Archive for August 2011
Alzheimer’s at Age 59?
We’ve always thought of Alzheimer’s as a disease of the elderly. But we’re now learning that’s not always the case.
Bravo for the courage of women’s college basketball coach, Pat Summit, to confront her diagnosis of early-onset Alzheimer’s Disease head on and in the public eye. She has a difficult journey ahead, but by bringing her diagnosis out into the open she, as well as we, benefit. She and her family can benefit from all there is to offer in terms of education, research, treatment and support. Her openness allows for early and effective life care planning going forward. We benefit from a new awareness that can hopefully bring about more research, treatments and support for families coping with the disease (www.alz.org).
For more information please contact Marsha Goodman
What’s happening with Reverse Mortgages?
I recently met with a client who wanted to do whatever she could to remain at home. Since she owned her home outright, I suggested that she consider a reverse mortgage as a way to access the equity for cash to pay for home-based care. I was surprised to learn that Wells Fargo is no longer issuing reverse mortgages. Wells Fargo and Bank of America, which discontinued offering reverse mortgages a few months earlier, had previously issued more than 40% of all reverse mortgages. As reported in the Summer edition of the National Academy for Elder Law Attorneys (NAELA) Arizona chapter newsletter, Wells Fargo said they had based their decision on ”today’s unpredictable home values,” and the restrictions on reverse mortgage holders that make it difficult for the bank to determine whether the homeowner can meet her other obligations, such as taxes and insurance.
Reverse mortgages have several restrictions, one of which is that the mortgagee must stay in the home, and the fees are significantly higher than those for traditional mortgages. However, for someone like my client, who is trying to pay for home-based care, and who has most of her net worth in that home, it has been one of very few options for financing that care.
Through a broker, my client was able to find an institution that would issue a reverse mortgage. Unfortunately, since a reverse mortgage will only secure up to 60% of the home’s current value, the amount of money available in the current housing market was barely worth the trouble.
If my client ends up spending all of her cash assets to pay for her care, she will be forced to consider applying for Medicaid, which will not count her home as an asset. It would be unfortunate, both for this family and for our cash-strapped state, if this women ends up accepting public benefits because she cannot access the equity she has accumulated over a lifetime.
For more information, contact Marsha Goodman.
Hospice in the Nursing Home
Many nursing homes or skilled nursing facilities (SNFs) do a wonderful job of providing appropriate care to people with dementia who cannot be cared for at home. But not all have the specific skills in symptom management, sensory stimulation and family support so crucial to a person with end-stage dementia. Therefore, it was not surprising to read about an analysis of hundreds of family surveys in the Journal of American Geriatrics Society, showing that “Hospice services substantially improved the provision of care and support for nursing home patients dying of dementia and their families.” For example, according to Dr. Joan Teno, a Brown University gerontologist and the lead author of the study, one in five family members of patients not in hospice reported an unmet need for shortness of breath while only 6.1 percent for people in hospice did. Everyone benefits, including the SNF staff, by the additional resources of hospice: expertise in pain and symptom management, volunteers, spiritual and emotional support.
This research comes as Medicare funding for hospice has been swept up in the debate over the federal deficit. Hopefully the positive results of this study will increase awareness of dementia as a terminal illness and highlight the appropriateness of hospice in caring for people with end-stage dementia and their families in the SNF setting.
