Estate Planning Issues Affecting the Sandwich Generation

If you're a member of the Sandwich Generation, make sure your parents and adult children have the necessary estate planning documents in place.
If you’re a member of the Sandwich Generation, make sure your parents and adult children have the necessary estate planning documents in place.

July is National Sandwich Generation Month, a time to honor those who are caring for both their children and their aging parents. This is a particularly stressful time for members of the Sandwich Generation who may not only be parenting their children but also spending the last few months homeschooling them. Older children who have lost their jobs or were unable to return to college after spring break due to the coronavirus may now be living at home. At the same time, members of the Sandwich Generation may be acting as caregivers for parents who are no longer able to look after themselves, or who are at a higher risk for contracting COVID-19.

Some of the stress of caregiving can be alleviated by making sure your aging parents and adult children have legally valid and up-to-date estate planning documents in place, and if they do not, encouraging them to have these important documents prepared. This is a relatively simple step to ensure that there will be no delays or uncertainty if you have to take action in an emergency to make medical and financial decisions for them. If they have the necessary estate planning documents in place, you will have the peace of mind in knowing that you will be able to avoid delays when you need to act quickly to preserve their safety and well-being.

What estate planning documents should you have for any person in your care?

  • A financial power of attorney – This will allow you to pay bills, manage financial accounts, file tax returns, talk to insurance companies, deal with issues related to benefits, hire a caregiver, and sell property on behalf of your parents. A financial power of attorney is also helpful in the event you need to handle financial matters on behalf of your adult child (over the age of eighteen), for example, cashing a paycheck for your child or signing a new lease on your child’s behalf.
  • A medical power of attorney – A medical power of attorney enables you to make health care decisions for your parents, if they are unable to do so themselves.  A medical power of attorney is also important for your children who are 18 or older. Once your child reaches age 18, you no longer have the authority to make medical decisions for your child.
  • A HIPAA Authorization – The Health Information Portability and Accountability Act (HIPAA) requires medical records to be kept private unless an individual consents in writing to sharing of protected health information with a named individual. If you are your parents’ caregiver, they should fill out a HIPAA authorization permitting your parents’ health care providers to keep you informed about their medical conditions and treatments. You should also keep in mind that you are not authorized to receive any medical information regarding a child of yours who is 18 or older. If your adult child wishes you to be involved in his or her health care you need a HIPAA authorization signed by the child allowing you to receive his or her medical information.

It is crucial for your parents to put these estate planning documents in place before they develop any cognitive loss that would prevent them from having the capacity to sign a legal document. If they develop dementia, for example, and are not able to understand the objective or content of a power of attorney or other document, they will be legally unable to execute the document. In that case, you will have to go to a court and ask to be appointed your parents’ guardian to manage their health care and financial affairs.

It is also important that these documents be put in place by your adult child, regardless of any health conditions, because once your child is a legal adult, you can no longer automatically act on your child’s behalf. The worst case scenario is that your adult child is unconcious or in an accident and you are unable to quickly get information from your child’s health care providers.

Members of the Sandwich Generation do not always remember to take steps to lighten their load. But one important step that can make things easier for you as a caregiver is to make sure that your parents and adult children have the necessary estate planning documents in place so that you can quickly make decisions on their behalf if you are called upon to do so.

For more information see https://galligan-law.com/everyone-needs-an-estate-plan/

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Gene May Be a Link between Dementia and the Coronavirus

Is a gene the link between dementia and vulnerability to Covid-19?
Is a gene the link between dementia and vulnerability to Covid-19?

The study in Great Britain is the latest to suggest that genetics may play a part in why some people are more vulnerable to COVID-19 than others. It may also help to explain why people with dementia have been hard hit.

“It is not just age: this is an example of a specific gene variant causing vulnerability in some people,” said David Melzer, a professor of epidemiology and public health at Exeter University and a co-author of the study.

The Guardian’s recent article entitled “Research reveals gene role in both dementia and severe Covid-19” explains that the study published in the Journal of Gerontology: Medical Sciences reports how researchers analyzed data from the UK Biobank, where genetic and health data on 500,000 volunteers aged between 48 and 86 has been collected.

The researchers focused on a gene called ApoE which gives rise to proteins involved in carrying fats around the body and can exist in several forms. One such variant, called “e4”, is known to impact cholesterol levels and processes involved in inflammation, as well as increasing the risk of heart disease and dementia.

They found 9,022 of almost 383,000 Biobank participants of European ancestry studied had two copies of the e4 variant, while more than 223,000 had two copies of a variant called “e3”. The former have a risk of dementia up to 14 times greater than the latter.

The researchers then studied positive tests for COVID-19 between March 16 and April 26, when testing for the coronavirus was primarily done in hospitals, suggesting the cases were severe.

The results showed that 37 people who tested positive for COVID-19 had two copies of the e4 variant of ApoE, while 401 had two copies of the e3 variant. After considering factors such as age and sex, the researchers say people with two e4 variants had more than twice the risk of severe Covid-19 than those with two e3 variants.

One professor observed that it is possible that the role of ApoE in the immune system is important in the disease. Future research may be able to harness this to develop effective treatments.

You may also be interested in https://galligan-law.com/the-symptoms-of-early-onset-alzheimers-disease/.

Reference: The Guardian (May 26, 2020) “Research reveals gene role in both dementia and severe Covid-19”

 

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How Can Caregivers Find Time for Self-Care?

Family caregivers need to take time out for self care.
Family caregivers need to take time out for self care.

It’s not uncommon for a caregiver to start their journey in a crisis when a family member gets a devastating diagnosis—like Alzheimer’s, cancer, or heart disease—that causes physical or cognitive restrictions on independent daily living.

Considerable’s recent article entitled “How family caregivers can use a Monday routine to reinvent self-care” reports that more than 34 million Americans are caring for a loved one over the age of 50.

Although many caregivers take on their role willingly, they may be forfeiting much needed time for self-care. These sacrifices can accumulate over time, since most caregivers spend an average of four years and 80-160 hours a month in their caregiving role. For individuals taking care of a person with dementia or Alzheimer’s, it can be double that with additional stress.

Creating a routine can give calm to caregivers. A program that is based on a healthy weekly routine is Caregiver Monday, part of The Monday Campaign’s nonprofit public health initiative.

Most caregivers have their regular routines drastically changed, when caring for a family member, This gives caregivers a feeling of a loss of control. When added to the inability to control the disease or disability that impacts loved ones, caregivers can suddenly feel overwhelmed with increased anxiety and chronic stress. This psychological state is called loss of locus of control and has two paths: (i) internal locus of control; and (ii) external locus of control. Caregivers can’t gain external locus of control over the situation or disease, but they can increase internal locus of control—that’s the response they have to these situations. Creating a new routine is part of reestablishing internal locus of control.

A routine can help caregivers cope with change, focus on healthy habits and decrease their stress. It can also help restore balance in a caregiver’s life. Monday gives us a natural refresh point, because it’s part of our cultural DNA. Monday is the start of the work week and the school week, so it makes sense that caregivers can use Monday as the start of a sustainable effort towards improved self-care.

Caregiver Monday provides self-care practices and promotion, and focuses on physical, emotional and social health behavioral change, by helping caregivers commit to weekly efforts. A 2019 survey of 1,000 adult Americans conducted by Data Decisions Group for The Monday Campaigns found that 64% of respondents said if they begin on Monday with a positive frame of mind, they’re more apt to remain positive for the rest of the week. Those surveyed reported they were also more likely to start exercise routines, eat healthier and make doctor’s appointments on Mondays.

Here are three ideas to begin a Caregiver Monday routine. Instead of the Monday blues, caregivers can use Monday as their personal “Fun Day,” to focus on themselves. Caregivers can:

  • Follow Caregiver Monday on Facebook, Twitter, or Instagram for ideas every week on finding self-care practices.
  • Get involved with the caregiving community on these social sites to feel less alone.
  • Ask friends and family to assist with respite care to get a self-care break.

Even with the disruption and the distress, caregivers can use Monday to have a little fun. You can don your favorite color on Mondays or watch YouTube videos of baby animals (a scientific study shows that this can have a positive effect on mood and productivity). Most importantly, thank yourself with little self-care activities and be grateful you can be there for your family member every day.

For more information on issues of concern for the elderly see  https://galligan-law.com/elder-financial-abuse-is-increasing/.

Reference: Considerable (May 11, 2020) “How family caregivers can use a Monday routine to reinvent self-care”

 

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