Misuse of Anti-psychotic Drugs on Nursing Home Patients

The Chicago Tribune recently published a series of articles on the use of psychotropic (or antipsychotic) drugs on elderly patients in nursing facilities.  The Tribune reviewed more than 40,000 state and federal inspection reports and found that many patients had been prescribed these powerful drugs despite the fact that they had no history of mental illness, no diagnosis of psychosis, and no display of any psychotic symptoms.

This trend is alarming for a variety of reasons, both for patients and their families.  The most commonly-used psychotropics carry the FDA’s highest advisory.  Some of the side effects include: severe lethargy, permanent involuntary muscle movements, restlessness, seizures and sudden death.  Non-psychotic patients who have been prescribed psychotropics are often described by family and nursing staff as “catatonic,” no longer able to talk or attend physical therapy and many have become so lethargic they must be hospitalized.  Similarly, as a result of this lethargy there have been a number of cases where nursing home residents suffered serious falls in which psychotropics possibly played a role; some of which led to serious injuries or even death.

Read the links below for some theories on why this is happening, information on your rights and where to direct any complaints. 

Five Things to Know About Psychotropics

Compromised Care: Psychotropic drugs given to nursing home patients without cause

Nursing home doctors untouched even as facilities are cited

Illinois Citizens For Better Care

Medical Students Experience Nursing Home Life

The New York Times posted a very interesting article about medical residents who spent a short time living in a nursing home to find out what it’s like to be a nursing home  resident.  One of the goals of the program is to generate interest in geriatric medicine, which continues to be one of the most underrepresented fields in medicine.  Additionally, participants found that their experience offered invaluable insight into how to be better physicians.

Click here to read the full article

Talking to Your Aging Parents About Financial and Legal Planning

Good Morning America had a great segment this morning discussing tips for talking with your parents about planning for their financial and legal future.  Financial contributor, Mellody Hobson, had some suggestions for talking points for that important conversation.  The full video is available here:  Talking to Aging Parents About Finances – ABC New.

The highlights were:

• Broach the topic by discussing your own plans for the future;
• Organize their legal and financial documents;
• Suggest direct deposit and bill pay for your parents;
• Research meal, transportation and in-home medical services;
• Discuss long term care planning; and,
• Encourage estate planning and the necessity of drafting a Will.

For more information about any of topics discussed in the video please contact our office to schedule a consultation.

Planning for Your Disabled Child

Few questions can cause as much worry and anxiety for our clients as “who will take care of my disabled adult child or grandchild when I am gone” and “how will she be provided for?”  In particular, our clients are gravely concerned about who will manage their child’s inheritance.  Who will make sure the money is spent appropriately for their child’s benefit?  Will the inheritance affect their child’s supplemental security check, medicaid coverage and eligibility for an adult day program or residential placement?  What if the inheritance disqualifies their child from medicaid?

These are the questions that keep the parents and grandparents of disabled adult children up at night.  Fortunately, through a special needs trust our clients can make sure that their adult disabled child or grandchild will receive an inheritance that is managed by a trustworthy individual in a way that will not disqualify that child from supplemental security income, medicaid, adult day programs or residential placement.

For those who qualify, a special needs trust can substantially improve a disabled person’s quality of life.  Through a special needs trust, a parent can make sure their disabled child is not disqualified from public benefits like medicaid and supplemental security income.  A parent can also make sure the inheritance they leave their child will be managed properly and in a way that enhances their child’s life.

Special needs trusts have enhanced the quality of life of so many disabled adult children and grandchildren.  And they have also given peace of mind to concerned parents and grandparents.

For more information on the benefits of special needs trust or planning for disabled children please visit our website, or call our office to schedule a consultation.  This post is adapted from Kathryn Casey’s article published in the July 2008 issue of Chicago Hospital News.

When the Trustee is not Trustworthy: Remedies for the Trust Beneficiary

Before my mother passed away, she established a living trust and named my sister as Trustee.  My sister, my two brothers and I are the beneficiaries of this trust.  I recently found out that my sister used my mother’s trust to pay for a cruise for herself and her daughter, and also remodeled her home with my mother’s trust monies.  What can I do?

Naming a Trustee of your Trust is perhaps the most important estate planning decision you make.  Unfortunately, this mother made the wrong decision in naming her daughter as Trustee after her death.  A Trustee has the fiduciary duty to act in good faith, in accordance with the Trust terms and purposes, and to act for the sole interest of the beneficiaries.  Even though the Trustee may herself be a beneficiary of the trust, she is breaching her duties as Trustee by using the trust assets for her personal benefit.

This beneficiary needs to act quickly to prevent the Trustee from continuing to spend the trust assets. If the Trustee/sister spends more trust assets than she is to receive as a beneficiary, it will be difficult to actually recover those trust assets from her.  The beneficiary should engage an attorney to file an emergency action to freeze the trust assets so the Trustee can’t continue to spend them; to remove the Trustee; to force her to account for her actions as trustee; and, ultimately, to pay back the misappropriated funds.  Because the Trustee acted intentionally in using trust assets for her own benefit, the beneficiary may be able to obtain punitive damages – a monetary penalty for breaching her duties to the trust – against the Trustee.

The Trustee will not be allowed to use trust assets to defend herself.  However, because the beneficiary is acting to protect the trust, it is possible that the beneficiary’s attorney’s fees will be paid from the trust assets.

Elder Abuse: What do you do if you suspect it?

It’s difficult when you suspect that an elder you care about is the victim of elder abuse.  While the majority of reported elder abuse concerns financial exploitation, abuse may be physical, emotional, or sexual in nature, or may take the form of neglect.  In addition, some elders simply do not have the capacity or ability to properly care for themselves and may fall victim to self-neglect.

Elder abuse does not discriminate between sex, ethnicity or social status.  Between July 1, 2005 and June 30, 2006, the Illinois Department on Aging received 9,191 reports of elder abuse and, sadly, the majority of abusers were family members of the victim.

What do you do when you suspect that someone you love or care about is the victim of elder abuse or neglect?  If you suspect that someone you know is in immediate or life-threatening danger, first call 9-1-1.  Otherwise, to report suspected abuse, exploitation or neglect of an older person you may make a report to your local police department.

You may also call the Illinois state-wide 24-hour Elder Abuse Hotline at 1-866-800-1409, 1-888-206-1327 (TTY).  Under the authority of the Elder Abuse and Neglect Act (320 ILCS 20/1 et seq.), the Illinois Department on Aging administers the statewide Elder Abuse and Neglect program.  Reports of elder abuse are investigated by elder abuse caseworkers at one of 44 provider agencies around the state.  These case workers are trained and certified by the Department on Aging.  You may also call your local elder abuse provider agency directly.

Anonymous reports are accepted and the identity of the reporter may only be disclosed with written permission of the reporter or by court order.  Under the Illinois Elder Abuse and Neglect Act reporters who act in good faith are immune from civil or criminal liability or professional disciplinary action as a result of the report.

For more information on Elder Abuse or to schedule an appointment to meet with an attorney visit our website or contact us at 312-899-0950.

Am I old enough for an Elder Law attorney?

We often get asked this question by potential new clients when calling to make an appointment for a consultation.   The National Academy of Elder Law Attorneys, Inc., (NAELA) states its goal is to establish “NAELA members as the premier providers of legal advocacy, guidance and services to enhance the lives of people with special needs and people as they age.”

Many attorneys who practice in the broad field of elder law are dedicated to planning for the needs of older adults; however, Elder Law is not simply limited to issues affecting those in their later years of life.  In addition to advising as to wills, trusts and simple estate planning, so much of elder law is concerned with disability law and planning for special needs.  Medicaid planning, guardianship, powers of attorney, living wills, and special needs planning are all essential issues to consider when developing an effective estate plan.

For example, a younger client who has a child with special needs may seek advice about the provision of a special needs trust to ensure that child’s needs are met upon the parent’s death.  Older couples who contemplate the need for nursing home care may consult an elder law attorney for Medicaid planning and asset protection.  An adult child may seek an elder law attorney to represent them in petitioning for the appointment of a guardian for a parent or family member who requires assistance with finances or health care decisions and has not designated an agent under power of attorney.

If you would like to meet with an attorney to discuss your particular needs and concerns visit our website or call 312-899-0950 to make an appointment.