Have you ever created intentional space in your work/life for grief?

I never knew it was possible until earlier this month.

I may be relatively young, but I’ve had my share of deaths to process in life. In all instances, I went through the motions and then seemed to just move on. As in, I went to a funeral, accepted condolences, and then got back to my routine – at work, at home, with loved ones and strangers.

This included my father’s passing a couple of years ago. My grief consisted of a few days on the couch, eating junk food and watching movies. Then I picked myself up and moved forward. No self-care, no reflection. That is certainly one way to handle it, but what I did this month was so much kinder to myself. And, just maybe, the kindest thing I’ve ever done for myself.

My grandfather died peacefully, a week short of his 93rd birthday. Knowing that he was only going to be with us for a short while longer, I made some very adult decisions.

1. Decision #1: There was literally nothing more important in my life than saying goodbye to my Poppi in the way that felt like I was honoring him.
2. Decision #2: I was going to allow my daily experience and grief to be the priority in my life by making space for it.

Once those decisions were cemented in my mind as the only things with real significance, everything else fell into place as if I knew exactly what to do…

1. I canceled all my non-essential meetings. There were FIFTEEN of them! To be kind to myself, I blind-copied everyone at once (opposed to personal emails for every person), told them why I needed to reschedule and counted that task as “done” in a matter of a few minutes. The immediate weight that came from reclaiming a minimum of 15 hours of my week was enormous. Everyone was so extremely kind and supportive of my need to reschedule. I kept 3 essential meetings (reviewing proposals and onboarding a new client) and used the rest of my time working on things that bring me joy and add great value to my business.  And it got me thinking…why did I have 15 non-essential meetings on my calendar, anyway?
2. Made space for self-care every day. Things like, taking a bath, reading, writing, getting a massage. Every day there was one scheduled item of self-care on my agenda. In a week, I had given myself the gift of self-care in a way that seemed like a pure indulgence. Each act of self-care rejuvenated me in a way that felt like, “Yes. My body is important to care for. My spirit is important to nourish. Thank goodness I can move slowly and be kind to myself.” When I look back, none of those actions were longer than 90 minutes and took way less than the time I had given myself space for by removing the non-essential meetings.
3. I reignited good habits. I meditated, did some form of physical activity and cooked the most delicious meals with my husband every night. These, again, seem like a luxury to me when I do all three in one day – let alone all three for weeks straight each day. These habits are direct reflections of my values and things that always make me feel centered and on a good path whenever I regularly activate them in my life. I just didn’t think I had space for them, all in one day, before. I was so very wrong.
   Having done these 3 things literally changed my life. It helped me to realize my values more deeply, appreciate the supportive people in my life and make space to cherish the memories of my grandfather.  In a time when we are all working so damn hard, it’s hard to push pause. But when you do, your soul thanks you.

I spent nearly two weeks making room for grief, which felt like I was swimming in warm molasses – in the best possible way. In a matter of minutes of making these executive decisions in life, I gained immense clarity and gratitude for the gifts in simplicity.

I am always saying, my goal is to “live a simple and purpose-filled life. The last gift my Poppi gave me was the realization that I can have that now. I am the one getting in my own way of making that a reality and that was an epiphany that I will take with me as I build the life I want to live.

So while I offer these suggestions as a possible guide in grief, we must remember that at the end of the day, grief is a walk alone. Others can be there and listen but you will walk down your own path, at your own pace, with your own pain. You will come to your own peace, in your own time, in whatever way makes sense for you. My experience is not yours and it is not a suggestion that one size fits all. It’s far from that when it comes to loss.

I was reminded that grief is the last act of love we give to those we loved. Where there is deep grief, there was great love. And that’s what my life has felt like lately. Fueled in love, reflection and gratitude. The grief isn’t gone, it’s just taken a new shape for me. One that I never knew was possible, one that I wish for everyone to experience if they’re able to make space for it in life.

MaryBeth Hyland, founder of SparkVision, believes that when you connect people through purpose, there’s no limit to what they can do. Her organization helps multi-generational teams who need an unbiased partner to identify the gap between their current and ideal culture.  Grounded in her BA in Social Work and MS in Nonprofit Management, this millennial leader is sought after for her ability to create movements that resonate. MaryBeth has been honored in Maryland as ’Innovator of the Year,’ ’Women on the Move,’ ’Top 100 Women,’ ’Top 100 Millennial Blog,’ ’Civic Engagement Leader’ and ’Leading Women.’

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As recently as this morning, I experienced a headache common to all of us living in the now almost-entirely-digital age.  I went to log on to my email from a different “platform” than I normally use (an old laptop, rather than my phone where I normally check email, and on which my email password is saved).  I typed in what I thought was my password.  No.  I tried a variation that I have sometimes used as a password.  No.  I tried variations on the variation that I have sometimes used.  No.  I cursed at the reality of the fact that I KNEW my password until I had to change it several weeks ago because of the security requirements that lead to a new password being necessary every few months.  Finally, I gave in and created a new password.  Which I likely will not remember, because now I am so many variations past my original password that my brain cannot contain which variation is the current one to access this particular account.

Sound familiar?

A friend who used to work at Google said that people would call in all the time, asking for the “help desk” to get them back into their email, from which they were locked out without any memory of their password, or the answers to their security questions, or access to the old phone number or alternative email where the “access your email” link would be automatically sent by Google in case of such dire straits.  For these poor souls, it was unhappy news to hear from my friend that Google does not have a help desk, and that there is, in such a situation, no way to get back into their email.

Given these real-world examples of the complications faced by us as the OWNERS of these digital accounts, how in the world can we expect our appointed Agents/Fiduciaries to access our digital accounts in the event of our incapacity or death?  Particularly if we don’t give them some mechanism for knowing where our digital assets are, or how to access them?  It is common now to keep all of our important information on our laptops or desktop computers – but if that device is password-protected or otherwise locked, and no one other than you has the information to access it – how will your appointed Agent/Fiduciary be able to access your computer, your email, your Facebook, your digital photograph storage service, your Amazon account, etc., etc.?

In recent years, the law has finally started to catch up with the reality of our digital world – though in typical, behind-on-the-curve fashion (the law is always a few years delayed on the timeline of mainstream culture).  In 2016, the Maryland legislature passed the Maryland Fiduciary Access to Digital Assets Act, codifying the right of a digital account user to broadly allow or prohibit access to that user’s digital accounts to a Fiduciary by way of a Power of Attorney, Will, or Trust.  Prior to the passage of this Act, such authority (for your Fiduciary to access your digital accounts) was dependent upon your completion of each and every website’s own Terms of Service – something I seriously doubt many of us thought or knew to do (I certainly did not).

But this is an imperfect solution, in and of itself.  The issue of how our appointed Agents/Fiduciaries might access our digital assets presumes that they will know what our digital assets are – not to mention any and all of our other, non-digital information.  The starting point is to imagine how anyone other than you will possibly know what you have, and where you have it (where do you have accounts?  With whom do you have life insurance?  Who is your doctor, financial advisor, estate planning attorney, etc.?).

A common approach in the past was to keep important documents and information in a safe deposit box.  But what if no one but you has access to it, and you become incapacitated or die?  Unbeknownst to most people is that a safe deposit box is only accessible by signatories/authorized users.  A Power of Attorney may or may not be recognized by your bank – and even if the bank does recognize the authority of your Power of Attorney, the bank may not recognize the authority of your Power of Attorney to access your safe deposit box.  And, after your death, when your Power of Attorney no longer has any authority or validity, NO ONE has access to your safe deposit box UNTIL a probate estate is open and letters of administration are given to the Personal Representative (sometimes called the Executor) of your Estate.  Which can lead to quite a circular mess if your Will, which should be filed to open your Estate, and which sets forth who you wish to be appointed as your Personal Representative, is housed in your safe deposit box. Or, even worse, if you established a Revocable Living Trust in order to avoid the opening of a probate Estate, but now,  a probate Estate must be opened in order to gain access to your safe deposit box.  Many a Trusts and Estates attorney has horror stories to share about the mess caused by important documents being stored in a safe deposit box that only one or two people have access to…

So what is one to do?

One client with whom I worked made it a pet project of hers, to put together a notebook of all of the information her children or siblings might need to know in the event she becomes incapacitated or after her death.  She put all passwords, all contact information (for her estate planning attorney and her financial advisor and her doctors, etc.), all asset type and financial institution information, EVERYTHING into this notebook.  Now, all that her children and siblings need to know is where that notebook is being kept.  Of course, the impetus is on her to keep this information updated.

For some, this old-fashioned recordkeeping is uncomfortable, whether because it is tedious, or considered too insecure.  As an alternative, there are various digital storage options on the market now – companies, such as DocuBank and Everplans, that provide the service of a “digital filing cabinet” for all of your important paperwork and information.  Of course, this method has its imperfections, too.  Ultimately, there is an argument to be made for a hybrid approach, for storing your important information in a variety of ways.  One of the best methods for ensuring that your important information is known and available to those who may need it to act on your behalf is to have an estate planning attorney who is familiar with you and your asset information – and, even better, to have a financial advisor and a CPA, too – that is, to have your own personal team of advisors.

There is a fine line between keeping our private information private and secure – and keeping it so private and secure that no one else is able to access it when we actually need them to.  We welcome you to discuss this particular challenge with us, and we urge the importance of keeping your information updated, wherever and however you choose to keep it.

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I don’t know how many people fly to various destinations across the U.S. from Baltimore via the Charlotte Airport travel hub, but I assume it’s quite a lot.  Having done so many times, my experience has been that on some of the small commuter airplanes that routinely fly the Charlotte route the ride can be quite rough.  My wife laughs at me when I affectionately refer to any Charlotte lay- over flight as a “rattletrap”, since one time in particular, the plane literally sounded like it was rattling and squeaking all the way, and figuratively lurching towards the runway touch down.  Of course there are very smooth flights to Charlotte from Baltimore, and I recently rode on one of those and it was amazing – a fifty minute scheduled flight that arrived fifteen minutes early!  And turbulence, let’s not forget about that.  I don’t like it, and again I will say that the southern flight routes always strike me as more turbulent than others, like the smoother long-distance Midwestern routes, to Denver for example (except for in and around Denver airport!).  Oh well,  I guess none of it is predictable!

All this thinking about the characteristics of modern flight travel gets me thinking about the current state of our politics, and more specifically, the 2017 Tax Act.  I’m serious!  How analogous can these two things be?  I mean you can’t make this stuff up, regardless of which side of the political runway (flight path) you’re on!  So first we’ve had a lot of shaking, rattling, and rolling for the past eighteen months in Washington and across the country.  Really?  Well yes –  unbelievable, and perhaps unprecedented events, including political infighting, eye-popping initiatives and attempts to foil them, upheavals, policy changes (both domestic and foreign), questions and shifts concerning traditional notions about government and its institutions, attacks on the press, interference in our electoral processes by foreign governments, turmoil of seemingly every kind, and much, much more.  And yet, from an estate planner’s point of view, by and through the 2017 Tax Act, along with Portability now a “permanent” fixture of the estate tax landscape, it is a remarkably smooth ride for 99% of U.S. citizens – from both an estate tax and income tax perspective.

Quite literally, the current administration and the Congress, despite the rollicking barrel rolls, vertical climbs, mid-air stalls, nose-dives, and general free ride of 2017 and through mid- 2018, have managed to land a legislative jumbo jet by passage of the 2017 Tax Act in December.  Now hold on some will say.  Okay, I agree we’re not talking about wins for seniors or people with disabilities here.  But from a pure estate planning perspective, this is a friendly monster with almost all the right colors and political stripes – a routine flight that intended to go cross-country but somehow became epic, broke the stratosphere, and landed on the moon.

Now, back to reality.  Let’s explore the Act in a limited way for purposes of this article.  You can read about it in further detail via a multitude of summaries and articles put out by tax services, brokerage firms, trust companies, and news organizations; or, you can read the complete voluminous Joint Explanatory Statement of the Committee of Conference.  First, let’s be clear – there are winners and losers due to the Act.  And like any legislation of this magnitude, there are purely personal and business income tax-related portions, which are hugely important and affect all of us; and concerning our further purposes here, estate and gift tax-related portions and their effect on clients’ estate planning.

Although the following is not meant to comprise an exclusive list, changes of major importance on the purely personal income tax side of the Act include:  new rate brackets, with top rate of 37%; changes to standard deduction and elimination of personal exemption; simplification of Kiddie Tax; increase of Child Tax Credit; changes to charitable deduction; limitation on deduction of home mortgage interest; limitation on state and local income tax deduction; non-deductibility of miscellaneous itemized deductions; Qualified Business Income Deduction (I.R.C. §199A); Alimony payments not deductible, and not income to recipient; increase in AMT exemption; elimination of health insurance mandate.

Changes of major importance on the purely business income tax side of the Act include: reduction in corporate tax rates (top rate of 21%); and tax-favored treatment of business income from pass-through entities (I.R.C. §199A).

The Act’s direct impact on estate planning (trusts and estates) cannot be understated – it is simply astonishing.  The federal estate tax exemption or the basic exclusion amount for individuals is now calculated by experts to be $11.18 million, or $22.36 million for a married couple.  That is more than eleven times the size of the basic exclusion amount then in existence when this writer first began his legal career.  This means that the federal estate tax, while not completely abolished, is practically eliminated for 99.5% of decedents. And the gift tax exemption? That is $11.18 million also. This changes everything! Well maybe not everything, because for example the new exemption amounts “snap back” to the prior exemption level of $5,490,000 per person in 2026; but it possibly changes many of the assumptions we’ve always made – for example, that strategic use of the now $15,000 annual exclusion gift amount or estate tax charitable deduction is so critically important.  But are they?  On the other hand many fundamental concepts in estate planning remain largely unchanged and most of the staple planning approaches used over the past several years remain viable and leading edge, such as QTIP trust planning between spouses; although of course there are different planning techniques available for people with assets under $5 million, assets between $5 million and $11 million, assets between $11 million an $22 million, and assets exceeding $22 million, and in any event men and women of all ages still (and always will) need to provide for their surviving spouses, partners, significant others, children, nieces and nephews, other loved ones, pets, and organizations the way they want, and at the lowest possible cost, while providing for the lifetime management of their own financial and health care affairs.  Except that now, it is possible to design and construct these foundational planning elements into your planning better, easier, and with more flexibility and asset protection than ever, and with the lowest possible income tax ramifications ever.  Yes, it is an exciting time to engage in estate planning.  But what is there to talk about now that the estate tax has effectively been eliminated (at least on the federal level)?  Well, … everything?  To name just a few topics of major concern:  understanding how and why income tax is the “new” estate tax; the ramifications of outright distribution; how to plan for disability or incapacity; dealing with long-term care costs; disposing of tangible personal property; understanding inheritance tax; how to leave assets between spouses; planning where there are unmarried partners; marital control; planning for retirement plan assets; long-term care asset protection for spouses; lifetime asset protection; planning for the shares of children and grandchildren; providing for pets; designing flexibility in planning; trust protectors and other special fiduciaries; asset protection for marriage – pre-nuptial and post-nuptial agreements; planning for persons with disabilities; housing issues; Social Security and Medicare; philanthropy; elder law and Medicaid issues; and much more.

In wrapping up this article, how do we keep from shaking and rolling too much during the years to come despite all the changes happening around us?  Well, if you are age fifty or older, you know that’s probably not possible – there’s going to be a lot of this during life and it’s unavoidable.  But if you responded “periodic plan updating”, you are not only right, you hold the key to the smoothest possible flying over time, with the least worry.  We all want a smooth flight versus a turbulent one – yet only a minority of people plan, and of those planning-oriented folks, only about one-third are willing to become truly educated about their planning, keep the plan updated throughout the years, and thereby remain in control of that one aspect of planning they have near complete control over.  I recently watched a film produced by the famous independent filmmaker, Werner Herzog, about the child (now an adult) who survived a Peruvian airplane crash (she was the only survivor).  Perhaps you’ve seen it, but if not the film outlines an amazing story of survival – not only the child’s actual fall from the sky into the rainforest, but her experience during the days and weeks following the crash as she walked out of the jungle, reached civilization, and was finally rescued.  We have the ability to control the outcome of our estate planning, and we don’t have to let it crash, even when the months and years ahead seem unpredictable, full of high speed turbulence, and unpredictable change.  Recognize that in estate planning, you are not a passenger – and you are not in a passenger’s seat – unless you choose to be.  You are the pilot.

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A nationwide movement has been underway since the late 1990s to improve end-of-life health care planning by individuals.  While Advance Directives including Living Wills and Do-Not-Resuscitate Orders (DNRs) have been widely used to address future decisions regarding life support, pain relief and the administration of nutrition and fluids, they do not capture a patient’s preferred level of medical intervention for care either on a routine basis or on an urgent basis due to an acute medical condition.  To give individuals the opportunity to express their medical treatment preferences, a process developed that begins with conversations between physicians and patients about available treatment options, and provides forms that record the patient’s preferences for all of the patient’s health care providers to see.  Throughout the various States, these forms are known as physicians’ orders for life-sustaining treatment (POLST), medical orders for life-sustaining treatment (MOLST), physicians’ orders for scope of treatment (POST), and medical orders for scope of treatment (MOST).  The National POLST Paradigm Task Force provides guidance for successful implementation of such forms.[i]  In Maryland we have the Maryland MOLST Training Task Force.  The State provided regulations for the use of Maryland’s MOLST form in July 2013.[ii]

Who Should Have a MOLST form?

Regulations require the MOLST forms be completed at assisted living programs, home health agencies, hospices, kidney dialysis centers, and nursing homes for newly admitted patients and at hospitals for certain patients.  In addition, the rule of thumb is that any person for whom it would be true that a doctor would not be surprised if the person died within the year should have a MOLST form.  Anyone of advanced age or frail health or both, should have a MOLST, even those individuals who are not terminally ill, in a persistent vegetative state or suffering from an end-stage condition.  Persons in these categories should have a conversation, or a series of conversations regarding end-of-life care with a health care provider.  Ideally, the conversations are a team effort by all involved in the person’s care and decision-making.  End-of-life care is an evolving field.  Understanding the nature and effects of treatments, procedures, medications, and methods is important for every patient, and requires open and frank discussion.

The Shortcomings of Advance Directives and DNRs

Most of us are familiar with a typical Advance Directive that includes a Living Will.  Such a document allows an individual to specify whether or not to be administered life-sustaining treatment, as well as nutrition or fluids, if the person has no expectation of recovery from a terminal condition, a persistent vegetative state, or an end-stage condition.  The Advance Directive is executed with a hypothetical future health event and goes into effect in the future, when the client is no longer capable of make health care decisions.  At such time, the agent appointed in the directive has decision-making authority on the patient’s behalf.

Most of us are also familiar with Do-Not-Resuscitate

(DNR) orders, which prevents resuscitation in the event of cardiopulmonary arrest.  Such orders are issued by physicians for certain patients after conversation with the patient or the patient’s decision-makers.

Neither the Advance Directive nor the DNR provides a client the opportunity to specify the kind and level of medical intervention, during or at the end of life, that reflect the client’s preferences, values and goals.  The choices are either for no intervention at all or full intervention.  A MOLST allows the patient to clearly and accurately identify the desired level of care from among the available treatment options as they are explained to the patient or the patient’s health care decision-makers by a physician, physician’s assistant or nurse practitioner.  The care related decisions can be addressed separately from the choice regarding DNR orders. Thus, a person may not want to be resuscitated, but, in all other situations, the person may want more or less aggressive care.  Since the patient may lose the capacity to participate in the conversations, it is still important to have an Advance Directive that appoints a health care agent, who can talk with the patient’s health care providers on behalf of the patient.

What Treatment Categories does the MOLST Cover?

The Maryland MOLST allows the patient to make informed choices regarding the administration of antibiotics, nutrition, fluids, ventilation, blood transfusion, hospital transfer, medical workup and dialysis, in addition to cardiopulmonary resuscitation (CPR).

As part of the conversation with medical staff regarding the treatment categories, the staff will summarize key facts and opinions about the patient’s medical situation and prognosis, and the relevance of various treatment options.[iii]  The medical staff is expected to ensure that the patient’s choices are informed as a result of the consultation with the physician, physician’s assistant or nurse practitioner, who signs the order.

Since a patient’s medical needs are likely to change over time, it is important to continue to have these conversations.  The MOLST can be updated when the patient reverses an earlier decision based on changes in his or her medical condition.

What is the Purpose of the MOLST Worksheet?

An individual who is not currently facing an acute medical condition and has capacity to discuss health care treatment options with a health care provider, has the option of completing the MOLST Worksheet.  The worksheet is part of the MOLST and allows a person to document treatment preferences for future situations.  If and when the time comes that the person needs a MOLST, the worksheet provides valuable input for the completion of the MOLST form.  The topics covered by the worksheet are the same as those addressed on the MOLST form. An individual may chose which of these topics to address.  There is no requirement that all categories be worked on.

Minors with Terminal Illnesses and Individuals with Disabilities

Some states allow minors with terminal illnesses to have POLSTs, and some provide a section for special concerns of individuals with disabilities.  The Maryland MOLST does not provide a section for individuals with disabilities.

MOLST Need to be Kept Where They Can Be Found – the Registry

Emergency Medical Technicians (EMTs) or first responders will respect and implement a patient’s wishes.  They can only do so, if they see the MOLST.  A physician can provide guidance on where to keep the form; on the bedside table or room door, for the bed-ridden patient, on the refrigerator, in the purse, or any other place where it can be discovered before procedures are started that may go against the patient’s wishes.

Some states maintain a registry for their residents’ POLST or MOLST forms.  The advantage of a registry is that EMTs and other providers have access to the forms.  Maryland has such a registry.

Legal Protections

A competent individual’s use of a MOLST, properly executed in accordance with local law, is protected by constitutional and common law.  The Due Process Clause protects our deeply personal liberty to reject medical treatment.  Since the form is completed after conversations with the physician, a patient’s informed consent, as well as the individual’s liberty and privacy concerns are satisfied.  A health care provider’s refusal to honor a MOLST would implicate common law and constitutional violations at the least.

The U.S. Supreme Court has been united in its view that a competent individual, absent a specific compelling public interest has a right to refuse medical treatment.

“On balance, the right to self-determination ordinarily outweighs any countervailing state interests, and competent persons generally are permitted to refuse medical treatment, even at the risk of death. Most of the cases that have held otherwise, unless they involved the interest in protecting innocent third parties, have concerned the patient’s competency to make a rational and considered choice.”[iv]  This language is decisive for the constitutional validity and enforceability of a MOLST.  It announces that each person has a fundamental liberty interest to control his or her medical care.

The MOLST Should Be Signed By the Patient

The Task Force recommends that the MOLST be signed by the patient to ensure that there was at least some communication about the form with the patient or the patient’s health care agent.  Such a requirement would increase the confidence that the form reflects the patient’s informed decisions.

Fiscal Considerations

Patients who do not wish to have very expensive treatments, benefit from having a MOLST that is properly implemented.

MOLST Has to Be Part of Estate Planning and Elder Law Consultations

The Medical Orders for Life Sustaining Treatment (MOLST) form and associated worksheet are part of a comprehensive estate planning consultation.  Estate planning and elder law attorneys needs to draw clients’ attention to the existence and function of this form.

[i] The Center for Ethics in Health Care at Oregon Health & Science University first convened the task force. See OR. POLST TASK FORCE, GUIDANCE FOR OREGON’S HEALTH CARE PROFESSIONALS 6, 17 (2013), available at http://www.polst.org/wp-content/uploads/2013/ 12/2013.12.26-OR-Guidebook-2013.pdf

[ii] The Department of Health and Human Services regulations are found in COMAR 10.01.21

[iii] See Health Care Decision Guide for Health Care Professionals by the Maryland MOLST Training Task Force, May 2012.

[iv] 1 Cruzan, 497 U.S. at 273 (quoting In re Conroy, 486 A.2d at 1225).

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There are right ways and wrong ways to go about rightsizing, home selling, and selecting your new home, and it’s never fun having to experience the “learning curve,” especially if it’s been many years since you have moved. The process of home selling has changed greatly thanks to technology and the invention of the Internet.  Expectations by Buyers are also very different these days, making an experienced agent invaluable for guidance and advocacy.  Remember, feeling that the move (the house, the contents, choosing where to move, setting up a new home) will be overwhelming is normal!

In my role as my Team’s senior move specialist, my joy is to work along with our real estate agents to help our older adult clients navigate the entire process with a complete array of resources and services in full support, all the way through settlement and beyond.

Previously in this newsletter, I provided guidance on choosing the right agent, what happens during the home visit by the agent including an examination of market analysis & pricing, timing of the sale, and staging.  Next steps for navigating the process?

Relocating:

Where are you going? This is one of the first questions your Agent should ask in order to understand the overview of your needs and to create your best path. Different and common scenarios include moving to a condo or one-level home, in with adult children, moving out of state to retirement meccas such as Florida and Arizona, and moving to local retirement communities. One of my passions is making sure that Sellers are as educated as possible about all of the choices available to them. Many people don’t know the very important differences between 55+, CCRC, Independent or Assisted Living communities and the health and financial formats for each can vary greatly. For example, some communities require health as well as financial clearances, some have buy-in fees and some do not. Some are fee-simple ownership and some have leases, even if they appear to be similar. If you are moving to a location that has not incorporated safety features found in “universal design” construction, be sure to ask for resources for the specialty companies who install grab bars for example, as these can literally be life-savers. Sometimes in-home care is needed if your loved one has been ill and needs help in the interim before the move. I take pride in being able to share these resources as well.

Senior Living Search:

Did you know that there are specialists who can help with your research into the various kinds of senior living communities? Life Care Managers are able to help guide you to the communities that would be your best fit and are also able to provide assessments for level of care, family counseling, and to be a part of the conversation between legal and financial advisors for families when a move is happening quickly or unexpectedly due to health events or the loss of a loved one. Sharing this resource with my clients is often a life-saver for families when events feel overwhelming and an expert is needed.

Downsizing:

Downsizing possessions is your next target. Ideally you have been chipping away at this task well ahead of time, as it can be a lot to tackle simultaneously with preparing your actual home. You will want to have a grasp of the square footage and storage you’re leaving and those figures for where you’re moving to, and you’ll also want a space plan to help you decide what you will want to take and, more importantly, what will fit, look great and serve you in your new home. Once you know what you’re taking, decide what you’d

like to offer to family and friends if treasured heirlooms or larger pieces just don’t work in the new space. Hold on to everything else in order to research and have the best outcome from a potential estate sale. The more items you have, the larger the sale, the more likely you are to have a higher-dollar final sale, so don’t let your items be “cherry-picked” prior to having a professional consult with an estate sale expert. Then you can identify what items aren’t saleable and arrange for donation and maybe a tax benefit. Finally, you may need your home to be “cleared” of any last items, which can be done by friends & family or by a professional hauler.

Moving:

If it’s been years since you have moved, you should rely on your Agent for recommendations for a trusted professional mover who is well-established and also offers short and long-term storage. For short-distance and smaller moves, some real estate firms offer free moving trucks as a convenience and cost-savings to their clients. Move Managers, also called Transitioners or Downsizers, are a relatively new type of moving service and they can be a boon to you if you are overwhelmed, busy, distracted, and in need of “more” than what an ordinary moving company is able to provide. These providers can help coordinate work being done to prepare the home for selling, estate sale processes, space planning the new home, sorting, packing, the actual move, unpacking and setting up on move-in day. Think boxes gone, pictures hung, clothes in closets and beds made. They are an amazing resource and the best ones work closely with your Agent.

Power Of Attorney:

I have many stories about the problems my clients have faced when they did not have a Power of Attorney in place. Many clients have one that turns out to be non-functional due to being old or “stale” or written without sufficient detail such that it is not enforceable. Make sure you have one, and make sure it’s recent and air-tight! Unforeseen health events that cause homeowners to be unable to complete contracts during the home selling process have caused a lot of heartache, trouble, expense and complete destruction of planned-for timelines in the sale/move/purchase timetable. Consulting your current attorney, or better yet, upgrading to an elder law specialist, is one of the best things you can do for yourself, your spouse, and your family.

Financial Management:

Even though the demands of selling and moving make you extremely busy in the short term, this is still a time when it is ideal to revisit or create the best financial structure for your future. Think both big and small picture. Having guidance for the savviest ways to handle your homeselling profit, your retirement community’s buy-in expenses, understanding capital gains, etc. are important opportunities to design the best outcome for the long term. For the day-to-day, I like to make sure there is awareness of professionals called Daily Money Managers. They are exactly what they sound like and are an important resource for people who no longer want the tasks associated with managing their finances, who are struggling to maintain them due to health reasons or the demands of technology, and perhaps most importantly for spouses who are at sea if the managing spouse becomes ill and is no longer able to maintain the household accounts. I strongly encourage all of my clients to consult with a Daily Money Manager as part of their pre-crisis planning, and if health issues are already looming, do not wait to learn about this service and put it in place. The opportunity for teamwork between the professional and both spouses is a golden one, and early intervention means that the ill spouse can be a part of the hand-off, and that a non-managing spouse can have peace of mind should anything unexpected occur going forward.

VA Benefit:

In the spirit of understanding there’s a lot going on when you’re selling your home BUT you don’t want to miss out on any resources to which you are entitled, please know about the Veterans Administration’s “Aid & Attendance Benefit” which can provide monthly income for Veterans and their spouses at the Assisted Living level of care. Having an elder law attorney who is certified to guide you on eligibility and the chance to learn about how he or she can help you to structure your assets to better position you for eligibility is an opportunity you don’t want to miss. Again, think pre-crisis research and planning!

For the past several years, twenty-five percent of all home sellers in the U.S. have been 65 years old or older. Being a home seller is a powerful position to be in both as a group and as an individual! I believe in harnessing all of the resources available to my clients with an emphasis on educating and supporting them along the way. My goal is for my clients to have the smoothest transition possible, with the clearest path to an organized, relaxed, risk-managed new and easier lifestyle!

Victoria Hathaway is the Director of The Silver Group of the Bob Lucido Team of Keller Williams Integrity. She is a Realtor, Certified Senior Advisor (CSA), Certified Senior Housing Professional (CSHP), Seniors Real Estate Specialist (SRES), Board Member of the Coalition of Geriatric Services (COGS), and serves the Aging Studies Advisory Board, Johns Hopkins University. She may be reached at 410-979-4284 or via email at Victoria@BobLucidoTeam.com.

Tags: estate, financial planning, financial power of attorney, news
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As the Client Care Program nears its two-year anniversary, the mission of the CCP (“planning that works”) remains the same – to provide CCP members with the comfort and assurance that their estate and elder law plans will stay updated over the passage of time and that clients and their families receive the education they need.  Though its mission remains the same, the CCP continues to grow in scope as CCP Member benefits grow, including most recently the ability for Members to participate in their own archival family video production at the Elville Creative Studio.  Members are encouraged to express themselves and share whatever they want future generations to remember – their wishes for family, values important to them, old stories they want to pass down for generations to come, and much more.  There are no limits, the creative possibilities are endless.

Elville and Associates’ first CCP Continuing Legal Education Event of the year, “A Round Table Discussion on the New Federal Income and Estate Tax Code (The 2017 Tax Act),” was held on Saturday, April 28th at the the Arnold campus of Anne Arundel Community College.  Guests were entertained and educated by Katz Abosch’s CPAs James Eaton and Michael Andrews along with Elville and Associates’ Principal Stephen Elville.  Yes, entertained!  These CPAs were colorful and brought the December 2017 Tax Act to life as they explored a broad overview of the huge changes in the laws.

The CCP’s second annual Social Event took place on Sunday, August 19th, as Members and their families enjoyed a matinee showing of the smash-hit musical, “Mamma Mia,” at Toby’s Dinner Theatre in Columbia.  After a delicious breakfast buffet was served before the sold-out show, guests were whisked away to the show’s setting, a Greek Island in the Mediterranean Sea, as extraordinary acting and memorable ABBA songs such as “Gimme! Gimme! Gimme!,” “Lay All Your Love on Me,” “Take a Chance on Me,” “The Winner Takes It All” and, of course, “Dancing Queen” entertained and transported everyone back to a younger time, some forty years ago.  As The Baltimore Sun’s review of the show stated, “If you didn’t know you were at a dinner theatre, you’d think you were at a disco!”

Elville and Associates’ 6th annual Client Event will be held on Saturday, October 20th, 2018 from 8:30 to noon at the Retreat and Conference Center at Bon Secours in Marriottsville.  This year’s theme is “Understanding Medicare Concepts 2018 – A Continuing Discussion with Mark W. Trent of Medicare Supplement Services.”  By popular demand, we are fortunate to have the engaging and informative Mr. Trent back again this year to update guests about the ongoing changes in the world of Medicare along with presentations by the Firm’s attorneys about Healthcare Decision Making in 2018; Maryland Law Update; Funding and ) Asset Alignment Retrospect; and Client Care Program Experience.  Along with the superb lineup of speakers, delicious food, door prizes, and gift baskets will once again highlight the morning.  Entertainment will be provided by the Max Vanderbeek Jazz Group – a professional jazz trio led by one of the Elville Center for the Creative Arts’ finest school partners and music directors, Dr. Maximus VanDerbeek of Wiley H. Bates Middle School in Annapolis.  Invitations will be forthcoming in The CCP’s final Continuing Legal Education Event of the year is scheduled for Saturday, December 8th, 2018, at the John A. Cade Center for Fine Arts.  Our guest speaker will be Ellen Platt, Geriatric/Life Care Manager with The Option Group, and her presentation, “Navigating Longevity,” will cover an overview of geriatric care management; cognition, brain health, and dementia; care options; and the importance of taking care of the caregiver.  Invitations and more information about this event will be provided in late October.

To learn more about the CCP, its many benefits and how to become a Member, please contact Mary Guay Kramer, Client Care Program Coordinator, at 443-741-3635 or mary@elvilleassociates.com.

Tags: estate, financial planning, financial power of attorney, news
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On Wednesday, May 23, I attended the McDaniel College Center for Aging’s update on Aging in Place. Not surprising, the results of a recent survey given to those over 60 indicated that over 90 percent of the aging population (which is rapidly growing) wants to age in their own home.

The exciting news is that more and more services are available to those who wish to “Age In Place.” The reality is that most are unaware of those services which exist and how to find them. Another reality, those services are fee for service not covered by insurance or subsidies. And finally, what the survey did not ask, are you willing to do what it takes to actually have the possibility of successfully aging in place?

It seems that everyone wants in on this new catch-phrase and yet the number of people who are willing to make the lifestyle, health or economic changes to be successful pale in comparison.

So what does it require on your part to age in place? First, proper planning and setting reasonable expectations is essential. If you wish to age in place, you just can’t “wish” it, you have to be proactive. Assuming that your home is an appropriate setting and refusing to make the appropriate modifications if necessary will most certainly not achieve the desired result.

It is important to take a good objective look at your current living environment. Is it safe and accessible? You may not be the one to make that determination. I can’t tell you how many times I’ve heard, “that rug is fine, it’s been there for 30 years and I’ve never had a problem.” You might not be shocked if you’re the child of a parent who has been putting up the good fight against change.

Ah, change. It’s the resistance to change that usually results in the change that we try so hard to control. We won’t change, we don’t need to change, we’re fine …

And then the crisis that brings us to the very thing we fear the most — dependence on others. If only we were hard-wired to roll with change and go with it before we are dragged there, things would be so much easier. But we aren’t, at least most of us.

So instead of putting some doubled-sided tape on the rug that slides under your feet or removing it, we say, “It’s fine.” Instead of moving to a home whether it be an apartment, accessible home or retirement community, we trudge up and down the steps with bad knees until we can’t and then it happens, the dreaded dependence.

Aging in place is entirely possible if you are open-minded and make a plan. If you think it’s just going to happen, you may be disappointed.

The survey, which asked if people wished to age in their homes, had some responses that indicated that they did not. Perhaps some of those people were realistic and knew that they must make a transition to a new home or living environment in order to age in place.

Planning cannot start too soon. What is it that you intend to do? Where do you intend to live? Is it accessible should the unexpected happen and you need to live on one floor with a full bath and all the things you need? Do you have doorways and a shower that can accommodate a wheelchair if needed for recovery from surgery?

If you want the best shot at continuing in your own home as you age, staving off chronic conditions such as high blood pressure, heart disease and diabetes is important. Improving or staying healthy requires a healthy lifestyle and exercise.

It’s not too late to become motivated to get up and get moving. The single best thing you can do is exercise 30 minutes per day. Do something, walk, play pickle ball, garden, exercise in a chair, whatever it takes to keep yourself moving!

I can’t help but remember the back of a T-shirt on a man I was following while running in a race: “I’m running faster than the guy sitting on the sofa!”

So get out there and walk, run or raise you legs in a chair faster than the guy sitting on the sofa! Do what it takes to have a shot at the golden dream: Aging In Place.

Jill Rosner is a registered nurse, certified geriatric care manager and owner of Rosner Healthcare Navigation.  She provides patient advocacy and care management services to clients with health and aging issues.  Contact her at JillRosnerRN@aol.com

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This past spring, Olivia R. Holcombe-Volke, Partner with Elville and Associates, co-founded the Community Advocacy Network (CAN), an initiative within the Maryland Volunteer Lawyers Service that inspires new attorneys and law students to give low-income Marylanders equal access to justice through pro bono work.

The MVLS is a private, non-profit legal services provider established in 1981 to help meet the need for civil legal services in Maryland that provides quality civil legal assistance to Marylanders with limited income at low or no cost.

Already a volunteer attorney with MVLS for the last 4 years, Ms. Holcombe-Volke, always an advocate for positive change in the communities in which she serves, worked for several months with the other founding members to make CAN a reality.

“Having served as a volunteer attorney with various pro bono legal services organizations for the majority of my years in practice, it is tremendously exciting to be a founding member of MVLS CAN,” said Ms. Holcombe-Volke.  “This initiative is aimed at connecting new attorneys – and sometimes, attorneys who are simply “new” to pro bono – with the vast resources available to them through MVLS and its network of volunteer attorneys, all with the end goal of increasing available pro bono services for the many Marylanders in need.”

For more information about the Maryland Volunteer Lawyers Service and the Community Advocacy Network, visit mvlslaw.org/mvls-can/.

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Stephen R. Elville, Esq., Principal and lead attorney at the elder law, estate and special needs planning firm of Elville and Associates, presented for a third consecutive year at the Financial Planning Association of Maryland’s Spring Symposium on Thursday, May 17th in Pikesville, Maryland.

Mr. Elville’s presentation focused on the 2017 Tax Act and offered certified financial planners in attendance a synopsis of the topics of interest discussed at January’s 52^nd Annual Heckerling Institute on Estate Planning in Orlando.  Mr. Elville discussed the 2017 Tax Act and its implications on how the Act affects estates and trusts, business tax issues, income tax issues, estate planning considerations, and asset protection.  

Mr. Elville works with individuals and families to provide a unique attorney-client experience and peace of mind solutions to the challenges they face with estate, asset protection, and tax planning issues, and with disability and a long-term care planning issues. He has extensive experience in working with clients involved in crisis situations. He also brings a unique and personalized approach to pre-crisis planning. Mr. Elville routinely handles clients issues in the followings areas: wills, trusts, powers of attorney, living wills/advance medical directives, Medicaid asset protection trusts, Medicaid planning and qualification, estate administration, fiduciary representation, nursing home selection, guardianships, special needs planning for children and adults, Social Security Disability Income (SSDI), Supplemental Security Income (SSI) and IRS tax controversy.

Mr. Elville was named to the Maryland Super Lawyers list in 2015, 2017 and 2018, and is a member of the National Association of Elder Law Attorneys, Elder Counsel, Wealth Counsel, the Academy of Special Needs Planners, and the National Network of Estate Planning Attorneys. He currently serves as a member of the Maryland State Bar Association Elder Law Section Council and the Charitable Gift Planning Advisory Committee for Anne Arundel Medical Center. 

He is a frequent guest presenter for banks and credit unions, businesses, the financial services industry and other organizations and is on schedule to present approximately 75 times this year regarding his areas of practice.  Mr. Elville also provides continuing education for financial advisors and CPAs through Elville and Associates’ bi-monthly Advisors’ Forum series.  His daily blog appears on elviilleassociates.com and WBJC.com and his articles have appeared in The Business Monthly.

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Stephen R. Elville, J.D., LL.M., and Principal at the estate planning, elder law and special needs planning firm of Elville and Associates, attended the Academy of Special Needs Planners 12^th Annual Meeting held April 12 – 14 in Las Vegas.

At Elville and Associates, the firm’s mission is to provide practical solutions to our clients’ problems through counseling, education, and superior legal-technical knowledge, so it is common for Mr. Elville to attend these important meetings around the country to remain on the leading edge of planning and what is new in the world of special needs, elder law and estate planning.  Mr. Elville recently attended the Heckerling Institute for estate planners in Orlando in January, and will be attending the National Academy of Elder Law Attorneys Annual Conference in New Orleans in May as well.

While at the Academy’s meeting, Mr. Elville had the opportunity to take part in cutting-edge educational programs designed to help professionals provide the best services for their clients.  He also met with colleagues from all around the country, which enhanced his knowledge and skills, and grew his ability to collaborate with other leading special needs planners.

Mr. Elville works with individuals and families to provide a unique attorney-client experience and peace of mind through a proactive and collaborative approach based on leading edge legal-technical knowledge.  Mr. Elville has extensive experience in working with clients involved in crisis situations.  He also brings a unique and personalized approach to pre-crisis planning.  Mr. Elville routinely handles client issues in the following areas:  wills, trusts, estate tax planning, powers of attorney, living wills/advance medical directives, Medicaid asset protection trusts, Medicaid planning and qualification, estate administration, fiduciary representation, nursing home selection, guardianships, special needs planning for children and adults, Social Security Disability Income (SSDI), Supplemental Security Income (SSI), and IRS tax controversy.

Mr. Elville was named to the Maryland Super Lawyers List for 2015, 2017 and 2018, and is a member of the National Association of Elder Law Attorneys (NAELA), Elder Counsel, Wealth Counsel, the Academy of Special Needs Planners, and the National Network of Estate Planning Attorneys.  He is the past Chair of the Howard County Bar Association Estates & Trusts and Elder Law Sections and is the past President of the Coalition of Geriatric Services (COGS).  Mr. Elville currently serves as a member of the Maryland State Bar Association Elder Law Section Council, and the Charitable Gift Planning Advisory Committee for Anne Arundel Medical Center (CGPAC).  He also serves as Chair for Law Day Maryland.

He can be reached by email at steve@elvilleassociates.com or by phone at 443-393-7696.

Authored by:  Jeffrey D. Stauffer – Community Relations Director, Elville and Associates

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