Will New Tool Help Dementia Patients and Their Doctors?

A new tool may help doctors predict life expectancy with dementia to enable patients and families to make important, informed decisions on long term care.

Researchers think that a new tool for dementia patients could help these individuals, as well as their care providers better communicate about the disease and risk of death and develop future care plans as it progresses by predicting life expectancy with dementia.

Dementia is a non-specific clinical syndrome that involves cognitive impairments with the level of severity to interfere with social or occupational functioning.  The disease involves at least two areas of affected cognition – memory, language, reasoning, attention, perception, or problem solving.  Memory loss by itself isn’t necessarily dementia, because there can be many causes of memory loss. Some of the most common types of dementia are Alzheimer’s disease, Lewy body dementia, frontotemporal dementia and vascular dementia.  Dementia may require substantial long term care, and life expectancy with dementia would be helpful for families to plan appropriately.  See here for more details.  https://galligan-law.com/elder-law-questions/

McKnight’s Long-Term Care News’ recent article entitled “New tool predicts life expectancy of dementia patients” reports that almost half (48%) of residents in nursing homes have a diagnosis of Alzheimer’s disease or other dementias, according to data from the Centers for Disease Control and Prevention.

“In those cases, a tool like this can be an incentive to start such a conversation, which should be held before there are too many cognitive obstacles.” said Sara Garcia-Ptacek, a researcher at the Karolinska Institutet in Sweden.  She went on to note that this discussion could be about where someone would prefer to live, at home or in other accommodation, or anything else that needs planning.

The tool uses four characteristics to predict life expectancy: sex, age, cognitive ability and comorbidity factors.

In the intensive research, investigators tested the tool using data from more than 50,000 patients who were diagnosed with dementia between 2007 and 2015.  These researchers found that that the tool was able to predict three-year survival following a dementia diagnoses with “good accuracy.”  The new tool also found that patients who were older, male and had lower cognitive function at diagnoses were more likely to die during that time period.

Although dementia is always a difficult situation, both for the patient and the family, this tool predicting life expectancy with dementia will help everyone make more better, more informed decisions about long term care and caregiving.

Reference: McKnight’s Long-Term Care News (Jan. 26, 2020) “New tool predicts life expectancy of dementia patients”

 

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Elder Financial Abuse Is Increasing

A recent study shows elder financial abuse is rising in retirement planning. Working with trusted advisors, other professionals and family can help.

A September 2018 Forbes report said that elder financial abuse would only get worse as we age. With 10,000 people turning age 65 every day for the decade, the demographics include a growing pool of potentially fragile retirees and the elderly, many of whom are susceptible to financial exploitation.

alphabetastock.com’s recent article entitled “Elder Financial Abuse Is Rising” says that, although the criminals are out there, a lot of elder financial abuse actually begins in the retirement system, because individuals must accumulate and handle a large amount of money designed to last an entire lifetime. With $14.5 trillion in self-directed retirement accounts in the U.S., it’s a big, enticing target for financial predators.  This is on top of other forms of elder financial abuse that come from scams online, via phone calls or sometimes even from family.

Elder financial abuse includes all of the frauds and scams targeting seniors and because it’s a hidden crime, many victims opt not to report it. Those that do report the crimes, frequently don’t prosecute.

However, when it comes to trying to promote real changes that will provide some material protections, the investment, insurance, and financial services industries directly or indirectly have been showing some reticence about the potential compliance expense. Some of these companies are lobbying to maintain a status quo—one that’s on a course to see a steady rise in elder financial exploitation.

Many retirement investors think their professional financial advisors are fiduciaries who are legally bound to act in their best interests. However, that’s not always so. Many professional financial advisors need only adhere to a lower legal standard of behavior. They can’t outright tell you a lie—but they can make recommendations that don’t put the customer’s best interests as a top priority.

A GAO study found elder financial abuse to be a growing epidemic. Rather than being able to live out their golden years in safety and financial security, the lack of financial safeguards are leaving an entire (and growing) group of older Americans at risk. These seniors are often left on their own and confused as to how the advisors they entrusted with their financial security are permitted to make moves that are motivated by high commissions and self-interest. These so-called professionals aren’t required by the law to place interests of their clients ahead of their own.

Theft and illegal behavior is one small component of the elder financial exploitation. A bigger part comes from abusive financial practices, such as higher fees and complex and unsuitable advice and recommendations from professional financial advisors who aren’t fiduciaries.  It is helpful to occasionally have your financial picture reviewed by another advisor or your friends and family.  More eyes may reduce financial elder abuse.

Be sure that you are working with a financial professional who is trustworthy and has your best interests at heart.  At The Galligan Law Firm we have worked with many excellent advisors and would be happy to make a recommendation.

Reference: alphabetastock.com (January 11, 2020) “Elder Financial Abuse Is Rising”

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Choosing a Nursing Home

Choosing a nursing home is more than looking at the website and brochure, examine the data on the homes before you need them to find the right place for you.

Choosing a nursing home may be a daunting task, but the best time to shop for a nursing home is when you do not need one. If you wait until you can no longer safely or comfortably live on your own, you probably will not be in a position to do a lot of legwork to investigate facilities. Do your research well ahead of time, so you know the nursing homes in your area that provide high-quality care and, more importantly, the ones that have significant problems.

As AARP suggested in a recent article, you need to know how to spot problems at nursing homes when comparing and choosing a nursing home.  The marketing brochure, website and lobby might be lovely, but you should base your decision about a long term care facility on much more data than those things.  My article on what to look for at assisted living facilities may also be helpful: https://galligan-law.com/checklist-when-visiting-assisted-living-facilities/ Here are some tips on how to dig for possible issues and resources to review when choosing a nursing home.

  • Online search. Check out the facility’s website to get an overview of the services it offers and the industry affiliations or certifications it has. Look at the daily menus to see if the meals are nutritious and have enough variety. Most people would not enjoy eating the same main course two or three times a week. Look at the activities calendar to see if you would be happy with the planned social events. On some websites, you can view the floor plans of the resident rooms.
  • Ask your primary care doctor to name a few facilities he would recommend for his parents, and those where he would not want them to live.
  • Local Office on Aging location. Every state has an Office on Aging. Contact them to get as much information as you can about safety records, injuries, deaths, regulation violations and complaints about local facilities.
  • Your state’s Long-term Care Ombudsman (LCO). Every state also has an Ombudsman who investigates allegations against nursing homes and advocates for the residents. Your state LCO should have a wealth of information about the facilities in your area.
  • State Online Database or Reporting System. Some states have online databases or collect reports about nursing homes.
  • Medicare’s Nursing Home Compare website. Medicare maintains an online tool, Nursing Home Compare, that provides detailed information on nursing homes. Every nursing home that gets any funding from Medicare or Medicaid is in this database. You can enter the name of a specific nursing home or search for all the facilities in a city or zip code. The tool includes information about abuse at long-term care facilities. On the webpage, you can explore the Special Focus Facility section to find nursing homes with a history of problems.
  • Word of mouth. Ask your friends, relatives and neighbors to recommend a quality nursing home. Personal experience can be extremely valuable in this context.
  • Make a short list of the top candidates. After you collect as much information as you reasonably can, narrow your options down to four or five facilities that best meet your needs and preferences.
  • Visit your top choices. There is no substitute for going to a nursing home and checking it out in person. Pay attention to the cleanliness of the place throughout, not just in the lobby. Give the facility the “sniff” test. Determine whether they use products to mask unpleasant odors, instead of cleaning thoroughly. See whether the residents are well-groomed and wearing fresh, clean clothes. Observe the interaction of the staff with the residents. Notice whether people who need assistance at mealtime, get the help they need without having to wait.
  • Take online reviews with a grain of salt. Fake reviews are all over the internet. If you see a nursing home with only a few reviews, and they are all five stars, be skeptical.  But, hundreds of excellent reviews is a great sign.

Once you gather this information, you will be ready in the event you need to stay in a nursing home for a short recuperation from surgery or longer term.

References:

AARP. “Finding a Nursing Home: Don’t Wait Until You Need One to Do the Research.” (accessed December 5, 2019) https://www.aarp.org/caregiving/basics/info-2019/finding-a-nursing-home.html

CMS. “Find a nursing home.” (accessed December 5, 2019) https://www.medicare.gov/nursinghomecompare/search.html

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