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Author: Wilsonsjulie Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: of 75340  
Subject: Re: Aldzheimers& a Trust Fund Date: 4/18/1999 9:36 PM
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I would like to thank all who have written to this post. You have helped me clarify things. This is an unexpected adventure, for sure, but i very much appreciate the suggestions offered.

dharmadollars had a list of questions:
DHARMADOLLARS:
"Several questions: Who has power of attorney for the money managed by the financial planner? Is he/she commission or fee compensated?"

ME:
My sister and I share this duty. We met with with an eldercare attorney and with the Aldzheimer's Association when we were first faced with taking over his finances. This financial planner came recommended by them because of his reputation and his donations of time to help with estate planning in the field of elder care. He is not cheap. He costs us 1% of the total held estate to maanage the funds. From what we can tell, and from what our tax accountant tells us, he seems to be doing a good job. He usually only manages accounts of $2million or more, but took my dad's estate because it was a diminishing estate and was *unique* in some respects because he would become more knowledgeable about the progress of aldzheimers disease and the planning for its many stages.

DHARMADOLLARS: "Does the trust include language stating that the turstees have absolute discretion, or does the language state that the income and corpus of the trust are to be spent for the care of your father? After your father dies, who is the beneficiary of any trust residue? "

ME:
In part, grandmother's trust states: Commencing with my death, the Trustees (my father's two sisters) shall pay the income from the 'Son'(my dad) Trust in convenient installments, at least quarterly, to my son during his lifetime.
The Trustees may also pay my Son such sums from principal as the Trustees deem necessary or advisable from time to time for his health, including nursing home care, maintenance in reasonable comfort, and his best interests, considering his income from all sources known to the Trustees.

DHARMADOLLARS: "After your father dies, who is the beneficiary of any trust residue? Who are beneficiaries under your father's will? Of what?"

ME: the estate will be divided among me and two siblings. At one point, he was angry with my brother and left him only 20% and my sister and I were to receive 40% each. Because of many things, the three of us will divide (any left) money equally, because it is much more important that a death bring family closer together...rather than doing damage that resentment would cause because of unfairness. My Grandmother's trust states that each of the three of us are to receive the remaining amount of the trust (if any). I must make it clear, that none of us expect for any of his money to be left...... we will be prudent with it, but the primary concern is that he is taken care of well with HIS money. But we don't want to be silly about how best to make the money generate income and security.

DHARMADOLLARS: "If the trust was constructed to provide maximum flexibility in providing for your father it would contain provisions that the trustee(s) have absolute discretion regarding disposition of both income and corpus"

ME: It seems that both have a lot of flexibility. In my opinion, there really is not a probable way that we will *spend down* his money in order for him to be medicaid eligible. One of the ideas behind keeping his pricipal residence for *when he returns to it, after getting better* is that we were under the understanding that if we were to spend down his money... he would be able to shelter his house, car and furniture if he should need medicaid. Those things are his and would remain exempt if he should have spent all his money on nursing care... there is a *look back* period of 5-7 years for full accounting of how his money was spent that would be presented to the medicaid people. With the NEW trust, now, it would seem that this will not be an issue.

The facts of aldzheimers: 7-12 is the *average* life span of a person after dianosis..but now there are medications like aracept, so who knows if this will affect the current generation who has aldzheimers and is taking the medication..... But in essence, dementia is the *ACCELERATED AGING of the brain* This process is not reversible. The huge damage this disease causes can be viewed in an obvious way to family members looking at mri scans that span as little as a year's time. Medically speaking, my father would defy odds to live more than 8 years(and this is conservative).

My father has had dementia for *about* 6 -7 years now from what we can estimate. We are beginning the 4th year in which the dementia has seriously impaired him.

Dementia can seriously dismantle a family. We have learned to communicate with each other to carry out specific plans for his care. One of the hardest things about his disease, is that little pieces of him keep getting taken away..We have all *hoped* that with enough care and with the proper medications and medical advice that we could beat this thing.... that was a long time ago, it seems... and now what we are left with is the stark knowledge that **this day, this very moment........is the VERY BEST moment in time of his life**.

I agree with the writers who are shocked at the care ammounts. We live in So. Calif, where even gas prices outpace the rest of the nation. We looked at many places, some more expensive and some less. When we chose his current digs, we were looking at the total picture of how the residents were treated and that is how we decided. The facility we chose is specifically for people with dementia..... with these beautiful corridors and garden paths all leading back to the same place: a large, beautifully done main activity center. It looks like a lovely gated community where the residents get to roam freely about in a comfortable way... never getting lost in this thoughtful design of architecture.

I had rounded his care figure(4k per month) up from the $3,500 he pays for the facility, because there are some non-covered expenses such as medicines and clothing and personal hygiene products ( yes! we DO have to supply mouthwash, toothbrush and paste, shampoo, lotion, razors, etc etc etc..every month!). He still likes to go out to eat at restaurants and pay for family members with his credit card and we indulge him in this, sometimes still.
He still enjoys being the Big Shot ;-)

Skilled nursing care can happen next. I say *can* because if he becomes immobile for some reason (dementia patients start to lose balance functions and fall as the disease progresses), a radical change in behavior (agression, self mutilation etc) may call for a change of facilities. If he remains in decline but ambulatory, he may just pass away at the current facility. but this is not what *usually* happens. Great physical impairments are more the standard and would need to be addressed by a higher level of care.

The higher the level of nursing care, the more expensive. The most expensive facilities that i know of top $7,500 a month. On average, stays at medical nursing care facilities are 0-3 years, with the final result being death in the person with dementia from the ravages of accelerated aging that attack not just the brain, but the whole body.

I noticed on the letter written by my Grandmother's trust, that the Trustees will initially fund the trust in Treasury Bills and they request a break-down of my dad's current financial situation in order to get a realistic picture of his needs and how to finance. So, with my presentation of more of the facts, any other opinions or suggestions would be greatly appreciated.
Thanks
Julie





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