Attorney offers advice about Alzheimer’s disease and dementia

Attorney Arthur Bergeron invited Leslie Clapp, executive director of the Martha's Vineyard Center for Living, to join him in providing information and advice at a free legal clinic about planning for and dealing with dementia. — Photo by Janet Hefler

Today, 5.4 million Americans are living with Alzheimer’s disease, according to the Alzheimer’s Association. Of Americans age 65 and over, 1 in 8 has Alzheimer’s and nearly half of people age 85 and older have the disease.

With those statistics in mind and the questions that arise about Alzheimer’s, health care and finances, Attorney Arthur Bergeron recently held a free legal clinic April 1 at the Tisbury Senior Center about planning for and dealing with dementia.

“I realized as we were thinking about these presentations for the next year, while people say they come to me for a variety of reasons or concerns, really, mostly, it’s because folks are worried about Alzheimer’s disease,” Mr. Bergeron said.

He invited Leslie Clapp, executive director of the Martha’s Vineyard Center for Living (MVC4L), to discuss Alzheimer’s disease, its warning signs, and resources for diagnosis and support. MVC4L runs a Supportive Day Program four days a week that deals with many participants with early and mid-stage dementia.

The main message from both Mr. Bergeron and Ms. Clapp is that spouses and families should get a professional opinion sooner rather than later if they think a loved one is exhibiting early signs of dementia.

Just a lapse in memory?

Alzheimer’s is a term often misused to describe dementia in general, Ms. Clapp said. However, it is actually just one form of dementia, so it is important to learn about what makes it different.

As she explained, Alzheimer’s is not just memory loss; it is a disease of the brain that actually causes a physiological deterioration of brain cells and nerve cells. As a result, the brain loses its capacity to take in and process the messages it receives, and disease progresses to death.

“They’re doing lots of amazing research into finding a cure,” Ms. Clapp said. “At this point there isn’t one, but there are a lot of things you can do to keep it at bay.”

Those include a heart-healthy diet and exercise, which happen to also be good for the brain, along with mental stimulation and social interaction.

“If you think your loved one might have a program with memory loss or you do, try to find out what’s going on,” Ms. Clapp said. “Get a professional opinion.”

The early warning signs of Alzheimer’s disease include memory loss that disrupts daily life, misplacing things and losing the ability to retrace steps, withdrawal from work or social activities, and changes in mood and personality.

Ms. Clapp said Hope Dementia and Alzheimer’s Services, based in Hyannis, provides free memory screenings and other resources for residents of Cape Cod and the Islands. Memory screenings also are available through Edgartown Council on Aging staff member Victoria Haeselbarth.

“I offer them to the whole Island community at my office here at the Council on Aging,” Ms. Haeselbarth told The Times. “The screenings take about 20 minutes. Afterwards we sit down and review them, and they’re a good starting point, providing information that the individual can then take to their doctor or neuropsychologist.” Screenings are available by appointment Monday through Friday, 9 am to 4 pm.

Ms. Haeselbarth also helps run a memory loss support group at Martha’s Vineyard Community Services (MVCS) with Nancy Langman, Island Counseling Center Program Director. The Farm Neck Foundation awarded Ms. Langman a grant to start the support group, which meets at MVCS at 9:30 am every Wednesday.

“It’s basically for people who are in the early stages of memory loss,” Ms. Haeselbarth said. “We provide people who attend a lot of information they can use to improve their lives.”

Worries about cost

“If you’re worried about early stage Alzheimer’s, then you need to be talking to somebody,” Mr. Bergeron said. “If you’re kind of in the middle of it, don’t just hide or just assume this is going to go away. You need to figure out a plan.”

“Later on, as the disease progresses, you don’t have to be afraid, especially if there are two of you, that whichever one develops this will inevitably have to go to a nursing home,” he added. “There are alternatives, and the government wants you to use those alternatives and to stay out of a nursing home.”

MassHealth is the one state government program that pays for the residential component of ongoing care in a nursing home, Mr. Bergeron said. There are, however, some strict financial eligibility rules.

For example, to qualify for MassHealth, a person can only have assets of $2,000 or less. If the person owns a home, MassHealth puts a lien on the house to recover funds after death.

Mr. Bergeron outlined some financial planning strategies that seniors can consider to legally protect their homes and other assets, which vary according to their marital status and family situations.

A married couple, for example, may protect each other by keeping their assets in individual names and by having wills with a testamentary trust for the benefit of the other spouse, Mr. Bergeron said. They should also have a power of attorney document, so that they can transfer their assets to each other if one goes into a nursing home.

The comfort of home

For seniors who want to stay in their homes, Mr. Bergeron said proper planning and knowledge of programs offered by MassHealth, such as the Frail Elder Waiver, can help. The waiver allows seniors that are in need of nursing home level care to receive substantial services in order to remain at home, even those with late stage dementia or Alzheimer’s. The home can be the senior’s home, a relative’s home or even an assisted living facility.

As Mr. Bergeron explained, waiver applicants must meet certain medical and financial eligibility requirements, in accordance with MassHealth regulations.

Once qualified for the waiver, a senior can receive services such as home health aides and/or visiting nurses, adult day care, transportation, and other home-based care. The program will even pay family members to provide care.

“The arbiter of whether you are eligible for nursing home care and whether there’s a plan that MassHealth should be paying so you won’t go to a nursing home is Elder Services of Cape Cod and the Islands,” Mr. Bergeron said. He suggested seniors contact their town Council on Aging for more information.

“Consider yourselves lucky that you’re on Martha’s Vineyard,” Mr. Bergeron said. “Because you’ve got programs here that in many other parts of the state just don’t exist. I think there’s a special sense of community here.”

About 50 people attended the April 1 program on dementia, the first in a series on elder law topics planned for 2013. Mr. Bergeron, an attorney in the Mirick O’Connell law firm in Worcester, has practiced law in Massachusetts for more than 30 years. Elder law, estate planning, probate and trust administration, and land use matters are his focus.

Mr. Bergeron frequently provides educational programs on elder law topics to Councils on Aging, which he began offering on Martha’s Vineyard in 2009. His paralegal, Brenda Costa, is a native of the Island and the daughter of Joe and Vivian Costa of Tisbury.

For more information:

Alzheimer’s Association, 24-hour helpline 1-800-272-3900,

Attorney Arthur Bergeron, Mirick O’Connell Attorneys at Law, 1-800-922-8337.

Edgartown Council on Aging, Victoria Haeselbarth, 508-627-4368, ext. 15, memory screenings and memory loss support group.

Elder Services of Cape Cod and the Islands, Martha’s Vineyard office, 508-693-4393,, information about MassHealth and senior services.

Hope Dementia and Alzheimer’s Services, 508-775-5656,, memory screenings and other resources.

Martha’s Vineyard Center for Living, 508-939-9440, Supportive Day Program.

Martha’s Vineyard Community Services, Nancy Langman, 508-693-7900, memory loss support group.

Alzheimer’s Disease

Early Warning Signs

*Memory loss that disrupts daily life

*Challenges in planning or solving problems

*Difficulty completing familiar tasks at home, at work or at leisure

*Confusion with time or place

*Trouble understanding visual images and spatial relationships

*New problems with words in speaking or writing

*Misplacing things and losing the ability to retrace steps

*Decreased or poor judgment

*Withdrawal from work or social activities

*Changes in mood and personality