Donate in the Name of a Friend or Relative Afflicted by Alzheimer's

Next Sunday I'll be participating in the Alzheimer's Walk at Lincoln Financial Center in Philadelphia. Will you support my effort by making a pledge to the Alzheimer's Association in the name of a loved one who either now has, or had the disease? If you do, you will receive a tax deduction for your contribution, and I'll place their name on my tee shirt when I participate in the walk. I'll also share photos or a YouTube of the walk. Click here for the donate page . (http://act.alz.org/goto/bobgasparro).

The odds are pretty good that you have a close friend or relative who suffered from Alzheimer's. Unfortunately, the odds are also good that unless they find a cure soon, you and I have to worry about the disease too.  Until they find a cure, age is the number one cause of Alzheimer's. Today, 47% of your neighbors over age 85 are afflicted with the disease.  Although it afflicts only 10% of those at age 65, that  risk increases with each additional year of age, until it reaches that 47% by age 85. In Pennsylvania alone our population of seniors is expected to double by the year 2030 That means we might expect to see millions in our state afflicted by Alzheimer's, compared to the 280,000 cases of Alzheimer's today. This translates into a significant number of seniors who wander from their home, and a lot of unpaid care-giving by relatives of the seniors.

However, current research has made headway into finding a cure. Right now there are drugs that might temporarily restore functioning of someone with Alzheimer's even though there is no way of reversing or preventing the disease. Recent studies have found genetic markers and life habits associated with the disease, but much more research is needed.

As an Elder Law attorney, I am very familiar with the Alzheimer's Association. They not only help my clients by advancing research to end Alzheimer's and dementia, but they also work to  enhance care for those living with the disease. Thanks to their research, caregivers get insight into how to structure a living area to minimize agitation, discomfort and falls of one afflicted with the disease. The Alzheimer's Association also helps organize support groups for caregivers.  


As for the walk on Sunday, I am walking on the Miller Men Team. I found it too difficult to choose between the National Academy of Elder Lawyers team, and the many local teams sponsored by many of our local care providers on the Main Line. I choose to walk on a team in honor of personal friends. 

Go here to donate in the name of a loved one and sponsor my walk. If you do, please send me an email at the address on the bottom of this post, telling me the name you want to be placed on my walking shirt. I'll also share with you, pictures I take during the walk by posting them on Picassa or YouTube and sending you the link.

I understand some readers might be reluctant to sponsor a lawyer, and that's okay too. My wife, a gerontological nurse practitioner is also on our team. If you are reading this and you are on a team who will be participating in the Walk next Sunday, then add a comment letting readers know about your team and how people can help sponsor your walk.

~~~~~~~~~~~~~~~~

Stay well until the next post.

Bob Gasparro

Bob Gasparro is an Elder Attorney.  He can be reached at Robert.Gasparro@lifespanlegal.com or (484) 297-2050. Comments to this post, and ideas for future posts are welcome.

Man Goes to Court to Prove He Is Alive-- Loses His Case

What happened in this case was the decedent, Donald Eugene Miller Jr. of Ohio, disappeared leaving a wife and kids behind. He also failed to pay any of his court ordered support, leaving the wife and children destitute.

Miller had been "last reported in Arcadia"  his home town, in 1986. He testified that he had lost his job, decided to look elsewhere for work, and then it just "kind of went further than I ever expected it to." (I.e., Florida.) After he'd been missing for eight years, his ex-wife asked for the death decree under Ohio Revised Code section 2121.01 et seq, so their children could get Social Security death benefits. Judge Davis agreed. According to the report, Miller returned to Ohio in 2005, whereupon his parents informed him that he was dead. He's apparently been okay with that for some time, but told the court and Judge Davis that he would like to be alive again now, so he can get his Social Security card and driver's license back.

The Ohio statute that defines how to establish a person is dead states that the finding can be reversed if the person is found to be alive within three years after the decision. There is a major problem with this law, but the problem is with the Ohio legislature who drafted the law rather than the judge who rendered the decision which everyone is laughing about. Courts are bound to follow the law, even if the statute is flawed or even absurd (something which happens more than you might imagine).

As a member of the Social Security bar,  I've represented widows whose husbands disappeared, leaving the wife to establish death in order to receive widows benefits. The last case dealt with a widow receiving disability benefits. If she were able to prove her husband’s death, she could obtain access to better medical care under Medicare, than Medicaid. She could also obtain benefits from Social Security rather than welfare, drawing from her husband’s earnings record. However, we had to establish a death in Africa following his visit there for employment. It was not easy to prove the case, and it entailed visits to the consulate in Washington D.C., and contacting people in other continents, most of whom spoke different languages. Not every country issues a death certificate nor keeps as accurate records as we do in this country. We are very fortunate to have tools like Skype and “Google translate”, but these are relatively recent innovations. Even with the innovations, an attorney and/or investigator needs to methodically build the case. 

Let us go back to the case of Donald Eugene Miller, Jr. of Ohio. There was a possibility that if the finding of death were reversed, the widow and children would have to pay back the social security benefits they received.  It did not seem any more likely that Mr. Miller was would pay the child support he owed in the first place. Legally, the judge, because of the flawed statute, could not recognize Mr. Miller as alive. Practically, to find him alive would allow him to profit from his wrongdoing. So the judge ruled against him. What do you think about the case?

Note: Since the time this article was originally written, a reader pointed out that an account also appears in the New York Times, and can be found here.  

~~~~~~~~~~~~~~~~

Stay well until the next post.

Bob Gasparro

Bob Gasparro is an Elder Attorney.  He can be reached at Robert.Gasparro@lifespanlegal.com or (484) 297-2050. Comments to this post, and ideas for future posts are welcome. 

Tags, social security, death benefits, social security widow benefits, deceased.

Special Viewing of the Film Quartet, Thursday, October 10th - 7-9pm At the Bryn Mawr Film Institute

Bryn Mawr Film Institute and The Eastern Pennsylvania Geriatrics Society Invite you to a special viewing of  the film, Quartet.

The Eastern Pennsylvania Geriatrics Society (EPGS) is the regional affiliate of the American Geriatrics Society (AGS) dedicated to the goal of advancing high standards of clinical care and quality of life for elderly individuals. The EPGS is a multidisciplinary group of health professionals involved in the care and services for the elderly. 

Bryn Mawr Film Institute (BMFI) is a nonprofit, member-supported, motion picture theater and film education center. BMFI is dedicated to promoting shared experiences that entertain, engage, and educate audiences through a diverse range of independent-minded films, a full curriculum of courses, and an extensive program of special events. 


In this film...

Cecily, Reggie, and Wilfred are in a home for retired musicians. Every year, on October 10th, there is a concert to celebrate Verdi's birthday and they take part. Jean (played by Dame Maggie Smith), who used to be married to Reggie, arrives at the home and disrupts their equilibrium. She still acts like a diva, but she refuses to sing. Still, the show must go on... and it does. Just as the recital is about to start, the director of the home is amazed at the energy displayed by the guests of the home, for whom the idea to rehearse and play before an audience, brings life back to them, leading her to the conclusion that old age and art go together.  The film is actor Dustin Hoffman's directorial debut. 
~~~~~~~~~~~~~~~~
Look forward to an Evening of Entertainment and Discussion
Admission is free but space is limited
Click here for directions and parking.

Click here to register.

~~~~~~~~~~~~~~~~

Stay well until the next post.

Bob Gasparro

Bob Gasparro is an Elder Attorney.  He can be reached at Robert.Gasparro@lifespanlegal.com or (484) 297-2050. Comments to this post, and ideas for future posts are welcome. 

Free 5 Session Course On Dementia

Symphony Square in Bala Cynwyd recently hosted a seminar about Alzheimer's Disease. The room was filled to capacity with caregivers and professionals, including nurses, educators, elder law attorneys, and family  caregivers. Since Alzheimer's affects approximately 13% of the population over age 65, and 40% of those over age 85, most were familiar with the disease. Despite the familiarity, nearly everyone learned at least one new fact during the seminar. Statistics about the disease, and it's devastating effects on seniors,  may be found here.   

The week following the presentation at Symphony Square I accompanied my spouse to attend the national convention of the Gerontological Advance Practice Nurse's Association in Chicago. Eavesdropping on some of the presentations, I learned about some of the new drugs and treatments for Alzheimer's, as well as more research conducted by nurse practitioners, hospitals, and others. 

One could easily spend weeks learning about the condition that affects so many seniors. Now, for those who have the time and/or incentive to devote that time, Coursera is offering a five session course on the topic so you can learn to be a more effective caregiver or professional.

Dr. Laura Gitlin, a professor at Johns Hopkins University (and formally from Jefferson University in Philadelphia), and Nancy Hodgson, an assistant professor at Johns Hopkins, are offering a massive open online course (M.O.O.C.) on dementia management through Coursera.  The 5-session course is free and begins October 14.  Click here for more information and to register. If you are a caregiver I encourage you to join me in taking the course. 

Stay well until the next post.

Bob Gasparro

Bob Gasparro is an Elder Attorney.  He can be reached at Robert.Gasparro@lifespanlegal.com or (484) 297-2050. Comments to this post, and ideas for future posts are welcome. 

Lankenau Medical Center To Sponsor Health Fair on 9/28/13, With Free Flu Shorts, Free Health Screenings for Osteoporosis and Stroke

Main Line Health recently opened the Heart Pavilion located at Lankenau Medical Center, at 100 Lancaster Avenue just beyond City Avenue, Wynnewood PA.. This five-story facility is designed to provide both outpatient diagnostics, as well as 96 private rooms for inpatient cardiovascular care. On Saturday, September 28, 2013, from 11 a.m. to 4 p.m. the hospital will host festivities for the entire family to celebrate the opening of the new center.


Of special interest to seniors, there will be free health screenings for osteoporosis and stroke. The U.S. Preventive Services Task Force (USPSTF) recommend that all women 65 years of age or older be screened by bone densitometry. The exam at Lankenau on Saturday will be a "Dexa Scan." It will be a quick and uncomplicated screening of the heel bone density to see if there might be a thinning of the bones requiring further attention. Of those over age 50, 16% of women and 4% of men are reported to suffer from Osteoporosis.

Stroke is the third leading cause of death in the U.S.and the leading cause of disability. Each year in the U.S. 700,000 people suffer from a stroke and about 500,000 are first time attacks. A stroke is caused when there is a disruption of the blood flow to the brain due to a build up of plaque or when the vessel bursts. A carotid artery screening is one way of discovering problems. On Saturday, Lankenau will provide a free carotid artery screen as well as a blood pressure check.

Most of the clients in our Elder Law practice naturally assume they will die in their sleep without many complications, and without becoming a burden on family or friends. However, only 1 in 8 people actually die in their sleep. Seniors are much more likely to suffer a stroke or heart attack, and that will take place between 6 a.m. and noon as the body starts up for the day. Of those who experience a stroke, only 15% will die shortly thereafter;the remainder will continue to live with some kind of impairment. If that is not bad enough, the risk of stoke doubles every ten years after age 55. After the stroke has occurred, and the senior is impaired, they lose their ability to live independently. It is much easier to get screened and avoid stroke with the many medications and medical procedures available today. We can still perform a valuable service for that senior, but with a different focus. Lankenau's Heart Center can also perform a valuable service for that senior, but with a different focus too.

In addition to the items of interest to seniors mentioned above, the day’s festivities will include rides and activities, live music and entertaining street performers, A Taste of Philly gourmet food trucks, fire trucks, ambulance and fire safety house simulations. There will be free parking for attendees.

Anyone over 50 might want to take this test to measure how much you know about strokes in adults. Knowledge is power, especially regarding minimizing the risk of stoke.

Stay well until the next post. Feel free to comment below with your personal reflection about stroke or osteoporosis. Also write robert.gasparro@lifespanlegal.com or call 484-297-2050 with ideas for future posts. A map showing the location of the event is below.View Larger Map

Pennsylvania's Bizarre Assisted Suicide Case Receiving National Attention

Pennsylvania has been making national news following the indictment against a 57 year old Schuylkill County nurse, Barbara Mancini, who allegedly she assisted her 93 year old father, Joseph Yourshaw, to commit suicide. Although Oregon, Washington, Montana, and Vermont have laws permitting assisted suicide, it is still a crime to do so in Pennsylvania. Our Crimes Code Section 2505 define it as a second degree felony (the same as involuntary homicide) if it results in death. The U.S. Supreme Court has already stated there is no such thing as a constitutional right to die, and the state has an overriding interest to protecting its citizens But, the Court said “that a patient has the right to use as much medication as they need, even if it hastens the time of death.” When we draft an advance medical directive in our office, every document contains a clause wherein the drafter may choose to have drugs administered to relieve pain, even if it shortens life. Many clients seem to choose that option but others, including Catholic clients and those who want to be used as a subject to advance medical research, do not. The drug of choice to reduce pain is morphine, It can reduce pain yet may cause death if too much is administered. Hospice workers are excellent at determining the correct dosage. However, it is illegal to increase the dosage for the sole purpose of causing death rather than relieving pain. There have been cases where a medical worker complained about a co-worker giving too high a dose, resulting in criminal prosecution against the worker administering the drug. That is exactly what happened here… the hospice worker found out about the morphine given to the patient by his daughter, and called the police. The police arrested the daughter who allegedly administered the lethal dose, and brought the hospice patient to the hospital to revive him. If convicted of the crime, the maximum penalty for Ms. Mancini is ten years. If this is her first offense, the optional sentencing guidelines call for a sentence between 3 and 9 years. Yet, this is not an open and shut case. The Ms. Mancini, admits that she gave the morphine for her father, but denies it was for the purpose of killing him. Her father was a hospice patient suffering from diabetes. He reportedly stopped taking any medication in 2011 and began to eat a diet that would be expected to worsen uncontrolled diabetes. In January of this year he reportedly told his family he wanted to die. After it was discovered he took the entire vial of morphine, the patient was taken to the hospital and given an antidote for opiate overdoses. He recovered and reportedly raised hell with everyone for reviving him and for picking on his daughter who tried to help. Yet he died four days later. The defendant and her attorney state it’s not plausible that the death was caused by the overdose if he died four days later after becoming conscious again. The standard of proof at a preliminary hearing which took place earlier this month is only whether there is enough evidence to hold the case over for trial. The question is: “if everything the complainant witness says is true, does that constitute a crime?” As you might expect, nearly every case is held over for trial. Only at trial will the judge or jury determine if all the facts alleged are true, and whether there is enough evidence to support them. Normally this case would be tried by the local district attorney. In this case there was a conflict of interest (the nurse may have assisted the D.A.’s office in another matter earlier) and so the D.A. asked the state Attorney General to take over the case. Another interesting fact about this case is the intervention of groups such as “Compassion and Choices” and their effort to organize people to write letters to the Pennsylvania Attorney general to drop the case. I originally posted this story yesterday, but withheld it after a conversation with my wife, a gerontological nurse practitioner who is quite familiar with hospice. She informed me the story may be misleading to readers as everyone else is reporting it. First, she asked, where did the extra morphine that was administered come from? Morphine is a controlled substance and some doctor must have written the prescription. "It is most likely," says my better half, "that the daughter was given the morphine to administer after the hospice nurse left, and she had every right to have it in her possession." Another issue is whether anyone performed an autopsy because the father may have just as likely gone into a coma if he was not treating his diabetes, either before or after the hospital admission. Another issue, it is very rare for a diabetes patient to want to die, it is such an easily controlled illness, so the mental state of the patient is questionable. And finally, it is posible that when the hospital staff realized they had been trying to revive a patient who was on hospice to begin with, they may have simply let him die four days later rather than continue medical interventions. All of these issues will be explored at trial, so stay tuned. Ignoring the bizarre nature of this case, what do you think? Should be change the law to allow assisted suicide in Pennsylvania? Do you think that suicidal wishes are merely symptoms of treatable depression? What would you put in your advance medical directive or living will? Stay well until the next post. Bob Gasparro