By Ruth Ratzlaff, Esq.
NAELA News Editor in Chief Ruth Ratzlaff attended the Summit and reviewed two of the sessions she attended.
Signs and Symptoms That Client Finances Are Off Track
Sheri Samotin, a member of the Board of Directors of American Association of Daily Money Managers (a Summit exhibitor— www.aadmm.com) did an excellent presentation on Signs and Symptoms That Client Finances Are Off Track.
Symptoms include piled-up mail, uncashed checks, lost checks, unpaid bills, bills paid twice, late fees, new credit cards, new debt.
Many operators target consumers and ramp up the pressure when the consumer shows vulnerability. Solicitation for donations increase in frequency when the first donation is sent. Magazine and newsletter subscription offers and renewal notices come ever more frequently once the consumer shows interest.
The speaker pointed out that financial incapacity shows before other types of incapacity surface. Free financial capacity assessment tools are available at www.OlderAdultNestEgg.com.
Seventy percent of individual financial abusers of older adults are relatives. Thirty percent are “roofers,” i.e., purported tradespeople working the neighborhood looking for repair work to do (incompetently, incompletely) and looking for names/addresses to pass on to other purported tradespeople.
Daily money managers take a holistic view of the client’s situation. Bookkeepers, in contrast, may collect mail and pay bills as submitted, but do not necessarily negotiate with creditors, cancel excess magazine subscriptions, budget donations, organize records for tax preparation, etc. Some daily money managers may also serve as fiduciaries or representative payees.
The American Association of Daily Money Managers is a national membership organization representing individuals and businesses in the growing profession of daily money management. These professionals provide essential financial services to seniors and older adults, people with disabilities, busy professionals, high net worth individuals, small business owners, and others. A daily money manager (DMM) brings clarity and order to an individual’s daily management of personal bills, budgets and record keeping.
Yikes! I’m an Agent — Now What Do I Do?
Susan Tolle, MD, and Judith Grimaldi, CELA, CAP, helped us learn how to counsel health care agents who may be overwhelmed by their duties.
They suggested that it might be helpful to have a HIPAA release as a separate document from a Health Care Proxy (or whatever it’s called in your state). The HIPAA release would help with health care bill-paying questions and insurance claim processing without the vendor learning about what choices the patient had made about health care options.
The Bazelon Center for Mental Health Law has developed a template for a mental health advance directive for states that do not have explicit forms. (http://www.bazelon.org/our-work/mental-health-systems/advance-directives/)
A principal may revoke an advance health care directive even after mental capacity is lost under a statutory provision in Oregon law, where Dr. Tolle practices.
Dr. Tolle advised us to counsel health care agents that medicine has two roles: extend life and relieve suffering. The life of a patient with advanced dementia is not extended with a feeding tube. The rate of death by pneumonia is the same with or without a feeding tube. Saliva is not swallowed and drains into the lungs causing pneumonia.
Hydration without nutrition results in skin breakdown, bedsores, and the need for restraints due to patient discomfort.
There are a number of tools that can be used to identify the wishes of the patient. The ABA Commission on Law and Aging Toolkit for Health Care Advance Planning (http://ambar.org/agingtoolkit), the Conversation Starter Kit (www.conversationstarter.org), Five Wishes (www.agingwithdignity.org), and the CTO Wish Game, from Coda Alliance (http://codaalliance.org/go-wish/).
The speakers admonished that good elder law attorneys need to do more than simply provide clients with documents.