Signs of Caregiver Stress

So much of the discussion about long-term care in this country is focused on the patients and the payments. That makes sense. Long-term care can be very expensive and it has an inestimable impact on the lives of the elderly who need it.

In giving those issues the attention they deserve, though, we mustn’t overlook one invaluable piece of the senior-care puzzle: the voluntary family caregiver.

About Health tells us that more than 22.4 million Americans are providing some form of informal, unpaid care to elderly or disabled relatives. Their efforts are noble but they can also be incredibly stressful.

We also know that the majority of visits to doctor’s offices in this country are stress-related. Stress is a real concern and a verified cause of illness. It is important, then, for caregivers to set a moment aside for serious self-assessment.

According to About Health, the following are the most common signs and symptoms of in-home caregiver stress:

  • Anxiety that doesn’t get better after a short time
  • Crying more than usual
  • Frequent sadness or mood swings
  • Low energy
  • Changes in sleeping patterns (i.e. insomnia, oversleeping, etc.)
  • Changes in eating patterns (i.e. loss of appetite, overeating, etc.)
  • Social isolation
  • Diminished interest in your usual hobbies
  • Feeling that you don’t have time for yourself
  • Tension headaches
  • Feeling angry or resentful toward the person you are caring for

If you’ve checked off more than one or two of these, the following resources can help you manage your stress, connect with other caregivers, and find some balance:

Staying in strong physical and emotional health isn’t important for only the caregiver. The elderly recipient of care also needs somebody who’s staying in good spirits and good health.

If you’re caring for someone at home and feeling a little overwhelmed, please know that it’s normal and that you aren’t alone. Allow yourself to take a deep breath and create some “me time.” If you need outside help, don’t be afraid to ask for it. Remember: you can’t help anyone else until you’re taking care of yourself too.

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A Marriage to Remember: A Touching Short Film on Alzheimer’s

In a new short-film documentary entitled A Marriage to Remember, filmmaker Banker White takes a starkly intimate look into his parents’ struggle with his mother’s early-onset Alzheimer’s disease.

In her youth, Pam White was a model and an actress. Later, she devoted her entire life to her family and her kids. Now, they’re paying her back with around-the-clock in-home care.

The film visits Pam at an interesting moment in the course of her disease. For the most part, she’s still in command of her mental faculties. In one candid car ride, her son asks whether the confusion has been difficult for her. Wittingly, she replies, “I’m not confused. You think I’m confused?”

She isn’t arguing or in denial. She’s just being precise. Confusion isn’t exactly her issue just yet. Ultimately, Banker agrees. That wasn’t the right word.

It’s a telling moment that keenly illustrates the sneaky progression of Alzheimer’s. Here is a woman who still recognizes, still remembers, still engages in conversation, and is clearly still quite sharp. And yet she is also undeniably struggling.

Her husband has to pull her out of bed and help her shuffle from one room to the next and down the stairs. He tells us that the change in just one year has been “profound.” Her son says there are early mornings where he’s sure she doesn’t recognize them at first. “That is beginning,” her husband says.

But while the narrative of Alzheimer’s is often a sad one, sorrow is not the prevailing sentiment in A Marriage to Remember — and that is what makes it so impactful in its brief, eight-minute runtime.

“Initially, I was quite distressed,” Pam tells us. “…But it doesn’t really change anything… I don’t feel sad and I don’t feel regret. I feel blessed that I have this wonderful family and a husband who is extraordinarily wonderful.”

Blessed. What an outlook. And truly, the film is as much husband Ed’s story as it is Pam’s. It reveals the unshakeable strength of a marriage that is so strong that not even Alzheimer’s can break it. Theirs is a love for times both better and worse. It is truly inspiring.

Silver linings and love help to redeem even the darkest diagnoses. A Marriage to Remember is a testament to that. It’s a very short film, and I think you’ll be glad you watched it. You can find it streaming for free at The New York Times.

If you and your family are currently going through an Alzheimer’s experience of your own, I also recommend getting in touch with the Alzheimer’s Association of Massachusetts and New Hampshire, as they offer a number of programs and services that can be of great help.

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Lights… Cameras… Estate Plans? When Wills Hit the Big Screen

From Philip Seymour Hoffman and Heath Ledger to Frank Sinatra and Elizabeth Taylor, Hollywood’s dearly departed have taught us a lot about estate planning over the years.

Forbes put together a list of those lessons last year, demonstrating how creative and chaotic estate planning can be in the spotlight of fortune and fame. That had me thinking — it isn’t only the stars themselves who impart insight on the prudence of planning. Sometimes their movies do too.

Here’s a look back at a few of the greatest movies to put estate planning front and center (or at least in the middle of a juicy plot twist):

Cover of "The Aristocats (Special Edition...

Cover of The Aristocats (Special Edition)

  • The Aristocats (1970) — When you think about complex legal concepts, Disney animated features aren’t the first things that spring to mind. Nevertheless, The Aristocats offers a textbook illustration of the classic “life estate with remainder in fee simple absolute” — in other words, an elderly widow who leaves her entire estate to her cats, with the remainder to pass to her butler after the cats die. Unfortunately, the criminally inclined butler isn’t eager to wait that long…
  • The Descendants (2011) — George Clooney plays an attorney and the sole trustee for a massive family trust containing 25,000 acres of beautiful Hawaiian land. A series of accidents and unfortunate timing force his enormous family to wade through the murky waters of wills & trusts. Most interestingly, the whole plot revolves around “The Rule Against Perpetuities” (a pesky legal rule that limits some people’s future interest in property if too much time passes before the interest vests). Notably, both Hawaii and Massachusetts have adopted the same uniform version of “The Rule Against Perpetuities.”
  • The Grand Budapest Hotel (2014) — Nominated for Best Picture at this year’s Academy Awards, Hotel’s haywire plot is anchored in a controversial bequest. When an older woman dies, she leaves a very valuable painting to her much, much younger lover. Naturally, her ne’er-do-well children are less than thrilled. They challenge the validity of her will, and while that proceeding plays out with a little more madcap action than most of the real-life cases I’ve seen, it’s a great showcase for how easily miscommunication and strife can muddle an estate plan.

In Hollywood as in real life, estate planning is a potential breeding ground for epic drama — no wonder it’s a favorite topic in the screenwriting world! Of course, most of the movies’ great estate capers could have been avoided with careful planning.

What did I miss? If you have any favorite films with a focus on estate planning, please feel free to share them. And should any of these cinematic classics spark a question about your own estate plan, don’t hesitate to give me a call.

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Amy Grant’s Three Tips for Family Caregivers

Amy Grant has made a career out of inspirational storytelling in song, earning six Grammy awards and more than thirty million record sales along the way. She’s one of the best-selling female recording artists of all time, but now she also has a new job title on her résumé: long-term care provider.

Grant’s parents were each diagnosed with different but severe forms of dementia late last decade. Her mother passed away in 2011, an experience that informed most of the songwriting on Grant’s most recent album, released in 2013.

Her father, meanwhile, still suffers from dementia so profound that he has lost nearly all his ability to communicate.

Grant sat down with Guideposts magazine to share three insights she’s found throughout the heartbreaking journey she’s taken with both her parents. Her tips for family caregivers include:

  1. Frame your experience in a way that gives meaning to what you’re going through.” Grant said that the key for them was finding a silver lining in an otherwise trying experience. “This is the last great lesson that we’ll learn from our dad,” she says.
  1. Spread the responsibility. Grant recommends making a list of all the people to whom this aging person matters. Rather than allowing an excessive burden to fall on just a few shoulders, encourage extended family and friends to realize that they’re a part of the puzzle too. She concedes, though, that relating to someone with dementia can be challenging for some family members, especially youngsters.
  1. Start preparing to fund long-term care as soon as possible. While Grant’s dad was a successful doctor and she herself has gone on to enjoy superstar fame, she recognizes that most families aren’t as fortunate. She stresses the need for parents and children alike to consider insurance and long-term care planning, even if everyone in the family is still in good health.

Her advice is well taken, and it is nice to see someone in the public eye shine a light on the need for long-term care planning, even as it comes in the midst of her personal sadness. For more of Grant’s eloquent and inspiring story, watch her Guideposts interview online.

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Is the Green House the New Nursing Home?

Every so often, cultural institutions give way to paradigm shifts. That might be the case with the conventional nursing home, according to a new report from The New York Times.

In today’s society, when parents age and become less self-reliant, they generally have three options: live with children or other close family members, hire in-home care, or move into a nursing home.

It’s not always a choice between the three, though. Living with family requires relatives with sufficient time and space for providing attendant care. In-home assistance, meanwhile, is extremely expensive — especially if it has to be around the clock.

So without adequate resources, many elderly people resign to the nursing home by default.

That isn’t always a bad thing. Some nursing home experiences prove to be happy and effective ones for their residents. But, as the Times argues, many would rather live somewhere else if given the chance.

As I mentioned earlier, though, paradigms change. Increasingly, seniors aren’t resigned to just the three conventional choices anymore. A variety of innovative approaches to senior living are diversifying the elder care marketplace.

One promising example is the Green House Project, a new kind of living environment for older Americans, already available in more than half the country. (There are currently two locations in Massachusetts — Westwood and Chelsea).

Green House residents live in pleasant cottages with their own private rooms and baths. The idea is to create a community in which seniors help take care of themselves and each other.

For example, those who’re able can help prepare the Green House meals, which are served in an inviting dining room rather than a stifling cafeteria. Residents schedule their own mealtimes and generally enjoy greater autonomy than they might have in a nursing home.

The Times talks about the project as a potential catalyst for industry-wide change. That’s an inspiring thought, especially when you consider that a variety of other nursing home alternatives are flourishing throughout the country at the same time.

Things keep looking up for the future of senior care in America, and I can’t wait to see what comes next.

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Happy Days Come with Age

Ezekiel Emanuel, the famous bioethicist and Ivy League professor, recently wrote an essay explaining why he’d like to die around age 75. For many, he reasons, it’s all downhill from there. Better to leave life in good shape and on his own terms, he argues.

Then, a few weeks ago, David Brooks published an op-ed in The New York Times, taking issue with Emanuel’s grim outlook on old age.

“The problem,” Brooks writes, “is that if Zeke dies at 75, he’ll likely be missing his happiest years.”

Indeed, senior citizens consistently report more widespread happiness than any other age group in America. That fact stands in stark contrast to the grumpy, cantankerous stereotypes we often find in the media.

Researchers have long noted that happiness and age tend to correlate along a bell curve.

People in their twenties love life and consistently say they’re very happy. Middle age, meanwhile, seems to bring on “the sour years.” After their fifties, though, people start getting happy again — and fast.

By the time seniors reach their early eighties, their rates of contentment are through the roof. Truly, if numbers are to be believed, those appear to be the happiest years of life.

Experts think it’s a combination of biology and life experience that lead to the U shape of lifelong happiness. Brooks says he likes to think of elderly joy as an achievement — a nice outlook, indeed.

It’s a lovely thought to know that happy days are still ahead for all of us. And, as The New York Times reminds us, that’s not just optimism. It’s fact.

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Not Your Grandmother’s Long-Term Care

I always love to see major media outlets shine a light on elder care. Not long ago, “The Today Show” aired a wonderful segment about long-term care, encouraging young people to take it seriously and start learning about it now.

Carol Levine, author of Planning for Long-Term Care for Dummies, joined the hosts to talk about the changing face of long-term care in the United States.

“The newer approach to long-term care is really not your grandmother’s long-term care,” Levine explained. Today’s approach differs from the previous generations in a few key respects. Generally speaking, she says, these include:

  • A wider range of options
  • Longer time periods, as people live longer
  • Care plans that are based on what people need, not on institutions’ needs.

But some things don’t change. Long-term care is still confusing and still very expensive. “Today” cited costs that span from $40,000 to $75,000 a year —sometimes higher. Often, it’s the families that end up paying for most or all of that.

Levine’s basic advice is golden. Do your homework, she says, and begin now.

She suggested starting small. Make your parents’ homes safer, more accessible, and more fall-proof. Falls often trigger an early need for elder care.

From there, you can start to put together a financial plan that might include savings accounts, trusts, long-term care insurance, retirement funds, health insurance, and more.

Like most things in life, long-term care is a mountain best scaled one stone at a time. Starting early is the key. If you’re feeling overwhelmed or have any questions whatsoever, don’t hesitate to pick up the phone and ask. I’m more than happy to help.

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A Real-Life Neverland for the Elderly

Loma Linda, CA: Where Older People Stay Young

We’ve all read stories about places where people never grow up. They stay young, strong, healthy, and always alive. Just last month, NBC raked in millions of viewers with its new take on the venerable Peter Pan.

Neverland is as good an example as any of the enduring fantasy of living like a young person for a very long time.

But what if it were real?

“The Today Show” recently featured a little town called Loma Linda, CA on its TODAY Health website. They say the place might have found the elusive “secrets of longevity.”

Less than an hour outside of Los Angeles, Loma Linda is home to a thriving population of elderly people who seem almost unaware that they are of old age. Many of them maintain social lives and daily routines that would make a twenty-something’s head spin.

Take 90-year-old Thelma Johnson, for instance. When she’s not cruising around the world with her friends, she and her husband hit the jogging trail or the gym every single day.

She isn’t alone. Indeed, that kind of schedule is par for the course in Loma Linda.

“Don’t let what you cannot do interfere with what you can do,” Johnson said in the “Today” interview. What a way to approach old age!

Of course, Loma Linda isn’t the only bustling blip on the map for older people. National Geographic recently released its list of the five places in the world where people live the longest. Japan, Italy, Greece, and Costa Rica what is the 5th? each have one of these so-called “Blue Zones,” all of them home to incredible vitality in an ever-aging population. But Loma Linda remains the only “Blue Zone” in the U.S.

That said, there are smaller elderly communities scattered all throughout America where people are finding that old age isn’t the limitation it once was.

Loma Linda is a perfect illustration of how rapidly we’re all evolving in our understanding of what it means to “grow old” in the 21st Century.

As Peter Pan might say someday, even in older age, life is still an awfully big adventure.

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Estate Planning for People Without Children

In talking about estate plans, much of the discussion tends to focus on children. How much should they inherit and when, what kinds of trusts do they need, who should serve as guardian in the event of tragedy, etc.

What about childless couples, though? That’s a question The Wall Street Journal recently asked, and I think it’s an important point for discussion. Even for people who don’t have kids now and may never have them in the future, estate planning is too imperative to simply shrug off.

The Journal breaks it down like this. People without kids have a primary checklist with just two boxes on it:

  • Set up a distribution plan to determine who gets your property when you die.
  • Assign someone to make medical and financial decisions on your behalf should you ever become incapacitated.

That’s a rather barebones approach to nonparent estate planning, but even those two items can be trickier — and more critical — than they seem.

As an estate planning attorney, I could accomplish those two tasks for my clients by drafting a will and a healthcare directive for each spouse according to their needs, but that could still leave the door open for unintended consequences.

Without a trust, for example, assets may be subject to costly and time-consuming probate when they pass to relatives.

Whatever your approach, it’s important for childless couples to remember that even though they don’t have kids, they do have relatives, friends, and other people they care about. When they die, their assets are going to go somewhere.

Without a strategic estate plan in place, it’s possible for one whole side of the family to be shut out altogether. Often, the default statutory procedures render rather undesirable distributions. But with some careful forethought, spouses can avoid those outcomes and rest easy, knowing that their best intentions are protected.

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Art Is In The Trust Of Fhe Beholder… Or Is It?

The Wall Street Journal is shining the light on a different kind of estate planner: the diehard collector.

Whether it’s comic books, baseball cards, home video libraries, music memorabilia, Disneyana, or what have you, collections can grow enormous over a lifetime. And with enormity comes value.

But as the Journal points out, the same aficionados who work so diligently to amass a dazzling collection during life often fail to make provisions for their allocation after death.

In deciding which beneficiaries to leave a collection to, and under which terms, there are a lot of things to consider: personal interest, the cost of storing and maintaining the items, the higher rates at which those gifts may be taxed, etc.

One option, of course, is to set up a trust to hold the collectibles during life or after death. Another is to gift part of the collection annually in order to reduce the total size of the taxable estate while staying within the tax-free gift-giving threshold each year.

Charitable donations are an option too, as are good old-fashioned sales. The collection can even be split up, with different portions distributed differently.

Whichever approach works best for you, you’ll need to be thorough in your paperwork and making sure you understand the tax liabilities for each decision. You’ll also likely need to have the collection itself professionally appraised so that you have an actual dollar amount to work with when making those decisions.

If you’d like to chat about the interesting things you collect and how you can best protect them for the future, feel free to give me a call. I’m happy to help.

 

Posted in Asset Distribution, Charitable Giving, Collectables, Estate Planning, Gifting | Leave a comment