A Nevada bill would make changes to adult guardianship by prioritizing less restrictive approaches.

Sen. Melanie Scheible, D-Las Vegas, the bill's sponsor, explained Nevada law promotes "supportive decision-making," a contract between a protected person and a supportive partner. She said the approach allows people to keep a level of independence and power when making important legal, financial and health care decisions.

Scheible pointed out the new measure would require Nevada courts to first explore the option or other less restrictive alternatives before a guardian is appointed.

"It requires the judge to put on the record, why, if they are going to appoint a guardian, they are doing that in lieu of a supportive decision-making agreement," Scheible outlined. "What about this person's capabilities makes them unfit to be in a supportive decision-making arrangement?"

The legislation would also require the review of guardianships being transferred from outside the state into Nevada. Backers of the bill said state standards are not all the same and want to ensure guardianship is truly warranted. The bill was heard in the Assembly Judiciary Committee this week and has not faced opposition so far.

Jonathan Norman, advocacy, outreach and policy director for the Nevada Coalition of Legal Services Providers, said he supports the measure because he wants people in the state to retain as many rights as they can when receiving medical care.

"SB 346 will lead to fewer unnecessary guardianships," Norman contended. "Many adults and seniors with disabilities find themselves facing the rest of their lives in a court-ordered guardianship, not because they need it but because less restrictive alternatives were not fully explored."

Ellen Marquez is the mother of Alysa Marquez, 22, who has Down syndrome. She said guardianship has been "the default" for too long. She believes while guardianship has its place, it can also strip people of their rights.

"If we all rely on guidance from trusted sources, why shouldn't individuals with disabilities and older adults have the same opportunity?" Marquez asked.


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June is Brain Awareness Month, and experts say Virginia seniors should consider decluttering their homes to improve brain health.

According to an expert with Hacksensack Meridian Health, decluttering can decrease stress, improve sleep quality, and increase focus.

Leslie Pendleton, community ambassador with AARP Virginia, said she often sees two types of seniors who want to declutter - those who have retired, and those who have begun to experience health struggles.

"Health issues that crop up that are signs that people need to start thinking about downsizing," said Pendleton, "and to downsize, you've got to declutter. That's the first part of the process. You can't take it all with you, in other words."

Experts with Nuvance Health says clutter makes it difficult for your brain to focus on one specific thing, splitting your attention and causing sensory overload.

They say constant sensory overload can lead to increased mental fatigue.

But who should be involved in the decluttering process? Many seniors have children, grandchildren, nieces and nephews that may desire to keep some of their relative's treasures.

Pendleton said having a plan about who gets what is essential.

"It can create family turmoil if the person who is downsizing and decluttering doesn't already have some form of an estate plan in place, a will," said Pendleton. "They haven't necessarily thought out who they want to have what, so that's part of the process too."

Pendleton added that younger people are part of what she calls the 'IKEA generation,' often having less clutter and wanting less things.

Those interested in learning more can are encouraged to sign-up for an upcoming ARP Virginia decluttering workshop led by Pendleton.

Memory care facilities in Arizona have a new set of rules intended to improve quality of care for patients and ensure more accountability for providers.

Brendon Blake, director of advocacy for AARP Arizona, said the set of rules, approved by the Governor's Regulatory Review Council last week, are a big win and an improvement over what he said had been a lack of guidance for facilities.

The changes are a result of House Bill 2764, signed into law last year. Blake pointed out the rules should fill in gaps by requiring dementia-specific training for memory care staff and managers, stricter monitoring and enforcement, and new procedures to prevent those with dementia from walking out.

"Right now, there's no statutory or regulatory standard that's being held to," Blake explained. "It's really on the consumer themselves to do a ton of work, in an interview with that facility, to know if their level of what they call 'memory care' is really actually best practices across the country."

The new rules are set to take effect July 1, although the Arizona Department of Health Services is expected to give facilities a grace period to come into compliance. Blake added the rules also increase penalties for facilities not in compliance or repeat offenders.

Blake stressed the new rules are the result of 18 months of work. While some have expressed concerns they might be too vague, he argued they are a huge step in the right direction.

"The problem with being too specific is that Alzheimer's disease may be the most common form of dementia, but it is not the only form of dementia," Blake noted. "We want training to be robust enough that it can still cover a lot of ground, so that way, staff and managers can handle all kinds of dementia."

To those considering a memory-care facility, Blake encouraged people to ask how they plan to start implementing the rules.

"Is it commensurate with the training that is being required of them now?," Blake asked. "On the facility side of things, I think it is important that all of them know that the department has committed to continuing to do stakeholder meetings, to provide assistance."

During Alzheimer's and Brain Awareness Month, mental health advocacy groups are highlighting treatment and medication advances in the last decade.

Developments are helping people see the early warning signs of dementia, and teaching them how to plan for the future living with a disease that, so far, has no cure.

The Alzheimer's Association Iowa Chapter's Communications Director Lauren Livingston said while a cure is still not on the horizon, all the work that has gone into research and fundraising has helped advocates make progress, and allowed patients to extend the time they have with their families.

"So just in the last, really, five to 10 years, we have learned so much more about Alzheimer's disease than we did in the previous several decades," said Livingston. "And because of that, there are treatments available for those in the early stage of Alzheimer's disease that can actually slow the progression."

She added that the Alzheimer's Association holds several fundraisers during June, including a bike ride to raise money on June 21, the longest day of the year.

More than 62,000 Iowans live with Alzheimer's disease.

Beyond treatments, Livingston added that researchers have also made other important discoveries about Alzheimer's in the last few years.

"We know a lot more about the risk factors that cause Alzheimer's disease and a lot of them, nearly 50% of them, are modifiable risk factors," said Livingston, "like your blood pressure and your health, and how much sleep you're getting and things like that."

The Alzheimer's Association has published a list of 10 healthy habits to stave off Alzheimer's and other forms of dementia. That, and a lot more information, is online at alz.org.




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