Lifestyle Diseases Being Blamed on Bacteria

Health experts have been advising people for years about unhealthy habits being the cause of “lifestyle” diseases that are increasing across the US. These lifestyle diseases become more common with age and include heart disease, type 2 diabetes, some cancers, and Alzheimer’s disease. Around the globe, these diseases account for 70 percent of all deaths. New Scientist magazine is reporting evidence suggesting bacteria are to blame for the diseases and that this finding will herald the coming of a revolution in medicine.

However, don’t stop healthy habits just yet; findings in disease after disease indicate that bacteria are covertly involved which complicates the problem. Bacteria will invade bodily organs and then co-opt the immune system in a sort of parasitic relationship as the bacteria boosts their survival while making the human body break down. In theory, if the bacteria microbes can be stopped, there is a potential to defeat disease conditions like heart attacks or Alzheimer’s.

How can such an all-encompassing and seemingly simple underlying cause be overlooked for decades? Bacteria have eluded scientists because they work very slowly. Like a terrorist sleeper cell, the bacteria can hide or lay dormant for long periods inside of cells, and that makes them difficult to grow as a culture. DNA sequencing informs scientists and researchers that bacteria are in places they were never known or supposed to be and shaping the body’s inflammation responses.

The medical community is up-ended by this startling paradigm shift in disease causation. The information is so contrary to the current medical understanding that some scientists and researchers are only cautiously optimistic. Many scientists have spent years looking for answers to the root cause of diseases and are left frustrated by their inability to identify the reasons.

The worst offenders in the link between bacteria and disease are gum diseases.  So it is bacteria that cause gum disease that is responsible for the most widespread disease of aging. Maurizio Tonetti of the University of Hong Kong calls gum disease “the most prevalent disease of mankind.” Gum disease is prevalent in 60 percent of Americans aged 65 or more. Germ theory finds the bacterial culprit known as Porphyromonas gingivalis  (P. gingivalis) is linked to the broadest array of disease conditions.

Gum disease is releasing bacterial P. gingivalis into your bloodstream and promoting inflammation long before an infected tooth falls out. Americans 30 and older have a 43 percent rate of some form of gum disease, and many find dental insurance an added expense they didn’t think worth the price. What a price it turns out to be. Since bacteria cause diseases and bacteria are prevalent in the majority of Americans, what can be done to manage the role of these bacteria within the body’s immune system?

Some companies are developing drugs that will block specific inflammatory signals or responses to slow disease progression. Even if the goal to prevent a limited number of signals or responses is successful, it is unclear what tampering with the human immune system can unleash. While being a relatively simple identification with the advent of DNA sequencing, bacteria still manages to host itself in the body’s vastly complex immune system. This situation makes for a complicated fix.

Once P. gingivalis enters the bloodstream, it changes its surface protein. This change allows the bacteria to cloak itself inside the immune system’s white blood cells. Even within the cells themselves, they enter into its lining arteries. Here it can remain dormant and primarily undetected until it wakes to invade a new cell. Because bacteria are so hidden, antibiotics will not identify it to kill it, and immune defenses do not respond to it. There is much to consider from research and experimental perspectives.

Understanding the underlying cause of many diseases is a breakthrough, but an application for preventing disease based on this information is still in the developing stages. While the future does look brighter, it is always a good idea to live an overall healthy lifestyle.

If you have questions or would like to schedule a time to discuss your planning needs, please don’t hesitate to contact our Reno office by calling (775) 853-5700.


How to Protect Your Child’s Inheritance

Estate planning for the future inheritance of your children and grandchildren should include protective measures to keep assets from disappearing or being claimed by a creditor.  A simple way to achieve inheritance protection is through a trust. A trust can pass your wealth bypassing probate. This allows specific trust provisions to ensure the money left to a beneficiary is neither squandered or through ill-advised spending or divorce action of the beneficiary.

Divorce is one of the primary obstacles to contend with when trying to minimize issues of wealth transfer and preservation. High divorce rates, especially among aging Americans, can make an inherited trust vulnerable if the property becomes commingled with the marital estate. Single and married children, as well as grandchildren of inherited wealth, should always maintain inherited assets and property as a separate entity whether as a trust or direct individual inheritance. Before any marriage, a pre-nuptial agreement should be signed to protect previously inherited wealth and the potential of future inheritance.

Whether your child or grandchild inherits an existing trust or establishes their trust after a direct bequeath, the terms of the trust can limit the potential problem of future loss of inherited monies or assets due to the possibility of lawsuits and creditor claims. A properly drafted trust can protect assets from legal action in the event your child is sued. A trust also protects the trust maker and the beneficiaries from the public process of probate. Anyone can research probate court records and determine how much your estate was worth, what you owned and how you chose to divide it.

If you believe your adult child has limited aptitude to manage money properly and might squander your grandchildren’s inheritance, then draft a will or trust that earmarks a dollar amount or percentage of the estate for those grandchildren explicitly. As an example, the will or trust can also specify that these inherited assets be allocated solely for a grandchild’s college education or wedding.

Another financial vehicle with some overspending controls is a “stretch IRA.” This inherited individual retirement account (IRA) has a required minimum distribution (RMD) that stretches over a more extended period based on the inheritor’s life expectancy. A monitored minimum distribution will allow the principal to continue growing. In the case a child or grandchild is too young to manage the RMDs it may be in their best interest to name an institutional trustee to direct distributions.

Whatever your intent is for your grandchildren, be sure to include a discussion with your child, expressing your resolve for your grandchildren to inherit and clearly stating them in your will. Also, speak honestly about your fears that your child may blow through their inheritance and discuss the value of limiting annual distributions to only investment income or a percentage of the trust’s value to preserve the aggregate of assets. In the event your child, who may have an addiction problem like gambling, drugs, or overspending, may require trustee oversight to temporarily end distribution of trust or IRA monies until they demonstrate wellness. At that time, the trustee may opt to restart money distributions.

Ultimately it is best to find a trusted estate planning attorney that is well versed in the laws of your state to help you craft a comprehensive approach to the dispersion of your estate that will protect your intentions from the mal-intent of others. Whether you need a lifetime “dynasty” trust, individual trust or direct inheritance, institutional trustee, inheritable stretch IRA, or a combination of inheritance vehicles, is all dependent on your unique financial position and personal desires for your legacy’s distribution. There is great latitude when drafting the structure for the distribution of your estate, so look to creative inspiration to open up possibilities.

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


American Seniors Carrying More Debt Than Ever

America experienced its worst financial crisis since the great depression between 2007 and 2010. Known as the subprime mortgage crisis, it happened because home prices fell in 2006, triggering loan defaults. Then the risk spread into pension funds, mutual funds, and corporations who owned the derivatives. It also spread into the global credit market resulting in higher interest rates and reduced availability of credit. Quantitative easing was necessary for several years to lower interest rates and spur economic growth. The cautionary tale to all Americans was learning to live beneath their means and do not carry excessive amounts of debt. Many Americans did not take heed and as a result, they are in substantial debt. One of the saddest cases of all of the debtors is the senior in their 60s and 70s in retirement years, and generally on a fixed income.

According to, the current financial debt crisis among seniors is worse today than it was in the earlier 2000s. First-quarter debt in the year 2019 among seniors in their 60s was 2.17 trillion dollars according to data from the Federal Reserve Bank of New York. That is almost 1 trillion dollars more than quarterly numbers being reported in 2008 just after the start of the great recession. Senior Americans in their 70s are experiencing double the collective household debt than in the late 2000s. Second-quarter 2019 debt is 1.16 trillion dollars comparative to the .54 trillion dollars of 11 years ago. While younger Americans are also experiencing debt, those numbers are more consistent or even lower than the quarterly obligations reported during the spring of 2008.

Mortgages account for the majority of household debt across all age groups with older Americans, aged 40 and beyond, typically holding the most debt. The trend of a home equity line of credit (HELOC) is highest among those in their 50s and 60s. In essence, a HELOC functions like a second mortgage based on the current value of the home. A HELOC is not the same as a reverse mortgage which requires no repayment of the loan until the sale of the house. Surprisingly even student debt accounts for over one-fifth of household debt for Americans in their 50s. Americans’ penchant for not saving and overspending is sabotaging many a retirement.

It is tempting to want to help a family member (usually adult children) by lending or cosigning a loan for education, a car, or home. However, this action can put you in great financial peril. Let that family member learn their fiscal responsibility rather than putting yours in jeopardy. Younger people have more time to rebound from an adverse economic situation. Those Americans in their 60s and 70s who are already retired and living on fixed incomes can experience crippling life events when carrying unpayable debt.

Remember that buying on credit increases the price of what you purchase. Within the credit card industry people who pay off credit cards in full every month are known as “dead beats.” Why? The lender can’t make any money off of the loan unless your payment is less than the full balance due. The lender makes the most money when you make the minimum payment and the lender can tack on interest to the debt. This is a negative debt cycle for the borrower.

Financial advisers will caution seniors to retire with as little debt as possible. If there is a real need to obtain cash or enter into debt, do not act rashly. Fixes like a payday loan will cost you a lot of money in the long run. It is much better to work with reliable professionals and lenders and create a realistic repayment schedule that works within your budget. If a reasonable loan cannot be struck, then look for ways to avoid needing the loan at all. The best question to ask about going into debt is, “Is this a want, or is this a need?”

We can help you work through how to handle existing or future debt as part of your overall legal plan. It does not take long for debt to pile up and destroy the hopes for a successful retirement.

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


Senior Lifestyle Decisions Linked to Alzheimer’s

Concerns about your memory or that of a loved one should never be ignored. There are many resources available through a simple internet search, and professional associations that provide education and guidance through a maze of questions you may have regarding how to approach someone you suspect may be experiencing memory loss, or how to ask for help if that someone is you. There is even a free online memory test you can take in the privacy of your own home.  But, did you also know that through many years of research, there is a link between diet, exercise and Alzheimer’s disease? It is never too late to start making proactive changes to your diet and lifestyle now to help lessen the risk of developing Alzheimer’s. Even if you have been given an Alzheimer’s diagnosis, a study published in late October by Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, noted that it is possible to improve cognition with modifications to diet, exercise, and sleep.

This study, summarized by the Wall Street Journal, acknowledged that the methods tested would not prevent Alzheimer’s, but through their findings, healthy individuals, as well as those with mild cognitive impairment who followed personalized recommendations over the 18 months of the study, did show improvement in cognition. The study included 157 participants who varied in age from 25 to 86 and who all had a family history of Alzheimer’s. A small group in the study had mild cognitive impairment and were asked, after going through certain measurements and many tests, such as blood, genetic and cognitive function, to adhere to a little over 20 recommendations of food selection, daily vitamins and personalized exercise plans. Those who followed at least 60% of the recommendations showed significant improvement from their baseline in cognitive testing. Participants who followed less than sixty percent of the recommendations experienced cognitive decline similar to the control groups. Cognitive decline is a precursor to memory problems.

The larger group of participants studied were healthy individuals who had no memory loss though some in this group had less than ideal cognitive testing. After 18 months of following recommendations, all participants showed improvement in cognitive testing compared to their baselines and the control group, even if all the recommendations were not followed. Results showed that younger participants did better in general than those who were over 60 years old.   Some of the measurements that went into developing a personalized plan included body fat and muscle mass, since the memory center of the brain, the hippocampus, is known to shrink as belly fat increases. Because cholesterol, blood sugar levels, and blood pressure are linked to an increased risk of Alzheimer’s, these values were monitored throughout the study.

In reviewing sites such as the Alzheimer’s Foundation of America, a free memory test was found that will test how quickly and accurately you recognize repeated images during a timed test. On the Alzheimer’s Association website, one can find many recommendations for diet and lifestyle modification to follow, which are also listed in the Wall Street Journal article. Some examples of diet modification include limiting red meat, adding foods to your diet that are high in omega 3’s, such as a certain type of fish, and foods high in antioxidants, such as strawberries and blueberries. A mix of aerobic exercise and resistance training/weight lifting was recommended for good brain and heart health. Hours of sleep and quality of sleep were other factors that can affect mood and memory.  It is generally recommended that a person try to get at least 7.5 hours of sleep each night and reduce caffeine consumption and ‘screen time’ well before bedtime to improve the quality of sleep. As for general brain health, meditation for stress reduction and learning a new skill, such as a foreign language were recommendations to keep you mentally sharp. There are many other ways to start now to improve or maintain your brain health with numerous online resources to help. If you have a family history of Alzheimer’s, don’t let another day go by worrying about what may happen. Educate yourself and take steps now that could minimize your risk of developing Alzheimer’s disease.

If you have any questions or need guidance with your planning or planning for a loved one, please don’t hesitate to contact our Reno, Nevada office by calling us at (775) 853-5700.



Seniors Are Awash in Prescriptions

According to the Centers for Disease Control and Prevention (CDC), heart disease in the US accounts for one in every four deaths or about 610,000 people. It is the leading cause of death for both men and women. And yet, is reporting that in the United States, Alzheimer’s disease deaths have increased by 123 percent while deaths from heart disease have decreased by 11 percent. Alzheimer’s is currently the sixth-leading cause of death in the US, and one of every three seniors dies with some form of dementia. These numbers should give the government, and the health care industry pause as the silver tsunami of baby boomers continues into retirement. Current projections of Alzheimer’s disease-associated costs could be as much as 1.1 trillion dollars.

Currently, Alzheimer’s disease has no cure, and there is little hope for a near term solution. One bright spot on the horizon is the application of precision medicine. Precision medicine essentially drops the “one-size” fits all treatment model. Instead, it customizes health solutions based on each individual’s unique situation using technology. This precision approach is increasingly moving into real-world clinical settings and meeting with success. The components of medical data needed for input include a patient’s genome, bio-specimens, medications, medical history, demographics, diet, and lifestyle. All of these elements play a role in the customization of a precision medicine health plan.

One company practicing precision medicine is uMethod. At there is a program called RestoreU METHOD that blends diagnostic tests, cognitive assessment, and lifestyle review information and then tailors a specific plan for each patient. These patients are specifically suffering from mild cognitive impairment, mild dementia, or mild Alzheimer’s disease. A personalized precision medical plan leads to better outcomes for patients. Data from RestoreU Method Health’s clinical efforts are reporting a very promising 76 percent improvement of memory or at least a cessation of the patient’s decline in memory.

One analysis by uMethod studies indicates that participants were on average, taking 15 drugs (not related to Alzheimer’s). Many of those drugs were contributory factors to the patient’s cognitive decline. The technology, specifically artificial intelligence (AI), proved far better at identifying issues and adjusting medications accordingly. AI is faster and more accurate at identifying drug to drug and drug to genome interactions that may worsen symptoms of Alzheimer’s. A potential drug interaction is when two medications known to interact are concurrently prescribed whether or not an adverse event occurs. These drug interactions may very well provoke life-threatening consequences, especially in the case of an elderly, frail patient. Because many seniors have co-morbidities the risk of an adverse drug reaction (ADR) is substantially increased. Over the past decade, the use of multi-drug regimes among the elderly has risen tremendously, and thus, the increased need for technology to be able to assess their complex interactions reliably.

Processing big data about patients allows AI to apply medical knowledge to specific criteria and thoroughly and quickly present an array of medical solutions and plans. These plans are highly detailed for the attending physician but are simplified for the patient. As a patient’s symptoms change over time, updated data can be input, and AI can recommend therapy changes that best address a patient’s dementia issues.

Developing treatments and possible drug cures for Alzheimer’s and other forms of dementia are going to remain a challenge for the foreseeable future. Multiple prescription medication interactions may be causing more harm than good to patients as the incidence of Alzheimer’s related deaths continues to increase at an alarming rate. What are your strategies in the event you become diagnosed with cognition problems that may lead to some form of dementia? Typically, dementias have a long pre-clinical phase followed by mild, medium, and severe category assessments. Medical directives that are specifically designed to address dementia issues are available. Check into precision medicine and how it might become part of a dementia directive you would like to have.

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


Hearing Loss May Bring These Health Risks

The findings from a 10-year study by the Journal of the American Medical Association (JAMA) have reported a link between hearing loss and health risks. The risks include a 50% greater risk of dementia, a 40% greater risk of developing depression and a nearly 30% higher risk of accidental falls. While hearing loss is becoming more prevalent in younger people due to the use of earbuds and noise pollution, it is the elderly population who are more quickly and significantly affected by adverse health risks because of their hearing loss.

There is a wide range of reasons that account for hearing loss. Some are genetic while others include noise exposure, medications, head injuries, and infections. While hearing loss is a frustrating experience for those who have it, along with their loved ones, the worst option is to ignore the condition. The sooner your hearing is tested, the better your ability to proactively save yourself from associated health risks due to hearing loss. According to Johns Hopkins University, brain scans indicate that loss of hearing has even been associated with more rapid rates of brain atrophy.

One of the first symptoms of hearing loss is trouble detecting high-pitched or soft sounds. This form of hearing loss is associated with stereocilia, which is the damaging of the fragile hair cells that convert sound waves into electrical signals your brain can understand. For example, high-pitched sounds might include children’s voices while soft sounds include phone conversations or background noise in a restaurant. If you are having any trouble hearing these softer or high-pitched sounds, make an audiologist appointment for a hearing assessment to get a baseline reading. Loss of hearing contributes to social isolation and the longer you wait to address hearing loss, the greater the risk of cognition problems. Meaning, you may hear the words but not be able to process their meaning.

Other than cost, there is no downside to hearing aids anymore. They are discreet, easy to learn how to use, and professionally adjustable over time to compensate for increased hearing loss. Once you factor in the cost of a potential fall, increased risk of dementia, social isolation, and depression, the cost of a hearing aid is comparatively minimal. If your hearing loss is profound already, there are cochlear implants, which are devices implanted into the inner ear to stimulate the auditory nerve. These devices can help to restore sound perception in adults with more extreme hearing loss. Your walking motor skills are dependent upon your hearing to pick up subtle cues that help you maintain your balance. Hearing loss mutes these critical cues and makes your brain work harder to pick up sounds, which can then interfere with some of the mental processes needed for safe walking.

While it is not yet proven that treating hearing loss can prevent dementia, unintended falls, or social isolation and depression, it is important to investigate as more than two-thirds of adults over the age of 70 have significant hearing loss that can impact their everyday quality of life. Older adults with hearing problems left untreated also incur substantially higher overall costs of health care. At the ten-year mark of untreated hearing loss in older adults, the incidence of hospitalization increases by 50% or so. There are also higher rates of hospital readmission and an increased likelihood of emergency room visits when compared to those elderly adults without hearing loss.

Communication between patients and health care providers is also problematic for those adults with hearing loss. A patient has less participation in their health care plan and can often become confused as to their diagnosis and possible courses of action for treatment.  Also, following instructions post-appointment or hospital discharge can be problematic. Costs associated with untreated hearing loss have prompted both health care companies and insurers to find better ways to serve patients with hearing loss.

Nearly 27 million Americans age 50 or more have a hearing loss while only one in seven uses a hearing aid or implant device. Hearing is often the most overlooked of the five human senses: taste, sight, touch, smell, and sound. Your ability to hear is incredibly important and the longer you put off addressing a hearing problem, the greater the possibility of associated adverse health events. Make good hearing part of your overall plan to age successfully. Like retirement planning and elder law planning, the sooner you address the issue, the better the outcome will be.

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


The Benefits of Inter-Generational Living

Master plans for inter-generational community living models are changing the shape of the aging experience from the ages of 8 up to 80 years of age and beyond. Dubbed “new urbanism” it is the belief that a living environment with high standards can have a positive effect on the quality of life, local economy, and public health. The goal of new urbanism for older adults is the offering of an active lifestyle enhanced by a vibrant and bustling community composed of varying ages and ethnicities. This can help keep the brains of aging adults more agile as they challenge themselves to socialize with new people of all ages, backgrounds, and world views.

Inter-generational living is similar to multi-generational homes, just on a larger scale. Many of today’s older Americans want to maintain a connection to their community at large; offering their life experiences, knowledge, wisdom, and skill sets that can enhance lives for people of all ages. While living in a multi-generational home provides the same opportunity, the scale and needs of the people change when it is opened up to those outside of a nuclear family system. While some aging Americans prefer a retirement community of similarly aged people, many older adults are finding increased vitality and quality of life mixing with children, teens, young adults, and middle-aged people. Many aging adults prefer the stimulation of being associated with a non-homogenous group, and with their life expectancies increasing and overall health levels improving these inter-generational communities are becoming a popular lifestyle solution.

Decades ago, these types of multi-generational homes and communities would have been the norm. The Pew Research Center has reported that in the 1900s, fully 57 percent of Americans 65 and over lived with their children, grandchildren, and other family members. Communities were highly integrated into everyday life. However, the post World War II era ushered in an increase in education and loans to buy homes and start businesses. The opportunities scattered many families across the US in search of building a more prosperous life. By 1990 another Pew Research report found that only 17 percent of those 65 and older lived with their families. Now, nearly in 2020, the downward trend is reversing due to several reasons.

Immigration is one factor that explains the trend reversal. It is very commonplace around the world that multi-generational family systems live together and communities are very integrated. Longer life expectancy and the cost of continuing care retirement communities and long term care are other reasons families seek to live together. A delayed marriage pattern of younger people, as well as “boomerang” youth, are other reasons for the pattern reversal. Many children coming out of college have student loans and often wind up moving back in with parents or grandparents until they can get out of debt.

Inter-generational communities are not complex to build. Thoughtful designs of parks where park benches face each other to encourage conversation, dog walking parks, festivals, live music, art programs and more are just some of the uncomplicated techniques that help break down barriers between different age groups of people and help aging adults stay vital and integrated into life. Older Americans can experience reduced depression and loneliness, better mental stimulation, more daily activities, and can build relationships that will help them learn to rely on others, as others learn to rely on them.

Tasks like grocery shopping can be simplified if an older adult provides a shopping list to a younger community member and watches over their children while groceries can be obtained for both the younger family and the older adult. Oversight by community developers can create programs that encourage this sort of “bartering” of tasks because just plunking people in the same physical space does not necessarily build connections.

Building these inter-personal partnerships in an inter-generational community will help older adults continue to age in place and rely on community rather than a big bank account to pay for much of the help they might need. While many people opt for aging in place at the age of 50, some are interested enough in this movement of new urbanism and its many benefits, committing to the process in their thirties.

Nobody wants to have to leave their lifelong home because of aging. Many seniors are finding every day to be an adventure with never a dull moment living in inter-generational communities. Aging Americans can lead fuller and happier lives by staying invested in the process of being connected to all ages.

If you have any questions or need guidance in planning for yourself or a loved one, please don’t hesitate to contact our Reno office by calling (775) 853-5700.


More Seniors Affected by Data Breaches

Data breaches have been one of the hot topics this year in the wake of the Capital One data breach which compromised nearly 100 million Americans. But what hasn’t been receiving much major media coverage are the recent breaches affecting seniors.

One such breach occurred last year in May, and that breach compromised the personal information of almost 4,000 clients and employees of home care and support services for seniors in the bay area. That “personal information” includes quite a lot, from names, emails, and phone numbers to Social Security numbers, financial records, and health information.

2018 saw three times as many records breaches as in 2017, with 15 million patient records compromised in the healthcare sector. And this issue has only been exacerbated in 2019, with potentially more than 25 million records breached as of July.

Just one security incident in April affected at least 60 facilities in Massachusetts, Minnesota, Missouri, and Tennessee, compromising the personal information an unknown number of patients in those four states.

This is an issue that is becoming increasingly important, in a variety of sectors but especially in the healthcare sector. However, many in this area are ill-prepared to handle it. Data breaches are going on for extended periods, and not being reported within the 60 days mandated by HIPAA.

Part of the problem is that HIPAA is not well equipped to deal with security needs today, in a technological landscape remarkably different from that of 1996 when HIPAA was enacted. Unfortunately, any legislation or regulation enacted today would face a similar problem: technology continues to adapt quickly, and the market pushes the healthcare sector to invest in technological advances as they come.

A few tips to protect your online information: 1) Never open an email from an unknown sender that contains an attachment. 2) When storing information online with a bank or medical provider, make sure you choose a strong password – one that contains a combination of letters, numbers, and symbols that is not easy to guess. 3) Do not store credit card or social security information online.

If you have questions or would like to discuss your planning needs, we would be happy to help. Get in touch with our Reno office by clicking here to send us a message or by dialing us directly at (775) 853-5700.

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The Need for Long-Term Care Insurance

Long-term care insurance is very beneficial for the elderly or disabled person who need services or support to meet their personal care or health needs.  However, it is important to understand long-term care insurance before the time comes when the benefits are needed. Unfortunately, many people wait and then miss out on what long-term care insurance can offer.

Should I get long-term care insurance?

There are a few things to consider before you go out and purchase long-term care insurance. First, consider your age. Age is important because it is much cheaper to get long-term care insurance at a younger age. Older adults and those who already have existing health conditions may have more difficulty getting long-term care insurance and the premiums are guaranteed to be costly.

Second, consider your support system. In other words, do you have family who will be able to help provide for your care needs in the future? If so, then you may not need long-term care insurance. This is definitely a good time to sit down and talk about the future with your family.

Third, consider your savings and investments. This is where a financial adviser or elder law attorney can help you understand ways to pay for long-term care and whether or not long-term care insurance is right for you.

What is the cost of long-term care insurance?

The cost of long-term care insurance cannot be attached to specific numbers. The cost depends on age, gender, marital status, the insurance company, and the amount of coverage. The younger a person is when they get long-term care insurance, the lower the premiums will be. Generally speaking, long-term care insurance policies are less expensive for men than women. This is due to the fact that women generally live longer and therefore are more likely to make claims on the long-term care policies. Married people have lower premiums than single people. Just like with any type of insurance, rates for long-term care insurance will vary from one company to the next. It is important to shop around and compare the costs of long-term care insurance with a variety of carriers. The amount of coverage desired greatly affects the cost of the long-term care insurance. Better coverage with fewer restrictions will come at higher premiums. Be sure to do your homework, talk to your financial planner, and elder law attorney to help determine long-term care insurance needs.

What does long-term care insurance cover?

Once you have a long-term care policy, you are eligible for benefits if you have dementia or another cognitive impairment or you are unable to perform at least two of six activities of daily living. These activities include bathing, dressing, eating, toileting, caring for incontinence, and transferring. When a policyholder is eligible and in need of filing a claim on a long-term care insurance, a variety of services may be covered. Nursing homes and assisted living facilities may be covered services. Within those services, policies may only cover room and board or they may cover more extensive services. Long-term care insurance also covers adult day care services for those who need a program for health, social, and other support services during the day. Home care is also provided under some long-term care insurance. This service helps with activities of daily living in the policyholder’s home. When home adaptations are necessary, such as ramps or grab bars, long-term care insurance can cover these services. Care coordination and future service options are also available services with within long-term care insurance policies. You will need to understand your specific policy to determine the specifics of the services covered and to what extent they are covered.

Long-term care insurance can seem very complicated. Remember there are professionals who specialize in helping to determine long-term care insurance needs and coverages. A great place to start is with your financial advisor and elder law attorney.

If you have any questions about something you have read or would like additional information, please feel free to contact our Reno office by clicking here to send us a message or by calling us at (775) 853-5700.


GAO Reviewing VA’s Nursing Home Rating System

Ranking member of the Senate Committee on Veteran’s Affairs, Senator Jon Tester (D-Montana), along with Senators Edward J. Markey and Elizabeth Warren (both Democrats from Massachusetts) are requesting a formal review by the Government Accountability Office (GAO) of the rating system of Community Living Centers (CLC) operated by the U.S. Department of Veterans Affairs (VA). The letter prompting this review request alleges “reports indicating poor quality ratings as well as disturbing anecdotal stories of substandard treatment and conditions at some” nursing homes throughout the years. The GAO response letter agrees to accept the request and work within its scope of authority to address concerns.

VA Community Living Centers currently use a star rating system. Survey stars, staffing stars, and quality stars are independent categories, as is the category of improvement quality measures. All of these categories combine for the overall star rating. This rating system is an adaptation of the version that Medicare uses. However, the Senators’ letter indicates a lack of public transparency about the detailed and specific methodology employed by the VA for developing the star ratings. GAO’s task is to examine how the star evaluation method and data extraction came to be. Responsibilities of a VA CLC are not solely intended for a veteran’s end of life care. It also is a residence where veterans can recover from a mental health crisis like Post Traumatic Stress Disorder (PTSD), or post-surgery recovery, and even respite care. The VA operates over 100 CLC’s across the country, serving thousands of veterans.

Recently some facilities have experienced bug outbreaks. In Atlanta veteran residents at a VA CLC were subjected to an ant infestation. Eagle’s Nest CLC officials confirm that ants bit as many as three veterans and that these ants were considered an outbreak in the facilities rooms. Sadly, a veteran and dying cancer patient was recorded to have more than 100 ant bites in the days before he died. While disciplinary and corrective action was taken at the CLC, the bug problem is not unusual. According to an internal email from the system’s director Barbara Oemcke, a Prescott, Arizona VA CLC reported an issue with bedbugs. A spokeswoman for the Prescott VA Mary Dillinger “reported the incident to pest control officials, who followed protocol by conducting preventive measures throughout the hospital and resolving the issue. No patients were found with bedbugs on their person, and this incident did not negatively affect patient care in any way.” While the bedbug infestation was quite limited, it is not unusual. According to the National Pest Management Association, about 60 percent of exterminators claim they encounter bedbugs in nursing homes. However, bug infestations are only one part of the overall problems facing CLCs.

The VA first released data using star ratings in 2018. According to the Senators’ information release, at that time, almost half of these centers received the lowest one-star rating. Current data is showing improvement, but vast improvements need to continue in support of our veterans. The VA countered the information put forth by the Senators’ showing data reflects 11 communities with one-star ratings at that time and that most facilities had scores of 4 or 5 stars. Somewhere there is a disconnect in the data.

VA spokeswoman Susan Carter has said the VA welcomes the GAO oversight. In defense of VA facilities, Carter writes, “Like any health-care provider — including those in the private sector — VA nursing homes sometimes encounter isolated problems, and when we find them, we fix them,” she said. “But overall, VA’s nursing home system compares closely with private-sector nursing homes, though the department on average cares for sicker and more complex patients than do private facilities. Many of our patients carry the wounds of war.”

All three Senators admit to appreciating the VA’s CLC disproportionately complex resident population who suffer from challenging medical conditions that tend to be multiple and chronic. The GAO review is tasked to identify what tools, resources, and staff training need to be in place to improve the quality of veteran care. They also must unravel the current star rating system to make its data-gathering methodology more transparent and assure accuracy in reporting. This GAO review can establish CLC national trends and find common problematic areas where fixes can be implemented on a large scale.

Advances in medical technology are allowing our veterans to survive injury and live longer lives with complex medical conditions. Excellence in facility standards, coordination of care, favorable outcomes, and transparency in the process of facility ratings are achievable with the proper oversight. The GAO review, prompted by Tester, Markey, and Warren, will provide much-needed information to assess the best way forward to support our veterans in CLC facilities.

If you are a veteran in need of help with your earned benefits, please don’t hesitate to contact our Reno, Nevada office by clicking here to send us a message or by calling us at (775) 853-5700.