The Whitworths of Arizona, bringing science to you in everyday language.

Thursday, September 14, 2017

An International Honor!

Today, we are tooting our own horn. We are so honored that our book, The Caregiver’s Guide to Lewy Body Dementia, has received international recognition: It has been included in the Caregiver Homes list of The Best Dementia Books: 50 Essential Reads For Anyone Coping With Alzheimer’s Disease Or Dementia. Caring Homes, located in the UK, has been providing direct support to family caregivers caring for patients with complex or chronic diseases for almost two decades. Criteria for inclusion in their list included:
  • Being on best seller lists. The Guide has been Amazon’s bestselling book about Lewy body dementia since 2011.
  • Earned high ratings by readers: The Guide has 125 five-star reviews and counting on Amazon alone.
  • Won awards. The guide received a Caregiver Friendly Award from Today’s Caregiver Magazine in 2012. It has also been named “Book of the Week” twice by Alzheimer’s Weekly and Dementia Weekly and is a featured book in the Colorado Chapter of the Alzheimer’s Association’s list of recommended books.
  • Written by experts. Nope. Neither Helen nor James were experts when they wrote the book, but their experience and research since then definitely qualifies them as “Dementia Caregiver Advocates” now.
  • Written by loved ones who shared insights into supporting and caring for someone with dementia: James shares his story of going through the Lewy body journey with his first wife, Annie in the late 1990’s, early 2000’s, when little was known about the disorder. Helen includes some stories about caring for her sister with late stage Parkinson’s. However, this book is not just about them. It is a go-to book illustrated by stories from many caregivers besides the Whitworths.
Since the Guide was written, we (Helen and James Whitworth) have written three more books and are working on a third. All of our books are written in our signature style, with well-researched, fact-filled but easy-to-read language illustrated by many caregiver stories. All of these book (except the one yet to be published) are available on Amazon, and on our website, LBDtools.com.
  • Riding a Roller Coaster with Lewy Body Dementia was actually their first book, written for staff. This book has been updated and republished. It has been used as a book accompanying trainings that we have presented and can be bought on Amazon. It makes a great gift to give to your in-home helper or to a residential staff member.
  • Managing Cognitive Issues of Lewy Body Dementia and Parkinson’s is about the early symptoms of LBD and the non-motor symptoms of Parkinson’s and how to deal with them, using a variety of non-drug options to limit the use of drugs themselves.
  • On the Road with the Whitworths. This is a hilarious memoir of our first year of RVing and teaching about LBD in Arizona, California, Oregon and Washington. A great book to read just for fun when you need a break from caregiving!
  • Unpublished: (working title: Dealing with the Behavioral and Psychological Symptoms of Lewy Body and Other Dementias.) This book walks the reader through the way dementia changes the brain and causes behavioral and psychological symptoms of dementia (BPSD). Then using this information, the book offers methods for dealing with these BPSD using more effective interactions, non-drug options and fewer drugs. Should be out by early 2018.
We also maintain this blog and our website LBDtools.com.  Our blog entries have been limited this summer while we enjoyed our travels but look for weekly blogs entries starting in October.

Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

Wednesday, September 6, 2017

Electronic Monitors

At a recent support group meeting, members were talking about various ways to electronically monitor their loved ones.

By the time I get to bed, I'm so exhausted that I sleep really deeply. My daughter came to visit and told me that she her father got up in the middle of the night and tried to go outside "to find your mother." She talked him into going back to bed, but how long has this been going on? What if he figures out how to unlock the door? I need a warning system. -- Maxine

Judy, another group member, recommended an alarmed door stop. They sell on Amazon sell from $3 to $7 each. (Or you can pay hundreds, but Judy says her cheaper one works just fine. ) These work just like one of those old rubber stoppers except that trying to move the door sets off an alarm. Here's a page of door stop alarms.

Howard takes afternoon naps that almost always last a couple of hours. I'd like to be able to get out and do some shopping and such when he's sleeping but I wouldn't feel safe doing that unless I could monitor him. I know there are baby monitors but I don't want to carry something like that around. Isn't there something I can put on my phone? -- Linda

A group member told Linda about the smart phone app she used as a monitor. We found a couple for you to consider. Which one you would prefer would depend on personal preference:

Presence requires two I-phones i05 or better. You set up one to be the camera to video and use your personal iPhone as the monitor. It can be set to start recording when it detects motion. You can also use the monitoring phone to initiate a two-way conversation. Neither picture nor audio is great, but it might get the job done. This app is free from the Apple Store.

iCamSpy comes in iPhone, Android and PC/Mac versions. It uses a PC with a webcam and microphone for surveillance and the phone for monitoring. You don't have any two-way features but the video is apparently quite good. You can set it up to start with low, medium or high motion sensitivity. This works well with Wi-Fi but poorly with 3G/4G. This app costs $4 from the Apple Store or Google Play.

We have the opposite problem. Jimmy likes to take walks and its pretty safe in our neighborhood. He can go around the block and never have to cross a street but still I worry. I've heard about tracker watches but don't know what to buy. -- Gladys

Colin is in a memory care facility. Our home is too far away for me to go every day but we can phone although Colin can't figure out how to use a cell phone and the land line is long distance. Surely there's something out there that will work for us. -- Yvonne

The Verison Gizmo Gadget would probably work for both Gladys and Yvonne. Caregivers who have tried it report that it is designed as a child's watch but "doesn't look childish." It has a GPS that Gladys can use to keep track of Jimmy. It is also a very simple phone. Colin need only tap a "ringing phone" icon twice to answer the phone or call a preprogrammed number. If Colin doesn't answer, the phone automatically answers in ten seconds, which would allow Yvonne to know what's going on around Colin. You have to be a Verizon customer to use this gadget and it costs $149 initially plus an additional $5 a month. However, it does have great reviews in a variety of places. This PC Magazine article describes it and Verison's ad does too. It has other features too but they only show up if you want them to. All Colin would see are the phone icons.

Getting Lew in and out the car is almost impossible for me anymore. I wish doctors still make home visits. We Skype my son and his family all the time. Wouldn't it be great if we could just Skype the doctor? -- Janice

We wouldn't recommend that Janice give up taking Lew to the doctor altogether, but Teledoc is a virtual health service that might act as a supplement for things like a UTI. Virtual visits to qualified doctors take place over the phone or through video. They also offer two- and three-party calling to keep you as the caregiver involved with every visit, giving you more flexibility. Available any time of day, seven days a week, they cover non-emergency care for such conditions as colds, flu, rashes, respiratory infections and more. The first visit may be free and following visits are $45 until Oct. 31, 2017, after which they are $49. AARP CARECONNECT for Family Caregivers.

To help collect information for your virtual doctor's visit you might like to use a fitness tracker. The URBST Fitness Tracker for is also a wireless Bluetooth 4.0 heart rate monitor and sleep monitor. It acts as a traditional watch as well. Sync it wirelessly to your smart phone or PC. Because it is waterproof and has a long life battery, it doesn't have to be removed very often. (I've worn a similar one for almost two years!) $38.90 on Amazon. It does only come in black. This one was relatively inexpensive and had five stars--a winner in our book! Click here to review or buy.

Feel free to make more suggestions. If we get enough, we'll do another blog!

We love and welcome comments but we will not print any that advertise a product or a commercial website. This is especially true for testimonials about miraculous Parkinson's cures.

* Acronyms:
LBD: Lewy body dementia
PD: Parkinson's disease
PlwD: person living with dementia
DLB: dementia with Lewy bodies
PDD: Parkinson's disease with dementia
PlwD, PD, LBD, PDD, etc: person/people living with dementia
PlwPD, LBD, PDD, etc.: person/people living with PD, LBD, PDD, etc.
MCI: mild cognitive impairment
MCI-LB: the form of MCI that precedes LBD
BPSD: behavioral and psychological symptoms of dementia

For information about Lewy body disorders, read our books:
A Caregivers’ Guide to Lewy Body Dementia
Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.


Sunday, August 20, 2017

NUTRITION THERAPY FOR DEMENTIA: USING ESSENTIAL OILS

This blog is by guest blogger, Regina Hucks, our consultant on alternative therapies.

You will find an enormity of Essential Oils on the web, in health food stores, specialty shops, even grocery stores but one thing I can state as absolute fact … Essential Oils are NOT alike.

Rather than use an explanation from a biased source (a manufacturer or supplier) I’ve gone to the dictionary to answer the question, “What IS an Essential Oil?”

“An essential oil is a concentrated hydrophobic liquid containing volatile aroma compounds from plants. Essential oils are also known as volatile oils, ethereal oils, aetherolea, or simply as the oil of the plant from which they were extracted, such as oil of clove. An oil is "essential" in the sense that it contains the "essence of" the plant's fragrance—the characteristic fragrance of the plant from which it is derived.[1] The term essential used here does not mean indispensable as with the terms essential amino acid or essential fatty acid which are so called since they are nutritionally required by a given living organism.[2]

Essential oils are generally extracted by distillation, often by using steam. Other processes include expression, solvent extraction, absolute oil extraction, resin tapping, and cold pressing. They are used in perfumes, cosmetics, soaps and other products, for flavoring food and drink, and for adding scents to incense and household cleaning products.”

Essential Oils cannot be reproduced in the pharmaceutical industry. Chemists can replicate some of the known constituents but it would be next to impossible to successfully replicate or recreate an essential oil in the laboratory without sacrificing purity and therapeutic value.

Essential Oils embody the regenerative, protective and immune strengthening properties of plants. These are very powerful antioxidants that neutralize free radicals which can cause cellular damage in the body. Many essential oils have antibacterial, antifungal, antiviral, anti-infectious, antimicrobial, antitumor, anti-parasitic and antiseptic properties.

So, right now you're asking, what does all of this have to do with dementia and nutrition? The answer is….quite a lot.

To read more about using Essential Oils in Nutrition Therapy, click here:

http://alternativetherapiesfordementia.blogspot.com/

To reach Regina with your questions or feedback, please, click the link below and fill in the form.
http://www.lbdtools.com/contact2.php

Next up: Touch and Massage Therapy using Essential Oils – We’ll discuss the recommended oils to use in both therapies and oils for specific disorders / diseases, improved sleep, reducing stress, depression and anxiety as well as effective massage techniques you can easily learn.

References:

1. Kiecolt-Glaser JK, et al. Omega-3 supplementation lowers inflammation and anxiety in medical students: a randomized controlled trial.
http://www.ncbi.nlm.nih.gov/pubmed/21784145

2. Kiecolt-Glaser JK, et al. Depressive symptoms, omega-6:omega-3 fatty acids, and inflammation in older adults. http://www.ncbi.nlm.nih.gov/pubmed/17401057

For information about Lewy body disorders, read our books:
A Caregivers’ Guide to Lewy Body Dementia
Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

Neither Regina Hucks nor Helen and James Whitworth are doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.



Saturday, August 5, 2017

Traveling with Stress

We've been traveling, and experiencing multiple challenges. Every year we plan to leave Arizona and spend a good share of the summer in Washington State. Usually we leave in late May or early June. We make a leisurely trip north, taking a couple of weeks, with stops along the way to visit family and friends. This year was different. We weren't able to leave until mid-July and we didn't have time for visits on the trip north.

Just getting ready to leave overly warm Arizona was a challenge. Jim needed several unplanned-for doctors appointments first. We finally left with stitches in his arm where the doc had removed a skin cancer. Nurse Helen removed the stitches and that is now fine. The thermometer hit 120 degrees before we were finally able to pack up and go. We managed a marathon five-day trip in the motor home, driving 7-10 hours a day to arrive in Kettle Falls WA, up near the Canadian border for a family reunion I'd been helping to plan. Then we went from there to the family farm where my daughter lives for some more family time. Both were enjoyable but we ate something...or did something...and we've been laid low with digestive problems ever since. (I definitely do not recommend living in a motor home with two people with diarrhea!)

Jim's illness was more serious than mine. It was also more worrisome because anything stressful can trigger his Crohn's disease which has been thankfully dormant for over a year. Thus, I have had the honor of being caregiver when I wasn't feeling my best. I am blessed that even when he hurts, Jim is a gentle patient. Even so, we are both stressed and that of course, makes everything worse--and the likelihood of the Crohn's greater although so far, it is still quiet. The whole thing is a vicious circle that is hard from which to escape The difference for us is that we know that we will both recover and be able to move on with our lives. Our hearts go out to all of you who are dealing with less temporary situations.

We are now on our own in a favorite RV park. I am feeling better and we hope that soon Jim will too. From the time we left until now, we've not opened our laptops and so this is the first chance I've had to post. I think that is the longest I've gone without checking at least my email for over a decade! Sorry this is so late. I planned to post ever two weeks but it's been much longer. That's the way it is when life throws you curve balls.

For information about Lewy body disorders, read our books:
A Caregivers’ Guide to Lewy Body Dementia
Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

Friday, July 7, 2017

INCORPORATING ALTERNATIVE THERAPIES FOR DEMENTIA CARE

This week, our blogger is Regina Hucks. See the x blog to learn more about this very knowlegable woman.

Medicine is traditionally considered a healing profession, and modern medicine claims legitimacy to heal through its scientific approach to medicine.[1]

The marriage of science and medicine has empowered physicians to intervene actively in the course of disease, to affect cures, to prevent illness, and to eradicate disease.[2] In the wake of such success, physicians, trained as biomedical scientists, have focused on the diagnosis, treatment, and prevention of disease.[3] In the process, cure, not care, became the primary purpose of medicine, and the physician’s role became “curer of disease” rather than “healer of the sick.”[4] [5]

The medical definition of ALTERNATIVE MEDICINE is : any of various systems of healing or treating disease (as homeopathy, chiropractic, naturopathy, Ayurveda, or faith healing) that are not included in the traditional curricula taught in medical schools of the United States and Britain.

There is an enormity of evidence that Alternative Therapies are becoming the norm rather than the rarity.[1] Physicians across the globe are now integrating alternative therapies into their practices as pharmaceuticals become more dangerous to use, lessening the effect of traditional treatments.

When Alternative Therapies are used in combination with traditional medical practices, it is called complementary medicine, or more likely, INTEGRATIVE MEDICINE. Many Americans have never heard of Integrative Medicine, but this current movement has left its imprint on many of the nation's hospitals, universities, and medical schools in recent years yet has been common practice in many European countries.

The Duke University Center for Integrative Medicine is a classic model of integrative care. It combines conventional Western medicine with alternative or complementary therapies, such as herbal medicine, whole food nutrition therapy, acupuncture, massage and touch therapy, biofeedback, music – sound therapy, yoga, and stress reduction techniques -- all in the effort to treat the whole person. Proponents prefer the term "complementary or alternative" to emphasize that such therapies are used to complement mainstream medicine, and not used as replacements for standardized medical treatments.

With progressively degenerative disorders, such as Parkinson’s, LBD or Alzheimer’s, the treatment goals are to alleviate pain, decrease stress and improving quality of life. Due to the serious issues with many of the drugs when normally used to meet these goals, traditional medicine has been only minimally effective.

Alternative therapies are often welcome additions to the traditional treatment regimen. These less conventional modes of treatment have the advantage of being much safer than traditional drug treatment while often being even more helpful. Caregivers can also benefit from incorporating these therapies into their daily care regimes.

One of the most important things I could ever say to you is this: Integrative medicine starts with and depends upon a partnership between the patient, caregiver and the doctor, where the goal is to treat the mind, body, and spirit [3], all at the same time. If you are reliant on your physician for traditional care, please discuss incorporating Alternative Therapies into a daily care regime before starting anything new.

While some of the therapies used may be non-conventional, a guiding principle within integrative medicine is to use therapies that have some high-quality evidence to support them.

Read more in Regina's blog, Alternative Therapies for Dementia, including:

TREATING THE WHOLE PERSON

PROVIDING OPTIONS

WHAT ARE COMPLEMENTARY AND ALTERNATIVE THERAPIES?

HOW ALTERNATIVE THERAPIES WORK WITH CONVENTIONAL MEDICINE IN RELATION TO NEUROLOGICAL DISORDERS:

The Problems with Conventional Medicine

Commonalities in Complementary and / or Alternative Therapies

SCIENTIFIC EVIDENCE OF THE MIND, BODY, SPIRIT CONNECTION & YOUR HEALTH

References [1 through 5] can be found at the end of Regina's full blog.

We love and welcome comments but we will not print any that advertise a product or a commercial website. This is especially true for testimonials about miraculous Parkinson's cures.

* Acronyms:
LBD: Lewy body dementia
PD: Parkinson's disease
PlwD: person living with dementia
DLB: dementia with Lewy bodies
PDD: Parkinson's disease with dementia
PlwD, PD, LBD, PDD, etc: person/people living with dementia
PlwPD, LBD, PDD, etc.: person/people living with PD, LBD, PDD, etc.
MCI: mild cognitive impairment
MCI-LB: the form of MCI that precedes LBD
BPSD: behavioral and psychological symptoms of dementia

For information about Lewy body disorders, read our books:
A Caregivers’ Guide to Lewy Body Dementia
Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

Saturday, June 24, 2017

Being Flexible

Because their job is so important to them, care partners often get caught in the trap of having much higher expectations for themselves than they do for anyone else. Wallowing in guilt and self-blame, they believe that if they lose patience, or don't do something as it "should be done," then they have failed. Everything that goes wrong must have been their fault. If they'd just done it better, or differently, or more, or.... This is a setup for stress, followed quickly by the behavior and psychological symptoms of dementia (BPSD).


Being flexible helps you to let go of those unrealistic expectations and escape the destructive guilt trap by accepting what is. Being flexible allows you to stop using failures as badges of shame and see them as learning tools, reminders, and yes, warnings. It is a process that involves:

  • Recognizing the problem or the failure, 
  • Looking for the lesson, 
  • Experiencing any guilt involved and making amends, 
  • Worrying a little and looking for a better way,
  • Taking action 
  • Trying again and again
  • Moving on.

Last night, George watched his favorite detective story on TV. Then I think he chased those bad guys all night long in his dreams. It was his favorite show...he's been watching it for years. -- Mary

• Recognize the problem. Sometimes that's easy. the PlwD expresses discomfort with BPSD. Often, it's less clear, as when the care partner is feeling overwhelmed. Sometimes it takes something serious such as a fall for awareness to come. More often it is simply a failure of some sort, like George's restlessness.

But I guess it is too exciting for him now. I know should have noticed this sooner. -- Mary

Feel the guilt and look for the lesson. Guilt's job is to trigger you into expressing your concern to anyone you may have hurt (including yourself!) and to point out the need to try a different way. Then, guilt's job is over.

Oh, well, I guess I'm not perfect! -- Mary

• Forgive yourself. Be as compassionate with yourself as you would be with anyone else. Making a mistake, even a serious one, does not make you a bad care partner. Like Mary, you aren't perfect. You don't have to be! Love yourself anyway. This self-caring will be mirrored by the PlwD as positive feelings towards them as well as yourself.

I remembered that someone in my support group talked about using DVDs instead of TV and I decided to give that a try. -- Mary

• Worry a little and look for a better way. A moderate amount of worry can lead to constructive, thoughtful evaluations of the situation, and motivate a person into taking action. What can I do? Who should I ask? What are my options? Is this the right one? Can I think of anything better? What else can I try? Then worry's job is done.

I ordered some with some old programs for him to watch instead. -- Mary

• Take action. This might mean that you'll set up a plan of what to do later. Or it may mean that you'll do something right away. But there needs to be a feeling of "doing" involved, even if it is only making a decision to do nothing. This helps you to let go of the guilt and worry and move on.

The first one I tried he hated. Then I put in Andy of Mayberry. He likes it and it doesn't make him restless. -- Mary

• Try, try again. If the first thing you try doesn't work, try again. This is a big part of being flexible too.

We are both happy campers!-- Mary

• Move on. Once guilt and worry have done their jobs, it is time to let them go. All too often a person hangs onto these and tries to use them to control the past and future. "If I can't do anything else, at least I can feel guilty or worry about it."

Flexibility may mean lowering your standards. Your house doesn't have to be spic and span. The PlwD may not need a shower every day, and so on.

It's got so I realize that I need 24/7 care for George, but our finances are limited. I checked with the state. They will help if he goes into a residential facility but not if I keep him at home. I did my research and found a wonderful assisted care facility. The problem is that the state will only pay for a two person room. I had so hoped that George could have his own room. -- Mary

Flexibility comes into effect with finances too. Dementia care is expensive. Even with help from the state or other sources, you may not be able to afford what you really want. Don't let this stop you from getting the best help you can afford. You can seldom have it all. Mary may need to accept a two person room in a good facility. She just has to make the best choice she can with the resources she has and then let go of what might have been and move on.

An a different subject, we are exercising our own flexibility by moving to a twice monthly blog for the summer. We will be traveling and researching for blogs becomes more difficult. Expect blogs around the 7th and 21st days of the month.

We love and welcome comments but we will not print any that advertise a product or a commercial website. This is especially true for testimonials about miraculous Parkinson's cures.

* Acronyms:
LBD: Lewy body dementia
PlwD: person living with dementia
PlwLBD: person living with LBD
DLB: dementia with Lewy bodies
PDD: Parkinson's disease with dementia
MCI: mild cognitive impairment
MCI-LB: the form of MCI that precedes LBD
BPSD: behavioral and psychological symptoms of dementia

For information about Lewy body disorders, read our books:
A Caregivers’ Guide to Lewy Body Dementia
Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

Sunday, June 18, 2017

Medicaid Requirements for Long Term Care

(Italicized words are defined in the mini-glossary below.)

Residential care is expensive…more expensive than many of us can afford, but there is help in the form of Medicaid. Each state has different names for this and different standards, although some things are basic government requirements. If you have assets that you want to pass on to your children, you need to start planning early. Any assets you give to your family beyond minimal amounts in the five years prior to your “snapshot date” will still be considered yours when eligibility for financial assistance is determined. This includes trusts. Always consult an elder attorney before making these plans, but here is a simplified outline of what is offered.

The following Medicaid requirements take into consideration the Federal Spousal Impoverishment rules:
  • Countable assets of both spouses are totaled as of the date the institutionalized spouse enters a hospital or long-term care facility and stays for at least 30 days.
  • The community spouse can keep ½ of this total, up to a specified amount (from $23,844 to $119,220 in 2016 depending on the state). State rules differ. Some states allow the community spouse to keep up to the specified amount of the combined total instead of being limited to half.
  • Income of the institutionalized spouse is counted for eligibility, but in most states, that of the community spouse is not.
  • The institutionalized spouse can keep about $2000 (differs with state).
  • The rest of the institutionalized spouse’s assets must be ‘spent down’ before they will be eligible for Medicaid. This can be spent only in certain ways. For example, it cannot be gifted, except in very small amounts. Don’t wait to give your children anything you want them to have. If you wait too long, it may fall within the five years prior to your snapshot date and will be counted as still belonging to you as far as eligibility goes. Consult an elder attorney about the ways to give gifts, and the limitations involved.
Post eligibility requirements:
  • Community spouses with higher incomes may be required to help pay for cost of the institutionalized spouse’s care. (Varies with states)
  • If the community spouse’s income is less than the state’s minimum monthly maintenance needs allowance (MMMNA), then they can keep some or all of the institutionalized spouse's income. (up to $2002.50 a month in 2016)
  • The home equity of the institutionalized spouse must be less than the state standard ($552,000.00 to $828,000.00 in 2016). 
  • The institutionalized spouse is allowed to keep a personal allowance of $60 a month.
  • The institutionalized spouse’s medical costs are also considered.
  • The institutionalized spouse is required to pay the institution what is left of their income after deducting the amount the amount that can be kept by the community spouse, their personal allowance and the allowed amount for medical costs.
It is always a good idea to consult an elder attorney when planning for retirement, long term care, and upon a diagnosis of any eventually incapacitating disease such as Parkinson’s or any dementia. At that time, ask about Medicaid requirements for long term care and how they apply to your specific situation.

Be aware that these requirements can change as the lawmakers in Washington DC hammer out new rules for the Affordable Care Act.

Mini-glossary:

Assets: Anything of monetary value: real property, art work, savings, pension plans, stocks and bonds, cash, etc.

Community spouse: the spouse who is NOT living in a hospital or residential facility.

Elder attorney: A lawyer who specializes in laws concerning the elderly.

Federal Spousal Impoverishment Rules: Medicaid rules which provide special protections for the spouses of Medicaid applicants to make sure that they have the minimum support needed to continue to live in the community while their husband or wife is receiving long-term care benefits.

Home equity: The  fair market value of a home, less debts, divided by the number of owners. Thus the institutionalized spouse’s share of a $900,000 mutually owned home where $100,000 is still owed, would be $400,000.

Institutionalized spouse: the spouse who is living in a hospital or residential facility.

Medicaid: Called by different names in different states. There are basic federal requirements and payments but states can add to these.

Minimum monthly maintenance needs allowance (MMMNA): a minimum monthly income standard for the community spouse, set at one-and-one-half times the Federal Poverty Level for a single person living alone. ($1,991.25 to $2,980.50 in 2016)

Residential care: Care in a hospital or an assisted living, memory care, rehabilitation or nursing home facility for at least 30 days.

Snapshot date: the date a person enters a hospital or residential care facility for a stay of at least 30 days.

For information about Medicaid requirements for long term care specific to your state, go to Find an Attorney, click on your state, and then "Key Medicaid Information" for that state.

For more information about Spousal improvishment standareds:
2016 SSI and Spousal Impoverishment Standards

For information about Lewy body disorders, read our books:
A Caregivers’ Guide to Lewy Body Dementia
Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

Helen and James Whitworth are not doctors or lawyers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a physician's or lawyer's advice.