Archive for the ‘Alzheimers’ Category

Proposed FINRA Rules Will Help Prevent Financial Elder Abuse

Monday, November 16th, 2015

Under new rule proposals soon to be released by the Financial Industry Regulatory Authority (FINRA), financial advisers would be able to delay disbursing funds from the accounts of senior investors if they believe financial elder abuse may be taking place.

Littman Krooks Elder LawOne of the proposed rules would allow financial advisers to wait up to 15 days to disburse funds from senior investors’ accounts if they reasonably believe that financial exploitation is occurring. The proposed rule defines a senior investor as a person who is age 65 or older, or an investor who may be vulnerable for other reasons. The rule would allow advisers to reach out to a person designated as a trusted contact.

A related proposal would require financial advisers to make a reasonable attempt to get contact information for a trusted person on senior investors’ accounts. Under the current proposal, if a senior investor declines to provide such information, the adviser is still permitted to open the account.

The proposed rules would require that if an adviser paused disbursements on a senior investor’s account because of suspected financial elder abuse, the adviser would be required to notify the trusted contact. However, if the trusted contact is the person suspected of committing the exploitation, then the adviser could notify another family member or other responsible party.

The proposed FINRA rules are similar to rules proposed by the North American Securities Administrators Association (NASAA) recently. The NASAA rules allow for a 10-day hold on disbursements when abuse is suspected, and provides for qualified immunity from civil or administrative liability for firms that report suspected financial exploitation of seniors.


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New NightCare Program for Seniors with Alzheimer’s at Sarah Neuman Offers Respite to Caregivers

Thursday, May 7th, 2015

Our guest blogger this week is Amy Brandwene, LMSW. She has a Certificate in Gerontology and MBA in Marketing from Fordham University. She has worked with older people and their families in skilled nursing environments, assisted living and continuing care retirement communities.

As the sun sets, anxiety increases for some elders with Alzheimer’s or other forms of dementia. That’s because of “sundowning,” a condition characterized by increased confusion and agitation which starts in the late afternoon or early evening and often includes nighttime wakefulness, aggression and wandering. The Alzheimer’s Association estimates that some 25% of people with dementia suffer from sundowning. It takes a huge toll on caregivers who must choose between care and vigilance and their own sleep, and so, is a leading reason for people with dementia to be placed in nursing homes.

Littman Krooks Elder LawThe Sarah Neuman Center at Jewish Home has introduced the NightCare program designed to comfort and engage elders with this level of dementia, and to provide respite for their caregivers. Offered several nights per week, from 7 PM to 7 AM, the NightCare program is staffed by experienced, caring professionals like Ruth Mederski, LPC. She explains, “At night when these seniors can become more anxious, we are there to give reassurance.”

In additional to providing a caring and safe environment, the NightCare program offers activities designed to help these elders connect with others; conversation, games, and art, music and recreational programs can all be beneficial. For those who can participate, falls prevention and safe walking programs, as well as Tai Chi and elder-friendly yoga are available. There is a nurse who can administer medication, and if the elder also participates in the Adult Day program at Sarah Neuman, there is coordination between the day and night nurses.

The NightCare program at Sarah Neuman offers dinner after arrival, snacks and breakfast. The program will also include a caregiver support group to help families cope with the strain of dementia care.

Perhaps the most meaningful offering of the NightCare program is peace-of- mind for the caregiver. The son of one NightCare client has shared that “it’s a great relief knowing my mother is safe and cared for at night. I can sleep.”

For more information contact: Amy Brandwene, LMSW at Jewish Home’s Sarah Neuman Center in Mamaroneck, NY 914-864-5804.  She is currently the social worker for the Sarah Neuman Center’s Day Center and NightCare program.


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Understanding the Stages of Alzheimer’s Disease

Friday, January 30th, 2015

Alzheimer’s disease starts with mild, sometimes unnoticeable symptoms that slowly have a more and more significant effect on a person’s ability to function. The rate of progression varies from a couple of years to twenty years or longer, but Alzheimer’s will eventually progress through the following stages, as described by Barry Reisberg, M.D. of the New York University School of Medicine’s Silberstein Aging and Dementia Research Center:

Littman Krooks Elder Law

Littman Krooks Elder Law

Stage 1: No symptoms of dementia are present. However, evidence shows that changes to the brain begin long before symptoms develop.

Stage 2: Very mild cognitive decline begins, which can be similar to normal changes associated with aging. The person may have trouble finding words or misplace things easily, but dementia cannot be detected in an exam.

Stage 3: Mild cognitive decline that starts to be noticeable to family or co-workers. Issues such as trouble remembering names, finding the right words, short-term memory, and planning and organization, but diagnosis may not be possible.

Stage 4: Moderate cognitive decline that can be diagnosed as early-stage Alzheimer’s disease. The symptoms are more clear in this stage, and will include short-term memory issues, trouble with mental math, difficulty performing complex tasks and changes in mood.

Stage 5: Moderately severe cognitive decline, also known as mid-stage Alzheimer’s disease. At this time, the cognitive decline is noticeable, and often the person’s ability to perform activities of daily living (ADLs) like cooking and grocery shopping begins to decline. Confusion is pronounced.

Stage 6: Severe cognitive decline occurs. Memory continues to get worse, and personality changes occur. The person may have trouble remembering their personal history, may forget the names of their spouse or caregiver and may need help with ADLs such as dressing and toileting. Changes in sleep patterns are common, and wandering can be a problem. Suspiciousness, delusions or compulsive behavior may develop.

Stage 7: Very severe cognitive decline, also known as late-stage Alzheimer’s disease. The person is no longer able to carry on a conversation, respond to the environment, or control their own movements. The person needs extensive help with ADLs, including eating and using the toilet. This stage of Alzheimer’s becomes fatal.

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The Walk to End Alzheimer’s (2014)

Tuesday, August 26th, 2014

The Walk to End Alzheimer’s (2014) Guest: Candace Douglas, Director of Constituent Events, Alzheimer’s Association, NYC Chapter


Advance Directives Need to Be Accessible

Tuesday, July 8th, 2014

When drafting advance directives, a common problem for many people is making these documents easily accessible for their loved ones.

What is an advance directive? A legal document in which a person specifies what arrangements should be taken for their health if they are no longer able to make decisions for themselves because of illness or incapacity. There are different ways of creating advance directives, including a living will, a durable power of attorney and also a health care proxy.

People may feel that their advance directive should be kept with their attorney or in a safe deposit box. However, decisions about medical treatment often need to be made quickly, so it is important that an advance directive be not only safe, but easy to get to.

If an individual’s advance directive appoints another person as health care proxy, then that person should have a copy of the document, or know where it is kept. If a patient is incapacitated, then it is important that the health care proxy be able to present the document to medical personnel.

It may also be wise to keep a copy of the document in electronic form, stored in such a way that it is accessible from a smartphone or other device. Such electronic copies have the same legal authority as the original paper document, and they can be accessed more easily. Ask your attorney what they recommend for digital or cloud storage for these documents to ensure the security of your private information. Learn more about our services within elder law and advance directives by clicking here.

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How Divorce and Remarriage Affect Social Security Retirement Benefits

Tuesday, March 11th, 2014

People considering divorce as their 10-year wedding anniversary approaches should know that delaying the split until after the decade mark can result in higher Social Security retirement benefits for a spouse with a lower earning record.

Taking the example of a divorced couple where the ex-husband had a higher earnings record, if the couple was married for 10 years or more, then the ex-wife can receive higher benefits based on his record, provided she is age 62 or older and has not remarried.

Even if the ex-husband has not applied for retirement benefits, the ex-wife may receive benefits based on his record, provided they have been divorced for more than two years. If the woman remarries, then she would no longer be able to collect the benefits unless the later marriage

Recent years have seen a rise in both marriages and divorces later in life, and statistics suggest that divorcing couples may take retirement benefits into account, as there is a measurable increase in divorce after the 10-year mark. As might be expected, the effect is most pronounced for couples nearing retirement age. A recent study found that for people 55 and older, there is an 11.7 percent increase in the likelihood of divorce at about the decade mark. For couples age 35 to 55, that drops to a 6 percent increase in likelihood of divorce at 10 years, and for people under age 35, there is almost no effect.

Other researchers are skeptical that many people take retirement benefits into account in their divorce decisions, pointing to studies that show that only 13 percent of people are very knowledgeable about how Social Security benefits are calculated.

Whether divorcing couples currently consider retirement benefits in timing their divorce, many advisers agree that they should. Divorcing just short of the 10-year mark could result in thousands of dollars in lost benefits, so it may be worthwhile for some to delay the process.

Financial considerations are often part of making decisions about divorce, so it is important to be aware of how Social Security benefits can be affected.


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Leaving Unequal Inheritances to Children Can Cause Problems

Wednesday, January 22nd, 2014

Many people creating or updating an estate plan are blessed with children and grandchildren, and enough assets to leave them a significant inheritance. However, deciding how to provide for future generations can lead to conflict, and much of that conflict stems from unequal treatment of children, whether it is intended or not. Here are a few pitfalls to avoid.

In some families, especially in previous generations, it was common to treat sons and daughters differently in regards to inheritances. A family business might be left to sons, while another asset such as a trust may have been created to provide for daughters. Needless to say, this can cause resentment and disputes. In modern times, such gender distinctions are less common. However, parents creating an estate plan often still choose to treat some children differently.

Parents sometimes consider providing for their adult children differently based on each child’s family income and assets. While this may seem like fairness, it is likely to cause resentment. It is, of course, one’s right to distribute one’s assets according to one’s wishes. However, parents may want to consider simply dividing their assets equally among their children. This simple solution can head off arguments and hurt feelings.

Distribution of assets to one’s children and grandchildren during one’s lifetime may be unequal for valid reasons. Paying for college may entail a greater cost for one child than for another. Helping to provide for grandchildren may mean that one’s adult children with more children of their own receive more help. These matters are best approached with openness and an attempt at fairness, keeping in mind individual circumstances.

When it comes to planning one’s estate, there may be a temptation to either mirror those inequalities by leaving more to adult children with more children of their own, or to make up for them by leaving something additional to one’s other children. However, the best approach may be the simplest: dividing one’s estate equally among one’s adult children, and providing that in the case of an adult child who has passed away, that any grandchildren receive that child’s share of the estate.

Passing on a family business may seem like a special case, but it need not be. If one or more adult child has had a special role in a family business, then that role will likely continue. Ownership of a family business may still be passed on to all adult children equally, with a child who has worked in the business continuing to be compensated for his or her work. Alternatively, a child who works in the business can receive ownership shares during the parents’ lifetime, so that the remaining family shares are distributed equally upon the parents’ death.

Passing on an inheritance to one’s children should be a cause for celebration rather than disputes. Making distributions as equal as possible is one way to keep it that way.



Different Types of Assisted Living Facilities Meet Different Needs

Tuesday, December 17th, 2013

Assisted living facilities are residences for senior citizens where help is provided with daily living activities, as needed. This can include making doctor’s appointments and taking medication, as well as bathing, dressing and grooming. Meals and housekeeping are also provided at such facilities. In the state of New York, all types of assisted living residences are licensed as adult care facilities by the Department of Health. However, there are different types of adult care facilities, which may also be called enriched housing programs or adult homes.

First, all adult care facilities are distinguished from nursing homes in that they are for people who do not need round-the-clock medical services or skilled nursing. People who need for medical staff to be present on a continuous basis are better served by a nursing home.

The two kinds of adult care facilities in New York, enriched housing programs and adult homes, both offer long-term care in a residential setting, including meals, laundry, housekeeping, supervision and assistance with personal care and medication. One major difference is that the law has stricter supervision requirements for adult homes, although a number of enriched housing programs may offer the same level of supervision. In addition, enriched housing programs usually provide apartment-style residences, while adult homes generally provide private rooms or two-person rooms.

The same types of service provided in enriched housing programs and adult homes may also be provided by assisted living residences and assisted living programs. In order to refer to themselves as providing “assisted living,” these facilities must meet additional requirements of providing certain disclosures and rights for residents. The goal of assisted living facilities is to provide the care necessary to allow individuals to live as independently as possible, emphasizing personal dignity and freedom of choice.

Finally, an assisted living residence that offers aging-in-place services and obtains additional certification may be designated an enhanced assisted living residence. A special needs assisted living residence is an assisted living residence that provides specialized care and meets additional certification requirements.

For more information, refer to the New York State Department of Health’s website on assisted living, available at


New Program Enlists Doormen to Watch for Elder Abuse

Friday, December 13th, 2013

A new program in New York City is training doormen who work in apartment buildings to watch for elder abuse.

The Harry and Jeanette Weinberg Center for Elder Abuse Prevention, part of the Hebrew Home at Riverdale, developed the program, which offers free training for doormen, porters, concierges and other building staff, at the building where they work.

Joy Solomon, the director of the Weinberg Center, said that many elderly people who were being abused did not come forward on their own, so advocates realized they would have to reach out to others who might be likely to spot the signs of abuse. The center has already helped to educate people such as estate lawyers, speech therapists, and those who deliver hot meals to seniors. Now building staff are being enlisted to help as well.

Many buildings in the city have a growing population of elderly residents. An analysis of census data by Queens College found that by 2040, an estimated 21 percent of adults in New York City will be age 60 or older, an increase from 17 percent in 2010.

At a training she led recently, Ms. Solomon told of an elderly resident of an Upper East Side apartment building, who was taken advantage of by a woman. Building staff witnessed the woman removing valuables from the man’s apartment, but did not step forward, perhaps because they did not want to overstep their bounds. Solomon said that when a staff member knows that something is wrong, it is important to take action. Several older apartment building residents said they would much prefer that building staff say something about a situation that does not appear right, rather than staying quiet out of a fear of prying into someone else’s business.

For elderly residents who do not have frequent visits from friends and family, a doorman may be the first person to notice an injury, signs of confusion, or other evidence that the person needs help.

Solomon said that the training would be provided initially to buildings with large populations of older people, but would eventually be available to anyone requesting it.


Milestones That Can Turn YOU Into A Caregiver (When Occasional Help Becomes Full-Time Assistance)

Tuesday, October 1st, 2013

In a third of all American homes, someone is providing care for a loved one. When a son or daughter is caring for an elderly parent, occasional help with some tasks can move rather quickly into regularly providing care for such essential daily activities as eating, bathing and dressing. The speed of the transition can sometimes be overwhelming for the person providing the care. It is important to recognize specific milestones that can mark the transition to full-time care, so that the caregiver is prepared and so that everyone involved can more easily recognize when help is needed.

Physical challenges are one such milestone. When a person is unable to walk without assistance, the need for full-time care quickly arises. Depending on the circumstances, it may not be safe for a particular caregiver to provide the lifting support necessary to help an older loved one in and out of chairs, automobiles and bed. Incontinence issues are another physical challenge that are often a tipping point for families to recognize that caregiving has become a full-time job and that help may be needed.

Behavioral and cognitive issues are another challenge that can quickly increase in significance. If an older loved one has symptoms of early Alzheimer’s disease or other dementia, the assistance he or she needs may be minor at first, but may progress quickly. If an elderly parent becomes prone to wandering or exhibits the aggressive behavior sometimes found in Alzheimer’s patients, this can be a turning point in the need for full-time care.

The needs of each individual and the way that each family provides care depend on individual circumstances, but it is important to recognize when the need for a little help has become the need for full-time care.


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