Challenges Caring For Special Needs

‘Tis the Season for Stress’ – Special Challenges

Once again the Holiday Season is upon us. ’Tis the season’ for mixed blessings. Along with the joys of the season come the stressors. This year you wonder how you will manage to get everything done. Your “to-do” list, as always, seems never ending with shopping, baking and decorating. This year, however, you know at the top of your priority list is providing the best possible care for your elderly loved one who suffers from increased dementia.

This time of year can likewise create stress for your loved one whose anxiety levels seem to mirror your own. Unlike yourself, however, the dementia affects your loved one’s ability to express himself or herself clearly. Simple changes in routine can cause unexpected anxiety which increases with the inability to verbalize what they are feeling.

In addition to the stress on both caregiver and care recipient, out of town guests add a whole new dynamic. Family members may feel shocked by your loved one’s mental and physical changes. This shock can produce feelings of guilt or anger that may be directed at you. Your loved one may also exhibit additional uneasiness — possibly viewing family members as strangers.

So the question remains, “How do you make it through the holidays and maintain some semblance of peace?” And, equally important, “How do you help your elderly loved one do the same?”

First of all, you may want to do some pre-planning. Waiting until the last minute often leaves a person feeling rushed and harried. To avoid this unnecessary stress, create a list of priorities.

If you plan to take your loved one with you holiday shopping, hit stores early in the day and on weekdays. Most malls and department stores are far less crowded at these times. Also, take along a picture of the person you are shopping for. This provides a reminder to your loved one and an opportunity for their input on the gift. Encourage your loved one to take part in wrapping the gifts when at home. (Be mindful, however, of their frustration levels.)

If you are doing any of the holiday cooking, establish the menu ahead of time. Plan to buy as many of the ingredients as possible a week or two in advance. Also, prepare whatever will keep in the refrigerator or freezer ahead of time so there is less to do on the actual day of your gathering. Most importantly, don’t be afraid to ask others to bring along a dish. Most guests would be happy to help.

Prepare your visiting family members for potential changes in your loved one’s status. Imagine how drastic changes and declines would seem if you had not been present to witness them. Sharing can help them prepare family and friends for the emotions they may feel when confronted with these changes.

Ultimately, you cannot eliminate stress from every environment. For this reason it is essential that you eat well, exercise and get plenty of sleep. With your own stress level in check, you can focus on monitoring the stress levels of your loved one.

If the stress gets overwhelming, consider getting help with your caregiving tasks. Home health care agencies can provide help a few hours a day or a few hours a week. Adult Day Care gives your loved one a safe environment in which to interact with others. If your holiday plans include an over-night visit or extended stay, check into Respite Care.

Update on Medi-Cal Planning

In previous ELT’s, we have written about the existing Medi-Cal rules, vs. the more onerous rules under the Federal Deficit Reduction Act. Although the Governor has signed the act into law in California, it is not yet effective. The act’s provisions will not be implemented until non-emergency regulations are filed with the Secretary of State, and this process could take several more months.

As a result, we are still working under the old rules which in part provide for a 30 month look-back period for gifting, with the months of ineligibility disappearing, starting the month the gift was made. Under the new rules, when they are implemented, there will be a five year look-back for gifts. And, the months of ineligibility begin to disappear after the ill person has spent or gifted their assets. This will make asset preservation and Medi-Cal planning more difficult. As a result, planning should be accomplished now, under the old rules.

Update your Loved One’s Estate Planning Documents

At the least, your loved ones’ estate planning documents should be updated to include elder law, government benefits planning language. That way, if your loved one loses mental capacity, his or her assets can be preserved by the successor trustee or attorney in fact, utilizing the special elder law language. As I explain in my seminars, 99% of all revocable living trusts and financial durable powers of attorney are defective if the maker of the documents loses capacity, and we want to preserve assets.

If your loved one has signs of Parkinson’s disease, Alzheimer’s disease, has taken a fall, has cancer or congestive heart failure, you should start your planning now for asset protection, and planning for government benefits such as Medi-Cal and the VA Aid and Attendance Pension Benefit. Remember that we are still able to protect the home for the family under both programs.

UPCOMING SEMINARS: Friday, Dec. 04 @ 2:00 p – 3:30 pm
Place: 1931 San Miguel Dr., Walnut Creek, CA 94596, in the Channell Room. Please call for reservations at 925-256-0298.

Happy Holidays to All!

Michael J. Young, Attorney at Law