Monday, May 14, 2012
Technological Transitions
Last month I made a decision to change website hosts. My oldest son recently graduated with a technical degree in artistic and graphic design and internet marketing and well, you know... nepotism is alive and well in small businesses. [In fact I think family small entrepreneurships are the wave of the future - but that's another topic]
Having seen the computer world explode unimaginably from giant room-sized key-punch card monsters to the tiny laptop I peck on just now, I would have thought that changing website servers would be a seamless operation.
Long story short, my professional e-mail is currently down, so I'm directing my readers to use my ever-reliable G-mail account: droidl316@gmail.com -- for the time being.
Meanwhile, I'll just have to blog more so that website traffic doesn't suffer seriously. In fact, luckily my website has been searched for so frequently in the past week, it comes up first on the search engines and I received a new client from just what Google has on the search page about me! Map and everything.
I like Google.
And I'm still glad to be switching to a more modern approach to my website management. Sometimes it takes a new dog to do new tricks that help get the message out that there is help out here for your aging parents.
Stay tuned....
Friday, February 24, 2012
ARE YOU LISTENING?
Recently the National Care Planning Council published an article discussing the old adage as we did not listen to our parents when we were teenagers, we are now concerned with convincing our parents to listen to US regarding their present and future care needs.
The article stated, “[Adult children] are finding themselves concerned about their aging parents and what their needs will be as their health and mental abilities fail them. In some cases the children must take the role as parent in securing the safety and well being of an elderly family member.”
I respectfully disagree. Although we are facing a reverse situation wherein our aging parents may not be using what we feel is good judgment, we should never presume to take a parental authoritarian attitude or approach toward our parents. In my experience, you will run up against a very thick brick wall.
While we need to ensure the safety and well-being of our parents and other vulnerable disabled persons in our lives, we should also defend their autonomy and right to self-determination to the furthest extent possible. Approaching an elder with concerns can be done in such a way as to accomplish this. If we try to force our authority and wishes on elders, they will dig their heels in further and become more wary and suspicious of any proposed intervention.
Elders are usually aware to some extent that their functionality is deteriorating. Fear of losing their autonomy can cause them to be very creative in their ability to hide their disabilities. When we call our parents, the conversation frequently sounds like this:
“How are you doing today Mom,” Julie asks?
“Everything’s fine”, Mother replies.
“Are you taking your pills?”
“Yes, everything’s fine.”
“Do you need anything?”
“Everything’s fine.”
Julie does not get much more conversation from her mother. Perhaps everything is fine, or perhaps Julie’s mother just wants Julie to think she can take care of herself. Even worse, mother could think all is fine and be forgetting her medication and not eating properly.
Is Julie really listening? ARE YOU LISTENING?
It may be time to put your face in front of your parent and listen. Assuming all is well and your elderly family member knows and does what is best for them, may be putting them at risk.
Rather than becoming authoritarian and considering yourself in a role reversal with you as the parent and they as children, become a partner with them in their care. The best time to form the partnership is before a crisis happens.
Donna Schempp, a licensed clinical social worker and program director at the Family Caregiver Alliance, states when talking with your parents, "The sooner, the better." If you bring up the subject before your parents need any extra support, "then it's not crisis driven," she explains. "It's not a way of saying, 'Mom, Dad, there's something wrong with you.”
A good way to begin this relationship is to sit with your parents and ask questions like, what are your concerns for the future. Do you want to remain in your home? Are you worried about losing your independence? Listen to their answers. You might relate your concerns as well, or your desire to be of help. LISTEN to what is behind their answers. Many elders will not come right out and list their fears; some do not really know what it is they fear. In their generation, most fears have to do with “being put in a home”. Their experience of long term care settings is rooted in the way nursing homes looked and operated several decades ago. They need to be educated about the options now available, and the cost affiliated.
The other part of forming this relationship and becoming a real partner in your loved one’s care planning is to understand what legal and financial arrangements are in place. Begin by asking, “What if you had a stroke, Mom? I need to know where your medical and insurance documents are and what you would have me do on your behalf.”
The next step might include accompanying them to their doctor appointment(s) so to understand the full scope of their medical needs and to be a part of creating a successful plan for future needs.
The National Care Planning Council's book “The 4 Steps of Long Term Care Planning” gives the following list of most common services family care givers will provide for their parents.
Feeding, walking, lifting, bathing
Using the bathroom, incontinence
Pain management
Preventing unsafe behavior, wandering
Providing comfort, assurance, professional counseling
Arranging therapy, meeting medical needs and appointments
Maintaining the household, laundry, phone
Shopping, errands, writing letters/notes
Providing transportation
Administering medications
Managing money, paying bills
Personal hygiene, grooming
Home repairs, yard maintenance
There are many resources available to help families in caring for their elder parents, including your local Area Office on Aging at 419-382-0624. Two great websites include www.longtermcarelink.net/8profiles.htm and www.caremanager.org. As you become involved you will know when it is time to include professional services or when the need to find new living arrangements is necessary. If you are not an expert in long term care planning and, or are having difficulty approaching your parents to begin these discussions, reach out to experts for assistance. Long term care expertise is fast becoming more complex and expansive and without professional involvement you may overlook important available resources.
Plan now to talk, listen and work together, but especially LISTEN – not just to the words that elders use, but to the potential hidden needs and fears that need to be addressed. Education and compassion are essential to promoting good decision-making with regard to long term care planning.
The article stated, “[Adult children] are finding themselves concerned about their aging parents and what their needs will be as their health and mental abilities fail them. In some cases the children must take the role as parent in securing the safety and well being of an elderly family member.”
I respectfully disagree. Although we are facing a reverse situation wherein our aging parents may not be using what we feel is good judgment, we should never presume to take a parental authoritarian attitude or approach toward our parents. In my experience, you will run up against a very thick brick wall.
While we need to ensure the safety and well-being of our parents and other vulnerable disabled persons in our lives, we should also defend their autonomy and right to self-determination to the furthest extent possible. Approaching an elder with concerns can be done in such a way as to accomplish this. If we try to force our authority and wishes on elders, they will dig their heels in further and become more wary and suspicious of any proposed intervention.
Elders are usually aware to some extent that their functionality is deteriorating. Fear of losing their autonomy can cause them to be very creative in their ability to hide their disabilities. When we call our parents, the conversation frequently sounds like this:
“How are you doing today Mom,” Julie asks?
“Everything’s fine”, Mother replies.
“Are you taking your pills?”
“Yes, everything’s fine.”
“Do you need anything?”
“Everything’s fine.”
Julie does not get much more conversation from her mother. Perhaps everything is fine, or perhaps Julie’s mother just wants Julie to think she can take care of herself. Even worse, mother could think all is fine and be forgetting her medication and not eating properly.
Is Julie really listening? ARE YOU LISTENING?
It may be time to put your face in front of your parent and listen. Assuming all is well and your elderly family member knows and does what is best for them, may be putting them at risk.
Rather than becoming authoritarian and considering yourself in a role reversal with you as the parent and they as children, become a partner with them in their care. The best time to form the partnership is before a crisis happens.
Donna Schempp, a licensed clinical social worker and program director at the Family Caregiver Alliance, states when talking with your parents, "The sooner, the better." If you bring up the subject before your parents need any extra support, "then it's not crisis driven," she explains. "It's not a way of saying, 'Mom, Dad, there's something wrong with you.”
A good way to begin this relationship is to sit with your parents and ask questions like, what are your concerns for the future. Do you want to remain in your home? Are you worried about losing your independence? Listen to their answers. You might relate your concerns as well, or your desire to be of help. LISTEN to what is behind their answers. Many elders will not come right out and list their fears; some do not really know what it is they fear. In their generation, most fears have to do with “being put in a home”. Their experience of long term care settings is rooted in the way nursing homes looked and operated several decades ago. They need to be educated about the options now available, and the cost affiliated.
The other part of forming this relationship and becoming a real partner in your loved one’s care planning is to understand what legal and financial arrangements are in place. Begin by asking, “What if you had a stroke, Mom? I need to know where your medical and insurance documents are and what you would have me do on your behalf.”
The next step might include accompanying them to their doctor appointment(s) so to understand the full scope of their medical needs and to be a part of creating a successful plan for future needs.
The National Care Planning Council's book “The 4 Steps of Long Term Care Planning” gives the following list of most common services family care givers will provide for their parents.
Feeding, walking, lifting, bathing
Using the bathroom, incontinence
Pain management
Preventing unsafe behavior, wandering
Providing comfort, assurance, professional counseling
Arranging therapy, meeting medical needs and appointments
Maintaining the household, laundry, phone
Shopping, errands, writing letters/notes
Providing transportation
Administering medications
Managing money, paying bills
Personal hygiene, grooming
Home repairs, yard maintenance
There are many resources available to help families in caring for their elder parents, including your local Area Office on Aging at 419-382-0624. Two great websites include www.longtermcarelink.net/8profiles.htm and www.caremanager.org. As you become involved you will know when it is time to include professional services or when the need to find new living arrangements is necessary. If you are not an expert in long term care planning and, or are having difficulty approaching your parents to begin these discussions, reach out to experts for assistance. Long term care expertise is fast becoming more complex and expansive and without professional involvement you may overlook important available resources.
Plan now to talk, listen and work together, but especially LISTEN – not just to the words that elders use, but to the potential hidden needs and fears that need to be addressed. Education and compassion are essential to promoting good decision-making with regard to long term care planning.
Monday, January 16, 2012
Is Insurance the Answer to Long Term Care Planning?
A recent USA Today article states that there is an increase in seniors
living over the age of 90. According to author Haya El Nasser “The
number of people living to age 90 and beyond has tripled in the past
three decades to almost 2 million and is likely to quadruple by 2050”.
Seniors who live longer generally have some sort of disability or need
help at some level of living. Sandy Markwood, CEO of the National
Association of Area Agencies on Aging, indicates that the focus
needs to be on being able to help these seniors live at home as long
as possible as nursing home cost could rise to average $72,000 a
year.
Long Term Care at any level, in the home, assisted living or nursing
home can add a tremendous cost to seniors and their families.
Government Programs Only Pay For About 16% Of Long Term Care
Government programs such as Medicare, Medicaid and the Veterans
Administration will cover the cost of long-term care under certain
conditions. Medicare will cover rehabilitation from a hospital stay or
limited care at home if there is a skilled (medical) need. The Veterans
Administration will cover the cost of nursing home care indefinitely if
the veteran is at least 70% service-connected disabled. The VA will
also cover other forms of home-based or community-based care if
there is a medical need.
Medicaid will cover both medical and non-medical related long-term
care but in order to qualify for Medicaid an Ohio resident has to have
less than $1,500 in assets and income that is insufficient to pay the
cost of care.
Funding Long Term Care with your Life Insurance Policy
Drawing cash from life insurance or changing a life insurance policy
should only be done after reviewing with an expert advisor. Loss
of the policy and death benefit could prove to be a detriment. If,
however you have accumulated cash in a life insurance policy and no
longer need the coverage you may consider using the cash for long
term care or purchasing a LTC rider to your current policy.
New insurance products are being developed to cover both life
insurance and long term care insurance. ElderLawAnswers reports:
“A new law makes the purchase of products that combine annuities
or insurance policies with long-term care insurance more attractive.
These "hybrid" products are gaining in popularity due to a law that
went into effect January 1, 2010, making distributions from life
insurance and annuities tax-free when used to pay for long-term
care. The same law also allows owners of annuities or life insurance
policies to exchange their old policies for long-term care insurance or
hybrid policies without being taxed.”
Combination sales which include life insurance, annuities and
traditional long-term care coverage are becoming popular with
insurance companies and may prove a method of financing long
term care. Investigate closely, however to find what exactly will be
covered. Some policies do not cover home care costs or complete
costs of nursing homes.
Long Term Care Insurance Funding for All Long Term Care Needs
The first long-term care policies were offered about 40 years ago.
These were primarily nursing home-only policies designed to take
over when Medicare rehabilitation ran out. They were not the
comprehensive benefit policies we see today.
Long Term Care Insurance policies today are greatly diversified in
their coverage. Home care, nursing home costs, adult day care,
physical therapy, skilled and non-skilled nursing care are some of the
services covered. Policies vary in price and what they cover. There
is also a very restricted qualification of physical and mental heath to
get a policy. Purchasing a policy at a younger age makes it easier to
qualify and also provides cheaper premiums. It is best to consult with
a long term care insurance professional about the type of policy that
fits your needs and budget.
Veterans Aid and Attendance Pension Benefit
Though not an insurance policy, the VA Pension Benefit should be
mentioned as a way to pay for long term care needs. A veteran or
spouse of a veteran who served during a period of war can receive
money, up to $2,019 a month, to pay for long term care medical
expenses, home health care, and assisted living cost. A qualified
Veteran Consultant can help you determine if you qualify for this
benefit.
Pre-Need Burial Insurance
One might ask what Pre-need burial insurance has to do with long
term care. The purpose of preneed life insurance is to set aside funds
for your funeral, before the need arises.
It is an insurance policy that covers the cost of the predetermined
expenses of a funeral, cremation or burial. It gives the purchaser the
opportunity to preplan the services and peace of mind in having it
paid for. This is usually an insurance policy that pays at time of death
for these expenses. There are many insurance companies that offer
these packages as well as funeral homes.
NOTE: If a person anticipates needing to apply for Medicaid after
all is said and done, it is unwise to start spending down assets until
having at least a consultation with a Medicaid specialist. In order to
retain the maximum assets for the community spouse, application
needs to be made first.
The saddest cases of long term care needs we hear are:
“Mother can no longer live alone and she has no money to go live in a
care facility.”
“ Is there someone that can come help me take care of my wife? We
live on our Social Security and I can not pay what home care costs.”
“Father died last night and we have no money to bury him, what do
we do?”
It is important to make the necessary arrangements to cover long
term care and end of life costs. There is no government program
that will cover all those needs. The National Care Planning Council at
www.longtermcarelink.net strives to educate people about long term
care services and encourages the planning that needs to be done to
prepare for future costs and needs.
The National Association of Professional Geriatric Care Managers at
www.caremanager.org has lots of good information as well as a list
of professionals around the country who specialize in long term care
planning and follow-through with families.
Debra Roidl, MSW, CMC
Care Manager, Certified
living over the age of 90. According to author Haya El Nasser “The
number of people living to age 90 and beyond has tripled in the past
three decades to almost 2 million and is likely to quadruple by 2050”.
Seniors who live longer generally have some sort of disability or need
help at some level of living. Sandy Markwood, CEO of the National
Association of Area Agencies on Aging, indicates that the focus
needs to be on being able to help these seniors live at home as long
as possible as nursing home cost could rise to average $72,000 a
year.
Long Term Care at any level, in the home, assisted living or nursing
home can add a tremendous cost to seniors and their families.
Government Programs Only Pay For About 16% Of Long Term Care
Government programs such as Medicare, Medicaid and the Veterans
Administration will cover the cost of long-term care under certain
conditions. Medicare will cover rehabilitation from a hospital stay or
limited care at home if there is a skilled (medical) need. The Veterans
Administration will cover the cost of nursing home care indefinitely if
the veteran is at least 70% service-connected disabled. The VA will
also cover other forms of home-based or community-based care if
there is a medical need.
Medicaid will cover both medical and non-medical related long-term
care but in order to qualify for Medicaid an Ohio resident has to have
less than $1,500 in assets and income that is insufficient to pay the
cost of care.
Funding Long Term Care with your Life Insurance Policy
Drawing cash from life insurance or changing a life insurance policy
should only be done after reviewing with an expert advisor. Loss
of the policy and death benefit could prove to be a detriment. If,
however you have accumulated cash in a life insurance policy and no
longer need the coverage you may consider using the cash for long
term care or purchasing a LTC rider to your current policy.
New insurance products are being developed to cover both life
insurance and long term care insurance. ElderLawAnswers reports:
“A new law makes the purchase of products that combine annuities
or insurance policies with long-term care insurance more attractive.
These "hybrid" products are gaining in popularity due to a law that
went into effect January 1, 2010, making distributions from life
insurance and annuities tax-free when used to pay for long-term
care. The same law also allows owners of annuities or life insurance
policies to exchange their old policies for long-term care insurance or
hybrid policies without being taxed.”
Combination sales which include life insurance, annuities and
traditional long-term care coverage are becoming popular with
insurance companies and may prove a method of financing long
term care. Investigate closely, however to find what exactly will be
covered. Some policies do not cover home care costs or complete
costs of nursing homes.
Long Term Care Insurance Funding for All Long Term Care Needs
The first long-term care policies were offered about 40 years ago.
These were primarily nursing home-only policies designed to take
over when Medicare rehabilitation ran out. They were not the
comprehensive benefit policies we see today.
Long Term Care Insurance policies today are greatly diversified in
their coverage. Home care, nursing home costs, adult day care,
physical therapy, skilled and non-skilled nursing care are some of the
services covered. Policies vary in price and what they cover. There
is also a very restricted qualification of physical and mental heath to
get a policy. Purchasing a policy at a younger age makes it easier to
qualify and also provides cheaper premiums. It is best to consult with
a long term care insurance professional about the type of policy that
fits your needs and budget.
Veterans Aid and Attendance Pension Benefit
Though not an insurance policy, the VA Pension Benefit should be
mentioned as a way to pay for long term care needs. A veteran or
spouse of a veteran who served during a period of war can receive
money, up to $2,019 a month, to pay for long term care medical
expenses, home health care, and assisted living cost. A qualified
Veteran Consultant can help you determine if you qualify for this
benefit.
Pre-Need Burial Insurance
One might ask what Pre-need burial insurance has to do with long
term care. The purpose of preneed life insurance is to set aside funds
for your funeral, before the need arises.
It is an insurance policy that covers the cost of the predetermined
expenses of a funeral, cremation or burial. It gives the purchaser the
opportunity to preplan the services and peace of mind in having it
paid for. This is usually an insurance policy that pays at time of death
for these expenses. There are many insurance companies that offer
these packages as well as funeral homes.
NOTE: If a person anticipates needing to apply for Medicaid after
all is said and done, it is unwise to start spending down assets until
having at least a consultation with a Medicaid specialist. In order to
retain the maximum assets for the community spouse, application
needs to be made first.
The saddest cases of long term care needs we hear are:
“Mother can no longer live alone and she has no money to go live in a
care facility.”
“ Is there someone that can come help me take care of my wife? We
live on our Social Security and I can not pay what home care costs.”
“Father died last night and we have no money to bury him, what do
we do?”
It is important to make the necessary arrangements to cover long
term care and end of life costs. There is no government program
that will cover all those needs. The National Care Planning Council at
www.longtermcarelink.net strives to educate people about long term
care services and encourages the planning that needs to be done to
prepare for future costs and needs.
The National Association of Professional Geriatric Care Managers at
www.caremanager.org has lots of good information as well as a list
of professionals around the country who specialize in long term care
planning and follow-through with families.
Debra Roidl, MSW, CMC
Care Manager, Certified
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