The Four Stages of Resolution
Naomi Feil in her book The Validation Breakthrough identified four stages of resolution. People who suffer from cognitive impairment may progress through these four stages: 1) Malorientation, 2) Time Confusion, 3) Repetitive Motion, and 4) Vegetation. Feil believes people will “enter a period in their lives in which they feel the need to resolve unfinished business in order to die in peace.”
With each stage physical decline is evident and the sufferer draws inward mentally and emotionally. It is important to remember people are fluid and are not necessarily fixed in one stage or another. Therefore sufferers can move back and forth between stages and may have characteristics of two stages simultaneously. However, one stage will typically dominate.
Mal-oriented old people are often well adjusted in many areas of daily living. However, their behaviors are triggered by specific fears about losses brought about by the aging process. Sufferers will demonstrate short-term or remote memory loss, hold to present reality by a rigid and inflexible lifestyle, accuse others when belongings cannot be found, hoard, and realize and be threatened by their own disorientation. Physically they will have tense and tight muscles, fear of losing control of body functions, a quick and purposeful gait, and have focused and good eye contact during conversation. Sometimes they will clutch things, such as a purse, sweater, cane or stuffed animal and hold personal objects close to their body. They can do their own personal care. They will respond best to recognized roles and persons in authority, but have a negative response to those less oriented. They do not want insight into their mental or emotional condition. They can read and write unless blind or illiterate. They carefully follow rules and conventions and are concerned that others follow “the rules.” They can have a sense of humor, but are often moody.
Time confused persons respond to both verbal and non-verbal cues; therefore, they move from one stage to another throughout the day. The dominant characteristic is disorientation to time, place and person. They do not keep track of the time of day, day of week, month, year or season. They may not know where they are and may not recognize familiar people and their names. They may not know who they are and lose a sense of self. Physically, muscles are loose and they are aware of incontinence. They are slow and have smooth movements, without purpose, and have a dance-like gait. Their voice is low, but rarely harsh. They sing and laugh easily; eyes are clear and unfocused. Although often downcast, their eye contact triggers recognition. They substitute memories and feelings from the past to give meaning to the present, often recalling past experiences that are unresolved. Sometimes they are unable to control emotions. They need assistance to complete the ‘Activities of Daily Living’ (feeding, dressing, bathing, etc.). They do respond to a nurturing tone and appropriate touching. They smile when greeted and may call present caregivers by names from the past. They use symbolism in speech. They do not trust caregivers who argue, correct or pretend to agree with them. They can read, but no longer write legibly or coherently. They make up their own rules, retain intuitive wisdom and may use objects as substitutes for people.
Sometimes the disoriented will engage in repetitive behavior such as wandering, tapping and repeating the same words, phrases or rhymes over and over again. They often shut out most stimuli from the outside world. They have their own sense of time. Physically, they may slump forward, are unaware of incontinence and are restless, pacing or rolling in a wheelchair. Their eyes are half-closed or unfocused. They use repetitive body movements to express emotions. They require total care for ‘Activities of Daily Living.’ They use few common words, do not complete sentences and do not listen or talk to others. They are not motivated to read or write. Early memories and universal symbols are the most meaningful. They may repeat early childhood movements and sounds.
People in vegetation have lost speech and the ability to think logically. Often, they give no indication that they recognize family, visitors, old friends or staff. They have no sense of time or place. Physically, their breathing is shallow or soft; they barely move on their own initiative and often lay in the fetal position. Their eyes are shut much of the time and their face is often expressionless. There is no effort to control incontinence. Emotions are difficult to evaluate. They require total care for ‘Activities of Daily Living.’
People working with the cognitively impaired are trained to recognize the characteristics of each stage and apply specific techniques to forestall or prevent further progression. In some cases, the stages can be reversed and the quality of life enhanced. I will share more about these techniques in my next article.
The Why of The Baptist Home
Many people understand ‘what’ we do; some may understand ‘how’ we do it. However, the ‘why’ makes all the difference. Today, many companies focus on the bottom line of making money. For The Baptist Home, money should not be an end to itself. On the other hand, money is a tool to help us accomplish our mission. We do need to operate with sound business practices in order to sustain this ministry until Jesus comes. And, we have a fiduciary responsibility to those who have invested in this ministry that we use each resource honorably and optimally to advance our mission.
One of the most difficult parts of my job is whether to make a decision based on good business practice or based on ministry. Many times they are compatible, but other times they are not. Some decisions cost money in the best interest of people and will not yield a financial gain. Thus, The Baptist Home focuses on ministry opportunities to improve the quality of life for those who are aged and prepare them for the Kingdom of Heaven.
Nevertheless, that is what we are called to do. To advance the Kingdom of God is a good investment. Some of my evangelical friends may not think of The Baptist Home as a contributor to the advancement of the Kingdom. For example, some believe that ministry to those who are in need of physical, financial, social, emotional and mental support should take a back seat to preaching and evangelizing. I rather think both ways are important and have the same purpose. Our ultimate goal is to lead people into a relationship with the living God through the saving grace provided by the Lord Jesus Christ. Is ministry not one and the same as preaching and evangelizing?
Our 2nd superintendent, Dr. D.J. Scott would have answered this way as he did in a newsletter article dated April 1945, “If this work is not preaching the Gospel, then I’m in the wrong work, and really we had better close the doors.” He went on to explain, “We are quite sure that at least 95% of those with whom we have conferred feel the sort of work being done here at the Baptist Home is one of the most effective ways of presenting Christianity to the world.” And, he acknowledged that the most effective method of telling the good news used by missionaries for many years was “by ministering to the physical needs of men and thereby finding the way to their hearts….”
Scott believed Jesus to be our greatest example in this effort. “Christ went about ministering to man’s physical needs. He fed the hungry, healed the sick, made the lame to walk, gave sight to the blind; in fact, He spent but very little of His time in actually preaching as we speak of preaching in order to convince the world that He was and is the Christ, the Son of God.” He illustrates that when John the Baptist inquired of whether Jesus was really the messiah, Jesus told his disciples to go back and tell John, “…the things you see and hear, the blind receive their sight, the lame walk, lepers are cleansed, deaf hear, dead are raised and the poor have the Gospel preached to them.” (Matthew 11: 3-5)
Scott concluded, “So after reconsidering the whole matter, we are more thoroughly convinced that the ministry of love that is being carried on here in the Home is an outstanding phase of Kingdom service, and a most effective way of presenting effective Christianity to the world.” As with Dr. Scott, “…we certainly believe in preaching the Gospel, but it takes living and serving to prove to the world that we are true to the messages we speak.”
IRA’s and Taxes: Tax Considerations of Assets with Deferred Income Tax
IRAs, 401(k)s, and 403(b)s are all excellent tools for preparing an enjoyable, financially worry-free retirement. However, without taking into consideration the effect of income taxes on your retirement plans, achieving the lifestyle you desire can be filled with unwelcome surprises.
Individual Retirement Accounts – IRAs
A tax deferred IRA is a valuable retirement planning tool. You are eligible to establish an IRA account, even if you are participating in a company retirement plan. Earnings accumulated in the account will not be taxed until you withdraw them – usually at a later time when your tax rate is lower. It should be noted that Roth IRAs do not have the income tax implications during life or at death.
Lump Sum Distribution vs. Direct Deposit to an IRA
If lump sum distribution from a qualified plan is an option for you, be aware of the tax withholding requirement. When requesting a lump sum distribution, 20% will be withheld for taxes. You will have 60 days from the date of distribution to make a tax-free rollover into an IRA account. The 20% withholding tax will be refunded, but this method allows the government to have interest-free use of your money. You may wish to consider the following:
Direct Deposit of Qualified Plan to IRA
To avoid the 20% withholding tax, you may have distributions placed directly into a qualified IRA account. It is suggested that you establish a separate IRA for this purpose rather than combining your distribution with money you already have in an IRA.
Taxation of IRA Distributions
Most often, IRA withdrawals are taxed as ordinary income. If you are less than 59½ years old, there will be a 10% penalty tax in addition to the regular tax. After you reach age 70½ , distributions are required based upon your life expectancy. If you are married, it can be based on the life expectancy of you and your spouse. Your IRA withdrawals will continue to be taxed as ordinary income.
The IRD Tax Problem
Many people do not realize that at the death of the owner of an IRA and/or the surviving spouse, funds remaining in the account become taxable income to the heirs of the estate.
Income In Respect of a Decedent (IRD) What does it mean?
The term Income in Respect of a Decedent refers to ordinary income items which are included in a deceased person’s estate, but have not been included on his/her final income tax return. IRD items usually pass to the estate unexpectedly, with the unforeseen tax liabilities seldom being included in the estate planning process. Common examples of IRDs are IRAs and qualified pension plan distributions, deferred gain on commercial annuities, and interest accrued on U.S. Savings Bonds (Series EE & HH).
A donor may designate The Baptist Home as beneficiary of an IRD asset at the donor’s death. Because of The Baptist Home’s tax-exempt status, the income tax on this asset will be avoided. IRD assets can also be left to a charitable remainder trust. It should be noted that to avoid the income tax the asset must pass to charity at the death of the donor. A lifetime transfer may result in the income being taxed to the donor at the time of the gift to charity.
There are solutions to the IRD tax problem that reduce taxes and provide benefits to heirs. In order for the tax on IRD to be avoided, the charitable gift must be properly structured. We recommend consulting a professional advisor to be certain your gift is handled properly.
This article has been written to assist you in achieving your long-term retirement goals and avoiding unnecessary tax liabilities through charitable giving. Naming The Baptist Home as the beneficiary of an IRA or other IRD asset can result in tax savings for your heirs, and the funding needed to sustain our mission for many years to come. It is also a simple way to make a charitable gift at your death.
If you have questions about the tax consequences of your IRA or other assets The Baptist Home Planned Giving would like to assist please contact The Baptist Home.
Communication with the Confused
Alzheimer’s disease is a catch all term today much like the older term “dementia.” Some prefer to call it the “old-timer’s disease.” However, Alzheimer’s is a very specific disorder that cannot be accurately diagnosed until an autopsy is performed. It is characterized by the presence of excessive neuritic plaques and neurofibrillary tangles in brain tissue. Although the course of the illness can be different for each individual, victims will demonstrate gradual, yet progressive cognitive dysfunction. Currently, there is no known cure or treatment that slows the progression of the disease. On average, sufferers have a life expectancy of about seven years from onset diagnosis.
Because there are many causes of mental confusion other than Alzheimer’s disease, it is recommended that any person with symptoms should be evaluated by a trained neurologist who specializes in cognitive impairments. Some causes are treatable and reversible, especially if caught early.
A reason for mental confusion of some older persons can be emotional. The older we become the more losses we have. We may lose significant persons, eyesight, hearing, the ability to walk, important roles, etc., etc. The impact of the accumulation of losses and grieving can add to the emotional stress of aging. In addition, people tend to repress, are distracted from or postpone dealing with life’s difficult issues until age catches up with them. Often times this accumulated stress can lead to cognitive impairment. A person may prefer a break from reality rather than emotionally working through deep and difficult personal issues.
Regardless of the cause of mental confusion, Naomi Feil has written a book to help people communicate with the cognitively impaired, The Validation Breakthrough: Simple Techniques for Communication with People with ‘Alzheimer-Type Dementia.’ Joy and Ed Goodwin first introduced The Feil method to The Baptist Home in the 1980s.
Joy Goodwin wrote, “Validation is a method for communicating with older adults who are exhibiting strange, bizarre and unusual behavior, without a reasonable explanation. Mal or disoriented old people can be labeled as having Alzheimer’s disease (AD) and related dementias. Through observation Feil began to notice that such people tended to use similar kinds of behaviors. Eventually, she identified four progressive stages with characteristics that distinguish different groups of mal and disoriented older adults. She also developed techniques for communicating with mal and disoriented adults. These techniques have been known to stop or slow down the progression of confusion and in some case reverse them to a prior stage. Validation Therapy is based on an attitude of respect. It stresses the importance of the caregiver to become the empathetic listener. The Validation trained person accepts the reality of the confused unconditionally. The therapy acknowledges that each person is unique, deserves individual attention and has a basic right to their reality. As trust develops, anxiety is lessoned, the need for physical and chemical restraints is reduced and a sense of self-worth is restored. Physical, social, mental, emotional and spiritual functioning is improved.”
Revocable Living Trust
A Flexible Planning Option
It is essential that you have an estate plan regardless of the size of your estate. It is also the only way to make sure the stewardship of your accumulation will continue, as you desire, after your death. Your estate plan can be carried out through a will or through a revocable living trust. Another reason to have an estate plan is to be sure that there is provision for the management of your assets if you are unable to manage them yourself. This can be accomplished with a durable power of attorney or a revocable living trust. The revocable living trust is the most flexible estate-planning tool in existence today. The living trust can provide estate continuity to benefit you and your heirs, and for organizations and ministries you want to assist.
Important Terms
There are several terms you will want to become familiar with as you learn more about revocable living trusts׃
Revocable means the estate owner can revoke, alter or amend the trust at any time. You stay in control because you can amend or revoke the trust should your situation change.
Grantor is an individual who establishes the trust.
Living Trust is a trust established by a grantor during his/her lifetime. This is the opposite of a testamentary trust, which becomes effective at death.
Trustee is the person or institution responsible for managing a trust. The trustee holds fiduciary title to assets, but is required to manage those assets in accordance with the terms of the agreement.
Successor Trustee is the person or institution that fulfills the trustee’s duties in the case of disability, death or resignation of the trustee.
Revocable-Self Declaration Living Trust is a trust established and managed by the grantor of the trust. The purpose of the trust is to distribute the grantor’s estate at his or her death while avoiding probate.
Advantages of the Revocable Living Trust
Using a revocable living trust in your estate plan allows you to avoid probate and the problems that are sometimes associated with it. Other key advantages include:
- Reduction of administrative costs;
- Speeds estate distribution;
- Avoids interruption of income to heirs at grantor’s (estate owner’s) death;
- Provides for the private distribution of estate;
- More difficult to challenge than a will;
- Capability to transfer management without court involvement if grantor becomes incompetent;
- The potential for greater diversity and security for investments if a corporate trustee is used.
The Living Trust Does Not:
- Reduce income or estate taxes. It can, however, establish and fund trusts that do save estate or income taxes at death;
- Eliminate the need for a will since disposition of assets not included in the trust must be provided for in what is usually called a pour-over will.
Establishment of the Revocable Living Trust
A trust agreement must be drafted by an attorney and signed by the principals involved. The trust is funded by transferring a title to the trust during life. Probate is avoided only to the extent that assets are transferred to the trust. Thus it is important to transfer title of all of your assets to the trust. Assets without a title can be transferred with a bill of sale or by assignment.
The Revocable Living Trust and Christian Stewardship
You can benefit The Baptist Home in your revocable living trust in several ways including:
- Leaving a percentage of the remainder of your trust to The Baptist Home;
- Leaving a specified amount to The Baptist Home;
- Establishing a trust which provides for family members during their lifetimes and then distributes to The Baptist Home;
- Leaving assets to The Baptist Home in exchange for a Gift Annuity for a loved one.
If you want more information about the Revocable Living Trust, please contact The Baptist Home.
Tips for Staying Independent as We Age
Tips for Staying Independent as We Age
This conference is based on the latest research on the practices of those who are maintaining an independent lifestyle well into their late older adulthood. Participants will gain an understanding that in making the right lifestyle decisions today will enable a person to maintain maximum control of her/his life as they age. The conference includes a discussion of ways congregations can help adult maintain their independence.
Avoiding Fraud and Scams as We Age
Avoiding Fraud and Scams as We Age
Older adults are the main targets of consumer fraud and scam artists in our country. Conference participants will learn the common types of fraud, steps to take to elude scams, who to contact it fraud is suspected and community resources working to prevent fraudulent business practices.
Options for Financial Planning
A Plan for This Life and Beyond
“Everything is taken care of.”
Whether you’re at work, on vacation, or in the middle of a busy time at home, that five-word sentence can be music to your ears. But when it comes to financial planning, can you ever be sure that everything is taken care of?
“If I retire, will I have enough to live on? Can I afford to continue to support the ministries I care about?”
“Can I be sure that my family will be provided for, no matter what happens?”
“When all is said and done, has my life made a difference in this world?”
The Baptist Home’s Options for Planning can help you answer all those questions. We can help set up a plan for organizing your estate with a will or trust, providing for you and your family through gift annuities, and supporting the Kingdom work of The Baptist Home through a variety of planning options.
Last Will and Testament: In a Will, you can provide for the needs of your spouse and other family members, and assure that some of your resources will continue to support the Lord’s work after your passing.
Revocable Living Trust: A revocable living trust can accomplish your estate planning objectives in much the same way as a Will. But a properly funded trust accomplishes lifetime objectives as well. The trust can provide management of assets during your lifetime. This feature of a trust is especially beneficial if you ever become incompetent.
Revocable Self-Declaration Trust: Allows the grantor to act as your own trustee. Under this option, you can manage your own assets as long as you are able and wish to do so. But the mechanism is in place for a successor trustee to take over management of your trust should that become necessary or desirable.
Living Trust: An excellent tool to use in reaching your goals of Christian stewardship by naming The Baptist Home as a charitable beneficiary. The staff of TBH can help you determine who should the trustee of your revocable living trust, or successor trustee of your self-declaration trust.
Gifts of Life Insurance: It may be possible for you to leave a substantial gift to TBH at your death through a gift of life insurance. If you transfer ownership of an insurance policy to The Baptist Home, you will be entitled to an immediate income tax deduction equal to the cash value of the policy. You may make annual deductible contributions to enable The Baptist Home to pay the policy premium. And, at your death The Baptist Home will receive a benefit larger than you may have thought possible.
Beneficiary Designations: Another way to benefit The Baptist Home at your death is by naming The Baptist Home as beneficiary of an IRA or other retirement account. Since The Baptist Home is tax-exempt, it will benefit from the full value of the retirement account, and will not have to pay income tax on these assets as family would have to pay. An IRA is the best asset to leave to charity at the estate owners’ death. The Baptist Home can also be named as a P.O.D. (Pay on Death) beneficiary of a bank account or T.O.D. (Transfer on Death) beneficiary for a securities account.
Remainder Interest in a Home or Farm: The tax laws allow you to transfer title of a home or farm to The Baptist Home, while retaining a life estate for yourself. You will be entitled to reside in the property and to receive all income from the property for the rest of your life. Upon death, the home or farm becomes the property of The Baptist Home. If the transfer is irrevocable, you receive an income tax deduction at the time of transfer.
Charitable Gift Annuities: A gift annuity is an arrangement whereby a donor gives a sum of money or publicly traded securities to The Baptist Home. In exchange, The Baptist Home pays a fixed lifetime income to the donor. A charitable gift annuity can also be set up for two-lives, to provide payments to the donor and a spouse or other beneficiary.
Charitable Remainder Unitrust: A Charitable Remainder Unitrust is an irrevocable trust, which pays income to one or more beneficiaries, and distributes the remainder to charity after the death of the beneficiaries, or a term of years.
*Important Note:Whether you leave money to The Baptist Home through your Will, Trust, or by beneficiary designation, all of these gifts are removed from your taxable estate, and are not subject to federal estate tax.
The Right Plan for You
The Baptist Home stands ready to assist you in your planning. Please contact us for further information. The Baptist Home has Stewardship Representatives who can call on you in your home or office to discuss your giving options and estate planning needs. For more information, call toll free at 866-454-2709.
The Beginning
IN THE BEGINNING: The Baptist Home Grew from One Couple’s Heart
In the year of our Lord, 2012, and the ninety-ninth year of The Baptist Home, we look ahead by looking back. When The Baptist Home opened its doors to its first “inmates” (as all residents of institutions were called at the time) in May 1913, it was the culmination of a dream and a calling for Milford and Mary Riggs. He had been a Baptist pastor in Missouri since 1890 and an early pioneer in Baptist development causes in our state.
While he was serving as a development officer for the Orphans Home, the plight of elderly Baptists—especially retired Baptist ministers, their wives and widows—began to weigh heavily on his shepherd’s heart.
After a lifetime of service to congregations, many of the Baptist preachers of that day lived in extremely meager circumstances, being dependent on family, churches or county poor farms.
Without sentimentality, Dr. Riggs would write in Word and Way that “the Humane Society would cause the arrest of a man who would work his horse till he was old and worn out and then turn him out unfed and unsheltered….Our denomination ought to feel itself disgraced by a condition of this kind. We ought to make ample provision for our aged and afflicted ministers whose indigent circumstances make help necessary.”
Mary Riggs’ heart was one with Milford’s own. She shared his compassion and his vision and was a full partner in the work. While he was innovative and tireless in raising funds for The Home, she was equally indefatigable in her ministry. While he travelled the state, she cared for the residents full time, often as nurse, cook, laundress and ex officio (and unpaid) superintendent.
There is a note of great sadness at the end of the Riggs’ ministry. All their efforts could not defeat the ravages of the Great Depression. In April 1932, Dr. Riggs resigned as superintendent. He and Mary departed The Baptist Home, never to return.
But the foundation laid by Milford and Mary Riggs now supports the original work at Ironton, campuses in Chillicothe and Ozark and a ministry outreach worldwide “in the service of aging humanity.” It is a legacy entrusted to all of us by the Riggs.
Q&A: Wills and Estate Planning
Q. Isn’t estate planning only for the wealthy?
A. Every adult should have an estate and financial plan — whether the estate is large or small. An estate plan is not just for the wealthy, nor does estate planning only refer to what happens following your death. A sound estate and financial plan will help you achieve your present and future goals for good Christian stewardship.
Q. Does an estate plan involve more than having a will?
A. A will is the first and most important step in an estate plan, but it is not the only step. A will states what is to happen to your probate estate after your death. There are also other arrangements that can be used to supplement your will.
Q. What other arrangements besides a will can be part of an estate plan?
A. An estate plan can include trusts, life insurance and other financial agreements. Financial and health care power of attorneys should be a part of everyone’s planning. Planned charitable gifts can also be part of an estate plan, especially when they benefit you, your family and charitable organizations that exemplify your Christian beliefs.
If you would like more information about wills, estate planning or planned gifts, please contact The Baptist Home.
Tips for Avoiding Mental Confusion as We Age
Tips for Avoiding Mental Confusion as We Age
This is a presentation of the facts about mental confusion and memory loss in older adulthood. Subjects covered include: the relationship between aging and mental functions, common causes of memory loss, tips to limit confusion and memory loss and the indicators of serious memory problems.
Move It or Lose It: Maintaining Physical Fitness as We Age
Move It or Lose It: Maintaining Physical Fitness as We Age
This is a presentation of activities and exercises designed to help aging adults maintain and build physical endurance, flexibility, balance and strength. Participants will learn the benefits and importance of regular exercise and will get “to practice” some beneficial activities.
