Caring Together, Living Better: New Program to Help Caregivers in South Suburbs

Caregivers in the Chicago’s south suburbs may be eligible to get a helping hand with their caregiving responsibilities from a program called Caring Together, Living Better.  The Chicago Tribune recently published an article on the program, which will begin in January of 2010 and will offer services to caregivers to help alleviate the demands of providing care for their loved ones.

Caring Together, Living Better began as a grant from the Harry and Jeanette Weinberg Foundation which was then awarded to AgeOptions, an agency that connects older adults with services in suburban Cook County.  AgeOptions sought out small communities with needy populations that had a genuine interest in helping their senior populations, preferably those who already had existing programs for seniors and/or caregivers. 

Several social service agencies and seven churches in Harvey, Riverdale, Midlothian, Markham and South Holland are part of the program, which will offer services for caregivers such as “respite care, transportation to doctor’s offices, leaf raking, snow shoveling and keeping elderly charges company. Church volunteers will offer the services to low- to moderate-income caregivers of relatives or friends age 60 and older.”

Click here for the full article.

NPR audio clip: 30% of Americans are Caregivers

This morning I found a brief audio clip from NPR’s “All Things Considered.”  The story focuses on a recent study released by the AARP and the National Alliance for Caregiving, which announced a staggering statistic- 30% of Americans are caregivers for an elderly parent or spouse or disabled child.  NPR’s Joseph Shapiro discussed how the time (an estimated 19 hours a week) and energy expended by caregivers is similar to that of a part-time job.  Nineteen hours a week is a great deal of time and for caregivers who also work and take care of their own families- how do they handle this kind of time and energy commitment?  Eleanor Ginzler of the AARP noted that as most caregivers are also employed, this creates some serious interference with regular work.  As a result, Ginzler said that “making accommodations in the work place has increased in several ways. In most cases, two-thirds of them means they either go in late, leave early or take time off.”  The study also shows that “at least 12 percent of caregivers say they’ve turned down a promotion, reduced their hours, taken a less demanding job, or they’ve given up work entirely to devote themselves to caring for a loved one.” 

Based on the feedback the article received, there are some who say that this is an unfair burden to place on the American workplace and that taking an increasing amount of personal time off is a drain on our resources.  However, for people like Kathleen Bowleg who has acted as a caregiver for both her parents, she explains that taking care of her parents is the thing she is most proud of in her life. 

Click here for the audio clip and/or transcript of the story.

Confusion Ensues After an Unexpected Trip to the Hospital

I’ve seen this so many times before- a senior makes an unexpected trip to the hospital then returns home without knowing what comes next, or in some cases without even knowing the extent of what happened at the hospital.  Those emergency room trips can be overwhelming for a number of reasons.  They’re unexpected, you’re worried about what this means for your loved one, how long will it take for someone to see us…the list goes on and on.  Regardless of how chaotic the situation may be, it’s important to remember to stay focused on the task at hand, which is helping the sick or injured person get better.

The Alzheimer’s Reading Room recently published an article titled, “After a Visit to the Emergency Room Most Patients are Clueless.”  As the article reminds us, going to the emergency room isn’t always enough.  Often, healing properly means physical therapy, medication or visiting a specialist among other things.  It is essential to know what your treatment plan entails once you leave the hospital.

In addition to the article, here are some tips on following through with your hospital visit:

• Ask questions, even if you think they sound simple (i.e. What does that mean? Can you explain everything to me once more? Where can I reach you if I have more questions?)
• Take notes!  This is always a helpful tool when you need to remember something, but doubly important if the thing you need to remember involves your health or the health of a loved one.  Don’t assume you’ll remember everything.  Trips to the emergency room can be harrowing and you may not recall everything the doctor or nurse told you or you may remember a different version.  Don’t risk it.   

Click here for the full article. 

12/9 Update:  On December 8th, The Washington Post  published a story titled, “Groups try simple steps to avoid hospital rebound,” which discusses the shift around the country to better prepare patients leaving the hospital in an  effort to prevent rehospitalization.  The article notes that, “one in five Medicare patients winds up back in the hospital within a month – even worse, one in four patients with heart failure.”  It goes on to add that a “major push is under way around the country to cut rehospitalizations, in part by arming patients with simple steps to keep their recovery on track – like getting past harried receptionists for quicker follow-up doctor visits, and reducing medication confusion.”

See this link for the full Washington Post article. 

Hospice Care is 35 Years Old and More Commonly-Used Than Ever

Seattle PI published an interesting article on the history of hospice care and its evolution over the past 3 1/2 decades.  As someone who has seen the benefits of hospice care first-hand, it was surprising to hear that hospice care was initially seen as a medical fad.  As some background, the first hospice was started just outside of London and didn’t make it’s way to the United States until about a decade later.  Today, more families than ever point to hospice as a means of guidance and support as they grapple with the physical and emotional tolls of loss.   One caretaker noted that the loss of her parents and husband was made ”bearable” with the assistance of hospice care.

So, how did hospice shift from being a “fad” to an accepted practice?

• 1982 decision by Congress to add hospice to optional Medicare services
• hospice now covered by public and private health insurance
• the medical community recently helped further legitimize the industry by offering certifications in hospice care for doctors, nurses and nursing assistants

Along with it’s shift into the mainstream, this acceptance of hospice care also acted as a catalyst for Americans to rethink their previous notions of death as a taboo subject.  Don Schumacher, president and CEO of the National Hospice and Palliative Care Organization, explained that, “The conversation about death and dying and grief and loss is much more part of the mainstream.”

 Click here for the full article.

Leave a comment to share your thoughts or experiences with hospice care.

Use Your Holiday Visit to Assess Your Senior’s Needs

Hard to believe it’s already that time of year, but the holidays are here.  For some, this may be the only time that you’re able to visit with the seniors in your life.  It can be difficult to provide care from a distance, but if you do, use your visit to spend some quality time with your family and use that time as an opportunity to get a status on their current care needs.  You may find that an updated care plan may be necessary, that their medication needs to be monitored more closely or something as simple as furniture adjustments might make the home a safer place.   

 Eldercare ABC (About Being Connected) Blog published an article on what to look for during your visit and what assessments should be made.  Click here for the full article.  Having a lengthy period of time to visit will help you keep an eye on:

•  medical conditions
• medical doctors
• medications
• home safety
• driving
• retirement care plan
• guardians
• resources
• costs

 It may also a good time to bring up other important issues, such as whether your parents have a power of attorney or a will in place.  These are not easy topics to discuss, but they are conversations worth having.  For some ideas on how to begin these kinds of discussions, see the 11/25/09 post on some “conversation starters.” 

Aging can be difficult, but you can make the process smoother for your loved one and yourself by planning ahead.  The article added that this, ”will also allow you to prevent emergency senior care planning later and eliminate the added stress last minute planning can cause.”

Ways to bring up sensitive, but important matters with your senior parents

Have a concern you’d like to bring up to your elderly parent or loved one, but just aren’t sure how?  Here is a great link featuring some “conversation starters” for those difficult, but important discussions.  Leave a comment about these or any other ways you’ve discovered that helped to approach a sensitive topic with your senior parent. 

 

Click here for: Conversation Starters for Sensitive Subjects

 

Topics covered:

When Health Changes Lifestyles

Did Dad Hit a Light Pole?

You’re Going to Wear That?

When the House Is a Mess

A Senior Moment or Something More?

The Medication Quagmire

Sibling Communication

Mom’s Not Safe at Home

The Money Talk

When Dad Starts to Date

Update: I just found a link to a free ebook you can download from your computer about this very subject.  SeniorCare Organizational Systems (SOS) published a book called “Having the Talk” which aims to help you navigate the sometimes scary road of caring for your elder.  Click here to link to SOS to download this helpful resource.

The Patient Protection and Affordable Care Act

Late into the day on Wednesday, November 18^th, Senate Majority Leader Harry Reid ( Dem.- NV) unveiled the proposed health care reform bill senate leaders plan to bring to a floor debate at the end of November. The bill, named the Patient Protection and Affordable Care Act, is a combination of the health bill approved by the HELP (Health, Education, Labor and Pensions) Committee and the Senate Finance Committee bill.

Key elder issues:

• Nursing Home Transparency and Improvement
• The Elder Justice Act
• Criminal Background Checks on Long-Term Care Workers
• The CLASS (Community Living Assistance Services and Supports) Act 

According to the NCCNHR, there’s no word yet on whether Senator Reid has enough votes to pass the bill, but he is expected to call for a procedural vote by this weekend.

Keeping up with all the recent health care reforms and bills can be quite a task. Luckily, Senate leaders prepared an overview and section-by-section analysis of the Patient Protection and Affordable Care Act.  Click here to view it.

11/23 UPDATE: On November 21st, the U.S. Senate Democrats got a “fililbuster proof 60 votes that will allow them to bring their version of health care refore to the Senate floor for debate.”  While the vote is considered historic, the passage of this bill is in no way a sure thing.  Read here for complete details from the Examiner.com.

Open Enrollment for Medicare Part D: 11/15/09- 12/31/09

Open enrollment for those with an existing Medicare Part D Drug Plan has begun.  From now until Dec. 31^st, 2009 people already enrolled in a Medicare drug plan can now switch to a different plan, and with the holidays quickly approaching, this window of opportunity will be gone before you know it.  Consumer Reports.org noted that more seniors than ever are expected to revise their drug plans for 2010,  and they suggest doing your homework this year, as sticking with a plan that isn’t right for you can be costly.

If you’re new to Medicare Part D, check out: www.medicare.gov or call 800-MEDICARE (633-4227) for enrollment information.

Already familiar with Medicare Part D?  Head right to “Formulary Finder -2010 Plan Data” and take a look at the plan comparisons.  While the comparisons are helpful, they can also be tedious so plan to spend some time there.

Geriatric Care Managers: Experts in Developing Personalized Care Plans

Caring for an elderly parent or loved one can be a full-time job. Even when a family can agree on a care plan, which is not always the case, the plethora of decisions that need to be made and the never-ending pile of documents that need to be filled out is overwhelming. In addition to that, you have your own life to live and yourself to take care of.

It’s tempting to want to handle everything yourself, but sometimes outside help can actually allow you to provide the best possible care for your loved one, not to mention allow you to take better care of yourself. In September, the New York Times published an article on geriatric care managers, or what they also refer to as the equivalent of a case worker. Aptly named, these care managers do just that–manage the care of your family member. They have both the time and the expertise that family members often do not, which can greatly improve your elder’s quality of life. (See complete article for costs)

A good care manager will thoroughly assess the individual and use that assessment to determine a care plan that will meet the individual’s needs. Amongst a variety of other changes, this could mean that home care is recommended, or that sleeping and eating times must be adjusted. Plus, using someone outside of the immediate family can help in a few ways. One family member explained that he couldn’t get his mom to listen to him, but she would always listen to the care manager. It also provides the family with the option to be the “good cop” while the care manager is the “bad cop.” Persuading an older person not to drive anymore is a good example of when the good cop/bad cop routine might come in handy (and be more effective).

Click here to see the article in full. It provides some examples of how geriatric care managers have assisted families in finding and maintaining the right kind of care, costs involved and ways to find the right care manager for your family.

Here is an interview from ChoiceElderCare.org with a registered nurse and care manager on the benefits of care management. 

November is National Family Caregivers Month

On October 30, 2009, President Obama proclaimed November 2009 to be National Family Caregivers Month.  Organizations across the country are encouraging caregivers to remember their own health and care this month and to consider senior care options.

Click here to read the President’s full proclamation.

Have a caregiver in your life that you’d like to celebrate this November, but not sure how?  Check out: Top 10 Ways to Celebrate National Family Caregivers Month.

Other related article: Caregiver’s stress: How to Care for Yourself While Caring for Others

Elder Abuse: What do you do if you suspect it?

It’s difficult when you suspect that an elder you care about is the victim of elder abuse.  While the majority of reported elder abuse concerns financial exploitation, abuse may be physical, emotional, or sexual in nature, or may take the form of neglect.  In addition, some elders simply do not have the capacity or ability to properly care for themselves and may fall victim to self-neglect.

Elder abuse does not discriminate between sex, ethnicity or social status.  Between July 1, 2005 and June 30, 2006, the Illinois Department on Aging received 9,191 reports of elder abuse and, sadly, the majority of abusers were family members of the victim.

What do you do when you suspect that someone you love or care about is the victim of elder abuse or neglect?  If you suspect that someone you know is in immediate or life-threatening danger, first call 9-1-1.  Otherwise, to report suspected abuse, exploitation or neglect of an older person you may make a report to your local police department.

You may also call the Illinois state-wide 24-hour Elder Abuse Hotline at 1-866-800-1409, 1-888-206-1327 (TTY).  Under the authority of the Elder Abuse and Neglect Act (320 ILCS 20/1 et seq.), the Illinois Department on Aging administers the statewide Elder Abuse and Neglect program.  Reports of elder abuse are investigated by elder abuse caseworkers at one of 44 provider agencies around the state.  These case workers are trained and certified by the Department on Aging.  You may also call your local elder abuse provider agency directly.

Anonymous reports are accepted and the identity of the reporter may only be disclosed with written permission of the reporter or by court order.  Under the Illinois Elder Abuse and Neglect Act reporters who act in good faith are immune from civil or criminal liability or professional disciplinary action as a result of the report.

For more information on Elder Abuse or to schedule an appointment to meet with an attorney visit our website or contact us at 312-899-0950.

When the Trustee is not Trustworthy: Remedies for the Trust Beneficiary

Before my mother passed away, she established a living trust and named my sister as Trustee.  My sister, my two brothers and I are the beneficiaries of this trust.  I recently found out that my sister used my mother’s trust to pay for a cruise for herself and her daughter, and also remodeled her home with my mother’s trust monies.  What can I do?

Naming a Trustee of your Trust is perhaps the most important estate planning decision you make.  Unfortunately, this mother made the wrong decision in naming her daughter as Trustee after her death.  A Trustee has the fiduciary duty to act in good faith, in accordance with the Trust terms and purposes, and to act for the sole interest of the beneficiaries.  Even though the Trustee may herself be a beneficiary of the trust, she is breaching her duties as Trustee by using the trust assets for her personal benefit.

This beneficiary needs to act quickly to prevent the Trustee from continuing to spend the trust assets. If the Trustee/sister spends more trust assets than she is to receive as a beneficiary, it will be difficult to actually recover those trust assets from her.  The beneficiary should engage an attorney to file an emergency action to freeze the trust assets so the Trustee can’t continue to spend them; to remove the Trustee; to force her to account for her actions as trustee; and, ultimately, to pay back the misappropriated funds.  Because the Trustee acted intentionally in using trust assets for her own benefit, the beneficiary may be able to obtain punitive damages – a monetary penalty for breaching her duties to the trust – against the Trustee.

The Trustee will not be allowed to use trust assets to defend herself.  However, because the beneficiary is acting to protect the trust, it is possible that the beneficiary’s attorney’s fees will be paid from the trust assets.

Planning for Your Disabled Child

Few questions can cause as much worry and anxiety for our clients as “who will take care of my disabled adult child or grandchild when I am gone” and “how will she be provided for?”  In particular, our clients are gravely concerned about who will manage their child’s inheritance.  Who will make sure the money is spent appropriately for their child’s benefit?  Will the inheritance affect their child’s supplemental security check, medicaid coverage and eligibility for an adult day program or residential placement?  What if the inheritance disqualifies their child from medicaid?

These are the questions that keep the parents and grandparents of disabled adult children up at night.  Fortunately, through a special needs trust our clients can make sure that their adult disabled child or grandchild will receive an inheritance that is managed by a trustworthy individual in a way that will not disqualify that child from supplemental security income, medicaid, adult day programs or residential placement.

For those who qualify, a special needs trust can substantially improve a disabled person’s quality of life.  Through a special needs trust, a parent can make sure their disabled child is not disqualified from public benefits like medicaid and supplemental security income.  A parent can also make sure the inheritance they leave their child will be managed properly and in a way that enhances their child’s life.

Special needs trusts have enhanced the quality of life of so many disabled adult children and grandchildren.  And they have also given peace of mind to concerned parents and grandparents.

For more information on the benefits of special needs trust or planning for disabled children please visit our website, or call our office to schedule a consultation.  This post is adapted from Kathryn Casey’s article published in the July 2008 issue of Chicago Hospital News.

Talking to Your Aging Parents About Financial and Legal Planning

Good Morning America had a great segment this morning discussing tips for talking with your parents about planning for their financial and legal future.  Financial contributor, Mellody Hobson, had some suggestions for talking points for that important conversation.  The full video is available here:  Talking to Aging Parents About Finances – ABC New.

The highlights were:

• Broach the topic by discussing your own plans for the future;
• Organize their legal and financial documents;
• Suggest direct deposit and bill pay for your parents;
• Research meal, transportation and in-home medical services;
• Discuss long term care planning; and,
• Encourage estate planning and the necessity of drafting a Will.

For more information about any of topics discussed in the video please contact our office to schedule a consultation.

Medical Students Experience Nursing Home Life

The New York Times posted a very interesting article about medical residents who spent a short time living in a nursing home to find out what it’s like to be a nursing home  resident.  One of the goals of the program is to generate interest in geriatric medicine, which continues to be one of the most underrepresented fields in medicine.  Additionally, participants found that their experience offered invaluable insight into how to be better physicians.

Click here to read the full article

Misuse of Anti-psychotic Drugs on Nursing Home Patients

The Chicago Tribune recently published a series of articles on the use of psychotropic (or antipsychotic) drugs on elderly patients in nursing facilities.  The Tribune reviewed more than 40,000 state and federal inspection reports and found that many patients had been prescribed these powerful drugs despite the fact that they had no history of mental illness, no diagnosis of psychosis, and no display of any psychotic symptoms.

This trend is alarming for a variety of reasons, both for patients and their families.  The most commonly-used psychotropics carry the FDA’s highest advisory.  Some of the side effects include: severe lethargy, permanent involuntary muscle movements, restlessness, seizures and sudden death.  Non-psychotic patients who have been prescribed psychotropics are often described by family and nursing staff as “catatonic,” no longer able to talk or attend physical therapy and many have become so lethargic they must be hospitalized.  Similarly, as a result of this lethargy there have been a number of cases where nursing home residents suffered serious falls in which psychotropics possibly played a role; some of which led to serious injuries or even death.

Read the links below for some theories on why this is happening, information on your rights and where to direct any complaints. 

Five Things to Know About Psychotropics

Compromised Care: Psychotropic drugs given to nursing home patients without cause

Nursing home doctors untouched even as facilities are cited
 

Illinois Citizens For Better Care

12/14 Update: A new article states that “Nearly 30% of the total nursing-home population is receiving antipsychotic drugs ”

Consider Dementia’s Physical Effects When Making Treatment Decisions

When thinking about the effects of dementia, most people view it as a disease that solely affects the mind– a debilitating illness that strips an individual of his/her memories, but appears to leave the rest of the body untouched.  However, a recent article in the New York Times reminds us that the body undergoes a physical attack as well as a mental attack.  The illness is progressive and as it weakens the brain it also shuts down the body.  Doctors advise that these often-overlooked physical tolls must be understood and taken into consideration when considering the future care of your loved ones. 

 The article explains that the lack of understanding about the physical effects of dementia means that many patients near the end of life are subjected to aggressive treatments, many of which cannot possibly help them, or can even increase symptoms such as confusion and anxiety.  Researchers in a recent Harvard study found there were stark differences in treatment decisions depending on what family members knew about dementia.  Dr. Susan L. Mitchell, the study’s lead author, explained, “When family members understood the clinical course of dementia and the poor prognosis, the patients were far less likely to undergo these distressing interventions.”  She concluded that, “Dementia is a terminal illness and needs to be recognized as such so these patients receive better palliative care.” 

For the full article, click here.