News

Understanding the Shocking Link Between Sleep Problems and Dementia

The Institute for Dementia Research & Prevention reports that approximately 1-in-10 men and 1-in-6 women will likely be diagnosed with symptoms of dementia after they reach the age of 55.  The most common form of dementia is Alzheimer’s disease. In fact, more than 60 percent of dementia patients are subsequently diagnosed with Alzheimer’s disease.

What Exactly is Dementia?

Dementia is a fairly broad term that includes a number of pathophysiological conditions. For example, the most common form of dementia is Alzheimer’s disease. Nevertheless, forms of dementia include Parkinson’s disease, Shy-Drager syndrome, Huntington’s disease, and Creutzfeldt-Jakob disease.

The Connection Between Sleep Disorders and Dementia

The link between sleep issues and dementia share the same conundrum as the chicken and the egg – do people with dementia simply have sleep problems, or do sleep problems contribute to the development of dementia?  The definitive answer remains unknown, but is the subject of multiple studies.

Check out this NBC News report about the link between sleep problems and dementia:

How Chronic Insomnia Could be an Early Predictor of Dementia

A link was discovered between sleep deprivation and increased risk for Alzheimer’s in a recent medical study. Researchers notes that levels of amyloid-beta protein in the bloodstream increased during waking periods and declined during sleep. This is important because amyloid-beta protein can be found in the brain plaques that are prevalent in patients with Alzheimer’s disease.
Patients with dementia often suffer from sleep apnea for much of their life, including chronic snoring and sleep disturbances. Many experts believe sleep apnea is directly correlated to the development of severe dementia. For example, studies have shown that 90 percent of Alzheimer’s patients reported at least five respiratory events per hour of sleep.

Have Questions About Long-Term Care? Speak to an Experienced Estate Planning Attorney

If you are taking care of an elderly loved one or are concerned about a loved one needing long-term care, consider reaching out to an experienced Ashburn estate planning attorney for advice. In addition, check out these helpful resources that go more in-depth on the link between dementia and sleep disorders:

Guide to Dementia and Sleep Disorders

Seniors’ Guide to Sleep and Aging

Skin in the Game – Should Doctors Comply with a “Do Not Resuscitate” Tattoo?

Many patients find it difficult to communicate their end-of-life wishes to family members and doctors at critical points of time, especially if you are confronted with a sudden or unexpected ailment. There are legal documents designed to help address this important issue. For example, your estate planning attorney can draft an advance directive that tells your doctor and loved ones what kind of medical care you desire if you are incapacitated or deemed unable to make such decisions. You can also draft a do-not-resuscitate (DNR) order to be included with your advance directive. A DNR is a request not to have CPR administered if your heart stops or if you stop breathing. Your doctor should place the DNR order in your medical chart and doctors and hospitals in most states accept DNR orders.

But what if you tattoo “Do Not Resuscitate” on your body? Are doctors obligated to treat this marking as a medical directive? Well, a hospital in Florida encountered this very situation.

A man was admitted to the hospital, unconscious, with a history of serious health problems and a high blood alcohol level. He had no identification and no family accompanied him to the hospital. Oh yeah, he had “Do Not Resuscitate” tattooed on his chest.

Upon discovering the tattoo, doctors were inclined to ignore it. They reasoned that a DNR is such a serious matter, they did not want to throw caution to the wind. They were preparing to treat the patient when the hospital’s ethics consultant chimed in and recommended the doctors comply with the DNR tattoo. 

Check out this news report about the Do Not Resuscitate Tattoo

The ethics consultant suggested that it was most reasonable to infer that the tattoo expressed an authentic preference, that what might be seen as caution could also be seen as standing on ceremony, and that the law is sometimes not nimble enough to support patient-centered care and respect for patients’ best interests, according to CNN.com. Another development strengthened the consultant’s recommendation. The hospital’s social work department found a copy of the patient’s “out-of-hospital” do not resuscitate order. As a result, the tattooed request was respected.

Navigating DNR Laws

The laws and regulations concerning DNR orders can be quite complex and will vary from state to state.

In Virginia, DNR orders are governed by § 54.1-2987.1(B), and states that a valid DNR order “may be issued by a physician for his patient with whom he has a bona fide physician/patient relationship as defined in the guidelines of the Board of Medicine, and only with the consent of the patient or, if the patient is a minor or is otherwise incapable of making an informed decision regarding consent for such an order, upon the request of and with the consent of the person authorized to consent on the patient’s behalf.” Although a DNR may be issued by a physician, historically an Advance Medical Directive has been the legal document that only licensed attorneys could counsel and draft for individuals.  This year, Virginia passed a law that would permit certified health professionals to counsel individuals on directives as well.  In Maryland, you should complete a Medical Orders for Life-Sustaining Treatment (MOLST) form. Keep in mind, under Maryland Statutes § 5-6081, a health care provider must sign the MOLST form to make it valid.

Speak to an Experienced Advance Medical Directive Lawyer Today

If you have questions about your Advance Medical Directive, or need this legal document drafted as part of a comprehensive estate plan, now the time to reach out to InSight Law to schedule a meeting. Sitting down with Bobby Feisee or one of the other seasoned lawyers at InSight Law to discuss your situation will be a productive and pleasant experience. The experienced attorneys at InSight Law can design a plan that perfectly matches your goals and needs, protects your assets and family, and provides you with peace of mind. Contact our office today by calling 703-654-6019 or filling out a quick contact form on our web site.

 

Estate Tax May Survive Federal Tax Reform

Congress is in the midst of debating tax reform which features an attempt to possibly repeal the federal estate tax (also referred to as the “death tax”). This tax typically effects high value estates that can result in a whopping 40 percent estate tax. In fact, the 40 percent estate tax affects approximately 0.2 percent of estates in America. That translates to 5,460 estates in 2017, according to the nonpartisan Tax Policy Institute. Though, there are sizable exemptions to the estate tax under current law. For example, in 2017, the estate tax exemption is $5.49 million per individual. This means an individual can leave $5.49 million to their heirs and pay no federal estate or gift tax, according to Forbes.

There has been long-held criticism behind the premise of the federal estate tax, especially in conservative circles. They point out that the estate tax is essentially a double-tax on hard-earned income and harms family-owned businesses and farms.

Stalled Negotiations Causing Lawmakers to Drop Estate Tax from Comprehensive Tax Reform

After months of debate, Republican members of Congress have found themselves between a rock and hard place. They are reportedly no longer even considering a full-fledged, comprehensive revamp of the tax code. Instead, they are focused on trying to put together a package of tax cuts for individuals and businesses that can pass both the House and Senate. In order to offset the lost revenue from these proposed tax cuts, members of Congress are considering keeping the estate tax since it is projected to raise revenue between $25 billion and $34 billion annually over the next decade.

If the estate tax repeal is dropped from the tax package, it could create a pathway to a bipartisan agreement where both Democrats and Republicans can get on board. However, dropping the estate tax repeal may actually make it harder to get through the House of Representatives since many conservative Republicans have campaigned on repealing the tax.

Other Legislative Options

If repeal is abandoned, there are other ways the estate tax could be modified. For example, lawmakers could create a higher exemption amount so even less estates are exposed to the 40 percent tax. Or, they could lower the tax rate so it is less onerous for the estates hit with the tax. Another option is a finite repeal where estates would essentially get an “estate tax holiday” for a few years. This would allow Congress to declare that they repealed the tax but keep some of the revenue projections in the legislation.

States Already Taking Action

I recently blogged about the steps many states have taken to modify or eliminate their estate taxes. It seems appropriate that the federal estate tax is now being reviewed by members of Congress. Whether or not the tax is actually repealed remains anyone’s guess.

Contact an Experienced Trust and Estate Planning Attorney Today

If you are concerned about how the estate tax might affect your estate plan, contact InSight Law today. Our team of experienced trust and estate planning attorneys possess a deep understanding of the estate tax and other relevant provisions within the tax code. Contact our office today to schedule a meeting.

Tips to Protect Yourself from The Equifax Credit Breach

Equifax, one of the “Big 3” credit reporting agencies (including Experian and TransUnion respectively) announced a massive data breach impacting an estimated 143 million consumers. Experts have declared this to be the worst consumer data breach in U.S. history. The breach means that nefarious characters now have access to Social Security numbers, dates of birth and address information of 143 million Americans.

Massachusetts Attorney General Maura Healey described the breach of Equifax to be “the most brazen failure to protect consumer data we have ever seen,” according to NPR.org. Several state AGs and the Federal Trade Commission have opened investigations into Equifax’s practices and policies. Members of Congress have demanded criminal investigations and a full accounting of what exactly happened to allow the personal information of 100+ million people to become accessible to criminals.

Take Action

Now is the time to take action and protect yourself and the health of your credit. One of the best tips being recommended my multiple financial advisors is to put a credit freeze on reports of Equifax, Experience, and TransUnion.

What Exactly is a Credit Freeze?

A credit freeze essentially prevents new credit accounts or loans from being opened in your name. After placing the freeze, you will set up or receive a unique personal identification number (PIN) to remove the freeze, according to Forbes.com.

A credit freeze will not help or harm your credit score. A credit freeze protects you more than enhanced monitoring or fraud alerts. With enhanced monitoring, agencies send an email or text if someone attempts to apply for a loan or account in your name.

Credit Freeze Not Free

There is a cost to freeze your credit and those costs vary from state-to-state. Residents of Virginia and D.C. typically pay $10 for a credit freeze and $0 to unfreeze the reports later on. Residents of Maryland pay $5 to freeze and $5 to unfreeze the reports. However, Equifax agreed to waive its freeze fees until November 21, 2017. Experian and TransUnion have not (as of yet) offered to waive their fees. If you were the victim of identity theft, you do not have to pay a fee in any state.
Unfreezing your credit will be necessary at some point in for you to apply for a new credit account or loan (e.g., mortgage, credit card, auto loan, etc.).

Other Steps You Should Take

In addition to freezing your credit, it is important to regularly check your credit reports. You are entitled to a complimentary, no-cost credit report every 12 months from each of the three major consumer reporting companies. You should also monitor every bank statement, put fraud alerts on your credit cards, and file tax returns as early as possible to try to prevent fraudulent filings, according to the aforementioned NPR.org article.

Do Not Delay

The moral of this blog is that you need to be proactive and take action. Just crossing your fingers and hoping you will not be effected is the wrong strategy. You need to protect your identity and your credit score

Multiple States Reducing Estate Tax Threat for Families and Businesses

Since 2014, approximately nine states have eliminated or lowered their estate taxes. This was accomplished primarily by modifying and increasing specific exemptions thereby reducing the number of households that could be hit with a large estate tax bill.

For example, Maryland is planning to raise its current $3 million estate tax exemption to $4 million in 2018. The District of Columbia is ahead of the game. In 2014, D.C. passed a major tax reform deal that included increasing its estate tax exemption amount from $1 million to $2 million at the start of 2017 and to ultimately match the generous federal exemption level ($5.49 million for 2017, indexed for inflation), starting in 2018, according to Forbes.

Other states are going even further. For example, New Jersey plans to eliminate its estate tax entirely, according to the Wall Street Journal. Currently, six states have repealed their estate taxes over the past 10 years, including Virginia.

Why are States Reducing Estate Taxes?

The modifications to estate tax laws is largely driven by competition between governors and legislatures hungry for affluent and wealthy taxpayers to relocate to their respective states. Such residents owe income taxes every year, but some are willing to move out of state to avoid death taxes.

Increased exemptions to estate taxes are not just a state policy. In fact, the federal estate-and-gift tax exemption increased to $5 million in 2011.

Check out Bobby’s video explaining the basics of estate taxes:

States Also Looking to Modify Inheritance Taxes

While most recent changes have been to state estate taxes, some states with inheritance taxes are looking to make reforms to ease the tax burden on families. Six states currently tax a beneficiary who inherits assets from a deceased loved one. Inheritance tax rates and exemptions often vary according to their relation to the decedent. For example, in Nebraska, there is no tax on assets left to a surviving spouse. However, if a sibling inherits an asset, they are subject to a 1 percent inheritance tax. Assets left to a non-relative (e.g., a close friend) in Nebraska are subjected to a potential 18 percent inheritance tax.

Maryland has both estate and inheritance taxes  and, as mentioned, the state legislature is planning to modify the estate tax exemption. There are no plans to modify the inheritance tax provisions under current law. Virginia, on the other hand, does not impose an inheritance tax. Also, as mentioned, Virginia no longer imposes an estate tax. The Legislature repealed the estate tax entirely in 2006. The more attractive and hospitable estate tax policies in Virginia make it much more attractive for high-income and wealthy individuals when compared to Maryland.

Speak to an Experienced Estate Planning Attorney Today

Although the gradual elimination of the state estate tax is a step in the right direction, the federal estate tax remains. In addition, taxes should not be the sole motivation for estate planning.  If peace of mind and protecting your family is an important goal for you then you should talk to an experienced estate planning attorney about the other risks your estate is faced besides the tax risk. Our team of experienced trust and estate planning attorneys possess a deep understanding of estate and inheritance tax laws as well as other common risks your family and estate will likely face. Contact our office to learn more.

Multiple States Reducing Estate Tax Threat for Families and Businesses

Since 2014, approximately nine states have eliminated or lowered their estate taxes. This was accomplished primarily by modifying and increasing specific exemptions thereby reducing the number of households that could be hit with a large estate tax bill.

For example, Maryland is planning to raise its current $3 million estate tax exemption to $4 million in 2018. The District of Columbia is ahead of the game. In 2014, D.C. passed a major tax reform deal that included increasing its estate tax exemption amount from $1 million to $2 million at the start of 2017 and to ultimately match the generous federal exemption level ($5.49 million for 2017, indexed for inflation), starting in 2018, according to Forbes.

Other states are going even further. For example, New Jersey plans to eliminate its estate tax entirely, according to the Wall Street Journal. Currently, six states have repealed their estate taxes over the past 10 years, including Virginia.

Why are States Reducing Estate Taxes?

The modifications to estate tax laws is largely driven by competition between governors and legislatures hungry for affluent and wealthy taxpayers to relocate to their respective states. Such residents owe income taxes every year, but some are willing to move out of state to avoid death taxes.

Increased exemptions to estate taxes are not just a state policy. In fact, the federal estate-and-gift tax exemption increased to $5 million in 2011.

Check out Bobby’s video explaining the basics of estate taxes:

States Also Looking to Modify Inheritance Taxes

While most recent changes have been to state estate taxes, some states with inheritance taxes are looking to make reforms to ease the tax burden on families. Six states currently tax a beneficiary who inherits assets from a deceased loved one. Inheritance tax rates and exemptions often vary according to their relation to the decedent. For example, in Nebraska, there is no tax on assets left to a surviving spouse. However, if a sibling inherits an asset, they are subject to a 1 percent inheritance tax. Assets left to a non-relative (e.g., a close friend) in Nebraska are subjected to a potential 18 percent inheritance tax.

Maryland has both estate and inheritance taxes  and, as mentioned, the state legislature is planning to modify the estate tax exemption. There are no plans to modify the inheritance tax provisions under current law. Virginia, on the other hand, does not impose an inheritance tax. Also, as mentioned, Virginia no longer imposes an estate tax. The Legislature repealed the estate tax entirely in 2006. The more attractive and hospitable estate tax policies in Virginia make it much more attractive for high-income and wealthy individuals when compared to Maryland.

Speak to an Experienced Estate Planning Attorney Today

Although the gradual elimination of the state estate tax is a step in the right direction, the federal estate tax remains. In addition, taxes should not be the sole motivation for estate planning.  If peace of mind and protecting your family is an important goal for you then you should talk to an experienced estate planning attorney about the other risks your estate is faced besides the tax risk. Our team of experienced trust and estate planning attorneys possess a deep understanding of estate and inheritance tax laws as well as other common risks your family and estate will likely face. Contact our office to learn more.