The Senex | No.15
Wiser Older (Hu)man
By: Jeremy L. Pryor Esq. | May 10, 2019
Dear Reader—
Welcome to the weekend. This week we’re focusing on dementia and caregiving. While it’s not a fun subject, we’re confident it affects you as much as it affects us.

Late last month The Virginia Alzheimer’s Disease and Related Disorders Commission ("Commission") released its Virginia State Plan for 2020-2024. The Commission was established in 1982, and "serves as an advisory board in the executive branch of Virginia’s state government and aims to assist people living with Alzheimer’s disease and related disorders and their care partners.” Among other items of note in the Plan, the following facts caught our attention:
- By age 85, one in three persons in Virginia will be living with dementia.
- The Alzheimer’s Association estimates the average lifetime cost of care for an individual living with dementia to be $350,174. 
- The Commission has a  website  that lists interdisciplinary memory assessment centers in Virginia
- Virginia offers a  $400 respite care voucher  for full-time family caregivers living in the home of an individual with dementia.
 
The Plan contains a fascinating and current breakdown of Virginia-specific facts related to dementia, as well as the Commission’s goals for the next five years. We’d recommend that you read the whole thing. 
 
 
This week we also discovered that the Alzheimer’s Association offers a toolkit for assessing incapacity. The  toolkit consists of relatively straightforward assessment instruments to be used for determining whether cognitive decline is occurring (and whether further assessment is warranted) during a Medicare Annual Wellness Visit. We’re pretty sure it's not something that can be appropriately used by non-professionals, but it is helpful to review what doctors and others use to assess capacity in a more clinical context.
 
For us as Elder Law lawyers, assessing cognitive capacity is something that we must do fairly frequently. While our judgment isn’t the same as that of a trained doctor, social worker, or gerontologist, we have to be confident that our clients possess the capacity to understand the nature and consequences of hiring us, and we have to be careful that our clients with cognitive limitations are not being unduly influenced by others. This is often one of the hardest parts of our job. In really hard cases, we may even ask our clients to get an evaluation from a professional to assist us in making our assessment. While this may seem intrusive, we have a responsibility to make sure that we’re communicating and assisting clients who can truly direct us. And it helps to prevent family members from questioning decisions made with our assistance from being challenged later. Litigation involving issues related to incapacity is only going to increase in the next few years, but we’d like to ensure that our clients and their families avoid it.
 
Lastly, about that voucher. We must confess that we were unaware that it was available until we read the Commission’s Plan, but you can be assured that we will be recommending that any family caregivers in our network take advantage of it. Given the amount of time and effort family caregivers provide it is a small token, but well deserved.
 
Happy Friday,
 
Jeremy
About The Senex
Carrell Blanton Ferris & Associates’ weekly update on aging, wisdom , and the law   | Edited by Jeremy L. Pryor, Chair of the firm’s Elder Law Section