An Often Misdiagnosed Dementia

Lewey body dementia is an often misdiagnosed dementia.
Lewey body dementia is an often misdiagnosed dementia.

Many people had never heard of Lewy body dementia until it was reported in 2014 that this was the disease that afflicted Robin Williams. While Lewy body dementia and Alzheimer’s disease are the two most common types of dementia, those who have Lewy body dementia are often misdiagnosed as having Alzheimer’s disease or depression. As a result, they do not get the treatment and support they need.

Considerable’s recent article entitled “The second most common type of dementia often goes unrecognized” reports that in one study, nearly 70% of people diagnosed with Lewy body dementia visited three consultants before receiving the diagnosis. For 33% of people with the disease, the dementia was misdiagnosed and getting the correct diagnosis took over two years.

There are two different conditions associated with Lewy body dementia: dementia with Lewy bodies and Parkinson’s disease dementia. In dementia with Lewy bodies, problems with memory and thinking occur simultaneously with problems involving movement, like those associated with Parkinson’s disease. In Parkinson’s disease dementia, a person who has had movement problems resembling Parkinson’s disease for several years, then develops difficulties with memory and thinking.

In addition to memory, thinking, and movement problems, symptoms of Lewy body dementia include issues with alertness and concentration, hallucinations and paranoia, acting out dreams during sleep, low blood pressure when standing, daytime sleepiness and depression.

Because the symptoms of Lewy body dementia often resemble other conditions, research reveals that the first diagnosis is commonly incorrect. For example, in one study 26% of people who had Lewy body dementia were misdiagnosed as having Alzheimer’s disease, and 24% were determined to have a psychiatric diagnosis like depression.

We saw this first hand at our firm when a family member was suffering with this kind of dementia. It went undiagnosed until it was too late to treat it properly. We feel it’s important to get the word out to family members who might think their loved one is suffering from depression, Parkinson’s disease, or another kind of dementia.

Failure to properly diagnose a person with Lewy body dementia can result in delay in treatment specifically targeted for that condition. Also, with the correct diagnosis, patients and families can seek out resources, such as the Lewy Body Dementia Association, an organization dedicated to helping people living with this disease. This group provides education on Lewy body dementia, helps patients and families know what to expect, connects patients and families to support and resources and helps them find research opportunities.

For more information on dementia issues see https://galligan-law.com/some-common-drugs-may-increase-risk-of-dementia/

Reference: Considerable (Aug. 14, 2020) “The second most common type of dementia often goes unrecognized”

Continue ReadingAn Often Misdiagnosed Dementia

Medicare Basics: What to Know

Many clients who are retiring or suffering job loss face key decisions about their healthcare. These Medicare basics will help make those decisions.

Medicare is a commonly misunderstood government benefit.  With so many baby-boomers retiring and especially with the impact of COVID-19 on the economy, many clients are faced with important decisions on their healthcare.  For that reason, I wanted to cover some Medicare basics to help readers understand these issues.

If you’re 65 or older and lose your job, you can keep your employer-based health insurance under a federal law known as COBRA. However, it also could be more expensive. In addition, COBRA coverage isn’t qualifying insurance in place of Medicare, and if you miss some deadlines for enrolling in Medicare without having the right coverage, you could pay life-lasting penalties, explains CNBC’s recent article entitled “What to know about getting Medicare if you are 65 or older and lost your job.”

Another critical Medicare basic is that Medicare isn’t free. However, if you find yourself currently with no employer-based insurance, it may be your best option. There are also ways to lower your costs, if your income has dropped a lot.

Provided that you have at least a 10-year work history, you’ll have no premiums to pay for Medicare Part A, which covers hospital stays, skilled nursing, hospice and certain home health services. If you don’t satisfy the eligibility requirements for it being premium-free, you could pay up to $458 per month for coverage. Either way, Part A’s deductible is $1,408 per benefit period, with some caps on benefits.

Part B covers outpatient care and medical supplies. It has a standard monthly premium of $144.60 in 2020, but higher earners pay more. There is also a $198 deductible in 2020. Once you meet the deductible, you’ll typically pay 20% of covered services. You are allowed eight months to sign up for Part B, once you lose workplace coverage.

You can get a standalone plan to have with original Medicare, or you can get an Advantage Plan (Part C). These plans are offered by private insurance companies and typically include prescription drug coverage. If you select this, your Parts A and B benefits will be delivered via the insurer offering the plan (which may or may not have a premium).

A Part D drug plan covers prescriptions. The average cost for this coverage in 2020 is roughly $42 a month, but high earners pay extra for their premiums. The maximum deductible for Part D is $435 in 2020.

If you already have Part A and are enrolling in Part B because of a job loss, there is a form that you and your ex-employer should complete to avoid late-enrollment penalties, by making certain that you had qualifying coverage during the period of time you were eligible for Part B but weren’t enrolled.

Another important issue of Medicare basics is what Medicare excludes from cover.  Consider how you’ll pay for items like dental work, routine vision, or hearing care. It also excludes long term care, cosmetic procedures and overseas medical care.  Clients often mistaken the skilled nursing facility rehab component of Medicare with long term care insurance, so see here for more detail on that.  https://galligan-law.com/long-term-care-whats-it-all-about/ 

Seniors frequently use original Medicare and a supplemental policy (“Medigap”) to help cover out-of-pocket costs, such as deductibles and coinsurance. Medigap policies are standardized, regardless of which insurance company sells them and your location. However, the premiums can differ from insurer to insurer and among locations. Therefore, it is critical that you know the differences you may see when evaluating your options. Look at a carrier’s premium rating system, its claims history and its customer service ratings.

If you go with an Advantage Plan, dental and vision coverage may be included. Note that these plans have their own copays, deductibles and out-of-pocket maximums.

Reference: CNBC (June 26, 2020) “What to know about getting Medicare if you are 65 or older and lost your job”

Continue ReadingMedicare Basics: What to Know

Long Term Care Costs Going Up Due to COVID-19?

Long term care costs are already expensive, but will likely increase due to costs from COVID-19. No one can predict how much, so it is better to plan now.

About 70% of seniors 65 and older will eventually require some type of long term care in their lifetimes. That care already isn’t cheap, but how will prices be affected by COVID-19?

Motley Fool’s recent article asks “Will COVID-19 Drive Up the Cost of Long-Term Care?” According to the article, unfortunately those figures may begin to look like a bargain in the coming years as facilities change their policies and long term care costs go up after COVID-19.

The impact of the coronavirus has been experienced throughout the country, but we all see that nursing homes are an especially hard hit. As of April 23, there were over 50,000 reported COVID-19 cases in long-term care facilities, according to the Kaiser Family Foundation, and to date there are well over 100,000. In six of the 23 states that are publicly reporting death rates (Delaware, Massachusetts, Oregon, Pennsylvania, Colorado, and Utah), deaths in long-term care facilities are at least half of all COVID-19-related fatalities.

Again as of April, COVID-19 has been detected in at least 4,000 long-term care facilities across the country and has caused more than 10,000 deaths among residents and staff members. As a result, nursing homes and other long term care facilities will most likely reconsider how they train and rotate staff and implement sanitary standards to avoid this from occurring again.

All of this is will likely come at a cost, and the question will be if that expense is passed on to seniors, who can hardly afford these facilities in the first place.  If so, long term care prices, already difficult for many to manage, will increase.

We can’t really predict if you’ll require long term care in the future and to what extent. We also don’t know how much long term care costs will go up in the coming years after COVID-19. However, you may be well served to purchase long term care insurance while young enough and healthy to qualify.  See here for more information.  https://galligan-law.com/when-should-i-consider-long-term-care-insurance/

The best time to apply is during your mid-50s, so that you aren’t paying those premiums for too many years. However, you’re also applying at a time when you’re relatively young and more apt to get a nice discount on your premiums based on your age and health. However, if you’re already past your mid-50s, you still should look at applying in your 60s, too, especially if your health is good.

Not all long term care policies are created equal. Different policies offer varying levels of coverage. Take the time to assess your financial resources, research the cost of long-term care in your area and determine the amount of coverage you think you’ll need.

If you don’t have a plan for the rising costs, then you’ll have to consider either private paying the higher rates, or seeking government benefits to cover the costs.  Time will tell what effect COVID-19 has on Medicaid.

Even if COVID-19 doesn’t directly mean big increases, the cost of long term care has already been increasing every year. The more financial protection you have, the less stress you and your family will have when you are older.

Reference: Motley Fool (May 5, 2020) “Will COVID-19 Drive Up the Cost of Long-Term Care?”

Continue ReadingLong Term Care Costs Going Up Due to COVID-19?