Have a Plan for the Unexpected

The continued rise of the coronavirus has left many both confused and unprepared. There are numerous reports of shortages of antibacterial hand sanitizer, disinfecting wipes, and even toilet paper. While we can’t predict when something like COVID-19 might strike, we can take steps to prepare for an unexpected crisis to help reduce the stress on ourselves and our family members.

Designate a family member who will check on elderly relatives. Make sure everyone knows who will responsible for checking in with an elderly loved one each day. Also set up a process for notifying other family members of an elderly loved one’s condition – this may including sending an email, text messaging, or phone calls. The method is not as important as agreeing to a process and sticking to it so all family members stay informed.

Seek medical advice in the event of a health care crisis. There has been a great deal of reporting about COVID-19, and some of it has been inconsistent. Reach out to your trusted medical team to understand what you and your loved ones should be doing in this, or any, health care crisis.

Make sure someone knows how to get your bills paid if you are unable to. This type of power can be provided to an agent under a financial power of attorney. Powers of attorney can include numerous powers so it is critical to talk with legal counsel before signing any type of legal document that gives someone else authority over your finances.

Be sure there is an accurate list of medical prescriptions readily available in your home. If you become ill, it is important that someone knows the medicines you take and the dosage. Keep this in your home where others can find it, and make sure the list is dated, noting any time it is updated. Many of us assume that our doctor has an updated prescription list, but if you are seeing multiple specialists, that may not be true.

Designate someone you trust to make medical decisions for you if you are unable to. This should not be a form that is downloaded from the internet. Deciding what type of treatment you want, where you want to live, and what should happen if you have a terminal illness are serious topics that should be considered carefully, then translated into a proper legal document.

Planning for an unexpected health care or financial crisis can help relieve a great deal of stress for you and your family. We would welcome the opportunity to help you come up with a plan that works for you. If you have questions or would like to discuss your estate planning options, please contact our Norman, Oklahoma office at 405-928-4075

 

Seniors are Changing Their Living Wills Due to COVID-19 Concerns

Kaiser Health News is reporting the coronavirus pandemic is prompting seniors to create or modify their living wills. Specifically, intubation is the topic that has many seniors crafting or rethinking their strategies amidst a wealth of disparate COVID-19 information that makes forming reliable conclusions for decision making, dubious at best.

Ventilators Options Seniors During COVID-19

Initial reports were suggesting that the use of a ventilator, a machine that pumps oxygen throughout a patient’s body while lying in bed, sedated, with a breathing tube down their windpipe, was showing signs of promise in severe cases of COVID-19. Yet, further into the pandemic timeline, these machines that help patients to overcome respiratory failure appear to have discouraging survival rates.

The prognosis of an older adult with COVID-19 placed on a ventilator with an underlying medical condition like lung, kidney, or heart disease is even more dismal. These older COVID-19 patients who do survive, spend considerably longer (two weeks or more) on a ventilator and tend to come out of the treatment extremely weak, deconditioned, often suffering delirium, and requiring months of rehabilitative care.

Opting Out of Ventilators

Many seniors are revising their advance health care directive to address the case of COVID-19 specifically, and they are opting out on the use of a ventilator. Joyce Edwards from St Paul, Minnesota, is unmarried and living on her own with no children spoke to the issue stating, “I have to think about what the quality of my life is going to be. Could I live independently and take care of myself, the things I value the most? There’s no spouse to take care of me or adult children. Who would step into the breach and look after me while I’m in recovery?”

Joyce’s situation is not uncommon in the United States. American seniors are more likely to live alone than ever before: the new mantra of “aging in place.” Living alone does not mean they do not have family, somewhere. Still, in the case of contracting COVID-19 and the difficulties recovery can present, many seniors prefer not to upend the lives of their younger children to prolong their own lives. Some seniors prefer to ‘go quietly into that good night’ after a life well-lived. They are conceding in writing that extraordinary measures to keep them alive are not how they wish to spend their final months, weeks, or days. It is especially true in the case of intubation, where a patient is essentially in a coma state and unable to communicate with loved ones before they might pass on.

pewresearch.org

COVID-19 Care Gray Area

Then there is the gray area of choice regarding respiratory failure due to COVID-19. While some seniors may be saying NO to a ventilator, doctors can give high-flow oxygen and antibiotics. Positive airway pressure (PAP) machines are another mode of respiratory ventilation. BiPAP and CPAP machines deliver oxygen but without the sedation required during intubation, which allows the patient to be alert, more comfortable, and have interaction with family and friends.

COVID-19 Discussions for Senior Care

Having discussions with your spouse, family, or doctor if you are alone, about COVID-19 and what to do if you contract the disease and how you might amend your living will to reflect your desires are more important than ever. Dr. Rebecca Sudore, a professor of medicine at the University of California at San Francisco, suggests directing the discussion away from using a ventilator or not, to a more general discussion of how an older adult sees their future.

The discussion should include questions about what is most important to you as an older adult. Do you treasure your independence? Or is time with your family more valuable to you? Is being able to walk and be physically capable important to you, or can you live happily with compromised lungs in a more sedentary lifestyle? Is your goal to live as long as possible? Or is it about the quality of your years on earth? In an open and calm discussion, answering these and other general questions will provide the context that will lead you to your decision about ventilators and other breathing machines.

There is a lot to think about when it comes to end-of-life wishes. We are here to help you decide what documents are appropriate to adequately express your wishes. We look forward to talking with you.

Education Funding Flexibility in Light of COVID-19

When it comes to returning to school in the fall, the details may still be unknown. Will students be attending classes in person, or will classes continue to be online? Will college students be allowed on campus, or will they be bunking with mom and dad for the fall semester? One thing is certain: education will still be costly. In times of uncertainty, it is important for your planning to be as flexible as possible while still meeting your needs.

Some techniques for funding education expenses require that the funds be spent only on certain items to take full advantage of tax breaks and incentives. Other tools are less restrictive regarding how the money can be spent, allowing for more flexibility—which is important during these uncertain times.

Qualified Education Expenses Only

Coverdell education savings accounts. Money that is invested in a Coverdell education savings account must be used for “qualified education expenses.” These expenses can be incurred at eligible postsecondary schools as well as eligible elementary or secondary schools. For elementary and secondary education, qualified education expenses include tuition and fees, books, and supplies. If the school requires or offers them, room and board, uniforms, and transportation may also be deemed qualified education expenses. For postsecondary schools, tuition and fees, books, supplies, and equipment are deemed qualified education expenses. Additionally, room and board may be considered education expenses if the student is enrolled at least half-time at the institution. Items such as computers and internet access are also considered qualified expenses for students at all grade levels as long as they are primarily used by the beneficiary (and for students in elementary or secondary institutions, the beneficiary’s family) during any years the beneficiary is enrolled in the eligible school. However, this does not include expenses for software that is not predominantly educational in nature.

529 plans. A 529 plan, also known as a qualified tuition program, requires that the funds be used for qualified education expenses to avoid paying income tax and a 10 percent penalty. For 529 plans that are used to save for elementary and secondary institutions, the funds can only be used to pay for up to $10,000 in tuition. Similar to a Coverdell education savings account, tuition and fees, books, supplies, and equipment are deemed education expenses for postsecondary education at an eligible institution. Additionally, room and board may be considered an education expense if the student is enrolled at least half-time.

Tuition Only

In order for payments on the beneficiary’s behalf from a health and education exclusion trust (HEET) to be excluded from gift and generation-skipping transfer taxes under Internal Revenue Code Sections 2503(e)(2)(A) and 2611(b)(1), the funds must be paid directly to the educational organization for tuition. With respect to a HEET, education expenses can include tuition for any grade level, from preschool to postgraduate, for part-time or full-time students. However, room and board, books, and other related expenses are not deemed education expenses eligible for the tax exclusion.

Education Expenses Are Your Choice

Revocable education trusts and revocable living trusts.  A revocable education trust or a provision in your existing revocable living trust can provide you with significant flexibility. As the person creating the trust, you can allocate the money and property to cover any expenses related to education. This includes not only tuition and institutional fees, but also room and board and other personal needs associated with attending school. An additional benefit of these planning tools is flexibility: if you need to change the amount of money you have given the trust, add or remove beneficiaries, or terminate the trust entirely, you have the ability to do so without any adverse tax consequences. A significant downside of revocable trusts is that there are generally no income or gift tax benefits available for setting them up.

Irrevocable gifting trusts. Similarly, an irrevocable gifting trust allows you to define what expenses can be covered by the beneficiary’s share of the trust. The main difference is that by placing money and property into an irrevocable trust, you no longer have control over it. However, irrevocable gifting trusts can provide some tax advantages that revocable trusts cannot. The rules listed in the trust document will be used for the entirety of the trust’s existence, with some limited exceptions. Therefore, it is important to work with an experienced estate planning attorney to make sure that you plan for as many contingencies as possible.

No Major Restrictions

Lastly, a Uniform Transfers to Minors Act or Uniform Gifts to Minors Act account does not impose any major restrictions on the use of the funds. When one of these accounts is created, the money or property is held by a custodian for the benefit of the minor. Because this property is technically owned by the minor, the custodian has the responsibility to manage, invest, and where appropriate, use the property for the benefit of the minor. While there are no statutorily enumerated uses for the account, it is generally understood that these funds should not be used to pay for expenses that would normally be considered parental obligations, such as food, clothing, and shelter. As soon as the beneficiary reaches the age of majority (eighteen or twenty-one depending on the state), the beneficiary is free to do whatever the beneficiary wishes with the money, with no restrictions.

We Are Here to Help

We are living in uncertain times, but we understand that providing for your family is always a priority. Having a plan in place designed for your family’s unique circumstances can provide substantial peace of mind. We are available, via telephone, video conference, or in person, to discuss the options available to you and your family as you navigate the current conditions and plan for your family’s education and financial future.

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