Find Out Why Only 1.5% Of Social Security Recipients Use This Program!

Q. My mother, Louise, was diagnosed with dementia when she was 60 years old. Her dementia has progressively gotten worse since then, and I am helping a lot these days with some caregiving tasks, and money matters.

My mother is currently living off of Social Security only. Since I am in charge of her finances at this time, is there a way to ensure that her Social Security benefits are managed properly (since she can no longer manage them herself)? Is it enough to have a Financial Power of Attorney and opt for direct deposit of her benefits? I heard about the Social Security Representative Payee Program. Is it a good idea to participate? Thanks for your help!

A. Today, millions of seniors are living almost exclusively on Social Security. Among beneficiaries 65 and older, 1 out of 5 married couples — and 2 out of 5 singles — receive at least 90% of their income from the program, according to the Social Security Administration. But what if (as in your situation), a parent or another loved one has dementia. How can you ensure that her Social Security benefits are managed properly? Turns out, the Social Security Administration has a program to help, but be aware, the program may actually be more bursensome than helpful.

The Social Security Representative Payee Program — A Last Choice

A representative payee is a person or an organization that is appointed to receive the Social Security or SSI benefits for anyone who can’t manage or direct the management of his or her benefits. Sounds like a good thing. Here’s why it often isn’t the best option

• The Social Security Administration is struggling to effectively administer the Representative Payee program. The agency’s frontline staff is undertrained and underfunded to make the kind of difficult judgments the program calls for. The agency needs more resources to develop better protocols and improve its ability to evaluate potential applicants.
• For about a decade, government oversight agencies have released a stream of reports documenting how the payee system is ripe for abuse and mismanagement.
• Due to program management issues, if a payee is committing fraud, it might not be discovered until 6 months later, or it may never be discovered!
• Sometimes, payees in the program make large expenditures with no supporting documentation. This can be a big problem for the payee if he or she is not keeping receipts for large expenditures.
• One of the biggest complaints about the program is its paperwork requirements. Social Security requires that representative payees file annual reports detailing every single penny spent with the beneficiary’s funds during the previous year.
• Payees often complain that they do not get the support from Social Security that they need.

A Power of Attorney is Usually a Better Choice

Currently only 500,000 Social Security beneficiaries have representative payees. This may seem like a large number, but the figure amounts to only 1.5% of retirees. The Representative Payee program is widely used for those with disability who collect SSI, and for these SSI recipients, often the Representative Payee program is their only option.

The program isn’t widely used by retirees because most people do not know about it and, in reality, most people actually do not need a representative payee, because a Power of Attorney is a much easier and much better choice.

A properly-drafted Financial Power of Attorney is the most important legal document that a person can have, and is an essential part of every Incapacity Plan and Estate Plan. It authorizes an agent, sometimes called “Attorney-in-Fact,” to act on your behalf and sign your name to financial and/or legal documents.

A Power of Attorney is more than sufficient to manage the finances of a loved one with dementia, including her Social Security payment, because the check is typically direct deposited into the recipient’s bank account. As an agent, you can automate your loved one’s finances as much as possible, so most income and expenses are handled seamlessly. Then, you can check that person’s bank, credit card, brokerage and mutual fund statements to be sure everything is on track.

Helping Your Loved One with Dementia

Every adult over the age of 18 should have an Incapacity Plan that includes a Financial Power of Attorney, an Advance Medical Directive (including a Long-term Care Directive), and an Advance Care Plan.   If you don’t have an Incapacity Plan in place, or if your mother has not planned for long-term care, now is the time to get started.  Call us to set up 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

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Critter Corner: When Will I Receive My Replacement Medicare Card Without my Social Security Number?

Dear Bebe,

I heard Medicare will be replacing our current cards with cards that don’t have our Social Security number on them. Do you know the timeframe for getting a replacement card?

Thanks,
Ann Nucard

Dear Ann,

You are correct. Medicare beneficiaries will be getting new ID cards soon that won’t carry their Social Security numbers. The Center for Medicare and Medicaid Services (CMS) said people will start getting new cards next April.

“Personal identity theft affects a large and growing number of seniors,” CMS said in a statement. “People age 65 or older are increasingly the victims of this type of crime. Incidents among seniors increased to 2.6 million from 2.1 million between 2012 and 2014, according to the most current statistics from the Department of Justice.”

The new cards will feature a Medicare Beneficiary Identifier (MBI), which is confidential like the SSN and should be protected as personally identifiable information.

Hope this is helpful,

Bebe

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It’s Alzheimer’s, Not the Plague!

Lindsay was at a family gathering with her mother, who she was visiting in Virginia Beach. Her favorite uncle, Fred, who she recently found out was diagnosed with Alzheimer’s, was there helping out in the kitchen. When she saw him for the first time since his diagnosis, she got a pit in her stomach. She didn’t know how to approach him, if he would remember her, or if he would act differently towards her. She retreated to the other room as long as she could and avoided him for the duration of the event.

On the ride home, Lindsay’s mother mentioned that her uncle asked about her. He wondered why she didn’t even say hello, when they used to be so close. Lindsay confided in her mother that she was apprehensive, because she didn’t know what to expect when she talked to him. What if he didn’t remember her? What if he was not himself?

Stan Goldberg, Ph.D., spent nearly a decade observing people with Alzheimer’s and their families. He said that in many instances, those in the early stages of the disease would tell him that their friends and loved ones would treat them as if they had a contagious disease. Sometimes, they would even stop calling or coming around.

Here are some examples of the reactions someone in the early stages of Alzheimer’s may experience, according to the Alzheimer’s Association:

Testing friendships: Friends may refuse to believe your diagnosis or withdraw from your life, leaving a feeling of abandonment or isolation.
Relationships with family may change. Family members may not want to talk about the disease, perceive you as having little or no quality of life, or may avoid interacting with you.
People think you are incapable of making decisions for yourself: Others may approach your care partner to ask about you rather than asking you directly how you are doing.
You may get turned off to other people’s help: The reaction of some friends and family to your diagnosis may prevent you from seeking help from others.

In many instances, the misconception among friends and family members who treat their loved ones in this way, is that the person with Alzheimer’s:

• stepped back into their childhood;
• possessed the mind of a developmentally delayed child; or
• became psychotic.

None of these things are typically true, yet as a society, we often treat those with dementia as if they are.

Fighting Alzheimer’s Stigma

Imagine how your life would be transformed if significant parts of your identify disappeared–sometimes quickly, and at other times slowly.

Life is full of choices. We can stay away from those with Alzheimer’s, either out of ignorance or fear of what we might eventually become, or we can choose to put ourselves in the place of someone with the disease.

Even if you choose to stay away, eventually, you will no longer truly be able to run or hide from Alzheimer’s or other forms of dementia. With the disease being so prevalent, if you don’t know someone with Alzheimer’s or another form of dementia, you likely will.

Don’t be afraid. Be aware! These are some things to consider the next time you interact with a person who has or you suspect has dementia:

Be Patient. It may take longer to process information.
Remember, memories are not willingly lost. There will be things someone with dementia won’t remember, both recent and distant. Not remembering has nothing to do with not trying.
Accept change. Dementia is progressive. The person’s abilities today may be different tomorrow.
Offer help to the person. There are few things more frightening then being disorientated, such as being a few blocks away from your house and not knowing how to get home. When you see someone who is obviously confused, don’t be afraid to offer help.
Offer help to the caregiver. Unless someone has been a long-term caregiver, they have no idea of the effort it takes. Offer to help. Anything will be appreciated. Knowing that people care is a blessing to the person receiving the offer.
These are some things you can do to dispel misconceptions about Alzheimer’s:
Engage others in discussions about Alzheimer’s disease and the need for prevention, better treatment and an eventual cure. Engage with others online using Alzheimer’s message boards and discussion forums, or in person but attending local support groups.
Communicate the facts. Share accurate information to clear up any misconceptions about the disease. Whether a pamphlet or link to online content, offer information to help people better understand Alzheimer’s disease. Learn the facts about Alzheimer’s and find an education program near you.
Don’t be discouraged by other’s denial or fear of the disease. Use this as an education opportunity.
• Learn how you can take action in the fight against Alzheimer’s.
• Enjoy their presence while you still can and offer them the support and compassion you would want if it was you who were in the same situation.

Do You Have a Loved One with Alzheimer’s or Another Form of Dementia?

Putting legal, financial and end-of-life plans in place is one of the most important steps you can take, especially while your loved one still has the capacity to make decisions for him or herself.

Here at the Farr Law Firm, we are dedicated to easing the 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 whenever you are ready 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

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Underestimating the Cost of Long-Term Care 

Q. My husband has Alzheimer’s, and needs more care than I can provide. It’s getting harder and harder to take care of him at home, but I’m not sure we can afford long-term care. I recently read something saying that nursing homes now average more than $100,000 a year across the U.S. If nursing homes cost THAT MUCH, then almost nobody can afford them without going completely broke.

I estimated years ago, when my husband was first diagnosed, that it would only cost about half that amount. If what I read is true, then in less than 2 years, that would deplete all the money we worked so hard for all these years, and saved for retirement. Please tell me that long-term care isn’t THAT expensive!

A. Unfortunately, what you read is correct. A new report by Lincoln Financial Group shows that for the first time, the cost of nursing home care throughout the country now averages over $100,000 per year, jumping 3.3% from last year. This is for a private room. Semi-private rooms average $90,000 a year! And, like many things, it is even more expensive here in the National Capital Region, where the cost of a nursing home averages between $120,000 to $150,000 a year!

Underestimating the Cost of Long-Term Care

According to a survey conducted by MoneyRates.com, nearly 57% of Americans believe a year in a nursing home would cost less than $75,000. Therefore, most people are in danger of saving less than is necessary to meet the need.

Nursing-home costs vary greatly from region to region, so not only is the average person underestimating the cost of a nursing-home stay, but in some areas they may be off by tens of thousands of dollars. For example, while the national average for a semi-private room is around $90,000 a year, in the New York City area the cost averages $141,620 (similar to costs here in the DMV)

These are some of the findings from the MoneyRates survey:

  • Survey responses about the estimated cost of assisted living were almost identical to those about the cost of a nursing home. This is inaccurate, because the average cost of assisted living in the DMV is $80,000/yr (compared to $120,000 – $144,000 a year for nursing home care) and quite a bit less in other parts of the country!
  • Two-thirds of Americans do not have enough set aside for one year in a nursing home.
  • 40% of survey respondents have set aside nothing for elder care, and a total of 67% have less than $75,000 set aside.
  • Long-term care insurance may or may not be the answer. 12% of respondents are counting on long-term care insurance to take care of their elder care expenses. Insurance can be a good way of meeting the rising costs of this kind of care, but be sure you check the details, such as how much your policy will provide annually, and what types of care are eligible.
  • Men and women are about equally naive about nursing-home costs. 56% percent of women and 58% of men incorrectly believe that a year in a nursing home costs less than $75,000.
  • Men are more likely to have money set aside for elder care. While men are slightly more likely than women to underestimate the cost of elder care, at least they are more likely to have saved for it.
  • 50% of women surveyed have set aside nothing for this eventuality, compared to 31% of men.
  • Most people age 55 and older recognize that a year of nursing care costs more than $75,000. Unfortunately, in each of three younger age groups surveyed, most believe the cost is less than $75,000.

Knowing what costs to expect and how you will pay for them can prevent financial stress from adding to these difficult emotions.

The significant costs of long-term care can impact retirement plans, savings, and assets, and the level of care one receives. That’s why it’s so important that people speak with a financial advisor and an experienced elder law attorney about their long-term care preferences and put a plan in place. We provide both of these services right here at the Farr Law Firm.

Medicaid Planning for Long-Term Care

Medicaid planning can be started while you are still able to make legal and financial decisions, or 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. In general, the earlier someone plans for long-term care needs, the better.  But it is never too late to begin your planning.

To begin long-term care planning (and incapacity and estate planning) right away, please call us now to make an appointment for a no-cost initial 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

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Critter Corner: Is Nursing Home Compare a Reliable Tool?

Dear Magic,

My father’s Alzheimer’s is getting worse and he will likely need skilled nursing home care in the near future. I found Nursing Home Compare in a Google search. Can I rely on this resource to help me find the right nursing home for my dad?

Thanks

Bess Tome-Fordad

—-

Dear Bess,

Nursing Home Compare (an online tool that is provided and regularly updated by the federal government’s Center for Medicare and Medicaid Services) is an extremely helpful resource; however, there has been some criticism about the tool. Recently, Harvard researchers Brian E. McGarry, Ph.D., and David Grabowski, Ph.D, argued that Nursing Home Compare is lacking in information regarding short vs. long nursing home stays, facility features or amenities, care coordination, and the culture and care philosophies of the facilities.

McGarry and Grabowski also recommend adding new information to the comparison website, such as building age, availability of private rooms, photos of the facility, and reviews from residents or their family members to offer data more in line with consumers’ concerns.

The last recommendation they would make is advertising the tool better, since many seniors and their loved ones don’t know it exists. CMS may have to consider making it mandatory for Medicare patients to be informed of the tools during their discharge planning process, and that they have web-enabled technology to access the sites from their hospital rooms.

Despite the ratings and whether or not Nursing Home Compare provides sufficient information, nothing can substitute for visiting a nursing home in person. Every nursing home will have some positives and negatives. In Evan Farr’s book, The Nursing Home Survival Guide (available at Amazon.com), he provides a Nursing Home Evaluation Tool to help consumers
compare nursing homes during personal visits.

Hop this is helpful!

Magic

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How to Avoid 3 Scams Following the Massive Equifax Data Breach

Wayne was planning on taking out a home equity loan last year to make his home more accessible for his mother, who was moving in with his family. One of the first things he did was order a credit report from Equifax, Experian, and Trans Union to check his credit. Little did he know that he would be among the 143 million American consumers whose sensitive personal information was exposed in a data breach at Equifax, one of the nation’s three major credit reporting agencies.

According to Equifax, the breach lasted from mid-May through July 2017. The hackers accessed people’s names, Social Security numbers, birth dates, addresses and, in some instances, driver’s license numbers. They also stole credit card numbers for about 209,000 people and dispute documents with personal identifying information for about 182,000 people.

Was Your Information Exposed?

There are steps to take to help see if your information was exposed, as follows:

• Visit Equifax’s website, www.equifaxsecurity2017.com.
• To find out if your information was exposed, click on the “Potential Impact” tab and enter your last name and the last six digits of your Social Security number. Your Social Security number is sensitive information, so make sure you’re on a secure computer and an encrypted network connection any time you enter it. The site will tell you if you’ve been affected by this breach.
• Whether or not your information was exposed, U.S. consumers can get a year of free credit monitoring and other services. The site will give you a date when you can come back to enroll. Write down the date and come back to the site and click “Enroll” on that date. You have until November 21, 2017 to enroll.

Avoid These Three Equifax Data-Breach Related Scams

There are three scams that experts believe will become prevalent in the aftermath of the Equifax data breach.

Imposter scams (even after you’ve initiated a credit freeze)

The Federal Trade Commission warned that it expected a new wave of imposter scams, with con artists posing as representatives of Equifax “calling to verify your account information.” Given that Equifax is providing free credit monitoring and credit freezes in wake of its data breach, the call may sound legitimate, the agency warned. But don’t ever provide any private information over the phone.

Tax identity theft that could rob you of your IRS refund

The IRS has been fighting tax identity theft for years. These scams involve criminals getting victims’ names, addresses, and Social Security numbers to file fraudulent tax refund claims. The agency cites data breaches as one of the main ways that con artists get the relevant information to pull off tax identity theft.

Victims often first figure out that there’s a problem when they file their annual tax returns and the IRS notifies them that another return has already been filed and their refund has been claimed. While the agency has a task force dedicated to these cons, they are complex and difficult to solve, often taking more than four months to investigate, according to the agency.
If your information was compromised in the data breach, make a point of filing your annual tax return promptly. And take immediate action if you are informed that more than one return was filed in your name; that you owe additional tax; or that IRS records indicate that you earned more than the amount of wage you reported.

If you believe you were a victim of a tax scam, be sure to file a police report and a fraud report with the FTC Identity Theft Hotline (877-438-4338). Also complete IRS form 14039, the Identity Theft Affidavit. You may be forced to file your tax returns on paper in the meantime. If you do not get a prompt response from the IRS, call the Identity Protection Specialized Unit at 800-908-4490 for assistance.

Spear-phishing to crack your bank and brokerage accounts

The data made available through the Equifax breach is also likely to spur what are known as “spear-phishing” scams that could put more than your credit at risk. Phishing scams are often unsophisticated email and phone cons aimed at getting you to reveal private data, such as your Social Security number.

Spear-phishing cons use your real data — the type of data compromised in the Equifax breach — to mimic legitimate communication from your bank or broker. The email may urge you to click on a link or open a PDF file to check your account or verify a transaction. However, if you click on the link, you could be downloading malicious software on your computer that would allow the crook to hijack your system or record your keystrokes.

How to Protect Yourself

 Check your credit reports from Equifax, Experian, and TransUnion — for free — by visiting annualcreditreport.com, a free website jointly operated by  Equifax, Experian, and TransUnion. The site was created in order to comply with their obligations under the Fair and Accurate Credit Transactions Act (FACTA) to provide a mechanism for American consumers to receive up to three free credit reports per year.
Accounts or activity that you don’t recognize could indicate identity theft. Visit IdentityTheft.gov to find out what to do.
• Place a credit freeze on your files: A credit freeze makes it harder for someone to open a new account in your name. Keep in mind that a credit freeze won’t prevent a thief from making charges to your existing accounts. It will only cost about $20 to freeze your account with all three credit agencies (Equifax is free, and the other two are typically $10 each), and you can easily do a temporary unfreeze ny phone if you need to when applying for new credit.

A few minutes on the phone with an automated system, plus $20, is much better than the nightmare that will ensue if your identity is stolen. Here are the phone numbers to initiate a credit freeze

TransUnion: 1-888-909-8872
Equifax: 1-800-349-9960
Experian: 1 888 397 3742

You must call all three!

• Monitor your existing credit card and bank accounts closely for charges you don’t recognize.
• Place a fraud alert on your files: If you decide against a credit freeze, at least consider placing a fraud alert on your files. A fraud alert warns creditors that you may be an identity theft victim and that they should verify that anyone seeking credit in your name really is you.
 File your taxes early — as soon as you have the tax information you need, before a scammer can. Tax identity theft happens when someone uses your Social Security number to get a tax refund or a job. Respond right away to letters from the IRS.

The best advice after the Equifax breach is if you get an email from your bank, broker, or credit card issuer and believe it’s legitimate, visit the company’s website or call their toll-free number. Do not click on the link.

Visit Identitytheft.gov/databreach to learn more about protecting yourself after a data breach.

Planning to Protect Loved Ones

Protecting seniors from scams is very important, which is why we continually share information about current scams and how you can protect yourself. It is also very important to plan for your future and for your loved ones. If you have not done Incapacity Planning, Estate Planning, or Long-Term Care Planning, or if you have a loved one who is nearing the need for long-term care or already receiving long- term care, please contact us to make an appointment for a no-cost introductory 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

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When a Loved One with Dementia is Violent


Q. My uncle Ed recently died in New York, and I got a ride to the funeral with my aunt and my other uncle from South Carolina, who were passing through our area. I hadn’t seen or spoken to them in a while. I knew from my mother that my uncle has had dementia for three years now, but I didn’t know the severity. We seemed to have a nice conversation on the way up. Then, the truth came out at a rest stop when my aunt confided in me about my uncle.

The man my aunt married was a sweet, kind and gentle person, who loved animals, cooking, and his family. Aside from the forgetfulness he is experiencing, the man he is now, according to her, is like Jekyll and Hyde. At times, he screams at her a lot, and throws things and has “violent” moments. At other times, he is the sweet and kind person she always knew him to be. She has no warning which personality will come out. She mentioned his diagnosis of fronto-temporal dementia.

I am concerned for my aunt. Is this a normal thing that happens when people have dementia? What can people do in her situation and how can she deal with him?

A.  Fronto-temporal dementia (FTD) is a form of dementia that can cause uncharacteristic behavioral problems in the patient. It is called FTD because the frontal lobe of the brain (located behind the forehead) is the center of judgment and self-control, among other things. It progresses more rapidly than most other forms of dementia, so behavioral problems can arise rapidly.

Often, before a diagnosis, you will see subtle personality changes and extreme behavior, such as getting very angry about something that wouldn’t normally cause such a reaction.  Often still strong and physically healthy, an otherwise gentle person can become physically violent.

Unlike most other forms of dementia, memory is not always affected in people with FTD, until later in the disease. However, FTD affects a person’s ability to communicate through words or writing, and can cause a decline in understanding the written or spoken word. Affected persons know what they want to communicate and can see the misunderstanding in others, which can cause frequent frustration and loneliness.

FTD typically strikes people at a relatively young age — usually between the ages of 40 and 60. However, FTD can affect individuals both younger and older than this range. For people under age 65, FTD is the 2nd most common dementia after early-onset Alzheimer’s disease. In fact, 250,000 Americans are estimated to be affected by it. For individuals over 65, FTD is the 4th most common form of dementia after Alzheimer’s disease, vascular dementia, and Lewy body dementia. FTD inevitably gets worse over time, but the speed of decline differs for every person.

The Challenge of FTD for Caregivers

Families, friends, and significant others will face many challenges as the person you know and love changes. Family relationships, loss of work, declining health, financial decisions, and long-term care are only some of the issues to be dealt with.

  • A caregiver may suffer the gradual loss of his or her loved one.
  • Basic skills such as organizing, planning, and following directions will become almost impossible for the person with FTD. Thus, such tasks will need to be added to the tasks of the caregiver.
  • With behavior changes, family members will need to deal with embarrassing and often alienating moments with friends and within the community.
  • Personal lifestyle changes will be ongoing. The stress of providing care for someone with FTD can be incredibly difficult both physically and emotionally.

Caring For a Loved One with FTD

Similar to all caregivers, care providers must first stay healthy themselves in order to create a compassionate and therapeutic environment for loved ones with FTD. In addition:

  • It is critical to build a support network that expands beyond professionals to include family, friends, and other community relationships and resources.  It is essential to have regular help from family or friends for a few hours, a day, or overnight. This will reduce stress levels and renew your patience and positive energy.
  • It is a good idea to join a support group online or in your community. Being with others who have similar experiences helps with strategies and provides strength for every step of the journey. These interactions can be an important way to deal with a disease that other people often don’t understand.
  • Try and spend time (or journal) remembering who the person with FTD was and still is. The person you love remains. Be angry at the disease, not the person.
  • Consult with and receive services from professionals who can help. For example, a speech language pathologist may be able to teach adaptations to enhance your loved one’s communication abilities. An occupational therapist may teach you or your loved one how to redirect behaviors and how to modify daily activities for the person to maintain his highest level of independent function possible. Help is also available from the Association for Frontotemporal Degeneration (AFTD), a nonprofit organization that provides information, education, and support to those affected by FTD and their caregivers.
  • It’s important to encourage and facilitate the person with FTD to participate in every task he or she used to perform. Engagement in even small portions of a familiar activity/task will help maintain skill, provide dignity and happiness, and help slow the progression of the disease.
  • Limit instructions to one-step directions. For example, say, “Please put the forks on the table,” not “Please set the table.”
  • Keep up with doctor’s visits: There are some medications and treatments that may help manage some of the symptoms, so it’s important to seek and continue receiving help from a doctor, such as a neurologist or a psychiatrist, as soon as possible.
  • Be honest with yourself: When caring for a person with FTD becomes too much to bear, even with the help of professionals, skilled nursing care may be necessary.

FTD can affect decision-making abilities early on, so it is important to begin making financial and legal decisions soon after the disease starts. Critical documents for the person with FTD to sign include a general power of attorney naming a spouse or adult child or other trusted person to handle legal and financial affairs and an advance medical directive (including a long-term care directive) naming a trusted person to make medical decisions. In addition to setting up these incapacity planning legal documents for health care decisions, financial management, and long-term care needs, caregivers should also consider having a driving evaluation for their loved ones, before driving becomes a problem.

Although voluntary incapacity planning is, in general, preferred over guardianship and conservatorship because of the legal complexities of “living probate,” in some cases of FTD, where there are significant behavioral changes, guardianship and conservatorship may be needed in order to strip away the rights of persons suffering from FTD, so that the they cannot make the short-sighted financial and legal decisions that they might otherwise make.

Persons with FTD and their families face special legal and financial needs. Controlling the high costs of caring for a loved one with dementia, and navigating the emotionally and physically demanding requirements of caregiving, require the assistance of a highly skilled and specialized expert in the field of dementia planning.

Here at The Farr Law Firm, 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. If you have a loved one who you believe is suffering from FTD or any other type of dementia, please call us as soon as possible to make an appointment for a no-cost consultation:

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

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Critter Corner: The High Stakes of Caregiver Stress

Dear Ribbit,

My father has dementia, and right now, my mother is his primary caregiver. I could tell that she is extremely stressed in her role. I know that can’t be good for my father. Have there been any studies about how caregiver stress affects loved ones with dementia? Thanks for your help!

Phil N. Strest

—-

Dear Phil,

Yes. In fact, a recent UC Berkeley study found that patients with dementia may actually die sooner if their family caregivers are mentally stressed.

From 2007 until 2016, UC Berkeley researchers tracked the mortality of 176 patients with neurodegenerative diseases, such as dementia. They also measured the mental health of the family members who took care of them.

Their findings, published in the Proceedings of the National Academy of Sciences journal, indicate that patients tended by caregivers with depression, anxiety, and other symptoms of mental illness typically died sooner than those being looked after by caregivers in good mental health. For example, compared to patients who were cared for by relatives in fairly good mental health, patients tended by family members in poor mental health died, on average, about 14 months sooner.

The study notes that poor mental health in caregivers can affect patients’ lives in a variety of ways. It can reduce the quality of patient care by raising the risk of neglect or abuse, weaken the patients’ immune systems by compromising social bonds between the caregiver and patient, or transmit negative emotions directly to patients through a phenomenon known as emotion contagion, in which one person in a relationship absorbs the emotional responses of the other.

The study is thought to be the first to link the mental health of caregivers to the mortality of patients who suffer from a diverse range of neurodegenerative diseases, researchers said.

So, please make sure your mother does everything she can to lessen the stress in her life, including taking time for herself (respite time), exercising, and getting support from friends, family, and medical professionals.

Hope this helps!

Ribbit

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When a Loved One is Alone and in Danger

Last weekend, Randy was walking his dog, when he ran into his friend, Jenny. Jenny seemed really nervous and upset. She explained how her father with dementia was living in a nursing home in Florida, and how he was located in an area where Hurricane Irma was projected to be a category 4. Jenny spoke to her father’s nurses and was told he was being stubborn, and refused to leave the home, when they were evacuating. Then, they lost phone service, and Jenny was left to worry about the fate of her father. Luckily, he eventually succumbed and evacuated and everything was okay.

Randy’s aunt lives in Florida also. She has some physical ailments, but still has her wits about her, so she lives alone in a senior community. Her only living relative is Randy, who is here in Northern Virginia. She never had any children of her own, and her husband passed away ten years ago, so she has become what is called an “elder orphan.”

What happens when a catastrophic storm hits where a loved one lives, and he or she is in a nursing home with dementia or at home alone with no family close-by?

When Seniors Refused to Leave

Under state and federal law, nursing homes and assisted-living communities must maintain emergency plans, including backup generators, food and water. Yet, some seniors, such as Jenny’s father, were reluctant to go anywhere.

So, how did nursing homes and assisted living centers in Florida get seniors who were being stubborn to leave? For one nursing home, learning that they needed to evacuate from Hurricane Irma could have been traumatic for the 40 residents with Alzheimer’s disease and dementia, so they told residents a comforting tale: The charter buses that arrived to go north were taking them “on vacation.”

At an assisted-living community north of Fort Lauderdale, staff and residents had been tuned to the weather channel when, on Friday morning, the staff lined up all 200 residents outside on the driveway. Nurses strapped color-coded ID-wristbands onto each resident and used white packaging tape to label walkers and wheelchairs.

For Elder Orphans Living Alone at Home

Many single seniors without children are happy, independent, and living quite well. But too often, it takes only a trip to the hospital or an unexpected emergency, such as a natural disaster, to throw their lives into a tailspin. There are a lot of elder orphans like this who are hidden in plain sight but people don’t know it.

Too often, older adults who are alone may feel shut out, forgotten and like they don’t matter, and have nowhere to turn should a disaster arise.

What Elder Orphans Can Do

Hurricane Harvey and Irma have passed, but there could always be another natural disaster on the horizon, or an unexpected medical emergency, and the best way to deal with it and with anything life throws your way is to be prepared.

Most of the issues associated with living alone can be overcome with increased watchfulness, safety precautions, and a plan for what to do when an emergency arises. Below are some ways for elder orphans, and those who are long-distance caregivers, to prepare themselves and their loved ones:

• Plan ahead, and think about who you (or the person you care for from a distance) considers “family” – even if it’s not by blood.
• Make an emergency preparedness kit. See FEMA’s website for details on what to include.
• Talk to friends about preparing for emergencies, getting help in the event of an evacuation and dealing with the aftermath of a disaster.
• Create a network of neighbors, relatives, friends and co-workers who can help in an emergency. Discuss needs and make sure everyone knows how to operate necessary medical equipment.
• Arrange for electronic payments of federal benefits or other retirement income. A disaster can disrupt mail service for days or even weeks.

Estate Planning for Seniors Who Live Alone

What would happen if you were to suddenly become incapacitated, and you were an elder orphan? Who would make medical decisions for you? If you haven’t worked with an experienced Elder Law Attorney, the answer to this question becomes quite complicated. Maybe it would be your next closest family member. Most likely, it would not be your best friend or whomever you would choose. Even if your closest friend would be your first choice, your friend would have no legal power unless you have your wishes legally documented in a properly-executed Advance Medical Directive.

And what about your finances? If you are unable to pay your bills and take care of your other legal and financial affairs, who do you think will do so? The answer to that is: whomever the courts say. And first off someone will have to go to court and have you declared legally incompetent.

Finally, what will become of your things if you should unexpectedly pass away? Who would have legal rights to your belongings, to your home, to your pets? You may think you know the answers, but without clearly outlining your wishes with an Elder Law or Estate Planning attorney, you have very little control over the matter. An experienced Elder Law or Estate Planning attorney such as myself can easily get you on the path to having these affairs in order.

Don’t put off asset protection planning for long-term care

Most people will need some kind of help with the activities of daily living, such as dressing, bathing, or moving around, in their lifetime. The need for such help can result from a natural decline of hearing, eyesight, strength, balance, and mobility that often comes with aging, or can stem from dementia, a stroke, or a chronic illness. If you live alone, or are married, it is never too early, or too late, to start planning to protect your assets from the devastating expenses of long- term care. Call us to make an appointment for a no-cost introductory consultation:

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

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Mastering the Non-Financial Aspects of Retirement

Q. My husband and I are close to retirement age. The life we’ve known so far has included working at our full-time jobs, occasional social events with friends, visits and holidays with family, and the every-day things associated with being a working person in the DC area.

This might sound silly, but when we are retired, how are we going to handle the new challenges in our lives? The life I have known for the past 40 years has been a lot different than what we are about to experience. How do we navigate the next set of life changes looming ahead of us — and what are some of the topics we should be exploring? In other words, is there a way to get yourself ready for the non-financial aspects of retirement? Thanks for your help!

—-

A. Five years ago, when he blew out 60 candles, longtime president and CEO of the National Council on Aging (NCOA) Jim Firman, wished there was something to help him navigate the life changes that were ahead of him.

According to Firman, “(t)here’s almost nothing to prepare us for this phase. I didn’t know how to age well. I figured by extension other baby boomers didn’t either,” he said.

In his role, he was positioned to do something about the knowledge gap. To help others like him (and like yourselves), he helped create the Aging Mastery® program, a ten-week NCOA course available to people age 50 and up.

NCOA’s Aging Mastery (AM) Program combines courses with expert speakers, group discussion, goal-setting, and small rewards to help older adults gain the skills and tools they need to manage their health, remain economically secure, and contribute actively in society. The curriculum takes on everything from sleep problems to healthy relationships and community engagement. It also does cover some financial fitness, but that’s not the main focus of the AM Program, as there are lots of financial retirement planners (including myself) who can help you through this part of retirement. Below are details about all the topics covered in the AM curriculum, and information you can access on these topics on our blog, whether or not you decide to do their program:

Other topics that Aging Mastery teaches seniors include best practices on medication management and community engagement ideas, including taking on meaningful volunteer opportunities.

The National Council on Aging surveyed graduates of the Aging Mastery program and found that 97% believe the course improved their quality of life. “We heard them say that it’s fun, and that’s a key to its success,” Firman added. “It’s fun because it’s meaningful.”

So far, AM has been hosted at more than 200 community sites across the country with 6,500 older adults participating. Learn more about the program and where it is offered here.

Planning for Aging, and for Your Future, Is Important

We are all getting older, and living longer than ever before. It is wise of you to prepare yourself and seek out tips and answers to questions you will likely face as you age.

Our firm is dedicated to helping protect aging and disabled adults (and disabled children) preserve dignity, quality of life, and financial security. As always, if you’ve not done Estate Planning or Long-Term Care Planning (or had your documents reviewed in the past 5 years – or last 3 years if you’re over 65), or if you have a loved one who is nearing the need for long-term care or already receiving long-term care, please call us to make an appointment for a no-cost consultation:

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

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