Alzheimer's caregivers, guardians, and conservators

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TheresaB
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Re: Alzheimer's caregivers, guardians, and conservators

Postby TheresaB » Wed Sep 09, 2020 11:53 am

redryder wrote:What do you think about the utility and feasibility of converting all available financial accounts to joint ownership? Please talk about the pros and cons of doing so. Thanks in advance.


It worked for my sister. My other sister, who lived nearby, was joint owner on her accounts and paid her bills with her retirement income. Will that work in every circumstance? Hard to say. I must admit I live in another state and I was concerned about the possibly needing to take over the financial concerns from my sister because I was so physically removed. It never came to that, (un)fortunately, as my sister who was unable to be in charge of her own finances passed away last year.

Here's an article that you might be interested in: Financial And Estate Planning Steps To Take Now: Special Considerations For Those With Brain Disease
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Re: Alzheimer's caregivers, guardians, and conservators

Postby CarrieS » Wed Sep 09, 2020 12:15 pm

redryder wrote:What do you think about the utility and feasibility of converting all available financial accounts to joint ownership? Please talk about the pros and cons of doing so. Thanks in advance.


While my mother was lucid enough to make legal decisions, I contacted a geriatric lawyer and completed all of the legal documentation that I would need as her disease progressed (will, durable power of attorney, living will / end of life decisions, DNR, etc). She was close to going in to care so we created a Revocable Trust and put all of her assets (her house, investments, etc) in it for me to use for her care and then any residue would then be transferred on death to my brother and I. She essentially had to "trust" that we would take care of her and not run off with her money. The DPOA allowed me to be added to her bank, social security, household accounts, etc and begin to pay what she was ignoring (like property tax) and also allowed me to keep watch on what she was doing with her money and stop suspicious activity (I found there were lots of scammers out there trying to take advantage of her). I changed the address on these too so that they came to me or they would get lost. Even though she really didn't realize that I oversaw everything, she still felt in control while I was able to preserve her assets to be used for her future care. I did this was 20+ years ago so I'm sure things have gotten easier to figure out. Getting the "legal stuff" taken care was the hardest but best decision that I made.
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Re: Alzheimer's caregivers, guardians, and conservators

Postby Nords » Wed Sep 09, 2020 1:04 pm

redryder wrote:What do you think about the utility and feasibility of converting all available financial accounts to joint ownership? Please talk about the pros and cons of doing so. Thanks in advance.

RedRyder, that’s easy to do but it makes lawyers really uncomfortable.

On the side of the person with Alzheimer’s, it takes care of all of their problems. You’re handling all of their finances and there are no gatekeepers to get in your way. When the person with Alzheimer’s passes away then hypothetically you still have access to the account (“with right of survivorship”) and can take care of their estate.

Except there are significant risks to the person with Alzheimer’s.

When the person with Alzheimer’s gives someone else a durable power of attorney or a revocable living trust, that someone else is legally obligated to handle the assets in a fiduciary manner for the benefit of the person who granted the DPOA or RLT. I’m not a lawyer or a financial advisor, but I don’t think that protection exists for a joint account.

If the joint owner dies before the person with Alzheimer’s dies, then those joint accounts are considered part of the deceased’s estate. That may not have been the intent of the joint account, but the probate court is more likely to side with the deceased’s heirs.

If the joint owner is sued (however the litigation happens) then the entire balance of the joint account may be at risk.

On the side of the person who’s been given the access of a joint account:

In most states, real estate and brokerage accounts pass to heirs without them being obligated to pay inheritance taxes. (Estate taxes are a different discussion.) Better yet, the heirs inherit with the cost basis at the owner’s time of death. (Not the cost basis of their original purchase.) That avoids a tremendous amount of capital-gains taxes when the asset is sold. If it was inherited from a joint title or a joint account, though, it might not receive that step-up in cost basis.

State Medicaid agencies are familiar with giving someone joint access to an account. If the account is drained within five years prior to the Medicaid claim then Medicaid could refuse to pay until the joint owner of the account can prove that all of the expenses were for the benefit of the person who granted the joint access.

The lawyer’s version of the right way to care for the finances of an Alzheimer’s patient would be through DPOAs and RLTs. For estate planning, there’s transfer on death/payable on death for financial accounts, and (in some states) even transfer on death deeds for real estate.

Here’s the estate plan that my spouse and I just put into effect a few months ago. It rests on our daughter (our heir), with our son-in-law as backup. We’ll reassess our plan every five years or so:
https://the-military-guide.com/family-estate-planning-for-your-disability/
And yeah, you really have to trust your co-trustee and DPOA holder. But lawyers can also draft the documents to include gatekeepers to oversee the process.

Outside of the DPOAs and RLT, we’ve made our daughter a joint owner of our checking accounts. Those accounts receive the deposits from our pensions (and eventually Social Security), and then the money is automatically transferred to investment accounts where our daughter has a DPOA (and a POD/TOD). That way the risk of the joint account is limited to one month’s deposits.

You could also use a “signature authority” on an account instead of being a joint owner, but our credit union didn’t offer that option.

This mess of DPOAs, RLT, and POD/TOD cost us many months of discussion and about $6000 in legal bills. However it also avoids probate expenses which could be much higher.
Author of "The Military Guide to Financial Independence and Retirement". Royalties go to military charities.
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Re: Alzheimer's caregivers, guardians, and conservators

Postby redryder » Thu Sep 10, 2020 12:41 pm

TheresaB, CarrieS, and Nords, thank all of you for your responses! I appreciate your insights.
Caregiver to 3/4 spouse w/MCI; following ReCoDe protocol as best we can (bofus)...

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Re: Alzheimer's caregivers, guardians, and conservators

Postby circular » Fri Sep 11, 2020 10:51 am

Nords wrote:If the joint owner dies before the person with Alzheimer’s dies, then those joint accounts are considered part of the deceased’s estate. That may not have been the intent of the joint account, but the probate court is more likely to side with the deceased’s heirs.

Such a good comprehensive response Nords, but I don't think the quoted portion is true unless it reflects state specific rules? An account in joint tenancy always or normally passes outside of probate (the "right of survivorship" part). When one of the joint tenants dies, their name is simply removed from the account for the remaining owner. This is why many use this tool when avoiding probate when a trust isn't needed.

As to the original question, if someone puts all their assets in joint tenancy, the entire estate will pass outside of probate, without need for a trust, to the joint owner(s). If there were other intended beneficiaries, whether or not stated in a will or outlined in a trust, there is no legal obligation for the joint owner to honor that (ie, the Will isn't probated because asset titles were such that they pass outside probate), but they might choose to do so.

One should also be aware, if the other person who might be named on an account is a spouse, of whether the couple lives in a community property state, where titles such as community property with or without right of survivorship might apply.

BTW, if someone died without a will or trust, each state has "intestate" laws to declare how any portion of the estate subject to probate would be distributed.

Disclaimer: I'm not an attorney, let alone one in every US state or country on Gaia, so please correct me if I'm wrong.
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Re: Alzheimer's caregivers, guardians, and conservators

Postby Nords » Fri Sep 11, 2020 11:23 am

circular wrote:
Nords wrote:If the joint owner dies before the person with Alzheimer’s dies, then those joint accounts are considered part of the deceased’s estate. That may not have been the intent of the joint account, but the probate court is more likely to side with the deceased’s heirs.

Such a good comprehensive response Nords, but I don't think the quoted portion is true unless it reflects state specific rules? An account in joint tenancy always or normally passes outside of probate (the "right of survivorship" part). When one of the joint tenants dies, their name is simply removed from the account for the remaining owner. This is why many use this tool when avoiding probate when a trust isn't needed.

I'm not a legal expert either, and I didn't personally experience it with Colorado, but readers have told me of this issue with their probate courts. It might be differences with state laws.

When the will is filed, then creditors (and presumptive heirs) can petition the probate court. Joint with right of survivorship or joint tenancy seems fine to me too, but the probate courts are still able to get involved.

Meanwhile with POD/TOD or TODD or a trust, the probate court doesn't get involved. A death certificate is filed with the corporation or the property records office (or they might just work from the Social Security Death Index), and the account/property is retitled.
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Re: Alzheimer's caregivers, guardians, and conservators

Postby circular » Fri Sep 11, 2020 1:29 pm

circular wrote:Joint with right of survivorship or joint tenancy seems fine to me too, but the probate courts are still able to get involved.

Thinking about it again, even though I was the one who conjectured there may be state differences in how JTROS is handled wrt probate, I'm more suspect of your readers using the terms correctly than of my belief (I'll call it as a non-expert) that JTROS isn't subject to probate (and thus to claims by heirs and creditors). They could sue to challenge the JTROS titling if they thought an asset was titled that way against the wishes of a competent asset owner, but that would be different from the probate itself.

I suspect it's possible the readers weren't using the terms accurately. They may have confused "tenants in common" with JTROS. TIC will go through probate and be subject to creditors claims and after that be distributed to the heirs named in the will that's being probated, but not JTROS.

Additionally, I'm fuzzy on this, but there may be a distincition between and account held as "joint tenants" and one held as "joint tenants with right of survivorship." I have a vague notion that I once read that in some places the simpler "joint tenants" assumes right of survivorship while in others it doesn't and ROS has to be clearly stated to bypass probate? Not sure.

It gets very tangled since states use different terms, and the best advice of all is to consult an expert in one's own state. (That said, bouncing these concepts around as we do here can still help someone know what to ask about.)

Further disclaimer: I once worked in probate but it's been a long time and I'm not an expert in it anywhere.
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Re: Alzheimer's caregivers, guardians, and conservators

Postby Tincup » Fri Sep 11, 2020 2:46 pm

I posted in this thread (3 years ago) about doing this 3 times. I avoided using JTWROS in any of these cases. My preferred approach is to have a trust with most of the assets, bank accounts with a POA for the trustee or person in charge and POD (pay on death) to the trust. I should note that most banks and financial companies want you to use their POA form, not a generic one. At the time of death, you just provide the bank or financial company with a death certificate to perfect the POD. Then you do whatever the trust says. This completely avoids probate. In my mom's case, she could still write checks when she wasn't "all there." But the damage she could do was limited. When I set up the bank account, the bank officer wanted to link the savings account with the checking for overdraft protection. I said no, I wanted any overdrafts to bounce - part of the protection. This approach completely avoids probate.

As I mentioned before, this requires a trustworthy person and agreement among the parties. I'm still trustee/executor for my first wife's mother, who is now 96 and very demented, even though we've been divorced for 8 years. As trustee, I gave POA's to my ex and her brother on all the financial assets. There is trust all the way around.

The trust does not have to be complicated, nor cost a lot.
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Re: Alzheimer's caregivers, guardians, and conservators

Postby Aromagician » Thu Feb 04, 2021 3:45 am

Hi all
I am the caregiver for my 77 year old mother who has Dementia, and Apoe 4 gene. I havent been tested yet, I had a dna test with Ancestry a while ago and found a website that said it could tell from those results- but it couldnt, and wouldnt refund the money !

Anyhow, we have her on the Bredesen program. But was very expensive and her funds are running low. I have joined here to find advice and support on how to deal with this.

her husband = my stepfather, died over 6 years ago= they were well off. But due to his ambiguous will ( which all income from his estate was to go to my Mum until she died but the appointing his children and shareholders of all their businesses and executors of his will, has prevented this occurring. Legal disputes are hideous. Of course as his wife of many years, and in the will 50% of everything is hers,
She had her income cut off as soon as he died. There are loans documented in the will to be paid to her, which have not been paid, and despite our best efforts the dispute continues.

My brother and myself were made Power of attorneys for finances about 5 years ago. I am the power of attorney for her health, but havent " activated" it yet.

The dispute over the estate has caused so much distress and worry for her, which has led to a further decline into negativity- repetitive negative thinking, which of course makes it all worse and is the hardest thing for me to handle.
She cries almost every morning. Wants to go home to her lovely home. But she cannot live alone at this point. She could live there with a paid caregiver at this point. But her money is tied up in the estate.

I have even contacted Aged Concern, as it seems like financial elder abuse. I hope to meet with them in the next few weeks I really think they are trying to string things out so she cannot have any of her own money at all. We spent two years negotiating a family deed arrangement, where we thought we were giving them all they wanted, only for them to change their minds at the time of signing, because they felt the businesses that my brother and run for Mums share for the two years of negotiation, without any recompense I might add, were now worth more and wanted some of that share.

Is a terrible situation and an injustice to my mum, who worked hard all her life, and even has two medals. A Queen Services medal, and another one for her services to the Order of St Johns.

I find the negativity the hardest. I have a 7 year old daughter, and Mum just does not like kids. Grumps and tells her off all the time.

I have her own a myriad of stuff from the Bredesen program still- mainly hormones- for increased homocysteine, and D3, Bcomplex, ashwaghanda, NAC, SPM, Mitolift, Bacopa, Zinc, Melatonin, Rlipoic Acid, Cogni mag, Vitamin C, Fish oil DHA and EPA, Glutiathione,
B12

We tested her for Mould as her house was filled with it. She has bad mould toxicity. So my brother started her on a naturopathic remedy that is antifungal and liver drainage. AS well as Ultrabinder- charcoal.

I have just ordered a nasal product as well.

But I am not seeing a big improvement. Been almost a year now- in March. We are unsure whether to engage the Bredesen Dr again for more, as is approx $14 thousand NZD for a year. Just dont have it now.

She was walking every day, but has a weak knee and protests strongly about any other type of exercise. Thinking of signing her to a gym., with work and a 7 year old ( who we took on as foster parents from my great niece and is needs a lot of " extra care") it is difficult to find time. She was living with my brother, for 7 months, but he said he cant do it any more, just before christmas.

I asked mum if she would rather I find her a residential facility, but she hates the thought of one, ( even more than staying with me ! )

She gets confused and doesnt know why she has to stay with me.
Some days she is quite clear, other days she is confused all day.
But still talks well and can clean and dress etc. have a conversation. Can make an omelette and a few household things. So not too bad.
Would say it hasnt deteriorated since she has been on the program. We are doing the diet. No sugar or carbs. Sometimes maybe has more chicken than recommended. She doesnt like sardines, and so I made a sardine pate that was nice.

I tried doing the diet with her, but find the high fat doesnt agree with me. I get Xanthelasma which worsens. Probably have the APOE 4 gene. Mum has 4 copies of it.
Anyhow thats enough from me for now. Good to have a place to talk about stuff.




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Re: Alzheimer's caregivers, guardians, and conservators

Postby lgoring » Thu Feb 04, 2021 10:11 am

Aromagician wrote:Hi all
I am the caregiver for my 77 year old mother who has Dementia, and Apoe 4 gene. I havent been tested yet, I had a dna test with Ancestry a while ago and found a website that said it could tell from those results- but it couldnt, and wouldnt refund the money !

Anyhow, we have her on the Bredesen program. But was very expensive and her funds are running low. I have joined here to find advice and support on how to deal with this...

I tried doing the diet with her, but find the high fat doesnt agree with me. I get Xanthelasma which worsens. Probably have the APOE 4 gene. Mum has 4 copies of it.
Anyhow thats enough from me for now. Good to have a place to talk about stuff.


Welcome Aromagician,

I am sorry to hear about your mom and your current situation. Besides caring for you family, you are trying to do what is best for your mom but what is also realistic, financially.

There are many pearls on this website that can hopefully point you in the right direction. If you haven't found the Primer yet, that is a good place to start if you are looking to read about the biochemistry and general information about the ApoE 4 gene. If you know a good amount about the gene, the Wiki is another great source to fine tune your understanding about the Dale Bredesen Protocol. Lastly, if you are interested working with a doctor or a health coach certified in the Bredesen protocol, they may be able to steer you through an individualized approach. Some providers and health coaches even provide a free meet and greet to do an introduction about their services and what you can expect about from their partnership. (Just a thought :) )

Besides that, keeping poking around through the topics or start a new topic that you would love to hear everyone's thoughts about! If you would like to search for a topic, you can use the magnifying glass icon on the Forum's page or click here.

Sorry for the link overload! :D I am currently one of the interns for the ApoE4 website so if you have any other questions about how to navigate the site, just let me know through this chain or you can private message me!

Wishing you the best,

lgoring
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