Eldercare In An Age of Scarcity:Who Will Care? Who Will Pay?

Elder Care in Dedham MA is Shifting Away from Nursing Homes

2009-07-02T12:24:00.002-04:00

Elder care shifting away from nursing homes

Here is a great article I found in USA Today that is helpful for anyone considering an adult day care center, assisted living facility or hiring a geriatric care manager in the Dedham MA area. If you have any questions, or need help with an aging loved one visit us at www.elderlifeplanning.com.

http://www.usatoday.com/money/perfi/eldercare/2007-06-24-elder-care-costs_N.htm

How Seniors Stay Sharp in Dedham MA

2009-06-27T16:14:00.002-04:00

Here is a terrific article about how seniors are keeping their minds sharp. If you need help in the Dedham MA area, visit www.elderlifeplanning.com.

Lucid Old Age: What Do Those Who Keep Sharp Do Right?

My Great Uncle Bill (by marriage) could be in one of these "lucid mind" studies, but he's too busy. He's busy researching, writing and having published his many articles on 1880s railroads, along with his volunteer work. He's closing in on 94, and other than his cane and a bit of a stoop, he doesn't seem much older than a decade ago. Likely, he's too busy to notice that he's considered one of the "very old" who are still spry and mentally sharp.

Aging is getting complicated. These days, to be old enough to be studied as "very old" you've got to be in the 90-plus age group. Scientists are looking at people who reach this age with bodies that still work reasonably well and brains that stay sharp and active. Active may be the operative word here, though even that is vague.

Finish reading here: http://www.healthcentral.com/alzheimers/c/62/73323/lucid-age-sharp

Long-term Care: A Long Neglected Component of Health Insurance and Retirement Planning

2009-06-22T09:45:00.004-04:00

Marilee Kern Driscoll, nationally prominent speaker and the author of “The Complete Idiot’s Guide to Long-term Care Planning.” Has raised attention to the fact that long-term care has been a long neglected component of health insurance and retirement planning. It’s “ugly stepsister” status, says Driscoll, has been consistent in public programs and the benefits offered by employers. What this means is that the vast majority of Americans have no way to pay for the kind of long-term care they desire when they are old, sick or hurt and need non-medical daily assistance.

But all that may change, if pending legislation in Washington, spearheaded by Sen. Ted Kennedy passes. For the first time, the federal government could offer citizens a chance to buy into an insurance-like program. First, some background.
Long-term care is not covered by private health insurance and is rarely covered by Medicare (only non-daily care is covered and it must follow a related hospitalization). Long-term care is defined as care needed for more than 90 days, due to a sever cognitive impairment (such as advanced Alzheimer’s) or due to help needed with activities of daily living (eating, bathing, continence, transferring, etc.)

Although many states, including Massachusetts provide incentives for those who purchase long-term care insurance, and the IRS provides a tax break for some individuals and all businesses who provide this coverage, only the government’s Medicaid program is designed to pay for such care. The catch? Medicaid is a means-tested program, with tough financial requirements making the coverage available only to those who are financially destitute in order to qualify. That’s why so many people give away their money as they approach old age – so they look poor enough to qualify for the Medicaid. The other catch? Medicaid pays primarily for nursing home care, and not for the kind of care most seniors want – in their own home, an assisted living facility or a continuing-care retirement community (CCRC).

Driscoll encourages consumers to ask questions and become better informed about this critical issue. One way to to do this is to subscribe to Driscoll's free newsletter, and find local help with long-term care anywhere in the U.S. at www.LTCmonth.com.

Keeping Seniors Safe at Home in Dedham MA

2009-06-19T16:51:00.002-04:00

Here is a great article about the very sensitive subject that many may face when their parents are living in an unsafe home. If you need help with an aging loved one in the Dedham Massachusetts area, visit www.elderlifeplanning.com.

How Do I Get Dad Out of His Cluttered, Unsafe Home?

by Carol Bradley Bursack

People want to stay in their own homes. You hear it and read about it all the time. And there’s some merit to that. Most of us can relate to the fact that relocating is emotionally charged. Add the fact that our parents get sick and tired of suffering the indignities of aging and often feel bossed around by everyone from the government to their kids, and you can understand why they often get stubborn. Where they live may be, in their minds, their “last stand.”

Many elders do well in their homes. They graciously accept the help they need, have cleaning people come in, and are even able to throw away the old newspapers that are piling up in the corner. They are content with adding some safety measures and feel cozy with a bit of clutter.

Then there’s the other side. Many seniors are living in the same home they raised their children in. These homes are modest, but worked well for raising their family and even for the early empty nest years. Often, however, they are two-story cottages, with the bedrooms and the only bathroom up a long flight of stairs. They have small closets and full basements, generally stuffed to the rafters with things they’ve forgotten but feel they can’t live without.

After four or five decades in this small home, the place is packed with memories as well as junk. Then, one spouse – let’s say Mom – dies. Dad is now alone in this house. He gets even more “thrifty,” and doesn’t want anyone coming to mow the yard. He’s a bit paranoid, and doesn’t want to pay a housekeeper, so the place is filthy. Electrical outlets are old and overloaded. Plumbing barely works and doesn’t get fixed. You try to help and he just gets more stubborn. He thinks you are trying to take over and guards his territory like a homesteader on the plains.

Newspapers and magazines pile up (generally unread). Food spoils in the fridge. But the worst of it is he is soiling his pants because he can’t get up the stairs to the bathroom on time.

You and your siblings have a conference and decide to intervene. You research assisted living centers, and offer to take him around for a tour. You tell him you are afraid he will fall going up and down the steps in a hurry. You nag him to move for his safety. You dangle pretty brochures about assisted living in his face. He just gets more stubborn. What do you do? I’ve known some people who have had to call Social Services, have them do a welfare check, and let them take over the task of getting an elder out of a cluttered, filthy, unsafe home.

Before going that far, I’d suggest that you try a couple of gentler things. First, get Dad to his doctor. You may have to go under the guise of a blood pressure check or something of the kind, but let the doctor know ahead that you are wondering about depression. Depression is often part of the problem, especially if a spouse has died. Depression also can cause people not to care about their surroundings and make it impossible for them to take action.

Then there is the fact that he can’t throw anything away. People of this generation grew up in the Great Depression. They have a hard time throwing things away because they are afraid they many “need it sometime.” Therefore, the house piles up with unusable and forgotten objects stuffed into every corner. Again, though an anti-depressant won’t cure this ingrained thinking, it may help Dad become more flexible. Once depression is ruled out or treated, appeal to his frugal side.

Tell him, “I understand why you want to stay in this house, Dad. It’s full of memories and represents your past. But it isn’t safe the way it is, because the bathroom is upstairs and so is your bedroom. I know you sleep on the couch a lot so you don’t have to climb the steps. But you still have to go to the bathroom. So, I’ve called a home remodeling company and we have an appointment with him to talk about adding a bedroom and bath onto your main floor. It can spread out onto the back lawn.”

Then, do it! Get really excited. Call someone to come over and give an estimate. Chances are that once Dad sees that he can make a decision to stay in his home, but that it will cost a ton of money to do it, he’ll likely say, “I’ve decided I don’t want to remodel. Let’s look at those assisted living brochures.” And you are on your way.

If he still won’t budge? Go ahead and plan. Maybe a remodeled house will work for him. If all else fails, get that welfare check from Social Services. They may have to force the issue. But your chances are good that he’ll find a better option. He’ll likely be more willing to check out those assisted living places you mentioned once he’s seen alternatives. It’s just that he needs to feel he is making the decision, not someone else. You can’t blame him, can you?

For over 20 years author, columnist and speaker Carol Bradley Bursack cared for a neighbor and six elderly family members. Because of this experience, she created a portable support group – the book “Minding Our Elders: Caregivers Share Their Personal Stories.” Her sites, www.mindingourelders.com and www.mindingoureldersblogs.com, include helpful resources as well as links to direct support. Bursack’s newspaper column, “Minding Our Elders,” runs weekly, she speaks at many caregiver workshops and conferences and has been interviewed by national radio, newspapers and magazines. She is the moderator of the AgingCare.com forum.

Original article appears at: http://www.agingcare.com/Featured-Stories/133954/How-Do-I-Get-Dad-Out-of-His-Cluttered-Unsafe-Home-.htm

The Hidden Secret of Elder Abuse in Dedham MA

2009-06-13T18:02:00.003-04:00

Many elderly people rely entirely on family or other trusted individuals to help them. Whether it is for physical needs or emotional needs, as people grow older they tend to need more and more help from others. This dependence on caregivers or family members makes an older person more vulnerable for abuse.

For example, an older person relying on her children to provide meals and transportation and help her with financial decisions finds it difficult to complain when one of her children takes advantage of her. If, for instance, the child takes her money, hits her or neglects her care, the parent may be threatened with loss of support from the child if the parent complains. The child may also use threats of violence to keep the parent in line.

It is estimated that 5% to 10% of elderly Americans are suffering abuse. According to the National Committee for the Prevention of Elder Abuse,

“Spiraling rates of elder mistreatment are reported by both practitioners and researchers. In a recent national study of Adult Protective Services (APS), typically the agency of first report concerning elder abuse, there were 253,421 reports of abuse of adults age 60+ or 832.6 reports for every 100,000 people over the age of 60 (Teaster, Dugar, Otto, Mendiondo, Abner, & Cecil, 2006). The National Elder Abuse Incidence Study (National Center on Elder Abuse, 1998) found that more than 500,000 persons aged 60+ were victims of domestic abuse and that an estimated 84% of incidents are not reported to authorities, denying victims the protection and support they need.”

Much attention has been focused on abuse in nursing homes but most of the elder abuse in this country is at the hands of family members or other caregivers in the home.

In 2004, Utah Adult Protective Services workers investigated approximately 2,400 allegations of abuse, neglect or exploitation of vulnerable adults. In Utah, a vulnerable adult is defined as an elder adult (65 years of age or older) or an adult (18 years of age or older) who has a mental or physical impairment, which substantially affects that person's ability to protect or provide for themselves. The majority of the victims were females between the ages of 60-89 and 60% of the perpetrators were family members/relatives, while 24% were non-related paid caregivers.

The protective needs identified were as follows:

self-neglect 31%
physical abuse 16%
exploitation 19%
caretaker neglect 12%
emotional abuse 19%
sexual abuse 3%

In conducting the investigations, it was not uncommon to find that adults who were self-neglecting were also being exploited or abused. As stated previously, these statistics are based on approximately 2,400 cases, thus, if only one in ten cases are ever reported, it is possible that there were actually 24,000 or more cases in Utah that year. We suspect 9 out of 10 is close to the actual ratio of unreported versus reported cases in Utah.

We also believe that Utah's lack of reporting elder abuse is not unlike other states in the country. We suspect all the states are experiencing close to the same ratios of underreporting as in Utah.

There are a number of reasons why incidents of abuse, neglect, or exploitation are not reported to Adult Protective Services or other authorities. One of the most common reasons is the victim's fear of losing support. Many of the perpetrators are family members and the victim fears that reporting the crime will result in removal of the caregiver, as the perpetrator may face incarceration or may discontinue relations with the victim once accused, charged, or convicted. Many of these victims fear that by reporting abuse they will be left alone and expected to care for themselves or they will be forced to live in a nursing home.

Many states have implemented mandatory reporting laws to assist in the prevention of abuse, neglect or exploitation of vulnerable adults. Utah is one of the many states to have a mandatory reporting law (U.C.A. § 76-5-111). Utah law states that any person who has reason to believe that a vulnerable adult has been the subject of abuse, neglect, or exploitation shall immediately notify Adult Protective Services or the nearest law enforcement agency. Anyone who makes the report in good faith is immune from civil liability in connection with the report; however, any person who willfully fails to report is guilty of a class B misdemeanor.

It is important to note that the anonymity of the person or persons making the initial report and any other persons involved in the subsequent investigation shall be preserved and may only be released in accordance with the rules of the division (U.C.A. § 62A-3-311). In addition, all investigation information is confidential.

The following is a list of indicators of abuse, neglect or exploitation. It is important to note that the following lists are merely indicators and may not always be violations.

Signs of Abuse:

Unexplained bruises, welts, fractures, abrasions or lacerations
Multiple bruises in various stages of healing
Multiple/repeat injuries
Low self-esteem or loss of self determination
Withdrawn, passive
Fearful
Depressed, hopeless
Soiled linen or clothing
Social Isolation

Signs of Neglect/Self-Neglect:

Dehydration
Malnourishment
Inappropriate or soiled clothing
Odorous
Over/under medicated
Deserted, abandoned or unattended
Lack of medical necessities or assistive devices
Unclean environment
Social Isolation

Signs of Exploitation:

Missing/"disappearing" property
Inadequate living environment
Frequent/recent property title changes or will changes
Excessive home repair bills
Forced to sign over control of finances
No/limited money for food, clothes and other amenities

Prevention can only occur if there is awareness, the statutes are adhered to, and any suspicions of abuse, neglect or exploitation of vulnerable adults are immediately reported to Adult Protective Services and/or law enforcement.

All states have agencies that receive complaints of abuse. In some states failure to report abuse of the elderly is a crime. To contact an abuse complaint department, call your local area agency on aging. To find an area agency on aging in your area go to http://www.longtermcarelink.net/eldercare/ref_state_aging_services.htm

Visit us at www.elderlifeplanning.com if you have any questions, or need help for an aging family member in the Dedham MA area.

California Budget cuts Will Eliminate Services for Thousands of Frail Elders

2009-06-09T11:30:00.003-04:00

Health care advocates are speaking out against Gov. Arnold Schwarzenegger's (R) budget proposals, which could cut about $3 billion from health programs, particularly those that target low-income seniors and children, the San Francisco Chronicle reports.

The possible health care cuts are part of the governor's plan to address the state's estimated $24.3 billion deficit.

California's Health and Human Services Department's $31 billion budget makes up the second-largest share of state spending behind education.
Elderly Care Cuts

Schwarzenegger's proposed cuts include eliminating the state Adult Day Health Care program, which would reduce state spending by about $117 million and suspend services for about 36,000 Californians. The cuts could result in layoffs for as many as 6,500 employees at the state's 300 centers, advocates predict.
The governor also has proposed cutting In-Home Support Services for all but the most severely disabled clients, which would reduce state spending by about $616 million. Of the program's 462,000 current recipients, about 36,000 would retain eligibility under Schwarzenegger's proposal.

In addition, the state could eliminate the Multipurpose Senior Service Program and Linkages, which serve elderly and disabled residents who otherwise might be placed in nursing homes or other institutions. Cutting such programs could save the state $25.2 million, and would affect more than 18,000 people (Colliver, San Francisco Chronicle, 6/8).

Advocates contend that the cuts to eldercare services could drive more people into nursing homes, thus costing the state more money in the long term.
Debbie Toth, executive director of the Mt. Diablo Center for Adult Day Health Care, estimated that California pays about $9,000 annually for each client in the local Multipurpose Senior Services Program, compared with about $30,000 annually for seniors who are re-directed to nursing homes.
If the state eliminates such programs, it will be extremely challenging to re-establish them, Toth said. She added, "The travesty is that elimination of these programs will force massive closures in the nonprofit world in senior care. The negative impact will be felt in future generations" (Kleffman,

Contra Costa Times, 6/7).

Source: http://www.californiahealthline.org/Articles/2009/6/8/Budget-Ax-Looming-Over-Calif-Elderly-Child-Health-Programs.aspx

Oprah Winfrey's Snake Oil Promotions Exposed in Newsweek Cover Story

2009-06-07T20:54:00.006-04:00

I read this week's cover story in Newsweek this afternoon and I was stunned to think that Oprah Winfrey would abuse her status as a celebrity to promote practices that are not only unsafe, but in some cases life threatening. Unfortunately this overpaid and over hyped phony appears in most TV markets during the late afternoon when many older viewers tune in.

Her lame defense of the Newsweek expose of her repeated promotion and favorable treatment of modern day purveyors of "snake oil" is "I'm not endorsing any of these treatments I'm just putting out information so viewers can make up their own mind". This defense is a sham. She's not presenting "information", she's promulgating lies and encouraging dangerous and unhealthy behavior.

When she exposes her huge audience to dangerous practices such as ingesting 60 vitamin pills daily, guests who encourage people to inject themselves with dangerous homones that have no positive value, that alone should be enough for the FCC to shut her show down. But scaring parents of young kids into thinking they should avoid getting these kids vaccinated against polio, mumps and measles by inviting guests who insist that there's a danger the child will develop autism, amounts to mass child abuse.

The myth that vaccines cause autism has been around for years and has been repeatedly repudiated in the most respected medical journals, while these vaccines have prevented tens of thousands of children from dying of once common diseases. That Oprah still has a huge audience, gullible enough to fall for her nonsense only proves that no matter what medicine you use you can't cure stupid.

Bob O'Toole encourages comments to this blog. He can be reached at bob@elderlifeplanning.com

Opportunity for Eldercare Professionals and Family Caregivers to Participate in Alzheimer's Research Clinical Trial-Elder Life Planning, Dedham MA

2009-06-01T12:25:00.004-04:00

Informed Eldercare Decisions recently signed a contract to provide ongoing consultant services to a major Alzheimer's research firm. Our client has successfully completed the first 2 phases of research trials, known as the ICARA study, on a breakthrough drug to treat Alzheimer's.(If you watched the HBO Alzheimer's Special recently, the drug, Bapineuzumab, along with the ELAN research team, was prominently featured.)

They have now received approval from the FDA to move into Stage III of the drug trials which allows them to expand the scope of the research nationwide and in Canada.

Our role in the project is to identify potential participants in the Stage III trial and assure their ongoing commitment and compliance with the clinical protocols. Participants will include elders who are showing signs of mild to moderate dementia and a designated caregiver. (Residents of dementia units would not be suitable as they are likely to be at a more advanced stage than the research criteria requires.)

We can recruit and screen subjects using home care agencies, assisted living residents, adult day health programs, and geriatric care managers.

There is an opportunity for geriatric care managers, assisted living facilities and home care agencies to play an active role in this project as well as other clinical trials in the near future. This could include helping us to follow subjects and family caregivers who are either living at home, or in assisted living facilities for 18 months.

There are some significant advantages for elder care professionals to participate in this study as it will be receiving widespread media coverage as the trial progresses.

This is the first time that the scientific community involved with cutting edge research on illnesses that primarily affect elders has worked with a nationwide network of eldercare professionals. We at Informed Eldercare Decisions believe that the time has come for professionals who interface with those most likely to benefit from this research to play an active role in these studies. This new partnership between the provider community and the research community also opens up new revenue opportunities for both non-profit and for profit eldercare agencies.

Rather than try to describe the project in any more detail in this newsletter, I encourage you to review an excerpt from the HBO Alzheimer's Special that specifically describes the breakthrough research we are now involved with.

If you think you or your agency or eldercare professional practice would be interested in exploring participation in these studies further please review the following excerpt from the

HBO broadcast.

"Inflammation, the Immune System, and Alzheimer's"

(Approx. 29:23 min) Featuring: Joseph Rogers, PhD-Banner Sun Health Research Institute; Dale Schenk, PhD- and his research team at Elan Pharmaceuticals.

You can view the video by placing either of the following links into your URL locator.

http://www.hbo.com/alzheimers/supplementary-inflammation-the-immune-system-and-alzheimers.html or at http://tinyurl.com/qq8x3h

An Invitation for Eldercare Professionals(home care providers, assisted living facilities and geriatric care managers), to sit in on a 40 minute discussion on how eldercare professionals are getting involved with Alzheimer's disease clinical trials and other cutting edge research on illnesses affecting elders.

Date: Wednesday, June 3, 2009

Time: 2:00 p.m. Eastern Time

Location: You can participate from your home or office by simply dialing into the teleconference.

As mentioned in the article above, there are some significant opportunities for elder care agencies to participate in the research studies that were prominently featured in the HBO Alzheimer's Special in May.

The study will continue to receive widespread national publicity.

During this 40 minute informational webinar on Wednesday we'll provide a brief overview of the role that providers can play. Senior management and research personnel from ELAN pharmaceuticals will be on the call to answer any questions you may have.

I hope you can be on the call and will invite other eldercare professionals whom you feel may be interested to sit in as well. We'll provide the call in number and conference code as well as a web site to view if you happen to be at a computer.

You can view the visuals from a computer but a PC isn't required. You can participate in the call from wherever you happen to be.

Let me know if you'd like to be on the call and I'll send you the conference call number and log in details.

I hope you can join us,

Warm regards,

Bob O'Toole

www.elderlifeplanning.com

There’s No Place Like Home For Growing Old in Dedham MA

2009-05-30T12:59:00.002-04:00

“The stairs are getting so hard to climb.”

“Since my wife died, I just open a can of soup for dinner.”

“I’ve lived here 40 years. No other place will seem like home.”

These are common concerns for older people. And, you may share an often-heard wish—“I want to stay in my own home!” The good news is that with the right help you might be able to do just that.

Click on the link below from the National Institute on Aging to read more. The tips there will help families know what to do first, the kinds of help available, where to start and what the costs are. If you have any further questions, or need help with an aging loved one in the Dedham MA area, visit www.elderlifeplanning.com.

Here is the link: http://www.nia.nih.gov/HealthInformation/Publications/stayinghome.htm

30 Reasons Your Loved One May Need a Caregiver in Dedham MA

2009-05-22T21:33:00.001-04:00

I found this article, and decided to pass it on to you. It provides extremely helpful information that may help you with your decision to choose elder care for an aging loved one in your family. The original article can be found at http://EzineArticles.com/?expert=Rebecca_Sharp_Colmer. As always if you have questions or need help, please visit our website www.elderlifeplanning.com.

30 Reasons Your Loved One May Need a Caregiver

By Rebecca Colmer

There are approximately 37 million people over the age of 65 and 5.3 million people over the age of 85. Each year millions of older people start requiring some sort of assistance to carry out their routine daily activities. Family members (family caregivers) provide most of the help.

It is not always easy to know when to intervene. It may seem like your loved one is in a gray area somewhere between competency and incompetence.

Your loved one can have a behavior that is not life threatening but still very serious. Making an assessment is the very step.

Here are some clues that your loved one may need some extra help:

1. Disheveled clothes

2. Stained or dirty clothes The same outfit worn everyday

3. Unkempt hair

4. Poor hygiene

5. Bad breath

6. Body odor

7. Having trouble walking

8. Having trouble sleeping

9. Dangerous driving

10. Extreme clutter in the home

11. Can't do light housekeeping

12. Items not returned to drawers or cupboards

13. Clothes strewn about or left on floor

14. Medication bottles left open

15. Medications taken out of original containers and mixed up

16. Not much food in house

17. Spoiled or rotten food

18. Unpaid bills

19. Penalties for overdue bills

20. Unopened mail

21. Put on or lost a lot of weight that is unexplained

22. Signs of confusion

23. Signs of forgetfulness

24. Signs of isolation

25. Signs of depression

26. Drastic mood swings

27. Extreme sadness or loneliness

28. Loss of interest in favorite hobby

29. Stopped doing things they used to enjoy like gardening, reading, going to church, seeing friends

30. Can't cope with everyday stress

If you do not live near your aging parents, ask a neighbor or friend to keep an eye on your parents and notify you if they notice any changes in their behavior.

Even if you determine that your loved one needs some assistance, keep in mind that they may be resistant to your help. Be gentle and compassionate when asking them to accept help.

It may take several tries before they start to accept your help. There is a big difference in offering help and completely taking away all of their independence.

However, if your parent's life is in danger and you can't find a way to intervene, call Adult Protective Services, which is a part of the Department of Social Services. They will send a nurse or social worker to your parent's home to determine the risks and find ways to protect your parent.

The caregiver role is complex and differs for everyone depending on the needs of the care-receiver. Many times, in the beginning, there may only be a few needs, such as providing transportation or helping with shopping or cooking. Over time, needs increase, requiring additional services, until the care-receiver is fully dependent on the caregiver.

Rebecca Colmer is an Eldercare Advocate, Author, Speaker, Publisher, and Caregiver Expert. You can find more caregiving tools and resources at her website: Caregiving Tools

Article Source: http://EzineArticles.com/?expert=Rebecca_Sharp_Colmer

How to Care for Your Parents and Keep Your Sanity

2009-05-21T07:59:00.003-04:00

Here's some worthwhile reading to consider over the Memorial Day weekend.

Caring for elderly parents can leave a person lost and overwhelmed

Every aging-parent scenario is unique; there are few generalities that apply

Caring for the elderly will force you to -- and help you -- face your own mortality

Our way of caring for the elderly is a clumsy, exhausting tarantella. It force-partners isolated caregivers (usually middle-aged women) with decline, disease, dementia, and death.

"Having aging parents simultaneously orphaned me, saddled me with two insane strangers, and shoved every nightmare about my own future right into my face."

Polly nearly bankrupted herself caring for her father, who has Alzheimer's.

Brooke has barely slept since her ailing mother-in-law moved in.

Jennifer had to testify against her parents in court so they'd be declared "incompetent to drive" before accidentally killing themselves or someone else.

For the complete text of this comprehensive discussion on a most diffiuclt subject go to the following link: Oprah Winfrey's Blog at CCNN.com: http://www.cnn.com/2009/LIVING/personal/05/15/oprah.caring.for.parents/

Seniors and Baby-Boomers in Dedham MA Keep Their Brains Young When They…

2009-05-16T16:51:00.004-04:00

This is an interesting article from the Fisher Center for Alzheimer's Research Foundation. If you have any questions, please visit www.elderlifeplanning.com.

Reading, Crafts Help Keep the Brain Young

More good news on the neurobics front: Reading books, playing games or engaging in computer activities or crafts like pottery or quilting helps keep the brain young into old age, according to a new report. And while reading was good for the brain, watching too much TV seemed to be bad for it.

The findings, to be presented at the American Academy of Neurology’s 61st Annual Meeting in Seattle in late April, add to a growing body of evidence that mental challenges, or “neurobics,” like crossword puzzles and word games help keep memory and thinking sharp.

The research, from the Mayo Clinic in Rochester, Minn., involved a random sampling of 1,321 men and women in their 70s and 80s. Among the participants, 197 had mild cognitive impairment, a form of memory loss that sometimes precedes Alzheimer’s disease. The remainder had no memory problems.

Both groups filled out questionnaires about their everyday activities during the previous year. They also answered questions about what they engaged in during middle age, when they were in their 50s and 60s.

The researchers found that during the later years, those who regularly engaged in mentally-stimulating tasks like reading, crafts and computer activities were 30 to 50 percent less likely to suffer from serious memory loss compared to people who did not do those activities. People who watched television for less than seven hours a day as seniors were 50 percent less likely to develop memory loss than people who watched TV for more than seven hours a day.

People who participated in social activities and read magazines during middle age were about 40 percent less likely to develop memory loss than their less social peers or those who read less frequently.

“This study is exciting because it demonstrates that aging does not need to be a passive process,” said study author Yonas Geda, M.D., M.Sc., a neuropsychiatrist at the Mayo Clinic. “By simply engaging in cognitive exercise, you can protect against future memory loss.”

The researchers warned that these kinds of studies, which depend on participants’ recall of long past events, can be unreliable. But a growing body of evidence points to the benefits of mental stimulation in helping to ward off memory loss. Such activities may help to preserve and strengthen connections between brain cells in areas of the brain critical for memory.

Visit ALZinfo.org, the Alzheimer’s Information Site, to learn more about keeping the brain sharp and prevention of Alzheimer’s disease. And for thought-provoking games and word puzzles, subscribe free to the Fisher Center’s “Preserving Your Memory” magazine.

By ALZinfo.org, The Alzheimer's Information Site. Reviewed by William J. Netzer, Ph.D., Fisher Center for Alzheimer's Research Foundation at The Rockefeller University.

Source: Yonas E. Geda, Rosebud Roberts, David Knopman, et al: “Cognitive Activities Are Associated With Decreased Risk of Mild Cognitive Impairment: The Mayo Clinic Population-Based Study of Aging.” The American Academy of Neurology.

Original link: http://www.alzinfo.org/newsarticle/templates/newstemplate.asp?articleid=346&zoneid=10

Half of Nursing Home Assistants (CNAs) in U.S. are injured on the job. Poor Pay Forces A Third to Be on Public Assistance

2009-05-15T14:07:00.005-04:00

Public release date: 14-May-2009 Nursing assistant workforce facing financial, health challenges
A pioneering study of certified nursing assistants (CNAs) in nursing homes reveals that more than half of them incurred at least one work-related injury in the previous year. One in three received some kind of means-tested public assistance, and nearly half of those without medical insurance claimed they could not afford their employer-sponsored plan.

These statistics, gathered from the first-ever National Nursing Assistant Survey (NNAS), are presented in an article appearing in the latest issue of

The Gerontologist (Vol. 49, No. 2). The lead author is Senior Policy Analyst Marie Squillace, PhD, of the Office of the Assistant Secretary for Planning and Evaluation within the U.S. Department of Health and Human Services.
"The care of 1.5 million elderly and chronically ill persons in the United States is largely in the hands of nursing assistants — the individuals who provide eight out of every ten hours of care residents receive in nursing homes. Turnover of these direct care workers is high, which profoundly decreases the quality of life and care of the residents," Squillace said.

Many reports — most prominently the Institute of Medicine's 2008 "Retooling for an Aging America: Building the Health Care Workforce" — project there will be a shortage of CNAs in coming years. The federally-funded NNAS can be used to develop a strong evidence base for policy, practice, and research initiatives to improve nursing assistant recruitment and retention efforts.

"The NNAS is useful for improving data quality and bridging knowledge gaps. As the only national database on CNAs in nursing homes, the NNAS will improve our current understanding of a vital job," states Squillace's team of researchers. Previous studies had only examined local or regional samples that were not representative of the country as a whole.

The survey results are based on the responses of 3,017 nursing-home based CNAs. To be eligible to participate in the NNAS, a nursing assistant had to be employed by a nursing home (and not as a contract worker); be certified by the state to provide Medicare/Medicaid reimbursable service; be a speaker of English or Spanish; and be employed more than 16 hours per week.

Slightly more than half (56 percent) reported they were injured on the job at least once in the previous year. Of those who were injured, almost one quarter were unable to work for at least one day as a result.

Approximately 16 percent had no health insurance; 42 percent of that group cited cost as the reason. Years of experience did not translate into higher wages among CNAs. Those with ten or more years of experience averaged just $2 per hour more than aides who started working in the field less than one year ago. The reported median hourly wage was $10.04.

As many as 40 percent of CNAs had at some point in their lives received public benefits (e.g., food stamps, rental subsidies, or Temporary Assistance for Needy Families); almost one third were currently receiving this type of aid at the time of the survey. Additionally, the vast majority of the survey respondents (92 percent) were female.

"These and other forthcoming results will figure prominently in federal and state labor, welfare, and health policy discussions on expanding the pool of workers and on reimbursement policy, regulation policy, and program design," Squillace said. "Ultimately, this will lead to improvements in the quality of life and care of older Americans in U.S. nursing homes."

The Gerontologist is a publication of The Gerontological Society of America (GSA), the nation's oldest and largest interdisciplinary organization devoted to research, education, and practice in the field of aging.

Eldercare Answers for the 21st Century

2009-05-14T12:15:00.002-04:00

We're always looking for valuable resources for caregivers and I want to highly recommend Elder-care-911(see the link below)

http://www.squidoo.com/elder-care-911
Is it still the children's job?
Our care giving delemma derives many of its frustrations and heartaches to our parents' and society's centuries-old expectations that caregiving for the elderly "is the children's job." This assumption is still the status quo even though you have no medical or gerontological training. It assumes that you will know the following-when, how and how much to intervene-how to manage insurance benefits-how to evaluate a nursing home-how to cope wth Alzheimer's disease-how to resolve a host of other new and life altering caregiving dilemmas.

The assuption also holds that yo will find time tocontinue:-nurturing your children-being a good partner-working in your career-maintaining your own perosnal time and spaceThe fact is that the world is a much different place than when our parents cared for their parents. They probably lived closer together, the women did not work outside the home and doctors spent more time with their patients, and the options for eldercare were very limited at best.

Now families may be scattered across the country or continents, both partners have spent years creating families and careers and there are so manyu options for a functional life expectancy that it takes a geriatric professional to understand them.Even so, in many familes guilt wins out, ao we continue the status quo.But wait... We are the first generation, ever in the entire history of the world, to face the difficulties of living in a time where we may spend more years caring for elderly parents than we spent caring for our children.

Eldercare 911 understands and respects the many facets of a caregiver's busy life. The goal is to deliver tested, practical problem-solving information that saves time and money. It is a realistic guide for dealing with today's caregiving situations.It has been recently Revised, Updated and Expanded to stay on top of the latest issues and resources.

Harvard Medical School Instructor Warns About financial Impact of Alzheimer's on Families

2009-05-12T09:27:00.003-04:00

May 11th, 2009
"With lost jobs and foreclosed homes, families caring for those in the moderate to advanced stages of Alzheimer's disease at home are hitting the breaking point. Recalibrating their expectations in ways they never imagined, families are looking for answers and we can't afford to ignore them." Dr. Zoë Ann Lewis stated at recent caregiver conference in Miami. "In this economy we are seeing financial barriers that prevent families from accessing help for their loved ones with Alzheimer's. For many confronting this disease, the finances targeted for their golden years evaporated and families are getting desperate with fewer options if they are caring for a parent at home."

Dr. Lewis, an Alzheimer's education activist, cites treatment and comprehensive care information should be given early on to all family members, preferably at the moment of diagnosis. She is creating a nonprofit startup, "Hope Through Knowledge" that would allow third parties to distribute her book for free, giving families and patients the earliest opportunity to create responsible plans for their future. "Without comprehensive planning, healthcare and other related costs involved in the care of those with Alzheimer's disease could sky rocket," Dr. Lewis warns. "It makes sense third parties motivated to contain their costs would sponsor efforts that provide information and resources to families as soon as they are diagnosed."

The author, Zoë A Lewis, MD, FACP, DAAHPM, is an elected fellow to the American College of Physicians, a Diplomat of the American Academy of Hospice and Palliative Medicine, and a former Harvard Medical School Clinical Instructor of Medicine. Her website zoealewis.com is dedicated to "hope through knowledge," encouraging the dissemination of information to practitioners and families regarding end-of-life care issues and Alzheimer's disease. She is producer and host of hospice radio on blogtalkradio.
Zoë A Lewis, MD, FACP

www.zoealewis.com

HBO to Begin Alzheimer's Miniseries

2009-05-09T19:52:00.002-04:00

Beginning May 10th, HBO will broadcast a new miniseries based on the accounts of those with Alzheimer's disease and those whose lives are touched by their condition. The 4-part miniseries is the cornerstone in an overall effort to raise awareness and increase public understanding of the disease that will also involve a public awareness campaign and book. HBO is ensuring that the series can be viewed by all-even if a person does not have HBO. Cox Communications for digital cable subscribers can find it On-Demand for free. Portions of each show will appear on YouTube, iTunes, MySpace and Facebook -and the entire series will be available on HBO.com in installments beginning May 8. The series is also available for purchase. Each episode will approach Alzheimer's disease from a different perspective:

The Memory Loss Tapes. This introductory episode presents the stories of several people with Alzheimer's, shedding light on the disease by showing it through the unique perspective of the person living with the disease.

Grandpa, Do You Know Who I Am? Hosted by Maria Shriver and based on her book, What's Happening to Grandpa?, this segment aims to help children and teens to cope with Alzheimer's disease in their families and understand how it can affect their loved ones.

Caregivers. This segment presents five stories of caregivers working with seniors in various stages of the disease.

Momentum in Science. This two-part installment is the hopeful core of the series, spotlighting various clinics and laboratories to showcase the latest advances and research in Alzheimer's treatment and the search for a cure.

The material for the miniseries is drawn from recent research, personal accounts of the disease, and a new HBO-commissioned Alzheimer's Survey inspecting the impact of Alzheimer's disease in America.

Refresher: HBO's new documentary series offers new insight on Alzheimer's disease for today's caregivers and future generations.

HBO air dates and times

Sunday, May 10 at 9 p.m. ET

THE ALZHEIMER'S PROJECT: THE MEMORY LOSS TAPES

Monday, May 11 at 7:30 p.m. and 8 p.m. ET

THE ALZHEIMER'S PROJECT: 'GRANDPA, DO YOU KNOW WHO I AM?' WITH MARIA SHRIVER

THE ALZHEIMER'S PROJECT: MOMENTUM IN SCIENCE (Part 1)

Tuesday, May 12 at 7 p.m. and 8 p.m. ET

THE ALZHEIMER'S PROJECT: CAREGIVERS

THE ALZHEIMER'S PROJECT: MOMENTUM IN SCIENCE (Part 2)

Visit www.elderlifeplanning.com with any questions, or if you need help with an aging loved one in the Dedham MA area.

Bill to Clamp Down on Dubious "Certified Elder Care Experts" is Filed in U.S. Senate

2009-05-08T16:02:00.005-04:00

We have warned our readers in the past about the dangers of some who claim to be "Certified Elder Care Experts", using misleading designations to convince older consumers that they have advanced levels of expertise and experience.

See the Friday, April 18, 2008 post, "Beware of the SMELIE's: Predators Out To Scam Older Consumers With Fraudulent or Incompetent Financial Advice"

Now after more than two years of investigations by state attorney generals, securities regulators, and congressional committees, a bill has finally been submitted to Congress to protect consumers from these shysters.

The bill, “The Senior Investor Protection Act of 2008,” offers states those resources necessary to protect seniors from unscrupulous financial advisors who prey on the retirement savings of the elderly by touting misleading or fraudulent senior designations. The proposed legislation would create a new grant program that encourages state regulators to adopt a uniform standard for the accreditation of senior financial advisors and assists states in their efforts to protect seniors from being duped by these misleading designations.

The bill sets the standard for legitimate certifications and designations that provide financial advisors with the expertise necessary to effectively serve seniors. According to the Senior Investor Protection Act of 2008, legitimate programs are offered by academic institutions having regional accreditation or meet the standards outlined by the North American Securities Administrators Association (NASAA) Model Rule on the Use of Senior-Specific Certifications and Designations or are issued or obtained from any State. Other programs meeting less stringent standards are referred to in the bill as “misleading designations.”

Larry Barton, PhD., President and Chief Executive Officer of The American College The American College praised the U.S. Senate Special Committee on Aging for advancing legislation that creates a single, national standard for determining appropriate professional designations held by financial professionals serving retirees.

“As the nation’s leading financial services college with the highest level of accreditation, and as a non-profit public charity dedicated to financial literacy, we strongly endorse the diligence and leadership demonstrated by Chairman Kohl, Senator Vitter and the Committee,” Barton said . “In an era when the public is concerned from Main Street to Wall Street, we need legislation that will help consumers understand that some ‘credentials’ in insurance and financial services are not worth the paper they are printed on, while other professional designations represent years of rigorous study.”

Barton also stated, “Those who mislead senior citizens with rogue credentials do a disservice to the many hard working agents and planners who are diligently assisting seniors achieve financial security.”

Dr. Barton has been a leading voice among financial services industry professionals in calling for increased scrutiny of weekend “rogue” designations. For more than three years Dr. Barton has challenged the industry, calling the growing number of unregulated designations “a dangerous situation.” His views have been widely reported in leading consumer and financial industry media including CNN, ABC, Bloomberg Television, National Underwriter, Investment News, Best’s Review, Senior Market Advisor and Agent’s Sales Journal where he has consistently blasted designations with questionable content, testing and certification. In addition, Dr. Barton has been featured at meetings of leading financial services associations such as the National Association of Insurance and Financial Advisors (NAIFA) and the General Agents and Managers Association (GAMA) where he has spoken passionately on this issue.

Barton concluded by stating, “This committee’s efforts are of vital importance to regulators, companies, financial advisors and the seniors they serve.” Reporters interested in interviewing Dr. Barton should contact The American College Office of Public Relations at 610-526-1450.

Demography is Destiny

2009-05-05T12:50:00.004-04:00

Dr. Ellen Brandt, who is always a source of useful information for elders, baby boomers and caregivers provided these latest demographic statistics:

Demographics is Destiny! - By 2030, all the Baby Boomers (now aged 46-63) will be over 65. The percentage of the US population aged 65 and over will stand at close to 20%, with those 75 and over comprising almost 10% of US citizens.- The chances of becoming disabled increases dramatically with age. For the population 80 years or older, the basic disability rate is a whopping 71%, with 56% described as being severely disabled.- People 65 and over made an astounding 230 million visits to physicians' offices in 2005, the last recorded data point, plus an additional 16.5 million visits to hospital outpatient clinics and 17.2 million trips to hospital emergency rooms. Over 16% of US GDP now goes to healthcare.

Note: Dr Brandt became part of the senior services sector a couple of years ago, when she established a business called Lifestories Limited (http://familyliferesources.wordpress.com) to videotape the autobiographies of "ordinary" - actually extraordinary - elders, either living independently or in assisted-living, nursing home, and other healthcare-related venues.

She's since branched out with a service called Recollections, conducting periodic generational history activity groups for residents of nursing homes and assisted-living sites, and another called Commemorations, which, in conjunction with mortuaries, videotapes reminiscences of recently-deceased loved ones as part of the bereavement and healing process.

Helping Your Older Parents Stay Happy and Healthy in Dedham, MA

2009-05-01T17:06:00.004-04:00

By Dr. Robert Stall MD, Geriatrician

If you're fortunate enough to have one or both parents still living, you may have noticed a role reversal taking place in your relationship. Remember the days when Mom shuttled you to the doctor whenever you were sick? Now, it may be you who's driving her to her medical appointments. Perhaps you've become even more involved in managing her healthcare needs – serving as her healthcare proxy, moving her into your home to care for her, or even having to select a nursing home for her to live in.

Whatever the case, it's natural to feel challenged – and, yes, intimidated – in the role you've undertaken. But if you stay positive and proactive, you'll be in a great position to advocate for your parents' optimal care. And, really, what better way is there to say "Thank You" for all they've done for you over the years?

The following six recommendations will help you understand what may be happening to your parents as they age – and what you can do to help.

1. Stay vigilant to sudden changes.
Typically, sudden changes arise from sudden problems. Your elderly father who becomes confused one week but was alert and oriented the week before, or becomes unsteady walking and starts falling, is likely experiencing an acute problem – an infection, medication side effect, or perhaps, a heart attack or stroke.

If you pay attention to your parent's baseline health and behavior, you'll be alert to sudden, and subtle, fluctuations. Being attuned to what's “normal” for your parent is critical in advocating for his care. By informing his physician of these changes, you help ensure that he receives a proper diagnosis and timely treatment – especially important in acute conditions.

2. Investigate the source of gradual decline.
Several years ago, I met an elderly woman living in a nursing home. Her family, assuming she had dementia, had moved her there after she had gradually stopped speaking.

After performing a brief procedure on her, I asked how she was doing. “I'm OK,” she replied.

A miracle? Not exactly. I'd removed bullet-sized pieces of wax from her ears. She'd stopped speaking because her ears were too plugged to hear.

A host of conditions can cause gradual decline. Before jumping to the conclusion – as many people do – that Alzheimer's disease is the culprit, recognize that your parent may be experiencing an altogether different problem: a vitamin B12 deficiency, an underactive thyroid, Parkinson's disease or depression, to name a few.

When discussing your parent's decline with her physician, make sure the two of you consider all the possibilities. To prepare for the appointment, make notes detailing how her decline has manifested itself – loss of appetite, a failing short-term memory and so forth – and how long you've noticed these changes. That way, you won't leave anything out. To help you, I've created a free checklist that either you or your parent can complete at seniorselfassessment.com – make sure you print or email the “Test Result Details” at the bottom of the page to analyze your responses and give you advice based on your answers.

3. Know thy parent's medicine cabinet.
Familiarize yourself with the medications your parent takes: what each one is for and how often he takes them. Make sure you notify each doctor your parent visits of all the medicine he takes, including over-the-counter products. Ask what side effects you might observe from each medication and whether it's potentially dangerous if your parent takes them together. You also want to tell the doctor whether your parent drinks alcohol or caffeinated drinks and whether he smokes, as these substances can affect some medications' efficacy and safety. To recognize which medications might cause the symptoms your parent experiences, check out drugscanmakeyousick.com .

4. Discourage ageist attitudes.
Simply put, ageism is prejudice against the elderly. It exists in many forms but can be particularly damaging to an older person's self-esteem when it assumes that all of her woes are age-related. Here are a couple of ways of expressing ageism to an elderly parent:

“What do you expect at your age?”
“You're not getting any younger.”

If you're ever tempted to utter something similar, remind yourself that by chalking up everything that ails her to her age, you sell your parent short. If she's depressed, it may have nothing to do with the fact that she's 80 and everything to do with a biological predisposition to depression. And remember that right-knee pain in a 90 year-old can't be just from age if there's no problem with her left knee. (More about Dr. Stall and a more in-depth article on the attitude of society towards medical care for the elderly can be found at http://www.longtermcarelink.net/eldercare/medical_care_issues.htm

5. Address not just symptoms—but emotions, too.
There is disease and then there is “dis-ease” – that is, a lack of ease, security or well-being. “Dis-ease” can manifest itself as myriad emotions in an elderly person: fear, grief, boredom, embarrassment and sadness among them. The fact is, these emotions can be every bit as debilitating as disease.

Take the case of a parent who's incontinent. Too embarrassed to socialize, she cuts herself off from friends. Without companionship, she becomes lonely. Instead of allowing her to become a hermit, discuss with her doctor how to address the incontinence. Together, you can consider different solutions that will ease her embarrassment and reinvigorate her social life.

6. Strive to maximize your parent's quality of life.
No matter our age, we all want to enjoy life to the fullest and have the capability to do the things we want to. Improving the enjoyment of life and a patient's functional ability are the cardinal goals of geriatric care. But you don't need a medical diploma on your wall to help your parent achieve either of those goals.

Being there to solve a problem or provide company are tremendously worthwhile services you can provide – no expertise required. Remember, as your parent gets older, his quality of life becomes more important to him than how much longer he lives. And he doesn't necessarily need medications or surgery to ensure that he's living the latter part of his life to the fullest.

If he enjoys books but has difficulty reading regular-sized type, check out sight-saving titles at the library. If he's grieving the loss of his best buddy, introduce him to new acquaintances at the senior center. If he's living in a nursing home, bring your kids there to share a meal with him.

Sometimes, it's the small gestures that have the most profound impact. As the child of an elderly parent, you are uniquely positioned to deliver these life-changing gifts.

Dr. Robert Stall is a geriatrician practicing in Tonawanda, New York and a clinical associate professor at the University of Buffalo's School of Medicine and Biomedical Sciences. He serves as medical director and attending physician at Beechwood Homes in Getzville and Blocher Homes in Williamsville. To learn more about senior care issues, visit his website at stallgeriatrics.com or call 716-213-4345. For information on a new program offering balance assessment and fall prevention tips, call 716-213-0772.

If you have any questions or concerns about elder care planning in Deham, MA visit www.elderlifeplanning.com.

2009-05-01T09:21:00.004-04:00

For the past year, this blog has been focused on the two most critical issues concerning long-term care of the elderly:

1. Who will provide the care needed by millions of Americans as our population grows older and frailer over the next 20 years?

2. Where will the money to pay for this care come from?

The social security act, providing at least a modest sense of financial security for older Americans, became law in 1935. Way back then, the average life expectancy for Americans was 67.

Today, thanks to everything from improved hygiene and public health programs to amazing advances in medications and surgical procedures, the fastest growing segment of our population is over 85.

One in five Americans turning 65 today will need at least five years of long-term care, according to testimony at numerous congressional hearings over the past 20 years. But the United States is one of the few industrialized nations that have no national policy for the care of its oldest citizens.

Sen. Jay Rockefeller of West Virginia, Chairman of the Senate Finance subcommittee on health care, held a hearing recently on "the role of long-term care in health reform." Rockefeller noted that Congress has done nothing to act on a recommendation of the Pepper Commission, 20 years ago, to provide a program for long-term care. Since then, Rockefeller said, the access to long-term care "has gotten worse."

Dr. Judith Feder, told the committee: "The problem with today's long-term care system is not that individuals and families fail to take responsibility. Rather, they simply do not have enough to give. The need for extensive long-term care is an unpredictable and catastrophic risk."

As I've stated several times in many previous posts, this is hardly a "crisis". Hurricane Katrina was a crisis, the tsunami that struck Indonesia and the terrible earthquakes in China and Italy were crises. They were unexpected, hard to predict and prepare for. The only alternative was to act after the destruction had occurred and thousands of lives had been lost.

The fact that tens of thousands of Americans are, or soon will be, in need of assistance from others to perform such basic daily functions as bathing, dressing, and managing chronic illness with inadequate resources to pay for the staggering costs this care requires is neither "unexpected" or "hard to predict". After all the 76 million baby boomers that are rapidly reaching age 65, didn't just appear overnight. They've been here all along.

When the Pepper commission issued its report 20 years ago to provide a program for long-term care, today's 65 year olds were 45 years old. Predictions for the future longevity of then middle aged Americans were already well documented.

The need to prepare for the inevitable long-term care needs of millions of "baby boomers" and their aging parents, who are now in their 80's and 90's, has been the subject of numerous studies and congressional hearings for the past 2 decades.

So what have we achieved as a result of all the research, all the congressional testimony, and hundreds if not thousands of newspaper, television and radio broadcasts sounding the alarm. The need for eldercare services -that we've known was coming for decades -has continued to grow while the quality and availability of care in the community and in nursing’s homes and other facilities has declined steadily and is now a national disgrace.

Only a small segment of the population is affluent enough to pay for the annual cost of long-term care which can easily run $100,000 a year or more.

Medicaid, the federal-state program for the poor, has become the only public, long-term care program, providing any substantial amount of care for people without long-term care insurance who wish to save their homes and life savings.

Those who can afford it have the ability to purchase private long-term care insurance which will pay policy holders as much as 5 to 7 times as much in claims as they have paid in premiums.(for more information on the costs of care and how long-term care insurance can meet these costs go to http://www.avoidmedicaid.com.)

Affluent Americans can sell their homes when they become frail and need assistance and move to attractive, well staffed assisted living or retirement communities that offer an extensive menu of services...but only if you can afford to pay $50,000 a year or more!

At $20-$25 per hour for a home health aide for 8, 12 or even 24 hours a day, only the wealthiest can afford home based care when they need it.

The huge population bulge of aging baby boomers will dramatically increase the need for long-term care at home or in a facility. But for the vast majority with modest retirement assets that have been depleted by the reckless excesses of Wall Street, there are few choices for those needing care and the family caregivers who are increasingly faced with the difficult task of juggling work, caring for aging parents, and planning for their own retirement. Unless these families have substantial financial resources they will forced into poverty before publicly funded programs will provide any assistance.

Joshua Wiener, director of aging research at RTI International, told the Senate Finance subcommittee on health care in March that despite $150 billion a year in public spending on long-term care, "The current long-term care financing and delivery system is broken. The U.S. does not, either in the public or private sectors, provide a satisfactory mechanism for helping people anticipate and pay for long-term care."

You might want to send a note to your representatives in Washington and ask them if the disgraceful inequities in the American long-term care system will be addressed in the upcoming debate on improving health care in the U.S.

The 250 Eldercare Questions Everyone Should Ask

2009-04-29T17:17:00.002-04:00

A just published new book has a title that may seem overwhelming. "The 250 Eldercare Questions Everyone Should Ask" by Lita Epstein (Adams Media, $10.95) is intended for children dealing with their parents.

It is hard-nosed about legal issues such as financial and medical decision-making and estate planning, but is sensitive to ways of discussing issues parents usually don't discuss with their children as well as elders' feelings of threatened autonomy.

Epstein offers good short definitions of important concepts such as durable power of attorney, various forms of trusts, informed consent, and Do Not Resuscitate orders.
Some advice:
• Handle resistance to eldercare questions by framing them in terms of your concerns about hypothetical but common situations, such as a medical emergency involving loss of consciousness.
• When dealing with difficult issues, move on to another issue if your parents give you two "no" responses -- but remember to come back to it.
• Turn to a social worker or senior counselor for assistance if an elder is intransigent about talking or sharing information for planning.
• Do not fail to seek legal, financial and medical advice from professionals recommended by people you know and trust, or by professional associations such as the American Institute of Certified Public Accountants.
• Don't be afraid to ask to see documents. Bills, checkbooks, multiple sources of income, insurance policies and debts must be brought into the equation.
• Carefully examine the upfront costs of reverse mortgages.
• Review insurance options for long-term care and to cover medical costs not covered by Medicare.
• Be sure there is a valid will.
• Include the elder in discussions about their care, even when they have reduced competence.

http://www.amazon.com/250-Eldercare-Questions-Everyone-Should/dp/1598698907/ref=sr_1_1?ie=UTF8&s=books&qid=1241039883&sr=8-1

When is a Good Time to Consider Geriatric Care Management in Dedham, MA?

2009-04-24T18:05:00.003-04:00

Here’s a great link to an article that is helpful to anyone considering starting elder care, home care, or geriatric care management services for an aging loved one.

Just click on the link below, and if you have questions or need help, please visit our website at www.elderlifeplanning.com.

My Mother’s Memory is Failing…..

http://donigreenberg.com/2009/02/28/dear-j-mother-memory-something/

Is This Protecting Patient Confidentiality? Or Hiding Behind It to Cover Up Abuse and Neglect?

2009-04-18T12:03:00.002-04:00

A nurse who secretly filmed for the BBC to reveal the neglect of elderly patients at a hospital has been struck off for misconduct. (news.bbc.co.uk)

A nurse who secretly filmed for the BBC to reveal the neglect of elderly patients at a hospital has been "Stuck off" (kicked out of the nursing profession in England) for misconduct.
The nurse filmed at the Royal Sussex Hospital in Brighton for a BBC Panorama programme in July 2005. She was denied the right to practice nursing by the Nursing and Midwifery Council last week after being a nurse for more than 20 years.
The panel said she "followed the behest of the filmmakers... rather than her obligations as a nurse".
The BBC believes that she has done the elderly population of this country a great service.

The chair of the panel said that the nurse had prioritized the filming and did not fulfil her obligations as a nurse. "In the view of the panel, this was a major breach of the code of conduct."
"Although the conditions on the ward were dreadful, it was not necessary to breach confidentiality to seek to improve them by the method chosen."

The BBC programme's producer, told the hearing there had been "an over-arching public interest" to produce the Undercover Nurse documentary because Panorama had received up to 5,000 complaints about conditions. The patient advocacy group Patient Concern issued a statement saying "This just demonstrates the priorities of the regulators - rules come before patients every time. The message that goes out to nurses is: however badly you see patients treated, keep your face shut."

You can read the whole story at the following link:
http://www.reddit.com/r/humanrights/comments/8cztj/a_nurse_who_secretly_filmed_for_the_bbc_to_reveal/

Trends: High Staff Turnover and Instability Leave a Trail of Casualties

2009-04-14T14:43:00.006-04:00

According to the industry publication "Long Term Care Wire", when a facility constantly
has short staffing, residents of that facility are affected in a number of ways.

For one, there’s the emotional toll. Residents are “crushed” when that one person
they countedon walks out the door, noted Jennifer Pettis, RN, RAC-MT, C-NE, in a
presentation at the American Association of Nurse Assessment Coordinators spring last week.

And “staff who constantly work short and fight fires never fully
recover from that adrenaline rush,” says Barbara Frank, a consultant
in Warren, R.I., who works with the Centers for Medicare & Medicaid
Services and facilities on culture change and staffing stabilization.

And while some people “may begin to incorporate that ‘hero/heroine’
mentality into their sense of self-worth,” keeping up that kind of
pace isn’t sustainable, Frank stresses. Eventually staff will burn
out.

There is a relationship between how Certified Nursing Assistants rate their workplace in
satisfaction surveys and the facility’s quality indicators, said Mary
Tellis-Nayak, MSN, RN. Evidence shows a high correlation between staffing
satisfaction, stability and turnover, and the quality of care -- and between
staffing stability and the facility’s financial health, she added.

“Nursing homes are facing very dark economic times with all the changes to
reimbursement” and statescutting already low Medicaid rates, says Gail Patry, RN,
says “if you are hemorrhaging staff” and constantly recruiting new staff, the
facility is spending money unnecessarily that could fund quality-of-care or
life programs.

NCOA Survey Shows Need for Chronic Care Reform

2009-04-08T10:49:00.003-04:00

NCOA Survey Results Show Need for Chronic Care Policy and Practice Reform
March 18, 2009

WASHINGTON, DC – A new survey commissioned by the non-profit National Council on Aging (NCOA), reveals a bleak and broken health care system for millions of Americans suffering from a variety of chronic conditions.

The results of the Re-Forming Health Care: Americans Speak Out about Chronic Conditions and the Pursuit of Healthier Lives survey shows many chronic disease sufferers are delaying health care due to cost, living in pain and feeling abandoned by their health care providers.

"Alarmingly, one in four (25 percent) survey respondents have delayed health care or not filled much-needed prescriptions due to cost in the past year, despite the fact that they are frequently or sometimes living in pain (71 percent), stressed (65 percent) or depressed (50 percent)."

"With chronic conditions as the central challenge to American health care today, NCOA seeks to identify gaps in appropriate chronic care, including self-care, to inform the national conversation about health care reform." said Nancy Whitelaw, Senior Vice President, Center for Healthy Aging with NCOA. "Given what the survey participants told us, we identified three areas of focus necessary for re-forming the health care system in order to support Americans with chronic conditions."NCOA characterizes the following three areas of focus as:
Policy: The federal government needs to make investments in community-based programs, and in primary care and hospital settings to ensure team-based, coordinated care across all settings.

Practice: Health care professionals have a responsibility to connect their patients to effective community self-care programs, as well as improve the quality and coordination of care to people with chronic conditions.

Personal Skills: Americans with chronic conditions need to develop the skills and confidence to manage their health and to advocate for the help and support they need.
According to NCOA, a key element for success resides in community-based programs that focus on self care, which includes teaching problem-solving, decision-making and communication skills that are needed by people with chronic conditions to manage their own health outside of the clinical setting."

The National Council on Aging is a non-profit service and advocacy organization headquartered in Washington, DC. NCOA is a national voice for older Americans - especially those who are vulnerable and disadvantaged - and the community organizations that serve them. It brings together non-profit organizations, businesses and government to develop creative solutions that improve the lives of all older adults. NCOA works with thousands of organizations across the country to help seniors find jobs and benefits improve their health, live independently and remain active in their communities. For more information, visit www.ncoa.org.