Good evening and thank you so much for watching us here on PBS Fort Wayne.
I'm Sandy Thomson, the host of this show called LIFE Ahead and you are our guest.
So really this is your show.
I'll be asking our guest Brian Nugent questions but I encourage you to give us a call if there's something that you would like to find out a little more information about in the area of law, let me introduce you if you've not met him before, although Brian, you've been here many times.
>> So I think most people out there if they're regular viewers know Brian Nugent specializing in elder law.
>> So nice to have you back with us.
Thank you, Sandy .
I appreciate it.
Well, you know, when you were here last month, Brian, we talked about it's kind of a new concept or a new way of handling seniors called life care planning and it's a it's an idea or a philosophy, right?
>> That's a great word, Sandy .
It is a philosophy.
So the philosophy is that you're providing for your clients more so than just doing a transaction.
So an attorney in your life care planning law firm might have on staff a nurse they could have on staff a social worker, someone that's skilled in Medicare so that the client of that firm may be coming in to prepare a will or prepare a trust protect assets but more importantly they would also be able to have a support staff there so they've had a change in their life circumstance let's say that they had a fall and they were looking to have a medical professional provide care for them or after the medical professional who provided care or should they go for rehab so that firm may have someone on staff, an elder care coordinator to be able to assist them to guide them.
These are facilities that have done a nice job as far as working with clients in the past.
Their scores are excellent and providing that rehab.
So you might consider those places to go also it could be a client working with that type of law firm like your planning law firm when it comes time to renew your Medicare in the fall of the year they would have somebody on staff that could look at your condition, what medications you're on, et cetera and assist you in reviewing what what health care plan may be best for you when you're choosing that health care plan.
Again, as I say in the fall of every year.
So the concept, the philosophy so it's much a much more holistic approach to providing care for your client, not just a transactional approach and that the client would come in, the attorney would prepare a document and the client will go away for an extended period of time.
>> The idea is that that law firm is a resource for the client.
>> The law firm may have year round year year round care of course because I will say elder law attorneys are seeing the clients coming into them and recognizing I may have worked with you for years and I'm seeing you change your family circumstances change a medical diagnosis may change.
>> So it's it can be frustrating for an elder law attorney to see somebody and not have more resources available to them to assist their client.
So you're going to be seeing a change in the elder law community estate planning community where over time you'll see more and more life care planning law firms or they're looking for providing a more of a holistic approach for their clients, not just a transactional approach where you come in and you leave.
>> Well, Brian, I'm curious.
I think I know the answer but but you're the expert this is the kind of a new concept here in the last couple of years.
But why do you think that's becoming a popular way of dealing with the agent or people that are needing some sort of assessment assistance like you said after surgery or whatever year round?
>> Why now instead of five years ago or ten years ago?
Why is it more popular?
I think over time what you've seen is that we have this aging population I've said it to before 10000 people a day turn age 65 that I I am always amazed at that statistic and we haven't hit our peak yet.
>> So you have this massive aging population so I think generally attorneys that are working the estate planning area, the elder law arena, they're empathetic to their clients and they want to provide care for them.
So it's a natural progression.
I can say when I first started practicing thirty years ago everybody knew the term estate planning.
If I said the term elder law people didn't know what that was.
Now elder law's on the tip of everyone's tongue.
You're hearing you know, you read articles about it and you hear recommendations to speak to elder law attorneys.
You have me labeled as an elder law attorney here.
Had you labeled me as an elder law attorney thirty years ago, nobody would have known what that was.
It's the evolution of the practice of of this type of care for seniors and it's life care planning.
>> It's the next natural step we need the very well and it's how do we assist them to age with dignity?
>> How do we assist them to secure resources to provide payment for their care?
How do we assist them to transfer wealth to the next generation?
It's more than just a one document profession and I think that those elder law attorneys estate planning attorneys are working regularly with seniors.
They recognize the need for this level of care and that's why you're going to see it becoming more and more prevalent.
>> It's it's in its infancy in this area.
I will say though, if we were to go to New York, if we were go to Miami, if we were to go to some other major metropolitan cities, it's not so unique in Indianapolis.
>> Oh, you mean they've been doing it longer?
>> Yes, it's very common.
Yeah, it's more common.
OK, if we were to go to Indianapolis you would see us as more prevalent in elder law and estate planning attorneys.
It might be unique to this area.
It's nothing it's not a service that an attorney would be subscribing to or a package that an attorney would be selling.
It's really a philosophy of how do I provide care for my clients in a holistic way so let's not get that confused.
>> Got it.
I understand and we've had a caller already sent a question to us here for you.
Brian Jamm called in.
He said he would like for you to explain the space program again.
>> That's Pace Fee.
Thank you for your call, Jim.
I don't know that we've got enough time today to explain the space program but the space program if you were to reach out to aging in-home services in wherever you're living, if it's Allen County aging in-home services here locally they would be able to talk to you.
It's based generally where you're living and there are additional benefits that are available to you through aging at home through governmental programs based upon the region in which you're living so that is something for you to look into depending upon the zip code that you're in, it may be available.
>> Those benefits may be available to you and they may not be available to you.
>> OK, all right.
Thank you so much for watching us here this evening.
I like the name Jim because I did want to give some kudos to our guests director tonight Jim Rickon.
>> He's back there running everything in the control room.
I worked with him for many years and TV so it's nice to see him here directing LIFE Ahead this evening.
OK, the rest of you give us a call here.
Brian, be with us for the remaining part of our half hour together.
Let's talk back about the life care planning you talked about these coordinators that would work with the clients or the patient or whomever.
What kind of training do they have?
How do how do I know that they're going to be reliable in helping me find resources?
So elder care coordinator is generally the term that's used.
Sometimes you'll hear people use an acronym s.E.C.
>> But Aleksi elder care coordinator OK, all right.
So the elder care coordinator typically you'll see social workers in the field of an elder care coordinator.
>> You'll see nurses in the field of working as an elder care coordinator.
>> So and typically they bring years of experience to that position.
>> So when I was referring earlier to there's a change in your you have a recent cancer diagnosis or you have, you know, a change in one's behavior, they're becoming more agitated, aggravated you have a dementia diagnosis.
So it may be that you're working with an elder care coordinator that's a social worker or a nurse that would be able to explain to you what's going on, would be able to put you in touch with resources.
You heard me mention aging in-home services a few moments ago so they may put you in touch with aging in-home services to talk about the space program that John was asking about.
They may refer you to the Alzheimer's Association locally to join a support group.
They're coordinating your care.
They're not necessarily providing direct care but they're putting you in touch with those resources, those individuals that may be of assistance to you.
>> So a lot of times that's just that's exactly what you need.
I mean maybe you know that that person that's recovering from a major surgery and they know they've got six or eight months of recovery time and they're going to need some help just getting through their daily and monthly monthly lives.
But critics and they can do it but they just so they've never had this so they don't know what's out there for them so they need somebody to help them find it.
>> So imagine OK, Sandy , you're at the hospital, OK?
You're being discharged and they're saying you need eight hours a day care.
Twenty four hour day care.
You're going to be leaving in three hours.
We're just letting you know you need this level of care.
The idea is that you're not caught flat footed.
You're working with that elder care coordinator.
You're working with that life care planning firm so that when that circumstance surprises you're ahead of it.
You have someone that's in those care plan meetings with you explaining to what's happening if you need care in the home organizing an agency to come in and provide that care if you're if you have the resources to provide for it privately.
If you don't have the resources to pay for it privately putting you in touch and coordinating the that care to be paid for by an outside source could be VA could be Medicaid, something like that.
>> So it's it's always sad for me and I'm sure for other elder law attorneys when you hear stories about when clients are talking to you I wish I would have known this when we were caring for mom.
I wish we would have known this a year ago two years ago.
So the idea is that when you're working in a holistic environment it's not a surprise.
>> You know that it's coming.
You have that team behind you the entire time and so it isn't traditionally what you would think of as a lawyer helping you find what agencies to come into your home.
But that law firm, that life care planning law firm would be able to point you in the direction of resources for you agencies to provide care for you.
>> I love that concept of their working together.
I mean, you know, the health care issues as well as the legal issues and financial kind of a whole big thing on financial asmus.
So let's say an individual has retired and they have they have funds but they're not sure how to invest them so that elder care coordinator could put you in touch with different financial advisors that you might speak with.
>> It isn't they're not generally pointing you in the direction of one saying this is the person they need to speak with.
>> It's more of an idea of these are individuals that we've had a history with.
I've done a nice job for other clients and so we want you and we encourage you to speak with them.
This is a good starting point.
If it isn't good, if it doesn't work out, it's not a good working relationship.
>> Not not to worry you would have somebody else that we could refer you to as well.
>> All right.
That sounds really, really good.
Now as with pretty much everything in life there are always pros and cons and I'm sure there many of you that would not have a need for this if you have a strong family support group nearby or living here.
>> But the thing is the world so transient now so a lot of family members may be living in different states or out of the immediate area so they can't be of much help.
>> Let let me challenge you on that for just a moment if you don't mind.
>> It is true that even if you have a strong familial support network, it's there's a difference between being let's say a care provider and being a daughter or being a son and I think to that our parents typically parents could be grandparents when we're working with them they may treat you differently than they would treat an outside care provider that's coming in.
So the the idea is that we want the children to be able to maintain that mother daughter, father daughter, father son relationship as opposed to being a direct care provider.
It's also not what you know always it's what you don't know .
So the actually the entire family should get to know that elder care coordinator and should work closely with elder care coordinator frankly more so than the attorney on an ongoing basis.
>> They might see them more than they would see they know exactly.
I have another question.
By the way, Bazza called and and I left this question for Brian tonight.
>> The question is what age should a person look for an elder law attorney?
>> Sixty five questionmark before or after retirement question what do you think?
>> Great questions.
So generally I would say elderlies it's very it can be broad elder law could even be working with an individual that has special needs.
Setting up trusts, setting up trusts for them so it could be earlier than sixty five but traditionally we think of elder law as being folks that are probably sixty five seventy seventy five when you're starting to think about gosh my health may change I may want to protect assets.
It may be that mom's going into a nursing home we didn't think we were going to need to protect assets so traditionally in nursing home stay you wouldn't think of in the sixties it could be in the fifties it could be but traditionally sixties seventy eighty.
>> The idea though if you're looking at that live care planning is that you aren't necessarily coming in to work with that type of a law firm when there's an emergency or when a particular event happens.
>> The ideal is that you have some type of an ongoing relationship so that elder care coordinator has a baseline to understand where you're coming from, what your issues are and can recognize when changes are taking place in your life .
>> But I would say Baza that's probably a fair age.
Sixty five, 70, 75, 80 that's probably a fair guesstimate for elder law.
I've said this before there's estate planning and there's elder law.
Every estate planning attorney does estate planning, every elder law attorney does estate planning and more.
>> So you want to make sure if you're looking for that level of assistance you're working not only within estate planning attorney which fills a very important role in our community.
But you'll want to work someone that has some background knowledge in elder law so that you can grow with them and if there is an event that's unique to the elder community that they would be well versed in it.
That's a good explanation.
I know a lot of people will even think I'm an elder law attorney that are younger.
I mean maybe if they are planning a big trip and they're leaving three or four little kids at home, you know, then people think I better have a will or I better plan a temporary guardian or something like that.
I when people typically typically are coming to estate planning attorneys, one of the first reasons that people are prompted to come in for estate planning is because they're taking their first big trip.
They've got this newborn right.
Your young people you don't have a lot of money but you've got this precious baby and you're wanting to put things together.
>> So without a doubt that's one of the first reasons people come to an estate planning attorney who could be an elder law attorney but definitely estate planning attorney.
>> I mean it's such good guidance anyway to make sure that you have all your ducks in a row.
>> I guess I wonder where that term came from that I'm not sure why something from the UK I would guess could be anybody knows calling and tell us what that phrase ducks in a row comes from.
>> OK, Brian, let's go back to the training if you will the coordinators.
If somebody is coming from a surgery and are going to be at home but they need somebody to come in and handle some of these things if require a medical background for therapies or whatever, do you send a certain person or does the firm whatever firm you're with, do they send specialized areas that certain needs?
>> So the key in the phrase elder care coordinator is the third word coordinator and so the firm isn't providing direct care.
Yeah, I understand that needing the care so they're looking for care that's appropriate for your situation.
>> So you hear phrases like, you know, mom's coming home from the hospital, she needs a nurse to take care for twenty four hours a day.
Frankly nurses don't provide they could but that's generally not how our system is set up.
General, we have attendance.
So if you're looking for assistance activities of daily living, you might want to receive attendant care if you need a higher level of care and it's medical care that would be the nurse that would be home health if we have an illness and that you've been it's been determined that this illness there could be a death as a result of this illness we might get involved palliative care or hospice care.
It's not that that law firm is providing the care.
They're coordinating it for the client and they're pointing out to the client these are different agencies.
These are different companies.
These are different medical offices that provide that care.
So we would encourage you to reach out to them if you've had a good experience.
We want to know about it.
If you haven't had a good experience that elder care coordinator would be able to point you in the direction of someone else.
>> OK, all right.
That makes good sense.
Katherine is called in also and we encourage and appreciate phone calls from you.
Well, Katherine has called in and says what is the estimated cost of this service now I know we can't give a definite no definite number because it's going to vary from from one person to another.
>> Is this something that most law firms would bill separately from their legal?
>> So the idea with the life care planning is that it's so once a year to write to your point I can't talk about specific dollar amounts.
I would encourage you to if you're reach out to somebody that that provides that service and and ask them those pointed questions but generally how this type of law firm works is that it is you come in and everything would be included with what you're doing.
>> So you could be doing your estate planning there.
You could be doing asset protection there.
You could be working with an elder care coordinator there.
You could have your Medicare review there.
You could work with VA benefits, their Medicaid benefits all for a fixed cost.
That's the idea is that it's flat fee such that a client wouldn't be concerned about asking questions on an ongoing basis.
They wouldn't be deterred by thinking I'm going to be charged on an hourly basis if you speak to the attorney once or five times the elder care coordinator once or five times the benefits coordinator on that staff one or five times it's the same cost.
It doesn't change.
So that's the idea.
It's really more holistic.
So instead of focusing on each product costs more money, it's that you are think of it like a subscription service.
>> You you're getting all of these services for a flat fee.
Yeah well I mean I guess it's kind of like buying car insurance or something you know you don't know if you're going to need it at all but you still pay your your annual fee or maybe you're going to need it five times, you know.
>> Yeah well thank you Catherine and Jan by the way, thank you for that question again we have a few more minutes here if you have another question you'd like to know, we do have one here.
This is from Lou and he says How do I find someone in my area for this service you mentioned I know, Brian, that this is is very common in larger cities than Indianapolis has many firms that offer this Fort Wayne is starting to it is and I think you're going to see it more over time.
I would recommend going online frankly I don't know typing in those words and finding firms that practice in the area.
I it's probably the best way for me to to encourage you to look for somebody if you think that that's something that you or someone in your family could could benefit from, I would suggest going online and looking for it that way.
Or if you have you know, somebody you've worked with before, call that office and find out if they've started offering the services yet.
>> OK, now we have just a couple more minutes.
Brian, what do you think's the most important thing that people need to know about life care planning?
>> Well, so is there an age where one would start to need it so unique to each person?
>> So I know the one caller had asked about age sixty five etc.
It's so unique to each client.
OK, so I don't know that there's a magic age that having been said I do think as we start to mature as you have a change in your life circumstance you recognize I am not immortal right.
Mom had a fall mom we are seeing that mom is maybe a little bit more forgetful than she's been in the past.
I would encourage you to start speaking with that life care planning law firm so that you have a baseline you understand who your elder care coordinator is here you the elder care coordinator can do an assessment of your your mother in this instance to find out where she is, where she needs to be can direct you to appropriate doctors to have a an assessment on write a diagnosis done.
Do we have a dementia coming on?
Is there something different than that?
Is it a medication issue?
>> So there isn't a magic time to do it but I would encourage the person to be ahead of the curve as opposed to being in the middle of a crisis.
You need to find somebody by Monday.
Yeah, yeah, yeah.
That's good advice and good counsel.
>> Thank you so much for that, Brian.
As far as the timing for this, let's say it's not a matter of an elderly person needing your help with services but maybe somebody younger that's just going to have some sort of major surgery or has something that's going to be a temporary situation.
>> So it's not like you have to I I don't want to use the word subscribe because that's not correct at all.
>> You're a client of the firm and the firm just happens to provide all of these other resources.
>> But you don't have to like do this every year if you if you decide to do it for one if it isn't appropriate.
If you're a younger person let's say you went through a bout of cancer and you were wanting that guidance during that period of time.
It isn't that you have to do it year after year.
>> Of course if it's useful to you and you you see that it's it's been a benefit to you.
I don't know why you wouldn't continue using it.
However, if you don't see as being useful for you the time period in which you needed that service has been completed.
>> Of course you don't need to renew it.
It's not well it's certainly a wonderful option that is available to people now that wasn't again a few years ago or a decade ago but as you mentioned since people are living longer and wanting to stay in their homes as long as possible, having these extra services or some help with it certainly makes sense, of course.
Well, I have loved talking to Brian as I always do.
>> You always share such good information.
Thank you, Sandy and Brian, by the way, will be back again next month.
>> Twenty six I think we tried it once in the in April and if you have legal questions for him, be sure and watch April twenty six.
Meanwhile watch us every Wednesday night at seven thirty we'll be here with new topics and new guests and hopefully we'll see you here.
>> Meanwhile stay safe and stay healthy.