January 2017 Newsletter

Reversible and Irreversible Dementias


The Mind

Most forms of dementias are irreversible, but not all. Some conditions can cause dementia or dementia-like symptoms. Often these signs of dementia present rather suddenly and acutely. With the right course of treatment, these types of dementia can be controlled and possibly cured. That’s why it is important to get a diagnosis as early as possible.  

Common causes of reversible dementias:

  • Depression
  • Medication (side effects, drug interactions, drug overdose)
  • Alcohol abuse
  • Drug abuse
  • Dietary, vitamin and mineral deficiencies (A, C, B-12 and foliate)
  • Traumas (due to falls, concussions or contusions to the head)
  • Hormonal dysfunction (thyroid problems)
  • Metabolic disorders (dehydration, kidney failure, COPD)
  • Infections
  • Heart disease
  • Brain disease (tumors)
  • Sleep deprivation

Please see your doctor if you are concerned about memory loss or any other symptoms of these conditions.

Irreversible dementias are progressive neurological disorders for which there is no medication to cure. Approximately 60% of irreversible dementia results from Alzheimer’s disease.

Another common cause of irreversible dementias is Vascular Dementia or Multi-infarct Dementia. This type of dementia is caused by a series of pockets of deteriorated tissue in the brain that cause a very erratic or unpredictable pattern. These, in turn, are caused by multiple, small "mini-strokes" in the brain brought on by bleeding or lack of blood flow to the brain's blood vessels. Hypertension (high blood pressure) and arteriosclerosis (hardening of the arteries) are precursors to these mini-strokes.

How is Vascular Dementia diagnosed?

Brain scans, such as a computerized tomography (CT) scan can check for signs of a stroke or brain tumor, or a magnetic resonance imaging (MRI) scan can detect any shrinking of the brain. A PET scan delivers the most accurate and suggestive results while diagnosing dementia. The most accurate form of PET scanning for types of dementia is called Stereotactic Surface Projection, which involves an advanced statistical analysis of the data. In addition, a heart rhythm test called an electrocardiogram (ECG) can be used in addition to determine the diagnosis.                      

Other neurological diseases causing irreversible dementia include:

  • Parkinson's disease
  • Huntington's Chorea
  • Pick's disease
  • Creutzfeldt-Jakob disease
  • Down's Syndrome
  • AIDS

More information on these types of irreversible dementias can be found on: https://www.caring.com/articles/types-of-dementia

If you have concerns or need a referral contact me


Reducing Caregiver’s Guilt



Anyone who is assuming the responsibilities associated with caring for a family member with dementia knows how difficult, demanding and time-consuming life has become. Dealing with the ever-changing nature of the disease impacts most caregivers often resulting in stress, fatigue, mounting worry and even depression.

In my work with caregivers individually and in caregiver support groups, I present options to lessen the load by dividing up caregiver responsibilities between family members, friends or paid help, I often hear a litany of why this isn’t possible. Typical responses are, “ I shouldn’t leave my loved one”, “I shouldn’t take time out for myself” or “I shouldn’t spend money on myself”.  Although these responses are understandable, they fall under the category of caregiver quilt.  So the question is, how do we reduce guilt?


Here are some tips that can help you:

  1. Recognize the warning sign of caregiver stress which can include: irritability, fatigue, over or under eating, sleeplessness, decline in social activities, confusion, depression
  2. Make a list of what you enjoy doing such as: taking a walk, reading a book, meeting a friend for coffee, going to a lecture or a movie, browsing in a store.
  3. Listen when friends or family members ask if there is anything they can do for you or anything you need. People who offer would like you to accept their help.
  4. Start taking time for yourself in small amounts and continue to build in small increments.
  5. Take time off from caregiving on a planned weekly basis.
  6. Follow up the assistance you receive with a phone call, note or even a hug.

Current research stresses that for caregivers to sustain their commitment to caring for another, they must take care of themselves while taking care of another. www.caregiverstress.com ›

If you are feeling stuck, contact me and I will support you with strategies to be a caregiver while, at the same time, caring for yourself. 



Effective January 1, 2017



The current Medicare and Medicaid allowances for 2017 has been revised. I am sharing this information that was passed on to me by Benjamin D.Eckman, an elder law attorney practicing in New Jersey. 

Medicare Part A deductible: $1316 for each benefit period.

Medicare Part A hospital stay day 1-60: $0 co-insurance for each benefit period.

Medicare Part A hospital stay day 61-90: $329/day co-insurance for each benefit period.

Medicare Part A hospital stay beyond 91 days: $658/day co-insurance for each benefit period.

Medicare Part B Premium: $134/month

Medicare Part B Deductible: $183/year

Medicare Skilled nursing home co-payment day 21-100: $164.50/day

Medicaid Individual Resource Allowance: $2000.00

Resource Allowance for a Couple who both reside in a facility: $3,000.00

Medicaid Community Spouse Resource Allowance: Minimum $24,180.00; Maximum $120,900.00

Medicaid Monthly Maintenance Needs Allowance: Minimum $2,002.50; Maximum $3,022.50

Medicaid Monthly Personal Needs Allowance: $35.00/month

Medicaid Divestment Penalty Divisor: $332.50/day

Medicaid Income Cap Limit: When is a Miller Trust required? $2205/month

Principal Residence Equity Exclusion: $840,000.00

Community Spouse Monthly Housing Allowance: $600.75

Standard Heating & Utility Allowance: $501.00

Federal Estate Tax Threshold: $5,490,000

Federal Gift Tax Exclusion: $14,000.00

NJ Estate Tax Threshold: $2,000,000.00

NJ Inheritance Tax: Class A & E exempt

For more information go to: http://www.nj.gov/humanservices/doas/services/ship/

Please feel free to Contact