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What Are The Benefits of a Living Trust?

A Living Trust is a planning technique that offers benefits to virtually all Californians. It is particularly appropriate for individuals who are older or who have substantial assets. If you own a home in California, a living trust makes sense for you.

In a very real sense, a Living Trust is a new being. It will hold your property while you are living, and it will continue in existence after your death.

When Is It Time to Review My Trust?

If you do not already have a living trust in place, you know that you should. A fully-funded trust avoids probate, saves money, and keeps your family out of the court system. A living trust is the cornerstone of your estate planning.

You should also review your living trust at least every couple of years. This is particularly true in light of the new Tax Act which makes the need even more apparent.

Having Memory Issues? Talk To Your Doctor

According to a new report released by the U.S. Centers for Disease Control and Prevention, 13 percent of U.S. seniors (ages 60 and up) report that they have experienced issues with their memory and have experienced an increase in confusion.

More than 30 percent of the people who reported memory loss or confusion issues admitted that they experienced issues at work, socially or while attempting household chores, and those situations were negatively affected by the lapse. Experts say that these reportings indicate a better screening tool is needed in order to identify early signs of Alzheimer's disease or dementia.

Individuals from 21 states in 2011 were surveyed on a number of questions, including questions about memory loss within the past twelve months. Only 35 percent of those who reported memory issues said they discussed the issue with a health care professional. The report, published in the May 2013 issue of the Center for Disease and Controls' Morbidity and Mortality Weekly Report, is the first of its kind, stated Angela Deokar, report co-author.

If you feel you are experiencing some cognitive decline, do not hesitate to discuss it with your doctor and request a full medical exam. You may have a treatable cardiac disease or metabolic disorder which is affecting your thinking process. Medical conditions which may cause memory issues and confusion, such as vascular dementia, are not reversible but can be slowed or halted with medication.

If the cause of cognitive decline is not reversible, you will want as much time as possible to plan for your future care needs. You must develop an Advance Directive, a Durable Power of Attorney, and take other protective steps with your estate planning attorney.

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Studies Indicate That Late-Life Depression Can Contribute To Dementia

The results of an analysis of more than 50,000 people in 23 different population studies indicates that depression later in life is associated with an increased risk for dementia and Alzheimer's disease.

Analysis of the studies also indicates that there is a significant risk of vascular dementia (stroke-based dementia), in older adults who have "late-life depression." According to the authors of the study, late-life depression is extremely common among older adults. The occurrence of that depression has been found to be highly reoccurring, difficult to treat and chronic, significantly affecting an individual's ability to function.

The study, published in the May 2013 issue of the British Journal of Psychiatry, shows a strong association between depression and developing Alzheimer's disease. Researchers stated that they believe one or more depressive episodes can increase someone's risk for dementia syndromes such as vascular dementia as well as Alzheimer's disease. Connecting the two may help researchers help develop proactive preventative measures as well as long-term predictive models for patients.

Researchers also stated that the prevention of even a fraction of the number of cases of depression might reduce the development of Alzheimer's disease in the tens of thousands. They also stressed that the risk for vascular dementia appeared to be much higher than the risk for Alzheimer's disease in the individuals who were late-life depressed.

The study looked at 23 different cohort studies which followed patients 50 and older who did not display any signs of dementia during baseline testing. The studies followed up every five years for dementia and Alzheimer's disease, vascular dementia studies were followed at six-year intervals. Depression was scored on a ratings scale without structured interviews.

Though it is not definitive that late-life depression is a cause of dementia, says paper co-author Meryl Butters, associate professor of psychiatry at the University Of Pittsburgh School Of Medicine, it seems likely to contribute to it. Current theory holds that depression can cause minor brain damage, which can lead to the degenerative process of dementia.

The study authors stated that public health policies which focus on the prevention or delay of dementia in older adults should focus on working to prevent depression and healthy behaviors which reduce cardiovascular risk factors. They also urged for clinical trials which would look at how preventing depression in older adults lowers the risk of cognitive impairment and dementia later.

A large body of research has amassed which also links late-life depression to increased health risks, social isolation and an increased risk of death.

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Nursing Home Alternatives

While countless seniors find care and comfort in nursing home settings, it is still a daunting prospect to many people who hope to live out their later years in their own home. Health issues and financial circumstances may dictate that your loved one cannot stay in their home the way they had hoped. However, there are alternatives to consider before making that move.

Share Care
In some families, a combination of paid care and family (unpaid) care can be a great help. A visiting nurse or home health aid can stop by daily to check on the senior; family members can also come by and meet some needs. When more care is needed or it becomes too financially or emotionally cumbersome to cover care this way, consider sharing the care by pooling resources. Perhaps the senior could move into a living arrangement with someone else in a similar situation. The potential companionship and support of roommates cannot be overstated. Both families can then share the family care efforts and hire one aid to come by for both seniors, which will significantly reduce the cost.

Reducing Living Costs
Another option is moving your loved one to a less expensive living arrangement. Reducing the amount paid for housing, food and utilities may give you the room you need to pay for in-home care. Or, consider moving them closer to a family caregiver, who can oversee a large portion of the care needed.

Collage Care
Patch-working different types of care is as simple as using more expensive care for some things and less expensive care for other issues. If your senior needs just a few hours of skilled in-home care for only a small portion of the day – bathing, transferring from bed, etc - and mostly needs companionship and simple meal preparation, you may be able to connect with the community to have a local volunteer, such as a high school student, that could come to the home. You may also be able to hire a college student through their campus employment office to run errands at a considerably lower rate than an adult caregiver would charge.

Adult Daycare
Adult daycare is another option; it has been shown to greatly reduce caregiver burnout for family members. Adult daycare can be anything from one or two hours a week to full days. Adult daycares typically provide a shuttle service, meals and socialization for people of different physical and cognitive levels. They often also provide services specially designed for people with Alzheimer's or other forms of dementia, and can be significantly less expensive than in-home care. While Medicare does not pay for adult daycare and while California’s Medi-Cal program does not, some state Medicaid programs do, as does long-term care insurance. Is your loved one a veteran? The Department of Veterans Affairs (VA) offers adult daycare centers for vets who qualify.

The key is learning about options and planning accordingly.

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