By the year 2030, one in five Americans will be of retirement age.

Beers Mallers - elder law attorneys counsel individuals regarding matters of setting up estates, trusts and help navigate difficult family situations.

Beers Mallers, attorneys at law with offices in Fort Wayne, LaGrange, and on the web at BeersMallers.com.

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>> Good evening and welcome to PBS for Wayne.

>> We have a really interesting show for you tonight here on LIFE Ahead.

I'm Sandy Thomson but the real focus are going to be on my two guests this evening.

We're going to be talking about a guide, if you will and remember that word guide.

We're going to talk about that a little more clearly to staying a little bit longer.

>> And from all we've talked about here on LIFE Ahead in many, many shows is that people tend to want to stay home longer if they're ill or if they have some sort of medical problems rather than going immediately to a nursing home or assisted living.

I mean maybe they eventually do that but if they can stay at home they try to we're going to find out more of how you can do that.

OK, I'd like for you to meet our guest this evening and if you have been watching then you know Janelle Sprinkel nice to have you always thank you.

>> Thank you for having me.

It's always great to be here.

>> Janelle, you've done this many times.

How many years now do you think?

Oh my goodness.

Kelly was just asking me the same thing and I honestly don't remember a time flies when you know it's been a few years.

>> Yeah.

Yeah.

Janelle, by the way is an attorney specializing in elder all right.

>> Yes, correct.

OK and Janelle has invited and brought with her Kelly All right, I'll get it Reeser Yeah.

>> OK, good.

Kelly Reesha rhymes with resus.

That's exactly.

>> And Kelly by the way is going to give you clearly a definition and an example of what people in the guide program do.

>> So stick around and also we want to hear what you would like to know about how to stay at home longer and again maybe even getting some legal advice (969) 27 twenty .

>> You can see that phone number there at the bottom of the screen and that'll appear periodically here in the next half hour Jim is our director tonight Jim Record and I'm sure he'll put that phone number up just so you can give a call with your question.

>> OK, let's talk first of all, Janelle, you're you're the first I was going to say victim.

>> Not bad at all.

No, you're the person with the first question evening where a loved one starts to lose the beliefs whether it's dementia, Alzheimer's or maybe even physical abilities.

What are some legal documents that they should make sure they have in place?

>> And that's a great question.

Yes.

A lot of times we think about it from our own perspective but with a lot of times when you're getting older and you're trying to stay at home, it's your loved ones that are really coming in to help you and they're the ones that are starting to look through your documents and see what you have because they need to rely on some of those things and they're hoping that you have had those prepared during your lifetime.

And the two most important documents that I always advise caregivers to make sure they have is the power of attorney and the health care power of appointment because both of those two documents allow them to speak on behalf and carry out your wishes so that it allows them to be able to come in and help you if you need help.

>> Well, which person who are you going to pick for those positions?

>> Well, are are there characteristics that that person should have should you have one person doing both are two different people.

>> How does that work?

You'd be surprised how often I get asked that question.

A lot of times parents struggle over that because they feel like they need to go on birth order or they're going to upset one child if they choose one over the other.

But the answer is who is the best person for you?

And the two documents ones vary.

>> The power of attorney is very geared towards financial transactions and calling offices and talking about business and moving property and finances around.

>> So a lot of times you're looking for someone in your life A that you trust implicitly or you have to if they're going to handle your finances.

>> Absolutely.

And someone who has that type of a good and responsible with businesses responsible, maybe they make good financial decisions in their own life .

So that's something to look for .

And then the health care power of appointment is maybe you have someone in the medical field in your in your life because that's very much speaking with doctors and and understanding your medications and understanding what questions to ask and being able to help you in the health related area.

>> So and they can be the same person they can be different people but I always say pick the best person for you and then have a backup or two because we discovered you could can you put that in in the legal document?

>> Absolutely.

I can say we want people rather than not enough.

>> We want to make sure there's someone there for you at all times.

Is it complicated if you're trying to pick two people for one of those drums?

>> No, not at all.

You can if you're picking two people to help you simultaneously we can talk about whether you want to put an or between their name meaning child or child and that means basically whoever gets there first can help you.

Yes.

Or you can think about putting it and you got it between their name and that is more that they both need to work together.

>> So that's very good if you want to make sure that they both agree before they do something.

But I always caution parents that a lot of times that also means it slows it down a little bit because both have to agree they both love each other and you guys sharing information if that were the case and they're doing some legal work with documents or instruments of some kind, do they both have to sign so that could get a little more if it's in the end.

>> Yes.

If you have indicated in your document that that they both need to act together, then yes, they both need to sign they both need to go the bank to open the bank account.

They both need to do everything together so it it does slow down a little bit I understand about you know, picking people that are right for the job.

>> Fortunately I only have two kids so narrowed it down and my son immediately when we talked about several years ago Mom don't make me in charge of finances.

>> I am not good at that.

>> Made your decision easy.

OK, thank you for that information.

I already knew it you know OK let's let's talk with you Kelly about what you used to do.

>> You were with our aging and in-home services for a long period of time and you were let's say dementia and integrated care is what was that position?

>> Yes.

So I've actually been with aging in-home services for eight years and so I worked in case management and then I transitioned into dementia care.

So I was the dementia integrated care and liaison and what that meant was I basically was the go to for all things dementia for the community.

So I was going out in the community learning about what dementia support were out there and we have a wide range of what we cover so we cover Allen County and all the surrounding counties.

>> So big job.

Yeah.

So I was driving all over the place talking to everybody about you know you have support groups for caregivers, you know are there day services here and different supports like that.

>> Are there just doesn't have to do necessarily with our topic this evening.

>> But are there day care, if you will, services I know there are some here in Allen County are there and other counties also there is one up in a northern county and I believe it Stuben County and it's a nursing facility but they do allow people to come in for the day.

>> Yeah, I had a friend once whose wife developed early dementia.

She was very young in her early fifties and but he was working he was an attorney also Janelle and so he had to go to work but couldn't leave his wife at home after a period of time again questions about turning off the stove or going for a walk and getting lost that sort of thing.

>> And he took his wife every day on his way to work to one of these daycare facilities and they took wonderful care of her and he picked her up on his way home from work every night.

>> So what a great program.

>> Yeah.

All right.

Now you're not doing that anymore.

You're still with aging and in-home services but they've developed a new program called Guide G.U.

IDC what is that CANALIS So a guide is actually a program developed by centers of Medicare and Medicaid Services or CMS.

So it is a national program and aging and in-home services apply to be a participant for that program.

And so Guide is a specific program for dementia people with dementia or cognitive issues and their caregivers.

>> Do you have to have some sort of a documentation or certification to be a part of it?

So we did have to apply with CMS so there were certain things that we had to put in place.

>> Yeah, like we had to hire a nurse practitioner for our clinic.

>> We had to have a care navigator to work with the caregiver and set up all of those types of things.

>> And what do you do with Guide right now I am the guide clinic specialist so that means that I am in the weeds every day figuring out this program we just started in July so it's new.

>> It's brand new and so we've had a lot of things to figure out and you know, I'm the marketer, I'm the person there.

I'm checking patients in.

>> I'm doing it all.

So then the primary service is that you do home health care if you will, or you provide respite for caregivers.

>> Which is it or is it it could potentially be both.

So the guide program if you're on it we provide social and physical clinical support through a nurse practitioner and what she will do is she'll focus specifically on that dementia diagnosis and then if there's a caregiver involved we have a care navigator who will help them reduce their stress and burden, provide them education on how to care for somebody with dementia and then yes, if they qualify they could potentially a respite benefit and that respite benefit could be in home respite.

It could be a an adult day center or even could be a facility stay OK, that's really a great topic and again a new program.

>> So if you have questions about it, give us a call.

OK, Janelle, I want to go back to you a little bit.

>> Kelli's mentioned dementia and I'm sure that since you work with a lot of elderly people in your profession, you come across dementia or a form of Alzheimer's a lot.

>> Are there special things you have to do?

Do you have to have somebody else be with them when they meet with an attorney or does everything have to be signed twice by somebody else in the family?

>> Do you need a doctor's notice that they do have an illness?

>> Yeah, well a lot of times when we see someone they are with a loved one that has come in and is asking these questions and a lot of time they're overwhelmed and they don't know where to start and they don't know what to do and they're asking exactly the questions that you are.

And so I do help them answer their legal questions and that's why it's fantastic to have a guide program to to help support and then going through this process because I can answer legal questions but they still have a lot of I don't know even where to start and that's what the guy program can get them started on.

>> But to answer your questions legally to to be able to create a legal document, someone has to understand what they're signing so they do have to have competency to be able to to create a legal document.

So if we're in the office and if their loved one says there's you know, there's just a newly diagnosed Alzheimer's or dementia, they're still if it's an early if we catch it early and they understand that yes, I really do want my daughter to be able to make these decisions for me for example, for a power of attorney maybe they don't understand every last intricate detail of their finances but they can articulate to me that they understand what that means and they want that diagnosis doesn't mean that they're uncap incapable of understanding.

>> So there is some leeway there.

But if their competency is in question, if if the attorney can't really ascertain that they they do indeed understand, then we usually rely on a medical statement from their physician to say whether they they are able to make their own financial and health care decisions.

>> But you know, that's why we always say you want to get in early because there does come a point or you're no longer capable or your loved one is no longer capable of creating these documents.

>> Well, OK, do you make that judgment call or if are you the one that decides after meeting with them I need the doctors not permit but yes yes if I don't feel comfortable that they understand what we're discussing in the document that that is in front of them, then I will I will there's a form that we can give them to talk to their physician or their neurologist or wherever they feel comfortable does have to be signed by a medical doctor.

But that the you know, I rely on the physician, the experts to to make that decision and if if the physician thinks yes they are they do they are capable of making the decisions they come back and I'm happy to to walk through with the document with them and have them sign but but but yes if if it's unclear I will defer to the doctor.

>> OK, all right.

How about speaking of the doctor, do you have to have a doctor's diagnosis or anything telling to sign up for the guide program?

>> So the nice thing is you don't you can have a dementia diagnosis or you can just be having some cognitive issues memory loss and maybe you think something is going on.

Our nurse practitioner is able to perform some tests and do some evaluation to determine whether or not you have dementia and then she can also, you know, say on what scale is it early?

>> Is it moderate?

Is it late stage?

Well, all right.

You mentioned in Michigan we've been through that several times tonight it is getting to be it seems not popular but very common.

>> It's a common issue for a lot of people.

What are some other things that they might be having Canley?

>> What about physical ailments that maybe they've just had a major surgery?

Yeah, they qualify not necessarily.

However, if you're not familiar or familiar if you go under anesthesia sometimes that can make the dementia, you know, come on quicker or early.

>> I don't know that yeah.

>> That's a little frightening.

Yes.

So sometimes people wake up and from the anesthesia and they're just not the same person or they can have a stroke and yeah they might have you know, some vascular dementia.

So it's possible that that memory loss could come on after a hospitalization.

>> OK, all right.

Getting back into the legal part of it, what about talking about you're talking to the client here and you've already done your phones.

>> You've done your power of attorney and your health care representative.

Anything else any other document that you work with people on and when do you start preparing these things?

>> Sure, I'm sure the two that you mentioned are we call them the lifetime documents.

Those are the documents that help you while you're living.

It allows a loved one to help you while you're living.

But of course the other important estate document is where do you want your assets to go when you pass away?

And that would be a will or a trust another type of an estate tool.

And I get asked that question very often everyone knows I want all of my things to go to my spouse.

>> Do I really need a will?

And the answer is yes because you exercising your right to prepare will allows you to say where you want your assets to go if you don't do that, unfortunately it's not where your family thinks you want them or where you've told people you want them.

>> It goes to where the Indiana code says they go and so that's the plan that depends on your family situation and and I usually use the example if you're married and have children you may want everything to go to your spouse .

But what the Indiana law says is half will go to your spouse and half will be divided among your children.

So a lot of times it's not what you would really want and verbal a verbal conversation with somebody in your family is not enough.

>> Now that's very interesting.

Indiana code I think we've talked about this some before on life for him and that's like the Indiana law legal code or list whatever exactly where your assets will go if you don't have a will and that's like farm you can't call somebody and say oh could you make an exception?

>> You're exactly right and a lot of times we have family members who think they can make those exceptions but but they can't unfortunately, you know, the bank will only release it to you.

>> You know, you have to have the courts order course authorization to unlock those funds and then you have to follow what the court directs you to do.

So there's really not any way around where those assets will go.

>> OK, lots of people ask this question too.

So I'm going to ask our attorney here what if you don't have a will you just never thought you needed one or you just never got round to it?

>> Yeah, that's what that's exactly what happens.

Your assets will be distributed to your heirs as defined under the by this law enforcement agency code .

>> You're exactly right.

So it looks at are you married?

Is that your first marriage?

Is it your second marriage?

Do you have joint children?

Do you have stepchildren?

>> It will go through your whole family situation and it will tell you how all of your assets will be divided.

>> Who does that work?

I mean who does the process of finding out what your assets are and pay any outstanding bills and who does that if you have not named it while I was just about to say that that that's your leaving it open to people anybody who wants to do it because in your ruling you also get to name not only do you name where you want your assets go, you name the person who's in charge of carrying out those wishes.

>> Trustee the personal representative is what it is under a will under a trustee.

You're correct.

It's the trustee so different hats, different names.

>> I know you guys abbreviated into your PR person represent yes.

right.

>> I keep learning all these documents here.

I try to use them whenever I can.

OK, so then that person takes over that duty.

>> Yes.

Yes.

If you've named him in your will.

But back to your question if you haven't named him typically it's someone who knows they will be inheriting some of your assets a beneficiary because it's it's in their best interest to make sure that your estate is process and that it does get to those individuals because they're one of them.

So typically someone will step up and take that role but it may not necessarily be the person you would have chosen to do that.

>> What if you change your mind or the family changes their mind and they decide Oh well I see what my brother has done here with all of the assets because of how mom and dad didn't have a will.

But I don't agree with and I don't think that's what should have happened.

>> What do I do generally?

Do I come to you and say file an appeal or something you can contest if you think that they were not handled correctly but again the brother in your situation, he doesn't get discretion to give them wherever he wants.

He has to follow the Indiana code .

>> So the only thing really you can contest is whether or not you feel like he followed the code correctly.

>> OK, all right.

See it's complicated but not so complicated if you do some pre work there.

Exactly right.

Exactly.

And he's always remind us about Kelly going back to you with the guide program.

>> I printed this out.

I was lucky enough to have it sent to me in an email but this obviously is like the instructions for Guide Dog that goes over everything.

>> You know that guide program and company provides yet eligibility.

>> Yes, all that so like all here can I put this off the website?

>> Oh yes.

If you even just Google Guide program OK it is like I said it's a national program so I be on the same all across the country but the qualifications and opportunities are all the same.

>> Yes they should be the same although there is a lot of flexibility.

For instance our program has a physical clinic where we have people come and we do their assessment there and some other guide programs do everything telehealth OK, some other guide programs do everything in the home so we do have the ability to go in the home if we need to to do that.

But most often we'll have people come into our clinic or we'll do a telehealth visit.

>> OK, that's making sense.

OK, I think we have just a few minutes left here on our program so I want to know from you first Janelle any last minute things you want to share with our viewers to make sure that they try to understand what they need to do, what their responsibility is as they get older?

>> Yes, I think the what you mentioned earlier early is better come in when you don't think you need it yet because you have time to think of things through.

Thank you.

The best person is for you get those documents made because you're making not only are you explaining where you want things to go but you're making it easier on your loved ones to be able to come in and help you if needed while you're living and also you're making it easier on them to be able to carry out your wishes as far as where you want your assets to go.

And I always like to say well someone says well what if I don't have a power of attorney?

And that really is a great example of making it more difficult on your family because a power of attorney is a half an hour in an attorney's office.

One document you sign it, you're on your way if you do not have that if your loved one does not have that for you when needed, the only other option they would have is to go through a guardianship which is a court process takes about three months.

They have to go to court.

You have to go to court.

>> You're you're there's another attorney that's assigned to speaking on the need for more time, more expenses.

Yeah.

Yep, you're exactly right.

So in the probate judge gets involved in naming your guardian that's much more complicated, much more complicated.

>> So getting in and talking to your attorney and getting a simple estate plan done is the best thing that you can do for your family.

OK, always good advice from General Sprinkel.

>> Thank you very much.

Yes, I tell you like thirty seconds to give a pitch on guide why should people be interested in guide?

>> Does it do for them?

Well you know what the individual is going to get a lot for this program.

You know, they get the nurse practitioner to focus on that dementia but really there's so much for the caregiver they get ongoing support education on how to care for somebody with dementia, help with not getting stressed out so they respect respect.

>> Yeah.

And they get education on how and stress reduction and so it's really important I'm going to echo Janelle and say you need to get in early before you got too stressed so that you never get to that point and we can keep people at home for as long as possible and that's the purpose of it.

>> Well, thank you all for watching us here tonight on LIFE Ahead what we're here every Wednesday by the way at seven thirty with different topics and different Gaspin.

But I want to thank again Janelle Sprinkel.

Thank you for all your legal advice and Kelli Arena, thank you very much for introducing us to guide valuable program it sounds like.

>> All right.

Good night to all of you and we'll see you here next Wednesday night Beers Mallers - Elder law attorneys providing information on legal matters of guardianship and financial issues relating to nursing home care.

Beers Mallers attorneys can also assist with Medicaid requirements and help navigate difficult family situations.

Beers Mallers - Attorneys at law with offices in Fort Wayne, LaGrange and on the web at BeersMallers.com.