54 The QUEE NS Courier • health • july 7, 2016 for breaking news visit www.qns.com ▶health The Elder Law Minute TM Alzheimer’s Diagnosis? What to Do Now If a loved one has been diagnosed with Alzheimer’s Disease, one of the first steps to take is to contact an elder law attorney to initiate a plan. There are several essential documents to help handle a person’s affairs once he has become incapacitated, but if these documents are not already in place upon diagnosis, the plan should be implemented very shortly thereafter, while the individual has capacity. It is important to note that having dementia does not necessarily mean that an individual is not mentally competent to make planning decisions. The level of capacity a person must have to sign many estate planning documents is that of “testamentary capacity,” which simply means that he or she must understand what he/she is signing, and the implications of what is being signed. Simply having a form of mental illness or disease does not mean that a person automatically lacks the required mental capacity. As long as the individual has periods of lucidity, he or she may still be competent to sign planning documents. An individual’s capacity is determined on a case-by-case basis. The following are some essential documents for an individual recently diagnosed with dementia: • Power of Attorney. A power of attorney is the most important estate planning document for someone who has been diagnosed with Alzheimer’s or another form of dementia. A power of attorney allows an individual to appoint someone to make financial decisions on his/her behalf. Without a power of attorney, family members and loved ones may be unable to pay an individual’s bills, manage his household, or assist him in qualifying for government benefits such as Medicaid without going to court and petitioning for guardianship, which is a time-consuming and expensive process. • Health Care Proxy. A health care proxy allows a person to appoint someone else to act as his/her agent regarding medical decisions. This document will ensure that an individual’s specific medical treatment instructions are carried out. In general, a health care proxy takes effect only when someone requires medical intervention and a physician determines that the individual is unable to communicate his wishes concerning treatment. • Medical Directive or Living Will. Medical directives and living wills explain what type of care a person would like if her or she is unable to direct his/her own care. A medical eld er law directive can be included in a health care proxy or it can be a separate document. It may contain directions to refuse or remove life support in the event that the individual is in a coma or a vegetative state, or it may provide instructions to use all efforts available to keep the person alive no matter what the circumstances. • Wills and Trusts. In addition to making sure agents are appointed to act on behalf of an individual with a recent diagnosis of Alzheimer’s, and ensuring that the individual’s wishes are clear, it is important to make sure his estate plan is up to date. An estate plan directs who will receive a person’s property upon his passing and who will manage his affairs. Once a person is deemed incapacitated, he will no longer be able to create such a plan for himself. An estate plan usually consists of a will, and often a trust as well. A person’s last will and testament is his legally binding statement specifying who will receive his property upon his death, while a trust is a mechanism for passing on one’s property outside of the probate system. (There are various types of trusts, a discussion of which is beyond the scope of this article, but which will be addressed in future articles.) In addition to executing these documents, it is also imperative to create a plan for long-term care. Long-term care is expensive and can be both emotionally and financially draining for family members. Developing a plan now for the type of care an individual would prefer and the method of paying for such care will help that person’s family members later on. An elder care attorney should be contacted for assistance in developing an appropriate plan and for drafting the necessary documents. Ronald A. Fatoullah, Esq. is the principal of Ronald Fatoullah & Associates, a law firm that concentrates in elder law, estate planning, Medicaid planning, guardianships, estate administration, trusts, wills, and real estate. Eva Schwechter, J.D. .recently graduated from Hofstra University School of Law, where she was a member of the Hofstra Law Review. The law firm can be reached at 718-261- 1700, 516-466-4422, or toll free at 1-877-ELDERLAW or 1-877-ESTATES. Mr. Fatoullah is also the co-founder of JR Wealth Advisors, LLC. The wealth management firm can be reached at 516-466-3300 or 800-353-3775. ROnald Fatoullah, ESQ, CELA* KEEN-MINDEDNESS AND AGING Definition: keen-minded – “mentally alert” – (Merriam- Webster Dictionary) Why are some elderly people more keen-minded than others? In youth and middle age some people are more mentally alert and vigorous than others. Keen-mindedness tends to be habit forming: a combination of fortunate genetic endowment and a lifestyle that keeps the intellect well honed. Evidence suggests that those who start off with strong mental assets are more likely to preserve them throughout the total life span. It’s not just that their functioning remains relatively high because it started high, but it is also because the rate and amount of falling off appears to be smaller. In fact, studies of very bright people throughout their lives indicate that growth may continue indefinitely in some areas and show little if any decline in others. How we make use of what we have also seems to be important in the mental as well as physical sphere. The athlete who “goes to pot” can be compared with the intelligent person who does not discipline and develop his thoughts or gird himself to meet mental challenges. Attitude and expectation play important roles here. Our society usually calls upon children to live up to expectations. If we do not expect a person to keep up with current events, to make responsible decisions, to continue learning, to create and innovate, then why should he expect this of himself? The 80-year-old may have nourished for many decades the expectation that 80-yearolds do not think very well or enjoy life much. He becomes the victim of his own expectations. It is the rare individual who can transcend the climate of such attitudes. But there is no reason to suppose this effect starts in old age. How many people continue to expect creative thought from themselves and others in middle age? Cultural expectations do not ensure, however, that all people will continue to develop their mental resources throughout life, nor do they prevent some people from doing so even when expectations are negative. It is clear, however, that the quality and zest we bring to our mental life in old age has much to do with the climate of expectations. Quotable Quote: “The secret of genius is to carry the spirit of the child into old age, which means never losing your enthusiasm.” Sheldon Ornstein Ed.D, RN Dr. Sheldon Ornstein is a registered professional nurse with a doctoral degree in nursing organization. He has specialized in the care of older adults and has published many articles on the subject. He has done post-graduate work in gerontology and has taught at several universities. In 2013, he was inducted into the Nursing Hall of Fame at Teachers College, Columbia University.
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