9 Essential Tips For Caring For a Spouse With Alzheimer’s Disease

9 Essential Tips For Caring For a Spouse With Alzheimer’s Disease


Caring for a spouse with Alzheimer’s disease can be an emotionally challenging and physically demanding journey. Alzheimer’s is a progressive brain disorder that affects memory, thinking, and behavior, making caregiving a complex and delicate task. To navigate this path with grace and compassion, you need guidance and support.

Below are nine essential tips based on valuable insights we’ve gained by helping families and individuals navigate the legal complexities of this disease.

  1. Educate yourself: Understanding Alzheimer’s is the first step in providing effective care. Learn about the disease’s stages, symptoms, and available resources to better anticipate your spouse’s needs.
  2. Seek legal and financial guidance: Consult with our legal team—or a trsuted estate planning and elder law firm in your area—to establish necessary documents, such as a durable power of attorney, wills, and advance healthcare directives. Planning ahead can help protect your and your spouse’s assets, and ensure their wishes are respected.
  3. Establish a routine: Creating a structured daily routine can provide stability and reduce anxiety for both you and your spouse. Consistency is key with Alzheimer’s care.
  4. Foster open communication: While your spouse may struggle with verbal communication, encourage non-verbal expressions like gestures, facial expressions, and touch. Maintain eye contact and show patience when trying to understand their needs.
  5. Safety first: Ensure that your home is a safe environment. Install locks, alarms, and remove any potential hazards that could harm your spouse.
  6. Respite care: Don’t hesitate to seek help from professionals or trusted family and friends to provide you with a much-needed break from time to time. Caregiver burnout is a real concern, and taking time for self-care is essential.
  7. Focus on nutrition: A well-balanced diet is crucial for maintaining physical and cognitive health. Consult a nutritionist if necessary, and ensure your spouse receives proper nourishment.
  8. Embrace support groups: Joining a local Alzheimer’s support group can offer emotional support and a sense of community. Sharing experiences with others in similar situations can be invaluable.
  9. Adapt and be patient: Understand that your spouse’s behavior may change unpredictably. Be adaptable and patient, and try to find joy in small moments of connection.

Caring for a spouse with Alzheimer’s is challenging, but with the right resources, support, and guidance, you can provide the best care possible. The nine tips above will help you navigate the day-to-day challenges with love and compassion, and the team at Miller Estate and Elder Law can offer legal guidance and support along your journey with this disease. 

Contact Miller Estate and Elder Law

Remember, you are not alone, and seeking help is a sign of strength and dedication to your spouse’s well-being. Call us at (256) 251-2137 to discuss your legal needs, or get in touch with us by completing the brief form below.

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5 Signs Your Parents May Soon Need More Healthcare Support

5 Signs Your Parents May Soon Need More Healthcare Support

woman and man with grey hair smile and look at each other doing yoga

The holidays are a time for warm family gatherings and togetherness, but if your parents are beginning to age, it can also be a chance to check up on how they are faring. Being tuned in to the health of your aging loved ones is important. Taking note of any early warning signs that they may need additional healthcare support is crucial to getting them the care they need, when they need it.

Below is a list of some of the most common signs that your aging loved ones may soon need more care:

  1. Difficulty with Standing or Mobility. As people age, their balance and strength diminish. If you notice a parent leaning over or looking wobbly, they may need additional help. In addition, if your loved one is leaving the house less often, they may have mobility issues that need to be addressed.
  2. Confusion or Forgetfulness. Did your mom forget what she was saying mid-sentence? Did your dad continually repeat himself? Forgetfulness or confusion can be a sign of cognitive decline and may indicate that your parent needs more healthcare support.
  3. Decline in Personal Hygiene or Housekeeping. If you notice that a parent’s grooming has begun to suffer, it’s possible that they may need additional help with daily tasks, such as brushing their teeth or bathing. If you visit their home and notice more clutter than usual, this may also be a sign that they can no longer take care of themselves sufficiently.
  4. Difficulty Keeping Appointments or Paying Bills. Missing appointments or leaving bills unpaid is a key sign that your parent may be experiencing cognitive decline. Look around for unopened mail and listen to any phone calls that your parents receive from bill collectors attempting to collect payment, or healthcare providers attempting to reschedule missed appointments.
  5. Loss of Interest in Favorite Activities. If your parent is no longer enjoying the activities or interests that used to get them excited, it can be a significant indicator that something has changed. Whether due to mobility issues or cognitive changes, isolation is a major sign that your parent(s) need more healthcare support.

Caring for an aging parent is difficult at best, and heart wrenching at worst. If you notice any of the above warning signs, don’t ignore them. Even if you still sense that your aging loved one will be able to maintain their independence for a few more years, now is the time to make sure you get the appropriate legal documents in place to ensure your ability to care for them when the time comes. It’s also a good time to start planning for the cost of long-term care—remember, Medicaid has a 5-year lookback period, so preparing to qualify for this program should start as early as possible!

At Miller Estate & Elder Law we have many years of experience helping people with all aspects of caring for their loved ones. We’ve developed a helpful guide, Caring for Aging Parents, which includes important information about preparing for and providing the care your aging loved ones may soon need. Complete the brief form below to gain access to this free resource.

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My Spouse Needs to go to the Nursing Home…Now What?

My Spouse Needs to go to the Nursing Home…Now What?

You’ve been married to your spouse for decades. Lately, you’ve noticed that they are losing the ability to look after themselves. You realize that they may soon need nursing home care. You know this requires a lot of planning. Are you prepared?

When a spouse needs nursing home care, most people find that they are ill-prepared for the expenses associated with it. Paying out-of-pocket is expensive. After all, you’ve worked a lifetime to purchase your home and build your nest egg you should be able to pass those down to your children and grandchildren…not lose them to the nursing home. Your other options are to apply for Medicaid, or use long-term care insurance. Sadly, long-term care insurance is often overlooked until it’s too late to get it, leaving Medicaid as the only option. However, Medicaid eligibility can be tricky, and most people wonder how their assets might be impacted.

What Happens to My Income?

If your spouse has to go to a nursing home, all of their income will go to the nursing home.  You can keep all of your income but in many cases that is not going to be enough.  Without proper long-term care planning and a loss of your spouse’s income, your life savings could be drained in a matter of months if you have to pay out-of-pocket. Becoming eligible for Medicaid is challenging, with inhibitive income and asset limitations that may leave your spouse unqualified to receive these benefits. As the spouse who is not going to apply for Medicaid (also known as a “community spouse”), your income will not be factored in to eligibility. However, your spouse’s monthly income (which cannot exceed ~$2,523 per month ) will be used to determine Medicaid eligibility, and to pay for care, if approved. This leaves you at home with just one income to cover all of your expenses.

What About My Other Assets?

The other consideration when determining Medicaid eligibility is the assets that are owned by you and your spouse, regardless of whose name they are held in. The Medicaid applicant cannot own assets valued over $2,000 to qualify, not including your primary home or car. You, as the community spouse, can keep half of your assets, up to a maximum of $137,400.

You might also wonder which assets are included—and which are excluded—in the Medicaid application process. Typically, liquid assets, like bank accounts, insurance policies valued over $1,500, stocks and bonds, mutual funds, and second homes and cars, are considered countable assets. It should be noted that your home and one car are not included. This is because the community spouse would continue to reside in and otherwise utilize these assets. Additional assets that are exempt from Medicaid include personal effects, burial plots, and life insurance policies valued under $1,500.

So, What Are My Options?

If your spouse needs nursing home care now, and you are faced with either having to pay out-of-pocket or qualify for Medicaid, you still have some options. You may be tempted to spend down or transfer your assets, but Medicaid will look back 5-years from your application date to ensure you did not give away money to become eligible. Medicaid qualification is a confusing area of law, so it is best to plan with an elder care attorney who can take the guesswork out of applying for Medicaid and help you to avoid common mistakes that may cause penalties and delays in approval.

If you expect your spouse will need nursing care in the not-so-distant future, it’s best to start planning immediately. This is also a good time to consult with an elder law attorney about best practices for maximizing retention of assets and nursing home care provisions for your spouse. Your elder law attorney may suggest actions like:

  • Paying down existing bills: Medical bills, car loans, credit cards, etc.
  • Home improvements: Repairing plumbing and heating systems, fixing the landscaping, purchasing household goods and furnishings, and making structural modifications.
  • Funeral trusts: Purchase a pre paid funeral plan which in not countable and while takes care of an inevitable expense.

At this point, you’ve probably determined that paying for long-term nursing home care can be complicated at best, with so many variances and challenges depending on your unique circumstances. Proper planning should be implemented sooner rather than later to prevent costly and stressful consequences. Miller Estate and Elder Law can help you strategize in order to yield optimum benefits for you, your spouse, and—ultimately—your entire family.

Watch our FREE webinar to learn more about Medicaid eligibility and how to get your spouse qualified for the care they need, without sacrificing your life savings.


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I Just Learned My Mom Needs 24/7 Care. What Now?

I Just Learned My Mom Needs 24/7 Care. What Now?

Hearing a doctor say that your loved one needs skilled nursing care, 24/7, can be a real shock. Chances are, you have not given much thought to planning for long-term care. If you have just learned that your dad or mom needs 24/7 care – or think this may happen in the future – continue reading to learn more about what you can do to help.

The Realities of 24/7 Care

If your mom needs 24/7 care, you are not alone. In fact, the following statistics tell an interesting story about long-term care:

  • 52% of people age 65 right now will need long-term care at some point.
  • 47% of men and 58% of women age 65 or older face long-term care.

Some people will need skilled nursing care for years. The cost of 24/7 care can be staggering. In Alabama, the monthly costs for long-term care in 2018 were:

  • $3,241 for homemaker services or a home health aide
  • $3,271 for an assisted living facility
  • $6,279 for a semi-private room in a nursing facility
  • $6,661 for a private room in a nursing facility

What can you do to help someone who needs 24/7 care?

Applying for Medicaid

Once you find a good nursing home, you need to figure out how to pay for it. This can be tricky. There are basically three ways to pay for long-term care: self-pay, long-term care insurance, and Medicaid.

You may need the Medicaid money now but don’t know how to get it or even if you will be eligible.

Medicaid offers a number of programs to provide medical care for people with limited assets and resources. To qualify, the application will need to meet certain asset and resource tests. For example, someone who needs 24/7 care must not earn more than $2,250 per month or have more than $2,000 in resources.

Applying for Medicaid can be frustrating and time consuming, in part because of the amount of supporting documentation. In addition, Medicaid case workers will review the applicant’s finances for a 60-month period prior to the application date. Certain transactions made during that time may disqualify the applicant from or delay benefits.

Medicaid Is Complicated. We Can Help.

It’s possible – and highly recommended – to plan ahead for incapacity and long-term care. Estate
planning can help, especially if Medicaid planning is included.
For a free consultation with an experienced Alabama estate planning attorney, contact Bill Miller
at 256-472-1900. Miller Estate and Elder Law is now located at 818 Leighton Avenue in
Anniston, but we serve clients in Gadsden, Hoover, Talladega, Vestavia Hills, and surrounding

How Much Does Long-Term Care Cost?

How Much Does Long-Term Care Cost?

Jackie wanted her mother to have the best care possible. At age 82, Mom needed more assistance than she could get at home, even considering the great in-home nursing options available. As Jackie looked for a nursing home for her mom, she wondered how much her mom’s long-term care would cost? She came face to face with reality: long-term care is expensive!

What are the chances someone will need long-term care?

According to federal government statistics, 20% of people age 65 will need long-term care for more than five years. And if you are 65 right now, you have an almost 70% chance of needing some form of long-term care.

The families of people needing long-term care are affected also. In addition to the stress of caring for another person, they must also find the right type of care. Family members also usually have to struggle to find a way to pay for that care.

What type of care is considered long-term care?

It’s not just residential care at your local nursing home. There are other options.

  • In-Home Care. Most older people want to stay in their homes as long as possible. When they need extra nursing assistance, they can often hire skilled in-home care providers.
  • Assisted Living Facilities. While this is residential care, as is a nursing home, the resident has greater flexibility and privacy. Assistance, often from a trained nurse, is available if needed.
  • Residential Care. Sometimes this type of care if unavoidable. Residents of nursing homes may lose some privacy but make up for it with greater skilled nursing care.

So, how much does long-term care cost?

It depends on where you live and what type of long-term care is needed.

The following figures reflect the 2017 cost for long-term care in Alabama:

  • $42,900 –           In-home care
  • $41,688 –           Assisted Living Facility
  • $73,000 –           Nursing Home (semi-private room)
  • $76,650 –           Nursing Home (private room)

These costs, of course, are averages and the actual cost may vary. Costs are expected to increase over time.

Start Planning Now.

At Adams & Miller, P.C., we make it our business to put our client’s needs first. We assist our clients in making thoughtful decisions regarding incapacity planning. For a free consultation, contact us at 256-251-2137 or use our convenient Contact Form. We have offices in Anniston and Birmingham and we assist clients in the Leeds, Gadsden, Hoover, Talladega, Vestavia Hills, and surrounding areas.

Gateway to Community Living: Helping You Manage at Home

Gateway to Community Living: Helping You Manage at Home

Phil M. lived in a rehabilitation center after suffering a stroke last year. Fortunately, he qualified for Medicaid benefits that covered the high cost of treatment. However, after six months, he and his family felt he was ready to move back to the community and live the independent life he desired. A wise friend pointed them in the direction of Gateway to Community Living.

What is Gateway to Community Living?

It’s a program administered by the Alabama Medicaid Agency. Through this program, elderly people or those with disabilities may be able to live at home with community assistance.

Phil seemed like an excellent candidate for this program. His rehabilitation left him able to care for his daily needs. More importantly, he had a strong desire to live independently for as long as possible.

What services are provided?

Home and community-based programs offer a spectrum of services to meet the population’s diverse needs.

Transition coordinators work with applicants to work out eligibility.  In addition, they help applicants work out a custom transition plan.

Specific benefits include:

  • Financial assistance with moving costs, and deposits for rent and utilities.
  • Help people find affordable, accessible housing.
  • Job search assistants for applicants who are returning to the work force.

Phil was able to work with his transition coordinator to find a comfortable apartment in an independent living facility. Gateway also helped him apply for part-time jobs that fit his physical abilities.

Who can receive Gateway to Community Living assistance?

Applicants must meet the following requirements:

  • Has lived in a nursing home or qualified facility for at least 90 consecutive days.
  • Received Medicaid for at least one day before transitioning to community living.
  • Expect to complete their transition within 180 days.
  • Be physically and mentally capable of living in the community with assistance.

People who feel they might benefit from Gateway to Community Living can ask the staff at their residential facility to refer them. Patients or their legal guardians and family members may also “self-refer” either online, by email, fax, or regular mail.

The social worker at Phil’s rehab facility referred him for Gateway benefits and helped him complete the required paperwork.

Learn More About Incapacity Planning.

Maybe you have an older parent facing elder law issues. Maybe you are looking ahead to your own future. Either way, it’s important to know what rights and protections are available for senior citizens. Schedule a consultation with one of our attorneys and find out where you stand. Our phone number is 256-251-2137, or you may want to use the Contact Form on our website. We have office in in Anniston and Birmingham and assist clients in communities like Hoover, Vestavia Hills, Irondale, and Calera.