Don’t Transfer Ownership of Your House to Your Kids Before You Read This

With the cost of long-term care (LTC) skyrocketing, you may be concerned about your (or your elderly parents’) ability to pay for lengthy stays in assisted living and/or a nursing home. Such care can be massively expensive, with the potential to overwhelm even the well-off.

Because neither traditional health insurance nor Medicare will pay for LTC, some people are looking to Medicaid to help cover this cost. To become eligible for Medicaid, however, you must first exhaust nearly every penny of your savings.

Given this, you may have heard that if you transfer your house to your adult children, you can avoid selling the home if you need to qualify for Medicaid. You may think transferring ownership of the house will help your eligibility for benefits and that this strategy is easier and less expensive than handling your home (and other assets) through estate planning.

However, transferring your home to the kids is a big mistake on several levels.

It can not only delay—or even disqualify—your Medicaid eligibility, it can also lead to numerous other problems.

Medicaid Changes
In February 2006, Congress passed the Deficit Reduction Act (DRA), which included a number of provisions aimed at reducing Medicaid abuse. One of these was a five-year “look-back” period for eligibility.

This means that before you can qualify for Medicaid, your finances will be reviewed for any “uncompensated transfers” of your assets within the five years preceding your application. If such transfers are discovered, it can result in a penalty period that will delay your eligibility.

For every $6,810 worth of uncompensated transfers made within this five-year window (the current North Carolina monthly divisor), your Medicaid benefits will be withheld for one month.  But, any transfers made beyond that five-year period will not be penalized.

So, if you transfer your house to your children and then need LTC within five years, it may significantly delay your qualification for Medicaid benefits—and possibly prevent you from ever qualifying. Rather than taking such a risk, consult with us to discuss safer and more efficient options to help cover the rising cost of LTC such as long-term care insurance.

A potentially huge tax burden

Another drawback to transferring ownership of your home is the potential tax liability for your child. If you’re elderly, you’ve probably owned your house for a long time, and its value has dramatically increased, leading you to believe that by transferring your home to your child, he or she can make a windfall by selling it.   Read more if you want to know about selling the home after qualifying for Medicaid.

Unfortunately, if you do that, she or he will have to pay capital gains tax on the difference between your home’s value when you purchased it and your home’s selling price at the time it’s sold by your child. Depending on the home’s value, these taxes can be astronomical.

In contrast, by transferring your home at the time of your death, your child will receive what’s known as a “step-up in basis.” It’s one of the only benefits of death, and it allows your child to pay capital gains taxes when he or she sells your home, based only on the difference between the value of the home at the time of inheritance and its sales price, rather than paying taxes based on the home’s value at the time you bought it.

We can help you choose the most advantageous estate-planning strategy to minimize your beneficiaries’ tax liability and ensure they get the most out of their inheritance.

Debt, Divorce, Disability, and Death

There are numerous other reasons why transferring ownership of your house to your child is a bad idea. If your child has significant debts, his or her creditors can make claims against the property to recoup what they’re owed, potentially forcing your child to sell the home to pay those debts.

Divorce is another problematic issue. If your child goes through a divorce while the house is in his or her name, the home may be considered marital property. Depending on the outcome of the divorce, this may force your child to sell the home or pay his or her ex a share of its value.

The disability or death of your child can also lead to trouble. If your child becomes disabled and seeks Medicaid or other government benefits, having the home in his or her name could compromise eligibility, just like it would your own. And if your child dies before you and has ownership of the house, the property could be considered part of your child’s estate and be passed on to your child’s heirs, creating a problem for you.

No substitute for proper estate planning
Given these potential problems, transferring ownership of your home to your children as a means of “poor-man’s estate planning” is almost never a good idea. Instead, with us as your Personal Family Lawyer®, we can help you find better ways to qualify for Medicaid and other benefits to offset the hefty price tag of long-term care and also keep your family out of court and out of conflict in the event of your incapacity or when you die.

We offer an array of estate planning strategies to protect all of your assets, while also enabling you to better afford whatever long-term healthcare services you might require.

Contact us today to learn more.

Call 919-883-2800, or schedule an appointment.

Tax benefits of owning a second home?

Buying a second home can provide you with a place to relax, unwind, and escape from it all. It can also provide you with substantial savings if you take advantage of these tax benefits of buying a second home.

Mortgage Interest

Mortgage interest paid on up to $1.1 million in debt on your first and second homes is usually deductible. Typically, this rule only applies if you treat your second home as a home and not a rental property. But some mortgage interest may still be deductible if you occasionally rent out your second home. To benefit from this deduction under current tax law (it changes), you must use the property for 14 days or more than 10% of the number of days you rent it out a year, whichever is longer.

Tax-Free Profit

You can take up to $500,000 in profit from the sale of a home tax-free if it is your primary residence and you meet the two-year ownership and use requirement. Typically, you do not get the same tax benefit from the sale of a second home. But people have taken advantage of this rule by converting their second home to their primary residence before the sale, thus reaping the tax-free profit.

But in 2009, Congress added a few more restrictions to limit the amount of tax-free profit you can take from a second home. Now, a portion of the profit from the sale of a second home is taxable. The portion is determined by the ratio of the amount of time after 2008 you treated the residence as a second home or rental property and the amount of time you owned it.

Buying a second home can offer many benefits. But to maximize the value of your investment, work with a lawyer to make sure you are not overlooking any potential legal, insurance, financial, or tax problems or opportunities. You must meet other requirements—such as living in the home for two years before you sell it—to take advantage of some of these tax benefits.

A Personal Family Lawyer® can help you ensure you meet the requirements, so you can reap all the benefits of owning a second home.

Contact us today!

Call at 919-883-2800 or schedule an appointment.

They know what I want…

A recent article from Northwestern Mutual says otherwise.

An astonishing 69% of people have not planned and NEVER ASKED the people they expect to provide care for them … those family members who will provide care for loved ones don’t know what is coming!

If they do not know what you want, or that you want THEM to be a part of the decisions, things WILL NOT GO AS YOU HOPE!

Don’t keep your wishes a secret!

Have the conversation with your loved ones about how you want to be treated, and how you want to be cared for as you age.  “Hoping” is not a plan.  “Thinking” about doing something is not a plan.

Take steps today to PLAN.  What should you set up first?

Money Matters

You should have Financial Powers of Attorney planned, completed, and recorded with your county (yes, I know, recording isn’t required anymore … do it anyway).  These powers allow someone to help make decisions for you when you cannot.  For example, paying your bills, making sure your living accommodations are taken care of, and keeping current with taxes.

Does it matter?

You bet!  I had a client a couple of years ago who stopped her auto-withdrawal from the bank for her mortgage.  She suffered from dementia and didn’t trust the bank and thought they were stealing from her.

Guess what?   You probably know … her house was foreclosed on, and she died alone in a nursing home.

What about Medical decisions?

Same thing … you need a Medical Power of Attorney to be sure that someone can make medical decisions when you cannot.  For example, if you have a stroke and need care, what are your planned wishes for care?  No one will know if you can’t speak for yourself.  Proper Medical Documents allow us to help you put your thoughts into writing, so you can speak through your agent.

Don’t delay!  Life can change in an instant!

Do you drive a car?  Then, you are at risk of an accident every minute!
Do you walk around your house or apartment?  Then, you can trip and fall!

I have clients for whom both have happened, with tragic results.

Come see us!

Make the plans.  Powers of Attorney, and Wills and/or trusts.  Then, have the conversation with your family!

We can help with all your needs, including protecting your children!!

Call today!  919-883-2800

Or, schedule a session with us.

Don’t wait!

No, I’m not kidding, do not wait another minute!  Call 919-883-2800 right now.

All trusts are the same, right?

I get this question from some of my estate planning prospects … “All trusts are the same, right?

Is it true?

Nope, not even close!

What kind of estate planning does your family need?  Do you know if you really need a trust?
If you do, does your attorney understand how to make one that fits YOU?

There are many forms of trusts, and not all are created equal.  Trusts are used for many purposes and serve different functions.  They must be tailored to the unique situations that you and your family find themselves in. It is a huge benefit to work with an attorney who understands trusts.

Estate Planning Tailored to your family … Isn’t that what you’d expect?

Today, I got this request over a local listserv…

Dear List-
Would anyone be willing to share a Revocable Family Trust agreement with me?
I am drafting a trust for a husband and wife ….

I really am just hoping not to start from scratch.

Hmmm … do you really want this from your estate planning attorney?

It seems from this request that he (or she) is about to embark on building a trust for the client … but he might never have completed a trust before.  What he or she creates will be a reflection of some “model” or “go by” document that might have NOTHING to do with the reality of the client’s needs.  The attorney is certainly very skilled in his field, but apparently new to trusts.

Don’t make a mistake with your family, their future, and your money …

Be choosy … pick an attorney who will work to understand YOU and YOUR FAMILY.
Personally.  Individually.  And competently.

When you work with a Personal Family Lawyer, you get all that, and more.

Call us at 919-883-2800 to find out why we are different from most other attorneys.

Or click this link to find out more.

Do you have young children?

Then you also need to discover kids protection planning.
Don’t let poor planning cause a disaster for your kids!

Call us today!  919-883-2800

Or, schedule a phone call to discuss your needs and find out how to get a Life Pathways Planning Meeting for free (valued at $750). Click this link for more and to schedule your phone call.

Or, just book the LifePathways Planning Meeting your self right now!

Books related to Alzheimer’s Disease

Books!

I suppose it is fine to read about things in email, as many of us do all the time these days!

But, some of us prefer to hold a book, and to that end, I thought it might be good to tell you about some books I have liked or that look relevant which deal with real stories about people with Alzheimer’s or dementia, or even stories about life and death. Yes, they are probably also on Kindle!

I have read some of these, not all.

Alzheimer’s books

Mom, Are You There? Finding a Path to Peace Through Alzheimer’s by Kathleen A. Negri Insights and lessons that can aid any caregiver in embracing the person with dementia in positive, healthy ways and in developing self-understanding.

Dementia: Living in the Memories of God, by Professor John Swinton. Professor Swinton uses his background in nursing, ministry, and healthcare chaplaincy to conduct research on the relationship between spirituality and disease. In Dementia: Living in the Memories of God, Swinton explores two main questions for people living with the disease: Who am I when I’ve forgotten who I am? and What does it mean to love God and be loved by Him when I have forgotten who God is? The book puts forth Swinton’s practical theology of dementia for caregivers, dementia patients, and others who offer them love, support, and guidance.

Still Alice by Lisa Genova Still Alice is a fictional story about the descent of a 50-year-old university professor diagnosed with younger-onset Alzheimer’s disease. The Association assisted author Lisa Genova with her research, which included interviews with several members of past Early Stage Advisory Groups. The Association is also featured prominently in the book’s plot. In addition, the Association worked with Genova to create the Still Alice discussion guide, specifically for people living with Alzheimer’s. The guide, the first of its kind, is intended to help people with the disease use Alice’s story to connect with their experience and explain it to others.

Learning to Speak Alzheimer’by Joanne Koenig Coste and Robert Butler Joanne Koenig Coste offers a practical approach to the emotional well-being of both patients and caregivers that emphasizes relating to patients in their own reality. Her accessible and comprehensive method, which she calls habilitation, works to enhance communication between care partners and patients and has proven successful with thousands of people living with dementia. Learning to Speak Alzheimer’s also offers hundreds of practical tips, including how to · cope with the diagnosis and adjust to the disease’s progression · help the patient talk about the illness · face the issue of driving · make meals and bath times as pleasant as possible · adjust room design for the patient’s comfort · deal with wandering, paranoia, and aggression.

Chicken Soup for the Soul Living with Alzheimer’s & Other Dementias by Amy Newmark With 101 encouraging and inspiring stories by others like you, this book is a source of support and encouragement throughout your caregiving journey.

The Forgetting By David Shenk. David Shenk’s prize-winning book is a scientific and literary description of Alzheimer’s and the research that is being done to find a cure. The Forgetting, Alzheimer’s: Portrait of an Epidemic is never boring, one feels in the hands of a caring expert. The British psychoanalyst and author Adam Phillips writes in his foreword: “This remarkable book will radically change our notions of looking after people and our assumptions about independence. Out of fear of mortality we have idealized health and youth and competence. The Forgetting reminds us, among many other things, that there is more to life than that.”

When It Gets Dark By Thomas DeBaggio. When it Gets Dark is essentially DeBaggio’s swan song. Although he lived eight years after the publication of this book, one can only imagine how painful the last years must have been for DeBaggio and his family as even in 2003 he was describing the terror, frustration, sadness and sometimes anger at his rapidly deteriorating mind. Although When it Gets Dark was written after DeBaggio’s Losing my Mind, it is more structured, and in chronological order, which is not the case with first book. DeBaggio expands on Losing my Mind, but also turns back to his past, recounting the early 1960s and 70s and his beginnings as an herb grower. DeBaggio was also a fisherman, and often used the language of fishing and horticulture to describe his daily battle: “My long-term memory is left battered; trying to find moments of the past is like fishing with a dull, rusting hook without bait.”

The 36-Hour Day: A Family Guide to Caring for People Who Have Alzheimer Disease, Related Dementias, and Memory Loss. Written by Nancy L. Mace and Peter V. Rabbins, The 36-Hour Day now is in its sixth edition. Completely revised and updated, this book has sold more than 3 million copies around the world and continues to be a top resource for those caring for people with Alzheimer’s disease and other forms of dementia. The 36-Hour Day guides family members and caregivers through coping with the challenges of dementia while addressing their personal needs and emotions.

The Alzheimer’s Action Plan: What You Need to Know – and What You Can Do – About Memory Problems, from Prevention to Early Intervention and Care by Dr. P. Murali Doraiswamy. Dr. Doraiswamy is a psychiatrist in the Duke Health system who serves as a brain health adviser for Men’s Health magazine and a health care expert panelist for The Wall Street Journal. He also co-authored The Alzheimer’s Action Plan with Lisa P. Gwyther and Tina Adler. This dementia book combines Dr. Doraiswamy’s medical insights with social worker Lisa P. Gwyther’s experience in working with families impacted by Alzheimer’s disease. Readers will understand how to determine whether their loved one’s memory loss is a symptom of Alzheimer’s and how to help her receive effective medical treatments as the disease progresses.

Dementia

What If It’s Not Alzheimer’s, A Guide to Dementia by John Trojanowski This book is the first comprehensive guide dealing with frontotemporal dementia (FTD), one of the largest groups of non-Alzheimer’s dementias. The contributors are either specialists in their fields or have exceptional hands-on experience with FTD.

Alzheimer’s Disease and Other Dementias by Nataly Rubinstein Written by a licensed clinical social worker with twenty-five years of experience, this easy-to-read book will give you the resources to make informed decisions regarding the best possible care for you and your loved one.

A Caregiver’s Guide to Lewy Body Dementia by Helen Buell Whitworth MS BSN This is the ideal resource for caregivers, family members, and friends of individuals seeking to understand Lewy Body Dementia.

For caregivers

Activities to do with Your Parent who has Alzheimer’s Dementia by Judith A. Levy. She is an occupational therapist who became the daughter of an Alzheimer’s patient. In Activities to Do with Your Parent Who Has Alzheimer’s Dementia, Levy uses her personal and professional experiences to support readers who are in a similar situation. She shares activities that promote patients’ abilities to care for themselves, remain mobile, and continue to socialize. She also describes how to create an environment that supports parents with dementia. The book contains more than 50 activities, activity assessment forms, ideas for preventing caregiver burnout, and much more.

Ahead of Dementia: A Real-World, Upfront, Straightforward, Step-by-Step Guide for Family Caregivers by Luciana Mitzkun’s. This guide for families caring for dementia patients provides an authentic look into managing symptoms, securing future care, and avoiding common mistakes as the disease progresses. Caregivers also will learn how to care for themselves while caring for their loved one, thanks to the concise information and meaningful anecdote included in the book. Busy caregivers appreciate the straightforward nature of Mitzkun’s writing.

Alzheimer’s Care: The Caregiver’s Guide to Understanding Alzheimer’s Disease & Best Practices to Care for People with Alzheimer’s & Dementia by Nancy J. Wiles. Alzheimer’s Care is a dementia book by Nancy J. Wiles that provides a look into Alzheimer’s for caregivers who want to know more about the signs and symptoms of the disease, how to help patients keep their memories for as long as possible, and much more. The book provides a comprehensive overview into dementia and Alzheimer’s and answers the questions caregivers have but aren’t sure how to ask when faced with caring for a loved one with the disease.

Intelligence

In Pursuit of Memory by Joseph Jebelli. It has become the salient fact of 21st-century life that, with an aging world population, Alzheimer’s will overtake cancer as the second leading cause of death after heart disease. We’re at a point, writes Joseph Jebelli, at which “almost everyone knows someone – a family member or friend – who has been affected.” Jebelli, a young British neuroscientist, has greater cause than many to make this claim. As a boy, he watched his grandfather acting strangely, before descending into the abyss of dementia in which he could no longer recognize his family. Jebelli’s testament, In Pursuit of Memory, is a moving, sober and forensic study of the past, present and future of Alzheimer’s from the point of view of a neurologist who has lived with the disease, at home and in the lab, from a very young age.

Curse of the High IQ by Aaron Clarey. Society, by statistical necessity, needs to focus on the majority. It needs to be built and designed for “the average.” Society, by moral necessity, also needs to focus on the disadvantaged and disabled. Helping those who cannot help themselves. But while the majority of society’s resources, attention, and infrastructure is dedicated to average or below-average intelligent people, little-to-none of it is paid to the abnormally intelligent. And while having a high IQ is an overall net benefit in life, being a statistical intellectual freak is not without its drawbacks. Welcome to the “Curse of the High IQ.”

Mortality

Being Mortal: Medicine and What Matters in the End by Atul Gawande. Like poet William Carlos Williams or The Man Who Mistook His Wife for a Hat author Oliver Sacks, Gawande is that rare soul who is as talented a writer as he is a doctor. In this call for a reevaluation of end-of-life care, he meditates on how to navigate age-related frailty and mortal illness so that not just the living, but the dying, can be comfortable.

On Death & Dying by Elisabeth Kübler-Ross. Ten years after her 2004 death, this new edition of Dr. Kübler-Ross’s definitive work was released, and it’s filled with her original insights about the psychological processes of dying as well as new resources for the ailing and their loved ones.

Enjoy!

When is it time to stop driving?

When is it time to stop driving or take the keys away?

At some time you will feel concern or even fear that your parents should no longer drive an automobile. AgingCare.com points out that in a recent year, over 14 million Americans were involved in accidents with elderly drivers. But is age the only issue in deciding if it is time to stop driving? Or, is it the risk of accidents?

Of course, it isn’t really just either of those!

If that were true, then, statistically, young adults should not drive! When driving, you are in control of a 4000-lb machine that can easily hurt you or someone else. And, we see people, young and old, who concern us while driving.

Physical and mental condition and abilities are probably the key area to consider. Even the airlines ask if you are “capable” of doing the things it takes to sit in the exit row. Why not ask this of other tasks, including driving?

What are some of the areas of concern?

  • Vision: Can the driver see well enough to drive? Can they see signs? Can they judge distances? Can they see at night? Can they physically see over the dashboard? Personally, as my cataracts get worse, I have less light entering my eyes. This will eventually reduce my focus ability and night vision. It isn’t a demonstrable problem yet, but I “keep an eye on it”.
  • Hearing: The driver must be able to hear sirens or RR-Crossing warnings.
  • Strength: Can the driver manage the vehicle? Turning the car at a slow speed can require a lot of arm strength. Have you ever tried to drive with your arm in pain? Or hit the brakes if your leg is weak from an injury? It is hard! And, risky.
  • Medications: Is the driver on any medications that could affect speed of thought? Or one that would make them sleepy? Both situations can spell disaster. Medications and their interactions can have serious effects.

Is there anything specific to dementia?

For the topic at hand, Alzheimer’s and dementia, there might be unique issues that cause changes to the abilities that can affect driving.

  • Forgetfulness can be an important consideration. Not just about destinations, or how to return home. That happens, of course. But, look for confusion about stop signs, forgetting to use blinkers, or making that left turn into the retirement home without regard for oncoming traffic (one of my clients had two car-totaling accidents this way before his license was revoked).
  • Judgments: When an emergency happens, can the driver make decisions fast enough to avoid an accident? Sometimes, that ability to judge what is coming up avoids the emergency in the first place. Alzheimer’s and other dementias can rob a person of the ability to process information fast enough to drive.  To compensate, some drivers with slow reactions may turn too late, stomp on the brakes after they pass their destination, or just drive slowly.

How can you evaluate the driving?

Ride with them. Watch how they drive. Observe without comments, but record what you see for later reference. Some of the warning signs showing that the ability to drive safely is beginning to decline include:

  • Difficulty changing lanes.
  • Suddenly drifting into other lanes.
  • Problems judging distance when braking.
  • Forgetting to use turn signals.

Check the vehicle. Look for dents on the car, especially at the corners. Ask about the missing mirror. Check the sides of the garage door for damage.

Again, a personal note … seeing how my mother-in-law drove even years before symptoms of Alzheimer’s appeared should have alerted us to impending problems. She had dents and dings on all four corners of the car and had some trouble being attentive to traffic. I didn’t want to ride with her anymore! We didn’t stop her from driving for a few more years, and fortunately, nothing serious happened.

How to actually take the keys, if you must…

Have a plan. If you take the keys, says the Huff Post website, you should be able to provide an alternative. You can drive, you can sign the driver up with a local transportation option, such as Durham Access, or even teach the driver how to use Uber.  But, don’t leave them with no options.

Have a conversation. This is a shared decision, and your loved ones should be a part of the process. Elizabeth Dugan, author of the book, “The Driving Dilemma: The Complete Resource Guide for Older Drivers and Their Families,” suggests that you ask them what to do and share your concerns (“I don’t want to lose you in an accident”). Use open-ended questions and focus on what you are worried about, not what they should do.

Involve a trusted third party. Leverage a doctor or therapist (or the DMV) for help.

Be creative. For some drivers, simply “losing the keys” is enough. We disconnected the battery, and the car just would not start.

What if your loved one still refuses to stop driving?

Here are two ideas from dailycaring.com to force the issue:

Contact the DMV. There is a form on the website (ncdot.gov) that allows you to report the driver and ask for a driving evalutaion. Failure to pass would limit their driving.

Use forgetfulness to your advantage. When mother-in-law’s car would not start, it wasn’t long before she stopped wanting to drive and accepted rides and help from others. If she asked, we simply suggested that the car could not be fixed. Similarly, you can lose the keys or even disable the car entirely (like we did with the battery cable).

Also, Protect your own car and keys. Some people will take another car in the household to drive. So, protect that car too by controlling your own keys.

If there is really a problem, don’t feel guilty. You are doing what is necessary.

What if you do take the keys?

If you feel that it is time for them to hand over the keys, recognize that you may run into resistance. Taking the car keys removes the parent’s independence, the ability to drive to the market or to meet friends for coffee, to church and the senior center, the library or to visit friends. The experience can be traumatic.

But, be aware that taking away the keys can mean an earlier move to assisted living.  Is that affordable or even a good idea?  Be prepared to step in with meaningful assistance during this transition.

Summary

The bottom line is that this is a hard conversation and will require patience and planning.

If you need help, check out the articles referenced on this blog or contact a geriatric professional care manager.

Does Brain Exercise help reduce the risk of Alzheimer’s?

Does Brain Exercise help?

We read in a lot of places that exercising your brain can help prevent dementia.

Is that true? If so, what makes sense to try?

No one can say for certain that exercise can prevent or stop the progression of Alzheimer’s disease. Still, some are certain that it helps, and there is a complete industry of brain-related exercises. You can get apps, web pages, games, workbooks, foods, and more. Is it all about the money .. capitalizing on our fear of dementia? or, does it work?

First, if we think it does help, that is itself helpful. So, look at sites like these for apps and games … some of these aim for “wellness”, others for exercises for your brain and thinking skills…

And more! The NIH has a site too.

You can exercise your thinking, and that is always good.

And, here are some really good ideas for brain health from Consumer Health Digest. Also, from Every Day Health.

But, Can it help with Alzheimer’s?

Some researchers think so, based on this general theory … if cognition improves in people without dementia due to brain exercise, then it must be of some benefit to those who do. Here is an article on Brain Exercise from the Alzheimer’s Society in the UK. But, they also point out that there is no evidence that brain exercise delays Alzheimer’s disease.

The Alzheimer’s Association in the US says this: “At this time, there is no treatment to cure, delay or stop the progression of Alzheimer’s disease.”

My experience

Personally, I know that my ability to “think” diminished over the years. I didn’t notice it, but it was certainly apparent when I went to Law School. Now, I didn’t start until I was 51 … well after most lawyers get their start! But, the key here is that I thought I was in fine shape, mentally.

When I got to class, I realized I would have to read, and remember, hundreds of pages of information … every night! I hadn’t read hundreds of pages in one day for 30 years! It was a struggle to re-learn how to learn. And, it took the whole first semester.

The important point? I turned the corner, and was able to learn, and retain massive amounts of information. Which proves two things to me … one, certain skills I had before atrophied, and two, exercising those skills brought them back.

So, I am a believer that brain exercise helps. I’m not so sure about avoiding Alzheimer’s, but exercising your brain is a very good thing!

What about body exercise?

Oh, yes, one more cool thing … physical exercise can help your brain too!

You know you feel better when you have a little exercise in your daily routine. That has a known reason. But, if you exercise, it turns out that you are also repairing neurons through “neurogenesis”. Since Alzheimer’s disease and other dementia have as one process the destruction of neurons, it is possible that exercise can slow the progression. Active mice show more nerve regeneration than inactive ones. Hopefully, our brains act like the mice brains!

So, be active, both mentally AND physically!

Join a local Alzheimer’s Walk!

Want an easy way to help with the fight against Alzheimer’s?

Held annually in more than 600 communities nationwide, the Alzheimer’s Association Walk to End Alzheimer’s® is the world’s largest event to raise awareness and funds for Alzheimer’s care, support and research. This inspiring event calls on participants of all ages and abilities to join the fight against the disease!

The Walk in Raleigh-Durham is held in September each year. This year, it will be September 15, 2018, at the North Carolina Museum of Art, 2110 Blue Ridge Rd, Raleigh, NC 27607 . The walk begins with registration at 8:30 am and kicks off at 10:00am. Don’t come late! There are activities and vendors, and over a thousand people all carrying flowers in memory or in honor of loved ones with this disease.

Someday, there will be a person carrying a white flower to symbolize survivors.

When you participate in a Walk, your fundraising dollars fuel our mission, and your participation in the event helps to change the level of Alzheimer’s awareness in your community. The Alzheimer’s Association provides free, easy-to-use tools and staff support to help participants reach their fundraising goal. While there is no fee to register, we encourage participants to fundraise in order to contribute to the cause and raise awareness.

Take the first step by finding a Walk near you. Once you register, you will have access to a wide range of tools and support through your customized Participant Center. Join us and lead the way to Alzheimer’s first survivor. Together, we can end Alzheimer’s disease!

What is Sundowning?

What is Sundowning?

And, what should I do about it?

The term “sundowning” refers to a state of confusion that often occurs in the late afternoon and may continue into the evening or night. Sundowning can cause or exaggerate some of the common behaviors associated with dementia. This could include confusion, anxiety, aggression, or ignoring directions. Your loved one might become demanding or suspicious. Sundowning can also lead to pacing or wandering.

Sundowning isn’t a disease, but a group of symptoms that occur at a specific time of the day that may affect people with dementia, such as Alzheimer’s disease.

What causes Sundowning?

The exact cause of this behavior is unknown. It might be related to light levels as the day wears on, or it might be related to fatigue if the person has been up and active for a while. They could even pick up on Caregiver fatigue!

There is speculation that the “internal clock” we all have is broken for people with dementia, so the day (and people around them) want them “awake” when their body tells them to “sleep”. Imagine how you would feel all mixed up, time-wise.

A more interesting theory to consider is that activity associated with later afternoon (shift changes, grandkids coming home from school, the dog needing a walk) may create a frustrating anxiety. The person with dementia might “remember” that they have to check on the dog, or pick up kids, or wrap up the day at work, even though this is not the current reality. Then, not being able to do it, or understand why they cannot, is frustrating and leads to behavior issues. That can include the need to “check in at home” which can lead to wandering behaviors.

Can it be prevented? How do we manage it?

The easiest approach to sundowning may be to change the stimuli of the environment. For example, keep lights brighter during the afternoon to “hold off” the shadows of evening. Close the blinds in the afternoon to avoid the changing light. The Alzheimer’s Association suggests the use of brighter lights during the evening.

You can also help the person get more or better sleep. Sometimes this might include little changes to medication or new patterns; talk to your doctor. You can arrange the bigger meal to be lunch rather than dinner/supper.

Schedule outside trips for times during the early part of the day. Go outside for a walk mid-day and limit mid-day naps, if possible. Avoid too much new activity during the time when the person with dementia seems to get agitated. Reduce noise and activity in the evening. Some people note that the TV is too distracting and suggest quiet music instead. Music can work wonders for some people with Alzheimer’s.

Care for the caregiver

Caregivers are stressed too. Take time to recover, sleep well, and relax as much as you can. Get respite help when necessary. There is no shame in asking for help and/or taking time for yourself.

For more information or help, contact a professional care manager, a home care agency, or an attorney familiar with these sorts of issues. Here is a more extensive case-study article.

Symptoms of Dementia

Symptoms of Dementia

In the past couple of emails, I noted that the dementia is progressive. That means it starts without symptoms, and then gradually the symptoms increase. Eventually, they interfere with daily life.

So, what should you look for?

Early signs of forgetfulness is often a key. This is sometimes described as forgetting why I went into a room, or where I left my keys. Of course, such things do not mean you have dementia, but they are possible symptoms. Forgetting directions to a common destination can also happen.

For others, poor decisions might be more apparent first. This can show up as a “lack of filter” in comments. I’ve heard seniors say amazing things they would never have said before the onset of dementia, and you probably have too. Another common example of poor decisions involves financial concerns. For example, a client lost multiple $100,000+ “investments” because he could no longer gauge the risk associated with the choices he was making.

Dementia in the general sense is different from the case of Alzheimer’s in the specific. Here is a list of Alzheimer’s symptoms you can read if you want more information.

What if I see a change?

People with memory loss or other possible signs of Alzheimer’s may find it hard to recognize they have a problem. Signs of dementia may be more obvious to family members or friends than it is to the person. Anyone experiencing dementia-like symptoms should see a doctor as soon as possible. If you see these kinds of changes in yourself or a loved one, don’t panic. It does not mean that dementia is starting! But, it is a good idea to check things out for yourself, and pay attention.

Keep an eye on changes, and consider planning ahead. You should look into legal documents, and be certain that IF there is a significant change in capacity, the family will be able to adapt and assist.

Help is available

If you or a loved one has been diagnosed with Alzheimer’s or a related dementia, you are not alone. The Alzheimer’s Association is the trusted resource for reliable information, education, referral and support to millions of people affected by the disease.

Call the 24/7 Helpline: 800.272.3900
Locate a chapter in your community
Use the Virtual Library

You are gaining knowledge by reading about dementia and Alzheimer’s disease, so use that knowledge to help your loved ones or yourself.

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