Jill Rosner, R.N., B.S.N. – Guest Contributor – Rosner Healthcare Navigation

Most of my articles come from my experiences in my daily life as an Aging Life Care Manager.  All of the topics are meant to educate my readers and bring awareness to issues related to health and aging.  Many of my clients are living with some form of dementia. The take-home message that I want everyone to know is that dementia does not come with a list of manifestations that do or will happen to everyone affected.  There is no cookie cutter Alzheimer’s disease or form of dementia.

The most frequently asked question in which I encounter from my client’s family members tends to be: “What is the difference between Alzheimer’s disease and dementia?”

The terms have become almost interchangeable over the years. The reason perhaps is because Alzheimer’s disease accounts for the largest percentage of diseases causing the symptoms, which are referred to as dementia.  Dementia itself is not a disease process; instead dementia is a group of symptoms caused by a disease.

It is perhaps easiest to think in terms of diseases that cause symptoms that have other consequences to the rest of the body.  For example, diabetes, which causes high blood sugar and the effects of having a high blood sugar.  The symptom of high blood sugar and the consequences that accompany diabetes is a result of an unhealthy pancreas, which is not functioning properly.  The pancreas either does not produce insulin or produces too little or is resistant to insulin, depending on what kind of diabetes is diagnosed.  So, the high blood sugar and other symptoms is not the disease itself but rather the result of an unhealthy pancreas or a disease affecting the pancreas.

The same holds true for dementia.  Dementia is not the disease but rather the symptoms caused by an unhealthy brain or neurologic disease affecting the brain.

Alzheimer’s disease

While Alzheimer’s disease has most often been considered to be the culprit of these symptoms, there are many other forms of diseases affecting the brain causing dementia symptoms. Vascular disease, high blood pressure, stroke or transient ischemic attacks (TIAs) can lead to damage in the blood vessels in the brain, which can lead to a condition called vascular dementia.  A condition, which causes formation of what is called Lewy bodies in the brain, which, causes a disruptive in the brain’s functioning, and is referred to Lewy Body Dementia.  Frontal temporal dementia affects the frontal and temporal lobes of the brain, and results in symptoms of dementia.  These are just the top of the list of causes of the symptoms of dementia.  Various other forms of dementia exist.

The most important piece to remember is that all types of brain diseases that cause dementia symptoms may have different manifestations or different symptoms.  This has been an increasingly important issue.  It’s no longer your great-grandmother’s dementia.  Once referred to as senility, the symptoms we think of are those of the very “old” person who has lost their memory and shuffles about – perhaps wandering and eating too many sweets – are the easiest to diagnose. However, the less common symptoms or behaviors are becoming more of a problem in the diagnosis of dementia.

I am seeing more and more patients affected by dementia at a younger age and more and more patients affected by symptoms that are not typical and may be less obvious signs.  I have seen patients dismissed and assured that they are just fine because they don’t fit the old, outdated mold.  I recently had a nurse say to me “she is too young to have dementia” when my client clearly had been diagnosed and had severe symptoms of dementia.  Even modern medicine and practice has not caught up to the realities of the epidemic of brain dysfunction that is causing myriad of symptoms.

The most disturbing lack of insight comes from the lack of knowledge that memory loss does not have to have the primary symptom of dementia.  Too may people are being misdiagnosed or not diagnosed at all because they are able to answer the typical type of questions such as “What’s your name?  What’s the date?  Who is the president?” and a few others.  Amnesia or memory loss is just one symptom, and for some forms of dementia, memory loss is not the prominent feature!

In the case where the frontal lobe of the brain has been more severely affected by frontal-temporal dementia, shrinking of the brain or injury of some sort in the case of vascular dementia, the symptoms may be very different from that of Alzheimer’s disease – where the memory is primarily affected.

The frontal lobe affects behaviors such as impulse control, the filter between the thoughts and the spoken word.  For example, some behaviors include: blurting out inappropriate language or taboo thoughts and executive functioning.  The ability to sequence and organize is affected.  Insight and judgment are affected.  This sets the stage for exploitation and poor decision-making.  Paranoia and delusions can be features of dementia.

More and more I see clients who don’t have the typical memory loss, and therefore are not being recognized as having a cognitive impairment or dementia.  These unfortunate people are making terrible decisions, are being financially exploited and are often taken advantage of during everyday life.  They are often subject of undue influence where they are easily manipulated into complying with the wishes of another, without understanding the consequences of their actions and acting of their own free will because their judgment is affected. This different or unusual manifestation of dementia often leads to the misdiagnosis and misunderstanding of dementia.

The main messages again is this:  Do not assume that all forms of dementia produce the same symptoms or have the same consequences.  Just because one’s memory seems to be fairly good does not mean that the person is not impaired.  Do not make assumptions! It’s a new and ever evolving world of dementia.  If you recognize that something is just “not right” with your loved one, friend or co-worker, I encourage you to tell their doctor, discuss your observations with others who have contact with the affected person, and advocate for intervention.  You could be saving that person from being taken advantage of or being overlooked as having a problem. Far too often the problem is not addressed until way too late in the course of the disease process.

For more information contact the Alzheimer’s Association at www.alz.org.

Jill Rosner is a registered nurse, certified geriatric care manager and owner of Rosner Healthcare Navigation.  She provides patient advocacy and care management services to clients with health and aging issues.  Contact her at JillRosnerRN@aol.com

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By: Jeffrey D. Stauffer – Community Relations Director, jeff@elvilleassociates.com, 443-393-7696

On December 10th, Elville and Associates hosted its first quarterly Client Care Program Continuing Legal Education Event at the John A. Cade Performing Arts Center on the campus of Anne Arundel Community College.  35 Client Care Program (CCP) members and other interested client guests attended the workshop titled, “What to Do Upon the Death of a Friend or Loved One – the Post Mortem Process for Estate and Trust Administration Explained.”  Presenting at the event were Stephen R. Elville, principal at Elville and Associates; Gary Greenwald, principal at the Law Office of Gary Greenwald, P.C.; and Matthew F. Penater, partner at Elville and Associates.  Attendees enjoyed gourmet box lunches, snacks, drinks and the opportunity to get to know one another during the Event.

Last fall, after much planning and design, Elville and Associates made the CCP available to its clients.  The mission of the CCP (“planning that works”) is to provide clients with the comfort and assurance that their estate and elder law plans will work no matter how their goals or situations may change over time, and to ensure planning remains consistent with changes in the laws.  Included in the program are educational workshops for clients, their families and fiduciaries; and funding updates; enrollment in DocuBank, an annual social event, and discounted services; coordination with your planning team professionals (financial advisor, CPA, insurance agent, advocate);  enrollment in Everplans – a state-of-the-art, digital archive for all of your essential information; and additional participant benefits such as fun family events.

On May 5^th and 6^th, 2016, the entire estate planning and elder law team of Elville and Associates, along with key support staff members, attended the Client Maintenance Academy in Boston, Massachusetts, to become certified in client maintenance and updating, becoming only the 43rd law firm in the U.S. to attend the Client Maintenance Academy.  Elville and Associates has always been a thought leader in client maintenance and updating through its on-going client legal education programs, family care meetings, and annual Client Education Event.  The firm’s affiliation with the Client Maintenance Academy now puts the firm squarely in the forefront as the leader in estate planning, elder law, and special needs client maintenance and updating in Maryland.

Elville and Associates’ next quarterly CCP event, “Trustee Workshop,” will be held on Saturday, April 1st at 10 a.m. at the same location on the campus of Anne Arundel Community College.

For more information about the Client Care Program, please contact Asset Alignment Coordinator and Executive Legal Assistant Mary Guay Kramer at 443-741-3635.  Information about the CCP may also be found on our website at www.elvilleassociates-staging.bgbshlgq-liquidwebsites.com.

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Jeffrey D. Stauffer, Executive Director, jeff@elvillecenter.org; 443-393-7696

A young girl is singing in a recording studio to music she composed herself.  A seventh grader who didn’t have his own trumpet last semester is now practicing at home to hit that high G for the first time.  A middle school jazz band is listening to a replay of its winter concert on a new stereo system with HD speakers in its classroom.  And, a third grader is handed a clarinet he’s always wanted to play for the first time and squeaks out the first note to the delight of his teacher.

Founded in 2014 by Mr. Stephen R. Elville, Esq., the mission of the Elville Center for the Creative Arts is to improve the quality of life of children of all ages by providing them the opportunity to learn music theory and application, experience cultural events related to the musical and creative arts, and to use music and the promotion of music-related activities to transcend social and economic divisions.

Since our last update, the Elville Center has continued to develop new relationships, including the music programs at George T. Cromwell Elementary in Glen Burnie, and Brooklyn Park Elementary in Baltimore.  We recently visited with the Instrumental Music Director of these schools, Ms. Carol Cox, and found her to be very dedicated to her students and working hard to give the gift of music to them despite few resources at her disposal.

Ms. Cox mentioned that lack of funding for music at her schools doesn’t allow her to replace supplies once they are depleted, nor fix equipment and instruments when they break.  The Elville Center encouraged her to provide a “wish list” of items that would benefit her classroom and students, which she quickly provided.  Ms. Cox was also the first teacher to invite me to visit one of her classes during a “live session,” and I gladly accepted her offer.

A follow-up visit was set in November to deliver much-need items to benefit her schools’ music programs, including: an LG stereo system with CD player and Bluetooth capability; a trombone hard case, alto sax case, bass clarinet case, and trumpet case; boxes of reeds for clarinets and saxophones, oils and rosins; mouthpieces for instruments; and swabs for saxophones and clarinets.

The November delivery was just the beginning for Ms. Cox and her students, as the Elville Center visited George T. Cromwell again in December for an early holiday delivery to fulfill more items on her wish list.  During this trip, the Elville Center assisted the music programs with three fully-refurbished violins with cases and new bows; three additional new violin cases for their existing instruments; snare drum stands, cello rock stop straps; and a bell kit with case.

“So many of our students don’t have access to an instrument or have the means to rent or buy one.  I’ve seen music brighten the lives of so many students who face difficult challenges in and out of school,” noted Ms. Cox.  “The school’s funds and equipment are lacking to meet the needs of all our students, so the extraordinary donations from the Elville Center for the Creative Arts are helping to bring music to more of our children.  The kids’ excitement when presented with new equipment can’t be compared to anything except to how they might respond to a ton of Christmas gifts!  Thank you to the Elville Center for elevating my students’ musical experience this year with your generous donations!”

The Elville Center’s relationship continues to grow with Dr. Max VanDerBeek and the music program at Wiley H. Bates Middle School.  As readers may recall, Bates Middle is home to a Performing and Visual Arts (PVA) Middle School Magnet Program, which is designed to provide students who demonstrate artistic ability, interest and potential a curriculum of rigorous training that emphasizes the creative process through collaborative opportunities.  However, due to financial constraints, many of the school’s students do not have the means to participate in music without some outside support.

Over the past several months, the Elville Center has supported Dr. VanDerBeek and the Bates music program with a wide variety of contributions, including three donated, refurbished trumpets; a donated Mapex drum set with cymbals; a donated set of conga drums; a donated, refurbished clarinet; two donated, refurbished flutes with new cases; a new keyboard case; new drum cases; reeds
for various instruments and contributions towards repairs for instruments in its current inventory.

“We can’t thank the Elville Center enough for its support over the past two years,” said Dr. VanDerBeek.  “We’ve received over 30 instruments from the Elville Center and the difference they’ve made in our music program can’t be put into words.”

In January, the Elville Center’s Executive Director, Jeffrey Stauffer, and Dr. VanDerBeek, were interviewed by Jonathan Palevsky, popular radio personality at 91.5 WBJC, to discuss our partnership with Bates Middle School as well as our partnership with the classical music station.  The interview can be heard in its entirety on the Elville Center’s website, www.elvillecenter.org.

“On behalf of the students and administration of Bates Middle School, we are extremely grateful to the Elville Center for our relationship,” said Dr. VanDerBeek.  “They’ve given us wonderful, responsive support that has benefited our program so much.”

Mr. Elville and the Elville Center were recently featured in the 2017 Maryland Edition of Super Lawyers Magazine in the publication’s “Good Works – Lawyers Giving Back” section.  The article discusses how Mr. Elville created the idea for the Charity, looked back on student Daniel Coleman’s initial involvement in developing the Charity’s first school relationship, and talked about the Charity’s desire to make an impact in the Baltimore City school systems, where the needs are most pressing.

“Mr. Elville and the Center have brought a whole new level of music to my life.  Now that we have the instruments to learn, my peers and I are able to not just enjoy other people’s music, but our own,” said Daniel.  “Students have spoken to me about how over the last couple of years, they were not able to play the instruments themselves, but rather on practice on paper.  At school, they used to print out a picture of a piano keyboard and my friends would only be able to ‘play’ on the paper; they never were able to heard the notes.  Now they get to enjoy the sound of the music they make.”

A link to the Super Lawyers article can be found on the Elville Center’s website, www.elvillecenter.org.

As was mentioned in the Super Lawyers article, the Charity has learned that, while there are needs to be fulfilled all over Maryland, the needs of Baltimore City schools’ are the most dire, and funding is needed for the Elville Center to work to fulfill the needs of these and other schools.  An example is Franklin Square Elementary and Middle School in downtown Baltimore, whose band director, Mr. Marcus Neal, contacted the Elville Center because his music program did not have working music stands, valve oils, trombone slide oils and other supplies for the third and fourth quarters of this year.  And, for every two children that want to play an instrument in his program, there is only one instrument to go around.

Fortunately, the Elville Center was able to fulfill Franklin Square’s initial needs, and we are actively working to add to the school’s musical instrument inventory.  However, these needs will reoccur, and for every school that contacts the Elville Center, there are 10 in Baltimore City and beyond we have not yet met that have the same needs.  Funding from donors is an integral part of the Charity’s ability to make a difference in the schools’ music programs.

The Elville Center is on the move in 2017, developing new partnerships and fostering existing ones as we continue to “Make a Musical Difference in the Lives of Children.”  And, as a non-profit organization, we depend on the generosity of donors to help make our vision a reality, including donations of used musical instruments and general monetary pledges.  The Elville Center continues to engage in new and exciting initiatives to capture the minds and hearts of our individual and corporate donors and surrounding communities.  These initiatives
and donor opportunities include:

• sponsoring a child (young musician);
• sponsoring a specific school’s music program;
• sponsoring/facilitating a fundraising event;
• making a specifically directed monetary donation;
• making a gift in memoriam;
• volunteering/donating time to the Elville Center; and
• sponsoring the Elville Center through one’s business.

The Elville Center is actively seeking donations to further its important work.  If you would like to donate or learn more about the Elville Center for the Creative Arts and its initiatives, please visit www.elvillecenter.org, or contact Jeff Stauffer at jeff@elvillecenter.org, or 443-393-7696.

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By:  Olivia R. Holcombe-Volke, J.D., olivia@elvilleassociates.com, 443-393-7696

Scenario One:  Mom and Dad meet with Attorney to prepare their estate plan.  Mom and Dad intend to leave their significant wealth to their only child, Daughter.  Happy with Attorney, they advise Daughter to meet with Attorney for her own estate planning.  Daughter, upon becoming a client of Attorney, discusses her plans for using Mom and Dad’s significant wealth after inheriting it.  A year later, following a family disagreement, Mom and Dad contact Attorney to change their estate plan:  now, they wish to leave 25% to Daughter, and 75% to Daughter’s arch-nemesis and rival in the family business, Cousin.

Scenario Two:  Son #2 contacts Attorney.  Dad is experiencing some minor memory loss and confusion.  Son #2 would like Attorney to prepare estate planning documents for Dad.  Attorney determines that Dad has sufficient mental capacity to understand and execute estate planning documents.  Attorney prepares, and Dad executes, the necessary documents.  Several months later, Son #1 contacts Attorney.  Dad’s mental and physical health have gone downhill, and Son #1 wishes to seek a court-ordered guardianship over Dad’s personal and financial affairs.

Scenario Three:  Niece is named as attorney-in-fact in elderly Uncle’s power of attorney.  Nephew is named as trustee in Uncle’s revocable living trust.  Niece and Nephew seek Attorney’s assistance in various aspects of handling Uncle’s property.  At a certain point, a major expense arises.  Niece and Nephew disagree as to whether the expense should be covered, and from which source of funds.

These three scenarios have one thing in common: the potential for, or actual existence of, a conflict of interest.

At the outset, the actions taken by Mom and Dad, Sons #1 and #2, and Niece and Nephew seem so logical.  Why wouldn’t parents who are happy with their estate planning attorney recommend their adult child meet with the same attorney for estate planning?  Why wouldn’t an adult child, faced with an elderly parent’s disability, seek assistance from the elderly parent’s attorney?  Why wouldn’t family members serving in different roles under a family member’s legal documents come to the same attorney for guidance?  These situations are so innocent – how can a conflict of interest possibly arise?

For guidance, it helps to know what a “conflict of interest” is, in the context of attorney-client relationships.  The Maryland Attorneys’ Rules of Professional Conduct, codified in the Maryland Rules at Title 19, Chapter 300 (Md. Rule 19-300.1 et seq) – specifically Rule 19-301.7 – states (in pertinent part):

…(A)n attorney shall not represent a client if the representation involves a conflict of interest. A conflict of interest exists if:

(1)  the representation of one client will be directly adverse to another client; or

(2)  there is a significant risk that the representation of one or more clients will be materially limited by the attorney’s responsibilities to another client, a former client or a third person or by a personal interest of the attorney.          

Of course, in Scenarios One, Two, and Three – as in most real-life situations – the potential for a conflict of interest does not mean that an actual conflict of interest will arise.
As attorneys, we are driven to say “yes, we can help you,”
and loathe to deny assistance to anyone seeking our guidance – so it is particularly difficult to know what to do for the sake of clients or potential clients, and how best to comply with the Rules of Professional Conduct, when a situation presents itself that might result in a conflict of interest.  Even where an actual conflict of interest may exist, Rule 19-301.7 takes this into account, stating (in pertinent part):

(b)  Notwithstanding the existence of a conflict of interest under section (a) of this Rule, an attorney may represent a client if:

(1)  the attorney reasonably believes that the attorney will be able to provide competent and diligent representation to each affected client;

(2)  the representation is not prohibited by law;

(3)  the representation does not involve the assertion of a claim by one client against another client represented by the attorney in the same litigation or other proceeding before a tribunal; and

(4)  each affected client gives informed consent, confirmed in writing. 

Conflicts of interest can arise in even the most innocent of situations.  They are never intended, so the best strategy for avoiding them is for attorneys to advise clients (and potential clients) regarding how (and in what situations) conflicts can be anticipated, and in some instances, to decline the representation.

Ultimately, the mere existence of the potential for a conflict of interest does not render the attorney-client relationship impossible, so long as the requirements of informed consent under Rule 19-301.7(b) are met.

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Kathrin Shenk – Guest Contributor – Owner and Chief Professional Organizer at FreeYourSpace, LLC.

A Zen parable tells of a wanderer who happened upon a river. He wanted to cross it, but there was no bridge. Afraid to wade across the river on foot, he spent hours building his own raft from vines and trees, which ultimately carried him safely to the other side.

However, once across the river, he thought to himself: This is a good raft; I might need it again if I must forge another river.

So the wanderer carried the raft with him for the rest of his life.

Are you carrying your own raft – belongings that once were of service, but quietly morphed into dead weight? Most of us do. Your closets, attic, basement and garage might be overflowing with a lifetime of accumulated possessions – not just your own, but other people’s.  Perhaps you are spending lots of time searching for things. Or you have paid good money to buy items you already own because you couldn’t find them.  Maybe you have lost gift cards, checks and bills in stacks of paper and had to pay late fees. You may have a vision for the basement or spare room which has to remain a dream, because the space has transformed into a storage facility.  Are you longing for an oasis of calm but somehow can’t unwind? That raft you are carrying might be to blame.

We have a love affair with stuff. Some experts estimate that the average American home contains 300,000 items. Items that don’t just cost money to acquire, but can make us pay dearly over time in terms of:

• Space: The U.S. Department of Energy reports that 25 percent of people with two-car garages don’t park any cars in their garages, and 32 percent only have room for one. According to the National Association of Professional Organizers (NAPO) we regularly wear 20 % of the clothes we own, while 80% mostly sit unused.
• Time: According to a study conducted by a Boston marketing firm, the average American burns 55 minutes a day looking for things they know they own but cannot find. The National Soap & Detergent Association estimates that getting rid of clutter would eliminate 40 % of the housework in the average home.
• Money: Harris Interactive reports that 23% of adults say they pay bills late (and incur fees) because they lose them. According to an article in Consumer Reports, one in 10 households resorts to renting space at a storage facility. The article goes on to say that “The average national monthly cost of a climate-controlled rental space is expected to reach $1.63 per square foot this year… That means you could spend nearly $2,000 in one year for the most popular 10’ x 10’ unit.” Storing things at home is not free either. Many of us have “outgrown” our first home and are now making payments on a bigger mortgage to house a collection of stuff we feel we can’t do without.
• Health: In a study done at Princeton University Neuroscience Institute, researchers found that clutter competes for your attention and wears down your ability to focus. A study from UCLA looked at families with homes that were filled with an abundance of toys and household items. The researchers found that the mothers’ stress hormone levels spiked when they were home dealing with their belongings, but dropped when they left. Organizing expert Peter Walsh noticed a link between overconsumption of stuff and overconsumption of food, resulting in weight gain.

That’s a hefty price to pay. It may be time to take a good hard look at the contents of your home and storage spaces, and shed some of that dead weight. Here are some practical tips to get you going:

• Before you start, decide where discards will go and make arrangements: You may decide to take a few bags and boxes to your favorite thrift store, or you may need to contact a hauling service.
• Evaluate what will serve you going forward: Treasured memorabilia, special family heirlooms, the right furniture, age-appropriate toys, useful appliances, select housewares, your favorite clothes and footwear.
• Start with an area that’s easy for you: Storage areas likely contain items you don’t need often. You may want to save memorabilia for last.
• Move from quantity to quality: We use 20% of our possessions, with 80% sitting dormant. Do you like it? Will you miss it? How easy is it to replace? Do you frequently use it or wear it?
• Watch your visceral response: Does a piece of clothing make you feel like a million bucks? Or does it make you feel guilty for spending all that money and it never fit right?
• Curate memorabilia: Select one or two objects that serve as the BEST reminder of an event, a relationship, or time in your life. Would you try to save this in a fire?

This can be a difficult process. Be realistic and be patient.  You won’t go through a lifetime of possessions in one weekend. In addition, this can be physically taxing work. It may require lifting, squatting, bending or moving up and down stairs. You may encounter dust, mold and perhaps
even critters and their leavings.

If, over time, you are making less progress than you like, consider this:

• Are you holding on to items that represent obsolete goals (scholar, gourmet cook, home improvement expert)? It may be time for a reality check.
• Are you feeling guilty letting certain things go (gifts, mementos, expensive acquisitions)? Give yourself permission to release them.
• Do you have trouble with the progress of time (loved ones pass on, kids grow up, your own declining health)? Be kind to yourself.
• Are you physically exhausted or unable to do it? You may need to ask for help.
• Are you overwhelmed with the sheer volume and/or emotional drain of the task? It may be time to call in a professional.

If attempts to get decluttered and organized on your own don’t lead to the desired results, consider hiring qualified help. Professional Organizers help clients declutter, organize and take control of their space efficiently and effectively. The National Association of Professional Organizers (NAPO) provides a convenient practitioner search tool at their web site www.napo.net.

As you progress you will enjoy giving select memorabilia and special heirlooms the attention and care they deserve. The right furniture, useful appliances and select housewares will enhance and support your lifestyle. Your favorite clothes and footwear will make you feel great. You will have more space and more time to enjoy life. You may save money. Your overall health might improve. You will be so glad you ditched that heavy raft that you may just jump right over the next river!

Kathrin Shenk is the owner of FreeYourSpace, LLC.  She is a member of the National Association of Professional Organizers (NAPO) and is fully insured through NAPOsure, a comprehensive program tailored specifically to the needs of Professional Organizers.  She can be reached at 301-233-3885 or via email at kathrin@freeyourspaceorganizing.com.

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By:  Jeffrey D. Stauffer – Community Relations Director, jeff@elvilleassociates.com, 443-393-7696

On December 13th, Olivia R. Holcombe-Volke, Esq., became a member of the Women’s Law Center of Maryland Board of Directors.

With her selection, Ms. Holcombe-Volke will work with other board members to further the Women’s Law Center’s vision of promoting a legal system that provides justice and fairness for women.  Board members also provide oversight for the organization by setting policy, developing and implementing plans and executing comprehensive fundraising plans to ensure financial stability.

“Civic engagement and community action are vital to the strength and success of humanity,” said Ms. Holcombe-Volke.  “It is my honor and privilege to join the Board of the Women’s Law Center of Maryland, an organization committed to perpetuating these very principles on behalf of the citizens of Maryland, and beyond.”

The mission of the Women’s Law Center of Maryland is to serve as a leading voice for justice and fairness for women by advocating for the protection and expansion of women’s legal rights through legal assistance to individuals and strategic initiatives to achieve systemic change.  The Women’s Law Center works to protect women’s legal rights in three ways—through representation, education and policy.  It serves over 11,000 individuals a year and engages in advocacy to promote systemic change and equality.

As an associate at Elville and Associates, Ms. Holcombe-Volke is an integral member of the firm’s busy estate planning team.  As an associate at Elville and Associates, Ms. Holcombe-Volke is an integral member of the firm’s busy estate planning team, working with clients at all asset levels to craft the perfect estate plan to accomplish their particular financial and non-financial goals. She also regularly addresses the needs of elder law clients, assisting with Medicaid and asset protection planning, special needs planning, and the difficult issues as a result of mental and physical incapacity.

Ms. Holcombe-Volke was also recently selected to the 2017 Maryland Rising Stars list by Super Lawyers.  She also currently serves as a volunteer attorney with the Maryland Volunteer Lawyers Service.

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By:  Jeffrey D. Stauffer – Community Relations Director, jeff@elvilleassociates.com,
443-393-7696

Stephen R. Elville, principal at Elville and Associates, has been selected to the 2017 Maryland Super Lawyers list. Each year, no more than five percent of the lawyers in the state are selected by the research team at Super Lawyers to receive this honor.  This is Mr. Elville’s second year having been named to the Maryland Super Lawyers list, as he received the honor in 2015 as well.

Super Lawyers, a Thomson Reuters business, is a rating service of outstanding lawyers from more than 70 practice areas who have attained a high degree of peer recognition and professional achievement. The annual selections are made using a patented multiphase process that includes a statewide survey of lawyers, an independent research evaluation of candidates and peer reviews by practice area. The result is a credible, comprehensive and diverse listing of exceptional attorneys.  The Super Lawyers lists are published nationwide in Super Lawyers Magazines and in leading city and regional magazines and newspapers across the country. For more information about Super Lawyers, visit www.superlawyers.com.

“I am honored and happy to be selected to the Maryland Super Lawyers list this year,” remarked Mr. Elville.  “But, I’m even more proud that my selection is likely a reflection of the good things we collectively are doing for clients and the community at Elville and Associates.”

Mr. Elville, founder of Elville and Associates in 2010, works with individuals and families to provide a unique attorney-client experience and peace-of-mind solutions to the challenges they face with estate planning, elder law, special needs planning, asset protection, tax planning, and with disability and long-term care planning issues.  Mr. Elville has extensive experience in working with clients involved in crisis situations, and he also brings a unique and personalized approach to pre-crisis planning as well.

Mr. Elville routinely handles client issues in the following areas:  wills, trusts, estate tax planning, powers of attorney, living wills/advance medical directives, Medicaid planning and qualification, estate administration, fiduciary representation, nursing home selection, guardianships, special needs planning for children and adults, Social Security Disability Income (SSDI), Supplemental Security Income (SSI) and IRS tax controversy.

He is a member of the National Association of Elder Law Attorneys (NAELA), Elder Counsel, Wealth Counsel and the Advisors’ Forum.  He is the past Chair of the Howard County Bar Association Estates and Trusts and Elder Law Sections and is the past President of the Coalition of Geriatric Services (COGS).  Mr. Elville currently serves as a member of the Maryland State Bar Association Elder Law Section Council and the Charitable Gift Planning Advisory Committee for Anne Arundel Medical Center (CGPAC).

In 2014, Mr. Elville founded the Elville Center for the Creative Arts, Inc., a 501(c)(3) non-profit corporation whose mission is to improve the quality of life of children of all ages by providing them the opportunity to learn music theory and application, and experience cultural events related to the musical and creative arts; and to use music and the promotion of music-related activities to transcend social and economic divisions.  The charity partners with schools’ music programs and other organizations to provide new and refurbished donated musical instruments to students, purchase music supplies, fund field trips, offer music lessons, and work with organizations to begin new music programs.  For more information about the Elville Center, please visit www.elvillecenter.org or contact 443-393-7696.

In 2015, Mr. Elville founded Waypoint Trust Group, a division within Elville and Associates.  Attorneys in the Waypoint Trust Group serve as trustees/co-trustees of trusts of all sizes, including trusts with assets below corporate trustee minimum requirements, irrevocable life insurance trusts, and special needs trusts.  Waypoint Trust Group’s attorneys also serve as trust protectors.

In addition to serving as trustees and trust protectors, Waypoint Trust Group offers the following services to individual and corporate trustees: legal representation, including but not limited to: compliance with the Maryland Trust Act requirements; court proceedings related to administering a trust (ex. modifications of trust terms, judicial terminations); and guidance on interpretation of trust terms; preparation of trust income tax returns; preparation of trust accountings; maintenance of trust books and records; assistance with initial set-up of new trusts (obtain tax ID number, organize trust management, open new trust accounts); manage trust terminations, including: calculating distributions, determining Inheritance tax due (if applicable); and preparing releases of liability for trustees.

This year, Mr. Elville developed a new estate planning initiative, Elville Self-Direct, a limited-attorney-assistance client education program for individuals and families.  The program’s goal is to offer certain clients an option who wish to streamline the estate planning process yet still receive the all-important educational component for which Elville and Associates is widely known.

Elville & Associates engages clients in a multi-step educational process to ensure that estate and elder law planning works from inception, throughout lifetime and at death.  Clients are encouraged to take advantage of the “Planning Team Concept” for leading-edge, customized planning.  The firm considers counseling and education of paramount importance while working with its clients and surrounding community.

For more information about Elville and Associates, please visit www.elvilleassociates-staging.bgbshlgq-liquidwebsites.com or call 443-393-7696.  You can also follow the firm on Twitter at @ElvilleAssoc.

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By:  Stephen R. Elville, J.D., LL.M., steve@elvilleassociates.com, 443-393-7696

At our September 17, 2016 Client Event, I gave a PowerPoint presentation outlining in very brief ten-minute fashion an overview of the major events affecting estate planning, elder law, and special needs planning over the past twenty-five (25) years since 1991.  What was revealing about this condensed information was not only how much change had occurred, but how some of those change events had come full circle – some events seemed to have changed the landscape forever, while others indicated change that once appeared permanent but in reality was only cyclical, with later observation revealing that further change negated the original change event or series of events, reverting back 180 degrees to the original law or status.  Then came the November 8 presidential election, and with it the specter of further change.  In its aftermath, many Marylanders are concerned about the changes that may come, while others anticipate and desire change – be it social, political, or otherwise.  From an estate planner’s and elder law attorney’s point of view, the challenge and the question is how to deal with change over time, and how to take care of clients, both during their lives and in anticipation of the end of their lives – all at some unknown date, time, and place many years from now, and under future circumstances none of us can predict or realistically anticipate?  And yet, time and inevitable change do not give us a reprieve.  We must answer this question.

The answer, it seems, can only reliably be derived from logic.  If we are driven by anything else (the news, current trends, financial considerations, personal opinions, the opinions of “experts,” anxiety, fear, or other emotions, overconfidence), we may reach a faulty conclusion.  Let us then restrict ourselves to logical reasoning as a means of testing for truth in our search.  Our process need not be lengthy, perhaps three (3) steps, and we can begin with some familiar statistics.  First, according to the American Bar Association (ABA), fifty-five percent (55%) of Americans have no estate planning.  This naturally means that only forty-five percent (45%) of Americans have an estate plan.  Of that minority of Americans who have planning in place, statistics from the National Network of Estate Planning Attorneys (NNEPA) show that those plans are only updated once every nineteen (19) years.  That fact becomes even more startling when we look at the brief list of historical events since 1991 in the presentation below – they include, among many others, the following:

• Since the early 90’s – continued changes in marital deduction planning, and in elder law and special needs planning;
• Low federal and state estate tax exemption amounts;
• OBRA-93 (Omnibus Budget Reconciliation Act);
• HIPPA;
• The Bush years – begin estate tax phase-out;
• Maryland’s estate tax decoupling;
• Deficit Reduction Act of 2006 – changes in Medicaid law;
• Maryland’s long-term care division for Medicaid – $4,300;
• Continued increases in estate tax exemptions through 2009;
• Proliferation of traditional estate planning;
• 2010 temporary elimination of the federal estate tax;
• 2011 – end of EGTRRA (Economic Growth and Tax Relief Reconciliation Act of 2011);
• Portability – effective 1/11/2011 (made permanent – 2012);
• Medicaid Manual Release MR-159
• The Affordable Care Act;
• Maryland’s estate tax recoupling;
• Maryland’s long-term care divisor for Medicaid changes to $7,940, and now $8,684;
• Maryland Trust Act;
• Augmented estate;
• Elder care explosion;
• Special Needs – ABLE, Special Needs Fairness, and other laws;
• Fiduciary Access to Digital Assets;
• Just to name a few.

If we accept that these few events represent an enormous body of change in the estate planning and elder law world over the past 25 years, we can now examine how this change is dealt with, or needs to be dealt with, in practical terms – the second phase of our process.  As a general rule, there is no proactive client education or maintenance/updating of clients’ estate and elder law plans across the country.  Let’s place the blame for lack of client care squarely where it should be – with the estate planning and elder law planning community – the professionals responsible for helping clients maintain and update their plans, and educating them.  According to the Client Maintenance Academy (CMA), Elville and Associates was only the forty-second (42^nd) law firm in the United States to complete training at the Academy for the purpose of designing and implementing a high-level Client Care Program.  While the firms who have been trained by the CMA are not the only law firms in the U.S. utilizing a client maintenance and updating program for their clients, it is safe to conclude that of the thousands of law firms across the country actively engaging in estate planning and elder law planning, only a handful have such a program, or even attempt to implement one – conservatively speaking, likely at least ninety percent (90%) have no such program.  So to realistically provide solutions and client care throughout the generations, the estate planning and elder law attorney must offer a client maintenance and updating program, and provide client education.  If there is no such offering, clients (non-professionals) cannot be expected to maintain and update their plans over the years and decades to come, and thereby avoid plan failure.

The third phase of our search for the answer comes back to the client – whether there is a real partnership relationship?  Once the estate planning or elder law attorney has recognized the importance of client care and has implemented a client legal education and maintenance/updating process, clients must reach out in partnership with the attorney/law firm.  It is when this union takes place that true power is achieved.  When real partnership exists between a client and their planning attorney, usually beginning at the time of the initial engagement, wonderful things can happen in the accomplishment of the client’s goals and objectives.  And the fulfillment of those goals and objectives can only be truly measured at a time of need or crisis, usually in the form of the following questions:  is the plan current and reflective of the client’s wishes and changes in the laws, with ample built-in flexibility?; and how are the client’s assets titled at the time of need or crisis (illness, incapacity, or death)?

So the answer to the question and challenge we are presented with is threefold:  (1) we must recognize the problem that most Americans have no estate plan or do not maintain their estate plans for extended periods of time during which enormous changes occur in the world; (2) we must accept that the vast majority of estate and elder law attorneys/law firms offer no maintenance and updating plan, and no process-specific legal education for their clients, leaving most estate plans poorly maintained or updated, and generations of family members without optimal knowledge of how to execute the plan, thereby creating plans that have a high probability of failure – attorneys/law firms must change from transaction-based models of planning to client care models, in order to offer clients the updating and maintenance programs that are essential to ensuring plan success; and (3) clients must embrace the client care and power in partnership concepts.

The point is this – changes of great import have already occurred over the past twenty-five (25) years, and will continue.  Changes in tax, health care, and other policy that will likely occur under the new administration are nothing more than a continuation of the past.  There is nothing to fear – rather, we are called upon to prepare for change.  And since we cannot stop or control change, preparedness in estate and elder law planning equals client education and continuous maintenance and updating through client care, by and through which we answer the challenge and the question.

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Authored by:  Olivia R. Holcombe-Volke – Associate, olivia@elvilleassociates.com, 443-393-7696

A common source of concern for estate planning clients is the disconnect between an estate plan and the people involved in its actual implementation.  Clients almost always ask “how much of this should I share with my medical agent/financial attorney-in-fact/personal representative/trustee/beneficiaries?”  The fact is, informing those who will be responsible for executing the plan is vital to ensuring that the plan succeeds.  The estate plan itself will not be implemented in a vacuum, and cannot, therefore, be created in a vacuum.

This does not mean that the medical agent/financial attorney-in-fact/personal representative/trustee/beneficiaries need to know every minute detail, particularly with regard to dollar amounts.  There is middle ground between sharing nothing and sharing everything with the players who are responsible for executing an estate plan.  At a minimum, it is important for those named in the estate planning documents to know that 1) a plan exists, 2) they are named in it in some capacity, and 3) there are professionals involved to whom they can turn for help.  These simple highlights will go a long way toward avoiding plan failure.  The amount of further detail that is shared is ultimately up to the estate planning client, and depends on the nuances of his or her particular plan.

The education of one’s named medical agent/financial attorney-in-fact/personal representative/trustee/beneficiaries is an important part of one’s estate plan.  If a family meeting or other form of education is not proactively offered by one’s estate planning attorney, it is something well worth requesting.

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By: Jeffrey D. Stauffer, Community Relations Director –  jeff@elvilleassociates.com, 443-393-7696

On October 14th, Mr. Stephen R. Elville, principal of Elville and Associates, presented the topic of “Exploring the Nuances of the Advance Directive for Mental Health Treatment” at the National Alliance on Mental Illness Annual Conference at Shepherd Pratt Conference Center in Towson, Maryland.

The presentation educated the attendees about the purpose of the advance directive and why it is important, the nuances involved in the document and in health care decision making, offered case studies related to the importance of having the document in place, and offered other considerations in planning for incapacity.
By the end of 2016, Mr. Elvillle will have presented at almost 50 workshops, forums, conferences and continuing education events.

NAMI Maryland brings people together to tackle our community’s mental health needs and to invest in lasting changes that improve lives. The organization focuses on recovery, resiliency, and the support that is essential to wellness and quality of life. It gives families a place to turn, a place to access a strong network of education, support programs and resources. One out of every four families are affected by mental illness in some way.

Elville and Associates engages clients in a multi-step educational process to ensure that estate and elder law planning works from inception, throughout lifetime, and at death. Clients are encouraged to take advantage of the Planning Team Concept for leading edge, customized planning. The education of clients and their families through counseling and superior legal-technical knowledge is the mission of Elville and Associates.

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