Archive for the ‘Alzheimers’ Category

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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Demand for Caregivers Increases

Wednesday, September 11th, 2013

A new study by the Pew Research Center and the California HealthCare Foundation found that the number of adult caregivers of family members has increased from 30 percent to 39 percent in the past year. The sluggish economy, an aging population and an increase in chronic illnesses all have contributed to an increased need for caregivers in the home. And more than ever, those family caregivers are turning to the internet for support and information.

Grandm_GranddThe U.S. population in 2000 included approximately 12 percent of adults 65 years and older; by 2020, adults 65 and older are expected to make up at least 19 percent of the population. The increased “graying” of the country means that more comprehensive services for elders and their caregivers, both professionals and family members, are an ongoing concern. Most of the adults who are caring for a family member – two-thirds – are either caring for a parent or a parent-in-law, researchers say. Caregivers typically are doing everything from managing finances to shuttling the elderly parent to medical appointments, and more.

Another cause for concern is that more seniors than ever before are living with complex chronic medical conditions, and living longer. Seniors are relying on family members to help with their medical issues, in large part due to the sluggish U.S. economy. More households are attempting to manage their care with limited funds and resources and caregivers are turning to the internet for information on illnesses, symptoms, medications and treatment. The study found that more than 70 percent of caregivers surveyed reported that they research issues online. Information on medical issues and the support of social media have never been more important to caregivers, researchers say.

But the Internet is only one resource, and not as comprehensive as many caregivers need. According to a 2012 estimate by the AARP, 50 percent of caregivers for the elderly are delivering complex medical and nursing care in their own homes.

The bottom line? The U.S. health care system and the social system are both struggling to keep up with the demand for elder care. For now, that need is still being met primarily at home.



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Traveling Tips for Families with a Loved One with Alzheimer’s

Monday, September 9th, 2013

If you have a loved one with Alzheimer’s or other dementia, you may be apprehensive about bringing your family member with you when traveling. However, with a little bit of careful planning, you and your loved one can enjoy a safe trip.

Before deciding on travel details, consider what would be best for the safety and comfort of your loved one with Alzheimer’s. People in the early stages of the disease often enjoy travel, but for some the experience is overwhelming. Keep your family member’s preferences and limitations in mind when choosing your transportation method. The best journey is one that does not unduly disrupt your loved one’s daily routine. A person with dementia is likely to prefer a destination that is familiar or that involves visiting loved ones.

Navigating airport security can be difficult for someone with dementia; if you must travel by air, consider informing the airline of your needs ahead of time. Even if a wheelchair is not necessary, it may be a good idea for your family member’s comfort and because you will have an airline employee to help you get around the airport.

During the trip, be aware of the fact that a change in environment can be a trigger for wandering, and take precautions. Also be sure to keep essentials on hand such as a comfortable change of clothes, all prescribed medications, snacks and drinking water. You should also bring important documents such as copies of any living will or advanced health care directives, health insurance cards, and doctors’ names and contact information.

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How Nursing Facilities Can Be Welcoming to LGBT Residents

Monday, August 19th, 2013

Nursing homes have always had lesbian, gay, bisexual or transgender residents, but they have not always felt comfortable identifying as such, for fear of how staff or other residents might react. It is important for nursing facilities to be open and welcoming to LGBT residents, and to this end the Alzheimer’s Association has published a guide for long-term care facilities welcoming LGBT residents. The guide is also useful for LGBT elders and their families considering a nursing facility, to determine how welcoming it will be.

According to the Alzheimer’s Association, a facility should first of all assume that there are LGBT residents, and not assume that staff can identify them. LGBT residents cannot necessarily be identified by external characteristics and they may have past life experiences such as being in a heterosexual marriage or having children that do not fit common assumptions about LGBT people.

The association also recommends that nursing home staff ask residents about their sexual orientation in a safe and confidential way, in the same way that any other factual though potentially sensitive question would be asked. However, if the resident appears uncomfortable, the matter should not be pushed, and staff should remember that sexual orientation is just one aspect of a person’s identity.

The association recommends – and LGBT elders should look for – signs of welcoming in a long-term care facility. A facility can show that LGBT elders are welcome by prominently posting its non-discrimination policy, including same-sex couples in marketing materials, and including LGBT-inclusive images or messages in the lobby and other public areas. Forms should include relationship options such as “significant other” and “partner.” Staff should be trained on how to recognize and address the needs of LGBT residents.

When nursing facilities take these steps, it will be apparent to LGBT elders and their families that the facility is welcoming to them.


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What to Do When an Older Loved One is Resistant to Care

Tuesday, August 13th, 2013


Caring for an older loved one can be a challenge, even more so if the family member is resistant to care. In dealing with this type of situation, it is important to understand the source of the resistance and how to encourage cooperation.

A family member who resists care, whether it is direct help by a loved one or professional care, is likely experiencing unhappiness due to loss of independence. Needing to be cared for involves a disruption of routine and loss of privacy, which can be disconcerting. An older family member may be feeling frightened of aging or feel guilty about being a burden on other family members. All of these factors can combine to cause a response that is understandable even if it is not very rational: resisting needed care.

An important part of dealing with resistance to care is knowing when and how to have the necessary conversations with your loved one. You should bring the subject up at a relaxed time when you will be able to take time to listen to each other. Be sure to ask questions about your family member’s needs and preferences. Even someone with Alzheimer’s or other dementia can express preferences. If your loved one is resistant to even talking about the care situation, try letting the matter rest for a while and bringing it up again later.

One effective strategy for encouraging cooperation is to suggest that a new type of care be introduced on a trial basis. Whether the change involves bringing in a home health aide or leaving home, much of the resistance may come simply from fear of the unknown. Once your loved one actually experiences the benefits of care, there may be less trouble accepting it. In the case of a home health aide, it can be useful to point out that this can help prolong independence.

Depending on the situation, it also may be helpful to have a professional such as a doctor, attorney or care professional explain the need for care and the benefits of a certain arrangement. Due to family dynamics, an older parent may be more likely to take the advice of a trusted adviser.

Resistance to care can be an enormous challenge. Communicating effectively with your family member can make all the difference.
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