Elder Law Firm of Steve Bailey

Does Alzheimer's Run in Your Family? Take These Six Steps Now to Protect Yourself

“These six tips might help you avoid the development of Alzheimer’s disease or slow its progress if you have symptoms.”

The experts agree – they do not yet know for sure what causes Alzheimer’s disease, the most common form of dementia. They have a good idea of a genetic connection in one percent of the cases, but for the other 99 percent, the researchers are looking at a wide range of possible causes or contributing factors. Since they do not yet know the causes of Alzheimer’s, it is difficult for people to understand how to prevent it.  However, the scientists offer some suggestions. Does Alzheimer’s run in your family? Take these six steps now to protect yourself.

What Lifestyle Habits Might Help You to Avoid Alzheimer’s Disease?

The researchers feel somewhat confident about these three tips, which should come as no surprise:

1. Get plenty of sleep. Your brain clears amyloid from your brain when you sleep, and there is a link between amyloid production and Alzheimer’s. Dr. Marshall, a Harvard-affiliated Alzheimer’s researcher, suggests a target of seven or eight hours every night.
2. Move around. Dr. Marshall says that people with symptoms of Alzheimer’s can slow the disease’s progress and people without it, can prevent it from developing through physical exercise. Do not worry; do not turn your schedule upside-down or become a gym rat. Just get moderately vigorous aerobic exercise for about half an hour a few times a week. A brisk walk is a good option that does not require you to buy any equipment or pay membership fees.
3. Eat delicious food – of the Mediterranean variety. Even adding just a few elements of this way of eating can make a difference. A Mediterranean eating plan includes lots of fresh vegetables and fruits, with whole grains, olive oil, and legumes. For protein, you would focus on fish and nuts, with poultry, eggs, and dairy in moderation and little red meat. And red wine in moderation.

Although they cannot say with as much certainty these next three tips will help you avoid the development or progression of Alzheimer’s, the scientists have evidence these lifestyle choices may be beneficial:

4. Be a social butterfly. Okay, do not go that far. However, you should not be a hermit. Observational studies hint at a connection between increased social interaction and avoiding Alzheimer’s. Your local senior center or community center should have multiple options for activities. Check with your city’s parks and recreation department for additional senior programs.
5. To drink or not to drink? Some studies show that one drink a day for women and one or two a day for men can reduce your risk of developing Alzheimer’s. Some studies challenge this conclusion. Dr. Marshall suggests that if you drink, do so in moderation.
6. Give your brain new toys. If you stop learning new things, your brain can suffer a decline in cognitive function. The more variety of new and different brain games, the better. Do the crossword puzzle every day or play bridge or read the newspaper, those are great for your brain, but throw your gray cells a curve ball now and then.
   
   If you always read novels, for example, now and then read a memoir or biography of someone who interests you. Listen to a different genre of music now and then. Try cooking a new cuisine. See a foreign-language film with subtitles. Get involved in activities with people from other age groups.

Having a healthy lifestyle can help you enjoy your golden years to the fullest. These six tips might help you avoid the development of Alzheimer’s disease or slow its progress if you have symptoms. To learn what you should do to protect yourself legally and financially during your retirement, talk with an elder law attorney in your area.

References:

Harvard Medical School. “What can you do to avoid Alzheimer’s disease?” (accessed March 21, 2018) https://www.health.harvard.edu/alzheimers-and-dementia/what-can-you-do-to-avoid-alzheimers-disease

Alzheimer’s Association. “Prevention and Risk of Alzheimer’s and Dementia.” (accessed March 21, 2018) https://www.alz.org/research/science/alzheimers_prevention_and_risk.asp

Is Co-Housing a Good Choice for Your Aging Parents?

 “Co-housing is an attempt to recreate the feeling of community you might have been lucky enough to experience when you were a kid.”

We can become isolated in retirement, since we no longer spend most of our waking hours with the people we used to work with all day. Scientists say that one key to happiness, good health, and mental sharpness as we get older, is to stay socially connected and active. If your folks have no interest in being around “a bunch of old people,” they are unlikely to consider an assisted living center when they think about downsizing. You wonder, is co-housing a good choice for your aging parents?

What is Co-Housing?

There are over 160 co-housing communities in the United States, and well over 100 additional developments are in the works. If you live in one of these “intentional communities,” you own your home or private living space, which you can sell to whomever you wish. Everyone puts money into a fund that pays for the maintenance of the site. You all decide how to spend the maintenance funds. The developments are:

• Entirely senior occupied
• Predominantly senior occupied
• Multigenerational, with grandparents, parents, and kids living in separate homes but within walking distance of each other

People living in a co-housing community can enjoy activities, including two optional group meals a week, or they can do their own thing. People share things like lawnmowers, so every household need not buy one. They pitch in with whatever their interests are, such as yard work or organizing events. An essential component of co-housing is that everyone must agree on decisions that affect how they will live, such as an acceptable noise level and how to spend money in the co-housing development’s fund.

Where Can You Find a Co-Housing Community?

Those who yearn for the peace and quiet of the countryside, can find rural co-housing developments. Those who prefer the energy and pace of the city, can choose urban communities. Of course, there is co-housing available in the suburbs.

One example of this movement is in Denver, where a group of people bought an old convent and turned it into a co-housing development. They each have their own private living spaces, and they share common areas.

What is the Purpose of a Co-Housing Community?

Co-housing attempts to recreate the feeling of community you might have been lucky enough to experience when you were a kid. Neighbors knew each other and would hold backyard cookouts in the summertime. The kids could play together, and everyone looked out for each other. You and your neighbor probably had keys to each other’s houses.

The co-housing movement in America tries to craft this feeling, based on a European model. There is a central building where people can hang out, play chess, watch the kids play, cook a meal or have a potluck dinner together or whatever they feel like doing. But unlike a commune, in co-housing, people have their individual homes or living areas.

What Are the Downsides of Co-Housing?

Not everyone enjoys all the togetherness that goes with co-housing. Some do not want to be bothered with the self-governing aspect. Some people might not wish to be bound by the decisions of the group. There is also the risk of mismanagement of the development or that property values could fall. It is similar to the risk of buying into a condominium.

If your parents are considering a co-housing development, they should talk with an elder law attorney in their area. The laws are different in every state, and this article is about the general law.

References:

The New York Times. “There’s Community and Consensus. But It’s No Commune.” (accessed March 24, 2018) https://www.nytimes.com/2018/01/20/business/cohousing-communities.html

How to Plan Your Care in Later Years Without a Spouse or Children

  “There has never been a better time to be aging independently, or as some call it, to be an elder orphan.”

Traditionally, people relied on their spouses and adult children to help them when they got older. However, many Americans today are widowed, divorced, or never married. Within this group, are people who never had children or whose children do not live near them or are not involved in their lives. For people who are childless singles, here are tips on how to plan your care in later years without a spouse or children.

How Your Smart House Can Watch Over You

You can get home technology that will keep a better eye on you, than most humans would. Monitoring systems can check on you at regular intervals throughout the day and notify designated people if you do not respond within a predetermined amount of time. Other systems provide reminders of when you must take your medicine.

Gadgets Straight from the Jetsons

Forget vacuuming. Your only questions after you get a robot vacuum will be why you waited so long to get one, and what to name it. Yes, people attach that to these gizmos. Technology like the Amazon Alexa can answer your questions, help you remember something you forgot, buy things you want, and make sounds to pester your pets. Perhaps the device is at least as interactive as a spouse, who considers grunting to be a conversation.

A New World of Services

An entire industry has sprung up to provide services for people too busy to handle these tasks for themselves or for people who could use a little help around the house, such as aging adults. You can access many services right on your cell phone with an app. Some examples are:

• Get a ride to your weekly social activities, doctor’s appointments, hairdresser, grocery store, or house of worship (Uber, Lyft, and other ride-share services).
• “Grandkids for rent” services which allow college students to earn a little money by hanging out with older adults to visit, play a board game, go to the movies, or take a walk.
• On-demand handyman, housekeeping, home maintenance, and yard work companies.

Not Driving? No Problem!

Now you can get almost anything delivered right to your home. For example:

• Fresh meals. Gone are the days of pizza and Chinese food being your only food delivery options. You can now get anything from a sandwich to sushi to a five-course gourmet dinner delivered to your front door.
• Do you want to cook your own meals, but not have to go grocery shopping? Every other month, a new player emerges in the “home delivery of fresh ingredients for meals” market.
• Everything else, including the kitchen sink. Amazon, QVC, eBay and other giants make it fun and easy to shop without leaving your living room.

Create and Nurture Your Network of Friends

Experts agree that we should stay connected socially at all ages. When we retire, maintaining friendships, both in person and with social media groups, can keep us happy, healthy, and mentally sharp. A bonus of these relationships is that you can look out for each other.

How Can You Maintain Your Independence?

A trip to your local elder law attorney’s office can set you up with the legal documents that will protect the independent lifestyle you worked so hard to build. Three of the primary papers you need are:

• Durable financial power of attorney. You designate someone to handle your finances and your non-medical decisions, if you cannot do so.
• Durable medical power of attorney. The person you choose will take care of your medical choices, if you cannot do so for yourself.
• Medical records (HIPAA) authorization. This paper allows your healthcare providers to give the person you name access to your medical records to make informed decisions about your well-being.

Talk with an elder law attorney in your area about these and additional ways to protect yourself and your lifestyle. Every state has different laws, and this article discusses the general law.

References:

The New York Times. “Single? No Kids? Don’t Fret: How to Plan Care in Your Later Years.” (accessed March 24, 2018) https://www.nytimes.com/2018/03/23/business/elder-orphans-care.html

Planning for Your Third Act? Better Understand the Things Medicare DOESN'T Pay For

If you need a type of healthcare that Medicare does not pay for, you will either have to carry another insurance plan that pays for it or pay for it out of pocket.”

Jane Fonda has a habit of shaking things up. When she spoke about life’s third act at a TED talk, she did not disappoint. If you also view the last three decades of life as a significant developmental stage in which you can succeed in whatever you pursue, whether in art, science, literature, or another field, you do not want to be held back by health issues or stifling medical bills. Therefore, are you planning for your Third Act? It is important to understand the things that Medicare DOESN’T pay for.

How the Items on This List Can Affect Your Enjoyment of Life

If you need a type of healthcare that original Medicare does not pay for, you must either carry another insurance plan that covers it or pay for it out of pocket. Forbes says that Medicare will only cover about half of your medical expenses in retirement.

If you must spend a significant portion of your fixed income in retirement on medical expenses, you will not have that money to do the things that can bring you joy, like traveling or visiting your grandkids. You might not afford the things that make life comfortable, like keeping the thermostat set where you are neither too hot nor too cold, buying nutritious food or replacing worn coats, shoes, and clothing.

The Uncovered Eight

There are eight categories of services and items Medicare will not pay for, that you must pay for through other coverage or pay out-of-pocket. These are:

1. Long-term care, also called standard nursing home care or custodial care. Nursing home expenses can gobble up your life savings within a year or two. Custodial care is one of the most sizeable costs a person can face. Medicare will cover medically-necessary skilled nursing care for a short period. However, it does not cover standard nursing home care. Medicaid pays the expenses of more nursing home residents than any other single payer.
2. Eye exams for getting prescription glasses. Medicare does not help pay for these exams, but they will cover medical procedures for the eyes.
3. Dental care. Medicare does not pay for most dental care.
4. Dentures. If you lose your teeth because Medicare refused to pay for your dental care, the harm is compounded because Medicare will also not cover the cost of your dentures.
5. Hearing aids and fitting exams. Hearing aids are expensive, but Medicare will not pay for either the devices or exams for fitting them.
6. Foot care. Many people experience problems with their feet as they age. Unfortunately, Medicare will not help you with the cost of routine foot care.
7. Acupuncture is a minimally-invasive treatment that can bring pain relief for many people, but Medicare will not pay for it.
8. Cosmetic surgery rounds off the list of the eight things Medicare does not cover.

Caveats: Even when Medicare pays for healthcare, you must still pay your premiums (usually nothing for Part A, but most people must pay Part B premiums), deductible, coinsurance, and copayments.

The information in this posting is general law. The law in your state may be different, and there may be other programs available where you live. Talk with an elder law attorney in your area.

References:

Forbes. “What Medicare Doesn’t Cover: A Preretiree’s Guide.” (accessed January 16, 2018) https://www.forbes.com/sites/nextavenue/2014/09/18/what-medicare-doesnt-cover-a-preretirees-guide/#1c1d4bee36ae

Centers for Medicare & Medicaid Services. “What Part A & Part B doesn’t cover.” (accessed January 16, 2018) https://www.medicare.gov/what-medicare-covers/not-covered/item-and-services-not-covered-by-part-a-and-b.html

TED. “Life’s third act: Jane Fonda.” (accessed January 16, 2018) https://www.ted.com/talks/jane_fonda_life_s_third_act#t-65423

5 Things You Should Know About the Older Americans Act

“The purpose of OAA services is to assist seniors in remaining independent and living in the community as long as possible, unless that arrangement is not safe or practical.”

If you are looking ahead to retirement and wondering what programs are available that could help you; acquaint yourself with the Older Americans Act (OAA). Here are 5 things you should know about the Older Americans Act.

Who is Eligible for OAA Services?

The OAA began in 1965 as a safety net for our most at-risk people 60 years and older. If you are at least 60, you meet the general eligibility requirements.  However, you might not actually receive help through the OAA, because these programs have a mandate to focus their limited funding on people who:

• Have the most financial need
• Have the most social need
• Have low-income and are members of a recognized minority category
• Live in rural areas
• Have low-income
• Are frail

Therefore, even if you are a senior and have little money, if you are not in critical need, you might be too low in the pecking order to receive benefits from the OAA.

What Services Does the OAA Provide?

The purpose of OAA services is to assist seniors in remaining independent and living in the community unless that arrangement is not safe or practical. OAA programs can provide:

• Meals delivered to the person’s home
• Meals served to multiple seniors in a setting like a senior center or adult day center
• Caregiver training and assistance
• Assistance in the home
• Transportation
• Some preventive medical services
• Elder abuse protection
• Job training
• Part-time employment in community settings, like senior centers, schools, and libraries

OAA Services Help Seniors Stay at Home in the Community, Instead of Nursing Homes

Providing these essential services is less expensive than paying for nursing homes, which cost an average of around $90,000 a year. When surveyed, over 85 percent of people getting OAA assistance agreed that the services helped them to continue living at home, instead of a nursing home.

Many Older Americans Who Need Help, Do Not Get OAA Services

The federal Government Accountability Office (GAO) says that fewer than ten percent of lower-income seniors get OAA-provided meals, and many of our elders who need help with daily activities get little or no OAA help in the home. Millions of older Americans are food insecure, yet hardly any of them get OAA assistance.

OAA Has Less Inflation-Adjusted Money to Help More People Than Before

In fairness to the OAA, you can only stretch a dollar. The number of Americans aged 60 and older increased about 30 percent from 2004 to 2014 and is expected to go up by 55 percent from 2014 to 2020. The funding for the OAA, however, when adjusted for inflation, went down from $1.04 billion in 1990 to $768 million in 2014. During that same time, the consumer price index went up 84 percent and the price of gas increased by 235 percent.

The federal government provides most of the funding for the OAA.  It distributes the money to states in proportion to the number of seniors living in each state. States must partially match the federal funds they receive.

OAA programs and services are different in every state, as are the laws. Talk with an elder law attorney near you.

References:

National Council on Aging. “OAA Basics.” (accessed January 17, 2018) https://www.ncoa.org/public-policy-action/older-americans-act/oaa-basics/

AARP. “The Older Americans Act.” (accessed January 17, 2018) https://www.aarp.org/health/health-care-reform/info-2014/the-older-americans-act-AARP-ppi-health.html

Tackling the Legal Issues Associated with Caring for a Parent with Dementia

“Your parent can sign several legal documents that will protect him and handle his legal issues. These documents include a durable power of attorney for health care decisions, a durable power of attorney for financial matters and a will or living trust.”

When caring for a parent with Alzheimer’s or some other form of dementia, it is easy to be overwhelmed with anxiety over the constant daily issues of her medical care and making sure that she does not wander off or accidentally set the house on fire while cooking. There is, however, another concern you should address for your parent, and that is tackling the legal issues associated with caring for a parent with dementia.

An adult suffering from dementia is vulnerable to physical harm and financial exploitation from others. He can do things that expose himself and others to danger and can create legal liability that could risk his assets. You can do nothing and hope for the best, or you can be proactive and protect your parent through the savvy use of legal documents.

When Your Parent is Still Legally Competent

If your parent still has the legal capacity to sign legal documents, it is much easier and less expensive to address her issues. The conversation with your parent may not be the most comfortable talk you have ever had, but it is necessary. You can explain that by preparing the documents now, your parent controls her outcome, rather than later asking a court to enter an order.

Your parent can sign several legal documents that will protect him and handle his legal issues. These documents include a durable power of attorney for health care decisions, a durable power of attorney for financial matters and a will and/or living trust.

A durable power of attorney for health care decisions will designate someone to make medical decisions for your parent when she cannot speak for herself or make appropriate health care choices. This document should name someone your parent trusts to make medical and life-or-death choices, including life support, resuscitation, feeding tubes and hydration. Your parent should have a candid conversation with the designated decision-maker to make her wishes and convictions known. She can change or revoke this document at any time, as long as she is competent.

With a durable power of attorney for financial matters, someone can manage your parent’s business and financial affairs for him. The power of attorney should be durable; otherwise, it will expire when your parent loses legal capacity. He can change or revoke this document at any time if he is legally competent.

Your parent must make a will and/or living trust while she is still legally competent, because she cannot make a valid will once she becomes incompetent. Both a will and a living trust allow her to decide who will inherit which items from her, but a living trust can also designate a trustee who can manage her financial and business matters, while she is still alive. The living trust can specify that the trustee’s authority will continue, in the event of your parent’s incapacity or death.

What to Do If Your Parent Is No Longer Competent

If your parent has lost legal capacity due to dementia or other health issues and he did not prepare the documents discussed above while he was competent, you may need to get a guardianship and conservatorship over him. A guardianship lets you take care of his daily needs, such as where he lives and the medical care he receives. A conservatorship empowers you to take care of his financial matters.

The court must declare him incompetent before it can grant a guardianship or conservatorship. These legal actions are expensive and can take several months or longer. It is better to get his documents completed, while he still has legal capacity.

This posting discusses the general law, and the law in your state can vary. Talk with an elder law attorney in your area.

References:

Alzheimer’s Association. “Planning Ahead.” (accessed November 16, 2017) https://www.alz.org/care/alzheimers-dementia-financial-legal-planning.asp

Money. “5 Essential Documents for Protecting a Loved One with Dementia.” (accessed November 16, 2017) http://time.com/money/4127552/dementia-care-legal-documents-need/

FindLaw. “Legal Issues: Caring for Parents with Dementia.” (accessed November 16, 2017) http://elder.findlaw.com/elder-care-law/legal-issues-caring-for-parents-with-dementia.html

Planning Ahead for the Care of Your Spouse Suffering from Alzheimer’s

“Once you have your legal documents in order and you have made an inventory of your assets and debts, you can tackle the financial aspect of your spouse’s diagnosis.”

You will never forget the moment you received the news that your spouse has Alzheimer’s disease. The vision you had of your future growing old together was shattered. After the initial shock, anger, and sadness, you took a deep breath and made the best of it. Your next step is planning ahead for the care of your spouse suffering from Alzheimer’s.

The future care of your spouse will involve three major components:

• Legal documents
• Financial preparation
• Make care decisions

Legal Documents

As your spouse’s disease progresses, she will lose the legal capacity to make important decisions and sign legal documents. Talk with an elder law attorney to discuss the legal documents that should be prepared right away, so there will be no question later on whether your spouse had the mental capacity to sign a legally enforceable document.

Assemble the legal papers you already have and go over them with your lawyer to update them for your situation. Make a list of your property and assets, including all investments and bank accounts, and your debts. Discuss with your lawyer the best way to protect your assets for the future and how to deal with your debts. Put your spouse’s preferences for health care and long-term care in writing.

A power of attorney document will designate someone to make financial decisions for your spouse, when he can no longer do so. However, make sure that it is a durable power of attorney, so it will still be valid after he becomes incapacitated. A health care proxy will name someone to make health care and end-of-life decisions for him when he cannot do so. Have him sign a medical release of information, so HIPAA regulations will not ban the person named in the health care proxy from seeing his medical records.

Make sure that your spouse has a will or living trust, so she can decide what to do with her assets after she passes.  If she does not have a will or living trust, the laws of the state will give her property to her legal heirs through the rules of intestacy, regardless of what she would have wanted.

Financial Preparation

Once you have your legal documents in order and you have made an inventory of your assets and debts, you can tackle the financial aspect of your spouse’s diagnosis. The Alzheimer’s Association provides a checklist of many of the costs you may expect to incur , whether your spouse will receive in-home or residential care services.

Explore every possible source of funding for your spouse’s future care costs. Funding sources often will cover some items but not others, so you must piece it all together like a quilt to have the best financial assistance package. Your spouse may be eligible for veterans or other government benefits to help with some services or expenses. If you have a long-term care insurance policy, see what benefits it will provide and for how long.

Make Care Decisions

Just as it takes a village to raise a child, you must put together a care team for your spouse. You cannot do this job 24/7 without some help. Talk with family members and close friends to let them know what to expect and the ways they can help. Make sure that your spouse develops a relationship with medical professionals in the early stages of the disease, so she will be comfortable with them later.

Seek community resources for services, such as government agencies, neighborhood organizations, churches and other social groups. Find out what in-home and full residential memory care services are available in your area.

The better you plan, the easier things will be later. The laws are different in every state, so talk with a local elder law attorney.

References:

Alzheimer’s Association. “Building a Care Team.” (accessed October 29, 2017) https://www.alz.org/i-have-alz/building-a-care-team.asp

Alzheimer’s Association. “Financial Planning.” (accessed October 29, 2017) https://www.alz.org/i-have-alz/financial-planning.asp

Alzheimer’s Association. “Legal Planning.” (accessed October 29, 2017) https://www.alz.org/i-have-alz/legal-planning.asp

What to Look for in a Retirement Community

“We want to enjoy our retirement years, while getting the care we need now and down the road.”

Many options are now available for retirement living. People are living longer and healthier lives. We want to enjoy our retirement years, while getting the care we need now and later. Some communities offer an active social life with numerous group activities depending on your interests. Others cater to an athletic lifestyle including golf, tennis, swimming and fitness classes. With so many alternatives, here are suggestions for what to look for in a retirement community.

Climate

Many people work hard for decades in harsh climates, while looking forward to moving to Florida or Arizona when they retire. If joining the millions of seniors living in the sunny South is your dream, check out retirement communities when you vacation during your working life. Tell your children well before your retirement you are planning to move. If they object to your living far away from them, remind them you are moving to a great vacation destination and you would love to have them come for visits.

Activities

Try to find a community that offers your favorite activities onsite, such as bridge, yoga, Pilates, or tai chi. Members of service clubs, like Rotary or the Lion’s Club, will want to locate near the closest meeting location. Some clubs hold regular meetings at retirement communities.

Carefree Lifestyle

If your budget allows, have the retirement community provide housekeeping and meal preparation, even if you are healthy. Assisted living facilities usually offer different levels of services. After working hard for so many years, pampering yourself a little during retirement will give you a well-deserved carefree lifestyle.

Current and Future Medical Needs

Some retirees have ongoing medical issues for which they need continuing care. Others are healthy, but want to move to a community that can provide whatever services they may need later, without having to move to another facility. Continuing Care Retirement Community (CCRC) residents range from healthy, independent seniors to those utilizing assisted living, full-time nursing care, or specialized care, such as Alzheimer’s patients.

Specialized Care

Some facilities focus on or offer a section of the site with specialized care, such as memory care, including Alzheimer’s disease. If you or your spouse needs a particular service, make sure the facility can meet your needs.

Costs

Get a list from facilities you are considering. Add up the total costs of living the lifestyle you want to live, so you can see whether you can afford it at those locations. Create a budget from all of your income sources and the benefits you are entitled to, including Social Security, military benefits, pensions, annuities, investments and other streams of income.

Financial Stability of the Facility

Walk around the entire community, looking for signs of deferred maintenance or shoddy upkeep. View things with a critical eye, since conditions deteriorate rather than improve. You do not want to buy into a community having financial problems.

Rules of the Community

All retirement communities have rules. Get a copy of the restrictions and regulations to will be allowed to enjoy your creature comforts, including your pets and hobbies.

The laws are different in every state, so talk with an elder law attorney in your area.

References:

U.S. News & World Report. “What to Look For When Shopping For a Retirement Community.” (accessed October 29, 2017) https://money.usnews.com/money/blogs/the-best-life/2013/08/19/what-to-look-for-when-shopping-for-a-retirement-community

Senior Living. “15 Helpful Tips in Choosing the Best Retirement Community.” (accessed October 29, 2017) https://www.seniorliving.org/retirement/best-retirement-community/

Overview of State Death with Dignity Laws

“As of June 10, 2017, residents of Oregon, Vermont, Washington, California, Colorado, Montana and the District of Columbia may legally choose to have physician-assisted death, also called “death with dignity,” under certain conditions.”

As of June 10, 2017, residents of Oregon, Vermont, Washington, California, Colorado, Montana and the District of Columbia may legally have physician-assisted death, also called “death with dignity,” under certain conditions, according to CNN. Death with dignity is legal in Montana, because of a court ruling. In the other five states and the District of Columbia, state statutes make assisted dying legal. If you or a loved one is contemplating aid in dying, you need an overview of state death with dignity laws.

Legalized Death with Dignity

Besides the six states and the District of Columbia with death dignity laws or legalization, 30 states are considering death with dignity legislation. That leaves only 14 states that do not have legalized death with dignity and are not considering the legislation at this time.

In the handful of states that allow physician-assisted death, a doctor cannot be criminally liable for prescribing medications that speed up death for eligible individuals. To be eligible, the patient must have a terminal illness and be expected to live no longer than six months, as confirmed by two physicians. The individual must be at least eighteen years old and mentally competent to make and communicate his health care decisions.

The approved method of death is different in each state.  However, the person must be able to take the medication without assistance. The District of Columbia law does not require you to be a resident, but all the states do.

The Terminology Involved

The Death with Dignity (DWD) National Center advocates the use of the term “death with dignity” rather than “physician-assisted suicide,” “doctor-assisted suicide,” “assisted suicide” or “euthanasia.” DWD argues these terms are incorrect, inaccurate and mislead the public. Descriptive terms recommended by the Death with Dignity organization to prevent judgmental implications are “physician-assisted death,” “physician-assisted dying,” “physician-hastened death/dying,” “aid in dying,” “physician aid in dying,” and “medical aid in dying.”

The Process for Death with Dignity

If you meet the eligibility criteria, it is not merely a matter of asking your doctor for a prescription. You must follow a multi-step procedure to utilize your state’s death with dignity laws. The steps for states that allow aid in dying are:

1. You make a verbal request to your doctor for aid in dying.
2. Your physician confirms whether you meet the eligibility requirements, including your current mental status.
3. Your doctor must advise you of your options and ask you to notify your next of kin of your request for aid in dying.
4. A second physician confirms your eligibility.
5. If both doctors determine that you may use your state’s death with dignity law, the first waiting period begins.
6. After at least 15 days, you can make your second request to your doctor. Your second request can be oral or written.
7. California and Colorado require no second waiting period, but in Vermont, Oregon, Washington and the District of Columbia, your doctor must allow 48 hours to pass after the second request before writing the prescription. You do not actually receive the physical piece of paper on which the doctor wrote the prescription. Your doctor can either provide the medication directly to you or send the prescription to a pharmacy.

With aid in dying laws, you are in control of the decision and the process. You may retract your requests, whether oral or written, at any time. You do not have to fill the prescription, even after it is sent to the pharmacy. You do not have to take the medication. No one has the legal right to compel you to do anything against your will.

The laws are constantly changing.  Therefore, before you take any action toward aid in dying, check with a local elder law attorney for the status of the laws in your state.

References:

Death with Dignity. “Take Action: Death With Dignity Around the U.S.” (accessed August 27, 2017) https://www.deathwithdignity.org/take-action/

Death with Dignity. “Death with Dignity as an End-of-Life Option.” (accessed August 27, 2017) https://www.deathwithdignity.org/faqs/

CNN. “Physician-Assisted Suicide Fast Facts.” (accessed August 27, 2017) http://www.cnn.com/2014/11/26/us/physician-assisted-suicide-fast-facts/index.html

Death with Dignity. “How to Access and Use Death with Dignity Laws.” (accessed August 29, 2017) https://www.deathwithdignity.org/learn/access/

What to Do When Your Parents Outlive Their Financial Resources – and Don’t Want to Go to a Retirement Home

People are living longer than ever. It’s, therefore, important that you help your aging parents plan their finances and living arrangements. Those born today in the United States will have an average life span of 78.8 years. People born in 1900 didn’t live past 50 on average. That’s a 58% increase in longevity in just a little over 100 years. Although increased longevity is one of the great modern accomplishments, it also means that people are living longer in their twilight years on fixed incomes.

Three Things to Consider in Helping Your Aging Parents

Grown children have no legal obligation to help financially strapped aging parents who cannot support themselves in their retirement.  However, most feel a moral obligation to do so. Seniors sometimes take out mortgages on their homes to have money to live on.  They may find that it’s not enough, even with their pensions and social security benefits. Many older people do not want to go to a retirement community. If so with your parents, keep reading.

1. Think now about your parents’ finances
   Don’t be afraid to ask your parents what their plans are for the future. Will they have enough money to live? What is their monthly cost of living? Remember that their situation will also affect you, so it is natural for you to ask these questions, if you have your parents’ best interests at heart.
2. Determine if other family members will contribute to your parents’ upkeep
   Talk with your siblings to determine if they will contribute to helping your parents. If they will contribute, determine if your combined contributions would be enough to keep your parents in their home. Are there others who could contribute, such as grandchildren or in-laws? The parents and contributing family members should consult with their accountants to get accurate pictures of their assets and liabilities.
3. Consider a live-in arrangement
   Let’s assume, for this example, that Dad has passed away and Mom is trying to figure out how to comfortably live out her golden years. If there is not enough for Mom to live on, even with family member contributions, one sibling and their family might consider a co-living arrangement with Mom. However, know that selling Mom’s property, adding names to deeds and transferring Mom’s residence are all actions fraught with legal and financial pitfalls that may not be immediately apparent. Don’t act without first consulting an experienced elder law attorney. Transferring assets could have far-reaching and dire consequences, if you don’t get competent legal advice first.

What to Do before Combining Households with an Elderly Parent

Should you decide that a joint living situation seems to make sense, you have things to think about.

1. Honestly consider whether your family and your parent or parents can live together harmoniously.
2. All siblings should meet to determine how much they can contribute to your parents’ care, so the entire responsibility is not on the sibling who will share a home. Once again, determine if other family members will contribute. Discuss the amount that each can contribute, and when and how those contributions will be made.
3. Think about long-term realities. Help your aging parents, but you must also think about your own necessities. It will not be helpful to put yourself into a situation where you do not have enough money for your own family.
4. Consult with an estate planning attorney and an elder law attorney. All agreements should be in writing, so all parties are protected and promises are kept. You should consult an elder law attorney about:
   1. How you and your siblings can best help your parents financially;
   2. How your parents, you and your family can be protected legally and financially;
   3. How you can combine households without unexpected legal and financial consequences;
   4. How available government programs can help your parents and how your parents can qualify for Medicaid, if necessary;
   5. How your parents can secure a place in a retirement community or nursing home later, should living at home become unmanageable.

Help Your Parents Plan for Their Future

This may all seem a little overwhelming, and it’s easy to put off talking with your parents about their finances. However, the time to do it is before the situation becomes a crisis and you are trying to decide under intense stress. Remember that you are not alone. Call a good elder law attorney and make an appointment, so they can help you help your parents.