A Mother’s Dilemma: Planning for the Special Needs Child

As an Elder Law attorney for over 15 years, I have worked with thousands of older people and their families. But some situations are especially memorable, and Elinor and Tommy’s is one of them.

When Elinor first came to see me, she told me that she and her husband had tried for some time to have a child, without success. They decided to adopt, and after a period of time, they were blessed to be able to adopt a healthy baby boy, whom they named Tommy. It seemed that their fondest wish had come true.

When Tommy reached age 3 months, Elinor took him to the doctor for a routine check-up. Tommy was pronounced to be in excellent health. He received the usual three-month immunizations, and went home.

A fever is always a source of worry and sleepless nights for a parent. Thankfully, in most cases they are not serious and do not last long. But Elinor’s worry turned to dread as Tommy’s fever soared, and he became listless. She took him to the hospital, where he was diagnosed with a brain infection, a very rare, but serious complication from the immunization. Tommy survived. But the doctors had grim news: baby Tommy’s ordeal had almost certainly left him with brain damage. This was in the early 1970’s, and the doctors had no way to estimate the degree of damage. They would just have to wait and see.

As it turned out, Tommy’s illness had left him mentally retarded. His adoptive parents vowed to give him the best care and quality of life. But they could not know the toll it would take on them, and on their marriage. They ultimately divorced, and the father passed out of Tommy’s life.

As Tommy became a young adult, he expressed a wish to live independently. In his early 20’s he moved into a group foster home. The problem was, the cost of the group home was more than the monthly income he received from the vaccine injury settlement. So Elinor began to withdraw her retirement savings to pay Tommy’s care bill. And she had come to see me, she said, because as of the next month’s payment, her retirement savings would be completely gone. She had spent it all trying to fulfill her promise of quality of life for her son.

The solution lay in a special needs trust for Tommy. His monthly income from the vaccine injury settlement went into the special needs trust. From there, it could be used to pay for goods and services that would improve his quality of life. Using the trust, we were able to get him qualified for Social Security benefits and Medicaid to help pay the adult foster home. We were even able to reimburse Mom for some of her retirement savings. Tommy lives with dignity and independence. Mom has peace of mind. And I have the satisfaction of knowing I made a difference.

Do you know someone with a special needs child? If so, please give him or her a copy of this article. When quality of life is everything, Special Needs Planning can make all the difference.

Elder Law is Special Needs Planning

Salute Our Veterans With Quality Care

When families come to see me regarding the long-term care needs of a loved one, we always identify two goals. The first, and most important goal is good quality care. The second is to obtain that care in a manner that does not completely impoverish the older person and his or her spouse. In developing a plan to pay for good care, we have to identify all sources of funds to help pay for that care. The most overlooked source of help with long-term care costs is a Veteran’s Administration (VA) benefit that pays monthly income to veterans and their spouses, and to the surviving spouses of deceased veterans. This benefit is commonly known as “Aid and Attendance Benefits.”

Have You Been Told Your Loved One Needs a Guardianship?

We often receive calls from potential clients who have been told that their loved one needs the assistance of a legal guardian. In the most common situation, the person has been living independently, but is showing signs of dementia, and has been doing things that put themselves or others at risk of harm. Examples include leaving the stove burners on, locking themselves out of their home, wandering out of their home and getting lost, and mixing-up their medications. Other times a senior will have a behavioral disturbance, such as striking out at care center staff and fellow residents, and a guardian is needed to consent to psychiatric medical treatment and consent to placement in a secure care facility.

When Should You Refer to an Elder Law Attorney for Medicaid Planning ?

Elder Law attorneys help older people and their families with all of the legal consequences of aging. These consequences tend to fall into three categories: surrogate decision making for finances and health care; estate planning; and long-term care cost planning. We use powers of attorney for finances and advance directives for health care, wills and trusts, and a variety of strategies to help people get and pay for good care. When an older person lacks the ability to pay for care over their life expectancy using private savings or long-term care insurance, an elder law attorney will advise him or her on qualifying for long-term care assistance through the Medicaid program.

Power of Attorney for Finances: An Essential Tool for Elder Care Planning

Most people understand the need to have a will, so that when they pass away, assets will go to their chosen beneficiaries. Most people do not realize that they also need to appoint a power of attorney to make financial decisions and manage assets for them, if they become incapacitated.

If you think about it, most any financial decision we make requires a signature. Selling a house, writing a check, entering into agreements, etc., all require that we be able to sign documents. A signature itself is not even enough; the law imposes a requirement that the person signing the document have sufficient mental capacity to understand what they are signing.

A Mother’s Dilemma: Planning for the Special Needs Child

As an Elder Law attorney for over 16 years, I have worked with thousands of older people and their families. But some situations are especially memorable, and Elinor and Tommy’s is one of them.

When Elinor first came to see me, she told me that she and her husband had tried for some time to have a child, without success. They decided to adopt, and after a period of time, they were blessed to be able to adopt a healthy baby boy, whom they named Tommy. It seemed that their fondest wish had come true.

Understanding Compulsive Hoarding

There was a fascinating program on OPB Radio today on compulsive hoarding. You can listen to it here: http://www.opb.org/thinkoutloud/archives/2009/jul/

We have all heard stories about compulsive hoarders. Maybe you have been to someone’s house and had to navigate via “goat trails” in and out of the person’s accumulated possessions. I have always thought of this as simply an eccentric behavior. But recently I read a story that caused me to think more deeply about this problem.

A man had been married to his wife for over 50 years. She was a compulsive hoarder. They had separate rooms in their home. His was meticulously clean; hers was absolutely jam-packed with junk. He took care of his wife when her health went into decline. As she was dying, her last words were not something like “I love you.” Instead, her last words were “please don’t touch my stuff.”

Hoarding is defined as the acquisition of, and inability to discard items, even though they appear to others to have no value. People with compulsive hoarding syndrome have immense difficultly throwing things away, even items of little or no value such as old newspapers, bits of string, worn-out clothes, and junk mail.

A person who is a compulsive hoarder has a variety of thoughts going through his or her mind. Items may be perceived to have sentimental value, and “If I throw it away, I am throwing away part of myself.” Hoarders have a difficult time making decisions. They fear making the wrong decision, so they will save an item to avoid making a “bad choice” of getting rid of it. Hoarders may feel responsible for those around them, so they will save items “just in case I or my loved ones need them.”

Hoarders also have control issues. They may feel that the moment they throw something away, they are no longer in control, and what happens to this item is in the hands of others. Hoarders are also afraid of forgetting what something looked like, or its content, and fear that “once the item is gone, it’s gone forever.” There is also a fear of “letting go.” For example, a hoarder may fear that once she has thrown something away, that part of her life, no matter how insignificant, is gone forever.

Hoarding also creates safety issues. Excessive clutter causes fire and tripping/fall hazards. People have trapped themselves in homes and apartments, and floors have collapsed due to the weight of hoarded materials.

Hoarding also creates a stress for family members, who may feel embarrassed, frustrated, or resentful of the hoarding behavior. They are ashamed of the clutter, but are forced to live amidst chaos. Family members often resort to “self-help” methods by attempting to clean or organize without the consent of the hoarder, which leads to arguments and fights.

Compulsive hoarding is considered to be a form of obsessive-compulsive disorder (OCD). There are two forms of treatment: medications and behavioral techniques. People working with compulsive hoarders should encourage them to find a psychiatrist or therapist who is experienced in the treatment of OCD who can prescribe appropriate medications and help teach the person to gradually begin to discard items.