Over the course of her career, Vera never emphasized private practice feeling it was too isolating in terms of her capacity to effect change.  Above all, she said she stressed the importance of distrusting simple answers and instead dealing with complexity in the area of human behavior.

After the passing of her husband, the nature of her work extended to a broader field as she did international consulting, establishing relationships in Europe.  “I had the great opportunity to meet some extraordinarily gifted people from whom I did learn much,” she said.

According to Vera, her profession was interrupted almost overnight when she lost the capacity to read over two years ago because of a physical change in the structure of her eye. As her eyesight continued to diminish, she found it impossible to operate independently with certain tasks such as money management.  Fortunately, she was connected to Kate Finan of Finan Financial Care, LLC, who has specialized in the daily money management needs of seniors in the area since 1993.

When Kate visits Vera, they consider the priority of items such as paying bills and making donations to charities; reconciling the checkbook; and reviewing and making decisions on how to respond to a fairly large volume of mail.  Vera has also appreciated the focus on her need for legal help as they have established a will and other important documents.  “She has been great in helping me organize the practical aspects of my life under the condition of diminished sight; she acts as an alter ego,” said Vera.

She also said she has found a connection with Kate as far as her capacity to see the complexity of what Vera has to deal with beyond simple solutions.

“In this relationship with Kate, what is paramount is the mutual recognition that the problem is not in a loss of mental capacity but rather in the capacity to deal with practical everyday problems,” said Vera.  “Without her help, I would have been stressed and unable to manage my current life.”

Excerpt from Consumer Guide to Understanding Financial Performance and Reporting enhancing PEOPLE’S LIVES in Continuing Care Retirement Communities. The guide is available free of charge at www.carf.org.

Miscalculating Retirement Needs
It’s important to determine how much money you’ll need to save to retire comfortably and to develop a plan save for retirement. If you miscalculate how much money you’ll need for retirement, you will have to work longer than you planned or figure out how to live on less. When calculating the amount you’ll need for retirement, keep in mind that although you might save money on clothing, commuting, and other costs associated with earning a living, your healthcare expenses may be higher. A general rule of thumb is that you can expect to live on 70 to 80 percent of your pre-retirement income.

Inadequate Insurance Coverage
Health care costs are skyrocketing at the same time when people are living longer than ever before. These are two important reasons to make sure that you have adequate insurance coverage. Having adequate insurance will help you avoid using your savings for unexpected things such as medical expenses or expenses resulting from an accident. Review all your insurance policies including health, home, car and life, regularly to ensure that you have adequate coverage.

Inappropriate Use of Equity
Home equity is the single largest financial asset for older Americans. As seniors age, they may choose to tap into these assets by getting a home equity loan. Others are tricked into using their home equity through home improvement scams. The best uses of a home equity loan are those that improve your financial situation such as debt consolidation, home improvement and education. These are wise uses of home equity because your money is invested in something that grows. Unproductive uses of a home equity are for things that depreciate or do not create an asset such as buying a car or paying for living expenses.

Lack of an Estate Plan
No one wants to think about death but failure to do so could mean that your wishes are not honored. Estate planning addresses how to best preserve your assets after you die. No matter your age, if you own a house and furniture, a car, or have money remaining in a retirement fund, you need to protect it through estate planning. Failure to draft an estate plan will add uncertainty, legal problems, and lengthy delays in distributing your assets when you die. There are several ways you can protect your estate including establishing a will, considering creating a trust, and designating powers of attorney to a trusted source.

Falling Prey to Scams
Seniors are particularly vulnerable to scam artists. Successful con artists sound and look extremely professional, credible and respectable. Don’t allow yourself to become a victim because you don’t want to appear rude. Always investigate strangers who have deals that seem too good to be true and beware of anyone who suggests putting your money into something you do not understand.

2) What are the co-pays? Familiarize yourself with your insurance co-pays for managed care. Co-pays can range from $25 – $125 per day and are your responsibility from day one of admissions. If Medicare is your primary insurance, it will typically cover 100% of the skilled nursing stay for the first 20 days of care. After that you will be responsible for the federally mandated co-pay of $128 (for 2008). There are secondary insurances that can be purchased to cover the $128 co-pay through Blue Cross, AARP, and other private insurance carriers.

3) Can I benefit from medical assistance? Services exist for those who are financially burdened and do not have medical insurance or cannot afford to pay the required co-pays. You can apply for medical assistance; however, it is not an automatic approval process. You must first apply, and to be eligible you must meet your specific financial criteria, including a 5-year history of your financial income and assets. You will be required to receive care in a medical assistance building or care may be administered in the home by a medical assistance provider.

4) Short term vs. long term care. am I covered? If the care you need is classified as short term, such as physical therapy needed to regain mobility, then short term insurance will cover the majority of the costs occurred. However, if the care you need is considered long term, then you are responsible for the costs occurred. Options for covering long term care costs include 1) paying privately, 2) long term care insurance, 3) medical assistance.

5) What is respite care and should I consider it? If your caregiver is temporarily unable to provide the care you need, you may want to consider respite care to ensure you still receive the assistance you require. If you are considering respite care in a skilled nursing facility or assisted living facility, the costs you incur will be your responsibility, unless you have long term care insurance. There may be federal and/or state programs that offer financial assistance, and will vary on the type of agency and services needed.

Michelle Russo is an Administrator at Harlee Manor located in Springfield, PA.

The executor will petition the court to make an order to distribute your estate. During the probate of your estate, the executor has the duty to account for the financial transactions of the estate and to keep the court and the beneficiaries informed as to the progress of the estate administration. After the court issues the order for distribution, the executor will distribute your estate pursuant to the terms of the order that incorporates the asset disposition provisions of your will.

A will does not have to nominate an executor to be valid. However, nomination in your will of the executor permits you to select the executor and to determine whether the executor should be bonded or not.

Carefully select your executor. Too many people feel that the job is merely honorary and that competence is a secondary consideration. Nothing could be further from the truth. A good executor will make the difference between an estate that is handled efficiently and expeditiously versus an estate that will get mired in eventual litigation and losses. A good executor is one who keeps detailed financial records, is not a procrastinator, and can make difficult decisions. Although the executor will most likely hire a lawyer for assistance, the responsibility begins and ends with the executor.

Excerpt from The Weekend Estate Planning Kit: The Fast and Simple Way to Maximize Assets, Minimize Taxes and Protect Loved Ones by Douglas E. Godbe, Attorney at Law.

MOST IMPORTANT: Because you may not collect for decades to come, be sure to buy from a company that has been around for some time and is financially stable. You may want to look up, from an independent rating agency, the financial strength ratings of a company you’re considering.

GENERAL GUIDELINE: Keep the premium for your long-term care insurance policy to seven percent of your income, or less. For example, if your monthly income is $4,000, the long-term care insurance premium should not be more than $280 per month. (This is what the National Association of Insurance Commissioners recommends in its Model Regulation for Long-Term Care Insurance.) Another expert advises that the income to use in this calculation isn’t your current income, but your expected income in retirement, since that’s the income from which you’ll be paying premiums for most of the policy’s existence.

Other ways of saving:
1. Find out if long-term care benefits are available through a group policy from your employer. Employers might subsidize the cost, lowering what you must pay.

2. Check whether you can add long-term care benefits as a rider on an existing life insurance or annuity policy. These “combination” arrangements can save because the insurance company gains operational savings that it can pass along to you.

3. Buy a policy with the longest waiting period you can afford. For example, choosing a 90-day period instead of a 30-day period can cut the premium by 30%. However, if you do need long-term care services, you should save some money to pay these costs until the waiting period ends.

4. If both spouses of a married couple are considering buying long-term care policies, look into buying one joint policy for both of you. Such a policy pays when either one needs care and can pay for both, if necessary, up to its benefit limits.

5. If you’re still looking to trim the premium further, consider buying a policy that will pay most, but not all, of the average nursing home costs in your area. For example, if a nursing home room now costs $120 per day, buy a policy that pays $100 per day. However, be sure to buy an inflation-protection provision.

6. Check with several companies and agents, comparing both benefits and costs. As with other types of insurance (and many other purchases), comparison shopping can save you money. Just be sure you’re comparing policies with similar provisions and companies with comparable financial strength and service records.

Reprinted with Permission from the Insurance Information Institute, Inc. Visit http://www.iii.org/ for more information.

On several occasions, executors have walked into a decedent’s house with no idea of where to find bank statements, life insurance policies or settlement statements just to name a few. Instead, he/she has found a house packed with drawers and file cabinets full of papers.

That means countless hours have to be spent searching. The job of an executor is an exhausting one. Add to that the grief and stress loved ones are feeling.

Think to yourself: Does your executor know where to find your Will and Trust documents? Have you destroyed outdated Trusts so that only your most recent documents are in your files?

Far too often, the executor walks into the decedent’s house with no idea where to find the most important records.

Laurie Siegel, CPA, P.C. developed a personal information organizer designed to help her clients organize their financial records and estate planning documents. As a result, everything the client and executor need is in one location.

“On more than one occasion, the process of organizing financial records has helped save hundreds of thousands of dollars that would have been paid in estate taxes,” she said. “Clients have realized that they had trusts but the trusts were not funded properly.”

Using the organizer has given clients and heirs peace of mind while minimizing loss and delay in settling the estate by ensuring that all assets are properly accounted for.

According to Laurie, the organizer does the following:

-Leaves a way for your heirs to honor your wishes, providing a smoother transition during a time that is very stressful.

-Prevents misunderstanding and minimizes conflict among beneficiaries by documenting asset locations as well as client wishes that are to be carried out.

-Provides a complete overview of the client’s financial picture for the financial or legal adviser to review and evaluate.

Imagine it this way: When you die, someone else must immediately step in and take over every detail of your life from every magazine subscription, credit card payment and telephone bill. This is in addition to the very important role of carrying out your wishes.

The job is huge, more than anyone imagines, said Laurie. When estate matters finally wind down, the executor is worn down too.

“Just when we are about finished, another asset pops up, maybe a small one, such as a bank account no one knew about, or maybe a newly-discovered stock certificate hidden away in the bottom file cabinet drawer,” she said.

The executor feels that the job is never ending and the time required is immense.

Having an organizer or a specified location for your documents can not only benefit the executor, but can help your heirs in what is a saddening and stressful time.

Born in Montgomery County, Hilda grew up during the Depression, during which her family often changed locations. Throughout her husband’s 42 years with the Norfolk and Western Railroad, their family experienced setbacks with company layoffs and strikes, leading Hilda to work part time in retail customer service to help with finances. When her husband passed away in 1973, she worked even harder to support her two children.

But her strong and self-reliant attitude could not stop her eldest daughter from assisting Hilda in one of her most important life changes. When it was decided that Linda’s mother would be moving to an assisted living home, her house of 55 years needed to be sold.

“It was very hard for her to leave her home, but it is the best thing that could have happened at this point in her life,” said Linda, “And if not for ElderLife Financial Services, it would have been much harder for me to make it happen.”

While Linda needed help getting the house ready to sell, she wanted to make sure her mom would be taken care of. When she and her husband visited Loyalton of Roanoke to complete the paperwork for her mother’s admission, they were referred to ElderLife. Linda found it was exactly what she needed to tide her family over until the house was ready.

“I did not know that such a service was even available,” said Linda, who had taken on the full responsibility of caring for her mother and assumed the role as her Power of Attorney. Aside from the stress of this responsibility, Linda was also an administrative assistant at a local church and has two grown children.

“ElderLife’s services are wonderful for folks who are going through the trauma of moving a parent into assisted living and trying to make sure they will be financially secure while getting everything settled.”

For Linda, the process turned out to be quite simple. She corresponded with Farrell Didio, the director of Family Relations, over the phone and internet.

“Farrell was always willing to listen as I tried to figure things out and was always there if I had any concerns or questions,” she said.

According to Linda, the staff made sure that payments were made to Loyalton on time and she never felt any pressure in terms of when the house would be sold.

“In fact, I was told that if necessary, I could extend the time of the loan if the house didn’t sell in the allotted time,” she said, “Much to our delight, we put the house on the market and it sold in less than a week.”

Although she no longer needs assistance from ElderLife, Linda said Farrell has called many times to check in and see how her mother is doing.

“Not only are they helpful, but they are also very efficient and trustworthy,” she said, “They have a real compassion for the elderly, their families and what it takes to do all of the things that need to be done.”

To this day, Linda recommends this service to others, as she feels it is extremely necessary for those who do not have a lot of money and depend on the sale of their homes as a means for entering a facility.

“I am just very thankful for them,” she said.

In the case of Edward Fitzpatrick, a very special friend was the one who stepped up to handle his medical and financial affairs when he was diagnosed with cancer.

“This man was virtually an adopted uncle to me,” said Mary Langmead, Edward’s caretaker and the daughter of his best friend. “He was closer to our family than a bunch of blood relatives – I’ve never known my life without him.”

After her own parents became unable to care for their friend “Uncle Fitz”, as he was known among their family, Mary sought the services of Ivory House Elder Care Experts Inc., a geriatric care service in Baltimore.

Edward was having trouble walking as a result of prostate cancer that had metastasized throughout his body, attacking his bones and giving him tumors that caused immobility. Yet, he was determined not to leave his home, said Mary.

After one of his doctors recommended Ivory House, they started slow, bringing in nurses three days a week. Eventually he required round-the-clock care, and from that point the Ivory House staff took over everything.

“I basically turned over orchestrating the doctor’s appointments, because it all got to be so much,” Mary said. “I couldn’t move him in my car anymore, and we needed two people to move him and bathe him.”

Keeping up with the medical terminology and scheduling appointments also became a challenge for Mary. Melanie, a nurse with the Ivory House, acted as a liaison to the medical community on behalf of Edward.

“Her agency picked up prescriptions, which changed so often I would have been running constantly,” Mary said. “When she called the doctors, they would get back to her right away and she was actually communicating with them.”

The WWII veteran who fought in the Battle of Normandy had been an asset to the community until his death at age 84. He was active in community associations and church, and was very close to his neighbors. At times, Mary admitted he could be rather stubborn-a trait perhaps attributed to his fierce independence and strong opinions.

“If there was somebody he didn’t get along with, they’d have somebody different the very next day,” she said, with a laugh. “If it didn’t work out for some reason, it seemed like they had an endless supply.”

However, Edward did have a soft side, which drew colleagues and lady friends to him until the very end.

“He was very into his Irish heritage, had a shamrock on his mailbox and everything. The Irish community loved him,” Mary said.

While not related by blood, Mary said she would have accepted nothing less than stellar care for her Uncle Fitz.

“He didn’t have to leave his home, that was his wish until the very end,” she said. “You can’t put a dollar sign on that.”

According to a study conducted by Harris Interactive, 37% of Americans aged 62-75 ranked fear of fraud ahead of concern for health crises and terrorism. An estimated five to ten percent of all health care expenses are due to health care fraud. Medicare alone lost more than $16 billion to fraud, abuse, and errors in 2004.

Health care fraud is an intentional deception which often results in an unauthorized Medicare or Medicaid benefit. Providers engaging in fraud will frequently bill for services or supplies that are not provided.

Any practice that is inconsistent with sound medical or business practices is considered abuse. Charging excessive amounts for services, filing claims for unnecessary services, or billing improperly are all incidents of abuse.

SMP is combating these abuses by enlisting the assistance of trained volunteers to work with beneficiaries to prevent, discover, and end fraud. The heart of the SMP program is education. Beneficiaries receive essential information about the prevalence of fraud and abuse and how to stop it.

Nationwide, SMP has over 45,000 trained volunteers and counselors. The program has already reached more than 1.8 million seniors in their communities and has played a role in the recovery or savings of over $103 million.

On the local level, the Virginia Association of Area Agencies on Aging (V4A) administers the SMP program. The association spearheads state-wide SMP outreach initiatives and utilizes the network of 24 Area Agencies on Aging to distribute educational information throughout the state. During a six month period in 2005, the V4A held over 370 educational events throughout the state, reaching nearly 15,000 beneficiaries.

This important effort not only helps seniors avoid losing money or benefits, but it also helps them to avoid the potential illnesses, injuries, and frustrations that can result from working with dishonest providers or utilizing bad equipment. In order to spot fraud and abuse before it occurs, consumers must be vigilant and informed.

Knowing what to look for and how to report suspected violations is the first step toward ending the abuses that are damaging our health care system. Informed consumers are a powerful defense against unnecessary spending and unscrupulous providers.

Medicare or Medicaid beneficiaries who suspect that they have been the victim of fraud or abuse should call 1-800-938-8885 (in Virginia only).