Estate Planning Blog Articles

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Does Government Have Financial Assistance for Alzheimer’s?

Social Security Disability Insurance (SSDI) provides financial support to those who’ve worked and paid into the Social Security system and are now unable to work due to a disability, including dementia. To be eligible for SSDI, a person must have enough work history and their condition must meet the SSA’s definition of a disability.

Help! Dementia recent article entitled, “Financial Costs and Planning for Dementia and Alzheimer’s,” explains that Supplemental Security Income (SSI) provides financial support to those who have a limited income and assets and are aged, blind, or disabled. People with dementia may be eligible for SSI, if they satisfy the income and asset limits set by the Social Security Administration.

The Area Agency on Aging has information and resources on financial assistance for those suffering from dementia. However, financial assistance can vary depending on the location and the services offered by the agency. Some services that the aging agency may provide include:

  • Information on government benefits, such as Medicaid, may be available to individuals with dementia and their families to help cover the costs of care.
  • Assistance with long-term care planning, like resources on long-term care options, including assisted living facilities and in-home care. They can help individuals with dementia and their families plan for their future care needs.
  • Information on financial assistance programs, such as grants and loans, may be available to individuals with dementia and their families to help cover the costs of care.
  • Life resource planners and elder law lawyers can be helpful to those with dementia and their families who need assistance with financial and legal planning.

Life resource planners are professionals who specialize in helping individuals and families plan for their future, including financial and legal planning. They can provide guidance on government benefits, caregiving and long-term care planning.

Elder law lawyers specialize in legal issues affecting older adults, including government benefits and long-term care planning.

Reference: Help! Dementia (Feb. 12, 2023) “Financial Costs and Planning for Dementia and Alzheimer’s”

Can a Dementia Patient Sign Legal Documents?

Once a diagnosis of dementia has been received, families need to immediately begin advance care planning, as explained in a recent article titled “Can Someone With Dementia Sign Legal Documents” from Health News. Depending on their medical condition, some patients with dementia, particularly in early stages, may be capable of making their own decisions regarding legal decisions. However, discussions must begin early, so the person can be involved and understand the planning process.

When family members don’t know the wishes of their loved ones, they are more likely to experience distress and difficulties in making decisions. Families report feelings of guilt, self-doubt and stress while making advance care decisions with no input from their loved ones.

Laws concerning advance care vary from state to state. An elder law attorney can help older adults interpret state laws, plan how their wishes will be carried out and understand financial options.

Advance care planning focuses on both long-term care and planning for funeral arrangements. These documents typically include a durable power of attorney for healthcare, a living will and Do-Not Resuscitate orders, often called a DNR. Depending on state law, there may also be a MOLST document, short for Medical Orders for Life-Sustaining Treatment.

The durable power of attorney for healthcare names another person who can serve as a proxy for the person with dementia, if and when the person is not able to make informed healthcare decisions for themselves.

A living will states a person’s wishes for end-of-life treatment. This documents their views about specific medical procedures including but not limited to dialysis, tube feeding or blood transfusions. If the person should become unconscious, then families may make treatment decisions based on what their loved one wanted.

A Do-Not-Resuscitate order is placed in a patient’s medical chart if the person does not want to receive CPR (cardiopulmonary resuscitation) if their heart stops or breathing ceases. This must be signed by a doctor before it is placed in the chart.

Planning for a funeral is a difficult task. However, it will alleviate stress and possible guilt in the future. People with dementia can tell their loved ones in advance what they want regarding a funeral or memorial service, burial, or cremation. If any arrangements are already in place, such as the purchase of a burial plot, providing details to family members will make it easier to manage.

Advance care planning can be a sensitive topic but seeking legal advice early on is useful so the family can focus on making sure their loved one has the care they want. Involving the person with dementia in the process is respectful. An elder lawyer attorney will be able to guide the family to ensure planning is done properly.

Reference: Health News (Jan. 11, 2023) “Can Someone With Dementia Sign Legal Documents”

What Games are Best for Brain Health?

Researchers at Columbia University in New York City and Duke University in Durham, North Carolina, recently found that older participants — with an average age of 71 — who were trained to complete computerized crossword puzzles showed more of a cognitive improvement compared with those who were trained to use web-based cognitive video games, reports Money Talks News’ recent article entitled, “Crossword Puzzles or Video Games: Which Better Protects Your Brain?”

In a summary of the study’s findings, Dr. D.P. Devanand, professor of psychiatry and neurology at Columbia, remarked:

“This is the first study to document both short-term and longer-term benefits for home-based crossword puzzles training compared to another intervention. The results are important in light of difficulty in showing improvement with interventions in mild cognitive impairment.”

The researchers explain that mild cognitive impairment is a stage between the cognitive decline that is normal with aging and full-blown dementia. Those with mild cognitive impairment may struggle with memory, language, thinking or judgment.

The researchers went on to note that those with mild cognitive impairment are at a significant risk for dementia, including Alzheimer’s disease.

As part of the study, 107 participants with mild cognitive impairment were trained for 12 weeks in either crossword puzzles or cognitive games.

Follow-up “booster sessions” were then held for up to 78 weeks.

While both forms of training were equally effective early in the course of disease, crossword puzzles were better in the later stages. Those who used crossword puzzles showed less brain shrinkage at 78 weeks.

Dr. Devanand says the study results show that further research on developing a home-based digital therapeutic for delaying Alzheimer’s disease “should be a priority for the field.”

Reference: Money Talks News (Nov. 5, 2022) “Crossword Puzzles or Video Games: Which Better Protects Your Brain?”

How Many Americans Suffer from Dementia?

In a nationally representative cross-sectional study of about 3,500 older adults, 10% (95% CI 9-11) were classified as having dementia and 22% (95% CI 20-24) as having mild cognitive impairment, according to Jennifer Manly, PhD, of Columbia University Irving Medical Center in New York City, and colleagues.

MedPage Today’s recent article entitled “Dementia Strikes One in Ten Americans Over 65” notes that dementia prevalence rates were similar by sex but varied by age, education, and race, and ethnicity, they reported in JAMA Neurology.

The findings are from the first representative study of cognitive impairment in more than 20 years and are based on participants in the Harmonized Cognitive Assessment Protocol (HCAP) project of the ongoing, longitudinal Health and Retirement Study (HRS). HCAP is a cross-sectional random sample of HRS participants who were ages 65 or older in 2016.

“Because the HCAP study is part of the nationally representative and long-running Health and Retirement Study, these data not only show the burden of dementia now, but will be used in the future to track the trends in dementia burden in the decades ahead,” co-author Kenneth Langa, MD, PhD, of the University of Michigan in Ann Arbor, said in a statement.

“Following those trends will be especially important given the likely impact of COVID and other recent population health changes on the risk for dementia in the coming decades,” Langa added.

Of the nearly 10,000 age-eligible HRS participants, roughly 3,500 were selected for HCAP and completed a comprehensive neuropsychological test battery and an in-person interview between June 2016 and October 2017.

Compared with White participants, dementia was more common among Black participants, and mild cognitive impairment was more prevalent among Hispanic participants. The rates rose dramatically with age: 3% of people between ages 65-69 had dementia versus 35% of people ages 90 and older. Every 5-year increase in age led to higher risks of dementia and mild cognitive impairment.

Each additional year of school was also linked with a drop in risks of dementia and mild cognitive impairment. The findings were similar to other recent estimates of dementia prevalence in the U.S.

“With increasing longevity and the aging of the Baby Boom generation, cognitive impairment is projected to increase significantly over the next few decades, affecting individuals, families, and programs that provide care and services for people with dementia,” Manly said in a statement.

The study provides a snapshot in time and cannot assess cognitive impairment incidence or rates of progression among people with mild cognitive impairment, the researchers said.

The HCAP study’s cross-sectional design “does not allow for examination of survival bias, which could inflate prevalence if some groups are living longer with dementia or decrease estimates in groups with higher mortality,” Manly and colleagues added.

Reference: MedPage Today (Oct. 24, 2022) “Dementia Strikes One in Ten Americans Over 65”

Why Does Government Deny Social Security Disability Benefits

Kiplinger’s recent article entitled “3 Main Reasons Why the Government Denies Social Security Disability Benefits” says three main issues are the primary contributors to the high denial rates and prolonged appeals process:

  1. Applicants fail to satisfy work history requirements. Anyone who pays FICA payroll taxes long enough, is typically insured for SSDI. However, that doesn’t mean they’re eligible for benefits. To meet the SSA definition of disability, one must have physical or mental impairments that prevent them from being unable to perform any substantial gainful activity (SGA) for at least 12 months or have a terminal diagnosis. SGA encompasses work performed for pay or profit, and for 2022, the monthly benefit one would receive after qualification is set at $1,350 a month, or $2,260 if you are blind.
  2. Applicants provide incomplete documentation. Detailed medical evidence is required to document a disability and its impact on the person’s ability to perform SGA—it’s a crucial part of the SSDI application. This should include diagnoses, medical tests and results, treatment history, prescription drugs, surgeries, ER and doctor visits and other relevant medical details to show not just that you have a problem, but also that you’ve been receiving regular medical treatment for your issue. This, along with details about how a disability influences your activities of daily living, is especially significant if you have an invisible disability, such as mental disorders, neurological conditions or cognitive dysfunctions caused by injury or disease. Regular monthly treatments and drug therapies with specialists and mental health professionals are an important part of your claim.
  3. Applicants not knowing they have the right to an SSDI representative. The SSA doesn’t tell initial applicants they have the right to retain a representative to assist them. As a result, most people try to navigate the complicated program on their own. You need an advocate to tell the story of your disability and its impact on you and your family. Less than 30% of applicants have an SSDI representative to help them apply. Those individuals are 23% more likely to get their application approved. It also means getting benefits in six months compared with a year or two!

Representatives are taking on more SSDI cases resulting from long COVID symptoms that have exacerbated physical and mental impairments. Long COVID may affect up to 30% of COVID patients, or an estimated 25 million people in the United States, especially those with respiratory disease, diabetes and cognitive issues.

Reference: Kiplinger (July 16, 2022) “3 Main Reasons Why the Government Denies Social Security Disability Benefits”

Can Traveling Help Seniors’ Mental Health?

A study to be published in the October 2022 edition of Tourism Management presents the thoughts of a cross-disciplinary team of experts in both dementia and tourism. Medical News Today’s recent article entitled “’Travel therapy’ may offer treatment for dementia and benefit mental health” reports that the research hasn’t yet been peer-reviewed, but experts think there may be significant benefits of travel for people with dementia, particularly in the areas of mental health and well-being.

Dementia currently has no cure, but some medications and treatments may help control symptoms.

Care is often supportive, including helping those with dementia do as much as they can on their own and helping them have a better quality of life.

Researchers are still working on how to best help those with dementia. One area of interest is how traveling may benefit people with dementia.

The researchers say that the potential benefits of tourism in treating people with dementia are called “travel therapy.” One definition of tourism the researchers used was “visiting places outside one’s everyday environment for no longer than a full year.” They note that the experience of tourism has four main components to it:

  • Affective Experience: how it impacts feelings, emotions and mood
  • Cognitive Experience: how it affects thoughts and memories
  • Conative Experience: how it impacts behavior; and
  • Sensorial Experience: how it impacts the senses.

The authors concluded that tourism may have a potentially positive impact on well-being and quality of life through a variety of components. However, the literature supporting this in the treatment of dementia is limited.

The study authors also noted that focusing on components of positive psychology, such as what people can do, positive experiences, and well-being may also benefit people with dementia.

They proposed a few options to implement components of tourism to help people with dementia, such as group travel that promotes social interactions or traveling to locations that stimulate the senses.

Reference: Medical News Today (June 30, 2022) “’Travel therapy’ may offer treatment for dementia and benefit mental health”

Can My Pet Help Me in Old Age?

Seniors who own a pet may slow their rate of cognitive decline, according to a preliminary study recently presented at the American Academy of Neurology’s 74th Annual Meeting.

Money Talks News’ recent article entitled “Sharp Mind in Old Age? Thank Your Pet” reports that the positive effect appears to be particularly pronounced for those who own a pet for at least five years.

The study looked at data from 1,369 older adults with an average age of 65.

All had normal cognitive skills at the outset of the study. Of the adults in the study, 53% owned pets, with 32% having had their pet for five years or longer.

After examining cognitive test data, the researchers found that after six years, long-term pet owners had a cognitive composite score that was 1.2 points higher compared than those who did not own pets.

In a press release, study author Dr. Tiffany Braley of the University of Michigan Medical Center in Ann Arbor remarked that the positive impact of pets may stem in part from the animals’ ability to reduce our levels of stress:

“As stress can negatively affect cognitive function, the potential stress-buffering effects of pet ownership could provide a plausible reason for our findings. A companion animal can also increase physical activity, which could benefit cognitive health.”

However, Braley — who also is a member of the American Academy of Neurology — said more research is needed to both confirm the results and identify underlying mechanisms that may be responsible for the link.

Earlier studies have found that the presence of pets can help reduce their owners’ levels of stress and even lower their blood pressure.

Reference: : Money Talks News (May 5, 2022) “Sharp Mind in Old Age? Thank Your Pet”

Elderly Woman Thanks Firefighters for Ride to Visit Husband at Nursing Home

An senior in San Diego was so grateful for the help of local firefighters, she wanted to thank them in person with a big bag of sweets, reports NBC San Diego’s recent article entitled “Stranded La Jolla Woman, 87, Brings Treats to Firefighters Who Gave Her a Lift.”

“It was a long time I was waiting for that cab. If it wasn’t for you, I’d be there all night,” La Jolla resident Sandy Lightman recalled telling San Diego Fire-Rescue Department Captain Jordan Buller on May 10, the night of her “rescue.”

The article said that Mrs. Lightman may have needed a fire engine to haul the three dozen cookies and four cheesecakes to Captain Buller and the Station 35 crew.

The 87-year-old explained that she’d just ended one of her daily trips to a nursing facility, where she cares for her husband who’s living with dementia.

She started requesting a cab around 8:20 p.m., but it didn’t show. So, she kept calling.

Hours later at 11 p.m., while on another call to the facility, Captain Buller and his crew recognized Lightman’s distress.

“She was frantically trying to call family and call a cab and we could tell she was distraught,” he said.

“I can’t walk that well, and I was only two-and-a-half blocks from where I live but I was afraid to go on the street by myself. I didn’t know if I’d make it home,” she said.

Since the cab wasn’t coming, the San Diego fire firefighters loaded Lightman into the cab of their engine.

They strapped her into the jump seat—and even gave her headphones to wear for the trip.

“It felt so secure, it made me feel so good because they were helping me and I knew I was safe, because I was afraid,” said Mrs. Lightman.

Back home safely, the grateful woman says she’s thankful to the local news outlet that was able to help track down the station who treated her with such kindness, so she could spoil them with some sweet treats.

Lightman and her husband will celebrate 40 years of marriage next week.

Reference: NBC San Diego (May 24, 2022) “Stranded La Jolla Woman, 87, Brings Treats to Firefighters Who Gave Her a Lift”

Can a Teddy Bear Help Elderly with Dementia to Communicate?

This cuddly bear engages with individuals with memory disorders.

WGAL’s article entitled “Talking teddy bear gives patients with dementia a new way to connect” reports that Cue Teddy is the brainchild of Dr. Roger Nelson.

Dr. Nelson is a retired physical therapist whose family dealt with dementia. He saw a need that was not being met.

“They lacked this ability of being able to talk and to think and then to connect with other people,” he said.

Dr. Nelson, therefore, teamed up with Rod Tosten, the vice president of IT at Gettysburg College, to bring the bear to life.

“Cue Teddy cues the individual to move and to stay active,” Tosten said.

The bear goes through a series of questions and commands, tapping into three areas of the brain: thought, motion and touch.

“One of the things we’re testing is what colors work well and what kind of fabric works well,” Tosten said.

But why a teddy bear?

“Everybody kind of remembers their first teddy bear they ever got and the name of the teddy bear,” Nelson said.

In addition, making people remember is part of the goal.

“I hope that a lot of people adopt it and use it because it’s a valuable tool,” Nelson said.

“To be able to help other people is just amazing. I just love working on this,” Tosten said.

Cue Teddy is currently in the early stages of development. When it is ready, the two creators will be looking for a partner to mass produce it.

Reference: WGAL (Feb. 14, 2022) “Talking teddy bear gives patients with dementia a new way to connect

Can Fluffy Come to the Nursing Home with Me?

Several studies show the benefits of pets, and senior care communities are increasingly adopting pet-friendly policies.

IAdvance Senior Care’s recent post, “How Senior Care Community Design is Changing to Become More Pet-Friendly,” explains that pets can provide many valuable benefits in senior care settings, particularly because of their effects on mental and physical health. One study found that the presence of dogs was linked to less agitation and fewer behavioral issues for Alzheimer’s patients. In fact, according to News in Health, pets have been shown to help decrease the stress-related hormone, cortisol and lower blood pressure in residents who interact with our furry friends. Studies have also proven that pets can boost mood, reduce loneliness and help seniors feel they have social support.

In addition to health benefits, pets can also provide an important consistency for those who may be moving into a senior care setting. Many people see pets as family members, and a pet-friendly community that permits new arrivals to bring pets with them can avoid a painful separation.

More senior care communities are adopting pet-friendly policies, which can require design changes.

According to Natalie Ruiz, AIA, LEED, AP, NCARB, CDT, associate principal at CallisonRTKL, senior care communities that adopt a more pet-friendly approach see multiple benefits. “For residents, having a pet helps combat loneliness, increases social interaction and gives a sense of purpose,” she explains. “For communities, they see their residents thrive with increased mobility resulting from walking a dog or grooming a cat. There’s also a simple uptick in the job and happiness that comes with the residents having a sense of purpose.”

Ruiz says that in addition to designs and renovations that accommodate residents’ pets, some facilities also benefit from pet therapy programs that introduce community pets for residents to enjoy. In these instances, the facility’s residents still have access to animal companionship but don’t have the time or financial commitments of pet ownership. With the benefits of pets, care communities are increasingly requesting new pet-friendly elements. Ruiz said more and more senior care communities are working to include dog parks with dog washes and pet water fountains. Dog runs are also popular requests.

Ruiz says that while facilities can easily create dog-friendly spaces, they should also give some thought to creating a space for cat lovers. She also suggests that a care center trying to become pet-friendly should designate a pet coordinator who can help the residents with pet care.

Reference:  iAdvance Senior Care (Nov. 30, 2021) “How Senior Care Community Design is Changing to Become More Pet-Friendly”