Saturday, June 7, 2008

Dementia and the importance of the Power of Attorney

Especially important if you care for someone with dementia is a Power of Attorney
It is one of the most important legal documents a
person can have. Without a comprehensive power of attorney, many
people are neither able to handle their loved ones' financial
matters nor make health care decisions without seeking court
intervention (Guardianship and/or Conservatorship).

We often have clients come into our office assuming that, just
because their assets are titled jointly with their spouse, parent
or partner, they are able to liquidate accounts to pay bills,
hire attorneys, sell their jointly titled real estate, etc.

Unfortunately, that isn't that case. In fact we frequently see
clients how have failed to put in place properly drafted Power of
Attorney documents allowing them to act. And now, their loved one
has developed dementia or is incapacitated in some other manner, an
can no longer legally create a Power of Attorney document (a person
must have capacity to sign legal documents). We have to tell those
people that in many cases, in order to handle the financial affairs
and medical decision making of their loved one,
A Guardianship (also called a Conservatorship in some states) is
likely required.

What is a Power of Attorney?

A power of attorney is a legal document where one person (the
principal) authorizes another (the agent) to act on their behalf.
There are financial powers of attorney which allow your agent to
make decisions regarding your property and healthcare powers of
attorney which allow your agent to make decisions regarding your
health care needs. NOTE: They go by different names in different
states such as Medical Power of Attorney, Health Care Power of
Attorney, Advance Directive etc.

Your power of attorney can be broad in scope, giving your agent the
ability to make any and all financial and personal decisions for
you (a General Power of Attorney) or you can limit your agents
authority by specifying the types of decisions you would like them
to make on your behalf (a Limited Power of Attorney).

You also have a choice whether you would like your agent to have
the ability to make decisions both now and if you become
incompetent (a Durable Power of Attorney) or your agent can be
limited to make decisions only when you become incompetent (a
Springing Power of Attorney).

What is a Guardianship?

Guardianship is a legal relationship whereby the Probate Court
gives a person (the guardian) the power to make personal decisions
for another (the ward). A family member or friend initiates the
proceedings by filing a petition in the appropriate court
where the individual resides.


A medical examination by a licensed physician is necessary to
establish the condition of the individual. A Court of law then
determines the individual is unable
to meet the essential requirements for his or her health and safety
and appoints a guardian to make personal decisions for the
individual. Unless limited by the court, the guardian has the same
rights, powers and duties over his ward as parents have over their
minor children. The guardian is required to report to the court on
an annual basis.

*A Conservatorship (sometimes also called a Guardianship in some
States. And to confuse matters, sometimes called both Guardianship
and Conservatorship) is a legal relationship whereby the Probate
Court gives a person
(the conservator) the power to make financial decisions for another
(the Conservatee).

The Court proceedings are very similar to those of a Guardianship
except the Court
determines an individual lacks the capacity to manage his or her
financial affairs and appoints a conservator to make financial
decisions for the individual. Often the court appoints the same
person to act as both guardian and conservator for the individual.
Like the guardian, the conservator is required to report to the
court on an annual basis.



The Differences

A power of attorney is a relatively low cost and private way to
decide which family member or trusted friend will have the legal
authority to carry out your wishes if you can no longer speak or
act for yourself.

If you do not have a power or attorney or if your power of attorney
is not drafted properly, and something happens that results in your
inability to make decisions, your
family/friends may later face court proceedings and court
supervised Guardianship and/or Conservatorship.

A court proceeding is not only costly, but the person appointed as
your
Guardian/Conservator may not be the person whom you would have
chosen yourself. Additionally, there can be constant court
supervision for that person's lifetime, with on-going reporting
required and permission to take almost any action on behalf of the
incapacitated person.

And, as stated above, not having a properly drafted power of
attorney could significantly limit financial and/or medical
decision making that could be done on behalf of the
principal.

I often tell my clients that if you do nothing else, at the
earliest signs of dementia (if you haven't already done so) get
properly drafted power of attorney documents put in place
immediately. They are really that important.

Until next time....

Warmly,

Brian Willie
Serving seniors and those who love them.

Monday, December 24, 2007

Mild Exercise May Counter Dementia

Moderate physical activity — even an unhurried 30-minute stroll a day — may diminish the risk for vascular dementia among the elderly, according to a new study published this week in the online journal Neurology.
click here for the whole story

Sunday, December 9, 2007

Exercise helps stave off dementia, research suggests

By LORI ARATANI
The Washington Post
Article Last Updated: 12/07/2007 01:43:00 AM PST


Older Americans play with video games that promise to keep their minds sharp. Some do crossword puzzles, try to master foreign languages or learn to play musical instruments — all in the hope of staving off Alzheimer's. Now, a growing body of research is offering tantalizing evidence that a brisk walk in the morning or some laps in the pool might accomplish the same task.
"There's an avalanche of neuroscience to support that (physical) exercise is good for the brain," said John Ratey, an associate clinical professor of psychiatry at Harvard Medical School and co-author of an upcoming book on the subject.

That's hopeful news for many who worry that growing old may mean losing their minds.

A 2006 survey conducted by Harris Interactive for the MetLife Foundation found that Alzheimer's was a bigger source of anxiety for Americans 55 and older than heart disease, stroke and diabetes.

"Losing one's mental faculties is people's biggest fear," said Shawn Brennan, who specializes in promoting senior health initiatives for Montgomery County's Department of Health and Human Services. "Whenever we have an event focusing on improving your memory, people just flock to it."

Dorothy Mudd, 80, of Chevy Chase, Md., has heard enough to change her habits. Her goal is be physically and mentally fit, so six months ago she hired a personal trainer. She was sore at first, but within a few months, she says, she felt stronger — and mentally sharper.

click here for the whole story

Sunday, November 25, 2007

High Blood Pressure Linked to Disability, Dementia

By Steven Reinberg
HealthDay Reporter
Monday, November 19, 2007; 12:00 AM

MONDAY, Nov. 19 (HealthDay News) -- People with high blood pressure are at increased risk for disability and dementia as they age, two new studies suggest.

In the first report, researchers found that high blood pressure increased the risk of developing disabilities, such as not being able to lift objects, walk up or down stairs, or bathe oneself.


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"High blood pressure affects many aspects of a person's life," said lead researcher Dr. Ihab Hajjar, an instructor in medicine at Harvard Medical School. "Not only does it affect the vascular system and the heart and the brain and kidney, but it also affects well-being -- the ability to be independent, ability to perform daily activities, and be physically active."
Click here to read the full story

Sunday, November 11, 2007

Eating Grapes May Protect Against Alzheimer's Disease

Study shows grapes' ability to block genes associated with the Alzheimer's
pathway and decrease inflammatory gene expression in the brain

FRESNO, Calif., Nov. 9 /PRNewswire/ -- Consuming grapes may help
prevent the onset of Alzheimer's disease, according to research presented
this week at the Society for Neuroscience conference in San Diego,
California. It is the unique combination of components in grapes, which
includes resveratrol, quercetin, catechins and other phytonutrients, that
is thought to be responsible for the protective effects.
Investigators led by Dr. Nancy Berman of the University of Kansas,
School of Medicine presented evidence from a study of aging mice that
compared the effects of a diet with and without grapes. Dr. Berman shared
her findings regarding the ability of a grape-enriched diet to dramatically
increase the expression of critical target genes that block the Alzheimer's
pathway and decrease inflammation in the brain. Alzheimer's is
characterized by the formation of beta-amyloid plaques in the brain.
Additionally, oxidative stress and inflammation are thought to play a role
in facilitating neurodegenerative disease.
The data presented by Dr. Berman showed that a grape-enriched diet
induced a 246-fold increase in the expression of transthyretin, a
beta-amyloid scavenger known to reduce plaque formation in Alzheimer's
disease. Additionally, the researchers observed significant inhibition of a
gene that is involved in the inflammation that occurs in normal aging and
appears to be accelerated in neurodegenerative diseases, such as
Alzheimer's.
These results suggest that regular consumption of grapes may be
beneficial for long-term brain health, specifically the prevention of
Alzheimer's disease.
"Preserving brain health is a key concern as we age," said Kathleen
Nave, president of the California Table Grape Commission. "The growing
evidence that eating grapes each day may help protect against degenerative
brain diseases such as Alzheimer's is very exciting."
The Society for Neuroscience Annual Meeting is the premier venue for
the world's neuroscientists to debut their cutting edge research to more
than 31,000 neuroscientists and exhibitors from around the world. The
meeting offers learning and professional development opportunities and
provides a place for scientists to gather to present and share ideas.

Sunday, October 28, 2007

Report Describes 300 Compounds in Development for Treatment of Alzheimer's Disease

Report Describes 300 Compounds in Development for Treatment of Alzheimer's Disease

(PRWEB) October 26, 2007 -- Piribo, the online destination for business intelligence for the biotech and pharmaceutical industry, has now added a new report which forecasts the market-share for various approaches in the treatment of Alzheimer's disease to 2016

"Alzheimer's Disease: New Drugs, Markets and Companies" reports that considerable research is in progress to understand the pathomechanism of the disease and find a cure. The only drugs approved currently are acetylcholinesterase inhibitors, beta amyloid deposits and neurofibrillary tangles. Acetylcholinesterase inhibitors do not correct the basic pathology of the disease. Also, several new approaches emphasise neuroprotection.

The study shows that acetylcholinesterase inhibitors are mostly a symptomatic treatment; however, some claims are made about a neuroprotective effect. Currently the only approved neuroprotective therapy in is memantine. Management of these patients also require neuroleptics for aggressive behaviour and antidepressants. There is an emphasis on early detection at the stage of mild cognitive impairment and early institution of neuroprotective measures. The value of mental exercise in delaying the onset of Alzheimer's disease is being recognized.

There are nearly 8 million sufferers from Alzheimer's disease in the seven major markets of the world, and this is anticipated to increase in the future.

Research in Alzheimer's disease still aims at elucidating the basic pathomechanisms. This can be made by animal models, which are important for research, particularly in testing some of the potential therapeutic approaches. There is considerable research in progress at the various centers, some of which is funded by the National Institute of Aging of the National Institutes of Health.
Click here for the full story

Saturday, October 20, 2007

Enjoy the time spent with those who have Alzheimer's disease or a related dementia

Susan Berg, author and dmentia healthcare professional, offers excellent strategies for having a great time with someone who has Alzheimer's disease or a related dementia
Here is strategy number one
Structure and routine. Try to follow regular predictable routines that include pleasant, familiar activities. Remind the person that everything is going according to plan. Designate a certain time get up, have breakfast, go for a walk, sit in the backyard together etc.
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