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Elderly face tough decisions in later years

March 22, 2009|By DAVE McMILLION

WASHINGTON COUNTY -- Imagine that you're a senior citizen who is being abused or exploited, and you want to get into a protected environment such as a nursing home or an assisted-living facility.

Or maybe your health is failing and you need to find someone to whom you can entrust your financial affairs.

Perhaps a nursing home or assisted-living facility is looking better to you than that big house with more space than you need and a lawn you no longer can manage.

Whatever the circumstances, determining the best course of action can be complicated and bad choices can end up causing problems for seniors, experts in elder care say.

Power of attorney



One way older people can get help managing their affairs is by giving to someone they trust power of attorney, which lets those appointed manage financial, medical and legal matters on the senior's behalf.

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But a power of attorney can lead to disaster if the person selected to handle one's affairs is unscrupulous.

"If you don't have someone who is trustworthy, there is a lot of room for abuse," said Catherine A. Drummond, a Hagerstown attorney who specializes in elder law.

A Boonsboro man who drew the concern of town residents because of his poor living conditions, including a lack of heat, was one of the more troubling cases local police and social services officials have witnessed, they said.

Authorities allege in court documents that the man, who suffered from dementia, was deprived of the sale of investment accounts worth more than $300,000 and of $325,000 from the sale of his antique car collection.

A Hagerstown couple to whom the man gave power of attorney was charged with obtaining property of a vulnerable adult.

There are no requirements that those holding power of attorney must follow, said Washington County State's Attorney Charles Strong.

But holding a power of attorney -- an instrument that gives another person power over one's financial or legal affairs -- is accompanied by a fiduciary responsibility to act in the best interest of the elderly person, Strong said. If interested parties such as family members believe that fiduciary responsibility is being violated, they can file a lawsuit, he said.

Establishing a power of attorney can be as simple as obtaining forms over the Internet or at an office-supply store, and Drummond said there is little oversight of the process.

In some states, powers of attorney must be registered, but not in Maryland, Drummond said. A power of attorney document is kept by the person who established it, she said.

In many cases, a relative or a friend can be counted on to serve as a power of attorney, Washington County Department of Social Services officials said.

Drummond cautioned that selection of a grown child or other relative might not always the best course. That might be the case, for instance, if the relative has a problem, such as a gambling addiction, that could put him or her in the position of needing cash in a hurry, she said.

"It's not just signing your name. It's understanding it. You're giving someone a lot power," Drummond said.

What if an older person does not have someone on whom to rely? In such cases, seniors can turn to experts, such as accountants, said Drummond, who noted that some accounting firms specialize in providing financial services to the elderly. Selecting such a firm, which employs licensed professionals, is preferable to choosing "just anybody" to handle one's finances, she said.

A client can ask an accounting firm to provide regular information about his or her finances, an arrangement she said an elder law attorney can help a client put into place.

Rating nursing homes



Selecting a nursing home or a similar type of long-term-care facility shouldn't be done without serious consideration, experts say.

Before a decision is made, there are ways to check out such facilities to see how they rank in terms of quality of care.

Maryland's Office of Health Care Quality conducts annual reviews of nursing homes and the results of the surveys can be viewed on the Web at www.medicare.gov/NHCompare.

At this site, nursing homes can be searched by name, by distance from a specific city, by state or by other search criteria. Nursing homes are rated from one star (much below average) to five stars (much above average) on such criteria as health inspections, staffing and quality measures. An overall rating also is given.

A recent search at the site found and listed ratings for 16 nursing homes within 25 miles of Hagerstown.

Group homes



Group homes, which usually provide living quarters for five to 15 residents, are another alternative for senior citizens, said John Kenney, program manager of Adult Services for the Washington County Department of Social Services.

One cause for concern, however, is that group homes are allowed to open after an application for operation has been accepted, but before they are licensed, Kenney said.

That means such a facility might accept residents before it has been inspected to determine if it meets all regulations, such as conducting background checks on employees, Kenney said.




Coming Tuesday



o Residents of a local retirement community talk about the scams they've faced.

o How some scam artists operate.

o Senior citizens who are seeking information on how to protect themselves from exploitation and fraud can turn to a local organization for information and advice.

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