Are you concerned about Alzheimer's?

Alzheimer Patients Planning

Alzheimer’s disease is the most common cause of dementia among people age 65 and older. Dementia is the loss of memory, reason, judgment and language to such an extent that it interferes with a person’s daily life and activities. Following is a description of the physical effects of Alzheimer’s through its various stages, as well as advice on how you and your family can prepare for a future with Alzheimer’s.

If you would like to consult with an experienced Elder Law attorney regarding Alzheimer’s patient planning, please contact the Elder & Disability Law Center for a consultation.

Physical Effects of Alzheimer’s Disease

No one knows exactly what causes the Alzheimer’s disease process to begin or why some of the normal changes associated with aging become so much more extreme and destructive in patients with the disease. However, we do know what happens in the brain after Alzheimer’s takes hold, and about the physical and mental changes that occur over time. Although the course of Alzheimer’s is not the same in every patient, symptoms seem to develop over the same general stages.

Preclinical Alzheimer’s Disease

Regions of the hippocampus in the brain, which is essential to the formation of short- and long-term memories, begin to atrophy ten to twenty years before there are any visible signs and symptoms. Memory loss is generally the first visible sign.

Mild Alzheimer’s Disease

The disease begins to affect the cerebral cortex of the brain, memory loss continues and changes in other cognitive abilities emerge. Symptoms include:

• Memory loss
• Confusion about the location of familiar places
• Taking longer to accomplish normal daily tasks
• Trouble handling money and paying bills
• Poor judgment leading to bad decisions
• Loss of spontaneity and sense of initiative
• Mood and personality changes, increased anxiety

Moderate Alzheimer’s Disease

At this stage, the disease has spread to areas of the cerebral cortex of the brain that control language, reasoning, sensory processing and conscious thought. Symptoms include:

• Increasing memory loss and confusion
• Shortened attention span
• Problems recognizing friends and family members
• Difficulty with language; problems with reading, writing, working with numbers
• Difficulty organizing thoughts and thinking logically
• Inability to learn new things or to cope with new or unexpected situations
• Restlessness, agitation, anxiety, tearfulness, wandering (especially in the late afternoon or at night)
• Repetitive statements or movement, occasional muscle twitches
• Hallucinations, delusions, suspiciousness or paranoia, irritability
• Loss of impulse control (e.g., sloppy table manners, undressing at inappropriate times or places, or vulgar language)
• Perceptual-motor problems, such as trouble getting out of a chair or setting the table

Severe Alzheimer’s Disease

This is the last stage of Alzheimer’s. Patients cannot recognize family and loved ones or communicate in any way. Other symptoms include:

• Weight loss
• Seizures, skin infections, difficulty swallowing
• Groaning, moaning or grunting
• Increased sleeping
• Lack of bladder and bowel control

Planning for the Future for You or Your Loved One

Are you concerned because you or a loved one is showing signs of Alzheimer’s disease? The early stages of Alzheimer’s can be a good time to prepare comprehensive estate documents in order to get all legal, financial and medical affairs in order before the disease progresses too far. There are several issues that you should consider as you plan for your or your loved one’s future.

First, it is important to get all of your affairs in order before you or your loved one no longer has legal capacity. You, or your loved one, have legal capacity when you are able to make a disposition of your property according to a rational plan based on your knowledge of who you want to receive your property and the nature and extent of that property. Capacity is only required at the time estate documents are executed, and does not require that you or your loved one be capable of managing all of his/her affairs or making day-to-day business transactions.

If you are worried about the onset of Alzheimer’s disease, or any form of dementia, meet with a lawyer soon so that you can make rational and informed decisions about the disposition of your property or that of a spouse, parent, child or grandparent.

The second issue concerns creating a durable power of attorney so that someone you trust will be in charge of your legal matters. You may also want to identify someone of your choice to designate as your guardian and conservator. A guardianship allows that person to in charge of your day-to-day personal care, and a conservatorship creates responsibility for the maintenance and management of your assets. As a final step, creating an Advance Medical Directive will ensure that your medical care complies with your wishes even when you are unable to vocalize those wishes.

Lastly, you will want to look into long-term care facilities to determine where you or your loved one will go when care at home becomes too difficult. In addition to choosing a facility, it will be important to determine how to finance your care. An Elder Law lawyer can help determine the best course of action, including effectively managing your assets for Medicaid Planning, Medicaid evaluations, and Medicaid applications.

The following tips can help you and your loved ones come to terms with a difficult disease:

1. Become informed: There are hundreds of good books and resources. See The 36-Hour Day: A Family Guide to Caring for Persons with Alzheimer’s disease, Related Dementing Illnesses, and Memory Loss in Later Life by Nancy L. Mace and Peter V. Rabins.
2. Contact the nearest chapter of the Alzheimer’s Association.
3. Consider joining a support group.
4. Discuss the situation and your feelings: Don’t hesitate to talk openly with your loved one about the situation, as well as your wishes for the future. Also discuss your feelings with other family members and friends who you can rely on for support.
5. Schedule a doctor’s appointment: When a loved one is experiencing memory loss, it is important to see a doctor sooner rather than later to get an accurate diagnosis and to obtain treatments that will delay some of the more severe symptoms.
6. Talk to your doctor about other matters: Discuss health care treatment wishes and end-of-life matters.
7. Meet with an experienced Elder Law attorney: It is important that the wishes of the patient be documented and that the proper planning is put into place. You may want to discuss advanced medical directives, powers of attorney, revising wills and trusts, changing property titles, strategies for asset transfers and financial or other gifts, and paying for long-term care.

An experienced Elder and Disability Law attorney can help you arrange your affairs and give you some peace of mind at a trying time. Contact the Elder & Disability Law Center for a consultation.