Dying in debt: What happens next?

It’s no secret that millions of Americans are struggling with debt. Most Americans start accruing debt in early adulthood and continue to pay off and accrue more debt over the course of their lives. 

But what happens to all that debt if a person dies unexpectedly, or if an elderly person dies with massive debt? 

When a person dies, any creditor with legal claims can place a claim against the decedent’s estate. Those claims become part of the process of probating the estate. 

Assuming that there are assets in the estate to pay the claims, a Judge will eventually oversee the payment of any valid claims before closing the estate and discharging the Executor.

Sometimes a person dies with more debt than there are assets to distribute. Then what?

In most cases, a Judge will decide on pro-rata shares to be distributed to the claimants. That means that each claimant would receive a portion of their total claim, based on the total value of the assets in the case. 

In cases where there is debt and there are no assets, those claimants will be forced to take a loss on the unsecured debt. 

If you are concerned about a loved one’s debt and the implications it could have on their estate contact our office to discuss your individual situation.

We specialize in educating and helping you protect what you have for the people you love the most. Contact us to learn more about how we can help.

Don’t wait for a crisis to occur

When it comes to managing your healthcare, the law makes it very clear about who can and cannot receive updates on your status, talk to medical professionals about your care, and help make critical medical decisions. These laws help protect your private information, but they also can make it difficult for your loved ones to help care for you.

Fortunately, there are ways to ensure your caregivers will have access to your records and be able to make decisions on your behalf when the time comes. Still, you must establish these legal permissions before they are needed.

Unfortunately, many people don’t realize they need legal documents to be able to help with the care of a loved one until it is too late.

Here are three documents you should consider having drafted to ensure that your caregivers have the authority to receive information and to make decisions for you when you are unable:

  • HIPAA Authorization Form – The HIPAA Act was enacted to keep medical information and records private. Upon execution of the document, you authorize doctors and other medical professionals to share important information with approved agents.
  • Power of Attorney – You may also hear this referred to as a durable power of attorney. It is a legal document that enables you to appoint a trusted friend or relative to handle transactions and make decisions on your behalf, should you become unable to act independently. In many instances, having a power of attorney helps prevent a loved one or caregiver from becoming financially responsible for your debts or liabilities.

  • Advanced Health Care Directive: You have probably also heard this document be referred to as a living will. It lets you record your wishes for end-of-life care. A living will spells out specific treatments that you can either accept or decline under specific circumstances. A living will provides comfort to the decision-maker, as it gives reassurance that your wishes are honored.

Once a healthcare emergency occurs, its usually too late to create these documents. Avoid unnecessary confusion and stress for your loved ones by talking to them now and getting these documents in place.

An elder law attorney can help answer your questions about these documents and help you get them in place before a crisis arises. Contact us to learn more about how we can help.

Compensating a family caregiver

Design space on black board

It is estimated that 48 million Americans are caring for an adult family member or friend and are spending an average of 24 hours per week providing the necessary services.

For a range of reasons, some families will decide to take on the caregiving role for a loved one to allow them to age at home rather than going into a facility. However, as the loved ones’ needs increase, so will the demands on the caregiver. As a result, caregiving quickly and often becomes a full-time job all of its own.

Not only are the caregivers spending their time providing the necessary care for a loved one, but it was also found they are incurring out-of-pocket expenses to help maintain the care of the person. AARP estimates that 78 percent of caregivers spend an average of $7,200 annually. This figure does not include unpaid leave a caregiver may have taken from their career to step into this role or their inability to save for their own retirement.

Many families are unaware there are options and ways to be compensated, even when caring for a family or friend. The chances of being paid are best if the person you are caring for is a Veteran or Medicaid eligible, but other options do exist.

If you, or someone you know, are caring for a loved one, an Elder Law (or Estate Planning) attorney can review your case and recommend options available for compensating you as a family caregiver. It is a complex situation with potential tax implications and can affect benefit eligibility. An attorney can assist you with covering all these issues and giving you peace of mind.

We specialize in educating and helping you protect what you have for the people you love the most. Contact us to learn more about how we can help.

The increased 2023 VA Aid and Attendance amounts for 1/1/2023

The 2023 increase Community Spousal Resource Allowance (CSRA) for Single or Married to qualify for Aid and Attendance is now $150,538.00.  Example if you make $2,000 a month gross income – $24,000.00 annually – You subtract $24,000 from $ 150,538.00 equals $126,538.00.  This is what you can have in assets and qualify for Aid and Attendance with checking and saving.  Remember Stocks, bond, CDs, Mutual funds, IRAs, Life Insurance with Cash value, or any other taxable income is not allowed. 

The increase for monthly/annually benefits is as following:

Two Veterans/Spouses   $3536 per month – $42,432 annually

 Married Veteran              $2642 per month – $31,713 annually

 Single Veteran                   $2229 per month – $26,751 annually

Widow                                  $1432 per month – $17,191 annually

We continue to have Family Training the first and third Wednesday of every month for education on Medicare, Medi-Cal and VA.  How do you use one or more the public benefits?  This seminar is FREE and there are no insurance products or financial product part of the training.  Plan now and don’t wait for the crisis.  Learn how to protect your retirement nest egg.     Go to https://www.advancedwellnessgcm.com/seminar-family-training-workshop/ and register for the next Family Training or call 916-524-5151 to talk VA Accredited Claim’s Agent. 

Just a reminder, it is STILL illegal to charge to assist Veterans, Widows of War Veteran, and their families with their VA Applications.  Many families are report and experiencing unqualified people charging $3000 to $10,000 to have application completed. 

Gifts That Say I Care

Choosing a gift can be difficult, especially for persons with dementia or other disabilities. Families often ask us what would be appropriate gifts to give our clients for the Holidays, so as a helpful resource here are some gift ideas.

Gifts to Improve Memory and Cognitive Function:

  • Crossword Puzzle Books (word search, Sudoku)
  • Hand-held video games such as Solitaire, Bingo (also helps with dexterity)
  • Board games – take time to play , i.e. Tri-ominoes, Tangos, jigsaw puzzles with large pieces, or
    board games such as Life Stories or Reminisce.
  • Books on Tape or MP3 players (books can be downloaded from the local library for little to no
    financial outlay) old radio show cassettes that can be played on an inexpensive tape player (Find
  • these at Cracker Barrel)

Gifts for Safety:

  • Medication compartment boxes, boxes with reminder alarms, alarm watches. Driver’s Safety Classes www.aarp.org/families/driver_safety to find classes in your area. Many automobile insurance companies
    also have programs—check with agent
  • Alzheimer’s Association’s Safe Return Program (pay the enrollment fee) www.alz.org/SafeReturn
    (800) 272-3900
  • Emergency Response Systems (Go on-line to find coupons for free installation and discounts)
  • Motion activated lights for path to bathroom, www.improvementscatalog.com
  • An electric tea kettle with automatic shut-off
  • For those who cannot/will not use a microwave oven: The Euro-Pro toaster oven has a timer
    control for automatic shut-off and is large enough for meals-on-wheels pans and frozen dinners.
    Available at most department stores.

Gifts for Comfort and Sensory Stimulation (Moderate to severe cognitive impairment):

  • Pillows and throws in unusual textures, stuffed animals, and small sculptures
  • A new bathrobe
  • ‘Pillow pal’ for something to cuddle that supports aching backs or something uniquely entertaining
    like a singing stuffed animal.
  • Potpourri, flameless scented candles/tart warmers and scented bath items–lavender scent is
    calming for “sundowning”—spray on pillowcase at bedtime or tuck a sachet in nightgown drawer
    or between linens.
  • Music box, wind chimes, portable radio or TV, audiotapes, or an audio-clock
  • Shatter resistant magnifying glass
  • Creative ceiling decorations for someone living in a small space such as kites, posters, or
  • Buckwheat neck pillow for when sitting in wheelchair or geri-chair
  • Microwaveable heating pads
  • Wheelchair Accessories – backpacks, oxygen carriers, rim covers, brake extensions, trays and
    seat cushions.

Gifts from the Heart — Gifts of Time (that cost little or no money):

  • Scrapbook
  • Creating a family memory video
  • Writing a memoir/personal history
  • Weeding their garden
  • Planting their flowers
  • Membership to local science center, zoo, museum (and you taking them!)
  • Trips to the local library
  • Enrolling the person in the Library of Congress’ Recorded Books Program for those with impaired
    vision or fine-motor coordination/strength www.loc.gov/nls or downloading MP3 audiobooks to
    inexpensive MP3 player (available at Wal-Mart, Staples, Target, Kmart) through local library:
    www.netlibrary.com/RecordedBooks . Some libraries carry audiobooks pre-loaded onto MP3
  • Compile family recipes into a book. You can even self-publish and print a hardcover version!
  • Pre-addressed & stamped family birthday/anniversary cards with the date to mail it written on the
    envelope flap so that the client can continue to be involved
  • Personalized Calendars with family photos and birthdates, other special anniversaries (Sam’s
    Club Photo, Costco, Shutterfly.com)
  • Jar with decorated lid (or box) filled with pieces of paper, each with a memory involving the elder
    and you. Open one each visit!
  • An IOU for a year’s worth of lawn care or 52 car washes from a teenager might be appreciated.
  • Personalized gifts, such as a deck of cards or jigsaw puzzles using their photo or a favorite
    grandchild or pet
  • Large poster of them with a grandchild for their walls
  • Bird feeder (plus the IOU to keep it filled) would add some interest to their window, and include a
    book on bird watching or a book or pictures of birds
  • Storage boxes in bright colors, personalized everything!, clothes, door decorations

Gifts for the active Senior who has everything:

  • Frozen steaks, salmon, gourmet dinners
  • Gourmet tea and coffee
  • Gift certificate for restaurants
  • Fruit of the month
  • Nuts
  • Fresh kitchen spices (these are expensive on a budget)
  • Tin of popcorn, microwave popcorn packets, a microwave popcorn popper that actually works:
    Presto® PowerPop® microwave multi-popper, or a hot air popper (both available at Target)

Gift certificates for:

  • Tickets to the movies, theater, zoo, or museum
  • Stores or shopping malls
  • Favorite hair salon
  • Massage, manicure, facial, salon/spa “day of indulgence”
  • Housecleaning
  • Subscription to magazines related to their interests
  • Plants or cut flowers:
  • Christmas cactus
  • Ficus
  • Norfolk pine
  • Corsage

Mindfulness-based Approaches for Elders and their Caregivers

Mindfulness is “paying attention in a particular way: on purpose, in the present
moment, and non-judgmentally”

Elders and their caregivers confront multiple, often simultaneous stressful challenges of loss, illness, and disability. Many are treated with Western medicine for pain and chronic conditions, which may be stress-related, often producing marginal results. In addition, studies now connect high levels of stress with lowered levels of cortisol, impacting our immune system’s ability to fight large and small diseases (R. Sapolsky, Why Zebras 2004). This is especially significant for seniors going through multiple emotional and physical changes, as well as caregivers who are at an increased risk for burnout. Now more than ever, elders and caregivers are turning to mind-body interventions, utilizing the connection between the mind, body, emotions, and spirit for healing. Personal experience may have already informed much of what science is now validating — the mind and body are connected!

Mind-body stress reduction skills are often taught as “mindfulness practice.” Mindfulness based interventions (MBIs) may be taught as a formal practice of meditation, walking, or yoga; or as an informal practice of learning to pay attention to daily activities- eating, working, talking, etc. Mindfulness skills promote an ability to respond, rather than react, to crisis. Mindfulness training has been shown to reduce anxiety and strengthen immune response, offering preventative tools for both mind and body (Kabat-Zinn, Full Catastrophe Living, 1994). Recent preliminary studies have found that these skills can be adapted to teach older persons with physical and cognitive frailties, and stress. The application of MBIs for professional and family caregivers is equally important. Caregivers are the primary contact for older persons, and if the caregiver is distressed, the older person will also be distressed. MBIs offer a means to heal and support both caregiver and care receiver.


I have found both frail elders and caregivers receptive to seated meditation. Frail elders may need shorter, more directive and guided experiences. With dementia patients, my non-verbal presence and tone helped participants understand the expectations. Some report this experience connects them with past spiritual practices, others find a sense of peace and control in the midst of distressing events. One frail elder with a history of paranoid schizophrenia, reported that the group meditation was the only place she found deep peace. She also reported that the meditation practice reminded her of lighting candles on Friday night, a part of her Jewish roots.

Gentle yoga or mindful movement

Adapted yoga serves many purposes for frail elders and their caregivers. The underlying principle of this practice leads to deeper understanding of our bodies, as well as our habitual emotional responses. Taught from the perspective of potential rather than limitation, yoga is available to everyone. Frail elders, as well as many caregivers, may not view their body as an ally. In yoga, they may begin to develop a new, friendlier relationship with their body. The role of instructor is key to supporting this attitude towards yoga and bodies which are non-competitive. For example, when stretching our arms, I might instruct that those who cannot use one or both arms, to just stretch the arm that is available to them. If they cannot move their arms at all, I ask them to focus on their breathing and imagine they are stretching with us. Demonstrating, verbal cuing and hands on assistance may be helpful, and for those who are less mobile, the internet is a good resource for researching chair and bed adaptations.

When working with caregivers, I have found mindful movement an excellent way to integrate practices into a busy life. Caregivers are encouraged to practice standing mountain pose any time they are waiting (for the elevator, in line at the store or bank…). Mindful walking can also be done, briefly, during a busy day. Deep breathing is also a skill that caregivers find useful in stressful moments. and once learned, the discipline of using the breath to stay calm can have advantages for the caregiver and the patient.

Informal practice

Frail elders are frequently reminded of their limitations and dependency; mindfulness practices offer choice and control over one’s response to situations. Caregivers also often feel their life is out of their control. Using our breath as an anchor for our attention, we can choose to stay in the present moment, whether pleasant, unpleasant, or neutral. As one caregiver reported: I feel less anxious about stress than I formerly did. I now think about ‘riding the waves’ instead of getting anxious about them or ‘fighting’ the waves. I feel less responsible for my mother’s well-being.
The first step for GCM’s interested in exploring and sharing mindfulness skills with the elders they work with is to learn more about meditation and yoga groups/classes in the community. Some assisted living communities have already integrated these non-traditional techniques for residents who are not particularly religious, but looking for alternative means to cope with stress. They become more resilient when dealing with multiple losses and show an increase in overall sense of well-being.

“Slow Medicine” and the Geriatric Care Manager An Interview with Dennis McCullough, MD

by Betsy Evatt

One highlight of the incredible NAPGCM Conference in Albuquerque was Dennis McCullough’s introduction to “Slow Medicine.” The audience was moved by both the content and the inspiring presentation, mixing poetry and philosophy into a captivating whole. We came away from the conference wanting more. This interview continues the dialogue with Dr. McCullough.

INSIDE GCM – Many of us left Albuquerque espousing the virtues of Slow Medicine to our clients, families, and colleagues. It is not easy to synthesize the concept into an “elevator speech” that is concise and understandable. How would you summarize this approach in the few minutes we often have for such conversations?

Dennis McCullough – slow medicine is both a philosophy and a set of practices. The philosophy is based on knowing that elders in these “later years” have a different mix of vulnerabilities and strengths from the “younger old.” The practices of slow medicine (understanding the unique circumstances of an elder’s life and issues; always, always slowing down the process of making decisions; and continually striving to make broader and better coordinated partnerships between elder, family, “circle of concern,” and
professionals) help maintain quality of life and decision-making by keeping the elder and family in control.

INSIDE GCM – How do you suggest we introduce the subject of Slow Medicine to the physicians we work with in a way that is not offensive?

Dennis McCullough – briefly say that an approach to frailer elders called “slow medicine” is being promoted to improve quality of care. “Perhaps you or some of your staff have heard of it?” (Pause) “it emphasizes teamwork in eldercare and interests me and ‘x’ and her family. Could we take a few minutes to talk about this approach at the next visit?” (It is important to plant the seed without trying to bring up the details immediately, for the physician likely will not have enough planned time for a discussion right then. Approach the task of introducing slow medicine in the same way that you want the physician to approach patient care–slowly and carefully, allowing time for things to sink in.)

INSIDE GCM – When the Care Manager accompanies a client to the physician’s office to serve as the health advocate, our mantra needs to be “why?” and “what are the side effects?” for every invasive treatment or medication addition. What else should our script always include?

Dennis McCullough – the most important task in every visit is listening and promoting a partnership between patient, physician, and yourself. It can be useful to explain that all the questions you are asking are meant to allow you to clearly explain the physician’s thinking to family (and patient again) after the visit is over. Your goal is to get the physician to expand his or her thinking about the issues by talking a little more extensively. As you listen, appropriate questions will naturally arise. This is too complicated for there to be a general script.

INSIDE GCM -You mentioned that due to today’s fragmentation of health care, and the myriad of specialists who step in and out of the elder’s life, there is a need for an individual who says, “I am with you until the end.” You described this as a “covenantal relationship.” This is a beautiful depiction of the role a care manager takes on with a client. Can you please elaborate on this idea?

Dennis McCullough – as we think about “re-balancing” medical care we need to recognize that some important human aspects of caring for elders have been lost. Extended relationships which engender trust through proven commitment to “be there” is one of the losses of greatest impact for elders, who need to be understood in depth and over time. As this role is being increasingly vacated by physicians (brought on in substantial part by medical organizations which have created specialized “silos of care”), others are appropriately filling this void and are much appreciated for it. This aspect of the work of geriatric care managers is “bedrock” to your profession and a special gift to your clients and their families.

INSIDE GCM -What is the first step a care manager can take to introduce the philosophy of Slow Medicine to our clients and their families? Dennis McCullough – explain that your goal as a care manager is to “slow down” to the speed of the world in which your client lives so that everyone can better understand and make decisions that make sense together.

When your children won’t talk to you

If your adult child has cut off contact, you are not alone. An estimated 11% of parents are estranged from their adult kids. That’s 1:8. But you wouldn’t know it to hear others talk.

There is such a stigma around the issue that estranged parents rarely talk about it with others. Instead, they tend to cover things over.

That means carrying around feelings of shame, guilt, and deep sadness, often in isolation. Sound familiar?

Why do adult children sever the tie? There are myriad reasons. Two-thirds (67%) of estranged parents say they have never been told the reason why. On some level, perhaps the specific details of “why” are not material. In the end, it may be wise to simply conclude that everyone remembers family dynamics differently.

Should you try to reconcile? Reconciliation involves both parties, although parents usually initiate the effort. Be flexible about the outcome. Estrangement may be the best outcome. The important part is how you process it.

Begin with yourself. A child’s rejection is not a measure of your worth as a person or a parent. Even fantastic parents go through periods when their children want nothing to do with them. Reach out to others so you have support. There are online and in-person groups for estranged parents. Talk with a counselor.

What adult children say they want. Surveys indicate that children who have split away want to “be heard” and to have their parent apologize for past actions. Expressions can be as simple as a sincere “I’m sorry. I wish I had been more ______.” Some also ask their parent to accept boundaries, such as a limit to the type or frequency of contact.

Things to avoid. Don’t issue repeated requests to meet. This can backfire: Your child may feel harassed. Try a light overture. If it is rebuffed, wait a significant time before trying again. If the door opens, prepare to just listen and empathize. “Correcting” them or stating your own feelings will likely bring everything to a halt. In fact, your child may never be open to hearing what it was like for you. And if those are the terms of reconciliation, you need to decide if that’s okay with you. For some parents, it’s simply not.

The goal is healing. Ideally, the healing involves getting back together. If it doesn’t, use your support system to help you get to a healthy resolution inside yourself. No more isolation. No more shame.

Considering a reconciliation? We can help.
Give us a call at 916-524-5151.

Planning to “retire” from driving

Did you know that we usually outlive our ability to drive safely by six to ten years? As we age, we naturally modify how we drive to address physical changes: Stiff joints, poor vision, slow reflexes. But a time will come when it’s simply unwise to continue behind the wheel.

We do plenty of planning and preparation before retiring from work. Similarly, it’s smart to take a moment and consider the probability that you may not be driving your last few years. How can you retire from driving without giving up an active life?

Most people find it works best to have more than one driving alternative. Check these out:

  • Family and friends. This is by far the most common strategy.
  • Ride-sharing apps. Services such as Lyft and Uber can be extremely helpful (and not that expensive when you factor in the costs of a vehicle, gas, insurance, etc., that you are being spared). Both services are exploring senior options with door-to-door assistance. No smartphone? Consider a phone service such as GoGoGrandparent.com.
  • Local transportation programs. Many churches and senior centers have volunteer driver programs that are free or low cost. These are ideal for errands or doctor appointments. Think about “paying it forward” by serving as a volunteer driver now.
  • Public transportation. Standard buses are an option. Some have a “buddy program or a “senior training day” to help you get oriented. Many public transit companies also provide “paratransit” services. This is a low-cost, door-to-door service available for those who meet disability criteria. Rides must be scheduled a day or two in advance.
  • Special service vans. Senior centers often put together ride packages to cultural events. Leave the driving and the parking to someone else! Medical or cancer treatment centers may offer transportation. Take shuttle services to the airport.
  • Self-driving cars. Wonderful to anticipate, but they are some time off as yet.
  • Online services. Spare the trip! Order online and take advantage of delivery services. Arrange for appointments to be done by video chat when possible.

Considering a move or downsizing? Factor in driving retirement. Would your new abode allow for easy walking to where you want to go? To public transportation? For assisted living, is there van service to doctors or shopping?

Find out now what’s available. Check out ridesinsight.org or call 855-607-4337 (toll-free, nationwide) to find local driving alternatives.

Learning how to age in your own style?
Give us a call at 916-524-5151

Age-friendly exteriors

When imagining an age-friendly house, many people think of ramps for wheelchairs and walkers. Indeed, ramps are essential—if and when they are needed. There are, however, modifications for the outside of a home that simply make daily life and basic maintenance easier. They help prevent falls by addressing the common conditions of arthritis, poor eyesight, or limited balance.

Some safety suggestions also deter thieves.

Lighting. To reduce shadows, point lights down rather than across. And use frosted glass fixtures or bulbs to reduce glare (a notable hindrance to seeing well as we age). Consider adding lights that come on automatically in low-light conditions or when motion is detected. Put them along all pathways and stairs, and at the corners of your house. Also install them at common destinations, such as all entry doors, the mailbox, a trash enclosure, and the garage door. Abundant light illuminates hazards while also discouraging burglars!

Stairs. Several modifications can make a stairway safer. Handrails, ideally on both sides, that are at least 1½ inches in diameter so they are easier to grip. And a textured or nonskid surface on the tread of each stair. Also take care to repair any broken steps so they are level and soundly anchored. Even out the rise of each step so they are all the same height. To make it easier on knees and hips, plan for the rise of each step to be no more than 7 inches and no less than 4 inches. The tread—space allotted for the length of your foot—should be no less than 11 inches. If you are reinstalling a staircase, plan for a landing for every 12 feet of vertical rise.

The entryway. Many activities occur at entryways: Opening a locked door, bringing in groceries, greeting visitors, retrieving delivered packages. In addition to good lighting and nonskid surfaces, consider elements that might facilitate these daily tasks. A lever doorknob is easier for arthritic hands. A keyless lock avoids the need to juggle groceries while finding the key. Perhaps a bench where you might set groceries down. A hinged chest/seat would enable delivery people to safely hide your packages. You might also consider a video doorbell to easily view who is there before opening the door. Video can also dissuade thieves—or at least get a recording if someone steals a package left on the doorstep.

Simplifying home maintenance. Add gutter covers to minimize the frequency of cleaning out leaves. (After a certain age, ladders are not your friend! Bones are too brittle if you fall.) Change to brick or vinyl siding to reduce the need for ladder-based maintenance of a wooden exterior. Similarly, resin-based decking will save hours of on-your-knees upkeep.

Looking to age in place?
We are the experts! Give us a call at 916-524-5151.

Learn more about our services for aging wisely.