Things You Should Know About Elder Abuse Law in NH

Did you know that you have a duty to report elder abuse?

Any person who suspects or believes that an incapacitated person may be the subject of exploitation is required under NH law to file a report with NH Bureau of Elderly and Adult Service (BEAS).  

However, the requirement to report extends to incapacitated adults only. Phone number for BEAS is 1-800-949-0470. The report to BEAS is confidential.

Additional facts:

• According to a 2011 MetLife study of elder financial abuse, as much as $2.9 billion per year is stolen from seniors.
   
• NH is the 4th oldest state in the U.S.
   
• Population of NH residents age 65+ is expected to double by 2025

Care Planning Resources

Here are some websites that may help you get the conversation about advance care planning going:

• The Conversation Starter Kit (www.theconversationproject.org)
• Consumer Toolkit for Health Care Advance Planning (www.ambar.org/healthdecisions) This website helps individuals discover what is truly important to them in the face of a serious illness. It even has a smartphone app you can download.
  
• PREPARE web site (www.prepareforyourcare.org)

Caretaker Resources... Part 2

In our previous post we referenced some of the online tools that can help you generate advanced directives; we also noted that it is very important to execute a health care power of attorney in accordance with state law requirements.  

For example, New Hampshire along with four other states has unusual formalities which would likely cause any such computer generated health care power of attorney to be invalid.   For that reason, we recommend that you execute your advanced directives through your physician’s office or through your estate planning/elder law attorney’s office. 

However, if you would like to explore some of these websites, they include:

• Five Wishes (www.agingwithdignity.org)
• Caring Conversations (www.practicalbioethics.org)

Caretaker Corner: Planning Tools

There are many tools available that can help you and your loved one think about the important questions related to health care decisions.   Here are some websites that may help you get the conversation about advance care planning:

• The Conversation Starter Kit 
• Consumer Toolkit for Health Care Advance Planning:This website helps individuals discover what is truly important to them in the face of a serious illness. It even has a smartphone app you can download  
• PREPARE web site

There also are tools online that will generate advanced directives for you. However, it is very important to execute a health care power of attorney in accordance with state law requirements.

Elder Law Questions

In several of our 2012 posts we answered a frequently-asked question about elder law, and also listed some of the components associated with our elder law practice.

Simply stated, our elder law practice involves helping individuals and families deal with a wide variety of issues including long term care, medical directives, incompetency, guardianship, disabilities, asset protection and Medicaid.

At Curtin Law Office, our services include reviewing estates for long term planning purposes, creating special needs trusts for disabled individuals and addressing concerns relating to the guardianship of a loved one. We also assist our clients with navigating the complicated legal waters of Medicaid.

Since many families are concerned about the high cost of nursing home care, we provide clients with advice relating to asset protection, should they require long term care either in a nursing home or at home. We also help to protect the community spouse’s assets and income, which may involve representation at elderly services and going to court for increased benefits.

Many people are unsure about the scope of elder law services, and we are happy to answer any questions you may have - please feel free to contact us!

Changes to NH Advanced Directives

The New Hampshire legislation has enacted changes to advanced directives relating to medically administered nutrition and hydration. These changes became effective on January 1, 2014. 

The intent of the legislature was to clarify the definition of medically administered nutrition and hydration and include it under the definition of life sustaining treatment. 
                                      
Unfortunately, while life sustaining treatment is defined to include medically administered nutrition and hydration in the statute, medically administered nutrition and hydration is not included on the definition on the proposed new advanced directive form. Furthermore, the legislature inadvertently neglected to change the disclosure form which specifically states that if you want to give your health care agent the power to withhold or withdraw medically administered nutrition and hydration, you must say so in your directive. Otherwise, your health care agent will not be able to direct that. This is problematic since a question relating to medically administered nutrition and hydration does not exist on the new health care power of attorney.                                          To resolve these issues, it is thought that the legislature will be making further changes to the statute in its upcoming session. For these reasons, we have modified our advanced directives slightly, but until the legislature addresses the present ambiguity and conflict in the statute, our advanced directives still include a question that specifically addresses medically administered nutrition and hydration.                                            We will continue to keep you updated.

Caregiver Questions?

As noted in our previous post, holidays or the beginning of a New Year are often good times to initiate conversations with loved ones about difficult topics, one of which is end of life wishes.

Here are a few ideas about important issues you might want to discuss:

1. These end of life wishes may include: Who should make the decisions regarding health care/financial matters when your loved one cannot? What medical treatments are acceptable? What are not? Whether or not your loved one wants to be resuscitated? Where your loved one wants to be in the event of a terminal illness?
2. Ensure that your loved one executes a health care power of attorney and financial power of attorney. If he/she already has these documents, they should be reviewed by an elder law attorney to ensure that they are in order.
3. How does your loved one want his or her assets to be distributed after death? Are the assets titled appropriately? Have steps been taken to minimize probate upon death? Are they consistent with your loved one's wishes? What is important to your loved one? Simplicity? Protecting his/her spouse? Providing an inheritance for children? Protecting a special needs beneficiary? Other concerns?

Questions relating to end of life topics can also be initiated by an elder law attorney. Our office, when possible, encourages family meetings so that everyone is on the same page. We find that good communication can often alleviate conflict and make planning easier for all involved.

Caregiver Conversations?

Often holidays are a time when family and friends get together and this being the case, it can be a good time to initiate conversations with loved ones about difficult topics, one of which is end of life wishes.  

Encouraging your loved one, not only to speak to you, but to speak to all family members about his/her wishes so that everyone is on the same page can minimize your stress down the road.                                                                                                                           

New Care Givers - Part 4

We have been posting ideas for newer family care givers, with hopes of helping people more easily adapt to these life-changing situations.

 

Along those lines, you might find it helpful to take advantage of community resources such as Meals on Wheels and adult day care programs.

 

These resources are available so that you don't have to do everything yourself, and to give you a break.

 

You can also see if there are caregiver classes and workshops offered in your community your local Caregiver Resource Center or Area Agency on Aging. These education programs will help you feel more confident and make the time you spend caregiving easier for both you and your loved one.

New Care Givers - Part 3

Continuing with our caregiver theme, if you're just starting out as a family caregiver, it's hard to know where to begin.

In our previous post we identified two initial steps you might consider taking to get started in a positive and productive way. 

Another suggestion you might find helpful is to invite family and close friends to come together and discuss your loved one's care. If possible, your loved one should be included in the meeting.

When you convene, you might list the tasks that are needed so they can be more easily divided up. Let everyone discuss their concerns, as well as how much and what kind of help each person can offer.

As the primary caregiver, it's best for you to focus on accepting what assistance your friends and family are offering, even if it's not exactly what you had in mind.