WARNING! Family Caregivers at Risk of “Dementia”

It has long been known that stress and sleep deprivation afflict family members caring for loved ones suffering from dementia.

But what has not been appreciated until recently is that such caregivers often develop symptoms which mimic those found in individuals diagnosed with dementia, including memory loss and disorientation.

In fact, most caregivers with such problems are not suffering from the degenerative brain condition labeled “dementia”. However, they are experiencing the toll of caregiving to a close family member. If steps are not taken to ease the stress, the symptoms will probably worsen.

In time, they will render the caregiver unable to provide necessary care – “burnout” will have occurred.

What to do? Try to step back emotionally. Recognize that all your love and attention cannot reverse the person’s condition. You can only do so much. And that is a lot. Don’t blame yourself.

And you deserve a break – a respite. You need to recharge your own battery to deal effectively with the unavoidable stress of your role.

Don’t hesitate to ask other family member to help out. They owe it to you since you’re already the primary caregiver. If they are unable or unwilling, contact local nursing and assisted living homes. They often provide short-term respite care – during the day or overnight – so you can get the break you need.

You’ll be of no use to anyone if you fall victim yourself to “dementia stress”.

Light Exercise is Good

Health authorities recommend that older individuals participate in 2½ hours of exercise per week. That can be a discouraging number since most of us consider exercise of that sort to require going to the gym or jogging in the neighborhood. But that is a misconception.

What is termed light exercising such as walking and gardening can also be beneficial.

Experts say you can get the same benefit as more strenuous activity by engaging in light exercise of this sort (including slow dancing!) but you would need to double your time commitment to a total of 5 hours each week.

Don’t Change Your Will On Your Own!!!

Many people don’t understand that you cannot effectively change the terms of your will by simply crossing out language or adding new language and then adding your initials or your signature to your changes.

A change to a will, formally called a “codicil” or amendment, requires the same formalities that are necessary to make a will legally binding in the first place.

In practical terms what that means is a codicil must be prepared to change the terms of the will with necessary witness signatures and notarizations (if such is required where you signed your will). If that is not done, the amendments you desire will be considered null and void.

As an aside, if you need to change the terms of your will, please let me know. I can make sure that the codicil is done right.

Confusing Legal Terms

Elder Law and Estate Planning lawyers often use confusing terms to describe the documents that they prepare. One example is a “living trust” also called a “revocable trust” or “inter vivos trust”. All of these refer to a document that attempts to avoid probate by having a trust set up to take possession of a person’s assets and spell out the terms of distribution in the document, thus avoiding the need to file for probate (but not always).

“Living Will”, often a part of a document called an “advanced directive”, does not refer to a Last Will and Testament. It is a document which recites an individual’s wishes about end-of-life decisions such as when treatment should be halted and nature allowed to take its course.

“Last Will and Testament” describes a document that is filed for probate and designates who gets what of an individual’s assets when he or she passes away.

How To Provide Immediate Cash To Your Personal Representative When You Die

A common problem confronting survivors of a loved one is coming up with money to pay for immediate needs such as a funeral or related expenses.

Unless you have a living trust, your personal representative may be delayed for several weeks before he or she can gain access to your bank accounts.

A simple solution is for you to open a specified bank account now naming your personal representative as a joint owner or designate that your personal representative is to inherit the account upon your death – that is known as a POD or “payable on death” account.

I recommend putting approximately $10-20,000 in that account which should be more than sufficient to tide things over until access can be had to your entire estate.

Doubtful Depression Treatment

Clinical depression is a common problem faced by many people as they age. In many, many cases, electroshock therapy (technically, electroconvulsive therapy or ECT) has been used by psychiatrists to treat the condition rather than, or in addition to, drug therapy.

Its use on patients with dementia is usually not recommended.

The procedure involves a risk of memory loss which can compound the problems of a person already suffering from memory deficiencies.

Preventing Falls

No one likes to fall at any point in their life but avoiding falls is particularly important as we age. That is because our bones are more likely to break upon striking objects or the floor. A particularly common problem for older people is breaking their hips. That is a particularly ominous event because statistics make it very clear that this type of injury and subsequent surgery appears to shorten one’s life. What can you do?

Take a careful look on the floor where you live. Is the surface uneven? Do throw rugs slip? Are there cords on the floor or loose items that require you to avoid them? Remove all of these hazards.

Such hazards are not the same problem when we are younger because we have a better sense of balance and are more able to avoid such risks without falling.

You don’t have to take, however, the loss of balance as a given as you age. It is possible that through exercises, you can help your balance, coordination, flexibility and strength. Exercise! Make it a regular course of your daily life to find opportunities to walk both in and out of your residence. Many people have also had success by practicing Tai Chi which focuses on slow and controlled movements which increase balance and prevent falls.

Further, a number of other factors can contribute to poor balance such as medications, poor vision, hearing, arthritis, depression, confusion and dizziness. Talk to your doctor if you have any of these conditions to see if adjustments and corrections can be made. 

Dangers of Living with Someone and Not Having a Will

For better or worse, co-habitation is increasingly common. If a long-term live-in relationship is intended to substitute for a traditional marriage, understand the following:

When a person dies without a will, the next of kin through marriage or blood generally inherit. Maryland is not a common law state and marriage is still defined as a relationship between a man and a woman which has been sanctioned by the State. That means that the law views your unrelated companion or partner as a stranger. He or she has no rights of inheritance absent a private will.

Helpful Ideas for Anyone Helping an Aging Parent

Maintain a care notebook. Keep a file of your parents’ medical records, including test results, current medications, allergies, insurance coverage and Social Security numbers, along with their physicians’ contact information. Collect e-mail addresses and phone numbers for neighbors and close friends, as well as the phone number for the nearest hospital.

Develop a relationship with your parents’ doctors. Doctors appreciate the input when adult daughters or sons accompany their parents to office visits, especially when they arrive with current medication lists and knowledge of medical issues. If possible, schedule your parents’ appointments while you’re visiting. To avoid future frustration, ask your parents to sign privacy releases giving their doctors authorization to speak with you by phone regarding their care.

Set up an alert system. If your parent lives alone, talk with him or her about an electronic alert system for emergencies. These systems, typically light-weight devices worn around the neck or wrist, require only a push of a button to generate an automatic call to summon emergency help. You might also want to arrange a daily check-in call or e-mail message.

Who Will Know If You're In An Accident?

Maryland drivers can now add three emergency contacts to their driver’s license so police will know who to call if an accident occurs. The emergency contact information is stored electronically on an individual’s driver’s license and will be available only to authorized law enforcement and medical personnel.

You can go to the MVA’s website at http://www.mva.maryland.gov/ and add your three emergency contacts in just a few minutes! Go to the website, click “Online Services” and choose “Emergency Contacts” to add your contact names, addresses and phone numbers.

Note: To perform this Emergency Contact transaction, you must be able to provide your driver’s license number, date of birth, and PIN or last 4 digits of your social security number.

 

The information you provide to the MVA will be available to law enforcement agencies and medical personnel.

Don't forget to periodically review and update your contact information.

 

Is It Too Late to Learn?

A recent article in The Wall Street Journal discussed the fact that many people, as they age, lose the capacity to learn despite popular beliefs to the contrary. There are countless examples throughout the world of older people taking on new challenges traditionally considered beyond them because of the person’s age.

Do you like to travel? Maybe you have your heart set on visiting Paris. Before you go, enroll yourself in a French language course. Because of your travel plans, you will have an incentive to commit yourself to learning something new. With that attitude, your chances of success are excellent and you will feel a sense of accomplishment that will brighten your spirit and encourage you to take on yet additional challenges. That motivation can be applied to a number of activities from acquiring or improving computer skills to boning up on current events.

And, if your health permits, the challenges need not be confined to mental activities. Even if you have never skied before, you can learn basics very simply and enjoy an invigoration outing in the wintertime. Learning to ski doesn’t mean you are undertaking a course to prepare for the next Olympics, after all!

And for warmer times of the year, how about golf? If you can swing your arms and walk without pain, you are certainly a candidate to try. And although you can get about in a golf cart on the course, golfing gives you the opportunity to get some simple walking exercise in beautiful surroundings as well.

Anxiety Medicine Can Increase the Risk of Alzheimer’s

Insomnia and anxiety are common conditions among the general population but particularly with the elderly. But if you have a history of Alzheimer’s in your family, please be aware that anxiety-reducing drugs such as Xanax and Valium can increase your risk of getting the disease.

Such drugs, known as benzodiazepines, have long been used in the treatment of early dementia symptoms of which anxiety is certainly one. However, a recent study provided evidence that the use of such medication may cause or hasten the onset of Alzheimer’s. So be sure to discuss any relevant family history with a doctor if a physician desires to prescribe such medication for you.

Exercise Can Ward Off Falls

As we age, our sense of balance deteriorates, making us more prone to falling. And falls can be serious. We have all heard of older people who fall and break their hips. Such injuries can have devastating effects in the future for such individuals even after surgical intervention.

Interestingly, there is some evidence (although much of it is anecdotal) that exercising can improve one’s balance and increase reaction time. (Many falls occur because a person loses his balance but is unable to move his body quickly enough to recover and, hence, falls). Apparently, a system of exercises from the Orient known as Tai Chi can help. It is particularly useful for older people because it does not involve strenuous activity. There is certainly no requirement that you sign up to lift weights at the local gym!

Tai Chi classes are conducted, for instance, at many senior centers.

Eat Vegetables To Be Happy?

For a variety of reasons depression appears to be more common as people age. Thus, it is of particular interest to note that a study in England suggests, controlling for other factors, the more vegetables a person consumes, the more likely he is to be in a good mood. However, the consumption of vegetables themselves may not be the cause of a good mood. Instead, the explanation may be as simple as the more fruits and vegetables one consumes, the less one is likely to eat other less healthy foods. Specifically, other research has also found a connection between depression and the consumption of fast foods, processed meats and high intakes of sugar.

Does a Reverse Mortgage Make Sense?

A reverse mortgage is a way of tapping equity in your home without incurring current interest payments.

Simply put, a reverse mortgage allows you to obtain a loan against your home with interest and payoff not due until you either leave the home or pass away.

The main drawback to reverse mortgages until recently is that upfront closing costs have been quite substantial. However, regulations have recently been changed significantly reducing those expenses and, hence, making a reverse mortgage more attractive.

If you need guidance in being directed to reputable firms offering reverse mortgages, let me know and I will do my best to help.

Be Careful If You Have a Will and Designate Beneficiaries on Financial Accounts

Many people do not realize that a Last Will and Testament only applies to assets and property that has not already been spoken for. What that means is that if you have a bank account, for instance, which names one child as a beneficiary (and you have 2 other children), that determines who gets the balance in that account at your passing. The language in the beneficiary designation in a financial account will override any distribution directions you may have given in your Last Will and Testament. The same principle applies if accounts are titled jointly or as tenants by entireties. Ownership of those accounts at your passing will be determined by who survives you. A specific beneficiary designation is not necessary.

What can you do?  There is certainly a convenience factor in using financial institution beneficiary designations and, as a practical matter, if you have no other assets outside of the financial institution, a will is not even necessary.  However, that is rarely the case. Thus, the solution is to make sure that your beneficiary designations with financial institutions match the wishes you have set forth in your will. An even easier way to solve the potential problem is to either leave the beneficiary designations blank on bank, etc., forms or to designate your estate as the beneficiary of your accounts.

Leaving your estate as the beneficiary can create problems of its own, however, if your estate is substantial. You would incur probate fees and potential tax consequences. Therefore, it is always a good idea to review your wishes with an attorney who can make sure that your documents are drafted properly and that your beneficiary designations are consistent with your Last Will and Testament wishes.