Halloween Can Be Scary for those with Dementia

Q. My mother-in-law has dementia and lives at home with a caregiver to assist her with activities of daily living. Before she was diagnosed, she loved Halloween, especially all the decorations, seeing the grandchildren dressed up in costumes, and the Reese’s Peanut Butter Cups. The children also loved trick-or-treating at her home, because she would go all out with the spooky decorations and scary sounds. This year, I am concerned about the stress that the doorbell ringing, the costumes, and the decorations may cause her. Do you have any suggestions so the evening doesn’t turn out to be overwhelming and stressful for her?

A. Seniors with dementia may face agitation and fear on Halloween, as a result of scary costumes, extra visitors, candy concerns, decorations, and spooky sounds.

In your mother-in-law’s situation, if you feel that the constant ringing of the doorbell is too much for her and hercaregiver to handle, then by all means suggest that they turn off the lights to discourage people from coming to your mother-in-law’s home. Or if she wants to participate in the festivities, she can place a bowl of candy at the front door with a note “Please take one” (even though trick-or-treaters have been known to take more than one. Just sayin’).

Below are some other suggestions that will hopefully make tonight less stressful for your mother-in-law:

  • Discuss plans for the evening with your mother-in-law, and describe what will be taking place. Don’t go into a lot of detail. Doing so will prepare her for what to expect, and may bring back some happy memories.
  • Show your mother-in-law pictures from past Halloweens to help spark her memory.
  • Songs like “The Monster Mash” can also bring back memories. View this great video of the seniors at Greenspring in Springfield, VA performing this Halloween classic!
  • Avoid using candles and instead use non flame candles or lights.
  • Put pumpkins up on tables to avoid tripping.
  • Limit decorations. They may cause confusion and agitation.
  • If there are decorations on the windows and your mother-in-law is picking at them, ask her caregiver to please remove or take them down.
  • Avoid floor mats that make sounds and scary decorations that are voice activated.
  • Avoid CD’s with creaking doors, ghost screaming, and other scary sounds.
  • Try non scary decorations like pumpkins and fall leaves vs. scary ghost, goblins, and witches.
  • Limit sugar intake such as candy because sugar increases the desire for more sugar. Instead offer fruit. Or even a caramel apple.
  • Keep the candy tucked away until the night of Halloween to limit consumption.
  • If your mother-in-law is not overwhelmed, encourage her caregiver to help her hand out the candy to the children. But supervision at all times is important to avoid elopement or other risky behaviors.
  • Create new memories by baking a pumpkin pie, decorating sugar cookies, or painting a pumpkin with grandchildren or other family members.

Halloween can be tweaked and personalized to communicate a meaningful updated ritual for your mother-in-law, her caregiver, and your family. Your family can make decorations together to maximize the occasion. In fact, doing art projects for those with dementia provides positive stimulation and creative self-expression. And while you are coloring and pasting, play music in the background, preferably from your mother-in-law’s time period, for added happiness.

Medicaid Planning for Dementia

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

Medicaid Asset Protection

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

Dear Commander Bun Bun,
My grandmother has gone through two bags of Halloween candy and there haven’t been any trick-or-treaters yet. At this rate, she will have to hang up a no more candy sign before school even lets out. This is not just the case on Halloween. She beelines for the candy aisle at the supermarket and will eat fruit only if it is chocolate covered. I want grandma to be around for a long time. Any tips on how I can get her to cut down on the sweets?
Candy Eden
Dear Candy,
I am glad to be a bunny, because by default, I am healthy. In fact, I think carrots and lettuce are divine (and chocolate covered anything is yucky)!
For your grandmother and others, it’s never too late to start eating healthy. No matter how old you are or how unhealthy you may have been in the past, caring for your body has enormous benefits that will help you stay active, sharpen your memory, manage health problems, boost your immune system, and increase your energy.
As you age, your relationship to food changes along with your body. A decreased metabolism, slower digestion, and changes in taste and smell may affect your appetite, the foods you are able to eat, and how your body processes food. Now, more than ever, healthy eating is essential to maintain your energy and health.
These are some tips for healthy eating:
• Eat lots of high-fiber whole grains, fruits, and vegetables. Consume fiber-rich foods such as fruit, vegetables, and whole grains. Take it from me — a distant cousin of the Energizer Bunny himself — they will help Grandma feel more energetic and give her the fuel to keep on going!
• Take Supplemental Digestive Enzymes. If all that fiber gives you a bit of gas now and then, your body may be deficient in the production of digestive enzymes. Digestive enzymes are necessary for digesting food, for stimulating the brain, for providing cellular energy, and for repairing body tissues, organs, and cells. Digestive enzymes ensure that we get the greatest possible nutritional value from foods. When foods are not well-digested, they remain in the stomach and can rot and putrefy. This can result in a buildup of waste in the colon which begins to decay, producing bacteria and toxins which eventually can seep through the bowel wall, where blood capillaries pick them up and distribute them throughout the body. This can result in all kinds of health problems, including constipation, stomach bloat, poor digestion, gas, fatigue, weight gain or weight loss, headaches, and more. Taking sufficientdigestive enzymes ensures that your foods are more completely digested, helping to eliminate potential problems due to toxins.
Source: http://www.betterway2health.com/enzymes-supplement-info.htm
• Watch out for dehydration. Because of physical changes, older adults are more prone to dehydration. Make sure your Grandma is drinking plenty of fluids, even if she doesn’t feel thirsty. If she’s not getting enough water, she won’t be as sharp and her energy will suffer. Keep in mind, water is best for people, but in my opinion, chilled carrot juice also tastes amazing.
• Host a social event (and maybe stage an impromptu mini-intervention). Invite Grandma and a group of her friends over for lunch or dinner or another social event and be sure to put out bowls of candy along with lots of healthy food choices. When Grandma over-indulges in the candy in front of all her friends, maybe her friends (with your encouragement) will gently nudge/guilt her in a healthier direction. Hopefully the peer pressure will steer her towards healthier eating, and you won’t have to be the “bad guy.”
Bottom line: you can’t control what anyone else eats, but you can certainly help educate and steer your grandma in the right direction. And while helping to educate your grandma about the downsides of all that sugar, you might want to also let her know that dark chocolate actually has some health benefits! If she’s going to eat candy, it might as well have some health value.
Hop this is helpful,
Commander Bun Bun


Caution: Our Top 10 SCARIEST Articles

With Halloween upon us, it is time to present you, our dear readers, with this year’s scariest creepiest stories.

From the nightmare of probate to court cases involving filial responsibility, we uncovered some scary ground. To celebrate Halloween, we’ve ranked our scariest articles for you to revisit (if you dare). As always, thank you for reading our newsletter and blog!

Note to our readers: if you’re someone who hates thinking about death or spending hundreds of thousands of dollars on long-term care, then you might want to stop reading. But if you’re curious, please read on. . .

10. Cool or Spooky? Funerals that Mimic Life: This recent article discusses the growing popularity of funerals that stage scenes from real life. For example, Miriam Burbank, who died at 53, spent her service sitting at a table amid miniature New Orleans Saints helmets, with a can of Busch beer at one hand and a menthol cigarette between her fingers for all who attended to see, just as she had spent a good number of her living days.

9.  Filial Responsibility: Elderly Couple May Be Responsible For Son’s Medical Bills: Filial responsibility laws have recently been increasingly getting enforced to recover medical expenses, including Medicaid payments. This article describes how Peg and Bob Mohn, who are in their 70s with a granddaughter who is about to go to college, were  expected to cover the cost of their deceased adult son’s medical expenses.

8. Will You Go Broke Paying for Long-Term Care?: According to NPR, there isn’t one state where long-term care is affordable for middle-class families. In fact, if paid out of pocket, home care services on average would consume 84% of the income of a typical older middle-income family. For nursing home care, it would consume a whopping 246%.  And these percentages are based on the national averages which are significantly lower than the rates in the DC Metro area.

7. The Five Biggest Estate Planning Mistakes: Failing to update your beneficiary forms after a divorce or death in the family can have disastrous consequences. For example, what if you left everything to your ex-spouse, while you were still married, and never made any updates.  She can then turn around and leave that money to her own children from another marriage. Read about this and some other super scary estate planning mistakes.

6. Are You Prepared For Incapacity? What would happen if you were in an accident, or had a stroke, or for another reason you suddenly became incapacitated or comatose, and were unable to make decisions for yourself? Less than a third of the population has completed Incapacity Planning documents, so for nearly 70% of Americans, family members will be forced through the nightmare of “lifetime probate.”

5. Visit Your Parents Often. . . or Else:  In China, the “Law of Protection of Rights and Interests of the Aged” was enacted last year. The law requires the offspring of parents older than 60 to visit their parents “frequently” and make sure their financial and spiritual needs are met. If adult children refuse to do so, they must pay their parents a monthly allowance. Could this happen in the U.S.?

4. Unusual Alternatives for Disposing of Your Body After Death: In our current economy and with environmental concerns at the forefront, many people are exploring non-traditional post-mortem options, such as eternal reefs or green burial, and some spooky ones such as cryonics, and even mummification.

3. Top 10 Medicaid Myths: Many people think that Medicare will cover their nursing home expenses, but in reality it doesn’t cover one penny. This is one of the scariest misconceptions many people have about the Medicare program. This article dispels the top myths about Medicaid (which is eerily complex and should not be attempted without the help of an experienced and Certified Elder Law Attorney, such as myself).

2. Is Living at Home Hazardous to Your Health? For most seniors with dementia, staying at home is a common goal; however, it can pose certain scary risks and can prove extremely challenging for family caregivers.

1. The Nightmare of Probate: How to Avoid It: We ranked this article at number one because probate really is that scary. Probate requires frustrating intrusion by the court, lawyers, and the public into a very emotional, private, family time, and the contents of your Will, if probated, lives forever on file at the courthouse, for all to read. Additionally, it takes a long time and the process costs a lot — an average of five to eight percent of your family estate is often taken by probate out of the hands of your beneficiaries and given to the courts and other outside individuals.

Do you know what else is really scary? Nursing homes in DC and Northern Virginia cost $10,000-$14,000 a month, an amount that will quickly wipe out all of the money you have worked your entire life to earn — if you don’t properly prepare for long-term care.

If you are now officially freaked out, and if you or a loved one has not done Long-Term Care Planning, Estate Planning, or Incapacity Planning (or had your Planning documents reviewed in the past several years), please call The Law Firm of Evan H. Farr, P.C. at 703-691-1888 in Fairfax, 540-479-1435 in Fredericksburg, or 202-587-2797 in Washington, DC to make an appointment for a no-cost consultation.

Caregiving Across the Miles

Q. I live in Northern Virginia, 700 miles away from my parents, who are in Florida. My father has Parkinson’s and insists on staying in our family home. His mobility has diminished, and I worry about him falling nearly every day. I cannot move closer because of my husband’s government job and my job, and the quality of education being afforded to my children here.  How can I effectively be involved with my father’s caregiving from a distance? 

A. Whether you live an hour away, in a different state, or maybe even in another country, caregiving at a distance presents very real challenges. Like yourself, many long-distance caregivers have families of their own and careers to manage while arranging care from afar. Despite the best intentions, adult children usually end up feeling guilty that they cannot spend more time with their parents and provide the care necessary. They also may feel overwhelmed by the challenges of arranging services long distance, especially if this role is new to them.

How can you be both a caring daughter or son and the coordinator of a multitude of tasks required when taking on the day-to-day responsibilities of a loved one? There is no one right way to be a caregiver; everyone’s situation is different. Here are some helpful tips to keep in mind for caring for your parent from a distance:

  • Preferences from your father: As much as possible, involve the one who needs care in any decision-making process, especially those related to care and housing. Be sure to listen to his or her expressed preferences and respect known values, even when these differ from yours. Provide any instructions to paid caregivers in writing.
  • Available Resources: Gather as much information as you can about available resources and services in the community (e.g. transportation, home health care, errand services, etc.) as well as about your loved one’s medical history. That way, in an emergency situation, you’ll have the information you need on hand. Although every area is unique in the type of services that are offered, similar kinds of services are found throughout the U.S. (e.g. adult day care, home care, case management, etc.). Eldercare Locator at (800) 677-1116 can direct you to the Area Agency on Aging appropriate for your parent(s). The Family Caregiver Alliance’s Family Care Navigator offers a state-by-state searchable database to help you locate help in your state.
  • Contacts in the community: It is helpful to have contacts in your loved one’s community who can serve as your eyes and ears and who can help you decide what issues can be dealt with by phone and what issues require a visit.
  • Care notebook: To keep things in order, long-distance caregivers often benefit from keeping a care notebook — a central place to keep the important information that you gather. Be sure your notebook contains current information on your parent’s prescriptions. If paid caregivers are employed to provide care to your loved one, you will want them to maintain a separate notebook documenting medication administration, vital signs, and other key physical and mental health status information.
  • Professional Guidance: Caregiving can be stressful. If you feel overwhelmed at any point, never hesitate to call in a friend or professional to help. Create a support network for yourself. Talk with friends and family. Allow yourself to hire help or involve other family members. Trying to do it all yourself is not healthy for you or your loved one. Please read our blog post, “Caring for Caregivers,” for more information.
  • Family Dissension: A social worker, geriatric care manager, or mediator can facilitate a family meeting to help prepare a care plan and/or deal with family dissension. If you are in Northern Virginia or Washington, D.C., please see our list of trusted referrals in the community.
  • Caregiver team: No one can master everything, not even the people who are experts in their field. The solution lies in putting together a team and using each team member’s strengths — including yours.
  • Legal documents, such as an Advance Medical Directive and Financial Power of Attorney should be prepared before a health condition makes it impossible for your parent to do so, and it is important to know where to locate these documents, if needed. At the Farr Law Firm, we offer a service called DocuBank to ensure that that the documents you’ve completed will be there when you need them most, such as when you or a loved one are hospitalized.

To help long distance caregivers, the National Institute on Aging developed the So Far Away booklet, offering tips you can use no matter who you are caring for—an older relative, family friend, or neighbor. The free booklet is organized in a question-and-answer format and can be downloaded or ordered here.

What happens when your loved one needs more help than you can provide? Nursing homes in Northern Virginia and Washington, D.C. cost $10,000 – $14,000 per month (a few thousand less in the Fredericksburg, Virginia area), which can be catastrophic even for wealthy families. By being proactive and helping your loves ones plan for long term care in advance, you can help make sure your loved ones always receive the care they need without worry or financial struggle. You’ll further avoid many costly legal headaches that often result when people are not prepared for incapacity or ongoing care needs. It’s never too early or too late to get started. Learn more at The Farr Law Firm website, or call us in Fairfax at 703-691-1888, in Fredericksburg at 540-479-1435, or in Washington, D.C. at 202-587-2797 to make an appointment for a no-cost consultation.



Dear Saki and Alley,

I am a caregiver for my mother with Alzheimer’s. I am realizing that I cannot do this alone. Can you provide suggestions on how to create a caregiver team?

Caryn Formom-Alone


Dear Caryn,

Taking a team approach to caregiving can be essential to preserving your well-being. What many caregivers fail to realize is that if they don’t care for themselves—and lighten the burden—there may be no one around to care for their loved one.

These are some steps to help you set up a caregiving team:

  1. Identify tasks you need help with: Start by identifying the tasks you need help with. Is it paying bills or preparing meals? Or, do you need help with assisting your mother with activities of daily living, such as bathing and hygiene? After you know what needs to be done, it will be easier to identify the right people for the job.
  2. Turn to siblings: Though you may be the lead caregiver, it’s critical to let other family members, such as siblings, know that they need to play a role, too.
  3. Look to friends and neighbors: Depending on the relationships you have, friends and neighbors can be another viable source of help. You may not want a neighbor to help pay bills, but you might feel comfortable asking her to watch your kids while you run your mom to the doctor’s. Be sure you are clear about what the person will be doing and the time commitment, as people are more likely to lend a hand if the expectations are clearly defined.
  4. Know which resources are available: The ElderCare Locator, sponsored by the U.S. Administration on Aging, is one place to start. You can also get information from local churches, synagogues, senior centers, and government agencies. Once you start looking, you may find a whole network of services available to help.
  5. Hire help: If you have the resources, you may consider hiring people to be part of your caregiving team. Hired help might include a geriatric care manager, who can help you plan and orchestrate your relative’s care. You may also consider hiring a home health aide, house cleaning service, a handyman, lawn care or transportation services.
  6. Find a support group: A support group can serve as a place for you to meet others in similar situations, ask questions about specific challenges, and get information about community resources. Be sure to check www.ALZTalk.org and your local Alzheimer’s Association chapter for a list of support groups in your area.
  7. Get some respite: Most caregivers eventually need a break from the rigors of caregiving. That’s when you should find someone to provide respite care. Whether it’s a couple of hours a week at an adult day care or a weekend break provided by your sister, the goal is to give you time away from your duties to recharge.

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


Alzheimer’s: Preserving Family Memories

Every year, Carol Magro would prepare a delicious Italian feast for the holidays. Five years ago, her daughter Barbara noticed that her mother was getting tired, confused, and didn’t remember the ingredients for some of the dishes that she had prepared for nearly 50 years. A few months later Carol was diagnosed with early stage Alzheimer’s disease.

In an effort to preserve her mother’s love of Italian cooking and the memories those dishes evoked, Barbara created a book called “Recipes To Remember.” And to show her commitment to the fight against Alzheimer’s, she donates a portion of the proceeds from her book to help fund Alzheimer’s research.

Like Magro, many adult children, siblings, and Alzheimer’s caregivers are taking steps to preserve their own family memories. As Barbara Magro says, “save it and savor it and write it down because when it’s gone, it’s lost forever.”

What are some things other families have done to keep memories alive?

  • Maria Shriver’s father is a member of the Pro Football Hall of Fame because of his tremendous football talent with Indiana University in the 1940’s and the Philadelphia Eagles in the 1940’s and 1950’s. To ensure that no one forgets about him and his extraordinary talent, she created two documentaries, entitled “ Dear Dad” and “PIHOS: A Moving Biography.” She interviewed people representing various times in his life, including famous coaches and players such as Coach Mike Ditka, Al Wistert, Bill Mackrides, and Pat Summerall, to reveal who he was as a man, a friend, a player, a teammate.
  • Banker White, a documentary filmmaker, co-produced a PBS documentary focusing on his mother’s and grandmother’s Alzheimer’s and his grandmother’s artwork, entitled “The Genius of Marian.” The documentary spanned the first three years of his mother’s illness, including footage of her everyday life and progressive illness and the therapeutic benefits of old family videos and showcased some of his grandmother’s whimsical paintings that hang on the walls of the White’s Massachusetts home. Read more about Marian on our blog.
  • Natalie Maines of the Dixie Chicks wrote a song entitled “Silent House,” about her grandmother who had Alzheimer’s and the house where she used to live. Read more and listen to the song here.
  • Susan Kiser Scharff and her sister Ann Kiser Zultner wrote a book entitled, “Dementia, the Journey Ahead” and created a Facebook reference guide for caregivers assisting those with Alzheimer’s, in memory of her husband, Red, who had Alzheimer’s and died in 2006.

One way you can preserve memories of the way a loved one was before Alzheimer’s is to hire a personal historian who can interview you and record your voice, craft a narrative and produce a book, turn your story into a video, or archive your photos and memorabilia. If you desire, you can produce a video on your own using simple software, such as Windows Movie Maker, or even simply use the voice recorder on your smart phone to record a personal history of your loved one.

An estimated 44 million people live with Alzheimer’s disease worldwide, and the global economic costs total $604 billion, according to Alzheimer’s Disease International. It is estimated that by 2050, the number of people living with Alzheimer’s could rise to 135 million. If you have a loved one with Alzheimer’s, you can keep the memory of who he or she was before the diagnosis alive through the ways described above, or in your own personal way.

Medicaid Planning for Alzheimer’s

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

Medicaid Asset Protection

People with Alzheimer’s live on average four to eight years after they’re diagnosed, but some may live 20 years beyond their initial diagnosis. Do you have a loved one who is suffering from Alzheimer’s? Persons with Alzheimer’s and their families face special legal and financial needs. At The Law Firm of Evan H. Farr, P.C., we are dedicated to easing the financial and emotional burden on those suffering from dementia and their loved ones.  If you have a loved one who is suffering from Alzheimer’s or any other type of dementia or memory loss, we can help you prepare for your future financial and long-term care needs.  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. Please contact The Law Firm of Evan H. Farr, P.C. as soon as possible in Fairfax at 703-691-1888, in Fredericksburg at 540-479-1435, or in Washington, D.C. at 202-587-2797 to schedule your appointment for a no-cost consultation.

Caring for a Difficult Parent

Q. Throughout my life, my mother has always been a difficult person. She complains about everything and is hyper-critical, overbearing and, as you can imagine, hard to get along with. She always compares me to my older sister, who is successful and has a big family, and berates me for being overweight and for taking ten years to finish my PhD. My therapist refers to her as “toxic,” based on the damage she has caused me emotionally.

Now, my mother is in the early stages of Alzheimer’s and needs my help. My sister is too busy with her own family and lives too far away. My mother’s bad attitude and non-nurturing personality is making it a challenge now that she needs me to nurture and care for her. I love my mother, but in all honesty, I don’t like her very much. Do you have any tips for someone in my situation, who has lingering anger and resentment, but knows that helping her parent is the right thing to do?


A. Being a caregiver is never easy, but if you’ve spent much of your life at odds with your parent, being thrust into the role of her caregiver is especially difficult.

Many people in your situation feel trapped by guilt, a sense of moral obligation, and a host of other difficult emotions when it comes to aging parents who are “difficult.” So what do you do when your conscience, your relatives, social workers, and everyone else in your life lets you know that the right thing to do is to help your parent?

You can walk away from the situation, but that could cause disastrous financial consequences for you, and there are always better ways. Although it may be a challenge no matter what, your caregiving experience could be easier than you think depending on whether you’re providing daily care, occasional care, or coordinating care from a distance. The earlier you begin the process, the better. And, remember, you do not have to personally provide the care – there are Home Health companies, Adult Day Care Centers, Assisted Living Facilities, and Nursing Homes that all exist to take care of people who can’t take care of themselves.

Regardless of which route you choose, hopefully the following tips will make caring for you mother a little easier:

  • Assess the situation: If the emotional ramifications are too great, consider those options that don’t place you in the role of primary caregiver. Depending on your mother’s wishes, limitations, and finances, research the appropriate options — Home Health, Assisted Living, or Nursing Care. Talk with a Certified Elder Law Attorney, such as myself, for strategies on placement and financial planning for long term care and asset protection.
  • Have a Conversation: As difficult as it may be for you, if you and your mother can maintain a reasonable conversation, ask your mother’s opinion about what kind of help, if any, would be acceptable for her. Don’t be surprised if your mother is of the opinion that everything is “just fine.” If your mother admits to needing help, you can offer to either pitch in to the degree you are able, or you can discuss the option of looking for community support for the things you are not willing to or cannot do.
  • Keep in mind that her personality might change. With certain types of dementia, life-long personalities can change drastically. I have many dementia clients whose personalities have changed from difficult to docile as a result of their dementia. Of course the reverse is also true – many people who were easy and fun-loving their whole lives become behaviorally difficult in later stages of dementia. Unfortunately, if your mother has always been critical, negative, and overbearing, it’s unlikely that simply growing older and suffering from poor health will improve her personality much. The good news is that as an adult, you’ve probably become more confident in yourself and have learned to deal with her more effectively — and if you haven’t, now is your chance to learn. Believe it or not, it’s never too late to make your relationship work more smoothly so that you can help her through this stage of life.
  • Seek help from family and friends: Whether you choose to take on the role of primary caregiver or remain as the point of contact for the care facility, get help. Try to lighten your load. Decide what you can and can’t do and delegate. Can your sister help out at all? What community resources are in the area? Adult daycare? A senior center? Meals on Wheels?
  • Connect with others and surround yourself with support: You should consider getting into a support group as soon as you start your mother’s caregiving journey. Solutions often present themselves when you surround yourself with supportive, understanding people. It helps to have others around who are going through similar situations, and it is comforting to know that your conflicting emotions are normal.
  • Take care of yourself: Be careful not to overextend yourself or neglect your own needs. Seek respite whenever you can.
  • Free yourself from guilt: Give yourself permission to feel the way you do. Vent to a close friend, an online support group, or a therapist. If you decide to make care arrangements in assisted living or somewhere other than your home or theirs, be at peace with the decision and move forward.
  • Concentrate on the caregiving tasks at hand, rather than the individual or the difficult past (or present). Don’t seek revenge in providing care — or in selecting an outside setting or professional caregiver — simply meet the needs as best you can.
  • Set boundaries and ground rules: Are there times of the day you aren’t available, except in an emergency, for calls, visits or errands? Let her know this, and don’t let her cross the boundaries. If you find your mother berating you, specify that you will hang up (if on the phone) or leave the room.

Caregiving is always emotionally and physically taxing, especially when you are caring for a difficult parent. Focus on being the bigger person; be proud of stepping up and doing the right thing despite the incredible difficulty.  And always remember, if you have kids of your own, you are modeling for them how they may take care of you someday.

At the Law Firm of Evan H. Farr, P.C., we recognize that caring for a loved one, whether they are difficult or not, strains even the most resilient caregiver. If you’re a caregiver, take steps to preserve your own health and well-being.  Part of taking care of yourself is planning for your future and for the future of your parent.  Please call us at 703-691-1888 in Fairfax, at 540-479-1435 in Fredericksburg, or at 202-587-2797 in Washington, D.C. to make an appointment for a no-cost consultation.

NASA SmartWatch, Implanted Health Devices, and Other New Technology for Seniors

Is Grandpa going gadget-crazy? Not quite yet, but we are getting there. According to a recent Pew Research survey, the number of older adults using the internet and related tech devices is increasing, with 59% of seniors reporting that they go online and 77% of older adults reporting that they have a cell phone. The Pew Research findings indicate that there’s still a long way to go, and stress how important it is for seniors to keep in the high-tech loop. This is because today’s technology can keep seniors engaged, connected, mentally active, and physically safe.

In fact, researchers say that “[o]nce seniors join the online world, digital technology often becomes an integral part of their daily lives.” So what devices should seniors and their caregivers have their eyes on?

  • The Apple HealthKit platform allows users to store data (such as weight, steps taken, and heart rate) from multiple devices in one place. These metrics can be displayed in the Health app in iOS 8, which acts as a “wallet” for personal health data. Right now a handful of large health providers — such as Mayo Clinic and Johns Hopkins — are working on ways to use HealthKit to collect data from certain patient populations, such as those with like congestive heart failure and diabetes.
  • Hearing Aid manufacturers, such as Starkey Technologies, are trying to make hearing aids “invisible,” by reducing their size and creating colors that blend with hair and skin tone. Starkey and other manufacturers are working on developing smarter hearing aids that can be geotagged, so the next time a hearing aid user walks into his favorite restaurant, it will automatically adjust to the noise levels. Hearing aids can also stream calls from your iPhone, and connect directly to your iPad or iPod touch, using Bluetooth 4.0 wireless technology.
  • After seven years of research into how to build wearable devices for space travelers, the NASA Smartwatch is so advanced that it can detect a bad mood or health problem before the person wearing it can. It can also operate for six months without a charge, even with its notifications function turned on. Consumers can pre-order the watch now at http://lifetrakusa.com/ for $129, or wait until it hits retail stores later this month.
  • Have you ever left your house without your keys? Now, there is no need to worry about being locked out.  A product called August was recently released and it works in conjunction with an app on your iPhone or Android handset. It attaches to most standard North American deadbolts on the inside of your door. You can tap inside the app to lock or unlock your door without fumbling with keys or punching in a security code. From inside, you can also manually turn the lock. August can also give temporary virtual key access to visitors, and can unlock the door as you approach the house (which is great for bad weather days or when you are carrying bags of groceries). It can be purchased for $249.99 at www.august.com.
  • According to Venture Beat, a development that is happening in labs around the world is implantable, microscopic sensor technology, which will make sensor technology invisible and part of the human body. According to the article, “Wearable (sensors) can be put on or taken off, which takes away the type of continuous monitoring that creates intelligent and actionable data. The current state of wearables is an important step toward something better and bigger.” Read more about invisible sensors.

As baby boomers age and face more health issues, including the treatment of chronic diseases, technology is projected to grow and change faster than ever to keep pace. Please read our blog for additional technology and smart device apps for seniors and caregivers.

We here at The Law Firm of Evan H. Farr, P.C. are pleased to see all of the advances in technology and apps available to help improve seniors quality of life, health, and well-being.  Now that you know about these technologies, it’s time to do legal planning for your future and for your loved ones’ future. As a Certified Elder Law Attorney, my focus is on helping protect seniors and their families by preserving dignity, quality of life, and financial security. Call the firm today at 703-691-1888 in Fairfax, at 540-479-1435 in Fredericksburg, or at 202-587-2797 in Washington, DC to make an appointment for a no-cost consultation.

Cool or Spooky? Funerals that Mimic Life

Louis Charbonnet, a New Orleans funeral director, arranges funerals that mimic life.

Q. My great aunt, Jane, is not afraid to talk about death. The things she loves most in life, besides family, are the Washington Redskins, playing canasta, and gardening. She often mentions how when she dies, she wants to be wearing her favorite football jersey while playing cards on the small patio next to her garden. She even indicated this in her estate planning documents.

It sounds like an impossible request to me, but when the time does come, of course we want to honor her wishes. Is there a way to do so?

Thinking about this makes me wonder about my own wishes for when the inevitable happens to me. Like Jane, I don’t mind talking about these things, and I don’t want a traditional burial. Are there other non-traditional alternatives available?


Note to our readers: If you’re someone who hates thinking about death or is squeamish about the subject, then you might want to stop reading.  But if you’re curious about the various options for disposing of your body after death, please read on. . .

A, Many may not know it, but according to a recent New York Times article, there is a funeral home in New Orleans that honors requests for funerals that “mimic life,” and they are becoming more and more popular.

The services began in the United States in 2012 with the death of Lionel Batiste, a brass band leader’s family wanted to capture him doing what he loved most in life. Word spread, and Miriam Burbank, who died at 53, spent her service sitting at a table amid miniature New Orleans Saints helmets, with a can of Busch beer at one hand and a menthol cigarette between her fingers, just as she had spent a good number of her living days.

In another example, a deceased biker in Mechanicsburg, Ohio, was towed to a cemetery in a homemade plexiglass coffin, his body astride his Harley-Davidson motorcycle. There, in accordance with his longstanding request, he was buried, motorcycle and all.

“It’s been a real boom in Puerto Rico,” said Elsie Rodríguez, vice president of a funeral home that honors such requests. “People have requested every type of funeral that could possibly come to mind. We have only done six so far, because the people who have requested the funerals have not died yet.”

Despite the recent interest, organizations representing funeral home directors say this kind of viewing is still rare, and just about everyone acknowledges that it is not for everyone. However, if you are interested in learning more, you can watch this ABC News video.

If funerals that mimic life are not for you, there are several other non-traditional alternatives to disposing of a body. In fact, we wrote a blog post about it earlier this year. Below is a sampling of alternatives from the post:

  • Natural Burial: These take place without embalming and without the concrete vaults that line graves in most modern cemeteries. Bodies are wrapped in a shroud or placed in a biodegradable casket, with the idea being that they will decompose naturally. Find out more about natural burial here.
  • Green Burial: This option uses liquid nitrogen to bring the body to a eco-friendly state. The body is frozen and is then slightly vibrated which turns it into a powder and then the powder is dried. The powder can then be placed in a corn or potato starch coffin and buried. This option reduces the impact on water, air and soil compared to the traditional burial or cremation. Learn more about Green Burials at http://www.greenburials.org.
  • Cryonics: This is the process of freezing a person’s body in the hopes that later medical science will make it possible to revive them, personality and memory intact. Despite the numerous barriers to this, including the toxicity of chemicals used in an attempt to prevent damage to cells from freezing, advocates have promoted cryonics since the late ’60s. Prices can range as high as $200,000 for whole-body preservation. Learn more about Cryonics at http://www.cryonics.org/.
  • Space Burial: You can get some of your ashes shot into space on a rocket already headed for the stars. Because of the high cost of spaceflight, only 1 to 7 grams (0.04 to 0.25 ounces) of remains are launched. According to Celestis Memorial Spaceflights, a company that offers the postmortem flights, a low-orbit journey that lets your cremains experience zero gravity before returning to Earth starts at $995, while having your remains launched into deep space costs $12,500. Learn more at http://www.celestis.com/.
  • Plastination involves preserving the body in a semi-recognizable form and is often used in medical schools and anatomy labs to preserve organ specimens for education. Plastinated bodies can be exhibited and posed as if frozen in the midst of their everyday activities. Learn more here.
  • Works of art or diamonds: Remains can be turned into a blown-glass work of art, or the carbon can be extracted from the remains to create a diamond. Read the Wikipedia page on Lifegem for additional details about the process.

What if you want to be cremated and for your ashes to be sent into space or planted with seeds to grow a new tree? What if you want take a chance on science and have your body frozen? Or, what if you decide that a funeral that “mimics life” is right for you, after all? How would your loved ones know if you haven’t indicated your wishes in your Advance Medical Directive? Our proprietary 4-Needs Advance Medical Directive™ enables you to set forth your preferences with regard to organ donation, funeral arrangements, and disposition of remains. The document also accomplishes several essential things. In your 4-Needs Advance Medical Directive™, you can appoint an agent and give that person the power to consent to medical and health care decisions on your behalf. This person can decide whether to withhold or withdraw a specific medical treatment or course of treatment when you are incapable of making or communicating an informed decision yourself.

Our 4-Needs Advance Medical Directive™ also contains a proprietary Long-Term Care Directive™ that allows you to address numerous issues that arise if and when long-term care is needed. You can also indicate your wishes concerning the use of artificial or extraordinary measures to prolong your life in the event of a terminal illness or injury. If you have not done Incapacity Planning (including our 4-Needs Advance Medical Directive™ and Financial Power of Attorney), 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 The Law Firm of Evan H. Farr, P.C. as soon as possible at our Virginia Estate Planning Fairfax office at 703-691-1888 or at our Virginia Estate Planning Fredericksburg office at 540-479-1435 or at our DC Estate Planning office at 202-587-2797 to schedule your appointment for our no-cost consultation.

Sandwich Generation: How to Survive Financially

Q. My husband and I are in our mid 40s and caught between raising our 10 and 14 year old children, working full-time, and caring for my father, who has Parkinson’s. We are particularly concerned about saving for college for our children and for our own retirement, while helping my father live safely and comfortably with all the assistance he needs. We are also stressed about long-term care, should my father need a nursing home in the future, since we are convinced that his savings will not last long.  Are there any strategies to help families like ours?

A. According to research conducted by the Pew Research Center, 47% of adults in their 40s and 50s are part of what is known as the “sandwich generation.” In other words, they are being pulled in many directions, with a parent age 65 or older who needs assistance, a job, and children who they are raising and supporting.

Life in the sandwich generation could be a bit stressful. Having an aging parent while still raising one’s own children presents certain challenges not faced by other adults, which often include:

  • Lost Time: It’s estimated that responsibilities, including driving parents to doctor’s appointments, running errands, driving the kids to after-school activities, and overseeing homework each night, can take up to 18 hours a week. That leaves little time left to work during the day.
  • Forgoing Full-Time Work and Benefits: Sandwich generation caregivers may have to give up important benefits, or turn away promotions and the higher salary because they can’t stay late at the office or travel for business. This can add up to a lot in lost income. In fact, “the average worker who takes time off to provide care for an aging parent sacrifices more than $300,000 in lost wages and benefits over a lifetime,” says Sandra Timmermann, a gerontologist and director of the MetLife Mature Market Institute.
  • Saving for college: According to the College Board, over four years it will cost $129,700 for a student who entered a private college in 2013, and $38,300 for an in-state resident at a public college or university. Many families have a hard time saving enough, but luckily there are other options that don’t require refinancing the house.
  • Costs of Long-Term Care: The latest 2014 report by Genworth Financial estimates that the national median daily cost of a private room in a nursing home is $87,600 per year, an increase of 2.62 percent over 2013. In the DC Metro area, the survey shows that the average cost of a nursing home in 2014 is $110,595 per year. That can quickly deplete an older parent’s hard-earned savings, and without proper Medicaid Planning the adult children can then become responsible for payment of the nursing home bills for the parent.

If you’re trying to juggle your own life and career while looking after aging parents and young children, here are some financial strategies to help get you through:

  1. Look for outside help: Those who experience Sandwich Generation stress need to recognize that they can’t do it all. If your kids need extra help in school, consider hiring a tutor. If your father’s home is not suitable for his condition, consider hiring a consultant to help make it more accessible. To learn more about these resources, the National Family Caregiving Support Program is a good place to start. We also have a list of trusted referrals on our Website.
  2. Keep saving: It’s often difficult juggling a mortgage, children’s needs, retirement, and costs for aging parents. A good place to start is by creating a budget and sticking to it.
  3. Think about your own retirement: Don’t sacrifice your own financial future to take care of a parent. The end result will be that your children will have to take care of you one day. Instead, work with a financial planner (see our list of trusted referrals) to build up your net worth.
  4. Fund a college savings plan: A 529 plan is a terrific way to save, and qualifying educational expenses can be distributed tax free.
  5. Plan ahead: It is prudent to be prepared, in case your father needs long-term care down the road. By being proactive and planning for long-term care in advance, you can help make sure your father always receives the care he needs without worry or financial struggle. You’ll further avoid many costly legal headaches that adult children face when they are not prepared for their parent’s incapacity or ongoing care needs. Generally, the earlier someone plans for long-term care needs, the better. But it is never too late to begin preparing. Even if your were father were already in a nursing home receiving long-term care, it would not be too late to do Long-term Care Planning, also called Lifecare Planning and Medicaid Asset Protection Planning.

Caring for kids and parents at the same time is extremely challenging. However, there are ways to work around the challenges. With a bit of advanced planning, it can be done successfully.

To do your own planning, or to help plan for the future needs of your parents, please call the Fairfax and Fredericksburg Long-Term Care Planning Law Firm of Evan H. Farr, P.C. at 703-691-1888 in Fairfax or 540-479-1435 in Fredericksburg to make an appointment for a no-cost consultation.


New PBS Documentary — “The Genius of Marian” — Explores How Alzheimer’s Runs in Families

Pam White and her son, Banker, by Marian Williams Steele.

Many people fear that Alzheimer’s disease in the family may be passed on to children and grandchildren. According to the Alzheimer’s Association, research has shown that those who have a parent, brother, sister, or child with Alzheimer’s are more likely to develop the disease. Early-onset Alzheimer’s disease, where symptoms first appear before the age of 65, is also more likely to cluster within families, sometimes with several generations affected.

As an example, Pam White, 67, was a model, social worker, mother of three, and the daughter of a renowned painter, Marian Williams Steele, who died of Alzheimer’s at 89 years old in 2009. To honor her mother, Pam set out to write a book exploring both her mother’s art and her unfortunate descent into the disease. The project was called “The Genius of Marian.” Only a few short months into the work, however, Pam, at the age of 61, developed the disease herself, and stopped writing the manuscript.

Pam’s eldest son, Banker White, a documentary filmmaker, decided to pick up where his mother left off in the form of a documentary focusing on his mother’s and grandmother’s Alzheimer’s and his grandmother’s artwork. The result was “The Genius of Marian,” which is co-produced with his wife Anna Fitch. The documentary (named after the book Pam was writing) aired last night on PBS and is now available online. It spans the first three years of Pam’s illness, including footage of her everyday life and progressive illness and the therapeutic benefits of old family videos and Marian’s whimsical paintings that hang on the walls of the White’s Massachusetts home.

The film provides an inside look at Pam’s Alzheimer’s and includes footage at doctor visits, tense conversations about medication, and many confused moments and absent stares that cross Pam’s face. One instance in the film includes footage of Pam forgetting how to dress herself. Another includes an appointment with her neurologist, where she can’t name the image on a flash card (a bench) and doesn’t know what year it is (“19-something”—it was 2011).

For years, the White family kept Pam’s condition a secret, while she vacillated between denial and acceptance. “I don’t have it. Yes I do. I do. I have it,” she says in the film. To care for Pam at home, her husband, Ed White, 69, retired from his investment management business. A part-time caregiver helps care for Pam, and their daughter, Devon, 37, who lives close-by, also visits often.

When asked about his role as a husband and caregiver, Ed mentions that he sometimes feels like he is “caged.” According to Ed, “I can’t even go buy a paintbrush without going through the big rigmarole of getting Mom dressed up and getting in the car,” Ed says in the film. “So I just have to—forget it. So? Remember the phenomenal life that she’s given me…. So I sure as hell owe her this, even if it gets frustrating.”

At the end of the film, Pam refers to her Alzheimer’s as “a little glitch” that she has developed. According to Pam, “Initially, I was quite distressed and upset about it, but it doesn’t really matter. It doesn’t really change anything, so I don’t feel sad and I don’t feel regret. I feel blessed that I have this wonderful family and a husband who is extraordinarily wonderful. I just feel like, maybe the way my mother did before she was dying. It just was the way it was. And remembering, keeping, cherishing all the times I had with friends and family. So it’s all good. No regrets.”

Many of us are in situations similar to the Whites. If you are caring for a loved one with dementia, please read our blog post on caregiver training for some helpful resources. For more details on art therapy, please also read about a fascinating nationwide program through the Museum of Modern Art that makes art accessible to people with dementia.

If you care for a loved one with dementia at home, it is always a good idea to plan for the future, just in case your loved one needs more adaptations and assistance than you can provide. Nursing homes in Northern Virginia cost $9,000 – $12,000 per month.  Life Care Planning and Medicaid Asset Protection is the process of protecting your loved one from having to go broke paying for nursing home care, while also helping ensure that he or she gets the best possible care and maintains the highest possible quality of life, whether at home or, in the future, in an assisted living facility or nursing home. Learn more at http://www.VirginiaElderLaw.com and call us at our Virginia Elder Law Fairfax office at 703-691-1888 or at our Virginia Elder Law Fredericksburg office at 540-479-1435 to make an appointment for a no-cost consultation.



Joan Rivers Death Reminds us to Have End-of-Life Conversation

Q. I am very close with my in-laws, who are both in their late 70’s, and all I want for them (and for everyone I care about) is to live a long happy life.  Unfortunately, the inevitable happens to us all, and when it does happen, I really want my entire family to be prepared ahead of time. However, in the case of my in-laws, this has been a really difficult task.

Whenever my husband and I bring up advance directives and end-of-life planning, my in-laws are completely averse to having the conversation, because it is too “depressing.” They change the subject every time. One Thanksgiving, my father-in-law confided in me that he would want to be taken off of life support should he become incapacitated and end up in a coma. I know that if there are no documents in place, my father-in-law’s wishes might not be met should the situation arise. 

My in-laws were huge Joan Rivers fans.  Do you know if Joan did end-of-life planning?  If so, and if it helped Melissa, maybe I use the example of Joan Rivers as a way to get my in-laws to have the end-of-life conversation that we so badly need to have.

A. Unlike so many of us, Joan Rivers was not uncomfortable talking about growing old or dying.  She told many jokes about death, and losing her memory because of aging was one of her favorite sources of comedy material. Joan’s willingness to make light of aging and dying almost made it appear that she would be immune to it.  Unfortunately, nobody is immune, but in Joan’s case, at least she was prepared.

All the jokes Joan Rivers told and everything she did to defy aging did not hide the fact that she was ready for the inevitable.  In fact, in recent TV tributes from her reality show from earlier this year, she earnestly pled with her daughter, Melissa, to be ready in case she did not make it out of an upcoming surgery.  Rivers told her daughter, over and over, that Melissa and Joan’s grandson, Cooper, would be fine when the day came.  Rivers attitude was that she had a remarkable life, even if it ended that day.

Joan Rivers died on September 4, 2014 at the age of 81, and based on her brilliant career and advanced planning, it is evident that she was smart, savvy, and that she made her end-of-life wishes well-known. When Melissa Rivers gave the final direction to take Joan off of life support, it was because Melissa knew for certain that Joan would not have wanted to stay on life support given the situation, because Joan had clearly expressed her wished ahead of time.

Talking about end of life issues is an emotional and difficult task for most of us, but it’s a vital first step to making sure your wishes are clear. Did you know that 60% of people say that making sure their family is not burdened by tough decisions is “extremely important,” yet 56% have not communicated their end-of-life wishes.  A conversation, followed by incapacity planning, can make all the difference, but must be done before it’s too late.

As you have experienced with your in-laws, it’s not easy to talk about how you want the end of your life to be. But it’s one of the most important conversations you can have with your loved ones. How do you get started? Below are some helpful resources:

  • Eldercare.gov, or the Eldercare Locator, recently released “Let’s Talk, Starting the Conversation about Health, Legal, and End of Life issues” that includes tips on preparing for the conversation, starting the conversation, keeping the conversation going, and community resources to aid in the planning process.
  • Pulitzer Prize-winning columnist Ellen Goodman co-founded The Conversation Project to help families have these important end-of-life discussions. In a recent U.S. News and World Report video, she shares her compelling reasons for helping start the group and how important it is for all family members to sit down and talk. She also shares a “Starter Kit” to help families have the conversation.
  • A growing trend in gatherings, called Death Cafés, is gaining attention for presenting a comfortable way talk about death with others. Death Cafés bring strangers together in a public setting to have end-of-life conversations while sipping coffee and eating comfort foods like cake and cookies. Read our blog post on this topic for more details.

You can always use the story of Joan Rivers to spark the conversation that may encourage your in-laws to stop procrastinating and finally take action.  And, as Joan taught us, it’s okay to use humor even when talking about this difficult subject.  In fact, doing so may make it a little bit easier.

As Joan Rivers said, there is no need to be afraid of dying.  It will happen, and it will undoubtedly be a sad and stressful time for the loved ones you leave behind.  So why not make it as easy on them as you can? Once you have taken the step of speaking with your loved ones about your wishes, it is important for them to sign Incapacity Planning documents, including an Advance Medical Directive and General Power of Attorney, to make their wishes legally enforceable. Once your in-laws are ready, have them call us at our Virginia Elder Law Fairfax office at 703-691-1888 or at our Virginia Elder Law Fredericksburg office at 540-479-1435 to make an appointment for a no-cost consultation.

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