Health Care Proxy. Should you have one?

Under the New York Health Care Proxy Law you can appoint someone you trust to make health care decisions for you if you lose the ability to make those decisions yourself. That person is considered your health care proxy or agent

A health care proxy is a way to eliminate confusion among your loved ones and health care providers about your health care wishes should you no longer b able t make those decsions yourself. Hospitals, doctors, and other medical providers must follow the agent’s decisions as if they were your own.

Here are a some common questions and answers about health care proxies:

Who can be your health care agent?

Anyone 18 years of age or older, including a family member or close friend can be your health care proxy.

A doctor can act either as your proxy or your attending doctor, but not as both simultaneously. A number of special rules apply to patients or residents of a nursing home, hospital, or mental health facility who want to name a staff member as an agent.

What powers do health care proxies have?

Your proxy can decide how your wishes apply as your medical condition changes, but he or she is legally obligated to always act in your best interest.

The person you select as your health care agent will have as little or as much authority as you want. You may allow your agent to make all health care decisions or only certain ones.

A health care proxy is different from a living will because it does not require that you know in advance all the decisions that may arise. Nevertheless, you may give your agent instructions that he or she must follow and specify on the form the treatments you do or do not want.

Also, note that you can continue to make health care decisions for yourself as long as you’re able. You can also cancel the authority given to your agent by informing him or her or your health care provider orally or in writing.

To appoint a health care proxy, you and your agent must sign a New York health care proxy form in the presence of two adult witnesses. This is best done in an attorney’s office like the Law Offices of Jeffrey Weinstein. Mr Weinstein is an estate professional and can guide you through what you need to do to insure your wishes are carried out.

Here are some instances when you would need a proxy:

  • You are in a coma from an accident or illness.
  • You are terminally ill and not expected to recover.
  • You have Alzheimer’s or another form of dementia.
  • You are under general anesthesia, when something unexpected occurs.
  • You are in a persistent vegetative state.
  • You suffered from an illness that left you unable to communicate.

 

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Ways to prevent elder abuse

The second man to walk on the moon, 88-year-old 88 Buzz Aldrin is fighting his two youngest children who he claims are colluding with his former manager Christina Korp to seize control of his estate by alleging that he has dementia. He sued the trio in a Florida court in June. Korp and the Aldrin children deny wrongdoing and blame Aldrin’s “increased confusion and memory loss.”

Wherever the truth lies, what is happening to Aldrin is becoming more and more common and not just to the rich and famous. The exploitation of the elderly is growing and is vastly underreported.

Julie Schoen of the National Center on Elder Abuse told AARP, “It’s such a hidden crime. Within families, victims don’t want to prosecute. There’s a huge gap in our system when it comes to recording these crimes. We need better research. Ninety percent of perpetrators are family members or other people the victim knows well, such as caretakers, neighbors or friends.

Schoen suggests some ways to help protect you and your aged loved ones.

  • When a person is still mentally sharp, help him or her make a plan that designates power of attorney and health care directives. “We tend to want to keep financial matters private, but if we don’t have those discussions, that’s what blows things apart.”
  • Stay connected with older loved ones through regular phone calls, visits or emails.
  • Develop a relationship with your parent’s caregiver. “They’ll be less likely to financially exploit Mother because they know you’re paying attention.”
  • Become a “trusted contact” to monitor bank account and brokerage activity.
  • Sign up for a service such as EverSafe to track financial activity and notify an advocate of unusual withdrawals or spending.
  • Set up direct deposit for checks so others don’t have to cash them.
  • Do not sign any documents that you don’t understand.

If you need legal help protecting an aging loved one, please call us here at the Law Offices Of Jeffrey Weinstein.   347-305-8752.

 

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Some people with markers of Alzheimer’s don’t develop the disease

A new study from The University of Texas Medical Branch at Galveston, published in the Journal of Alzheimer’s Disease  has uncovered why some people that have brain markers of Alzheimer’s never develop the classic dementia that others do.

Alzheimer’s is the most common form of dementia and affects more than 5 million Americans. People suffering from Alzheimer’s develop a buildup of two proteins that impair communications between nerve cells in the brain, plaques made of amyloid beta proteins and neurofibrillary tangles made of tau proteins.

Curiously, researchers were at a loss to explain why not all people with those signs of Alzheimer’s ever develop any cognitive decline.  The question then became, what sets these people apart from those with the same plaques and tangles that develop dementia?

Giulio Taglialatela, director of the Mitchell Center for Neurodegenerative Diseases said

“In previous studies, we found that while the non-demented people with Alzheimer’s neuropathology had amyloid plaques and neurofibrillary tangles just like the demented people did, the toxic amyloid beta and tau proteins did not accumulate at synapses, the point of communication between nerve cells. When nerve cells can’t communicate because of the buildup of these toxic proteins that disrupt synapse, thought and memory become impaired. The next key question was then what makes the synapse of these resilient individuals capable of rejecting the dysfunctional binding of amyloid beta and tau?”

To answer this question, researchers used high-throughput electrophoresis and mass spectrometry to analyze the protein composition of synapses isolated from frozen brain tissue donated by people who had participated in brain aging studies and received annual neurological and neuropsychological evaluations during their lifetime. The participants were divided into three groups, those with Alzheimer’s dementia, those with Alzheimer’s brain features but no signs of dementia and those without any evidence of Alzheimer’s.

Results showed that resilient individuals had a unique synaptic protein signature that set them apart from both demented AD patients and normal subjects with no AD pathology. Taglialatela said this unique protein make-up may underscore the synaptic resistance to amyloid beta and tau, thus enabling these fortunate people to remain cognitively intact despite having Alzheimer’s-like pathologies.

Taglialatela sai they still didn’t understand the mechanisms responsible for this protection,” but “understanding such protective biological processes could reveal new targets for developing effective Alzheimer’s treatments.”

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Rethinking the “stroke rule”

In 1993 neurologist Camilo Gomez, M.D., coined a phrase that for the last 25 years has been a  fundamental rule of stroke care: Time is brain! That rule means the longer post-stroke treatment is delayed the less effective it will be.

Now a new study by Dr. Gomez is rethinking that rule and the idea that “Time is brain” may b more complicated than believed.

In an editorial 25 years ago Dr. Gomez wrote: “Unquestionably the longer therapy is delayed, the lesser the chance that it will be successful. Simply stated: time is brain!” In the August, 2018 Journal of Stroke & Cerebrovascular Diseases he writes that it is still true that it isimperitive to call 911 immediatelythe longer the wait, the less effective the treatment, but the effect of time can vary from patient to patient.

Gomez writes that “depending on the blood circulation pattern in the brain, emergency treatment could greatly help one patient, but be too late for another patient treated at the same time.It’s clearly evident that the effect of time on the ischemic process is relative.”

About 85 percent of strokes are ischemic, meaning the stroke is caused by a blood clot that blocks blood flow to an area of the brain. Starved of blood and oxygen, brain cells begin dying.

Traditionally, there was little physicians could do to halt this process, so there was no rush to treat stroke patients. But in his groundbreaking editorial, Dr. Gomez wrote that rapid improvements in imaging technologies and treatments might enable physicians to minimize stroke damage during the critical first hours.

 

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Social Security, Medicare and Retirement

If you’re an older worker and decide to file for Social Security before you reach full retirement age, you need to account for the impact that income will have on your benefits. That’s because your benefits would be reduced temporarily and up to 85% of your benefits would be taxed if your combined income exceeds a certain threshold.

More income can also push you into a higher tax bracket and that can trigger Medicare surcharges.

For more details read this article at Kipplinger.

And what about longevity? Non-smoking 65-year-old women have a 50% chance of reaching the age of 88, while their male counterparts have the same chance of living for 20 more years, says Kipplinger.com

So you should get long-term health care coverage, plan for incapacity and avoid probate and estate plan to lessen your tax burden. Kipplinger suggests,  “Estate planning techniques such as credit shelter trusts, giving assets away during your life, or even changing the state in which you live, can help minimize the impact of these taxes.” 

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