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Keeping Seniors Safe During Hurricanes and Storms

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Celebrating Our Team

Those of you who know us well recognize that we keep a hectic pace throughout the day.  Clelia and I are obsessed with taking care of clients, vetting outside professionals, and building a great team. Twelve hour days fly by and then it’s time to exercise and share experiences with family and friends.  We also spend a lot of time thinking about our team as they are an extended family and, in fact, an extension of our philosophies (teaser: see more in Clelia’s upcoming book!). This morning, I want to thank my staff publicly.

In all the years of running the elder law firm we have never had a team like this.  Passion, compassion, work ethic, comradery, support, excellence.  Fill in the blanks – they have it all.  Every single team member is devoted to his or her area of expertise and it shows.  It is rare that a prospective client doesn’t sing the praises of Marlena or Jessica.  Later, when the client is in the midst of our process, the accolades continue: “I can’t thank you enough for the consistent follow up.  We never would have accomplished the plan with everything else that is going on with mom.”  Natalie, our newest team member is a force in the world of Medicaid and public benefits and Toni has been right by our side from the start helping families distribute assets in the face of heartbreaking loss.

Then there is the travel:  Ever since we welcomed the talented Christina Candido aboard as our Client Care Coordinator, our staff has become obsessed with travel.  What’s an employer to do?  We say, “Go! See the world, explore, come back with stories and experiences.”  Recently, Marlena left for ten work days to explore France.  She had never before left the country.  How would we survive for ten full days without the team member who touches every single prospective client, active client, and professional that calls or walks through the door? Oh, and did I mention that we are busier than ever?

I’m not going to say it was easy because there is no way to minimize what Marlena does.  But, the team came together seamlessly.  Every team member grabbed a piece of Marlena’s day and executed it in an extraordinary way.  Did we feel her absence?  Were there moments of overwhelming stress?  Most definitely.  Did we accomplish our goals and grow together?  Yes!

Thursday night we celebrate our six-year mark as a law firm (our actual anniversary was September 8).  We work hard to accomplish our goal of being the best elder law firm and we know that teamwork is the key.  The last six years have been incredible.  As any business owner knows, keeping great people is imperative. I’m thankful each and every day to surround myself with this great group of leaders in our industry.

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The Danger of Old Estate Planning Documents

Where old wills are concerned, the saying, “it’s better to have something than nothing at all” doesn’t always prove true.  This year alone at least five of our clients found this out the hard way.  I highlight two below.

In the first instance, an adult child passed away unexpectedly, leaving two children that had no relationship with their elderly grandmother. She did not want to leave them an inheritance, but due to the fact that she left her estate in part to her son, “per stripes” (a term that means in the event he predeceased her his share would go to his children) she was now leaving one-half of her estate to these absentee grandchildren.  GLG re-drafted her will to exclude them in accordance with her wishes.

In another instance, a terminally ill divorcee left her entire estate to her elderly mother living in a nursing home. She had executed her will shortly after her divorce and didn’t want her minor child to receive an outright distribution. This had two potential unintended consequences: First, it effectively disinherited her only child. Second, had her estate gone to her mother, it would have been taken by the state to repay it for funds used under the Medicaid program for her mother’s care. To make matters worse, when the client discovered this she already had terminal cancer. During the drafting period, she took a turn for the worse necessitating GLG to rush her documents and move up her signing appointment so that she could make these important changes days before her death.

Reasons to review estate documents every few years:

Change in estate tax laws
Change in estate planning techniques
Family members die and are born
Family dynamics change
Financial fortunes grow and decline
Family members suffer a disability, drug addiction, financial crisis, lawsuit, or bad marriage
People move out of state
Mistakes in current documents
People change their minds

As a corollary to this, also review your beneficiary designations.

At GLG, we’re here to help make certain that you and your family receive the most effective estate planning and elder law guidance. We always strive to guide our clients in an intelligent, compassionate, creative, and efficient manner.

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The Part Where I Realized I Was My Clients’ Families

Back in my grandparents’ house, we decided to get the house ready for when grandma came home, because she was definitely coming home (We are Italian, after all!). We all chipped in, pulled up all the carpeting, threw out all the throw rugs, tossed some clutter, and hired Back Home Safely to install a new railing and to ensure the house was safe and functional.

Back at the rehab grandma was making progress. She was getting PT 2x/day, her vitals were regulated and after almost three months of me annoying her to push herself she was walking with a walker on her own and would even walk on her own holding my arm.  Yet again, my grandmother showed her strength, defying all the doctor’s predictions that she would never walk or even stand again. The good thing….

SHE MADE IT TO MY WEDDING!

Eric then started drafting estate planning documents since my grandparents, both age 82, did not know they needed them. He also went over all their financials (which took all of about 10 minutes since they had nothing) and advised us to apply for Medicaid to pay for grandma’s care at home.

Grandma was about to come home in need of care and they were in no position to pay for it nor accept it mentally. We had spoken to the rehab about requesting the PAS so that she would be covered for her stay in the rehab as well as the soon-to-be care at home. The PAS is an extremely important request often overlooked due to the overwhelming care responsibilities families have getting their loved one back into “good health”.

I started the Medicaid application, collecting all the documents and financials the County requested. As I stated in an earlier post, it should have been a simple Medicaid application since they had nothing left. Well…. SURPRISE, SURPRISE. We knew that my aunt was on all the bank accounts since she lived with my grandparents and helped them with the bills but didn’t know it would possibly cause a penalty. My aunt also deposited some of her money into these accounts to help contribute to the house that was titled in her name. My grandparents contributed to the mortgage and property taxes on a home they didn’t own and there was no rental agreement. My grandmother was also the sole beneficiary on my grandfather’s life insurance policy. As you can see, even seniors with no money have complicated lives. The trail is too intertwined and confusing for a lay person to navigate without the help of a trained professional.

I cleared up the confusion in this Medicaid story for the County caseworker and made my appointment to submit the application. I appeared on May 5, 2013 (Cinco de Mayo) and waited over an hour, aggravated after the case manager informed me that his staff was out celebrating the holiday. My caseworker finally returned from lunch, drunk, yes DRUNK. Thankfully, Eric was with me and handled the matter in an unemotional professional state and answered all the questions I had worked so hard to make clear for this individual.

I am Clelia Pergola, and even though I helped start Goldberg Law Group I realized that my most important lesson was happening in real time – a role reversal – I was just like my clients’ families.

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Rehab is a Term for the Entire Family

Back in my everyday life, I was working at an another eldercare law firm, where I was getting into work before anyone got in to ensure the work was being done, I was weeks away from my bridal shower and I had just, within that week of grandma going into ICU, moved out of my grandparents’ house living on my own for the first time ever. I NEVER missed a day of work yet NEVER missing a day with my grandmother. I would run to the hospital and sit by her bed side from 5:30 to 10:30 sometimes even later, because if I didn’t see her she would pass away (Italian Guilt). Weekends I would be there all day long, holding her hand and talking to her.

We were all so relieved to know Nonna could breathe on her own once again. Then she spoke, a bit raspy but nonetheless was communicating. But what did that communication entail but hallucinations and paranoia. Grandma called a family meeting, so I waited for the family to be there and facetimed my mom. Then she told us, the nurses and doctors were trying to kill her and stealing all her important documents that were hidden behind the bed. Although any other person outside the situation would see this as a red flag we as a loving devoted family said this must be just because she has just gone through so much and moved onto the kidneys failing as our next plan of attack.

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To further complicate matters, I began building Goldberg Law Group with Eric Goldberg. Although it was the most stressful time of my life, I recognized the good fortune that I had found a career that paralleled my life experiences and I sought to make a difference in the elder care world. Little did I know during that turbulent stage of my life, with my grandmother’s health hanging in the balance, that Eric and I had started building what many consider to be the most compassionate and process-driven eldercare law firm in the region.

Back at the hospital, grandma’s organs were all functioning but with a lot of assistance from all the medications she was now being given. The doctors were advising us to speak to the discharge planners to have her transferred to a sub-acute facility by the end of the week. They also informed us that she would never walk again or even stand up on her own. My family and I were devastated but we remained optimistic.

We looked into various options and decided on a 5 Star Medicare Rated facility. WELL… within less than one week she was already having medical complications because the facility was not following the treatment plan established in the hospital. So, back to the hospital she went. I then reached out to my contacts in the industry to guide me going forward. A week later, she was discharged once again to another sub-acute facility and this time we made sure we communicated with each department to ensure they were following the new orders. I visited her twice daily to help and encourage her to do her exercises.

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My bridal shower was that weekend and as expected she was unable to stand on her own. I dressed in my outfit and drove to the facility so she could see me, her only grandchild (and for all intents and purposes, her fourth child) and off to the “celebration” I went. The next morning, it was back to reality. My goal was to get her standing and walking in preparation for my wedding four short months away.

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My World Has Changed Forever

After six years of caring for my grandmother, and finally ready to tell my story, my Nonna has passed away. I started this blog to connect on a deeper level with those of you who are caregivers in the industry and also to share my experience with those who cannot imagine the challenges of caregiving. The struggles of a family caregiver are surreal in that the caregiver is both emotionally and physically involved with the loved one while attempting to stay afloat in the outside world.

Caregiving is not something one necessarily speaks about and sometimes one might not even admit that she has, in fact, become a caregiver. The unfortunate truth is that the people that once loved and cared for us will inevitably decline and need us to love and care for them. We need to make decisions, some of which are life altering or life threatening, on another life that we care so deeply about. Sounds simple, right? I mean we all know right from wrong. Wrong! When we are emotional, caught by surprise, multi-tasking, exhausted and then asked to make important decisions, we may choose the wrong path or simply be distracted from what needs to be done.

Over the last six years, Grandma went through so many ups and downs; from hospital visits, to rehabs, all types of therapy, dementia, to losing her best friend, her husband. We, as a family, stuck by her side always willing to do whatever it took to help but never realizing what she was going through since we couldn’t possibly experience her pain. To compound matters, after grandpa passed away, Grandma became mostly non-verbal so it was hard for her to communicate what she was feeling.

Six years ago Grandma was a hard working Italian woman; cooking, cleaning, and acting as an AMAZING caregiver to her kids (including myself). She never realized that she was the ultimate role model, teaching and touching so many people with her motherly ways.

Then, one morning while making the bed (because if the bed isn’t made then the room is a mess) BOOM!!! She fell. She was rushed to the emergency room with blood clots traveling to her lungs. Diagnosis: Pulmonary Embolism. The doctors did emergency surgery to save her life. She spent the next few months in a corner room in the ICU at St. Joseph’s Hospital in Paterson unresponsive and on a ventilator due to her collapsed lungs and kidney failure.

My family and I went every day to be by her side. We were convinced she was still thinking and hearing us as we noticed she would wiggle her toes in response to our questions. We all took various responsibilities whether it be to comfort her, tasks at home, doctors, finances and documenting each and every day and conversation. We focused on one organ at a time trying to juggle different parts of her body that were shutting down.

As she began to improve, the doctors told us that we needed to get her 100% off the vent so that they could pull it out and she could breathe on her own. So, we would “coach” and encourage her to breathe and breathe with her. But after two failed attempts the doctors began discussing a tracheotomy. We had no choice but to agree that if she failed one last time they would be forced to move forward with the procedure since they could not aggravate her esophagus any further. Grandma with a trach! Ughhhh. Well, they pulled out the tube one last time and miraculously she began to breathe. She had beat the odds, BUT at a grave expense. Grandma was changed forever.

I will continue the story in a few short weeks. While it is cathartic to me, I feel it is also important to tell the story, for if it helps one person to understand the challenges of caregiving or to recognize that it is truly a national epidemic it has been worth telling.

Thank you to all who have been following. I look forward to sharing.

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Clelia’s Caregiving Story Update

Last week, Clelia’s caregiver journey finally ended. Two weeks prior to her 87th birthday, Lidia Barone, “Ma,” took her last breath lying in bed surrounded by the people who loved her dearly. I watched as a family joined together in her last days waiting for the inevitable. The last two weeks were a gift to the Barone family. Due to her inability to swallow, Lidia stopped taking the medications prescribed to help ease her pain. As a result, she regained some of her clarity and began to enjoy her family again. The family cried and laughed together. They truly bonded over the undeniable loss of their matriarch. I listened as they told stories of the small Southern Italian town that is always at the center of their lives, Marano Principato.

Marano Principato, the town that draws them back to live, pushes them away, and then draws them back again time and time again. The residents of Marano Principato are both kind and untrustworthy. They are generous yet vicious. Fun yet cold. The town and its people have shaped the Barone family more than any typical place ever could.

As I looked at the dozens of photographs displayed around Lidia’s room it occurred to me that the woman lying in the nursing home bed had accomplished everything she set out to do. She married a fine man who needed to make a living. When there were no jobs in their small Italian town, they emigrated to France. From France, they moved to the United States. When they thought it best for their children, they moved back to that mystical town of Marano Principato. Then, once again it was time to leave and come back to the U.S., but only after their children reached adulthood and Olga had given birth to Clelia.

As I looked at a photo of a twenty-something Lidia Barone in France, I realized that her life must have felt like a fast train traveling through time – on board it feels like your destination is so far away, but the stops come faster and faster until the conductor cries, “Last stop. Everyone must disembark.”

Time moves swiftly. In our practice we see our clients’ wartime photos. Pictures of young men and women – strong and patriotic – not quite the confused elder needing our assistance to figure out how to pay for care. Those moments frozen in time must be cherished and not forgotten. For those are the people behind the mask of wrinkles and physical pain. Those are the people that once had hopes and dreams.

Every death is not only the end of a story, but the beginning of new chapters in a continuing saga. Where there was just Lidia and Domenico, now there are children, a grandchild, and great grandchildren. Lidia Barone may have had an interesting life filled with adventure and love, but in the end her family has only photos, memories, and lessons learned.

Did she live the American Dream or did she merely play her role in raising a good family, affecting some of the people she met along the way? We can only surmise her impact on the thousands of people that she touched, but her family is a testament to the power of one individual and what she can accomplish in 87 short years. Rest in peace, Ma.

-Eric R. Goldberg, Esq.

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Why You Need a Certified Elder Law Attorney

When you look for an attorney to help you with a special needs or elder law issue, you should look first at Certified Elder Law Attorneys near you. Why? Because they have demonstrated that they understand your legal problems, and they can help you.

The Certified Elder Law Attorney (CELA) certification has frequently been referred to as “the gold standard” for elder law and special needs practitioners. This reflects the hard work and proof required before an attorney can proudly proclaim that he or she holds the valued designation.

Preparation for a CELA designation includes several steps and several different types of qualification, all of which are designed to assure that clients receive good legal care. Before being certified, an applicant must:

Have practiced law for at least five years, and have focused at least half of their practice in the special needs/elder law field for at least the last three of those years.

Demonstrate “substantial involvement” in special needs and elder law practice, by demonstrating a minimum number of individual cases, spread across a number of different categories making up the “elder law” definition.

Study for, take and pass a rigorous, day-long written examination. Recent pass rates have been below 50% — and that is of applicants who have already met the experience requirements.

Undergo a review by peers and colleagues, focused on the applicant’s reputation for ethical and competent representation in elder law and special needs planning matters.

There are over 400 CELAs in the country, so not every community has even one person who has been certified. Your lawyer should be a CELA — it is your surest method of independently confirming that she (or he) is more than just qualified. After all, you deserve the best legal representation available.

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New Year & New Beginnings

The holidays and The New Year have come and gone and with them so many celebrations and emotions. This past weekend I celebrated my youngest son, Gino’s, 1st birthday. He was born Christmas Day and while it should have been such a happy event, it was ironically bittersweet. It was the first event that my Nonna would miss due from here on out.

I have hosted Christmas Day at my home since my eldest child, Dante, was born. Today is that day. My husband, Brandon, and I are shocked awake when Dante runs into my room, “Mommy, let’s go see if Santa ate the cookies and milk we left out for him.” We run into Gino’s room and pick him up on the way to the kitchen. The cookies and milk are gone, MAGIC! Then we run into the living room and witness Dante’s eyes light up in response to all the toys. He looks back at us in disbelief. Brandon and I smile. Dante opens all his presents and plays while I put the finishing touches on all the dishes I started two days prior, finish all the sides and appetizers, and swiftly clean the house in preparation for my family. My excitement builds.

Soon, the entire family arrives, including Nonna. Frankie and Marisa pick her up from the nursing home and bring her to the house. My dear Nonna comes in and we all say “Hi”, looking at her so very closely, almost like a mom looking at her child to detect the signs of an oncoming illness. We all hope this will be a good day with Nonna . . . but then it begins. My uncle informs us the nursing home didn’t have her ready. My aunt adds that the nursing home didn’t give her the correct medications. So now we have thoughts, concerns and actions that need to be taken care of. But we move on since it is Christmas. My impulse is always to act immediately. Today, I hope it can wait.

We sit down and eat. I had pureed food so Nonna can enjoy exactly what we are eating. She spits a lot now which I have learned is from her dementia. It’s tempting to correct her, to tell her to stop. I have learned that it doesn’t matter what I say anymore. The disease has taken over and it is slowly taking my Nonna away. We put Italian folk songs on and dance and sing in my grandfather’s memory as we do every time we get together. My mom and I run over to my grandmother grabbing her hands and waving them back and forth – a silly dance with her. She smiles and our hearts warm up. I begin to clean up. As it grows dark outside we prepare Nonna to leave. It strikes me that I may as well be dressing my toddler.

As my mother and I walk her to the front few steps I feel Nonna’s weight bearing down on my arm. I yell to Frankie to grab a chair, “She’s gonna fall!” Just in time we get her to sit on the chair half in and half out of the front doorway. I kneel down, look into my grandmother’s eyes and realize she’s getting that glazed look. I tell my family she’s losing her color. My mother cries. My grandmother begins convulsing. I sit there and hold her knowing that this will pass after she vomits. This time, she spares me this indignity. We get her inside and on the wheelchair and affix the ramp to the front stairway my mother had bought years ago thinking this time would never come. With effort, we help my Nonna into the car and Frankie drives her back to the nursing home. Once again, we now have a lot to do: We will call the nursing home so they can call a neurologist first thing tomorrow morning, question the nurses about the severity of her convulsions when we are not there, and call her other doctors to ask why this is happening. Does she have a UTI? Has something else changed? Is this an indication that her dementia is worsening?

In the meantime, we do our research as a family and find that with dementia sometimes too much activity and glimpses of memories can trigger episodes such as these. But, soon I will host the next family event, Gino’s 1st birthday. I so very much want my Nonna there to celebrate with us. We are devastated but agree as a family that we can no longer take her out of the nursing home to attend events just so we feel better about the situation. Family events have become torture for her. Now we realize that we have entered yet another chapter in this terrifying part of life.

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