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Alzheimer’s Awareness Month

Alzheimer’s Awareness Month

Ryan McNeil | November of 1983 marked the official designation of Alzheimer’s Awareness Month. Communities since then have made it their mission to not only increase awareness of the disease but raise funds toward the research for a cure, too. What is Alzheimer’s? According to the National Institute of Aging, Alzheimer’s disease is a form of dementia. It is an irreversible, progressive brain disorder that slowly destroys memory and thinking skills, and, eventually, the ability to carry out the simplest tasks. There is no cure for Alzheimer’s. However, with new medical treatments, clinical trials, and with the help of advancements in technology doctors provide Alzheimer’s patients with a somewhat better quality of life. The Centers for Disease Control and Prevention (CDC) reports “The number of people living with the disease doubles every 5 years beyond age 65 and this number is projected to nearly triple to 14 million people by 2060.” Symptoms of Alzheimer’s Every person who is diagnosed with Alzheimer’s is the not the same. There are signs or indicators that manifest differently in people. However, there are symptoms that you should be on the look out for. According to the Alzheimer’s Association there are 10 symptoms of Alzheimer’s Memory loss that disrupts daily lifeChallenges in planning or solving problemsDifficulty completing familiar tasksConfusion with time or placeTrouble understanding visual images and spatial relationshipsNew problems with words in speaking or writingMisplacing things and losing the ability to retrace stepsDecreased or poor judgmentWithdrawal from work or social activitiesChanges in mood and personality Who Does Alzheimer’s Affect? Regular responsibilities like remembering to pay bills, turning off electrical appliances or just trying...
What is a MOST Form?

What is a MOST Form?

By David Inabinett, Attorney at Law We often talk about the importance of having Advance Directives as part of your estate plan. These documents help you maintain control over your care even if you are not in a position to make a decision for yourself. A MOST form (Medical Orders for Scope of Treatment) is a formal medical order that goes beyond the standard healthcare directives and allows the patient to define exactly how extensive treatment should be. The MOST form must be completed with your doctor. He or she will review each statement and ensure you understand the implications of your choices. Section A of the document is a standard Do Not Resuscitate order (DNR) that indicates whether you want CPR performed should your heart stop. Sections B, C and D cover various medical interventions, from administration of antibiotics to whether you wish to be put on a ventilator. After you complete the form with your doctor, you will both sign it and it will become part of your medical records. You and the doctor must review the form every year and re-sign to indicate your decisions are still the same. If you change your mind, the old form will be marked VOID and a new form completed. Healthcare providers at the doctor’s office, hospital, or long-term care facility will follow the MOST instructions and call your doctor for follow up care. (Note: EMTs in North Carolina and many other states are required to make every effort to save your life; they are not able to honor MOST or DNR agreements. Depending on your situation, you may want...
What is Medicaid Planning?

What is Medicaid Planning?

When we talk about estate planning and preparing for retirement, we often include a discussion on long term care expenses and how to pay for those costs. Many clients believe they have saved sufficient funds for retirement and assume they will never need government assistance. But what happens if your expenses are significantly higher than planned (for example, you or your spouse require expensive long-term care), your investments do not provide as much income as expected, or you simply outlive your money? Even if you never need to apply for Medicaid, it is worth planning as if you might need that kind of assistance. What is Medicaid? Medicaid is a state and federal partnership providing medical assistance to those with low income, the elderly, pregnant women, children, and disabled individuals. The program is run by each individual state, so the rules may differ. In 2017 it was estimated that 64% of nursing home residents in North Carolina received Medicaid assistance to pay all or a portion of the cost of care. The Affordable Care Act changed the Medicaid application process and some of the income rules surrounding eligibility. Some states have approved Medicaid expansion, extending the program to additional residents who would not otherwise have any healthcare coverage. As of the date of this writing, the North Carolina General Assembly has not approved Medicaid expansion. Why Plan? Consider the following situation: A married couple with grown children owns their $350,000 home outright and has $250,000 in retirement savings and investments. One spouse falls ill and is placed in a long-term nursing facility with no expectation he will return home....
How Often Should I Review My Estate Plans?

How Often Should I Review My Estate Plans?

By Ryan McNeill, Attorney at Law That is a great question, and at the risk of sounding like an attorney, it depends. I typically recommend clients review their estate plans every two or three years, though if you have a life change, your estate plans should change immediately. A life change includes such things as marriage, separation, divorce, the birth of children, death of a spouse, and so forth. If the laws related to estate planning (federal or state) are changed, it is also a good idea to discuss the impact of those changes with your estate planning attorney. When Should I Review My Estate Plans? I mentioned some obvious life changes above, but there are other conditions that might cause you to consider reviewing your plans. You inherit money or property. This may or may not change your estate plans, but it is a good idea to review how your property will be distributed on your death to make certain no changes are warranted.You dispose of property referenced in your estate plans. For example, you may decide to sell the family home and move into a retirement community. You will want to update your documents to reflect that the asset no longer exists. Some retirement communities structure their financial commitment such that some percentage of the investment will be distributed to your heirs on your death. You will need to name these beneficiaries. A loved one is injured, becomes ill, or is diagnosed with a condition that will require long-term care. You may wish to discuss a special needs trust with your estate planning attorney. This trust can...
Steps to Take When a Loved One Dies

Steps to Take When a Loved One Dies

The death of a loved one, whether it is expected or not, can throw you and your family into turmoil as you enter a period of grieving. There are so many things that must be handled, it is easy to become overwhelmed. Some things must be dealt with quickly, while others can wait a few days or weeks. In some cases, these items may be handled by a friend or family member, while in others they must be completed by the Executor of the estate or another individual specified by the decedent or by law. Here is a list of the top 10 things that typically must be handled. Note this list is not comprehensive and other tasks may still need to be completed. If your loved one dies in the hospital or a nursing home, hospital staff will issue a legal pronouncement of death, discuss their process, tell you what they need from you, and advise what help they will provide. If the death occurs at home while under Hospice care, contact them, otherwise, call 9-1-1 to report the death. You may wish to get multiple certified copies of the death certificate (a dozen or more are often required). The funeral home typically assists with obtaining these.If your loved one is an organ donor or has left his or her body to science, time is of the essence. Medical professionals should be made aware if a terminal patient desires to be an organ donor. If death is anticipated in the hospital, doctors there will likely speak to the family about their loved one’s wishes. If the deceased did...
Updates to the ABLE Act

Updates to the ABLE Act

What is the ABLE Act? The North Carolina Achieving a Better Life Experience (ABLE) Act was signed into law in 2015. The ABLE Act enables individuals with special needs or their families to open savings accounts that do not count as assets (within stated limits) when determining eligibility for Medicaid, Supplemental Security Income (SSI), or other government benefits. These savings accounts are intended to cover qualified disability expenses for the individual with the disabling condition. This may include housing, transportation costs, assistive technology, job training, and more. The IRS determines which expenses qualify. Who is eligible to open an ABLE account? The ABLE Act has two criteria that must be met: The disabling condition must have occurred prior to age 26. The savings account may be opened after that age, but the disability must have existing prior to the 26th birthday.The individual must be considered disabled based on criteria set by the Social Security Administration (SSA). If he or she already receives SSI or SSDI payments and meets the age criteria, then approval is automatic. If not, then self-certification of disability is possible, but it would be advisable to have a medical doctor sign a letter certifying the individual does meet the functional requirements outlined by the SSA. ABLE Act Limits for 2019 In general, the current annual contribution to an ABLE account from all sources is $15,000. If the account beneficiary works and his/her employer does not contribute to a retirement plan, then the individual may contribute employment earnings over and above the $15K (with limitations). If the individual receives SSI and the ABLE balance exceeds $100,000, SSI...