How do you respond to a health care emergency involving a senior loved one? The COVID-19 crisis has forced millions of families to confront this important question. The pandemic has hit elder adults disproportionately harder than the rest of society. Too often families realized they lacked the basic health care documents needed to act effectively on their behalf.
The coronavirus scare is far from over and taking steps to protect a senior relative means addressing key estate planning items. Many people think of estate planning as pertaining to wills and trusts, but it also means drafting legally sound health care documents, such as a health care surrogate, a living will, a health care privacy release, and more.
Whether a hedge against the coronavirus, or other health considerations like dementia and Alzheimer’s Disease, let us discuss four mistakes to avoid when using estate documents to advocate for a senior loved one:
Failing to understand a living will. A living will differs from a last will and testament. It is a completely separate legal document that tells others what an elderly family member’s personal choices are concerning their health care, and, in particular, end-of-life medical decisions. A living will is also different from a health care surrogate in that the elder adult’s “agent” must abide by the instructions laid out in the living will document.
Not knowing what the elder adult wanted. If an elder loved one’s health care wishes are either unknown or unclear, then even the most expertly drafted documents can be lacking. Make sure to have specific conversations with an older loved one about health care and put them in writing. This can serve as the basis for constructing accurate health documents, or updating them, and provide future guidance to more effectively advocate for them.
Failing to understand a health care surrogate. A health care surrogate may be one of the most important health care estate items an elder family member and trusted advocate can have. They may be useless, however, if poorly constructed or if the agent fails to understand his or her granted authorities.
Choosing the wrong “agent.” Advocating for an elder loved one involves a lot more than legal documents. While critical, they cannot impart tenacity, communication skills, or the ability to observe and question results. Those qualities must come from the chosen advocate. If they are lacking, families should not wait long before choosing someone who is up to the task.
Health care planning may have never been more important than it is now in these times of great uncertainty. If you or someone you know would like more information or guidance on related legal matters, contact our office to schedule a meeting.
A positive Alzheimer’s Diagnosis is a life-changing event both for the person receiving it and for those who care about him or her. Did you know that understanding the diagnosis and early stages of the disease are critical for identifying effective medical treatments, caregiving options, and future planning items aimed at providing long-term care?
June is Alzheimer’s and Brain Awareness Month. Alzheimer’s is a brain disease and the most common form of dementia, which is a general term for memory loss and degenerative mental capability. Toxic changes in the brain occur long before any Alzheimer’s symptoms are exhibited. Abnormal protein deposits form plaques throughout the brain and cause healthy neurons to cease functioning. To diagnose Alzheimer’s, doctors conduct tests to assess memory impairment, cognitive reasoning skills, functional abilities, and behavioral changes. They also perform a series of tests to rule out other possible causes of impairment.
While there is no known cure for Alzheimer’s Disease, family caregivers and adult children can better understand a senior loved one’s diagnosis by asking the evaluating physician important questions, such as:
What tests or tools were used to determine the diagnosis?
What were you measuring when the tests were performed?
How will the disease progress?
What treatment options are available?
What care planning services do you provide?
What support services or resources are available to help with the disease?
Early detection usually provides the best opportunities for long-term care and access to clinical trials. Traditional and experimental drug and non-drug interventions can ease the burden of the disease, and slow memory loss and other symptoms. If diagnosed during more developed stages, specializing physicians can still impart caregiving strategies to enhance safety and maximize quality of life for as long as possible.
Understanding an Alzheimer’s Diagnosis also helps families plan for the future. For example, a trusted family member can obtain a durable power of attorney document that would allow him or her to make binding decisions on the elder adult’s behalf when the elder adult is no longer competent. Advance health care directives, medical privacy releases, and updates to estate plans are also important planning items for long-term care needs and inheritance wishes.
If you or someone you know would like more information or guidance on related legal issues, we are here to help. As an elder law firm, we are committed to providing legal counsel on matters relating to degenerative diseases such as Alzheimer’s. Contact us today to schedule a meeting.
Since 1963, the month of May has been devoted to honoring and supporting the nation’s senior population. Older Americans are an indispensable part of our shared society and the annual May designation of National Older Americans Month formally recognizes their value. May is also National Elder Law Month, which is dedicated to promoting and providing legal support for a wide range of senior-related issues.
Without the aid of family caregivers, however, millions of seniors could be at risk. Indeed, family caregivers are integral to year-round elder care. In honor of National Older Americans Month, National Elder Law Month and family caregivers across the country, let us share a few much needed resources on our blog.
1. Respite care. Caregiving can be a tremendous sacrifice in terms of time, money, and opportunity costs, especially if a senior loved one has a physical or mental health disability. Often, caregivers are at risk of developing their own health problems due to exhaustion and unmet needs. Respite care, however, can allow caregivers to take breaks and care for themselves.
National Adult Day Services Association. This is a professional organization that provides adult day care consumer resources, including an adult day care locator and counseling on choosing the right facility for a senior loved one.
Senior Corps. Senior Corps’ Senior Companions program provides respite care by matching older volunteers with seniors who need help with daily tasks.
2. Health Care. Older Americans need good health care. They also need to find a way to pay for it. Let us share a few resources with you that can help you and your family with both.
Department of Veterans Affairs. The V.A. provides a vast array of support services for qualifying senior veterans and their families, including a paid family caregiver benefit. The program is called Veteran-Directed Home and Community Based Services. Elder law attorneys are potent advocates for senior veterans’ rights and often help secure V.A. benefits if they are denied.
Medicare. Medicare is a massive federal health program for people aged 65 and older. Senior caregivers might not realize that Medicare covers home health and skilled nursing services in certain circumstances.
Medicaid. Medicaid is a federal-state partnership program that provides health coverage for people with limited income and assets. Medicaid can also pay for long-term care in nursing homes.
SHIPs. State Health Insurance Assistance Programs, or SHIPs, provide free support to Medicare beneficiaries and their caregivers.
3. Legal. You need a trusted advocate on your side at all times. Navigating the myriad of issues that Older Americans and their families face, is not always easy. Know that, at all times, we are here to help.
National Academy of Elder Law Attorneys — NAELA is a nonprofit association of lawyers and organizations that provides legal services for older adults and people with special needs. NAELA established National Elder Law Month as a way to acknowledge the elder law profession and provide critical support for the nation’s senior community.
We know that you may have questions based on these resources we are sharing with you. If you or someone you know would like more information or specific guidance on legal matters, do not wait to contact us today.
Human beings are social creatures. Similar to animals, we live in family groups for much of our lives and tend to seek out companionship. For the most part, we also seem to find comfort in human contact during stressful or difficult times. If the findings of a recent survey are any indication, this instinct or need to be together persists throughout our lives.
Let us share a bit more information here. In the 2019 survey of people with loved ones in nursing homes,nearly 55 percent said they do not spend enough time visiting. Those who felt this way visit their loved ones four times per month, and devote less than two hours to each visit. By contrast, participants who said they spend enough time visiting their loved ones did somore often. They also devoted more time to each visit.
Now, with the Coronavirus Pandemic prompting skilled nursing homes across our state to halt visitation, residents cannot see their loved ones in person at all. We all worry about not only how our loved ones are being cared for, but also want to ensure that they do not feel increased isolation or depression. Let us share some simple tips to keep in touch and ease your fears during this time.
1. Send photographs and small gifts. Start by checking with staff to see if it is okay to send your loved one a care package. If you can, send a homemade card along with a few of his or her favorite things. Depending on his or her preferences, consider sending paperback books, music, snacks, puzzles or games. Exchanging photographs is another easy way to stay connected while visits are prohibited. If they have not done so already, ask the nursing home staff about starting a program to facilitate this activity. That way, your loved one could send photos to you, and you could take photos to send to them.
2. Use technology to facilitate communication. If your loved one has access to email, feel free to communicate that way. You may also want to ask if your loved one can have access to video conferencing services such as FaceTime, Zoom, or Skype. If not, there is nothing wrong with making routine telephone calls or sending letters.
3. Get the information you need as well. Do not hesitate to request regular updates from facility staff, including administrators. This may alleviate any fear or concerns you have about your loved one’s well being. You can also request information about any protocols implemented to promote staff and patient safety.
In the meantime, we are here to address any legal concerns you may have about visitation. Simply contact our law firm to arrange a telephone consultation with attorney Scott Selis at your convenience.
It is a story as old as time. Our parents care for us when we are young. Many of us return the favor as our parents age. While it sounds simple in theory, that is seldom the case in reality, especially now as we find ourselves facing these uncertain times. In addition to Covid-19, one of the biggest challenges formillions of young caregivers is how to take care of their aging or ailing parents while juggling demanding jobs.
Did you know arecent estimate puts the number of unpaid caregivers in the United States at more than 40 million? The same estimate indicates that most of these family caregivers have difficulty coping with work and caregiving responsibilities. Unfortunately, there are two significant, but unintended consequences. The first is that a caregiver’s job performance often suffers, with work productivity dropping byat least 18 percent. The second is that these caregivers need to take time off from work, resulting in lost work hours valued at more than $25 billion.
Studies show that another, less reported, consequence of spending less time at work or quitting work to take on full-time caregiving responsibilities may include the loss of benefits. Examples of these benefits that are needed by young families may include not only a loss of a paycheck but health care insurance, company sponsored retirement plans, or all of it.
How can we help these families? In our firm, we work every day to help both Florida seniors and their adult children get the elder care support they need. In addition to what we recommend in our meetings, experts recommend the following to help young caregivers balance work and caring for a loved one:
Create a family calendar to track relevant appointments, delegate chores and manage medication
Seek support and guidance from your local agency on aging
Review your employee handbook to see which if any policies apply to your situation.
Try to limit caregiving tasks, such as scheduling medical appointments, to personal time as much as possible
Arrange for a coworker to cover for you if you have to leave work suddenly when possible
As a caregiver and employee, it is important that you are open and honest with your employer. By speaking with him or her about your situation, you may be able to create a plan that works for everyone. During your conversation, be sure to askabout:
When you can take paid or unpaid leave
The possibility of flexible scheduling
How to get help through Employee Assistance programs
Finally, be sure to ask your employer about your rights under the Family Medical Leave Act, or FMLA. This is a federal law that allows certain American workers to take up to 12 weeks off of work per year. Under the law, eligible workers can do so without pay, but without risk of losing their jobs. To be eligible for time off under the FMLA, you and your employer must meetspecific requirements. If you do not, all is not lost, however. You may have similar rights under applicable state laws.
We understand it may be difficult to have these conversations, so we are here to support you on this and any of your elder care concerns. Please do not wait until you feel completely overwhelmed to ask for help. Contact our law office to schedule a meeting with us today.
Growing old gracefully is easier said than done. Many of us often have trouble asking for help. Further, it is often difficult for Florida seniors to admit when they are having difficulties with things that once came easily, especially when it comes to understanding the difference between Activities of Daily Living and Instrumental Activities of Daily Living.
This is just one of the reasons why having objective means for assessing their needs is so important. In the context of elder care these can include Activities of Daily Living, or ADLs, and Instrumental Activities of Daily Living, or IADLs. Let us share a few key differences that can help you and the Florida seniors you love in understanding the difference between Activities of Daily Living and Instrumental Activities of Daily Living and navigating the challenges surrounding long-term care.
Let us start by answering the question: What are Activities of Daily Living (ADLs)? In all, there aresix ADLs. They include:
1. Walking, or otherwise being able to move from one place to another on foot, either indoors or outside. The clinical term for this is “ambulating.”
2. Feeding, or the use of fingers or utensils to move food from a plate or bowl into one’s mouth.
3. Dressing and grooming, or the ability to choose what to wear, putting clothes on properly, and shaving, brushing one’s hair, brushing one’s teeth and so on.
4. Toileting, or the ability to get on and off the toilet, use it properly, and cleaning oneself.
5. Bathing, or the ability to clean one’s face and body in the bath or shower.
6. Transferring, or the ability to shift from one body position to another. This includes the ability to maneuver from a bed to a chair, or into a wheelchair. This can also include the ability to stand up from a bed or chair in order to access a walker or similar device.
When you enlist the help of a health care provider, the amount of assistance that the Older American needs with each ADL is also noted in assessment of overall function.
By contrast, let us share key insight into Instrumental Activities of Daily Living (IADLs). While ADLs may be classified as basic life skills,IADLs are more complex. They can include:
Household chores: Including dusting, vacuuming, doing dishes and so forth.
Laundry, including making sure that clothes and other items are washed or dry cleaned as needed.
Managing finances, such as paying bills on time, keeping track of bank balances and so on.
Medication management, which can include taking prescription medications as directed.
Making meals, which can include preparing and cooking or making food.
Shopping for food, and other lifetime necessities.
Transportation concerns which can include the ability to get from place to place by driving, or on public transit, moving from one residence to another and so forth.
Using communication devices which can include the ability to use the phone and computer to contact friends and family or call for help if needed.
It is important for you to begin to understand how ADLs and IADLs are used. Although assessments of IADLs are not used to determine whether someone can qualify for public benefits programs such as Florida Medicaid, assessments of ADLs are. Specifically, Florida Medicaid states that to be eligible, someone must need help with two or more ADLs.
In general, health care providers use these tools to evaluate a person’s physical and mental capabilities as they age. By doing so, they can determine what type of care and supervision is warranted. As elder care lawyers, we also work with seniors and their loved ones each and every day to understand these issues. We know the challenges you face and we encourage you to schedule a meeting to discuss this and any other concerns you may have.