The Hughes Law Firm

Caring for a loved one with Alzheimer’s Disease can present a variety of challenges…a number of our upcoming entries will focus on providing area caregivers with answers to some of the questions that we hear in our Denver Elder Law office on a regular basis. For more information on Alzheimer’s Disease and Dementia, please request our FREE Guide for Colorado Alzheimer’s Caregivers.

How can I make my home safe for my loved one?

More than likely a person with Alzheimer’s disease is going to walk a lot or pace. Not all individuals with dementia experience this behavior, but many do. Caregivers must allow this behavior by structuring the environment to be as safe as possible. A person with Alzheimer’s Disease is likely to have perception difficulties. Carpet with black trim may look like a “black hole” to be stepped over. A shiny tile floor may appear wet. Good lighting without a lot of glare will reduce misperception, thus reducing anxiety. Removing clutter from around the home is very important. Items like foot stools, baskets on the floor, plants on the floor, papers and magazines lying around can increase confusion. Remove these obstacles wherever possible.

There are many products that can help with increasing security and decreasing the caregiver’s level of anxiety. Bells, alarms, and locks on the doors can aid in keeping track of the person with dementia. Baby monitors are also used for monitoring, especially during the night. If your loved one has trouble with falling out of bed, put the mattress on the floor or put an extra mattress next to their bed to help prevent injury.

Information for purchasing home safety devices can be found at The Alzheimer’s Store. Other safety devices may be found at Radio Shack. Baby monitors can be found at most stores that sell baby products.

Filed under: Alzheimer's Disease, Colorado Elder Care by Richard Hughes
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Currently, more than a million Americans live in an estimated 36,000 assisted living facilities. It is expected that the industry will grow to become a $20 billion per year industry within the next several years. Almost half of all assisted living facilities have been opened since 1992 and the median age of facilities is three years. Eighty-eight percent of assisted living facilities are for-profit; 12% are not-for-profit facilities.

Approximately 80% of assisted living facilities are parts of a chain, while 76% are free standing, while 18.9% are part of 85 facilities that combine an assisted living facility with a continuing care, independent living or skilled nursing facilities and 4.6% of facilities offer only independent living. The average length of stay in an assisted living facility is 26.4 months.

It is believed that the explosive growth of the business is due to the aging population and the increased net worth of the elderly. Many elderly persons live alone; women often outlive men, many more couples divorce nowadays, and large numbers of people choose not to marry. The growth in the older population means that more individuals are living to an age where assistance is needed to remain in their own home or to go into institutionalized care. The average occupancy for assisted living residences is near 93%.

In addition, more people are able to afford assisted living facilities because the cost of such facilities is generally less than a nursing home and incomes have risen. Costs vary considerably in Denver, Colorado assisted living facilities, depending on room size and the types of services required. The average cost of assisted living is $2,500 for a studio-type apartment. Medicare does not pay for assisted living directly because it is not considered a reimbursable care setting such as a hospital or skilled nursing facility. However, since the facility is considered the residents home, Medicare in Colorado will pay for some home health services such as nursing services under the direction of a professional registered nurse, physical therapy, occupational or speech therapy, medical social services under the direction of a physician or the part-time or intermittent services of a home health aide. However, if either state law or the assisted living facility contract requires the facility to provide the services, then Medicare typically will not pay for those services.

Medicare in Colorado will also pay for durable medical equipment used by the resident in an assisted living facility if the facility is “used as a home.” Medicare will also pay for physical therapy on an outpatient basis or in the assisted living facility. Hospitals and skilled nursing centers do not qualify under the definition of the beneficiary’s home, but there is no exclusion for assisted living facilities.

Assisted living residents may also receive assisted living facility services if they elect to use this benefit. This is generally less than the cost of combined housing and home health care costs or the cost of a nursing home.

It should be noted that most assisted living centers require an “up-front” fee. Some assisted living facilities bill extra for each ADL they provide while others bundle services together using a tiered pricing formula.

Assisted living facilities are regulated and licensed at the state level. Each state does so according to its own laws– there are no federal regulations on assisted living. For information on Colorado Assisted Living regulations and a listing of Colorado Assisted Living Facilites, please visit the Colorado Senior Answers web site.

Filed under: Colorado Assisted Living by Richard Hughes
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In selecting a Denver, Colorado Skilled Nursing Facility (SNF), you are deciding how someone you love will live for the next few months or years. In our experience, these ten considerations are important, if not crucial, when selecting a Skilled Nursing Facility.

1. Approach a Prospective Nursing Facility with a Positive Attitude
   Despite the horror stories that provide fodder for the evening news, most people who work in nursing facilities are professionals who take pride in their work. Of course, some facilities are better than others, and that is why you are evaluating more than one. (more…)

   Filed under: Colorado Assisted Living, Colorado Elder Care, Colorado Nursing Homes by Richard Hughes
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VA Programs Also Help Pay for Long-Term Care Expenses

The losses suffered by someone diagnosed with Alzheimer’s Disease go far beyond the physical and emotional. The disease can cause a great financial strain as well. Recent studies show that the average direct cost of caring for an Alzheimer’s patient from diagnosis to death is $174,000.

One source of financial help many people overlook is the Veteran’s Administration. The agency offers funds and services to disabled veterans who can show a financial need, regardless of whether or not they have a service-related disability. (more…)

Filed under: Colorado Assisted Living, Colorado Nursing Homes, Veteran's Benefits by Richard Hughes
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Many of the children of our older clients are exhausted with their caregiving chores. Limited sleep, juggling time with their own families, traveling from one house to another…it’s overwhelming. There’s help, however, if they know where to look. Here’s one very valuable resource.

Families–not social service agencies, nursing homes, or government programs–provide the majority of long-term care (LTC) for older persons in the United States. More than 22.4 million informal caregivers provide unpaid help to older persons who live in the community and have various limitations. (more…)

Filed under: Colorado Elder Care by Richard Hughes
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Over the years, I’ve discovered that most people are confused about how much Medicare (not Medicaid) will pay for nursing home expenses. This post from Elder Law Answers should clear this up:

Many people believe that Medicare covers nursing home stays. In fact Medicare’s coverage of nursing home care is quite limited. (more…)

Filed under: Colorado Medicaid, Colorado Medicare, Colorado Nursing Homes by Richard Hughes
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I did something this weekend that I never thought I would do. I started the Nutrisystem™ weight-loss program.

Over the past couple of years, I’ve watched my midsection grow as my age increased. Where I used to be able to see my belt buckle when I looked down, I now have to stick my neck out. Those slacks with elastic on the sides have become my favorite garments. The buttons on my sport coats no longer match up with the button holes without sucking up.

Even though I was getting concerned about the extra 15 pounds I was carrying around, I couldn’t seem to figure out exactly how to deal with the problem. I started persuading myself into thinking that I was eating less or more healthy, but I would find myself dropping right back into the same old routine and over eat at almost every meal.

I even bought a juicer and started buying mega quantities of vegetables at King Soopers instead of potato chips, Oreos and ice cream. While my juicer served a worthwhile purpose (making me feel better about myself), it started to get old after awhile. I turned back to my old habits.

I could go on and on with all of the same excuses that you’ve heard before, but to spare everybody, I will simply cut to the solution: A system. (more…)

Filed under: Colorado Estate Planning by Richard Hughes
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Yesterday I had a little spare time, so I decided to surf the net to see what was out there about estate planning…and man, did I find plenty. Most of what I found were websites that promised a flawless estate plan—complete with a living trust—for under a hundred bucks. They all claimed how easy it was to “do-it-yourself” and avoid the expense of an attorney. Some even promised you could do it all in less than 30 minutes.

Intrigued at the prospect that an internet program could so completely replace me, I signed on to LegalZoom.com and paid the money to generate my comprehensive, all-inclusive estate plan for the low, low price of $149. (more…)

Filed under: Colorado Estate Planning, Colorado Trusts by Richard Hughes
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The trust that Mary sets up could be either revocable or irrevocable. The type of trust that Mary would set up would depend on a number of different circumstances, both personal and financial. An irrevocable trust would afford asset protection with respect to problems the other children may have over the years, including divorces, lawsuits, debt problems and irresponsible behavior. A revocable trust will not offer those protections, but is easier to maintain and administer over the years. Counseling with the family will help determine which way to go here. (more…)

Filed under: Colorado Medicaid, Colorado Trusts by Richard Hughes
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As I mentioned in my previous blog, giving assets away to a trust that you set up for yourself is probably not the way to go in today’s strict Medicaid world. It’s this type of “self-settled” trust that the Medicaid folks are coming down on hard. Instead, give assets away to your children as a group or to your most trusted child and have that child or your children hold the money for your future needs. (more…)

Filed under: Colorado Medicaid, Colorado Trusts by Richard Hughes
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