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Increasing focus on the “invisible patient:” it’s time to recognize and treat caregiver burden

It has long been known that those who care for an elderly or incapacitated loved one can suffer physically, psychologically, financially and socially. These caregivers have been known for years in the medical community as the “invisible patients.” Little has been done for them. According to the New York Times, there are more than 40 million adults in the United States who provide care for an aging family member or friend -- and that number is set to rise.

Today, health care providers are asking themselves if recognizing the problem is enough. Do doctors have a duty to identify and provide support to individual caregivers who may be suffering?

Studies have shown how intervention can improve health and well-being in caregivers. But most medical professionals do not make it a common practice to identify and intervene in cases of caregiver burden. As Baby Boomers age and the number of caregivers swells, some in the medical community are reconsidering how the caregiver burden is handled.

Recently, the Journal of the American Medical Association (JAMA) published an article on caregiver burdens that encourages doctors treating a patient to proactively assess whether a caregiver in the situation might benefit from support or medical attention. Not only could the caregiver benefit, but the original patient might end up receiving better care as well.

The JAMA article alerts doctors to the risk factors for caregivers who might be suffering, and it gives doctors concrete steps to take when they suspect that a caregiver might be suffering undue physical or emotional hardship. The process begins with a series of questions that identify problems that may be occurring. Treatments can range from support groups to individual therapy to medication.

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Estate planning and the single person

Many discussions about estate planning revolve around couples and families. Yet a large percentage of Americans are single. Some are divorced, others are widowed and still others never married.

Single people may want to adopt estate planning strategies that differ somewhat from those a married couple would use, depending on the situation.

For example, an increasing number of married couples are moving away from the strategy of gifting major assets to friends or family members during their lifetime, because the combined exemption for federal estate taxes now exceeds $10 million. But a single person with assets over $5 million may want to gift some of those assets during his or her lifetime in order to avoid hefty federal estate taxes.

It is important to point out that the recently widowed may want to use any unused portion of their deceased partner’s exemption. Individuals in this situation should contact an estate planning attorney to determine if there is a benefit to doing this and, if so, how to do it.

It is especially important for unmarried adults to prepare an advance health care directive. While hospital staff members defer to a spouse in an emergency situation, they increasingly will not allow parents, children or other interested parties to make medical decisions without written permission.

The most important piece of estate planning advice remains the same for single people and married people alike: it is vital to have an estate plan that covers both what happens in the event of incapacitation and after death. Without one, the state can and will make all of the decisions, and the results are unlikely to correspond to what an individual would have wanted.

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