Answers to Tax Questions Caregivers Ask Most

(AgingCare.com) With tax time comes rules, exceptions, exemptions, requirements – and lots of confusion. AgingCare has gathered a list of frequently asked questions that caregivers ask most, with responses from the IRS website.

Q: Can I claim my elderly parent who lives in my home as a dependent on my tax return?

A: You may claim your parent as a dependent if the following tests are met:

  1. You are not a dependent of another taxpayer.
  2. Your parent does not file a joint return.
  3. Your parent is a U.S. citizen, U.S. national, U.S. resident, or a resident of Canada or Mexico.
  4. You paid more than half of your parent’s support for the calendar year.
  5. Your parent’s gross income for the calendar year was less than the exemption amount.
  6. Your parent DOES NOT have to live with you in order to claim them as a dependent, if you’ve meet the above criteria. Relatives who quality who do not have to live with you include: mother, father, grandparent, stepmother, stepfather, mother-in-law, father-in-law.

(See Publication 17, Your Federal Income Tax, and Table 3-1 on page 27, “Overview of the Rules for Claiming an exemption for a Dependent.”)

Q: I am a caregiver and my elderly parent lives in my home. Can I file as head of household?

A: You may file as head of household if you meet the following requirements:

  1. You are unmarried or “considered unmarried” on the last day of the year.
  2. You may claim a dependency exemption for your parent.
  3. You paid more than half the cost of keeping up a home for your parent for the tax year.

Your dependent parent does not have to live with you. Your parent DOES NOT have to live with you in order to claim them as a dependent, if you’ve meet the above criteria. Relatives who quality who do not have to live with you include: mother, father, grandparent, stepmother, stepfather, mother-in-law, father-in-law.

(See Special rule for Parent , in Publication 17, under Qualifying Person. See also Publication 501: Exemptions, Standard Deduction, and Filing Information.)

Q: Can I claim modifications to my home to accommodate my parent’s medical condition as a medical expense?

Yes, but only if your parent was your dependent at the time the medical services were provided or at the time you paid the expense. Also, the amount of the allowable medical expense is the cost of the modification decreased by any resulting increase to the value of your home. Finally, your total deduction for medical and dental expenses must be reduced by 10 percent of your adjusted gross income (7.5 percent if either you or your spouse was born before January 2, 1949).

(See Publications 17 and 502 for additional information.)

Q: My parents occasionally give me money to offset some of the cost of their care. Do I have to pay taxes on these funds?

A: An amount of money that your parents give you to offset their expenses is not taxable to you, however, you should take this amount into account in determining whether your parents are your dependents.

(See Publication 501, Exemptions, Standard Deduction, and Filing Information)

Q: I pay for some of my parent’s expenses medical expenses. Can I deduct these expenses on my tax return?

A: If you can claim your parent as a dependent, you also may be able to claim a deduction for the portion of your parent’s medical or dental expenses that you paid. However, your total deduction for medical and dental expenses must be reduced by 10 percent of your adjusted gross income (7.5 percent if either you or your spouse was born before January 2, 1949).

(See Publication 17, pages 140-144, for additional information. See also Publication 501, Exemptions, Standard Deduction, and Filing Information; Publication 502, Medical and Dental Expenses.)

Q: As a condition of acceptance to their assisted-living facility, my parents relinquished all home ownership rights to the community. Does this arrangement have any tax consequences?

A: Yes, this transaction will be considered a sale of their home. The property was transferred for services.

(See Publication 523 “Selling your Home” for additional information.)

Q: My parent is suffering from dementia. I cash his/her monthly social security check and use the proceeds for his/her care. What are the tax consequences?

A: Your parent’s social security benefits are not taxable to you. However, in determining whether your parent is your dependent, you should consider the benefits used for your parent’s support as support provided by your parent.

(See Publication 501, Exemptions, Standard Deduction, and Filing Information, for additional information.)

Q: My parent signed his/her home over to me. Does this transaction have to be reported to the IRS?

A: Yes. If certain conditions apply, this transaction would be considered a taxable gift from your parent to you. Generally, your parent must file a gift tax return ( Form 709) if any of the following apply:

  1. Your parent gave gifts to at least one person (other than his/her spouse) that are more than the annual exclusion for the year. Check Publication 950 for the annual exclusion.
  2. Your parent and his/her spouse are splitting a gift.
  3. Your parent gave someone (other than his/her spouse) a gift of a future interest that he or she cannot actually possess, enjoy, or receive income from until some time in the future.
  4. Your parent gave his/her spouse an interest in property that will be ended by some future event

NOTE: If any of the above conditions apply, your parent is required to file a Form 709, even if a gift tax is not payable.

(See Publication 950 for additional information on gifts.)

Q: I received a death benefit from my parent’s life insurance policy. Do I have to pay taxes on that money?

A: Life insurance proceeds paid to you because of the death of the insured person are not taxable unless the policy was turned over to you for a price. This is true even if the proceeds were paid under an accident or health insurance policy or an endowment contract. However, interest income received as a result of life insurance proceeds may be taxable.

(See Publication 525 for additional information.)

Links to IRS Documents Referenced in this Article

Publication 17: Your Federal Income Tax

Publication 501: Exemptions, Standard Deductions and Filing Information

Publication 502: Medical and Dental Expenses

Publication 523: Selling Your Home

Publication 525: Taxable and Non-Taxable Income

Publication 950: Estate and Gift Taxes

Citation

https://www.agingcare.com/articles/caregiver-tax-questions-and-irs-forms-148709.htm

By Marlo Sollitto

Copyright 2016 AgingCare, LLC.

 

Helping Family and Friends Understand Alzheimer’s Disease

(National Institutes of Health) When you learn that someone has Alzheimer’s disease, you may wonder when and how to tell your family and friends. You may be worried about how others will react to or treat the person. Realize that family and friends often sense that something is wrong before they are told. Alzheimer’s disease is hard to keep secret.

There’s no single right way to tell others about Alzheimer’s disease. When the time seems right, be honest with family, friends, and others. Use this as a chance to educate them about Alzheimer’s. You can:

  • Tell friends and family about Alzheimer’s disease and its effects.
  • Share articles, websites, and other information about the disease.
  • Tell them what they can do to help. Let them know you need breaks.

Tips for Communicating

You can help family and friends understand how to interact with the person with Alzheimer’s disease. Here are some tips:

  • Help family and friends realize what the person can still do and how much he or she still can understand.
  • Give visitors suggestions about how to start talking with the person. For example, make eye contact and say, “Hello George, I’m John. We used to work together.”
  • Help them avoid correcting the person with Alzheimer’s if he or she makes a mistake or forgets something. Instead, ask visitors to respond to the feelings expressed or talk about something different.
  • Help family and friends plan fun activities with the person, such as going to family reunions or visiting old friends. A photo album or other activity can help if the person is bored or confused and needs to be distracted.

Remind visitors to:

  • Visit at times of day when the person with Alzheimer’s is at his or her best.
  • Be calm and quiet. Don’t use a loud voice or talk to the person as if he or she were a child.
  • Respect the person’s personal space, and don’t get too close.
  • Not take it personally if the person does not recognize you, is unkind, or gets angry.

When You’re Out in Public

Some caregivers carry a card that explains why the person with Alzheimer’s might say or do odd things. For example, the card could read,

“My family member has Alzheimer’s disease. He or she might say or do things that are unexpected. Thank you for your understanding.”

The card allows you to let others know about the person’s Alzheimer’s disease without the person hearing you. It also means you don’t have to keep explaining things.

Helping Children Understand AD

When a family member has AD, it affects everyone in the family, including children and grandchildren. It’s important to talk to them about what is happening. How much and what kind of information you share depends on the child’s age. It also depends on his or her relationship to the person with AD.

Give children information about AD that they can understand. There are good books about AD for children of all ages. Some are listed on the Alzheimer’s Disease Education and Referral (ADEAR) Center website, www.nia.nih.gov/alzheimers.

Here are some other suggestions to help children understand what is happening:

  • Answer their questions simply and honestly. For example, you might tell a young child, “Grandma has an illness that makes it hard for her to remember things.”
  • Help them know that their feelings of sadness and anger are normal.
  • Comfort them. Tell them no one caused the disease. Young children may think they did something to hurt their grandparent.

If the child lives in the same house as someone with AD:

  • Don’t expect a young child to help take care of or “babysit” the person with AD.
  • Make sure the child has time for his or her own interests and needs, such as playing with friends, going to school activities, or doing homework.
  • Make sure you spend time with your child, so he or she doesn’t feel that all your attention is on the person with AD.
  • Help the child understand your feelings. Be honest about your feelings when you talk with a child, but don’t overwhelm him or her.

Many younger children will look to you to see how to act around the person with AD. Show children they can still talk with the person, and help them enjoy things each day. Doing fun things together can help both the child and the person with AD.

Here are some things they might do:

  • Do simple arts and crafts.
  • Play music.
  • Sing.
  • Look through photo albums.
  • Read stories out loud.

Some children may not talk about their negative feelings, but you may see changes in how they act. Problems at school, with friends, or at home can be a sign that they are upset. You may want to ask a school counselor or a social worker to help your child understand what is happening and learn how to cope. Be sure to check with your child often to see how he or she is feeling.

A teenager might find it very hard to accept how the person with AD has changed. He or she may find the changes upsetting or embarrassing and not want to be around the person. It’s a good idea to talk with teenagers about their concerns and feelings. Don’t force them to spend time with the person who has AD. This could make things worse.

Respite Care

If the stress of living with someone who has AD becomes too great for a child, think about placing the person with AD into a respite care facility. Then, both you and your child can get a much-needed break. See “Respite Services” for more information about respite care.

Other Resources

For more caregiving tips and other resources:

Citation

https://www.nia.nih.gov/alzheimers/publication/helping-family-and-friends-understand-alzheimers-disease

National Institute on Aging

 

Alzheimer’s Disease and Planning for Care

(UCSF Memory and Aging Center) The first step in planning care is getting an accurate diagnosis.

Diagnosis

Seek out a dementia clinic at a university hospital or ask your doctor to refer you to a neurologist with expertise in dementia and neurodegenerative disease.

Educate Yourself

Learn what you can about dementia and neurodegenerative disease. Understanding what is happening to your loved one will help you cope better with the changes and behavioral symptoms of the illness and help you to communicate with the medical team providing care. Accepting that the behavioral symptoms are part of the disease process will help you direct your energy toward workable solutions. When looking online, read well-known medical sites like the National Institutes of Health.

Join a Support Group

Talking with other caregivers who have gone or are going through a similar experience to yours can provide emotional support and practical advice. Contacts and support groups can be found through online communities or local organizations.

Assess the Situation

An objective analysis of your health, medical coverage, emotional state and other commitments will help you figure out how much you can and cannot do yourself, and what type of outside support will be needed to ensure your loved one’s health and safety.

Write down your assessment of:

  • Your loved one’s ability to function independently, both cognitively and emotionally.
  • The safety and adaptability of your home or physical environment.
  • Your own health and emotional resources.
  • Your other responsibilities at work, at home, to other family members and in the community.
  • The availability of family and friends to give you support and to share the care.
  • Your financial resources, including insurance coverage and, if the person had been working, private disability insurance and the federal program, Social Security Disability Insurance (SSDI).
  • Late stage preparation for you and your family member.
  • End-of-life preparation for you and your loved one.

A written document helps to avoid neglecting important issues. Review and update these observations periodically to help you determine if you need to make changes along the way.

Keep Good Records

Keep up-to-date records of emergency numbers, doctors, daily medications, special diets, back-up people with contact information, behavioral triggers and other pertinent information relating to your loved one’s care. Consider making copies of this record for the medical team and another trusted caregiver in case the information is needed in an emergency and you are unavailable.

Develop a Care Team

Keep a list of people you can contact for help, emotional support or respite. Use these pages to explain to others that the seemingly bizarre behaviors you cope with are part of the brain disease. Your list may be short, but don’t preclude people that can help by doing even small chores for you (grocery shopping, babysitting, dog walking, etc.). The critical thing is to be willing to accept help from others and tell them what you need.

Establish a Routine

A straightforward daily routine can be a stabilizer, especially for people who find change upsetting and confusing.

Hold a Family Conference

A formal meeting offers family members the chance to discuss the diagnosis and its likely progression, share caregiving responsibilities, and reduce misunderstandings and fears. It can help to have a member of the clergy, a professional care coordinator or a trusted friend serve as an impartial moderator. Let everyone know they can play a role, even if they are a thousand miles away, and help you, the primary family caregiver, from bearing the brunt of all the work all of the time.

Prepare for the End

Planning for the difficult decisions can make it much easier for the person with dementia and their family and caregivers to manage their healthcare, financial and legal affairs. Start early, so that you can be part of the process and share your wishes with the people who may need to make decisions on your behalf. It is vital that you think through what to do if you should be incapacitated.

Caregiving Resources

  • Printable list of online resources
  • Administration on Aging (AoA): The mission of AoA is to develop a comprehensive, coordinated and cost-effective system of home and community-based services that helps elderly individuals maintain their health and independence in their homes and communities.
  • Aging in the Know: A health care site created by the American Geriatrics Society Foundation for Health in Aging (FHA).
  • AGS Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults (2012): A medication guidelines and recommendations site created by the American Geriatrics Society Foundation.
  • alzheimers.gov is the government’s free information resource about Alzheimer’s disease and related dementias.
  • Alzheimer’s Association: The Alzheimer’s Association works on a global, national and local level to enhance care and support for all those affected by Alzheimer’s and related dementias.
  • Alzheimer’s Disease Education and Referral (ADEAR) Center: The ADEAR Center website will help you find current, comprehensive Alzheimer’s disease (AD) information and resources from the National Institute on Aging (NIA).
  • Alzheimer Research Forum: The Alzheimer Research Forum reports on the latest scientific findings from basic research to clinical trials; creates and maintains public databases of essential research data and reagents, and produces discussion forums to contribute to the global effort to cure Alzheimer’s disease.
  • American Association of Retired Persons (AARP): The AARP is a consumer group that posts policy statements and position papers.
  • American Geriatrics Society (AGS): AGS provides professional and consumer information.
  • Assisted Living: Personal Care: This is a checklist from the National Caregivers Library of personal and health care questions to ask when you and your loved one visit an assisted living facility
  • Assisted Living: Quality of Life: This is a checklist of questions from the National Caregivers Library dealing with socializing, meals, safety and other issues to consider when you and your loved one visit an assisted living facility.
  • Assisted Living: Costs and Contracts: This is a list of financial questions to ask when you and your loved one visit an assisted living facility.
  • California Advocates for Nursing Home Reform (CANHR): CANHR is a nonprofit advocacy organization dedicated to improving the choices, care and quality of life for California’s long term care consumers.
  • California Alzheimer’s Disease Centers (CADCs): The CADCs effectively and efficiently improve AD health care delivery, provide specialized training and education to health care professionals and others, and advance the diagnosis and treatment of AD through a network of ten dementia care Centers of Excellence at California medical schools.
  • California Caregiver Resource Center: Information, education, respite, care planning and support for families and friends caring for adults with chronic, disabling health conditions.
  • CalQualityCare.org: This website provides information about long term care options and quality ratings for different providers in California.
  • CaringBridge: CaringBridge provides free, easy-to-create and use websites that connect people experiencing a significant health challenge to family and friends, making each health journey easier.
  • Caring Connections: Caring Connections, a program of the National Hospice and Palliative Care Organization (NHPCO), is a national consumer and community engagement initiative to improve care at the end of life, supported by a grant from The Robert Wood Johnson Foundation.
  • Department of Health and Human Services Healthfinder: Health issues from food, safety, government health, prevention and self-care from children to seniors.
  • Department of Motor Vehicles (DMV): Information about the DMV (of California).
  • Family Caregiver Alliance: Caregiver resource center for brain impaired adults, support groups, education, care planning, research and advocacy.
  • Medicare: Information about the federal health insurance program for people age 65 or older.
  • National Institute on Aging: The NIA has many free publications
  • Next Step in Care: Information and advice to help family caregivers and health care providers plan safe and smooth transitions for patients with careful planning, clear communication and ongoing coordination.
  • PayingForSeniorCare.com and Eldercare Financial Resource Locator Tool: this website helps families and caregivers locate information about long-term care resources for their loved ones and find the public and private programs available to assist in covering the cost of such care.
  • PubMED: PubMed, a free service of the National Library of Medicine and the National Institutes of Health, includes approximately 20 million citations for biomedical literature.
  • Social Security information: general information about social security, legislation, benefits and public information resources.
  • UCSF Neurology Caregiver Corner: A listing of resources put together by a UCSF multidisciplinary group seeking to make information easily accessible for friends and family caregivers caring for someone with a neurological condition.
  • UCSF Osher Center for Integrative Medicine: has a series of materials produced as part of the Caregivers Project to support family caregivers of loved ones with serious illness.
  • Whole Brain Atlas: A primer on neuroimaging and anatomy.
Citation

http://memory.ucsf.edu/caregiving/planning

© 2017 The Regents of the University of California

 

Alzheimer’s Disease and When to Stop Driving

(Mayo Clinic) If your loved one has Alzheimer’s, he or she may not be safe on the road. Explain the risks — then provide other ways to get around.

Driving is a powerful symbol of competence and independence, besides being a routine part of adult life. But the focused concentration and quick reaction time needed for safe driving tends to decline with age. Alzheimer’s disease accelerates this process dramatically. If you’re caring for a loved one living with Alzheimer’s, you may need to modify his or her driving – or stop his or her driving completely.

More than Memory Problems

Dimmed short-term memory makes it easy for a driver who has Alzheimer’s to get lost, even in familiar surroundings. Perhaps more dangerous, however, is a decline in the ability to judge distances and predict upcoming traffic problems. A driver who has Alzheimer’s may also have trouble prioritizing visual cues. An irrelevant sight, such as a dog jumping behind a fence, may distract the driver from important cues — such as brake lights or traffic signs.

When to Stop Driving

Driving concerns often surface during the early stages of memory changes. People with dementia are especially likely to minimize the complexity of driving and overestimate their abilities. Opinions vary on whether driving should be allowed at all after an Alzheimer’s diagnosis. Research indicates that drivers with Alzheimer’s disease are more likely to get into motor vehicle accidents. For some people, it may be easier to give up the wheel early on, when they can still grasp the potential hazards. On the other hand, people in the early stages of the disease may be able to safely limit their driving to short daytime trips in familiar surroundings.

If your loved one continues to drive, pay attention to warning signs of unsafe driving, such as:

  • Difficulty navigating to familiar places
  • Inappropriate lane changing
  • Confusing the brake and gas pedals
  • Failing to observe traffic signals
  • Making slow or poor decisions
  • Hitting the curb while driving
  • Driving at an inappropriate speed (often too slow)
  • Becoming angry or confused while driving

According to a report from the American Academy of Neurology, one of the more accurate predictors of driving trouble is a caregiver’s assessment. If a caregiver (generally a spouse) believes that his or her relative with dementia is driving unsafe, the caregiver is likely to be correct. If you’re not sure whether it’s safe for your loved one to drive, ask yourself whether you feel safe riding in a vehicle driven by the person who has Alzheimer’s — or if you’d feel safe having your children or others drive with that person. If the answer is no, then you know it’s time for him or her to retire from driving.

How to Ease the Transition

When your loved one stops driving, arrange for alternative transportation. Perhaps family members and friends can run errands with your loved one, or you can arrange transportation through a senior van route. You may be able to establish a payment account with a taxi service so that your loved one can go places, but won’t have to handle money.

Also consider ways to limit your loved one’s need to drive. Many items — such as groceries, meals and prescriptions — can be delivered to your loved one’s home. Some barbers and hairdressers make house calls as well.

Remain Firm as the Disease Progresses

If your loved one wants to continue driving despite the hazards — or begins driving again after a period off the road — consider these strategies to keep him or her out of the driver’s seat:

  • Get it in writing. Sometimes it helps if an authority figure — physician, lawyer or insurance agent — tells your loved one to stop driving. Having something in writing can be a useful reminder.
  • Keep keys out of sight. Park the vehicle around the corner or in a closed garage, and don’t keep keys in plain sight. If your loved one insists on carrying a set of keys, offer old keys that won’t start the vehicle.
  • Disable the vehicle. Remove a battery cable to prevent the car from starting, or ask a mechanic to install a “kill switch” that must be engaged before the car will start.
  • Sell the vehicle. If you can make do without your loved one’s vehicle, consider selling it.

Whether your loved one stops driving all at once or in stages, he or she will probably grieve the loss of independence. Be as patient as you can, but remember to stand firm. The consequences of unsafe driving can be devastating.

Citation

http://www.mayoclinic.org/healthy-lifestyle/caregivers/in-depth/alzheimers/art-20044924

References:

  1. Driving. Alzheimer’s Association. http://www.alz.org/care/alzheimers-dementia-and-driving.asp. Accessed March 14, 2013.
  2. Martin AJ, et al. Driving assessment for maintaining mobility and safety in drivers with dementia. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006222.pub2/abstract. Accessed March 14, 2013.
  3. Snyder CH. Dementia and driving: Autonomy versus safety. Journal of the American Academy of Nurse Practitioners. 2005;17:393.
  4. Ott BR, et al. A longitudinal study of drivers with Alzheimer disease. Neurology. 2008;70:1171.
  5. Iverson DJ, et al. Practice parameter update: Evaluation and management of driving risk in dementia. Neurology. 2010;74:1316.
  6. AskMayoExpert. Alzheimer’s disease: Should patients with Alzheimer’s dementia be allowed to drive? Rochester, Minn.: Mayo Foundation for Medical Education and Research;2012.

© 1998-2017 Mayo Foundation for Medical Education and Research. All rights reserved.

 

Stages of Dementia: How Does the Disease Change Over Time?

(MedicalNewsToday) Dementia is not a specific illness or disease. It involves a variety of symptoms associated with impaired thinking, memory, and communication.

To have a diagnosis of dementia, the decline in functioning must affect a person’s ability to perform everyday activities.

This article will look at several types of dementia, and how they change as the condition progresses.

Types of Dementia

Dementia may have different causes. Changes to the brain depend on the type of dementia a person has. Common types of dementia include Alzheimer’s disease, vascular dementia, dementia with Lewy bodies, and mixed dementia.

Alzheimer’s Disease

The most common cause of dementia is Alzheimer’s disease. According to the Alzheimer’s Association, between 60 and 80 percent of dementia is caused by Alzheimer’s.

It is not entirely clear what causes Alzheimer’s, but clumps of a protein called beta-amyloid are found in the brain of people with this type of dementia.

Vascular Dementia

Vascular dementia may occur when there is reduced circulation to the brain due to a stroke or other conditions, resulting in damage to the blood vessels in the brain.

Dementia with Lewy Bodies

Dementia with Lewy bodies happens when abnormal proteins develop in the brain, called Lewy bodies. The protein deposits may be found throughout the brain, including the cerebral cortex, the area involved in language and thinking.

Mixed Dementia

Mixed dementia involves more than one cause. Blood vessel problems may be present along with abnormal proteins in the brain, for example.

How Do Symptoms of Dementia Change Over Time?

Regardless of the cause, symptoms of dementia tend to worsen over time.

The rate of progression varies from person to person. Genetics, age, and overall health may play a role in how fast the disease progresses.

Early Symptoms

Dementia often, but not always, starts with a mild decline in the ability to think. For example, someone may forget a recent conversation or the name of a familiar object.

At this point, the decrease in memory may not greatly affect a person’s ability to function daily.

Early symptoms may also include a decreased ability to perform certain tasks, such as paying bills or following a recipe. Subtle changes in personality may also be noticed by people close to an individual with dementia.

At this stage, a person with dementia may start to realize something is not right, but they may choose to hide their symptoms.

Moderate Dementia Dymptoms

As dementia progresses, symptoms become harder to hide. More noticeable symptoms may develop. Help with self-care or everyday activities may be needed.

Personality changes may become more noticeable. The person may experience paranoia or fear. Symptoms may include increased confusion and memory loss.

People with moderate dementia commonly forget their address or other personal information, including their phone number. Sleep patterns and mood may change.

Late-stage or Severe Dementia Dymptoms

Gradually, dementia can progress and become severe. Memory is often significantly affected. Someone with dementia may not recognize family members.

During late-stage dementia, symptoms may include an inability to communicate, walk, and control bowel and bladder function.

A person with late-stage dementia may have muscle rigidity and abnormal reflexes. Full-time personal care is usually needed for eating, bathing, and dressing. People with severe dementia are vulnerable to infections, including pneumonia and bed sores.

How Do Treatment Options Change Over Time?

Currently, there is no cure for dementia, including Alzheimer’s disease, but there are treatments. Treatment usually aims to decrease symptoms and manage behavioral changes.

Treatment may also change over time. Different classifications of medication may be prescribed, based on the stage of the disease.

Medications may reduce symptoms by affecting chemicals that carry messages to the brain cells.

These drugs are called cholinesterase inhibitors. They are often prescribed for people with mild to moderate symptoms. Cholinesterase inhibitors treat symptoms associated with confusion, communication, and memory.

In people with moderate-to-severe dementia, treatment may also include memantine. Memantine is a drug that may help improve language, thinking, and memory.

Memantine works by regulating glutamate, a chemical in the brain that is involved in memory and learning. Memantine may delay the progression of symptoms temporarily for some people.

Treatment options may include medications that reduce behavioral changes, such as anxiety and sleep problems.

In later stages, different medications may be needed, as symptoms develop. Particular drugs may be recommended to treat specific symptoms, such as fear, restlessness, and hallucinations.

As dementia progresses, treatment may also focus on improving the quality of life. For example, occupational therapy may be useful to teach people with dementia how to use adaptive equipment or to improve fine motor skills.

Diagnosis and Outcome

No single test can determine if a person has dementia. Tests will focus on the ability to think and neurological evaluation.

Tests evaluate skills such as reasoning, language, and memory. Movement, balance, and visual perception are also examined.

A medical history and blood tests can help to rule out other causes of symptoms.

Imaging studies, such as a CT or PET scan, can determine if a specific protein is deposited in the brain, or if there is any interruption to the blood flow to the brain.

Dementia scales can help to decide if dementia is present, and how far it has progressed.

The Global Deterioration Scale may be used to determine the severity of overall dementia.

Ratings range from one to seven, where seven indicates the most severe stage. A combination of tests may be used to make an assessment.

The outlook for people with dementia varies. Age at diagnosis and response to treatment affect how the condition progresses.

People with Alzheimer’s dementia often live for about 10 years after diagnosis, according to the Mayo Clinic.

However, everyone is different. Some people with dementia survive 20 years or more after diagnosis.

Living with Dementia in the Later Stages

It may be helpful for a person with dementia to be involved in decisions about their care before they become unable to communicate their wishes.

Advanced care planning allows an individual with dementia to state what they want and do not want, such as living in a nursing home or being cared for at home.

Living with late-stage dementia can often be challenging for patients and caregivers. As symptoms progress, more care is required.

Strategies that may help someone with late-stage dementia include techniques to jog memory, such as visual clues or notes.

Assistive technology devices include communications aids, automatic shutoff devices, and computerized recall devices.

Caregivers should create an environment that is calm and safe. It is important to identify and correct safety concerns. This includes removing tripping hazards and making sure rooms are easy to get around.

Caregivers should also ensure that medication is taken correctly, and that nutritional needs are met. Late-stage dementia can also be a difficult time for caregivers. Having a strong support system and allowing time to recharge is essential.

Citation

http://www.medicalnewstoday.com/articles/314209.php

Written by MaryAnn de Pietro

Reviewed by Timothy J. Legg, PMHNP-BC, GNP-BC, CARN-AP, MCHES

References

© 2004-2017 MediLexicon International Ltd, Bexhill-on-Sea, UK. All rights reserved.

 

Alzheimer’s Disease: Tax Deductions and Credits

(Alz.org) As a caregiver, you likely pay for some care costs out-of-pocket. Because of this, you may qualify for tax benefits from the Internal Revenue Service (IRS). Tax rules are complex and can change. Be sure to get advice from your tax adviser or accountant before filing your returns.

  • Medical expenses
  • Child and Dependent Care Credit
  • Flexible spending account
  • State tax credits

Medical Expenses

The person with dementia may be considered your dependent for tax purposes. If so, you may be allowed to itemize his or her medical costs. Currently, you may deduct only the amount by which your total medical expenses exceed 7.5 percent of your adjusted gross income. Beginning in 2013, you may deduct only the amount by which your total medical expenses exceed 10 percent of your adjusted gross income. Only expenses that have not been reimbursed by insurance can be counted toward the medical expense deduction.

See IRS Publication 502: Medical and Dental Expenses, for a complete list of allowable expenses. Here’s a brief list:

  • Medical fees from doctors, laboratories, assisted living residences, home health care and hospitals
  • Cost of prescription drugs
  • Cost of transportation to receive medical care
  • Home modifications costs such as grab bars and handrails
  • Personal care items, such as disposable briefs and food

See IRS Publication 501: Exemptions, Standard Deductions and Filing Information to learn more about claiming the person with dementia as a dependent.

Child and Dependent Care Credit

If you paid someone to care for the person with dementia so you could work or look for work, you may be able to claim the “Child and Dependent Care Credit” on your federal income tax return. If eligible, you would be allowed a credit of up to 35 percent of your qualifying expenses, depending upon your adjusted gross income.

To qualify:

  • You must have earned income
  • The person with dementia must be unable to physically or mentally care for him or herself
  • The person with dementia must be claimed as a dependent on your tax return

See IRS Publication 503: Child and Dependent Care Expenses for more information.

TIP: If you pay someone to come to your home and care for the person with dementia, you may be a household employer and may have to withhold and pay Social Security and Medicare tax and pay federal unemployment tax. See IRS Publication 926: Household Employer’s Tax Guide.

Flexible Spending Account

If the person with dementia is a dependent under the tax rules, you might be able to use your own workplace flexible spending account (FSA). A flexible spending account allows payment for out-of-pocket medical expenses and dependent care expenses with pretax dollars, for a potential savings of about 20 to 30 percent.

State Tax Credits

Many states have additional tax deductions or tax credits to provide financial relief to caregivers. These tax programs build on the federal tax credit, which reduces the amount of income taxes a family owes. Each state program differs by name and eligibility requirements.

Help Is Available

The Internal Revenue Service (IRS) offers free tax forms and publications explaining various tax deductions and credits.

AARP’s Tax-Aide program provides free tax preparation and counseling information to all low and middle-income taxpayers, even if you are not an AARP member.

Other Resources

Note: This information is not intended as tax advice. The determination of how tax laws affect a taxpayer depends on the taxpayer’s situation. A taxpayer may be affected by exceptions to the general rules and by other laws not discussed here. Therefore, taxpayers are encouraged to seek advice from a competent tax professional.

Citation

http://www.alz.org/care/alzheimers-dementia-tax-deductions-credits.asp?WT.mc_id=enews2017_01_17&utm_source=enews-aff-&utm_medium=email&utm_campaign=enews-2017-01-17

Copyright © 2017 Alzheimer’s Association. All rights reserved.

 

Alzheimer’s Caregiving: Bathing, Dressing, Grooming

(NIH Senior Health) At some point, people with Alzheimer’s disease will need help with bathing, dressing, and grooming. Because these are private activities, people may not want help. They may feel embarrassed about being naked in front of caregivers. They also may feel angry about not being able to care for themselves.

Bathing

The person with Alzheimer’s may be afraid. To reduce these fears, follow the person’s lifelong bathing habits, such as doing the bath or shower in the morning or before going to bed. Here are other tips for bathing.

Bathing Safety Tips

  • Never leave a confused or frail person alone in the tub or shower.
  • Always check the water temperature before he or she gets in the tub or shower.
  • Use plastic containers for shampoo or soap to prevent them from breaking.
  • Use a hand-held showerhead.
  • Use a rubber bath mat and put safety bars in the tub.
  • Use a sturdy shower chair in the tub or shower. This will support a person who is unsteady, and it could prevent falls. You can get shower chairs at drug stores and medical supply stores.
  • Don’t use bath oil. It can make the tub slippery and may cause urinary tract infections.

Preparing for a Bath or Shower

  • Get the soap, washcloth, towels, and shampoo ready.
  • Make sure the bathroom is warm and well lighted. Play soft music if it helps to relax the person.
  • Be matter-of-fact about bathing. Say, “It’s time for a bath now.” Don’t argue about the need for a bath or shower.
  • Be gentle and respectful. Tell the person what you are going to do, step-by-step.
  • Make sure the water temperature in the bath or shower is comfortable.

During the Bath or Shower

  • Allow the person with Alzheimer’s to do as much as possible. This protects his or her dignity and helps the person feel more in control.
  • Put a towel over the person’s shoulders or lap. This helps him or her feel less exposed. Then use a sponge or washcloth to clean under the towel.
  • Distract the person by talking about something else if he or she becomes upset.
  • Give him or her a washcloth to hold. This makes it less likely that the person will try to hit you.

After a Bath or Shower

  • Prevent rashes or infections by patting the person’s skin with a towel. Make sure the person is completely dry. Be sure to dry between folds of skin.
  • If the person has trouble with incontinence, use a protective ointment, such as Vaseline, around the rectum, vagina, or penis.
  • If the person with Alzheimer’s has trouble getting in and out of the bathtub, do a sponge bath instead.

Dressing

People with Alzheimer’s often need more time to dress. It can be hard for them to choose their clothes. They might wear the wrong clothing for the season. They also might wear colors that don’t go together or forget to put on a piece of clothing. Allow the person to dress on his or her own for as long as possible.

Dressing Tips

  • Lay out clothes in the order the person should put them on, such as underwear first, then pants, then a shirt, and then a sweater.
  • Hand the person one thing at a time or give step-by-step dressing instructions.
  • Put away some clothes in another room to reduce the number of choices. Keep only one or two outfits in the closet or dresser.
  • Keep the closet locked if needed. This prevents some of the problems people may have while getting dressed.
  • Buy three or four sets of the same clothes, if the person wants to wear the same clothing every day.
  • Buy loose-fitting, comfortable clothing. Avoid girdles, control-top pantyhose, knee-high nylons, garters, high heels, tight socks, and bras for women. Sports bras are comfortable and provide good support. Short cotton socks and loose cotton underwear are best. Sweat pants and shorts with elastic waistbands are helpful.
  • Use Velcro® tape or large zipper pulls for clothing, instead of shoelaces, buttons, or buckles. Try slip-on shoes that won’t slide off or shoes with Velcro® straps.

Grooming

For the most part, when people feel good about how they look, they feel better. Helping people with Alzheimer’s brush their teeth, shave, or put on makeup often means they can feel more like themselves. Here are some grooming tips.

Mouth Care

Good mouth care helps prevent dental problems such as cavities and gum disease.

  • Show the person how to brush his or her teeth. Go step-by-step. For example, pick up the toothpaste, take the top off, put the toothpaste on the toothbrush, and then brush. Remember to let the person do as much as possible.
  • Brush your teeth at the same time.
  • Help the person clean his or her dentures. Make sure he or she uses the denture cleaning material the right way.
  • Ask the person to rinse his or her mouth with water after each meal and use mouthwash once a day.
  • Try a long-handled, angled, or electric toothbrush, if you need to brush the person’s teeth.
  • Take the person to see a dentist. Some dentists specialize in treating people with Alzheimer’s. Be sure to follow the dentist’s advice about how often to make an appointment.

Other Grooming Tips

  • Encourage a woman to wear makeup if she has always used it. If needed, help her put on powder and lipstick. Don’t use eye makeup.
  • Encourage a man to shave, and help him as needed. Use an electric razor for safety.
  • Take the person to the barber or beauty shop. Some barbers or hairstylists may come to your home.
  • Keep the person’s nails clean and trimmed.

For more caregiving tips, see NIA’s guide, Caring for a Person with Alzheimer’s Disease.

Citation
https://nihseniorhealth.gov/alzheimerscare/personalcare/01.html

 

The American Heart Association’s Diet and Lifestyle Recommendations

(American Heart Association) A healthy diet and lifestyle are your best weapons to fight cardiovascular disease. It’s not as hard as you may think!  Remember, it’s the overall pattern of your choices that counts. Make the simple steps below part of your life for long-term benefits to your health and your heart.

Use up at least as many calories as you take in.

  • Start by knowing how many calories you should be eating and drinking to maintain your weight. Nutrition and calorie information on food labels is typically based on a 2,000 calorie diet. You may need fewer or more calories depending on several factors including age, gender, and level of physical activity.
  • If you are trying not to gain weight, don’t eat more calories than you know you can burn up every day.
  • Increase the amount and intensity of your physical activity to match the number of calories you take in.
  • Aim for at least 150 minutes of moderate physical activity or 75 minutes of vigorous physical activity – or an equal combination of both – each week.

Regular physical activity can help you maintain your weight, keep off weight that you lose and help you reach physical and cardiovascular fitness. If it’s hard to schedule regular exercise sessions, try aiming for sessions of at last 10 minutes spread throughout the week.

If you would benefit from lowering your blood pressure or cholesterol, the American Heart Association recommends 40 minutes of aerobic exercise of moderate to vigorous intensity three to four times a week.

Eat a variety of nutritious foods from all the food groups.

You may be eating plenty of food, but your body may not be getting the nutrients it needs to be healthy. Nutrient-rich foods have minerals, protein, whole grains and other nutrients but are lower in calories. They may help you control your weight, cholesterol and blood pressure.

Eat an overall healthy dietary pattern that emphasizes:

Limit saturated fat, trans fat, sodium, red meat, sweets and sugar-sweetened beverages. If you choose to eat red meat, compare labels and select the leanest cuts available.

One of the diets that fits this pattern is the DASH (Dietary Approaches to Stop Hypertension) eating plan. Most healthy eating patterns can be adapted based on calorie requirements and personal and cultural food preferences.

Eat less of the nutrient-poor foods.

The right number of calories to eat each day is based on your age and physical activity level and whether you’re trying to gain, lose or maintain your weight. You could use your daily allotment of calories on a few high-calorie foods and beverages, but you probably wouldn’t get the nutrients your body needs to be healthy. Limit foods and beverages high in calories but low in nutrients. Also limit the amount of saturated fat, trans fat and sodium you eat. Read Nutrition Facts labels carefully — the Nutrition Facts panel tells you the amount of healthy and unhealthy nutrients in a food or beverage.

As you make daily food choices, base your eating pattern on these recommendations:

  • Eat a variety of fresh, frozen and canned vegetables and fruits without high-calorie sauces or added salt and sugars. Replace high-calorie foods with fruits and vegetables.
  • Choose fiber-rich whole grains for most grain servings.
  • Choose poultry and fish without skin and prepare them in healthy ways without added saturated and trans fat. If you choose to eat meat, look for the leanest cuts available and prepare them in healthy and delicious ways.
  • Eat a variety of fish at least twice a week, especially fish containing omega-3 fatty acids (for example, salmon, trout and herring).
  • Select fat-free (skim) and low-fat (1%) dairy products.
  • Avoid foods containing partially hydrogenated vegetable oils to reduce trans fat in your diet.
  • Limit saturated fat and trans fat and replace them with the better fats, monounsaturated and polyunsaturated. If you need to lower your blood cholesterol, reduce saturated fat to no more than 5 to 6 percent of total calories. For someone eating 2,000 calories a day, that’s about 13 grams of saturated fat.
  • Cut back on beverages and foods with added sugars.
  • Choose foods with less sodium and prepare foods with little or no salt. To lower blood pressure, aim to eat no more than 2,400 milligrams of sodium per day. Reducing daily intake to 1,500 mg is desirable because it can lower blood pressure even further. If you can’t meet these goals right now, even reducing sodium intake by 1,000 mg per day can benefit blood pressure.
  • If you drink alcohol, drink in moderation. That means no more than one drink per day if you’re a woman and no more than two drinks per day if you’re a man.
  • Follow the American Heart Association recommendations when you eat out, and keep an eye on your portion sizes.

Also, don’t smoke tobacco — and avoid secondhand smoke.

Learn more about quitting smoking.

For more information on the American Heart Association Diet and Lifestyle Recommendations:

Citation

http://www.heart.org/HEARTORG/HealthyLiving/HealthyEating/Nutrition/The-American-Heart-Associations-Diet-and-Lifestyle-Recommendations_UCM_305855_Article.jsp#.WLIubPLMbv0

©2017 American Heart Association, Inc.