When Siblings Don’t Agree About Mom and Dad’s Care

Remember the fights you used to have with your brother over who got the last Ring Ding?  (Okay, maybe that was only me).


I’m an independent woman, an elder lawyer, no less.  Yet, when it comes to making decisions about my Mom, I turn first to my brother.  After all, my Mom is his Mom, and I don’t want to totally take charge, although it would be easy to do so. But mostly I like having someone to share the burden with.  Although I help families make decisions about their aging parents, when it comes to mine, I lean on family.


But what happens when you never got over that sibling rivalry?  Or when you honestly just disagree about how your parents should be cared for?


This article offers one solution—elder mediation.  A mediator may well be able to help siblings struggling with how to care for elderly parents and how to pay for that care.  Many elder lawyers are equipped to help work through solutions, but there are mediators in New York who specialize in elder problems.


Alzheimer’s or a Vitamin Deficiency?

According to an article in today’s New York Times by health writer Jane Brody, below normal levels of B-12 can sometimes mimic the signs of Alzheimer’s Disease.


According to Brody, Vitamin B-12 is absorbed less readily as we age, and a deficiency can cause symptoms of memory loss and confusion–the same symptoms as an early Alzheimer’s diagnosis.


A study in the American Journal of Clinical Nutrition found that supplementing people without deficiencies of B-12 did not improve cognitive impairment with normal levels of the vitamin, but did improve cognition among women with a low intake of B vitamins.


Although I’m not a doctor, it seems to me that testing for Vitamin B-12 deficiency in older adults should be a routine procedure.

The Survey Says: NY a Winner in the High Cost of Long Term Care

In this survey, New York “only” comes in fifth in the country on the list of most expensive annual cost for a private room at a nursing home.  The survey is using median rates, and also averaging the cost of nursing homes throughout New York State. On Long Island, the cost of a semi-private room is right around $430/day.  That translates to $146,000 annually.  Each year.  $146,000.00.


If you find this as shocking as I do, you should contact an elder lawyer who may be able to help you protect your hard-earned assets.



The Real Reason You Should Have Paid Attention in High School French


In a recent interview in the New York Times Science Section, cognitive neuroscientist Ellen Bialystock was interviewed about recent studies that have found that being bilingual delays the onset of Alzheimer’s symptoms by an average of five to six years.

Unfortunately, the occasional use of a second language does not qualify for bilingualism.  The second language must be used regularly in your every day life.

The study of 211 diagnosed Alzheimer’s sufferers found that the onset of symptoms in bilingual patients occurred more than 5 years after those monolingual patients, and were diagnosed 5 years later.  Interestingly, the monolingual patients were more educated.

Too Late to Learn a Second Language?


It is probably too late for most of us reading this to learn to speak a second language fluently enough to reap the benefits of this study.  However, it has been well documented that those adults who remain socially, mentally and physically active are better protected against the onset of dementia.

So, you might say that a bit of je ne sais quoi can delay non compos mentis.


A Physician’s Guide to End-of-Life Decisions (MOLST)

The denial of death is one of the strongest of human defense mechanisms. In fact, there’s an entire book about it.  We don’t want to think about our end-of-life care wishes. (Although some have instructed, “Wave a martini in front of me — if I don’t respond, pull the plug.”) I don’t like to think about it any more than the next person. But I also don’t like to think about my family and doctors arguing over keeping me on a ventilator when I could have easily told them in advance what I want in that situation. In the past, the only option would be the use of an “advance directive” or health care proxy.  That’s still a good idea, but some might wish to also involve their doctors in the discussion. Another technique known as Medical Orders for Life-Sustaining Treatment (or MOLST) is becoming more popular. As a recent article in The Wall Street Journal makes clear, a growing number of states, including New York, are promoting MOLST to help guide physicians with a patient’s specific instructions.

New York is one of the more forward-thinking states in instituting the program known as Medical Orders for Life Sustaining Treatments (MOLST)

MOLST is different from other advance directives such as living wills and health care proxies because it is physician generated instead of client/patient generated.  A licensed physician must always sign the MOLST.  It is printed on bright pink paper so that hospitals and nursing homes cannot fail to notice it.

While the MOLST is a good addition to helping people get their wishes fulfilled, it is most often employed for the elderly who are in need of life-sustaining care.  It should not replace the health care proxy and living will you would create along with your wills and financial powers of attorney.

I found myself filling one of these out several years ago, when we had to check my mother into a nursing home.  Despite years of seeing gerontologists and living in an assisted living facility, this was the first time we’d been presented with the option of discussing the MOLST.

You may want to discuss this with your physician or elder law attorney so that you too can participate in your own decisions on your end-of-life care.


Is the Doctor In? Not if You’re on Medicaid

A major difficulty for people on Medicaid is the inability to find doctors and dentists willing to accept the plan.  For those people who need primary care, the result is often hours and hours in clinics waiting to see a general practitioner and month-long waits for specialists.


According to the New York Times, having a Medicaid card does not in any way assure access to care.  Medicaid patients cannot find surgeons willing to operate on them, or find mental health specialists willing to see them.


Unfortunately, the new health laws that depend heavily on Medicaid to help the already uninsured are only likely to put a bigger burden on states that are looking for ways to cut back.