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Elder Living

Living Alone in Your 50s and 60s Increases Your Risk of Dementia

Living arrangements for aging Americans are decidedly leaning towards aging in place. Nearly all older adults prefer to age in the comfort of their long time homes and familiar community surroundings. Aging in place often means living alone. Pew Research findings show that older people are more likely to live alone in the United States than in any other country worldwide. This preference of living solo, however, comes with hidden danger. Research from Science Times reports that living alone in your fifties and sixties increases the likelihood of dementia by thirty percent.

The conclusion drawn is based on a report from sciencedirect.com, a website replete with large databases of scientific, academic, and medical research. Findings indicate that social isolation is a more important risk factor for dementia than previously identified. In this age of gray divorce (also grey divorce) and social distancing due to the coronavirus pandemic, adults living alone in their fifties, sixties and beyond, are at greater risk than ever for cognitive decline, leading to dementia.

Understanding the Causes of Dementia Cases

The lead author of the study, Dr. Roopal Desai, says that overall increases in dementia cases worldwide can be due to loneliness, stress, and the lack of cognitive stimulation that living alone brings. Biologically, cognitive stimulation is necessary to maintain neural connections, which in turn healthily keep a brain functioning. Staying socially interactive is as important to cognitive health as staying physically and mentally active.

Strategies for Seniors Living Alone

Health care professionals in the U.S. are implementing a “social prescribing” strategy to improve the connection of a patient who lives alone to a prescribed range of services like community groups, personal training, art classes, counseling, and more. Unfortunately, in the days of COVID-19 social prescribing is limited to virtual connections between people. However, virtual social engagement is better than no social engagement at all.

Why can’t an adult, choosing to age alone, maintain their health with physical exercise, crossword puzzles, and other activities that stimulate their brains without the input of human socialization? It turns out that social isolation presents a greater risk for dementia than physical inactivity, diabetes, hypertension, and obesity. Brain stimulation is vastly different when a person engages in a conversation rather than in repetitive games and puzzles. Carrying on a conversation, whether in person or virtually, is far more stimulating and challenging to the brain’s regions.

Conversation with other people chemically evokes neurotransmitters and hormones, which translates into increased feelings of happiness and reduced stress through purpose, belonging, improved self-worth, and confidence. It turns out that being human is undeniably an experience at its most healthy when shared, and a mentally healthy person is prone to stay more cognitively capable.

The Importance of Human Connection to Decrease Dementia

Maintaining this human connection can be challenging, particularly if you are one of the many Americans who are opting to age in place. In the first place, aging is replete with reasons to reduce activity and become isolated when facing particular types of stressful events common to later life years. Role changes associated with spousal bereavement through death or divorce, household management, social planning, driving, and flexibility all fall prey to functional and cognitive limitations. Without the benefit of an involved family or social prescription, it is easy for an aging adult to spiral into social isolation, loneliness, and depression, all of which are causally linked to cognitive decline.

If you or your aging loved one actively chooses to live alone, it is imperative to maintain a vibrant social life. Staying cognitively healthy is associated to satisfying social engagement as well as physical activity. If you live alone, reducing the risk of developing dementia will allow you to continue living out your years as imagined, with independence and control, thanks to your continued human interactions.

If you have concerns about your current living arrangements (or those of a loved one who needs care), please reach out. We help families create comprehensive legal plans that cover care and financial concerns. Please contact our Reno office by calling us at (775) 853-5700. We’d be honored to speak with you.

Elder Law, Elder Living, Estate Planning, Healthcare

Will the Cost of Long-Term Care lead to the Loss of My Home?

People work hard all their lives to own a home, and it is often their most valuable and significant possession. Homeownership is the American Dream. So, when health begins to fail and the need for long-term care arises, we often get this fear-filled question from our clients: will they take away my home?

The enormous and on-going costs of nursing-home care are astronomical, on average around $8,500.00 a month depending on location. The joint federal and state Medicaid program foots the bill for one in four of around 75 million recipients in this country. This is an enormous drain on government funds. To recoup some of those costs, then, the Medicaid rules permit states to take the value of a recipient’s home in some cases, to reimburse the program for funds it has expended.

Yet, because a home is such an essential family possession, the rules treat a primary residence as exempt – that is, its value is not counted as available to pay for nursing-home care from the home-owner’s pocket, before Medicaid kicks in. The home is protected, to a certain extent, for the benefit of Medicaid recipients and their close relatives.

That protection can be lost, however. The value of the house can be counted against a Medicaid applicant, and benefits denied or curtailed, when:

*     A home-owner has no living spouse or dependents, and

*     The owner moves into a facility permanently, with no intent to return home, or

*     The owner dies.

In other words, as long as the owner expresses the intent to return home, and the owner’s spouse or disabled or blind child live in the home, the home will not be counted against the owner for Medicaid-eligibility purposes.

Once the owner passes, however the state may place a lien on the home, to secure reimbursement of the value of the Medicaid services the owner received. This lien makes it impossible to sell the home or refinance a mortgage, without first paying the state what it may be owed.

As elder law attorneys we know a number of ways to protect homes from this kind of attachment. If you come to us at least five years before you anticipate needing nursing-home care, we can preserve your home or its value such that Medicaid will not count it, or lien against it, at all.

Or, if a child moves into the home and cares for an ailing parent for two years, permitting the parent to stay home and out of a nursing home, the house can then be given as a gift to that child without any Medicaid penalty or disqualification. Ordinarily, Medicaid heavily penalizes giving away property, but this is one exception.

There are other strategies available. The home can be given to a disabled child without penalty or disqualification. Or, you might keep the right to live in the house for your lifetime and deed the remainder interest to others, who will then own the house after you pass. However, each strategy comes with risks that must be fully explored before determining the correct one.

An overall plan that is tailored to suit each individual, and to meet as many contingencies as possible, requires juggling a number of puzzle-pieces. There is no one cookie-cutter solution. The key is to plan before you or your spouse may need nursing-home care.

As one piece in the overall picture of a balanced estate plan, we can help you save your home. We welcome the opportunity to work with you, please contact our Reno office by calling us at (775) 853-5700.

Estate Planning

The Importance of Family Values as Part of an Inheritance

Addressing and legally formalizing inheritance of family values and assets can be challenging, especially if parents wait too long to begin instilling family values.  Undoubtedly the best time to teach and empower your children as eventual inheritors of your family legacy is during childhood, then continuing throughout adulthood. Waiting until your later stages in life to discuss family values as a guide to handling inherited worth is often ill-received as grown adult children prefer not to feel parented anymore, particularly when they are raising children of their own. 

There is value in the spiritual, intellectual, and human capital of rising generations, and it is incumbent upon older generations to embrace this notion and work with their heirs rather than dictating to them their ideas about how to facilitate better outcomes. While the directions taken by newer generations will likely differ and can sometimes be downright frightening than that of their elders, there can still be a deep sense of service and responsibility to family values and stewardship of inherited wealth. Allow your children to exert their influence over the family enterprise early on in life and make adjustments that create synergy, connection, and like-mindedness.

If this description of a somewhat ideal family system does not resemble yours, take heart. Most families do not conform to perfect standards of interaction. The more affluent a family is, the higher the failure rate to disperse assets without severe fallout. The Williams Group conducted a 20-year study and determined there is a 70 percent failure rate that includes rapid asset depletion and disintegration of family relationships during and after inheritance. Establishing inheritable trusts can provide real benefits. Benefits include avoiding probate, reducing time to handle estate matters, privacy protection, the elimination or reduction of the estate tax, and can be effective pre-nuptial planning. A parent who wants to control outcomes should focus on these benefits of the trust instead of trying to legislate their future adult children’s behavior.

It is imperative not to allow your values and legacy to become weaponized within the family system. A sure-fire way to inspire conflict is via “dead hand control,” meaning trying to control lives from the grave. Most often, if you put excessive trust restraints on adult children, they will act accordingly to your perception that they are not adult enough to handle wealth. Instead, consider enrolling them in a few classes about managing wealth. Spark an interest in them to learn how you have created wealth, the mechanisms you used, and what their future endeavors may look like long after you are gone. Formally educate your children about finances, the earlier the better, and instead of talking about who gets what the conversation can shift to the mechanics of managing wealth. This tactic resets the context of the issue and aligns purpose and intended long term outcomes.

Estate planners try to encourage trust choices that lead to flexibility. If a beneficiary is genuinely incapable of making the right decisions, a trustee can be appointed to make distributions in the beneficiary’s best interest. This trustee discretionary power of money management can help a well-funded trust survive for generations.

You can also write a letter of wishes or provide a statement of intent to your children. Though these are not legally binding, it gives you a platform to remind them of family values and your desire for these values to be maintained for future family generations. This type of letter is an opportunity for you to convey your vision for how your wealth can bring growth and chance for fulfillment to beneficiaries.

Prosperity should positively shape lives. Family trust beneficiaries hopefully already have a self-driven life that includes purpose, responsible behavior, and a basic understanding of personal finance. If you worry your children may squander inheritable assets, create the opportunity for them to succeed through classes that teach them about managing legacy family values and wealth. Address your concerns legally and directly through a detailed trust that can help but not overly constrain them to achieve what you envision they can become. Start an honest conversation early on, but remember it is never too late to make good choices and create positive family value influences for the coming generations. A well-known Ann Landers quote sums it up neatly, “In the final analysis it is not what you do for your children but what you have taught them to do for themselves that will make them successful human beings” – a worthy goal of any family value system.

If you are interested in establishing a trust to pass wealth on to your children, we can help. We can also guide families on how to pass on family values in a meaningful way. We look forward to hearing from you, please contact our Reno office by calling us at (775) 853-5700.

Uncategorized

Social Security Disability Income and Qualifications 101

Temporary or permanent disability can happen to anyone at any time. Do you understand the role social security can play? Some projections are estimating that Americans in their 20s today have an approximate 30 percent chance of experiencing a disability profound enough to cause them to miss three or more months of work before retiring. Despite the risks, most Americans do not carry short or long-term disability insurance. Close to half of all mortgage foreclosures are due to owners being struck with a disability, and fewer than 15 percent of people who purchase life insurance opt for disability insurance. The Social Security Administration (SSA) was tasked in 1956 to address disability and work income by creating a disability insurance program. Throughout its long history, additional rules have contributed to its complex regulations and eligibility requirements that make applying for disability benefits difficult.

What Are the Disability Benefits and Eligibility?

The disability benefits are in the form of monthly payments to provide a safety net for qualified individuals who have become too disabled to work. The benefits are paid through the Social Security Disability Insurance (SSDI) or the Supplemental Security Income (SSI) Programs. Both of the programs are intended for disabled workers, but they have different benefits and qualifying requirements as well as different funding sources.

To become eligible for the SSDI program, you will have worked a required number of years in a job where you paid into the social security taxes (FICA, Federal Insurance Contributions Act). You have to have accrued a certain number of work credits. You can earn up to 4 work credits per year. Workers that do not have the required number of work years and who also have low income and minimal assets can apply for SSI. In both programs, you are not eligible to be engaged in a substantial gainful activity (SGA), earning a certain amount of income from some other work.

The number of work credits required as a qualification for SSDI benefits depends on the age at which you became disabled. Generally, it is possible to qualify if you have earned at least 20 credits in the ten years before being disabled and if you have earned credits that total 40 or more. If you do not have enough work credits to qualify, there is a chance you can become qualified based on a spouse or parent’s work record. There are many regulations governing eligibility for SSDI, and each individual has a varied work history. To understand how to qualify and how much you should be able to receive, it is best to contact a legal professional for help.

Maintaining Disability Qualifications and Benefits

Once you qualify from a work history perspective for SSDI, then you must prove you meet medical eligibility requirements. SSDI benefits are available to those workers who have a severe, long-term, or total disability. A severe disability is a condition that interferes with general work-related actions. Long-term disability means you are unable to perform “substantial gainful activity” (SGA) for a minimum of one year. Total disability is a person’s inability to work in their own or any other occupation for which they are suited by training, experience, or education due to a sickness or injury.

SSI medical qualifications are similar to medical terms used in SSDI qualifications; however, these individuals must also have limited resources and a low income. The benefits from the SSI program are funded through general tax revenue and not dependent on your work history or having paid into the social security taxes known as FICA.

For either program, it can be challenging to qualify for the SSA’s definition of disabled. To be considered disabled by the SSA, your condition has to last a year or be expected to last a year. Or your condition should be expected to result in your death. Your condition must also significantly limit your abilities to do necessary work activities like walking, sitting, standing, or retaining and remembering information. Additionally, your condition must be listed in the SSA’s “Listing of Impairments” (Blue Book) or have medical equivalency to listed conditions. Finally, your condition must prevent you from doing any work for which you qualify before your disability.  

The Approval Process for Social Security Disability

Becoming approved for benefits is a lengthy and often frustrating process as many people are denied on their first application. A myriad of forms, doctors’ recommendations, personal medical history, work, and tax documentation all contribute to becoming accepted into either program. You can apply online or at your local social security office. It is best to contact the office to schedule an appointment to submit your application for benefits. Regarding financial qualification, be prepared with your work history and current earnings, household assets and income, your bank, and financial institution information. Also required is your current and past employers and up to five jobs you have held in the past 15 years, any other benefits you may be receiving, your status of citizenship, and, if applicable, any paperwork from a military discharge.  Pay stubs, proof of citizenship, W-2s or 1099s, information about your disability, and detailed medical records are all pertinent data to bring.

An initial application that is denied has multiple stages of appeal. You can enter a request for reconsideration or even go up as high as an appeal to a federal court. If your condition has made you very sick and you are experiencing a severe medical condition, there is a streamlined process known as the SSA’s Compassionate Allowance List. This list primarily includes adult brain disorders, certain cancers, and several rare disorders that affect children. If and when you are approved for disability income through SSDI or SSI, there is a waiting period. Benefits will not be made available to you until you have been disabled for a full five months, and, likely, you will not be approved for six months to a year, including the likelihood for at least one level of appeal. Be prepared from the outset for a lengthy process and improve your chances for approval with a well thought out, legally reviewed application for disability income. If you have questions or would like to discuss your situation with us, please do not hesitate to contact our Reno office by calling us at (775) 853-5700.

Estate Planning

The Power of a Personal Property Memorandum with a Will or Trust

Arguments can take place over things like a coffee mug, a piece of jewelry or a painting. Family members often end up arguing over mom or dad’s favorite items when that parent dies. These types of arguments can be eliminated by filling out a personal property memorandum and keeping it with your will or trust.

A personal property memorandum is designed to cover who should receive items owned that don’t have an official title record. Personal property includes furniture, jewelry, art, and other collections, as well as household items like china and silverware. Personal property memoranda may not include real estate or business interests, money and bank accounts, stocks or bonds, copyrights, and IOUs. 

When writing your memorandum, it is best to keep things simple. Personal property memoranda generally resemble a list of items with the attached names of the inheritors. It can be handwritten or typed but should always be signed and dated.

All items should contain sufficient detail so that argument and confusion can be avoided. Complete contact information including address, phone, email, and a backup contact if possible should be included. Do not include items that you have already explicitly left in your will or trust.

The beauty of a separate list of personal items and their planned distribution is that if you later decide to change who receives what, you simply update your current list, or replace the list altogether. You can destroy an old record or maintain signature and dates on each of your personal property memoranda so that it is easy to identify your most current set of wishes.

 A personal property memorandum for your tangible personal effects is a simple way to address how you want your personal property to be distributed. We would be happy to help you create a legal personal property memorandum along with any other estate planning documents you may need. We look forward to hearing from you, please contact our Reno office by calling us at (775) 853-5700.

Healthcare

Coronavirus Pandemic Dilemma for the Senior Living Workforce

It’s a cautionary tale that provisions in a coronavirus-related relief action by the US government could have severely curtailed the workforce in senior assisted living, independent living, memory care, and continuing care retirement communities. The bill, HR 6201, is a multi-billion dollar aid package known as Families First Coronavirus Response Act. The bill has recently been signed into law by the US President. Influential leaders, CEOs, and corporate Presidents in the senior care and housing industry addressed facility workforce concerns directly to the House Speaker Pelosi (D-CA) and Senate Majority Leader McConnell (R-KY) before the passing of H.R.6201.

Families First Coronavirus Response Law

The Families First Coronavirus Response Law expands unemployment and Medicaid benefits, provides for free coronavirus testing, and mandates paid sick leave and childcare. Now that schools have closed throughout the country for an indefinite time, the fear is that many senior care workers will, unsurprisingly, put their family before their healthcare worker employment. A reprieve of sorts was added before the law being enacted, which states that only certain employees can qualify for paid sick leave.  Because of these loopholes, healthcare workers like first responders, and hospital and nursing home staff are ineligible for paid sick leave per the Families First Coronavirus Response Law (FFCRL) amid fears of staffing shortages among medical providers.

Healthcare worker exemption from some FFCRL benefits is a relief to the senior housing industry but by no means mitigates other workforce challenges during the coronavirus pandemic. The pervasiveness of this contagion means that healthcare workers will be exposed to, and some will fall ill with full-blown coronavirus symptoms and illness. Obviously, in these cases, the healthcare worker will be removed from the senior living facility for quarantine and recovery and to protect the facility’s residents and staff. One coronavirus confirmed healthcare worker begins a domino effect within a facility. Regular operations become short-staffed, and operators face the Centers for Disease Control and Prevention (CDC) protocols that co-workers must also face quarantine.

How Healthcare Workers are Responding to COVID-19 Pandemic

Beyond coronavirus exposure, symptoms, and the diagnosed virus itself, there is the problem of how healthcare workers respond in a pandemic. The non-stop news and social media coverage of the coronavirus has put many Americans on edge, including health care workers. In a crisis, some people respond logically and calmly, while others may become fearful of their own circumstances and respond emotionally. Most healthcare workers would put their own family’s health needs and care before any employment, and in a free society, there is nothing to compel them to stay in a job if they choose to tend first to their own family.

If your loved one is in a senior living facility, what can you do to mitigate the negative consequences of workforce disruption due to the coronavirus? In the short term, if you are able and your senior is well enough, you can put them under your care. Beyond family care, unless you have the resources for private pay at any cost, you, like the rest of us, are in the system and have to wait out the virus and its effects. There is no guarantee moving forward how the coronavirus will play out in senior living communities, America, and around the world.

One of the few things you do have control over is to assure your loved one has proper legal documents for end of life decisions. Take the time to review them to ensure they are in order. A do not resuscitate order (DNR), durable medical power of attorney, and end of life wishes should be on file with your loved ones living facility and the local hospital. Additional legal copies of these documents should remain in your car or on your person in the event a facility is unable to locate the paperwork. Preparing for the worst-case scenario is a harsh reality; however, it could make the difference between chaotic suffering and a peaceful passing.

We can help draft appropriate documents for you and your loved ones. Learn more about your options and contact our Reno office by calling us at (775) 853-5700.

Healthcare

Understanding HealthCare Power of Attorney: Specific VS. General

You have the right to decide what kind of medical treatment you want to receive from doctors and health-care providers. If you can speak up at the time, you can express your wishes yourself. But if you become incapable because you’re ill or injured, you need to plan in advance. Designate a person whom you trust to speak for you. You do this by creating what’s known as an “advance directive” or health care power of attorney.

You also have a choice about the kind of document you prefer. You can ask for a short document that simply conveys general authority on your agent to make health-care decisions for you – or you can opt for a longer document that details the specific powers you give to your agent.

For both versions, we offer a checklist to assist you in discussing your wishes with your agent beforehand.

The General Version

This version is short, clear, and easy to understand. It states, generally, that you have given your agent the authority to speak for you. Your agent knows your wishes, because you have discussed those wishes with him or her beforehand.

The Specific Version

This version goes into detail about what you would like your agent to do for you. For example, it includes the request that providers and your agent consult with you if possible. If not possible, it includes a list of procedures that you authorize your agent to decide on your behalf. Included are decisions about what kind of residential facility you want to be placed in, that an agent can visit you and bar others from visiting if appropriate, can advocate for pain relief, can consent to psychiatric treatment, can decide about anatomical gifts and organ donation, and the document provides procedural details about enforcement.

You will be covered with either version. The choice is yours.

Living Will

You may also want a separate Living Will for end-of-life decisions. This document becomes effective when you can no longer care for yourself, walk, talk, recognize loved ones, or are in the final stage of an incurable illness. At that point, you can decline expensive, high-intensity care that likely would not improve quality of life.

Choosing Your Agent

The person you choose to be your health-care agent must be someone you can depend on to have good communication skills, remain calm in difficult situations, and deal flexibly with complexity that might arise in reconciling your wishes with available medical options. Choose that person carefully.

Health Care Preferences Checklist

We can offer you a checklist, to help you discuss your wishes with your agent. This is not an easy conversation. It’s hard to contemplate a time when our health has declined or we suffer injury or accident. It is also challenging to try to imagine various scenarios involving situations that can be complicated by numerous medical contingencies.

Still, your agent needs to know what you would want in a variety of situations. These include whether to decline or accept life support and mechanical interventions, when you would opt for or decline surgery, and your preferences about blood transfusions, medication, and religious observance.

For certain states, the checklist also contains a signature line that proves you have discussed your wishes as to feeding and hydration tubes. Otherwise, if your agent doesn’t know what you would decide, the law in some states would take away from your agent the right to decide about those kinds of measures.

Don’t hide your documents!

When it comes time to use your documents but they can’t be found, or if your agent or family don’t understand them or ignore them, you will have spent your time, effort, and money in vain. Make sure your documents are readily available. Give a copy of them to your agent and ask your doctors to include them in your medical records.

You will have done your best to see that your values and health-care choices will be honored. We are here to help, please contact our Reno office by calling us at (775) 853-5700.

Elder Living

Alternative Views on Facility Living with Alzheimer’s Patients

As the aging population rises, Alzheimer’s Disease is also on the rise for elderly moving into nursing home facilities. The National Institute of Health (NIH) Library of Medicine reports the most common form of dementia is Alzheimer’s disease, accounting for approximately two-thirds of all diagnosed cases of dementia. Alzheimer’s is also one of the most expensive diseases to treat and often results in financial strain on families trying to find and pay for the best care. In the past, care in facilities often resulted in Alzheimer’s patients being separated from others. However, as you’ll read below, facilities are now exploring better ways to treat Alzheimer’s patients while living in a facility.

Medical breakthroughs that increase our understanding of how to best treat and introduce disease modification therapies for people living with Alzheimer’s and other neurodegenerative diseases provides future hope. However, according to the Alzheimer’s Association, there are already more than 5.8 million Americans living with Alzheimer’s disease. These individuals may not live long enough to benefit from new therapy discoveries since new treatments must undergo rigorous testing and clinical trial phases. Current projections indicate that unless some of these medical breakthroughs have practical applications very soon, more than 14 million Americans will be clinically diagnosed to be living with Alzheimer’s by 2050, with many more struggling in the long-preclinical phase of the disease.

As senior living facilities become more saturated with dementia patients in all stages of progression, there is a shift underway towards non-segregated memory care living. Alzheimer’s patient reintegration into general senior living residence status is shifting dementia care into a human-centric model. It provides insights and lessons into eldercare facility living, its providers and staff, family members of residents, and all of the patients, not just memory care patients. This human-based approach is a kinder, more medically practical and appropriate, and in the long term, a more cost-effective method for facility residents who have dementia.

Before there were outcome-based clinical research findings to support the segregating of dementia patients care facilities began creating stand-alone memory care units, floors, and facilities.  Families knew their loved ones were safely locked away in a highly monitored unit, and staff could focus their training and efforts in a more specified range of care. Because this isolation model became overwhelmingly profitable for business operators, it became the de facto standard of memory care operation. Profits were trumping the human condition. At the outset, it seemed rational enough to put like-patients together, yet because everyone’s memory disease progression is unique, the concept was flawed. Living circumstances for humans is an emotional experience, and the sad outcome for assembled memory care patients was faster disease progression in their isolated, shrinking worlds. This accelerated mental decline was partially due to the lack of broader social and emotional connection with non-dementia residents. It seems integrating patients of all types and generations enriches and expands what residents can do, creating a diverse human model focusing on the positive aspects of life and personal interaction.

Some of the conditions all aging adults share, not just those living with dementia, include difficulty hearing and seeing, finding mental focus more demanding, becoming more concerned about being in large crowds, and noises that increase their stress levels. For a community of residents, no matter what the patient illness, facilities can create an atmosphere that addresses these common concerns. These shared needs include not only medical care but activities that are available in a 24-hour cycle and the encouragement of socialization in smaller, quieter circles. Interactions among residents in this calming style of environment tend to create friendships organically and provide enriching connections among patients irrespective of their illness type. The overall common conditions of aging require sameness in approach, no matter how varied the residents’ medical conditions are.

Technology that allows for digital wrist monitoring of patient location and vital signs permits ease of monitoring residents, particularly as they wander their living space.  Even the proper lighting, carpeting, and circular hallway architecture reassure residents’ feelings of safety, comfort, and familiarity, which appeals to all, regardless of diagnosis. When an entire senior living facility is dementia friendly, and all staff is trained in memory illness and care, every employee can add value to a resident’s enjoyment of life from the medical professionals to the social workers to the landscapers.

A diagnosis of Alzheimer’s can strike fear and worry in America’s aging population because of the emotional, physical, and financial upheaval associated with it. An older person might recognize the onset of some memory problems and become terrified, thinking about Alzheimer’s and the possibility of being relocated from their home and community to a dementia unit. There is a sense of dread that you may never feel seen, heard, and loved again by other people. Interpersonal relationships and connectedness are a hallmark of the aging communities in America. AARP reports large percentages of technology use in older Americans is related to interpersonal connections like email, viewing photos of family and friends, and using social media and the internet. Even in digital spaces and experiences, elderly community residents are looking to create personal networks, connecting to the world at large. The human spirit inclines to be expansive.

Appropriate social and physical environments play a significant role in healthy aging. Compartmentalizing memory care patients into homogeneous units will increase their memory decline, isolate their human connection, and spiral the patient into an ever-shrinking world of interaction, often making them non-verbal. Alzheimer’s patients who experience higher levels of social integration respond conversely, expanding their horizons as they experience and feel the extension of human love and support. There is no one set of symptoms for Alzheimer’s patients, and all patients are on their own trajectory of the disease. Mistakenly putting them together in a one size fits all approach of care has been a disservice to their health and well being and to the future care of others who will become afflicted with Alzheimer’s. The memory care model is shifting for the better and not a moment too soon.

We help families who have a loved one with dementia. We explore possible sources to help pay for care, like Medicaid, and we make sure our client’s wishes are stated in properly drafted legal documents. If you have a loved one with dementia, give us a call and let’s work on a plan to ensure your loved one has the best care possible, and their home and savings are protected. If you have questions, please do not hesitate to contact our Reno office by calling us at (775) 853-5700.

Estate Planning

Steps to Discussing Finances and Estate Planning with Aging Parents

Sometimes these conversations can be difficult but it’s essential that as your parents’ age, you have conversations with them about their finances. To broach the topic, you might bring up current events like the coronavirus pandemic, its effect on economic conditions, and how it relates to the security of their financial future. The conversation should come from a calming place of love and concern. Speak to them respectfully about how the coronavirus pandemic has you thinking about the importance of their planning and preparedness.

Once you begin the conversation, move away from the pandemic as your introductory technique as you do not want to create a sense of panic or fear.  Instead, delve into legal and financial reviews, processes, and parameters. US News reports that your parents’ financial analysis should include essential legal documents, financial accounts, and associated vital contacts, long-term care decisions, and claims. If you live apart, lay the groundwork to help them with their finances remotely.

It is generally most comfortable to begin your conversation with legal documents that hopefully your parents already have in place like a will, trust, living will, and a health care proxy. If your parents do not have these documents, they must retain an attorney and create the ones that best suit their needs. If you need to help your parents manage their finances, you must have a durable power of attorney. A durable power of attorney allows you to make financial decisions for your parents in the event they become incapacitated. This is an essential estate planning document. In the absence of a durable power of attorney, the courts become involved, and solving health or financial issues becomes a lengthy, expensive process over which you have little control. If your parents already have their legal documents drawn up, find out where they keep them and review them carefully. If any documents need to be amended, suggest that your parents meet with an attorney to make the relevant changes. Be sure their documents reflect the state law in which they reside.

Once you have assessed your parents’ legal documents, it is time for some financial discovery. Even if your parents do not currently need help, having an overview of their finances and a durable power of attorney to help them in the future is crucial to their aging success. Begin by listing all of their accounts, account numbers, usernames, and passwords as well as employee contact names. Include insurance policies, the agent’s name, and where the policy is, as well as how they pay their premiums. Include any online medical accounts or list their doctors’ names and office numbers. The idea is to create a comprehensive list of all of these accounts. Gather your parents’ Medicare and Social Security numbers and their drivers’ license numbers. Know where they keep this information so that in the future you will know where to look. Also, learn about any online bill paying or automated, re-occurring activity. These usually include monthly bills like electricity, natural gas, water, etc. but may also include quarterly payments or annual subscriptions.

If your parents still live in their long-time home, discuss if it is viable that they live out their days there, or if downsizing to a retirement community or moving closer to where you live appeals to them. Help them come to a decision that is best for their set of circumstances.  If they do not have long-term care insurance or some other mechanism to aid them in times of need, talk about the topic, and try to come up with a solution. If they do have long-term care, be sure you have a copy of the policy, contact information, and the name of the insurer and agent. Review the requirements for receiving benefits so you can help them when they need to file a claim as most policies have a waiting period of 30 to 90 days before benefits begin. Know what to expect.

Digital technology has made oversight of parents and their finances easier than ever as long as you have a durable power of attorney and access to their account information. If they do not yet pay their bills online, or use auto payment, help them set up this option for their monthly bills. Remind them you will provide oversight to ensure proper billing. Offer to help them with their annual tax filings. Your help relieves some pressure on them and provides you with information about the goings-on in your parents’ accounts. For your parents’ peace of mind, you can establish a monthly video chat to let them know their bill payments are progressing normally. Your involvement will allow you to identify any abnormalities in account activity, which may indicate scam attempts.

Having these financial and planning conversations with your parents today can help them live more securely and with less stress as they age. Most parents will try to avoid these discussions with their children because they may not be adequately prepared for what can lie ahead. Conversations that focus on proper legal documents and gathering financial account information will give you the data you need to help protect your parents.

We would be happy to help you and your parents with critical planning documents. We are open and taking new clients, and we hope to talk with you soon about your particular needs. If you have questions, please do not hesitate to contact our Reno office by calling us at (775) 853-5700.

Estate Planning

During COVID-19 Americans of All Ages Are Creating Their Wills

Understandably, the coronavirus pandemic has created the scramble to set up wills and end-of-life-directives. There has been an explosion in the numbers of Americans rushing to make their will online. However, online do it yourself (DIY) wills are often deemed invalid as they do not comply with all of the legal requirements of your state. According to Caring.com, the prevalence of will and estate planning has been on the decline since 2017 but this trend is quickly reversing itself with the advent of the coronavirus pandemic.

So, who needs a will? Ask yourself if you care who gets your property or money if you die? If you have minor children, do you care who will act as their legal guardian? The answer is anyone married, anyone with children or anyone with assets needs a properly executed will. Wills are governed by state law. Your will should reflect your wishes in the language and format required by the state in which you live for it to be valid.

Many law offices are turning to teleconference with their clients to address social distancing protocols while still providing legal services such as writing a will. Businesses like Zoom are experiencing a quadrupling of daily users. Part of this significant increase includes hosting secure attorney/client meetings for will preparations. The importance of an attorney guiding you through the process of creating a will cannot be understated as they understand the nuances of how things need to be written. Once your will is complete, it must be correctly notarized as mistakes made in the will-signing process can potentially invalidate your will.  Your attorney will guide you through the signing process, and could involve signing during a video conference.

Beyond the creation of a will, many Americans are increasingly concerned about their powers of attorneys, health care surrogates, living wills, and end of life directives. These “life documents,” as they are active while you are alive, are equally as important as your will. Named executors, successors, beneficiaries, power of attorneys should have several back-up representatives as the mortality rate due to the coronavirus remains unknown.

According to research in a recent New York Times report, health care workers are more likely to contract COVID 19 than the average person. During this pandemic, many doctors and other medical professionals are rushing to have their wills drawn up. In addition to doctors, anyone on the front lines in the fight against COVID 19, from hospital custodians to nurses to EMS responders, should either make a will or review and possibly update their existing one. However, the truth is no matter what your profession or likelihood of contracting this virus, you should have a properly executed will during this time of considerable uncertainty.

There are few things you can act on during the COVID 19 pandemic that can bring you assurance and a sense of relief. The legal creation of your will and life-directives is an action you can take that protects you and your family. We can help. If you have questions, please do not hesitate to contact our Reno office by calling us at (775) 853-5700 to schedule an appointment.