Three knowledgeable women outline problems and their possible solutions
What do I do if I or someone I love is diagnosed with Alzheimer’s Disease? How can I find help? Ann Carter, Southern Colorado Regional Director of the Alzheimer’s Association, set up a program to help with many questions that may come up and also volunteered her help by phone or internet later. Helping her were Attorney Myka Landry, who specializes in elder law, and Janine Pierce-Vasquez, Otero County Adult Services Director. Landry and Pierce-Vasquez also offered to follow up with questions a person may have later.
First of all, Carter made clear one should not hit the panic button when facing an Alzheimer’s diagnosis, whether for one’s self or one’s relative or friend. The main danger is loss of cognition, and that usually does not occur for a long time after the diagnosis. In fact, she emphasized the person with Alzheimer’s should be kept in the loop even after significant loss of cognition has occurred. “Involve the person in the conversation whenever possible,” said Carter. Even in advanced stages, cognition comes and goes. Landry said, “Take him to the doctor when he’s at his worst and to the lawyer when he’s at his best.” The doctor needs to know the worst and the lawyer needs the best cognition.
The five important documents everyone should have in place in case of death or incapacity are as follows: 1. Will or revokable trust, 2. General durable (financial) power of attorney, 3. Medical durable (Healthcare) power of attorney, 4. Living will (end of life declaration), 5. HIPAA release. Carter explained the power of attorney may or may not go to a close relative; make it someone whose judgment you trust. Also, designate one person as primary power of attorney and another as backup, not two with the same authority. The other most important item is the HIPAA release. Without it, your friend or relative or even another doctor will not be able to see your medical records.
“If you already have long term care insurance, good for you,” said Carter. But if you don’t, you need to explore your possibilities. It is best to do this with a counsellor - financial or legal. “This is not being fraudulent,” said Landry; “it is just making the best use of your assets.” Medicaid pays for long-term care; Medicare does not. In the case of a married couple, it is possible one spouse may be Medicaid-eligible even if the other is not.
Also, if you are the caretaker or the diagnosed, many items you may not have considered are tax-deductible - personal care items, home improvements, in-home care, nursing services, assisted living and nursing home care. If you are considering buying a long-term care policy, ask if Alzheimer’s disease is covered; it usually isn’t. Other questions should be - When can a person with dementia begin to collect benefits? What is the daily benefit? How long will benefits be paid, and is there a maximum lifetime payout? What kinds of care will the policy cover? Are there tax implications for receiving benefits?
A reverse mortgage may seem attractive, but there are pitfalls: eligibility for other government programs may be affected; closing costs and service fees can vary greatly; sole homeowners who stay in assisted living or a nursing home for over a year must repay the balance of the loan, which may result in loss of the home. When a person dies, the balance of the mortgage is due immediately.
“You can’t do it all by yourself,” said Carter. “Your relatives are your first line of defense. Don’t say, ‘I don’t want to be a burden to my children.’ Your children will be glad to help you.” Landry added, “My parents are living with us now, and it’s a joy to be able to help them.” Also, friends can help out. One man loved his Lion’s Club meetings, and a member came by and picked him up to go to the meeting, giving the caretaker a little rest, keeping her from having to drive him and also from having to wait through the meeting. “Mostly, friends just need to know something specific they can do to help you,” said Carter.
Janine Pearce-Vasquez told of the services available right here in Otero County. A service for driving you to out-of-town medical appointments is available. Sylvia Rocha, Kevin Jaramillo and others are available to help you with problems, or to help you fill out applications. To call Pearce-Vasquez, the number is 383-3166. Her office is on the ground floor of the Otero County Courthouse and the technicians work at the Third Street Extension Office. The Alzheimer’s Association 24/7 Helpline is 800.272.3900 and the Online Caregiver Center is at alz.org/care. The Alzheimer’s local group, directed by Leonard Vance, meets on the third Thursday of the month at the Woodruff Memorial Library meeting room at 3 - 4 p.m. Veterans and veterans’ wives have special perks. Check with Veterans Service Officer Jay Scott at 383-3148. “We can’t fix it, but we can make the journey easier,” said Ann Carter.