Care Planning Now Available For Those Living With Alzheimer’s Disease
November 8, 2016
Millions of Americans living with Alzheimer’s and their caregivers will benefit from a recently announced decision by the Centers for Medicare & Medicaid Services (CMS). Under the decision, Medicare will pay for “cognitive assessment and care planning for persons with Alzheimer’s Disease.”
“The news will expand access to critical care planning information and services that may improve the quality of life for the individual, their family and caregivers,” Alzheimer’s Impact Movement Executive Director Robert Egge was quoted as saying.
Prior to the announcement only about “half of those living with Alzheimer’s disease have been diagnosed. Of those who have been diagnosed, fewer than 45% of them or their caregivers are aware of the diagnosis. Physicians either do not diagnose Alzheimer’s disease, or do not disclose the diagnosis, because of the lack of time and resources to provide information and support to the patient and his or her caregivers.
“Until now, without approval by CMS there was an issue of reimbursement and a lack of training, leaving many dementia patients without guidance from the medical professionals following a diagnosis. With this new legislation, additional support will be part of the plan, shedding much needed guidance for the families affected,” says Miles P. Zatkowsky, who works nationally with Robert Egge on advocacy issues.
To read more about this legislation, click here.
Caregivers, here is a resource listing the ten warning signs of Alzheimer’s disease.
Our partners, Andy Dutcher and Miles Zatkowsky, have dedicated themselves to Elder Law and related practice areas since 1976 and 1981, respectively. The decision to focus on this area of the law was because both partners had experienced first-hand the anguish, frustration, soul-searching and doubt that comes with having to place a parent in a nursing home, together with the emotional and financial toll it takes on all members of the family.
Gene Wilder Kept His Alzheimer’s Diagnosis a Secret to Protect His Young Fans
September 2, 2016
Gene Wilder died earlier this week. I grew up admiring the comic genius of Gene Wilder. I first saw Gene Wilder in The Producers with Zero Mostel in 1967. That same year, I saw Bonnie and Clyde not realizing that he was also in that movie.
Even as a pre-teen, I got the sarcasm and satire of Gene Wilder’s role. Of course, in 1974, as a late teen, I became an instant fan of Blazing Saddles, a comedic classic. Standing the test of time, I have watched it many times with my daughters (at the appropriate age), and still watch it today with them and their husbands admiring how they laugh as if the movie was just released.
Just last week I was discussing movies with an old friend and mentioned that I miss those movies with Gene Wilder. We wondered why he had not done anything in years. Then the news of his passing.
As a member of the local Board of Directors of the Alzheimer’s Association in Rochester, New York, I felt a real loss at Gene Wilder’s passing from complications of Alzheimer’s. The loss became more profound when I read that he kept his diagnosis of Alzheimer’s a secret so as not to spoil the smiles on the faces of his fans. Gene Wilder did not want his young fans, particularly those still experiencing the 1971 version of Willy Wonka & the Chocolate Factory, to associate that brilliant fantasy movie with the dreadful disease. Despite living with the disease that robbed him of his memory, Gene Wilder still thought of the impact on his fans, including the new fans whose parents may not have even been born in 1971.
See the article on Yahoo: https://www.yahoo.com/movies/gene-wilder-lifelong-dedication-making-000000009.html
Now that Gene Wilder’s battle with Alzheimer’s disease is out in the open, it is an opportunity to talk about it. Together, we can eliminate the stigma associated with disease. While we all wish to be remembered for our best years, the fact is as we age, we will become more infirm and have to deal with certain obstacles.
Celebrity spokespeople do and should play a critical role in raising awareness on public health issues. Most result in raising more money for research to cure the ailment. Alzheimer’s is the sixth leading cause of death in America and the only disease in the top ten that has no diagnostics until after the disease has caused its irreversible damage, has no cure and no treatment. That is unacceptable in the 21st century.
Here are the 10 warning signs: http://www.alz.org/10-signs-symptoms-alzheimers-dementia.asp
At Dutcher & Zatkowsky, we are raising money for the cure by walking on September 24, 2016. Please join us or contribute to the cause: http://act.alz.org/goto/RochesterElderLaw
Four Documents You Must Have
June 29, 2016
What ideas should you be familiar with when going to see an estate planning attorney?
An article on cincinnati.com says there are four things you should know a little about before your first meeting with your estate planning attorney.
- A basic will. A catch-all to make sure your assets and properties be passed on according to your wishes. You might also consider a living trust. It stays out of the public record.
- A durable power of attorney. This names an agent to act on your behalf in case of disability.
- A health care power of attorney. It names a person to make important health care decisions on your behalf.
- Beneficiary designations. Make sure to list beneficiaries for all of your retirement accounts and life insurance policies.
Estate Planning Mistakes By Celebrities
June 22, 2016
Celebrities continue to make huge mistakes where estate planning is concerned.
A story on insurancenewsnet.com examines a number of cases where celebrities failed to do the right thing where estate planning was concerned. Among the celebrities mentioned in the roundup are football player Steve McNair, singer John Denver, and Elizabeth Edwards, wife of politician John Edwards.
McNair, who was murdered by his girlfriend, had not even drafted a will. His widow had to beg a probate judge to release some money from his $20 million estate, which had been frozen pending payment of taxes.
Denver also did not leave a will. His family had to wait six years until his estate went through probate.
Brando supposedly made an oral promise to leave his housekeeper a house but there was nothing in writing. She sued but settled for far less than the house.
Edwards tried to cut her philandering husband out of her will, which she signed six days before her death. But the law in her state does not allow that.
The story details many other celebrity estate mishaps as examples of what not to do when dealing with one’s estate. The latest one is singer Prince, though he is not included in this story.
Working Daughters Face Special Crisis
June 15, 2016
Working moms have it rough, but there are resources available to them to navigate the choppy seas.
An article in The Atlantic says working daughters have few such resources.
There are 44 million unpaid eldercare providers in the United States, and most are women. But there are very few support programs to help these women who are struggling at work and at home.
Many times, they have to switch to less demanding jobs, take time off or quit. As a result, they suffer loss of wages and job-related benefits such as health coverage.
The story suggests family leave is starting to be framed as both a childcare and an eldercare issue, but it isn’t there yet. A study shows most Americans believe caring for two elderly adults would be tougher than caring for two toddlers.
The article includes a number of examples and is an in-depth look at the problem. I recommend reading it if this is an issue that you are facing or are going to be facing in the future, which is most everybody.
Life Changes That Signal It Is Time to Get a Will
June 8, 2016
Life can change dramatically in a flash. So you’ve got to be ready.
A story on doughroller.net says being prepared for life’s changes includes the estate planning process. It means planning for your death or for incapacity.
Estate planning includes a will, living trust, financial power of attorney, advance medical directive and more.
The story lists several life events that should cause you to get or update a will.
They include: marriage, birth of a child, death of a spouse, death of a child, separation or divorce, receiving an inheritance, moving to a new state, birth of a grandchild, sale of a business and having a beneficiary with special needs.
Not Enough Geriatricians?
May 25, 2016
Geriatrics is one of the few medical specialties in the United States that is contracting even as the need is growing.
An article in the New York Times says it ranks at the bottom of the list of specialities that internal medicine residents seek to pursue.
These specialists are needed more than ever as life expectancy increases. Yet residency slots go unfilled.
One reason there are so few going into the specialty, according to the story, is that young doctors believe they can’t cure old people’s problems, so why try?
It is also one of the lowest paying specialties. Reimbursement rates by Medicare make it difficult for doctors to thrive financially. And nearly all elderly patients are on Medicare.
Some doctors who have geriatrics training don’t advertise it, as they don’t want too many Medicare patients.
There are primary care physicians who say the specialty is unnecessary as the ailments seen in the elderly are also common in middle-age patients. But others say that is just not true.
The story says, however, that some in the field believe geriatrics will soon receive the recognition it deserves. New payment models may see to that.
Is Alzheimer’s Catching?
May 18, 2016
Some disturbing news from a Swiss medical journal suggests that Alzheimer’s may be transmissible during some medical treatments.
An article on nature.com says that autopsies done on the brains of seven people who died of the rare brain-wasting Creutzfeldt-Jacob disease found that five of the brains showed some of the signs associated with Alzheimer’s.
All of the people had received surgical grafts of dura mater — the membrane that covers the brain and spinal cord — from human cadavers that were contaminated with the protein that causes C-J disease.
The researchers suggested that the transplanted dura matter may have been contaminated with small seeds of amyloid protein, which some believe may be a trigger for Alzheimer’s, along with the prion protein that gave the recipients C-J disease.
The study does not imply that Alzheimer’s could ever be transmitted through normal contact with caretakers or family members.
A Prescription For Confusion
May 11, 2016
Taking medications at the correct time is a special problem for the elderly.
They take quite a few more drugs than younger people do, many take seven or more a day.
Still, studies show that the more times a day you have to take a medication, the lower the chances of adhering to the proper schedule, according to a story in the New York Times.
When patients can’t stick to the plan, the consequences can be severe.
There are several reasons why the elderly often can’t comply with the proper medication plan.
Perhaps they can’t afford the pills once they get into the Medicare Part D “donut hole.”
Or they may not even fill their prescription to begin with because it is not included in their plan’s formulary.
In some cases they don’t take them on purpose because they don’t like the side effects.
But many times it is because the schedules for taking each drug may vary and it gets confusing.
The article suggests a universal medication schedule. This means labels on pill bottles would set out four standard times — morning, noon, evening and bedtime — for taking drugs.
A study showed that patients who got such patient-centered labels made significantly fewer errors in taking their prescriptions. California actually has called for this type of labeling, though it is not required.
The story also suggests pills should be consistent in appearance. Generics, for example, can often have a different shape or color than the brand name drugs.
The story says there is a free program available through Medicare called Medication Therapy Management that will review prescriptions, doses, costs and other questions for older people who take multiple medications.
Half of Prince Estate to go to Government
May 4, 2016
Since music superstar Prince did not have a will, it appears more than half of his $300 million estate will go to the government.
Both the federal and Minnesota governments have estate taxes. The top federal rate is 40 percent. In addition, Minnesota takes 16 percent over the first $1.6 million.
If Prince had been married, his estate would have gone to his spouse tax free.
As a single man, he might have taken advantage of some tax reducing strategies, but the government was still going to take a large share, the Daily Signal notes in a story.