The American Recovery and Reinvestment Act of 2009, the $787 billion stimulus package that President Barack Obama signed into law February 17, 2009, includes a number of provisions that help the elderly in need, as well as the economy. Here are the highlights:

• A one-time payment of $250 in the form of a tax rebate to Social Security recipients, Supplemental Security Income recipients, and veterans receiving disability and pensions. For details, click here;

• $87 billion to temporarily increase the federal Medicaid match to states (FMAP), which could help many adults who receive long-term care services through Medicaid (“Called Medi-Cal” here in California.) . For details, click here;

• An increase in the reverse mortgage loan limit to $625,500, from the former limit of $417,000, for the rest of 2009. For details, click here;

• An additional $120 million for the Senior Community Service Employment Program (SCSEP);

• An extension until December 2010 for the Qualified Individual (QI) program that pays Medicare Part B premiums for certain low-income Medicare beneficiaries.

• $100 million for grants to states for elderly nutrition services, including Meals on Wheels and Congregate Meals;

For a link to the full text of American Recovery and Reinvestment Act of 2009, which is more than 1,000 pages long, go to: http://www.opencongress.org/bill/111-s1/show

Con artists have wasted no time in figuring out how to use the stimulus package to bilk Americans out of what little money they may have left. For a Los Angeles Times article, "Don't get taken by these stimulus scams," click here.

Elder financial abuse costs older Americans more than $2.6 billion a year and is most often perpetrated by family members and caregivers, according to a new report released by the MetLife Mature Market Institute entitled, Broken Trust: Elders, Family and Finances.

The 40-page report notes that for each case of abuse reported, there are at least four that go unreported. This is expected to increase during, the economic downturn..

The report states that up to one million older Americans may be targeted yearly. Family members and caregivers are the culprits in 55 percent of cases, although financial losses are higher with investment fraud scams.

The National Adult Protective Services Association (NAPSA) suggests that the "typical" victim of elder financial abuse is between the ages of 70 and 89, white, female, frail and cognitively impaired. She is trusting of others and may be lonely or isolated, although reports show that there is a very diverse population of victims.

"Elder financial abuse has been called the 'crime of the 21st century,' " said Sandra Timmermann, Ed.D., director of the MetLife Mature Market Institute. "With the present state of the economy, older Americans are at a greater risk than ever of having their financial security threatened. And, for every dollar lost to theft and abuse, there are still more related costs associated with stress and health care and the intervention of social service, investigative and legal entities.

"This is also a growing problem made greater by the increase in the number of older Americans as targets, the relative wealth of this group, a change in family structure and the availability of technology that may make such abuse somewhat easier," said Timmermann.

Sixty percent of substantiated Adult Protective Services cases of elder abuse involve an adult child, the report found. Sons are 2.5 times more likely than other family members to take advantage of parents. Signs of abuse include indications of intimidation by or fear of a caregiver, isolation from family and friends, disheveled appearance, anxiety about finances, new "best friends" and missing belongings.

"One trait perpetrators of elder financial abuse have in common is that they exhibit excellent persuasion skills," says the report. "They are very good at cultivating relationships and convincing older adults that they are worthy of their trust and money. In general, perpetrators are not bound by conventional norms or business ethics, and rationalize their criminal and abusive behavior."

According to the report, elder financial abuse can be prevented by the following:

1. Education about one's rights and about the various types of consumer fraud and scams;

2. Financial conservatorship and/or power of attorney for those who are vulnerable;

3. Assignment of responsibility to a trusted outside person, if children are a concern;

4. Additional media attention for this issue;

5. Training financial professionals to properly assist older customers;

6. Assistance from social services, medical/nursing personnel, government agencies;

7. Reporting suspected cases of financial abuse to local authorities.

Anyone in San Diego suspecting financial elder abuse should, recommends San Diego Elder Law Center attorney Philip Lindsley, call Adult Protective Services at 800-510-2020 (within San Diego County) or 800-339-4661 (outside the County).

The financial crisis, coupled with possible changes in the estate tax law, make this a good time to review your estate plan. The future of the estate tax will likely be up for debate in Congress soon. One of the priorities of the Obama administration is making the estate tax permanent. Given the uncertain climate, it is important to make sure your estate plan does what you want it to do.

Under current law, the estate tax rate is 45 percent for 2009, but the estate tax will be eliminated in 2010. The tax is scheduled to return in 2011 at a rate of 55 percent. The amount of an estate that is exempt from taxes also changes under current law. It is now $3.5 million, but will drop to $1 million when the law is reinstated in 2011. The Obama administration would like to eliminate the one-year repeal of the estate tax. It isn't clear what the permanent rate would be, but according to an article in the New York Times, most tax experts believe the exemption will be kept at $3.5 million and the rate will stay at 45 percent.

The Times article identifies several things to consider when reviewing your estate plan:

* Formula clauses in wills. Wills that give specific amounts to trusts can be problematic given the change in the estate tax. Instead of naming a specific sum to go into a trust, your will could name a percentage of whatever limit is currently in place.

* Bypass or credit shelter trusts. Bypass trusts allow you to put any money up to the exemption amount into a trust. Your spouse would receive income from the trust and the remainder would go to other family members after your spouse dies. The problem with this is that with the exemption being so large, most of your estate could go into a trust, thereby limiting your spouse's inheritance. You may need to make sure the trust is structured in a way that allows your spouse access to the funds.

* State estate tax. States have different exemption amounts that may be less than the federal amount. You may put more money in the bypass trust to avoid paying federal estate taxes, but end up still having to pay state estate taxes. Consulting with an attorney is a option to determine a way to provide your executor with flexibility to deal with this issue.

* Grantor retained annuity trust (GRAT). A GRAT is a way to avoid gift tax for lifetime gifts of more than $1 million. You put appreciating assets in a short-term (two-year) trust and keep the right to an income stream for the life of the trust. If assets appreciate above a rate set by the IRS, your family members will receive the appreciation. Current law allows you to set up a GRAT that will result in little or no gift tax, but Congress is considering changing the law, so setting up a GRAT now may be especially appealing.

* Family limited partnerships. Family limited partnerships are another giving technique. You can put assets like securities, real estate, or businesses into such a partnership. Then you can give away shares of the partnership to family members. Because these shares can't be sold to non-family members, the price is discounted. Congress is considering ending the discount, so if you want to establish one of these partnerships, you should probably act soon.

* Beneficiary designation forms. Money from a retirement account usually passes outside an estate to the person you designate on your beneficiary designation form. With all the consolidation in the financial industry, you should make sure your 401(k) or other retirement account has the correct beneficiary designation form. 

To read the entire New York Times article, click here. For a related Times article, click here.

Still Alice, by Lisa Genova

It is estimated that the number of Californian’s with Alzheimer’s disease will nearly double to 1.1 million within the next 20 years.  With this staggering growth projection, it is likely that almost everyone will be faced with some aspect of this disease affecting their life in some way.

Although a work of fiction, Still Alice by Lisa Genova paints an eye-opening view of coping with the reality of Alzheimer’s disease from not only the viewpoint of the main character, Alice, but her family as well.  One cannot help but form a bond with this family as they embark on their life-altering journey.  This is an incredibly engaging story that will certainly remain with you.

Alice is a 50-year-old cognitive psychology professor at Harvard University.  After an initial visit to her doctor for some help dealing with perceived symptoms of menopause, Alice received the devastating news that she was afflicted by early onset Alzheimer’s disease.  The author takes us through Alice’s journey as she tries to grasp what this means for her, in the present and the future.  She begins to focus on what she wants out of her life, and what she doesn’t want her life to become.  As a parallel, Alice’s adult children undertake their own realization that they may be genetically at risk, while Alice’s husband reexamines what his own future might hold. As the disease progresses, Still Alice carries us along while Alice, her family, colleagues and friends watch Alice disconnect from them.

What makes this story so meaningful is the illustration through Alice’s perspective as the disease distorts her life.  It increases the awareness of how ordinary everyday activities and routines can suddenly wreak havoc with someone afflicted with Alzheimer’s and affect their ability to cope.  Through this touching and heartfelt story, Lisa Genova offers insight into understanding what is happening as dementia progresses, and encourages us to think about how we approach dealing with someone with dementia.  It makes it very clear that this is not a disease that can be battled alone, and reinforces the dire need for more services and support groups for this growing population on the horizon.

For more information on Alzheimer’s and support services please see our links page.