Developments in elder care and Alzheimer’s disease

Researchers at Weizmann Institute of Science, Rehovot, have discovered a unique type of immune cell, the orderly activation of which could be the basis for future treatment of the currently fatal Alzheimer’s disease.

Their findings have led to new concept in how Alzheimer’s is perceived, based on a mechanistic understanding of the central role of microglial cells – the brain’s unique immune cells – in the disease. Prof. Michal Schwartz of the neurobiology department at the institute, said the discovery could eventually lead to new therapy for Alzheimer’s.

​Alzheimer’s, the most significant cause of dementia in the elderly population, is a neurodegenerative disorder manifested by various neuronal pathological processes and a significant reduction in brain function.

In the degenerative disease, beta-amyloid protein, or plaques, accumulate within and between brain cells. Due to both structural changes and the weakening of chemical communication pathways, the synapses, or junctions between neuronal cells, are lost. In addition, the cytoskeletal proteins of the axons, or nerve fibers, lose their normal structure, impairing their function and causing massive death of nerve cells.

The brain is a fragile and unique organ that has its own specially tailored immune system separate from the rest of the body. The primary role of the microglia is to recognize, disassemble and dispose of various substances that do not function properly in the brain, from dying cells to various cell debris and protein aggregates. Yet, microglial activity is under tight regulation to allow them to dispose of waste without harming adjacent healthy neurons that retain important information.

The microglia’s activities, from essential immune function to the risk of damaging healthy neurons due to hyperactivity, are well balanced in young healthy individuals, but might become a disadvantage in aging and under certain neuropathological conditions. A key question is why the brain’s own immune cells are not effective in repairing the damage associated with Alzheimer’s disease.

Schwartz has shown over the years that mobilizing cells from the systemic immune system does not always cause harm, and in fact, if well controlled, even help in coping with various brain pathologies. But no one had answered the question whether the microglia are helpful, harmful or useless to the body.

Working together with Prof. Ido Amit of the institute’s immunology department and members of their research groups – postdoctoral researchers Drs. Hadas Keren-Shaul and Assaf Weiner and research students Amit Spinrad, Orit Matcovitch-Natan and Raz Dvir-Szternfeld – Schwartz has now provided an answer to this question, along with a new research approach toward finding ways of treating the disease.

They studied a genetically engineered mouse model of Alzheimer’s, whose genetic makeup includes five mutant human genes that cause an aggressive form of the disease. The brains of these mice exhibit features similar to those that take place in the brains of humans suffering from the dementia.

A significant barrier to understanding the roles of immune cells in Alzheimer’s and other neurodegenerative diseases is the ability to accurately distinguish between similar cells with different functions, and thus understand which is “friend” and which is “foe.”

The team employed advanced single-cell genomic sequencing technology – a “genetic microscope” developed in Amit’s lab in recent years – to fully sequence the genetic material of single cells, allowing them to identify the unique function of these immune cells, even when they are extremely rare.

In this study, they sequenced the RNA content of all the immune cells in the brains of the Alzheimer’s disease mouse model and repeated this experiment at different points in the disease progression and compared the results with those from healthy mice.

​Credit: Jerusalem Post

For questions on how Alzheimer’s disease affects your estate planning, contact Mina Sirkin, Probate Attorney.

LOS ANGELES CONSERVATORSHIP CALIFORNIA CONTESTED CONSERVATORSHIP MATTERS 818.340.4479

CONSERVATORSHIP & ELDER CARE ATTORNEYS LOS ANGELES CA & SAN FERNANDO VALLEY

Conservatorship Attorneys, Lawyers & Advisors to Conservators Caring for Adult Members of the Family


What is a Conservatorship?  A Conservatorship in California is a judicially created relationship where an adult is given the legal authority and responsibility to care for another adult.   Our Los Angeles Conservatorship counsel and lawyers can assist you with the conservatorship process in Los Angeles County.

Types of Conservatorship:

General Conservatorships in Los Angeles County can be three basic types:

1) Conservatorship of the person; 2) Conservatorship of the Estate; and 3) Conservatorship of person and estate.

There are several other types of Conservatorship matters also available such as LPS Conservatorships (mental health) and Developmentally Disabled (Limited) Conservatorships.  Parents of Special Needs Adults should also look into a Supplemental Needs Trust to protect their child or loved one’s benefits.

Who can file for a Conservatorship?

Generally, spouses, children, relatives, friends, the public guardian, and professional fiduciaries.

If there are several persons who have filed competing petitions for conservatorship requesting that each becomes the conservator, the court will decide who shall become the conservator.  Preference rules exist for making such a determination. Contested Conservatorship proceedings can take long and may sometimes result in a trial.

A conservatorship must continue until the court terminates and orders the conservator relieved from his or her duties. This can happen if the conservatee dies, or is restored to capacity, or if the estate is all used up.  if the conservatee regains his or her capacity; or if the conservator becomes unable or unwilling to act. In the last situation, the court will assign a successor conservator.

Conservatorships are time-consuming and expensive. They should only be used when absolutely necessary
Candidates for conservatorships are usually disabled.  Some conservatees may have Alzheimer’s disease, dementia, parkinsons, autism, or other diseases.   Once a Conservators is appointed, the Conservator can ask the Court for permission to do Medi-Cal planning for the Conservatee including substituted judgment petitions to protect the assets from Medi-Cal, and to purchase or sell property of the Conservatee.


PROTECTING THE ELDERLY AND DISABLED WITH A CONSERVATORSHIP IN LOS ANGELES

Conservatorship proceedings and actions of conservators are court supervised.   Bonds protect the estate in Conservatorships of the Estate.

Family members are given notice of the proceeding and financial records of the conservatee are summarized in an accounting filed with the court.

When a Conservatee needs psychiatric medications, the Court reviews a doctor’s declaration regarding the need for the medication.    The ability of the Conservator to administer dementia medication depends on the court’s approval of administering such medication.

When a Conservator wants to sell real property or purchase real property, the court must give permission for such a transaction, especially when it involves moving the Conservatee from his or her home.

A PVP attorney is sometimes appointed for the Conservatee.  The role of this type of attorney is to advocate the wishes of the proposed conservatee when there is litigation, or when rights of the Conservatee are affected.  We have served Los Angeles California Residents since 1992.

California Conservatorship Process:

Conservatorship proceedings usually start when a person is so incapacitated that he or she cannot manage his/her own affairs. The person who is the caretaker is called the conservator, and the person who is being taken care of is called the conservatee.

The conservatorship proceeding begins with a petition filed with the court, followed by an investigation by a court investigator and a court hearing. Many factors can affect a conservatorship. For example, if the conservatee objects to the conservator’s appointment, he or she may object and the court will assign counsel for the conservatee for that purpose.

A conservator of the estate is required to provide accountings that give details of the conservatee’s assets, income and expenses, showing exactly how the conservatee’s money was spent. Additionally, the court will require that the conservator of the estate to post a bond. The conservator is paid by the conservatee’s estate and the court supervises the reasonableness of the payments to the conservator.

Why are Power of Attorney Documents Not Enough in Certain Situations?

1.   You cannot force a patient to take psychotropic medications with a power of attorney.   Doctors cannot administer psychotropic medications without the patient’s consent, even if there is a power of attorney.
2.   You cannot prevent the elder/ disabled from entering into a contract, transferring assets and property, or prevent them from marrying with a power of attorney.
3.   If the disabled person lacks capacity at the time of siging, you will have an invalid power of attorney.

While a valid power of attorney document can authorize the power of attorney holder to accomplish certain tasks of a conservator, a power of attorney cannot prevent the ill person from contracting, conveying property or marrying. For example, a patient with Alzheimer’s disease may become subject to fraud or undue influence by unscrupulous persons. 


While he or she could have given a valid power of attorney while he or she was well, he or she may be befriended, may marry, and convey his or her property to a new spouse. In that situation, the probate code provides that a conservatorship may be established, and the conservator may ask the court to set aside any contract entered into by the ill conservatee.

The advantage of the conservatorship is that it can safeguard against fraud or undue influence by a third party against the ill person.   Conservatorships can get costly when there is litigation involved.  Persons filing for conservatorship should consider the costs before filing.   Los Angeles Ca residents have hired us for over 22 years to assist them with Conservatorships.

What is a Contested Conservatorship or Conservatorship Litigation matter?

Contested Conservatorship and conservatorship litigation can involve any of the following situations:

1. Objections to the initial appointment of a particular person as a conservator.

2. Removal of an existing Conservator for cause.

3. Actions requesting appointment of a successor conservator to which others object.

4. Disputes involving contested conservatorship accountings.

5. Determination of a undue influence on an elderly or disabled person.

6. Objections to Proposed Actions by Conservator including substituted judgment actions and trusts.

7. Family mediations in determining the best conservator.

8. Requests to terminate a conservatorship or modify powers in a conservatorship.

9. Determination of rights to assets and disputes relating to ownership and title.

10. Conservatorship trials.

Our Los Angeles California attorneys are ready to serve Los Angeles County residents with Conservatorships.  Call us at 818-340-4479 for more information on conservatorship and contested conservatorship and conservatorship litigation matters.  Attorneys for Conservatorships in Los Angeles; Conservatorship Attorney Los Angeles.   Free Conservatorship Consultation.