Everyone should do some estate planning.

Everyone—regardless of how small their wealth—should do at least some estate planning. 

Some things to consider include:

• A will: This is the most basic of estate-planning documents, yet a Caring.com survey this year showed that more than half of Americans don’t have a will. That’s surprising and troubling all at the same time. A will can provide certainty and clarity and eliminate  the grey areas when property is moving from one generation to the next. Don’t just assume everything will end up with the people you want it to if you fail to leave specific instructions.

• A trust: Not everyone needs a trust, but it often makes sense. Basically, a trust allows you to control your assets from the grave. You can set certain restrictions, which is especially helpful if your kids are young or they don’t really manage money well. That way you may be able to keep them from blowing their inheritance all at once. For example, a restriction might be that they don’t receive the money until they earn a college degree.

• Power of attorney: It’s important to assign someone power of attorney so that if you become incapacitated that person can speak on your behalf and sign important documents. You can also have a living will to outline your wishes, which could help your family make tough decisions about your healthcare.

If you don’t plan for your long term care who will?

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Sources of Help for Seniors

There are many government-supported benefits for seniors, including some programs that are not widely known. Seniors and their caregivers can find services through some helpful online resources listed below.

The National Association for Home Care & Hospice has a Home Care and Hospice Agency Locator and a Caring Store with workbooks and manuals for caregivers.

The Visiting Nurse Associations of America has a Find-a-Provider website.

The Eldercare.net website contains a searchable database of resources that are available at the state and community level. For example, there are connections for legal services, elder abuse prevention, health insurance assistance, home health care, and long term care. Users can enter their data to search for specific programs to meet their individual needs.

The National Council on Aging provides a website called BenefitsCheckUp.org on programs for the elderly, which it says can help some seniors save thousands of dollars on the basic costs of living.

The Older Americans Act of 1965 (OAA) established a national network of federal, state, and local agencies that help older adults live independently, called the National Aging Network. Anyone 60 or older is eligible for services under the OAA; those most in need get priority. The network includes 56 State Agencies on Aging, 622 Area Agencies on Aging, and more than 260 Title VI Native American aging programs. Its programs are supported by tens of thousands of service providers and volunteers. A few examples of the many programs in the network are:

EyeCare America provides access to free medical eye care and annual eye exams;

Program of All-inclusive Care for the Elderly (PACE), which provides stay-at-home alternatives to living in a nursing home;

Chronic Disease Self-Management Program (CDSMP), which gives workshops that help people manage health conditions such as arthritis, asthma, emphysema, bronchitis, cancer, depression, anxiety, diabetes, heart disease, high blood pressure, stroke, osteoporosis, and HIV/AIDS.

For information on Long Term Care Insurance, see the Guide To Long Term Care

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How Your Genes Affect Insurance

images-2Genetic testing can be very useful for diagnosis, prevention, and treatment of hereditary diseases. The ability to predict what health problems may come up in the future has a great potential benefit to health. Early diagnosis and treatment can be life-saving; also ruling out diseases can be a relief. By knowing in advance what diseases they may get, people can modify their diet and other habits to delay or prevent health problems as they age.

However, scientists’ new ability to predict illness through genes leads to ethical questions. Insurers can use genetic testing to predict which individuals are a good or bad risk, and then to decide who will be eligible for insurance and at what premiums.

The Genetic Information Nondiscrimination Act of 2008 (GINA) forbids health insurance companies and most employers to discriminate based on the results of genetic testing. The Affordable Care Act makes it illegal for health insurers to deny coverage or charge higher premiums because of pre-existing conditions, including hereditary conditions. 

However, GINA does not cover life insurance, disability insurance, or long term care insurance. Only in a few states are there laws prohibiting these types of insurance from being denied based on genetic testing. In the rest of the states, insurers can use genetic testing results to make decisions about coverage and premiums.

images-1People who suspect they have a hereditary condition may get a test from a doctor. But there are also companies that offer genetic tests online directly to the public, for fun and to learn about one’s ancestry, with some health information included. The customer mails in a saliva sample. These tests are not presented as serious medical tests; however, if you get any genetic test and later apply for insurance, you will be required to report health information you learned, even if the test was not from a doctor. If you withhold medical information, you can have your policy terminated or your claims denied later, when the information comes to light.

Another drawback to genetic testing is that finding out about heredity diseases can sometimes change a person’s outlook on life, if he or she knows that a progressive degenerative disease will likely develop. This knowledge may also affect relatives who could have similar genes.

So far, genetic tests are only available for a small percentage of diseases. Some argue that it is unfair to discriminate against whose tests show the few diseases that can be identified, when other people have health conditions that will not show up. Also, though genes can show the possibility of disease, there are other factors (such as environment, lifestyle, diet, life events) that determine a person’s health and longevity.

People who are considering genetic testing may be wise to enroll in the insurance policies they want before getting the tests. There are genetic counseling services that can help applicants understand the benefits and risks.

To find out more about long term care insurance, including life insurance and annuities with a long term care rider, see Guide To Long Term Care.

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Term vs Permanent Life — Which Costs Less?

This short video compares Term life insurance with Whole or Universal life insurance. Keeping this in mind, there are Whole and Universal life insurance policies available that have long term care riders. If you use a portion or none of the life/LTC policy for long term care (tax-free) your beneficiaries will receive a tax-free death benefit.

If you currently have a Whole or Universal life policy that has a cash value the Pension Protection Act allows you to convert it to a Whole or Universal life policy with long term care benefits without paying tax on gains. Contact us for quotes or more information.

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How Innovative Technology Is Changing Long Term Care

There are many challenges of providing long term care to people who need help with activities of daily living, including how to minimize physical limitations, how to assure safety, how to help clients remain as independent as possible, and how to control costs. Inventors have stepped up with some technology solutions to these challenges, which include everything from non-slip socks to high tech robotic technologies.

For example, wearable medical alert pedants have been popular for years, so seniors who might fall can set off an alarm and get quick help. Now there are enhanced alert technologies: motion sensors, bed and chair alarms, and automatic fall detectors the patient can wear. There are sensors that can alert caregivers of changes in sleep quality, or heart and breathing rates. “Smart textiles” have circuitry built into clothing; for example, pants that can tell whether the wearer has fallen; heart monitor shirts; a bowel monitor embedded into clothing that alerts the user to get to a bathroom. A cell phone app gives the user a portable way to track vital signs.

For seniors suffering from memory loss or dementia, wandering can be a problem: radio-frequency transmitters, global positioning systems (GPS), and cellular signal-based systems are available for tracking the patient. A transmitter can be worn in a bracelet or ankle strap, or embedded in clothing. There are shoes that have GPS embedded in the sole.

One of the most advanced devices is the Apple Watch. The Apple Watch is a computer on your wrist and it can do many things. It can track your health with built-in sensors that include heart rate, GPS and accelerometer for fitness workouts. It can remind you to take your medication. It provides hands-free iPhone dialing and it uses Siri for voice recognition (“Call Doctor”).

For Alzheimer’s, there is new technology that addresses the health condition itself: for example, the Ybrain wearable device stimulates brain activity. The device, which can be worn at home, consists of a headband with two sensors in the front that emit electronic signals. Clinical trials indicate that wearing the device for about half an hour a day is 20% more effective than taking oral Alzheimer’s medications. Another possible solution being studied is ultrasound devices for Alzheimer’s treatment.

Digital memory devices include hand-held memory aids which allow the user to record reminders about appointments, tasks, medication, passwords, etc. Another helpful memory aid is automated medication dispensers that alert the user when it’s time to take a pill.

Technologies to facilitate communication are constantly being improved. Alternative communication devices can supplement or replace speech and writing when an individual’s ability to communicate is temporarily or permanently impaired. For the hard of hearing, incoming and outgoing voice amplification can improve telephone calls. Touch screens and graphic interfaces can help those with hearing or vision problems, by using large numbers and icons, voice controls and other innovations.

Computer interfaces can provide social connection and entertainment for long term care patients who might otherwise be isolated. Games can provide mental and physical stimulation and promote fitness.

Electronic health records maintain complete information about patients including their conditions, allergies, medications, needs and preferences, in one place. These systems are designed to reduce medical errors. Electronic medication administration records can be used by staff to document that residents are taking their medications as prescribed.

Long term care staff and caregivers benefit from mobile Internet devices, which provide access to data from anywhere. Because long term care patients often move between hospital, long term care facility, and home care, data sharing can help improve patient care and lower costs.

Telemedicine can improve healthcare by allowing long term care providers to remotely access highly trained clinicians and specialists. Some advantages are the ability to have patient consultations through videoconferencing, the transmission of diagnostic images, and remotely monitoring vital signs.

There are also advances in assistive devices for lifting and transferring patients, bathing, dressing, and wound care, and improvements in mechanical devices such as beds, walkers, and chairs. In the future we will probably see more robotic devices used in care settings.

(more tech innovation for long term care @ forbes.com)

One of the difficulties about creating long term care insurance policies is predicting what long term care recipients will need ten or more years into the future. Increasing lifespan plays a part; also medical trends, advances in treatment, and the health issues that come up with people who are living longer and being active longer. Insurers and caregivers must provide appropriate care while managing costs. Creative innovations in technology will help us meet these challenges.

With a 70% chance of needing long-term care it is likely you will need it at some point. The three ways to pay for care are:
1. Self insure, pay out of pocket.
2. State pays, Medicaid only allows you to have $2,000 in cash assets.
3. Long term care insurance. Insurance is always cheaper than paying yourself. Get long term care insurance quotes from multiple companies.