The 7 Stages of Dementia and How to Support Your Loved One Through Each

The 7 Stages of Dementia and How to Support Your Loved One Through Each

by | Feb 20, 2023 | Asset Protection, Blog, Caregivers, Estate Planning, Long-Term Care, Nursing Home

7-stages-of-dementia

If a loved one has been diagnosed with Alzheimer’s disease or another form of Dementia, you know you will be facing a hard road ahead. Seeing a family member or loved one’s mental state deteriorate can be a trying emotional experience, but knowing what to expect can help ease the mental burden. By understanding the 7 stages of dementia, you will be able to provide valuable assistance to your loved one at each step in their progression.

The 7 Stages of Dementia

Although there are different common classifications of Dementia’s stages, the progression is most often divided into seven parts. Here are the different stages and what you can do to help a loved one at each one:

  1. Normal Behavior. Because the mental deterioration associated with dementia consists of a steady progression, the early stages are not yet classified as Dementia proper. In stage one, there are no outward signs of any mental decline. This is the perfect time to talk to an elderly parent or other relative about their wishes, should they begin to decline mentally—and to make sure the right legal documents are in place!
  2. Very Mild Changes/Forgetfulness. At this stage, changes will be subtle and, in some cases, you may not notice them at all. They include light memory loss and difficulty finding the right words. At this stage, you should be absolutely sure that your loved one’s living will and health care proxy are in place, and you will need to begin watching them more closely.
  3. Mild Changes. At Stage 3, the signs of dementia will begin to be more noticeable. Memory loss will become more acute, with your loved one having difficulty with words and names, and trouble paying attention. You will have to begin taking a more active role in managing aspects of their lives, including paying bills, making appointments, and ensuring that they take their daily medications.
  4. Moderate Decline/Mild Dementia. At this stage, your parent or relative can be said to be experiencing the early stages of Dementia. They will still remember most of their past and they will know who you are. That said, their memory will continue to decline, with short term memory difficulties becoming especially prevalent. They will require more help with everyday tasks and will likely need someone to look after them daily. They will also no longer be able to drive.
  5. Moderately Severe Decline/Moderate Dementia. By now, your loved one is entering mid-stage Dementia. They will begin experiencing personality and mood changes and begin to have problems with bathroom use and eating. They will still recognize you, but will begin to forget some of their past. At this point, they will need more intensive care, such as help with dressing and bathing. If you are unable to provide this level of care, you will need to begin making arrangements to hire a health care professional.
  6. Severe Decline/Moderately Severe Dementia. In stage 6, memory loss becomes more significant and your loved one may no longer recognize you. They will forget most of their past and need significant help performing daily tasks. At this point, in addition to ensuring health care assistance, you will want to find ways to continue to connect to your loved one. Even simply talking to them can help.
  7. Very Severe Decline/Late-Stage Dementia. In late-stage dementia, your loved one will not remember anything of their past or recognize anyone they used to know. They will no longer be able to speak or eat by themselves and they will lose all bathroom function. They will require 24-hour assistance. Helping them with any daily tasks you can and continuing to talk to them can help out in a difficult situation.

Dealing with a loved one going through the stages of dementia can be an emotionally trying situation. That’s why it’s important to prepare ahead of time so you know what to expect. Working with a loved one to ensure that all their health care documents are in place, in particular, can help give you peace of mind. That way, if your parent or other relative does begin to experience cognitive decline, you can be sure you will have the authority to make financial and medical decisions for them, and be operating according to their wishes moving forward.

Contact Miller Estate & Elder Law

At Miller Estate and Elder Law, we have many years of experience helping clients navigate the complexities of the estate planning process. Having the right legal documents in place now can save you from a major headache later. Contact us today to get started providing for your and your family’s future, or complete the brief form below to download our free guide: The 5 Legal Documents Every Adult Needs.


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5 Common Situations When an Estate Plan is Surprisingly Important

5 Common Situations When an Estate Plan is Surprisingly Important

by | Feb 8, 2023 | Asset Protection, Blog, Caregivers, Estate Planning, Long-Term Care, Nursing Home

Not everyone recognizes the need for an estate plan. Contrary to popular opinion, estate planning is not reserved for only the wealthy or elderly. In fact, anyone who owns anything—a house, a car, a bank account…literally anything—should draft even a very simple estate plan to ensure that their belongings are distributed according to their wishes after they pass away.

But, again, contrary to popular opinion, estate planning isn’t just about what happens to your “stuff’ after you die. It very much helps protect you, physically, as well as your hard-earned assets while you’re still alive.

Here are five common instances you probably haven’t thought of where having an estate plan in place is a good idea:

  1. Having Minor Children: If you have minor children, it’s important to have a well drafted estate plan in place to ensure that they are taken care of in the event of your death. This includes appointing a guardian for your children, and outlining how their inheritance will be managed and distributed.
  2. Owning Property in Different States: If you own property in different states, it’s important to have an estate plan in place to ensure that your property is distributed according to your wishes. Without a plan, your property may be subject to the intestate laws of the state in which it’s located, which may not align with your wishes.
  3. Having a Special Needs Family Member: If you have a family member with special needs, it’s important to have an estate plan in place to ensure that they are taken care of in the event of your death. This includes setting up a special needs trust to provide for their care, and naming a Trustee and Successor Trustee who will manage the trust’s assets.
  4. Starting or Owning a Business: If you’re a business owner, it’s important to have an estate plan in place to ensure that your business continues to run smoothly in the event of your death. This includes designating a successor to take over the business, and outlining how the business’s assets will be distributed.
  5. Having a Large Estate: If you have a large estate, it’s important to have an estate plan in place to minimize taxes and ensure that your assets are distributed according to your wishes. This includes setting up trusts and utilizing other estate planning tools to minimize taxes and protect your assets against creditors and predators.

No matter what stage of life you’re in, it’s important to be prepared for the many uncertainties of the future. Whether you’re a business owner, the parent of minor children, or a caretaker for a special needs family member, planning ahead is never a bad idea. Be sure to work with a qualified and experienced estate planning attorney who can help you create a plan that is tailored to your unique needs and goals.

Contact Miller Estate & Elder Law

At Miller Estate and Elder Law, we have many years of experience helping clients navigate the complexities of the estate planning process. Having the right legal documents in place now can save you from a major headache later. Contact us today to get started providing for your and your family’s future, or complete the brief form below to download our free guide: The 5 Legal Documents Every Adult Needs.


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bill@millerestateandelderlaw.com

What Does Long-Term Care Actually Cost?

What Does Long-Term Care Actually Cost?

by | Jan 23, 2023 | Blog, Caregivers, Long-Term Care, Nursing Home

Elderly man walking with walker and nurse assistance

Although no one likes to think about it, as your loved ones get older, there’s a good chance that they will need more intensive medical care. Whether that means having a home health aide look in on them a few times a week or moving them into a nursing home full-time, it can be a difficult and emotionally wrenching situation to care for a family member who can no longer take care of themselves.

In addition to the emotional demands, long-term care is extremely expensive, and can drain your loved one’s savings account…fast! That’s why it’s essential to plan ahead and work with an estate planning or elder law attorney who can help protect you or your loved ones from running through their savings. This helpful guide will take you through the basics of long-term care planning, specifically when it comes to caring for your aging parents. Below are some answers to common questions about the cost of long-term care.

How Much Does Long-Term Care Cost?

Long-term care takes many different forms, but it can generally be divided into two categories: in-home care, where trained professionals care for your loved one in their own home, and residential care, where they leave their home and live in an assisted living facility or nursing home.

Whichever form of care is right for your loved one, the costs can be challenging. For in-home care, the average hourly rate in Alabama is $20/hour, but it can easily range upwards of $30, depending on your location and the level of care provided. For assisted living, the average cost in Alabama is about $3,500 per month, although this rate may be higher in more expensive areas, such as Birmingham or Florence.

The most expensive option is a nursing home residency. Costs vary considerably, but one recent study puts the average yearly cost for a semi-private room in Alabama at $80,000 a year, and the price for a fully private room at $84,000. Needless to say, these costs can stretch the budget of the average household more than just a little bit.

Planning for Long-Term Care Expenses

Although these numbers can be head-spinning, there are resources available to help you meet them. Medicare benefits can serve as a valuable bridge for when your loved one first requires more intensive medical assistance, but are not a long-term solution. Medicare benefits only cover 80 percent of costs, and only cover 100 days of care. In addition, they typically only cover skilled nursing care, and limited home care.

Medicaid benefits, though, cover most of the additional long-term care costs that Medicare cannot. Medicaid is need-based, but there are ways to qualify…no matter what your financial situation. With proper legal planning and the correct organization of your assets, you will be able to protect your savings and pay for whatever assistance your loved ones may need.

The Importance of an Elder Care and Estate Planning Attorney

Navigating the costs of long-term care can be a complicated and challenging experience, which is why it’s so important to plan ahead. The need for long-term care can arise suddenly, and if you haven’t properly prepared for this possibility, you may find yourself scrambling for help. Meeting with an experienced elder care and estate planning attorney can help you plan for whatever may happen to you and your family, and help you rest easy knowing your family’s assets are safe.

At Miller Estate & Elder Law, we have many years of experience helping people care for their loved ones—while protecting their hard-earned savings. Contact us today and start putting your family first.


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Preventing Falls in Nursing Homes: How to Ensure the Safety of Your Loved Ones

Preventing Falls in Nursing Homes: How to Ensure the Safety of Your Loved Ones

by | Jan 15, 2023 | Blog, Caregivers, Long-Term Care, Nursing Home

Elderly man walking with walker and nurse assistance

As an elder law and Medicaid planning attorney, I help a lot of families protect their assets from the cost of long-term care. However, I also care deeply that your loved ones are in good hands after they transition into a nursing home facility. If a loved one is going into a nursing home—or if they already reside in a long-term care facility—it’s important to be aware of the fall prevention practices that are in place.

As your loved ones age, their risk of falling increases tremendously. Each year, millions of seniors suffer falls at home, in public places, or in long-term care facilities. According to the CDC, approximately one out of four seniors fall each year, and falling once doubles the chance of falling again. Falls are frequently fatal, but even non-fatal falls lead to serious injury about 10-20% of the time. This can be anything from broken bones to serious head trauma.

The repercussions from these types of falls are much greater than the physical injuries alone. Falling can result in a functional decline, reduced quality of life, and fear of falling again, which can lead to feelings of depression, helplessness, low self-esteem, and social isolation. 

When visiting your loved one in the nursing home, check to ensure the facility has addressed the following risks: 

Environmental Risks – Environmental factors can be a huge contributor when it comes to falls. Things to look for include loose carpeting, slick or glossy floors, poorly arranged furniture, and dim lighting. Along with this, residents should be encouraged to wear rubber-soled athletic shoes or lace-up or strap-on shoes that fit snugly, rather than just socks or slippers. 

Health Risks – Each resident should be assessed by the nursing home staff to identify any health issues that may make an individual more prone to falls, such as fainting, low blood pressure or certain medications. The health history should also explore if there are any past incidents of falling and if there are any mobility issues.

Exercise – The nursing home should offer a daily exercise program and promote an overall active lifestyle for their residents to improve balance, strength, and gait, and therefore help reduce the risk of falls. Oftentimes residents are assigned wheelchairs though they have little need, and the reliance on the wheelchair eventually erodes their endurance, strength and balance through neglect. 

Staffing – Staff members should be provided educational programs that teach them how to provide the level of care and attention that residents need. They should be able to recognize when a resident is at risk of falling, and there should be proper procedures in place in case a fall does occur. The facility should also be adequately staffed especially during high traffic times such as meals. 

When a loved one transitions to a nursing home, you want the absolute best for them in terms of their wellbeing—and we want to ensure their wellbeing, also.

If your loved one is not prepared for the potential cost of long-term nursing care, and you are beginning to notice a decline in their physical and/or mental health, it’s important that you take certain legal steps…and fast.

Download the Free Guide and e-Book Now!

Start by downloading our free guide: Caring for Aging Loved Ones. In this guide, you’ll learn which questions you should be asking, how to have “the talk” with your aging loved ones, the 6 steps to take before (or during) a crisis, and which mistakes to avoid while preparing to qualify for Medicaid.

 

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The Difference Between a Power of Attorney, Guardianship and Conservatorship

The Difference Between a Power of Attorney, Guardianship and Conservatorship

by | Jan 5, 2023 | Blog, Caregivers, Estate Planning, Healthcare Proxy

A power of attorney (POA) and a guardianship/conservatorship are different types of legal arrangements, each of which dictates who will care for you and your estate if you become incapacitated. Although each of these arrangements has their place, having a durable power of attorney in place is generally a more proactive way to plan for the “what ifs” of the future. If you need to be able to make decisions on behalf of your incapacitated spouse or aging loved ones, having power of attorney is much easier than going through the burdensome process of establishing a guardianship or conservatorship. Filing for guardianship/conservatorship is not only more expensive, but it’s also more time-consuming, and…a judge may decide not to grant you these roles at all!

What is a Durable Power of Attorney?

A durable power of attorney (POA) is a legal document in which you name a person who will act on your behalf if you become incapacitated or are otherwise incapable of looking after your finances. The agent that you appoint will typically have the power to handle most of your financial matters, including opening and closing bank accounts, signing checks or contracts, and buying and selling real estate. There are several different types of power of attorney documents, but a “durable” power of attorney is one that is specifically designed to remain valid in the event of incapacitation or mental incompetency. A durable POA must be signed while you or your loved one is still of sound mind and body.

What are Guardianships and Conservatorships?

A guardianship is a court proceeding in which someone is given legal control over another person’s personal situation. The individual who assumes guardianship has the right to make decisions involving the other person’s healthcare, whether to put them in assisted living, or otherwise where they should live, etc.

A conservatorship goes hand-in-hand with a guardianship. It is a court proceeding, but rather than being granted the power to make personal decisions, this arrangement grants another person legal control over financial matters: paying bills, cashing checks, accessing bank accounts, etc.

If you were to become incapacitated or otherwise incapable of making financial decisions—and you do not have a durable power of attorney in place—then the court will assign you a guardian and/or conservator. This person—or, in some circumstances, these people—will typically be given the power to make legal, financial, and health decisions on your behalf, and may or may not require court approval to enact these decisions. Before the court approves a guardianship or conservatorship, it requires the testimony of a physician who has personally examined the ward and found that they are indeed incapacitated.

What are the Differences Between a Power of Attorney and a Guardianship/Conservatorship?

There are several major differences between a durable power of attorney and a guardianship/conservatorship, but the most significant is that in the former, you get to choose your agent, while in the latter, the court decides who will be entrusted with the decision-making on your behalf.  Although the court also assigns an attorney to represent the incapacitated individual and ensure that the guardian and/or conservator is acting properly, you can never be sure that this agent will truly be operating in your behalf. The thought of not being able to choose your own agent should give anyone pause.

Another difference between the two arrangements is that a guardianship/conservatorship is much more expensive and burdensome to acquire. A power of attorney is easily and affordably arranged, while a guardianship/conservatorship is a far more intensive process involving at least one doctor and at least two lawyers, all of whom need to be paid.

Don’t Hesitate

The bottom line is that, by ensuring you have a durable power of attorney in place, you can save not only time and money, but your dignity as well. No one likes to think about what will happen if they should become incapacitated, but it’s impossible to predict the future and it’s far better to prepare for any possibility now. Whether for yourself or for an aging loved one, making sure a power of attorney is in place well before the onset of a cognitive disorder is crucial to the security of your estate.

At Miller Estate & Elder Law, we have many years of experience helping our clients establish durable powers of attorney, and navigating difficult medical and financial situations. Contact us today and ensure that you or your aging loved one has a say in their own future.

 

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How to Become a Paid Caregiver for a Family Member in Alabama

How to Become a Paid Caregiver for a Family Member in Alabama

by | Aug 14, 2022 | Caregivers, Elder Law

caregiver standing next to bed with older man laying down

Being a caregiver for a loved one is no easy task. Not only is it a time-consuming and physically demanding job, but it is an emotionally draining job, as well. Caring for the elderly at home may be—and often is—a full-time job. Because caregivers are often unable to work another job, they need to be compensated for their labor.

Luckily, there are multiple ways for people providing senior home care for their loved ones to get paid. These options vary depending on the specific circumstances of your loved one, but all are designed to ease the heavy burden that caregivers shoulder in order to fulfill their duties.

How to Become a Paid Caregiver for a Family Member in Alabama

Below are some of the options for caregivers to get paid in Alabama:

  • Medicaid Waiver Programs: If the person you are caring for receives Medicaid, they may be able to have you named as an official caregiver. Medicaid offers several waiver programs that are designed to prevent older people from being placed in nursing homes and allow you to continue caring for the elderly at home.

    The Alabama Medicaid Waiver for the Elderly and Disabled (E&D Waiver) assigns elderly people and people with disabilities a case manager, who helps them design a person-centered model of care which may include a provision for an at-home caregiver. Another option is the Personal Choices program, which allows elderly or disabled Alabamians more choice and flexibility in the type of care they receive. Other waivers are designed to benefit people with specific disabilities, such as the Technology Assisted Waiver for Adults (TAW), which covers people who are ventilator dependent, or who have a tracheotomy.

  • Veteran Directed Care Program: The Veteran Directed Care Program (VDC) allows eligible veterans to determine the course of their own care. They are given a flexible budget, which allows them to hire and supervise their own caregivers. They also have access to additional resources, including care planning assistance, financial management services, and ongoing counseling support.
  • Alabama Cares Program: The Alabama Cares Program offers caregivers a variety of resources that can help ease the burden of caring for the elderly at home. These services include training, access to information and advice, and support services such as personal care, adult day care, and limited homemaker services. Caregivers providing services for people over the age of 60 qualify for the program, as do caregivers helping patients with dementia, and caregivers who are over the age of 60 themselves, and who are caring for children aged 18 or younger.
  • Sign a Caregiver Agreement: If you are providing caregiving services, you can get paid for those services.  We recommend that you sign an actual caregiver agreement or contract.  In the agreement, you set up the number of hours per week you will provide care and the hourly rate you will charge for that care.  You do not want to get paid “cash” or under the table so to speak.  Caregiving expenses are a proper Medicaid spend down but you must do it the right way.  Otherwise, your loved one risks getting penalized by Medicaid if they ever have to file a Medicaid application for nursing home care.

Hiring an Elder Law Attorney

Registering as a primary caregiver can be a complicated process and is difficult to navigate alone. Hiring an experienced elder law attorney can make the process much easier and can ensure that you are getting qualified for all of the services available to you and your loved ones. We want to make sure your aging parent receives the senior home care they deserve.

At Miller Estate and Elder Law, we are experts in understanding how to become a paid caregiver for a family member in Alabama. Contact us today using the brief form below to find out more about our services for caregivers.



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