1 mile west of the Chicago Premium Outlet Mall (800) 810 3100
After a long hiatus, we’re back to posting regularly on our blog!  We’ve been very busy over the past  year and can’t wait to share what we’ve been doing with our readers; but first, we want to share some important information about an issue that affects many of the clients who come into our office, and something we’d like to help prevent: When dementia hits the pocketbook.  We hope you find this information helpful, and please come back next week to read about the exciting things we’ve been doing in our firm and in the community! The first signs of Alzheimer’s or dementia are not always easy to see.  Families may go months or more before they realize that a loved one is forgetting a few too many things or confused about more than just the new DVD player.  One of the first signs of Alzheimer’s or dementia is also one of the most dangerous—a growing inability to understand and handle financial matters.  Elder care lawyers often hear stories that reveal that one of the first signs of dementia is an inability to understand money, personal finances, and contracts.  Client families need to take steps to protect the family finances when a loved one grows vulnerable to financial manipulation.  There is no legal standard for ‘vulnerability,’ but vulnerable individuals are easy prey for scam artists and just plain poor financial decision-making.  One novel idea used by a family to stop the loss of thousands of dollars being spent by a loved one to obtain supposed lottery “winnings” was to limit the affected person’s checking account balance.  In addition, family members actively created a lottery game to distract and amuse their loved one.  It worked! If family members live far away, some of the first people likely to notice these telltale signs of dementia are the senior’s own advisors—doctor, lawyer, or financial planner.  Unfortunately, these advisors often don’t always have the ability to take action.  Both doctors and lawyers, for example, are bound by patient or client privilege; even if they want to inform the family of their suspicions, they may not be able to.  Recent changes to Illinois State Bar Association Code of Ethics do allow an attorney to take action to protect a client when there is a reasonable belief that the client has become incapacitated and is in danger.  The American Medical Association also is not insensible to this issue, and has guidelines for dealing with patients who show signs of incapacity.  Unfortunately, doctors are under pressure to spend minimal amounts of time with patients.  Many people are able to ‘fake it’ during a short interview by doctors, lawyers, and financial advisors.  It is extremely important that the healthy spouse and/or responsible adult child get actively involved in pointing out to professionals any abnormal acts of vulnerability.  This may mean doing something that feels very uncomfortable, but is absolutely critical to get the protection needed.  No one will ever know what the family is seeing and experiencing at home unless you tell the story to your trusted advisors and friends.  It is dangerous to keep your fears a secret.  Almost everyone has a loved one who has been or will be affected by the progressive loss of decision-making capacity. What can families do to recognize the signs of dementia and prevent the financial fallout that often results?  First of all, it should be a topic of family conversation early and often, long before Mom or Dad is at risk.  Talk about the possibility and how it should be handled.  Geriatric care managers and elder care lawyers welcome input from the entire family of their clients.  Familiarity with the entire family gives more options if signs of dementia do start to appear, and an atmosphere of open communication can go a long way toward preventing suspicion and family fights later on.  Attorneys need to know who among the family the client believes are their ‘honest and reliable adult children’ who may be able to safeguard family finances and provide ongoing care and attention to the situation.  Care managers will recommend how best to combine family resources with professional services.  Experienced elder care attorneys and care managers can help the family to plan for future financial and health care needs.  Most families underestimate both the financial impact, emotional burden, and care needs that will be required due to the dementia of a beloved member of the family. Once a family has discussed options for the future and who might be the best person to take control of Mom or Dad’s finances in the event that they are unable, then an elder care attorney can assist them with the development of appropriate legal documents and Power of Attorney for financial decision-making.  These documents give a nominated agent the power to make financial decisions for the affected loved one.  The time to work on these plans is while the forgetful one still has sufficient capacity to make a Will, Trust, Power of Attorney for Health Care, Power of Attorney for Property, and any other estate protection plans.  Lawyers trained in this area of planning work to make sure that the healthy spouse is not excessively impoverished by long term care expenses. The onset of Alzheimer’s or dementia affects the entire family, and should be discussed as an entire family.

Law Elder Law, LLP, is a law firm focused on the issues of estate planning, long-term disability planning, veterans benefits, and Medicaid assistance. Our eighteen staff members are attorneys, paralegals, and other support personnel.  But oddly enough, our firm did not begin with a lawyer.  Rather, our firm began with a phone call from a woman named Luise May. Nine years ago, Luise May called me with panic in her voice, “Rick, Bob has been diagnosed with Alzheimer’s.  What are we going to do?  Am I going to lose my home? Are we going to lose everything?” At the time, I was a tax and real estate attorney; I didn’t have an answer for Luise. But Luise and her husband Bob had been friends for years, and I wanted to help her. “Luise,” I said, “I don’t know the answer to that, but I promise I will find out.” The problem was, I didn’t know where to start looking for answers. I wanted to make sure Luise and Bob wouldn’t lose their home, but I had never even heard of the term “elder law.” Fortunately, I discovered a capable attorney right in my home community who was doing work in what he called the Elder Law Center. I called him and told him Luise’s story, then asked if this Elder Law Center could help people in their situation. His answer was immediate; “Yes Rick, bring them on over.” We explained that Bob had recently been diagnosed as having some type of dementia, most likely Alzheimer’s. Steve (the capable attorney) reassured my friends that he would work to make sure they would keep their home and control of their assets.  He was not able to prevent them from having substantial costs related to long-term care, but they would not lose everything, as they feared. After the first meeting, I was stunned at the transformation in Bob and Luise.  They were exuberant. They were reassured that they would not lose their home, and in addition they had found a capable counselor to walk along beside them, serving as a guide as they moved further and further into the valley of shadow and darkness. As I observed the legal work being done for my friends, I knew that this was the type of law that I wanted to be doing.  Three years later, I made the decision to become an elder law attorney, so that I could help more “Bob and Luise” couples. Bob and Luise eventually moved to Georgia to live near their daughter who is a nurse practitioner. Bob has been able to live at home for more years than they initially thought possible, and it is only during the last six months that Bob finally needed to move to a long-term care facility. Bob and Luise remain close and valued friends. Last week, it was our privilege to host Luise in our office. She had come to attend the wedding of my youngest daughter, Catherine. She was kind enough to come and share her experiences as a caregiver for a husband with Alzheimer’s. And we want to share her experiences with you, our readers. Come back next week to read her story here on our blog.

Have you ever had the experience of hearing a brilliant speaker share a truth with you that wrings your gut? The kind of feeling you get when you find out that the car you bought has the worst service record in automobile history, or the company whose stock you bought will be declaring bankruptcy? You double up inside, like you just got punched in the gut. It’s a sick kind of “AH HA! moment.” Well, this is what happened to me while listening to University of Pennsylvania neurologist Dr. Jason Karlawish speak to a group of lawyers about clients who may have Alzheimer’s disease or some other type of dementia. During the last eight years as an attorney I have specialized in long-term illness.  Every day I learn more about the subtleties and surprises within the elder care journey. At Law Elder Law we often work with families who have a loved one affected by some type of dementia. As we non-medical people observe folks with memory loss, we assume that the individual is losing his or her memory on a constant downward sliding path.  According to Karlawish, however, that is not the right way to think about memory loss. Dr. Karlawish taught us that we need to change the way we look at memory loss.  He helped us understand that different brain functions are affected with differing rates of decline. “Attorneys are linear thinkers. You are trained to think in a linear and logical fashion, and so you believe that if your clients can give the correct answer to a fact based question, then they are still capable.  You assume that if they know that 2+2=4, then they are capable of managing their affairs.” He shook his head and stated, “Nothing could be further from the truth.” It turns out, someone who is suffering from dementia can retain their linear thinking, but lose their ability to comprehend the consequences of what that answer means. As I listened to him speak, it hit me that this was exactly what was happening with one of my clients. This client was responsibly caring for his wife, but the family was continually calling to tell me that “Bill” was making foolish decisions with money, and it was running out at a frightening rate. But when Bill came into my office, nothing seemed to be wrong; he drove himself, he brought his accounting books and we would go over his records together. He seemed capable of handling all his affairs because he gave me all the right answers. Nonetheless, within the next day or two he would do something as bizarre as hiring an $800 ambulance service to get his wife to her weekly hair appointment. Suddenly I realized that although Bill was able to tell me how much was in his bank account, he could no longer understand the meaning of those numbers. If someone you know seems to be on that slippery slope of memory loss, but you keep reassuring yourself that they’re okay because they understand that 2+2=4, it’s time to consider that they may not know what the implications of that solution means. If you are perplexed about a family member’s actions, it may be time for a visit to a neurologist.