Massachusetts Estate Planning & Asset Protection Blog

The Costs of Dementia: For the Patient and the Family - Part III What Can be Done

Posted by Dennis Sullivan & Associates on Mon, Apr 17, 2017

In the last installment of our three-part blog on the Costs of Dementia, we discuss the steps you can take to help alleviate the burden of caring for someone with dementia.

elderly-mother-and-daughter-1.jpg

What can be done?

Planning is important. Challenges that caregivers face include finding relief from the emotional stress associated with providing care for a loved one, planning to cover the responsibilities that could jeopardize the caregiver’s job or career, and easing financial pressures that strain a family’s budget. Having options—additional caregivers, alternate sources of funds, respite care for the caregiver—can help relieve many of these stresses. In addition, there are a number of legal options to help families protect hard-earned assets from the rising costs of long term care, and to access funds to help pay for that care.

Plannng ahead is the best way to ensure you have options if a loved one has dementia or any long term illness. Unfortunately, most people fail to plan ahead. According to the Genworth survey, the top reasons people fail to plan are they didn’t want to admit care was needed; the timing of the long-term care need was unforeseen or unexpected; they didn’t want to talk about it; they thought they had more time; and they hoped the issue would resolve itself.

Waiting too long to plan for the need for long-term care, especially for dementia, can throw a family into confusion about what Mom or Dad would want, what options are available, what resources can help pay for care and who is best-suited to help provide hands-on care, if needed. Having the courage to discuss the possibility of incapacity and/or dementia before it happens can go a long way toward being prepared should that time come.

Watch for early signs of dementia. The Alzheimer’s Association (www.alz.org) has prepared a list of signs and symptoms that can help individuals and family members recognize the beginnings of dementia. Early diagnosis provides the best opportunities for treatment, support and planning for the future. Some medications can slow the progress of the disease, and new discoveries are being made every year.

Take good care of the caregiver. Caregivers need support and time off to take care of themselves. Arrange for relief from outside caregivers or other family members. All will benefit from joining a caregiver support group to share questions and frustrations, and learn how other caregivers are coping. Caregivers need to determine what they need to maintain their stamina, energy and positive outlook. That may include regular exercise (a yoga class, golf, walk or run), a weekly Bible study, an outing with friends, or time to read or simply watch TV.

If the main caregiver currently works outside the home, they can inquire about resources and accomodations at work that might be available. Depending on how long they expect to be caring for the person, they may be able to work on a flex time schedule or from home. Consider whether other family members can provide compensation to the one who will be the main caregiver.

Seek assistance. Find out what resources might be available. A local Elder Law attorney can prepare necessary legal documents, help maximize income, retirement savings and long-time care insurance, and apply for VA or Medicaid benefits. He or she will also be familiar with various living communities in the area and in-home care agencies.

Conclusion

Caring for a loved one with dementia is more demanding and more expensive for a longer time than caring for a loved one without dementia. It requires the entire family to come together to discuss and explore all options so that the burden of providing care is shared by all.

We help families who may need long term care by creating an asset protection plan that will provide peace of mind to all. Attend one of our free educational workshops to learn more about what you can do to enhance the security of your spouse, home, life savings and legacy.

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Tags: Alzheimer's Disease, alzheimers care, caregiver, caretaker, care costs, dementia, seniors, costs of dementia

Sooner or later

Posted by Dennis Sullivan & Associates on Mon, Oct 20, 2014

Sooner or later, you’ll probably need long-term care – be prepared | Massachusetts Eldercare Attorney

 alzheimers

 

According to a recent article by George Morse in the AAA Membership newspaper

Sooner or later, you’re probably going to need some form of long term care.

Just look at the statistics:

About 70 percent of people turning 65 can expect to use such services during their lifetimes, according to the US Department of Health and Human Services, and their younger population isn’t immune. A 2003 study by Georgetown University’s Long-Term Care Financing Project reported slightly more than one-third of those with long-term care needs were younger than 65.

Long term care insurance is one way that individuals can ready themselves for covering the costs associated with this kind of need. While some may believe traditional health insurance or Medicare will address such an expense Doug Ross, AAA’s Expert on long-term care insurance, said those plans aren’t aimed at the same kind of services associated with long-term care.

“Health insurance is really good at paying for care that’s designed to make you get well again. Long-term care is care to help people with activities of daily living,” he said.

These activities include eating, bathing, dressing, toileting and transferring.

The primary government-support program for long-term care, Ross said, is Medicaid, though individuals must meet both income and asset requirements to qualify.

Your mid-40’s is a good time to start looking at long-term care insurance because coverage rates are age-based, and it’s less likely that a pre-existing medical condition will prevent you from getting coverage. Ross said some companies have even added blood work to their medical underwriting.

Long-term care policies can be crafted to fit an individual’s need and budget.

“One of the biggest challenges with it is that there are a lot of misconceptions. When you hear the words long-term care, the first thing you’re going to think of is your parents or a nursing home, things that have nothing to do with you. What we need is for people to understand it’s something to think about or look at when you’re young and healthy,” Ross said.

A major consideration when looking at a potential policy is to examine resources that could supplement the benefit, such as a means of receiving care at home instead of in a nursing facility.

An inflation protection rider can also be helpful, maintaining the policy’s value to keep pace with inflation.

 

For further information, take a look at our new book, The 10 Biggest Estate and Asset Protection Mistakes People Make and How To Avoid Them now including the special bonus chapter, The Biggest Long Term Care Planning Mistakes that goes more in-depth on your options, works and how to plan for your future.

 

 

At the Estate Planning & Asset Protection Law Center, we provide a unique education and counseling process which includes our unique 19 Point Trust, Estate and Asset Protection Review to help people and their families learn how to protect their home, spouse, life-savings, and legacy for their loved ones, click here for more information. We provide clients with a unique approach so they understand where opportunities exist to eliminate problems now as they implement plans for a protected future.

We encourage you to attend one of our free educational workshops, call 800-964-4295 and register to learn more about what you can do to enhance the security of your spouse, home, life savings and legacy.

 

Click Here to Register For Our Trust, Estate & Asset  Protection Workshop

Tags: long term care, elder care, long term care insurance, caretaker, AAA

Dealing with Financial and Emotional Costs of Dementia

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Wed, Jun 11, 2014

Helping Families Deal With the Financial and Emotional Costs of Dementia 

 Estate Planning, Alzheimers, Hardships, Dementia, Elderly, Nursing Homes, Assisted Living Homes, Financial Protection, Writing a will, Asset Protection,

Last month was National Elder Law Month A time for us to help educate the public about Elder Law and how we can help seniors and their families by providing solutions to the unique issues that come with aging.  Today we will discuss a debilitating condition that many Americans eventually face as they age:  dementia.  First, we will describe what dementia is and what it isn’t.  Then we will turn our focus to its costs to the individual, the family and our nation.  Statistics show that Massachuestts costs range from $13,800 - $16,000 per month for a Nursing Home, $5,400 - $7,500 per month for assisted living, and $15 - $32 an hour for in-home care. We are specially situated to help find solutions to many of the problems this condition brings with it.  While we can’t stop dementia, we can help protect those in its clutches while the medical world continues to seek prevention, treatment and reversal of the condition.

            Dementia Defined  

The Alzheimer’s Association defines dementia as, “a general term for a decline in mental ability severe enough to interfere with daily life. Memory loss is an example. Alzheimer's is the most common type of dementia.” 

 

Dementia is not actually a specified disease.  It describes, instead, a general decline in memory or other thinking skills and is identified through a variety of symptoms.  Alzheimer’s disease accounts for 60 to 80 percent of dementia cases.  In order to be characterized as dementia, at least two of the following mental functions must be significantly impaired:  visual perception; reasoning and judgment; memory; communication and language; or ability to focus and pay attention.  Dementia is not a normal part of aging as the terms “senility" or "senile dementia” infer. 

If a loved one is having trouble with any two or more of these mental functions, it’s a good idea to get it checked by a doctor.  Dementia is progressive and typically takes over the mental functions over time.  In this way, it provides the individual and the family with time to plan for its disastrous affects. [1]

 

Cost to the Individual

The cost to the individual with dementia is difficult to quantify.  Because dementia is a progressive condition and one where aging is the greatest risk factor, it is logical that at the beginning and younger stages of dementia, the cost to the individual is minimal.  As dementia progresses, so does the need for assistance with daily activities. 

This assistance often comes in the form of meal preparation, help with grooming and hygiene, transportation assistance, as well as help with many other daily activities.  Dementia patients can become so mentally challenged that they may place themselves in dangerous situations, such as roaming neighborhoods and getting lost.

  While the individual affected by dementia may need only a few hours of help per week at the beginning of symptoms showing, soon they may need around the clock supervision, not only for assistance with daily activities, but to protect them from themselves.  The individual’s costs will include medical expenses as well as paying a caretaker. 

Caretaking for one with dementia varies depending on the quantity of care required.  Statistics show that Massachuestts costs range from $13,800 - $16,000 per month for a Nursing Home; $5,400 - $7,500 per month for assisted living; and $15 - $32 an hour for in-home care. 

 

Cost to the Family

Where the individual with dementia is fortunate enough to have family nearby, the family will often step up to assist the ill loved one with their daily activities.  Again, the process can be gradual and before the helpful family member realizes it, they may find themselves missing work and, finally, quitting their job altogether in order to give proper care to the dementia patient.  Obviously, the cost to the family includes the loss of income from this family member’s job. 

The less recognizable cost to the family, however, is the emotional strain that is placed on the family member caretaker.  In order to save the family money, many family members will work nearly twenty-four hours, seven days per week.  The ramifications are physical, mental and emotional health problems to the caretaker.  The medical costs and possible future psychological costs to the caretaker, then, must be considered.

 

            It is important that family members: take a step back from the situation and assess this cost.  Providing a caretaker with time off every day, week and year is a must to ensure the caretaker’s health.  The caretaker must have appropriate support in order to keep caring for the loved one.


Cost to the Nation

As a nation we have begun to recognize the devastation that dementia has caused and will continue to cause.  Organizations such as the Alzheimer’s Association have been effective in lobbying for monies to be put towards the research of dementia treatment, prevention and reversal.  The cost of dementia to our nation has been a great motivator for politicians to fund such research.


A study conducted by RAND Corporation in 2013, estimated the national cost of dementia to be between $159 billion to $215 billion (including an estimate for the monetary value of informal care provided).[2]  The majority of the costs associated with dementia are for institutional and home-based long-term care and not medical services. 

Medicare and Medicaid pay for some of this cost, which amounts to a taxpayer burden.  According to the Alzheimer’s Association March 2013 Fact Sheet, in 2013 it is estimated that Medicare and Medicaid paid approximately $142 billion in caring for those with Alzheimer’s or other type of dementia.[3]

           

It is clearly in the best interest of the nation’s economy to continue research on prevention, treatment and reversal of dementia.

 

            Conclusion

 The costs of dementia can be devastating to the affected individual, their family and the nation.  While scientists continue to search for solutions to the debilitating condition, the families affected with it must face its challenges.  It is recommended that those families seek emotional support by way of a therapist or support group. In our recent book, “Senior and Boomer’s Guide to Health Care Reform and Avoiding Nursing Home Poverty” we provided helpful information how families can obtain quality care and protect a loved one with Alzheimer’s.  In addition, seeking out an Elder Law attorney can benefit the affected individual and family members in several ways.  We can also ensure that the family’s assets are being used in the most efficient manner considering other available resources and the family’s individual goals. 

 

Becoming educated and involved in planning for the challenges ahead is one of the MOST important steps a family facing the impact of dementia will take.  If you or someone you know is affected by dementia, we can help and we welcome the opportunity to do so.  To attend a workshop call 800-964-4295 or register online at DSullivan.com. For more information regarding our books, free workshops, and a DVD entitled,

“Helping People and Their Families on the Alzheimer’s Journey,”

Call our office at 781-237-2815.

 

 Click Here to Register For Our Trust, Estate & Asset  Protection Workshop

[1] http://www.alz.org/what-is-dementia.asp
[2] http://www.rand.org/news/press/2013/04/03.hml
[3] http://act.alz.org/site/DocServer/2012_Costs_Fact_Sheet_version_2.pdf?docID=7161 
 

Tags: Estate Planning, Alzheimer's Disease, MassHealth, dementia, VA benefits, alzheimers, caretaker

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