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Build Your Empire

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Empire State's BuildingRecently, I took my family to New York City, the Big Apple, the city that never sleeps, as sort of a celebratory rite of passage for my oldest son’s 16th birthday.  As I sat on the plane preparing for takeoff, for what seemed like an eternity, I had that feeling in the pit of my stomach… You know, a little anxious, a little scared, but mostly excited. “What if something happens?” I thought as my wife and 16 year-old sat beside me. Luckily for my family, I have my foundations or foundational documents (GDPOA, HCPOA, Living Will, Will) in place just in case something happened to me. Others are not so fortunate, although with a little planning and a quick trip to the office, they too, could have that peace of mind.

Without proper planning, the assets that you have worked so very hard for, for an entire lifetime could all be lost.  And then you would be unable to pass your assets down to your family, and to leave a legacy to help your children and grandchildren.  A legacy built upon your hard work.

Many in Manhattan know this. Wealthy Manhattanites hire lawyers to draft trusts and implement wealth protection strategies to care for their families well into the future.

Why should you not be afforded the same protection? Why should your family not be given the same chance to build upon the foundation you have laid through your lifetime of hard work?

Empires like Manhattan were built over many generations… Each generation building upon the foundation of the last… Passing on wealth and legacy.

Start laying the foundation for your empire today!

Call me if you have any questions:

Greg McIntyreGreg_Full
Elder Law Attorney
McIntyre Elder Law
123 W. Marion Street, Shelby


What Happens if a Family Member Becomes Incapacitated? The Unpopular Topic of Discussion Every Family Needs to Have

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What Happens if a Family Member Becomes Incapacitated?

The Unpopular Topic of Discussion Every Family Needs to Have

Just bringing up the possibility of someone in your family becoming mentally or physically incapacitated is often difficult. We tend to think of only the very elderly needing long-term, hands-on care, but a recent report by the Alzheimer’s Association found that one in nine Americans age 65 or older currently have Alzheimer’s. With the baby boom generation aging and people living longer, that number may nearly triple by 2050. Dementia isn’t the only reason for long-term care, of course, but almost everyone knows someone already affected by it.

Waiting too late to plan can throw a family into confusion about what the Mom or Dad would want, what options are available, and what resources can help pay for care. Rushed decisions are often the most costly. Having the courage to discuss the possibility of incapacity now can go a long way toward being prepared should that time come. By the way, because anyone can become incapacitated at any time due to illness or accident, the entire family would benefit from planning for every family member.

Planning/Discussion Considerations

Care Options: Depending on the type and expected duration of care needed, options range from in-home care to adult daycare to assisted living facilities to nursing homes. Assistance with activities of daily living (ADL), which include eating, bathing and dressing, are generally not covered by health insurance. Professional care can be expensive; the national average for basic assisted living services is now about $42,000 per year. Care for those with dementia can last longer and cost more. Family caregivers, who provide the bulk of in-home care, are often unpaid, and the emotional and financial tolls can be considerable. Your discussions need to realistically consider family finances and circumstances.

Finances: Where will the money come from to pay these expenses? What resources will be available? Health insurance does not cover assisted living/nursing home facilities or help with ADLs. Medicare covers some in-home health care and a limited number of days of skilled nursing home care, but not long-term care. Medicaid, which does cover long-term care, was designed for the indigent; to qualify, the person’s assets must be spent down to almost nothing. VA benefits for Aid & Attendance may be available for veterans and their spouses. If there are significant assets, you can self-insure and pay the costs as you go. Home equity and retirement savings can also be a source of funds. If you want to protect these assets for your family, long-term health insurance may be an option. (Premiums are much lower when you are younger.)

Documents: Everyone over the age of 18 needs basic legal documents. These include an advance health directive or healthcare power of attorney (legally appointing another person to make healthcare decisions for you if you cannot make them yourself); a durable financial power of attorney (legally appointing another person to make financial decisions for you if you cannot make them yourself); and a trust and/or will.

Having the Discussion: Your parents may be harboring secret fears about what will happen to them if they need long-term care. Talking about this honestly, listening to their fears and desires, and putting a plan in place before it is needed can help reassure them (and you). If you want to talk to your children, reassure them that you are just being realistic. Starting with a story about someone you know or an article you read can be a good way to break the ice.

How to Get Help: An attorney who specializes in Elder Law has already helped many families in these same situations, and will be able to make recommendations that will save you considerable time, money, and stress. He/she can also work with other advisors (financial/investment, insurance, CPA, etc.) to help put together the best plan for your family’s circumstances.

Call me if you have any questions:

Greg McIntyreGreg_Full
Elder Law Attorney
McIntyre Elder Law
123 W. Marion Street, Shelby




Medicaid Crisis Planning – Part 2

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MedicaidWe’re talking crisis. We’re going to get down and dirty today.

We had a new article come out in the ‘Shelby Shopper’ this month called, ‘Are wills obsolete?’ I know a lot of people are talking about that, and the real problems with the probate and wills process okay.
And we’re going to talk about that today, really centered around Medicaid planning, which is Medicaid Crisis Planning.

Are Wills Obsolete?

What happens if you find yourself a spouse, a mum or a dad, or a family member in a crutch where they’re
headed to a nursing home, or in a nursing howtoobsolete-800home, or assisted living facility, and money is being spent down like crazy, it’s being thrown away like water.

What do you do?
Well, you come to me.

There’s crisis everywhere at the moment? It’s a blood red market right now. The Dow is down 300 points, crisis, panic, panic. That’s really troubling for a lot of retirees.

People have worked hard to acquire things and you don’t want to just give them up or lose them in the end, or at some point in the future.

Watch the full show here:

My grandfather always planned and saved so he could leave something to his children, so he could help them start out on their own. And my father always saved and invested.

We all want to leave a better lot in life for our children, give them a leg up. I think that’s just human nature, don’t you?

It’s something a lot of people don’t think about.
They don’t think about it because they don’t realize what they can do. They also don’t know what will happen if they don’t do certain things to protect their assets.

This is something people should pay close attention to, because knowledge is power. If you don’t know what you don’t know, you can’t make the best decisions for your future.

That’s why you need to come and consult with someone who knows, like myself, like the people at our office.

Why is all this important to seniors?
A lot of us have invested in the stock market, and 401Ks and IRAs that are going up and down like a rollercoaster.

Listen to the Full HD Podcast Here:

You’re watching your retirement go down but you know it always comes back up eventually, it’ll bounce back, you can’t afford to panic right? We’re in it for the long haul.

But what else can make your retirement disappear?
It’s something much faster than the stock market.

Going into a nursing home is going to cost you somewhere around $50’000 to $75’000 to $100’000. That’s probably a lot more than you’ll lose on a 300 point drop on the stock market.

Watch that money disappear at a clip of $75’000 to $100’000 every year, year after year after year. That’s when I’m sitting with someones wife who is crying and upset because she believes she is going to be poor and destitute because of a long term health care situation that her husband has. Perhaps he has early onset dementia.

The sad thing is, they both worked their whole lives, just hard workers who worked to build their retirement, and it’s just disappearing like water over a waterfall. And it’s not their fault.

The Money Situation
This elder couple have paid out 40 to 50 cent on every dollar they’ve earned through income tax and from sales tax.
They pay 3 times what it cost to buy their house from the interest over 30 years on their mortgage. So, if they paid $100’000 when they bought their house, they end up paying the bank $250’000 to $300’000.
Then in order to access a benefit like Medicaid for long term care, they have to spend down all the money from the 50 cents they got to keep, their dollars, and are potentially forced to sell their property or have a lien placed on their house, or taken away if it goes through a will or passes by a will. (??)

That is why you should read my article ‘Are Wills Obsolete,’ because that’s where liens are attached, that’s where that Medicaid lien attaches and takes that away from your family and from going to your children. That’s a college education for a grandchild right there.

I don’t like that in our system. I can’t reconcile that everyone doesn’t agree with me on those points.

Look, from my perspective you really have to get behind your clients position, you have to get those blinders on and be just die hard loyal to that person and their position. And that’s how I view my job.

The client in the hot seat is a senior, and I’m helping them have as many health care options as possible. I’m helping them if it’s a couple or family, protect their hard earned assets they worked their entire lives to get, and keep those assets in their control.

I hear a lot about what age should you start giving away your property or your land?

The normal person would say about 60 to 65.

The real answer is, absolutely never. NEVER.

A hundred percent, a hundred and fifty percent never ever ever ever ever should you give your property away. Maybe that’s the way our programs and our legislature have set things up but their wrong. And the system is wrong. And we need to fix it.

You do all that, and then?
In the end you access the health benefit to help pay for long term care. That’s the same benefit that is causing all your assets to disappear. That’s the 50 cents on the dollar you got to keep, and the house that you paid 3 times as much for to the bank, you’ve got to give all that away in order to access that same benefit.

And who paid for that benefit in the first place? You did, with that other 50 cents that was taken away in taxes. And that’s the position that I take.

I am talking here about an emergency and crisis situation but I’ll lead into that by talking about wills.

So, what is a will?

It’s a document that’s created that designates, when you pass away, where your property is to go and/or to whom.

When you take a will to the court house to probate it, you have to wait a 90 day waiting period, whether it’s a small or regular sized estate, and possibly publish that in the paper to give the public notice and wait 90 days before you can do anything.

Why do they do that? Why do you open up that 90 day waiting period?

It’s in case you owe money to someone, if you have creditors or something.

If you don’t have a will, don’t worry, the laws of NC already has a program set up to pass all your property any way the state sees fit.

I’m sure everyone trusts the state to pass that property the way you would want right?
No absolutely not.

It benefits people to know how the state will administer your estate. Usually it’s a pretty fair deal. The state is usually going to split it up equally among kids. The problem comes in if there’s a spouse. It could pin the children and the spouse fighting against one another for assets.
In a family where there are step fathers, step mothers, step brothers, or step sisters, it just gets crazy.

I’m going to be really clear. The state is doing what it can to anticipate a fair way, or try to think of a fair way to distribute your assets. But it might not be your way.

You may want your wife to get everything. You may want your children to get everything. You may want a church to get a portion, or a charity but it’s not necessarily going to happen that way. It’s rare that it happens just the way you want it to, unless you draft a will.

Why would Medicaid have to come in and pay for long term care for someone who requires nursing home or assisted living care?

This happens if you have exhausted your Medicare.

How long will Medicare pay?

20 days.

And what happens after 20 days?

If you have a supplemental, it will pay up to 80 days. So 100 days in all if you have a supplemental. So you have a very short period of time from the time you actually walk into a facility, until the time you begin paying out of pocket, or your long term care insurance kicks in, if you have it. If you don’t have it, you should try to get it.

Why should you have a long term care policy? And why is this such a big issue?

What are the odds that people over 65 years old are going to need some form of long term care?

According to the current statistics, it’s just around 70%. 70 percent of seniors. That’s frightening.

Medicaid Crisis Planning Seminar
That’s why I do a hard core Medicaid crisis planning seminars that you need to come and see. I’m giving seminars this year. I’m giving 6 in Cleveland County on Medicaid crisis Planning.

They are going to be limited to between 5 and 20 seats or 5 to 20 couples. If you want to come to a Medicaid crisis planning seminar we have one in February.

You have to qualify for these seminars. You have to have a loved one going into nursing home or assisted living long term care. We are going to sit down and talk about the secrets of Medicaid crisis planning.

You can save your money and property of your loved one and your family.

It could be a person whose parent is headed to or in a nursing home or assisted living facility, and their parents assets are quickly disappearing. It could be a wife or husband who is scared because all their retirement is rapidly going away.

And they’re scared because they have been told they can only keep $2000. Well that’s not true.

Monetary information.
Generally a healthy spouse can keep $119,220 under the current rules in their name, or the community spouse as they’re called.

The person receiving care can keep around $2000 or less in their name. But we can save more than that.

There are strategies that can be employed, and there are spend downs that can be used correctly. That’s what we need to take a look at.

There is strategic deed planning, we talked about Medicaid Asset Protection Trusts last week in part 1 of this show, but moving on to a crisis, there is deed planning even in a crisis. There are Ladybird deeds we can employ to save property right now and avoid the 5 year look back period.

These are the things we need to talk about. And these are the things we will get down and dirty about at our Medicaid Crisis Planning seminars.

You need to see an attorney who knows about long term care and Medicaid and special assistance Medicaid.

For those who would like to call and talk about how to save your money and property, call my office and sit down with me for a free consult. Just mention you heard me on the radio show ‘The Elder Law Report.’

Our number at the office is 704 259 7040.

I’m Greg McIntyre, the elder law guy, lawyer Greg, and I have a firm called McIntyre Elder Law, that’s what we do.

We help seniors protect their assets and legacies.

Call me if you have any questions:

Greg McIntyreGreg_Full
Elder Law Attorney
McIntyre Elder Law
123 W. Marion Street, Shelby



2016 New Years Resolutions – Making Resolutions and Taking Action.

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It’s a New Year again. Welcome to 2016 everyone. I’m totally jumping into 2016 this morning. It’s a new year, I can’t believe it’s a new year. Where’d the last year go man? I’m not ready. It went by quick. Maybe as we get older we sleep through a lot of it.

This is my year end review show or blog. I’m going to talk a little bit about resolutions and planning for 2016, and what that entails.

Resolutions are such a sensitive subject. “What are your resolutions?” They’re personal but general at the same time. Most of us throw out the same resolutions each year as if they’ve just become part of the tradition of New Year. Maybe that’s why so many of us fail to achieve our resolutions, and fail so quickly.

I want to change that.

I want to make a difference because your resolution should be something that can make a difference to you and even others in the new year.

And maybe that should be the first step to achieving your resolutions:
So my first point is this: Have a resolution (or resolutions) that make a difference, not just for you but for someone else also.
I know, resolutions are supposed to be or usually are self-centered or ego-centric. They’re supposed to be about how I can change something about myself that I don’t like, or improving something like finances, health, job or whatever.

Let me explain my thinking.

So that’s another year. We reflect on the year, we do the new years celebration thing, and then we set out to make new years resolutions for next year right. And that’s what everyone is doing right now or has already done.

Just a short while ago, I was looking at Time magazines top ten of all time broken new year’s resolutions. I chopped that down to the top five.

No.1- Lose weight and get fit.
No.2- Quit Smoking.
No.3- Learn something new.
No.4- Eat healthier and diet.
No.5- Get out of debt and save money.

I think those are the top resolutions made and broken.

Most resolutions as I mentioned are self centered or ego-centric. That’s not that we’re deliberately trying to exclude other people, we just want to make improvements for ourselves.

And it occurred to me that if you make resolutions that include others, that can benefit another person, you’ll be more likely to succeed in those resolutions. That brings me to my second resolution point: Accountability.

Having a resolution that can benefit another, even if that benefit is secondary to your own, will push you to follow through. You will feel accountable.
So if you want to get fit, start riding bikes with your kids. Or resolve to do something where you have support from others, who support your goals.

If you want to resolve financial goals, bring your spouse in on it. If you have someone who is an advocate with you, you won’t want to let them down. You become accountable to them, which pushes you to succeed.

Hayden who works in my office said on our New Years Radio Show that, “the best exercise program I ever did, I did with a friend and I would feel I let her down if I didn’t do it. It helps your plan if you make a commitment to someone else.”

So, what are your resolutions for 2016 and how are you planning on keeping to them. Figuring that part out is as important as the resolution itself, if not more so.

For me, I grew a lot this year, personally and professionally. I really focused on estate planning and elder law services. I didn’t spread myself thin. And that’s really amazing, I call it the X factor, I’ll write a book about it one day.

Doing this allowed me to take action. I mean real action

And that brings me to my third resolution point: Don’t spread yourself thin. Don’t have 20 wildly differing resolutions all going at the same time in different directions.

Having just a few resolutions to focus on will allow you to achieve the next point much more effectively. So point four is: Take action. “Actions speak louder than words.”

So, here they are:
• Choose your top two or three resolutions and commit to them. Just a couple of them. Focus on those only.
• Then make sure you bring someone in with you. Someone who will maybe benefit from your resolution also, who will support your goal, and hold you accountable. Who will keep you on track.
• Take action. Don’t let your resolutions just be words. Put action behind them.

And finally and possibly the most important point of all, make sure you really want to achieve your resolution. I know how that may sound. What I mean is, choose the resolutions closest to your heart.
Example: If you need to lose a few pounds but you’re only doing it because people are telling you that you should, the chances are you will drop it like a stone at the first opportunity. Choose from your heart.

What are the most important things to you that you want to resolve this New Year?

Good luck and Happy New Year everyone.

Call me if you have any questions:

Greg McIntyreGreg_Full
Elder Law Attorney
McIntyre Elder Law
123 W. Marion Street, Shelby


Alzheimer’s and Dementia with Expert, Teepa Snow

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Teepa Snow

For this very special episode, I was honored to be able to interview expert on Alzheimer’s and Dementia, Teepa Snow. During our discussion, Teepa and I spoke about everything from care to causes and what needs to change in the systems to allow for more humane treatment of loved ones with Alzheimer’s and Dementia. 


How did you come to be the expert’s expert in Alzheimer’s and Dementia? 

It’s interesting, I would have never thought that. But I started off doing a lot of work with the USD School of Medicine and I was part of a team when I graduated and got my Occupational Therapy degree. I have worked in long-term care, so when they were looking for somebody it seemed like a good match and I had the good fortune to work with a good nurse, a good social worker, and then a couple of really good strong, family practicing general internal medicine physicians who understood geriatrics really well. That allowed me to learn the art of working with lots of disciplines, but to work with people that have Dementia. 

Then I did some work with head injury, and I did that for three years. I also went back and worked again with Dementia in a psychiatric setting. Then I did home care and community care, and I worked at the VA. During all this time I kept building expertise in geriatrics and I find more and more I understood Dementia and could work with those with Dementia and show improvement while working with their caregivers a lot better than most of my colleagues. I found it interesting and exciting, not scary and awful. During that time I’d also be doing in-services and training, so as time went by people would start going with me to do things. Then I worked for the Alzheimer’s Association as the Education Director in the eastern North Carolina area. We made a couple of training videos because we were doing workshops, which lead people to want more and more workshops. So we thought, “Okay, let’s develop a video now.” The video became the video used nationally by many groups that addressed the issues one would face when trying to care for someone with Dementia. From there it snowballed. 

Listen to the full interview here:


What would you say has been your experience with patients with Alzheimer’s and Dementia? And what is the difference between the two? 

That is the most common question I am asked. Think about Dementia as a great big umbrella, and under that umbrella, one of the boxes is Alzheimer’s disease. But there’s other boxes: there’s frontal temporal lobe Dementia, there’s alcohol-related Dementia. So we’ve got a lot under that umbrella, but if it is under the umbrella it means four things: 1.) that at least two parts of the brain are starting to die, and what’s causing it will vary. 2.) as of right now, if it truly is Dementia, there is nothing we can do to slow it, stop it, or turn it around. We don’t have anything to rid of it; none of the drugs change the disease. 3.) if it’s truly Dementia, it’s going to get worse, it’s going to progress. All sorts of Dementia are neuro-degenerative, meaning they kill off the nerve cells in the brain. 4.) they’re all terminal illnesses, and once you have it, if nothing else kills you first then it will kill you. It will destroy so much of your brain that your brain can’t run your body anymore. So if you make it to the end, you’ll die of pneumonia because you can’t coordinate your swallowing and your breathing and your ability to fight infection, so you’ll get an infection in the blood stream that you can’t fight. If you get dehydrated and your brain says, “You don’t need any fluid”, your brain then says that you’re done. 

We didn’t used to keep track of that as Dementia, but it’s actually the Dementia that’s causing your body to shut down. And now it’s the 5th leading cause of death for people over 65 and the 11th leading cause of death for all ages. 


And the only one we don’t have a cure or treatment for. 

That’s right, nothing that does anything for the disease. The only thing we have is some people benefit from some of the medications some of the time for a short period of time. That’s it, that’s all we have. Care therefore becomes the critical feature, and yet if we look at our care patterns and what the government support is, it’s nothing. We do nothing for people living with Dementia, we manage their acute medical illnesses poorly because primarily we don’t know what to do with Dementia but I can fix the UTI. So what I’ll do is tie you down and give you antibiotics. Well, what’s going to happen the next time? We’ll do it again and again, but where are we going with that? So we unfortunately put people through a lot of distress because no one really understands what the disease looks like. Doctors think, “I can treat that” but yet they can’t treat the Dementia.


Does a living will help in these situations in any way? 

Well, let’s say I have an advanced directive that with any other health condition would be honored. The only state in the nation right now if I developed Dementia would be Oregon. In every other state, Dementia precludes me from having my directive followed. 


You unveil an important point, which is the living wills apply to when someone is terminally incurable, brain death has occurred and they’re being maintained by respirators. That doesn’t count for this situation where the mind is not coordinating with the body. 

This idea of competence is really complicated when it comes to Dementia because although I may not be competent to handle financial affairs, I might be competent to decide whether or not I want turkey or chicken for dinner. But that’s not how we’ve divided the pie here; it’s all black and white. 


So the legislature needs to work with people like you that are on the front lines in developing laws and directives to account for situations like Dementia and Alzheimer’s. 
Yes, because they don’t exist. With feeding tubes, they came to the realization that actually we weren’t improving anybody’s life and the value of doing that was actually nil. It actually didn’t change the quality or quantity of life, it made people more likely to have bad things happen. 


You deal in the healthcare industry on a regular basis. How much abuse of those directives is present? 

It’s possible, but let’s figure out what’s going on, and I would think the abuse that goes on to the people who have Dementia is much worse right now because they are put through things that I don’t know how anyone can do to another human being. And they call it “care”. 


I’ve said before, we treat animals in end of life situations better than people. 

Right, where is that going to take somebody? And to get people to take that step back and go, “Guys, this is not euthanasia like you’re talking about. I’m not taking somebody’s life away from them, I’m helping them do the things that they really value.” And yet we are more than willing to restrain people, tie them up, give them additional medications to make them protest so that I can deliver the “treatment” I believe they should have so they can live three more days. 


With zero quality of life and lots of pain. That’s ridiculous. 

How many times are we going to put somebody through this before we say, “You know, they said no.” Okay, let’s people together and work through this before we get to this place so that we’re really acting in the person’s best interest. Not working from anyone’s opinion, but what the patient clearly asked for before this started. 

This is going to be a movement from the ground up. I think Wisconsin and Minnesota are dealing with the issues, and they’re dealing with the issues because they, like North Carolina, have a large rural aging population. The resources are changing, the care situations are problematic. And people would rather die on their farm than move into a facility and lose their sense of identity and purpose. So how are we going to deal with this? Something needs to change about how care is delivered; people would never choose that. You walk into these places and you go, “Yes, better than it used to be”, but would I live here? Absolutely not. 

People pay phenomenal sums of money for an intensive care stay at the end of life for no decent outcome whatsoever, no quality of life during the process. And yet we will not pay a penny for the person to be cared for in a different situation. 


With 2/3 of the population being over 65 since 2010, Dementia and Alzheimer’s on the rise, you have to be able to identify it and then know how to react to it to give proper medical care. 

And yet there is no requirement at all for hospitals to have any kind of training in Dementia, for EMS services to have any kind of specific training in Dementia or police and fire departments, yet they’re the front lines, they’re the people out there in the community. 

The civil rights issue for people living with Dementia is finding that balance between what support and care I do need, and people making decisions about me without me, and me being able to be incarcerated for the rest of my life without a trial. If you put me in a secure unit, I may never get out again. Who’s to say that I’m there by virtue of what’s best for me versus what’s best for my oldest son who decided that I was causing a lot of trouble and it would be easier for him to manage my estate without me being present. 

Right now across North Carolina, it is permissible to lock people up and it doesn’t matter what they want or what they think. It’s rampant, and it’s a knee-jerk reaction. At a national level, the conversation is happening regularly. Yet nobody wants to address this because you’d actually have to address this. 


That leaves a good question on the civil rights issue: who’s going to fight that issue, and how do you fight that issue when you really don’t have a client that’s competent to be had? 

What I think we’re going to see is more and more younger onset patients say, “No, you’re not going to put me here.” And what happens is they typically get kicked out to the psyche unit and back because they get in trouble. So people are not sure what to do with the young onset people, and I think some will end up being lawyers and judges and someone is going to say, “I’ll take you to court.” I think we’re getting to that point where there are enough higher profile people who are getting this condition who are smart people, and they’re going, “Wait a minute, you can’t just do this to me.” And up until now there’s been just a few of them, but I think the numbers are starting to rise a little bit. 


Has this always existed throughout time with humanity? Or is this something new? It seems like this wasn’t the case when I was little; it was senility. But were we just calling it something else? 

Some of it has been around but not the amount and not the intensity. Our lifestyle is dramatically changing and our environment is changing, not only the environment of the brain but our environment and how we live our lives is very different than it was a generation and a half ago. I think when you start doing that over time, what we’re finding is high stress, sleep deprivation, and high sugar intake with limited opportunities to socialize and engage leads to certain types of Dementia in that umbrella. Certain types have become much more prevalent than what we used to see. We never saw it like we’re seeing it now. We’re also seeing more young onset situations. So I think we have lots of different things happening, but now we’re seeing an increased number of survivors who live long enough to whom the things that wouldn’t have happened because they were gone, are now happening. If you look at many of the young onset folks, you’re going to see the high intensity people, and they worked really hard to the point where they never gave themselves a break. We know that with people who are high-risk worriers – worrying is a bad habit because you can’t let it go – the risk goes up. 

It’s been a pleasure to interview you. Thank you 

Call me if you have any questions:

Greg McIntyreGreg_Full
Elder Law Attorney
McIntyre Elder Law
123 W. Marion Street, Shelby

Senior Living from A to Z with Regional Vice President of Operations for Brookdale’s Southeast Division

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Kellee Agee

Kellee Agee – Regional Vice President of Operations for Brookdale’s Southeast Division

Brookdale Senior Living is a premier nationwide provider of senior living services and has nearly 80,000 associates. Regional Vice President of Operations for Brookdale’s Southeast Division, Kellee Agee, talks about assisted living, senior services, the future of the industry, and more. 


How did you come to hold the position of Regional Vice President of Operations? 

Such a wonderful story. As with anyone in healthcare, there is an interesting hook at some point in their lives. About 20 years ago now, a best friend of mine who was in assisted living as an executive director running a community, she and I would many times talk about our jobs. I was a business woman but I wasn’t in healthcare but I had a tremendous amount of stress as she did, I dealt with laws, regulations, budgets, and employees. But she had such stories abo
ut having an impact with people’s lives, and it spoke to me on such a level that when I became pregnant, I had a very early somewhat mid-life crisis where I felt I wanted to do something more meaningful. So I spoke to my family about wanting to get into senior living. But I was told I couldn’t just come in and run without having experience in the healthcare aspect. I was willing to take a step back and become a part, so I was hired as the business manager of a community after I convinced them I was serious. 

At that time, after about 4 months in the business office capacity, I was promoted to my own building, which is unheard of and I don’t know anyone else who was that fast paced. But in North Carolina at the time, there wasn’t any kind of formalized training or certification that you had to go through. From day one when I walked into the industry, I had to take home manuals to learn what people were saying around me. But looking back, I can’t imagine doing anything else; I feel so privileged to care for people. It kind of chose me, I feel. 

Listen to the entire interview here:

How many assisted living facilities do you have nationwide? 

At Brookdale we’ve got a little over 1,100 properties. The region that I oversee has 35 properties across North Carolina and Virginia, and so that’s my area of expertise at this given point. We have such tremendous heart at the head of this company, and you almost have to experience it. Our former CEO was such a tremendous man that set a benchmark of excellence and of being a person first, and allowing that to translate into what we do. Andy Smith, when he took the reins and getting the chance to see Andy respond, interact, and communicate with our company – as large as we are – he has continued that same standard. It’s a privilege. We truly have people that understand the results come from doing the other things right and doing them well, and that you’re going to have periods of time where there’s going to be a lull. 


If a family out there who is in need of an assisted living facility is looking for the right place for the father, mother, husband, etc., what should they look for in an assisted living community? 

That’s a great question, and I think it’s something – to be honest with you – I wish more families would better equip themselves to visit different communities. There’s such an emotional state of mind when someone is in need of help or support with a loved one. They thus tend to put too much weight on how they connect with an individual person – be that a salesperson or a person in administration – and it needs to go beyond that. The people aspect is critical, so one of the things I tell my own family members and neighbors, people who don’t have Brookdale as an option, is when they go into any healthcare setting, talk to and pay attention to all of the people within the walls of the community. Talk to as many as you can to get a sense of their satisfaction, their happiness. What kind of feel do you get from people who are there day in and day out? 

Definitely interact with the residents, if possible. Sometimes it’s not as beneficial, but they will tell you if they are happy, engaged, if they’re treated with respect from the staff. If that’s not part of the initial walk-through, then take that initiative and try to talk to other people. Even with something like Brookdale, it’s all about having great people who are called to do what they’re doing, who are well trained, and who have the resources. You don’t have to be overly-educated or understand all the jargon or ins and outs of regulations and requirements; it really comes down to a family going into a community and getting a sense of the people working within the community, and the confidence they can have. That makes the difference, and that’s something that Brookdale understands; it’s threaded in everything that we do, that people are the key. It’s not the corporate office, it’s not me, it’s not having state-of-the-art programs; it’s about investing in the caregiver, the cook, in the housekeeper. That’s where you’re going to get the most impact, in the people working within the community who are actually providing the care. 

With the caregivers, you need to look into, are they certified by a state program? Are they actually required to be certified nursing assistants? Do they have nurses Monday through Friday? Do they have them around the clock? I think they need to be empowered to ask every hard-hitting question that they possibly can and ensure they get good answers, specific quantified responses. 


Obviously, care takes money, just like anything else. How should a family look at making sure that they have the funds available to go to an assisted living facility, one that has the quality of a Brookdale community? And what are alternative ways to pay for care? 

Generally depending on the situation, I think that’s where Social Security and annuities or retirement is not enough to cover that. What you find is that you have more and more families that are either looking at a limited amount of savings for retirement benefits that they have, and it only gets them so far. There are other options out there, but they’re not foolproof. Some states have a some level of assisted programs either through Medicaid or some other branch of social services to provide some assistance. Overall, when it comes to paying for care needs and as care needs advance between a resident using their savings, retirement, we’re seeing more companies getting on board to provide additional options with reversed mortgages. You definitely have some of those options, cash-out options on life insurance policies and things of that nature. 

But I am so thrilled to see the uptick in long term care insurance. Others will need it far longer than any of the best planning could have foreseen if they don’t have some sort of long term retirement or family wealth that’s going to sustain decades of advanced care needs. 

I’m seeing an increase in awareness, but people have to get more educated and plan better for long term and how they’re going to provide for themselves. We’ve seen a lot of scare with even something that was considered a given: Social Security. People understand we are living longer, and unfortunately we’re becoming less and less healthy as we live longer. More of us are going to need longer term but more expensive provision as we age. 


What do you see coming for the future of assisted living communities and care for seniors? 

I see a lot more tattoos and nose rings, to add comic relief to it. I definitely see that with coming generations, there’s a different level of expectation. There’s a different level of education, so I think we’re going to have far more demanding consumers, both residents that need the services as well as their families to where all companies are going to have to step up and meet the changing needs of the Baby Boomers. Their needs are very different than the previous generation. 

I think we’re also seeing the younger people coming into the workforce having a much more demanding expectation of what they want in an employer. So maybe work ethic is one way to put it, but we’re looking at the fact that we’re going to have to have a different model of who’s going to be that caregiver 10 years from now. When you look at the fact that our aging population is going to explode over the next couple of decades, the workforce based on projected numbers doesn’t look to keep up with that. So I really think that we as a society are going to have to think of some ingenious ways to bring technology and synergies into senior living to maximize the benefit provided for seniors outside of what individual person to person is going to provide. I think that also may be a benefit to people who are living at home, as well. There’s going to be a lot of change. 

Call me if you have any questions:

Greg McIntyreGreg_Full
Elder Law Attorney
McIntyre Elder Law
123 W. Marion Street, Shelby

American Legion, Veteran’s Benefits and Programs with District Commander, Evan Thompson

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Official Seal

VA Healthcare and Veterans’ Benefits

Evan Thompson is the District Commander for the American Legion of Cleveland and Rutherford Counties. Evan took the time out of his schedule to discuss with me the needs of our veterans in the community. We also touched on how you can get involved in the American Legion and how groups such as those are serving veterans in their respective communities. 

Evan has a rich background stemming from his time spent in the Marine Corps, and when he came out of the Marine Corps, he joined the North Carolina Air National Guard, which he would later claim was not a smart move for him. After realizing this, Evan went to the Marine Reserves where he spent one year before moving on to the Army Reserves in 1976. 


For the 2013 American Legion World Series, Evan Thompson of Shelby has been, as the baseball saying goes, “on deck” for the national anthem at every game, meaning he's ready to perform if the scheduled singer cannot.

Evan Thompson, District Commander

What were your duties as part of the Army Reserves? 

I was an infantry training instructor, so I taught things like mechanized infantry, 50-caliber machine guns, and things like that. I stayed in the Army Reserve until 1992, and during that time I went back on active duty with the Army and I spent one extended tour at Fort Jackson training soldiers for an entire training cycle. I also did a tour of duty at Anniston, Alabama, at the Chemical and Biological Warfare Center. I therefore had a very long career, 23 years. I retired in 1992 as a Brigade Sergeant Major with the rank of Command Sergeant Major. I enjoyed it all, and I loved my military service. I think military service gives people skills that they wouldn’t otherwise have. 

Now you’re in the American Legion, working as the District Commander. Let’s talk about some of the great things the American Legion does. 

The American Legion is such a great organization, and I have only one regret about it: that I didn’t join earlier than I actually did. I’ve only been a member 5 years and had I known what the American Legion does, how beneficial it is to veterans, I would have joined a long time ago. So I think one of the best things a veteran can do today is join the American Legion. 

There are obviously a number of veteran service organization, such as the Marine Corps League, the VFW, DAV, all those are great organizations; but the American Legion is the largest veteran service organization boasting a membership of over 2.4 million not only in the United States but in foreign countries, as well. The American Legion is also based on four pillars, which really determine what the Legion does. They are: Americanism, national security, children and youth, and veterans and veterans’ benefits. To give you an idea of what’s in those pillars, for instance, one of the main programs from the Americanism pillar is our baseball program, and we’re fortunate in Shelby, NC, to be the home of the American Legion World Series. That is a tremendous honor and it’s something that not too many services can boast. The Series brings so much to the economy of Cleveland Country during that time of year, and the support from the community and volunteers is incredible. 


What are some other benefits offered by the American Legion? 

Of course, things we like to really focus on in the American Legion is helping our veterans and helping our youth. These can be children or grandchildren of veterans, but it’s not limited to that. That’s one thing about the American Legion: you don’t have to be a member to get the benefits that the Legion has to provide. One thing I want to point out to everyone regards the GI Bill; the American Legion is responsible for bringing that piece of legislation about. That’s been a very important piece of legislation in many veterans’ lives. I know for me, when I got out of the service, I already had my Bachelor’s, but I got my Master’s degree, then worked on my 6-year Specialist degree, then I had some time left and went back to get an Associate’s, followed by some work on my Doctorate. The GI Bill paid for most of that, which is a tremendous benefit. 

The Legion is also responsible for the development of the legislation that brought about the VA Healthcare system, and so lots of veterans enjoy benefits from that. So if you are a veteran and not tried to enter the VA Healthcare system, you need to make an application to that. 

Many veterans who are just coming out of their service don’t know about this system and what is available to them. It could be because they don’t have major healthcare issues at the time. But one thing about eligibility is you have to have served over 180 days of active duty to be eligible, and then the healthcare system has categories. There are 8 categories, and based on your physical condition, whether or not you served in combat, whether you have a service-connected disability, and others all determine the category that you’re placed into. From there, if you’re in category 8 like I am – I don’t have any disabilities connected to my service – you’d thus have to pay co-pays as a result, which are very small. Pretty soon, I’m going to be able to get hearing aids, which I need badly and the VA is going to pay for all of that. That’s a tremendous savings for me, all because I was a veteran. 


How does one get into the American Legion? 

To be qualified for the American Legion, you have to have at least one day of service during a war time period. Now, there are very few periods that were not war time periods since 1917. One period in there is between 1955 and 1960, we were not engaged in conflicts anywhere. So those are the veterans that kind of fall through the cracks when it comes to being a member of the American Legion, but this is just the way that Congress chartered the American Legion. There’s nothing we can do about it; we’d love to have you as a member, but according to the charter, you’re not qualified.

So if you would like to become a member of the American Legion and you qualify as such, there are several things you can do. Many times, you’ll get information as a veteran from the American Legion and you can sign up, but when you do that, you’re not assigned to your local post. You’re assigned to a pool of American Legion members down in Raleigh. What I can do for you is if you happen to be in that situation – and there are quite a few people that are in that situation – if you’d like to transfer to Post 82, then I can do that for you. You just need to give me a call at (704) 484-2902. If you want to become a member, you can call that same number. The reason we use that number is we don’t have anyone down at the post during the day; we meet once a month on the second Monday of each month, so there’s no one there at the post most of the time. We therefore give out my phone number for people to call, and I’d certainly love to have you as a member of the American Legion. This is what we’re here for: we’re here to serve vets, and if you become a member, then you’ll be serving other vets. 


What are some of the other programs available?

One of the incredible programs we have under the youth pillar is called Boys’ State, which is a great program we have down at Catawba College to train young men who want to learn more about the government of the state and the country. It’s a good item to have on your application for college, too, especially if the young men are applying to a military academy. You’re given ten additional points for entry if you’re completed Boys’ State. 

Another thing we carry on is the Oratorical Contest every year. Students from all the local high schools can get involved in this contest, and if they win and go all the way up to the national competition, they can win up to an $18,000 scholarship. The Contest is coming up and will be held locally at Ascension Lutheran Church on January 9. So if you are a local high school student and are interested in being a part of the Oratorical Contest, then you need to talk with your school counselor, because we’ve already put out information to all the local high schools about the contest. You need to then get your speech planned, so time is limited on this program. 

I can only encourage people to become a part of the American Legion because it’s an organization that I’m totally dedicated to, and I’m willing at any point in time to help any veteran in any way that I can. As District Commander, I have 8 posts under my jurisdiction, and those are posts all the way from Chimney Rock down to King’s Mountain. I’m not the commander of those posts, but I help the post in every way that I can. I’ve become the liaison between the State Department American Legion and the local posts. 

Our meetings are once a month, the second Monday night of each month. So if you can’t contact me, feel free to come to our post. It’s at 1628 South Lafayette Street in Shelby. We’d love to have you as a guest! We always have a meal before our meetings, too. Our Christmas party is coming up, so it’s going to be a little different for this year’s party. We’re growing, and we’re about to outgrow it, which is why we’re having this year’s party over at the VFW. 

If you’d like more information about these benefits, please contact our office at (704) 259-7040, and we can get the Veterans’ Aid and Attendance information out to you, as well as American Legion information to you.

As a reminder to my readers and listeners, Veterans’ Aid and Attendance benefits are provided to veterans who have served at least one day of war time service. This doesn’t mean they have to be in a combat zone – they could be stationed in Nebraska at an Air Force Base. But they have one day during a war time event, and they meet the proper criteria: they have a healthcare situation where they may have someone caring for them at home, such as a husband or wife. It could also be a nursing home or assisted living situation, and it can add a max benefit of around $2,800 to the income of the veterans that are married. It’s a great way to help care for the veterans, even adding income to the mix when a spouse is caring for the veteran. It’s also available for the spouse of a veteran or the spouse of a deceased veteran, as well. 

That said, McIntyre Elder Law handles Veterans’ Aid and Attendance applications, and we do so free of charge for the veteran. We charge for the planning associated around that, such as the elements that go into the estate planning, but we do handle these matters right in our office. I am a certified attorney with the US Department of Veterans’ Affairs, the only one in Cleveland and Lincoln county. I’m very proud to be a certified attorney through the US Department of Veterans’ Affairs for those purposes. 

Call me if you have any questions:

Greg McIntyreGreg_Full
Elder Law Attorney
McIntyre Elder Law
123 W. Marion Street, Shelby



Senior Dental Care with Dr. Kendalyn Lutz-Craver!

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Senior Dental CareThe Importance of Senior Dental Care

I’m very proud to be here with Kendalyn Lutz-Craver from Cornerstone Dentistry in Shelby, NC. There’s a huge need in the community for proper senior dental care. There’s a hole in the Medicare/Medicaid system to pay for proper dental care for seniors, and many times seniors will either put off care or not receive proper care when they actually need it. There’s proof of a connection between longevity and dental care. So it’s an issue that’s germane to seniors and is certainly something that needs to be addressed. Therefore, Kendalyn and I have been talking, trying to figure out how to work on some of these issues and have given it a fair amount of discussion and thought. I wanted to bring those thoughts of mine and of Kendalyn’s to you. 

Cornerstone Dental Associates is a pretty amazing facility. 

Thank you, we’re very proud of it. We’ve been in there 6 years now, and it’s the first green building in the county. We were really thoughtful about the process and wanted to take something that’s not fun for anyone – dentistry – and make it a more comfortable environment, an environment where you’re excited to come get care and you feel like you’re a part of the family. 


It’s the first green building in the county? 

Yes, a few patients did ask me if we were going to actually paint the building green. But this means that it is LEED certified, LEED referring to Leadership in Energy and Environmental Design, and so it’s a point system. You work with the architect, you work with the contractor and you achieve different points to get your certification. We recycled about 75% of our construction waste. Every employee is guarantee a daylight view. We do things that reduce the chemicals that come off the paints and furniture. The fresh air comes in, so that exchange is permitted. You just do a series of things to make it a positive work environment, and a lot of research has shown that with green buildings, you produce healthier employees as well. There are less sick days. 


What made you want to be a dentist? 

I was part of that small percentage of people that always loved going to the dentist; it was always fun for me, I had a great dentist growing up. Teeth are very important. If you ask people what they notice when they first meet people, eyes and teeth seem to be the two that come up. And it changes the demeanor of someone if they don’t have confidence in their teeth. You see it tremendously. As for my journey, I grew older and figured out what I liked in school. I loved math, I loved science and then thought about what my goals were into adulthood and that I loved the idea of having a career where I could be my own boss. And I could use the math and science that I like, but also have some flexibility of schedule. It was important to me to have a work-life balance, to be able to be a mom as well as a dentist. 


What do you do when you see a senior? 

We start every patient with what we call an initial exam, and it’s a long appointment. You’re going to hang out with me and my assistant for an hour and a half. We’re going to take any needed X-rays and photos, and we’re just going to talk about the goals you have and figure out the needs you have, the best way to tackle them, and how to make them affordable for you. A lot of patients are surprised when they call our offices because they think, “Well I just need to come in and get a cleaning.” But what people don’t realize is there are different types of cleanings based on your needs and it’s crazy to jump in before we know what’s going on. I love that chance to get to know the patient and for the patient to start to get to know me, to build a good relationship with me. I want patients that are comfortable asking questions any time. So we start there. 

Sadly, dental insurance is not like health insurance, so more than anything we think of it as a benefit. And in this day in time, it’s a benefit some people get with employment. I don’t know if there’s any anymore that get dental benefits after they retire. So we offer lots of payment plans, lots of ways to make it affordable, and we try to work with our patients once they hit the age of about 50-55, until 65 or whenever the retirement horizon is to get their mouth ready for retirement, ready for the time when hopefully they just need maintenance. It’s very much like pre-planning. 

For instance, if you had big fillings and we need to transition them to crowns, we’re looking at what we have to do over the next five to ten years. Doing it all at once would be overwhelming and extremely expensive, so we break it down; we do a little bit at a time to step patients along. Many seniors are on a fixed income, so the biggest message to get out to patients first and foremost is, just because you don’t have dental insurance doesn’t mean that dentistry is not available, that it’s so far out of reach that sometimes we have a tendency to equate dental costs with health costs. Dentistry doesn’t have the same cost as one would have with health care; it is an investment. It’s not cheap by any means but it is not prohibited if you do not have dental insurance. 


So it’s a misconception to think if you don’t have dental insurance, you can’t afford dental work? 

Yes. We figure out first everything you need. If you only need two hygiene visits a year with diagnostic X-rays, we have some patients that pay that and divide it up into twelve payments. They make a payment every month if they want a small payment. Others choose to pre-pay before their visit, if you pre-pay you get a 5% discount. Some divide it every three months. There’s lots of different ways to do it. 


What about longevity? I’ve always wondered if there’s a connection between longevity and dental care, and I understand that there is. Is that right? 

There definitely is. 20 is our magic number. At the office, we do a party every year to celebrate all of our patients, 80 years or older, with 20 or more of their natural teeth. But all the research shows that 20 teeth have to function together. So 10 top and 10 bottom lined up. If you have 20 or more, you’re going to function well, it’s going to improve longevity; less than 20, we see an increase in mortality rate. So as you begin to lose teeth and pass that tipping point, your life expectancy decreases. That’s big. Keep as many of your natural teeth as you can. 


What about gum care? 

Gum care is huge, and a lot of people are becoming more familiar with that, but periodontal disease – this is an inflammatory process, it’s caused by bacteria. That leads to chronic inflammation, bacterial issues, Diabetes, and cardiovascular disease. Some studies now are looking at dementia. It’s all linked. But it makes sense, and if we stop and think about it, sometimes we think about our mouth as a completely different part of our body. It’s not; it’s where everything starts. And so it has a huge systemic impact, and that comes into hygiene care. It is so important to keep your gums healthy. 

The other thing we like to work with patients: I’m a huge proponent of electric toothbrushes, but especially as we get older because if you think about a small toothbrush, you need good dexterity and you need a good grip for a small, narrow toothbrush. But a nice big toothbrush, we love Sonicare, it does better than anything we can do. I love to get patients with an electric toothbrush. We also have patients who are on medications, and what’s a side effect of those medications? Dry mouth. Dry mouth leads to increased cavities, and it all cycles. So when you come, throw in a fluoride treatment with your hygiene visit and then do fluoride rinses at home. We also like to look at diet. Sadly, we’re a country of a lot of diabetics and obese people; a lot of that comes from poor diet choices such as soft drinks, sports drinks – sugar or sugar free, because a lot of that is the acidic component. Once you get dry mouth, you want to keep your mouth wet so we start grabbing candies to suck on. So it’s thinking about all those things. If you’re going to keep them, you’ve got to get smart about it. 

Everything has to do with longevity. Once you begin to lose teeth, you start to chew with less efficiency. And when it comes to dentures, you’re affected there as well. Not only do the bones shrink, but your jaw muscles begin to atrophy because you can’t apply near the biting force onto a denture that you can with your natural teeth. So for anyone with dentures who wants to chew a good steak, they have to chew seven times more than someone without dentures because of the decreased force. All that adds up. You don’t have as many teeth, it’s hard for you to chew, and what do you do? You start eating more processed foods, and everything just devolves. That’s a lot of the increased mortality, losing teeth. 

If you think about the history of dentists in this country, you realize it’s crucial. If you let a toothache go on long enough, that can be a heart issue and an infection. Dental care is extremely important to longevity and health. 

Call me if you have any questions:

Greg McIntyreGreg_Full
Elder Law Attorney
McIntyre Elder Law
123 W. Marion Street, Shelby

Get It Together with Debbie Vaughn

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Today’s post is about getting your things together. I can’t stress enough how important it is to consolidate your important papers: legal documents, bank records, healthcare records, what you want to happen to what you own, down to how you want your funeral to go. I spoke with Debbie Vaughn from Life Enrichment Center who is an expert on this topic. There is always the need to pre-plan and make sure that your documents are where they need to be, and that all of your information is up to date to ensure that no one – not you or your loved ones – are saddled with issues when it becomes too late.

Debbie Vaughn sat down with me to talk about what I like to call the “Get it Together” workbook, which is a binder-like book that you can compile with all of your important documents and other files that you might have never considered consolidating.

What do we mean when we say “Get yourself together?”

First of all, that’s the reason we have Journey. It’s a coalition of different agencies like Life Enrichment Center, the Senior Center, and Care Solutions to do that so you can put all your documents in one place. What I found to be interesting was before I found Journey, my mother had pancreatic cancer. We knew she was going to pass and it was a waiting game, but not one of us three children thought to ask her where the insurance policy was. But then when she did go to meet the Lord, we were like, “Oh gosh, where would she put it?” We had to be detectives and think like she would. We tore her little apartment apart until we found it, and that’s what made it seem real to me that I didn’t want to put my son through that. I wanted to put everything in place so that my son would know exactly where everything was.

And it’s important to remember that it’s not only death. If something were to happen – say I had a stroke or an illness and could not speak for myself, this book can speak for you. It can tell my son such as who I would use as my plumber, who I would use as my carpenter, people that know my house. He might not know the people that come to my house and work on it on a regular basis. You know how it is, if you find a good plumber, carpenter, or electrician, you want to use the same ones you know, love, and trust. Same thing goes for the doctor – I want him to know what doctors I prefer. So that tells him exactly who to go to and you can slip their business card right in this folder for him to consult if something happens.

How is this folder organized?

It has several copies of what you need because this is a work in progress. Things change. There’s a section on medications, for instance, but the medications you took 6 months ago might not be the medications that you’re taking now. You can make copies of these so you can keep it updated. It’s sort of like a hobby, in a way; keep putting your information in as it changes.

Bottom line is your kids might fight over what you want. You have a chance to tell them right now on paper how you want the last years of your life and beyond to go. You can prepare for some of the aspects of your funeral, such as the photo you want to use for your obituary and other items like that. I look at the planning aspect this way: if you’re fixing to get married, you’d spend a year or so planning and preparing for that wedding. You’d do the same thing if you’re having a baby. This process is no different: you need to plan and prepare. It gives you the chance to leave a legacy for generations to come. And it doesn’t have to necessarily be about death; there might be things that you want your children to know about you in your life.

So it’s not just about the will or the money, it’s about the life that they’ve lived, their experiences, and the legacy. The “Get it Together” workbook is an extremely valuable tool that you and your loved ones will be thankful for.

Call me if you have any questions:

Greg McIntyreGreg_Full
Elder Law Attorney
McIntyre Elder Law
123 W. Marion Street, Shelby


Can you differentiate between home care and home health care?

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As part of my continued quest to bring the most varied information out there about Elder Law and elder care, I had the opportunity to speak with Ruth Huffstetler from Helping Hands Nursing Services, Inc. To give a little background on this company: it was founded in 1975 and is current located at 1105 Earl Road in Shelby.

Ruth provided some invaluable facts, figures, and information about what Helping Hands does, as well as what the differences are between home care and home health care.

Many of you know that I continue to remind my listeners and readers about the statistics. 7 out of 10 seniors are going to need some type of care, whether it’s in-home, assisted living, or nursing home care. Although North Carolina is renowned for its assisted living and nursing home facilities, who is really going to jump on the opportunity to spend their elder years outside of their home? Ruth discussed this idea and many others in our conversation:

What are some of the services that Helping Hands offers?

There’s no doubt that people want to stay at home. It can be a very traumatic experience for our elders – especially if they are suffering from dementia or Alzheimer’s – if they are taken from the surroundings that make them comfortable. Continuity is so important, so by keeping them at home, we’re able to stay with them and monitor them. We can go in and make sure that they’re not turning on the stove, putting tin foil in the microwave, wandering out in the streets or the middle of the night.

We can also dispense medication. The thing about us is we’re doing whatever the family has asked of us. If the family wants us to walk the patient around the house three times at noon for exercise, then that’s what we do.

What about nursing services?

Again, if we come to you and your parents are diabetics, and you need them to have certain meds or certain injections as far as their insulin and whatnot, then we help them with those medications or injections. Whatever the family asks of us, we do.

With home health, the doctor is ordering certain physical therapy, occupational therapy, speech therapy. With us, the family is calling and saying, “I’ve got to go to work, somebody needs to be with Mom and this is what we want done while you’re there” or “My mom lives in Shelby but I live in California now. I need 24 hour care and this is what I want done.” Sometimes we’re truly the only family around because everybody is long distance, and we’ll take them up to see the leaves change colors. We’ll take them to go visit the old people at the nursing home so they can stay in touch with their friends. We’ve learned how Chick-fil-A has bingo on certain days and different places we can take them. They can stay involved with their friends.

Can you differentiate between home care and home health care?

The biggest difference in simple terms is that in home health, you have an RN that is supervising everything that’s happening, there has been an assessment done and a list of needs that the doctor has ordered. That is home health. They’ve ordered all the different therapies and there’s an RN supervising and making sure those things happen. With home care, you as a family member says, “This is what we need, whether it’s someone to be here so we can go see our grandson play football for 4 hours” or “We need 24-hour care”. Whatever you want is what you’re going to ask us for. That’s home care.

Do home health care agencies sometimes refer to you?

Yes they do. Let’s say the doctor orders a bath three times a week. They’ll have a CNA that’s going in on Monday, Wednesday, and Friday giving a bath. There’s no set time. It could be at 9 in the morning, it could be 4 in the afternoon. So if the family says, “We need somebody here during the day so we can go to work”, those home health agencies will refer to us and say, “Okay, if you call Helping Hands Nursing Service, they can refer someone to you that can be here from 7 in the morning until 5 in the afternoon. They’ll be here the whole time to prepare the meals”, and then when Home Health comes in to do the therapy or the bath, we let them in, we can assist them, but it’s their doing, and then they leave. But we stay.

Do you screen your employees?

First thing is, I have no employees. They are all independent care givers because we are a referral service. Past that, they are all criminal background checked and reference checked. So if you call and say, “I need a caregiver to come out and bathe my mother Monday, Wednesday, and Friday”, then we’re going to find where you live and what kind of limitations your mom has and we’re going to pick who we feel is a good choice based on what you’ve told us. We’ll then refer that person to you. Very important question about the personality: just because I think they’re a great choice and I love them dearly, your mother may hate redheads and “I don’t want that redhead in my house because she reminds me of my ex son-in-law’s wife” or whatever. It doesn’t matter. Whatever that case may be, you make a simple phone call and we will send someone else out. You don’t have to give us a reason at all because there’s personality conflicts with the greatest of people; they just don’t see eye to eye.

Do the people you refer provide the transportation or do they take the family’s car? Are they paid by the mile if they use the car?

All of the above. If we take their car, of course there’s no fee and we can drive them. If the caregiver uses her own car there is a charge which is just the government rate, I think 0.55 and a half cents now. They do add mileage to their hourly rate.

Do you have written policies for these people or contracts?

What we have is a contract with the caregiver since they are referred and they are actually paying us to keep them working. If they have to call in sick at 3:00 in the morning, they’re not calling the family, they’re calling me. I make sure someone else is there so you can still go to work. We do have guidelines that we require of them, things that just make me happy as far as what they wear and tattoos not showing, things like that. They are my guidelines. But as far as written rules, it’s whatever the family wants. Again, the family may say, “You can take Mom to the beauty shop” and that’s all or “Mom’s been dying to go see her friend at the VA in Salisbury, would you mind spending a day and taking her there?” And we’ll do it. A lot of times the family’s car is easier to get in and out of than the caregiver who might drive a big SUV or a little sports car that’s hard to get in and out of. So we’ll do whatever is best.

How can people pay for home care?

Home care is paid out of pocket or if their long-term policy will allow assignment back to the family, so the family is getting reimbursed for what they have paid. We can assist with that, but it is an out-of-pocket. We do not take Medicare, Medicaid, or private health insurance. Insurance might pay for some home health benefits, but they will not pay for the home care.

If you’d like to get in touch with Helping Hands, call them at the office at (704) 419-8222.

Call me if you have any questions:

Greg McIntyreGreg_Full
Elder Law Attorney
McIntyre Elder Law
123 W. Marion Street, Shelby


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