Dementia

Ellen Goodman, Co-Founder and Director of The Conversation Project, says the primary reason people gave for not talking to their loved ones was "It’s too soon." But it’s always too soon … until it’s too late.

"In some recess of my mind, I still assumed that death came in the way we used to think of as 'natural.' I thought that doctors were the ones who would tell us what needed to be done. I was strangely unprepared, blindsided by the cascading number of decisions that fell to me in her last years. I had to say no to one procedure and yes to another, no to the bone marrow test, yes and yes again to antibiotics. How often I wished I could hear her voice in my ear telling me what she wanted. And what she didn’t want."

Read her New York Times blog post here... maybe it will help start your own conversation.

An Annals of Internal Medicine paper reports that the money needed to treat dementia in a patient’s final five years is greater than for heart disease and cancer. Take a look at this New York Times article by Gina Kolata.
 
Three diseases, leading killers of Americans, often involve long periods of decline before death. Two of them — heart disease and cancer — usually require expensive drugs, surgeries and hospitalizations. The third, dementia, has no effective treatments to slow its course.

So when a group of researchers asked which of these diseases involved the greatest health care costs in the last five years of life, the answer they found might seem surprising. The most expensive, by far, was dementia.

The study looked at patients on Medicare. The average total cost of care for a person with dementia over those five years was $287,038. For a patient who died of heart disease it was $175,136. For a cancer patient it was $173,383. Medicare paid almost the same amount for patients with each of those diseases — close to $100,000 — but dementia patients had many more expenses that were not covered.

On average, the out-of-pocket cost for a patient with dementia was $61,522 — more than 80 percent higher than the cost for someone with heart disease or cancer. The reason is that dementia patients need caregivers to watch them, help with basic activities like eating, dressing and bathing, and provide constant supervision to make sure they do not wander off or harm themselves. None of those costs were covered by Medicare.

"Everything gets complicated when a person has dementia," noted Dr. Christine K. Cassel, a geriatrician and chief executive of the National Quality Forum.

Maine Center for Elder Law attorneys have helped many seniors and their families with estate planning designed to fit each unique situation. We never know what life will bring our way, but we do know we can plan in advance--for everyone's sake.

Read more of the NYT article here.

91-year-old Real L'Heureux broke out of the dementia care facility he resides in to be with his girlfriend.

Maine Center for Elder Law attorney Barbara Schlichtman was interviewed for this recent Portland Press Herald story written by staff writer Matt Byrne. The story is a bittersweet one of aging, love and decision-making. The article brings up many important issues families have to consider when faced with a decline in a loved one's abilities. Senior's Daring Escape Raises Troubling Question.

There are various reasons why our elders are such easy prey for these thieves.  One root cause is isolation and loneliness, a fact of life for many seniors who are not closely monitored by loved ones.  A pleasant, slick professional calls on the phone in a friendly and engaging manner and traps the vulnerable elder with kind words, attention and a feeling of connection.  The thieves are trained and smart.  They smell the kill. They know exactly what to say to get the elder to trust them.

Another very important factor is diminished cognition in the elder.

Read full story, http://www.forbes.com/sites/carolynrosenblatt/2014/02/13/why-do-elderly-parents-fall-for-scams-that-seem-so-obvious-to-us/

We recommend this quilt because its textures seem to comfort people with fidgety hands.

Sensory Quilt is now on the market. It makes a great holiday gift or can be a tool used by caregivers to help soothe clients. For those of you who haven't seen it, the Sensory Quilt is a colorful, beautiful lap quilt with five different textures and various activities.

http://sensoryquilt.com/

The House passes a bill to deter assets exploitation as Maine prepares for a surge in its population of seniors.

L.D. 527, sponsored by Rep. Mark Dion, D-Portland, a former Cumberland County sheriff, was passed by the House on Tuesday. It now awaits votes in the Senate.

The bill would clarify state law to say that people with dementia and other cognitive impairments cannot consent to financially abusive conduct by caregivers that would be criminal without the consent.

In a state plan released last year, the Department of Health and Human Services said one in five Mainers older than 65 have been exploited financially by family members, caregivers or scammers.

Dion, who is now a lawyer, said that as a police investigator, he often walked away unsatisfied from unprovable cases involving elders. Often, many seniors couldn't "consent the way the general public understands consent," he said.

Full Story

Maine Association of Area Agencies on Aging offered testimony in support of LD 527, which would clarify state law to say that people with dementia and other cognitive impairments cannot consent to financially abusive conduct by caregivers that would be criminal without the consent.

http://www.maine4a.org/image_upload/LD527Testimony.pdf

The result is 10 items that mature drivers can look for when shopping for a new vehicle that will likely make their driving experience safer and less stressful.

"Our primary interest was equipping consumers to have this info so when they go shopping they can bring our list and talk to the salesman and use it in the decision-making process," Olshevski said.

While the list includes some technologies like lane-departure warning or parking assist systems that may only be available on more expensive vehicles, others are more common: electronic stability control is now mandatory for all passenger vehicles made after 2011.

http://www.latimes.com/business/autos/la-fi-mo-autos-hartford-10-technologies-mature-drivers-20121030,0,7744146.story

This video is created by the National Academy of Elder Law Attorneys and Stetson University College of Law, which offers a master's of law in Elder Law.  The video is targeted toward upcoming attorneys to explain "What is Elder Law?"  However, it is a good explanation of issues that an elder law attorney can address.

This video could also be useful for caregivers trying to decide what issues they face.  In our office, we often see adult children who want to take care of their parents, but don't know where to begin.  This video is a good resource.

http://player.vimeo.com/video/46297718

The clip shown on NPR's website is part of a documentary called Alive Inside, which follows social worker Dan Cohen as he creates personalized iPod playlists for people in elder care facilities, hoping to reconnect them with the music they love. Cohen tells NPR's Melissa Block that the video of Henry is a great example of the link between music and memory.

"He is able to actually answer questions and speak about his youth, and this is sort of the magic of music that's familiar for those with dementia," Cohen says. "Even though Alzheimer's and various forms of dementia will ravage many parts of the brain, long-term memory of music from when one was young remains very often. So if you tap that, you really get that kind of awakening response. It's pretty exciting to see."

http://www.npr.org/2012/04/18/150891711/for-elders-with-dementia-music-sparks-great-awakenings

Larry King talks to HLN's Dr. Drew Pinsky about his special "Unthinkable: the Alzheimer's Epidemic."

http://www.cnn.com/video/#/video/bestoftv/2011/04/29/drew.larry.king.int.hln?iref=allsearch