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    Walking and Alzheimer’s – Check Your Gait

    The way people walk appears to speak volumes about the way they think, so much so that changes in an older person’s gait appear to be an early indicator of cognitive impairment, including Alzheimer’s disease.

    Cognitive impairments, like Alzheimer’s and dementia, are difficult to diagnose, let alone manage. Still, these impairments are a reality for millions of Americans and their loved ones, not to mention many more of us in the future. Consequently, we must remain informed and vigilant.

    Cognitive disease symptoms steadily destroy our ability to plan for the disease itself. This troubling fact carries over to the legal issues of “mental capacity” when it comes time to plan your estate. So, what are the outward warning signs of present or future issues?

    Some new studies have come to light about walking and dementia. The New York Times recently addressed this connection in an article titled “Footprints to Cognitive Decline and Alzheimer’s Are Seen in Gait.” According to recent findings, a person’s gait – the way he or she walks – can be an early indicator of oncoming impairment for some. It seems the more difficulty a person has walking, the more difficult it is to process certain information.

    In fact, the results of testing were even more dramatic when persons where required to engage in various mental exercises while walking. Although neither conclusive nor confirmed, there seems to be a link between exercise and cognitive impairments.

    Contact Meier Law Firm to discuss how we can help you with your estate planning.

    Reference: The New York Times (July 16, 2012) “Footprints to Cognitive Decline and Alzheimer’s Are Seen in Gait

    Avoiding the (Medicare) “Doughnut Hole”

    Depressed Medicare beneficiaries in the so-called coverage doughnut hole were more likely to cut back on their antidepressants than those who had full insurance coverage, a study has found.

    Even with the Affordable Care Act (ACA) – Obamacare by any other name – in place and affirmed by the Supreme Court, the costs paid and lifestyles lived by many is being tied to the “doughnut hole.” This is especially true for seniors taking depression medications.

    As recently reported in Med Page Today, a new study by Yuting Zhang, PhD, of the University of Pittsburgh, Medicare may not fully cover depression medications for seniors, despite the ACA. The article is titled “Antidepressants 'Fall' Through Doughnut Hole.”

    If you are unfamiliar with the “doughnut hole” issue, you are not alone. It is the coverage gap created by Medicare Part D. For those whose income is at the lower end, there tends to be coverage. Likewise, for those who have an upper-end income, there is still coverage…with a gap in between.

    According to the new study, and sheer intuition, patients that fall within the doughnut hole are associated with a significant drop in medication use – 12% on average. That is always relevant, but perhaps especially so in the case of depression medication. While discontinuing any prescribed medication is never advisable, it is often easier to justify foregoing depression medication than other medications.

    I recommend reading the original article for more details regarding this study, should this issue be relevant to you or someone you love.

    Contact Meier Law Firm to discuss how we can help you protect everyone you love.

    Reference: Med Page Today (July 5, 2012) “Antidepressants 'Fall' Through Doughnut Hole

    Government Now Tracks Time Spent Providing Elder Care

    Every day, Bureau of Labor Statistics interviewers ask Americans to detail how they spent the previous 24 hours, how many minutes and hours they devoted to everything from shopping to child care to phone calls. The results, culled from 12,500 respondents, make up the American Time Use Survey. It began in 2003, but only last year did the bureau start asking about a key activity for millions of people — elder care.

    There’s rarely a shortage of personal stories about giving care to an elderly loved one. While there has been some private sector data on the subject, now there is official governmental information directly from the Bureau of Labor Statistics.

    The Bureau is the very same agency that publishes information on the Consumer Price Index, the Producer Price Index, and just about every government statistic, including the American Time Use Survey. This survey works to quantify how much time Americans devote to various tasks – and have to devote to those tasks in the first place. Interestingly, the survey has begun to include the activity of providing unpaid care to someone over age 65 “because of a condition relating to aging.”

    As reported in a recent post in The New York Times – The New Old Age Blog in an article titled “New Numbers on Elder Care,” the Bureau has wanted to track this activity since 2003. Nevertheless, the addition is fairly recent and the results for 2011 have been published. The summaries shed light on the experiences of many Americans.

    One of the key lessons to learn is that it is never too early to plan for the caregiving of elder ones loved ones. Contact Meier Law Firm to discuss how you can help care for your loved ones.

    Reference: The New York Times – The New Old Age Blog (July 5, 2012) “New Numbers on Elder Care

    Art Therapy for Alzheimer’s Patients

    “Art offers [patients with dementia] a way of communication that doesn’t rely on their verbal skills and allows them to contribute in a way that they don’t often get to do,” said Nancy Lee Hendley, dementia care trainer for the New York City chapter of the Alzheimer’s Association.

    Caring for an elderly loved one with dementia or Alzheimer’s is a difficult thing, often both for the caregiver and the patient. This is especially true when it comes to effective communication. Enter “art therapy.”

    According to a recent article in The New York Times (The New Old Age Blog) titled "Art Therapy For Alzheimer's Patients," art helps to comfort and often even invigorate a patient by giving them “something” with which to associate that does not require verbal interaction. As a result, various museums have begun programs with care professionals to provide guided tours for patients. These tours through exhibits offer patients the opportunity to associate with and discuss the art on display.

    According to the article, the experience also has proven to be a pleasurable activity for the caregivers, even if neither the caregiver nor the patient was an art-buff beforehand.

    So, if you have a loved one who has Alzheimer’s or dementia, then you might check with your local art museum and inquire about an art therapy program. Who knows, perhaps your suggestion just might initiate a similar program in your hometown.

    Reference: The New York Times – The New Old Age Blog (April 13, 2012) “Reconnecting Through Art

    Seniors and Singles Without Family – Consider A Care Committee

    People without much family simply plan the best they can, setting up advance directives and crossing their fingers, hoping they can afford paid care when they need it. Ms. Cotter has taken her preparations a step further, however. When she consulted [with her elder law attorney] for help with estate planning, he made a suggestion: She could set up a Care Committee.

    Unfortunately for many elderly and single persons, the legal system and, perhaps to an even greater extent, the healthcare system, are designed around family-based persons. The primary caregiver and decision-maker for so many of our elderly is an unpaid family member, usually an adult child. So, to whom can the single elderly person turn when they have no children?

    This is a question that comes up often, but the answers tend to be sparse and inadequate. Enter a relatively new development: the Care Committee. The New Old Age Blog on the New York Times recently addressed this concept in an article titled Care by Consensus.

    More likely than not, an elderly person without children already turns to other people in his or her life for advice and counsel. These other people serve as surrogate family members. In a sense that is all a Care Committee is, with the added benefit of legal organization.

    Here’s how it works: You ask and appoint members of your Care Committee and task them with carrying out your intentions when you are not able to articulate them yourself. Accordingly, they assume these powers only when you are incapacitated. Think of it as establishing an extended type of living will, or advanced directive. You can even spell out your intentions and simply ask your committee to follow them, or else appoint a guardian or care manager to follow them instead.

    It is at least one possible solution for a fairly intractable problem. Nevertheless, committees always have their drawbacks, especially when there are disagreements. Of course, your family members also can (and likely will) disagree at times.

    Another practical problem concerns the very friends you would appoint to your Care Committee. Unless they are significantly younger, they may have their own medical care emergencies and concerns, causing you to constantly revise and refine your committee choices.

    Nevertheless, forming a Care Committee may be a solid option for an elderly person in the right situation. Certainly, this is an option worth considering. I would recommend the original article for your reading. At any rate, if you are considering a Care Committee, be sure to engage competent elder law counsel to help evaluate this option and prepare the proper legal instruments.

    Reference: The New York Times (March 21, 2012) “Care by Consensus

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