Is Alzheimer’s Contagious?

 

There are currently 5.2 million Americans who suffer from Alzheimer’s, and the number is expected to triple by 2050.  It has long been believed that Alzheimer’s is caused only by age and genetics, but new research says person-to-person transmission of the protein that causes Alzheimer’s may be a possibility.

So, does that mean that Alzheimer’s is contagious? According to Scientific American magazine, Alzheimer’s isn’t exactly contagious. However, a protein that goes on to form the disease could pass to patients during surgery, meaning there could be an acquired form of the disease, a new study finds. The study, published in the journal Nature, is the first to suggest that the degenerative neurological disease can be spread between humans.

To explore the question of human transmission, John Collinge, a neuroscientist at University College London and his colleagues, studied the brains of eight people, 36 to 51, who died of Creutzfeldt-Jakob Disease (a rare disease with symptoms similar to Alzheimer’s, but the symptoms appear more rapidly). These were the findings:

– Alzheimer’s isn’t contagious in the same way that colds are, but its proteins may be passed between people under certain circumstances.

– Accidental exposure to prions, or “proteinaceous infectious particles,” by way of a contaminated hormone treatment the people in the study were given, increased the production of the protein that causes Alzheimer’s in their bodies. (Note: the treatment, using human-derived hormones, is no longer used due to the risk of contamination.)

– None of the participants had any history of Alzheimer’s in their family, and they were all young (36-51).

– Of the eight patients tested, four had significant deposits of the Alzheimer’s protein. Only one patient showed no sign of the protein. The researchers suggest that had the patients not died young, they would have developed Alzheimer’s disease later in life.

– Alzheimer’s proteins have been found to stick avidly to metal surfaces of surgical instruments and are resistant to typical sterilization methods. Studies are now needed into whether other procedures, such as blood transfusions and the repeated use of surgical instruments, pose a risk.

Collinge emphasized that he “doesn’t think we need to worry excessively.” According to Collinge, “this is an observational study, that, alone, does not suffice to prove that the Alzheimer’s disease process can be induced in one individual through contact with another’s brain tissue.”

More Research is Needed

Another prominent Alzheimer’s researcher, John Trojanowski of the University of Pennsylvania (my alma mater), who was not involved in the study, asserted that Collinge’s research does not provide a clear answer about whether Alzheimer’s pathology can spread between humans. He believes that the study will “generate more confused thinking and stoke unreasonable concerns by the public about the infectivity of  Alzheimer’s,” which he thinks “does not help the field of AD research.” He points to the small size of the study and the fact that the subjects did not show other signs of Alzheimer’s. According to Trojanowski, “studies show that Alzheimer’s proteins begin to deposit as early as the second and third decade of life, which means the subjects could merely have aging-related deposition of Alzheimer’s proteins.” Other researchers, however, found the study to be an important contribution to Alzheimer’s research that should be further explored, and that the research “may be a first step toward answering the question of whether human-to-human transmission of pathological proteins is possible.”

To read more about the study and its findings, see the articles: “Study finds seeds of Alzheimer’s may have spread in medical procedure” in Reuters, “First Evidence that Alzheimer’s Proteins May Have Passed from Person to Person,” in Time and “Can you Catch Alzheimer’s?” in Popular Science.

Medicaid Planning for Alzheimer’s and Other Types of Dementia

Alzheimer’s is the biggest health and social care challenge of our generation, and a diagnosis of the disease is life-changing.  When it comes to planning for long-term care needs, generally, the earlier someone with dementia plans, the better.  But it is never too late to begin the process of Long-term Care Planning, also called Lifecare Planning and Medicaid Asset Protection Planning.

Medicaid planning can be initiated by an adult child acting as agent under a properly-drafted Power of Attorney, even if your loved one is already in a nursing home or receiving other long-term care.

Medicaid Asset Protection

Do you have a loved one who is suffering from Alzheimer’s or any other type of 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.  We 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 such as Medicaid and Veterans Aid and Attendance. Please call us as soon as possible to make an appointment for a no-cost consultation:

Fairfax Alzheimer’s Planning: 703-691-1888
Fredericksburg Alzheimer’s Planning: 540-479-1435
Rockville Alzheimer’s Planning: 301-519-8041
DC Alzheimer’s Planning: 202-587-2797

Self Care for a Special Needs Parent

Dear Angel,

My daughter, Valerie, has autism spectrum disorder (formerly known as Asperger’s Syndrome, but now under the ASD umbrella). She is very bright, and for the most part is in an inclusive environment at school. However, when she gets home, she has panic attacks often, and needs constant attention. I spend all of my time thinking about her needs, and no time on myself, and the stress is taking a toll on my mental and physical health. Do you know of any suggestions for finding caregiving help/respite for a special needs parent? I don’t trust just anyone with my daughter, and really need some time to go for a run, read a good book, or just to unwind.

Thanks in advance,

Alla Boutval

—-

Dear Alla,

Being a parent is stressful. And, as you know, being a special-needs parent can be challenging. Below are some resources for finding qualified caregivers and respite programs, so you can make time to care for yourself and relieve some stress!

Caregiving

•Start with your family, friends, neighbors, and your child’s classmates’ parents. Anyone of these might have a great connection that they never thought of until you asked.
•Ask for childcare recommendations from any of the online autism parent groups you belong to.
•Put a “childcare needed” notice in nearby religious institutions such as churches or synagogues, in your local library, and in colleges or universities with special education programs.
•Ask your child’s pediatrician, teachers, early intervention workers, and therapists for recommendations. See if the aides in your child’s class, or the assistants in your child’s toddler group, are allowed to babysit.
•Search online for special needs’ caretakers, and also look into nanny and child care referral agencies. Be sure to ask for references from other parents who have used their services.
•Contact your local chapter of the following groups that provide support and services to people with disabilities and their families:

Living with Fewer Rights than a Convicted Felon


Q. My 30 year old cousin, Donnie, is intellectually disabled. He works at the Wendy’s near my house, serving burgers and greeting customers with a smile. He has a bank account, and saves most of the money he earns, makes a mean chili, and drives to work each day. Yet, his mother has guardianship over him, leaving him with less rights than a convicted felon.

All Donnie wants is to be independent and the interesting twist in his situation is that his mother agrees with him. She wants him to find the apartment he’s been saving for, and to be independent, as he wishes. However, the court disagrees, and will not remove the guardianship. In addition, if anything happened to his mother, Donnie’s guardianship would revert to the courts, and he could be forced out of his mother’s house and into a group home, be forced to quit the job he loves, be cut off from friends, and even have all his passwords to his favorite websites blocked.

This is unbelievable! Is this the norm? What is being done to help people like him?

A. Guardianship is an extreme form of intervention in another person’s life, that is typically used for those who are mentally incapacitated due to dementia, brain injury, mental illness, or other disability. For an incapacitated adult, a “guardian” is a person that is appointed by the court to be responsible for another person’s personal affairs, including making decisions regarding their support, care, health, safety, habilitation, education, therapeutic treatment, and residence.

The law does not make it easy for someone to obtain guardianship, unless the person they are trying to help really needs it, because doing so takes away so many legal rights of the protected person, including control over personal and/or financial decisions for an indefinite, often permanent period of time. As you can see in the situation with your cousin, once established, guardianship can be quite difficult to revoke. This is why I advise that guardianship should only be used as a last resort.

Supported Decision-Making

Currently, there is a nationwide movement to replace overbearing guardianships with something called Supported Decision-Making (SDM). SDM is designed to make the person with cognitive challenges “the ultimate decision-maker,” while still providing the support the person needs to thrive, according to the National Guardianship Association.

SDM offers an opportunity for many adults with disabilities to make their own decisions, consistent with fundamental human and legal rights. For example, with SDM, someone such as your cousin would be able to make life decisions for himself, while still receiving the help he needs to understand the choices he faces. All this, without the need for undue or overbroad guardianship.

Introduced as part of the United Nations Convention on the Rights of Persons with Disabilities (CRPD), SDM can be a key element for improving experiences and opportunities for many people with different life conditions. In fact, according to the American Bar Association website, under Article 12 of the UN CRPD, people with disabilities enjoy “legal capacity to act on an equal basis with others in all aspects of life. States have a duty to provide persons with disabilities access to the supports they may require to exercise their legal capacity. States must ensure that these measures provide for safeguards to prevent abuse that are both proportional and tailored to the individual’s circumstances.”

The legal group that met at the UN CRPD came to a consensus that SDM, with adequate resources, must be put in place before guardianship, and that guardianship should only be considered if SDM has not succeeded. Unfortunately, SDM is generally not known to the general public, policymakers, judges, and many lawyers. A model for SDM currently exists in British Columbia, however, there is generally no clear policy framework in the U.S. Therefore, guardianship laws and practice still dominates in this country. The challenge for leaders is to identify the steps they can take within their scope of influence AND work with others to create new SDM policies, systems and practices.

What To Do Until SDM Becomes Mainsteam

Very few people want to have court oversight and be unable to make decisions without getting someone else’s permission. For your cousin, I sincerely hope SDM becomes available in this country. For others, not wanting their rights taken away is a big reason why proper legal planning is so important. The very same protections achieved through guardianship can usually be achieved without any court proceeding, through the use of good Power of Attorney documents for medical and financial decisions. If you and your loved ones don’t already have up-to-date power of attorney documents in place, then it’s critical to do so right away.

Please click here for additional details about guardianship and less restrictive alternatives.

Special Needs Planning

Until something can be done to help your cousin regain his independence, it is important for his family to plan for his future.

A special needs trust is an essential tool to protect a disabled individual’s financial future. Also known as Supplemental Needs Trusts, this type of trust preserves legal eligibility for federal and state benefits by keeping assets out of the disabled person’s name while still allowing those assets to be used to benefit the person with special needs. Read more here.

When it comes to special needs planning and guardianship, we can guide families through this process and discuss the best strategies/alternatives. Please call us to make an appointment for a no-cost consultation:

Fairfax Elder Law: 703-691-1888
Fredericksburg Elder Law: 540-479-1435
Rockville Elder Law: 301-519-8041
DC Elder Law: 202-587-2797

Lending a Paw for Veterans


Robert Soliz, a 31-year-old former Army Specialist, participates in Paws for Purple Hearts. (Joseph Matthews, Veterans Affairs Photo)

After being married for just six weeks, Mark, a U.S.Army veteran who was stationed in Iraq, sustained severe combat injuries, rendering him quadriplegic. When he arrived home, he felt despair and sadness. He could no longer do the things he once loved, and he had to depend on others for assistance.

The last thing Mark wanted to do was overburden his new wife. He struggled with how he could be more independent, until the day he met and fell in love with Gus.

Mark met Gus for the first time at an intense two-week training program at Canine Companions, a non-profit organization that enhances the lives of people with disabilities by providing highly trained assistance dogs. Gus is a handsome yellow Labrador/Golden Retriever that is cross trained to respond to approximately 50 commands. Gus has changed Mark’s life for the better, giving him more independence and the confidence that he could still do many of the things he loved in life before he became disabled.

In another instance, Robert Soliz was one of 300,000 U.S. veterans of the wars in Iraq and Afghanistan with a diagnosis of post-traumatic stress disorder (PTSD). When Soliz arrived home, he could no longer show affection for his children as he did before he left, couldn’t go to movies anymore without having a panic attack, and was always scanning behind him to make sure he wasn’t going to get attacked.

Soliz felt isolated and his family was deteriorating. He turned to his local VA Medical Center, and credits a bag of dog treats hanging on a closet door at the hospital with sparking the idea that saved his life. He now participates in Paws for Purple Hearts, one of four experimental programs nationwide that pair veterans afflicted by PTSD with Labrador and golden retrievers. Launched in 2008, the program arranges for a veteran to spend six weeks with a dog, training it to be a mobility-assistance animal for a physically disabled veteran. With the help of his therapeutic pet, Soliz says his life is slowly coming back to him. He now can go to the movies without panicking—and hug and kiss his two kids.

Evidence also shows that cats can also help those with PTSD. Please read the Cat Fancy article, “Feline Comfort – Evidence Suggests that Cats Can Help People Cope with Post Traumatic Stress Syndrome,” for more details. We will certainly cover cats who lend their paws for therapy in a future article or in Critter Corner!

Benefits of Therapeutic Dogs for Veterans

It’s no surprise that dogs can soothe and relax people, but other benefits are less predictable. These are some of the profound benefits that dogs have had on veterans:

• The animals draw out even the most isolated personality.

• Having to praise the animals helps traumatized veterans overcome emotional numbness.

• Teaching the dogs service commands develops a patient’s ability to communicate, to be assertive but not aggressive, a distinction some struggle with.

• PTSD soldiers paired with a dog are more likely to work, encouraging independence.

• The dogs can also eases the hypervigilance common in vets with PTSD. Some participants report they finally got some sleep knowing that a naturally alert soul was standing watch.

• Paired with the right dog, soldiers are less likely to require drugs for their condition, or least as many drugs or lower dosages (limiting side effects), and even less likely to commit suicide (a real issue among returning veterans).

• Researchers are accumulating evidence that bonding with dogs has biological effects, such as elevated levels of the hormone oxytocin. Oxytocin improves trust, the ability to interpret facial expressions, the overcoming of paranoia and other pro-social effects—the opposite of PTSD symptoms.

About 300 vets have participated in therapeutic pet placement programs for veterans, and some graduates report impressive strides. So, where can a vet get a pet?

Canine Companions for Independence: Canine Companions for Independence provides professionally trained assistance dogs for people with physical disabilities. The specially-bred Labradors and Golden Retrievers help with everything from turning on lights to getting cash from an ATM. Through Canine Companions Wounded Veterans Initiative, assistance dogs are available to Veterans with physical disabilities resulting from military service, free of charge.

Paws4Vets: Paws4Vets’ primary mission is to train and provide qualified individuals with certified assistance dogs custom trained to fit their individual requirements and needs.  Currently, placements will be considered in the nine Mid Atlantic states where they have a presence. (VA, WV, OH, PA, MD, NC, SC, GA, FL).

Paws for Purple Hearts – Bergin University of Canine Studies:‎ If you are interested in requesting a service dog, please contact Bergin University’s dog program manager at servicedogrequest@berginu.edu

America’s VetDogs: America’s VetDogs trains and provides guide dogs for veterans who are blind or visually impaired, service dogs for veterans and active duty personnel with disabilities other than blindness, combat stress relief dogs for in-theater deployment, and therapy dogs to provide physical and emotional therapy services at select military and VA hospitals.

Canines for Service: Canines for Veterans, a program of Canines for Service, is a national program that provides Veterans with disabilities quality trained service dogs. The program works with military prisoners teaching them how to train rescue dogs as service dogs for the wounded and injured Veterans. Service dogs are provided to qualified recipients at no cost to the recipient.

Patriot Paws Service Dogs: Patriot Paws Service Dogs is a nonprofit organization that trains and donates service dogs for disabled Veterans. Service dogs are able to assist physically disabled individuals to accomplish daily tasks that would otherwise be difficult or impossible. Each dog is customized to the individual needs of the owner.

Veteran’s Aid and Attendance

If you are a veteran, you may qualify for a special pension benefit called Veteran’s Aid and Attendance. As an Accredited Attorney with the U.S. Dept. of Veterans Affairs, I understand both the Aid and Attendance Benefit and the Medicaid program and the interaction between both benefit programs. The Veterans Aid and Attendance benefit can provide more than $25,000 annually for an eligible married veteran, more than $21,000 annually for a single veteran, and over $13,000 annually for the surviving spouse of a qualified veteran. (Please visit our website to see the 2015 figures.)

Eligibility criteria includes:

• Those over 65 do not have to be disabled; veterans under 65 must be 100% disabled. The veteran or spouse must be in need of regular aid and attendance due to inability to dress oneself, feed oneself, loss of coordination or other conditions, as described on our website, and there must be actual ongoing caregiving services being received from someone else.

• You or your spouse must have served on active duty for at least 90 days, at least one day of which occurred during a period designated as wartime (see our website). There must have been a non-dishonorable discharge as well. Single surviving spouses of such veterans are also eligible.

For more details about Veteran’s Aid and Attendance and other veterans’ benefits, please sign up to receive my Aid Attendance 4-Part Mini Series via e-mail.

Applying for veteran’s benefits, such as Veteran’s Aid and Attendance, is always a confusing and arduous task, fraught with perils along the way. Here at the Farr Law Firm, we work with veterans and their spouses to evaluate whether they qualify for the Veterans Aid and Attendance Benefit and/or Medicaid, and we take care of all the paperwork. Please contact us as soon as possible to make an appointment for a no-cost consultation:

Fairfax Veteran’s Attorney: 703-691-1888
Fredericksburg Veteran’s Attorney: 540-479-143
Rockville Veteran’s Attorney: 301-519-8041
DC Veteran’s Attorney: 202-587-2797

P.S. Another benefit of being a veteran is a 15% discount off all services at the Farr Law Firm. We hope to see your family soon!

Critter Corner: How Can The ABLE Act Help My Special Needs Daughter?



Dear Baxter,

My daughter has intellectual disabilities. I read in one of your newsletters that Virginia was the first state to enact the ABLE Act. I don’t know much about it, but it may be something that can help my daughter with her education expenses, without jeopardizing her benefits. Can you explain more? Also, who is Stephen Beck, Jr, and why was the act named for him?

Thanks!

Abel Tahelpper

Dear Abel,

Last December, the Stephen Beck, Jr. Achieving a Better Life Experience Act of 2014 (ABLE Act) won final congressional approval and was signed into law by President Obama. As you mentioned, in July of this year, Virginia became the first state to approve it.

The ABLE Act allows for savings accounts for individuals with disabilities for certain expenses, including education, housing, and transportation, without jeopardizing certain important federal benefits such as SSI and Medicaid. To be eligible, an individual must be someone who becomes disabled before age 26 and (1) receives Social Security Disability Insurance (SSDI) or SSI; or (2) obtains a disability certification under rules that the IRS will write.

Sadly, the man who conceived and worked tirelessly to pass the legislation, Steve Beck of Burke, Virginia, died suddenly right around the time the law was passed. Steve was 44 years old and the parent of two daughters, including Natalie who has a disability. Steve, along with a group of parents around his kitchen table, conceived the idea of a savings account for his daughter, similar to the 529 account used for college savings. The passage of the Act is a wonderful tribute to the memory of Steve Beck.

Although federal law applies uniformly to all states, individual states may regulate ABLE accounts differently.  Under current law, states provide different tax benefits for college savings accounts, which are similar to ABLE accounts. For more details about the ABLE Act, by state, please see the ARC website.

If you haven’t started planning for your daughter with special needs (or for yourself), please call one of our offices to make an appointment for a no-cost consultation.

Arfs and Kisses,

Baxter

Straying from Loved Ones

photo from UPMC.com

Q. This past summer, I went to Burke Lake Park with a friend, Mary, who has a child with autism. While purchasing a ticket for the carousel for another child, Mary’s son wandered off. After searching for a bit, and involving the park authorities and the police, he was found near the train tracks (and luckily he was fine!).

That same day, I received a notice via Nextdoor (an online neighborhood  bulletin board), that an 80-year old woman with dementia left her home while her caregiver was taking a shower. She was found at a nearby shopping center (on the other side of a major road), completely disoriented.

I read that half of all children with autism, and 3 out of 5 people with dementia, wander. And for autism, more than 40% of such cases involving children under age 9 have ended in death. This is extremely alarming. Do you know if anything is being done, on a national or local level, to help with this problem? Also, what can people like my friend and my neighbor do to prevent wandering from happening?

A. Similar to wandering behaviors in seniors with dementia or Alzheimer’s, children with autism are prone to wandering away from a safe environment. Unfortunately, many cases end in tragedy. Luckily, in both situations, advocacy groups are banding together to call for federal action to help prevent wandering, and the same groups are developing educational resources to help. Below is what is being done:

Autism and Wandering

Research suggests that 50% of children with autism have a tendency to wander, and as you mentioned, more than 40% of such cases involving children under age 9 have ended in death. A collective, called the Autism Safety Coalition, launched earlier this summer to promote wandering awareness, is putting its weight behind federal legislation known as Avonte’s Law. The bill would provide funding to law enforcement agencies for wandering-prevention efforts and allocate federal dollars to offer free electronic tracking devices to children with autism and other developmental disabilities who are prone to bolting.

The legislation is named for Avonte Oquendo, a 14-year-old with autism who went missing in 2013 from his New York City school. His remains were discovered months later.

“Children and adults with autism and other disabilities frequently wander from safe settings, often with tragic consequences. It’s time for federal action,” said Wendy Fournier, president of the National Autism Association, who indicated that the legislation would offer many of the same resources to the disability community that are already provided to those affected by Alzheimer’s disease.

U.S. Sen. Chuck Schumer, D-N.Y., first proposed Avonte’s Law last year and introduced the legislation earlier this year. Unfortunately, thus far, the bill has not gained traction.

Whether or not federal efforts pan out, awareness is the most effective tool. The following resources are recommended by Autism Speaks. To report an active case of wandering, click here.

AWAARE Family Wandering Emergency Plan (FWEP)
6 Tips to Help Prevent Wandering and Wandering-Related Tragedies
7 Steps You Can Take to Prevent Wandering at Your Child’s School
A Digital Guide for Caregivers: Learning to Prevent Wandering
AWAARE Wandering Discussion video
Autism Safety Project
Autism Safety Resources and Products
Other Wandering-Related Resources

Wandering and Dementia

More than 60 percent of those with Alzheimer’s or another form of dementia will wander, and if a person is not found within 24 hours, up to half of individuals who wander will suffer serious injury or death.

As many states use an “Amber Alert” system to identify lost or abducted children, the majority of states also have “Silver Alert” systems to help find seniors who have wandered off and gotten lost. In Virginia, for example, the Virginia Senior Alert Program was passed in 2007. The legislation established a way to issue a state-wide alert when an over 60-year-old person with a cognitive impairment has been reported missing. The program uses a variety of methods to get information out concerning the missing person: the Emergency Network System, the Virginia Criminal Information Network; the Virginia Missing Person Information Clearinghouse; and even the public utilities’ communication system. Maryland also enacted a Silver Alert program in 2010, and DC did so in 2013.

Unfortunately, not every state participates in Silver Alerts. Because of the variation in Silver Alert laws, directories, and registries, some advocates and lawmakers have called for a Nationwide Silver Alert program. In 2010 a bipartisan coalition of Congresspersons proposed a bill that would have funded a national silver alert program, but seemingly more pressing troubles occupied Congress’ time that year and the bill was never voted on. A renewed effort to invest in such a national program could go a long way to mitigating the Alzheimer’s wandering crisis.

For resources on Alzheimer’s and Dementia and wandering, please visit the Alzheimer’s Association Alzheimer’s and Dementia Caregiver Center. Please also read our blog, “Alzheimer’s Caregivers Need to See This, for additional resources.

How You Can Help Prevent Wandering and Wandering-Related Tragedies

• Secure Your Home: Consider contacting a professional locksmith, security company or home improvement professional to promote safety and prevention in your home. You may find it is necessary to prevent your loved one from slipping away unnoticed by installing secure dead bolt locks that require keys on both sides, a home security alarm system, inexpensive battery-operated alarms on doors, fencing your yard, adhering printable STOP SIGNS to doors, windows and other exits, etc.

• Consider a Tracking Device: Check with local law enforcement for Project Lifesaver, MedicAlert, or LoJak SafetyNet services. These tracking devices are worn on the wrist or ankle and locate the individual through radio frequency. Various GPS tracking systems are also available.

• Consider an ID Bracelet: Medical ID bracelets will include your name, telephone number and other important information. They may also state that your loved one has autism or dementia. If your loved one will not wear a bracelet or necklace, consider a temporary tattoo with your contact information.

• Alert Your Neighbors:
It is recommended that caregivers have a brief visit with all neighbors to introduce their loved or provide a photograph. Knowing your neighbors can help reduce the risks associated with wandering.

Whether you’re a caregiver for a loved one with autism or dementia, we urge you to plan for your future and for the future care needs of your loved one.  To learn more about special needs planning, please click here. If you have a loved one who needs long-term care now or in the future due to Alzheimer’s or any other type of dementia, please contact us. We 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 such as Medicaid and Veterans Aid and Attendance. To make an appointment for a no cost consultation, call us:

Fairfax Elder Law: 703-691-1888
Fredericksburg Elder Law: 540-479-1435
Rockville Elder Law: 301-519-8041
DC Elder Law: 202-587-2797

“Life Reimagined”- Guidance for Retirement Planning

When it comes to retirement, money is certainly important, but don’t forget that there are other important things to consider along the way. For this very reason, AARP recently released its Life Reimagined Website, offering a map to guide you in this new life phase.

What is “Life Reimagined”?

Life Reimagined is an initiative designed to help people get on the path that will bring them the most happiness during your retired years.

The core idea behind this website is that it provides programs to help clarify your goals, desires, and priorities. These programs are split into three categories: Well-Being, Work, and Relationships. By focusing on these three facets, retirement will hopefully be marked by thriving, not just surviving. Best of all, these programs are free. Although they can take anywhere from 1 to 7 days to complete, if you take them seriously, you may find that they offer a lot of intangible value.

How it works:

  1. Choose a program on relationships, work and well-being.
  2. You’ll get different tasks—videos to watch, meditations to listen to, quizzes to do, etc.
  3. Programs are just one part of the Website. You can keep exploring with articles, inspiration, and more.

Life Reimagined involves practices that guide you through change. You can start at a place where you currently are in your life, and see where the possibilities lead you. Be sure to check out the Life Reimagined Website, and see all it has to offer!

More Great Resources for Retirement Planning

Life Reimagined is a helpful resource, but certain questions still remain for the soon-to-be retiree. For example, you may wonder how long you can expect to live given your current lifestyle, what kind of paperwork you should take care of before entering retirement, and once in retirement, what are you going to do with your time and energy? Here are some other helpful web apps to help you prepare for a comfortable and lively life as a retiree:

·     Vitality Compass: Vitality Compass is an app by Blue Zones, a project that started as an exploration by National Geographic to find the longest living cultures across the world. The app calculates things like your overall life expectancy and analyzes how many years you’re losing due to poor lifestyle habits. It consists of a simple six-part questionnaire, including a few questions about your background, outlook, diet, exercise, environment, etc. It takes less than 10 minutes to complete and the results are helpful as a preparatory tool to see “how much retirement” you can look forward to.

·     How Long Will I Live?: Sometimes it’s good to get a second opinion. “How Long Will I Live?” is another life expectancy calculator that gives more accurate-than-most results. The team of researchers behind this app are from the University of Pennsylvania, a well-regarded research-oriented Ivy League University (and also my alma mater). As part of this project, they explain how the calculations are performed, including a rundown of basic concepts and a mathematical summary. Based on the questions alone, you’ll see that it looks at different factors than the Vitality Compass, so it’s a good supplemental tool to use. (Remember: these are just apps. As you know, nothing can definitively tell you how long you’ll live!)

·     Life Planning For You: Once you have an idea of how long you can expect to live, it’s time to decide what you’re going to do during those years. Life Planning For You aims to help you reorganize your money in a way that lets you pursue your greatest dreams. The website offers a set of questions (called Exploration, Vision, Obstacles, Knowledge, and Execution, or EVOKE exercises) that help you pinpoint what exactly you want from life.

·     Social Security Planner: As you know, Social Security benefits will make up a good chunk of your retirement income. What most people don’t realize, however, is that they might not be receiving as much money as they could. By using the Social Security Planner app, you will be able to analyze the income you estimate that you will receive and discover the optimal strategy for securing as much money as you can.

·     Retirement Income Planner: This income planner is specifically designed for people who are within five years of retirement or are already retired. It’s a 30-minute process that will optimize how long your retirement money will last.

Successful Retirement Requires Planning

No matter where you are on the road towards retirement, continued planning is critical to success. In addition to catching up with good personal finance habits, it is also important to plan for yourself and for your loved ones. Why? Because planning in advance enables you to sort options and make smarter decisions ahead of time.

Every adult reaching retirement age should have certain legal documents in place: an Incapacity Plan (to avoid lifetime probate) that includes a Financial Power of Attorney, an Advance Medical Directive, and an Advance Care Plan; and an Estate Plan (to avoid after-death probate) that includes a Living Trust and a Pour-over Will.  If you or your loved ones have not done or Incapacity Planning or Estate Planning (or have not had your documents reviewed in the past several years), please call us as soon as possible to make an appointment for a no-cost consultation or second opinion.

Fairfax Elder Law Attorney: 703-691-1888
Fredericksburg Elder Law Attorney: 540-479-1435
Rockville Elder Law Attorney: 301-519-8041
DC Elder Law Attorney: 202-587-2797

Critter Corner: Learning to “Speak Alzheimer’s”

Dear Angel,

My mother was diagnosed with Alzheimer’s a couple of years ago. She used to be a college professor and is a brilliant woman. I began noticing that when someone hears of her Alzheimer’s, they ask me questions that she could very well still answer for herself. How can I convey to others that my mother can still speak for and advocate for herself? Also, when she can no longer speak for herself, how will I be able to communicate with her?

Thanks!

Sy Lenst

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Dear Sy,

Millions of people with Alzheimer’s or other dementias are intelligent people, like your mother, who are still actively advocating for their own rights and needs. Unfortunately, most people don’t understand the disease and, therefore, don’t know how to listen to people with Alzheimer’s.

According to a recent article in NextAvenue, “just like anyone else with unique challenges and special needs, people with Alzheimer’s need to be able to communicate their needs, wants and fears without being judged.” The article states that “(m)any continue to advocate only to be ignored, until it’s too late and the disease begins quieting their “voice” and ultimately steals their ability to form words and communicate verbally.”

A solution to people not listening to your mother now could be simply not answering for her. Defer to her and wait for her to answer for herself, or say “Why don’t you ask her?”

When your mother is no longer able to communicate her thoughts verbally, it will be important to learn to listen with your eyes, ears, and heart. In addition, it will be helpful to learn to “speak Alzheimer’s.”

Speaking Alzheimer’s

During a free, one-hour, interactive workshop on the Together in This Website, tips strategies are offered to help caregivers and loved ones have successful communication with persons with Alzheimer’s disease and related dementias.

The following is discussed during the workshop:

·     The relationship between the 7 stages of Alzheimer’s disease;

·     How communication is affected by Alzheimer’s disease;

·     Communication strategies that focus on the person and not the disease;

·     Why a person-center approach to care improves communication;

·     The “step-by-step” communication technique.

You can watch the 1 hour workshop or listen to the audio file by clicking here, and hopefully it will help you to communicate with your mother when the time comes that she can no longer speak for herself.

Hope this is helpful!

Meows and kisses,

Angel

Finding Joy in Alzheimer’s


Photo from everydayfamily.com

Q. It’s National Grandparent’s Day on Sunday, September 13. My children want to do something special with their grandpa, who is in the early stages of Alzheimer’s. Unfortunately, ever since the diagnosis, he has resigned himself to the fact that he is sick, and has not left his house. My children can’t think of anything to do with him when we visit that everyone will enjoy. I also hope they don’t get upset when they see their grandfather this way, since he lives in Yorktown, VA, and we don’t see him often. How can we make the most of our time together as a family?

A.  Alzheimer’s is a devastating illness, and as symptoms start to progress, the person affected, their caregiver, and their loved ones, may begin to think that the person can no longer enjoy life. In the early stages, those affected may fall into a period of deep depression and despondence. Grief is another feeling that can develop, followed by anger at the situation, and sometimes anger at God for letting the person develop this disease in the first place.

What many don’t realize is that it doesn’t have to be this way. In the book, Creating Moments of Joy: A Journal for Caregivers, by Jolene Brackey, several experts on Alzheimer’s were interviewed about the disease, and a different picture of the disease emerged. Yes, they unanimously agreed that Alzheimer’s is a terrible disorder, but they also stated that people who have it can and do still have the capacity to enjoy life.

In fact, according to Teepa Snow, a nationally renowned expert on Alzheimer’s caregiving, almost all people with Alzheimer’s “can enjoy life if they have the right support and environment.” The book’s author, Jolen Brackey, concurs, stating, “We are not able to create a perfectly wonderful day [for people who have Alzheimer’s], but it is absolutely attainable to create perfectly wonderful moments – moments that put smiles on their faces, a twinkle in their eyes or trigger [pleasant] memories.”

So, how can you create joyful moments for your father and his grandchildren? According to the book, if your father is reluctant to leave the home, your children could bring the following:

Photo Albums: Bringing in family photos can brighten your father’s day. A nice supplement to photos of your children could be a picture of you at the same age. It will give him some much-needed context. Also, avoid showing pictures on your cell phone. If your father has impaired vision the often accompanies aging, photos that are at least 5 x 7 in size, are best.

Bring CDs or use a music app on your phone/tablet/computer:
Make sure the CDs or artists selected contain the music your father loves. Songs sung by Sinatra, Sammy Davis, and Perry Como might not be what you want to hear, but if that is the music your father has loved throughout his life, it’s likely that he will be transported back to a better time when he hears it.

Bring questions: You and your children can spend time asking questions of your dad, even if you know the answers. Ask him what he did for a living, where he worked, about his favorite job, and about his favorite part of that job. Ask about his motorcycles, pets, or baseball card collection (or whatever his was into). This will help jog his memory and lift his spirits.

Bring your laptop or tablet: Visit websites like the Internet Archive. This and other websites offer full episodes of old radio and TV shows, TV newscasts, and commercials from the 50s and 60s. Your father will likely enjoy it and chances are, you will enjoy the nostalgia too.

Bring a well-behaved pet: Contact a local shelter to see if they have a pet therapy program that can be scheduled to come to your father’s home, or bring in your own pooch or kitty, as long as he or she is well-behaved and vaccinated. We all need unconditional love, and pets are more than willing to give it and receive it.

As your father reaches the middle and later stages of his Alzheimer’s, let your children know that things like looking at old pictures or watching movies together may become somewhat passive. With a little thought, however, you can still find active ways to spend time together, such as giving the person ‘props’ the two of you play with together.

More Insight Into Things to do with Dad

Teepa Snow, in partnership with Senior Helpers, an in-home care company, developed ’Senior Gems’, a system that classifies Alzheimer’s patients into 6 categories, each named after a gem. The ’Gems’ table shows the basic characteristics of people at each level (or each stage of Alzheimer’s) and provides tips for interacting with them. Senior Gems is also used to train and prepare caregivers to engage in activities that seniors at each stage can do. The gem categories, from Sapphires to Pearls, enable trained caregivers to assess, prepare, and engage with seniors who exhibit the symptoms of Alzheimer’s.

For example, according to the ‘Gems’ table, Diamonds (who are in the early stages of Alzheimer’s): “like to feel competent and valued, and it is important for them to feel comfortable and in control. They typically prefer familiarity, and may have difficulty with change. They may repeat themselves by telling the same stories and asking the same questions. Activities you can do with them can include having lunch or dinner at a familiar place or at home, and chatting on the porch to get fresh air.”

Helping Your Children Understand Alzheimer’s

The topic of children and Alzheimer’s gained national attention when HBO, in conjunction with the National Institute on Aging, made a poignant documentary called “Grandpa, Do You Know Who I Am?” Narrated by Maria Shriver after her father was diagnosed with Alzheimer’s, it tells the stories of five children, ages six to 15, coping with grandfathers or grandmothers suffering from Alzheimer’s. Ultimately, the film shows how important it is to “go with the flow,” offering up a variety of perspectives on how kids can handle a grandparent’s loss of memory through kindness, patience and compassion.

Medicaid Planning for Alzheimer’s and Other Types of Dementia

When it comes to planning for long-term care needs, generally the earlier someone with dementia plans, the better. But it is never too late to begin the process of Long-term Care Planning, also called Lifecare Planning and Medicaid Asset Protection Planning. Medicaid planning can be initiated by an adult child acting as agent under a properly-drafted Power of Attorney, even if you are already in a nursing home or receiving other long-term care.

Medicaid Asset Protection

People with Alzheimer’s live on average four to eight years after they’re diagnosed, but some may live 20 years beyond their initial diagnosis, and they face special legal and financial needs. Here at The Farr Law Firm, we are dedicated to easing the financial and emotional burden on those suffering from Alzheimer’s and their loved ones.  We 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 such as Medicaid and Veterans Aid and Attendance. Please call us as soon as possible to make an appointment for a no-cost consultation:

Fairfax Alzheimer’s Planning: 703-691-1888
Fredericksburg Alzheimer’s Planning: 540-479-1435
Rockville Alzheimer’s Planning: 301-519-8041
DC Alzheimer’s Planning: 202-587-2797

Critter Corner: What Does CELA and CAP mean after Mr. Farr’s Name?

Dear Commander Bun Bun,

I noticed that Mr. Farr has the letters “CELA” and “CAP” after his name. What do they mean?

Thanks,

Aubrey Veations

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Dear Aubrey,

Good question. I used to ponder the same thing myself. I found the answers online on the National Association of Elder Law Attorneys (NAELA) and the National Elder Law Foundation (NELF) websites.

This is what I found:

CELA

CELA means that Mr. Farr is a Certified Elder Law Attorney.  The National Elder Law Foundation describes the CELA certification as “the gold standard” for elder law and special needs practitioners. It is the only Elder Law Certification that is approved by the American Bar Association. Currently, Mr. Farr is one of only around 500 CELAs in the country that meet the stringent criteria, and who are therefore qualified enough to hold this valued designation.

What does an attorney need before he or she can be qualified as a CELA?

·     Have practiced law for at least 5 years, and have focused at least 50% of their practice in the special needs/elder law field for at least the last three of those years.

·     Demonstrated substantial involvement in special needs and elder law practice, by demonstrating a minimum number of individual cases, spread across a number of different categories making up the “elder law” definition.

·     Studied for, took, and passed a rigorous, day-long written examination. Some pass rates on these exams are lower than 20% — and that is of applicants who have already met the experience requirements.

·     Underwent a review by peers and colleagues, focused on the applicant’s reputation for ethical and competent representation in elder law and special needs planning matters.

CAP

CAP means the Mr. Farr is a member of NAELA’s Council of Advanced Practitioners, which is an invitation-only council that was founded by NAELA for Advanced Practitioners. Members of the Council are:

·     recognized as innovators of the profession;

·     instrumental in leading the future of Elder Law;

·     a major source of speakers, writers, and leaders of NAELA programs; and

·     NAELA’s role models, providing a “vision” for NAELA and mentoring for NAELA members.

Membership in CAP is available to preeminent Elder Law Attorneys. Eligible Candidates must be: a NAELA member for a minimum of 10 years, AV rated by Martindale Hubbell, and either a NAELA Fellow or a Certified Elder Law Attorney (CELA). You can read more about CAP on the NAELA website.

Not everyone is qualified to give Elder Law and Medicaid advice. Mr. Farr is currently one of only 8 attorneys in the Northern Virginia / DC Metro area that holds both the CELA and CAP credentials.  Before moving forward with an attorney, ask about his or her credentials and training, or look them up online at the links given above. Keep in mind that a CELA (and CAP) certification is confirmation that your lawyer is “more than just qualified” and that you are getting “the best legal representation available.” (source: The National Elder Law Foundation).

Hop this is helpful,

Commander Bun Bun

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