I recently received the following email from a gentleman who was at a crossroads, unsure of what steps to take next:

“My mother is 89 and has lived with me for the past 3 years. She has been getting more confused lately, and of course I know it’s Alzheimer’s. You have to have a lot of patience! Sometimes I cry when I see my mom so helpless. She used to care for me, now it’s the other way around. I’m at the point where I have to make a decision. How do you know when it’s time for a nursing home?”

My initial worry was that he had assumed his mother had Alzheimer’s disease, but hadn’t gotten a diagnosis. When I asked him about it, it turned out that he had not… so I got him connected with a good doctor to help assess his mother’s condition and help him find out what would be the right next steps.

It’s extremely important that when there are signs pointing to a disease like this, that a diagnosis is made – as opposed to an assumption. First, you want to be sure your loved one is safe, and that it’s not a reversible condition that has just caused her to become confused lately. Second, the drugs we have on the market now for Alzheimer’s work well at slowing the progression of the disease… that’s why a test at the first signs of symptoms is the best thing to do. The longer you wait, the more the disease has a chance to take hold of your loved one before you can slow it down. The fact is, with modern medicine, your loved one may be able to stay at the stage they are now for quite some time.

How does a diagnosis work? Diagnosing Alzheimer’s disease is a process called “rule-out,” which is exactly what it sounds like. The process of diagnosis “rules out” any other disease that may be treatable. In addition, while there is still no cure, medications can help if her doctors do think she has Alzheimer’s. As stated earlier, the sooner you catch the disease, the more treatable it is.

The move to a nursing home is different for every family, and doesn’t need to be a sad event!

Very often, people with Alzheimer’s disease do well when placed in a home that provides excellent Alzheimer’s care. They are able to form new relationships with peers, engage in activities that are safe, entertaining and appropriate for them, and can find new meaning and purpose in life.

You will know the time is right when your loved one’s care exceeds what you feel you can do while still maintaining her health, safety and stimulation… and yours, too. The decision process can be trying for any caregiver, and often creates a sense of guilt and indecision. That’s why it’s important to remember Absolute #4: Never Walk Alone, Instead Accept Help.

Please allow yourself to get help. If my office can provide any of that help by giving you a referral or helping you safeguard your loved one’s assets and future, please give me a call at (913) 338-5713.

Whether it’s a call to my office to talk about the next steps or find the right nursing home, or getting involved with a care coordinator to help you make the right decisions, I wish you and your loved one the best!

Today you’re going to learn how to select someone who’s fluent in elder law. Why is this important for you? An Elder Law attorney concentrates their practice in the area of estate and longevity planning, Medicaid, special needs trusts, and VA benefits for the over 65. Anyone nearing or over that age should know what steps they may need to take to get the right documents in place so that their plans for their finances and their family can be realized.

I recently looked at a bar association listing of attorneys who identify themselves as elder law attorneys. Frankly, I was a little surprised to see that some individuals who are really general practitioners also consider themselves to be elder law attorneys. I was a little disturbed when I saw this, because drafting simple wills and trusts does not qualify an attorney to be an elder law attorney. Wills and trusts may be part of the elder law process at times – but there is so much more involved than that!

Really, wills are what I call “death planning” – they really only control what happens after you die. Today’s seniors need an estate and longevity plan – this will help their families know what their wishes are in the event that they become incapacitated before they die. If you are married, then it’s highly probable that one of the two of you will spend a substantial amount of time in a nursing home before you die.

Will the real elder law attorney please stand up?

When trying to find an elder law-focused attorney, it’s important to understand how elder law differs from traditional estate planning (death planning). A traditional estate plan is typically designed to do three things:

1. Minimize estate taxes
2. Avoid probate court
3. Distribute assets from the deceased person to his or her heirs.

Elder law, on the other hand, is death planning plus long-term disability and care planning – what I call “longevity planning.” The elder law attorney is not only dealing with your estate plan, but must also think ahead for life care issues in the event that you or your spouse has long term health care needs during your lifetime.

These days, it is quite common to see families spend several hundreds of thousands of dollars when both a husband and wife have long term care needs. The key focus of an elder law attorney is to help the family to try to protect their assets during their lifetime, to avoid such a catastrophic loss.

No one wants to be out of money and out of options before they are out of breath. While it’s not possible to guarantee specific results, the elder law attorney works with clients and families to guide them through the minefield of public benefits, veteran’s benefits, Medicare, Social Security, special needs trusts, powers of attorney, and Medicaid. Our job is to increase the quality of life of our clients, not just to figure out who-gets-what after you pass away.

So if you are trying to figure out who is the real elder law attorney, please ask these questions:

- How many Medicaid applications does your firm do in a year?

- How many veterans does your firm assist with the VA aid and attendance benefits per year?

- How many elder law oriented estate plans has your firm done this year?

If you are looking for an elder law attorney to do any of these things, please use an attorney who can demonstrate that he or she is working in that area every day. The issues are complex, and you deserve to work with someone who is fluent in elder law.

Good communication can decrease or even prevent many behavior problems. So what’s the best way to communicate with your loved one?

The number one tip to remember is to treat your loved one as an individual with a disease, not a diseased individual. He has an entire history of life that stays with him throughout this journey. He will continue to have many of the same characteristics he had before. If he was laid back before, he may be more so now. If he had high energy/anxiety, he may be tightly wound now as well.

All people need to have their feelings validated. A person with Alzheimer’s is no different. In fact, because of memory loss and insecurity issues, he or she may need it even more. An example: Your father who has Alzheimer’s is angry with your husband most of the time. They have had a great relationship in the past, but now your father blames him for everything. As difficult as it is, keep in mind that it’s the dementia talking, not your father. You can say, “I don’t blame you for being angry” and then move on. What he is feeling is real to him, even if it is not accurate. You will probably have to coach your husband as well. Let him know that this action isn’t against him personally; it is the nature of the illness and “this too shall pass.”

Individuals with Alzheimer’s respond well to affirmation. When they do anything, no matter how insignificant it may be to you, praise them with “good job” or “thank you.”

Other tips:
- When beginning a conversation, identify yourself. If your loved one says “I know who you are,” laugh or say something humorous.
- Slow down when you speak and use short simple sentences.
- Ask one question at a time. Give adequate time for response. Yes/no questions are best.
- When speaking, maintain eye contact.
- Lower the tone of your voice; a high pitch may be interpreted as anger.
- Eliminate distracting noise. Turn off the TV or radio, or go to another room to talk.
- Smile and be pleasant.
- Use touch to get attention (hand on shoulder, hand on knee, hand on hand).
- When your loved one is upset and you can’t communicate, try a hug. Soon anger will be forgotten and you can try again.
- Be aware of their body language. A sudden sit-to-stand change in position may indicate the need to go to the bathroom or some other kind of discomfort. Be aware of your body language too — try not to appear tense.
- Don’t argue.
- Don’t order the person around or be condescending.
- Don’t talk about your loved one as if he isn’t there; you never know just how aware he might be.

Caregivers often want to know: how do you know what your loved one is feeling and experiencing as they progress in the disease? No one can truly empathize with any situation without having been there themselves. Even then, each person handles life differently. Perhaps the best way to try to understand how your loved one is feeling is to read what several people with Alzheimer’s disease have written and published to educate those who want to know.

These books walk you through their personal journeys. It can be heart-wrenching to read about the devastating things they go through, but it is good for learning and understanding. Reading these books may bring out many of your own emotions, but it may also help you know how your loved one feels.

- Living In The Labyrinth: A Personal Journey Through the Maze of Alzheimer’s
by Diana Friel McGowin
Copyright 1993, Dell Publishing/ Doubleday Dell Publishing Group

- Show Me The Way To Go Home
by Larry Rose
Copyright 1996, Elder Books, Forest Knolls, California

You can find these books at your nearest Alzheimer’s Association or at any bookstore or online book source.

Many caregivers find it very difficult to visit their loved one in a care center. If that’s you, you may find you don’t know what to say or what to do. This causes some caregivers to avoid going to see their loved ones at all, which then makes them feel terribly guilty. Is there a way to make visits easier?

Yes! In fact, there are lots of ways to make visits more pleasant. Caregiving Absolute #7 tells us: Never Say “You can’t,” instead show what they can do – and your loved one may be able to do a lot!

First, don’t be so hard on yourself for the times you haven’t gone to see your loved one. You must recognize that you are suffering the loss of the role your loved one has played in your life. They can’t be the person they once were, the “one in charge” any longer, but they can be your beloved friend with whom you can share favorite things, smiles, hugs, laughter and even tears.

Go on your visits intent on sharing something: bring their favorite ice cream, a magazine with pictures of things they like, a bouquet of wildflowers, a family photo album, a CD of music you both might enjoy, or anything else you can look at or do together. When you arrive, greet your loved one warmly, hug, and say something like “I am so happy to see you! Look what I brought.” Then spend time sharing your treat or looking at what you brought.

Make comments about it rather than asking questions, and watch and listen for her to show interest, react, or smile. You don’t have to stay long if you find it too difficult, but if you plan what you are going to do that day, you will see your visits improve and will find it easier to go. Your loved one will also be able to read your body language, so if you are smiling, hugging and joking, it will put you both at ease. That’s something we can all use a little more of.

Just received this email from one of our readers:

I am reading ‘Everything You Always Wanted to Know About Alzheimer’s But Were Afraid to Ask – Answers to Over 92 of The Most Frequently Asked Questions at the Alzheimer’s Resource Center.’ I find this eBook interesting and it has given me a lot of helpful insights into managing a better relationship with my mother, who unfortunately has Alzheimer’s.

I have a few concerns as I’m researching more about how to care for her.

My mother doesn’t have many assets or much money. How can your Elder Law services help me?

I’m concerned that eventually I’ll need to place her in a nursing home. She has barely enough money between her social security check and my dad’s pension to cover half of the monthly nursing home fees. My brothers and I will have to chip in to cover the rest.

Nursing home fees are expensive!

How can you help us help my mother?

-Kathy

Dear Kathy:

Yes, nursing home fees are expensive. There is a solution for you, however.

With proper planning and safeguarding of some of your mother’s assets, she may qualify for Medicaid coverage.

The key word here is “qualify.” The criteria for qualifying for Medicaid is inflexible and complicated. Unfortunately, some people attempt to submit all the paperwork without help from an expert and only end up further complicating the process.

If the paperwork is filled out incorrectly, or something is missing, the applicant is turned down. This sets a negative precedent for any future communications.

When a second application has to be submitted, you’re in a pickle – you’ve likely already lost time and money paying for care that would have been covered if things had been done correctly the first time.

Also, Medicaid nursing home coverage varies by state. Depending on the state she lives in, and the state where she will reside in a nursing home, another layer of confusion is piled on. It’s not uncommon for children to relocate their parent to a nursing home closer to them.

In a situation like yours where there aren’t many assets or much money to place in a trust, we help our clients accurately fill out the paperwork to apply for Medicaid coverage to pay for nursing home fees.

We understand the complicated requirements when applying for Medicaid. We’ve had a lot of success in helping our clients qualify. We can help you too.

If you’ve already made a mistake by giving away assets or filling out an application incorrectly, there may still be hope for qualifying.

At our firm, we offer a free initial planning consultation. We specialize in Disability and Elder Law so after we review your situation, we may be able to help you qualify for Medicaid coverage or suggest other viable options.

Call my office at (913) 338-5713 for your free phone consultation. At the end of the call, you’ll know the next step and at a minimum, we’ll point you in the direction of resources that can help you.

There is no obligation to you. The consultation is completely free.

Our goal is for you and your loved ones to have peace of mind and a pleasant ongoing journey.

Over the next 6 weeks, I’m releasing my most valuable gems about how to get help paying for nursing home care, one new secret about where to get help, and the kind of dangers you might encounter if you do nothing.

Why?

Because I want to help you know where you can find help, and what mistakes to avoid.

I want to make sure that even if you’ve already unknowingly made a “mistake,” there may be things you can do to keep from experiencing huge penalties.

To get an email with each new installment, go to www.LearnMedicaid.com/hammond to enter your name and email. You don’t want to miss out.

- Day 1: You’ll begin to discover how NOT to go totally broke when you have long term care costs.
- Day 1, Part 2: 7 Secrets to Surviving Medicaid Spend Down… and what it means for you
- Day 2: When Medicare no longer cares for you… and it’s sooner than almost all seniors think!

I challenge you to take my e-course, “Don’t Go Broke in a Nursing Home” so that you and your loved one don’t end up unnecessarily out of money and out of options.

On the first day of my series, today, I’m filling you in on how to keep from making 3 Big Money Mistakes that many seniors unknowingly make! Click below to sign up:

www.LearnMedicaid.com/hammond

Before you go on your exciting family vacation to Disney, you’ll check the extended weather forecast. You’ll need to see if the temperature is in the 90’s or in the 60’s. Knowing the temperature helps you prepare.

If the weather heats up during the day in the high 90’s, you’ll pack your luggage with shorts, bathing suit, suntan lotion, and a hat. If the weather remains rainy and cool, you’ll prepare with pants, sweater, and maybe a wet suit or rain gear.

Consulting with weather.com helps you know in advance how to plan for an enjoyable journey. You won’t be caught off guard or left uncomfortable.

When Patricia’s mom developed Alzheimer’s, there was no website or crystal ball to show her how to prepare. Each day consumed Patricia’s energy in caring for her mom. As her mom’s illness progressed, Patricia felt overwhelmed.

In the spring, she moved her mom into a nursing home.

The nursing home expenses devoured much of her mom’s annuities, family savings, and any remaining cash within one short year. After all the assets were spent down, Medicaid covered her nursing home expenses.

At age 68, Patricia’s mom wore dentures, eyeglasses, and a hearing aid. Before dinner, her mom would place her dentures on the tray. Twice within the same year, her costly dentures were accidentally thrown away, burning a hole through Patricia’s pocket.

Three months later, Patricia lost her job in the grueling economy.

Later in the same year, her mom broke her glasses. The added expense to spring for new eyewear squeezed Patricia’s diminishing purse strings.

Medicaid sets limits on its coverage. Under Medicaid, a patient is allowed a personal income allowance of only $30 to $60 per month. Medicaid doesn’t cover glasses, hearing aids, dentures, manicures, or pedicures. It may limit fees covered for dental work.

A patient needs a way to pay for these ancillary expenses.

Unfortunately, when it comes to caring for Alzheimer’s patients, there are no forecasts or crystal balls. You need someone who can help you foresee the challenges ahead.

Most people don’t realize it, but when Medicaid picks up the tab for long-term care, the state does a complete audit on all your expenditures FOR THE LAST 5 YEARS. The state can and does deny benefits for checks written to family members or to charities as gifts.

In order to safeguard money so you have something left to cover ancillary expenses, the state laws need to be followed closely.

Like the weather, state laws on how to protect your family’s savings changes frequently. You need a legal advisor who’s intimate and current with the laws concerning elderly care.

At our firm, we offer a free consultation to figure out how to help you plan. We specialize in elder law so when we look at your situation, we can help you prepare the right legal structures to shield your family’s income and savings.

Call my firm at (913) 338-5713 for your free phone consultation. At the end of the call, you’ll know the next step and at a minimum, we’ll point you in the direction of resources that can help you.

Our goal is for you and your loved ones to have peace of mind and to never be needlessly impoverished.

Communication with your loved one with Alzheimer’s can be difficult.

But you may be surprised to find there are ways to communicate and identify with your loved one’s situation. Let me tell you a story from one of my clients.

* * *

Carla was frustrated. Her husband was becoming more and more difficult to care for.

It seemed whenever she tried to ask him to do simple things, like putting on a sweater when it was too chilly, he refused. She felt that she couldn’t force him, either… he was still bigger and stronger than she was.

I passed along some communication tips to her, and suggested she take a listen to my MP3 featuring caregiving expert Jo Huey, “Caring For and Communicating With The Alzheimer’s Patient.”

She found that with a few simple changes in her communication style, things became less stressful for her and she was able to get him to cooperate more.

* * *

I always appreciate my clients sharing their stories with me.

As roles change between you and your loved one with memory problems, he may not always react well to being “told what to do,” as you direct him so he’s safe and cared for.

Always aim to treat him as an equal, as an adult. Include him any way you possibly can, even if it means asking him a question related to the task at hand.

For example, if you are sitting down together to pay bills, you can ask him which one to pay first, the light bill or the phone bill. He can stuff the envelopes and put the return address sticker and stamp on the envelope. You can go together to the post office or to put the mail in the mailbox. Let him stay involved at a level that is comfortable for both of you.

Talk with him. Let your loved one answer, whether it’s accurate or not. Just nod and don’t argue.

Use a sense of humor. Laugh together when things don’t go quite the way you had planned.

Choose your battles. If you are telling him to take off a layer of clothing and it agitates him, don’t worry about it. It’s not how he would have dressed in the past, but at the same time it’s not hurting anyone.

Treat him like an adult — with respect and dignity. Frequently validate his feelings of frustration and loss. He needs to know you care.

Read books that will help you empathize with what he’s experiencing. Think about how you would want to be treated if you were him.

Try to put yourself in his place: you wake up one morning and the most simple things you could do yesterday, you can’t do today. Things like not knowing where you are in your own home, remembering to go to the bathroom, how to get dressed, how to set the table, how to take the dishes to the sink after meals. Treat your loved one as a person with a disease, not as a “diseased person.”

To find out more about how to communicate gently with your loved one, click the link below to listen to my MP3, “Caring For and Communicating With The Alzheimer’s Patient.”

www.AlzheimersResourceKit.com/hammond/resources/caring.html

This diagnosis of Alzheimer’s is difficult for both you and your loved one. He was independent and now needs help with things that once came easy and naturally.

Give yourselves a break. This is a very difficult situation, to say the least. When things get really tough, step back, take a deep breath, and move forward. Take each moment one at a time, each day one at a time.

Talking about what happens after you pass away isn’t an easy thing to do.

Most people don’t want to do it. And that’s normal!

But, we have to remember that after we breathe our last breath, something does happen to our estate… whether we planned for it or not.

When an individual who has written a will dies, and he or she owns property solely in his or her name, a formal court procedure (“probate”) is usually required to confirm to whom the property will pass.

If the person dies without a will, the property also goes through probate court and will pass to the individual’s heirs at law. The state laws determine who the individual’s heirs are and what they receive.

In some states probate practices have become streamlined and cause few problems. In other states, probate can be a time-consuming process with statutory requirements (i.e., requirements that are regulated or authorized by law) that can last from months to years.

The process can also be expensive. In addition, probate is a matter of public record, and this sometimes leaves heirs open to calls from unscrupulous salespeople and others.

I have seen too many people fail to plan properly, and it’s their children and other heirs that pay the consequences… through months or years of legal proceedings, and thousands of dollars in attorneys fees.

Often, with a few documents in place that work with your specific circumstances, you can relieve the burden of the probate process for those you love.

It is possible to legally pass property to another person without going through probate.

However, keep in mind that although it is often beneficial to avoid probate, because it can be costly and time consuming, such devices have pitfalls; probate is sometimes the best option.

It’s best to consult a professional to see what’s right for your family.

This information is general. Before taking action to avoid probate, you should consult an elder law attorney in your state who can examine your specific situation and advise you accordingly.

To find out more about the benefits and pitfalls of each of these options, open the guide “Everything You Always Wanted to Know About Alzheimers But Were Too Afraid To Ask – Answers to Over 92 of the Most Frequently Asked Questions at the Alzheimer’s Resource Center” and read articles 96 through 99.

Always be sure to consult an elder law attorney before taking any steps. These general guidelines may work for some people, but for others, probate is the best way to go. Find out what’s right for you.

www.AlzheimersResourceKit.com/hammond/resources/everythingaboutalz.html