Wills, Trusts & Estates Prof Blog

Editor: Gerry W. Beyer
Texas Tech Univ. School of Law

Friday, May 26, 2017

Walking May Help with Dementia

Brain A new study indicates that exercise may bolster the brain function and thinking skills of people afflicted with a certain type of dementia. Vascular cognitive impairment, the second most frequent form of dementia after Alzheimer’s disease, is caused by decreased blood flow to the brain. The condition typically stems from damaged blood vessels and is associated with high blood pressure and heart disease.

In the early stages of the disease, the brain begins to function less efficiently. Areas of the brain associated with memory, attention, and decision-making show increased levels of neural activity. The damaged brain is being forced to work harder when dealing with routine processes relative to a normal, healthy brain. Researchers at the University of British Columbia decided to see if moderate exercise might potentially alleviate these symptoms. The researchers divided previously sedentary volunteers afflicted with the disease into two groups: a group that would begin working out for one hour at the lab three times a week, and another that would remain inactive.

At the end of six months, members of the exercise group showed less activation in the portions of their brains required for attention and rapid decision-making than did the control group. While the differences were subtle, the results of the study were encouraging.

See Gretchen Reynolds, A 1-Hour Walk, 3 Times a Week, Has Benefits for Dementia, N.Y. Times, May 24, 2017.

Special thanks to Lewis Saret (Attorney, Washington, D.C.) for bringing this article to my attention.  

May 26, 2017 in Current Events, Elder Law, Science | Permalink | Comments (0)

Wednesday, May 24, 2017

Aging Spaces

Old-man-walker-raising-his-hands-full-length-portrait-isolated-white-background-38695234Ernie MacNeill, a longtime contractor and a Certified Aging in Place Specialist (CAPS), points out problem spots as he tours Elliot Goldberg’s home. MacNeill makes note of carpet that needs to be taken up to remove it a possible tripping hazard, doorways that need widening to possibly accommodate a wheelchair, and discusses moving a closet to make space for an electric lift. Goldberg, 71, has difficulty traversing the multi-storied space . Despite living in a three-floor, split-level home, memories of a deceased wife and family keep him from relocating. MacNeill, part of a growing group of specialists, focuses part of his practice on remodeling homes for aging homeowners that may have mobility and access issues.

There are currently around 3,500 CAPS graduates spanning across the country, but their dispersion is uneven and focused in large cities. While the need for such individuals may be growing, their relative scarcity leaves a gap that has been partially filled by occupational therapists. Though not performing the work of tearing down walls and ripping up carpet, these individuals make suggestions to clients to alleviate some of the common risks found in the home. These suggestions include installing bars in the tub, adding curbless showers, improving lighting, and installing stairless walkways.

While these solutions are practical and may potentially save trips to the emergency room, many of these changes come at a high price.  To counter this, some architects have proliferated the idea of a “universal design.” This would encompass some safety features, like a zero-step entrance, with a selling point considering not just the elderly but also the parent hauling twins with a stroller in tow. By incorporating these design features into new homes and scheduled remodels, contractors create a living space their clients can enjoy even as they age and become less mobile.

See Paula Span, Planning to Age in Place? Find a Contractor Now, N.Y. Times, May 19, 2017.

Special thanks to Lewis Saret (Attorney, Washington, D.C.) for bringing this article to my attention.  

May 24, 2017 in Current Affairs, Disability Planning - Property Management, Elder Law | Permalink | Comments (0)

Friday, May 19, 2017

Virtual Reality Helping Dementia Sufferers

4063D61E00000578-4510896-image-a-28_1494941292204The progression of dementia can be a slow and agonizing process for both those afflicted and for the people who love and care for them. Difficulty recalling precious memories is among the prominent and more terrible symptoms associated with this disorder. There is some new hope for individuals struggling with dementia, and it comes from an unexpected source. The Oculus Rift headset, a virtual reality system capable of immersing the user in a virtual world, has been integrated into a therapeutic package. The package includes a number of relaxing scenes ranging from beaches, to forests full of animals, to a view of Earth from space. The user maintains varying levels of control in each of the simulated scenes. The goal is to refresh the memories of dementia sufferers. Many who have used the headset recalled memories correlated to the scenes they were shown. The kit also includes a number of activity cards healthcare professionals may use in conjunction with the device that have specific questions used to pinpoint particular memories. While the system has shown some promise, it does not come cheap at a cost of just over $5,000.

See Shivali, Touching Moment a Virtual Reality Headset Helps Elderly People with Dementia Recall Precious Memories, Daily Mail, May 16, 2017.

May 19, 2017 in Current Events, Disability Planning - Health Care, Elder Law, Science, Technology | Permalink | Comments (0)

Tuesday, May 16, 2017

How Gene Testing Is Threatening Long-Term Care Insurance

Gene testingApproximately 5.5 million Americans have Alzheimer’s disease, making up half of all nursing home residents, but very few people have been tested for the ApoE4 gene. Last month, however, the gene testing company 23andMe started offering tests that reveal whether people carry the gene, while assessing their risks for developing certain conditions. Following the wave, other genetics companies are planning to offer similar tests, allowing many Americans to get a better grasp on their medical futures. Although a benefit to the American people, insurance companies selling long-term care insurance might experience a disaster, sending risky patients in search of policies and damaging an already fragile business. The potential impact of gene testing has the ability to increase adverse selection, which in turn could impact the availability and affordability of certain products.

See Gina Kolata, New Gene Tests Pose a Threat to Insurers, N.Y. Times, May 12, 2017.

Special thanks to Joel Dobris (Professor of Law, UC Davis School of Law) for bringing this article to my attention.

May 16, 2017 in Current Events, Disability Planning - Health Care, Elder Law, Estate Planning - Generally, Science, Technology | Permalink | Comments (0)

Friday, May 12, 2017

Let's Talk About Death

Bad at deathFor years now, the medical profession has left unanswered the question of what we should do when there is nothing left to do. Despite research recognizing that more care is not necessarily better care, many Americans still receive substantial doses of medicine in their final days. Specifically, 80% of patients say they would like to avoid hospitalization and intensive care at the end of their life, but in their last month, half of Medicare patients go to the emergency room, one-third are admitted to an intensive care unit, and one-fifth have surgery. Two inventions have shown to help patients live their final days according to their wishes: earlier conversations about their death goals and greater use of palliative care. Patients who implement advance care planning are more likely to have their wishes met, and family members are less likely to experience trauma from the death of a loved one.

See Dhruv Khullar, We’re Bad at Death. Can We Talk?, N.Y. Times, May 10, 2017.

Special thanks to Joel Dobris (Professor of Law, UC Davis School of Law) for bringing this article to my attention.

May 12, 2017 in Current Events, Disability Planning - Health Care, Elder Law, Estate Planning - Generally | Permalink | Comments (0)

Thursday, May 11, 2017

What Puts You at Risk for a Gray Divorce?

Gray-divorceRecent headlines about increasing gray divorces, or divorces among people fifty years old and up, are concerning, so what is behind this phenomenon? A sizable share of these gray divorces are found in couples who have been married for over thirty years, but in fact, divorce risk is not evenly transmitted among those aged fifty and older. And fortunately, the divorce rate for this age cohort is really not all that high. When determining the triggering events for these gray divorces, studies show that consistencies like couples who own property and have increased wealth are more likely to stay married. The studies also showed that gray divorce was more common among those who were remarried than first-time married couples. And even further, perhaps marital quality played a significant part in the likelihood of a gray divorce. Understanding these factors can help assess our chances of getting divorced and lead us to different solutions to help solve the increasing gray divorce rate and its consequences.

See Naomi Cahn & June Carbone, Who Is at Risk for a Gray Divorce? It Depends, Institute for Family Studies, May 1, 2017.

May 11, 2017 in Current Events, Elder Law, Estate Planning - Generally | Permalink | Comments (0)

Tuesday, May 9, 2017

Family Alleges that 95-Year-Old Was Swindled by Council on Aging Director

AmarAllegations of coercion and violations of state ethics rules are mounting at the East Baton Rouge Parish Council on Aging over a will written for 95-year-old Helen Plummer by Dorothy Jackson. The will reportedly favors the executive director at the Council on Aging, Tasha Clark Amar. Plummer began going to the Council on Aging two years prior to her death, sharing her legacy of laughter, claims her family. Unfortunately, Plummer’s family was unaware that a will was prepared for her during her time spent there, naming Amar as the executor and trustee of Plummer’s estate. The family is now alleging that Plummer was coerced into signing the will and its contents. Further, some critics are claiming that state ethics laws have been violated due to the business relationship between Amar and Plummer at the Council on Aging.

See Chris Nakamoto, Family Claims 95-Year-Old Swindled by Council on Aging Director, WBRZ 2, March 29, 2017.

Special thanks to Elizabeth Carter (A.N. Yiannopoulos Professor of Law, Louisiana State University) for bringing this article to my attention.  

May 9, 2017 in Current Events, Elder Law, Estate Planning - Generally, Trusts, Wills | Permalink | Comments (0)

Wednesday, May 3, 2017

Filial-Responsibility Laws Could Cost You

Filial responsibiltyFilial-responsibility laws exist in twenty-eight states and intend to hold family members financially responsible for other family members. For example, under these laws, children can be held responsible for their parents’ nursing home costs. For decades now, these laws have not been widely used because of programs like Social Security, Medicare, and Medicaid. However, as retirees are increasingly unable to pay their expenses, some providers are turning to filial-responsibility laws for debt payments. So, how can you avoid paying off your parents’ debt? A long-term care and estate plan will ensure sufficient funding is set aside to cover these end-of-life expenditures. Failing to plan for retirement cannot only impact your life but also the lives of your children.

See Jamie Hopkins, Family-Responsibility Laws Could Cost Your Clients, Barron’s, April 22, 2017.

Special thanks to Joel Dobris (Professor of Law, UC Davis School of Law) for bringing this article to my attention.

May 3, 2017 in Disability Planning - Health Care, Elder Law, Estate Planning - Generally | Permalink | Comments (0)

A Better Death

Better deathDeath was horrific and sudden many centuries ago, but today, dying has turned into a medical experience, specifically how, when, and where death happens has changed greatly over time. Approximately two-thirds of deaths happen in a hospital or nursing home, and nearly a third of Americans who die after sixty-five years of age will have spent some time in an intensive-care unit in their final three months. More importantly, these deaths do not seem to be what people want, as most Americans prefer to die at home. Further, these Americans want to die free of pain, at peace, and surrounded by loved ones. Too often, doctors are administering drastic treatment in spite of the patient’s dying wishes. Changes in physician-assisted suicide, palliative care, and the way doctors talk about death can help create a broad shift in the way health care systems deal with illness and death. After all, a better death means a better life.

See How to Have a Better Death, Economist, April 29, 2017.

Special thanks to Joel Dobris (Professor of Law, UC Davis School of Law) for bringing this article to my attention.

May 3, 2017 in Disability Planning - Health Care, Elder Law, Estate Planning - Generally, Science | Permalink | Comments (0)

Monday, April 24, 2017

Article on Legal Appearances of Dementia in Court Rulings

Dementia in courtIsrael Issi Doron, Perla Werner, Benny Spanier & Ori Lazar recently published an Article entitled, The Legal Appearances of Dementia in Court Rulings: Mapping the Terrain, 29 Int’l Psychogeriatrics 755 (2017). Provided below is an abstract of the Article:

Background: Individuals with dementia may appear before the court in different roles: as victims, as witnesses, and as those standing up for their rights. While there is growing interest in the rights of older persons with dementia, relatively little empirical data exists regarding their actual interactions in courts. Therefore, the goal of this study was to empirically map this legal terrain.

Methods: This study used a descriptive quantitative method. A computerized search of a national legal database limited to the period 2004-2014 and a screening process for the results were used to establish a sample of 280 court rulings that directly addressed dementia. All cases were analyzed and categorized into the following four criteria groups: characteristics of the person with dementia; characteristics of the legal procedure; the legal substance of the case; and the legal outcome.

Results: The majority of cases involved a single, very-elderly (i.e. over 80) woman, living in the community, with unspecified dementia. The majority of cases were heard and decided in lower level courts, addressing a broad range of primarily non-criminal legal issues. Finally, in the majority of non-criminal cases, the person with dementia was found to be legally capable, while in the majority of criminal cases, the person with dementia was found incapable.

Conclusions: The legal needs and rights of persons with dementia are much broader than issues of legal capacity or social protection. Deeper knowledge and more research is needed in order to fully understand the contexts in which dementia is constructed under the law.

April 24, 2017 in Articles, Elder Law, Estate Planning - Generally | Permalink | Comments (0)