|
A Successful Easter Dinner for Someone with Alzheimer's
Q. This year, Grandma Pearl will be joining us for Easter
dinner. She has Alzheimer's and her caregiver will be joining us, as well. We are
concerned that the dinner could present challenges for her, since she is on a
regimented meal time schedule each day. Can you suggest any tips to make the
meal a success?
A. Many
of our favorite experiences and memories include preparing and sharing holiday
dinners with family members. However, when a person has Alzheimer's disease or
another type of dementia, the ability to eat independently may diminish, and
mealtimes can become challenging. Often, too, the person with dementia may be
experiencing changes, such as decreased appetite, that are part of normal aging.
To make your Easter dinner with grandma a success, familiar routines, rituals,
and food choices may need to be adapted to meet her day-to-day needs and to
address changes that occur as the disease progresses. Below are a few tips to help
things go smoothly:
- Reduce noise: Lots of noise and activity at mealtimes can be very distracting, causing the person with memory loss to lose interest in eating their meal. Therefore, keep extraneous noise to a minimum. While it's nice to play music in the background, be sure it is Grandma's favorite music, not yours, and that it's not too loud or too fast.
- One person at a time: When assisting the person with memory loss during mealtime, only one person at a time should be talking to them. More than one voice can be distracting, and might even cause them to become more confused or agitated.
- Place fewer items on the plate: Placing too much food on a plate can be overwhelming to some, which can cause them to either play with it or ignore it. If grandma becomes easily confused, place fewer items of food on her plate or simply serve one food item at a time.
- Allow her as much independence as possible: If grandma can still manage their utensils, allow her to do so. If she can still cut their food, don't cut it for her. You might be surprised to see that she will sometimes still take a few bites independently if she is just provided the opportunity! If you notice that grandma can no longer manage utensils, don't immediately begin to feed her. First try some hand-over-hand assistance by gently placing your hand over their hand which guides them to complete the activity.
- Provide verbal and visual encouragement: As you raise the fork to your mouth with a pleasant tone of voice you might say to grandma, "The ham is delicious, you should try some, too." Your encouragement might prompt her to take a bite.
- Allow her to walk and eat: If grandma no longer likes to sit during her meal, place finger foods in a bowl with non-spill edges or in a wide-mouthed cup, which will enable her to carry her food and eat as she walks. If she doesn't have the urge to drink liquids, you'll also want to be sure that you are providing her with adequate hydration by offering drinks, popsicles, or gelatin.
Despite ongoing challenges, a successful family meal is possible, and can be yet another opportunity for grandma, her caregiver, and her loved ones to bond and succeed together.
Persons with Alzheimer's and their families face special legal and financial needs. At The Fairfax and Fredericksburg Alzheimer's Planning Law Firm of Evan H. Farr, P.C., we are dedicated to easing the financial and emotional burden on those suffering from Alzheimer's or other dementias. If you have a loved one who is suffering from Alzheimer's, or a family member who is nearing the need for long-term care or already receiving long-term care, call us at 703-691-1888 in Fairfax or 540-479-1435 in Fredericksburg to make an appointment for an introductory consultation.
Changes Make Reverse Mortgages Harder to Get
I was considering a reverse mortgage last year, but now I hear they are more difficult to get. What are some of the changes that have taken affect, and do reverse mortgages affect Medicaid eligibility?
Ega G. Torm
-----
Dear Ega,
To be eligible for a reverse mortgage you must be at least 62 years old, own your own home (or owe a relatively small balance) and currently be living there. You also need to undergo a financial assessment to determine whether you can afford to make all the necessary tax and insurance payments over the projected life of the loan. Below are some of the changes that have recently occurred:
- Increased Lender Scrutiny: Now, lenders will look at your sources of income, assets, and credit history. Depending on your financial situation, you may be required to put part of your loan into an escrow account to pay future bills. If the financial assessment finds that you cannot pay your insurance and taxes and still have enough cash left to live on, you will be denied.
- Only HECM Reverse Mortgages Are Insured: Currently, the only reverse mortgage insured by the U.S. Federal Government is called a Home Equity Conversion Mortgage or HECM, and is only available through an FHA approved lender.
- Enhanced Qualification Criteria: The amount you can get through a reverse mortgage depends on your age, your home's value, and the prevailing interest rates. Generally, the older you are, the more your house is worth, and the lower the interest rates are, the more you can borrow. To calculate how much you can borrow, visit reversemortgage.org.
- Additional Fees: Reverse mortgages currently have a number of up-front fees including a 2% lender origination fee for the first $200,000 of the home's value and 1% of the remaining value, with a cap of $6,000; a 0.5% initial mortgage insurance premium fee; along with an appraisal fee, closing costs and other miscellaneous expenses. In addition, you'll also have to pay an annual mortgage insurance premium of 1.25% of the loan amount. Most fees can be deducted for the loan amount to reduce your out-of-pocket costs at closing.
- More Ways to Receive Funds: You can receive the money in a lump sum, a line of credit, regular monthly checks or a combination. In most cases, however, you cannot withdraw more than 60% of the loan value during the first year. If you do, you'll pay a 2.5% upfront insurance premium fee.
- Counseling Requirement: All borrowers are required to get face-to-face or telephone counseling through a HUD approved independent counseling agency before taking out a reverse mortgage. For more details, visit hud.gov or call 800-569-4287.
For additional details on why new rules have gone into effect, please read our blog post on the subject. Keep in mind that keeping money in a reverse mortgage line of credit in Virginia, and in most other states, will not count as a resource for Medicaid eligibility purposes so long as the house itself is an exempt resource. (For Medicaid payment of long-term care, the applicant's principal residence is excluded from countable resources for the six months of continuous institutionalization provided the applicant intends to return home and provided the equity in the home property does not exceed $536,000. Regardless of the amount of home equity, after six months of continuous institutionalization the nursing home resident's home will become a countable resource, unless the home is occupied by a spouse, dependent child under age 21, or a blind or disabled child.)
However, transferring the money from the reverse mortgage line of credit to a bank account and leaving it there past the end of the month would convert the exempt home equity into a countable resource and therefore would affect Medicaid eligibility. This important distinction between countable resources and exempt assets is not a simple black and white issue -- if you or your loved one is facing the possible need for long-term care, you should get an opinion from a Certified Elder Law Attorney, such as Evan H. Farr. To make an appointment for an introductory consultation, please call The Fairfax Medicaid Asset Protection Law Firm of Evan H. Farr, P.C.
About Baxter:
Baxter is a terrier mix that belongs to Justin Cohee and his girlfriend Ashley. He was originally a stray, but was found by a family in Frederick, Maryland who brought him to the local animal shelter. He loves attention and has a lot of energy and can jump up to Justin's nose (Justin is 6'4). He loves to go on runs and hikes as well. Despite his energy, he is a cuddler and frequent napper, often to the discomfort of others. At night he either sleeps at Justin's feet or climbs atop a mountain of pillows and makes a nest where he eventually rests with his paws on Justin's face. |
|
|
|
Find Us |
|
|
|
Upcoming Events |
All Fairfax events are at The Law Firm of Evan H. Farr, P.C., 10640 Main Street, Suite 200, Fairfax, VA 22030, and all Fredericksburg events at at 501 Westwood Office Park, Fredericksburg, VA 22401 from 10 a.m.-12 p.m. RSVP today! We hope to see you there.
---
----------
Was this newsletter forwarded to you? Subscribe today to keep up with elder law news, "Ask the Expert" topics, and articles of interest for seniors.
|
|
Mailing Address |
|
Fairfax:
10640 Main Street
Suite 200
Fairfax, VA 22030
703-691-1888
Fredericksburg:
501 Westwood Office Park
Fredericksburg, VA 22401
540-479-1435 | |
