This book provides advice on the legal and ethical aspects of caring for a family member with Alzheimer`s disease. Each chapter explains a different benefits program or set of laws designed to protect the rights of older Americans. Security and Medicare take up more than half of the book. Discussions of Medicare applications and appeals are particularly thorough, with examples of summary Medicare notices explaining what the sometimes confusing columns of numbers mean. There are also chapters on Medigap policies, veterans` benefits, private pensions and 401(k) plans, and federal pension benefits. However, if you`re looking for detailed information about Medicaid coverage of nursing home costs, this isn`t your best resource. While basic Medicaid eligibility rules are briefly discussed, the complexity of transferring assets to qualify for Medicaid benefits is not. The resulting problems are compounded by the reluctance of many older adults to cooperate in reporting and investigating their own abuse. For example, a decision-making older person who is physically vulnerable may passively accept physical or emotional abuse, financial abuse, or neglect of basic needs such as hygiene or medication by a family caregiver for fear that a referral to Adult Protective Services (APS) may result in their transfer from the home environment to a nursing home. For older adults whose decision-making capacity is significantly reduced, family members may act as substitute decision-makers who make decisions on behalf of the older person, or as aids for a person capable of exercising supported decision-making. In both cases, when decisions concern medical care, the doctor must be centrally involved in providing information and recommendations to the family and assisting them in decision-making and implementation.

Senior counsel can work with people who are currently capable of making decisions and their families prior to health planning, such as advising them on screening options and helping the client-family unit implement their wishes and values. Senior counsel can be helpful to the physician by helping to define legally authorized substitute decision-makers or by using the legal system to clarify issues of legal authority. The physician and lawyer may work together to present cases to an institutional ethics committee or ethics consultant if there are serious disagreements between family members, between family members and patient preferences, or between families as surrogate mothers and professional caregivers` opinions about the patient`s well-being. Elder abuse by others is a serious problem. Medical and legal puzzles have become more complicated and therefore even more accessible to interprofessional collaboration when it comes to self-neglect. A significant percentage of older people, who live mostly alone, do not regularly meet their own needs or well-being in terms of health care, hygiene, nutrition and other issues. The majority of cases reported to PSG agencies by health and social service professionals and family members are triggered by suspicion of self-neglect. The health care system is making significant efforts to respond to these situations in order to prevent an increase in hospitalizations, nursing home stays and even deaths. In many situations, professional medical or legal services for older adults are necessarily associated with family problems. Families often act as caregivers (sometimes paid, but more often volunteers) for elderly parents who lack complete independence.

When examining families working in this capacity, health professionals play an important role in identifying and mitigating caregiver issues that can endanger both caregivers and the person who depends on their care. Senior counsel may inform relevant parties, including the patient`s physician, of public or private sources of financial support or other forms of support for caregivers, such as the availability of benefits under the federal Family and Medical Leave Act and/or state counterparts. If you have legal issues related to care, long-term care, elder abuse or estate planning, you`re not alone. You can also contact other experienced carers for answers, advice, and support on the caregiver forum. In situations where self-neglect is suspected, the physician`s role is crucial in identifying the potential problem, characterizing the nature and severity of the risk, and attempting to identify clinically and socially viable intervention strategies. Among other concerns, issues of decision-making capacity almost always arise in these cases.