The Top Ten Elder Law Strategies for Alzheimer’s Patients & Their Families

10 Absolutely Essential Principles for Preserving Quality-of-Life When Dealing with a Medical Diagnosis of Dementia

A Special Report By David A. Cutner, Esq.

Alzheimer’s disease and dementia-related illnesses are among the most costly of all medical conditions to manage. That fact, along with the long-term and mentally incapacitating nature of these afflictions, makes it critical to take advantage of every possible option to pay for care. For the vast majority of patients, that means achieving eligibility for Medicaid coverage.

The question is whether you’ll get Medicaid and be able to retain the benefit of the savings, investments and property you’ve accumulated over a lifetime, or end up dissipating almost everything you have under Medicaid’s onerous “spend down” regulations. The answer is often the difference between having the funds necessary to assure a dignified future, or the eventual poverty Medicaid rules can impose.

Elder Law offers a wide variety of methods, procedures and techniques to help keep your assets and income working for you and your family. Among these, certain strategies are of vital importance in client situations in which Alzheimer’s or dementia is a factor. In this fast reading, easy-to-understand Special Report, you’ll discover what these approaches are.

Prepared by leading Elder Law attorney David Cutner, you’ll be able to benefit from the very same strategies Lamson & Cutner has successfully employed on behalf of hundreds of clients with dementia-related illnesses. You will get clear, practical guidance on:

• Why you need to look into planning right away if there’s even a hint of dementia• How asset protection is the cornerstone of future financial stability• Why taking action even at the last minute is vastly superior to doing nothing• How to get benefits you’re legally entitled to • Establishing financial predictability as the disease progresses• Selecting the proper person to make major decisions for you when you cannot• Hiring your children as caregivers – a powerful planning strategy• Making sure your wishes and preferences regarding medical care are honored• The advantages of getting Medicaid in New York State• How to avoid Medicaid recertification problems

David Cutner has first hand experience in dealing with all these concerns not only as a lawyer, but also as a son. Having had to deal with his own mother’s long decline and dementia, he understands what clients and their families go through better than many other legal professionals do.

To get additional complimentary copies of this Special Report, or to find out more about Lamson & Cutner’s services, simply call the firm toll-free in New York City at 877-471-7117, or visit: www.lamson-cutner.com

When you’re dealing with Alzheimer’s Disease, the path to the best possible

future begins with smart planning.

David Cutner

9 East 40th StreetNew York, NY 10016www.lamson-cutner.com

Tel: (646) 963-2664Toll Free: (877) 471-7117

inquire@lamson-cutner.com

Lamson & Cutner, P.C.

101010

Attorneys who care and get results

Getting results for clients is what it’s all about at Lamson & Cutner. Here’s what you can expect to receive when you hire the firm:

• a proven track record of success in gaining Medicaid approval of home care and nursing facility care applications

• sophisticated, thorough and effective Elder Law, estate planning, and tax counsel, to protect your money, income, investments, and property

• experienced, knowledgeable attorneys, paralegals and staff

• lawyers and support personnel who listen carefully to your needs

• clear answers to all your questions

• all legal documents completely explained to you

• comprehensive follow-up to make sure that strategies have been implemented correctly

• attentive, courteous service

• fast return of your phone calls

Call today to learn about effective strategies for guarding yourfinancial future and making life better for yourself and your family.

Lamson & Cutner, P.C.9 East 40th Street

New York, NY 10016Tel 646-963-2664

Toll Free 877-471-7117 www.lamson-cutner.com

Email: inquire@lamson-cutner.com

What clients say about Lamson & Cutner...

“The law firm of Lamson & Cutner saved my mom . . .”“My mother was diagnosed with Alzheimer’s Syndrome. A nursing home was not an option. Although she could no longer care for herself physically, she was still aware mentally and would become depressed if confined to a facility…. Attorney Karen Mancuso, Jack Lippmann, and other staff members took the time to take my calls and explain, in clear and simple language, the steps that I had to take. They provided me with exact details and were always patient and pleasant – never condescending or abrupt. As a result of their help, I was able to enroll my mother in the Medicaid program and secure full at-home service for her…. The law firm of Lamson & Cutner saved my mom, and my entire family, from an enormous burden. We are not wealthy people, but I feel that hiring this firm was one of the best investments that my mother ever made! …. I will always be grateful for what they did for us!”

J.W.

“. . . what you and your staff accomplished was to enable me and my family to keep Elaine at home and provide her

with the best care possible . . .”“From the first meeting that we had with you and your staff we always received a very clear explanation of what our options were and what needed to be done to accomplish our objective … the document your staff produced was thorough and very professional looking and it accomplished its task of getting Medicaid approval for Elaine…. In human terms what you and your staff accomplished was to enable me and my family to keep Elaine at home and provide her with the best care possible and that’s a wonderful thing because Elaine thrives in this familiar environment. I would highly recommend your firm to any family that is looking for an excellent Law firm to handle their case….”

J.F.andJ.F.andD.F.

“We’ve worked with a couple of other law firms in New York. . . neither of them were as thorough and professional.”

“… it was a pleasure having you as our representatives. We’ve worked with a couple of other law firms in New York on my aunt’s business in the past seven years, and neither of them were as thorough and professional. Thank you for a job well done!”

J.Z.andR.Z.

Attorney AdvertisingPrior results obtained by the firm do not guarantee a similar outcome in future cases.

The photograph used on the cover of this special report is of professional models, not clients of the firm

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The Top Ten Elder Law Strategies for Alzheimer’s Patients and Their Families

10 Absolutely Essential Principles for Preserving Quality-of-Life When Dealing with a Medical Diagnosis of Dementia

A Special Report By David A. Cutner, Esq.

Of all the challenges an individual can face as he or she becomes older, there is perhaps little more frightening than to be given a diagnosis of Alzheimer’s disease. It’s often as emotionally traumatizing for family members as it is for the patient.

Aside from medical considerations, quality-of-life issues are some of the biggest concerns people have. Fortunately, Elder Law planning provides many advantages for those afflicted with Alzheimer’s and for their families. There’s a wide variety of extremely effective strategies for obtaining Medicaid benefits to cover the cost of care, and for preserving the money, investments, and property you’ve acquired over a lifetime.

These methods are particularly vital when dealing with a medical condition that involves any form of dementia, since these illnesses often result in extremely high medical and health care expenses. This is due partly to the drawn-out, degenerative nature of the disease, which can span many years, and also because of the need for specialized, continual supervision.

For these reasons, Alzheimer’s disease tends to involve a more complex planning process than most other infirmities, and certain strategies take on greater importance. This discussion is a “critical points” overview of the planning process when you’re dealing with Alzheimer’s or any other form of dementia illness. It’s about essential things Lamson & Cutner strongly recommends you consider to get the best possible result from your legal and financial planning. It’s designed to work hand-in-hand with Lamson & Cutner’s publication, 25 Strategies to Prevent Financial Ruin from Long-Term Health Care Costs, which gives you more details on the actual nuts-and-bolts of implementation, and in-depth explanations of specific methods.

In this report, you’ll find specific ideas, approaches and techniques of proven value to you and your family members. Ideally, successful planning achieves two outcomes. First, it qualifies you for Medicaid benefits as quickly as possible, once it becomes clear that long-term care is required. Second, it protects your financial resources and property from being subject to Medicaid regulations requiring patients to pay for treatment until their reserves are almost completely exhausted.

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Although some of the discussion in this report may be useful to those living in other states, these methods are relevant specifically to residents of New York. Be aware that laws vary widely in different jurisdictions. You should consult a qualified Elder Law attorney in your location if you live in another state. This material does not constitute legal advice. Every situation is unique and needs to be thoroughly evaluated by a competent Elder Law attorney in order to be addressed properly.

1. If you even suspect Alzheimer’s, investigate planning immediately.There’s a variety of possible planning procedures that need to be considered in light

of your particular situation, in order to obtain an optimal result. Most of these techniques also require drafting of detailed legal documents to protect your assets and income.

Time is of the essence when planning involves Alzheimer’s disease because, by law, you need to have sufficient mental capacity to understand and approve the plan designed for you, or to sign documents authorizing others to act on your behalf. It’s vital to realize that the sooner you act, the greater control you’ll have over the legal and other decisions that determine how your financial future will unfold.

Even if you are already in the mid-stages of the disease, you may still legally be considered as having sufficient mental capacity to make these choices. However, your opportunity to act could fade quickly. That’s why it’s to your advantage to schedule a consultation with an Elder Law firm if dementia is suspected. If you take the steps and make the necessary decisions while you still have the mental capacity to do so, you can structure the best possible outcome for yourself going forward, rather than leaving your future to chance.

2. Asset protection is imperative. The course of Alzheimer’s disease can be relatively brief, or it could extend over

a period of many years. Many Alzheimer’s and dementia patients do not develop serious physical ailments until the later stages of the condition. Since you may need care for quite a long time, it’s crucial to have a plan for dealing with the exorbitant costs of medical and health care services that will be required to manage the illness. Professional assistance with daily activities may be needed beginning as early as the very first year.

For Alzheimer’s and dementia, planning has to take into account increasing levels of care, including around-the-clock supervision. As an example, home care can involve two or three 8-hour shifts of health care attendants. Medicaid typically doesn’t cover three, or even two shifts, although live-in assistance may be available in certain cases. That means it’s vital to conserve the value of existing savings, investments, income, and real estate. This is a critical step in assuring that funds will be available to pay for living expenses and optimal care if you want to stay in your own home, instead of residing in a facility.

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There is another aspect of asset protection to consider, aside from the issue of having the money to pay your health care costs, which is especially relevant when you stay home. Even with professional home care attendants doing a lot of the daily “heavy lifting,” so to speak, and Medicaid footing the majority of the bill, it’s still not an easy experience for spouses and other family members, either emotionally or financially. For this reason, most Alzheimer’s patients want to consider their family’s future after they’re gone, so that their lives can be as stable and fulfilling as possible.

What that will require is estate planning. Elder law techniques do the work of providing for your financial needs while you’re alive. Estate planning gives your family economic support after you die. And as a practical matter, Elder Law and estate planning go hand-in-hand, particularly when planning involves a married couple. All other things being equal, the best possible scenario you can have with regard to legal representation is an Elder Law firm that has estate planning counsel on staff.

With what these two legal disciplines can offer, it’s possible to have sufficient financial security to pay for all the care you need, and enough money left over to take care of your loved ones.

As an example, we represented an 89-year-old widow who suffers from Alzheimer’s disease, arthritis, hyperlipidemia and diabetes. She is also incontinent and requires help with most activities of daily living. She was paying for both home and adult day care from her own funds, covering approximately eight hours per day, six days a week, and rapidly depleting her assets. In addition, she actually needed more care and attention than she was getting.

We prepared and submitted a Medicaid application for home care services, and created a special trust to preserve her surplus income. Her condo apartment and remaining financial assets were transferred to her niece, who is now administering these resources for her aunt’s benefit.

The happy outcome of this story is that with effective planning, our client gained the advantage of enjoying the benefits of her savings, income and property while she is alive. Her niece will retain ownership of anything that’s left over after she dies. In addition, she now gets twelve hours per day of home care, seven days a week, providing the extra pro-fessional assistance she needs. And it’s all paid for by Medicaid.

3. Planning late is better than never planning. The most obvious yet overlooked Elder Law strategy is simply to be proactive. But

most people don’t plan, and as a result suffer severe financial consequences. Asset-

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preserving steps can even be taken after you’re already in a nursing home. So it’s never too late to plan, and to accomplish something that’s financially worthwhile.

In some instances, planning mistakes can even be corrected relatively long after they’ve been made. For example, let’s say you gave $100,000 to a son or daughter within the “look back” period. For nursing home care, this would be a penalized transfer under Medicaid regulations, and you would be ineligible for Medicaid benefits for approximately 10 months or longer, depending on where you live in New York State.

However, with Elder Law strategies, it is possible to save from 40% to 50% of the money that you gave to your child. There are a number of Medicaid-compliant techniques that work well for this circumstance, such as creating private annuities, or promissory notes, using the money for exempt purposes, and others. The methods that are appropriate for you depend on your unique situation. Several of these approaches are fully explained in the companion publication to this report, 25 Strategies to Prevent Financial Ruin from Long-Term Health Care Costs.

The bottom line is that Elder Law planning can deliver a great overall benefit to you and ultimately to your family, as opposed to the alternative of depleting your assets under Medicaid’s spend down rules. Most important of all, you’ll have the financial ability to preserve a better quality-of-life for yourself. Anything left over after you pass on can be left to your children, or others you choose. If you don’t plan effectively, there’ll likely be little, if anything, to distribute when you die.

4. Get everything you’re entitled to.There are many programs and services that assist those with Alzheimer’s disease,

which are largely unknown. In some instances, families may be aware of them, but they can’t afford the cost or assume that Mom or Dad is ineligible. Fortunately, with proper planning you can qualify, opening the door to a whole new world of dignity-preserving solutions.

One particular benefit that Alzheimer’s and dementia patients and their families can avail themselves of is Adult Day Care services. These programs provide you with a stimulating, daily social environment, professionally monitored for safety. They give you an opportunity to get out of the house, be with other people and just as importantly, family members get a break.

This is just one example of the extraordinarily valuable resources that are available if you pursue them and take the appropriate steps to become eligible.

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5. Predictability is essential.The essence of successful planning is predictability. You know exactly what’s going

to happen because you set it up that way, using the best possible information, advice and methods available.

This is why it’s critical to retain competent professionals to handle your work, both at the initial stage and annually, for Medicaid’s required recertification each year. Elder Law attorneys have detailed knowledge of trusts, estates, elder financial planning, Medicaid, Medicare, guardianship considerations, as well as experience in drafting all the necessary documents properly. Errors can be very costly. How will you pay for your care if your benefits are denied or revoked?

When you select a firm, you’ll want to know something about its philosophy, because there can be some key differences in approach among Elder Law attorneys. Here are three specific elements to look for. If a firm can meet these criteria, you’ll likely get the best possible result from its representation:

• Tried and true techniques. The lawyers you choose should employ methods that have a proven track record of producing reliable outcomes. While aggressive, “cutting edge” strategies might sound appealing, they usually come with added risks that may be difficult to quantify. There are firms that will, in certain circumstances, use approaches that could result in litigation with Medicaid. This is the equivalent of courtroom roulette with a client’s future. If a matter ends up in court, there’s no guarantee as to how it will turn out, even if your case seems very strong. Novel strategies are potentially dangerous to your future financial stability. You shouldn’t be exposed to that risk, even if it’s a small one. Always ask your lawyer if what he or she is suggesting is a well-established method, and carefully consider whether you can afford to assume the risk of an unproven strategy.

• Focus on results. When you sit down with an Elder law attorney for an initial consultation, you have the right to expect a detailed analysis of your circumstances, as well as specific recommendations as to what should be done to get the best overall legal and financial result. If you don’t come away from the meeting with a clear idea of the benefits that can be obtained and specifically how to achieve them, that should give you cause for concern.

• Personal attention. Dealing with a diagnosis of Alzheimer’s or dementia is frightening and unsettling for anyone, including family members. The last thing you need is more stress from your lawyer. You want personalized service, attention to detail, and prompt, professional responses to your questions and concerns.

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That makes your life a lot easier. If you don’t have the sense that a firm’s attorneys and staff are service-oriented, don’t hire them.

These are the cornerstones of Lamson & Cutner’s approach to representing all of its clients. It’s why the firm has a well-established history of offering a conservative, service-based approach, and a track record of delivering reliable results.

6. A trusted person needs the power to act.The distinguishing and most disturbing characteristic of Alzheimer’s, and all other

dementia-related illness, is the gradual loss of ability to act on one’s own behalf. Because this is not a question of “if,” but rather “when,” it’s absolutely essential that you appoint an agent to make decisions and take appropriate actions for you, when you no longer can. Central to all effective Elder Law planning is the appointment of this agent through a Durable Power of Attorney. For the types of strategies discussed here, a “standard” Power of Attorney is insufficient. Your Power of Attorney needs to be comprehensive enough for your agent to make decisions and take the necessary actions to protect you, your money and your property. For this reason, a Durable Power of Attorney that is broad in scope is essential.

Please see 25 Strategies to Prevent Financial Ruin from Long-Term Health Care Costs for a thorough discussion of how this document is used in Elder Law planning. Here we want to address a couple points that are of particular relevance to Alzheimer’s and dementia patients.

If you don’t have a Durable Power of Attorney, you will impose a costly and time-consuming burden on your family. They’ll have to petition the court for the appointment of a guardian. Your fate will now be determined by a judge, who’ll select the person to handle your most critical and intimate personal and financial decisions. That person may not even be a member of your family and could be, for instance, a court-appointed attorney. If for any reason you or your relatives don’t enjoy a good rapport with the guardian, you will have to face an additional expensive and exhausting court proceeding to try to make a change.

Here’s an example of why it’s so important for your agent to be able to legally act on your behalf. In one case, our client had significant pension income of her own, as well as from her late husband. In her later years, she developed Alzheimer’s disease, which caused her to lose her memory and become completely unable to deal with ongoing obligations in her daily life. She fell behind in payment of her income taxes to the point where she received a Final Levy from the IRS, even though she had ample resources from which to pay her taxes.

Because we had earlier prepared a Durable Power of Attorney that contained the necessary scope of powers, our client’s niece was able to take appropriate steps to protect her aunt.

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We helped the niece to satisfy her aunt’s tax obligations, drafted all the necessarydocuments, and protected remaining assets and income by creating two special trusts. As a result, our client was able to remain in her own home at the standard of living to which she was accustomed. Without these steps, she would have been subject to Medicaid’s spend down regulations, and lost almost every financial resource she had acquired over a lifetime of work.

Keep in mind that a Durable Power of Attorney gives your agent the immediate ability to make decisions on your behalf, which is a significant advantage if your illness takes a sudden turn for the worse. The agent’s authority to act on your behalf will continue through and after the point you become mentally incapacitated. However, you need not give the document to him or her until you feel ready, thereby preserving a measure of personal control over your own affairs until you’re no longer able to handle them.

7. Gain multiple advantages by ‘hiring’ your children. Statistics reveal that approximately 70% of Alzheimer’s patients receive care at

home. In these situations, that of course means relatives are doing a significant amount, if not all, of the work of attending to a patient’s needs.

A Caregiver Agreement, also called a Personal Services Contract, is a legal contract under which you employ a son, daughter, relative, friend or an agency, to assist you with the support services you need. There are several advantages to these agreements for a medical profile that includes Alzheimer’s disease or dementia-related conditions.

First, home care attendants or a nursing facility staff are sometimes not equipped to provide all the services and companionship you may want or require. The reality is that if the extra support doesn’t come from a family member or friend, you might not get it.

Second, family members often suffer from “compassion fatigue” in caring for an elderly and ill parent. Burnout is a real danger, especially given the insidious nature and demands of Alzheimer’s disease. Frequently, there are the financial pressures on the family member or friend who is providing care, and compensation through the Caregiver Agreement can ease that burden.

Third, a Caregiver Agreement is a valid way to compensate others in a Medicaid-compliant manner. The payments to the caregiver can help avoid or reduce costly penalties that would arise if the money were simply given to the individual without a formal contract. These agreements can be structured to transfer either a lump sum or periodic payments, and therefore have great flexibility for planning purposes.

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8. Family members need definite instructions.Unlike some illnesses in which a prognosis can be widely variable, the

progression of Alzheimer’s disease is known. Although the time frame may vary from patient to patient, the various stages of the condition are well documented. Ultimately of course, this means that people with the disease will lose the ability to make informed decisions on their own behalf.

This makes the whole subject of Advance Directives of critical importance to you and your family. With regard to medical and health care decisions, a crucial part of an effective plan is the Health Care Proxy. This is a legal document in which you designate a specific individual who will make vital choices regarding your medical care when you no longer can, including end-of-life decisions.

Those who are ill, yet feel they will retain their mental clarity to the end of their days, sometimes resist having a Health Care Proxy drafted for them. They find the whole idea of loss of control too threatening and uncomfortable to consider, and delay or dismiss taking this important step. While some people do retain their decision-making capacity right up to the end of their lives, unfortunately this isn’t the case with Alzheimer’s victims. And that means if you don’t have a Health Care Proxy, once again your family members may become subject to costly and draining guardianship proceedings in court.

In that case, paradoxically, you end up losing any control you had hoped to hold onto, because a judge will select the person who’ll make your health care decisions.

With a Health Care Proxy, while you still have your presence of mind, you have the advantage of selecting a person you feel will understand your ideas, philosophy and wishes about your life, health and medical care. In turn, this person will then do his or her best to make the decisions you would make, were you able to. Certainly, it needs to be someone you trust.

The recent Family Health Care Decisions Act, enacted March 2010, gives family members and others of close relation the ability to make medical and life-sustaining decisions for you. However, as with any new legislation, it’s hard to know in advance how it will be applied. There are some ambiguities in the law that may be problematic. Consequently, Lamson & Cutner strongly recommends having a Health Care Proxy that appoints a specific individual you have confidence in to make these decisions, which in turn avoids conflict with family members and concerned parties. The good news is, with a properly constructed Health Care Proxy and a good choice of the agent, your desires are carried into the future intact. You won’t be subject to treatment you would not want if you were in a position to make your sentiments known. And there’s peace of mind in knowing that.

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9. Position yourself advantageously.Where you live has a major influence on the benefits you can get through Medicaid.

Since Medicaid is partly funded by state and local dollars, the state in which you reside will determine the scope of the program through which you’ll receive your benefits.

New York has a particularly generous Medicaid program. Unfortunately many other states don’t. So what that means is that it’s a good idea to consider your residency going forward. If professional home care is eventually needed, which can be an exorbitant cost, you may not be able to obtain sufficient home care benefits to pay for it in other states.

The whole notion of retiring or residing in a state with a warmer, more attractive climate, such as in the South or Southwest, presents this issue. You may want to investigate the benefits and programs available in the state where you would like to live, as well as the number and quality of service providers there.

Since care for Alzheimer’s disease is among the most expensive of all medical conditions, the cost is far beyond the resources of most patients and their families, unless they’re wealthy. So, all things considered, it can be to your best advantage to stay here in New York, or to move back here if you’re now living elsewhere. You’ll then have access to one of the most well funded Medicaid programs in the entire country, as well as a wide choice of service providers.

10. Get professional recertification.Once you’re eligible for Medicaid, you’ll have to go through a process of

“recertification” every year, to qualify you to continue receiving benefits.

Some people who initially get Medicaid with the help of an Elder Law firm, make the mistake of attempting to recertify themselves, and end up being denied any additional benefits.

The Medicaid recertification application is a complex document, and is best prepared with professional assistance. Attempting to save an attorney’s fee by doing the work yourself is often very short-sighted, given the long-term, costly nature of Alzheimer’s and dementia, and the serious implication of losing the financial support Medicaid benefits supply.

An additional important consideration is the current regulatory and economic environment. We live in a time of unprecedented changes with regard to health care, with many confusing and unclear laws, rules, and policies. If you’re not an attorney who deals with this information on a daily basis, how can you reasonably expect to keep up-to-date on these changes, which may impact your benefits?

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Again, with Alzheimer’s and dementia, the best approach is the safest one. Get professional help to make sure the job is done properly, and that you and your family have the ongoing legal support you’ll need.

Preserving financial stability and personal dignityis an achievable outcome of effective planning.

Money makes a difference when you’re dealing with disease. It can be the deciding factor in whether you’ll have access to the medical and health care you need.

You now know the ten “must have” elements in legal and financial planning for Alzheimer’s or any other dementia-related medical condition.

These proven methods have a long and successful history of making a vast difference in the quality-of-life for Alzheimer’s patients. All you need to do is put them to work for you and your family.

If you need assistance, call Lamson & Cutner toll-free at 877-471-7117. Elder Law and estate planning is all we do, and the firm has extensive experience in representing clients with Alzheimer’s disease and other dementia illnesses.

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Other Special Reports by David A. Cutner, Esq.

25 Strategies to Prevent Financial Ruin from Long-Term Health Care CostsA Special Report for Seniors, the Disabled,

and Their Families

The Elder Law Crash Course30 Essential Points in 15 Minutes or Less

A Master Checklist of Strategies to Qualify for Medicaid & Still Retain the Benefit of Your Money, Income & Assets

About David A. Cutner, Esq.

David A. Cutner, Esq. is an Elder Law attorney practicing in New York City. He is a founding partner of Lamson & Cutner, P.C., one of New York’s preeminent Elder Law firms. The firm’s practice is devoted solely to sophisticated elder and estate planning approaches for senior citizens and the disabled. The firm has broad experience in addressing the specific needs of clients and families facing Alzheimer’s disease and other dementia-related afflictions. As a compassionate advocate for the elderly and infirm, Mr. Cutner is dedicated to protecting the rights and financial security of every client.

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Special Report DisclaimerThis Special Report is offered free of charge by Lamson & Cutner to seniors, the disabled, and their families for informational purposes only. It is not intended to provide, or to be relied upon as, legal advice concerning your individual situation. Although a group or collection of cases may be said to involve similar themes or fact patterns, every case has its own unique facts. These unique facts may call for a different approach or strategy than other cases which may appear - at least superficially - to be similar. Only an experienced attorney, giving individual attention to the specific facts of your case, is in a position to provide you with reliable legal advice.

In addition, Federal and New York State laws and regulations are constantly changing through new legislation and rules, and through new decisions and interpretations handed down by administrative law judges and courts. Reliable legal advice must take these changes into account. Sometimes, these changes are subtle or affect only a small number of cases, and thus are not necessarily included in a general informational discussion. These are further reasons why general discussions can never substitute for concrete, individualized legal advice regarding your specific situation.

Individuals who reside in, or who are subject to the laws of other states, should be aware that this Special Report is designed primarily to inform residents of New York State. The laws and rules governing programs for the care of the elderly and disabled may differ in your state.

David A. Cutner and Lamson & Cutner disclaim any liability for any actions taken or not taken in reliance upon this Special Report. David A. Cutner and Lamson & Cutner disclaim responsibility for any errors or omissions contained in this Special Report. This disclaimer is governed by the laws of the State of New York.

Lamson & Cutner’s prior results do not guarantee a similar outcome in future cases. This Special Report is Attorney Advertising.

The content of this Special Report reflects the ideas, concepts, and thinking of David A. Cutner and the other attorneys at Lamson & Cutner. However, professional writing services were employed in the creation of this Special Report.

Certain of the actual cases mentioned in this Special Report were commenced by Carole Lamson or David Cutner prior to the formation of Lamson & Cutner. The staff attorneys and paralegals who worked on these cases joined Lamson & Cutner when it was formed, and the clients involved all transferred their legal representation to Lamson & Cutner.

Communications with Lamson & Cutner will be treated as confidential by the firm. However, such communications do not create an attorney client relationship with Lamson & Cutner, which may be established only by a written agreement signed by the firm and the client.

Lamson & Cutner accepts no responsibility for the security of communications sent to the firm via email or text message, or through the Internet.

Attorneys who care and get results

Getting results for clients is what it’s all about at Lamson & Cutner. Here’s what you can expect to receive when you hire the firm:

• a proven track record of success in gaining Medicaid approval of home care and nursing facility care applications

• sophisticated, thorough and effective Elder Law, estate planning, and tax counsel, to protect your money, income, investments, and property

• experienced, knowledgeable attorneys, paralegals and staff

• lawyers and support personnel who listen carefully to your needs

• clear answers to all your questions

• all legal documents completely explained to you

• comprehensive follow-up to make sure that strategies have been implemented correctly

• attentive, courteous service

• fast return of your phone calls

Call today to learn about effective strategies for guarding yourfinancial future and making life better for yourself and your family.

Lamson & Cutner, P.C.9 East 40th Street

New York, NY 10016Tel 646-963-2664

Toll Free 877-471-7117 www.lamson-cutner.com

Email: inquire@lamson-cutner.com

What clients say about Lamson & Cutner...

“The law firm of Lamson & Cutner saved my mom . . .”“My mother was diagnosed with Alzheimer’s Syndrome. A nursing home was not an option. Although she could no longer care for herself physically, she was still aware mentally and would become depressed if confined to a facility…. Attorney Karen Mancuso, Jack Lippmann, and other staff members took the time to take my calls and explain, in clear and simple language, the steps that I had to take. They provided me with exact details and were always patient and pleasant – never condescending or abrupt. As a result of their help, I was able to enroll my mother in the Medicaid program and secure full at-home service for her…. The law firm of Lamson & Cutner saved my mom, and my entire family, from an enormous burden. We are not wealthy people, but I feel that hiring this firm was one of the best investments that my mother ever made! …. I will always be grateful for what they did for us!”

J.W.

“. . . what you and your staff accomplished was to enable me and my family to keep Elaine at home and provide her

with the best care possible . . .”“From the first meeting that we had with you and your staff we always received a very clear explanation of what our options were and what needed to be done to accomplish our objective … the document your staff produced was thorough and very professional looking and it accomplished its task of getting Medicaid approval for Elaine…. In human terms what you and your staff accomplished was to enable me and my family to keep Elaine at home and provide her with the best care possible and that’s a wonderful thing because Elaine thrives in this familiar environment. I would highly recommend your firm to any family that is looking for an excellent Law firm to handle their case….”

J.F.andJ.F.andD.F.

“We’ve worked with a couple of other law firms in New York. . . neither of them were as thorough and professional.”

“… it was a pleasure having you as our representatives. We’ve worked with a couple of other law firms in New York on my aunt’s business in the past seven years, and neither of them were as thorough and professional. Thank you for a job well done!”

J.Z.andR.Z.

Attorney AdvertisingPrior results obtained by the firm do not guarantee a similar outcome in future cases.

The photograph used on the cover of this special report is of professional models, not clients of the firm

The Top Ten Elder Law Strategies for Alzheimer’s Patients & Their Families

10 Absolutely Essential Principles for Preserving Quality-of-Life When Dealing with a Medical Diagnosis of Dementia

A Special Report By David A. Cutner, Esq.

Alzheimer’s disease and dementia-related illnesses are among the most costly of all medical conditions to manage. That fact, along with the long-term and mentally incapacitating nature of these afflictions, makes it critical to take advantage of every possible option to pay for care. For the vast majority of patients, that means achieving eligibility for Medicaid coverage.

The question is whether you’ll get Medicaid and be able to retain the benefit of the savings, investments and property you’ve accumulated over a lifetime, or end up dissipating almost everything you have under Medicaid’s onerous “spend down” regulations. The answer is often the difference between having the funds necessary to assure a dignified future, or the eventual poverty Medicaid rules can impose.

Elder Law offers a wide variety of methods, procedures and techniques to help keep your assets and income working for you and your family. Among these, certain strategies are of vital importance in client situations in which Alzheimer’s or dementia is a factor. In this fast reading, easy-to-understand Special Report, you’ll discover what these approaches are.

Prepared by leading Elder Law attorney David Cutner, you’ll be able to benefit from the very same strategies Lamson & Cutner has successfully employed on behalf of hundreds of clients with dementia-related illnesses. You will get clear, practical guidance on:

• Why you need to look into planning right away if there’s even a hint of dementia• How asset protection is the cornerstone of future financial stability• Why taking action even at the last minute is vastly superior to doing nothing• How to get benefits you’re legally entitled to • Establishing financial predictability as the disease progresses• Selecting the proper person to make major decisions for you when you cannot• Hiring your children as caregivers – a powerful planning strategy• Making sure your wishes and preferences regarding medical care are honored• The advantages of getting Medicaid in New York State• How to avoid Medicaid recertification problems

David Cutner has first hand experience in dealing with all these concerns not only as a lawyer, but also as a son. Having had to deal with his own mother’s long decline and dementia, he understands what clients and their families go through better than many other legal professionals do.

To get additional complimentary copies of this Special Report, or to find out more about Lamson & Cutner’s services, simply call the firm toll-free in New York City at 877-471-7117, or visit: www.lamson-cutner.com

When you’re dealing with Alzheimer’s Disease, the path to the best possible

future begins with smart planning.

David Cutner

9 East 40th StreetNew York, NY 10016www.lamson-cutner.com

Tel: (646) 963-2664Toll Free: (877) 471-7117

inquire@lamson-cutner.com

Lamson & Cutner, P.C.