Senate and VA Look to Protect Veterans from Scams

Elder abuse scams are everywhere, but they are reaching a new level of sophistication in targeting their potential victims. Forbes is reporting about the problem that unscrupulous scam artists are contacting veterans and service members pretending to collect money to aid other vets or enlist them in a fictitious government program that requires their personal information as well as an initial payment. Other scams include home refinancing loans at extremely reduced rates, the offer of an upfront lump-sum payment of benefits for signing over all their future monthly benefit checks, fake charities, and posing as an old friend with a “sure thing” investment just for them. The problem has become so vast that the Senate Aging Committee is tasking the Department of Veterans Affairs to do more to protect veterans.

Much of the focus of the Veterans Administration has been to deliver quality and timely health care. The Senate Aging Chair Susan Collins (Maine-R) acknowledges the precedence to fix VA health care issues pushes protecting veterans from financial fraud to a lower priority. Now the committee is calling for a specific two-step action plan that will not require additional resources and can be implemented immediately.

According to Collins, the first step would be to elevate veteran claims of financial fraud to the Federal Trade Commission (FTC) and the Justice Department (DOJ). The FTC has a public service announcement on its website to educate people on how to identify an actual veterans charity organization that properly uses donations to help veterans. Many fraudulent charities have the word veteran in their name specifically to mislead people into giving them money. The FTC is the central point of contact for reporting fraud outside of the VA.

At this time, the DOJ references consumer fraud complaints to the FTC toll-free phone line or website to access the FTC’s fraud task force. The DOJ recognizes veteran benefit fraud and misuse by refocusing the problem back to the VA but does not have a specific veteran consumer fraud complaint program. Collins is asking the VA to increase the visibility of the veteran fraud problem to the DOJ through the forwarding of complaints. In keeping with the VA prioritizing veteran health care over victims of fraud, the DOJ Office of Inspector General has a newly created Veterans Affairs Health Care Fraud Task Force. It may take some time before more is done about veterans and scams, but elevating VA fraud complaints to the DOJ is a start.

The second step in the committee’s recommendation is to distribute a brochure to all veterans from the combined efforts of the American Association of Retired Persons (AARP) Fraud Watch Network and the United States Postal Inspection Service (USPIS). The educational pamphlet can also steer veterans to the OperationProtectVeterans.com website, where more information about veterans scams can be found. This website features videos, lists of the most common scams, and the tips veterans need to know to avoid becoming a victim to a scam. The USPIS, in conjunction with the DOJ, is working on getting more authority from Congress to prevent veteran financial abuse.

According to the AARP, veterans are twice as likely to fall victim to scams as the population at large. They also have twice the rate of Post Traumatic Stress Disorder (PTSD) as that of the general public. PTSD is one of the leading reasons veterans fall prey to fraud. Because of their disorder, veterans living with PTSD find it more challenging to recognize and then resist the emotional manipulation scammers employ. Because of their vulnerability, veterans are heavily targeted by scam artists. According to an AARP study, 80 percent of retired military persons maintain they have encountered at least one veteran-specific scam and that 16 percent have lost money to scammers, again double the rate of the general public.

Surely the veterans of America deserve to be better protected against financial fraud. The Senate Aging Committee is making scams targeting veterans a priority and pressuring the VA to take more action. Until more programs and education are in place, there are some general rules to follow that every veteran and family of a veteran should know:

  • Do not give personal information over the phone.
  • Do not feel pressured to “act now.”
  • Consult a trusted family member or your local veterans’ affairs office before providing a donation.
  • Get and check references and do your due diligence before signing anything. Check with the Better Business Bureau or consult your lawyer.
  • Do your research and take your time. Legitimate veterans businesses and charities will not try to rush you.

Be aware if you are a veteran who has PTSD. Seek out legitimate charities or businesses to employ through your efforts. Being susceptible to emotional manipulation is difficult to combat because of your disorder. If you begin to feel uncomfortable with a person or entity trying to get a donation or sell you something, shut the conversation down immediately and talk to a trusted loved one, then contact the VA.

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


Guide to Advance Directives

Kevin stands at the door of Winnie’s nursing home room, tears streaming down his face. The medical staff just finished inserted a feeding tube into Winnie – an act Kevin knew she didn’t want. Unfortunately, Winnie couldn’t express her wishes due to advanced dementia, and she had no legal documents that expressed her wishes not to be fed by artificial means.  Kevin had no choice but to sit back and watch his wife go through a procedure she didn’t want.

The situation with Kevin and Winnie could have been avoided through the use of proper advance directive. An advance directive is actually a collection of documents. What that includes differs depending on your needs and wishes, along with what the law allows. However, it usually means at least a Living Will and a Power of Attorney for Healthcare.

The purpose of this set of documents is to allow you to control what happens to your health care in case you cannot speak for yourself. If certain criteria are met, your doctors must consult with your advanced directive before making decisions about your care.

Usually, what this means is that two doctors agree that an individual is terminally ill, permanently unconscious, or at the “end-stage” of a condition. Once that happens, and the individual cannot express their preferences, doctors turn to the advance directive to figure out what the individual wants.

A Living Will determines what happens to an individual making it, unlike a Last Will and Testament, which determines what happens to their money and possessions. A Living Will describes what healthcare providers can and cannot do to prolong your life and/or ease your pain when you cannot express those preferences yourself. For example, do you want to be placed on a ventilator if you cannot breathe on your own? Do you want a feeding tube and IVs set up, and if so, for how long? Do you want to be an organ or tissue donor?

A Durable Power of Attorney for Healthcare lets you choose someone to make healthcare decisions for you when you cannot. They still must follow your Living Will, but they will be able to make decisions not explicitly considered by your Living Will, in accordance with the facts of the situation. In most states, there are “default surrogate consent laws” which allow family members to make treatment decisions on your behalf, but who is chosen to make these decisions and what they choose to do may not be in accordance with your wishes, as it hopefully would be with a Durable Power of Attorney.

Other documents may be part of an advance directive by law, or they may be worth including on your own volition. These include Do Not Resuscitate orders and Physician Orders for Life-Sustaining Treatment, among others. You might also consider an advance directive in case of a mental health crisis.

This is a difficult subject to consider, and it always seems like it won’t be necessary. But nearly 70 percent of Americans don’t have plans in place for a worst-case scenario, which means for some of them, decisions may be made for them with which they would not agree if they had the capacity to choose. For that reason, it is worth thinking about implementing an advance directive even if it seems unnecessary now.

If you or a loved one would like more information about advance directives, please don’t hesitate to contact our Reno, Nevada office by calling (775) 853-5700.


Having a Power of Attorney Can Protect Your Right to Vote

Your right to vote is a fundamental lynchpin of what it means to be a citizen – yet you could lose your right if you become a ward in a guardianship. Having a strong power of attorney is essential to avoid that drastic, but little-known, consequence.

A power of attorney gives a trusted person the authority to act on your behalf. Support like that is especially important if there is any question that you might have become unable to make decisions for yourself. Sometimes, however, that situation is far from clear. Elderly people can be dragged into unnecessary guardianship proceedings, not of their choice.

This can happen, for example, if you are temporarily hospitalized and a not-so-friendly person – maybe related to you by a second marriage – sees an opportunity to seize control of your finances. Any adult person can file a petition seeking a guardianship. If you had designated your trusted agent before hospitalization, your agent could defend against that kind of predatory danger.

The danger is real. You could lose not only your money and your independence but also your right to vote. For example, until relatively recently a provision in the Arkansas Constitution stated that “no idiot or insane person shall be entitled to the privileges of an elector.” That provision had the force of law until 2009. And again in Arkansas, once a person is placed in a guardianship, court approval is required before the ward is permitted to vote. Laws like these are by no means exceptional. Many states disqualify from voting persons who have been adjudicated incompetent, incapacitated, or of “unsound mind.”

But the standard to decide whose mind is “unsound” is far from clear. For example, a diagnosis of dementia can encompass a wildly variable population, depending on the point of view of the evaluating professional. And judges usually have no specialized education of their own in psychology.

Whether a person can handle their finances or retains the ability to drive, are far different questions from whether a person retains enough sense to vote. A citizen who votes for any winning candidate joins the majority of the electorate. Determining, in advance, that one vote of all those is irrational discriminates against that particular voter – when many uninformed voters, who might choose candidates based on the brilliance of their smile, say, would not be subjected to that kind of scrutiny.

How much better it would be, then, to avoid that battle in the first place. With the help of an elder law attorney, you can create an effective power of attorney that will do just this.

If you have any questions or need guidance in 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.


Solidifying Your Health and Financial Security Before Turning 65

In the United States, turning 65 years of age is a milestone on many levels, but before this birthday, there is a hefty checklist that you need to address to continue aging successfully. Overall the most crucial thing to do before turning 65 is to invest your time wisely crafting the best approach possible for your health and financial security well-being.

Can you afford to retire? Are you married? Estimate your total annual spending, including a cushion for periodic or unforeseen expenses like home repairs or dental work. Total all of your potential retirement-income sources and understand the tax implications associated with their spending. Run through several scenarios where you change what year you claim social security benefits to see if you should defer collecting it to a later age. Be realistic and start adhering to a modest budget today. Very few Americans can withdraw a lot from personal savings and investments without risking running out of money too soon. As you start to gather your assessments in general about how you view your retirement, find a qualified retirement planning expert that can help you with projections that are based on realistic assumptions.

Familiarize yourself with Medicare and its associated program variations. If you are retiring, you will approach Medicare differently than if you continue to work and have health care available through your employer. If you no longer will have health care through an employer, learn about Medigap supplemental insurance policies as Medicare will not cover all of your health care. Health insurance becomes quite complicated and varies widely depending on your overall health and personal financial situation. The National Council on Aging (NCOA), in partnership with private companies Aon Retiree Health Exchange™ and Via Benefits™, provides a checklist and timeline that can guide you through the process of enrolling in Medicare and assessing how you will cover the cost of prescription medication. If your income is low, you may qualify to enroll in Medicaid, which covers more expenses than Medicare. If you have already begun to take your social security benefits, then you will automatically be enrolled in Medicare. A packet entitled “Welcome to Medicare” will be sent to your address three months before turning 65. There are essential actions to take and deadlines associated with this packet, so read through the material carefully and meet those deadlines.

There are resources available to help you understand what your options are and the best way for you to proceed. As you approach the age of 65 many private insurance companies will lobby for your insurance dollars that will be spent on supplemental insurance. Finding a retirement planning company with insurance brokers that can sell you policies from many different insurance companies is more advantageous than locking into a group that will only sell plans that are associated with their company. A reputable insurance broker should not charge for helping you to assess your situation as they make commissions from the insurance company providing the policy to you. Check with the Better Business Bureau (BBB) online where you can plug in the name of an insurance group or retirement counselor and find out how long they have been in business, their accreditation, BBB rating, and customer reviews and complaints.

If you are over the age of 50, you can contribute an extra 1,000 dollars annually to your IRAs and an additional 6,000 dollars to 401(k)s up until the age of 65, according to Kiplinger. If you are still working, this is an excellent way to boost your retirement spending money. Before 65, you need to explore the option of a long-term care insurance policy, which helps to pay for any assisted living care needs you may require in the future. Long-term care policies can be expensive. If you do not enroll in a long-term care plan before the age of 65, the policies will become practically unaffordable.

Before turning 65, you should also come to terms with your will, advance medical directives, trusts, and the difficult conversation with your spouse or children about your end of life wishes and any funeral arrangements. Take heart, turning 65 is far from a death sentence as many Americans are living long and active lives well beyond the age of 65; however, meeting with an elder counsel attorney can save you and your heirs’ plenty of money and heartache. Do not wait until an adverse medical event forces your family or loved on to act on your behalf financially or medically. Decisions made under duress do not provide the best outcomes. Beyond your will, power of attorney and power of medical attorney, consider a dementia directive as well.

Projections for the aging US population indicate an ever-increasing number of seniors who have Alzheimer’s and other forms of dementia. Your elder counsel attorney can guide you through your options. Some states even have working templates for dementia directives. As you age, you can review your legal strategies from time to time and make adjustments as you deem necessary. It isn’t easy to discuss your end of life scenario, but once you have had the discussions and put proper legal documents into place, you can move forward with a sense of relief. It is freeing to make decisions and act on your future behalf, knowing you can always revisit your choices.

Now for the fun stuff; get excited about the senior discount. While it is true that there are discounts available as early as 55 and 62, nothing beats the senior discount at age 65. You can check off that bucket list of yours with deals on restaurant meals and travel excursions, clubs, retail stores, hotels, cinemas, smartphone plans, AARP membership discounts, and more. If you do not see an offering for a 65 senior discount posted, by all means, ask.

Beyond Medicare eligibility, you can get a onetime free physical exam if you have Medicare Part B insurance coverage. Gyms and community programs offer discounted or free physical fitness programs so that you can keep yourself moving and as healthy as possible. If you have Medicare, check out your eligibility for SilverSneakers for a 65+ fitness program. Your local senior center can keep you socially active and connected to people your age. Making friends and enjoying the simple act of conversation is known to have many benefits for your cognition and staves off isolation and depression issues.

If you retire from your job at 65, you can finally begin to collect on your pension plan or 401(k). That in itself is worth a celebration after many decades of hard work. You might also opt to collect your social security benefits, but it is generally advisable to wait until you reach full retirement age.

Homestead benefits and property tax exemptions are a considerable benefit for those who already own or plan to own a home or property. Benefits vary by state, so you will need to see what you can qualify for where you live. Your local comptrollers’ office can provide information about offers regarding homestead benefits. For property tax exemptions, you must contact your local comptroller or tax assessor’s office for exemption information.

There is a lot to discover, learn, and know about how to proceed in life at age 65 and beyond. With Social Security benefit determinations, health insurance policies, and legal documents in order, you can begin to enjoy being 65. Start your education about being 65 or more today. Stay vibrant and healthy and enjoy those things you dreamed of doing when you were your younger self.

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


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 marketwatch.com, 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, mcknightsseniorliving.com 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 umethod.com 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.