Category: Financial Matters

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Here’s what happens to your partner if you’re not married and you die

There are a number of documents that unwed partners can put in place if they want to make sure each is protected if the other person dies.

By Sarah O’Brien

Maggie Kirchhoff and her partner of 13 years, Matt, have no intention of ever getting married.

They also know it means they won’t get the automatic rights and protections that legally wed spouses get — particularly when it comes to death.

“A lot of spousal rights are inherent with a marriage certificate,” said Kirchhoff, a certified financial planner with Business & Personal Finance in Denver. “For unmarried couples, though, you have to make a concerted effort to cover all your bases.”

The number of unmarried couples who live together reached 18 million in 2016, a 29% jump from 14 million in 2007, according to the Pew Research Center. Among adults age 50 and older, however, the increase was 75%: About 4 million were cohabiting in 2016, up from 2.3 million in 2007.

Although the arrangement has gained broad societal acceptance, according to a separate Pew Research report, such couples still face some key differences from their married counterparts.

For example, filing a federal tax return as a couple is off the table. If your employer happens to extend health insurance to your partner, the amount your company contributes is taxable to you (vs. being tax-free for a spouse).

And, as mentioned, end-of-life considerations need some attention.

About five years into their relationship, Kirchhoff and her partner — who also is a CFP — signed a variety of documents that will dictate what happens if one of them either becomes incapacitated or dies.

In other words, they created an estate plan.

The basics

Remember, “estate” simply refers to everything you own — i.e., financial accounts, real estate and your belongings.

Experts say that creating a plan for what happens to your estate — regardless of how meager or massive your assets — is key for unmarried couples who want their commitment to each other protected in the event of death.

“If I’m married and die without an estate plan, it would be a mess, but the general default would be that everything ends up with my spouse,” said Nick Rosenbauer, an estate planning attorney and founder of the Rosenbauer Law Office in West Chester, Ohio.

“But if I’m not married, the default wouldn’t be my partner,” Rosenbauer said. “It might be my kids or my parents or siblings, but my partner who isn’t legally my spouse would be out of the picture.”

If you die without a will — called dying intestate — the courts in your state will decide who gets what. That process is public and often messy if would-be heirs have competing priorities and conflicting notions of what is rightfully theirs.

That said, a will alone won’t necessarily cover all your bases.

Retirement accounts

If you want to make sure your tax-advantaged retirement accounts — i.e., Roth and traditional individual retirement accounts, 401(k) plans and the like — end up with your partner, make sure that person is the named beneficiary on those accounts.

Even if you have a will that states otherwise, whoever is listed as the beneficiaries on those accounts will get the money. Same goes for insurance policies and annuities.

If no beneficiary is listed, where the money goes depends partly on the retirement plan agreement and on state law. Typically, though, those retirement assets would end up being included in your assets that are subject to probate.

That’s the process of the court validating your will (if there is one) after your death. If there is no will, the court will pass everything on according to state law — which typically means assets will go to the closest living family member who, again, is not going to be your unmarried partner.

Probate is also when creditors can come after your estate for amounts owed and other would-be heirs can contest your will.

Bank and brokerage accounts

If both of your names are on checking, savings or investment accounts, there’s no worry about either of you being able to access them if one of you were to die. The same can’t be said for those with only one person’s name on it.

For any account with only your name on it, contact your bank to find out what form needs to be filled out so the money is left directly to your partner.

“You’d either want to add what’s called a transfer-on-death or payable-on-death designation,” Kirchhoff said.

Again, without those designations, the assets would end up in probate and distributed either in accordance with the will or state laws.

The family house

Regardless of whether you split the mortgage — or whose name is on that loan — the person named on the deed is the owner.

“If the house in one person’s name, it won’t automatically pass to the partner,” Kirchhoff said. “It would become part of the probate estate.”

One option is to make sure both of you are named as joint owners on the deed, “with rights of survivorship.” In that case, generally speaking, you each equally own the house and are entitled to assume full ownership upon the death of the other.

However, there could be other factors to consider before adding a partner’s name to an existing deed, including the cost, tax implications or protection from potential creditors. In other words, you might want to consult with a professional before making the move.

Another option is to leave the house to your partner in your will. Remember, though, any asset passing through the bounds of your will is subject to probate and the potential snags that can come with that.

Consider a trust

Depending on the complexity of your financial situation and the type of assets you own, a trust could be one way to ensure that your partner ends up with what you want them to without any of it being subject to probate.

However, there are other considerations that should factor into whether you create one or not, including whether it would make sense tax-wise, and if the cost (which can be several thousand dollars) is worth it.

Communication

It also is probably worth letting any pertinent family members — i.e., adult children, parents or siblings — know the general intentions included in your estate plan.

While you don’t necessarily need to go into dollar amounts, managing expectations can help avoid discord between your partner and any other family members.

“I always recommend that clients discuss these plans with family to avoid hurt feelings or missed expectations,” said Eric Walters, a CFP and managing partner and founder of SilverCrest Wealth Planning in Greenwood Village, Colorado.

Other considerations

Generally speaking, your partner has no legal say in your medical treatment if you end up in a situation when you cannot make decisions yourself.

If you want to give the person that right, you can give them a durable power of attorney over health care. That will let your partner — or whomever you name — make important health-care decisions if you’re unable to.

This is separate from a living will, which states your wishes if you are on life support or suffer from a terminal condition. This helps guide your proxy’s decision-making. And if you have no one named, medical personnel must follow your wishes in that document.

Additionally, you might want to give your partner durable power of attorney for your finances. This would allow them to handle your money, including accessing your accounts as necessary, if you cannot.

And, Kirchhoff said, don’t forget to put contingent decision-makers on those documents.

“If there’s a likelihood that you and your partner are going to be traveling together, and something were to happen to both of you, then who’s in charge?” she said.

Similarly, if you and your partner have dependents, make sure you designate a guardian for them in your will. Otherwise, that decision will be left to the courts.

Complete Article ↪HERE↩!

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The Ethical Will

Life Is About More Than Your Possessions

By Deborah Quilter

Have you considered how to pass on your non-material assets?

When people find out Debby Mycroft helps people write ethical wills, she always gets a predictable response: The Lament.

“They say, ‘Oh, I wish I had a letter from my dad or grandmother or great aunt,’ whoever that person was. I have not come across a single person who has not wanted a letter from that special person,” says Mycroft, founder of Memories Worth Telling.

Unlike legal wills, ethical wills — also known as legacy letters — are not written by lawyers, but by you. They can include life lessons, values, blessings and hopes for the future, apologies to those you fear you may have hurt or gratitude to those you think you have not thanked enough. Traditionally, they were letters written by parents to children, to be read after death.

People who do not have children address them to friends or groups. One of Mycroft’s clients was placed in child protective services when she was quite young because her parents were addicts. “She had a rough upbringing. She intentionally decided not to have children herself. But she wanted to write an ethical will to other foster kids to let them know [they] can survive this,” Mycroft explains.

Why Write an Ethical Will?

Think that your life isn’t important enough to warrant an ethical will? Mycroft disagrees, saying, “You don’t have to be a war hero or a Nobel Peace Prize winner for your story to have value. When people accept awards at the Olympics, they thank the people who had an impact on their life, like Mom or Dad, who was always there to take them to training.”

But there’s an even more important reason you might want to consider a legacy letter. According to Barry K. Baines, author of Ethical Wills: Putting Your Values on Paper, such documents can bring enormous peace of mind.

Baines recalls one dying patient who was bereft because he felt there would be no trace of him when he left. “The first wave would wash away his footprints. That sense of hopelessness and loss was overwhelming,” says Baines. The man rated his suffering at 10 out of 10; after he wrote his ethical will, his suffering reduced to zero.

Don’t wait until you are on your deathbed to do this, Baines warns. As soon as you articulate your values, suddenly you start to live your life more intentionally. Especially if you share it.

“Live your life as you wish to be remembered,” Baines advises. Plus, he adds, legacy letters can help with making amends, addressing regrets and healing relationships.

Ethical Will: Telling Your Own Story

If you don’t feel capable of writing your legacy letter yourself, you can use an online template, take a workshop, read a book about it or work with a professional writer.

But don’t judge your skills harshly. Baines finds that whether people are educated or not or if their letters are simple or complex, they always have a certain elegance because of the truth they contain. “When the families get one, they just glow,” Baines says, adding, “This is a unique gift that only you can give.”

When you write your letter, don’t just say, “My core values are consideration, gratitude, kindness, simplicity,” advises Mycroft. Tell a story about how you’ve lived these values.

In her own legacy letter, Mycroft told her kids about a temp job she had as a teen. She appeared nicely dressed in a skirt, blouse and heels. When she walked in, the employers gave her a funny look and asked, “Why do you think you are here?”

She explained the agency had sent her out for secretarial work. Then her employers handed her a hard hat and steel-toed shoes. “That’s when I look at them quizzically.”

Turns out they were a plastic-bag manufacturer and she was supposed to sort through damaged goods to salvage the ones that could be sold.

“I was so angry that that agency had sent me out on that job. It was hot and humid in Virginia. I was fuming,” Mycroft says. “When I got home, my parents started grilling me. They said, ‘Did you agree on this job?’” And Mycroft confirmed that she did.

They asked what the contract said. Mycroft replied that the contract was pretty clear. Did she sign the contract, her parents wanted to know?

“Yes, but,” she says she told them. “And my parents said, ‘You signed it; you’re committed to it.’”

Mycroft stuck with the job as promised. “That was my first lesson in integrity, perseverance and diligence,” she recalls. She did what she said she would do. As a postscript, she got fantastic jobs from the agency over the rest of the summer. They knew they could count on her.

What Goes Into the Legacy Letter and What Stays Out

Ethical wills are often likened to letters from the heart, so perhaps the best advice is to literally write a love letter.

Love letters don’t recriminate. They don’t judge. They don’t scold. A love letter is there to show how much someone matters to you.

Criticisms and judgments should be left out, advises Mycroft. It’s okay to include regrets and family secrets, even if they hurt. If worded properly, these could bring the family to a place of acceptance and understanding.

She notes, “Sometimes when those things are hidden for so long it causes a lot of resentment — as in] why didn’t they tell me I was adopted? I wish I had known.”

“Definitely avoid manipulation,” Mycroft advises. “Legacy letters are beautiful expressions of love and encouragement, telling other people what is so fantastic about them. I do not think they should be hands reaching up from the grave slapping you or saying, ‘I told you so.’”

Think about how your letter might be received. Baines worked with a woman who had a very hard life. “Every part of her ethical will was blame and guilt-tripping,” he recalls. While some people can turn around a bad experience and use it is an example of what not to do, this woman could not.

“It almost seemed like she was purposely trying to hurt people,” Baines says. But eventually she realized that and gave up, sparing her family the hurt she would cause them.

Get a Second Opinion

Baines believes writers should show their legacy letter to a trusted friend before passing it on, to avoid inadvertent errors. Your reader might say, “You mentioned your two children, but you only write about one and not the other.” That could be extremely hurtful.

Baines also urges people to share the letters while they’re living. It might be painful, but there’s still potentially an opportunity to mend wounds. After you die, there’s no recourse at all.

What About Videos or Selfie Videos?

Some people make videos or selfies of their ethical wills, but keep in mind that technologies can become outmoded.

Mycroft gave both her children the letter and a video of her reading the letter so they not only have her words, but can also hear her voice.

“I’ve heard of people saving voicemails of people who have passed on,” she says. “Can you imagine saving a voicemail and all it says is ‘Susie, are you there? Can you pick up? Hello?’ If you’re willing to save that message just to hear their voice, how much more powerful would it be to hear your voice reading that letter?”

The Time Is Now

The time to write your spiritual legacy is now. Mycroft provides a case in point about her mother, who knew the family lore and lineage.

“I gave her one of these fill-in-the-blank family history books because I wanted to make sure it was preserved,” says Mycroft. “Five years later, when she had passed away and I went to clean out her office, I found the book. It was completely empty.”

Complete Article ↪HERE↩!

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6 Ways to Reduce Stress at the End of Your Life

It’s not easy nearing the end of your life, but that doesn’t mean you need to be stressed.

By Morgen Henderson

Death may be the ultimate stressful moment in our lives. Just thinking about the end is enough to cause your heart to beat faster. And while some levels of depression and anxiety are inevitable, those feelings need not overwhelm the death experience for you or your family. In fact, it’s possible to die well — to experience a sense of wellbeing as you approach the end. You can leave this life with a feeling of closure and a sense of contentment. That’s the difference between completing your life and merely ending it.

But stress disrupts well-being. It distracts you from prioritizing love, family, and dignity. Worry and fear interrupt precious time with family and friends. That’s no one’s idea of a good death. And while it’s easy to think you’ll skip this stressful step and go suddenly from a heart attack or stroke, the reality is the majority of us will need end-of-life care. So, put some thought and preparation into your passing now. Reducing stress will make it easier for you to say goodbye, and for your loved ones to let go. Here are six ways you can make dying the experience you want, rather than the experience you get.

Finalize Your Burial Arrangements

Preparing your burial arrangements lowers stress in several ways. For one, it puts you in control. Eliminate worry by outlining the type of service you want, the manner of internment, and the organ donation process. Burial arrangements also relieve financial stress from your family and friends. Carrying out your last wishes doesn’t have to be a financial burden for your family. So, find the best final expense insurance policy to cover costs. Or get a pre-paid funeral plan that kicks in after you’re gone. You’ll feel less stress knowing everything is taken care of.

Finally, by tending to your funeral arrangements yourself, your loved ones can focus more on spending time with you in your last day. And their grieving will be easier when they’re not weighed down with administrative tasks. Mourners often feel guilty devoting time to such business matters after a loved one dies.

Create a Living Will

If you become incapacitated before death, someone will have to make decisions for you. That’s a heavy responsibility to place on a family member or friend who may only have a rough idea of your wishes. But without a health care power of attorney (or proxy) to speak for you, you may end up being kept on life support longer than you’d prefer, or the opposite. An advanced directive or “living will” is a legal document that lists specific medical treatments you wish to receive and those you don’t. The directive takes the decision-making burden off your family’s shoulder.

To get started, have the end-of-life conversation with one or two people you would want to serve as your proxies. And also talk with your doctor so that everyone is on the same page. Living will forms vary by state. So, download your state’s advanced directive form to get started. If you don’t have the resources to create a living will, other forms of non-legal directives can work as some form of “proof” for your wishes. For example, write a letter to a family member expressing your wishes. Or record audio/video explaining what you want. While these aren’t formally recognized legal documents, they work better than nothing at all.

Make Amends

One thing that makes dying harder is knowing you’re leaving behind unsettled issues, old hurts, and past grudges. When possible, make amends with those you’ve hurt or who’ve hurt you. Now is the time for unburdening yourself and being honest with those you love. While you can leave those hurt feelings behind, your loved ones will carry them after you’re gone. And many will regret they didn’t say something when they had the chance. Knowing this will make leaving this life more stressful for you.

So, don’t put off making amends. Request a private audience with a loved one or wait for the right moment to broach the subject. Be honest and take responsibility for your part in the situation. Refer to the past event/issues that caused the rift, but don’t relive it all over again. And don’t bring up their responsibility; just explain your regrets and apologize. They will reciprocate. Think of this less as a discussion and more as a confession. So, listen more than you talk. The goal of making amends is to replace hurt and anger with forgiveness and love.

Revisit the Past

For those facing imminent death, the bulk of the conversation often focuses on medical needs, medications, or staff visits. While these are immediate needs are necessary, don’t forget the past. Revisiting old memories help us replace the current situation with one of our choosing — at least for a moment. Rather than a form of denial of death, recalling memories is an affirmation of our lives and our effect on others. For friends and family, recounting a past event is a handy way to show how a dying loved one impacted their lives. It’s often difficult for the dying person or loved one to find the right words in these moments. Words of condolence or regret can seem empty. But a pleasant or meaningful story can be a beautiful expression of our gratitude.

Recalling old memories is also a stimulating activity for Alzheimer’s patients. It fosters emotional connections and reduces anxiety. Use family albums, music, videos, or heirlooms to help prompt memories. Encourage family and friends who can’t travel or live too far away to send a short letter or audio recording. And don’t avoid humor. Include funny moments, old jokes, or humorous anecdotes. It may feel awkward at first, but laughter is nature’s way of helping us relieve stress and anxiety while connecting us.

Use Music Therapy

Studies suggest that music therapy has emotional and physical benefits for hospice and palliative care patients. Researchers found that patients who listened to music reported “less pain, anxiety … as well as an increase in feelings of well-being afterward.” Music therapy has a profound effect on people with cognitive and mental decline. The rhythmic nature of music requires little mental processing and helps stimulate memories. Choose music that your loved one enjoys, tunes from their childhood era, or a neutral New Age track. But don’t overstimulate; that can create stress. Take note of the other noises in the room. When mixed with many different sounds, even soothing music at a low volume to create a cacophony of stress.

Ask for Pain Medication When You Need It

Palliative care is about making patients feel as comfortable as possible until the end. And pain management and medication are part of this process. Unlike other vital signs, hospitals and staff can’t measure your pain. You have to help them know when you’re feeling discomfort. Still, some patients forego their pain meds because they want to stay awake to see their friends and family. Others see pain medication as “bad” substances or only for the weak or needy. But these are myths. Pain meds are integral to the palliative care process. And there’s no reason to forego pain medications that’s more important their your comfort. You may think you’re being strong for your family, but having to watch you fight intense discomfort will only increase their stress levels. Ask for pain medication when you need it.

These six tips will increase well-being and reduce stress when you’re nearing the end of your life. But once you’re faced with death, it’s important to know when it’s time to let go. Too often, we hold on too long out of a primal urge to keep going or fear of leaving our loved ones. Death is a natural process we all share. Take comfort in that immutable fact. Let your loved ones know you’re ready to go. They, too, will hold on to you, fearing that letting you go is “giving up.” This creates enormous amounts of stress. When it’s time, reassure them that — while you’re not ready to die — you have accepted it.

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Musicians must prepare estate plans for their musical works

Chris Osgood of Suicide Commandos performing at the Turf Club

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Whether or not we want to plan for it, we all inevitably die. A hard subject for some to grasp, death can bring forth a variety of emotions, conflict, or even chaos, depending on whether or not the deceased had a pre-established estate plan.

To some extent, everyone has assets, but what happens when music is one of those assets—specifically song lyrics and the recording of those songs? We often think about the physical attributes of an estate plan after someone dies—like jewelry, amplifiers, and guitars—but how does a musician plan their legacy that will proceed their death?

Some Minnesota musicians and artists have developed assets over time and have developed their own plans for their music as part of their estate planning process.

Musician Chris Osgood, one-third of the punk-rock trio The Suicide Commandos, has spent time organizing his own musical assets with his fellow bandmates, and for himself, as he continues his own estate-planning process.

“People like myself have a tendency to forget non-physical property is still an asset,” Osgood says over the phone. “When you are doing your death planning, the first thing you think about is, who gets which guitar and objects? The last thing you think about is intellectual property, like your songs, that hopefully will continue.”

Working with musicians, artists, and other talent, attorney Ken Abdo has helped create estate plans that include music assets and legacy planning.

“An artist’s music assets, in the context of estate planning, are really just one of many assets that an artist has,” Abdo says. “The estate planning does not limit itself just to the music aspect. They may have a house, debts, other property, other children. It is part of the whole estate of an individual.”

When you are a musician, prominently known or not, you may have the additional, non-physical assets of copyright, trademark, and even name and likeness potentially included in estate planning. All of these assets together are better known in estate planning as intellectual property.

“When we are talking about music assets, we are really talking about the greater world of intellectual property,” says Abdo. “Copyright is one of those parts. There are two different copyrights involved in the recording of music: there is the underlying composition or songwriting part of it, and then there is the recorded version of that song.”

Protected under United States copyright law, a musician’s compositions and recordings are preserved for 70 years past their death. Musical assets can continue making money well past the death of the musician—an estate plan can determine who benefits from or administers these royalties. Once the copyright period expires, the music enters into the public domain, which helps explain the popularity and exorbitant recordings of songs like “Silent Night,” or other classical hits—because the originator is no longer protected, anyone can write and record the song without the penalty of payment.

Osgood and the other members of The Suicide Commandos have a musical history that spans back to 1975. Planning everything from songwriting credits to publishing rights to trademark, Osgood and his fellow bandmates recently meticulously combed through their catalog and assigned the appropriate credits for their music to each band member.

“When we put out the last record “Time Bomb,” we got a publishing deal from a company called Words and Music down in Nashville,” says Osgood. “It was mandatory when we accepted that contract, to go through each song of our entire catalog and figure out who wrote what and make sure that all parties were content with the fractions. It was easy for us to agree. Songwriting credits are pretty easy to divvy up. Song lyrics hold equal weight to the music.”

A newer technology is helping to preserve intellectual property: holograms. Holographic tours have grown in popularity amongst some musicians, and although the process to create a holographic tour is complicated, it can help protect an artist’s name and likeness, trademark rights, copyright rights, and enable an income source for heirs.

As for reputation and how musicians want people to see their image after death, they can include that in their estate planning under the right of publicity, also known as “personality rights,” which applies to 23 states and controls the commercial use of their identity.

“When you die, that is an asset, where you can bequeath the rights to your name and likeness to another person,” says Abdo. “If you died and were famous and branded, you would want to make sure that your name and likeness fall into the right hands. You would designate that person for trustee, or someone who could shepherd your legacy by making good and correct use with guidance, to keep your legacy going—it survives your death. [For] most people, when you die, you’re dead. But when you are a famous person, you have a name and likeness that has value after your death.”

Although most people do not start their estate planning process until their 50s according to a national survey, Osgood believes being pragmatic is important when dealing with assets- especially when creative assets such as music, are a part of the process.

“It’s still mailbox money and money that can go to someone who is handling my estate,” says Osgood. “I think a lot of people overlook that and don’t think a lot about it. For most of us this side of Steely Dan, it’s not that big of a deal one way or another. It could be, and it often is, if someone’s song gets picked up for a movie or an ad posthumously.”

The Suicide Commandos performing for the Current’s 10th Anniversary Celebrations at the Turf Club

For anyone that has music as an asset, Osgood believes that musicians should include their work in their planning, even if they do not work full-time in the industry.

“For any creative person, don’t sell yourself short or think that because you are not making a complete living from your art, whatever it happens to be, that it isn’t important or that it wouldn’t be important for future generations,” says Osgood.

Reflecting on artists like Aretha Franklin, who recently made headlines for not having a formal estate plan, Osgood believes that musicians and others who have assets can learn from those public eye experiences.

“It’s a cautionary tale for anyone,” says Osgood. “You are taken aback that somebody of that stature hasn’t given that some thought. Maybe they didn’t because they were afraid of death, or something spooked them. It doesn’t spook me. It’s the last part of life. You have to prepare for it the same way you fill up your car before you take it on a trip.”

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The Cost Of Dying

Hospice’s Biggest Fans Now Have Second Thoughts

The rapid growth of the hospice industry has exposed the burden of putting the family in charge of the death bed.

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The booming hospice industry is changing what it looks like to die in the U.S. Rather than under the care of doctors and nurses in a hospital, more Americans than not now spend their final days in familiar surroundings, often at home, being cared for by loved ones.

While hospice has been a beautiful experience during a difficult time for many families, a yearlong reporting project by WPLN finds end-of-life support often falls short of what they need.

“Our long-term care system in this country is really using family, unpaid family members. That’s our situation,” says professor Katherine Ornstein, who studies the last year of life at Mount Sinai Hospital in New York. “As we increasingly see that we want to provide home-based care, we’re relying even more on caregivers. And it does take a toll.”

The federal government has found that families often misunderstand what they’re entitled to when they elect hospice. And many still have to pay out of pocket for nursing home services or private caregivers, which Medicare rarely covers — all while the hospice agency is paid nearly $200 a day.

Hospice has catapulted from a sector led by nonprofits and volunteers to one dominated by investor-owned companies — including several based in the Nashville area such as Amedysis and Compassus — with more growth expected.

In the process, hospice has ballooned into a nearly $19 billion industry. It’s now the most profitable service sector in health care, as the industry’s business model relies heavily on unpaid family caregivers.

“This seems like it’s in sync with patient-centered care,” says Ornstein, “but the reality of that situation may be very, very challenging.

“I think we have a responsibility to really think about whether the families can handle this.”

‘A Longer-Term Thing’

The Fortners could be the poster family for hospice of old. On an overcast morning last May, they gathered with dozens of other grieving families at Alive Hospice’s residence in Murfreesboro for the nonprofit agency’s annual butterfly release.

McCoy Fortner, 8, opened a triangular box and a dormant monarch began to twitch.

“You can also whisper to it to tell the person in heaven what you want to say,” he explained.

He held the winged messenger on his forefinger until the black and orange wings perked up and stretched out. He relayed a few words to his father, Jeremy, who died two years ago of cancer.

“Thank you for being my best dad,” he said as the monarch took flight.

McCoy’s mom, Elicia, stood behind her son with tears in her eyes. Her husband called off endless chemotherapy. He was on hospice at home and then moved to a residential hospice facility where he passed away. Between the two, he was on hospice for 10 days.

Elicia Fortner said she just wishes they had stopped curative treatment and switched to hospice sooner.

“I don’t know if I really understood the options,” she said. “I didn’t realize hospice could be a longer-term thing.”

The Hospice Nudge

The average amount of time patients spend on hospice has been creeping up steadily, amid an industry-wide push that has aligned most of the interests in health care. The Affordable Care Act gave hospitals new incentives to reduce the number of deaths that occur in the hospital or shortly after a patient’s stay. Some studies suggest that’s caused an uptick in hospice use. And many doctors have been sold on the idea of prioritizing quality of life in the final days.

More patients are also eligible: Hospice has expanded beyond cancer to any terminal illness.

Very few people now die in a hospice facility. More often, hospice is received at home or, increasingly, in a nursing home.

But some of the biggest end-of-life evangelists are beginning to see unintended consequences of putting families in charge of the death bed.

Jessica Zitter, an emergency physician in Oakland, Calif., wrote a book about needlessly dying in the hospital on ventilators with very little consideration about quality of life. She advocates for prioritizing comfort care, which often means recommending hospice. When a patient has been told they have less than six months to live, Medicare and most private insurance will allow them to sign up for hospice services meant primarily to help them die in peace.

Zitter filmed one documentary called “Extremis.” It showed the impossible end-of-life decisions that have to be made in a hospital.

Then, she decided to make a second documentary, still in production, following a husband who took his wife home on hospice after ending cancer treatment.

Zitter met with Rick Tash and Bambi Fass for the nine weeks she spent in at-home hospice. The storyline didn’t play out as expected.

“It made me realize how naïve I — the doctor of death — was,” Zitter says. “This is this beautiful love story of these two people. Then you hear him say, ‘I didn’t sign up for this.’”

Tash became overwhelmed — from managing Fass’s morphine doses to getting her to the toilet every few hours.

With at-home hospice, everyday caretaking — and even many tasks that would be handled by professionals in a hospital or nursing home — are left to the family.

Medicare requires agencies to provide a few baths and a nurse check-in each week. But government data reveals that, on average, a nurse or aide is there at the house only about half an hour a day.

Zitter sat Tash down at his kitchen table, with his granddaughter on his lap. She encouraged calling in reinforcements.

“Asking for more support from hospice, if you need it, is really important,” she told him.

“Yeah, but what they offered me was a volunteer for two hours, one day a week,” Tash responded.

“That’s it?” Zitter asked.

“That’s what they offered,” Tash said.

Zitter was stunned. She realized Rick was getting all hospice had to provide, and it wasn’t nearly enough.

“The good death isn’t as easy as you might think,” she says. “We’ve got to put some things in place here so we can make it more likely that people can achieve that.”

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Struggling with care — When is ‘end of life’ too much?

By GARRY OVERBEY

A 94-year-old Venice man allegedly shot and killed his wife, who suffered from dementia. He then tried to turn the gun on himself, authorities said, but the weapon jammed. He told the 911 dispatcher, “I’ve had a death in the family.”

Cheryl Green, 73, lost her husband of 54 years in July after a long struggle with Lewy body dementia.

When Green read about the arrest of Wayne S. Juhlin — currently the oldest inmate at the Sarasota County Jail, charged with first-degree murder — she felt sympathy for him — and guilt, for her husband.

“Unless you’ve walked in his shoes, you don’t know what’s going on,” she said. “He (Juhlin) probably saw something in her condition, that killing her was a mercy.”

The would-be murder/suicide made her think of her husband, and the horror of his final days in a Lake Placid nursing home.

“If I had the means and the courage, I would have ended his misery,” Green said.

She contacted the Sun following Juhlin’s arrest, objecting to the narrative put forth by authorities that help for caregivers is readily available but ignored.

“It sounded as if there were many options open to the man and he just didn’t know they were there. The options are few for individuals who don’t have a lot of money,” she said.

Had her husband been accepted into a long-term care facility, she said, she would have depleted their savings in two months.

A former Washington state employee with a degree in social work, Green said she’s not naive about Medicare and Medicaid and how easily people can slip through the cracks of a bureaucracy. But she was stunned to find herself marginalized in Florida’s elder care system.

“If you’re indigent and you need long-term care, you can get Medicaid,” she said. “But if you’re in the middle — if you’re not wealthy enough to afford $3,000 to $5,000 a month (for nursing care) — you’re stuck.”

Through the looking glass

Cheryl and Drew Green both grew up in upstate New York. High school sweethearts, they met while working in the same grocery store and married while still in their teens.

They moved to Seattle, where she got her master’s degree in special vocational education, he opened his own business as an electrician, and they raised their two children. She worked for the state, running and developing programs for people with developmental disabilities and mental health issues.

Drew was extremely handy and could do almost anything that needed doing around the house.

“He was an excellent craftsman,” Green said. “People liked him because he was so good at what he did.”

Around his mid-50s, things changed.

“He started making mistakes at work,” Green said. “He would say, ‘I don’t know why, but I can’t figure things out anymore.’”

The man who had once built her a backyard gazebo was now forgetting things and had trouble with basic tasks.

Doctors told them he had dementia, but it would be years before one finally diagnosed him with a specific type: Lewy body dementia. LBD is a progressive form of the disease, with visual hallucinations, that affects thinking, behavior, mood and movement. Life expectancy is usually five to seven years.

Drew couldn’t work and his business folded. Green quit her job to care for him. Seattle was too expensive under those circumstances, so she looked for a cheaper place to live. In 2010, they moved to Burnt Store Lakes in Punta Gorda.

They lived off their savings and took early Social Security benefits. As his health declined, they were relieved when he qualified for Medicare.

“He was living in an alternate reality,” she said. “He had delusions and thought he had to act on them.”

For instance, Drew once thought he could go upstairs by walking through a mirror.

His condition steadily worsened over the years.

“He still had a sense of humor. He stayed kind,” she said. “But he became really delusional and started lashing out at people.”

Drew would sometimes stay up and wander the house for three or four days at a time. He would walk into sliding glass doors.

“I was under the delusion that I could take care of him,” she said.

Green, who had been diagnosed with lupus in the last year after struggling with fatigue her whole life, was exhausted and finally reached out for help. Earlier this year, she contacted Charlotte County’s Senior Services. They agreed to send someone to help for four hours twice a week to provide respite care — giving the caregiver a break for a few hours and helping with household chores. But when the worker arrived, Green was shocked to learn she didn’t speak English. Green was handed a cell phone and told to talk to a supervisor, who would translate Green’s instructions. A second worker spoke some English, but she mainly sat and did puzzles while Drew watched.

The county’s Senior Services cannot discuss details of a specific case because of privacy, but there are limitations on help that can be provided.

“Vendors do have difficulties providing services in more remote areas of the county, weekends and evening service, and we have no vendor willing to handle heavier chore tasks,” said Deedra Dowling, manager of Charlotte County Human Services/Senior Division. “We depend on the subcontracted vendors to provide the staff for service provision and we do monitor for contract compliance. … We have had clients who have tried every worker, every agency, and finally left with no service provision as they could not be satisfied. While this scenario is extremely rare, it has happened a few times over the years. Overnight services have always been extremely difficult to staff for a variety of reasons.”

Dowling added she wishes there were “many more resources.”

Green said she needed someone to come three nights a week, and someone on call at night.

She started sleeping on the couch so she could keep an eye on the doors to make sure he didn’t leave the house.

“I didn’t understand what I needed. I thought, I’ll keep him until I can’t keep him home anymore.”

Resources were few. Her children, who live out of state, helped when they could. Neighbors helped, but Drew’s aggression scared them.

“It’s difficult to ask anybody to help restrain someone in the middle of the night.”

Reality check

In May, Drew escaped through a window. Green searched the neighborhood and found him wandering the streets in his boxer shorts. The next night, he got out again. This time, she found him unconscious in the bushes near the alligator-infested lake behind their home.

She brought him to Fawcett Memorial Hospital May 19. He was placed under observation, but Medicare wouldn’t pay until he was actually admitted, which happened once he began having heart issues and his blood pressure shot up.

His decline accelerated. “He started punching people,” Green said. “He was scary aggressive.”

At Fawcett, she credits one doctor with giving her a reality check on what she knew were her husband’s last days: “He said, ‘This isn’t a fairy tale. Grandpa isn’t going to come home and be surrounded by loving grandchildren.’ He said he’ll be ranting and raving and lashing out at people.”

One night in the hospital, to keep him from jumping out of his bed, Green wrapped him in a bed sheet and held it tight.

He was beyond being helped at home. A doctor said he would need three people caring for him around the clock.

“Obviously, he was lots and lots of work wherever he went.”

She tried to get him into Tidewell Hospice, but was turned down. She said she wasn’t given a reason, only that he “didn’t meet the criteria.”

“I knew he was dying,” she said.

A hospital social worker started looking for a nursing home, but no one local would take him, Green said, “because he was aggressive and had Lewy body, and they didn’t have the experience or the staff to deal with him.”

Only two facilities in the state would take him. Online reviews for the one in Clearwater were so bad it was unthinkable, so she went with a facility in Lake Placid.

“I hoped maybe he could have some rehabilitation, maybe learn to feed himself again.”

Fawcett insisted he be transported to Lake Placid by ambulance, a $3,000 trip the hospital agreed to cover.

‘The old person’s friend’

The Lake Placid facility turned out to be worse than she could have imagined.

“The place was dirty, the staff overworked and the administration was less than helpful.”

Drew’s conditioned worsened.

“He could not feed himself or use the bathroom,” Green said. “He cried when he saw me. He was wet, dirty and being fed food he would never eat in his former life. He was frightened and tried to keep the staff away from him. He was usually put in an old wheelchair missing half its parts and was slumped to the side.”

After 20 days, the facility notified her he would be taken off Medicare because he wasn’t making progress. They would let him continue to stay there for $260 a day. Had Green agreed, “I would go through any money I had left very quickly,” to keep him in a place where “I would not keep my dog.”

“I wanted someplace stable where I could visit him, but that was not available to me at all,” she said. “I looked every day for a new place. He was terrified and I was miserable.”

Suffering from infections, pneumonia and near-continuous seizures, Drew was taken to the emergency room. From there, he was finally accepted to a hospice in Clermont, near Orlando. Green noted someone telling her pneumonia was called “the old person’s friend” — “because it takes them away when they have other diseases.”

“It was a wonderful place to be,” she said of hospice.

She was able to be with him that night. The next morning, July 16, a nurse’s aide told her he had died.

A better ending

Three months later, Drew’s last days haunt her.

“What an awful way to die — thinking you’re not safe, that you’re being attacked all the time, no help from anybody, and the nursing home didn’t want him anymore.

“To have him in that place, to see him crying and scared,” she said, shaking her head. “I’ll never get over the guilt.”

She adds: “I shouldn’t have lived in a delusional state that I could take care of him.”

If he could have gotten into a hospice earlier, she said, “his life would have had a better ending.”

Her thoughts roll back to Juhlin and others like him who took action to end a loved one’s suffering.

“I don’t think I could kill anybody, especially someone I loved. But I wish I could have ended his misery.

“It’s horrible when the person you love most, you think they’d be better off dying. My last three dogs got so sick I had to put them down. I loved those dogs. I didn’t murder them.

“I wouldn’t shoot anybody, but I might have given him too many sleeping pills.”

Green said she visits online forums for people with loved ones suffering from Lewy body dementia. But she is reluctant to participate.

“I don’t want to tell my story because I don’t want them to know how bad it’s going to be.”

She wants to be an advocate for raising awareness about the condition, and offers advice for those in similar situations.

“Don’t think that anyone is going to automatically be there to help you.”

She recommends getting an elder care attorney once it becomes clear a loved one is going to require long-term care.

“Sit down and talk about Medicare and Medicaid options, and whether you can keep your house after your loved one passes away.”

Green still owes a little money on their house, and she’s confident she can keep up with home repairs without having to take out a loan.

Nine years of Medicare “doughnut hole” expenses for Drew’s medications, as well as retiring early, ate up their savings.

Still, she’s able to get by on Social Security and her pension from Washington. Plus, she says with a little chuckle, Social Security gives her a widow’s pension — $37.91 a month.

She’s adjusting to life without her husband.

“I had a man who could do everything,” she said. “Now I’m figuring out how to do everything.”

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How to handle a dead person’s credit report

It’s best to notify agencies

By Gerri Detweiler

While it’s not something many people think about until faced with the issue, obtaining a credit report for a dead person is important. You may need to make sure the credit report is accurate and take stock of any creditors you need to notify of the death, or see if there’s any unresolved debt that you’re not aware of.

It’s not uncommon for criminals to try to take advantage of the fact that someone who has died isn’t checking their credit, which can increase the chances of identity theft and credit card fraud. That’s why it’s crucial to handle this process as quickly as possible.

Obtaining someone else’s credit report

In general, only the person who is the subject of the credit report should have access to it. But there are times when you may need to pull someone else’s report, such as the death of a loved one. Other instances may be when you’re checking someone’s credit as part of an application for a job or a rental property or if you’re helping someone work on their credit. Here are some commonly asked questions about obtaining someone else’s report.

  • How do you check someone’s credit history? You must have permission to check someone’s credit history, which can be as simple as them checking a box on a rental or job application. Once you have their permission, you can use their Social Security number, name and date of birth to do a background check that includes a credit history.
  • Can you look up someone else’s credit file? Yes, you can, but you have to have their permission and their personal information to be able to pull the correct report. This is common in situations where an agency or individual is helping another person repair their credit or address inaccuracies after identity theft.
  • Should you notify credit bureaus of a death? Yes, you should notify the three major credit bureaus as soon as possible after a death to ensure that the account is marked as deceased and no one else can open credit in the person’s name.
Obtaining the credit report of the dead

One of the most common situations where you will need to obtain someone else’s credit report is if a loved one dies and you are the financial power of attorney and/or executor of the estate. Here are the steps you need to take to obtain your loved one’s credit report after they’ve died and how to protect their legacy.

1. Collect all the paperwork

It’s a lot easier to begin the process of obtaining a credit report if you already have the paperwork needed. Each of the three different credit bureaus may have different requirements to be able to report someone dead and obtain their report, so you may want to call and find out what documents are required beforehand. The most commonly requested are:

  • A copy of the durable financial power of attorney, if applicable
  • Proof that you have been named executor of the estate
  • Testamentary letters from the probate court
  • An official copy of the death certificate

It’s a good idea to get at least one copy of these documents for each of the three bureaus, but you’ll also probably want a copy for yourself and another backup just in case.

2. File the will if necessary

Before you can start the process of obtaining the credit report, you’ll need to file the will with the probate court. To do this, you’ll need a certified copy of the death certificate, which can be obtained from your local health department for a small fee. If there is no will or named executor of the estate, you may need to file with the courts to be named as executor.

3. Submit a death certificate and other documents to the credit agencies

Once you have all of your documents gathered together, you’re ready to start submitting the paperwork to the credit bureaus. Remember that you’ll need to report the death and ask for the report from all three major bureaus: Experian, EXPGY, +2.72%   TransUnion TRU, +1.66%   and Equifax. EFX, +1.13%   Along with the death certificate, power of attorney and testamentary letters, you’ll also need to include a cover letter explaining that the person has passed and that you need to obtain the reports to put their affairs in order. Your letter should also include:

  • The deceased’s name
  • Last used mailing address
  • Social Security number

You may also need to send along a check or pay via phone or online to obtain the report, depending on the bureau’s policies and how recently the credit report was last obtained.

4. Review the credit report

Go through the credit report thoroughly checking for any inaccuracies—name and address misspellings are common—and make note of any open accounts that need to be paid with the estate or notified of the death. It’s a common misconception that all debts are automatically cleared when a person dies, but this isn’t the case, so it’s important to know what will still need to be taken care of. Make sure to be on the lookout for anything unusual–it could be a sign of suspicious activity.

5. Update any creditors and the Social Security Administration

The last step is to update the credit bureaus, any outstanding creditors and the Social Security Administration of the death. You may be asking, “What happens to your credit report when you die?” Until the credit bureaus are notified that a death has occurred, nothing happens to the credit report. Once the proper documentation has been submitted and the request made, the bureaus will mark the account as deceased.

This means that no further credit will be extended in the person’s name and no additional accounts can be opened up, which helps protect against identity theft and credit card fraud. The death certificate should be all that’s needed to complete this step.

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