By Andrea K. Kovar, Attorney, Generation Law

Alzheimer’s disease is the most common type of dementia. It affects parts of the brain that control thought, memory, and language. It is progressive, often beginning with mild memory loss and possibly leading to the inability to carry out daily activities. In addition to the legal planning issues that arise with an Alzheimer’s diagnosis, we thought it would be useful to also briefly address the known causes and warning signs of ADRD, as well as the steps you can take to potentially reduce your risk of developing the disease.

What causes Alzheimer’s and other dementias?

Scientists do not yet fully understand what causes ADRD. According to the Centers for Disease Control and Prevention (CDC), there are likely several factors that contribute to the development of Alzheimer’s and those factors can affect each person differently.

Age is the most significant risk factor for Alzheimer’s disease. Family history/genetics also play a role. According to the Alzheimer’s Association, “those who have a parent, brother, sister or child with Alzheimer’s are more likely to develop the disease.  The risk increases if more than one family member has the illness.  When diseases tend to run in families, either heredity (genetics) or environmental factors, or both, may play a role.”

What are the warning signs?

Memory changes as we age. However, according to the CDC, memory loss that disrupts daily life is not a typical part of aging. Examples include:

  • Forgetting events, repeating yourself, or relying on more aids to help you remember
  • Having trouble paying bills or cooking recipes you have used for years
  • Difficulty completing familiar tasks at home, work, or leisure
  • Confusion with time or place
  • Having more difficulty with balance or judging distance, tripping over things at home, or spilling or dropping things more often
  • Having trouble following or joining a conversation or struggling to find a word you are looking for
  • Misplacing things and losing the ability to retrace steps
  • Falling victim to a scam, not managing money well, paying less attention to hygiene, or having trouble taking care of a pet
  • Not wanting to engage in activities that you usually do
  • Changes in mood and personality

How can I reduce my risk of developing Alzheimer’s?

Studies have shown that healthy behaviors may reduce the risk of ADRD. The CDC recommends that people over age 55 prevent and manage high blood pressure, manage blood sugar, maintain a healthy weight, be physically active, avoid excessive drinking, prevent and correct hearing loss, and get enough sleep.

Doesn’t Medicare cover expenses related to ADRD like assisted living and nursing home care?

Many people are surprised to learn that Medicare does not pay for nursing home costs. Medicare only provides health care benefits for acute medical care, rehabilitation services, and prescription drugs. To borrow from Wikipedia, “acute care is a branch of secondary health care where a patient receives active but short-term treatment for a severe injury or episode of illness, an urgent medical condition, or during recovery from surgery.” In medical terms, care for acute health conditions is the opposite of longer-term care.

Will Medicaid cover the costs of long-term care that Medicare doesn’t cover?

It depends. Medicaid requires that the person needing care and their spouse (if applicable) meet strict income and assets limitations set by the state in which the person resides. Under current law, an unmarried or widowed person living in Illinois would not qualify for Medicaid if he or she owns assets with a value greater than $17,500. These limits are described as “means tested.” Accordingly, if a person has sufficient means (as defined under applicable law), he or she will not qualify for Medicaid long-term care benefits.

For most people, Medicaid long-term care benefits are an absolute necessity. With the cost of skilled nursing hovering around $10,000 a month, even people who have worked and saved for decades risk losing their life savings if long-term care becomes necessary, as is often the case with ADRD.

What can you do if your resources exceed Medicaid eligibility limits to avoid spending down assets on long-term care?

Consult an elder law attorney as soon as possible following an ADRD diagnosis! Time is the most important tool in the Medicaid planning process. There are legal devices and strategies that can be implemented to protect assets and still qualify a person for Medicaid long-term care in the future. Medicaid planning can help avoid impoverishment of a healthy spouse due to the nursing home costs of ADRD care.  Medicaid planning can help preserve the family home from loss due to nursing home costs for the benefit of the healthy spouse and/or an adult child with a disability.

Who makes decisions for people who become incapacitated because of ADRD?

Again, this is where advance legal planning is critical. In cases where a loved one is developing dementia or Alzheimer’s disease, powers of attorney should be put in place as part of a comprehensive Medicaid plan while he or she still has the mental capacity to do so. If you do nothing, your loved ones will be forced to seek guardianship of you in court.


Re-publish of post from June 2023