Getting a diagnosis of Alzheimer’s for those under age 65 can be difficult. Early-onset Alzheimer’s, which can even strike people in their 30s and 40s, affects less than 5% of all Alzheimer’s patients. Because doctors don’t usually suspect Alzheimer’s at such young ages, the symptoms are often attributed to other causes, such as depression, stress, and even (in women) menopause.

But it’s important that employees get the diagnosis as early as possible, in order to maximize benefits that are available to them. If you are fired before anyone knows what is going on, you won’t be able to take advantage of the benefits for which you qualify.

As soon as you have a diagnosis, tell your employer and ask for an accommodation before it becomes a problem. The Americans with Disabilities Act (ADA) does not list specific medical conditions that are covered, but an employee with dementia will typically qualify. Work with your employer to determine steps that will allow you to work as long as possible, such as teaming up with another employee, having written instructions, setting short-term deadlines, ride-sharing and flex-time.

Next, contact your Human Resources to determine the benefits that are available to you and work out a timetable to make sure you take full advantage of them. These include:

Short-term and long-term disability insurance. These will replace part of your income when you can no longer work.

Paid leave. You may be eligible for 12 weeks of paid leave under the Family and Medical Leave Act (FMLA). Some employers are exempt from providing the leave, so be sure to ask about it.

COBRA. When your health insurance discontinues, you will be offered the opportunity to buy continuing coverage. To continue coverage until Medicare begins (see below), you will need to provide the insurance company proof of disability. COBRA can be expensive, so you will want to compare costs and coverage to other plans in the marketplace.

Social Security Disability. Early-onset Alzheimer’s is on the list of conditions that expedite access to Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) eligibility. Social Security disability benefits begin five months after an employee develops a disability, with payment starting in the sixth month. Begin the application process when you go on short-term disability.

Medicare. Coverage will start about two years after you have been on disability. When Medicare begins, Medigap coverage can be purchased to help pay for deductibles and co-pays that Medicare does not cover. There are also Medicare Advantage Plans that provide Medicare coverage along with prescription coverage.

 

Call Marsala Law Firm to learn more about legal and financial planning at (310) 237-3872.

An estimated 5.3 million Americans have Alzheimer’s disease—an irreversible, degenerative disorder of the brain that affects problem-solving abilities, behavior and speech. It is typically associated with old age, and many of us have older family members who have been affected. As baby boomers age, the number of Alzheimer’s victims is expected to increase.

But approximately 200,000 of those diagnosed with Alzheimer’s are under age 65. Known as early-onset Alzheimer’s, the disease can even strike people in their 30s or 40s—at a time when they are beginning to build their careers, their savings and their families, and are least likely to have the financial and emotional abilities to cope.

A diagnosis of early-onset Alzheimer’s can be devastating. The person with Alzheimer’s will become unable to work. The spouse often has to work less or even stop working to become the caregiver. Savings can be wiped out quickly. With an average life expectancy of just 8-10 years after diagnosis, dreams of a long life together fade as the Alzheimer’s patient slips away.

Early-onset Alzheimer’s is difficult to diagnose, primarily because it is not expected at such a young age. And because it progresses gradually, it is often confused with other conditions. It’s easy to blame stress, depression and menopause (in women) for early symptoms, which can include fatigue, disorientation, not being able to find the right words, inability to focus and engage, and forgetfulness. Practically everyone has forgotten where we put something or why we came into a room, and we don’t give these lapses much thought. Medications, a brain tumor, even a urinary tract infection, can cause similar symptoms.

Often, co-workers may be the first ones to spot that something is truly wrong. Reports and tasks that were routine may become extremely difficult, take much longer and/or have errors. At the same time, it’s important not to assume that these changes in performance mean that someone has Alzheimer’s.

That’s why it’s important to get the proper testing. Early-onset Alzheimer’s often has a genetic component, with several members of the same family having it. Cognitive testing is also recommended. Ultimately, it may take a brain scan to confirm the diagnosis.

While there are no cures yet, there are medications that can slow the progression of Alzheimer’s, but they need to be taken early to be most effective. That’s another incentive to have the testing done as soon as you suspect something may be wrong.

Click here for Early Signs of Alzheimer’s Disease.

Marsala Law Firm works closely with the local Alzheimer’s organizations, and can not only give you direction on where to get help, but also on ensuring your legal and financial plans are in place.  Call now at (310) 237-3872.

Americans are getting older, and most want to stay in their homes and communities as they age. As a result, many homeowners are taking steps to modify their homes so they will be able to safely and comfortably remain in their homes for as long as possible. This is called “aging in place.”

With the average annual cost of assisted living at $43,200 and nursing home care at $80,300 you will likely save money over the long run by investing in aging-in-place home improvements. Also, if you have long-term care insurance, it may help cover some of the costs.

Here are some of the most popular home improvements to consider if aging in place is important for you or a parent. You’ll notice that many are designed to help prevent the risk of falls, which dramatically increases with age.

 

In the bathroom:

• Install a shower with a zero threshold entry (no curb) to minimize tripping and to make accessible for a wheelchair.
• Add a shower chair (for those not in a wheelchair) and a hand-held showerhead.
• A comfort-height toilet (17-19 inches off the ground) will make getting on and off easier. (You can also buy a toilet seat extender, which sits on top of the existing toilet seat.)
• Install grab bars near the toilet and in the shower.

 

In the kitchen:

• Create counters at multiple heights to have the option to sit or stand when preparing meals.
• Install an under-the-counter microwave instead of one overhead.
• Add pull-out shelves in cabinets.

 

Throughout the home:

• Install nonslip floors, such as textured stone or linoleum.
• Increase lighting.
• Install remote controls for lights and window coverings.
• Lower electrical switches and raise outlets.
• Change doorknobs to lever-style handles and cabinet knobs to handles.
• Move the master bedroom to the first floor and install a bathroom if necessary.
• Add a ramp to the entrance and widen hallways/doorways to accommodate a wheelchair.

Many of these options, and more, are thoughtfully being included in new construction for those who want to purchase aging-in-place-ready homes. Custom homes being built for some of our disabled veterans are filled with innovative ideas. You can also consult a design or home improvement specialist who has experience with aging-in-place features.

 

Call Marsala Law Firm for your FREE life planning consultation.

How to Take Care of Yourself as You Take Care of Others

Raising your kids, working, trying to take care of yourself, and now caring for an aging parent? That makes you part of the Sandwich Generation. You are not alone—almost half of America’s 40- and 50-year olds are in the same boat.

Most of us have adjusted to balancing children, work and finding some time for ourselves. But when we add caring for an aging parent, it often becomes too much. And usually it’s the “me” part that is sacrificed…until you hit burn out.

Here are some ways to leverage your time and resources so you can also take care of yourself.

Enlist Your Kids

Even the smallest child can spend charming one-on-one time with a grandparent. If your parent lives with or near you, they can spend time together in person. If your parent is not near you, they can Skype on the computer, use FaceTime or play multi-player online games. Your children, no matter what their ages, will benefit from spending time with Grandma or Grandpa, they will see how you value and care for aging family members—and you will get some extra time to return phone calls, make dinner, or even catch a quick nap!

Ask About Options at Work

Check with your employer’s human resources department about resources that might be available to you. Depending on how long you expect to be caring for your parent, there may be a multitude of options available to you, including elder care research and referral services, flex time, even working from home options. The Family and Medical Leave Act (FMLA) calls for eligible employees to receive 12 weeks of unpaid job-protected leave. (Private employers with less than 50 employees are exempt.)

Seek Assistance

There are legal and community resources that can help you make the best care and financial decisions for your parent. A local Elder Care attorney such as the Marsala Law Firm can prepare the necessary legal documents and help you maximize your parent’s income, long-term care insurance and retirement savings, and qualify for VA or Medi-Cal benefits, if applicable. He/she will also be familiar with various living communities in the area and in-home care agencies. You can also hire someone to review and verify/dispute insurance claims and medical billing.

Find Your “Me” Time

Stress is your biggest enemy and you have to find ways to reduce it. Joining a caregiver group, in person or online, will let you share your questions and frustrations, and learn how other caregivers are coping. Don’t be afraid to ask favors of friends and other relatives, such as picking up your kids while you go to the doctor with your parent. You could also learn to order in dinner every now and then without feeling guilty. Learn what you need to maintain your stamina, energy and positive outlook. That may include regular exercise (a yoga class, walk or run), a weekly outing with friends, or time to read or simply watch TV.

The Unpopular Topic of Discussion Every Family Needs to Have

Just bringing up the possibility of someone in your family becoming mentally or physically incapacitated is often difficult. We tend to think of only the very elderly needing long-term, hands-on care, but a recent report by the Alzheimer’s Association found that one in nine Americans age 65 or older currently have Alzheimer’s. With the baby boom generation aging and people living longer, that number may nearly triple by 2050. Dementia isn’t the only reason for long-term care, of course, but almost everyone knows someone already affected by it.

 

Waiting too late to plan can throw a family into confusion about what the Mom or Dad would want, what options are available, and what resources can help pay for care. Rushed decisions are often the most costly. Having the courage to discuss the possibility of incapacity now can go a long way toward being prepared should that time come. By the way, because anyone can become incapacitated at any time due to illness or accident, the entire family would benefit from planning for every family member.

 

Planning/Discussion Considerations

Care Options: Depending on the type and expected duration of care needed, options range from in-home care to adult daycare to assisted living facilities to nursing homes. Assistance with activities of daily living (ADL), which include eating, bathing and dressing, are generally not covered by health insurance. Professional care can be expensive; the national average for basic assisted living services is now about $42,000 per year. Care for those with dementia can last longer and cost more. Family caregivers, who provide the bulk of in-home care, are often unpaid, and the emotional and financial tolls can be considerable. Your discussions need to realistically consider family finances and circumstances.

 

Finances: Where will the money come from to pay these expenses? What resources will be available? Health insurance does not cover assisted living/nursing home facilities or help with ADLs. Medicare covers some in-home health care and a limited number of days of skilled nursing home care, but not long-term care. Medicaid, which does cover long-term care, was designed for the indigent; to qualify, the person’s assets must be spent down to almost nothing. VA benefits for Aid & Attendance may be available for veterans and their spouses. If there are significant assets, you can self-insure and pay the costs as you go. Home equity and retirement savings can also be a source of funds. If you want to protect these assets for your family, long-term health insurance may be an option. (Premiums are much lower when you are younger.)

 

Documents: Everyone over the age of 18 needs basic legal documents. These include an advance health directive or healthcare power of attorney (legally appointing another person to make healthcare decisions for you if you cannot make them yourself); a durable financial power of attorney (legally appointing another person to make financial decisions for you if you cannot make them yourself); and a trust and/or will.

 

Having the Discussion: Your parents may be harboring secret fears about what will happen to them if they need long-term care. Talking about this honestly, listening to their fears and desires, and putting a plan in place before it is needed can help reassure them (and you). If you want to talk to your children, reassure them that you are just being realistic. Starting with a story about someone you know or an article you read can be a good way to break the ice.

 

How to Get Help: An attorney who specializes in Elder Law has already helped many families in these same situations, and will be able to make recommendations that will save you considerable time, money, and stress. He/she can also work with other advisors (financial/investment, insurance, CPA, etc.) to help put together the best plan for your family’s circumstances.

 

Contact us today or a life planning session.

If you were involved in a serious accident and was unable to answer questions, how would emergency personnel know your essential medical information such as allergies or health care directives?

One of the first places emergency personnel will look at is your smart phone.

It takes only a couple of minutes to add the right information to your phone so emergency personal know who to contact.

Add an ICE Contact – “In Case of Emergency”

Add an emergency contact in your phone named “ICE” which stands for “In Case of Emergency.”

The Name field should only say “ICE”.  Don’t add the name of your emergency contact in the Name field. You can add the name of your emergency contact in the Company field.

In the Notes section, you can add other essential information such as your medical condition, allergies, medication, blood type, and anything else you believe emergency personnel should know while treating you. You can add any information someone needs to know in order to give you the appropriate care in case of an emergency.

 

 

 

 

 

 

 

However, if you lock your smart phone, emergency personnel will not have access to your contacts.  There are 2 solutions to this problem:

1. Download an app that allows access to information while your phone is locked; or
2. Change your locked screen wallpaper to a picture with your ICE information.

Heath App on iPhone

If you own an iPhone, the Health App has a Medical ID feature that allows access to critical information while your iPhone is locked.

When you open the Health App, it will bring you to the Dashboard.  Click on the Medical ID link on the bottom right hand side.

 

Then you can add the relevant information in the Medical ID screen, including your emergency contacts, medical conditions, allergies, medications, and other notes.

 

 

 

 

 

 

 

 

 

 

Make sure the Show When Locked is enabled so emergency personnel can access the information.

To reach the Medical ID information from a locked phone, the emergency personnel would click on “Emergency” from the locked screen, then on “Medical ID.”

   

 

 

 

 

 

 

 

 

 

 

Smart tip:

If you are having trouble adding a particular contact as an emergency contact in the Health App:

1.       Double check that the emergency contact is added as a contact first before designating as an emergency contact.

2.       If the contact is grayed out and is not available to be selected from the Health App, try editing the contact to unlink any social media accounts. 

The holiday season is the time that families gather together, often from long distances. If you haven’t seen your parents in a while, you may notice they are aging more than you remembered. Here are some things to watch for the next time you visit.

Physical Appearance: Is your parent clean and presentable? Not keeping up with daily routines could be a result of physical, mental, or emotional decline. Do you notice any weight loss? Cooking may have become difficult. Also, some medications can affect taste and cause a lack of appetite. Pay attention to how your parent walks. Is balance or gait a problem? Unsteadiness can increase the risk of falling, which can result in serious injury.

Home Environment: If your parent has always maintained the yard, home repairs, a clean house and paid bills on time, a neglected yard or repairs, a cluttered or dirty house, or stack of unpaid bills could be clues that things are not quite right. Is your parent able to handle their medications? Should they be driving?

Memory Loss: Everyone loses their keys or forgets things occasionally. But having trouble with common words, getting lost in a familiar neighborhood, or not being able to follow directions could be indications of something serious. By the way, it’s not always dementia—a urinary tract infection that can be cured with antibiotics, other medical issue, or even a medication can often present with memory loss or confusion.

Emotional Well-Being: Watch for signs of depression, including withdrawal from social activities, changes in sleep patterns, or loss of interest in hobbies.

What can you do?

1. If you see things that concern you, talk to your parent. Have an honest conversation about what you are noticing and see if they are aware of any changes.
2. Encourage regular medical check-ups and possibly a medical assessment. You may want to go with your parent and discuss results and suggestions with the doctor.
3. Address any safety issues and prioritize a to-do list. Simple things like adding non-slip pads under rugs or installing handicap bars in a bathroom can prevent falls. Medic alert systems are also valuable.
4. Identify all available resources. (Also see #6 below.) Maybe you need to hire a housekeeper, someone to run errands, or a home health aide.
5. If you have siblings, involve them if possible.
6. Make a list of medications, doctors, and medical issues.
7. Make sure your parent has all appropriate legal documents, including financial and healthcare powers of attorney and estate planning documents. An Elder Law attorney can be a valuable resource as she has walked this road before with other families, and can help with securing benefits from the VA and Medi-Cal, if applicable.
8. Long-term care insurance can help preserve your parents’ finances and yours. But don’t wait too long; your parent could become uninsurable.

Above all, you want your parent to have as much independence and participation as possible. Be reassuring in what can be a scary time for many people. Remind them that you care about them and want them to be happy, healthy and safe—now and as far into the future as possible.

Our firm is committed to helping families navigate the scary, sometimes confusing maze of long term care.  Please contact us if you would like to discuss your particular situation.

There is no formal area of practice called “life planning.” So why do I call myself a life planning attorney? What services do I provide, and how are my services different from what other attorneys provide?

A life planning attorney evaluates your current financial and legal status, and analyzes potential problems that may arise in the future. A life planning attorney will create a customized “life plan” that addresses those future problems.

When I decided to start my own law practice, I struggled with how to describe my services to others. I knew that I wanted to educate and advise clients on legal strategies to not only avoid litigation, but also on how to use their assets to the fullest extent to live the life they desire.

Generally, my “formal” areas of practice are estate planning and elder law.  I am also familiar with other areas of practice such as unlawful detainers, civil litigation, etc. By pigeon-holing myself into one area of practice, it was difficult to explain how my approach differed from other attorneys because everyone had a preconceived notion of each area of practice.

My goal is to help clients celebrate life. Hence, life planning.

Life planning is a holistic approach

I provide a holistic view on what steps a client should take in order to achieve their short and long term goals. Clients are encouraged to discuss anything with me during the initial consultation and planning meeting, even if seems to be unrelated to the services I am currently providing. Through an open dialog, we can analyze all the potential areas that a client needs legal help.

For example, Bob needs help trying to how to pay for long term care for his mother. His mother became incapacitated due to dementia but Bob can’t care for her at home anymore. Further, he would like to save his mother’s house since it was the family home and his sister and her family is living there.  A life plan for Bob would filing a conservatorship action for his mother, exploring whether she needs to apply for Medi-Cal to pay for long term care, arranging for a backup caregiver for his mother should Bob be become incapacitated, evaluating how the family home can be protected in a fair manner, and preparing estate planning documents for Bob.  Also, since Bob owns a small business, a life plan would also examine his business policies and procedures to ensure he is protected from liability.

Further, I encourage my clients to keep in touch with me so we can update their life plan as needed.  Otherwise, a carefully thought-out life plan may become useless.

A life plan must cost more, right?

A life plan doesn’t cost more. I don’t charge a premium for clients who say they specifically want a life plan over those clients who come in for a limited purpose.

Life planning is my style, my approach. A life plan is merely a my way of evaluating what services you may want to consider have done; every attorney does this to some extent as part of the consultation. A life plan may simply be guidance for you to do certain tasks on your own, in essence giving you control over what you pay for. A life plan differs from what many other attorneys do because it indicates my ongoing commitment to you to ensure that your needs are being met.

Whenever possible, any services I provide are billed on a flat fee basis so you are clear on the fees and costs for the scope of services provided. In addition, I offer free initial telephone consultations so we can evaluate whether we would work well together. I offer flexible meeting times, and am willing to travel to you (within reason).

If you decided to proceed, you’ll find that my fees are highly competitive and you get more value for your money.