For more than 12 years, Decades has provided trusted professional guardianship and conservatorship services. A conservatorship is established by the courts with a conservator appointed to manage and protect the financial interests of an individual, determined by the court to lack the capacity to make their own financial decisions. Incapacitated individuals who did not previously establish a Durable Power of Attorney may require conservatorship. One such form of incapacity can arise from extreme cases of Parkinson’s Disease.

When actor Michael J. Fox developed Parkinson’s disease, it threw a spotlight on this neurodegenerative disorder. And, since 1983, April is the month when awareness about it is especially high, geared towards education, care and fundraising.

I say ‘education and care’ because, despite significant research, there is no cure. Treatment options vary and include medications and surgery. And, while Parkinson’s itself is not fatal, disease complications can be serious. As I wrote above, its impact goes beyond motor functions, possibly into mental impairment, leading to the need for a conservatorship protecting the financial assets of the affected individual. And, beyond that, complications from PD is the 14th cause of death in the United States (according to the Centers for Disease Control).
The progression of symptoms differs from one person to another and can slowly develop over years. People with PD may experience:
• Tremor, mainly at rest and described as ‘pill rolling’ tremor in hands.
• Bradykinesia – slow movement
• Limb rigidity
• Gait and balance problems

As with many things, the first step to living well with Parkinson’s

Disease is to understand it and its progression. In fact, it is possible to have a good to great quality of life with PD. Working with your doctor and following recommended therapies are essential to successfully treat symptoms, using dopaminergic medications (meant to increase levels of dopamine in the brain). People with PD need this medication because they have low levels or are missing dopamine in the brain.

Ironically, while we often associate Parkinson’s with obvious tremors and changes in movement, these symptoms are ‘late bloomers’, showing up long after the disease has taken hold in the brain. For that reason, scientists are exploring ways to identify biomarkers for PD that can lead to earlier diagnosis and more tailored treatments, thus slowing down the disease’s progression. Currently, all therapies used for PD improve its symptoms without slowing or halting the disease itself.
So, how can you tell if you or a loved one has Parkinson’s disease before it has advanced to a life-altering stage?
Below are 10 signs that you might have the disease. No single one of these means that you should worry, but if you have more than one sign you should consider making an appointment to talk to your doctor.
Tremor
Have you noticed a slight shaking or tremor in your finger, thumb, hand or chin? A tremor while at rest is a common early sign of Parkinson’s disease.

Smaller Handwriting
Has your handwriting gotten much smaller than it was in the past? You may notice the way you write words on a page has changed, such as letter sizes are smaller and the words are crowded together. A change in handwriting may be a sign of Parkinson’s disease.

Loss of Smell
Have you noticed you no longer smell certain foods very well? If you seem to have more trouble smelling foods like bananas, dill pickles or licorice, you should ask your doctor about Parkinson’s.

Trouble Sleeping
Do you thrash around in bed or act out dreams when you are deeply asleep? Sometimes, your spouse will notice or will want to move to another bed. Sudden movements during sleep may be a sign of Parkinson’s disease.

Trouble Moving or Walking
Do you feel stiff in your body, arms or legs? Have others noticed that your arms don’t swing like they used to when you walk? Sometimes stiffness goes away as you move. If it does not, it can be a sign of Parkinson’s disease. An early sign might be stiffness or pain in your shoulder or hips. People sometimes say their feet seem “stuck to the floor.”

Constipation
Do you have trouble moving your bowels without straining every day? Straining to move your bowels can be an early sign of Parkinson’s disease and you should talk to your doctor.

A Soft or Low Voice
Have other people told you that your voice is very soft or that you sound hoarse? Sometimes you might think other people are losing their hearing, when really you are speaking more softly.
Masked Face
Have you been told that you have a serious, depressed or mad look on your face, even when you are not in a bad mood? This is often called facial masking.

Dizziness or Fainting
Do you notice that you often feel dizzy when you stand up out of a chair? Feeling dizzy or fainting can be a sign of low blood pressure and can be linked to Parkinson’s disease (PD).

Stooping or Hunching Over
you not standing up as straight as you used to? If you or your family or friends notice that you seem to be stooping, leaning or slouching when you stand, it could be a sign of Parkinson’s disease (PD).

And, while all these symptoms relate to physical appearance and behaviors, Parkinson’s poses the chance of cognitive decline as well.
When an adult fails to do his or her estate planning and then later becomes incapacitated, as can happen with Parkinson’s Disease, it may be necessary for the court to step in and place the adult under the care of another. This is called a guardianship. If the adult has financial assets, a conservatorship may also be needed. Conservators are assigned by the court to oversee the financial assets of an adult who can no longer manage those assets. The role of guardian and conservator can be served by the same person or separate individuals as appropriate.
Of course, incapacity often occurs from cognitive decline through dementia – perhaps Alzheimer’s or Parkinson’s disease – but can also be a result of trauma, mental illness, and disease, most frequent of which is stroke.
A court determines if an adult is incapacitated by considering whether the adult is capable of effectively receiving and evaluating information about her/his health, well-being, and finances. Any physical or mental decline that results in the adult being unable to provide for his or her own health, safety, and medical and financial needs may give rise to a guardianship and conservatorship. These terms are sometimes used interchangeably yet can also be defined for a single aspect of living, such as conservatorship of the person or conservatorship of the estate.
It is important to note that with advance proper planning, including the execution of a properly drafted advance medical directive (also known as a living will) and a durable power of attorney, a guardianship (and conservatorship) can almost always be avoided.
For more information about any of the varied forms of legal protections mentioned here, we welcome your call, no obligation is implied:
Santa Fe
505.983.7787
Albuquerque
505.345.5529

Celebrating Decades: The 60’s
Is it ironic that the Older Americans Act, part of President Johnson’s Great Society reforms, was passed in the 60’s on behalf of Americans in their 60’s? Re-authorized in 2020, it includes provisions for social and nutritional support through nearly 60 state agencies and 20,000 service providers. If you or a loved one seeks support with any needs related to aging, you can learn more here. And, of course, don’t hesitate to reach out to us at Decades Group for any healthcare or financial decisions associated with aging.

Celebrating 2 Decades of Service in the New Mexico Community:


 

Resources Used:
The Parkinson’s Foundation
Administration for Community Living
American Parkinson Disease Association
Michael J. Fox Foundation

For Attorneys

Are you a senior or older adult with questions about how the Affordable Care Act may affect you?

The Affordable Care Act requires everyone to have health insurance coverage. If you are already enrolled in Medicare, Medicaid, or if you have employer-based health insurance, you already have coverage and don’t have to make any changes. If you are not currently enrolled in any of these programs and you don’t have health insurance, you will need to obtain coverage or pay a penalty.

You can purchase insurance through the Health Insurance Marketplace, and depending on your income you may qualify for assistance to pay your monthly premium. Premium assistance is only available to those not eligible for Medicaid who purchase health insurance through the Marketplace.

There are four ways to apply for Marketplace coverage:

  1. Paper Application. You can fill out a paper application and mail it in. You will receive an eligibility notice by mail. The paper application is available at healthcare.gov
  2. Apply Online. While the Marketplace website experienced technical issues when first launched, you can now apply online in four steps. Visit healthcare.gov to get started.
  3. Apply by Phone. To apply by phone, call 1-800-318-2596, 24 hours a day, 7 days a week (TTY: 1-855-889-4325). A customer service representative will work with you to complete the application and enrollment process.
  4. Find in-person help. In all states, there are people trained and certified to help you review your coverage options and enroll in a Marketplace plan. Visit LocalHelp.HealthCare.gov to find help in your area. Additionally, Decades can provide in-person help to clients and their families.

Three important dates to keep in mind are January 1, 2014: All individuals are required to have health insurance by this date, December 23: The deadline to file an application for coverage starting in January and March 31, 2014: Marketplace open enrollment ends.

If you have more questions about what the Affordable Care Act means for you, Decades can help. Our team offers free consultations so you can learn about the services that we offer, including medical advocacy and care management.

Have you noticed that your parent or elder adult in your family is acting differently lately? In some cases, changes in behavior can mean that an elder loved one suffered an Acquired Brain Injury. Understanding and recognizing the warning signs can help ensure senior family members receive the care they need.

An Acquired Brain Injury (ABI) can happen in day-to-day life from:

  • Falls
  • Motor vehicle accidents
  • Motorcycle accidents
  • Heart attack-respiratory arrest
  • Stroke

More unusual causes of ABI can include gunshot or knife wounds, near drowning and anaphylactic shock (a serious allergic reaction). An ABI can effect an individual’s memory, ability to execute tasks, and can prevent them from taking appropriate initiative, like paying their taxes on time.

Early signs of behavioral changes include restlessness, tardiness, and increased confrontational or argumentative behavior. These warning signs can escalate to more dangerous behaviors including property destruction, pushing or shoving, increased use of alcohol and refusal to do normal tasks or activities.

If you notice these behaviors in a senior family member, it’s time to ask for help. There are many options available to families. One place to start is with a Decades professional geriatric consultation. Coordinated by a licensed professional, consultations can take place in the home or at the Decades office. Following the consultation, Decades will provide a detailed written report covering options, local resources and services that are most appropriate for the individual situation.

To learn more, read about our consultation services here, or contact us.

National Guardianship Conference LogoHeld annually by the National Guardianship Association, the National Conference on Guardianship is the largest gathering of guardianship organizations in the United States. Decades participated in the 25th annual conference in October, attending cutting-edge presentations and bringing back knowledge on today’s top concerns in guardianship.

While we attended many informative sessions, the highlight of the conference was an interactive Guardianship Scene Investigation where we “walked in the shoes” of a person under guardianship. One of the most challenging aspects of serving as a professional guardian is gathering information about the person under guardianship. The more we know about a person’s history, the better we can ensure we make decisions that are both in their best interest and reflect their wishes.

During the Guardianship Scene Investigation, our team learned how to obtain knowledge from items found among a person’s property, when they are unable to speak for themselves. By taking clues from items like documents, medical equipment, hidden treasures, cultural indicators and lifestyle objects, we can build a better picture of the person.

Scene investigation skills are vital when we work with elder adults who have become mentally or physically incapacitated. It’s also important for families and elder adults to be educated on the options available to them before a situation arises where they can no longer speak for themselves. One way to ensure your wishes are followed is through the Decades Springing Care program. You and your family can establish a plan that Decades will execute on your behalf in the event of a serious medical condition or other emergency. To learn more, download our Springing Care flyer here.

by Paula Span, New York Times

The chilling dilemma of “the unbefriended elderly,” who don’t have family or close friends to make medical decisions on their behalf if they can’t speak for themselves, generated a bunch of ideas the last time we discussed it.

One reader, Elizabeth from Los Angeles, commented that as an only child who had no children, she wished she could hire someone to take on this daunting but crucial responsibility.

“I would much rather pay a professional, whom I get to know and who knows me, to make the decisions,” she wrote. “That way it is an objective decision-maker based on the priorities I have discussed with him/her before my incapacitation.”

Elizabeth, it turns out other people have been thinking the same way.

A few years back, Elena Berman, a retired administrator at the University of Arizona, was trying to put her own paperwork in order and wondering about her health care proxy. She’s single and has no children, and her only sibling lives halfway across the country.

“When I tried to think whom I might ask to fill this position, no relative came to mind,” she told me in an interview. Two friends agreed to be her decision-makers, but they are about her own age. “That’s great if I die in five years or so,” said Dr. Berman, who is 66. “But after that, it’s up for grabs.”

With people living longer and families having fewer children, she pointed out, “I see this as a growing population.”

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Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”