William & Mary Elder and Disability Law Clinic

Serving Seniors in the Greater Peninsula Area

Month: November 2015

Alzheimer’s and Elder Law: What Do You Need to Know?

By Ambria Armstrong, Elder Law Clinic Student, Fall 2015

Today, there are over five million Americans living with Alzheimer’s, and it is the sixth leading cause of death in the U.S. No one wants to consider the possibility that their loved one may be showing signs of Alzheimer’s disease, but recognizing the early signs is important – for proper care, and for legal purposes.  It may be harder than you think to determine if your loved one is competent to make his own decisions, and it may be uncomfortable to bring up the possibility.  Some signs of Alzheimer’s or dementia might appear to you like simple signs of old age. The Alzheimer’s Association provides ten symptoms to watch for:

  1. Memory loss that disrupts daily life. However, a typical age-related change would be to sometimes forget names or appointments, but remembering them later.
  2. Challenges in planning or solving problems. Making occasional errors when balancing a checkbook is nothing to be concerned about, but having trouble following a familiar recipe might be a sign of Alzheimer’s.
  3. Difficulty completing familiar tasks at home or work. Needing help driving to a familiar location or remembering the rules to a favorite game may be signs of Alzheimer’s, but you shouldn’t be worried about helping your loved one to use technology, for example.
  4. Confusion with time or place. People with Alzheimer’s can lose track of dates, seasons, and the passage of time, or trouble understanding something if it is happening in the future.
  5. Trouble understanding visual images and spatial relationship. Vision changes related to cataracts or old age are nothing to be concerned about, but you may want to consider all of these factors if your loved one has trouble judging distance or determining color.
  6. New problems with words in speaking or writing. People with Alzheimer’s may have trouble holding a conversation; they may repeat themselves, struggle with vocabulary, or call things by the wrong name.
  7. Misplacing things and losing the ability to retrace steps.
  8. Decreased or poor judgment. They may, for example, give large amounts of money to telemarketers, or pay less attention to their cleanliness.
  9. Withdrawal from work or social activities. People with Alzheimer’s may have trouble keeping up with their favorite sports team or remembering how to do their favorite hobbies. They may also avoid being social because some of these other changes they have been experiencing.
  10. Changes in mood and personality. A person with Alzheimer’s may frequently become confused, suspicious, depressed, fearful, or anxious.

If you notice these signs in yourself or your loved one, you should make an appointment with your doctor. Do not ignore them.  With early detection, you can get some treatments which may help with some of the symptoms, and you can plan for future care, living arrangements, and legal options for your estate.

Just a few weeks ago, there was a Walk to End Alzheimer’s here in Williamsburg. So what kinds of research are medical professionals doing to work towards the end of Alzheimer’s?  Out of the top ten leading causes of death, Alzheimer’s is the only one that cannot be prevented, cured, or slowed. There are medications for some of the symptoms of Alzheimer’s, such as medications for memory loss and confusion, irritability, anxiety, depression, or sleep changes. Researchers are working to understand brain functioning to determine what causes the changes in the brain with Alzheimer’s disease.

If your loved one is not competent to make his or her own decisions, it’s important to make sure they are properly cared for.  If your loved one has a full durable power of attorney, that will be sufficient to allow their directed agent to make decisions regarding care of the elderly person. However, if no durable power of attorney exists, a friend or family member can petition the court to obtain guardianship or conservatorship.  This is another way to make sure that someone with Alzheimer’s receives the care and living arrangements they need.  It is important to recognize the signs and symptoms of Alzheimer’s early, so that the elderly person’s wishes can be known and carried out in their best interest.  For more information on Alzheimer’s disease, please visit the Alzheimer’s Association website.

Assisted Suicide or Elder Abuse

By Shaina Salman, Elder Law Clinic Student, Fall 2015

In 2014, Time Magazine reported that five states currently have death with dignity laws. Those states—Oregon, Washington, Vermont, New Mexico and Montana—each have a variation of a statute or legal precedent that permits euthanasia. Essentially, terminally ill patients, in consultation with their doctors, can request a prescription for doses of lethal medications that will allow them to end their own lives. Proponents of the law argue that assisted suicide is a practice that places the decision of dying within the hands of the patient, giving them autonomy to decide on their own terms when and how they want to die. However, opponents argue fiercely that patients might be pressured to take their own lives by family members and others who wish to save money or end the burden of caring for someone with a debilitating illness. Time Magazines’ data shows that the average age of those dying from taking assisted suicide medications is 71 years old in Oregon. This demonstrates that the majority of those taking the drugs are the elderly. Since 1998, the state reports that 1, 173 people have had assisted suicide prescriptions written while 752 of that number actually died from taking the medications.

The sheer number of cases alone may not be very alarming, but the median age of those who are dying from the drug should be. The Oregon Stateman Journal published an article in 2014 that cited a 10% increase in allegations for elder abuse While the study does not distinguish between financial and physical abuse, advocates for the elderly are sure that this is no coincidence. A columnist for the New York Times points out a gaping hole in the law. “Neither [Washington’s or Oregon’s] act requires witnesses at the death. Without disinterested witnesses, the opportunity is created for an heir, or someone else who will benefit from the patient’s death, to administer the lethal dose to the patient without his consent. Even if he struggled, who would know?”

The narrative looks like this: an elderly patient is diagnosed with a terminal disease. Out of fear of losing autonomy or being a burden, the patient asks his doctor to prescribe him a lethal drug that will allow him to die when he is ready. The fear is that this patient, may change his mind and become a victim of an interested party forcing the pill down the throat of the patient to hasten death and attain his inheritance. This narrative is not so far-fetched as proponents suggest. Elder abuse is a prevalent issue in this country. The National Center on Elder Abuse reports an upward trend in the problem with anywhere from 7.6-10% of the elder population being abused. These numbers indicate that this may become a larger issue in the future.

With the growing size of the elder population, and the growing popularity of assisted suicide laws, legislators should be concerned with the consequences of such laws for this vulnerable segment of the population. Ultimately, assisted suicide and elder abuse are not –so-strange bedfellows because one appears to certainly be implicating the other. As others have said, assisted suicide appears to be ripe for elder abuse. The laws make the tools for abuse much more readily available and leave the elder much more at risk. Ultimately, with the growing popularity of these laws nationwide (this month alone, California’s governor signed a bill into law allowing for assisted suicide), proponents and naysayers should both be looking at this issue through the lens of the most vulnerable and taking affirmative steps to protect the elderly.