While Marilyn Friedman had always dreamed that one day she and her mother would have a closer relationship, it was not to be. Her mother had dementia. She forgot the word for “dog.” She got lost on the way home from the grocery store. She experienced hallucinations of flashing lights at 2am and strangers in her bedroom. She stopped eating and lost 20 pounds in a month. She’d fallen several times, could no longer write a check or drive. When her doctors recommended 24-hour care, her mother rejected it. This is the story about a family, their mother’s dementia and the memory-care unit.
In a New York Times article, The Dementia Heist, Ms. Friedman tells the heartbreaking story of caring for her mother. In this story, Ms. Friedman and her sister resorted to tricking their mother to get her into the memory-care unit. They hid in the back of a car and watched a paramedic escort their mother into the facility.
She felt like the worst daughter ever, yet she was doing the most caring thing
Ms. Friedman reminded herself that her mother had had a hard life. At 27, she fell from a train, shattered her kneecap and nearly died from gangrene. Friedman’s parents had abandoned everything when they immigrated to the U.S. from Russia in 1964. Mother-daughter relationships are often complex, and they can be volatile and unpredictable. For the Friedmans, good moods meant blueberry blintzes and movies; bad moods resulted in an endless cycle of slaps.
The sisters toured memory-care facilities
“My sister worked hard to enable mom to remain at home, but she couldn’t juggle my mother’s multiplying needs with those of her own family. Our choices were to let her die alone from starvation or trick her into memory care.”
The sisters toured memory-care centers, where cost is based on the level of care. They found a facility with a B&B vibe and patient staff members who gave lots of hugs. They signed a 40-page contract making their mother liable if she injured another resident or destroyed property.
Next up: Getting mom admitted to the facility required “therapeutic lying”
The sisters had her admitted to the hospital, blaming her high blood pressure. Professionals call it “therapeutic lying” because honesty can increase anxiety. Once she was in memory care, the sisters couldn’t contact her for ten days—an effort to help her adapt. They did, however, get reports: Mom wouldn’t sleep in her room; rather, she parked herself in the lobby all night.
Their mother’s belligerent behavior continued in her new environment
She refused to eat. If she kept starving herself, she’d be sent to a more depressing, regular nursing home. She refused medication because the pills were making her lose her memory. The staff hid meds in her food, but she resisted her glaucoma drops, risking blindness. When finally allowed to visit, Ms. Friedman found her mother belligerent, insisting that her daughters take her home. They resisted for a number of reasons.
Understanding that the last chapter of her mother’s life would be painful
“We ate cake at a courtyard table beside a classic convertible. She complained that everyone there was crazy, so we changed topics–another strategy for dealing with dementia patients. This next chapter of her life would be painful. My only hope was that she’d become enveloped in a pleasant memory.”
Testamentary capacity is a growing legal concern
Testamentary capacityis the legal term defining a person’s legal and mental ability to make or alter a valid Will. With the increased occurrence of some kind of dementia, the matter of testamentary capacityis being raised more frequently when it comes to signing legal documents. In every case, capacity is specific to each time and situation. Legal capacity can fluctuate. In terms of the law, there is a presumption of capacity until it is disproved. If you have legal documents that need to be signed by someone who has been diagnosed with dementia, it’s important to do this as soon as possible. Most important are a Living Trust, a Power of Attorney and Advance Healthcare Directive.
We encourage all of our clients to create a Living Trust so their families can avoid Probate. Unfortunately, there’s one critical step that sometimes gets left out of this equation and leaves families vulnerable to Probate. Simply having a Trust is not enough; Living Trusts need to be funded–your assets need to be moved into the Trust. Without this action, your family will likely be facing Probate. There are five steps to funding your Living Trust.
A Trust has five asset categories that can be funded:
Bank and brokerage accounts
Life insurance policies
Tangible personal assets
1. Real property—property that is fixed in place
Real property is a building or a piece of land, designated by a Deed. When a Trust is formed, the owner listed on the Deed must change the name from the name of the person to the name of the Trust. If James Smith owns a house, and the house is in his name, he must transfer the Deed into the Trust, and the “Living Trust of Jonathan Williams” becomes the new owner. This must then be registered with the county for the Trust to be funded. California Document Preparers prepares Trust Transfer Deeds for our clients who are funding their Trusts.
2. Bank and brokerage accounts
Creating multiparty bank accounts can seem like a convenient solution for those caring for ailing family members, but it can create family conflict. If that ailing family member dies, all of the money in that account defaults to the person whose name was also on the account. If, for example, there are other siblings who expected to inherit some of that money, it can result in family discord.
In most cases, you will want the funds to go to multiple persons or organizations. Putting the accounts in the name of the Trust will ensure that funds can be transferred easily to all parties specified by the documents of your Trust. For example, if you want your Procter & Gamble stocks to be divided equally among your three children, you will need to put them in the name of the Trust. Each bank and brokerage has a procedure for this and will be able to assist with transferring the account name to that of the Trust.
3. Life insurance
While you can state in your Trust that your life insurance policy will go to your oldest daughter Joan, it’s important to know that the beneficiary noted on the actual policy is the beneficiary of record—not the person named in the Trust. Joan will not inherit that policy if she’s not named on the policy. If divorce or death means a change to your beneficiary designation, it’s imperative that you make this change to the life insurance policy itself—not your Living Trust.
4. Retirement accounts
Retirement accounts, like life insurance policies, specify a designated beneficiary. For married couples, this is typically one’s spouse. Where retirement accounts can get problematic is in naming their alternate beneficiary. A Trust is often a very valid choice for this secondary designation. Having one’s retirement account go to the Trust, to be distributed according to Trust specifications, can be a safe way to avoid Probate and ensure that your assets are distributed according to your wishes.
5. Tangible personal assets
Tangible assets that need to be included in your Trust include valuable jewelry, artwork, furniture, cars, etc. These items can be placed in a Trust through a Deed of gift or a bill of sale. The Deed of gift or bill of sale is necessary to “fund” the Trust with these items. Items that are high in value will have to go through Probate if not properly placed in the Trust.
One more thing: Identifying the distribution of sentimental items
If there are items that have nominal monetary value but significant sentimental value, these should be identified in a Trust along with their respective recipients. When Robin Williams died and left much of his estate to his second wife, his children sued to get the memorabilia that they believed were rightfully theirs. The more detail you provide, the more seamless the process of settling your estate will be for your family.
Beginning Oct. 1, 2020, if you want to travel within the U.S. on a domestic–not international—flight, you will need the driver’s license/ID card known as a Real ID. Haven’t heard of the Real ID? Get in line. It’s part of enhanced efforts to improve national security. Each state is responsible for their Real ID rollout, and in many cases, it’s being met with confusion and anxiety.
The Real ID was conceived in 2005, part of post-9/11 legislation
The Real ID requires people to show security-enhanced IDs to pass through airport security checkpoints or to enter certain federal facilities. Note that you can also use passports and certain other federal documents as alternatives to a Real ID.
Also called the Star Card because most states are marking their Real ID cards with a star in the top right corner, it also must include an encoded “machine readable zone,” with a person’s scannable information. What differentiates this card is that the government requires you to provide more documentation than what you provide to get a driver’s license.
What you need to know about getting a Real ID:
Getting a Real ID requires a trip to the DMV. You’ll need documents proving your age, Social Security number and address. Bring a birth certificate or passport, a Social Security card or tax form such as a W-2, and two proofs of address. If you’ve changed your name through marriage, you’ll need a marriage certificate.
Your old-style driver’s license is still lawful for driving and still available as an option. However, if you plan to fly after October 1, 2020, you driver’s license won’t be enough to get you through security and onto a plane. You will need a Real ID or a passport.
Real ID remains a work in progress. Twelve states have yet to issue them. Other states have been issuing Real ID cards for several years now with little fanfare. Some are using them with a fair amount of confusion.
Those concerned about privacy issues should know that each state maintains its own records
Many states have delayed getting the cards into circulation because some residents and legislators worry that the Real ID is a way for the government to collect personal information for a national database. People from all states should be reassured that the program is a state-maintained card. There’s no national database. Each jurisdiction maintains its own records, and controls who gets access to those records and under what circumstances.
Paperwork problems can also cause delays
For some people, getting the proper paperwork is a problem; their birth or marriage certificates may not actually be from the state in which they live and, therefore, they do not have sufficient information. In Maryland, residents who are 65 or older are allowed to submit other documents, such as military discharge paperwork.
Real ID: Look for a more aggressive information campaign
Many people remain unaware of, or are simply confused by, the new card’s rules, and the clock is ticking. I was aware of the card only because I renewed my license last fall. I didn’t have the necessary documentation with me to create a Real ID, and I had very little interest in making another trip to the DMV. Because I travel internationally two or three times/year, my passport is always current, and this solution is fine for me.
The Department of Homeland Security has called on travel agents as a way to reach consumers and increase the number of Real ID-compliant users. Look for more public service announcements as they step up their public education campaign.
How to expedite the Real ID card process in California
Make an appointment at your local DMV. It’s not required, but you want to take advantage of anything that will make your experience with the DMV easier.
Complete the online application prior to your visit.
Review the list of documents that you’ll need to take with you to verify your identity, to include social security number and California residency.