Jarvis Law Office

How to Recognize the 6 Stages of Dementia

Dementia is not an all-or-nothing disease – it progresses over time, adding more and more levels of complication as time passes. While there is no cure for dementia, it is possible to treat it and slow its effects if it’s caught early enough. Knowing the different stages of dementia can help you support your loved one appropriately and prepare for the right level of care when it’s needed. The following is an explanation of the six stages of dementia, including the significant changes and milestones you should be aware of for your loved one:

Stage 1: Early Cognitive Decline

The first stage of dementia is sometimes masked by the typical signs of aging. There may be some forgetfulness and a slight decline in cognitive functions, but for the most part, someone in this stage of dementia can still function independently. You’ll want to encourage your loved one to visit the doctor regularly for check-ups to ensure the physician is aware of the situation.

Stage 2: Mild Cognitive Decline

The symptoms of dementia will become clearer during this stage as forgetfulness becomes more prevalent and your loved one has more trouble performing everyday tasks, like driving or problem-solving. This is usually the stage where you’ll also notice your loved one misplacing items, like putting a purse in the refrigerator or car keys in a medicine cabinet without even realizing it. It’s a good idea to begin looking at dementia care options during this stage. 

Stage 3: Moderate Cognitive Decline

At this point in the journey, your loved one will need assistance in just about every area—it’s no longer safe for them to drive or manage finances alone. Their dementia symptoms will be very clear in this stage, and you may want to look into assisted living communities that specialize in dementia care.

Stage 4: Mid-Stage Dementia

Short-term memory is nearly gone by this stage, and your loved one will need help with all activities of daily living: eating, bathing, dressing, toileting, transferring and continence. A live-in aide or dementia-specialized assisted living community is critical during this stage.

Stage 5: Severe Dementia

During this stage, you’ll notice that your loved one has forgotten names of close family members and will have no short-term memory. They will also start losing their ability to communicate and suffer from anxiety, depression and compulsions. If they’re still in the home or at an assisted living community, it’s probably time to determine how to move your loved one into a specialized memory care or skilled care center.

Stage 6: End-Stage Dementia

A person in end-stage dementia will likely not have any control over their activities and will need significant assistance in communicating, walking and performing all activities of daily living. Round-the-clock care is required at this point, and caregivers often seek to give comfort and improve their loved one’s quality of life at this time.

If you have more questions about helping to care for a loved one suffering from dementia, or if you believe your loved one is ready for a higher level of care and need advice, please contact our Ohio elder law office at 877-653-3450 to schedule a complimentary initial consultation.

Understanding Your Healthcare Directives

As we age, the importance of our healthcare directives increases along with the likelihood that we’ll need more care in a hospital or care community. Healthcare directives come into play if you become incapacitated, and they let your family and care providers know what level of care you want, who should make healthcare decisions for you and who should be made aware of your medical conditions. There are three main types of healthcare directives: living will, healthcare power of attorney and HIPAA release form.

Living Will

The living will is the document that allows you to make decisions about the type and level of care you want if you’re ever unable to communicate those wishes to your healthcare providers. For instance, if you suffer from severe dementia or enter a coma without leaving behind instructions for your healthcare, you run the risk of being kept alive through artificial means—even if that’s something you would never want. The living will makes it clear to healthcare providers if you do not want to be kept alive on a breathing machine or with a feeding tube if there is no real chance that you would ever recover.

Healthcare Power of Attorney

The healthcare power of attorney (HCPOA) gives the agent of your choice the ability to make healthcare decisions for you if you are ever incapacitated. This is a separate document from the living will, which addresses specifically who should be in charge of your healthcare if you can no longer make or voice your decisions. Your agent—typically a spouse or adult child—communicates your wishes to your healthcare providers, so it’s important to make your wishes known to them before the time comes. Everyone 18 and older should have a HCPOA since we could all experience a time when we are unable to communicate our wishes—even if for only a short period of time.

HIPAA Release Form

The HIPAA release form, which may also be called a health information privacy release, allows people of your choosing to speak with healthcare providers about your condition. There is no decision-making ability given in this release as it’s only meant to help family members and other loved ones stay up to date about your medical conditions if you wish. Otherwise, doctors and other healthcare providers cannot share any of your information with your family members due to HIPAA laws.

If you have any questions about your existing healthcare directives, or if you would like to discuss creating a new living will, healthcare power of attorney, or HIPAA release, please contact our Ohio elder law office at 877-653-3450 to schedule a complimentary initial consultation.

Tips to Help a Loved One with Dementia

Paid caregiving services are not always possible for people suffering from Dementia, which means loved ones usually act as caregivers during a difficult time. The primary caregiver, usually a spouse or adult child, may have to provide round-the-clock care, which can exact a heavy toll on the caregiver. Caregivers often require a break to recharge and may turn to other loved ones to help if they can’t afford to hire a professional. Stepping in to help a loved one with Dementia can be tricky, but there are ways to make it work. Here are some tips to help you if you’re providing care for a loved one with Dementia:

Brace Yourself
Unfortunately, you’re going to be helping a loved one who may not be the same person you remember. If you’re pitching in to provide some respite care, make sure you understand what that care entails, and get familiar with your loved one’s new condition. This might mean spending time assisting the primary caregiver before you take over, or even just spending some extra time with them.

Be Aware of Your Situation
You should always be mindful of how you approach your loved one, as certain situations can heighten their anxiety. For example, you should always walk slowly and approach them from the front, as this lets them know that someone is coming and gives them time to adjust. A sudden movement or approach from behind could cause problems.

Provide Hand-Under-Hand Assistance
Depending on the severity of their condition, some Dementia patients require assistance with everyday tasks like eating with utensils or brushing their teeth. In these cases, you’ll want to place your hand under their hand to help guide them while performing these activities. Many times this will jog a memory for them, and they can continue the activity unassisted. Other times, you may just need to provide that extra support for them as they move through their day.

Keep Emergency Information Close
If a problem ever occurs, you want to make sure you have the right contact information ready. Calling 911 is the most obvious option, but you should also have the contact information for your loved one’s physician, as well as information about medication they’re taking or any other medical issues that are a concern. Knowing that you have this information close by can help reduce your anxiety during this time, as well.

If you have more questions about helping to care for a loved one with Dementia, or if you’re currently providing care but your loved one needs a higher level of support, please contact our Elder Law office at 877-653-3450 to schedule an initial consultation.

Should I Change My Estate Plan as I Age?

As people age, new challenges arise – even for issues they thought were already taken care of. For example, many people create estate plans when they’re younger, usually when they first have children, and then leave those plans untouched for several years. During that time, changes occur, and the initial plan might not be suited for your current situation. This is especially true as children age and loved ones pass away as these changes could have a serious impact on the effectiveness of your estate plan. Here are some considerations you should think about for your estate plan:

Last Will and Testament

Most people create a Last Will and Testament when they’re younger to ensure they have a say in who takes care of their children in the event they pass away. This is no longer a concern when the children are grown, however, so it’s a good idea to look at your Last Will and Testament in light of your changed situation. You may want to leave behind a legacy for your kids as well as your grandkids, or perhaps you want to leave something behind for a close niece or nephew. It could even be that you’d rather have your entire estate go to charity. It’s up to you, but keep in mind that the choices you made back when you first created your Last Will and Testament may not apply now to your current situation.

Power of Attorney and Living Will

The Power of Attorney and Living Will let others act on your behalf for financial and healthcare concerns, respectively, if you ever become incapacitated. In both cases, you should take a look at who you named as your agents in both documents and ensure that they’re still the right choices for now. People who create an estate plan when they’re younger sometimes name their parents or siblings on their documents, but when they’re older, those are probably not the best choices. Instead, most seniors will name their adult children to make those decisions for them if they’re incapacitated. You can also decide if you want one agent to take the lead or if your agents must work together. It’s also a good idea to re-examine the choices you made regarding your healthcare as your mind may have changed over the years about the type of care you want to receive.

If you’d like to have your existing estate plan updated to meet your current medical needs, please contact our Elder Law office at 877-653-3450 to schedule a complimentary initial consultation.

How to Approach a Parent About Alzheimer’s

You may have noticed some troubling behavior from your parent recently. Bouts of confusion, difficulty remembering simple details, or maybe car keys being put in a strange place, such as the refrigerator. Unfortunately, these are all early warning signs of Alzheimer’s disease. If you suspect your parent has Alzheimer’s, it’s imperative that you get them to a doctor as soon as possible to confirm the diagnosis and start treatment right away. While there’s no cure for Alzheimer’s, there are several treatments available that can slow down the disease.

However, before you can begin, you’ll have to approach your parent with your concerns. This is not always easy, but it’s critical if they’re going to receive the care they need. The following are some steps you can take to approach your parent about the possibility of them having Alzheimer’s:

Decide Who Needs to Be Involved

When you’re planning to have a difficult conversation like this with your parent, you may not want to have it alone. Siblings or a spouse can offer support during this time, but there are some pitfalls you should be aware of. For instance, a sibling may be in denial about your parent’s condition and disagree with you, which could cause problems. You also do not want to overwhelm your parent by having too many loved ones confront them all at once about their condition. Use your best judgment when deciding who should broach this topic.

Speak with a Professional for Advice

This conversation may be one of the most difficult you’ll ever have to have, so it’s best that you don’t go in unprepared. There are a number of professionals you can speak with for advice and help. Physicians, social workers, and experienced elder law attorneys are all excellent resources to contact if you suspect your parent has Alzheimer’s disease. If you give them some context about your parent’s situation, they should be able to advise you on the best way to proceed.

Speak with Your Parent as Early as Possible

The earlier you can speak with your parent and start getting them the care they need, the better it will be for everyone involved. This is especially true before their cognitive functions start to decline as it may be much harder to convince them to seek treatment once the disease has fully set in.

If your parent has recently been diagnosed with Alzheimer’s and you have questions about your next steps, please contact our Elder Law office at 877-653-3450 to schedule an initial consultation.

5 Questions to Ask a Dementia Care Community

At a certain point, your loved one with Dementia may not be able to remain at home and will instead need to reside at a care community that can meet their needs. But, choosing the right Dementia care community can be a daunting task as you need to make sure it’s the correct facility for your parent’s condition and meets other important needs, such as location and cost.

Here are five questions you should ask when choosing a Dementia care community for your loved one:

What level of care is provided?

This is an important question as some facilities only focus on early- or late-stage Dementia. Depending on your loved one’s situation, you need to choose the facility that provides the right level of care for them and, if possible, can also scale to meet their future care needs.

What amenities are available?

While most facilities provide typical amenities such as housekeeping, laundry and meals, you’ll want to find out exactly which amenities are provided as this can impact your loved one’s well-being. For example, an early-stage Dementia patient may find it beneficial to carry out some normal daily routines to keep their mind active.

What is the staff-to-patient ratio?

In addition, you’ll want to ask how that ratio changes at night. You don’t want to leave your loved one in a situation where the staff is completely overwhelmed with patients, and you also want to know if enough personnel will be available if there’s an emergency during the night. You should ask for the breakdown of physicians, nurses, nurse practitioners and other staff, if possible.

What are the security conditions?

Dementia patients can easily get lost and confused, which is why many facilities secure their grounds–and even some wings–with security protections. Find out how the security is set up in the facility to ensure your loved one’s safety and what protocols are in place in case a patient leaves the facility unattended or if there is an emergency.

Are there any special needs they don’t address?

If a senior has Dementia, chances are that they also suffer from at least one other condition, such as diabetes or heart problems. The facility needs to know about any conditions your loved one currently has and should be able to tell you if they’re equipped to treat those conditions along with Dementia.

If you’re currently looking for a Dementia care community for your loved one and need advice on what to look out for, please contact our Elder Law office at 877-653-3450 to schedule a complimentary initial consultation.

What are My Options for Social Security?

Social Security benefits represent a large portion of most seniors’ retirement income, but because of the way the system has changed since its introduction more than 80 years ago, it is has become extremely complex and difficult to navigate. Hundreds of amendments have been made to the Social Security Act during that time, which is why it’s important to speak with an elder law attorney in Ohio to find out which Social Security options are out there and right for you.

For example, a lot of people don’t know that they don’t have to quit working entirely in order to begin collecting Social Security benefits, but this small bit of information can make a huge impact on their income levels. In fact, there are at least four ways that a single person can collect Social Security, while law attorney who can walk you through all of these options is a good way to find out what’s available to you and how it can benefit you in the long term.

As far as married couples are concerned, we must keep in mind the fact that the wife usually survives the husband and will then be eligible to collect his Social Security benefits. This is very important, as almost a quarter of widows and other single female seniors live below the poverty line. This reason alone makes it critical to spend time with an Ohio elder law attorney in order to put together a comprehensive plan that covers either spouse in the event that the other passes away.

While it might be tempting to go it alone or seek advice from friends and family who are collecting Social Security benefits, the fact remains that the system is complicated, and everyone’s individual situation is different. Ohio elder law attorneys are well-versed on how Social Security works and can provide solid advice. Whether you plan to live strictly off of your Social Security benefits, or if those benefits will be used in other ways as a part of your long-term retirement plans, this is not an area to take lightly.

If you’d like to learn more about your options for Social Security benefits, or if you’d like to have your current estate or elder law plans reviewed to make sure they still fit your needs, please contact our Ohio elder law office at 877-653-3450 to schedule a complimentary initial consultation.

How to Help Your Grandkids with a 529 Plan

If you already have grandchildren or know your family will grow in the future, it makes sense to consider a 529 plan to help pay for their college education. 529 plans are set up before your grandkids even head out to college and allow you to put money aside for tuition so it will be there when they need it. There are several benefits to using this type of program with the most well-known being the possibility of locking in today’s tuition prices. With the ongoing increase in tuition, paying 2019 prices for a plan which might not be cashed in until 2032 makes good financial sense.

In addition, there are some attractive tax benefits available to those who take advantage of 529 plans when planning for their families’ futures. The money invested grows tax-deferred, and later college costs are free from federal taxes, while Ohio may offer some additional, considerable tax benefits. An experienced elder law attorney can help you navigate the tax benefits and determine exactly how a 529 plan can benefit both you and your family.

529 plans are typically run through states or institutions, which causes some concern for grandparents about whether or not kids growing up in Ohio have to attend specific schools in the state. Fortunately, most plans will allow students to choose from a variety of schools and do not limit them to one geographic area. It is actually fairly common for grandparents from one state to invest in a 529 plan on another state, either because of personal preferences or because that’s the state where their grandkids reside.

One thing to note is that there are two different types of 529 plans available for consideration when planning for your grandkids’ future. Savings plans are similar to retirement plans because your contributions are invested in things such as mutual funds. The value of this particular 529 plan depends on how these investments perform. Prepaid plans allow you to pay the tuition in advance and can usually be converted for use at out-of-state or private colleges.

If you have questions on setting up a 529 plan and whether it’s the best option available for your grandkids, or if you currently have a 529 plan and want to have it reviewed to see how it fits in with your current retirement plans, please contact our Ohio elder law office at 877-653-3450 to schedule a complimentary initial consultation.

PREVENTIVE HEALTH MEASURES THAT MAY DELAY DEMENTIA IN SENIOR CITIZENS

What is Dementia?

According to the Alzheimer Association, Dementia is not a specific disease. It's an overall term that describes a group of symptoms associated with a decline in memory or other thinking skills severe enough to reduce a person's ability to perform everyday activities. Alzheimer's disease accounts for 60 to 80 percent of cases. Vascular dementia, which occurs after a stroke, is the second most common dementia type.

Dementia Statistics in the United States

According to statistics, it’s estimated that one out of every six women and one out of every ten men living past the age of 55 will develop dementia. With around 5 million individuals in the US affected by dementia, it is common to have a friend or relative diagnosed with dementia.

Although there are several forms of Dementia, in the US, around 70% of cases are as a result of Alzheimer’s. While these figures may rise in the near future, health scientists are beginning to discover several preventive health measures that may help delay dementia in elderly citizens.

Five (5) Preventive Health Measures That May Help Elderly Citizen Tackle Dementia

In a recent report by the National Academics of Sciences, Engineering, and Medicine, scientists have been able to postulate three key methods that may be able to slow down the impact of Dementia in older citizens. These strategies included: being physically active, high blood pressure control, and participating in cognitive training exercises.

Below are five (5) ways elderly citizens can reduce the effect of dementia and related cognitive conditions based on the NAS report.

1. It is confirmed that biological and lifestyle changes associated with the various forms of dementia (Alzheimer & Vascular Dementia) usually begin a decade earlier. It is advisable to implement a healthy diet, as well as physical and lifestyle changes before symptoms of dementia become evident.
2. Being able to manage your blood pressure is the only strategy thought to have the potential to prevent or delay the risk of Alzheimer’s disease. Although, scientists are yet to ascertain its role on age-related cognitive decline.
3. Participating in physical activities is a great strategy that may delay dementia in senior citizens. While the report didn’t state the type or duration of the physical activity, walking briskly for 15-20 minutes daily is a great idea.
4. Reducing sugar intake may be all you need to reduce the impact of dementia. Several studies have regarded Alzheimer’s as one of the forms of dementia as a third type of diabetes. It is advisable to manage your sugar intake and blood sugar level especially when the individual is above 50 years of age.
5. When it comes to preventing dementia, one of the most common causes of the development of Alzheimer’s is stress. A lot of researches in the past have linked anxiety as one of the causes of dementia especially in elderly citizens who are already at risk of being affected by the disease.

Above all, visit your healthcare provider or a medical facility for proper diagnosis and medical check-ups regularly. If you would like to discuss these issues with an experienced Ohio Elder law attorney, please call our law firm at 877-653-3450 to schedule a consultation.

Everything You Need to Know to Apply for VA Benefits

One of the major benefits of serving in the United States armed forces is the ability to receive healthcare coverage and services through the Veterans Administration. There are many different benefits available for both veterans and their surviving spouses with varying criteria for each. For instance, wartime veterans are eligible to receive the Aid and Attendance benefit, which helps cover long-term care services.

Experienced Ohio elder law attorneys can work with veterans and their spouses to ensure that they receive the VA benefits they’ve earned through their service. However, in order to start the process of receiving VA benefits, it is necessary to go through the application process.

The process can be started online at the Veteran Administration’s website at http://www.va.gov/healthbenefits/online/. On this site, you will be able to fill out the 10-10EZ form, which is the enrollment application for health benefits. Before you begin, you should make sure that you have the proper documentation available in order to provide all of the relevant information:

• Discharge papers
• Medical Evidence
• Proof of medical expenses

If you’re applying for benefits that were earned by your deceased spouse, you will need additional information including:

• Marriage certificate
• Spouse’s death certificate

One significant problem, however, is that the application process can take as long as a year to complete, so starting the process as early as possible is better than waiting until you absolutely need the benefits. Luckily, the VA’s website will keep your information on file for re-evaluation at the point when you’re eligible if you don’t qualify for benefits right now. When you are approved, however, your benefits will be paid retroactively beginning with the month after you submitted your application, so once again, starting the application process as soon as possible is better than waiting.

In addition to using the website listed above, veterans and spouses may apply for healthcare benefits at their nearby VA medical center or by calling 1-877-222-VETS (8387).

If you have questions about how to qualify for VA benefits, it may be a good idea to speak with an elder law attorney who is experienced in VA eligibility and qualification. The attorney can assess your situation by examining your income and assets and then recommend different ways to improve your chances of qualifying for the VA benefits available to you and your spouse. Wartime veterans may also be entitled to an additional benefit, known as Aid and Attendance, to cover the costs of long-term care. In many cases, additional planning with an elder law attorney is necessary in order to legally fall within the VA’s income and asset guidelines.

If you want to learn more about qualifying for VA benefits, or if you are currently in the process of applying for VA benefits and would like some advice, please contact our Ohio elder law office at 877-653-3450 to schedule an initial consultation.