Saturday, August 13, 2011

Wolfeboro, Carroll County, New Hamphsire

Plan for Long‑Term Care

Long-term care includes medical and non-medical care for people who have a chronic illness or disability. Non-medical care includes non-skilled personal care assistance, such as help with everyday activities like dressing, bathing, and using the bathroom. At least 70% of people over 65 will need long-term care services at some point. Medicare and most health insurance plans, including Medigap (Medicare Supplement Insurance) policies don’t pay for this type of care, also called “custodial care.” Medicare only pays for medically-necessary skilled nursing facility care or home health care if you meet certain conditions. Long-term care can be provided at home, in the community, in assisted living, or in a nursing home. It’s important to start planning for long-term care now to maintain your independence and to make sure you get the care you may need in the future.

Paying for Long‑Term Care

Long-term Care Insurance—This type of private insurance policy can help pay for many types of long-term care, including both skilled and non-skilled (custodial) care. Long-term care insurance can vary widely.  Some policies may cover only nursing home care.  Others may include coverage for a range of services like adult day care, assisted living, medical equipment, and informal home care.

Note: Long-term care insurance doesn’t replace your Medicare coverage.

Your current or former employer or union may offer long-term care insurance.  Current and retired Federal employees, active and retired members of the uniformed services, and their qualified relatives can apply for coverage under the Federal Long-term Care Insurance Program.  If you have questions, visit, or call the Federal Long‑term Care Insurance Program at 1-800-582-3337.  TTY users should call 1‑800‑843‑3557.

Personal Resources—You can use your savings to pay for long‑term care.  Some insurance companies let you use your life insurance policy to pay for long-term care.  Ask your insurance agent how this works.

Other Private Options—Besides long-term care insurance and personal resources, you may choose to pay for long-term care through a trust or annuity.  What option is best for you depends on your age, your health status, your risk of needing long-term care, and your personal financial situation.  Visit for more information about your options.

Medicaid—Medicaid is a joint Federal and state program that pays for certain health services for people with limited income and resources.  If you qualify, you may be able to get help to pay for nursing home care or other health care costs. 

Home and Community-based Services Programs—If you’re already eligible for Medicaid (or, in some states, would be eligible for Medicaid coverage in a nursing home), you or your family members may be able to get help with the costs of services that help you stay in your home instead of moving to a nursing home.  Examples include homemaker services, personal care, and respite care.  For more information, contact your State Medical Assistance (Medicaid) office.  Call 1‑800‑MEDICARE (1‑800‑633‑4227), and say “Medicaid” to get the telephone number, or visit  TTY users should call 1-877-486-2048.

Veterans’ Benefits—The Department of Veterans Affairs (VA) may provide long-term care for service-related disabilities or for certain eligible veterans.  The VA also has a Housebound and an Aid and Attendance Allowance Program that provides cash grants to eligible disabled veterans and surviving spouses instead of formally‑provided homemaker, personal care, and other services needed for help at home.  For more information, call the VA at 1-800-827-1000, or visit

Programs of All-inclusive Care for the Elderly (PACE)—PACE is a Medicare and Medicaid program offered in many states that allows people who otherwise need a nursing home-level of care to remain in the community.  Coming SoonThe Community Living Assistance Services and Supports (CLASS) Program is a national, voluntary insurance program to help you pay for services and supports so you can maintain independence in your community if you become disabled.  People over 18 who are working will have the opportunity to enroll in the CLASS program starting in late 2012, through either payroll deductions or individual enrollment.  Enrollees who become disabled (at any point after a five year vesting period) and need help with basic daily living activities such as eating, using the bathroom, and getting in and out of bed will be able to get a benefit that will average no less than $50 a day to help pay for supports to stay independent.  Talk to your employer or benefits administrator for more information.

Long-Term Care Contacts

Use the following resources to get more information about long‑term care:

--Visit  You can also visit or to compare nursing homes or home health agencies in your area.

--Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

--Visit to learn more about planning for long-term care.

--Call your State Insurance Department to get information about long-term care insurance. Call 1-800-MEDICARE to get the telephone number. You can also call your State Health Insurance Assistance Program

--Call the National Association of Insurance Commissioners at 1-866-470-6242 to get a copy of “A Shopper’s Guide to Long‑term Care Insurance.”

--Visit the Eldercare Locator at to find your local Aging and Disability Resource Center (ADRC). You can also call 1‑800‑677‑1116. ADRCs offer a full range of long‑term care services and support in a single, coordinated program.

C E N T E R S F O R  M E D I C A R E & M E D I C A I D  S E R V I C E S

Medicare & You  2011

Wednesday, April 20, 2011

Rochester NH man accused of neglecting his elderly mother, 85

G. Thomas Bickford
Wolfeboro, NH.   After failing to plan for his mother's long term care, a Rochester, NH, man faces felony charges for neglecting his elderly mother.

According to the Fosters Daily Democrat,
Leo Gordon Carter, 55, of 12 Crockett St., was indicted on Class B felony charges of criminal neglect of an elderly, disabled or impaired adult and second-degree assault as well as a misdemeanor charge of endangering the welfare of an incompetent person.

Fosters reported "according to a news release from the New Hampshire Attorney General's Office, in July 2010, emergency medical services responded to Carter's residence, where he was the sole caretaker of his 85-year-old, bedridden mother. The woman was found to be suffering from malnutrition, severe dehydration and infected bedsores.

An indictment is not an indication of guilt; rather, it means a grand jury has found sufficient evidence to warrant a trial."

According to WMUR TV,
"investigators said Leo Gordon Carter, 56, called for an ambulance in July 2010 because his mother was unconscious.

Rescue workers said Elsie Carter, 85, was taken to Frisbee Memorial Hospital, just down Crockett Street, where mother and son lived.

Medical staff said they alerted the authorities after they found that Elsie Carter was malnourished, dehydrated and covered with infected bed sores.

"She (Elsie Carter) was also covered in dried feces and urine, had urine burns on her back and there were also insects crawling on her at the time she was admitted to the hospital," Assistant Attorney General Tracy Culberson said.

Investigators said that Elsie Carter's son is her sole caregiver.

Elsie Carter, who suffered from dementia, stayed at the hospital for one month before she was transferred to a nursing home, where her health improved; but investigators said she died just four months after first going to the hospital."

While an extreme case, caregivers can reach out to State and local area agencies for help with caring for their loved ones, before they become overwhelmed. Such agencies include ServiceLink 1-866-634-9412, and your own doctor for a referral to your local visiting nurses agency or private home care agency.

Seniors and their caretakers can avoid similar situations by consulting with an elder law attorney and exploring their long term care options, including long term care insurance for in-home and nursing home care, personal care contracts with their children and Medicaid Home and Community Care Benefits and Nursing home benefits.  I would be glad to help you explore your long-term-care options for the future or right now.  Feel free to call me at (603) 569-0241 or write to me, Tom Bickford, to make an appointment.

If you are concerned that someone is unable to take care of themselves or is being physically neglected, abused, or financially exploited, you can make a confidential call to the NH Bureau of Elder and Adult Services (BEAS) at (603) 271-7014 or Toll Free from within NH at (800) 949-0470.

When you tell BEAS that your worried that a senior is unable to care for themselves, (also known as self-neglect) BEAS will start a confidential investigation to see if a senior living alone can care for themselves and, if not, what services can be provided to help them to remain living independently in their own home. When alerted to cases of caregiver neglect BEAS conducts a similar investigation into the allegations and if providing services to the caregiver can solve the problem. In cases of criminal neglect and intentional abuse and financial exploitation, BEAS will work with the local police and NH Attorney General's office to protect the victim and prosecute the perpetrator.

Your calls to NH BEAS are always confidential.

Please visit us at

Monday, April 4, 2011

Natalie Choate on IRAs, Individual Retirement Trusts and Conduit Trusts

Natalie Choate discusses using "individual retirement trusts" and "conduit trusts" to stretch out IRA benefits and protect the IRA from spendthrift children in her column in the MorningstarAdvisor dated 10/13/2006.