What's In A Name?

What do the following pairs of drug names have in common:

Atenolol - Tenormin
Warfarin - Coumadin
Lanoxin - Digoxin
Temazepam - Restoril
Naproxin - Naprosyn

If you answered that one of each pair is the brand name, and one is th generic, you would be right.

Would your elder know that the container labeled Atenolol is essentially the same medication that last month came labeled as Tenormin? How about if the tablets don't look the same?

Would you?

Ask the pharmacist to make a note in the computer to always label generic drugs as "substituted for" the brand name if there's a change being made from one to the other. Samples from the doctor's office are almost always branded. When the doctor writes a prescription to be filled at the pharmacy it may well be for a generic. They don't always look the same, and they will certainly be labeled differently.

This can cause confusion. If the patient doesn't realize or doesn't want to admit to confusion, bad things can happen. Get both names on the container.

Why Every Caregiver Needs A Team

This comes directly from my inbox last week. This person and I exchanged a couple of emails. I've paraphrased her question, because it's a common one. I've re-printed my final answer just about verbatim.

Sadly, I never heard back. I hope she sought good advice from a "team," because otherwise she and her mother/aunt will only have a partial picture of what's before them and they'll probably never really know what their options could have been.

Question: My mother and my aunt live together in my mother's house. They are both getting on in years and they both have some medical problems. They would like to talk to an attorney about how to preserve their assets and get the care they need at home. Can you refer me to someone?

My Answer: If anything cries out for a team approach, your question does. I don't think any one individual is going to have all your answers.

1. An estate planning attorney will be able to give you advice about how to structure a will, create a trust, and preserve an estate. He or she will probably not be the best person to advise you about how long the money will last or how best to invest it because this isn't an attorney's area of expertise. Knowing how long the money will last is a function of how old
the individual is, what the medical issues are, and how much several different things cost in your area. It's an unusual attorney who is knowledgeable in these things.

2. A CPA will help you with your taxes and any possible deductions for medical and care expenses. A CPA isn't an investment advisor or a care counselor.

3. A certified financial planner will be able to help you with investments and growing/preserving the estate. He or she will have information about long-term care insurance (more for you than your mother and your aunt, as they probably no longer qualify). A good investment advisor will have some
information about the costs of long-term care, but it will most likely be generic information provided by national insurance carriers.

A stockbroker, insurance agent or "investment advisor" at your bank is not a financial planner - they have a vested interest in selling you the "products" offered by their institutions. You should consult with an independent CFP who will offer you a plan for a fee and then let you decide whether you want to use the planner's services to implement the plan. Yes, it costs, but it's worth it.

4. An experienced care counselor will be able to give you information about what you can expect in your own individual eldercare situation - how diagnosed medical issues can be expected to progress, things that can be done to increase safety at home, what things cost in the local area, who provides what kind of help, and how to put together a long-term care plan
given the financial, emotional and physical facts. The information you will get from a geriatric assessment is valuable to both your certified financial planner and your estate planning attorney as they assess your particular financial and legal situation.

So, I think you need four advisors, working as a team. You and any advisors you consult will be working blindly if you don't know what to expect or what your real long-term care options are.

If your relatives already have a good plan for passing on whatever is left of their estates when the time comes, you might be best off to start with a geriatric assessment and a good financial planner. If they don't have up-to-date individual estate plans (will, powers of attorney, advanced
directives, trusts, etc.) add an estate planning attorney into the mix right away.

Best regards,

Molly