Care Management Chronicles: Ravings of an Aging Baby Boomer

Is Insurance the Answer to Long Term Care Planning?

2012-01-16T11:07:00.000-05:00

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

Downsizing and accessibility for seniors

2011-05-11T22:42:00.000-05:00

Downsizing, Organizing, Handicap Remodeling or Relocating
May 10, 2011

When Robert and Anne bought their family home thirty years ago, their plan was to live through retirement in this home. They had furnished their home with refurbished antiques acquired from their many trips together. It was one of their cherished antique coffee tables that Robert tripped over, breaking his hip. Now with his return from the hospital in a wheelchair, the overwhelming task of making their home accessible for Robert’s wheelchair and safe for both of them faced Anne.

Remodeling for wheelchair access, organizing home furnishings and daily living items or downsizing and relocating to a smaller living area are monumental tasks that are many times thrust on senior home owners. Sometimes the need to do this is brought on by injury or age related illness. Home and yard maintenance can become a daunting chore for even the healthiest of seniors, requiring them to make a downsizing decision.

There is a large and growing industry of specialists who understand these challenges of elderly homeowners and are ready and willing to help with remodeling, organizing or the sale of the home and with the move to a new location.

A professional organizer provides skills in making the home safe and manageable. Relocating furniture, removing hazards such as electrical cords, throw rugs, heavy objects on shelves that might fall are some of the ways they make a home more senior friendly. They specialize in helping seniors part with items that clutter or have no valued use, so to make rooms less crowded or to make ready for a move to a smaller living space.

Handicap remodeling services and senior safety services offer help in adding wheelchair ramps and widening doorways. Bathrooms are made more accessible and safe, with hand rails, walk-in bath facilities and easier access to toilets.

If moving to a smaller retirement home or care facility is the best solution there is another senior specialty provider to call on called a Seniors Real Estate Specialist.

The Senior Real Estate Specialist concentrates more on a complete service package for the sale of the property and/or the purchase of a new living arrangement. The specialist also arranges for the services of a relocation specialist or Senior Move Manager to provide a complete, stress-free package for the elderly homeowner.

A move often requires downsizing and getting rid of a tremendous number of acquired possessions. The relocation specialist or Senior Move Manager, as they are often called, will typically provide a turnkey operation that includes assessing and identifying items to keep, arranging for auction or other disposal, cleaning the home, moving the belongings and setting up the new residence. The manager may also work closely with a real estate agent to arrange for the sale of the home and may also be involved in the financial transactions necessary to move into a new living arrangement.

All the help available to seniors may in itself be overwhelming. How do seniors choose the right service provider for their needs? How do they know they will hire someone qualified, responsible and honest? Area Agencies on Aging and State Better Business Bureaus are good resources to check out available service providers.

Family, friends and religious leaders can be valuable resources to seniors in referring service providers and helping to manage the hiring and supervision.

The National Care Planning Council’s website www.longtermcarelink.net provides educational articles and information on eldercare providers throughout the nation.

Using Your Home Equity for Long Term Care

2011-04-20T16:18:00.003-05:00

In my business as a Professional Geriatric Care Manager, many seniors and their families come to me with questions about how to pay for long term care. Most seniors want to stay in their own homes, and some may be able to if they can afford the care that they require now, and in the future. For many seniors the equity in their home is their largest single asset, yet it is unavailable to use unless they use a home equity loan. But a conventional loan really doesn't free up the equity because the money has to be paid back with interest.

A reverse mortgage is a way of tapping into home equity without creating monthly payments and without requiring the money to be paid back during a person's lifetime. Instead of making payments the cash flow is reversed and the senior receives payments from the bank. Thus the title "reverse mortgage".

Many seniors are finding they can use a reverse mortgage to pay off an existing conventional mortgage, to create money to pay off debt, make home repairs, or for remodeling.

For those seniors who are in need of long term care and want to stay in their home, a reverse mortgage can create the money needed to pay for in-home personal and medical care. They can also pay for needed medical equipment and handicap adaptation to their home.

There are no income, asset or credit requirements. It is the easiest loan to qualify for. You must be at least 62, own and live in, as a primary residence, a home [1-4 family residence, condominium, co-op, permanent mobile home, or manufactured home] in order to qualify for a reverse mortgage.

A reverse mortgage is similar to a conventional mortgage. As an example:
• The bank does not own the home but owns a lien on the property just as with any other mortgage
• You continue to hold title to the property as with any other mortgage
• The bank has no recourse to demand payment from any family member if there is not enough equity to cover paying off the loan
• There is no penalty to pay off the mortgage early
• The proceeds from a reverse mortgage are tax-free and can be used for any legal purpose you wish

False Beliefs Regarding Reverse Mortgages
• "The lender could take my house." The homeowner retains full ownership. The Reverse Mortgage is just like any other mortgage; you own the title and the bank holds a lien. You can pay it off anytime you like.
• "I can be thrown out of my own home." Homeowners can stay in the home as long as they live, with no payment requirement.
• "I could end up owing more than my house is worth." The homeowner can never owe more than the value of the home at the time the loan is due.
• "My heirs will be against it." Experience demonstrates heirs are in favor of Reverse Mortgages.

There are some things to be aware of when thinking of using a reverse mortgage. According to Walter Updegrave, a senior editor at MONEY Magazine and author of "Investing for the Financially Challenged," closing costs and other fees can run into thousands of dollars. If the borrower remains in their home for many years after taking the reverse mortgage, and uses the money to stay independent by paying for caregivers, for example, then the costs may be worth the risk. If, however, the borrower dies or has to move to a more protected environment within a few years, the fees may not be worth it. (http://money.cnn.com/2004/03/30/pf/expert/ask_expert/)

The amount of reverse mortgage benefit for which you may qualify, will depend on
• your age at the time you apply for the loan
• the reverse mortgage program you choose
• the value of your home
• current interest rates
• and for some products, where you live

As a general rule, the older you are and the greater your equity, the larger the reverse mortgage benefit will be (up to certain limits, in some cases). The reverse mortgage must pay off any outstanding liens against your property before you can withdraw additional funds.

The loan is not due and payable until the borrower or borrowers no longer occupy the home as a principal residence (i.e. the borrower sells, moves out permanently or passes away). At that time, the balance of borrowed funds is due and payable, all additional equity in the property belongs to the owners or their beneficiaries.

Other considerations regarding reverse mortgages are that interest rates and fees can vary widely among reverse mortgage lenders. Mr. Updegrave states, “… it can be very difficult to compare the true costs of different loans from different lenders. The best way to do that is to compare each loan's ‘TALC,’ or total annual loan cost.
This figure, which reverse mortgage lenders are required to disclose by federal truth-in-lending laws, takes all loan costs into account as well as the timing on the payments you're projected to receive.”
( NEW YORK (CNN/Money) - What are your feelings pro and con about reverse mortgages?
-- Josephine Amato, Wyckoff, New Jersey) (http://money.cnn.com/2004/03/30/pf/expert/ask_expert/)

The most popular reverse mortgages are the so-called HECM loans. HECM loans require that the applicant meet with a government approved counseling agency to be sure the applicant understands the reverse mortgage process.

The Federal Trade Commission states:
“Before applying for a HECM, you must meet with a counselor from an independent government-approved housing counseling agency. Some lenders offering proprietary reverse mortgages also require counseling. The counselor is required to explain the loan’s costs and financial implications, and possible alternatives to a HECM, like government and nonprofit programs or a single-purpose or proprietary reverse mortgage. The counselor also should be able to help you compare the costs of different types of reverse mortgages and tell you how different payment options, fees, and other costs affect the total cost of the loan over time. Most counseling agencies charge around $125 for their services. The fee can be paid from the loan proceeds, but you cannot be turned away if you can’t afford the fee.”

A Reverse Mortgage Specialist in your area can answer your questions, calculate the amount of loan you can receive and advise the type of loan for your needs. The National Care Planning Council (http://longtermcarelink.net/a7reversemortgage.htm) has a list of Reverse Mortgage Specialists in your area. Also, the AARP website has a section on reverse mortgages at http://www.aarp.org/money/credit-loans-debt/reverse_mortgages/. Do your homework and make sure that you also consult with your own financial advisor about whether a reverse mortgage is the best way for you to utilize the equity in your home.

Planning Ahead for ElderCare

2011-02-13T12:51:00.005-05:00

I've received more requests than usual recently for assistance with planning ahead for aging parents. This is an indication that more people are seeing what is happening around them with long term care. The general population has no idea what services are available, appropriate, affordable to alleviate stress and improve quality of life as we age.

Take a look around. Talk with your friends and neighbors. Notice how many people are engrossed in the task of caregiving. Tell them there is hope. There are resources. And there are experts in the field that can guide and assist them through their journey.

Make sure you are educating yourself about what your parents need, what they have, and what they do not have. Where are their finances? Who are their doctors? What hospital do they prefer? What legal documents have they updated (healthcare Powers of Attorney, financial POAs, Trusts, Living Wills, etc.).

Don't wait for the crisis. Plan ahead. You will be much more prepared and experience less stress if you take your head out of the sand and look around to prepare.

Phobias

2010-10-07T20:50:00.001-05:00

October 7, 2010

People love their phobias. Withn the anxiety and the trepidation, there is something that makes us hold on to them.

For example, just now, thinking about really trying to desensitize myself with regard to my arachnophobia, I actually felt kind of … sad. Like I would miss the drama, the attention that I make to myself of this inordinate fear of spiders. I would actually miss the fear?

Or am I just talking myself out of trying to desensitize myself.

I truly am afraid of spiders. No reason, really. No memory of a traumatic event. Maybe it’s a past-life thing. Actually, yes, come to think of it, there is an early memory of being in bed, waking up sleepily, and with every stuffed animal I owned having a sleepover that night. A spider. Small but large to my young eyes (4 year old, maybe? 6?), crawling relentlessly, and rapidly – startlingly – across my bed, and under my bunny rabbit. I could not save my bunny rabbit. Stuffing 12 other beloved toy animals in my two little arms, screaming bloody murder for my other - is my next memory. And my mother, so calm, so comforting. I will always admire mama for her lack of fear and the chivalry of her nestling it into a tissue to set it free outdoors.

Today, they get in my house, they're dead. Sorry. Outside, i avoid you, spider. Inside, you weren't invited and you scare me!

Spiders are always running, rapidly, startlingly, across one’s vision. Often towards me, it seems. Coming right at me. Relentless. Purposeful. Driven. Because it knows I’m afraid of it and is coming to scare me.

I really don’t think they’ll bite me – unless I provoke them, of course, the spiders “are just afraid of you as you are of them” (yeah, right). It’s just that they startle me, and they seem to do it on purpose. "BAH". “I am in front of your face you stupid human and you didn’t see me coming and I might TOUCH you.”. Their tickling touch – ick!

Okay, I’m changing the subject now. Thanks for listening.

Rantings of an aging baby boomer.

Happy Halloween, everyone.

2009 -- it was a very good year

2009-12-09T17:38:00.003-05:00

I must have been very busy this year since I haven't blogged since January! Business is still supporting me; new referrals come in every month. I love counseling seniors and caregivers and I love helping adult children with their aging parents. I have a dog now, having had cats all my adult life and no dog since my first marriage in Wichita! Zelda is 9 months old now, a German Shepherd, Schutzhund quality sable coated brainiac. She's smarter than I am!

oh, and i'm married again. Yes, again. But this time, three's a charm, right? Martin Roidl and I have known each other through Taoist Tai Chi(r) for over 8 years. We were both married to others when we first met. Things happen for a reason, and at the right time, and we married on August 15th in Columbus at the Columbus Tai Chi Center. We honeymooned in the Upper Peninsula and now know what a Yooper is.

I've broadened my interests, focused my energies, and found that what does not kill me actually does make me stronger. Just call me Wonder Woman.

Aging Parents of Adult Children

2009-01-03T23:42:00.002-05:00

Yes, I know; the topic is usually the other way around: how aging Baby Boomers are dealing with their aging parents.

But think about it from your parents’ perspective. Just for a minute. Look at your own child to whom you gave birth a mere 10 to to 20 or even 30 years go, and imagine having THEM in charge of YOUR life.

No matter the mental age of a person in winter life stage, their children are still their children.

However, the mental age of a person in winter life DOES have to do with how much they can understand and/or retain of what they need to know to remain independent. They begin leaning on you, calling you, guilt-tripping you into taking them to their physician appointments; regardless of your being in trouble with the boss already in this job-risky economy.

And you DO want to do those things for your parents. Even if they have been less than perfect parents (show me a perfect parent, I’ll show you a Ph.D. study topic). Society expects, and we expect of ourselves, that we will care for our aging parents whether we are good at it or not.

Let’s face it. Some of us are not good at taking care of our own parents. And the long term options, bureaucracy, and lack of continuity make it a more than part-time hobby. Surgeons do not operate on their relatives; counselors cannot counsel their own relatives, so what makes people think they’re obligated to become sudden experts in the face of audacious and meandering system of unrelenting menu choices on a doctor's office's or insurance company's telephone service.

So, we need to flesh out several topics from the above:

*No matter the mental age of a person in winter life stage, their children are still their children.

*The mental age of a person in winter life DOES have to do with how much they can understand and/or retain of what they need to know to remain independent.

*Some of us are not good at taking care of our own parents. And the long term options, bureaucracy, and lack of continuity make it a more than part-time hobby.

*Just who IS going to take care of US? And who do we want helping us take better care of our oldest generation?

Passionate about Helping Families with Seniors

2008-05-20T17:41:00.002-05:00

I just read something amazing about how to help more people in my business. According to Dr. Symeon Rodger (Dr. Symeon Rodger [MemberServices@MindsetBootcamp.com]), who sends wonderful tidbits, and teaches marvelous full courses in the Law of Attraction (you know, "The Secret"(r)), instead of focusing on what I WANT, I need to be focusing on what makes me passionate. What I am passionate about is helping people in a unique way. When family members call me, and they tell me, "Why didn't I know about you 6 months ago!" When I am able to help them with problem-solving, with finding the right housing location, with advocating for a long term care facility not to discharge their parent without a viable discharge plan. I get very passionate about that. I love it.

I'm going to start focusing on this passion, and appreciate the fact that I do help people in a way that no one else really can except for other trained Professional Care Managers who see the big picture, and work specifically for the good of the client and not for a facility or insurance conglomerate.

I'm smart. I'm intelligent. And, by golly, people like me!

Seniors: Safety versus Denial

2008-04-16T15:50:00.002-05:00

I sat with a brother and sister last week who needed to vent about their widowed, childless aunt. Aunt Edna, we'll call her, was supposed to attend the meeting as well, but she conveniently decided to go shopping with her grand-nephew when he came over earlier to see how she was getting along. "It's nice that your son helps out when he can," I observed. "But that's just it!" lamented the niece, "We offered to take her shopping yesterday, and she refused. She knew we were having this meeting and didn't want to be here, so when he came over she rooked him into taking her. She takes advantage of us and we have to find a better solution than this piecemeal kind of scheduling!"

I was visiting as a home health social worker in this instance, I contract with several agencies in town, making up to two visits to help people find resources and educate them about long term care issues to keep them out of the hospital as long as possible. This scenario is typical. Grown "Sandwiched Boomers" have become caregivers for their parents and other aging relatives. They still work fulltime, have grown kids and grandchildren of their own in many instances. And sometimes the senior just isn't interested in changing anything about the situation. They helped create it. As I told this brother and sister, "She's trained you very well." They rolled their eyes exasperatedly.

One of the primary referrals I wanted to make for this 90+year-old woman still living in her own home, alone, was for an Emergency Response System (ERS). I had offered it on my first visit, and she had refused. This time, when she returned from shopping, she agreed to the referral and I had her niece and nephew as witnesses. An ERS (remember: "help, I've fallen and I can't get up") is one way to increase a senior's safety and successful retention of their independence. Even if they do fall, if they receive help within an hour the chances of returning home are around 80%. If they lie on the floor for hours, there is an 80% chance they will spend the rest of their lives in a nursing facility.

So, I made the referral, to the relief of the caregiver family members. Two days later I received a call from the ERS company: she politely refused to have them install the system. Two days after that I received a call from the nephew: "Aunt Edna is in the hospital. She fell and no one found her for about 4 or 5 hours. We need some help with planning for the next stage."

I hope I can get her home with assistance. She'll probably need extensive rehab. She was dehydrated, of course. Had she had the system, she would have been rescued before dehydration had set in.

Some people just don't listen. It's frustrating. I keep trying anyway.

Time - where does it go?

2008-02-26T15:25:00.003-05:00

When I first started blogging I intended to write daily, or at least weekly. Looking at the dates of my posts, it is evident that my life is busier than I expected. Where does the time go? How do we find the time, make the time, for our families and the things that are important in our lives?

My senior clients tell me that their grown children do not have time for them. The sandwich generation struggles with balancing time between their aging parents, their growing children, and their own careers and relationships. Time is one thing we can't reproduce. Once it's gone, it's gone forever.

Too many regrets fall from the lips of people at the end of their lives: "I should have seen my parents more often." "I should have spent more time with my children growing up."

Someone told me recently: "Things are not important. People are."

If we keep that thought in the forefront of our minds, perhaps there will be fewer regrets at the end of life.

Holidays and Seniors

2007-12-20T20:37:00.001-05:00

Lots of people will be traveling home for the holidays soon. Many of us "flew the coop" after high school or college, and left our parents to age back in our home towns. I get many calls this time of year when folks come home to less than ideal circumstances.

Mom and Dad have aged, and they've done a very good job of hiding it from us in those weekly/monthly telephone calls. When you get home this season, do some checking around if you have some suspicions that things aren't right. Ask them about their finances, if they are getting their bills paid on time. Look in their medicine cabinets to see if they're hoarding prescriptions, failing to throw out expired items, and for the more recent prescriptions count how many are left in the bottle and, based on the date the script was written, ask yourself if they are taking the medication as prescribed.

Offer to go to a physician appointment with them while you're in town. Make sure you, or another family member, has HealthCare Power of Attorney. Establish a relationship with their primary care physician (PCP) so you can call the doctor's office from time to time with concerns. Give your contact information to the PCP's office.

Establish a system for what your parents should do if an emergent situation arises. If there are many children in the family - whom should they call first? Establish a phone tree, and don't leave anyone out!

Holidays can be wonderful times to show your parents how much your care by becoming a little more involved in their lives. And, if they're resistant? Well... that's another blog.

Read more about Holidays and Caregiving at: http://www.professionalcareforyou.com/holidayhomecoming.htm

Stay tuned, and stay well.

Helping people is my thing

2007-10-12T16:00:00.000-05:00

I hope you haven't missed me too much, but I've been very busy helping families with aging parents make the best of what they have.

Most recently, my average client age is 90. Most of them are in their own homes and want to stay here. I'm helping them accomplish that goal by pulling resources together that meet their needs and their budget.

I love answering questions and educating people about choices and community resources.

I've also been having a little fun for myself, and practicing what I preach to caregivers: Take care of YOURSELF.

Happy Autumn, everyone. I promise to write more soon and tell you some specifics about keeping our seniors safe and independent.

The Greatest Generation

2007-07-30T20:11:00.001-05:00

It's not a cliche, it's the truth. The World War II generation deserves its nickname. They survived the Great Depression. They volunteered to fight a war they believed in, and those who did not lose their lives, still they lost their innocence.

How will we care for them now? What do they deserve? Institutional extended care facilities with overworked, underpaid staff? Move them out of their homes because it's too expensive to care for them there? Put them in rooms with linoleum floors and roommates who scream and food brought in refrigerated trucks?

Why not something better? What will it be? What will we want when we are finished earning a living and need to rely on what we have saved and what others will donate through taxes or willingly?

We will want to be asked. We will want to be a part of the decision of where and how we live out the last years of our lives. What do you want? Tell someone.

I want to be in my home with my kitties and my family. If I can afford it, I will want to stay at home and watch television all night now and then. I want to eat when I feel like it. I want to be able to take up new hobbies that I'll finally have time for: piano lessons, reading the Great Classics, learning a foreign language or two, writing the Great American Novel finally. I want my computer internet working, a stereo, and whatever newest electronic toys are coming out. I want unlimited visits from children and grandchildren, grown or otherwise. I want a garden to sit in.

Respect, comfort, kindness. These are the things I wish for all aging people.

The Wasp Lesson

2007-07-17T21:03:00.000-05:00

I got stung by a wasp on Sunday afternoon. It had been a beautiful day, until that moment; I was being incredibly productive, working on several outdoor projects. The garage door needed repairing and I was finally getting it done! Unfortunately, I was in conflict with an unknown adversary. I was getting too close to the wasp's nest (attached to the underside of my son's slide!) with power tools. I saw it fly near me, but didn't realize it was actually after me until I felt the intense pain on the meaty part of my forefinger. "Sonofagun stung me!" exploded out of me and I dropped the tools and leapt to another part of the yard. The ice cube helped but it was a big unnerving, I must admit. I sat on the couch the rest of the afternoon, milking my ego and babying my finger.

Then it struck me. How beautiful a day I had been having. Productive, happy, content, beautiful weather. And one little sting could be so powerful as to interrupt and change the whole atmosphere of the day. So, looking back on this day, what will I remember? That I had a beautiful day with gorgeous weather and productivity? This is the day I finally repaired my garage door! It works now without scraping the floor and falling off of the hinges! Or will I remember the sting of the wasp, the pain, and the surprise of the attack.

You know what? I'll remember it for the lesson of the wasp. That even though the sting is powerful, the attack intense... I can choose to relish in the good things that happened, and make even the sting a good thing. Thank you, Wasp, for reminding me that a little sting doesn't have to be the whole day. Just a moment of the day, another incident, experience, lesson. Interrupted, yes. Ruined, no.

Nice People Rock

2007-05-02T18:26:00.000-05:00

Seniors are easily intimidated. There are a lot of people that seniors must deal with that choose to be intimidating instead of helpful. Today I met an example of the most, and the least, helpful personalities whose job is to serve the public.

I accompanied a client to the Title Bureau of a nearby county. Despite the cliche expectations that the BMV will be the bad example, this expectation was put to rest as soon as we walked into the office. "May I help you?" said a woman behind the counter. "There's no line?" I was shocked. She had a smile on her face, and met my client's eyes as she stepped up to her counter. This state employee made my client feel at ease by being friendly and warm, willing to help. Even though it took a good 10 to 12 minutes of standing (I offered to get a chair for my client, she declined), the process of creating new Titles for both her mobile home and her vehicle was made comfortable and easy.

Then we went to the VA office in the same building. The woman who handles all VA benefits requests for that county is known for being ... difficult to work with. She lived up to that expectation. My client, Mrs. C, had called this public service office twice and been told that she could expect a return phone call. When none came, Mrs. C wrote a letter. Still no reply. She was trying to get her spouse's VA Aid and Attendance benefit sent automatically to the bank (for the past 8 months). Since the office was nearby, we dropped in. It was ten minutes to 3. We were told to wait please, that the caseworker was in her office. Indeed, we could hear said person on the telephone, loudly complaining to some unfortunate soul.

Another citizen walked in with a three pm appointment with the caseworker. At 5 minutes to 3, the caseworker walked out to the reception area where we all were waiting patiently, reading the newsletters, making small talk with the receptionist about the weather. "Do you have a very brief question, because I have a three o'clock appointment!" she barked with a sour smile on her face. She was intimidating looking with a long wild shock of gray-streaked hair. When her eyes landed on me, I pointed across the area to my client and said as loudly, "Yes, Mrs. C has a very quick question for you, Ma'am."

Her answer to my client's question about the delay was this: (In a sarcastic tone of voice) "Well the paperwork was only sent in on April 20th. It will take several weeks for it to start going directly to the bank."

Here's where things get neat. I smiled broadly, walked toward where she and my client were standing (with the counter between them), and thanked the woman genuinely for her time. The smile she returned to me broke open her porcelain demeanor. She felt appreciated. She thanked my client for coming in, smiled at her, and changed the atmostphere of the encounter.

As we left, Mrs. C rolled her eyes at me and, when the door shut behind us, said, "Whew; she's something else!" We giggled like schoolgirls leaving the principal's office as we walked to the elevator.

One of my favorite bumper stickers is "Mean People Suck." But, actually, without mean people, we would maybe not appreciate the nice ones as much.

~debra

Caregiver Guilt

2007-04-28T21:14:00.001-05:00

For weeks, friends and colleagues have said I should write about caregiver guilt. Since it was first mentioned, I've noticed the common theme as caregivers speak about their experiences with their care person (care person = person needing care; I've stopped assuming that "loved one" is an appropriate description for the relationship between the caregiver and the person needing care, hence, I've adopted the neutral term "care person" to describe the recipient of the care).

How can these people feel guilty? I ponder. It is an oxymoron in the face of reality. While caregivers definitely vary widely in the actual time committed to caregiving tasks, it is my opinion that caregivers give much of their emotional energy to the fact of caregiving, and that they give all that they can, given their individual emotional, financial, and physical capabilities. Guilt should be far from their repertoire, and yet, there it is. Guilt is an entity that makes itself known and felt in broad strokes through families as they make their way through life.

From the daughter who spent 8 hours straight at the side of her dying mother, "I shouldn't have left to have dinner, she wouldn't have died alone."

From the long distance son, "I should have moved mom closer to us; I would have been able to spend more time with her."

But, there's: "when I moved dad to the city where I live, I wasn't able to spend as much time with him as I intended. Work and family took precedence, and I ended up feeling guilty that I moved him away from his familiar neighborhood and friends."

We can never anticipate everything that we might feel guilty about later. It seems we're very good at creating guilt no matter what our actions have accomplished.

The next time guilt starts taking hold, try imagining the life your care person would have had without you. Start listing the things you have done that have made a difference to someone else. Be grateful for the opportunity to be a caregiver; what a marvelous and blessed role it is.

Take care.

~debra

Sally, 66 years old

2007-04-27T18:27:00.000-05:00

Last Saturday I helped to admit her and spent time advocating in the ER for pain control. (ER nurse: "She says she's not in pain." Me: "Please looka t her face and listen to the groans of pain. That is not normal for my
client.")

Sunday when I checked on her they told me she was dying. I called her daughter, who also came, but I stayed to be with my client. It was a service I had provided for 3 years. Comfort, advocacy, camaraderie. I knew her better than any one. Her dtr had visited 4 times in the last year.

Today, at the funeral, I wanted to ask the 30 or so persons in the room who they were and where they had been for the last 3 years. The family took care of all the belongings at the nursing home.

I was there for the client. Representing her real, current life. They were a part of her past, and also important to be there. I was also there for myself, because I did love her.

Thanks for listening. Have a beautiful weekend.

Beginning

2007-04-27T17:22:00.000-05:00

I am a social worker. I love people. Growing up, I didn't know I was a social worker. I just knew that I loved people. Especially elderly people. The work that I do now is extremely rewarding, and helpful to others who don't want to go it alone. I am a Professional Geriatric Care Manager (PGCM).

The people I work with are very special to me. I want to share their stories so that they can be special to you as well. They want to help you. Help you to avoid the mistakes that they made. Help you to learn from their wisdom. Help you enjoy life more and have more quality time with your family and friends.

Come along, if you'd like. You might find something of interest, of help. I'd be grateful if you did.

~