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The Ultimate Role Reversal

By HYMAN G. DARLING, Esq.

Hyman G. Darling

Hyman G. Darling

One of the most challenging aspects of aging can be the role reversal that often occurs as aging parents need care from their adult children.

This dynamic can be very unsettling for all involved; it is difficult for some parents to admit they need help, and then to accept that help, and it is difficult for some children to provide the care and support an elderly parent may require. Where possible, it is always best to address these situations as a family group, and as far in advance as possible.

If you see a situation arising in which your parent will need care, you should begin planning to assess their needs and wants. If a parent has multiple children, this planning should include them all. Sadly, siblings often perceive each other as taking advantage of parents for financial gain. Even more sadly, some children do indeed take financial advantage of elders. A family group working together can benefit both parents and children, with the hope that the joys and hardships of caring for parents will be shared between siblings.

Seeking Help

It is often a good idea to enlist the services of a geriatric care manager. These professionals generally possess a wealth of information about available services and programs, and can provide support to elders and children alike. A care manager can also assist with admission to an assisted-living or nursing facility, if and when that becomes necessary. They will have ideas and strategies to share about every aspect of elder care, from financial considerations to mental health resources; from medication management to respite for caregivers.

The plan must focus on parents’ needs. These will almost always include transportation, medical care, dietary needs, hygiene, assistance with finances or record keeping, and household duties. The plan should also include possible avenues to recognize and adapt to parents’ changing needs, because medical issues may increase, and additional services may become required. Some ideas or services that families find helpful include adult day-care facilities, permanent or temporary institutionalization, or perhaps even moving parents between siblings.

The needs of parents, however, are not the only consideration. Children caring for aging parents may become depressed or overwhelmed, so any well-thought-out care plan must also include support for caregivers.

These caregivers often need counseling, particularly those caring for a parent with dementia, which comes with its own unique set of demands and challenges. There are many counselors and support groups that can help caregivers realize they are not alone, help to deal with ongoing or changing issues at home, and preserve their own mental and physical health. Additionally, paid home care may be a good supplement to care from family members, when the primary caregivers need respite.

Financial Matters

Financial planning is also a crucially important part of the considerations. Often, caregiver children may need to use the Family Medical Leave Act to take a leave of absence from employment. Some may even stop working in order to stay home and provide care for the aging parent. The family may wish to meet with an attorney and draw up a written agreement where parents will financially compensate children for care. These ‘parental-care agreements’ can be an important tool to use when an elder is staying at home.

Finally, be ready to recognize that in-home care from children may not be possible or appropriate for every family. In some cases, it is simply not possible to avoid a nursing home. This may be due to financial considerations, extensive care needs that a child cannot provide, or some combination thereof. Institutionalization in a nursing home is generally quite expensive, and can cost upwards of $10,000 per month in some cases.

It is heartbreaking to realize that a lifetime of savings may be wiped out by long-term-care expenses. There are, however, strategies that families may use to cope with the expense.

Faced with a health crisis and the possibility of nursing-home care, many families are tempted to transfer money from parents to children as soon as illness strikes. Such a transfer is not an effective way of securing family assets. In many cases, any transfer of funds from the elder will commence a five-year waiting period for federal and/or state long-term-care benefits. With very rare exceptions, this five-year waiting period applies to all elders who have made a transfer, regardless of the value of the gift or the intention behind it.

Long-term-care insurance is becoming more and more appealing as a means to protect assets in the event of institutionalization. Generally, this insurance may be used to cover or defer the cost of a nursing-home, or even to pay for in-home care. Some insurance companies may even combine life insurance, annuity, and long-term-care benefits within a single policy.

Those considering purchasing a long-term-care insurance policy should consider all the risks and benefits. Those will be determined by income, ability to pay premiums, and the value of other assets that the family wishes to preserve. The need for long-term-care insurance has become so prevalent that it should likely be considered a ‘required’ policy, similar to life, homeowner’s, and disability insurance. It is very important to have a trusted agent review elders’ financial situation carefully to ensure the proper amount of insurance coverage is purchased. A policy with at least five years of coverage may make it possible for elders to gift away some assets upon entering a nursing home.

Their care would then be covered by the insurance policy for the next five years, and upon termination of that insurance coverage, the elders will then potentially qualify for Medicaid. This type of planning must be done very carefully, preferably with the advice of a trusted elder-law attorney possessing specific knowledge and experience.

Plan Ahead

If you foresee a situation arising in which your parent will need your care, begin planning as soon as possible to assess the needs of all parties, hopefully before a crisis demands immediate action. This will bring peace of mind to you and your parents, and will assure the best possible chance of successful planning, health, and happiness for parents and children alike.

Attorney Hyman Darling is chair of Bacon Wilson’s Estate Planning and Elder Law departments. His areas of expertise include all areas of estate planning, probate, and elder law. He is a frequent lecturer on various estate-planning and elder-law topics at the local and national levels; (413) 781-0560; [email protected]

Departments People on the Move

Insurance Center of New England (ICNE), one of the largest privately owned independent insurance agencies in the Northeast, has announced the appointment of four new staff members:
Marie Rosema has been named marketing coordinator. She earned her master’s degree in marketing management and holds a bachelor’s degree in graphic design and marketing;
David Farwell has been named account manager in ICNE’s Small Business Unit. He is a certified commercial lines coverage specialist and holds a bachelor’s degree in criminal justice;
Mary Leveille has been named benefits administrator. She holds a bachelor’s degree in health science; and
Colleen Caban has been named personal lines account manager. She is a licensed insurance broker for personal lines.
“As an independent insurance agency, we put the needs of individuals, families and businesses first,” said William Trudeau, president and CEO of Insurance Center of New England. “We are independent agents for more than two dozen insurance carriers, but we represent our customers, working as their advocate and advisor in the often-complex world of insurance. We are proud to add Marie, Dave, Mary, and Colleen to our staff to continue our commitment to putting customer needs first.” ICNE is headquartered in Agawam and has six other locations throughout the state.

•••••

University Products Inc. (UPI), manufacturer and distributor of archival quality storage products for museums, libraries, and archives worldwide, announced the realignment of its management team:

John Adamson

John Adamson

Bob Boydston

Bob Boydston

• Chief Financial Officer John Adamson, who joined UPI in 1995 and has worked in sales and marketing, human resources, and accounting, has been appointed president of the company and will be charged with coordinating and implementing the future direction of the company;
• Company founder David Magoon will continue as chairman of the board;
Scott Magoon will continue as CEO; and
Bob Boydston, who joined the company in 1976, will remain as senior vice president and is also chief operating officer of the corporation.
University Products is a privately owned business and manufacturer and distributor of archival quality materials. Museums, libraries, historical societies, archives, and similar institutions are among the company’s worldwide clients. UPI offers products for conservation, restoration, and preservation of books, photos, documents, collectibles, textiles, artwork, artifacts, and natural-history specimens.  University Products is also the manufacturer of Lineco brands, sold and distributed worldwide by art and framing retailers.

•••••

The Naismith Memorial Basketball Hall of Fame announced that John Ritenour, chairman of Insurance Office of America (IOA), has been unanimously elected to the Hall’s board of trustees. He will serve as one of 33 members, beginning a three-year term immediately. “It is an honor to be named to the board of trustees and to represent the Naismith Memorial Basketball Hall of Fame,” Ritenour said. “I look forward to working with the highly talented and prestigious group that guides the Hall, including many legends of the sport and the outstanding roster of civic and business leaders, such as Chairman Jerry Colangelo and President and CEO John Doleva and his accomplished staff.” Ritenour and his wife, Valli, founded Insurance Office of America in Florida in 1988 with a vision to have an organization that gave ownership to its sales associates. The company now boasts more than 225 sales partners and more than 600 employees who claim ownership. IOA has grown from $188,000 in revenue the first year to more than $120 million today. “The Basketball Hall of Fame has had a tremendous relationship with IOA for a number of years,” said Doleva. “As a well-respected businessman, philanthropist, and fan of the game, John Ritenour will be an excellent addition to our board of trustees.” The trustees are responsible for preserving the fundamental mission and financial well-being of the Basketball Hall of Fame. They serve as ambassadors for the Hall, promoting its core mission, which is to celebrate the greatest moments and people in basketball. Made up of individuals that work in or have worked in the game, as well as business leaders that have supported the game, the board also elects all governors of the Hall.

•••••

First Connecticut Bancorp Inc., the publicly owned holding company of Farmington Bank, announced the election of John Green to the respective boards of directors of the corporation and the bank. “John’s extensive experience as both a leader of a successful, multi-generational family business and a tireless volunteer for many nonprofit organizations makes him a wonderful addition to our boards of directors,” said John Patrick Jr., chairman of the board of directors of First Connecticut Bancorp and chairman, president, and CEO of Farmington Bank. “In addition, John’s leadership of a successful retail business in today’s changing retail climate will be a valuable asset in the boardroom as we continue Farmington Bank’s organic growth strategy.” Green graduated from Boston College in 1978 and from the Gemological Institute of America in 1979. He earned the titles of registered jeweler and certified gemologist appraiser with the American Gem Society in 1981. In 1992, he was elected president and CEO of Lux Bond & Green. Today, Lux Bond & Green, established in 1898 by Green’s great-grandfather, has grown to seven locations in Connecticut and Massachusetts with more than 100 employees. Green has served on many nonprofit organizations and leadership positions within the Hartford community, including the Connecticut Historical Society, Old State House, Greater Hartford Convention and Visitors Bureau, Connecticut Science Center, Bushnell Park Foundation, TheaterWorks, Hartford Ballet, Hartford Downtown Council, Young Presidents Organization, Connecticut Business and Industry Assoc., and Connecticut Bank & Trust Co. Currently, he serves as treasurer on the Saint Francis Hospital Foundation and a member of the economic-development committee of the West Hartford Chamber of Commerce.

•••••

Berkshire Hills Bancorp Inc. has appointed Ron MacDonald to the position of senior vice president, corporate auto sales leader. MacDonald joins Berkshire from First Niagara Bank, where he served as first vice president, national sales manager, focused on expanding the indirect auto finance business across the Northeast. He has more than 30 years of experience in the automotive business, including previous roles at TD Bank as the national sales manager for auto finance and various positions within the auto-dealer community. He received his bachelor’s degree from the University of New Hampshire. “I am excited to have Ron join the bank and take on a leadership role in expanding our prime indirect auto unit,” said Sean Gray, executive vice president and head of Retail Banking. “With his extensive auto-lending relationships and experience across New England, he is the right person to expand on the successful platform Berkshire has established in New York. Ron will be leading Berkshire’s indirect team, providing strategic direction to develop and expand relationships throughout our footprint, with a focus on building long-term partnerships and managing the secondary marketing of this product. This is another example of our commitment to ongoing leadership recruitment and revenue diversification, and we look forward to profitable growth from this business line.”

•••••

Mary-Anne DiBlasio

Mary-Anne DiBlasio

Marge Pietras, founder of All About You, LLC, has appointed Mary-Anne DiBlasio chief operating officer of the eight-year-old home-care company. All About You has steadily grown since its inception. “With DiBlasio now as part of the team, we are excited to see the company expand its reach in an ever-growing market where families are keeping their loved ones at home and we, of course, are here to support them in those efforts,” Pietras said. “With her experience recruiting and marketing, we are focused on delivering the confidence of quality care to directly meet the ebb and flow of the market needs.” DiBlasio comes with years of healthcare experience in both elder care and staffing, and Pietras said both will provide value to the company’s mission.

•••••

Michael Ipekdjian

Michael Ipekdjian

Holyoke Medical Center has appointed Michael Ipekdjian as the hospital’s director of Transitional Care/Case Management.
With vast experience in nursing and case management in the community-hospital setting, Ipekdjian will lead HMC’s transitional care and case-management programs. In this role, he will oversee the hospital’s registered nurses and social workers, and communicate with internal and external partners to improve case management and care coordination. “Mike brings the leadership and vision necessary to help HMC achieve the highest levels of patient care,” said Spiros Hatiras, president and CEO of Holyoke Medical Center and Valley Health Systems Inc. “We are confident in his ability to leverage his case-management experience to ensure that patients can access a full scope of community services across the continuum.”
Added Ipekdjian, “joining HMC is a tremendous professional opportunity. I look forward to working with a highly committed team of colleagues to ensure that patients can access complete, comprehensive healthcare and the important community resources that contribute to quality healthcare.” Most recently, Ipekdjian served as case-management supervisor at Mount Nittany Medical Center in State College, Pa, where he coordinated the day-to-day operations of the Case Management department. He managed 21 full-time employees, including case managers and RN nurse navigators/transitional-care nurses. He coordinated with community agencies to facilitate communication and assure continuity of care, and reviewed and developed readmission programs and chronic-disease-management metrics. As that medical center’s MSICU case manager, he planned, coordinated, and facilitated the care and transition of patients through two intensive-care units Ipekdjian is a graduate of Pennsylvania State University, earning both his associate and bachelor’s degrees in nursing. He is pursuing an MBA in healthcare management at Western Governors University and is expected to graduate in 2016.

Daily News

EASTHAMPTON — Marge Pietras, founder of All About You, LLC, has appointed Mary-Anne DiBlasio chief operating officer of the eight-year-old home-care company.

All About You has steadily grown since its inception. “With DiBlasio now as part of the team, we are excited to see the company expand its reach in an ever-growing market where families are keeping their loved ones at home and we, of course, are here to support them in those efforts,” Pietras said. “With her experience recruiting and marketing, we are focused on delivering the confidence of quality care to directly meet the ebb and flow of the market needs.”

DiBlasio comes with years of healthcare experience in both elder care and staffing, and Pietras said both will provide value to the company’s mission.

Business of Aging Sections
Innovative Method Helps Caregivers Engage with Clients with Dementia

Christina Vernon

Christina Vernon shows off just a few of the items she may include in ‘engagement boxes.’

As the over-65 generation is set to dramatically expand, so will the number of Americans suffering from Alzheimer’s disease and other forms of dementia. For those struggling with the cognitive and memory loss associated with these conditions, it’s beneficial to keep their minds active as much as possible. But how? Research by an intern at Homewatch Caregivers into a concept called ‘engagement boxes’ is setting a local standard for helping people with dementia hang on to memory, identity, and quality of life.

Christina Vernon calls it the “beach box.”

Inside are dozens of items that evoke the seashore — a jar of sand, a toy shovel and rake, a plastic bucket, a miniature beach ball, collections of seashells and sea glass, even a CD of beach-themed music.

To the average person, this array might evoke memories of a pleasant day soaking in the sun and the surf. But to someone suffering from dementia, the beach box may be nothing less than a catalyst for recovered memories and identity.

And it’s only one of dozens of such ‘engagement boxes’ that Vernon, a social-work student at Elms College, has carefully assembled for Homewatch Caregivers in West Springfield, where she works part-time, with the goal of focusing the minds of dementia patients through sensory stimulation and memory retention.

“These boxes hold items that trigger memories based on the five senses and promote conversation with people with dementia. It keeps them connected to conversation and lets them enjoy moments where they remember the past,” said Vernon.

For example, one brightly colored box might contain an old pair of white gloves, a child’s book of nursery rhymes, a small tea set, a beaded purse, and a jar of cold cream. “We might begin the activity by asking the client, ‘did you ever have a tea set?’ It may surprise you what your loved one comes out with.”

Sensory activities, she explained, involve many parts of the brain, including emotional, motor, and cognitive areas. They can allow someone with dementia to reawaken personal memories and help maintain the person’s quality of life, increase engagement with loved ones, and improve mood, behavior, and cognitive functions.

The key is to make sure the activities and conversations between caregiver and client are meaningful and individualized for each family.

“Nobody else is doing this, exactly,” said Judy Yaffe, co-owner of Homewatch Caregivers. “They’re very specialized for every client we’re working with. What happens is, we do a client history, get to know them a little more. We find out what they like and don’t like.”

Hence, the beach box would be ideal for a client who used to enjoy the beach or water activities. Other themed boxes contain baby-care items, art supplies, and vintage jewelry and toys — and Vernon often mixes and matches items to create individualized boxes to bring to clients. Caregivers engage the client with the items during visits, and, afterward, complete assessment sheets detailing what worked and what didn’t.

“The point of developing activities through the use of these boxes is to promote cognitive stimulation as an intervention for people with dementia,” Vernon said, noting that the roots of the philosophy can be traced back to 1950s research into ‘reality orientation,’ which was developed in response to confusion and disorientation in older patients in hospital settings.

Sensory exercises like the boxes Vernon maintains at Homewatch are coming more to the forefront in elder care as demographics are trending dramatically older. In short, Americans are living longer than ever before, with the massive Baby Boom generation heading into its golden years, and the number of patients with dementia — and, therefore, demand for services to assist them — are on the rise.

“Unfortunately, Alzheimer’s and dementia are going to increase,” Yaffe said. “We’re looking at a Baby Boomer tsunami.”

Engaging the Past

Engagement with dementia clients takes a variety of forms, Vernon said, showing off a pack of picture cards she uses during visits. She also shared a video of a session with a client in the early stages of dementia. Holding up a picture of stacks of coins,” she asks the client, “what is this?”

“It’s money.”

“Do you have money?”

“No.”

“Where is your money?”

“The children took it.”

“The children took it? How many children? A boy or a girl?”

“Girls. The girls took it.”

“The girls took it. Hmm,” Vernon says, while switching to a card with a picture of a game of jacks. “Did your girls ever like to play with these?”

And so on — each image, each conversation pathway leading to another cue to engage the client. The boxes Vernon has assembled take the concept a step farther, by providing something to touch, feel, hear, even smell, in addition to viewing.

“She did this as a project for her school, an internship she developed,” Yaffe told BusinessWest.

“I was responsible to do a full research project for the company I was interning for,” Vernon said, referring to Homewatch. “Basically, I found myself working with dementia clients. So I decided to do my research on sensory stimulation boxes and memory.”

Judy Yaffe

Judy Yaffe, with a few of Homewatch Caregivers’ dozens of engagement boxes, says matching boxes with clients is a matter of learning their history, likes, and dislikes.

She bought several boxes worth of items on her own to test the concept. “I visited clients daily with boxes and researched what worked and what didn’t work. At the end of 16 weeks, [Homewatch] offered me a position 10 hours a week to create this program and run with it. It’s been very exciting.”

Since then, Yaffe has purchased most of the items for subsequent boxes. They include a collection of vintage toys, like a yo-yo and an original Slinky; to a “baby box” ideal for clients who love children; and a box of clip-on earrings from the ’20s, ’30s, and ’40s, which Vernon brings to a client who loves jewelry. “I made it a game; I ask her to put the pairs together, and then ask if she wants to try them on. It just keeps her active.”

In addition to the boxes, Homewatch has a growing collection of books, DVDs, and CDs of various genres and topics, all aimed at helping clients with dementia keep their minds stimulated.

“The items aren’t always cheap,” Vernon said. “When I go out, I make sure the client has at least three options, and if those don’t work, I go back and find something that does work.”

Sometimes that involves a bit of role playing. “When you’re working with a dementia client, if you’re comfortable entering their world, it really works,” she said.

Yaffe agreed, noting that each client is at a different place in their disease progression and how far back their memories lie. “We’re looking at where they are in their dementia. It could be back to their childhood, could be back to their first job, and that’s where we go. Entering the client’s world, to us, is really important.”

For clients at less-advanced stages, the more hands-on the activity, the better. “One was an avid artist in sculpture, so we bring him books about sculpture,” Vernon said. “We’ve bought sketch pads and watercolor pastels, just things to keep his mind as active as possible.”

It’s all about giving caregivers tools they can work with, Yaffe said. “We’ve developed quite a library here.”

Peace of Mind

While researching the effectiveness of engagement boxes at an assisted-living facility, interviewing five people over a period of weeks, Vernon — who will graduate in May and go on to pursue her master’s degree at Springfield College — came to understand the detrimental effects of an inactive mind.

“When you’re bored, when you’re not doing anything, when a client is sitting idle, their memories are fading faster than when they’re engaged with someone,” she said. “It’s better for the client’s overall well-being to be engaged. It’s great to see people light up, to see people talk about things based on the items we take out. It’s rewarding work.”

Yaffe said eliminating isolation and loneliness are two of the goals of her agency, and the engagement boxes are now a major component of that — not to mention a practice that family members can continue after a professional caregiver has ended a shift.

“Activities bring pleasure to people with Alzheimer’s,” Vernon told BusinessWest. “Keeping people involved in prior hobbies and interests that once gave them pleasure is important. Family members should take a flexible approach that is broad-based. Read the newspaper, look at books, cook, watch family videos — and remember to concentrate on the process of an activity and not the results. Perhaps develop your own engagement box for your loved one. It’s the joy of doing and discovery that can make the difference in their quality of life.”

Many clients don’t have dementia, but do suffer from some memory impairment, and the boxes — which can be checked out and brought back to Homewatch by families — can be effective tools for them as well.

“It’s really great for a family when they see mom or dad remembering something; it really gives the family a sense of purpose, as well as direction,” Vernon said. “We constantly exchange items and find out what’s working, find out what activities are good for a client.

“A lot of it is based on the individual person,” she continued. “I talk to the client and caregiver, spend an hour getting to know them, and after the initial meeting, I have a greater idea of what I can do to enhance their experience.”

Yaffe said Homewatch has long embraced other forms of sensory engagement with clients, especially music, which the Alzheimer’s Assoc. calls one of the main catalysts to recovering memory.

“We do a lot of music with our clients. If they remember something, it’s usually music from their teenage years, and they often remember it word for word,” she said. “It’s all about engaging people in the moment — but that moment can last the rest of the day for some people, and that’s important. It’s an easy activity if you can engage them.”

Added Vernon, “you see people light up when they hear their music. I think that’s an essential thing. That’s why most of our boxes have a CD with it. For the beach box, there’s beach-themed music. For the baby box, it’s lullabyes, softer music.”

Of course, she reiterated, the best boxes are the ones that engage all the senses. “It’s so worth the time and effort to make life better,” she said. “It works. We’ve validated it, and we know that it works.”

Joseph Bednar can be reached at [email protected]

Employment Sections
O’Connell Care at Home Tries to Keep Up with Soaring Demand

Danielle Lord

Danielle Lord says home care is in demand, and so are qualified home-care aides and nurses.

Growing up in Holyoke, Fran O’Connell lived with an extended family, including an elderly aunt and grandfather. In those days, the family took care of each other, in sickness or health; no one had heard of home care.

These days, as owner of O’Connell Care at Home in Holyoke, he helps other families take care of their loved ones at home, away from institutional settings, through a broad range of home-care services, in addition to nurse-staffing services for a variety of clients.

Almost three decades after he launched the enterprise in 1987, O’Connell continues to see steady growth in his business, and explosive growth in the home-care industry — growth that’s being held back only by a national shortage in qualified home health aides. That’s because, as people live longer than they used to, and with their caregivers and children (often one and the same) more aware than ever of the care options available to them, demand for home care and other nursing services is only expected to increase.

“Really, there’s such a need in the community for home care,” said Danielle Lord, the company’s vice president of operations, who essentially runs the company’s day-to-day activity. “As the population of Baby Boomers age, more want to stay at home — or where they’re currently at, maybe assisted or independent living — rather than go to a nursing home.”

Lord came on board in 2007 and has seen significant change since then, including a move to larger quarters on Bobala Road in Holyoke; the company plans to move again this year, from Holyoke to Springfield. In addition, it opened a South Deerfield office last year.

“We opened that office to better serve the Franklin County and northern Hampshire County areas. While doing that, we decided to move our Holyoke office to Springfield to better serve Hampden County and southern Hampshire County,” she explained. “Business has tripled in the last five to seven years. We are really growing; there’s such a need in the community. We still could probably grow more, but home health aides and qualified home healthcare workers are so in demand right now.”

That’s the key issue right now for home-care companies — one O’Connell is addressing through an ambitious array of job fairs, recruitment efforts, and in-house training, all with the goal of keeping more Western Mass. seniors living safely and happily at home.

Fertile Ground

Before starting the firm, Lord said, O’Connell was a nurse practitioner who had taken care of his own grandfather at home. After earning his nursing degree from Columbia University in 1984, he returned to Holyoke and discovered that several of his friends had caught the entrepreneurial bug and were opening their own businesses.

While most nurses worked at specific settings, such as hospitals, he simply incorporated himself and started selling himself as a nurse. “If someone needed a nurse for the day, or someone got out of the hospital and needed a private-duty nurse, I did that,” he explained. “Word got out quickly, and I couldn’t do every shift, so I started bringing in friends, and before long I had 10 people subcontracting for me.”

Someone pointed out that O’Connell was essentially running a temp agency, so he took the next step and employed his fellow nurses, and the business was on its way.

“There weren’t home-care services out there in the ’80s, so it started really as a staffing business, then gradually turned to home care,” Lord said — a shift that began when O’Connell started getting calls from the Holyoke Visiting Nurses Assoc. and other organizations that service seniors.

O’Connell found he loved home care, and went on to earn his master’s degree in nursing in 1996 and was later certified as a family nurse practitioner.

Home care encompasses myriad services, Lord said, from basic household help to medication management to transport to appointments. “Primarily, it’s all your activities of daily living, the things you need to do to stay at home. We do homemaking and meal preparation, help people get up, get dressed, take a shower, toileting, all those sort of things.”

Home-care companies typically offer a wide range of time commitments as well, she added. “It’s everything from two hours once a week to help get someone groceries, to around-the-clock care because someone can’t be left alone, for dementia or hospice, or someone who wanders and can’t be left alone. It’s really such a broad spectrum.”

And it’s not just the client who benefits from home care, she added, but their family as well. “We help people figure out how to stay home, where they want to be, but also support other family members. Especially if the husband or wife is declining, we can help the spouse, help the family around the house, make sure they’re not getting overwhelmed.”

The staffing piece of O’Connell Care at Home — such as its contract work with Highland Valley Elder Services and various VNA organizations — is different in some ways, Lord said. “We’re still doing home care in those situations, but they provide the clients and have care plans already written. If an adult day service needs a nurse, we’ll try to staff a nurse. On [student] field trips, we’ll provide a nurse for the day. If a VNA has somebody on vacation and they have higher census and need home health aide, we’ll provide that. So, yes, we do some staffing, but it’s primarily home care.”

Transportation is another facet of the company’s service. “That’s all private pay — we’ll take somebody to the doctor or a family event on the weekend or around the holidays,” she explained. “We’re very busy with that around Christmas; people call us and ask, ‘can you transport my mother to Christmas dinner and then home?’ We have a wheelchair van for that. It’s a popular service around those times.”

Training Days

In fact, all O’Connell’s services are becoming more popular, which keeps the pressure on to continually add more talent. That’s easier said than done, with Forbes and U.S. News & World Report both listing home-care aide as one of the most in-demand jobs in coming years. Simply put, there aren’t enough bodies to meet the need.

“We recruit all the time, and we frequently have job fairs for people interested in the job,” Lord said. “The need for home health aides hinders our growth. Other companies are dealing with the same thing; they’re all looking for qualified workers. I think that’s across the board. We’re fighting now with hospitals, nursing homes, assisted living, independent living, home care, nursing homes. But we’re willing to train our own people. If someone has an interest, we’ll train them. We want to put the best person out there to care for clients — the kind of people I’d want to take care of my own family.”

The reason strikes at the heart of why home care is so important, she went on. “We want to make sure families feel their loved ones are safe at home. We write a care plan for the people we take care of. We learn what this person likes, doesn’t like, and decide who’s the best person we can send. We try to match their interests and send someone they can form a relationship with. Home care aides can take care of people for years, in many cases. They become a really important part of the family and increase their quality of life.

“We’re not perfect at it,” she was quick to add. “We’re honest with people that the first person you get may not be a perfect match, but we’re going to find you someone you end up clicking with — someone they’ll look forward to seeing each day.”

Lord said O’Connell mainly hires people who have been trained as home health aides or CNAs, “but if there is somebody who has other kinds of experience and thinks this is something they want to do, someone who’s caring and compassionate and really wants to take care of older people — because we primarily do elder care — we can offer some training to get them up and running, to become a home health aide.”

Beyond the basics, though, “we’re looking for someone reliable, with good common sense, someone who’s going to get there in a snowstorm,” she went on. “We want someone really caring who considers the needs of their clients and really wants to take care of them and do what’s best for them. They care about the people they’re taking care of.”

O’Connell says he takes pride in seeing people come work for him as CNAs, then go on to get PN or LPN degrees and return as nurses. He stressed that it’s not an easy job, but as a career path, it can be rewarding and — important for job seekers these days — stable.

Lord agreed, and said families appreciate the stability of a reliable home-care nurse or aide.

“We do a lot of training and have a lot of supervision,” she said. “We meet the family, write a care plan, and try to be really thoughtful. We’re trying to make good matches and keep people where they should be — and improve their quality of life.”

Joseph Bednar can be reached at [email protected]

Departments People on the Move

Robinson Donovan, P.C., announced the promotion of two attorneys to Partner: Jeffrey Trapani, Esq. and Michael Simolo, Esq.

Jeffrey Trapani

Jeffrey Trapani

Mike Simolo

Mike Simolo

Trapani, who joined the firm in 2007, concentrates in civil litigation, including insurance defense, employment law, municipal liability, business litigation, and professional malpractice. He also represents landlords in summary-process actions and housing-discrimination claims, and insurance companies in unfair-settlement claims and coverage issues. “Jeff is highly deserving of this designation,” said Nancy Pelletier, Esq., head of the Litigation Department at Robinson Donovan. “His expertise in civil litigation — both in the courtroom as well as in mediations and arbitrations — is a true asset to our firm.”
Simolo, who joined the firm in 2009 and specializes in corporate and business counseling, estate planning, and litigation, plays a number of roles at Robinson Donovan, including supervising the organized transfer of wealth from clients to their beneficiaries. “Michael has deep knowledge of our shared practice areas and is a constant source of insight,” said Jeffrey Roberts, Esq., managing partner at Robinson Donovan. “He forms great relationships with his clients, getting to know their circumstances and helping them develop the kind of foresight that is beneficial for them in the long run.”
•••••
Monson Savings Bank recently announced three promotions:
Robert Chateauneuf

Robert Chateauneuf

Corinne Sawyer

Corinne Sawyer

Robert Chateauneuf has been promoted to Vice President, Commercial Loan Officer. He joined Monson Savings Bank in 2012 as assistant vice president and is a key member of the bank’s commercial-lending team. He possesses indepth knowledge of the Western Mass. small-business marketplace and is a trusted advisor to business customers. He is a member of the 2014 class of BusinessWest’s 40 Under Forty, and is a graduate of UMass Amherst;
Corinne Sawyer has been promoted to Vice President, Business Development Officer. She joined Monson Savings Bank in 2001 and was promoted to assistant vice president in 2007. She works with the bank’s business customers to optimize cash flow, financial workflow, and efficiency using the bank’s deposit, cash-management, and eBanking products. She serves on the board of directors of the East of the River Five Town Chamber of Commerce and is a graduate of Elms College;
Dodie Carpentier

Dodie Carpentier

Dodie Carpentier has been promoted to Human Resources Officer. She joined Monson Savings Bank in 2006 as assistant branch manager and was promoted to branch manager in 2008. In 2012 she assumed a dual role as branch manager and education coordinator. With her growing interest in training and HR, she obtained certification in Supervision in Banking and Human Resources Management from the Center for Financial Training. She was awarded the position of human resources officer after an extensive search to replace her predecessor, Elaine Grimaldi, who retired last year.
•••••



Matthew Boilard

Matthew Boilard

The local, family-owned-and-operated supplier of building supplies A. Boilard Sons Inc., announced that Matthew Boilard has joined the family business. His appointment as Sales Associate continues a legacy of family leadership, now in its fourth generation. “This company has always been a part of my life, and I look forward to adding my own outside perspective to the business,” he said. “I’m proud to have an opportunity to be part of a family business, and my goals are to grow the business and look for new opportunities to help it succeed.” Boilard is a 2011 graduate of Bentley University, where he earned a bachelor’s degree in corporate finance and accounting.
•••••
Jewish Geriatric Services has named Anne Thomas Vice President of Residential Services and Administrator of the Leavitt Family Jewish Home. Thomas brings more than 25 years of diverse experience in elder healthcare to this position. She will be responsible for the day-to-day management of the Joint Commission-accredited, 200-bed, long-term-care and short-term-rehabilitation facility located in Longmeadow, and will also oversee management at Ruth’s House Assisted Living and Genesis House. Before joining the nursing home, Thomas served as the executive director and administrator of Hebrew Senior Life in Dedham, the largest provider of elder care in the Boston metropolitan area. In this role, she oversaw the day-to-day operations of more than 500 employees and 268 residents and their families, and was responsible for all aspects of financial and clinical outcomes. She also spearheaded the opening of a state-of-the-art healthcare center in the small-house model of care, which honors resident choice and quality of life. Prior to this, Thomas served as vice president/assistant administrator of Schervier Nursing Care Center, a member of the Bon Secours Health Care system, in Riverdale, N.Y.; and director of Chelsea Adult Day Health Care Center in New York City. Thomas is a member of Leading Age Massachusetts, the American College of Nursing Home Administrators, and the Assoc. of Health Care Executives. She holds a master’s degree in social work from Hunter College in New York, and a bachelor’s degree in social work from Providence College in Rhode Island. She is licensed as a nursing-home administrator and social worker, and is certified as a yoga instructor.
•••••
Dr. Holly Michaelson

Dr. Holly Michaelson

Dr. Holly Michaelson of Cooley Dickinson Medical Group General Surgical Care was among 1,640 initiates from around the world who recently became fellows of the American College of Surgeons (FACS). Michaelson received a medical doctorate from Temple University Medical School and completed a general surgical residency at Drexel University College of Medicine. She earned board certification from the American Board of Surgery in 2005, and is the director of minimally invasive and robotic surgery at Cooley Dickinson Hospital. Michaelson has a strong professional interest in advanced minimally invasive procedures, particularly surgeries of the colon and gastrointestinal tract as well as breast surgery. She holds membership in the Alpha Omega Alpha Honor Medical Society. The American College of Surgeons honored new initiates during its convocation ceremony at the college’s 2014 annual Clinical Congress in San Francisco. By meeting the college’s stringent membership requirements, fellows of the college earn the right to use the designation FACS (Fellow, American College of Surgeons) after their names. An applicant for fellowship must be a graduate of an approved medical school; must have completed advanced training in one of the 14 surgical specialties recognized by the college; must possess certification by an American surgical specialty board or its Canadian equivalent; and must have been in practice for at least one year at the time of his or her application. Before admission into fellowship, the surgeon must further demonstrate ethical fitness and professional proficiency, and his or her acceptance as a fellow of the college must be approved by three-fourths of its board of regents. The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and to improve the quality of care for the surgical patient.
•••••
The Gray House inducted Teresa Spaziani to a three-year term on its board of directors at its January board meeting. Also elected were four new officers for one-year terms:
Michael Walsh, President;
David Chase, Vice President;
Paul Mitus, Treasurer; and
Candace Pereira, Secretary.
Spaziani is a quality-assurance manager at the Children’s Study Home in Springfield. She has held that position since February 2014. Previously, she was its community relations and outreach manager. Spaziani holds a bachelor’s degree in business administration from Western New England University, graduating magna cum laude in 2012. Walsh was the current board president and was re-elected for another one-year term. He is an adjunct instructor in Political Science at Westfield State University and a consultant and legal advisor at MIRA Associates. Chase has more than 20 years of banking experience. He is a vice president and commercial lender at Hampden Bank in Springfield. Mitus previously served as vice president. He has 25 years of banking experience and is currently a portfolio manager at Hampden Bank. Pereira has more than 10 years of banking experience. She is a commercial-portfolio loan officer for Farmington Bank in West Springfield. The Gray House is a small, neighborhood human-service agency located at 22 Sheldon St. in the North End of Springfield. Its mission is to help neighbors facing hardships to meet their immediate and transitional needs by providing food, clothing, and educational services in a safe, positive environment.
•••••
The American Assoc. of Community Colleges has selected HCC professor emerita, alumna, and major donor Elaine Marieb for its 2015 Outstanding Alumni awards. Marieb taught anatomy and physiology at Holyoke Community College for 25 years after receiving her Ph.D. in zoology from UMass. While teaching, she enrolled in HCC’s Registered Nursing program, earning her associate degree. Her teaching and education led her to write a series of anatomy and physiology textbooks that have gone on to become international bestsellers. Last year, Marieb donated $1 million toward HCC’s Building Healthy Communities fund-raising campaign, which is supporting two building projects at the college, a new Center for Health Education on Jarvis Avenue, and the Center for Life Sciences on campus. The AACC award recognizes community-college alumni for their career achievements, philanthropic contributions, and inspirational impact.

Daily News

LONGMEADOW — Jewish Geriatric Services has named Anne Thomas vice president of Residential Services and Administrator of the Leavitt Family Jewish Home.

Thomas brings more than 25 years of diverse experience in elder healthcare to this position. She will be responsible for the day-to-day management of the Joint Commission-accredited, 200-bed, long-term-care and short-term-rehabilitation facility located in Longmeadow, and will also oversee management at Ruth’s House Assisted Living and Genesis House.

Before joining the nursing home, Thomas served as the executive director and administrator of Hebrew Senior Life in Dedham, the largest provider of elder care in the Boston metropolitan area. In this role, she oversaw the day-to-day operations of more than 500 employees and 268 residents and their families, and was responsible for all aspects of financial and clinical outcomes. She also spearheaded the opening of a state-of-the-art healthcare center in the small-house model of care, which honors resident choice and quality of life.

Prior to this, Thomas served as vice president/assistant administrator of Schervier Nursing Care Center, a member of the Bon Secours Health Care system, in Riverdale, N.Y.; and director of Chelsea Adult Day Health Care Center in New York City.

“Anne brings to Jewish Geriatric Services a wealth of administrative and clinical experience across a full spectrum of elder-care services,” said Martin Baicker, president and CEO of JGS. “Her experience in implementing innovative, person-centered care will be invaluable as we expand and enhance services through Project Transformation, our program to bring the small-house model of care here.”

Thomas is a member of Leading Age Massachusetts, the American College of Nursing Home Administrators, and the Assoc. of Health Care Executives. She holds a master’s degree in social work from Hunter College in New York, and a bachelor’s degree in social work from Providence College in Rhode Island. She is licensed as a nursing-home administrator and social worker, and is certified as a yoga instructor.

DBA Certificates Departments

The following Business Certificates and Trade Names were issued or renewed during the month of December 2014.

AGAWAM

Alpha Nine
23 Losito Lane
Daniel Renaud

Bessette Hardscapes
76 Pheasant Run Circle
Gene R. Bessette

Best CPR Certifications
313 Springfield St.
Thomas Devine

C. Trimboli Landscaping
49 Center St.
Cosmo Trimboli

M. Perry Appraisal Services
57 Hunting Lane
Michael Perry

CHICOPEE

Boutin Rental Properties
726 Chicopee St.
Robert Boutin

Northeast Industrial Diesel
63 Dorrance St.
William Heyn

Santana’s Kung Fu Studio
4 Center St.
Maria Santana

GREENFIELD

Aromatic Fillers
127 Leyden Road
Todd Green

Art’s Tire Inc.
10 Silver St.
James LaFleur

Greenfield Garden Cinemas
361 Main St.
George Gohl

Novelli Computer Consulting
25 Pine St.
Thomas Novelli

Padula Brothers Inc.
191 Shelburne Road
Caroline Mansfield

Pristine Orientals
16 Butternut St.
William Noyes

HOLYOKE

Best Buy Mobile
50 Holyoke St.
Todd G. Hartman

Herrera Auto Sales
395 Maple St.
Jose Herrera

Holly’s Nail
2257 Northampton St.
Loan Tran

Jay’s Auto Repair
170 Main St.
Jesus Vargas

Jiordany’s Grocery
301 High St.
Veronica Roman

MC Transportation
219 Elm St.
Manuel Contin

Sam’s Quality Motors
170 Main St.
Samuel Rosa

Twin Stop
625 Homestead Ave.
Rajendra I. Swadia

LUDLOW

C.O.P. Transportation
270 West St.
Frank Arduino

Purely Caribbean Sunless Tanning
271 East St.
Katie Schebel

Studio Dic
48 Pine St.
Denise L. Catrogno

The Luxy
200 Center St.
Lisa Tereso

PALMER

Griswold Glass & Aluminum
1184 Park St.
Jeffrey Griswold

Lasting Impressions
1552 North Main St.
Mark Corbett

Walnut Street Café
8 Walnut St.
Doris Theodore

SOUTHWICK

Athena’s by Bev
25 Gillette Ave.
Beverly Labombard

Cote Property Maintenance
68 Granville Road
David Cote

Extreme Custom Embroidery
25 Gillette Ave.
Beverly Labombard

Helping Hands Elder Care
268 Feeding Hills Road
James Bouley

J & R Consulting
8 Pearl Brook Road
Janet Brodalski

Jimmy’s Pizza, LLC
81 Point Grove Road
Travis Softic

New England Peddler
23 Feeding Hills Road
Michael Albro

Tastefully Tan
610 College Highway
Angela Rivera

Whalley Precision Inc.
28 Hudson Dr.
John Whalley

SPRINGFIELD

ABC Supply Company
270 Rocus St.
American Builders

Acacio M. Serranzina
88 Enfield St.
Acacio M. Serranzina

Admiral Building Products
75 Page Blvd.
Todd Buehl

AsapcompuTerracenet
414 Walnut St.
Aaron Blanine

Asian Bazaar
607 Dickinson St.
Yasmin Siddiqui

Asian Market
19 Pomona St.
Truong Nguyen

Atwater Associates
140 Atwater Terrace
Carmen Rosa

B & R Leasing, Inc.
622 Cottage St.
Faramarz Bahrehmand

BMT Lock and Key
306 Hermitage Dr.
Walter Kulas

Bradco Supply
270 Rocus St.
American Builders

BTJ Transport
37 Newport St.
Traceyann Anderson

Cabo Fashion and Footwear
795 Liberty St.
Edwin Acevedo

Fara Leasing, Inc.
622 Cottage St.
Faramarz Bahrehmand

Felix Auto Sales
237 Dickinson St.
John DeCesare

WESTFIELD

Angela’s Hair Salon
78 Franklin St.
Yevgeniya Gnidenko

Bee Tree Acres
67 Old Quarry Road
Bee Tree Acres

CJ’s Electronic Cigarettes
26 North Elm St.
Round of Nine Inc.

Granddaddy Frank’s Barbeque
57 Katherine St.
Claude G. Stanley Jr.

Meadowbrook Antiques
658 Montgomery Road
Timothy J. Crane

Pat’s Platoon
350 Elm St.
Joshua M. Kelsey

Law Sections
Now Is the Time to Review Documents and Create an Action Plan

By LISA L. HALBERT, Esq.

Lisa L. Halbert

Lisa L. Halbert

As the end of 2014 approaches, articles are published that recap the year’s events (“the best of…,” “the worst of…”), or that encourage changes in behavior (how-tos) for 2015. Among that genre are the top 100 videos, 10 most influential people, and my perennial favorite, “how to lose that first 10 (or 50) pounds this year.”

In this respect, the field of elder law and estate planning is not terribly different. The new-year celebration is an opportunity to review legal documents and consider an action plan for estate-planning needs during the coming year.

Estate-planning documents need to be reviewed at least every five years and also upon major life events, to make sure they continue to be relevant. Even attorneys can neglect this periodic review, and as this article is written, I am reminded to pull out my own documents and confirm that my wishes are properly reflected. As for those who do not yet have documents, read below for the potentially serious consequences of not having documents in place.

What follows is a list of estate-planning documents, action steps, and paperwork to consider, and advice for the coming year.

Prepare a Comprehensive List of Assets

Make this less daunting by doing it in stages. When next balancing your checking account, before you get up from your desk, start an asset list and add all bank accounts and possibly real estate. Then set a time to consider what you hold in securities, retirement funds, insurances (life or disability), annuities, business valuations, and tangible personal property, such as art, furniture, and jewelry. Make a column and indicate who owns the asset, whether it is held in your name alone or jointly with another. See the section about beneficiary designations for further information.

This list should also include any assets held in a trust. Sharing this list with your estate-planning attorney is a good beginning point. Understand that, after your estate plan is fully developed, the titling of your assets may change to accommodate the plan.

Durable Power of Attorney

The DPA allows you to appoint people to assist with financial management of assets in your name while you are alive. The person who creates or grants the power is referred to as the ‘principal,’ while the person who is appointed to act on behalf of another is sometimes referred to as the ‘attorney-in-fact’ (AIF). The principal gets to determine the amount of authority to grant the AIF, with the exact terms set forth in the DPA. The benefit to a DPA is that you, not a court, choose who can have access to your financial information. A DPA can allow the AIF to access your assets even though you are fully capable of thinking and acting for yourself (for example, as a convenience for you while away on vacation), or it can be written to allow access only if and when you start to fail mentally.

A DPA does not change the ownership of any asset or account. It merely allows another to act as your fiduciary — to step into your shoes and make decisions as your agent. If an asset is owned by you alone, then at your death, the authority of the AIF terminates and the asset then goes through your will, unless there is a beneficiary designation attached to it.

Whether a copy of the DPA is immediately provided to your appointees or held to be distributed at a later time is a discussion to have with your attorney. Remember, if no one knows about it, or you fall ill and cannot communicate where the document is located, court action might still result.

The issue always comes up about whom to appoint and how many to serve at any one time. Should it be one person, or two people serving together? And if two serve, do they need to act together, or may they act unilaterally? From a purely administrative perspective, it is easiest to identify one person to act alone. But in families where there may be friction, or differing skills in terms of money management, then appointing two people to act may be the best choice for that particular family.

Decisions about whether to require two signatures or one are made by the principal after considering the benefits and burdens of both choices.

If a DPA does not exist or cannot be located, and you are unable to manage your financial affairs, then without a DPA in place the family may find itself needing to go to court to obtain a conservatorship over the accounts. In the alternative, the matter might linger and not be addressed in a timely manner. For example, through oversight, a deadline may be missed to pay a premium for life or disability insurance, causing the policy to lapse. Either way, the financial consequence could be much greater than the cost associated with having the document prepared and gaining control of who has access to the accounts.

Healthcare Proxy

Review your HCP to confirm that it identifies those you would want making healthcare decisions for you if and when you can no longer make or communicate them on your own. List appointees to serve in consecutive order, and make it long enough so that it stands the test of time. Discuss the prudence of additional provisions. For example, do certain religious beliefs impact healthcare decisions, and how should they be articulated? Would you allow certain drugs to be administered that might otherwise require court approval? Do you want your healthcare agent to choose a nursing home for you if it becomes necessary?

Once signed, provide your HCP to your healthcare providers and other physicians and hospitals. Some people keep a copy on the refrigerator, in the car, in their luggage, or with other important papers. And, of course, provide a copy of your HCP to those you have appointed as decision makers.

Remember, an HCP is not a medical release that allows an appointee to look into your private medical records or make changes to current treatments. Rather, a physician or certain nurses must invoke the HCP when you are no longer able to make informed decisions about your healthcare, or cannot communicate them. And just because the HCP is invoked does not necessarily mean that you do not have capacity to handle your own finances or manage other contracts.

If you have a surgical procedure, remember to bring a copy of your HCP with you, or ask the facility if you can e-mail a copy for their records. Many medical facilities provide a boilerplate form for completion prior to a procedure. Patients then dutifully fill it in, not necessarily realizing that this new form will revoke a previously signed HCP. It is always better to supply a doctor or hospital with your own HCP document, which will likely be a more considered and thorough document than the hospital’s standard form.

Without an HCP, if healthcare decisions need to be made for you, a court will appoint a guardian. This process takes time and costs money, and you may no longer get to control who is appointed to serve. The benefit of an HCP is that you get to choose those individuals you trust to make decisions for you as you would want for yourself, as opposed to having a court choose.

Massachusetts Medical Orders for Life-sustaining Treatment

The MOLST is a relatively new medical form and not a legal form. It is intended to be used by patients of any age who suffer from an advanced illness. It addresses current medical orders about life-sustaining treatment(s). It involves the medical provider/clinician and the patient, and it is effective as of the time of signing. It serves a different purpose than a HCP. Those with advanced illness or the loved ones of those same people are encouraged to discuss a MOLST with their clinician, or visit molst-ma.org.

Nursing Homes and Long-term-care Facilities

This is one of those cautionary tales that cannot be ignored. Too many times in 2014, clients have come in to ask for assistance in dealing with a collection issue concerning a loved one in an assisted-living residence, nursing home, or similar facility. For example, Barney Rubble arrives in the office stating that an assisted-living facility is looking to collect against his own assets to pay for his friend Fred Flintstone’s stay. It seems that the insurance that might have covered the experience had a glitch and is not paying.

Barney is Fred’s trusted friend and is appointed as Fred’s healthcare agent and AIF. On Fred’s application for admission to the facility, Barney signed as the ‘responsible party,’ because he felt that, since he was helping his friend Fred, he was therefore responsible to make sure Fred’s bills were paid. Although Barney was well-intentioned, in most cases, he missed the mark. While he is the AIF, it is only with respect to using Fred’s funds. Barney never intended to promise to use his own funds.

Before signing any paperwork, slow down and carefully read the application. ‘Responsible party’ frequently means that the person signing is actually financially responsible for the person who is going into the facility. Therefore, the proper way to have completed this area of the form so as to insulate Barney’s assets was: ‘Fred Flintstone by Barney Rubble, his AIF.’ Otherwise, Barney may be setting himself up for the facility to come after his own assets, in addition to Fred’s.

Last Will and Testament

A last will and testament controls assets that are held in your name alone without a designated beneficiary, at your time of death. These are the only assets that go through the probate process. Your will is a road map as to whom you would like to receive your probate assets, so long as it is not illegal.

It can also provide for forgiveness of debt or allow someone temporary use of an asset (such as living in a home until X age, or Y event occurs). Generally, a will allows you to control and determine who inherits your estate at your death. (A surviving spouse and minor children, however, do have certain statutory rights that take priority over the terms of the will, even if you intended to try to disinherit the spouse and/or child.)

When you die, the Mass. Uniform Probate Code (MUPC) controls the probate process. The MUPC is intended to expedite the process and no longer requires as much court intervention or oversight, although court supervision is available where appropriate. For those with new probate matters, be aware that, as of the end of October, a new rule was issued that requires seven days’ notice must be given to the Division of MassHealth before a petition for probate is filed with the court.

While this usually will not pose a problem, compliance is required. Because the MUPC is still relatively new, attorneys continue to identify nuanced changes relative to how the rules are to be implemented. And while the law was intended to be user-friendly and more streamlined, another caution is to seek legal counsel, especially where a decedent dies owning real estate.

If you pass away without a will (referred to as dying ‘intestate’), state law dictates how your assets get distributed. Under the MUPC, if you die intestate and are survived by your spouse and children of both you and your spouse (whether biological or adopted), then your spouse will receive your entire estate, without any portion specifically allocated to the children of the relationship. If there are stepchildren (on the side of the decedent or the spouse), then a different distribution is dictated.

Under the MUPC, your spouse has priority to serve as the personal representative (formerly executor) for your intestate estate. The statute, however, provides that, if your spouse does not want to accept the position, he or she may designate someone else to act, effectively skipping over an adult child who might have anticipated taking on that role. So, while you might not think you have enough assets to have a will prepared, having control and choosing the beneficiaries is likely the best route to go in case that late-bought lottery ticket is found, or a family member inadvertently left you as a beneficiary.

A will can also have some significance prior to your death. During your lifetime, if you become incapacitated and another is put in charge of your assets and financial management, there may be occasions where gifts are appropriate. The AIF or conservator can look to your will in order to figure out who or what entities are most dear to you and help implement some of those dispositions even before you pass away. The will, therefore, may offer some guidance even during your lifetime.

Trust-based Planning

Depending upon your assets, intended beneficiaries, and other information, a trust might be a better option to accomplish your preferred distributions than a will. A trust is a document with three major players — the person who creates it (you, also known as the grantor), the trustee (who could be you and/or others and is the one who actually administers or managers the assets), and the beneficiaries (who could be you and/or others who receive a benefit under the trust). The trust document provides direction as to how you want your assets (and debt) managed, invested, and distributed. It is especially useful if there are minor beneficiaries and you want to know that instructions are followed long-term, or where another needs some long-term financial assistance or management (such as a special or supplementary needs trust.)

This year, irrevocable trusts have become a topic of much discussion among elder-planning attorneys. Irrevocable trusts have been used by elder-planning attorneys as one way to provide the elder ‘income only,’ but save the principal for others. When created, counsel and clients knew that income-only trusts would leave the income exposed and in the sights of MassHealth, and available to pay for care.

This past year, however, MassHealth more frequently required that the principal also be made available to pay for the elder’s care. MassHealth’s position seems based on an interpretation of text that might allow for the trustee to alter or exchange assets within the trust. While there is some myopic interpretation which, when taken out of context, might allow for an elder to receive what was formerly characterized as principal, when considered in total, most of these irrevocable trusts do not allow for such dispositions.

The legal battle continues to heat up, and for the immediate future, an irrevocable income-only trust, where a MassHealth application might someday be required, should be approached with extreme caution.

Beneficiary Designations

Review beneficiary designations on your various accounts to confirm that they remain current and in line with your overall estate plan. Types of assets that frequently carry opportunities for beneficiary designations include insurance, annuity, retirement accounts, and some brokerage accounts (accounts that hold securities and other investments).

Designating a beneficiary completely avoids the asset going through probate, and there may be some income-tax advantages to naming a direct beneficiary. Most people, however, forget that the first-named beneficiary might not outlive them, and do not properly name a contingent beneficiary. Also, if your estate plan is premised on having assets go through your probate estate, but the designations are not changed, then your plan may be defeated.

An estate plan, once completed, may use a blend of assets that are directed to specific beneficiaries via designation, as well as assets that go through probate or a trust. Retirement assets may have a better income-tax benefit if directed to specific individuals or charities (especially if you are looking to save an income-tax bite to the estate), while life insurances might be more appropriate to go through probate. Each client situation is different.

The MUPC effectively revokes certain beneficiary designations to a prior spouse. Therefore, if you are divorced and yet still intend for your ex-spouse to receive assets via a beneficiary designation that has not been changed since the divorce, revisit the designation.

Further, there are many insurance companies that do not yet respect the MUPC and stand by their own rules stating that, where a spouse is named as a beneficiary, even after a divorce the prior designation stands. So, even if your separation agreement holds that the ex-spouse is not a beneficiary, some companies ignore that text. Rather than cause your family unnecessary angst, it is best to affirmatively confirm or change beneficiary designations after a divorce is finalized.

Same-sex Spouses

A year ago, significant ink was used getting the word out that same-sex spouses could qualify for spousal benefits in Massachusetts and under the federal law. While not exactly breaking news, spouses (including same-sex) are once again encouraged to review all financial aspects that might impact their married life. For planning purposes, this impacts your federal income taxes, Social Security benefits, FMLA, and health-insurance coverage.

Retirement benefits from a qualified retirement plan will be required to allow the surviving spouse of a married couple, whether same-sex or not, to withdraw the funds over the surviving spouse’s lifetime. IRAs that allow a spouse to roll over inherited assets into his or her own IRA are now allowed. There are more than 1,000 federal benefits that may be impacted by this ruling. Check beneficiary designations as well as federal tax withholding. By now it should be old news, but I will remind you that same-sex spouses may file joint income-tax returns.

From an estate-planning perspective, we are in the second year that same-sex couples can take advantage of the unlimited marital exemption to transfer assets between spouses during life, as well as at death. For high-wealth couples, ‘portability’ of the estate-tax exemption at the death of the first spouse to a surviving spouse is now allowed. With an estate-tax exemption currently at $5.34 million per spouse (and $5.43 million for 2015), this allows a same-sex married couple to have a combined $10.68 million ($10.86 million for 2015) estate-tax exemption.

While this may not currently impact you, if the surviving spouse wins a large lottery ticket, or comes into money for any other reason even after the first spouse’s death, having elected portability may result in a significant estate-tax savings.

Do-not-resuscitate Order

A DNR is not prepared by your attorney. It is available to be signed in your physician’s office, and it states that, if your heart stops, you do not want extraordinary measures taken to restart it. A DNR is not interpreted to mean that you want to be taken off of medical machinery (and be allowed to die) if you are being kept alive only by such mechanical devices.

Passwords

Regrettably, I am electronically challenged. So, the best advice I can offer is that you need to figure out an appropriate way to track all of your passwords and user ID information, and consider how to leave this information so that your attorney-in-fact or personal representative can access it in the future. There is an old-school view, which is to write it all down and keep it in one place, and there are those who use the cloud or other programs.

Either way, while you still have capacity, think about and organize the information. From experience, the list should include bank accounts, ATM cards, brokerage access, credit and other loans, and even health-related information. Document the answers to applicable security questions.

From a practical perspective, it is frequently very hard for your AIF to establish online access; it is much easier to continue access which you have established. Yet, where many AIFs do not live proximate to the principal, online access is the best solution. So before your memory fades, or an unexpected accident arises, consider whether you want to figure out a solution that makes it much easier for those who might have to assist you.

Important Papers

Organize a filing system for important papers. Whether alphabetical or by category (bank papers, insurance, etc.), consider putting all important papers in one place. Documents to be retained include Social Security cards, copies of birth certificates, and legal documents (will, trust, HCP, DPA, marriage license or divorce decree, and funeral-related paperwork). Include on this list your children or next of kin and their addresses. If you should die, and a non-family member is involved, it makes locating family much easier.

This checklist provides a starting point. For more information, contact an estate-planning professional for a comprehensive review of your plans.


Lisa L. Halbert is an estate-planning, elder-law, and real-estate attorney with the regional law firm Bacon Wilson, P.C. She is especially focused on legal matters relating to elder care, estate planning, and asset protection; (413) 584-1287; baconwilson.com

Daily News

LONGMEADOW — Joelle Tedeschi, LPN, has been named executive director of Ruth’s House, an assisted-living facility of Jewish Geriatric Services (JGS).

Tedeschi brings more than 25 years of diverse experience in elder care to this position. She will be responsible for the day-to-day management of the assisted-living community located in Longmeadow. She will also continue to oversee business development at the Leavitt Family Jewish Home, the position she’s held since coming to JGS in July.

Before joining the nursing home, Tedeschi served as the regional director of sales for Golden Living in Canton, Mass., where she was responsible for the sustainable growth of 18 hospice and direct-living centers. Prior to this, she was the regional director of Sales for Kindred Healthcare in Louisville, Ky. She holds a bachelor’s degree in sales and marketing from Massachusetts Bay College in Wellesley.

“Joelle clearly brings us a wealth of business-development experience in senior living,” said Martin Baicker, president and CEO of JGS. “In addition, she is also a licensed practical nurse, and we feel confident that, under her leadership, Ruth’s House will continue to flourish.”