$25 Billion in Medicaid Funding

An additional $25 billion in Medicaid funding was included in President Obama’s fiscal 2011 budget. As discussed in the Washington Street Journal article, “Medicaid Could Get Billions,” this inclusion speaks to the government’s adaptation to the sloth-like progress of health legislation in Congress. The article notes that some states “were so confident Congress would pass a health bill that they included the extra Medicaid funds in their state budgets.”

However, the election of Republican Scott Brown over Democrat Martha Oakley in the Massachusetts race for the U.S. Senate seat formerly occupied by the late Ted Kennedy could throw a serious wrench into the President’s health care plan, and it sent governors “scrambling to plug the hole.”

During a conference call on Friday, January 29, Health and Human Services Secretary Kathleen Sebelius assured governors that President Obama’s fiscal 2011 budget would include a six-month extension (which requires congressional approval) of the Medicaid funding increase that was part of last year’s stimulus package. Without an extension, the extra money would expire at the end of the year.

“The move would help ease a strain on state budgets as the recession is sending more Americans into Medicaid, the health-insurance program for the poor that is jointly funded by the federal government and state governments. To cover the shortfall, governors had considered cutting education funding, reducing payments to doctors and hospitals through Medicaid, and taxing soda, candy and chewing gum.”

Click here for the complete article.

Janna Dutton & Associates, P.C. has extensive experience in understanding both federal and state Medicaid regulations, and devising the best approach for each of our clients so that a Medicaid application has the best chance of succeeding in each situation.  For comprehensive legal assistance with your Medicaid concerns, contact the elder law attorneys at Janna Dutton & Associates.

Study: Higher Medicare Co-Pays Means Older Patients Cut Back on Doctor Visits

On January 28^th, the New England Journal of Medicine published a study examining the relationship between the usage of inpatient and outpatient care among those with Medicare plans that have nearly doubled their co-payments compared to those with similar plans whose co-payments have remained steady.  

Not surprisingly, the study found that while outpatient visits increased over time among all enrollees, those with raised co-payments had slower increases (about 19.8 fewer outpatient visits per 100 enrollees).  If the increase in co-payments was designed to keep people from going to the doctor as frequently, then in a way, the higher prices were a success, right?  Perhaps in the short term the raises are cost effective, but the study also found that in the long term, (expensive) hospital admissions for those with higher co-payments increased per year.  As a New York Times article on the topic explains, “When Medicare plans raise co-payments for outpatient care, older people cut back on doctors’ visits, then wind up needing more expensive hospital care.”

After all is said and done, is raising the price of co-pays actually effective?  Dr. Amal N. Trivedi, the study’s lead author and an assistant professor of community health at Brown University, noted, “This is an ill-advised containment strategy.”  He went on to explain that, “The increase in outpatient co-pays appears to produce both greater health care spending and worse health.”

For help with planning for your own long term care needs, contact the experienced elder law attorneys at Janna Dutton & Associates.

Suddenly, You’re a Caregiver

For some, becoming a caregiver is a decision that has been talked about amongst family, planned for, and decided upon before a time of real necessity.  For others, the role of caregiver is unexpected.   In an instant, this responsiblity is thrust upon them when a seemingly healthly and independent older parent takes a fall or is taken to the hospital. 

Today, I stumbled upon an article written for those who suddenly find themselves in the role of caregiver, appropriately titled, “Senior Life: Suddenly, you’re a caregiver.”  The article provides some insightful tips on navigating your first steps as a caregiver, such as what questions to keep in mind when speaking with your loved one’s health care professionals, what documents to have available, a reminder to keep the patient/family member involved in the process and keeping a journal of medications, insurance information and other important information. 

The article also touched on an aspect of caregiving which can often go undiscussed, which is the importance of caregivers caring for themselves.  As the article notes, ”Take regular breaks from caregiving to give yourself a fresh start to your responsibilities. Caregivers often take on the additional worries and burdens, which can, in the long run, have a stressed effect on their own mental and physical health.”

Preparation is often not an option when it comes to caregiving, so remind yourself that much of the knowledge you will gain as a caregiver is “on-the-job.”  When it comes to handling the responsibility of providing care for a loved one, a solid supoprt system and some personal leniency can go a long way.

Click here to read the whole article.

Another important component to a complete care plan, is ensuring that your loved one’s affairs are in order.  For legal assistance with estates, trusts or other elder law issues, contact the experienced attorneys at Janna Dutton & Associates.

2/1 Update: A reader replied to this posting, urging that family members can and should prepare for the tasks involved in caregiving.  As she noted, “Caregiver training is available in classes in many communities; online caregiver training is also available though the Institute for Professional Care Education, www.IPCed.com… (t)he 40 hour comprehensive online Personal Care Aide Certification course is designed to help the home caregiver provide care longer, with less stress, than on-the-job learning yields.  Details:  www.IPCed.com.”  Thank you for your comment!

Medicare Database Can be Downloaded for Free

Last Friday, as part of President Obama’s promise for government transparency, the Obama administration posted a huge amount of government data on the Internet (http://www.data.gov). The posting follows a Dec. 8 White House directive that each Cabinet-level department must post online at least three collections of “high-value” data that have never previously been disclosed.

Before Friday, the Medicare database was available on CD ROM for a fee of $100. Now, the database can be downloaded for free and provides detailed breakdowns of payments for Medicare services and is sortable by the type of medical service provided.

 In a Washington Post article on the subject, Ellen Miller, executive director at Sunlight Foundation, a nonprofit group focusing on the use of technology for greater government transparency, said the effort represents “a sea change in the government’s attitude,” with newfound support of the idea that government data belongs in the hands of citizens instead of locked away in the basement of a federal agency.

The Post included a list of departments required to release the three new data sets, which include the departments of  ”State, Treasury, Defense, Justice, Interior, Agriculture, Commerce, Labor, Health and Human Services, Housing and Urban Development, Transportation, Energy, Education, Veterans Affairs, Homeland Security and the Environmental Protection Agency, the offices of the U.S. Trade Representative and the U.S. ambassador to the United Nations and the Council of Economic Advisers.”

For the full Washington Post article: “Government posting wealth of data to Internet“

For experienced elder law attorneys, contact Janna Dutton & Associates.

Effects of Estate Tax Expiration

According to a recent New York Times article, most tax advisers anticipated that Congress would extend the estate tax before it expired at the end of 2009. However, the Senate did not act on this and the tax is currently gone for one year and unless Congress takes action, the tax will return at a higher rate and lower exemption in 2011.

Along with the estate tax also went the IRS provision for date-of-death valuations, meaning heirs may now be responsible for capital gains on any appreciated property when they sell it.

Most expect that Congress will revive the estate tax and make it retroactive from the date of expiration, but most also didn’t think it would expire in the first place. The article notes that this situation has “thrown a wrench in the core tenet of estate planning: set up everything as if you would die tomorrow. What happens if the law changes by then?”

Before, “lawyers often wrote provisions into wills that put the maximum amount into trusts that could be transferred tax-free. What was left usually passed to the surviving spouse.  Now, those exemption limits are gone.” The NYT’s advice?  Review your will.

For assistance reviewing your will or to discuss how the expiration of the estate tax may affect you or a loved one, contact the experienced attorneys at Janna Dutton & Associates.

Click here to read the full New York Times article, “A Bizarre Year for the Estate Tax Will Require Extra Planning.”

 

Recent GAO reports on “extraordinary” price increases for some prescription meds

On January 11, the Government Accountability Office (GAO) issued a report finding that prices on an increasing number of prescriptions have skyrocketed in recent years.  Apparently, the ballooning prices are due to consolidation in the drug industry, which leaves fewer companies manufacturing niche medications as well as third-party providers who repackage drugs for patients.

The GAO conducted the study to understand the growing cost of brand-name prescription drugs, as they drugs affect “patients, payers, and providers of health care—particularly when price increases are large and occur suddenly.” 

The Associated Press (AP) reported on the GAO study and noted that, “Congressional investigators say the number of extraordinary price hikes on drugs doubled between 2000 and 2008. The drugs affected are mostly specialty medications but also include some popular products like Bayer’s antibiotic Cipro and the Eli Lilly schizophrenia treatment Zyprexa.” The AP goes on to say that the GAO’s findings could put new pressure on drugmakers to contribute billions more to the health-care reform effort being finalized by Congressional Democrats.

Click here to read the Elder Law Prof blog’s summary.

If you would like to speak to an attorney about estate planning for long term care, including the costs of long term care, contact Janna Dutton & Associates.

Janna Dutton Speaks on Legal Issues Facing Those with Parkinson’s Disease

The Parkinson’s Disease Foundation recently hosted a webinar entitled, “Legal Issues: Planning ahead when you are living with Parkinson’s.”   Attorney Janna Dutton led the presentation, which offered tips on navigating the legal issues that face people living with Parkinson’s disease as well as issues such as care plans, advanced directives and wills. 

 

You can view and listen to the full presentation by clicking here.

If you or a loved one need help understanding your planning options, contact Janna Dutton & Associates.  

Pass on Your Passwords

You can do almost anything on the internet today- check your bank statement, pay your bills, purchase clothes, order your groceries, rent movies …the list goes on and on.  For many seniors, the appeal of the internet is clear- all of these tasks can be done from the comfort of your own home, at your own pace.  Yet, with each of these accounts comes the responsibility of yet another username and password.  They are designed to keep identity thieves out, but what happens if someone else needs to get in? 

Many of us use similar passwords and usernames for different accounts, and (give or take some occasional trial and error) we can remember all this information without writing it down.  However, if something were to happen to you and a family member or agent needed to access that information, would they be able to?

This was the subject of an article I read earlier today entitled, “Don’t Forget to Pass on Passwords.”  As someone with a variety of online accounts, this article reminded me about the importance of maintaining a list of those accounts including both the usernames and passwords and providing it to an agent or trusted family member.  Not doing so could cost time (searching for physical documents, making phone calls to companies in an attempt to access your account, guessing at possible passwords) and money (i.e. recurring payments for a cell phone that is no longer in use, or overdue charges for a credit card that a family member was unable to access and pay off). 

For more information or assistance with other long-term planning issues such as wills, trusts, and powers of attorney, contact the experienced elder law attorneys at Janna Dutton & Associates.

Retirement Communities Affected by Current Economy

The recent Newsweek article, “Bankruptcies Hit Retirement Communities,” highlights the impact that the country’s current economic woes are having on the senior population, specifically those in retirement or continuing-care communities as well as those looking to enter one.  The companies managing these communities explain the difficulty of surviving, let alone succeeding, in the current economic landscape.  As a result of obstacles such as high care costs, restrictive Medicaid budgets and tight credit markets, many companies are posting huge losses, raising their prices, modifying their means of operation, selling themselves to bigger chains or simply leaving the market entirely.  

The question then is: how do these changes affect current or prospective residents?  The answer isn’t a comforting one.  Fortunately, no one can be “kicked out” of their residence… at least not immediately.  However, when struggling senior communities raise their prices many residents are no longer able to afford their care, and are forced to leave.  In other cases, the initial deposits made to get an apartment (can get up to $150,000 or more) are disappearing.  For 170 people in a Pennsylvania senior community, this is exactly what happened when their facility was sold and the new owners did not take on that liability, which had been established by the previous owner. 

With rising costs of care and deposits lost, it is easy for seniors to run though their personal savings, money they thought would have taken care of them for the rest of their lives. 

“You’ve got to keep your eyes open,” says Eric Carlson, director of the long-term-care project for the National Senior Citizens Law Center. “If you look at the agreements, sometimes what you’re being promised is not that much. The provider may be reserving the right to force you to leave for various reasons.” Often there’s a generic “can’t meet your needs” clause in the contract.

He recommends that refundable deposits be set aside in escrow accounts, and that anyone signing a long-term-care contract run it by an elder law attorney first.

If you have questions about financial planning for long-term care or want to schedule an appointment to review your nursing home contract, contact the attorneys at Janna Dutton & Associates.

Click here to read the full Newsweek article.

Impact on Seniors No Longer Able to Drive

There is a freedom and independence many of us to take for granted that comes with being able to grab your car keys, jump in your car and drive to wherever you want or need to be.  Unfortunately, the older we get the more difficult it becomes to stay behind the wheel for a variety of reasons, but largely due to declining eyesight, hearing and reaction times. 

How does this loss of independence effect the senior population?

A recent article featured in The Boston Globe titled, “Off the road,” discussed both the physical and emotional effects that result when an elder is no longer able to drive.  Sadly, the article explains that “there is an increased risk of depression, isolation, and even, studies suggest, of ending up in assisted living.”  Some studies, most notably by geriatrician Richard Marottoli, an associate professor of medicine at Yale University Medical School, have found an increase in depression and a drop in out-of-home activity levels among older adults after they surrender their license.

This begs the question.……what next?  Considering what these studies have shown, what alternatives are available for these seniors?

As Boomers face the driving dilemma with their parents and as they get closer to dealing with this issue themselves, there is a growing need to develop more comprehensive transportation alternatives that will allow seniors to retain some of their independence and allow them to remain engaged outside of the home. 

Elinor Ginzler, the AARP’s senior vice president of the livable communities initiative, says that despite the impeding number of aging drivers (roughly one in four will be 65 or older by 2025), “many local, regional, and state agencies are failing to include alternatives to automobiles in their planning.” 

A ray of hope: the article featured a fantastic service called Independent Transportation network, a 24-hour driving service run by volunteers which allows seniors who surrender their car to the network to receive the equivalent of the vehicle’s value in free rides.  Or you can simply join without the trade in and pay by-the-ride (which is about half the cost of a cab fare for the same route).  In the 14 years since it started, the group has organized 280,000 rides nationally.  Founded in Maine, the program has now spread to communities in 10 other states.

For more information on long-term care planning for yourself or a loved one, contact the attorneys at Janna Dutton & Associates.

12/30 update: Click here for another recent article by Choice Elder Care discussing this growing problem and the funding cuts many states have faced for their senior transportation programs.

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.

Am I old enough for an Elder Law attorney?

We often get asked this question by potential new clients when calling to make an appointment for a consultation.   The National Academy of Elder Law Attorneys, Inc., (NAELA) states its goal is to establish “NAELA members as the premier providers of legal advocacy, guidance and services to enhance the lives of people with special needs and people as they age.”

Many attorneys who practice in the broad field of elder law are dedicated to planning for the needs of older adults; however, Elder Law is not simply limited to issues affecting those in their later years of life.  In addition to advising as to wills, trusts and simple estate planning, so much of elder law is concerned with disability law and planning for special needs.  Medicaid planning, guardianship, powers of attorney, living wills, and special needs planning are all essential issues to consider when developing an effective estate plan.

For example, a younger client who has a child with special needs may seek advice about the provision of a special needs trust to ensure that child’s needs are met upon the parent’s death.  Older couples who contemplate the need for nursing home care may consult an elder law attorney for Medicaid planning and asset protection.  An adult child may seek an elder law attorney to represent them in petitioning for the appointment of a guardian for a parent or family member who requires assistance with finances or health care decisions and has not designated an agent under power of attorney.

If you would like to meet with an attorney to discuss your particular needs and concerns visit our website or call 312-899-0950 to make an appointment.

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.

To set up a consulatation to discuss your particular needs, contact the experienced elder law attorneys at Janna Dutton & Associates.

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

For legal assistance, contact the experienced elder law attorneys at Janna Dutton & Associates.

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

For legal assistance from experienced and compassionate attorneys, contact Janna Dutton & Associates.

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

12/21 Update: Yesterday, The Chicago Tribune published another article in their “Compromised Care” series, this one discussing what rules are being sought in order to control the usage of  anti-psychotic drugs and the doctors who prescriev them.  “Medical care should help you get better, not get worse,” said Wendy Meltzer of Illinois Citizens for Better Care (see our blog post on ICBC’s important work).  To provide quality care health advocates are calling for tough new rules, including having Illinois: refuse to pay for certain medications, require nursing homes to use standardized consent forms, centralize information regarding nursing home doctors, so that any issues regarding those doctors can be looked at in their entirety (not just piecemeal) and require drugmakers to publicly disclose payments to doctors so that their patients can be aware of a possible conflict of interest.  See the full article here.

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.

For more information on long-term care planning for yourself or a loved one, contact the attorneys at Janna Dutton & Associates.

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. 

For legal advice on long-term care planning for yourself or a loved one, contact the attorneys at Janna Dutton & Associates.

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

For caregivers, another important aspect of caring for someone is making sure their affairs are in order.   For assistance with long-term care planning for yourself or a loved one, contact the experienced and compassionate elder law attorneys at Janna Dutton & Associates.

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.

Learn more about financing your long-term care by contacting the experienced elder law attorneys at Janna Dutton & Associates.

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.

For more information on how these proposals will affect-term care planning for yourself or a loved one, contact the attorneys at Janna Dutton & Associates.

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 reform 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.

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

For more information on long-term care planning for yourself or a loved one, contact the attorneys at Janna Dutton & Associates.

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.

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.”

For more information on long-term care planning for yourself or a loved one, contact the experienced elder law attorneys at Janna Dutton & Associates.

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.

For more information on long-term care planning for yourself or a loved one, contact the attorneys at Janna Dutton & Associates.

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.   

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. 

For more information on long-term care planning for yourself or a loved one, contact the attorneys at Janna Dutton & Associates.

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.

For caregivers, another integral piece of the care puzzle is long-term care planning, both for yourself and your loved ones.  Contact the experienced elder law attorneys at Janna Dutton & Associates for assistance.

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.

For more information on long-term care planning for yourself or a loved one, contact the attorneys at Janna Dutton & Associates.

Times Especially Tough for Rural Seniors

The New York Times recently published an article on the increasing hardships many rural seniors face as they age.  The article showcased stories of fortitude in the face of hardship that were fascinating, but that you would be equally terrified to read if they were your own parents.  Take Norma Clark, an 80-year-old farm wife who fell and broke her hip in four places, then dragged herself for three hours through snow and mud to get back to her house, only to then call her daughter to have her come feed the farm’s horses before calling for help.  It is both astounding and heartbreaking to hear, but situations like this and plenty of others are happening across the country as rural seniors battle to age at home. 

As the article so appropriately notes, growing old is hard enough as it is.  This is compounded when there is virtually no public transportation, limited access to medical care, and unreliable cell phone and internet service, not to mention a wave of devastating state and local budget cuts to programs catering to the elderly.  Even churches have consolidated or closed, further limiting social opportunities for already isolated seniors.                   

Yet, despite it all, these seniors remain firmly where they are, surrounded by familiarity and their lives’ memories.  Some rural America scholars believe that the current and future state of the economy could make remaining at home too difficult, while others argue that these elders are rooted to the land and won’t leave it regardless of the obstacles they may face by doing so.  

Whether this applies to your family or not, I encourage you to check this article out.  Click here for the full story.

For more information on long-term care planning for yourself or a loved one, contact the attorneys at Janna Dutton & Associates.

HHS Announces Availability of $27 Million to Help Older Individuals with Chronic Conditions

On Wednesday, the U.S. Department of Health and Human Services (HHS) announced the availability of $27 million dollars nationwide to older individuals with chronic conditions. The money, made available through the American Recovery and Reinvestment Act, will work to help these individuals improve their health and reduce their use of costly medical care. Thus far, the Recovery Act has provided up to $650 million dollars to HHS for the Communities Putting Prevention to Work initiative launched earlier this fall to promote evidence-based prevention strategies in communities and states across the country.

The HHS press release notes that, “Research has shown that prevention programs can improve the quality of life for older individuals, including frail seniors with multiple chronic conditions, and also reduce health care costs. The Recovery Act funds will put the results of HHS’ research investments into practice at more than 1,200 community-based sites across the country — reaching tens of thousands of older Americans and their families.”

“Too many seniors do not receive the recommended preventive and primary care they need,” said Assistant Secretary for Health, Dr. Howard K. Koh. “This program will strengthen the health care that our seniors need and deserve by coordinating and integrating care in the community.”

Click here to read the complete press release and for information on funding availability.

For more information on long-term care planning for yourself or a loved one, contact the attorneys at Janna Dutton & Associates.

Amendments to the Elder Abuse and Neglect Act

Janna Dutton & Associates attorney Melissa Howitt authored an article discussing the original and amended provisions to the Elder Abuse and Neglect Act.  These amendments will be in effect beginning January 1, 2010 (which is closer than you think!).  The article highlights: the development of a program to target self-neglect, the amended provisions governing access to elder abuse records, and legal remedies under the Act.

Click here for Melissa’s article.

Visit www.duttonelderlaw.com for other helpful resources or to contact an elder law attorney.

Spotlight On: Illinois Citizens for Better Care (ICBC)

Janna Dutton & Associates recently published an article on the incredible work of the ICBC.  Their mission is to achieve and maintain quality, dignified and compassionate care for nursing home and other long-term care facility residents.  The organization works directly with families to help choose the right nursing home, shorten or avoid nursing home placement by finding alternative care, improve poor or abusive nursing home care and navigate the waters of Medicare and Medicaid.  Their database aides this work by providing information on services various nursing homes provide, their violation histories and the experiences members have had with those homes.

ICBC also works as an advocate for nursing home residents with Congress, the Illinois legislature and various government agencies.

On top of all of this- they do not charge for their services and do not receive any government grants. 

Read the whole article by Janna Dutton & Associates, another advocate for seniors and their families.