Monday, October 11, 2010

Concerns About Aging Parents: Why Won't They Listen to Me???

We often hear from adult children of aging parents who are worried about Mom or Dad, but struggle with how to approach the subject...or have tried with little success. The approach and the way things are presented can make all the difference in the outcome. Here are some pointers:

 Think about the person’s perspective and take time to listen to their concerns, thoughts and questions.
 Don’t push—sometimes it is better to drop the subject and let your relative process the information and come to some conclusions on his/her own.
 Be aware of differing communication styles, which often have an age and/or generational basis. You may want action and lose patience with styles you view as rambling, indecisive,and repetitive. Pick appropriate time and place for discussions and set aside time. Realize how your own emotions may be impacting the conversation and increasing resistance.
 Enlist the help of a professional geriatric care manager, trusted advisor, or other family members. Sometimes a different approach, differences in relationships (or the neutrality of not having a personal stake) makes a difference.
 Attempt to talk about proactive changes prior to crisis, with a focus on maintaining independence and choice. However, when a crisis occurs, use the opportunity to introduce necessary changes (i.e. this may be time for a “respite” or “rehab” stay at a care facility which perhaps will lead to an easier transition).
 Prioritize and rethink what you feel are “necessary” changes. Perhaps there is a compromise that can be reached that doesn’t compromise your loved one’s safety.
 Act as a facilitator. How can you help your loved one? Have your listened to them and looked for options that may better suit their desires? What are their objections and values underlying their choices?
 Talk to an expert when Alzheimer’s or other forms of dementia are involved. Memory disorders may change the needs, and mean your loved one is less able to logically process choices and make safe decisions, but it can be hard to draw these lines.
 Know what resources to turn to, particularly if your loved one becomes a danger to themselves or others. Visit www.eldercare.gov for local agencies and 1-800ABUSE in Florida for elder abuse or neglect reports.

We invite you to read more on our website, including books we recommend to help you better prepare for eldercare issues, addressing caregiving concerns with aging parents and resources to assist your family.

Monday, September 27, 2010

New Medicare Assistance Available to Help Retirees

In 2010, there were about 1500 stand alone (private drug plans, Part D) in the Medicare program. Average nationwide premiums for 2010 are about $38/month. However, in Florida there are Medicare Advantage plans that include drug costs for as little as $0/month and a range of options for receiving coverage, from standard Medicare with a stand alone drug plan, to Medicare Advantage (bundled services provided through insurance companies instead of standard Medicare), or dual eligibility such as Medicare/Medicaid, VA, and private employer/retiree plans.

As healthcare costs across the board continue to increase and as we each more carefully analyze how we will fund our longevity, healthcare coverage during retirement is a key component.

Aging Wisely offers a new service to help retirees and families with these important decisions:
New Medicare Assistance Available to Help Retirees

We also invite you to download our Medicare Fact Sheet for 2010.

Friday, September 24, 2010

Aging Wisely Care Manager Chosen as Finalist in National Healthcare Awards

Aging Wisely, LLC, is proud to announce that Julie Scott, Geriatric Care Manager, has been chosen as a national finalist in the Dorland Health People Awards.

Dorland Health, an influential healthcare publishing and educational organization, offers this description: “The Dorland Health People Awards set the benchmark for outstanding patient care and systems delivery achieved across the diverse healthcare team…the Awards honor the diligent, the influential—in short, the special—practitioners who coordinate and provide care.” The finalists will be honored at a banquet on October 4th at the National Press Club in Washington, D.C.

“Julie has worked as a Professional Geriatric Care Manager for Aging Wisely for 9 years and has had a tremendous impact on clients, families, our internal team/colleagues and the other professionals we see as part of our team,” states Linda Chamberlain, President of Aging Wisely, LLC. “We receive many thankful letters from families that Julie helps, but we also see the ways she uses her creativity, knowledge and leadership to help strengthen our team and processes.”

In addition to her work with older adults and their families, Julie specializes in care management for clients with special needs, Alzheimer’s client and family support and comprehensive assessments for complex cases and legal matters. Julie recently led the development of a new Medicare Analysis program. Last year, she contributed to a chapter on disaster preparedness in a textbook widely used by the geriatric care management profession. Click to view Julie Scott’s bio.

Friday, July 30, 2010

Tips for Being a Good Medical Advocate

Whether caring for an aging parent or helping a friend or spouse facing a diagnosis and treatment options, everyone needs an advocate at times. When any person is facing a diagnosis, surgery, or hospitalization, having such an advocate can be invaluable. Even if you are very savvy, there is a lot to absorb and consider in these situations. Here are some tips for you to be a good advocate:

1. Help gather important information. Help your loved one organize their medical records, health history and important documents (advance directives, insurance information).

2. If your loved one has not completed advance healthcare directives and decision making paperwork, encourage them to do so (including Durable Power of Attorney, Healthcare Surrogate/Power of Attorney, Living Will).

3. Help in preparation for the appointment, procedure, hospitalization (as feasible). Prepare purpose of the visit, symptoms, concerns, list of questions. For procedures or treatments, find out what to expect and ask questions. How long will you be there? What do you need to bring? Will the patient need a ride home? Will they need aftercare? While many people don’t need formal aftercare, consider the challenges one ofte faces after a surgery or hospital stay. Often, you can drive the patient home and get them settled, but it may be easier to have additional help as you may need to pick up prescriptions or may not be able to help if the patient is very weak or ill.

4. After an appointment, use your notes to review what was discussed and consider next steps/pros and cons, for example regarding treatment options. It is important to help the patient think through things in a less rushed/stressful manner, when possible. If you are making decisions on behalf of a loved one who cannot do so any longer, have an advocate for yourself…someone you can talk things through with. Sometimes an outside party is best for this and can help you think through all the ramifications, and gain a clearer picture.

5. Help your loved one ascertain second opinions when needed. However, bogging someone down with a lot of information (or misinformation) from the internet, for example, can be less than helpful. It is most helpful to identify the most expert resources and assist in clarifying information and making a comfortable decision feeling informed, not overwhelmed.

6. Review this NY Times article about 6 questions to ask for elderly patients being hospitalized. If you cannot be with your loved one at the hospital or emergency room, it is a good idea to get a friend, relative or geriatric care manager to be there. This is not only for your loved one’s well being, but to ensure the hospital staff gets the accurate information they need to do the best job. http://well.blogs.nytimes.com/2010/06/24/six-questions-to-protect-elderly-patients/?emc=eta1

Visit www.agingwisely.com for more information on healthcare advocacy services and ways you can prepare yourself or your loved one to take on your health needs head on.

Friday, July 2, 2010

Driving Safety & the Elderly

Every time I speak about this topic with people, they nod their heads knowingly and tell me a story about an older relative or client and their concerns...and usually the stress over trying to convince them it was time to stop driving. Here is a good article from the Mayo Clinic on this topic:
http://bit.ly/ahuY2O


We also have a handout which helps families consider how to approach this issue, and provides some resources to help: www.agingwisely.com .

It is important when you approach this issue with a loved one to consider how you are going to help your loved one maintain their life--so that taking away the car keys is not the end of life as they know it. Most areas of our country, unfortunately, don't have readily accessible, convenient public transportation systems--so if you don't live in an urban area, you'll probably have to search out options. Some aging services organizations offer transportation, particularly for medical needs. Most bus systems have an application process for individuals who cannot navigate the bus system due to disability, where there is access to either van or cab service at special rates. And, hiring private driving services is often more affordable than one might think. When you consider the average cost of operating a vehicle is about $600/month (per the Dept. of Labor Bureau of Statistics), that buys you a great deal of time/services. Most local private duty home care companies can provide these services. Check all of this out before you approach this issue...have a plan and options...

Tuesday, June 8, 2010

Long Distance Caregiving

If you are caring for a loved one from a distance, it can leave a scary feeling in the pit of your stomach--especially when the phone rings...

I hear many family members talk about "the call"--when they were suspicious Mom or Dad wasn't doing so well (or maybe they really were doing quite well), but were hoping for the best...and it all changes when you receive that dreaded call that he or she has fallen, is in the hospital, etc.

Here's a couple good articles to review on the subject:

http://www.agingwisely.com/what-happens-when-moms-neighbors-head-north-for-the-summer/

http://networkedblogs.com/4Axly

Monday, May 17, 2010

Family Conflicts in Elder Care

Sibling rivalry, family dynamics...in some families we laugh about these things and share funny stories from youth, but in others there is a lot of deep seated anger and hurt. For other families, anger and hurt come out when highly charged issues arise. Perhaps you are not that close to your siblings, but now find yourselves thrown together at Dad's hospital bedside, forced to make tough decisions together. Or, maybe you were once very close to your Mom but have become distant since she remarried and you don't get along with her new husband.

The decisions that need to be made towards the end of life can be tough enough--fighting over them with family members can be heartwrenching. And, if you're the one who Mom or Dad has chosen to help them (with finances, healthcare decisions) and you have a "disgruntled" sibling, it is not unusual nowadays to find yourself in the middle of a legal battle (for example, over guardianship, or later estate litigation).

Here are a couple things to think about:
1. We're big proponents of planning ahead--for all of us as we age, having conversations about what we want and completing the proper legal documents (healthcare power of attorney/surrogate, Durable Power of Attorney, Living Will, estate planning docs).

2. Consider family mediation if conflicts or concerns arise. Consider working with a professional care manager who can lead discussions, coach family members through challenges and act as a liaison to different parties. As well, a professional opinion and assessment often helps everyone see things more clearly.

3. Consider a family or care agreement/putting wishes in writing. This may help everyone be clear about my wishes and how I wish money to be spent for my care, even if it is more guidance than an official document. Meet with a professional to discuss how to do this, or to do a family consultation/meeting early on to lay out your desires and create a plan(for example, my husband and I could say we wish to use all our assets-as need be-to remain in our own home and we acknowledge we have purchased long term care insurance but may also need to use our assets and wish to exhaust those before considering a care facility--or--if I am alone, I wish for my family to help locate a good care facility for me, I prefer to be moved to be near my oldest son and suggest the family seek professional help finding the place that is best for me). A professional care manager can also answer your questions about what is available and realistic as you talk about these issues.

4. Know your family and plan accordingly. Consider things like the value of a professional trustee or other professional advisor being on board.

Friday, April 16, 2010

Florida Boomer Lifestyle Conference: Inspiring!

Yesterday was an action-packed day at Ruth Eckerd Hall, with hundreds of people coming together to explore the trends and opportunities around the Boomer generation--everything from Boomer reinvention (especially given the impacts of the recession), The Boomer Economy, Florida's Boomers, Boomer Trends and Caregiving. The day started with a great report from Schwartz Consulting (http://www.schwartzconsulting.com/) with their latest research on Florida's Boomers. Timely information and a great snapshot...not just old, stale data. A lively presentation about Boomer Men followed, given by the creative, energetic Brent Green, author of Marketing to Leading Edge Baby Boomers. Mark Miller (author, The Hard Times Guide to Retirement Security and President of 50+Digital) and Roger Chiocchi (author, Baby Boomer Bust? How the Generation of Promise Became the Generation of Panic) did a great job reflecting on the generation's struggles during the recession--looking back and looking forward.

Some of the other highlights: Laurie Orlov's trend report on aging in place technologies. I hope her visions for where we can be come to fruition at the fast pace that technology in general is moving. Check out Laurie's great Aging in Place Technology Watch blog. Lots of good presentations re: technology including Bernie Borges (Find and Convert) and Jody Haneke (Haneke Design)'s great discussion re: social media and mobile apps. I had no idea almost 1/2 the U.S. population is on Facebook! And, for a social media, viral marketing success story...who hasn't seen "Will it Blend?"--if you haven't and your an iphone or ipad fan, you may want to think twice about watching:-)

We had great audience interaction at our session about multigenerational family trends. It was an honor to be on the panel with Alex Chamberlain, Executive Director of Easy Living and Jack Levine, Founder of 4Generations Institute. We could have talked for hours about all the trends and needs of family caregivers and the multigenerational (many with 4 generations now!) family. Aging Wisely and Easy Living plan to continue striving to meet those needs and finding ways to innovate. With individuals like Linda Chamberlain, Jack Levine and Sallie Parks advocating for elders and the families who care for them, we're sure to see positive strides.

Check out the conference webpage for all the great speakers, sponsors, and press releases: http://www.floridaboomerlifestyle.com/.

Tuesday, March 30, 2010

Controlling Your Healthcare Destiny

April 16th: National Healthcare Decisions Day (www.nationalhealthcaredecisionsday.org).

Putting aside the heated discussions and implications around healthcare reform...if you want to have some control over the way you are cared for, especially at the end of life, you should consider advanced care planning. Our laws allow us to put our wishes in writing through advance directives, and one of the most important pieces of that puzzle is appointing a healthcare surrogate (sometimes called Healthcare POA or proxy) to make decisions on our behalf if we are unable. Although there's been some progress in the number of people completing advance directives, still only about 1/3 of elders have these documents.

And...even those who have completed the documents often neglect to talk to their family/healthcare surrogate and doctor about what they want. We find time and time again, individuals have gone down a path they would not have intended, or start to ask why they are completing certain tests and procedures. It can be hard to take a step back, especially in the middle of a crisis, and consider desires, goals/expected outcomes and options.

Reflect on these things as we approach National Healthcare Decisions Day and consider putting your wishes in writing if you have not already done so. Talk to your family, especially if you are facing a new diagnosis or chronic illness. Consider talking to a professional care manager (healthcare advocate) as you face decisions...whether for yourself or when acting as your loved one's surrogate. See: http://www.agingwisely.com/advocacy/ for more info.

The American Bar Association offers a Proxy Quiz, which is an interesting exercise in what you would want, and what your proxy perceives you would want...great starting point for a discussion...

Monday, March 8, 2010

Medicare Out of Pocket Costs: Plan Ahead

There was recently a NY Times blog post (http://economix.blogs.nytimes.com/2010/03/02/getting-old-is-expensive/) regarding a subject I have covered for many years in presentations regarding Medicare, Aging Wisely and planning ahead--the cost of healthcare in later years. Very few people think about this stuff ahead of time...why would you? We're all busy dealing with our current health insurance, employment, etc. So, people generally know Medicare exists (and often seem to have the impression it will take care of everything with little/no cost) but rarely understand all of it's working parts, costs, etc.

As this article quotes as recent study and has been shown in studies for a # of years, out of pocket/uncovered costs from 65 til death usually rank in the $250,000 range. Check out our Medicare 2010 Fact Sheet for some info. on the many premiums, copays and deductibles of the various parts of Medicare for the primary costs: http://www.agingwisely.com/2010-medicare-fact-sheet/. Still, as one person pointed out in response to the NY Times blog, when you consider similar costs for employer based insurance, this may not be such a bad deal or the horrific figure it is made out to be. I just worry that people don't factor it in to their retirement planning or get much education about Medicare prior to the need. I always get a lot of great questions when doing my "Medicare 101" presentations or when we do a consultation with someone as they plan to retire...just wish more people would get that type of info. This should be an absolute part of anyone's retirement planning process.

Thursday, February 18, 2010

Early Onset Alzheimer's Disease and Social Security Benefits

Social Security Administration (SSA) has added early-onset/younger onset Alzheimer's to the list of conditions under its Compassionate Allowance Initiative, giving those with the disease expedited access to Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). This is potentially great news for individuals and families devastated by such a touch diagnosis. The Alzheimer's Association played a key role in advocating for this change and has information about what it means and other important checklists and information for families on their site and the specific link below:

http://www.alz.org/living_with_alzheimers_social_security_disability.asp?type=homepage

Also, visit Aging Wisely's page about Alzheimer's and Dementia support: http://www.agingwisely.com/alzheimers-and-dementia-support/ and assistance with benefits such as Social Security Disability, Veteran's benefits, Medicaid, Medicare and community services.