Wills, Trusts & Estates Prof Blog

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

Tuesday, February 5, 2019

Study Offers Hint of Hope for Staving Off Dementia in Some People

AlzA new study presents evidence that people with hypertension who received intensive treatment to lower their blood pressure were less likely than those receiving standard blood pressure treatment to develop minor memory and thinking problems. Often these type of problems develop into dementia and Alzheimer's disease later in life. This large study started in 2010 and involved over 9,000 racially and ethnically diverse patients, but all that had hypertension.

Though the study only showed these positive results in patients age 50 or older who had elevated blood pressure and who did not have diabetes or a history of stroke, this actually extends to a large number of people. 75% of people over 65 have hypertension. Dr. Kristine Yaffe, a professor of psychiatry and neurology at University of California San Francisco, said “I think it actually is very exciting because it tells us that by improving vascular health in a comprehensive way, we could actually have an effect on brain health.” Dr. Yaffe did not participate in the study.

The main goal of the study was to determine how much lower blood pressure levels would decrease with intensive treatment rather than standard treatment. The cognitive arm of the study continued to follow the participants for three more years. Those in the intensively treated group had a 19% lower risk of mild cognitive impairment. Because dementia may develop over many years, Alzheimer’s Association said it would fund two more years of the study.

See Pam Belluck, Study Offers Hint of Hope for Staving Off Dementia in Some People, New York Times, January 28, 2019.

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

February 5, 2019 in Current Affairs, Current Events, Disability Planning - Health Care, Elder Law, Estate Planning - Generally, Science | Permalink | Comments (0)

Wednesday, January 30, 2019

A Neuropsychologist’s Take on Mental Capacity Evaluation [California]

AlzJonathan Canick, Ph.D., who spoke last year at the Sacramento Estate Planning Council on the subject of “Aging, Cognition and Capacity," has practiced neuropsychology for over 30 years. He has assisted attorneys and family members when there is an issue of a person's mental and testamentary capacity, even when the assessment is performed posthumously.

Dr. Canick says that, contrary to popular belief, " significant changes in cognitive and mental functioning are not a normal part of aging." If a change or decline does occur, it usually involves the beginnings of a disorder or disease or other negative influence. Though instances of dementia increase once a person is past their seventh decade, it has been noted that those that live into their 90s do not suffer from major cognitive disorders. "Aging is not a neurodegenerative disease," and the ability to generate new brain cells and learn new things occur throughout a person's life.

The California Probate Code specifies that determination of mental capacity does not rest solely on a diagnosis, but on the amount of ability a person has for effective information processing. Thus, a person with a diagnosis of dementia or Alzheimer's may still retain testamentary capacity while a person without a diagnosis does not have that capacity. A neuropsychological evaluation can identify deficits and strengths in mental functioning and helps determine whether a person has or lacks sufficient cognitive function to perform a given act.

See Jeffrey S. Galvin, A Neuropsychologist’s Take on Mental Capacity Evaluation, Trust on Trial, January 22, 2019.

Special thanks to Jim Hillhouse (Professional Legal Marketing (PLM, Inc.) for bringing this article to my attention.

January 30, 2019 in Current Affairs, Elder Law, Estate Planning - Generally, Science, Trusts, Wills | Permalink | Comments (0)

Tuesday, January 29, 2019

Ashes to Diamonds: Austin Startup Finds Unusual Way to Remember Loved Ones

DiamondAdelle Archer, along with co-founder Garrett Ozar, founded Eterneva in 2017 in the capital of Texas, providing the service of using cremated ashes of a loved one to create a diamond. The company has made more than 200 diamonds from the remains of humans as well as pets, but when Florian Oger and his wife Renee Rouleau came in for their consultation, it was the first time to meet with the person who was requesting to be the diamond.

Oger had been diagnosed with terminal cancer and only had a few months to live. He wanted his ashes to be created into a diamond so that his wife could carry him with her on her adventures.

The company allows personalization of the diamonds with color choices. Oger chose black for his son and green for his daughter as those were his race car colors, and his wife also chose green but because she characterized his as "a green type of guy."

The diamonds offered can range from $2,400 to $20,000, and Archer said that the average customer usually designs a diamond that is around $9,000. With cremations becoming more and more utilized, this could serve as a more personal and tangible memory of a loved one instead of an urn next to the fireplace.

See Nicole Cobler, Ashes to Diamonds: Austin Startup Finds Unusual Way to Remember Loved Ones, Statesman, January 25, 2019.

Special thanks to Joseph C. Gagen (Austin, Texas Attorney) for bringing this article to my attention.

January 29, 2019 in Current Affairs, Death Event Planning, Estate Planning - Generally, Science | Permalink | Comments (0)

Saturday, January 26, 2019

Why Long-Term Care Policy Premiums are Rising so Sharply

LongtermcareConsumers around the country have seen steep increases in their premiums on long-term care policies in recent years.  Regulators approved rate increases of 40% or more on about half the requests that insurers made according to a 2016 survey conducted by the consulting firm Milliman. A little more than a quarter of their requests secured premium increases of 20 to 39%. The 26 respondents of the survey had annual premiums that represented 73% of the long-term care industry.

Each state's agency of insurance regulators determines whether insurers can adjust and increase the premiums. Many agencies also govern whether the companies are entitled to a rate increase and it cannot merely to increase their profit margins. "An insurer must justify its request by identifying which of its original pricing assumptions were inaccurate, and by demonstrating how they developed the new premium based on revised projections," says California Department of Insurance spokesperson Allison Castro.

Castro explained that large increases are currently being allowed for insurers because where long-term care insurance was introduced in the 1990s, the companies looked at consumer behavior with other insurance products when predicting how many would purchase the plans and eventually make claims. These predictions ended up being far too optimistic according to Castro, and "most companies' long-term care rates were too low to keep up with the cost of claims that were made years later." Life expectancies are longer and claims are higher than expected, and the original assumptions can no longer keep up.

See Cathie Anderson, Why Long-Term Care Policy Premiums are Rising so Sharply, Sacramento Bee, January 24, 2019.

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

January 26, 2019 in Current Affairs, Disability Planning - Health Care, Elder Law, Estate Planning - Generally, Science | Permalink | Comments (0)

Tuesday, January 22, 2019

Could an Alzheimer's Vaccine be on the Horizon?

AdvaccineCompanies struggling to conquer Alzheimer's have been hindered by the side effects to patients even when there have been promising results. A start-up out of Dublin may be on the right path though they are hesitant to claim that they have solved the mystery of the disease.

United Neuroscience Inc. reports results from a small clinical, Phase II trial that show a 96% response from patients given the vaccine and without any serious side effects. The trial consisted of 42 individuals with mild cognitive impairments and believed to by in the early stages of Alzheimer's. The patients that were administered the vaccine currently called UB-311 by the company demonstrated improved brain function and showed a reduction in the protein plaque gumming up their neurons. Chief Executive Officer Mei Mei Hu says that there were improvements across the board compared to the placebo.

No one quite knows what causes Alzheimer's nor what exacerbates the disease, but the possible suspects are a couple families of proteins, amyloid and tau, that build up and then clump together and attack the brain. United’s vaccine stimulates the patient’s own immune system to attack amyloid, which many assume is the primary perpetrator. The vaccine's goal is to lessen and slow the clumping and possibly reverse some damage and restore brain function. 

The small number of participating patients may not allow United to draw any major statistical conclusions, the company is encourage enough to move forward with development of the vaccine, possibly with a larger partner, according to Hu.

See Ashlee Vance, United Neuroscience’s Alzheimer Vaccine Just Might Work, Bloomberg, January 16, 2019.

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

January 22, 2019 in Current Events, Elder Law, Estate Planning - Generally, Science, Technology | Permalink | Comments (0)

Thursday, January 10, 2019

Dementia May Never Improve, but Many Patients Still Can Learn

DementiaDr. Linda Clare, a clinical psychologist at the University of Exeter, directed a recent trial of cognitive rehabilitation in England and Wales. She has been studying cognitive rehabilitation and it evolved out of methods used for patients with brain injuries. The trial found that this therapy can help patients with dementia learn and preserve everyday tasks that they are struggling with.

Dr. Clare emphasizes that the therapy cannot reverse dementia and patients with not score higher on mental ability tests. But it can improve their capacity to perform the activities that they have decided will help them manage themselves. Those improvements persist over months, perhaps up to a year, even as participants’ cognition declines in other ways.

As pharmaceutical methods have failed, cognitive rehabilitation may be the future for many patients struggling with the illness. A smaller trial of cognitive rehab by Belgian researchers found that patients with early Alzheimer’s disease remained better able to do their chosen activities after a year. In the United States, Dr. Laura Gitlin, dean of the College of Nursing and Health Professions at Drexel University, has developed something called the Tailored Activity Program (T.A.P.). It is a similar therapy with the goal of reducing the troubling behaviors that can accompany dementia, such as repeated questions, wandering, rejecting assistance, verbal or physical aggression. A pilot study found that with T.A.P., the frequency of such behaviors decreased compared to a control group

See Paula Span, Dementia May Never Improve, but Many Patients Still Can Learn, New York Times, January 4, 2019.

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

January 10, 2019 in Current Affairs, Disability Planning - Health Care, Elder Law, Estate Planning - Generally, Science | Permalink | Comments (0)

Article on Digital Asset Planning for Minors

DigitalNatalie Banta & Naomi Cahn recently published an Article entitled, Digital Asset Planning for Minors, Wills, Trusts, & Estates Law eJournal (2018). Provided below is an abstract of the Article.

This article is one of the first to explore minors, digital assets, and estate planning. It argues that there are special considerations when it comes to minors and their control over their digital assets upon death or incapacity. First are issues concerning the capacity of minors. This is important in two contexts: the capacity of minors to execute a binding estate planning instrument and to enter into a contract with a service provider. Second, it observes that internet law does not treat all minors under the age of eighteen the same. The article offers guidance on how parents, children, and estate planners might approach digital asset planning.

January 10, 2019 in Articles, Current Affairs, Estate Planning - Generally, Science, Technology | Permalink | Comments (0)

Tuesday, December 11, 2018

Article on Sustainable Trusts and Estates and Real Property Practices

SustainableMary E. Vandenack recently published an Article entitled, Sustainable Trusts and Estates and Real Property Practices, Probate & Property Magazine, Vol. 32, No. 6, November/December 2018. Provided below is an abstract of the Article.

Many lawyers  are concerned with how their practices can remain relevant and profitable as the legal industry changes. There are many reasons for such concern. Although the legal industry is changing, it is possible to design a law firm that will sustain itself both today and in the future. To achieve such a solution requires mindful attention to the current state of one's law firm and the industry as a whole. In addition to changes in the industry, changes in the workforce must be considered.

December 11, 2018 in Articles, Current Affairs, Estate Planning - Generally, Science, Technology | Permalink | Comments (0)

Monday, December 10, 2018

Cancer and Marital Status: Singles may get Less Aggressive Treatment than Married People

PillsThough you may have heard that married adults are more likely to survive cancer than singles, there is an aspect of that that has yet to make headlines: patients with spouses are more likely to get surgery or radiotherapy treatment.

When determining treatment, patients are often asked if they have adult children or spouses to help them cope and manage the side effects. A review of 59 studies based on the Surveillance, Epidemiology, and End Results Program (SEER), maintained by the National Cancer Institute, covering over 7.3 patients with 28 different forms of cancer showed reported significant differences in treatment rates between married and unmarried patients.

Unmarried patients were more likely to refuse, but the proportion was small. Of 278,015 unmarried patients whose physicians recommended surgery, 1,441 refused. For radiation, it was 1,055 out of 79,303. Conspicuously absent from these studies is any analysis of the physician's role in recommending treatment.

Psychiatrist Jonathan Metzl, author of "Prozac on the Couch," says doctors view stereotyping "as bad, something we're supposed to eliminate." But judgements are inherent to human nature, and even doctors are humans. "Frame the discussion in terms of what the patient actually needs, rather than focusing on whether it's provided by people in specific roles," says Susan Brown, co-director of the National Center for Family & Marriage Research. "Our whole system is built around traditional family roles, and that doesn't work for many people."

See Joan DelFattore, Cancer and Marital Status: Singles may get Less Aggressive Treatment than Married People, Chicago Tribune, December 3, 2018.

Special thanks to Naomi Cahn (Harold H. Greene Professor of Law, George Washington University School of Law) for bringing this article to my attention.

December 10, 2018 in Current Affairs, Disability Planning - Health Care, Elder Law, Estate Planning - Generally, Science | Permalink | Comments (0)

Friday, December 7, 2018

The Cremated Remains of 100 People Have Been Launched into Space on a SpaceX Rocket

ElysiumThe cremated remained of 100 individuals were launched into space in a memorial satellite by the company Elysium Space. Based out if San Francisco, the company placed samples of each person's remains on the SpaceX Falcon 9 rocket for $2,500 each.

The remains of average citizens are joined by veterans and other aerospace enthusiasts who believed their loved ones would enjoy being "within the poetry of the starry sky," Elysium Spaces said in an emailed statement. The ashes, each in an individual capsule, were placed in a 4-inch square satellite called a cubeseat, which will orbit the Earth for 4 years before it inevitably falls back, according to Elysium Space Founder and CEO Thomas Civeit.  Sixty-four small satellites from thirty-four different companies were aboard the rocket, part of a rideshare mission organized by Spaceflight.

Families will be able to track the process of the satellite as it orbits the planet, knowing that their loved ones is above them in the stars.

See Dakin Andone, The Cremated Remains of 100 People Have Been Launched into Space on a SpaceX Rocket, CNN, December 3, 2018.

December 7, 2018 in Current Events, Death Event Planning, Estate Planning - Generally, Science, Technology | Permalink | Comments (0)