How End-of-Life Discussions Can Save Your Life

Couple meeting with doctorAmy Berman is a nurse and a nationally recognized expert in senior care. She’s also a cancer patient with Stage 4 inflammatory breast cancer. In a recent Washington Post editorial, she explains that advance planning and end-of-life discussions have saved her life, even as she faces a terminal prognosis.

For Berman, that began with a decision to focus on palliative care. In other words, she and her doctors are more interested in making the rest of her life as enjoyable and painless as possible, as opposed to employing extreme treatment options that may or may not make any difference but that would almost certainly leave her feeling less than her best.

As Berman puts it, it’s about her quality of life, not quantity of days.

Palliative care isn’t always the right focus. It’s a personal choice and a highly diagnosis-dependent one. But Berman says you need to have an honest conversation with open-minded doctors (and get second opinions) to make sure you’re embarking on the best course.

But advance planning doesn’t stop in the doctor’s office. There’s a lot you can do on the legal side of things, too.

“High-quality advance-care planning discussions help people like me understand their options and make their wishes known,” Berman writes. “They can identify a surrogate to make decisions when they are unable to, and they can document their preferences in their medical records. These discussions — which should be ongoing, not just one-time — can revisit decisions in the face of new challenges…”

Wills, trusts, healthcare directives, and power of attorney are documents that all Americans should have in place, not just those living with end-stage cancer or other terminal diagnoses.

If you’d like help preparing for your own future, my Middlesex County estate planning attorney services can help. It’s never too early to talk about how you’ll handle those final chapters in life — in fact, it’s even better to have that conversation when “the end” is still a long way away! Give me a call today.

Old Age Is Never an Identical Experience

Joyful senior stretching his legs in a parkThe New Yorker calls them “the oldest old” — people aged 85 and above. It isn’t exactly a flattering term, but it makes the columnist’s point: most people younger than that age have a hard time grasping what it could possibly be like to be that old.

Popular media relies on two stereotypes: the cantankerous geriatric and the flighty eccentric. New Yorker columnist Ceridwen Dovey recently realized just how powerful those stereotypes are. In trying to create a new novel with an octogenarian protagonist, the author kept slipping into those archetypal modes, quite by accident.

Upon further investigation, though, Dovey discovered that there’s really nothing uniform about old age. It’s a different experience for everyone who goes through it.

Maybe that shouldn’t be a surprise. After all, do any of us ever experience anything in life in exactly the same way? Why should aging be any different?

It isn’t.

In realizing that, we should also note that old age can be a better experience for some people than others. Much of that has to do with how carefully we’ve planned for our latter years. Happiness is often earned by preparation.

One of my passions in life is helping people create a reliable, well-protected future for themselves — right on into old age. That’s what my Middlesex County elder law practice is all about. I’d like to help you make the best of yours. Call me or contact me online to set up an easy, confidential consultation. I’d love to chat.

When Family Matters Are Messy, an Attorney Can Help

Rich elderly man with gold-digger companion or wifeFamily issues can be so tricky. The Chicago Tribune recently ran a story about an elderly father with a much younger girlfriend. He’s handed over a large portion of his assets to his new love, much to the chagrin of his now-grown children.

They say the girlfriend is out for their dad’s money. She says she’s his caregiver and they’re very much in love. The father agrees with her, and it’s his money. But is he of sound mind? So far, a doctor hasn’t said anything to the contrary, but the adult children believe that just such a declaration isn’t too far off in the future.

Meanwhile, an impartial observer looks at the whole situation and simply shrugs. Who’s to say who’s in the right here?

As a Massachusetts estate planning attorney, part of my job is to walk my clients through thorny family issues like the one contemplated in the Tribune. The issue of who’s “right” matters in some cases more than others. Often, there is a practical path to be found, one that leads to a better outcome than emotionally entangled relatives might be able to reach on their own.

Advance planning and honest communication are both key to the whole process. With respect to the latter, part of my job as the estate planning attorney is to make sure that you, the client, have a clear understanding of whose interests I represent (i.e. yours).

Maybe what’s best for you isn’t what’s best for your children or your significant other. The nice thing about a private meeting in our office is that we can consider those kinds of questions coolly, calmly, intelligently, and confidentially. I can answer all your questions and help you reach a decision that is ultimately yours to make — and yours alone.

If that sounds like a conversation you’re ready to have, give me a call. I’d love to help.

More People with Mental Illness Are Reaching Old Age

Sadly, it has long been the case that people with severe mental illness — especially schizophrenia and similar conditions — tend to die at much younger ages than those who are not suffering from mental illness. But now that’s starting to change.

The University of Iowa’s Center on Aging reports that more and more people who suffer from severe mental illness are living into old age. That’s largely due to advances in treatment therapy, improved social programs, earlier diagnoses, and an improved focus on tending to these patients’ underlying ailments.

That’s certainly good news. Society’s inability to meet the mentally ill’s needs has been an ongoing source of sadness and tragedy. A documented improvement in their average lifespan, not to mention their quality of life, is very welcome news indeed.

Society will now need to plan to address the needs of a growing elderly population with increased mental illness, though — needs that might differ significantly from those of their younger years.

“It’s a very difficult social problem, and we’ll have to start thinking carefully about how best to meet that need,” Dr. Susan Schultz recently told The Des Moines Register. Dr. Schultz is a geriatric psychiatrist and the director of UoI’s Center on Aging. “It’s a big question that will become more important over time.”

Family members will need to do some thinking and planning too, as will the mental health patients themselves. Long-term care costs are already expensive as it is. Coupled with additional psychological and/or psychiatric care, those costs could become overwhelming. Proactive planning can help.

If you or a loved one suffers from mental illness, now might be a good time to begin thinking about your options for paying for long-term care. Figuring out those solutions isn’t always easy, but they are absolutely attainable — and I’m here to help. I invite you to give my office a call so we can talk more about your options.


Proactive vs. Reactive Estate Planning

As Walt Disney once said, “The way to get started is to quit talking and begin doing.” If only everyone applied that philosophy to estate planning.

I recently came across an editorial out of Pittsburgh, weighing the benefits of proactive estate planning vs. reactive estate planning.

Proactive estate planning is what it sounds like — making plans before you need them. The proactive crowd is keen on foresight. They know they’ll need estate plans someday, so they get all their ducks in a row now, while everything is going well. No one’s sick, no one’s in the hospital, no one’s in the last chapters of their lives — but should disability, illness, injury, or unexpected death rear its ugly head tomorrow, they’ll be prepared.

The reactive camp isn’t so big on preparation. Oh, sure, they end up with estate plans eventually — but only when they’re running a race with deadlines and hoping they stay a little ahead of “too late.” Reactive types don’t give estate planning a second thought until someone’s health has taken a turn for the worst, or maybe when someone dies without warning. To quote the article, these are people “in crisis.”

The Pittsburgh Post-Gazette editorialists sum it up like this: “While there are almost always options available at the eleventh hour (often limited because of timing), obviously advance planning will save time, money and stress.”

Advance planning also leads to better decision-making. Crisis situations limit options and tie hands. Rash choices are made. But when you come into my office and sit down for a conversation during “a time of peace,” if you will, cooler heads can prevail. We can take a long look into the far-off future and account for every contingency so that you aren’t terribly blindsided someday.

No one has ever regretted being proactive in their estate planning. The reactive folks, though? They know a thing or two about hindsight.

One Hundred and Happier Than Ever

She’s never been in a nursing home. She lives alone, takes care of herself, and appears to be in perfect health. She’s the envy of many — thriving, highly respected, and seemingly happy as can be.

She’s Ann Husfloen of Wisconsin, and she is 100 years old.

I recently came across a news article about Husfloen’s one-hundredth birthday party (apparently something of a town-wide affair), and her high spirits and great health made an impression on me. After all, most people her age utilize some kind of assisted living service, and most can’t quite claim picture-perfect health.

But there is Ann Husfloen, looking radiant and not a day over 70 in her newspaper profile. She’s living like most twenty-year-olds… by herself and playing cards with the neighbors at night for fun now and then.

Interesting, when she was in her twenties, she got a job as an assistant care provider for ailing elderly women in her area. Maybe that experience helped her approach old age with the grace that now earns her the neighborhood’s admiration. She is “such a lady,” her property manager says.

Of course, things aren’t exactly the same as they were eighty years ago. She doesn’t drive anymore (she gave that up at age 93!), and she does have some help cleaning the house for a couple of hours each day. Otherwise, she isn’t anyone’s idea of what 100 looks like.

Maybe Ms. Husfloen is the face of the future, though. With new advances in medical science and an ever-expanding average lifespan, it’s likely that more Americans will reach age 100 in the decades ahead.
Naturally, most of us will need a little more help along the way. The challenge for now is keeping ourselves healthy, embracing a positive attitude in the face of growing older, and making financial arrangements to provide for what might be a very long life.

That last goal is a big part of what I help people with as a Middlesex County elder law attorney. If you were as touched by Ann’s story as I was, give my office a call and we can talk about practical ways to secure a bright future for you too. I’d love to help.

Blended Families Have Unique Estate Planning Needs

There is no such thing as one-size-fits-all estate planning, and that’s especially true when it comes to blended families in Massachusetts.

When you think about it, even “nuclear families” (a husband and wife who’ve never been married before and maybe have a couple of kids together) have their work cut out for them when creating estate plans. Most families have amassed their fair share of assets — even if it’s just a trove of trinkets with little more than sentimental value. Fairly providing for everybody in the family takes times and consideration.

Add divorce, second marriages, stepparents, and step kids to the mix? Then things really get complicated.

I recently came across a helpful article on this subject in Gannett’s The Spectrum, an online news magazine. It focuses on the single biggest estate-planning dilemma that any member of a blended family faces: balancing the many competing interests in a network of “exes” and “steps” who might not see eye to eye.

“Your challenge,” Spectrum tells blended families, “is to divide your assets among your heirs according to your wishes, while minimizing both estate tax and animosity among family members.” Easier said than done! With the right strategies in place, though, it can be accomplished.

In “nuclear” or “original” marriages, there is a temptation among spouses to simply leave everything to each other. That isn’t an ideal approach for anyone, but it’s especially problematic in the blended context.

Consider, for example, someone who had kids in her first marriage and then remarried and had additional children in the second marriage. Leaving everything to the new spouse might more or less take care of that second family (though not without some potential problems), but what about the children from the first marriage?

Of course, that’s just one example of the “blenders’ burden.” Families are complicated and so are the laws of inheritance. There is a lot to consider, so it’s generally not a good idea to try to square everything away on your own.
If you’re in a blended family, it might be time to update your estate plan to account for the latest changes in your life. If you’d like some experienced counsel and advice along the way, I’d be happy to help. Just give me a call.

New Saliva Test Could Offer Early Alzheimer’s Detection

When it comes to fighting chronic and terminal illnesses, early detection means everything. Once upon a time, that was a real challenge. We simply lacked affordable, accessible, and accurate diagnostic tools.

That’s rapidly changing on a number of disease fronts, though — cancer, diabetes, HIV, etc. But Alzheimer’s and dementia have been harder to catch early, in part because doctors have only recently begun to understand the causes and predispositions.

CNN has a promising new report, though. Researchers recently announced a cutting-edge saliva detection test that could tell patients if they’re vulnerable to Alzheimer’s with a simple swab and a few minutes of patience.

“Though research is still in its infancy,” CNN says, “the saliva test represents the exciting future of diagnostic tools in development for the detection of the neurodegenerative disease.”

Can scientists really find Alzheimer’s in saliva of all things?

Yes, more or less. Technically, they’re looking for metabolites, which are molecules created by chemical changes in the brain. Some specific metabolites have been linked to neurological changes specific to memory loss or dementia, and those are the metabolites the new test looks for.

Conclusive? No. Final? No. Promising? Extremely.

This Alzheimer’s detection test is just the latest brushstroke in a new picture of the future, when serious diseases might be diagnosed in mere minutes using nothing more than a cotton swab or (in some cases) an iPhone.

If we’ve learned this much in only a few years, just imagine how much more we might know by this next time next year!

Driverless Cars Are Likely to Liberate the Elderly

In the UK alone, some 1.5 million senior citizens are largely confined to their own homes due to incapacity or lack of transportation, reports The Telegraph. That’s an astounding number, and the statistics are undoubtedly even more wowing here in the U.S.

But problems only persist until technology can solve them, and it looks like the days of “default house arrest” may soon be over for elderly people all around the world. Just thank the driverless car.

Self-driving automobiles have been all the rage in technology circles for a few years now. Indeed, they’re already on their way. Major manufacturers have whole fleets in development, and experts are working to refine their reliability and safety features. They may be just a few years away from the mainstream.

In a new report by the International Longevity Centre UK, researchers conclude, “whilst a few years ago the idea of driverless cars would be firmly in the realms of science fiction, the rapid advancement of technology means that driverless cars are now a real possibility – and they are likely to be on the roads in years, rather than decades.”

That could utterly revolutionize life for seniors, empowering them to access everything from the local supermarket to the emergency room whenever they need it. In a sense, gone would be the days when someone has to stop driving because they’ve gotten “too old.”

The really interesting thing about this article is that, when we first started hearing about driverless cars, I dare say no one imagined elderly people inside them. It just goes to show how endlessly applicable modern technology and the imagination can be in the realm of senior care and modern aging.

It’s a fast-emerging future, speeding toward us so steadily that it’s practically driving itself.

Wine & Dine at Age 89? Why Not?

The assisted living industry is out to make a new name for itself, or at least certain parts of it are. As seniors live longer lives, they’re increasingly interested in finding better places to enjoy their time. For many, the conventional nursing home just doesn’t cut it, and the market is becoming ever more aware of that fact.

I recently came across an English-language article in a Finnish newspaper, and it reveals some of the fascinating new developments in Finland’s senior care.

A slew of new retirement homes are opening there, each designed to cater to popular pastimes or specific hobbies. One home emphasizes gardening, for instance, and its residents spend much of their day outdoors. Others, meanwhile, focus on providing fancy four-course dinners and excellent glasses of wine every night.

There are even “old-age homes,” as they call them, that specialize in environmentalism, cultural media, and sports! Those options have apparently proven quite popular there, though the more diverse selections are largely confined to Helsinki and other big cities.

Cost is a major concern, too. Even by-the-book senior care is expensive, so more specialized services like these come with a considerable upcharge. That makes them an option only for the wealthy or those who’ve planned prudently and well in advance.

Stateside, we’ve started to see specialization and innovation in our own senior care industry as well, though perhaps not yet quite so creative as the Finns. As the pendulum continues to swing in that direction, we’ll probably see much more specialization in the years to come. Of course, cost will be an all-important factor for America’s seniors, too.

If you’re peering down the road into your own future and think that a different kind of “old-age home” might be right for you, the time to start planning is now. One of my primary focuses is helping people employ sensible strategies for saving and utilizing all the available resources out there to secure their futures in advance. Give me a call to talk about what we can do together.