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Adviser’s Guide to Counseling Aging Clients and Their Families, Fully Revised and Updated—Including the Deficit Reduction Act, discusses the planning problems unique to your older clients and their families and helps you understand the options available to them. This thorough, yet easy-to-read reference focuses on the tax, health care, and legal concerns that challenge aging clients and gives you the necessary tools to address their retirement, long-term care, and estate planning issues. This revised edition brings you up to date, including coverage of significant changes in the elder care practice area due to the Deficit Reduction Act. Topics include:
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Overview
Introduction
The overriding goal of Adviser’s Guide to Counseling Aging Clients and Their Families is to help you, the practitioner, advise your elder clients and perhaps their families as to how to provide for their retirement, long-term care and estate issues, and the possibility that they may be incapable of continuing their current lifestyle. It is intended to develop your awareness of planning problems unique to the elderly and to build a foundation upon which you can develop an understanding of the complex issues facing your elder clients and the options available to them.
This book discusses some of the benefits available to the elderly population, such as Social Security and Medicare. It examines how we can supplement Medicare with private insurance and reviews who qualifies for Medicaid. It discusses asset protection through transfers and trusts and explains how they affect Medicaid. Special income tax issues, as well as estate and gift tax issues, as they pertain to the elderly, are also highlighted.
Providing Elder Care Services
One of the goals of this book is to provide the reader with an understanding of elderly people. Yes, we all know the stereotype that they drive slowly and in the left lane. And no, that is not what we mean by “understanding” them. In order to best serve an elderly clientele, you must have a good understanding of their physical limitations, psychological makeup, fears, and desires.
In addition to substantive legal compliance and planning issues, the book will attempt to teach you how to identify clients in need of planning assistance and advice. It will also teach you to identify the problems of the elderly client and to analyze whether it is better to plan for them the “traditional” way, with an ordinary estate plan, such as a will, or whether the client is best served by “non-traditional” planning, such as the divestiture of assets with a view towards attaining Medicaid eligibility. Chapter 1, “Our Aging Population — Identifying the Client in Need of Planning,” and Chapter 2, “Understanding the Elderly Client,” explore these issues.
Adviser’s Guide to Counseling Aging Clients and Their Families
Social Security and Veterans Benefits
Chapter 3, “Social Security and Veterans Benefits,” discusses these federal government programs’ roles in retirement and long-term care planning.
Medicare, Medicaid, Medigap, and LTC Insurance
A substantial portion of the text (see Chapter 4, “Medicare Benefits,” Chapter 5, “Medigap and Long-Term Care Insurance,” and Chapter 6, “Medicaid Benefits”) is devoted to a discussion of Medicaid and Medicare and when each applies. These chapters will also explain the mechanics of a hospital stay from admission to discharge. It is crucial for you to understand this process because questions along this vein are among the most commonly asked by clients when they or their family members are facing discharge from a hospital. You may be asked to explain the various appeals processes available when a hospital seeks to discharge a patient or when a nursing home says that Medicare will not cover the stay.
Wills and Trusts
Chapter 7, “Wills: A Primer,” covers the basic concepts of Last Wills and Testaments. The chapter also discusses “testamentary substitutes,” other ways of avoiding probate.
Asset Protection Planning
Asset protection planning can be an overriding concern for some clients as they plan their estates, both for retirement/living purposes and beyond. Therefore, a significant amount of the book (see Chapter 8, “Protecting Assets by Transferring Them,” Chapter 9, “Using Trusts to Protect Assets,” and Chapter 10, “Asset Protection Planning Versus Traditional Estate Planning”) is devoted to the discussion of Medicaid planning (divestiture of a client’s assets) and traditional estate planning topics. Knowing when to forego one in favor of the other is the key to preventing a client from making a mistake that might result in the unnecessary payment of estate, gift, or capital gains taxes, as discussed in Chapter 11, “Income Tax Issues Affecting the Elderly,” and Chapter 12, “Estate, Gift, and Trust Taxation.”
Powers of Attorney, Living Wills, and Health Care Proxies
Chapter 13, “Powers of Attorney,” discusses all aspects of powers of attorney and their importance as well as the various types of powers of attorney, what each covers, revocation, and so forth. It also contains several sample power of attorney documents. Chapter 14, “Medical Self-Determination: Living Wills and Health Care Proxies” discusses all aspects of medical selfdetermination from health care proxies and living wills to the “right to die.”
Guardianships
Chapter 15, “Guardianships,” explores all aspects of a court proceeding for the appointment of a guardian for the person and/or property of an elderly client. It explains and helps guide you in your role in such a proceeding.
Planning for Disabled Children
Chapter 16, “Planning for Disabled Children,” discusses planning options when the elderly
client’s concern is not exclusively the loss of assets as a result of nursing home placement, but
also planning to make sure that a disabled adult child is taken care of after the client’s death.
ElderCare/PrimePlus Services
Finally, Chapter 17, “CPA Eldercare/PrimePlus Services,” discusses how to identify opportunities where you can assist your clients, whether they are adult children or older adults themselves. There are many ways to identify potential clients for elder care services. One of the most useful for a CPA is to include questions in the annual tax planning checklist or review the client’s annual tax return to identify potential CPA ElderCare/PrimePlus clients.
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