News from the Dementia Consortium

Yesterday, one of our staff members attended the Northern Virginia Dementia Care Consortium in Alexandria, VA. At the conference, leading experts on Alzheimer’s disease and related dementias offered insights and shared best practices for caregivers and senior-serving professionals.

The following is a compilation of some helpful information that our staff member gleaned from the presentations:

  • Dr. Paul D. Nussbaum spoke about the power we all have to shape our lives for balance, health, and happiness, and preventative measures to stave off dementia. He described the importance of physical activity, nutrition, mental stimulation, spirituality, and socialization in maintaining brain health and wellness. According to Dr. Nussbaum, “we can influence the state of our physical and mental/emotional health by eating well, exercising and managing stress.” He also emphasized the importance of massage and yoga to reduce stress, heal the body, and regain balance on a spiritual, emotional and physical level.
  • Dr. Jonathan Evans discussed challenging behaviors sometimes exhibited by those with dementia, including aggression, shouting out, combativeness, eloping, and sometimes even violence. He described how most of the behaviors are in response to something, such as a perceived threat, an unmet need such as dehydration or boredom, or a result of feeling frightened, humiliated, or frustrated. He emphasized how important it is to understand the behaviors and what is triggering them, in order to deal with them effectively.
  • Christi Clark spoke about how music reawakens memories in those with dementia and reduces the need for anti-psychotic medications. According to Clark, “musical memory is profoundly linked to emotions. Alzheimer’s may destroy memories, but it doesn’t take away the connection between a favorite song and important life events.” She discussed and showed a snippet from the award winning film, “Alive Inside: A Story of Music Memory,” a documentary about the profound healing power of personalized music.
  • Dr. Steven Sabat discussed the importance of empathy when caregivers, loved ones, and professionals deal with persons with dementia. According to Sabat, “it is important to consider what it means to the person to be experiencing certain losses of ability, how they react to those losses, how caregivers react, and what the reactions of caregivers mean to the person diagnosed.” Dr. Sabat’s work uncovers and challenges negative and potentially detrimental stereotypes of dementia sufferers—for example, that they are passive, vegetables, antisocial, or irrationally angry. Such stereotypes make it easy to mistreat and misinterpret individuals with dementia. While Dr. Sabat’s approach requires considerable commitment, the results of his work reveal that persons with dementia are often hardly as disabled as they are socially expected to be.
  • Greg Risberg told inspiring stories and offered simple suggestions for anyone trying to stay hopeful and energized in a stressful world.

There is great value in sending our staff to conferences such as this one, giving us the opportunity to stay abreast on new developments in Alzheimer’s and other diseases that affect our clients and our loved ones, and giving us the opportunity to share what is learned with you – our devoted readers.

Medicaid Planning for Dementia

A diagnosis of dementia is life-changing for both diagnosed individuals and those close to them.  While it’s not easy to think about, if your loved one has recently been diagnosed with dementia, it’s imperative to make an appointment with a Certified Elder Law Attorney, such as myself, to determine who to name to make legal, financial, and medical decisions when your loved one is no longer able to do so. In addition, if your loved one hasn’t done so already, it is also of utmost importance to determine how he or she will pay for long-term care without financially bankrupting the family.

Medicaid Asset Protection

People with dementia live on average four to eight years after they’re diagnosed, but some may live 20 years beyond their initial diagnosis. Do you have a loved one who is suffering from dementia? Persons with dementia and their families face special legal and financial needs. At The Law Firm of Evan H. Farr, P.C., we are dedicated to easing the financial and emotional burden on those suffering from dementia and their loved ones.  If you have a loved one who is suffering from dementia, we can help you prepare for your future financial and long-term care needs.  We can help protect the family’s hard-earned assets while maintaining your loved one’s comfort, dignity, and quality of life by ensuring eligibility for critical government benefits. Please contact The Law Firm of Evan H. Farr, P.C. in Fairfax at 703-691-1888, in Fredericksburg at 540-479-1435, or in Washington, D.C. at 202-587-2797 to schedule your appointment for a no-cost initial consultation.

Gifting and the 2015 Gift and Estate Tax Exclusion Numbers

grandmagiftgiving

Q. I recently got married and my husband and I found the perfect starter home in Fairfax County. The owners accepted our offer and my mother generously offered to give us $20,000 to help with the down payment. She also has a history of giving small monthly gifts to the animal shelter and to her church. If my mother requires nursing home care next year (which we think is possible), would she be penalized for the gift she gives to us and the recurring donations to the animal shelter and church?

A. Congratulations on your marriage and on the pending purchase of your new home. To answer your question, when it comes to Medicaid eligibility, YES, your mother would be penalized for the help she is offering for your down payment.

Gift giving can be a risky venture for people who may need Medicaid coverage within five years. Medicaid presumes that all gifts made in the 5 years prior to filing for Medicaid were made in contemplation of applying for Medicaid. Individuals seeking eligibility for long-term care Medicaid benefits must disclose all gifts made by the individual or his or her spouse within the prior 5 years. Medicaid presumes that gifts made within 5 years of the eligibility request date were made in order to qualify for benefits.

If someone has a history of giving small weekly or monthly gifts to a charity, as your mother does, most Medicaid offices will not construe those to be disqualifying gifts. For instance, in Virginia, these types of regular gifts are not penalized so long as they are under $4,000 per year and there was a regular pattern of making this gift for years prior to applying for Medicaid.

Does this potential risk of a Medicaid penalty suggest that all giving should cease? Not necessarily. However, those who may need nursing home care within the next five to ten years must weigh the joy of giving against the potential cost of losing much-needed Medicaid benefits.

For more information about gifting and Medicaid eligibility, read “Medicaid: The Perils of Gifting FAQ” on our website. Please suggest to your mother that she call 703-691-1888 in Fairfax, 540-479-1435 in Fredericksburg, or 202- 587-2797 in Washington, DC to make an appointment for a no-cost consultation.

Q. Also, on the topic of gifting, my husband and I would like to make gifts to the Alzheimer’s Association and are not sure if we should do so this year (in 2014) or next. What are the new gift and estate tax exclusion numbers for 2015 and how do they compare to the current ones? If we do start making gifts, should we update our estate planning and, if so, how often?

A. The IRS recently released the gift and estate tax exclusion amounts for 2015. Under the provisions of the American Taxpayer Relief Act of 2012, the lifetime gift and estate tax exemption increased from $5,120,000 in 2012 to $5,250,000 in 2013 and the tax rate increased to 40%. In 2014 and future years, the exemption amount continued to be indexed for inflation and the tax rate remained at 40%. The 2014 lifetime gift tax exemption as indexed for inflation was $5,340,000, and the 2015 lifetime gift tax exemption is $5,430,000 (an increase of $90,000).

In 2014 you can gift up to $14,000 per person, per year, without incurring any federal gift tax. These gifts are referred to as annual exclusion gifts and are not subject to the federal gift tax at all and therefore do not use any of your lifetime exemption from gift or estate taxes. The annual exclusion amount is indexed for inflation but can only increase in $1,000 increments. Therefore, the 2015 annual gift tax exclusion remains at $14,000. However, always beware of making lifetime gifts if you are over the age of 65 — read the Perils of Gifting webpage on our website for more details.

For spouses, there is an unlimited deduction from estate and gift tax that postpones the tax on assets inherited from each other until the second spouse dies. Married couples can combine their annual exclusion gifts and gift up to $28,000 per person, per year, but “split gifts” must be reported to the IRS on Form 709, United States Gift (and Generation-Skipping Transfer) Tax Return.

The new inflation adjusted numbers are available in Revenue Procedure 2014-61, issued October 30, 2014.

With all of the frequent changes that take place in the tax laws, and even more frequent changes in Medicaid rules, I recommend that everyone should revisit their estate plans every year. The Farr Law Firm’s Lifetime Protection Program, ensures that your documents are properly reviewed and updated as needed, so that they will have the proper effect under the law.

Caregiving in Other Countries- What We Can Learn

international

Each November, National Family Caregivers Month focuses on the challenges facing family caregivers. Sponsored each year by the National Family Caregivers Association (NFCA), this commemorative month recognizes more than 50 million family caregivers who spend an estimated 30 billion hours every year providing emotional, financial, nursing, social, homemaking, and other services to friends and loved ones. The estimated value of these caregiving services, if paid, would cost upward of $522 billion a year, according to a new RAND Corporation study.

While caregiving is not always without joy, it is also never without sacrifice. For many, caregiving takes a toll on emotional well-being, physical health, careers, and quality of life. There is also a lack of support and training for caregivers (although resources do exist). Are these truths about caregiving the same everywhere, or just in the US? Below, we will explore two other countries and see for ourselves.

United Kingdom (UK)

According to Carers UK, and based on recent census research, around 6.5 million people (1 in 8 people) in the UK provide care on an unpaid basis for a relative, friend, or neighbor in need of support due to old age, disability, frailty, or illness. Forty-five percent of caregivers have given up work to care for a loved one, and many more are juggling caregiving, work, and family.  While caregivers save the UK economy an estimated £119bn (149 billion U.S. dollars) a year, 49% of caregivers are struggling financially themselves.

With big legal changes in the Care Act 2014 coming into force in April 2015 in England, caregivers in the UK will be looking ahead to new rights and services.

Canada

According to the most recent General Social Survey on Caregiving and Care Receiving, there are more than 8 million caregivers in Canada. Most are women between the ages of 35 and 44 that are part of the “sandwich generation” — they help parents or parents-in-law, while also having at least one child under age 18 living at home.

In Canada, the most common type of help, provided by 73% of all caregivers, is transportation to run errands, shop, or attend medical appointments, and 22% of seniors who receive caregiving support live in care facilities, including assisted living and long-term-care homes. About half of caregivers in Canada report that they are feeling some psychological distress, for example depression or isolation.

In Canada, 19% of caregivers receive some form of financial support. Help from family and friends was the most common at 12%, followed by government programs at 7% and a federal tax credit at 5%. Training for caregivers is pretty accessible in Canada, and is available through online courses and university offerings.

Last week, Canada’s Citizenship and Immigration Minister, Chris Alexander, announced significant reforms to the Caregiver Program that include ending the live-in requirement, and providing eligible caregivers who are not Canadian citizens with two pathways that will lead to permanent residence within six months.

No matter where you live, caregiving for a loved one can be rewarding, and both emotionally and mentally taxing. During National Family Caregivers Month, and always, please encourage your family caregivers to take advantage of services that offer respite and support, and thank them for their strength, courage, and commitment in providing long-term patient care.

At the Farr Law Firm, we recognize that caring for a loved one strains even the most resilient people. If you’re a caregiver, take steps to preserve your own health and well-being.  Part of taking care of yourself is planning for your future and for your loved ones. Please call us at our Fairfax office at 703-691-1888, at our Fredericksburg office at 540-479-1435, or at our DC office at 202-587-2797 to make an appointment for a no-cost initial consultation

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