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Exercise Much Better for Preventing Alzheimer’s Disease than Prescription Medications

CATEGORIES:  Elder Law, Elder Care Attorney, Winston Salem, North Carolina, NC.

Given time, any brain can succumb to dementia — memories fade, thoughts scatter, basic abilities wither on the vine. Brains don’t come with lifetime guarantees, but there is one major step you can take to protect yourself from Alzheimer’s or other causes of mental decline: exercise your body. Nothing protects the brain quite like regular exercise, says Jennifer Heisz, a cognitive neuroscientist at McMaster University in Ontario, Canada. Not crossword puzzles, not supplements, not prescription medications. Exercise seems to beat them all, reducing the risk of Alzheimer’s disease or cognitive decline by about 35 percent to 45 percent, according to the latest evidence. People who don’t exercise as they age are taking a gamble. In a study of more than 1,600 older adults published in January in the Journal of Alzheimer’s Disease, Heisz and colleagues found that a lack of exercise was about as risky as having certain types of genes that raise the risk of Alzheimer’s. Genes are forever, but exercise habits can change.

Exercise enhances the release of chemicals known as nerve growth factors that help brain cells function properly, according to Teresa Liu-Ambrose, director of the Aging, Mobility and Cognitive Neuroscience Laboratory at the University of British Columbia. Nerve growth factors probably also help build new brain cells, giving the brain an extra cushion against age-related losses.

Studies in rodents show that exercise encourages formation of new brain cells in the hippocampus, an organ in the medial temporal lobe of the brain that plays an important role in memory.

“It’s like investing in a retirement fund for the brain,” Liu-Ambrose says. Exercise enhances blood flow to the brain, which can help keep it healthy and nourished. Liu-Ambrose notes that exercise also helps prevent hypertension and diabetes, which are two major risk factors for dementia.

There’s no particular type of exercise that seems to be best for the brain. Heisz notes that most of the subjects in her study walked three times a week. “It could be as simple as that,” she says. About 2.5 hours of moderate to vigorous aerobic exercise every week would be a reasonable goal, she says.

“Even a 15-minute walk per day would be much better than doing nothing at all,” Liu-Ambrose says. “People just need to do it.”

Sources:
National Academy of Elder Law Attorneys, (May 24, 2017).

Chris Woolston, Why exercise is the best medicine for your brain, Los Angeles Times (May 18, 2017),

Combination of Strength and Aerobic Training Found Best Medicine for Obese Elderly

CATEGORIES:  Elder Law, Elder Care Attorney, Winston-Salem, North Carolina, NC.

For obese people over age 64, the combination of aerobic exercise and weight training is better for improving physical functioning than either form of exercise alone, a new study concludes.

Each type of exercise, and a combination of the two, produced 9 percent reductions in body weight over six months. But the combination provided the best mix of protection against muscle and bone loss with improved aerobic capacity. Aerobic exercise and weight training (also known as resistance training) “have additive effects in improving your physical function,” chief author Dr. Dennis Villareal of the Baylor College of Medicine and the DeBakey VA Medical Center in Houston told Reuters Health by phone.

The findings in the New England Journal of Medicine have broad significance because one third of older adults in the United States are obese, and frequently experience all the health risks that obesity creates.

Lifestyle and Southern diet factors place a large number of North Carolina seniors at risk for obesity, and being sedentary places seniors at an even greater additional risk.  Those risks, however, are mostly preventable.  An improved diet, and regular exercise, can help seniors remain independent, active, healthier, happier, and in control of their business and legal affairs much longer, adding to quality and length of life.

Sources:

National Academy of Elder Law Attorneys, (May 24, 2017).

Dennis Villareal, at al, Aerobic or Resistance Exercise, or Both, in Dieting Obese Older Adults, New England Journal of Medicine (May 18, 2017), http://www.nejm.org/doi/full/10.1056/NEJMoa1616338

Smart Genes Make Autism More Likely

CATEGORIES:  Special Needs Law, Elder Law, Guardianship, Winston Salem, North Carolina, NC.

Researchers have found a surprising connection between intelligence and autism. On May 23, scientists announced the discovery of 40 new genes linked to human intelligence, and found that many people with the genes were also on the autism spectrum. The findings could one day help shed light on the condition’s origins.

Autism, more properly known as autism spectrum disorders (ASD) – includes Asperger’s syndrome. It has long been known that some sufferers have superior abilities in areas such as mathematics and science. The neurological condition affects four to five times as many males as females, believed to be around 1.5 percent of all children. Its exact cause remains unknown, and diagnosis requires many doctors specializing in a number of different disciplines.

The 40 new genes were discovered by researchers from the Centre for Neurogenomics and Cognitive Research in Amsterdam, based on a study of 78,000 people of European descent. Most of the newly discovered gene variants linked to elevated IQ play a role in regulating cell development in the brain. Computers have made it possible to scan and compare hundreds of thousands of genomes, matching tiny variations in DNA with diseases, body types, or in this case, native smarts.

Many of the genetic variations linked with high IQ also correlated with other attributes: more years spent in school, bigger head size in infancy, tallness, and even success in kicking the tobacco habit.

People with autism may require special care, and may need some type of government assistance during their lives, including Medicaid assistance.  Medicaid and similar government programs may have strict asset or income limits. Thus any will or trust bequest left to an autistic person should be directed to a special needs trust (SNT), which will leave such needed government benefits intact.

Sources:

National Academy of Elder Law Attorneys, (May 24, 2017).

Shiviali Best, Autism is Linked to Intelligence:  People With “Smart Genes” are More Likely to Have the Disorder, London Daily Mail (May 23, 2017),

Best and Worst IRA Beneficiaries

man-w-grandson-on-shouldersWhen you choose beneficiaries for your IRA account, you insure out-of-probate transfers to those beneficiaries when you die.

But picking proper beneficiaries can be tricky.  Here’s a list of the best and worst IRA beneficiary choices:

BEST IRA BENEFICIARIES

  1. Your Spouse

If you are married, it’s likely that the first person you want to benefit is your spouse.  Your spouse is the only person that the Internal Revenue Service allows to “rollover” the IRA participant’s IRA to their own IRA account.  The rollover will allow your spouse to then control your IRA assets, and to invest them as he or she likes.

If your spouse does not need the IRA funds immediately, he or she can keep them growing tax-deferred until April 1 following  the year he or she reaches age 70 1/2.  At that time, annual taxable Required Minimum Distributions (RMD) will begin.  The remainder of the account not required to be distributed can continue tax-deferred growth.

  1. Your Children, Grandchildren, or Younger Individuals

With the exception of your spouse, choosing an individual (or individuals) as your IRA beneficiary  allows that beneficiary (following your death) to receive the money as an inherited IRA.

With the inherited IRA, Required Minimum Distributions (RMDs) will begin in the year following the original account owner’s death.  These RMDs are calculated based on the beneficiary’s age-based actuarial life expectancy.  The IRS provides a worksheet for calculating RMDs at https://www.irs.gov/publications/p590b/index.html

The younger beneficiary can pull out more funds than the annual RMD requires if needed, but the additional withdrawals will also be taxed.

If the younger beneficiary can afford to let the IRA principal continue to grow tax-deferred, the younger beneficiary’s longer life expectancy can lower the annual RMD, and stretch the IRA’s tax-deferred growth over a longer lifetime.  Intentionally using this strategy to grow the IRA’s tax-deferred principal from one generation to the next is called the “stretch IRA” concept.

When used properly, growing your IRA by leaving it to a younger individual(s) who can afford to stretch out the inherited IRA’s tax-deferred growth can provide significant returns to the beneficiary.  Assuming a 7% return with only the annual RMD withdrawn, a $100,000 IRA left to a 20 year old child or grandchild can provide $1,765,731 in income over that child’s expected 63 year lifetime.  Please see the chart below:

TOTAL INCOME FROM IRA OVER BENEFICIARY’S LIFETIME
Age Life Expectancy Value of IRA When Inherited by Beneficiary
    $50,000 $100,000 $500,000
20 63 $882,865 $1,765,731 $8,828,658
50 34.2 $201,067 $402,134 $2,010,671
  1. A See-Through Trust

A trust which qualifies as a “see-through” trust under IRS regulations can be an appropriate beneficiary for your IRA.  There may be many practical reasons to employ a trust instead of giving IRA assets directly to a beneficiary.  For example, a father wanting to leave a $250,000 IRA account to his 14 and 16 year old children would be wise to protect the proceeds with a trust instead of directing the funds to his children directly.

In general, leaving an IRA to a non-human entity like an estate or a trust ruins “stretch IRA” optimization, because such beneficiaries must withdraw all funds within five years (instead of 63 years for a 20 year-old individual, for example.)

But under IRS regulations, the “see-through” trust is able to “see through” the trust entity to the individual life expectancy of the oldest beneficiary of the trust.

To qualify as a see-through trust, the trust must meet the following IRS rules:

  • The trust must be valid under state law;
  • The trust must be irrevocable following the IRA participant’s death;
  • Trust beneficiaries must be identifiable;
  • The IRA plan administrator must be provided with proper documentation regarding the trust beneficiaries and/or the trust by October 31 of the year following the participant’s death;
  • All trust beneficiaries must be individuals.

Typical testamentary trusts (found in wills) or revocable living trusts become irrevocable after the death of the will testator or trust grantor.  If properly drafted, and with proper beneficiaries, such trusts may qualify as see-through trusts under the above IRS rules.

  1. A Charity

A tax-deferred account  may be appropriate to give to a charity, if none of your human beneficiaries need the funds.  You can transfer the full tax-deferred IRA value to the charity because the charity will pay no income taxes when it receives the money, and the account will not be included in your taxable estate when you die (reducing the amount that your family will have to pay in estate taxes, if applicable.)

WORST IRA BENEFICIARIES

  1. Your Estate

Naming your estate as your IRA beneficiary is a bad idea.  This insures that the IRA funds must now go through probate, increasing the time, complexity, and expense of your probate estate.  The IRA’s creditor protection will be lost, making your IRA funds newly eligible to pay estate debts.  Your intended beneficiaries will no longer be able to stretch out their Required Minimum Distributions over their lifetimes (and save tax dollars) because the IRA funds will now be required to be fully withdrawn (and taxes paid on the withdrawals) within five years.

  1. An Individual and an Entity

In order for tax-saving  stretch IRA provisions to be available to your human beneficiaries, all of your IRA assets must go to human beneficiaries following your death.

For example, you may intend for your two children to be able to stretch out their Required Minimum Distributions over their lifetimes, leaving 95% of your IRA to them and 5% of your IRA to your church.  But even this small bequest of your IRA funds to your church will trigger the five-year IRA distribution rule for your children.  Having to fully distribute all of your IRA proceeds (and pay the associated taxes) over a short five-year period can greatly reduce the stretch IRA tax savings available to your children.

  1. A Person who has Problems Managing Money or who is in Debt

A person who cannot manage money would withdraw the inherited IRA funds very rapidly, with income tax having to be paid on every withdrawal, negating the potential stretch IRA tax savings of an inherited IRA.

In addition, unlike with a traditional IRA, a 2014 U.S. Supreme Court decision held that the proceeds from an inherited IRA are fully available to creditors.  Thus if you leave your IRA outright to someone in debt, they may lose all of that money to creditors in a short amount of time.

To protect your IRA assets directed to a beneficiary with money management problems, or with creditor or debt problems, consider setting up a see-through discretionary trust for the beneficiary.  You could then choose another responsible family member to serve as trustee to manage the IRA funds, and to make the spending decisions on behalf of the encumbered beneficiary.

  1. An Older Individual

Leaving an IRA to an older person frequently insures that the Required Minimum Distributions will be accelerated, leading to increased taxes.   If the beneficiary really needs the funds, however, and there are no alternative assets to transfer, the increased taxation rate may be less important than taking care of the beneficiary.

REFERENCES

Daniel A. Timins, Who Should You (Not) Leave Your IRA To, Kiplinger (August 2016), http://www.nasdaq.com/article/who-should-you-not-leave-your-ira-to-cm660234

Understanding the Stretch IRA Strategy:  Preserving Assets for Your Heirs, T Rowe Price Investor (March 2011), https://individual.troweprice.com/staticFiles/Retail/Shared/PDFs/StretchIRA.pdf

Natalie B. Choate, Life and Death Planning for Retirement Benefits, (7th ed. 2011).

Understanding Who Should Be Beneficiary of Your IRA, Estate Planning.com, https://www.estateplanning.com/Beneficiary-of-Your-IRA/

Click here to download a PDF of this article.

Mediation: An Important Tool in Settling Elder Law Disputes

Mediation: An Important Tool in Settling Elder Law DisputesCategories:  Elder law, Winston-Salem, NC.

Often, elder law disputes involve close family members and can involve emotions such as jealousy and greed. When such emotions are present, long and costly litigation can also permanently destroy family relationships.

Mediation can serve as a much better technique for resolving such emotional family disputes, and can often better preserve family peace, privacy, and can frequently result in a settlement in much less time and using much less money.

The parties in an elder law dispute may all voluntarily agree to use mediation as a means to seek a mutually accepted settlement of their dispute. But, where the opposing party remains contentious about using the mediation process, it may be more effective to use a “carrot and stick” approach to frame mediation as the most reasonable alternative. For example, an attorney may file a lawsuit or a motion with a court, then offer mediation to the opposing side as a more reasonable dispute resolution alternative than litigation. Or, in cases where competency may be an issue, an attorney may file a petition for guardianship of the elder, then offer to mediate after the guardianship application has been filed.

Because of the specialized subject matter involved in elder law, the mediator should be carefully selected to make sure that he or she has sufficient specialized experience in settling elder law disputes, and a good reputation among his or her peers.

Because mediation is private, and because a mediator may shuttle between parties during a mediation rather than having parties face each other in the same room, the environment may be much less threatening than in a courtroom, and may be used to to find more creative solutions for resolving disputes than is possible in a courtroom.

According to Shirley Berger Whitenack, President of the National Academy of Elder Law Attorneys and a professional elder law mediator, mediation of elder law disputes may be appropriate and successful under the following circumstances:

  • The parties have or had an ongoing personal relationship and have communication problems,
  • The primary barriers to settlement are personal or emotional,
  • The parties want creative solutions to fit their particular needs,
  • There is an incentive to settle because of the time or cost of litigation,
  • The parties want a confidential forum to resolve their dispute.

Source: Shirley Whitenack, Mediation: A Possible Option for the Dispute Involving Your Client, NAELA News Jul/Aug/Sept 2015,
https://www.naela.org/Public/Library/Publications/Publications_Main/NAELA_News_Archive/NAELA_/JulAugSept2015/PracticeSuccess_Mediation.aspx?WebsiteKey=24646538-b6f0-4066-8569-164bcf663977

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