Elder Law Office of David Wingate, LLC

Is your family dealing with Alzheimer's disease?

There is no easy way for a family to deal with a senior grappling with a cognitive mental disease like dementia or Alzheimer's. Like any health problems faced by loved ones, a family's initial reaction is to try to get the senior the help they need. However, at our Elder Law firm we understand that cognitive conditions are tricky, because the injury is not physical and often the senior may not be fully aware that they are even suffering from the problem at all.

One elder law advocate recently discussed this challenge in response to a reader question explaining her family's difficulty dealing with her mother's dementia. As published in the L.A. Times, the reader revealed that her 82-year old mother, who has dementia, began accusing the family of spying on her. As a result, the mother admitted to her doctor that she wouldn't share anything about her health with them. The family has been left wondering what to do to help their ailing matriarch get through this difficult phase. Many local families visit our Elder Law office with the same concerns about helping relative with cognitive issues.

For one thing, in many cases a doctor will not be willing (or legally able) to discuss the mother's condition without legal documents in place. This is particularly true when the doctor suspects that there may be a family rift. Creating those legal documents is a large part of the work done by our office. The documents help ensure that the senior can receive help with their legal, financial, and healthcare decisions. Creating a trust may allow a third party to manage an ailing senior's assets. A durable Power of Attorney allows financial decisions to be made by another. Health Care Proxies are needed to make key medical decision when another is unable to do it on their own.

As the advocate notes in the article, "Having all of those documents together is the biggest gift a person could [give] their family and friends."

Without these documents in place, the only other option is usually guardianship proceedings. This process is expensive, time-consuming, and rife with uncertainty. It should be avoided whenever possible.

Family members who are able to make financial and medical decisions for their ailing senior can also ensure that various long-term care planning is done as well. For example, depending on the senior's assets, setting up a Medicaid Trust may be important to protect assets from long-term care costs down the road.

Of course, the process of getting these legal affairs together before a senior suffers from a cognitive mental problem is always ideal, because it is a much more arduous process after something like dementia has set in. However, even if a senior is already suffering from dementia, there may still be time to have the planning conduced. Dementia is a progressive disease that, while getting worse over time, still leaves the individual with moments of lucidity and reason. Catching a senior at that time and having frank discussions about the need to conduct proper planning is important. At the same time, even if the senior agrees to conduct the planning, he or she must be competent enough at the time of the legal transaction to legally make decisions these issues. It is a fine balance that is tough to gauge perfectly, particularly when dealing with dementia and Alzheimer's.

Don't be an Ostrich regarding Elder Law Issues i.e. head in ground

Some mistakenly dismiss elder law as something with which they need not concern themselves until they personally need help getting by each day. However, at the Elder Law office we work with many local residents on these issues decades before they need care themselves. That is because many adult children are forced to deal with these concerns on behalf of their parents--many of whom have serious health concerns that arise quite quickly.

With demographic changes leading to a boom in the elderly population, the need to care for aging parents is catching more and more adult children by surprise. According to the AARP, more than 42 million individuals (usually adult children) provide caregiving for elderly friends and family. Another 61.6 million provide partial caregiving support at various times throughout the year. A story from Life Stages discussed the very serious worries faced by those who are unexpectedly forced to wade through a myriad of confusing and complex issues (including many related to elder law) when their parents can no longer get by on their own each day.

The story profiles one woman whose story is shared by many in our area. Her eighty three year old mother had a massive stroke last summer which led to her becoming paralyzed. Her father, also eighty-three years old, was unable to provide the care that she needed. The hospital recommended that the mother be moved into a nursing home. Before taking that step, the daughter wanted to learn if she had any other options.

The daughter soon discovered that other options did exist, but procuring the extra help needed to keep her mother out of the nursing home was made difficult without elder care planning having been conducted ahead of time. For example, an advanced care directive--including a durable power of attorney, health care proxy, and living will--ensure that children do not run into any stumbling blocks when trying to make quick decisions in the midst of health emergencies.

Beyond ensuring the proper paperwork is in place, many adult children are similarly unprepared to navigate the confusing long-term care system. Understanding the difference between skilled care nursing homes, assisted living facilities, and at-home caregivers is crucial. Each provides different levels of support, but funding mechanisms for each are different. Medicare doesn't cover extended long-term care and Medicaid requires the spending down of assets.

Adult children who have already gone through this process note that learning about these issues before an emergency is essential. Not only will it lead to better options for parents but also less stress for child caregivers. This is a very real concern. According to a 2010 MetLife study, caregiver burnout is common--20% of female caregivers over 50 years old reported symptoms of depression.

Tough questions about the availability of Medicaid

A Wall Street Journal article this weekend asked some tough questions about the availability of Medicaid nationwide. At the Elder Law office we realize that many local residents are understandably concerned about the program in our state--it is an essential lifeline for many seniors. The latest WSJ article suggest that some states are making it harder for individuals to receive Medicaid help to pay for long-term care costs--however, the "crack down" on Medicaid expenditures is advancing very differently in certain states.

According to the Kaiser Family Foundation, Medicaid now accounts for about 40% of long-term care spending nationwide. The program is a joint state and federal effort that provides healthcare resources for those unable to afford it. There are federal qualification guidelines, but states are free to work within those guidelines to set specific standards about what is required before a resident is able to receive Medicaid support. As a result of this state flexibility, there can be significant differences in qualification factors in different parts of the country.

Considering that most state are experiencing budget shortfalls, many are looking into different ways to save on these costs. Of course, Medicaid changes and proposals are frequently in the news, as local policymakers continue to explore various ways to save money. As the article notes, some of those proposed changes include tinkering with the ways that the state can recover costs from the estates of those who used the program. At the Elder Law office we closely follow those issues, so that local families are best positioned to receive the care they need while saving as many assets as allowable under the law.

Some states have proposed cuts to Medicaid, adult health program closures, and tightening of qualification standards are all possibilities in states with particularly tough budget scenarios. That is not to say that there may not be changes to the system in our state in the coming months and years. But, there is no need for local residents to make any misguided assumptions about the elimination of the program entirely. The article notes that, as always, it is prudent to visit with professionals when in need of Medicaid help. Professionals in this area can explain "look-back" rules, trusts, and long-term care insurance that may all factor into prudent planning in your specific situation.

NPR radio series "Family Matters" deals with financial planning with multigenerational households.

The program, "Family Matters," focuses on financial planning for multigenerational households.  At the Elder Law Office we work with many local families in this situation, often with aging parents who move in with adult children when their health deteriorates.

One of the first episodes of the program delves directly into elder law issues. The program shares the story of a family that was forced to make many adjustments when a woman's 84-year old father needed a caretaker. The woman explained that the adjustment was not easy. Not only did the job of caretaker not come naturally, but figuring out how to make it all work financially seemed a near-impossible challenge.

There remains a stark contrast between public expectations about the need to conduct long term care planning for aging parents and the reality. For example, an Aflac WorkForces Report found that only 13% of individuals claimed that they thought long-term care planning would affect their households. This is likely why, according to some estimates, fewer than one in five families take even the most basic steps to prepare legally and financially to care for aging parents.

However, while families may not expect these issues to affect them, caring for aging parents is becoming a reality for more and more residents. The MetLife Mature Market Institute found that "the percentage of adult children providing personal care and/or financial assistance to a parent has more than tripled over the past fifteen years." This shift has been caused by a variety of factors, including a growing elderly population and rising life expectancy rates.

A theme throughout the radio program is the need to re-adjust expectations. Most families understand that they may be providing financial support to children--even adult children. The flowing of money from older generations to younger generations seems natural. However, far fewer families consider the possibility that they will have to financially support aging parents who may have seen their life savings exhausted.

Times remain tough for many families, but the pressures can be overwhelming when families are forced to deal with their own issues on top of helping adult children and parents. When it comes to preparing for these potential costs, timing is crucial. At the Elder Law office we know that there is a world of difference between trying to handle a parent's declining health or medical emergency when no planning has been done compared with having a Power of Attorney, Health Care Proxy, a Medicaid Asset Protection and other legal strategies in place.

Those interested in learning more about the radio program can take a look at the NPR series website here.

Financial Scams on the Elderly

A federally funded National Institute of Justice study found that about ten percent of Americans over sixty had been targeted for some form of financial exploitation. Also, a Met-Life study last year estimated the annual loss from this financial abuse was nearly $3 billion.

Scammers target everyone, but seniors often make the ideal target because some have disabilities, may be less knowledgeable about the Internet or tech issues, and often live more isolated lives. To top it off, after a lifetime of building and working, many seniors can be counted on to have some assets and savings used to fund their golden years.

According to an AARP writer who pens a weekly column on these issues, some of the most commonly used current scams include:

1) Lottery Scam: A senior is told that they have won the lottery and need only to make a payment to claim their prize. At times the senior is even given a fake "prize money" check that they can deposit into their own account. The prize check will bounce but often after the senior has paid "fees" or "taxes" to the scammer. Many of these scammers live out of the country (particularly Jamaica) and calls from the area code 876 should also be taken with caution.

2) Grandparent Scam: A scammer posing as a grandchild will call from abroad and claim to need money. Often the grandchild will say that they are in jail and need help to get out. They ask the senior not to tell anyone because of the specific situation. In a similar scam, grandparents apparently receive a call from a grandchild they have serving in Iraq or Afghanistan in need of funds as part of their homecoming.

3) Toilet Paper Scam: Many scammers attempt to pose as members of government agencies. In a popular version, the caller will claim that the senior needs to purchase some product to comply with the law. For example, in one case last year a group of scammers took a reported $1 million from various seniors claiming that new toilet paper needed to be purchased to avoid ruining their septic tanks.

All of us should do our part to raise awareness of these issues to prevent senior financial abuse before it occurs and identify it after it occurs so that those involved can be held accountable.

Estate Plan Forgery: How to Tell and What to Do

The question of will forgery or undue influence of the person making the will is not a common question, but one that does come up periodically in an estate planner’s office. The movies have given people certain expectations when it comes to a death in the family and probating a will: a book-lined office, the entire family assembled for a formal reading of the will, shocked and angry reactions as a loved one’s fortune goes to an unknown and unlikely character…

This Hollywood portrayal may be generally off base, but the basic premise is based on the very real feelings that come with the death of a loved one: helplessness, confusion, familial bonds, and sometimes even betrayal. A will doesn’t have to be forged for there to be strong feelings of anger or suspicion when the contents end up being different than the family was led to expect. And while forged or secret wills may not be as common as the movies would have us believe, they aren’t completely unheard of either.

So what should you do if you suspect that the will of a loved one has been forged or tampered with? First of all, don’t try to deal with the situation alone. Dealing with the death of a loved one is stressful and emotional, and everyone—including you—is likely to be quicker than usual to react without thinking. Instead, seek the advice of a trusted third party (an estate or probate lawyer is ideal,) someone who can help you distance yourself and look at the situation objectively.

Will forgeries are very rare, but incidents of testators (especially elderly testators) being unduly influenced by a selfishly motivated caregiver or family member are much more common. If you suspect foul play was involved in the creation of a loved one’s will, make an appointment with an estate or probate specialist. We can help you work through your suspicions in a safe environment and explore your options should you feel the need to take action.

The High Emotional—And Financial—Cost of Alzheimer’s Disease

Alzheimer’s is a disease that affects everybody it touches—husbands, wives, children and grandchildren—they all bear witness to their loved one’s slow demise. Sadly, emotional stress is not the only stress that accompanies Alzheimer’s disease; those loved ones serving as caretakers may carry a huge amount of financial stress as well. The cost of caring for an Alzheimer’s patient can run anywhere from $64 a day to over a $100,000 a year, and because Alzheimer’s disease can be such a long-lasting disease (a person can suffer from Alzheimer’s for up to 20 years) the costs of care can end up being astronomical. It’s obvious that people can’t do it alone.

Long-term care insurance can be very helpful in paying for the costs of care necessary for a loved one suffering from Alzheimer’s… if your loved one has thought ahead and purchased the policy before they or their spouse began suffering from symptoms of Alzheimer’s. Some people may not have thought ahead and hope that government programs will be able to help with the high cost of care. Medicaid can be helpful … if you fall in the right category and know how to navigate the complex system. (Medicare doesn’t cover the cost of long-term care.)

 Unfortunately, learning how to navigate the system is not something you can do in an hour or two. Because your experience will depend on a number of unique factors we can’t give you an easy set of instructions to follow. The best advice we can give is to say that right now, the best way to navigate the Medicaid system is to find someone who knows the system to assist you. Most estate planning and elder law attorneys help their clients with these issues on a regular basis. If you want to ensure that you and your loved ones will be cared for no matter what the future may bring, don’t be afraid to ask your elder law attorney for help.

Have You Seen This Person?

If you are a Caucasian woman, aged 35 or older, possibly married, very likely working full or part-time—then there is a good chance that you are also (or will soon be) serving as a caregiver for an aging parent or relative. At least this is what a recent report released by the National Alliance for Caregiving, AARP, and MetLife indicates.

The entire report, entitled “Caregiving in the U.S., A Focused Look at Those Caring for Someone Aged 50 or Older” is 73 pages long, but you needn’t read the entire thing to get an insider’s peek at the state of caregiving today. And the report isn’t limited to caring for an aging relative; it includes statistics on those caring for special needs children, as well as family members of any age.

Some of the more interesting statistics listed in the report are:

* 40% of Caregivers are aged 50-64.

* 63% of those receiving care are over the age of 75.

* 67% of Caregivers are women.

* 76% of Caregivers are Caucasian.

* 89% are caring for a relative (36% of the time it is the caregiver’s mother.)

* Over half of caregivers are employed while caregiving; and…

* Caregivers provide an average of 19 hours of caregiving per week (in addition to their regular employment.)

It is worthwhile to note that according to this study most of these caregivers are unpaid for the care they give, which makes sense if they are caring for a family member and are doing it voluntarily—but a full 43% said that they felt they did not have a choice to take on the role.

Our office can’t prevent you from one day needing a caregiver (or one day having to serve as a caregiver) but we can help you plan for when that day may come. Thinking and planning ahead can keep you—and your loved ones—from ending up in a situation where you feel you have no choice.

The Alzheimer’s Association Greater Maryland Chapter’s Awareness Video

The Alzheimer’s Association Greater Maryland Chapter’s Awareness Video

Take the first step to a world without Alzheimer’s

Sign up for the Alzheimer’s Walk to end Alzheimer’s Disease.

 

The Alzheimer's Association Walk to End Alzheimer’s™ is the nation’s largest event to raise awareness and funds for Alzheimer’s care, support and research.

The Alzheimer's Association Walk to End Alzheimer’s™ is the nation’s largest event to raise awareness and funds for Alzheimer’s care, support and research.

Walk to End Alzheimer’s unites the entire community — family, friends, co-workers, social and religious groups and more --- in a display of combined strength and dedication in the fight against this devastating disease. While there is no fee to register, each participant is expected to fundraise in order to contribute to the cause and raise awareness. The Alzheimer’s Association provides free, easy-to-use tools and staff support to help each participant reach their fundraising goal.

When you participate in Walk, your fundraising dollars fuel our mission-related initiatives of care, support and research. In addition, your actions, both through fundraising and participating in the event, help to change the level of Alzheimer’s awareness in your community. At a Walk event, you can learn more about Alzheimer’s disease and the support programs and services offered by your local chapter. You will also have unique opportunities to get involved with the cause through advocacy initiatives and clinical trial enrollment. These experiences, in addition to other on-site opportunities, help each participant connect to their reason for walking.

Take the first step to a world without Alzheimer’s

To sign up for this walk hit. Alzheimer’s Walk

Once you register, you will have access to a wide range of tools and support through your Participant Center, ensuring a successful and fulfilling experience.