Living–and Thriving–with Alzheimer’s

Laurie Scherrer, 55, a hardworking sales executive, found herself forgetting customers and unable to perform simple math calculations. She was diagnosed with early onset Alzheimer’s disease and frontotemporal dementia, which causes deterioration in behavior and ability to understand language.

Ms. Scherrer gave herself some time to feel sorry for herself, then took action. Knowing that her life now had limits, time became more precious. “I began to appreciate the joy and beauty around me,” she said. Ms. Scherrer knew that she still had plenty of time to live–and thrive–with Alzheimer’s.

Creating a team of professionals became an immediate priority

Creating a Living Trust, naming a Power of Attorney and an agent for her Advance Healthcare Directive were important priorities. She knew she would need these as her disease progressed. Her doctor and financial planner were important members of her team, along with her husband and children.

As part of her planning, Ms. Scherrer  began to research dementia. She found a group called Dementia Mentors, and joined the group’s virtual memory café. The format: Nine or so people, each in a box on a screen, shared strategies to ease symptoms, medication tips and learn from each other. She learned to avoid those things that caused confusion, to celebrate her achievements and to savor the good things in her life.

Those with Alzheimer’s can still lead fulfilling lives and plan for the future

Ms. Scherrer has gotten involved in the Alzheimer’s community. As a member of the advisory board of the Dementia Action Alliance, she speaks at conferences of policymakers and neurologists. She contributes suggestions for better, more sensitive, care. Her advocacy could help other baby boomers who are reaching the age when the risk for dementia rises. The number of people with Alzheimer’s who are 65 or older is projected to climb to 7.1 million in 2025 and 13.8 million in 2050, up from 5.5 million today, according to the Alzheimer’s Association.

Among challenges for families: Assessing ability to understand and sign legal documents

A challenging question for families is whether the person with dementia can understand and sign legal documents. Even mildly impaired persons may need to be carefully evaluated.

An Advance Healthcare Directive provides guidance on end-of-life treatment. A person with dementia may live for a long time after a diagnosis, and instructions could include details for caregivers, and how and where patients choose to spend their final days. Ms. Scherrer has directed her Agents to withhold treatment, under certain circumstances, for serious illnesses like cancer.

The economics of long-term care

Evaluating assets to pay for long-term care also becomes a priority. Patients go through different levels of care, and there are different costs associated with each level. Medicaid, which is financed by state and federal governments, pays for care for people with limited assets, though state laws differ. The Scherrers expect to sell their four-bedroom house, which they no longer need. A smaller place would be easier to manage and free up cash for long-term care. Ms. Scherrer  has looked at assisted living facilities, though members of her family have promised to care for her at home for as long as possible.

Another challenge: Dealing with the loneliness of Alzheimer’s

People with dementia stress the importance of developing social connections. Communicating with others who still engage in hobbies, sports and other activities keeps patients from feeling isolated. Many chapters of the Alzheimer’s Association offer early-stage support groups where individuals and caregivers can socialize.

Ms. Scherrer  has created and signed her legal documents and made financial plans

The article about Ms. Scherrer, by Susan B. Garland in The New York Times, provides an insight into how life-altering a dementia diagnosis can be—especially at the age of 55. Yet dementia can be a slow-moving disease, and Ms. Scherrer  knows she’s lucky to be surrounded by a supportive family. She’s making the most of the time she has left and knows that each day is a blessing.

For those who are diagnosed with dementia, getting a Power of Attorney and Advance Healthcare Directive while they still have testamentary capacity is critical for their long-term care. Schedule an appointment to get started on your Trust today by contacting us at one of our three Bay Area offices. Our dedicated team is helpful, compassionate and affordable.

Living Trusts and the Issue of Mental Capacity

These days, hardly a day goes by that we don’t hear about someone we know being diagnosed with Alzheimer’s or some form of dementia. In some tragic cases, it comes way too early and it’s agonizing to see a life cut short.

Alzheimer’s: No hope, no cure

Alzheimer’s is one disease for which we have no cure, no revolutionary treatment. It violates every demographic, and the statistics indicate that nearly 80% of us will experience some kind of dementia before we die—it may not be the complete debilitation of Alzheimer’s, but we’ll have some degree of memory loss and inability to deal with our surroundings. For those who are in the process of creating a Living Trust, along with a Power of Attorney and Advance Healthcare Directive, this presents a potential problem. At what point is someone incapable of creating and signing a legal document such as a Living Trust?

Legally, everyone is presumed to be competent

However, the presumption that someone has legal capacity can be challenged in court. If the challenge is successful, the court will invalidate the Living Trust, making it necessary for the heirs to go through Probate to settle the estate and distribute the deceased’s assets.

Possession of a mental deficit

In California, testamentary incapacity does not refer to physical or mental disorders, but rather to one of three factors: The inability of a person to understand and sign estate-planning documents, the presence of an unsound mind or the possession of a mental deficit “so substantial that, under the circumstances, the person should be deemed to lack legal capacity.”

It’s important to note that age, illness and disease in themselves are not factors in the determination of testamentary capacity. People can be well into their 90s or suffering from debilitating disease, yet still have the capacity to be fully cognizant of what they are doing, legally able to sign a Will and Living Trust.

Under California law, deficits that may affect testamentary capacity are divided into four categories.

• Alertness and attention. The court would be looking for poor arousal or consciousness; a weak orientation to time, place, person, and situation; inability to concentrate.
• Information processing. This includes deficits in short or long-term memory; the inability to understand or communicate with others; the lack of recognition of familiar objects and people; the inability to understand and appreciate quantities; the inability to reason logically and to carry out a plan or action.
• Thought processes. Extreme examples of inability to complete thought processes would be hallucinations, delusions and uncontrollable, repetitive thoughts.
• The ability to modulate mood and effect. In this case, there would be evidence of persistent, recurrent moods inappropriate to an individual’s circumstances, including euphoria, anger, anxiety, fear, panic, depression, hopelessness, despair, apathy or indifference.

The presence of one or more of these factors does not necessarily mean someone is incapable of making decisions regarding his/her estate or signing related legal documents–an illness or prescribed medications may temporarily influence testamentary capacity, for instance. Once the prescribed drug treatment is finished or the illness has passed, the person may be fine once again.

With a diagnosis comes some immediacy

But evidence of any one or all of these factors in at least some degree raises the need to take extra precautions if you or someone in your family is creating estate-planning documents. Once people have been diagnosed with dementia, there is, of course, the need to create end-of-life documents as quickly as possible. In addition to the issue of testamentary capacity, there are very practical considerations–they may soon need these documents to be in place if they are no longer able to take care of their own affairs and make decisions about their own care. They will need to identify a Power of Attorney and an Agent for their Advance Healthcare Directive.