January-March 2015
Alzheimer’s Disease: An Epidemic
Alzheimer’s disease is a progressive degeneration of brain tissue.
Alzheimer’s is the most common
cause of dementia, and affects intellectual functions such as memory,
comprehension, and speech. Shortterm memory is typically affected
first. As time goes on, long-term
memory becomes cloudy, and then
is gone. Ordinary daily activities
grow increasingly difficult, reasoning skills diminish, and behavioral
issues often surface (such as frustration, combativeness, paranoia,
etc.) Often these behavioral issues
worsen at night, and are often referred to as “sundowners”. Dramatic mood swings are not uncommon with many seniors diagnosed
with Alzheimer’s. They may wander, or intentionally escape. The
disease can cause combativeness,
Attorney
Jane M. McNamara
Guiding families
through the Complex
Issues of Long-Term
Care, Asset Protection
and Elder Law.
Contents:
Alzheimer’s Disease:
An Epidemic
1
Social Security
Increase for 2015
1
Getting to Know
Carrie E. Barnes
1
10 Signs that Families
Need Help
2
Time to Make A Plan
2
The Cost Of Nursing
Care3
Managing Unpredictable
Behavior3
Essential Legal
Documents 4
Press Release
Upcoming Events
4
posing a danger to themselves or
to those around them. They may
become sexually aggressive, say
inappropriate things to family and
strangers, accuse spouses of affairs, believe everyone is stealing,
urinate in public, and have other
bizarre and unpredictable behaviors. Combinations of medications are required to ease the behaviors, which unfortunately, can
become a “trial and error” process.
As the disease progresses, the patient often cannot be cared for in
the home. Finding an appropriate
facility to meet the specific needs
can be challenging and expensive.
Eventually, the Alzheimer’s patient
may become physically helpless,
incontinent, and unable to communicate entirely. Alzheimer’s disease can run its course from onset
to death in just a few years, or it
may play out over a period as long
as 20 years. More often, however,
people suffer with Alzheimer’s
disease for about nine years. It is
the sixth leading cause of death in
the U.S. One person out of eight,
age 65 and over, has the disease.
Women are more susceptible than
men, and half of all nursing home
residents suffer from Alzheimer’s
or related disorders. Since there
is no “cure”, and it is progressive
and terminal, families must have
the knowledge, education, and
tools to cope with this disease. It
is up to the families to seek out
appropriate and correct information, create a plan, and make the
best choices possible.
Social Security Announces a 1.7 Percent Increase for 2015
Monthly Social Security and Supplemental Security Income (SSI) benefits for nearly 64 million Americans
will increase 1.7 percent in 2015. This “COLA” adjustment will begin in January 2015 for Social Security
beneficiaries. SSI beneficiaries will receive increases beginning on December 31, 2014.
The Social Security Act ties the annual increase to the Consumer Price Index. For more information, please
visit www.socialsecurity.gov/cola. For information about Medicare changes for 2015, please visit www.
Medicare.gov.
Getting to Know Attorney Carrie E. Barnes
Carrie E. Barnes has been a lawyer for 25 years. She spent many years as a trial
attorney litigating business, contract, personal injury and construction lawsuits.
Carrie now uses her advocacy skills to assist our clients with the legal and financial issues involved in aging such as estate planning, asset protection, medical and
long-term care options, Medicare and Medi-Cal benefits and insurance coverage
(including long-term care insurance). Carrie is also a Veterans Administration accredited attorney, and assists our clients obtain and maintain VA benefits that help
pay for long-term care.
Page 2
10 Signs That Families Need Help
Are you, your family members or friends struggling to meet the needs of an elderly loved one during a chronic
illness, incapacity, or disability? If you see one of these signs of distress, the family may benefit from the LIFE
CARE PLANNING and ELDER LAW services of the McNamara Law Firm:
Legal Planning
Advocacy
Public Benefits
Asset Protection
Support and
Information
1. The primary caregiver is suffering from burnout, ill health, frustration, guilt, or confusion.
2. Family members are confused about care options, what to do next or where to get help.
3. The elder was recently diagnosed with Alzheimer’s disease, dementia, Parkinson’s disease,
or other chronic condition.
4. The elder is ill or disabled with children or family who live out of town.
5. The elder has experienced an event such as a fall, medication mistake, or accident.
6. Family members have discovered the elder wandering, malnourished, dehydrated, or unable to
provide self care.
7. The elder suffered a medical event such as a stroke or heart attack.
8. There are worries about paying for long-term care in the future.
9. Adult children are voicing concerns about a parent’s debilitating diagnosis.
10. The elder is hospitalized and the family has been told that returning home is not an option.
A LIFE CARE PLAN is a written “roadmap” prepared by The McNamara Law Firm, PC, which sets forth a customized and detailed action plan for the elder. The LIFE CARE PLAN details the process to meet the unique care
needs, pay for care, receive appropriate monetary benefits to help pay for care (Medi-Cal, Veterans Administration
benefits, etc.), and meet other important goals. The LIFE CARE PLAN helps the family clearly understand what
needs to be done to meet these goals (proper care, dignity, asset protection, relief for the well spouse or family
members, etc.). Our team at the McNamara Law Firm assists every step of the way.
Time to Make a Plan
Once a diagnosis of dementia, Alzheimer’s, Parkinson’s, or other progressive illness has been
made, it is extremely important to map out a plan to manage the disease and its devastating
financial aftermath. It is essential to have professional assistance to help with this plan.
The McNamara
Law Firm, PC
provides these essentials for
the elderly and their families
dealing with Alzheimer’s,
dementia, stroke, and
illnesses related to aging.
Please visit our Web Site
for our updated
Calendar of Events
and information.
www.theMcNamaraLawFirm.com
Developing a Plan: Plan as soon as possible. Many families use the services of an elder law
attorney, who is well-versed in the complexities of Medi-Cal eligibility and asset protection,
care options, and VA Aid and Attendance benefits for care. The plan should consider legal and estate planning, long-term
care options, insurance issues, Medicare and Medi-Cal, and planning for the best quality of life possible for the elder.
Legal and Estate Planning: There will come a time when the ill elder can no longer sign legal documents. The person
will be deemed “incapacitated”, and it will be unlawful for them to sign documents. This will create great difficulty and
frustration for the family member trying to conduct financial transactions, make medical decisions, or engage in asset
protection measures to protect the home and life savings. Legal documents should be completed BEFORE the disease
renders the person incompetent.
Page 3
The Cost of Nursing Home Care
Seniors are living longer with chronic diseases, dementia, diabetes, and the effects of stroke. Unfortunately, many are unable to pay for their needed
care on a long-term basis. If nursing home care is required, many seniors simply do not know their options. They use all of their savings to pay
for that care – at a cost of over $7,500.00 per month. Many do not understand the California benefit for long-term care called Medi-Cal. Medi-Cal
can provide assistance, if the senior is eligible.
However, Medi-Cal can later seek “recovery” against the senior’s home for this nursing home financial assistance. A lifetime of savings and frugal
living is lost, because the senior had an illness or condition that required nursing home care. The senior or the family never considered or were
aware that there were other options and asset protection possibilities.
Alternatively, many seniors live in assisted living facilities, board and care homes, or have private in-home caregivers. Again, the senior’s savings
is the primary source of payment, and often the senior outlives their funds. Families are looking for tools, information, and advice on how to afford
care for elderly loved ones, without using all of their life savings, and possibly losing the senior’s home. They need information on Medi-Cal, VA
benefits, community resources, and other alternatives.
Many seniors wrongly believe that their insurance, such as Medicare, will cover their care needs. Not so. Medicare, SCAN, Kaiser, Secure Horizons, Blue Shield, HealthNet, and all the other insurance companies do not pay for long-term care. They only cover short-term nursing home
care for older and disabled patients, after hospitalization. After this initial period expires, the patient must privately pay for the expensive care.
However, Medi-Cal covers long-term nursing home care for seniors who are eligible. Additionally, many eligible veterans and their spouses receive
VA Aid and Attendance benefits, which provide monthly monetary assistance for care expenses, such as in-home caregivers and assisted living
facilities.
Making wise decisions is very important when faced with these challenges. Having all the information, and understanding the options is critical
in making wise decisions.
Elder Care Coordinator Corner
Managing Unpredictable Behavior in Dementia Patients
Behavior management in
Alzheimer’s and dementia
patients is often challenging
for the caregiver and family
members as the disease progresses.
Lisa Krzyzewski,
Elder Care Coordinator
The Law Firm’s
Elder Care
Coordinators:
Advocate on behalf of
the client
Regularly visit to
ensure proper care
Support family members
through the decisionmaking process
Assist with VA and
Medi-Cal applications
Provide information,
resources, and guidance.
The changes in the brain often lead to unusual and unpredictable thinking and aggressive/paranoid behavior.
For example, your loved one
may become anxious around
family members, neighbors,
or friends whom he or she
may no longer recognize.
The dementia victim may
lash out. Sleep patterns are
often disrupted. He or she
may become withdrawn,
wander, become aggressive,
and/or become angry and irritable.
Although medications are
often successful in managing
outbursts, they do not “cure”
the situation. Here are some
tips to help you manage the
behavior changes that often
accompany Alzheimer’s disease:
Be calming. If your loved one becomes agitated or aggressive, redirect
their attention. Some methods to do this include changing the subject or
environment, playing music or a video that they used to enjoy, or reminisce
about the family, or activities once enjoyed.
Routines often work. Try to minimize any changes in the surroundings
or to your loved one’s daily routine. Avoid situations that require the person with Alzheimer’s to make decisions, which can be very frustrating and
cause anxiety for them.
Gently remind. Help your loved one maintain his or her orientation and
dignity. Provide the names of the people around them. Remind them of the
day of the week, and what the schedule is for that day.
Reassure. Use a quiet voice, and be protective and affectionate. If they are
delusional, be reassuring rather than defensive.
Watch medications and health. Be sure your loved one gets the right
medications at the right time. Watch for reactions and possible side effects of medicines, such as depression or agitation. Consult with the doctor
about giving any over-the-counter medicines (even “PM” medications), because they may react with prescription medications and cause side effects.
Changes in behavior may also be caused by urinary tract infections and
dehydration, which are all too common in senior citizens, but not always
diagnosed.
Identify triggers. Try to identify any actions, words, or situations that may
“trigger” inappropriate or dangerous behavior.
Be honest. Recognize when the person’s behavior is more than you can
handle. Your own, as well as your loved one’s safety, must be considered
at all times.
Page 4
Essential Legal Documents
If you or a loved one has been diagnosed with a progressive disease, it is necessary to consider legal and financial matters. Even those without such a diagnosis need
proper legal documents in place, as even the healthiest individuals unexpectedly may have a health crises. People with Alzheimer’s, dementia, and other illnesses may
have the capacity to manage their own legal and financial affairs right now, but as the disease progresses, they will need to rely on others to act in their best interest. This
transition is never easy. However, advance planning allows people with progressive brain illnesses, and their families, to make decisions together for what may come.
Legal Documents
Clearly written legal documents that outline your loved one’s wishes and decisions are essential. These documents authorize another person
to make health care and financial decisions, including plans for long-term care.
Obtain legal advice and services from an elder law attorney - one who is well versed in the maze of issues you are or will be facing. As you
plan for the future, ask the attorney about the following documents:
• Power of Attorney. This gives a person an opportunity to authorize an agent -- usually a trusted family member or friend -- to make legal
decisions when he or she is no longer competent.
Estate Planning,
when done
properly, can be
invaluable.
• Power of Attorney for Health Care (Advance Healthcare Directive). This gives the person an opportunity to authorize an agent to make all decisions regarding
healthcare, including choices regarding medical providers, medical treatment, and, in the later stages of the disease, end-of-life decisions.
• Trust. Enables an appointed Trustee to manage Trust assets during the grantor’s cognitive impairment. However, a Revocable Living Trust does not offer protection
from Medi-Cal recovery. For asset protection planning, an Elder Law attorney should be consulted to determine if specialized Irrevocable Asset Protection Trusts are
appropriate.
Without comprehensive legal documents, court intervention (“Conservatorship proceedings”) may be needed, giving the “conservator” legal authority to make decisions and carry out financial transactions. Unfortunately, the affected person’s wishes may ultimately not be carried out, as all court rules and procedures must be strictly
adhered to; and after death, the Probate Court may be required to handle estate assets. Typically “pre-planning” is the wiser choice for most individuals.
CALENDAR OF EVENTS
February 7, 2015, Saturday, 10:00 am—3:00 pm
Golden Year Expo—Hyatt Hotel, Valencia
Keynote Speaker
March 20, 2015, Friday, 11:30 am—1:00 pm
Hosted by Avan All-Valley Aging Network Pacifica Senior Living, Santa Clarita
Panel Speaker
May 9, 2015, Saturday
Caregiver Resource Day, Senior Center, Newhall
Keynote Speaker
Please visit our Web Site for our updated Calendar of Events and
information. www.theMcNamaraLawFirm.com
PRESS RELEASE
Attorney Jane M. McNamara Elected To LCPLFA Board
Principal Attorney of McNamara Law Firm Will Serve On National Law Board To
Advise On Elder and Life Care Planning Law
St. Louis, MO – National attorney association LCPLFA (Life Care Planning Law
Firms Association) elected Attorney Jane M. McNamara of Valencia, CA to the Board
of Directors at the organization’s annual meeting earlier this month in St. Louis.
Attorney McNamara has been serving the unique needs of the elderly in law practice
since 1991. The McNamara Law Firm specializes in assisting seniors, the elderly, and
the disabled obtain services, care, and appropriate public benefits so they can enjoy
the highest quality of life possible. Attorney McNamara’s practice focuses on guiding
seniors and their families through the maze of legal issues dealing with dementia, illness, long term care, and asset protection. Attorney McNamara is also accredited with
the Veterans Administration, and assists clients obtain VA benefits to help pay for long
term care. The firm offers guidance for clients during a difficult and overwhelming
stage of life, and takes pride in effectively advocating on behalf of clients to ensure
they receive proper and appropriate care for their unique circumstances.
The Life Care Planning Law Firms Association Annual Meeting took place earlier this
month in St. Louis, where Attorney McNamara was elected to the Board. LCPLFA is
a national attorney organization dedicated to dealing with the unique needs of elderly
clients. Attorney McNamara’s extensive experience in the field will certainly lend itself to the benefit of the organization.
To learn more about the LCPLFA, visit www.lcplfa.org.
www.theMcNamaraLawFirm.com www.VAbenefits4seniors.com
28212 Kelly Johnson Parkway • Suite 110
Valencia, CA 91355
www.theMcnamaraLawFirm.com • www.vabenefits4seniors. com