Tips For When An Elderly Loved Ones Health Declines: Elder Law Insights

In Episode 25, Kim Hegland discusses the critical need for elder law planning, emphasizing the pitfalls of will-based planning, particularly in second marriages with his and her children. Kim shares insights into Medicaid's five-year look-back period, the importance of trust planning, and the differences between Lady Bird deeds and transfer on death deeds. The conversation extends to the challenges faced by families dealing with dementia diagnoses and the comprehensive support offered by Kim's practice.

There's something new to learn every week, so make sure you subscribe, hit the like button, and save this video to a playlist. If you need, help hop over to https://willowwoodsolutions.com to contact Sherri Lund.


🌟 Key Do's and Don'ts:

-Do Consider Trust Planning: Opt for trust planning, not will-based planning, to safeguard against unintentional disinheritance, especially in blended families.

-Don't Gift Without Guidance: If considering gifting, consult with professionals to navigate Medicaid's five-year look back program and prevent costly mistakes. Kim lays out a few good examples in this episode!

- Do Choose Lady Bird Deeds: Consider Lady Bird deeds over transfer on death deeds for smoother property transitions, as they can help you avoid potential title insurance challenges and creditor access.

-Don't Delay for Dementia: If faced with a dementia diagnosis in a spouse or parent, don't hesitate to seek legal advice promptly. An elder law professional can help.


🤝 Contact Kim Hegwood, Elder Law Attorney
Phone: 281 218 0880
Website: https://yourlegacylegalcare.com


🤝 Contact Sherri:
Sherri invites you to explore her toolbox of resources on the Willow Wood Solutions website and encourages you to reach out to her through the contact form. For direct assistance, call or text Sherri at (832) 640-2997.

No one should navigate life's transitions alone. Let Sherri be your guide through probate, senior transitions, and beyond. Connect with Sherri today.

📍 Website: https://WillowWoodSolutions.com 
📞 Contact: (832) 640-2997

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Transcript

0:22

Hi, there my name is Sherri Lund and this is the Probate Podcast I'm so glad that you're here. I'm the founder of Willow Wood Solutions and I help families and individuals that are overwhelmed and stressed out trying to navigate this senior transition time, downsizing, figuring out what to do with all the stuff moving into probate and beyond. And so I help with people, pets, property, personal belongings. I'm also excited to be the host of the Probate Podcast. My goal here is to educate people with my guests that I have so that you can experience the people that I interview, you can get to know them before you ever come face to face with them. You can get your questions answered. I wanna get the conversation started to reduce the mystery that surrounds estate planning, probate in these end of life conversations. They're hard to have, but we need to have them. And so I'm glad to welcome Kim Hegwood today as my guest. She is an elder law attorney in the South part of Houston, but she can serve anybody in Texas. We'll talk a little bit about that in a little bit. So you're going to want to grab your favorite beverage. You're going to want to grab your pen and paper because the things Kim and I talk about today are going to be something you're going to want to know for yourself or for someone else that you might know. You're going to want to refer back to these things because these are important topics that don't go away. We just might change them a little bit in the law but, necessary topics to know so. Kim, welcome to the podcast. I'm so glad that you're here today. Sherri, thank you so much for having me. Yeah, I'm excited to have you. Let me tell you a little bit about Kim. Kim is a Houston girl. She's a Texas girl for sure. She was born in Bay City and she's an elder law and estate planning attorney based in Houston, Texas. She's a member of the National Academy of elder law attorneys. She watched her grandparents struggle to maintain their independence as they grew older, trying to navigate the challenges of aging and deal with the legal, financial, and emotional challenges in their golden years. Kim decided to dedicate her career to helping families preserve their dignity and protect their assets. She's an undergraduate at the University of Houston. And Kim graduated from South Texas law in 1996 and passed the bar in 1997. In 1998. Kim opened her practice and she focuses exclusively on elder law, asset protection, estate planning Medicaid, crisis planning, probate. guardianship, and special needs planning. Kim's passionate about educating her clients. She hosts a podcast herself and she's helping her clients to choose legal strategies that will achieve their goals so they can age with security and dignity. Seeing what her grandparents endured and with the growing number of dementia diagnoses, Kim understands what her clients are going through. She aims to treat each of her clients as if they were family. Kim takes pride in helping families facing the diagnosis of dementia to avoid a costly guardianship process. She continues to expand her practice to better serve the needs of individuals going through their golden years. As a mother of three, Kim enjoys spending most of her free time with her children and grandchildren when she's not volunteering at one of her favorite charities. Kim is one busy lady, one busy lady helping a lot of people from the whole spectrum of life right from the little ones all the way up to the big ones to the older ones. And I love that. Our paths. Our journeys are real similar in that way, and I appreciate what you're doing. Thank you, Kim. If we were let's say walking along one of the parks down around Clear Lake, such a pretty spot down there and the great are both of our grandkids. All of our grandkids are about the same ages and we're meeting at a park and they're playing. We're just chatting. And I said, Kim, you seem like a nice person. Tell me about you. Not thinking about attorney stuff, like who are you as a person? It's funny, You ask that question. And the 1st thing that always pops into mind 1st is a mom from there, my kids are adults and I've been blessed with lots of grandchildren, so I tell people, now I'm a G mama, so I get to spend, lots of time with, with grandkids and for me, it's all about family and it always has been we have a very close family. And with my mom and two sisters and family has always been very important for us growing up. And so I wanted my grandkids to spend time with each other because I spent a lot of time with my cousins growing up. And so I wanted my grandkids to have that same opportunity. So sometimes it almost feels like they're, brothers and sisters, when they're, added to each other, but but yeah they get along really well and they hang out and they seem to enjoy spending time with each other, which is good most of the time. And so that's it. After that, I, I love to travel. I read not anything important because when I read, I want it to be mind numbing. I have to think all day when I want to, when I read, I just want it to be relaxing. I've been traveling a lot with my mom, which has been lots of fun. We're working through her bucket list. And so that's been good. And and so just good food, good wine, so just your normal, normal things. That's awesome. Thanks for sharing that. Your Bio mentioned your grandparents journey and the experiences that you had with them as they aged. Can you talk a little bit about how their journey influenced where you are now, or was there something else that had an impact on you? As far as where my practice is today there that they were the biggest impact on how I progressed in my practice. I like to tell most people I'm a reformed litigator. So I was litigating at the time. They started to decline. I did that for probably about the 1st, 8 years of my practice. And then they started to decline, my kids were teenagers so here I was running back and forth, between courthouses. I had teenagers, my three teenagers, an extra teenager that I had in, had at the house with me as well. Two dogs, two cats, and then grandparents started to decline. My grandparents were like my second parents. I, we lived with my grandmother till I was six. My grandparents, and when I moved back after I after I got married, my early early, early 20s. And I saw my grandparents all the time, two to three days a week, just, almost, every other weekend, you know, easy. When it got time for me to go to law school, they did everything they could to help me. They babysat, the girls went to dance and my son went to karate and and they paid for those things. It gave me an opportunity to study and it gave time for them to spend time with them. Little things that they did for the kids that made a really huge difference. When I started really looking at things, I realized my grandparents had a a long time attorney. He'd been their attorney for years. And and all they had were wills. And me, I'm brilliant, right? I draft all these power attorneys that I know they need and I take them to the house and I sat down at the table and I said, hey, guys, George did, wills for you. But you need these documents as well, so I need you to look at them and then I'll make any changes you want to make and whoever you want to pick a spot to plug some names in thinking about what you might want. And my grandfather looked down at them and he slid them across the table. And he says, he said, I don't need these. And he stomped out and my grandmother looked at me and she says, Kimmy, if Papa won't sign them, I can't sign them either, and because she wasn't going to do anything that was going to contradict the decision he'd already made. And so I said, look, when he calms down, just read them. Just, I'm happy to talk to you about them, but I know you need them. And and they sat on the microwave cart for years, probably and, and my grandmother started to decline and and she had never been truly well most of my life, when it got towards the end, she had she had severe osteoporosis. So everything was painful and she was laid up and my grandfather retired, back in his seventies to stay home and take care of her. And then I'd say, Papa, do you need anything? Do you need me to run any errands? What do you need me to do?'cause you shouldn't be doing this all by yourself. And he goes, oh no, I got this. I retired so I got this. I know you're busy, so don't worry about it. And he had his first stroke. So then I took real charge real fast. Before he could do anything hard to caregiver and put some things in place. So that by the time he got home from the hospital, I'd already organized things a little bit, so he came home from the hospital. No, he was sitting in the hospital. And by then my grandmother had already declined such that she couldn't sign power of attorneys anymore. She was heavily medicated on pain medication and so she couldn't sign them. And I was sitting beside him in the hospital room and so, and I'm sitting beside his bed and I leaned over and I said, listen here, old man, I'm fixing to give you your come to Jesus speech. He goes, what? I said, I need you to understand that if something happens to you. It's not going to be me making medical decisions, it's going to be my mom and her two sisters. He goes, what? I said, remember those papers I wanted you to look at and sign? He goes, yeah. I said, that would have allowed me to make your medical decisions. I said, the other document I wanted you to sign was that statutory power of attorney that allows me to pay the bills, take care of Nani if something happens to you, make sure things get done because I would have had the power to do that for her. I said, she can't sign those documents now. Your job is to outlive her, so you've got to take care of yourself. Because I knew in my family, it was going to get ugly if he went first. So I'm walking, I'm talking about all the documents, and all the pros and cons of why he should have signed them a long time ago, and he leans over and told me to get my little hiney home and get his documents. And I'm like well, they're old now. I've got to give you, I got to go draft new ones! One of my long time paralegals went and executed them because I didn't want to be the one to notarize his documents. And so she went and did it for me. And he lasted 9 months after my grandmother and which I was so thankful for. And because it wasn't too bad when she passed away, but we went through the probate from hell, so to speak, when he passed away. And and so I remember my grandmother worried about that, worrying about it. She worried about it a lot. And I said, it's going to be fine. I got this. Don't worry about it. I'm a big girl. I said, in the courtroom, don't worry, so it's not a big deal. But it really brought home. It really brought home that. I was not forceful enough with them in the sense of really trying to make them understand what they needed and I regret that. And that I should have been more. I'm thankful. Thank God that my grandfather, signed all his documents. When it came time, for him to pass, it was super easy. The hospital had all my stuff so it was never a question over, me making the decisions on what to do, the day he passed and but so for that, I felt blessed because it was easy because, the ER doctor that was talking to me knew that I was the one that was going to make the decisions, so there wasn't any there wasn't anybody going who's in charge, what kids are here and, trying to find somebody to do that because it's very difficult when you've got, when you don't have those kind of documents in place, especially that medical power returning. When somebody has to make end of life decisions or even any medical decisions, if you've got two people sitting in there and they don't agree, the doctor has to decide. And in the meantime, the person is dealing with whatever they're dealing with while these two are over here squabbling about something. Yes. And it's not uncommon. It's not uncommon for people to disagree over what's going to happen. And so we really spend a lot of time talking to our clients, particularly going, you've got to have the person in place that can make hard decisions. Be okay with those hard decisions, they most people don't make Hard decisions in a vacuum, I tell people. My cousin was sitting there. I made the decision and then turned around and looked at her and said, are you good with that? She said yes. I'm like, okay, that's what we're going to do. And cause she was sitting there with me at the time and it's very seldom that people do that just once, but if they can't agree, you've got to have the one person that knows what mom or dad wants or grandma and grandpa, you got to know what they want. And I think that's hugely important and that's what gives you the freedom to, to pass with dignity, is making those choices. So someone else doesn't have to make the hard choices. And and I think that's really important and we want to empower our clients to do that to make the choices so that someone else doesn't have to absolutely. Yeah. I love that. The dignity part of it that you talked about security and dignity in your bio, because it is such a vulnerable time when. When people are older, they're frail, maybe they're not mentally as sharp as they once were, and that's on a good day, but you put them in a hospital when there's medication or there's pain or something like that. And they're desperately looking for somebody to take care of them and they need they need someone there that can be definitive about that. Let's talk about elder law and how an elder law attorney differs from a regular estate planning or probate attorney. I tell clients that an elder law attorney is an estate planning attorney on steroids. There's a lot of practitioners out there a lot of attorneys out there that, you know, do generalized, type stuff and they'll do power of attorneys for clients. The problem you have is that most of your traditional power of attorneys don't take care of long term care issues. And I tell clients this all the time, from the time you're 18 coming in doing power of attorneys, you know, to the time you might get married, do that will package to the time you move up to trust. We're always assuming that you're going to need long term care at any point in time in your future. We have done crisis Medicaid for clients in their thirties, in their forties, you can end up in a facility at any age, so it's really important to make sure that you've got all your bases covered. But as we age and we start looking at the things that are important for an elder law attorney is that we have to know more. Not only do we have to know estate planning, but we have to know probate, we have to know VA benefits and Medicaid benefits because those two conflict sometimes depending on what you need. Asset protection, all those things that come with aging, hugely important. So it's very important that you have someone that as you're aging for sure, you want an elder law attorney drafting those power of attorneys. I have clients all the time go, there's a lot of stuff in here. Are you sure I need all that stuff? Absolutely. It's there. We hope you never have to use it. Right. You need it? Those provisions have to be in there. And having a very powerful statutory durable power attorney is crucial to long term care planning. Can you talk about what Medicaid crisis is? So when we talk about Medicaid crisis planning, because we do Medicaid pre planning and then Medicaid crisis planning means that somebody's called me because their loved one is in the hospital heading to the nursing home, or they're in the nursing home for rehab and the nursing home's telling them they're not going to be able to go home, and they have no plan in place. When you're single, it's very painful because Medicaid says you can only have $2000 in assets. And I should say non exempt assets. Then it's an income issue so that we start off in Medicaid crisis planning looking at income because income determines how much assets we can protect. And then a lot depends on what type of assets that you have, that makes it easy or not easy. When you have really good power of attorneys, that agent can do a lot of things to help that process along and make it faster and easier. Because of all the things that we put in there allows them to do things like change beneficiaries if we need to, because once that person's in the nursing home, we don't want them to inherit anything. want it to go somewhere else because I spent a bunch of money doing Medicaid crisis planning. We don't want you to have to redo it. Exactly. So the goal always is to do the best thing for the client and then secondary do the best thing for the family. And so when you're doing planning, but I tell clients all the time, most of the time with married people, we can protect most of your stuff. WiTh single people, we can protect at least half of it and but you never want to be in Medicaid crisis planning as your first plan, because if I pre plan, I can do a whole lot more things and I'm all, all about options. I can do Medicaid pre planning and do some beautiful things for you. And you can still choose to private pay for a facility. You can still choose to do lots of other things. But if you don't pre plan, you don't have those options. It's basically you've got one plan and it's usually ugly. So for us, it's all about making sure that they have options. And then you get to decide, you know, Hey, you know, I have clients that do asset protection trust for long term care. Okay. And and one of them was in the office and I said do you still have him? And I named the facility. She said, yeah, I said, you know, that's a private pay. She goes, I know. I said, we did the planning. So you didn't have, she goes, I know, she says, but I love where he's at in the care he's getting. She had that option and for me, that was so important and she felt good about that, and that's, what's important to be able to say, I planned, but I had options. And I chose the one that was best for me and my family. Right. And you want that, that peace of mind the ability to say, we did a good job, and did a good job. And then you're making informed decisions. You're empowered with the options that you have. And while you have the mental capacity to say, this looks like the best 1 for me. It really sounds like you guys are in my mind, like the weather radar scanning the horizon to see what's out there. You're taking in all these variables that clients bring to you. And you're saying, we can navigate this wind pattern over here. We can navigate this turbulence over here and, we're going to have you smooth sailing right to your destination. If we follow this path. So I like that a lot. Does Medicaid, would a Medicaid crisis plan be for someone like you mentioned in their thirties. It's not just for elderly people. Is it.. We plan as if we don't know when your crisis plan is going to occur. Got it. And so the goal is my 18 year olds get the same power of attorneys as my 70 year olds. Okay. 1, because you'll never know. I Get that. So Medicaid crisis is not when you're in a crisis trying to figure out what you can do. That's not the, that's an option. It's not the best option. No, we want you to have more options, having the ability to do things. I'll give you an example. The client comes in him and his wife and they're like, we don't need asset protection, we're just going to do revocable living trust. ONe of them gets the diagnosis of Alzheimer's and we know from years of experience in education that, Alzheimer's is minimum, it's a 10 year horrifying experience. And so maybe the spouse didn't do it at the time, or maybe they've lost a spouse and this arriving spouse is starting to decline and they're the ones that have Alzheimer's. The kids can come in and do that planning that says, what do we need to protect over the next five years while mom or dad is still good enough to stay at home. before they might end up in long term care. So our power attorneys allow you to do that. And so sometimes it may not be, like clients will maybe do will packages and then they come back in. I'm like, Oh, I need you to do a trust. Because this is what I need you to do. You have a client that came in and said, my wife has pretty severe dementia. She is one of our power of attorneys. He can do all kinds of things for her and his goal is to protect her. He said, if I go first, I need to make sure that she's going to be okay. So you set the trust up to take care of her during her lifetime. So you do the things that is important to the family. And then that gives them, gives them options and gives them that peace of mind, knowing that they made the right decision for themselves and that everything's going to be okay to the best that they can do at the time. And in planning a state planning is not a 1 and done. We talk all the time. Oh, it's not a 1 and done. Don't kid yourself. You're going to. Once you set it up and there's maintenance that has to get done because your life changes over time three years I went from no kids to two kids, you know kind of thing. So a lot of things happen over time and so so you want to make sure that your state plan graduates with that, you know in our office We want to see you every three years We update power of attorneys every three years because they get old after that the financial ones financial institutions Don't want to take them if they're very old at all They're very reluctant to take them if they haven't been signed an attorney's office. And and then I have clients that come in that have done their own power of attorneys that do nothing. And then we end up in guardianship court trying to do medicaid. Can we talk about guardianships? Guardianship is a process that you have to go through the court system to be able to make medical decisions and financial decisions for someone who either has no plan in place at all, or the plan they have in place doesn't work. Like having poorly written power of attorneys. Traditional standard power of attorneys that a general estate planning attorney will give you is a good document, it's just not enough. You need a bunch of extra stuff in there, things they don't normally put in there because they don't know. And it's just, it's not their wheelhouse. They don't do elder law, so that's not what they do. So having those extra things in there helps. What happens with a guardianship is, if you have no power of attorneys, then you are very court controlled. I tell clients all the time, you're going to easily drop $4000 to $5000 right at the very beginning, and you will have spent probably close to $10,000 the first year, assuming the family's not fighting about who's taking care of mom or dad. Every year you, with the guardianship of the estate, you have to do annual accountings. You have to account for all the money. You have to ask the court for permission to spend money. It is very court controlled, very costly, and so for us, it's like, why would you do that on purpose? Let's do some planning. Let's avoid that. It's rare. It's rare that, with having good planning, you'd never have to usually never have to worry about it. The only time you worry about it, even doing good planning is when the kids are fighting. And and that, that happens more than you'd like to see because people should be on the same page, taking care of mom and dad, but a lot of families don't talk about it. I laugh and tell people we talk about it in my family. Oh, my gosh, at the kitchen table. We've talked about everything you could possibly experience during life. Do you still do litigation? December 22nd, was the very last jury trial I will ever have in my practice. I refuse. So I've done a jury trial in probate court. I've done a jury trial in guardianship court, and I've done a jury trial in family court, and I don't want to see either one of those courts again as far as litigation. And so I've had the experience, I've been blessed with that, you know, I've had a lot of trial experience over the years but my goal is to stay out of the courtroom. I have attorneys that go to court. We don't do a lot of litigation here. But, my goal is to do planning so that the families are on the same page. We'll do generational planning where mom and dad might come in, then the grandparents come in, and then the kids come in, the grandkids come in so that people are planning well, and they're doing it generationally so that there's no surprise over who's doing what, who's in charge, why the decisions were made because I think transparency lessens problems you have in life. I agree 100%. Can you describe your typical client? Sounds like they're all over the place. Our typical clients usually mid to late 50s, married kids. We see them his and her kids. I've got clients with his hers and ours. But those clients that are on second marriages, his and her kids, it's imperative that you do good planning. Yes. Because when you do will based planning in that circumstance, it's very easy to disinherit children. So when couple comes in. Unintentionally, not that you would want to, but it's. No, it's very unintent, it's very unintentionally, don't get me wrong, we've disinherited children, but it's been very intentional in the documents.. but you know, Unintentionally, so second marriage, his and her kids, if the best thing that somebody gets from this today is never do will based planning. You always want to do trust planning because it gives you the ability to lock in those beneficiary designations. So you never have to worry about whether or not your kids are going to get something. And or whether it's going to go to them and not your step kids, and vice versa. And so it's really important to get those things in place and to do better planning. But I find that it's difficult for people to realize how important it is to do better planning. I totally get what you're talking about. How would outcomes be different if your typical client went to somebody else instead of coming to you? What we find is that we have we have clients that have gone to other attorneys. They've come to us I've had to fix a lot of things over the years. And a lot of attorneys that don't do elder law, the clients don't get what they need and they don't know it. And so it'll be random. A lot of times we do a lot of webinars, a lot of educational webinars. And because I didn't want people to be in the position that my grandparents were in, but just not knowing what they didn't know right now. And so they'll watch a webinar, then they'll come in and I go I think I've got a good plan. My attorney did this for me. And you sit down and you're like this is good and this is good, but you're missing, A, B, and C, and it would be better if you added X, Y, and Z kind of thing. And so maybe we transition into better planning. But, and that happens sometimes a client will come in and they've got for their circumstances. They have a perfectly good plan. We might just update power of attorneys because the statutory power of attorney is the really the crucial 1. that's so important for long term care planning and the ability to. To do just about anything as an agent. And sometimes, more than not, we end up doing better planning, we'll redo their plans. I've had a client come in one time and another attorney that gets a lot of time on just CLEs and things like that. And and she came in and she says, This isn't what I wanted and I haven't, I never signed it because this wasn't what I wanted and I sat down with her and and looked at it and ask her what she wanted and I'm looking at this trust that had been drafted and and she told me what she wanted. I'm like, you're right. This doesn't do it. So we just redid it. And I gave her a whole new trust that did exactly what she wanted. We sit down with clients. We'd walk them through their, walk them through their stuff ask her any questions they have, give them their documents to review. I want them to read them. I tell them, read to this point and then. This stuff, the rest of it has to go in there. Read that when you have trouble sleeping. I'll be the first to admit there is some legal stuff that is very dry and it's not very entertaining. So.. Sure. But necessary stuff, and then in our planning we include all kinds of contingency stuff that may or may not happen. But if it does. It works. It still works. Everything works. It just you just adjust internally with the planning that we put in place. And I want clients to be able to have that because you never know, and I'm a prime example. I had trust planning done. It, when my youngest daughter was 14, became physically disabled. Had I passed away right after that, my trust would have taken care of her portion because it had a mini special needs trust built in. Not as good as the standalone I did for her, but the mini special needs trust was a catch all. It's there just in case. Would have taken care of her. No problem, the things that you don't know we put trust protector provisions and all our trust and everybody's that's, we're not sure we like that. It's very powerful. I said, yeah, but you hardly ever use it. But it keeps you out of probate court. So now your stuff maintains its privacy. So now everybody doesn't get to see what you've done. And if you need it, it's great. And if you don't worry about it. It's just extra pages in your binder, yeah. Sometimes it's just better to be overly prepared than to be very under prepared. It sounds like you've got a real safety net. That sounds like your directives are several pages longer than the typical attorney that we might find. Well, our power of attorneys are a whole lot longer and so I will tell you on our directive to physicians that living will I changed the second page on ours. There's a paragraph on it that says, if I need any additional request, write them on the lines. No one in my practice in 26 years, except one person wrote on those lines because nobody knew what to write. She knew what to write because of her experience, and she told that to me. And every time I do a signing, I tell the client the same story because I think it's so powerful. And I'll give you an example. I'll tell you what I, what she told me. She wrote down antibiotics and IV fluids. And I said, why did you do that? No one ever writes on these lines. She said, grandpa was in the hospital. Doctor came out to grandma. It was his time. She said, okay, let him go. She said, my mom's an RN. She says, no, give him antibiotics and IV fluids. The doctor said, okay. A week later, grandpa went home. I tell that story all the time because I think it's so powerful. And I found that taking care of my grandfather specifically. I got very disillusioned, learning the things that I learned when I was taking care of him, doctors are not always right. They're not God. they make a lot of mistakes. You have to advocate for yourself, because if you don't, no one else will do it for you. I had to really advocate for my grandfather because, the doctor wrote the wrong prescription for him. The pharmacy filled a prescription they should never have filled for him. The man was like crazy for two days before that. It all worked its way out of his system, and I was one of those that never really read the little white pages, I'm like, if the doctor did it and the pharmacist prescribed it, it must be good. Yeah, no, it must be good. And I will tell your listeners doctors know very little about pharmaceuticals.... better have a good conversation with your pharmacist because when you read the little white paper, it says, do not give to the elderly and I was like, and the pharmacist filled it. I was so angry. I was angry. I was livid. I'm ranting and raving in the house and he's I'm fine. I'm fine. It only lasted a few days. Calm down. I'm like, no, they all should, nobody should be practicing doing that kind of stuff. And he said, no, I'm good. Leave it alone. And so I just got to scream and yell at the doctor the next time I saw him. So I might get it together. But yeah it's really important to have those people in your life that can do that for you. Absolutely. Absolutely. Can you talk about Medicaid's five year look back program? So Medicaid is a five year look, look back for gifts. They're looking for you, for people that are giving away their assets and then trying to qualify for Medicaid. And when I first started practicing was only a three year look back and then it changed to a five year look back shortly thereafter there. So basically if I'm going to transfer something to a family member, or even to an irrevocable trust, because we do a lot of irrevocable trust planning, then there's a five year look back. So those clients have to be one of two things. They have to be young enough in good health, or they have to have enough assets to private pay if they don't make it through those five years. So those are the things that we look for. And but we tell clients all the time, don't do the gifting by yourself. Because if you mess it up, it's very expensive and painful, so we'll walk you through of what to gift and how to gift it. And I never, when I'm doing pre planning, I never gift outright to kids because they never have it when you need it. So we always gift into trust. Because that way it sits there until I know that five years have passed and then if they want to give stuff to the children they can. But if you gift to kids, I tell clients all the time, if you handed one of your kids 10, 000 would they have it in a week or two? They're like, no, then we don't want to gift to them right now either. So we do it in trust so we can control it. And we always want to be able to do that because we may need some of that money before the five years are up. So we want to make sure that we're doing the planning. Gifting from Medicaid is as simple as giving to your church, to your charity. They complain about everything. So cash coming out of your bank accounts, we tell you don't take cash out. Cash is a red flag for them.. Anything over 200 they're looking for and they want you to have a receipt. Who has a receipt for cash? Nobody does. And so you want to make sure that all those things are done. If you're gonna try to get step away in order to qualify for Medicaid, because maybe you can, maybe you can't, but talk to somebody qualified to know. You may not need to. A lot of people assume that they have to do something with the house because Medicaid is going to take it. Medicaid doesn't want your house. They come in as a creditor in probate. Only in probate. That's the only way they can get paid is in probate. So as long as you avoid probate, you avoid Medicaid estate recovery, because that's the only way they can get paid. And a lot of people have missing, even title companies sometimes have so much misinformation that you have to give them the statute that says no, they're a creditor in probate. They're not an automatic lien. So they don't get paid. It doesn't matter. And and so a lot of times it's just sometimes even educating title companies on what you're selling, real property. What's your take on the Lady Bird deed and the transfer on death? We do the Lady Bird deed a lot. We've really enhanced ours and and we don't do transfer on death deeds at all. One of the big takeaways on the transfer on death deeds is that creditors can get to it, the property for up to two years. So most of your title companies won't give, if you're trying to sell it, they won't do title insurance on it for two years. Really? That's the big one that for us, that was the big one. That is a big one. And yeah, if you're trying to sell a house as a child, inheriting this house, trying to sell it and you can't sell it, for two years, you do not have title insurance. Or, as a buyer, I would buy a private piece of property without title insurance. And so it makes it problematic for the kids. There's another things that, unfortunately people were so excited about being able to fill in the blanks and do their own deeds without having to pay an attorney. And then nobody really at the initially they didn't talk about all the fine print that our ignorant legislators put in some of this stuff. Why would you do something to benefit a family and then allow creditors to still come back and get to it for 2 years? That means there's somebody that was in their ear going, hey, you know what I contributed to your campaign. Obviously, you've got to take care of us, but it's, on the 1 hand, they were giving something and then they were taking it away on the other. Which is it's just wrong, so we do life estate deeds. Lady birdies. If you want to call them, they've worked phenomenal throughout our practice. So we've, we have very few issues with them at all. Maybe a title company that needed a little bit more education, but for the most part, we've been doing this so long. We don't have problems with title companies around here and it works just as well, because the house is a protected resource for Medicaid. Thank you. It doesn't, doesn't have to be in, if it's in the trust, it's not we have to do things to get it into the trust to avoid probate and we do that with life estate deeds, ladybird deeds. What if 1 of our listeners has a spouse or a parent with a dementia diagnosis and they're on the fence about whether they should call you. What would you say to them? I would tell them as soon as they got that diagnosis to call, because there's so much more that we do in my practice, besides documents, we have our elder care navigation program where, we walk clients through the initial diagnosis we work with geriatric care managers to put the care plans together for clients so that the, they can, figure out is the home safe? If not, what do we need to put in place? Some of the biggest things is just, Okay. Bye. So we want to make sure that they can, that they understand and get those documents in place early in case something happens and then every year we try to update those documents because it gives us an opportunity to check them, make sure they're still good, to sign, because depending on the type of dementia that someone's diagnosed with depends on how fast they decline and we find that a lot of clients don't get Really good diagnosis sometimes, like the primary care physician will say, oh, it's dementia. But if you don't know what kind of dementia, you don't know how fast they're going to progress, assume that it might be faster than the client wants, and then I look at things like, because Alzheimer's is now under the dementia umbrella, but with Alzheimer's patients, they're usually disgustingly healthy. Except for the Alzheimer's. So I always ask clients, how's your, how's their health? How's your health if they have an early diagnosis? Because if they're healthy, that tells me, my odds are, if they don't have that really good diagnosis, that odds are they might have Alzheimer's because. People that are not, that have any kind of issues are not normally an Alzheimer's patient with those. We know 10 years minimum is what you're looking at of having to deal with this. And that's a long time to be a caregiver. It is. I was probably, a good couple of years. We had private caregivers with my grandparents. So on holidays, I brought him home. And and my house was noisy, and because between the teenagers and the dogs and the cats and everything, bless his heart, he sat on the porch a lot. And it was one of those things where, it was one of the best days because I had wheeled him out, he was in his wheelchair at the time because he couldn't get up. He couldn't walk anymore. The second stroke, after the second stroke. He started having T. I. A. So little many tiny little strokes you have. And so they was just debilitating his body. But his brain was still fantastic. And we were sitting out on the porch one day and I was sitting in the swing and he was in his wheelchair and I asked him, I said, I said, I know you're in the military, but I don't know what you did. And nobody really talks about it. I'm like, were you bad, and so then he started telling me what he did, something I'd never heard before. And I wish so bad because, he passed away in 06, before you could pick up your phone and hit the record button and, and things like that, and families should record that stuff. The stories and the history and just the things that are just phenomenal that you just. If you don't get it you lose it, so he told me what he did in the military and it was just phenomenal, of what he did and and so it was such a, it was such a good day to be able to sit and listen to those stories. Early in my practice I had a gentleman come in and I said, Hey, hon, how was your weekend? Cause it was a Monday. And he's one of our clients and he walked in, I don't remember what he came in for, but he came in and he said, I spent the weekend with my grand, with my grandsons. And I said that's great. He goes no, it wasn't. I'm like, were they bad? He goes, no, they had their history books with them. He said, and they had some little history homework. He says, Kim, he says, the history books are wrong. They don't tell history like it really was. And and he sat down on the couch and for the next two hours gave me an education. And so I literally sat and talked to him for a couple hours, everybody was in the office was walking by and would stop and listen for a while, because he said our history books tend to write history, teach our children history the way they want us to, where they want them to learn it, not the way it was, and I was like, I'm shocked, I was shocked, but so definitely it was very eye opening, when you think about the things that you take for granted, that you have no idea, You break. And if you hadn't asked your dad, that's that question when you it could have been lost. Like you would have never known that opportunity would have been gone. And yeah, no one would have ever known. And it was really incredible because my grandfather was his family was from Czechoslovakia. And so during World War Two, he served as an interpreter. And so he was in the army, and so as they were gaining, as they were, getting these enemy transmissions, in Czech, he was translating. Wow. During the war, and so I was like, I was so proud, and it just, it was just really such a cool experience, and I'm, I'm calling my mom, going, guess what Papa did when he was in the military, and my sisters, and so just really telling the family, because none of us really knew, because, I asked my grandmother one time, she goes, Oh, he doesn't talk about it. So I left it alone thinking, it must've been a bad experience because I have talked to clients that had served during the war. Not so much now because most of our World War II people are gone, but early in my practice, when a lot of them were still alive, still, a lot of them had some real horrifying experiences, so they did talk about it. And Because the roles of engagement in war have changed over time and I was surprised to find out that's not even something that most of us even know anything about. And but yeah, it's rolls all back to just really educating ourselves and getting good information getting there. Kim, what is your what is your process? I, I referred someone to your practice last week and I had. They were needing some information right now and maybe some of the people that are listening today might think that they can just call you and have an appointment with you and get their process started whatever they decide to do. But it's not always instant. That is it talk about the typical process and what it looks like in your office. Normally what happens with the state planning is clients will see 1 of our client services directors 1st. And so their job is to determine a, if the client needs us the types of things that the clients, might want, find out what their pain points are to see, this is the kind of direction they need to go. They don't give legal advice and that's not their job. And so when the client retains, the next appointment is always with an attorney and we go back and look at that again to make sure they're getting all the right stuff. So our process is very it's little lengthy. So they come in for a, complimentary consultation, they'll come back for a design meeting, they'll come back for a review meeting, they'll come back for a signing meeting. When you do trust planning, we actually help you with all the funding, making sure your assets are either in the trust now, or they fall into the trust upon death, because if you don't do that, it doesn't work. So a full time funding coordinator that works with that as well. Probate, guardianship, and what tiny bit of family we do, probably more prenups than anything else. And because of the language we put in all our stuff then the attorney normally sees you first. And not necessarily all the time, but most of the time. And so she'll do those consultations because she can tell right away. I can tell right away by how people answer the questionnaires what, what they need. And so for state planning, I can look at the questionnaires as long as they filled it out and did answered all the questions that we asked them to in the information. Because don't get me wrong. We ask for a lot of personal information. Sure. Nothing that. Nothing that, we don't ask for social security numbers. We don't ask for bank accounts. We just ask for how much do you have in an IRA? How much do you have a non retirement assets? Because it makes a difference in how the conversation goes, do you have long term care insurance? What's important to you? Is it important to avoid probate? Is it important to protect your assets for long term care? Filling out that information and being very transparent with this makes it easy for us to walk you through the pros and cons of determining the best plan for you and then letting you decide. Okay. And so because that's important you give them options when you come in and you're well, you're Alive well, and everything in life is good is the best time to plan because then you've got lots of options when you wait to a crisis, you have very few options. And usually there's just 1 and that's never it's never pretty until clients crisis planning is never pretty. Right. And it, it takes up time when there's a crisis going on, then your attention needs to be on. Whatever the crisis is, but if you have to come up with an estate plan to and make decisions on who's going to do what that takes a different part of the brain. The executive part of the brain is hard to act when you're under stress like that. I'm hearing 6 weeks. At least a month, maybe 2 months in there, depending on how much planning is going to go back and forth. Pace yourself. I was surprised when we came up with our plan. It takes a while to do this. And part of that was on us to come up with the names and who wants to do what or who's going to do what? Kim, how can people find you easy to call the number 281 218 0880. That same number you can schedule appointments through any of our locations. Our main office is down here in clear Lake and and we have an office in the gallery area. 1 out and in memorial. I 10 and the beltway. We, we call it our Katy office because it's that direction. And then I have an office in Bay City because I grew up down there. So I know a lot of people in Matagorda County. So I tell people my mother knows everybody in God down there. It's, it helps when you're doing elder law for her to be as connected as she is some days. And then all the people that I went to school with their parents are declining. It helps as well. You've got several offices that people can meet up with you at as well as over zoom, I assume. We do a lot of when they're far enough away. We do, you can do your initial by zoom. You can do your design meeting by zoom. I can even do your review meeting by soon, but your signing has to be done in, sitting somewhere with a pen and but we make arrangements for clients. I have clients all over the state of Texas. Even as far as El Paso, so it's easy enough to find a place for them to execute their documents with witnesses and a notary and get them done well. And then you're on LinkedIn, Facebook got a website, all of that. You've got that there Go to LegacyLegalCare.Com. And I can tell you, I'm on a few of those things. I personally am not on those things. Is there anything that you feel like we have not talked about with. Regard to elder law, guardianship, estate planning or something that you is burning in you to talk about or to mention that we haven't covered yet. Probably 2 things. 1st thing is plan get a plan in place., No matter what age circumstances get a plan in place. If you're a caregiver, because I'm a huge advocate of caregivers I watched my grandfather decline because he didn't take care of himself, so we're a huge proponent of caregivers taking care of themselves, making sure they get sleep, making sure they get respite, making sure they get help, so that's really important to me because, I watched what happened to him by not taking care of himself. And and you got to let people help. You have to let people help. And there's most people are more than willing to do just about anything you want them to. So you just have to, you got to let go of the, I got it. When it comes to being a caregiver, I can handle it because it's very stressful. It is. And so you just keep adding one more thing to your back, one more thing to your back until you just can't do anymore. Most caregivers don't take care of themselves at the expense of the person they're taking care of. And and a lot of them will pass away first because they don't. And and I caution clients about that. I'm probably a little harder sometimes on clients than they expect, but sometimes you have to be blunt and you have to say, this is how things are. What do you want to do? And and I think that's important for clients to, to understand that, sometimes our advice may not be what you want, but it's 1 of those things where, we try to give you the best advice that we can based on, what we know. For sure, Kim, thank you so much for your time today and your insights, your tips. So, I really do appreciate your time and your busy schedule. I appreciate that so much. Not a problem. It's been a pleasure being on and it's so nice to meet you and we look forward to seeing you in the future. Thank you. Kim.