Critter Corner: Beating the Winter Blues


Dear Saki and Alley,

I get depressed at this time of year, ever since my husband passed away. I had a full house for the holidays and everything seemed great, but now that it is over and the tree and decorations are gone, I am sad. I have physical and financial limitations that keep me in the house. My sister, Elizabeth, visits as much as she can, but my daughters and grandchildren live far away. I feel isolated, and the cold, snowy weather doesn’t help. Do you have any suggestions to help me feel better at this time of year?


Liv Salone

Dear Liv,

Your situation is not uncommon during the cold, winter months. Although the season’s celebrations brought joy and enjoyment, for those who have lost loved ones, memories of holidays past may also bring up feelings of sadness or grief that linger on long after the holidays are over. The colder weather itself can also spur loneliness by making it harder to see family and friends.

Here are some things you can do to defeat loneliness and beat the winter blues:

  • Phone calls: A daily phone call with your daughters, grandchildren, and/or friends can make the world of difference. Skype is also a great way to see them while you chat with them!
  • Internet or apps: Getting online can be a great way to beat isolation, and can be a good source of mental stimulation. Find discussion boards relating to hobbies and passions and you’ll soon be interacting with other people who share their interests. Be sure to be careful on the Internet. For ideas of apps for seniors, please check out our recent blog post.
  • Letter/e-mail writing: Keeping in touch with friends and family by corresponding through email or letters can help break isolation
  • Alternative Therapies: Consider alternative therapeutic options to improve your state of mind. St. John’s Wort, aromatherapy, massage, Reiki, and flower essences may be effective, and some therapists will visit your home.
  • Continuing education: You’re never too old to learn something new! Adult education provides intellectual stimulation, and many classes are available online! You can learn more about technology, study a subject you always wanted to know more about, or learn a new language. Sky’s the limit!
  • Sing along to old records/songs: Take out some of your old records (if you still own a record player) or find your favorite artists on Spotify or Pandora. Singing or simply listening to music can bring back happy memories and help lift your mood!
  • Watch a movie: Turn on the Hallmark channel (or whatever you like to watch) and find a movie that makes you feel good.
  • See your doctor: When depression persists longer than a couple of weeks, you should reach out to a mental health professional. Prolonged depression and the stress it places on the body is a serious matter that requires medical assistance. Your primary physician, a visiting nurse, or a social worker can help recommend a treatment that is right for you. Keep in mind also that some medications you may be taking for something else can add to depression. If you think that might be the case for you, speak with your physician to see if alternative medications could help.

If you have difficulty getting around town, inquire whether community or religious organizations have a transportation assistance program that sends community members into the home. Hosting card games or get-togethers at home can also help alleviate feelings of isolation.

Once you decide what you would enjoy doing, try to make it a routine, giving you something to look forward to each and every week! Hope these ideas are helpful and that you feel happier soon!

Saki and Alley

Hospice Care For Mom? But, She Isn’t Dying.


Q. My mother, Roxanne, 76, has suffered from lung disease for ten years. She still has her wits about her, and spends her days knitting, reading historical novels, and sipping tea. Recently, her doctor recommended hospice care, and I was perplexed by his recommendation. She has been living fine for a decade with her lung disease, and it doesn’t seem to be getting worse. Why would he recommend hospice now? I thought hospice was for people who were dying. I have also heard horror stories about the quality of care that hospices offer. Have you heard anything about this, and am I right to be concerned?

A. Hospice is an alternative to regular medical care for people in the final months of life. Instead of continuing to try curing or delaying a fatal disease or condition, hospice ends treatment altogether. If someone chooses hospice care, it means he or she can leave spend his or her last weeks or months at home or, in a few cases, in a specialized hospice facility.

You are right to be concerned. A recent series of articles in The Washington Post, entitled “The Business of Dying” investigates whether hospices are safe and how they sometimes decline to provide proper care. To conduct the study, The Washington Post analyzed the Medicare billing records for more than 2,500 hospice providers, obtained an internal Medicare tally of nursing care in patients near death, and reviewed complaint records against hundreds of hospice providers. They did so because Medicare pays for the vast majority of hospice care in the United States. Let’s explore the findings uncovered by the Washington Post:

  • Patient neglect: Hospices are supposed to be able to provide either “continuous” nursing care at home or inpatient care at a medical facility. However, when some home hospice patients encounter crises—including pain, breathing troubles, seizures— and need sustained attention, they are sometimes not getting the assistance they need. According to the Post investigation, one in six U.S. hospice agencies, serving more than 50,000 of the terminally ill, did not provide crisis care to any of their patients in 2012. In fact, at 445 hospices, a third or more of patients died without having seen a skilled nurse in the 48 hours before their death. Read more in “Part One: Terminal neglect? How some hospices decline to treat the dying.”
  • Safety concerns: The typical hospice provider in the U.S. undergoes a full government inspection about once every six years, according to federal figures, making it one of the least-scrutinized areas of U.S. health care. By contrast, nursing homes are inspected about once a year, and home health agencies every three years. According to the Washington Post, “the dispersal of patients makes oversight difficult to begin with, but the infrequency of inspections means shortcomings are even less likely to be detected.” So, how can we really know if a hospice is safe? Read more in “Part Two: Is that hospice safe? Infrequent inspections mean it may be impossible to know.”
  • Rising discharge rates: Even though hospices aim to care for their patients until they die, at hundreds of U.S. hospices, more than one in three patients were released alive, according to a new study funded by Medicare. This is a sign that patients may be leaving to seek treatment elsewhere. It is normal for a hospice to release a small portion of patients before death (15%), but when the rate of patients leaving hospice care alive is double that level, it can signify either that agencies are driving the patients away with inadequate care, or enrolling patients in the first place who aren’t really dying — in order to pad their profits. Read more in “Part Three: Rising rates of hospice discharge in U.S. raise questions about quality of care.”
  • Lethal doses: With the surge of hospices enrolling patients who aren’t close to death, hospice patients who are not actively dying are nevertheless being treated with powerful pain-killers that are routinely used by hospice providers in order to ease suffering and at the same time hasten death. There are no statistics on how often such abuses may be occurring, but complaints from around the country illustrate the potential dangers of overdosing and drug dependency and addiction caused by enrolling a non-dying relative in hospice care. Read more in “Part Four: As more hospices enroll patients who aren’t dying, questions about lethal doses arise.”
  • Quality of hospices: Though the federal government publishes consumer data about the quality of other health-care companies, including hospitals, nursing homes, and home health agencies, it provides no such information about hospices. State inspections are often unpublished, and when they are, they are often hard to understand. So, again, a family is typically choosing hospice care blindly with no idea if it is safe for their loved one. Read more in “Part Five: Quality of U.S. hospices varies, patients left in dark.”
  • A warehouse for dying: Nurses and clinicians at hospice facilities feel powerless to change the system. Although they feel frustrated and may disagree with the aggressive treatment and whether it is necessarily warranted, they have to do what they are legally required to do. Read more in “Part Six: Warehouses for the dying’: Are we prolonging life or prolonging death?”
  • Dying and profits: As for-profit companies transformed the hospice movement, which was once dominated by community and religious organizations, into a $17 billion industry, patient care suffered along the way. According to The Washington Post investigation, patients who need hospice care are typically much better off using a non-profit hospice facility, because the typical for-profit hospice: spends less on nursing per patient; is less likely to have sent a nurse to a patient’s home in the last days of life; is less likely to provide more intense levels of care for patients undergoing a crisis in their symptoms; and has a higher percentage of patients who drop out of hospice care before dying. Read more in “Part Seven: Dying and profits: The evolution of hospice.”

As you can see from The Washington Post’s investigation, many hospice providers are failing to provide quality care for patients, and the industry suffers from safety concerns due to infrequent inspections, lack of crisis care, lack of reporting consumer data, admission of people who aren’t dying and who eventually get discharged, and other issues. In fact, the Consumer Reports from November 2014 takes on end-of-life care and recommends that families steer away from newer, for-profit hospices. If you do decide that hospice care is best for your mother, The Washington Post published a consumer guide to the nation’s hospices to fill the void of public information about them. However, this consumer guide has one very significant limitation, i.e., it does not indicate whether the hospice provider has an actual hospice facility or whether it is just a hospice provider that provides care at private homes and nursing homes. To compound this problem, The Washington Post Consumer Guide gives an address for each hospice, even though for most hospice providers this address is merely a corporate office, and not an actual hospice facility. For example, if you search for Hospices in Fairfax County, Virginia, 5 are listed; however, not one of these has an actual hospice facility.

As mentioned above, nursing home facilities are inspected once a year and have much consumer data and research available to help you choose the right facility. However, please keep in mind that should your mother need a nursing home now or in the future, in the DC Metro area, they cost $10-12,000 a month. To protect your family’s hard earned money and assets from these catastrophic costs, the best time to create your long-term care strategy is before you actually need long-term care. If you’re over 65, we recommend that you begin your asset protection planning now. Even if you are currently receiving services for yourself or a loved one, it’s still not too late to plan.

If you have 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, 301-519-8041 in Rockville, MD, or 202-587-2797 in Washington, DC to make an appointment for a no-cost consultation.


How Nursing Homes are Collecting Debts- More Reason to Plan Ahead

Dino and Lillian Palermo, at the Mary Manning Walsh Nursing Home, which filed a guardianship petition.

Dino Palermo serenading his wife, Lillian. (Picture from the New York Times.)

Lillian Palermo, a 90-year old retired insurance executive, entered a nursing home after she began experiencing dementia, falls, and surgical complications. Her husband, Dino, who is eight years her junior, visits her every day. He sings her favorite songs, feeds her home-cooked Italian food, and pays a private aide to be there when he cannot.

Prior to entering the nursing home, Lillian prepared for incapacity by entrusting her beloved husband to be responsible for all decision making in her Power of Attorney and Advance Medical Directive documents. One day last summer, Dino was shocked to find a six-page legal document waiting on his wife’s bed. It was a guardianship petition filed by the nursing home, Mary Manning Walsh (located in New York), asking the court to give a stranger full legal power over Lillian and complete control of her money. A lawyer for the nursing home told the New York Times that guardianship “is a legitimate means to get the nursing home paid.”

According to the New York Times article, few people are aware that a nursing home can take such a step, but it is not uncommon. Interviews with veterans of the system and a review of guardianship court data conducted by researchers at Hunter College at the request of The New York Times show the practice has become routine. In fact, in a random sample of 700 guardianship cases filed in Manhattan over a decade, Hunter College researchers found more than 12 percent were brought by nursing homes; and that 29% of the requests for guardianship petitions in Manhattan came from hospitals and nursing homes combined. Although it is a drastic measure, nursing home lawyers argue that using guardianship to secure payment for care is better than suing an incapacitated resident who cannot respond.

In the Palermos’ case, the issue was resolved and the nursing home dropped its petition for guardianship after cashing Dino Palermo’s check for the outstanding balance. However, the anguish and stress Dino felt has not gone away. He recalled the fear, anger, and sleepless nights he experienced when he first read the nursing home’s petition “Who better than me, the husband for 47 years, that she gave power of attorney?” he asked. He also spent more than $10,000 in legal fees.

From the article, we cannot tell what type of long-term care planning the Palermo’s did, if any. The reason the nursing home sought to obtain guardianship was presumably because Mr. Palermo was not paying the nursing home bill. Had Mr. Palermo engaged an experienced Elder Law attorney to protect their assets and get his wife on Medicaid, he could have protected 100% of their assets and quickly obtained Medicaid coverage for his wife, presumably avoiding the need for the drastic measure taken in this case by the nursing home.

Can a nursing home seize control over patients to collect payment in Virginia, DC or Maryland? Yes. It happens regularly, but typically not when there is already an agent under power of attorney properly acting. And in this case, “properly acting” means hiring an experienced Elder Law Attorney to engage in Medicaid asset protection — protecting all of the assets of a married couple and obtaining Medicaid coverage for the nursing home spouse.

Medicaid Asset Protection

Medicaid Asset Protection is the process of protecting assets from having to be completely spent to pay for the devastating expenses of long-term care, while helping to ensure that you (or your loved one) get the best possible long-term care and maintain the highest possible quality of life, whether at home, in an assisted living facility, or in a nursing home. This process is also called Life Care Planning because it is designed to be an ongoing, life-long process.

Medicaid Asset Protection can be started any time after a person enters the “long-term care continuum,” meaning that a person is starting to need assistance with Activities of Daily Living (eating, dressing, bathing, toileting, transferring, and walking) or Instrumental Activities of Daily Living (such as cooking, cleaning, caring for pets, paying bills and managing finances). This type of planning can be started while you are still able to make legal and financial decisions, or can be initiated by a spouse or 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 assistance. In fact, the majority of our Medicaid Asset Protection clients come to us when nursing home care is already in place or is imminent.

If you are still healthy and not yet on the “long-term care continuum,” then the type of Medicaid Asset Protection Planning you should consider is our Living Trust Plus Asset Protection Trust, which is a simpler and less expensive method of Medicaid asset protection for clients who will most likely not need any long-term care for at least five years.

Nursing homes in the DC Metro area cost $10-12,000 a month. To protect your family’s hard earned money and assets from these catastrophic costs, the best time to create your long-term care strategy is before you actually need long-term care. If you’re over 65, we recommend that you begin your asset protection planning now. Even if you are currently receiving services for yourself or a loved one, it’s still not too late to plan.

If you have a loved one who is nearing the need for long-term care or already receiving long-term care or if you have 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, 301-519-8041 in Rockville, MD, or 202-587-2797 in Washington, DC to make an appointment for a no-cost consultation.


New Apps for Seniors with Memory Loss

We here at the Farr Law Firm are pleased to see all of the advances in technology and apps available to improve quality of life, health, and well-being for seniors with memory loss. If it turns out your mother’s memory loss is more than senior moments, 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 can help protect your family’s hard-earned assets while maintaining your loved one’s comfort, dignity, and quality of life by ensuring eligibility for critical government benefits. Call us today at 703-691-1888 in Fairfax, 540-479-1435 in Fredericksburg, 301-519-8041 in Rockville, MD, or 202-587-2797 in Washington, DC to make an appointment for a no-cost consultation.

Would You Want This In Your Advance Medical Directive?

Jerome Medalie can’t imagine life with Alzheimer’s. And, he has made it known that he doesn’t want to be around if he can’t “recognize his loved ones” or “articulate coherent thoughts and sentences.” He did so formally and legally in his Advance Medical Directive.

According to a recent New York Times blog post, if Jerome Medalie, who resides in Massachusetts, develops Alzheimer’s disease or another form of dementia, he has specified that he refuses “ordinary means of nutrition and hydration.” He specifically listed 10 triggering conditions, and if any three such disabilities persist for several weeks, he wants his health care proxy — his wife, Beth Lowd — to ensure that nobody tries to keep him alive by spoon-feeding or offering him liquids.

VSED, short for “voluntarily stopping eating and drinking,” is not unheard-of as an end-of-life strategy, typically used by older adults who hope to hasten their decline from terminal conditions, such as dementia. Including VSED in Advance Medical Directives sparks several ethical considerations. (Please see italicized text below.) Readers, we want to hear from you! Please comment with your feedback on the following:

In your opinion, do you think people who develop dementia should be able to use VSED to end their lives by including such instructions in an advance directive? As the New York Times article states, “Can one’s current, competent self make decisions on behalf of one’s future demented self — who may find modest pleasure, years later, in a life once deemed intolerable? What if that later self asks for, or points to, applesauce?”

Thanks in advance for your comments on this topic!

The Healing Power of Music — “Alive Inside”

Music has power—especially for individuals with dementia. When used appropriately, it can help shift mood, manage stress, reduce agitation, stimulate positive interactions, and can even triumph where prescription medication falls short. Even in the late stages of dementia, the healing power of music has been known to spark compelling outcomes.

How do we know this? Besides lots of documented research, we can see for ourselves in “Alive Inside,” a documentary that chronicles the astonishing experiences of people around the country with dementia who have been revitalized by listening to music. The film follows a social worker named Dan Cohen, who is campaigning to bring iPods to nursing homes. What Mr. Cohen discovers by accident, and scientists have been studying for years, is that a person suffering from memory loss can seem to “awaken” when given music that they have an emotional attachment to. As Neuropsychologist Oliver Sacks explains in the film, “Music imprints itself on the brain deeper than any other human experience. Music evokes emotion and emotion can bring with it memory.”

In the film, the effect of music on the patient, the family, and the caregiver is both touching and inspiring. Music seems to open doors and make connections, especially for those with the least ability to interact. For example, in the film, Henry, a nursing home patient with Alzheimers, who normally assumes a vegetative state, “comes alive” when listening to his favorite songs. The film hopes to encourage widespread adoption of personalized music programs in nursing homes across the country, since “the reward is enormous and the cost is low.”

In an interview about the film, Michael Rossato-Bennett, the producer and director, said “[t]he saddest thing in the world is a person who’s spark has gone out and the most beautiful thing in the world is another human being awakened. It is my hope that when it is done, this film awakens people’s hearts and helps make it possible to bring music to those in nursing homes, people who don’t even know how deeply they need music’s gifts.”

In a recent Washington Post article about Alzheimer’s and the arts, Kathryn Dodd, a resident in a Manassas nursing home’s experience concurs with the film’s findings. To Dodd, listening to tunes by James Taylor and Mary J. Blige allows her mind to wander to pleasant memories from years ago. According to Dodd, “music brings memories. I basically try to remember the good times — I don’t like to dwell on the bad times — and music brings those out,” Dodd said. “I got a lot out of it.”

How is music so powerful?

  • Reawakens memories and emotions: Most people associate music with important events and a wide array of emotions. The connection can be so strong that hearing a tune long after the occurrence evokes a memory of it. Selections from the individual’s young adult years—ages 18 to 25—are most likely to have the strongest responses and the most potential for engagement.
  • Stimulates and promotes movement: Stimulative music, with percussive sounds and fairly quick tempos, tends to naturally promote movement, such as toe taps. This type of music can assist with activities of daily living: for example, at mealtime to rouse individuals who tend to fall asleep at the table or during bathing to facilitate movement from one room to another.
  • Calms and sedates: Sedative music, including ballads and lullabies with unaccented beats, no syncopation, slow tempos, and little percussive sound, can be the best choice when preparing for bed or any change in routine that might cause agitation.
  • Lessens frustration and agitation: Non-verbal individuals in late dementia who become agitated out of frustration and sensory overload can become engaged in music. Singing, rhythm playing, dancing, physical exercise, and other structured music activities can diffuse this behavior and redirect their attention.
  • Promotes emotional closeness: As dementia progresses, individuals typically lose the ability to share thoughts and gestures of affection with their loved ones. However, they retain their ability to move with the beat until very late in the disease process.

How can you use music with your loved ones who have dementia?

Early stage:

  • Dance in the house.
  • Listen to music that the person liked in the past. If they say it sounds horrible, turn it off.
  • Encourage an individual who played an instrument to try it again.
  • Compile a musical history of favorite recordings, which can be used to help in reminiscence and memory recall.

Early and middle stages:

  • Use song sheets or a karaoke player so the individual can sing along with old-time favorites.

Middle stage:

  • Play music or sing as the individual is walking to improve balance.
  • Use background music to enhance mood.
  • Opt for relaxing music—a familiar, non-rhythmic song—to reduce sundowning, or behavior challenges at nighttime.

Late stage:

  • Go back to the music collection of old favorites that you made earlier.
  • Sing-along with the person to “When the Saints Go Marching In” or other tunes sung by rote in that person’s generation.
  • Play soothing music to provide feelings of comfort.
  • Exercise to music.
  • Do drumming or other rhythm-based activities.
  • Use facial expressions to communicate feelings when involved in these activities.

Many researchers agree evidence seems promising that music can improve cognitive function and memory, bolster a person’s mood and sense of well-being, and reduce stress, agitation, and aggression. We hope these ideas will be helpful for you, in interacting with your loved one with dementia.

Dementia Planning

Nearly six million people in the U.S. are struggling with dementia and memory loss and 10 million more people are connected to them. There is no known cure and the numbers of sufferers is on the rise. At the Farr Law Firm, we are encouraged by how music is enhancing the quality of life for dementia patients. 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 Farr Law Firm, 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, 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. Call us today at 703-691-1888 in Fairfax, 540-479-1435 in Fredericksburg, 301-519-8041 in Rockville, MD, or 202-587-2797 in Washington, DC to make an appointment for a no-cost consultation.

Is Tai Chi for Me?


Dear Ernie and Jannette,

My neighbor, Harry, is 80 years old and has gotten really into Tai Chi. He says it helps him stay fit, maintain balance, and avoid falls. I am 77, have arthritis and high blood pressure, and am not sure if Tai Chi is for me. Before I sign up, do you have an opinion on whether Tai Chi is worthwhile for someone like me?


Nasure Tychee


Dear Nasure,

Developed in China more than 2,000 years ago, Tai Chi, as it is practiced in the west today, is similar to yoga (but done with more continual motion) and meditation combined.  It is a gentle form of meditative exercise that features slow and focused movements along with deep breathing. Researchers have found that Tai Chi provides a great physical and mental workout and can benefit seniors in a number of ways including:

  • lowering blood pressure
  • improving symptoms of arthritis
  • reducing stress
  • improving balance
  • providing pain relief
  • enhancing flexibility
  • easing symptoms of Parkinson’s disease
  • improves feeling of overall well-being

Senior citizens who experience degenerative conditions can benefit greatly by incorporating Tai Chi into a daily exercise regimen to invigorate and build the energy levels in the body, ultimately boosting the immune system and promoting clear thought processes and a healthier body.

If you want to see a bit of what Tai Chi is like, watch this video.  But like most things, seeing is very different from doing. So if you’re interested, give it a try. Your body and mind may thank you.

Ribbit up!

Ernie and Jannette

Veterans: Don’t Miss Out On Benefits


Q. My 72-year old father, Phil, served during the Vietnam War, and suffers from Parkinson’s Disease and Post Traumatic Stress Disorder (PTSD). My mother, Ruth, is his caregiver. They live on Social Security checks and his pension. In my opinion, there have to be more benefits that they can take advantage of, especially for an honorably-discharged retired veteran and his spouse. If I am correct, can you help me lead them in the right direction about benefits they may be missing out on? Thank you for your help!

A. Yes, you are correct. Currently, there are more than 25 million veterans, like your father, who served our country during wartime and may be eligible for some form of veteran’s benefits. However, many veterans aren’t aware of, or taking advantage of, the benefits available to them and their spouses.

In fact, NPR (along with seven public radio stations around the country) recently chronicled the lives of America’s retired military and released a three-part series about veterans benefits. The project, “Back at Base,” examines how many veterans and their families are missing out on the benefits for which they are entitled because they don’t know about them or do not understand them. The story offers ways to navigate the complex processes involved in applying for benefits.

As in the NPR story, at the Farr Law Firm, our goal is to provide information about programs that veterans and their families may be entitled to. Below are some examples:

Medical Benefits

The VA operates the nation’s largest healthcare system, with more than 1700 hospitals and clinics, caring for more than 6.3 million veterans annually. Those who qualify based on household income and assets receive free care. Others use their VA benefits to supplement private health insurance and cover co-payments required with private policies.

In recent years, mental health benefits for veterans have been expanded. While the system is not perfect, the VA does provide a significant healthcare benefit that should not be overlooked.

Veteran’s Aid and Attendance

One particular benefit, called a Special Pension benefit (also called Veterans Aid and Attendance), can provide more than $25,000 annually for an eligible married veteran, more than $21,000 annually for a single veteran, and over $13,000 annually for the surviving spouse of a qualified veteran. (Please visit our website to see the newly released 2015 figures.)

Eligibility criteria includes:

  • Those over 65 do not have to be disabled. However, the veteran or spouse must be in need of regular aid and attendance due to inability to dress oneself, feed oneself, loss of coordination or other conditions, as described on our website, and there must be actual ongoing caregiving services being received from someone else.
  • You or your spouse must have served on active duty for at least 90 days, at least one day of which occurred during a period designated as wartime (see our website). There must have been a non-dishonorable discharge as well. Single surviving spouses of such veterans are also eligible.

For more details about Veteran’s Aid and Attendance and other veterans’ benefits, please watch this video. If you would like to sign up to receive my Aid Attendance 4-Part Mini Series via e-mail, please click here.

Burial and Memorial Benefits

The Veterans Administration offers a number of burial and memorial benefits to veterans who were honorably discharged, as follows:

  • National and State Cemetery Benefits: Eligible veterans can be buried in one of the 131 national or 93 state VA cemeteries at no cost to the family. This includes a gravesite; opening and closing of the grave; perpetual gravesite care; a government headstone or marker; a United States burial flag that can be used to drape the casket or accompany the urn (after the funeral service, the flag is given to the next-of-kin as a keepsake); and a Presidential memorial certificate, which is an engraved paper certificate signed by the current President expressing the country’s grateful recognition of the veteran’s service. National cemetery burial benefits are also available to spouses and dependents of veterans.
  • Private Cemetery Benefits: Benefits available include a free government headstone or marker, or a medallion that can be affixed to an existing privately purchased headstone or marker; a burial flag; and a Presidential memorial certificate. There are no benefits offered to spouses and dependents that are buried in private cemeteries.
  • Burial Allowances: In addition to the many burial benefits, some veterans may also qualify for a $734 burial and funeral expense allowance (if hospitalized by VA at time of death), or $300 (if not hospitalized by VA at time of death), and a $734 plot-interment allowance to those who choose to be buried in a private cemetery. To learn more about eligibility, see

Certain forms may need to be completed which are always better to be done in advance. For a complete rundown of burial and memorial benefits, eligibility details and required forms, visit or call 800-827-1000.

Applying for veteran’s benefits, such as Veteran’s Aid and Attendance, can be confusing and arduous. Here at the Farr Law Firm, we work with veterans and their spouses to evaluate whether they qualify for the Veterans Aid and Attendance Benefit and/or Medicaid, and we deal with all the paperwork. As an Accredited Attorney with the U.S. Dept. of Veterans Affairs, I understand both the Veterans Aid and Attendance Benefit and the Medicaid program and the interaction between both benefit programs. Please call us in Fairfax at 703-691-1888, in Fredericksburg at 540-479-1435, in Rockville, MD at 301-519-8041, or in Washington, DC at 202-587-2797 to make an appointment for a no-cost consultation.

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



Can Pets Get Dementia?


Earl and Linda’s silver poodle, Sophia, is fifteen years old. Recently, they have come home from work to find Sophia wandering aimlessly through the house and have noticed the trouble she is having finding the doggie door. Sophia used to jump up and twirl on her back legs for a treat, but she seems to have forgotten that trick. Earl is having flashbacks of when his mother, Mildred, had dementia and how she forgot things she used to know so well. He is beginning to think Sophia has dementia also. Linda thinks he is going crazy and should have his head checked for thinking such a thing. Turns out he may not be.

We take our pets to the veterinarian for heart worm testing, lethargic behavior, and hip dysplasia. Have we thought about their mental state too? According to a recent New York Times article, with advances in modern veterinary medicine, domestic dogs and cats often live long enough to develop cognitive dysfunction, and studies in both cats and dogs show that they can in fact experience symptoms of dementia as they age. What are the symptoms we should look out for?

If You Have an Older Dog

A study at the University of California-Berkeley has shown that 62% of dogs between ages 11 and 16 demonstrate one or more signs of dementia (called canine cognitive dysfunction (CCD) in dogs), and the percentage goes up as dogs get older.

How do you identify possible CCD?

If You Have an Older Cat

Researchers from the University of Edinburgh now believe 50% of all cats over the age of 15 and 25% aged 11 to 14, are suffering from dementia (or geriatric onset behavioral problems). The same team was also the first to discover cats could suffer from dementia. Their research involved scans which showed changes to the neural system of confused elderly cats were similar to those seen among humans with the conditions, and found that the same beta-amyloid protein found in humans with dementia was present in the cats.

How do you identify possible geriatric onset behavioral problems?

If you think your pet could have CCD or geriatric onset behavioral problems, you should make an appointment with your veterinarian to have them tested. Other illnesses have to be ruled out first, before cognitive dysfunction is definitively determined.

How Can We Help Senior Pets Live Better Lives?

Although there isn’t a cure, there are ways to manage cognitive dysfunction and help your older pets live better lives, as follows:

Even though senior pets may have dementia-like symptoms as they age, they are still wonderful pets for senior owners. The SPCA recently reported that in a study of 100 Medicare patients, even the most highly-stressed dog owner had 21% fewer physicians visits than any non-dog-owner. In addition, seniors who own pets are more likely to keep up with daily activities, have better overall physical health due to exercising with their pets, and have lower blood pressure and cholesterol levels than those living without pets. From personal experience, I can tell you that the tuxedo cat that Jeannie and I adopted from our local animal shelter when he was 9-years old is the most gentle and loving animal that I have ever had the pleasure of knowing, and has brought incredible joy to our lives and the lives of our two other rescued cats at home. Read more about the benefits of senior pets on our blog.

Don’t Forget about the Pet

Many of us who think of our pets as family members want to ensure that they are cared for after we become incapable of doing so. One way to fulfill this responsibility is to set up a pet trust, or a legally sanctioned arrangement that provides for the care and maintenance of your pet(s) in the event of their your disability or death. For more details, read the Pet Trust FAQ on our Website.

What if it is your (human) family member who is suffering from dementia? At the Farr Law Firm, 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 call 703-691-1888 in Fairfax, 540-479-1435 in Fredericksburg, 301-519-8041 in Rockville, MD, or 202-587-2797 in Washington, DC to make an appointment for a no-cost consultation. If you come to the Fairfax office, be sure to visit with all of the animals who live here, including Alley (our Siamese cat), Angel (our Tortoiseshell cat), Ernie and Jannette (our African Dwarf Frogs), and Commander Bun Bun (our lop-eared love bunny). And be sure to follow our “Critter Corner” column that appears most Fridays in our weekly “Ask the Expert” newsletter and on our blog.


Critter Corner: Helping Seniors with Winter Hazards


Dear Commander Bun Bun,

My 80-year-old mother is having a rough time with this winter weather. Do you have any suggestions to help her deal with winter hazards?

Thanks for your help,

Cole Dowthere
Dear Cole,

The frigid winter weather we are experiencing can present severe challenges and potential hazards for seniors. Luckily, there are strategies that seniors and caregivers can employ to help avoid cold weather hazards:

  • Falls on the ice: Slips are a major risk for seniors in winter, so it’s important to wear shoes with traction, such as warm boots with rubber soles.
  • Driving: Seniors should avoid driving when road conditions are bad, and if they must drive, they should make sure snow-tires are installed and warm blankets and food are available in the car, should the vehicle become stranded or disabled.
  • Hypothermia: According to Center for Disease Control (CDC), more than 50% of hypothermia deaths are among seniors. Older adults who do venture outside in cold weather should make sure to layer their clothing and dress warmly. Seniors should keep their thermostats above 65 degrees, and seek assistance if they lose heating.
  • Social Isolation: If your mother has been spending a lot of time alone at home due to inclement weather, try to visit her often and spend time with her in her home. Arrange transportation to the local senior center, your mother’s church or synagogue, or other places where she can socialize.
  • Seasonal Affective Disorder (SAD) or “the Wintertime Blues”: Many seniors experience a decrease in happiness and energy during the winter, which is caused by decreased daytime light in winter. This phenomenon is known as “seasonal affective disorder” or “SAD”. During times of year when daytime is shorter, seniors are at highest risk. Open curtains and blinds during winter to let natural lighting in. Seniors experiencing depression should of course talk to their doctors.
  • Sundowning:  Seniors with Alzheimer’s and other forms of dementia sometimes experience sundowners syndrome, which may include increased memory loss, agitation, confusion, and even anger during the evening hours. Sundowning is often exacerbated during winter, because the season’s low light can disrupt the body’s circadian rhythms. To help seniors experiencing sundowning, establish a routine, let light into the home, and promote a relaxing, quiet environment in the evening.

Be safe this winter!

As a Certified Elder Law Attorney, Evan Farr focuses on helping protect seniors and their families by preserving dignity, quality of life, and financial security. Call us anytime at 703-691-1888 in Fairfax, 540-479-1435in Fredericksburg, 301- 519-8041 in Rockville, MD, or 202-587-2797 in Washington, D.C. to make an appointment for a no-cost consultation.

Warm Winter Wishes,
Commander Bun Bun


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