you to reach out to the Alzheimer's Association.

Now I know this isn't meant to be a medical show, but what would be some of the first signs or symptoms?

>> So if somebody is concerned whether their parents or grandparents or themselves are beginning to show some signs of dementia walking into the room and not remembering why you were coming into the room normal stuff we always say thank goodness that's normal stuff.

>> I go upstairs and forgot what I went up to get.

Yeah, typical when you see someone let's say they have a dish that's supposed to go into the cupboard and they they have that dish on their hands and they know it's supposed to go somewhere they're supposed to put it away but they can't quite figure out where to put it.

They open the refrigerator and they put it in the refrigerator .

So a dish a plate that should be stored in the cabinet, they're putting it in the refrigerator or something simple that they're used to doing a recipe for example, that you know, Mom's made this pie for years and it's her it's her recipe.

She understands it.

She's always been doing that year over year and all of a sudden it's Thanksgiving and for the life of her she can't remember that that recipe that she's made that she's made hundreds of times a simple card game euchre we're in we're in the Midwest.

Everybody everybody plays euchre and it's been a family favorite to play euchre and now you just can't remember the rules.

You can't remember how the game goes.

So those types of things are are things that we might look at to determine is there something brewing there?

I would encourage and the Alzheimer's Association encourages this as well you might if you're seeing those things yourself or a loved one, you might consider having a neurological assessment done figure out your baseline.

Do I really have something going on here?

Is it mild cognitive impairment that's a normal part of aging or is that truly a disease that we have something to be concerned about?

>> So typically you'll hear doctors recommend having that baseline established with that assessment and if you are forgetfulness or your misplacing of things etc.

continues you would go back on a regular basis to see that if you're deviating from your baseline.

Yeah, yeah.

Unfortunately we don't have a cure for Alzheimer's.

>> I know and you know they're continuing to do research.

There are advancements but I personally am not aware of one yet which is heartbreaking.

I think that attorneys the elder law practice estate planning practice we're regularly dealing with folks that have some type of dementia and concerns.

>> That's something that oftentimes comes up and we've talked about dementia as well when you've counseled Brian on estate planning and in power of attorney.

>> Oh yes.

Who's going to be your trustee and so important these documents seem so basic power of attorney health care representative designation with living with language hit by waiver Health Insurance Portability Accountability Act.

Those documents seem to be so basic but they're not they're essential to have in place from somebody an 18 year old going off to college to middle aged folks, to seniors having those those documents in place will permit you to avoid a guardianship will allow others to step in immediately when you need help.

So I would encourage everyone to have those in place.

I oftentimes will have people say to me do I really need that my wife will make the decision for me.

I've told my kids that can make the decision.

That's not how it works if it's not reduced to writing you have to oftentimes go to court and have the court designate a guardian on your behalf to make those health care and those financial decisions on your behalf.

So these are very basic documents that everybody needs to have in place and and to make sure you understand what the document is saying, sometimes attorneys in this area will see documents that maybe somebody is found online or and they're not you know, they were finding something that that really wasn't appropriate for them or came from a different state.

So I would encourage folks if you are going to have those documents prepared to make sure you know what they say that they came from a very solid source and you are making sure that what you have in place is what's appropriate for you.

>> Why risk it if you're going to hire someone to do it?

They're not incredibly expensive but so so important and can avoid a lot of heartache and a lot of problems and frankly a lot of expense on the other side if you do need to have that guardianship established.

>> Good advice obviously and you in terms of the statistics that you were sharing in the increase in baby boomers and in with so much now advanced in the medical world, these these people are living longer.

>> Yes.

And healthier and healthier.

>> Yeah.

Which is like good news.

Bad news.

The good news is you're living longer, living longer.

The bad news is it's going to cost some money somehow.

Let's talk medical care.

>> Sure.

So I have brought a slide along for some of those costs as well.

These are average costs in the state of Indiana monthly cost if we're looking at in-home personal care.

So that's an attendant that's coming to your home and caring for you and this is the figure that I have the five thousand eight hundred and fifteen is not twenty four hour a day care.

That's a few hours a day.

So that figure is on average what folks are spending for in-home care but it will cost you significantly more if you're wanting one on one care in your home 24 hours a day through something like a licensed personal service agency.

So those are licensed agencies that are licensed to the Indiana Department of Health that care we know that those those providers are insured to those providers have training but on average you're going to be spending around fifty eight hundred dollars a month if you're looking at adult daycare in the state of Indiana ,you're looking around fifty eight hundred dollars per month.

I just was at a presentation a week ago speaking to a group of seniors about adult daycare and I said what's adult daycare and adult daycare?

It's just like it is for kids but it's for seniors and their activities that are there and allows you to have a safe environment to and you're able to get out of your home and meals oftentimes are prepared there and so forth.

But if you're looking for adult daycare in Indiana the average cost is fifty eight hundred dollars a month is per per month.

>> What kind of hours are we talking about?

You said daycare.

Yeah, it wouldn't be overnight.

It would be during the day.

Yeah it could be it could be two hours it could be six hours based upon those that person's needs you know I think it's wonderful and I know that's available even here in Fort Wayne there are some stores I do have some friends once that the wife's early dementia very early dementia.

Yeah.

And the husband of course was still working and so he would take her but he was afraid to have her home alone that she might leave the stove on or something and he he dropped her off at the daycare every morning and pick her up on his way home from work at night.

>> Well, what you're seeing with these two services that you spoke about in-home care, an adult daycare the idea is that if the longer that we can maintain a regular routine, the longer that you can remain in your home the better.

And there isn't an encouragement for you to it isn't necessarily that we're throwing a switch at home.

Everything's healthy and all of a sudden you're not health and you're going to a nursing home or to a memory care unit sometimes just a little bit of help in the home or in this instance you are providing Sandy with your friend where the wife is going to adult daycare.

You're you're extending that time for the person to as independent as possible so long as that makes sense for them to be at home, as long as that makes sense for them to have a little bit of care.

>> One of the figures that we hd shown on the screen just a moment ago though was the cost of nursing home care.

The average cost of nursing home care in Indiana on the monthly basis is I'm sorry assisted living care.

I'll start there being assisted living just over five thousand dollars a month and then in Indiana if you have a nursing home stay you're looking at a semiprivate room meaning you have a roommate seventy eight hundred per month and then if you have a private room ninety seven hundred dollars per month those those are Indiana averages.

>> Yeah in Fort Wayne our numbers are actually higher.

>> Oh no seriously.

Well you know all the all the more reason that we talk about so many things here on this show and hopefully other things that you want to read you have to be prepared and that's why I appreciate so much even when we talk about estate planning, can you give tips on that?

>> You have to plan ahead and know somebody needs to pay that amount.

>> You're talking about it, isn't it?

Not only planning ahead for protecting your assets but planning ahead if I do need help in the home, I am seeing those signs that you were asking about a moment ago.

So what do I want to have done?

So I'm recognizing that my memory may be fading.

I'm recognizing that maybe struggling a little bit to maintain myself.

So maybe I look at different agencies to provide care for me.

Maybe I look at different assisted living facilities where I might stay.

So if you can be proactive as opposed to being reactive and being in a crisis mode when something like that happens, I would encourage everyone to do that.

>> Take a look at the facilities, take a look at the home care ,educate yourself.

So if and when that instance happens, you know where you want to go.

You know the care that you want to receive at those assisted living facilities at those nursing homes, memory care units they're used to having tours.

>> They're used to introducing folks there.

It's not a situation where they're, you know, putting your thumbs device and saying you got to move in tomorrow.

You got to do this.

It isn't like that at all.

They're wanting to introduce you to the services if they have and make sure it's a good fit for you.

>> What may be a good fit for one person at a facility isn't necessarily a good fit for the next person.

>> Some people want may want to go to a facility where there are lots of activities they want to go play bingo and swim in.

>> The next person is more inclusie and they don't need all the activities they want a nice garden to walk in.

>> Yeah exactly.

So good reason to make tours now and I've also heard Brian that you should be if it's a good home you should be able to arrive at any time and get a tour schedule in advance and you'll also get a better view of what it's really like maybe as well.

>> And to that point if you have a loved one that is in a facility, the idea is to drop in at random times and be seen .

Do you know how you get good care?

It's about that.

Let the people know that you're there, that you have concern for the loved one that you're going to be stopping in not just Sunday morning after church.

Yeah, but you're going to be dropping in randomly at different times of day and different days of the week.

>> Good point.

OK, Gene has called in and here's her question or situation if you will.

>> She owns two farms and she has three children on transfer of death.

I know you call Todd.

Would it be wise to switch the transfer to the children now with a provision that she can stay at the farm?

>> So I'm not a huge fan of gifting now there was a time when the federal estate tax was much lower that you saw more gifting taking place with estate planning.

But to transfer that if you transfer the real state now you lose something called a step up in basis so you step up in basis.

>> OK, so if you inherit the property your your basis or what you're taking the ground at the then current fair market value.

So if your children inherit property whether through a will or a trust or in this instance a transfer undef deed, their basis is not what you paid for the farm.

Their basis would be what the farm's then current fair market value is.

So if at some point they sell the property rights not our intention for them to sell it but if at some point in the future they actually sell the property the capital gains tax that they pay would be much lower because they've got that huge step up in basis.

>> One other point I might make here if you make a gift of real estate and you at some point do need Veteran's Administration benefits or you do need Medicaid benefits depending upon the length of time during which you gave the property, when you're applying for those benefits you may be creating ap.

So generally in Indiana for about every seventy six hundred dollars you give away of an asset you lose one month's worth of benefits.

So if the facility if your facility is going to cost you ten thousand dollars a month and you gave away seventy six hundred dollars so you've made that gift of seventy six hundred dollars now you have a penalty of one month it's going to cost me ten thousand dollars.

It would have been better for me not to have given that gift away.

So no I'm not a huge fan of your making the gift to your children now if you want to make sure that you're avoiding probate you've done that through the transplant death deed which your three children you're giving a piece of real estate to three children which an be a sticky wicket by itself for three children to own real estate together.

>> I'm very cautious about doing that.

I like to change it up a little bit and maybe permit the children the opportunity to purchase the ground either you inherited assets or their own money so that instead of having three people own it together which may have three complete different opinions that we're allowing them to maybe secure the property the different way and we're hopefully suppressing fighting that may go on and the family.

So if one child says I want to sell it, the other child says I don't want to sell it and the third one says I want to give it to my kids so now we've got three different views of what they're going to do with that real estate.

>> I was very cautious about how we're giving it away.

>> The other costs like OK, property tax or all of that a third from yeah well so so did what he said and exactly.

>> Very complicated.

OK, talk to me about options for paying for some of this care we're talking about.

>> So if you're looking at we can bring that up on the screen as well if you're looking at ways to pay for your care.

So Medicare long term care insurance self pay right.

Friends, family yourself VA Medicaid so Medicare sometimes folks have the notion that Medicare will pay for your stay in a nursing home, will pay for your stay in a memory care unit.

Medicare does not do that.

Medicare will pay for your rehabilitation in those facilities for a period of time but wouldn't pay for your care long term.

And I think because mom's care is paid for by Medicare when she was at the nursing home for rehab, folks have the notion that Medicare will pay for a long term skilled state and it doesn't long term care insurance if you can afford it is a product that will pay for your care, can pay for your care, can pay for in-home care the facility as well.

I'm not seeing as many long term care insurance policies as I once did at the beginning of my career just because the expense of it it continues to increase self pay.

Of course you can deplete your your life savings.

You can run through your money and pay for your care personally if you care too.

If you are a veteran the VA can pay for in-home care for you or pay for your stay at a nursing home if it's a facility that does take VA and then Medicaid, Medicaid is really the big bucket that pays for a lot of folks care both in their home and at places like a nursing home or a memory care unit.

So oftentimes Medicaid is the resource that pays for a lot of folks stay there averages between sixty five and eighty percent of residents in nursing homes have their state being paid for by Medicaid, which tells you that the care is just as good if you paying for it privately or if it's being paid for by Medicaid.

>> And I know Brian has told us before that if Medicare or Medicaid is paying you're going to get the same care without it except for the business office the people that work there even though I do know is private pay and that's not OK. >> We just have just oh no we don't have any time left bridge you give us so much information just a half an hour and I appreciate you all watching and paying attention to the advice Brian is sharing with us here.

>> A lot to think about.

And again, if you're a baby boomer you're one of the statistics that Brian's talked about.

We're going to see you right here next Wednesday night, by the way, at seven thirty.

Have a nice night Nugen Law; specializing in estate planning and elder care law, emphasizing independence and quality of life.

Serving Indiana, Ohio, Michigan, and Florida.

More information at NugenLaw.com.