Cheri L. Elson and Allen G. Drescher, Retired
21 S. 2nd St. ● Ashland ● Oregon ● 97520

What is Dementia?

I often hear people refer to all types of dementia as Alzheimer’s.  While Alzheimer’s is the most common of dementias, it is by no means the only type.  Dementia describes a group of symptoms affecting memory, thinking, and social abilities severely enough to interfere with daily functioning, such as paying bills or becoming lost while driving.

Dementia is caused by damage to brain cells, which interferes with their ability to communicate with each other.  When brain cells are not communicating normally, thinking, behavior, and feelings can all be affected.  Different types of dementia affect different areas of the brain. 

Most types of dementia are progressive, Alzheimer’s being the most common; however, there are dementias which are reversible, such as side effects to medication, excessive use of alcohol, and (surprisingly) urinary tract infections.  Treat the underlying issue, and the dementia goes away!

There is no one test for dementia, and doctors typically diagnose it based on medical history, physical examination, tests, and changes in the patient’s “base line” functionality. For example, picture a person who is normally neat to a fault, always dressed and coiffed nicely, and has an orderly home.  If they start to let things pile up, let the house get dusty, forget to bathe, or wear the same clothes for days at a time, these may be signs that some kind of dementia is occurring.  However, a person who was never overly concerned with cleanliness and personal hygiene would not raise any flags because their house was unkempt or they wore the same clothes more than one day in a row. 

If you are concerned that a loved one may be suffering from dementia, the best place to start is with their primary care physician.  They are most likely to know the person’s “norm” and be able to determine if dementia is a concern.  Diagnosing the type of dementia is more difficult and may require the assistance of a specialist such as a neurologist or gero-psychologist. 

As scary as a diagnosis of dementia may seem, the longer the condition remains undiagnosed, the fewer options are available to slow down the progression of the disease; the medications available today are most effective on patients with mild to moderate impairment. It is also important to remember that, even with a diagnosis, it is very possible to continue to lead active, healthy lives, to continue enjoying one’s hobbies, to maintain loving and meaningful friendships and relationships.  Of course, dementia does make it more difficult to do certain things, but with the right knowledge and support, it is possible for someone with dementia to live a full and wonderful life.

2019 Alzheimer’s Disease Facts and Figures

Published annually, the newest release reveals current trends in Alzheimer’s prevalence, mortality and morbidity, the burden on caregivers and the astronomical costs of health care and services.
Here’s a startling glimpse at the impact of Alzheimer’s disease in the United States:

  • More Americans than ever — an estimated 5.8 million — are living with Alzheimer’s, and this number is expected to rise to nearly 14 million by 2050.
  • Total payments for health care, long-term care and hospice for people with Alzheimer’s and other dementias are projected to increase from $290 billion in 2019 to more than $1.1 trillion in 2050.
  • In 2018, more than 16 million caregivers provided an estimated 18.5 billion hours of unpaid care, a contribution to the nation valued at nearly $234 billion — an increase of $2 billion compared to last year.
  • 82 percent of seniors say it’s important to have their thinking or memory checked, but only 16 percent say they receive regular cognitive assessment

Read the latest report here:  Alzheimer’s Facts and Figures Report 2019

How to Choose a Successor Trustee

Choosing a Successor Trustee is not something to take lightly.  When an estate plan is centered around a revocable living Trust, the bulk of one’s assets are owned by the Trust and, therefore, under the control of the Trustee.  As long as you are capable (have legal capacity) of managing your own affairs, you are the Trustee, and continue to control your assets.  If you become incapacitated, the Successor Trustee manages the assets in the Trust for your benefit.  At your death, the Successor Trustee is charged with managing or distributing the Trust Estate in accordance to the directions you provided in the Trust.

Whom you name as Successor Trustee depends greatly on your current situation and will most likely change over time.  In fact, it is one of the most often-changed part of an estate plan.  For instance, if young children are involved, the Successor Trustee should someone who will manage the money for the children in the same way you would, and who will ensure it is used for the children’s best interests. 

The older we become, however, the more likely it is that someone will need to step in to assist us with our own finances.  While adult children may be fine paying final expenses and closing up the estate, it is not a given that they are the best choice to take care of your finances if you are unable to manage them on your own.  Family dynamics should be taken into consideration when deciding if children will be named as Successor Trustees or not.  If siblings do not get along, naming them as Successor Co-Trustees could be disastrous.  Or, the children may be lovely and wonderful and not so good with money.  In this case, placing them in charge of your finances would seem less than ideal.

When deciding on a Successor Trustee, it is important to take into account all these factors.  Often, it is a family member tasked with this job; however, it does not have to be and should not be unless there is a family member truly able and willing to do the work.  If there is no one appropriate within the circle of family or friends, an outside, neutral party may be the best choice.  A professional fiduciary can be a perfect solution in this instance.  As an estate planning attorney since 2001, I have seen time and time again where this is the better choice over the relative or friend.  What’s most important is having an in-depth conversation with your estate planning attorney to ensure that all potential issues are addressed and all options investigated.

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