About Shannon Cavers
Generalized Anxiety Disorder and the Elderly
Posted on February 14, 2013 by Shannon Cavers
Many adults cope with generalized anxiety disorder (GAD) by working with counselors, taking medications, and/or using cognitive behavioral therapy (CBT) skills to manage their symptoms. Therapy, CBT skills, and medication can be effective in alleviating GAD symptoms. However, when working with the elderly population, the health care community has to alter the approach. That is because most elderly people view psychology, anxiety medications, and therapy as things for “crazy” people or those with serious emotional disturbances. That prevalent mindset closes the door the elderly need to feel better and maintain a good quality of life. When the person suffering from GAD is elderly and socially isolated their anxiety can become worse. While most people worry about things from time-to-time, people who suffer from GAD are consumed with worry about almost anything, and the thoughts are so intrusive that they can be debilitating. For example, an elder person may worry about falling or driving. There are symptoms beyond just feeling angst, which may include insomnia, headaches, depression, and even avoidance of certain situations. To illustrate, if Grandpa is afraid of falling, he may avoid going to the grocery store or pharmacy to pick up much needed items. Adult children may wonder why Grandpa is always eating take-out or fast food from the drive-thru lane. Most caretakers will not put together than Grandpa is using avoidance techniques to manage his fear of falling. So, what is a caretaker to do? In the Houston elder care and elder law community, there are many resources for the aging and their families. The Houston Gerontological Society presented a lecture about managing GAD in the elderly population and how techniques used for younger adults can be adapted to help the aging population. The principal investigators have learned that providing more education about psychology, less psycho-jargon, going at a slower pace, using more visual aids, and involving family members makes management techniques more effective. This research is called The Peaceful Living Project and is associated with Baylor College of Medicine.
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2013 Spring Caregiver’s Conference
Posted on February 13, 2013 by Shannon Cavers
Saturday, March 9, 2013 from 8:30 a.m. to 2:30 p.m. Interfaith CarePartners is sponsoring a conference to answer the many questions that confront us when caring for aging or disabled loved ones. There is no cost to attend this conference, but those interested must register so that the host, St. Luke’s United Methodist Church, knows how many people to expect for lunch service and so presenters know how many materials to bring. There are three different workshop sessions at 9:45 a.m., 11:05 a.m., and 1:20 p.m. with professionals teaching about topics such as Medicare, life care planning, Medicaid benefits planning, caring for loved ones with dementia, and how to handle stress as a caregiver. The speakers at each of the workshops are professionals in fields such as elder law, in home health care, counseling, and so on. Having been a past speaker on Medicaid benefits and a conference attendee, I can say that there is much to learn. There are exhibitors at the conference, but they are separate and apart from the workshops. The workshop presentations are meant to provide educational services to the Houston community, and not be a sales pitch for services. For more information on how to register for these workshops and take advantage of these learning opportunities, please visit the conference website.
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Caring for Aging Loved Ones: Housing Challenges
Posted on February 7, 2013 by Shannon Cavers
If you’re reading this post, then it’s likely you are facing the possibility of caring for aging parents or other loved ones. Even under the best of circumstances, planning for the future is stressful because it involves the unknown: (1) How long will my loved on live? (2) How healthy will s/he be going forward? (3) How much will future care cost? Though these questions produce anxiety, issues like managing assets, housing, health care, transportation, and estate planning are important to confront now rather than later. As in all things, the future depends on preparations made in the present. Today’s post focuses on housing for aging loved ones. Research tells us that people prefer to remain in their own homes for a variety of reasons; not the least of which is retaining independence and not burdening the family. Staying at home is referred to as aging in place, which can be a very good option if your loved one is able to care for their basic needs alone or with a modicum of assistance from family or helper. It is usually much less expensive than senior living facilities. Another option is to bring the loved one home with you. This can be helpful if s/he can remain at home alone while family members are at work, or if an in-home helper is available to tend to his/her needs. Senior living facilities offer a range of options from independent living apartments, to assisted living, and in some instances nursing home care. Knowing which option to choose is difficult and persuading your loved one to make changes to his/her lifestyle (even if it’s to have an in home helper) can create conflict among the family. Though all involved want the same thing – what’s best for Mom or Dad – simply agreeing on what is best is difficult. However, there are competent professionals in the Houston area whose careers are in elder law, geriatric medicine, geriatric care, and home health care because these professionals are committed to helping families in this period of transition. Future posts on housing will discuss independent living, assisted living, nursing home care as well as financial and legal planning.
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Child Custody: Why Trials Destroy Families
Posted on January 7, 2013 by Shannon Cavers
When I first started my career, a wise Houston family law attorney and mediator told me after successfully settling a high conflict case, “Trials destroy families.” Obviously, I knew trial was not the optimal way to bring order from chaos of divorce and custody battles, but I recall judging her statement was somewhat melodramatic. Having spent some years in the trenches now, I agree that experiencing a custody trial as either Mom or Dad from start to finish is a very effective way to destroy co-parenting, trust, respect, and once treasured memories. The judge is not King Solomon, and cannot split the child in half. However, if you ask a child involved in a custody dispute, that image is close to how s/he feels. A North Carolina attorney specializing in family law posted from a court reporter’s transcript, the statements of a presiding judge asking the parties and their attorneys to settle their case before asking the court to decide. This judge paints an accurate description of what trial attorneys have to do to accomplish their client’s objective. Though not King Solomon, this judge perhaps has his wisdom. Even after the parties leave the courtroom, a custody ruling can scar the family for years to come. This is not to say that child custody trials should never occur, but to encourage parties to be very aware of consequences and make every attempt to put their children first.
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Estate Planning Under The American Taxpayer Relief Act of 2012
Posted on January 3, 2013 by Shannon Cavers
Whatever one feels about the “averted” fiscal cliff, the President, or Congress, The American Taxpayer Relief Act is now law. No one should get too excited because annoying issues like the country’s debt ceiling (i.e., US Government’s credit card limit) will revisit all Americans in about 60 days. Nevertheless, here is some basic information to satisfy curiosity about the estate tax. Many clients whose estates exceeded $1 million dollars worried about what could happen with their estate plan after December 31, 2012. Fortunately, the estate tax did not revert the former $1 million figure. The estate tax exemption remains at $5 million (adjusted annually for inflation since 2011). The 2012 estate tax exemption was $5,120,000.00, and the 2013 estate tax exemption is anticipated to be $5,250,000.00, with estates over that $5.2 million threshold taxed at the rate of 40%. This is a 5% increase from 2012 for estates that exceeded $5.1 million dollars. Lots of people laugh off the $5 million figure as far beyond their estate, but sometimes clients have more than they think. When combining real estate, life insurance proceeds, cash, stocks, and other assets, one’s estate can easily exceed the $5 million threshold, and be subject to estate tax (a/k/a death tax). Therefore, having an annual sit down to examine one’s assets and estate plan is time well spent. Busy people tend to toss wills and other estate documents in the safe or file cabinet, and not think about them. Taking time each year to revisit an estate plan is just as important as having an annual physical. This task need not involve a horrid trek through the file cabinet or the cloud. These days there is user friendly software that helps individuals track their net worth, and most brokerage houses have online tools associated with a client’s account. While entering data on the front end may be a small time investment, once it’s done the task becomes fairly painless. The benefit of making this annual review of one’s estate is that the individual and his/her attorney can update the existing estate plan to minimize future estate tax implications. Happy New Year to all!
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Dodging Bullets Post Divorce and Posthumously
Posted on October 4, 2012 by Shannon Cavers
Perhaps the most welcome day in the life of a person going through divorce is the day all the documents are signed, sealed and delivered, the decree is entered by the Court, and the damn thing is FINAL for all practical purposes. Despite the good work by one family law attorney, the estate of his client became entangled in probate court over an Individual Retirement Account (IRA). Before husband and wife married, the man opened an IRA naming his fiancé and father 50/50 payable on death beneficiaries. The parties married and subsequently divorced, with the final decree awarding 100% of the IRA to the husband as his separate property (Olmstead v. Napoli, 2012 Tex. App. LEXIS 7641 (Tex. App. — Houston [14th Dist.] September 6, 2012). Though Texas law presumes that if you’ve gone to the trouble to divorce your spouse, that you do not want him/her to inherit from you after you’re dead. See Tex. Prob. Code § 69 and Tex. Fam. Code § 9.302. Whether you prefer calling detailed diligence “wearing a belt and suspenders” or saying “an ounce of prevention is worth a pound of cure”, either would have been helpful in this case. Unfortunately the ex-husband did not change his beneficiary designations on the IRA he was awarded. The ex-husband’s father predeceased him, and thereafter the ex-husband passed away as well. When the estate requested distribution of proceeds from the IRA, the financial institution refused because the ex-wife was still a designated beneficiary on the account! Though I wasn’t there I’m fairly certain the bank was given a certified copy of the divorce decree with the section about the IRA highlighted. That apparently did not help. The estate not only had problems with the bank, but also the ex-wife who showed up to claim her half of the IRA, making the argument that she was made a beneficiary before marriage and that Texas law addressing these circumstances to an ex-spouse and not a fiancé. The 14th Court of Appeals didn’t bother interpreting the statutes and her argument. Because language in the final decree was well drafted to withstand future challenges, and because there was no question that the ex-wife gave up any right she previously had to the IRA proceeds, the Court ruled in favor of the estate. The take-home lesson is this: After divorce, there is still work to do such as updating your will, revoking former powers of attorney, drawing up and recording a new power of attorney, and changing beneficiary designations. While justice prevailed (at least in my opinion), ask yourself how much the estate had to spend in legal fees to deal with the bank and the ex-spouse. That doesn’t even take into consideration the added emotional distress to a family grieving the loss of a loved one.
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What’s So Special About October 1, 2012?
Posted on October 1, 2012 by Shannon Cavers
Not only is today the first of October, which hopefully leads to fall weather in Houston, but it is also the beginning of the US Supreme Court’s term. While Washington, D.C. is far away from us Houstonians, the nine legal minds hold the potential to impact the lives of families across the country. Obtaining certiorari (the opportunity to be heard by the high court) is a topic for another discussion, but cases the court may hear this term which impact family law includes review of the Defense of Marriage Act (DOMA) and California’s controversial Proposition 8. DOMA is the federal law defining marriage as between a man and a woman, and President Clinton signed this legislation into law in 1996. Proposition 8 is California voter’s response to the state’s brief once approval and recognition of same-sex marriage. Six states and the District of Columbia recognize same-sex marriage or civil unions, so the times have changed a great deal since DOMA in 1996. Texas has a state constitutional amendment that prohibits same-sex marriage, but that does not mean same-sex families do not migrate to Texas or have family legal issues that emerge. A prime example is the McMurrey v. Close case in the 247th District Court of Harris County, Texas involving a same-sex couple that used in-vitro fertilization and a surrogate mother to become parents. The surrogate mother claims she was to be a co-parent and did not know the couple was gay. Presently there is a declaratory judgment action pending to determine parentage and the rights of the parties.
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Who Are the Elderly?
Posted on September 26, 2012 by Shannon Cavers
Ask yourself the question, “Who are the elderly?” Who do you think of? If you’re like my father who is 67, then you’re likely to respond, “Not me!” There’s no set age where a person magically turns “old” and most people consider multiple factors before labeling someone, such as: physical health, mental health, functional capacity, social connectedness, in addition to age alone. However, contemporary American society categorizes the elderly as persons who are 65 years old and beyond, just as the young are categorized as those under the age of 18. Age is purely a chronological measurement, but 65 is the starting point for retirement and qualifying for government benefits. The further I move beyond 40, the more averse I become to identifying 65 as elderly.
Subjectively, the elderly might be one’s 86-year-old grandmother, a parent who retired and is now on Social Security and Medicare, or one’s spouse who just celebrated his/her 65th birthday. Personally, the images of my dearly departed grandparents and my aging parents are what come to mind. Then again, I think about Betty White. She is 90 years old, and is probably just as popular as an actress now as when she appeared on Mary Tyler Moore and The Golden Girls. She makes us laugh on contemporary TV shows such as Saturday Night Live and Off Their Rockers. Betty is the image of who I want to be at 90 years old! She is irreverently funny, amazingly ambulatory, does what she enjoys, and doesn’t take any nonsense off of anyone. What could be better than that?
While there are the lucky few who are what I call the active elderly (e.g., going to the gym, driving their “old” friends to the doctor, and leading active social lives) many are not that fortunate. With age come experience, wisdom and hopefully respect from others, but age also imposes limitations on the body. While medical advances continue to become available, there just isn’t a way to fix everything that wears out on the body, such as the eyes, ears, musculoskeletal system, internal organs, or the mind. It is the limitations and failings of the body that make being elderly extremely challenging and overwhelming, and our modern culture makes it even harder. A generation ago most families kept elders close by, or even in their own homes where they and their children lived. Today, that is the exception rather than the rule as our society is highly mobile.
The physical challenges that come with being older make it hard to drive, keep house, prepare meals, remain socially active, and in some cases even ambulate in the home. Challenges stemming from chronic medical conditions, natural decline in mental acuity, age related dementia, or Alzheimer’s disease can create barriers to handling financial affairs, taking medications, and personal safety.
All of this matters because the Baby Boomers (those born between 1946 and 1964) are coming of age for retirement. In 2000, 35 million Americans (12.4% of the population) were over 65. The US Census Bureau projects that by 2020 there will be 53 million elderly in America – over 16% of the population of this country. Since people are living longer than ever before, not only will society need to care for the elderly, but also the “super elderly” who are 85+. Many of us will face these challenges directly in caring for our aging parents. These challenges create public policy debates, legal issues, and financial matters, but they also bring an opportunity to forecast, plan for the future, and hopefully help ourselves and others be the ideal elderly person. We hope that the articles and resources presented here will be informative and thought provoking.
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Elder Abuse and Its Many Forms
Posted on September 17, 2012 by Shannon Cavers
It is my core value that all people should be treated with respect and dignity, and I think most people feel that way. This is especially true of elder members of our Houston society, who may be particularly vulnerable. According to The American Psychological Association there are 2.1 million cases of elder abuse reported annually, and the thought is there are many more cases where the abuse is not reported because the victim is isolated, disabled or afraid of their caregiver. Most people believe that most incidents of elder abuse occur in nursing homes, but sadly most cases occur in the person’s home. The perpetrators are family members, other household members, and paid caregivers. Discussing the reasons or triggers for elder abuse is way beyond the scope of this brief article, but there are interventions you can read about elsewhere. The focus of this article is to make the public aware of the kinds of elder abuse. The most obvious form of abuse is physical in nature and is revealed by bruises and broken bones, but there are many subtle forms of abuse and neglect. Neglect may include leaving someone with dementia alone (even for a short time period), failure to provide nutrition, medication, and items like glasses, walkers or canes. Caregivers and family members can engage in emotional abuse of their elder one by isolating them from friends and other family members, denying them access to activities outside the home, being verbally demeaning or aggressive, taking away all autonomy from the person’s life, or by generally being uncaring. Financial abuse occurs more often than you might expect. Examples of financial abuse include: coercing or tricking the elder to sign a statutory power of attorney thereby giving the agent broad power over all the person’s assets; failing to provide for the elder person even though the person has financial resources; using the elderly person’s monthly Medicare benefit for unintended purposes; and, adult children and grandchildren who coerce the elderly person to gift away large amount of cash, property or other items of significant value. Transactions like these can have sweeping effects on the elderly person’s legal rights. Finally, sexual abuse of the elderly is the vilest, and this becomes evident when symptoms of sexually transmitted diseases present in one who had no prior history of STDs. One thing is certain – if we live long enough, we will all be elderly, and with that goes some level of vulnerability. Some advance planning with an elder law attorney or life care planner can go a long way to prevent some of these abuses – especially in terms of financial abuse. If you suspect that an elderly person may be a victim of physical, emotional, financial or sexual abuse, then contact the Texas Department of Protective and Family Services, Adult Protective Services division, to make a report at 1-800-252-5400. However, if you suspect immediate harm, then call 911 to make a report. This can be done anonymously.
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You Need the Medical Power Attorney? Oh *&$%!!
Posted on September 15, 2012 by Shannon Cavers
I follow the legal advice I give my estate planning and probate clients, but recently, I made a mistake that could have been a huge problem. To set the scene, it was a lovely Saturday night in Houston. The hubby and I were enjoying dinner on the patio at one of our favorite restaurants. Without warning he lost consciousness while sitting across the table from me. Fast forward through the drama of my worst fears and ambulance ride to the hospital, to the point where I’m with the admission personnel.
She asks, “Do you have a medical power attorney?”
I respond, “Of course. I have a medical power of attorney, advanced directive and a durable power of attorney.” I’m an attorney after all!
She says, “Great. We need a copy of the medical power of attorney and advanced directive.”
Now I look like a deer in the headlights. It’s Saturday night. The bank is closed until Monday. So, the earliest I can get my hands on this important document is Monday at 10:00 a.m.! Surely I have a copy at home? But, I’m not leaving the hubby at the hospital for all the world’s riches. Now I don’t feel so smug.
The mistake was keeping our probate and ancillary documents like the medical power of attorney too safe in the bank box. I advise my clients to keep their documents in a safe place like a bank box, as well as a copy readily available. Unfortunately, in this case, having copies somewhere in the piles of paper at home was useless. It’s not like people carry these legal documents on their person! But, can they? Do they? Yes. It occurred to me that I should have scanned images of the documents and stored them as a .pdf on my Drop Box account because that’s almost as good as carrying the hubby’s medical power of attorney in my purse, because I can pull it up on my smart phone or even the hospital computer. We have incredible technology at our fingertips through the Internet, so why not take advantage of it. Even if you don’t like cloud computing, it’s possible to e-mail yourself a .pdf of such crucial documents. Fortunately, the hubby is okay following a three-day stay in the hospital, and I never had to challenge anyone at the hospital on making medical decisions (I am the next of kin after all), but things could have turned out differently. When you’ve got the stress of a loved one in the ER or hospital, you don’t need the added anxiety of having to wonder about where you put the medical power of attorney. Never in my wildest dreams would I have expected my super healthy hubby to keel over and conk out on me, but it happened. If there is a next time, I’ll be prepared. So, please learn from my mistake and plan for life’s little surprises.
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