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Estate Planning

Preparing for the Future with Your Parents

It’s very difficult for anyone to think about their parent becoming elderly or ill, but if no advance planning has been done, there may be little, if any, time to figure out which living option is the best for them.

So, listen to mother. Plan ahead with your parents, if possible, so you will have your strategy ready when it’s needed.

Would your parents want to stay home? Move to a retirement community? Relocate to be closer to children?

Research the options. You might be surprised at how attractive many retirement communities are. There are increasing opportunities for independent or assisted living. Some facilities also offer transition into memory care, if that becomes needed.

Look into Caring.com, or call 800.973.1540. This is a comprehensive resource that offers information and guidance nationally, for living options and caregivers. Then, when you have researched what’s out there, talk with your parents about the pros and cons of the various choices.

Most people want to stay home for as long as possible. In-home care might be an option.

To connect with caregiving services for older adults and families, consult Eldercare Locator, a service of the U.S. Administration on Aging, on-line at eldercare.acl.gov or at 1.800.677.1116. The Eldercare Locator also provides information on local Area Agencies on Aging. These can be very helpful.

A care manager might be an option. These people have the experience and expertise to coordinate the many elements involved in elder care: medical providers, financial planners, elder-law attorneys, and rehabilitation specialists. Or, such people can work on an hourly basis, to pick up prescriptions, accompany your parent to doctors’ appointments, and coordinate communication with long-distance family. Find care managers through the Aging Life Care Association, aginglifecare.org, or at 520.881.8008.

If possible, urge your parents to get their legal documents in order while they are still in good health.

That is the best time to make sure that your parents have done the necessary legal documents. They may want to visit our office by themselves, but suggest to them that they provide you with copies of the documents. That way you will have the papers ready when you need them, and you won’t have to search for them under time pressure.

You can hope for the best, or you can plan for your parents’ well-being.

Do both. Call us now. If you have questions or would like to discuss your personal situation, please don’t hesitate to contact us. Please contact our Reno office by calling us at (775) 853-5700.

Estate Planning, Healthcare

Planning and Preserving Quality of Life

As lawyers prepare powers-of-attorney documents so that when our clients can no longer act for themselves, the documents will convey on other trusted people the authority to act on our clients’ behalf.

But when it comes to actually using those documents at the time of a health-care crisis, clear and powerful documents are just the beginning. The decision-points can (and must) be put down on paper in advance, but when it comes to end-of-life situations, the clarity on which we lawyers thrive can be very hard to find.

Sitting in her lawyer’s office, the client may have been quite certain about health-care decisions. She does not want her life prolonged by a battery of aggressive treatments, where these would not preserve her quality of life. She does not want blood transfusions, dialysis, repeated courses of antibiotics and chemotherapy, cardiopulmonary resuscitation, or breathing and feeding tubes. She does not want to die inert in the ICU, surrounded by machines and strangers. She wants to die at home, surrounded by loved ones, at a time when she retains presence of mind to make her peace.

But that goal doesn’t just happen from wishing it and stating it. It happens with additional careful preparation for the realities. As the end of life approaches, the clarity we lawyers enjoy can be elusive. When a person gets a prognosis of two to five years (maybe), where, along that continuum, would be the time to start declining aggressive treatment? When there’s always one more intervention that may (or may not) produce a good result? When one decision could create an ever-widening array of complications? When, step by step, the patient becomes less and less able to exercise autonomy, and where treatment decisions by caregivers are not in line with the care the patient was clear about when she was sitting in the lawyer’s office?

No matter how clear the powers-of-attorney documents, with all these imponderables, the patient can end up in a situation many miles away from what she wanted. And there’s no possible do-over.

Powerful and clear power-of-attorney documents are an essential first step and we lawyers are glad to take care of that part. Beyond that, though, thorough preparation is essential.

Consider that the best result may be one that cares for comfort right now, in the moment. The question is not necessarily about how long life can be prolonged. The question may be, rather, how comfort can be maintained – in this moment, and then the next moment, and the next. The question is how life can be made better right now. Watch a video by palliative-care physician B.J. Miller, on why this is so important, here.

Make concrete plans. These include specifying what you want to happen if you’re no longer able to live independently; choosing wisely whom you want to act for you, to make sure your plans will be followed; being ready with your health-care documents before you find yourself deposited in the emergency room or ICU; and seeking the reassurance that your loved ones will be cared-for when you’re no longer there. Judy MacDonald Johnson has prepared simple, forthright worksheets to help with this process, here.  She speaks about these worksheets in this moving video.

There is no doubt that the process in safeguarding quality of life at the end of it is possibly the most challenging of all. But if that process can create as much pleasure as possible through an extremely difficult time of life, and if forthrightly engaging in that process would facilitate a passing more in line with what we would envision, the worth of the process will be felt. The transition will be smoother and more meaningful for the dying person, and a kinder legacy will be left behind for those who accompany us on this journey.

If you have questions or would like to discuss your personal situation, please don’t hesitate to contact us. Please contact our Reno office by calling us at (775) 853-5700.

Estate Planning

Retirement Planning and Saving

Many Americans are saving nothing or very little in their day to day lives for retirement. While the unemployment rate has previously been  low and wages are seeing an increase the American worker is not saving enough of their income which will inevitably lead to short falls of operational cash during an unexpected crisis and in their retirement years further down the road. (https://www.cnbc.com/2018/03/15/bankrate-65-percent-of-americans-save-little-or-nothing.html)

Bankrate maintains that half of all Americans will not be able to maintain their standard of living once they have stopped working. GoBankingRates corroborates these findings citing that over forty percent of Americans have less than $10,000 dollars saved for their retirement. These statistics point to a dismal retirement future for nearly half of all Americans.

This doesn’t have to be your future. It doesn’t matter how little you currently save. You don’t have to become the horror story of retiring and meeting financial ruin like so many do. What matters is that you change the trajectory of your retirement life by proactively examining how you are spending and saving. The sooner you begin the better your chances of success.

The first and most important strategy to implement is learning to live beneath your means. That translates into saving money: probably more than you currently do. Saving money is an underestimated survival skill. To save begin by tracking your spending habits for thirty days. Once you have the data create a realistic and doable budget. Fluid expenditures like groceries, eating out, clothing, gasoline and auto maintenance need to have a set monthly budget. Create a simple two columned sheet of paper with budgeted and actual expenditures to monitor your progress. Typical categories where you can reduce expenditures include; cable packages, phone plans, groceries, entertainment costs, gym memberships, clothing and dining out. Start asking yourself over and over “Is this a need or a want?” and if it is a need, how can you make the cost lower. The game is how much money you can save, not spend.

Consolidate your non essential debt and pay it off, completely. Make it a primary goal to get out of debt. Stop being a debt slave. In the credit card industry there is an insider term used for people who fully pay their credit cards off each month. Guess what it is? It is a deadbeat. Companies cannot make money off of you if you stop becoming a slave to debt. If you can’t afford it then find a way to live without it.

Double check your insurance rates on your car, homeowner, and health. Do not purchase flight insurance, extended warranties, and disease insurance. Check this site for fifteen insurance policies you don’t need. (https://www.investopedia.com/insurance/insurance-policies-you-dont-need/). Get rid of the policy all together or find wiggle room for reduced premiums or get a more competitive provider to save money.

Get rid of automatic payments attached to your banking accounts. Most people can eliminate expenditures they forgot they are even locked into. This also forces you to take control of your bill/payment cycles. Being involved in the day to day of bill payment keeps you far more aware of your financial situation and keeps your mind active.

Consider downsizing your home. If you are in a two story house it is inevitable that one day you will not be able to climb those stairs. A one story home or a first floor condo or apartment can help you purge your life of ‘stuff’ you no longer need. Some of those things can be sold and the proceeds can be saved. Any profit left over from downsizing immediately goes into savings or a financial investment vehicle to provide and protect your senior years.

These are some but not all of the ways it is possible to change your savings habits. Guidance from a trusted professional is key to the pathway of success because there will always be roadblocks and setbacks that you must make adjustments for.  Structuring a legal plan in connection with a retirement plan can provide added protection and allow you to enjoy retirement more thoroughly.

Contact our office today and schedule an appointment to discuss how we can help you with your planning. Please contact our Reno office by calling us at (775) 853-5700.

Elder Living

Solo aging, Housemates, and Individual Living

In the baby boomer generation, solo aging is becoming more prevalent, but many Americans don’t have family caregivers to assist them in their quest for elderly living independence. The ratio of caregivers to care recipients has fallen and is projected to continue to do so for the next forty years. According to the Pew Research Center, the rate of childlessness among baby boomers is about 20 percent. That number is double the previous generation. Additionally, these boomers who are aging solo, without a spouse or partner and have children living more than 500 miles away, bring the total of solo agers in America to nearly 40 percent of adults over the age of 65.

Because solo agers who own their own home prefer to reside there, many of them are finding creative ways to share costs as well as reduce the workload, stress, and isolation of living alone. Welcome to your new housemate, but don’t call them that and don’t call them roommate either. The boomer generation is adopting the term “POSSSLQ,” (pronounced “possle-cue”) short for People of Similar Sensibilities Sharing Living Quarters. This moniker is a wink at the former US Census Bureau designation for unmarried couples; “Persons of the Opposite Sex Sharing Living Quarters.” Whatever the preferred terminology, this new housemate trend is a demographic and economic shift which is redefining the “golden years” of retirement.

It is no surprise that at a historic shortage of homes pushing up housing costs coupled with the fact that many boomers realize they have not saved nearly enough for retirement has fueled this housemate solution. Some of the best ground rules to follow are to find someone you may already know, perhaps of similar background. Also, keep your “POSSSLQ” in a narrow age range to your own. Seniors who are looking to be housemates and are of a certain age can find each other on websites, some of which are Roommates4Boomers and Let’s Share Housing. It is a great way to stretch retirement dollars and still have independence in a shared living experience without loneliness or feeling like a burden to family.

Women account for most of these new housemate living arrangements. Women tend to live longer and have less in retirement savings as compared to their male counterparts. Women also tend to be more adept at making a home and creating companionable spaces in which to cohabitate.

The rules of roommates are usually broad and general. Some specific ground rules may be non-negotiable such as pets, loud music, or romantic sleepovers; however many women have a more flexible approach and often work out smaller details in day to day conversation. Often the secret to housemate living is to embrace its unexpected nature so long as an established basic framework remains intact. These boomer housemates are expressing creativity in problem-solving issues related to their golden years and want their focus to be on living life rather than the end of life planning.

The cautionary tale of baby boomer housemate living is to be confident you enter into the relationship with a legal document that outlines home ownership, household expenses, chore responsibilities, house rules, as well as identification of objects you already own in your home (if the owner) or what you may bring into the house (as the new housemate). Remember that you spend the first half of your life trying to get something and the second half of your life trying to keep it. Another issue to discuss and lay legal ground rules for is what happens in the case a housemate gets a diagnosis of dementia? A housemate living situation should not evolve into a caretaker situation.

Whether you are the homeowner or the housemate, it is imperative to have a legal document signed and notarized defining the living arrangement. Contact our office today and schedule an appointment to discuss how we can help with the planning and execution of a housemate agreement. Please contact our Reno office by calling us at (775) 853-5700.

Uncategorized

Discussion Points for You and Your Aging Parents

Your parents are getting older, but you don’t have a clear idea if they have a plan in place for their care.  It is a difficult topic to broach; no one wants to talk about death and the financial realities that come with aging.  Instead of having a proactive conversation early in a parent’s aging process most families have a reactive discussion under high levels of stress and emotions while their parent is experiencing an adverse health event.  The Public Broadcasting Service (PBS) has reported that 85 percent of time long-term care decisions are made during a medical crisis. The message is clear, be proactive and start discussing the important financial questions with your parent.

Prepare Yourself

Your parent will be feel more comfortable and at ease if you have processed your feelings before talking to them.  Conduct research so that you are knowledgeable enough to present a clear and concise set of options for your parent.  Having options allows your parent and family to make decisions and feel in control of the process.  You are seeking progress, not perfection. It may not all become settled in one conversation, but the price of silence about your parent’s plan may be very costly to you.

Review Documents

Two of the most critical personal legal documents are a durable power of attorney (DPOA) and a healthcare proxy. All older adults should have these documents as it gives legal authority to a designated representative to make financial, legal, and health care decisions on your parent’s behalf. If your parent does not have a DPOA and becomes incapacitated, you will have to go to court to get appointed as your parent’s guardian which can be a complicated legal process at a time when your energy is better spent in the care and decision making for your parent. If they do not have a DPOA and health care proxy in place make arrangements for them to meet with a trusted elder law attorney to properly draft the legal documents.

Often a parent will have a will, retirement account information and insurance policies that have not been revisited or updated in years, sometimes decades. When was the last time your parent reviewed beneficiary designations? Family circumstances change, and the birth of a child, death or divorce can affect how your parent may want beneficiaries designated. It is best to review financial and insurance data annually with your parent and make adjustments if necessary. For example, if the parent’s children are grown it might be best to cut back on the amount of life insurance they carry to save money on annual premiums.

Long Term Care Plan

Address the issue of long-term care. According to the PBS, a full 70 percent of all seniors will need some long-term care as they age. Even if your parent is healthy today odds are they will require long-term care and the costs are staggering. Some life insurance companies will add a long-term care rider to an existing policy. Medicaid also can cover some long-term care costs, but neither standard health insurance nor Medicare will cover your parent’s long-term care expenses.

Meet the Team

Ask your parent about their financial advisors and request a brief introduction to them.  Find out who they are and how you might contact them in the event your parent is unable to do so. This information will allow you to keep an eye on your parent’s accounts and be confident the advisors are trusted, objective and well versed in elder financial issues. Oversight by you in a slightly detached way provides your parent privacy and independence about their finances but allows you to protect them from unscrupulous advisors. 

Understand Filing System

The last thing you need to discuss is where this vital information is filed so that before a crisis hits you know where to find the important documents, online passwords, and forms of ID you will need to facilitate your parents well being. While you do not have to see all the specific contents of the information, particularly the financials, knowing where they keep the data is critical in a crisis. Remember that as your parent ages they may start to change the location of the information. Check with them a couple of times a year to ensure the information is still in the same place and physically look to be sure it is.

Discussing your parent’s strategy is best begun while they are healthy.  Proactive planning is the best way to help your family as your parents age.  Contact our office today and schedule an appointment to discuss how we can help you and your family.Please contact our Reno office by calling us at (775) 853-5700.

Uncategorized

2018 VA Mission Act

It has been no secret that the Department of Veterans Affairs (VA) has faced criticism in the past for its treatment of wounded veterans and their caregivers. On June 6, 2018, President Donald Trump sought to remedy this by signing the VA Maintaining Systems and Strengthening Integrated Outside Networks Act, or VA Mission Act. The Act was primarily designed to provide options and aid to expand private health care options through the VA. The Act also will eliminate, in stages, the previous limitation for caregivers of veterans who were wounded before 9/11 to receive government training and stipends.

Before the Act was passed by an overwhelming majority in both the House and the Senate, Representative Phil Roe, (R-TN) chairman of the House Veterans Affairs Committee, warned Congress to ensure that the VA has the resources to implement such an expansion. In a statement published by the American Legion, Roe said, “There has been miscommunication, confusion, and frustration from veterans, caregivers, and VA employees alike concerning practically every aspect of this program — from eligibility determinations to clinical appeals to revocations and more,” he continued, saying, “no veteran and no caregiver from any generation is well-served by having access in name only to a program that has the deficits this one does and is as ill-prepared as this one is to accept a sudden influx of new beneficiaries with complex, widely different caregiving needs from those veterans the program is currently serving.”

Roe’s foresight proved to be true as the VA and Congress have both struggled to provide direction and funding to move the program forward. The Senate estimates the cost of the Act will be around $55 billion over the next five years. However, Congress and the White House are locked in disputes over how to fund the program. As for the caregiver support portion of the Act, the cost is expected to be about $3 billion per year and increase from 21,000 veterans served to over 150,000 veterans and their families.

When the Act was signed, $5.2 billion in funding was provided to keep the current Veterans Choice program running through May 2019. Where funding will come from beyond that point continues to be unclear. Part of the reason for the funding crisis is that when Congress passed the VA Mission Act, it moved funding from mandatory appropriations to a discretionary program which must fit into overall domestic discretionary caps. However, the discretionary budget cap for 2019 and the projected caps for 2020 and 2021 do not include the increased costs necessary for implementing the Act, thus possibly leaving Congress with the inability to fund the program.

Eligibility for caregivers to receive training and financial assistance continues to plague veterans and their families. Congress still struggles to define exactly which veterans and caregivers are able to receive assistance. Currently, only post-9/11 veterans and those who suffered “severe, service-connected wounds or injuries” before May 1975 are eligible for benefits.

We will continue to post updates as Congress and the White House work out ways to pay for the VA Mission Act to take care of our veterans who have already done so much to take care of the citizens of this country. Please do not hesitate to reach out to our office if you have any questions. Please contact our Reno office by calling us at (775) 853-5700.

Estate Planning

Who Does a Probate Lawyer Represent?

Knowing the lawyer’s role, whether you are the Executor or an heir of the probate estate, is one of the first steps you should take at the beginning of the probate process. One of the biggest sources of conflict in probating the estate is understanding the role of the lawyer hired by the Executor of a probate estate. Many Executors do not understand the probate process and leave the tasks up to the lawyer. The heirs of the estate may hear only from the lawyer or may hear the Executor say, “This is what the lawyer says we have to do.” This often raises the question, does the lawyer owe a fiduciary duty to the heirs of the estate since the Executor owes a fiduciary duty to the heirs?

The answer to that question depends on the state in which the estate is being probated. To be clear, this question is specifically about whether a lawyer owes the heirs of a probate estate a fiduciary duty, and not whether a lawyer owes a fiduciary duty in other contexts, such as to the beneficiaries of a trust when hired by a trustee, or a ward when hired by a guardian or conservator. The answer varies depending on each different circumstance.

Also, before answering the question, it is helpful to have an idea of some common activities created by fiduciary duties in the context of probating an estate:

  • Duty to communicate: a duty to notify the beneficiaries the estate exists, identify the Executor, provide a copy of the inventory, provide copies of court filings, generally explain documents that require a beneficiary’s signature, etc. This duty to communicate is not the same thing as an attorney-client relationship, which means there is no attorney-client privilege and the attorney cannot give legal advice.
  • Duty to account: provide regular estate accountings, which includes explaining funds paid out of estate accounts for expenses.
  • Duty to treat all beneficiaries equal: distribute estate funds at the same time, if a question arises as to how something in the Will is to be interpreted the attorney cannot interpret it, the court must interpret it.

Turning back to the question, whether the lawyer owes a fiduciary duty the heirs of a probate estate depends on the state in which the estate is being probated. Only a few states require the lawyer to meet the same fiduciary duty to the estate heirs as the Executor. These states believe that since the Executor owes a fiduciary duty to the heirs and the lawyer owes a fiduciary duty to the Executor, the duty flows from the Executor to the lawyer.

Most states, however, take the position that the lawyer does not owe a fiduciary duty to the estate heirs. These states view the fiduciary duty owed by the Executor to the heirs as unique from the fiduciary duty owed by the lawyer to the Executor. Also, these states want to maintain the Executor’s ability to have protected communication with the attorney.

There is a small third set of states, including California, New Mexico, and Illinois, that apply a balancing test to determine who was the actual intended beneficiary of the attorney-client relationship, the Executor or the heirs? Each state has established their own test criteria, but some common questions the courts ask include: who was the intended beneficiary of the attorney’s services, the Executor or the heirs; what was the foreseeability of the harm to the heirs as a result of the malpractice; and what was the proximity of the misconduct and the damage to the heirs?

If you are the Executor hiring the attorney, ask what the law is. If you are an heir of the estate, the lawyer should give you some guidance. If the probate estate is in one of the majority states, the first letter from the attorney should start with a sentence that reads, “I have been retained by Mr. Smith, Executor of the Estate of Ms. Smith. It is important that you understand I do not represent you.”  Otherwise, call and ask.

Everyone’s goal should be for the settling of the probate estate to go smoothly. Understanding the lawyer’s role will go a long way towards achieving that goal.

If you have questions or would like to discuss your personal situation, please don’t hesitate to reach out.

Elder Law

The Benefit of an Elder Law Attorney

An elder law attorney specializes as a legal advocate for aging adults and their loved ones. Elder law encompasses a wide range of legal matters affecting an older or disabled person. Issues related to guardianship, retirement, health care including advance directives, long term care planning, Social Security, Medicare and Medicaid, and other relevant matters to aging all fall under the umbrella of elder law.

An older family member who legally prepares for their aging process helps their family members by addressing day to day issues that affect their actual care through proper legal documentation should the senior become incapacitated. Seniors often falsely assume that a close family member, including a spouse, will automatically be able to make decisions on their behalf if something goes wrong with their finances or health. Postponing legal document preparation through an elder attorney generally winds up being more problematic and expensive to a senior’s estate and wellness.

Many seniors find making legal preparations uncomfortable at first, as the task forces them to confront and assess their mortality. Further into the process, many aging adults experience relief, having removed the fear of the unknown of aging to the best of their ability. Legal preparation can keep a senior from health or financial ruin if they become incapable of making informed decisions regarding these matters. In the absence of legal documents, their family is left with the expensive and time-consuming process of petitioning the courts for legal authority to act on their loved one’s behalf – referred to as establishing a guardianship. By planning early and making sure the correct legal documents are prepared stress on the senior and the senior’s loved ones is greatly reduced.

Personal choices regarding end of life care and the disposition of assets and property outlined in legal documentation guarantees that your wishes will be respected by law. This documentation is especially important for seniors when a family member might seek control over the process, whether moral or self-serving, to follow their whims when handling your wellbeing when you are most vulnerable. Besides adhering to your expressed wishes, having your choices documented relieves family members from guessing what you want.

When preparing for your aging process, seek out a well-regarded attorney who specializes in elder law. While many general practice attorneys may have some experience with elder law topics, regulations are ever-changing and complex. It is best to find an attorney who specializes in elder law so that you get the best and most up-to-date advice.

Proactively address your aging process with a qualified elder attorney to ensure your wishes are carried out now and in the future, regardless of what happens with your health. Both you and your loved ones will garner invaluable peace of mind knowing that your wishes are known and legally documented. We would be happy to help you with your planning, and we look forward to hearing from you. Please don’t hesitate to contact our Reno office by calling us at (775) 853-5700.

Elder Law

Legal planning Related to Alzheimer’s Disease

Currently, there is no cure for the more than 5 million Americans who have Alzheimer’s disease. Projections by the Alzheimer’s Association (alz.org) are that by 2050 more than 14 million Americans will suffer from this disease. What can you do if you are medically diagnosed with Alzheimer’s? Aside from following the advice of your medical doctor an important step in your overall estate plan is an advanced directive to ensure your future wishes are met when you are no longer able to think or communicate clearly because of your disease progression. Having an advanced directive that accurately and legally reflects your financial and health care wishes allows you to focus on enjoying your life knowing you are doing all that you can to address your future circumstances.

You may already have advanced directives. It is a general term for various documents like a living will, instruction directive, health care power of attorney, and health care proxy. Now that Alzheimer’s disease is the 6th leading cause of death in the US, a newer advance directive specifically addressing dementia is becoming more common and is called the Alzheimer’s Disease and Dementia Mental Health Advance Directive.

An advanced dementia directive takes a comprehensive look at living with Alzheimer’s. Issues like where you will live, coping with profound changes in intimate relationships, how to finance your care, your preferred caregiver and healthcare agent, care of your pets, when you stop driving, and more. The essence of a dementia directive is to make life decisions that will span the course of time you survive with the disease. Life expectancy after a diagnosis of Alzheimer’s can range from as short as three years, with an average of eight to ten years, and as long as twenty years. Your advanced dementia directive provides you a measure of control and a sense of relief that your intentions are known when the time comes when you can no longer communicate them effectively. This document also serves as a detailed guideline for your loved ones to follow.

Some advanced dementia directives may even include an end of life strategy known as “voluntarily stopping eating and drinking” or VSED.  A VSED is considered a legitimate way to hasten death and is used in cases of terminally ill patients. Originally a VSED addressed a patient experiencing physical decline while maintaining cognitive function. In the case of Alzheimer’s, a VSED addresses the opposite issue of cognitive decline. Most people, when faced with a future of being mentally unfit in a body that will not quit, prefer to find an exit strategy they consider has a modicum of dignity. A VSED can prevent distressing situations for yourself and your family system.

Though requests for VSED are currently uncommon there is a groundswell of patient-driven need. This need says that if incapacitated through dementia, their choice is not to endure what can be a long physical decline while cognitively absent. Most people do not want life prolonged beyond the point where they are participating in it. Still, state and federal laws have to catch up to VSED as, by law, long term care facilities are required to offer daily meals with feeding assistance if necessary.

A directive that addresses Alzheimer’s disease and other forms of dementia does not replace the more standard advance health care directive. Most conventional health care directives address cardiopulmonary resuscitation, the use of ventilators, artificial hydration (intravenous fluids) and nutrition (feeding tube), participation in research and clinical trials, organ donation, comfort care, and pain relief services. Having both advanced medical and dementia directives in place not only assures you but also provides relief to your family. Your clearly defined choices can lighten the suffering your own family will feel when you can no longer communicate with or recognize them. Reconciling end of life scenarios is always challenging, but once handled, it frees you up to get on with the joy of living. 

We would be happy to help you determine the correct advanced directives for your needs and desires. Please contact us if you would like to discuss this matter further. Please don’t hesitate to contact our Reno office by calling us at (775) 853-5700.

Elder Living

The Best Technology for seniors Aging in Place and their caregivers

A big part of American life now includes technology and it is becoming more pervasive in senior populations as the tech industry targets this growing market demographic. A new survey by AARP projects by the year 2030 close to 132 million Americans aged 50 or more will annually spend more than 84 billion dollars on technology products. Today, 91 percent of those aged 50 or more use a computer, and 94 percent say that technology allows them to keep in touch with family and friends. Even smartphone use in older Americans (80 percent) maps out to the same number as the population at large. Also, many parents and grandparents are spending considerable amounts of money on tech-focused gifts for children and grandchildren. Even people aged 70 or more are showing a growing interest in technology and its applications to better their lives.

A Cambria Health survey finds that an estimated 100 million people, 45 percent of the US population, currently care for a loved one and that 64 percent of these unpaid caregivers are increasingly using digital tools to help them. Technology applications are ubiquitous in the paid caregiver world. Applications that are most commonly used include virtual medicine and health trackers worn as digital watches, home automation, motion-sensing devices, medication reminders, GPS devices, and emergency response systems.

The Consumer Electronics Show (CES) held every January in Las Vegas, NV showcases more than 4,400 exhibiting companies from all sectors within the technology industry attended by 170,000 people from 160 countries. The blog, Aging and Health Technology Watch, which tracks industry market trends, research, and analysis, identifies ten intriguing new technologies that currently address the older adult digital tools market. While these are specific to proprietary development companies, there is an expectation as the technology takes off, other tech companies will follow suit. Some of these digital tools are available, while others are not. The booming market for senior technology tools and their associated applications is undergoing very intensive development.

CarePLUS, though not yet available on the open market, uses discreet cameras throughout a household which can detect not only motion but the postures of loved ones. Through the use of artificial intelligence (AI) the system is capable of releasing warning messages in a moment of danger in real time. The artificial intelligence can detect hazards, including falling, sitting for too long, remaining too long in the bathroom, leaving home at an undesignated time, skipping medications, and more. This system reduces the need for multiple individual digital tools by combining many monitoring aspects into one technology product.

The Essence Group Fall Detector Radar is exclusively a multi-sensor fall detection system using Texas Instrument radar technology. Though this product is not yet available, the application programming interface (API) works with Essence’s Care@Home™ monitoring platform for seniors. Radar mmWave (extremely high-frequency millimeter-wave bands) technology tracks a person’s position in their home and provides immediate detection of a fall, alerting healthcare providers. 

For those aging adults with hearing loss, HeardThat™ is capable of turning a smartphone into a hearing assistant by tuning out background noise. Through the use of AI, this technology enables individuals who have hearing loss to more clearly hear speech, allowing them to more fully engage in conversation. The “de-noised” environment can also work with Bluetooth-enabled hearing aids and other listening devices like earphones in conjunction with your smartphone. While this is not yet available an invitation to become involved in the beta testing program and information about a release date is available through their webpage.

AARP Innovation Labs is developing an augmented reality application HomeFit AR™ that enables users to scan a room, discovering what improvements can be implemented to help seniors who choose to age in place have a safer home environment. Appliances such as refrigerators and microwaves, commonly used spaces like sinks and stairs, are identified for specific fixes to put in place that will make a home safer as well as a more comfortable fit for senior living. While the HomeFit AR Guide is still in beta version (part of a software release cycle), the public release date is slated for the year 2020.

Voice-enabled AI is adding integrated voice and conversational intelligence into your digital products using an independent platform that is continuously learning. Houndify™ is a “speech to meaning” engine that can interpret language with unprecedented accuracy and speed. Deep Meaning Understanding™ technology allows a user to ask multiple questions and receive filter results all at once. As the platform is non-brand specific, it can work with your existing device.

A smart remote caregiver solution known as Kytera Companion™ can provide insight into the activity of aging at-home seniors. This home system solution includes data collection, a mobile app for loved ones and a dashboard for professional caregivers. This product can detect both hard and soft falls using a wristband, location sensors, a base unit, and an internet-connected dashboard. Soft falls are the most common type of fall among the elderly and this is the first technology able to assess such a fall. Using AI the system provides comprehensive wellness monitoring that can detect physical and mental deterioration, and be predictive as to evolving disease conditions like depression, dementia, and UTI all based on behavioral symptoms.

Created by physicians and medical device engineers, MedWand™ helps to fulfill the potential of telemedicine. The wand incorporates multiple diagnostic tools in one and is a handheld device. Clinicians are able to conduct remote office visits through the real-time collection of multiple vital sign readings allowing for key patient assessments among numerous medical conditions anywhere in the world.

Orcam MyEye 2 is an advanced wearable assistive technology for the visually impaired or blind. It helps to provide independence by audibly conveying visual information. It can read a text, recognize faces, identify products, and more by simply clipping the device onto your glasses. For the hearing impaired, OrCam Hear is a wearable assistive technology device that uses artificial intelligence, combining lip reading with simultaneous voice separation for better listening. The wireless hearing aid is worn as a necklace with camera modules and microphone sets, allowing for hands-free operation and crisp, isolated voice reception even among crowds.

A companion robot called PECOLA is in development by Industrial Technology Research Institute (ITRI). It incorporates ambient intelligence for the elderly through the collection and analysis of the user’s life and physiological data. It is capable of detecting abnormal behaviors of a loved one allowing for preventative rather than responsive healthcare which can provide best outcomes. By following the senior around their home, PECOLA can identify emotions as well as perform video-generated diet analysis and fall detection. It can conduct sleep assessments through breathing and heart rate readings. The daily generated activity reports are then automatically provided to the user’s caregiver.

The Zibrio SmartScale is available for pre-order and enables a home user to measure and track their balance with a safe and simple 60-second test. The test itself is eyes open, stand still for 60 seconds while the scale assesses balance and provides a score (1-10); the lower the score in seniors 65 or more, the higher the risk for falls. This scale also provides personalized insight into lifestyle factors that affect your balance. 

Other notable new products are available for review at these websites:

Digital technology innovation specifically designed to address older adult care needs provide new ways for seniors to age in place successfully. Consultation with your healthcare providers as to what systems they employ can help synchronize your healthcare and reduce doctor office visits through the use of telemedicine and at-home monitoring. It also can provide unpaid caregivers reliable, real-time information about a loved one’s well-being that can help reduce stress on the part of the caregiver.

If you are caring for a loved one, please give us a call to see how we can help to ensure that the proper legal documents are in place for you and your loved one. If you have questions or would like to discuss your personal situation, please don’t hesitate to contact us. Please contact our Reno office by calling us at (775) 853-5700.