Bernard A. Krooks - Littman Krooks LLP > New York Elder Law Blog > 2013 > July

Archive for July, 2013

Prepare as Soon as Possible After Diagnosis of Alzheimer’s Disease

Wednesday, July 31st, 2013

Though the diagnosis of Alzheimer’s disease can be a distressing time for the patient and his or her loved ones, elder care advocates say that it is critical they begin advance planning for financial arrangements and health care as soon as possible. Alzheimer’s is a progressive disease of cognitive decline, but it can last for many years. Putting plans into place early can help make a significant difference in how that time can be spent.

If someone suspects that there are memory issues or other cognitive concerns, they should see a neurologist, geriatric assessment clinic or memory clinic for testing. If there is a formal diagnosis of Alzheimer’s disease, the results will give a baseline which may help when charting out a plan of next steps.

A person with a diagnosis of Alzheimer’s disease should then work with an elder law or estate planning attorney to ensure that their legal planning is thorough. Documents to be addressed include health care documents such as an advance directive which explicitly instructs health care choices (sometimes called a “living will”), and a durable power of attorney for health care decisions. The financial documents to be developed include a will, a durable power of attorney for finances, and possibly a living trust.

An elder care lawyer or estate lawyer can also assist in mapping out the financial options available for care. Some people find that spending down their assets to qualify for Medicaid is the option for them, but those assets need to be released at least five years before applying for Medicaid. Many states now have some level of a partnership-eligible, long-term-care policy available to help individuals protect some of their assets while using Medicaid. The purchase of a partnership policy which covers as much as $250,000 of care may allow the patient exhaust benefits and qualify for Medicaid while still holding onto assets up to $250,000.Other financial concerns for people with an Alzheimer’s diagnosis include checking with their bank’s policy on power of attorney and whether they need their own forms. Some banks require that they have their own power of attorney forms on file, which may be difficult to procure later on.

 

For more information about our legal services, visit www.elderlawnewyork.com.

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Making the Home Safer for the Senior Resident

Thursday, July 25th, 2013

Many older people require the assistance with daily needs and safe environment that are found in an assisted living facility. Others prefer to age in place, bringing health care assistants into the home. In these cases, changes may also be needed to make the home safer for the senior resident.

Seniors may have trouble moving about or be at risk for falling. Improvements can be made to the home to make life easier, but older people or their adult children may not be aware of what changes can or should be made. An occupational therapist can be of great service, with some specializing in performing an analysis of the home environment and producing a detailed improvement plan that a contractor can follow.
There are some simple and inexpensive changes that can be made, such as installing brighter light bulbs and removing rugs that may cause slipping. More extensive safety features that may need to be installed can include grab-bars for walking assistance or an electric stair lift to get from one level to another easily and safely. Seniors may also need for the height of chairs to be increased slightly to make them easier to get in and out of.

When it comes to paying for such improvements, long-term care insurance can help. If you have such a policy, and it covers home improvements, then hiring an occupational therapist can help in demonstrating that the changes are necessary for the resident’s health. A reverse mortgage or home equity loan can also help pay for safety improvements, but consult with a financial adviser before taking out such financing.

 

For more information about our legal services for seniors, visit www.elderlawnewyork.com

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Elderly Care: When An Aging Parent Needs Emergency Care

Tuesday, July 16th, 2013

The American College of Emergency Physicians (ACEP) has released tips for the adult children of elderly parents who find themselves facing a medical crisis. The emergency room can be a daunting experience. These tips may make the experience slightly less stressful.

When possible, the caregiver or accompanying adult should bring to the emergency room a completed Medical History Form. The form should list any allergies, the medications the elderly person is taking, and both past and current medical conditions. This form should be given to the intake attendant.

In addition to the Medical History Form, have on hand a list of the medical health professionals the elderly patient sees, such as cardiologist, oncologist, etc. Have their names and contact information written down, as well as the reasons for their care and how long the elder has been under their care. Also include any information about recent surgeries, such as pace makers or hip replacements, and include complete insurance and identifying information.

The emergency physicians also suggest that any caregiver or attending adult bring a change of clothing and personal items, and should expect that the elderly individual will be admitted for overnight or extended care. While this may not happen, arriving prepared will save time and effort later. The items can always be left in the car “just in case.” Also, caregivers may wish to bring reading material to pass the time while the patient is waiting to be seen or for test results. Elderly patients make take longer than expected to have a complete workup, especially if they have multiple issues or complaints which must be investigated.

The ACEP also suggests that the caregiver clarify to the attending physician if the patient’s state of mind is altered or if he or she is confused. If the caregiver is given information and instructions, he or she should share that information with the patient; work to keep them informed and allow them to make their own medical care choices.

Many elderly patients downplay their symptoms when in the ER, doctors report. Be prepared and willing to clarify with additional information, if needed.

And long before that trip to the ER is a possibility, they say, consider discussing with the elderly parent about the possibility of their drafting a living will. When in the midst of tough decision-making such as when the condition is a life-threatening one, it can make a significant difference in how family members approach some choices that must be made.

 

For more information, visit www.elderlawnewyork.com.

 

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Phrasing Affects Do Not Resuscitate Choices

Wednesday, July 10th, 2013

 

Researchers at the University of Pittsburgh recently studied what factors affect the decisions of people who are designated health care surrogates for a loved one. The researchers showed 252 people a video simulation of an actor posing as a doctor appraising them of a certain health condition and asking whether the patient should be resuscitated. They found that the way information is phrased makes a significant difference in what the health care surrogate chooses.

The study, developed in part by Dr. Amber Barnato and published in Critical Care Medicine, found that two factors made the biggest difference in the decision. One factor was whatever the health care surrogate believed other people in the same situation had chosen. When people were told that most people want CPR to be performed if the patient’s heart stopped in a certain situation, 64 percent also wanted CPR to be tried. If they were told that most people do not choose for CPR to be performed, then only 48 percent chose CPR.

The other significant factor was whether the “doctor” in the video used the phrase “allow a natural death” rather than the phrase “do not resuscitate.” When the latter phrase was used, 61 percent chose for CPR to be performed, but that figure dropped to 49 percent when the phrase “allow a natural death” was used.

Other factors had little effect. Expressions of sympathy from the “doctor,” being shown a photo of the loved one, or being asked to think about the choice from the perspective of the loved one all made little or no difference in the choice.

 

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