Although it was billed as a housing fair, the three dozen seniors who attended Northeast Senior Services’ Senior Housing Fair Sept. 20 came away with more than brochures for retirement living. They also received expert advice on financial and other concerns that come with aging.
Nancy Przymus, executive director of Northeast Senior Services, Inc. introduced Margaret Grathwol, a founding member of the Minnesota chapter of the National Academy of Elder Law (NAELA), noting her more than 30 years’ experience in the field. Przymus recalled meeting Grathwol as a St. Catherine’s freshman, and reconnecting after 40 years. “I saw her picture in a guide book for the elderly … and I just knew that I had to have her here.” Grathwol in turn introduced Jessica Keating, an associate in her firm.
The two attorneys were there to demystify the setting up of wills, trusts and estate planning to meet people’s goals and desires about where their assets will go, and how, after they themselves are gone.
Grathwol spoke about the pros and cons of wills and trusts: “Without a will, your assets still go to somebody, through the laws of intestate succession. That’s fine for a lot of people, but in a will you get to pick who’s going to be in charge.
“We’ve been oversold on the idea that we have to get revocable trusts, otherwise we’d have to go through probate, as though that’s a bad thing. It’s the same process. It’s the same accounting, it’s the same making sure that the beneficiaries know what we’re doing and that they are informed. The only difference is we’re not telling the court what we’re doing. But if you have to write a letter to all the beneficiaries, saying, here’s how much dad owned when he died, and you’re copying the court on it, it’s no more work to go through probate, basically. So what I would want to just have you hold in your head today, a trust isn’t necessarily a solution to the process of moving assets from one name into the next.”
Grathwol said a will along with a beneficiary designation is always a good idea because it minimizes the fight.
Elder IQ Website
Nancy Haugen, president of Elder Voice Advocates and Elder IQ, is a registered nurse with a master’s degree in mental health nursing. She also serves on the board of the Minnesota Department of Health’s Home Health Care and Assisted Living Advisory Council. She said by 2017, Minnesota was the only remaining state in the U.S. where assisted living residences were not licensed.
The Center for Disease Control says about 20% of adults have or are living with a disabling condition. At age 65, that becomes 60%. If you are a person who is receiving services in your home or in a long-term care community, that’s 100%. Haugen said there is a powerful long-term care industry lobbying program that includes nursing homes and assisted living, with minimal accountability. Before licensure, fines were assessed only if violations were not corrected, and there were few fines over $500.
Haugen added, “We’re not deterred by challenges. We have the objectives of transparency, we want people to have access to data that’s either hidden from public view, or very hard to find. If anybody here has tried to look up a community on the Department of Health website, you will know how difficult that is to find. We need to expose wrongdoing.”
Haugen pointed to a five-part series in the Star Tribune in 2017 on the long-term care industry in Minnesota, adding that Elder Voice Advocates was one of the primary instigators and advocates for the assisted-living licensure law that became effective August 2019. The Legislative Task Force on Aging at the capitol is looking at the lives of older adults, in cities and in rural areas, whether or not they live in a long-term care community, have transportation, food, access to medical care and access to activities in the community.
Haugen noted that during COVID, the difficulties of seniors in long-term care homes was made more acute because people couldn’t be with the people they cared for. COVID exacerbated a pre-existing critical shortage of staff and long-term care homes. “So when you need care, what’s important is being in a safe place, being involved in decisions about your own care, not having someone tell you what is the best thing to do, but really being consulted, and you want best-practice nursing and personal care. Minimum standards are a good start but it’s not enough. You want your preferences to be honored. You want an active family and resident counseling, and you want a person-centered approach.”
Haugen demonstrated the Elder IQ website and how to screen for senior/disability care providers. The site locates providers by ZIP Code and tells whether the provider has a history of neglect, abuse or exploitation and if it is nonprofit or for-profit.
Vulnerable adult abuse protection
Deb Schmit is a social work unit supervisor with Adult Protection Services of Hennepin County, where she has worked for eight years. She also had four years’ experience investigating cases of vulnerable adult maltreatment and provided protective services for those victims. She defined a vulnerable adult: “If I were in a hospital after a car crash or something, I would be considered a vulnerable adult because I would be dependent on the hospital staff to make sure that my basic needs were being met: care, food, clothing, shelter, everything. But once I’m out of the hospital and back home, then I’m no longer a vulnerable adult.” Some states have statutes where a vulnerable adult is anybody over the age of 65. In Minnesota, a vulnerable adult is defined as any person over the age of 18 who either lives in a licensed facility or depends on another person for a basic need.
Schmit said since 2015, the Minnesota Adult Abuse Reporting Center (MAARC) issues reports of suspected vulnerable adult abuse. The Minnesota Department of Health investigates reports of abuse at licensed facilities; Hennepin County investigates all other reports.
Reports may be about assaults, physical abuse, sexual abuse, neglect (caregiver neglect or self-neglect) and financial exploitation. She noted that during COVID, there was a huge uptick in financial exploitation reports and scams. “And if you take nothing else away from what I say today, just know that the Geek Squad will never email you directly about a threat to your computer, sweepstakes will never, ever ask you to pay taxes ahead of time to get a sweepstakes prize and your grandchild is not in jail in Canada.”
A great number of reports deal with self-neglect and financial exploitation. Self-neglect is when a person either declines recommended services or assistance such as necessary medications or treatments that are offered to them and can be harmed by their refusal.
Financial exploitation can be perpetrated by someone who has a fiduciary relationship – a power of attorney or are some other legal conservator, guardian or a trustee – or has power to make decisions about how a person’s money is spent. Financial exploitation can also happen without a fiduciary relationship.
Schmit said self-determination was a very important part of the Elder IQ philosophy.
“And it’s actually also very important to the adult protection philosophy. We’re all social workers. And self-determination is a huge ethical part of who social workers are. So we will listen to you.”