Weather The Storm

Life throws us many curveballs, and suddenly becoming the ” parent ” to your parents is a major one for both parties involved. When you believe a family member or other loved one is in need of senior care, then what is the best way to start a discussion? Several factors often compound this sudden reversal of roles: the feeling of meddling in our parents’ lives, the reluctance to accept that our parents are in fact aging; guilt or anxiety about who will care for them, and the potential for your heartfelt intentions coming off as insulting.  The first thing in getting necessary care is to get past the reluctance to talk about this issue. Gilbert Guide has assembled some suggestions to help make this process as painless as possible:

Listen, listen, listen. Show your genuine interest, concern and sensitivity.

Be supportive and remember not to be judgemental.

Ask your loved one open-ended questions to find out his/her personal circumstances and opinions.

Share your own thoughts about your own aging and what you plan to do.

Reassure your loved one that they are not alone in their concerns.

Be prepared to accept your parents’ opinions or decisions, even if you do not agree.

Determine how important it is to your parent to remain as independent as possible.

Who can always help with Long-term Care Decisions? Solicit the help of non-family members in evaluating the type of long-term care your loved one may need. People of authority who are not related to you can offer a neutral opinion. Consider the following figures:

Your doctor or your loved one’s personal doctor.

Friends and neighbors whose opinions you trust, and who may have already faced a similar situation.

A clergy member who might be able to refer you to senior care groups or agencies.

County care service agencies.

Area agencies on aging or other senior information and referral services.

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Adult Day Care: Community Work With the Elderly

Developing Holistic Care for Long-term Conditions

Long-term care insurance standards: Hearing before the Subcommittee on Commerce, Consumer Protection, and Competitiveness of the Committee on Energy and ... One Hundred Second Congress, first session

Because We're All in This Together: The Case for a National Long Term Care Insurance Policy

Sharing the Burden: Strategies for Public and Private Long-term Care Insurance

Hospice services are available twenty-four hours a day, seven days a week. There is always a nurse on call at night and on weekends. The nurse will remember to visit the patient as long and as often as necessary to ensure quality senior care. Due to this wonderful service, a lot of people are under the impression that hospice care is expensive, and believe they cannot afford such treatment. However Medicare, Medicaid and private insurance companies cover hospice care and services. This would include, but is not limited to, medications, medical supplies, nursing care, home health aides and social services. Back at 1983, the Congress have established the Medicare Hospice Benefit, covered under Medicare Part A, to ensure that all beneficiaries could receive high-quality end-of-life care. In order to receive the Medicare Hospice Benefit, the patient must meet three key criteria.

First of all, the doctor must approve, with the use of his or her best clinical judgement, that the patient is ill with a terminal disease and life expectancy is only within six months or less. If the patient lives longer than six months, he or she can continue to receive hospice care as long as the doctor re-certifies that the patient is terminal and with declining health. The next criteria would be that the patient is willing to recieve comfort care instead of curative treatments for their disease. For example, a patient could not be getting chemotherapy to cure their illness and be getting hospice care simultaneously. Hospice is intended be used once curative treatment is no longer an option. Finally, the patient needs to enroll in a Medicare-approved hospice program. This should be one of the first questions you should ask in determining which hospice agency to use. More than 90% of hospices in the United States are certified by Medicare.

CCRCs are living communities for seniors. Most have three levels of residence: independent living, assisted living and skilled nursing. Each level of residence is tied to the level of care that the resident requires. The primary concept behind a CCRC is that it offers a wider spectrum of care, so that once a senior moves into the community, he or she will be able to receive the appropriate care as his or her needs change.

Related Reading:

Managing Long Term Conditions and Chronic Illness in Primary Care

Medicare Audist in Long-Term Care: A Guide to Macs, Racs, and Zpics

Current Topics in Long Term Care

Start Your Own Senior Services Business: Adult Day Care, Relocation Services, Homecare, Transportation Service, Concierge, Travel Service and More

Lippincott's Textbook for Long-term Care Nursing Assistants: A Humanistic Approach to Caregiving

Forty-one years after the 1964 murders of three civil rights workers in Mississippi, former preacher and Klan Kleagle Edgar Ray Killen was convicted of manslaughter and sentenced to three twenty-year prison terms. Finally, the victims and their families received a measure of long-overdue justice. Killen should have been convicted at the original trial in 1967. But that begs the question: while vindication and punishment are vital, who is really bearing the brunt of keeping the now 82-year-old Killen, frail, evil, balding and with little to no use of his right hand, in prison? The answer, dear readers: we are. In the year 2002, America’s prison population has reached around 2 million, according to a report from the Justice Department’s Bureau of Justice Statistics.

Researchers at the San Francisco VA Medical center have predicted that over one-third of the U.S prison population will be geriatric (people over 65) by 2030. Part of the jump is the result of aging baby boomers. The rapidly increasing numbers of elderly prisoners, coupled with the mounting costs of housing this population incurs is a nationwide problem;for several reasons. The average cost of housing just one elderly inmate is approximately $65,000 every year, costing taxpayers three times as much as it does to incarcerate someone in the general prison population. Senior prisoners do not receive Social Security, nor do they have access to Medicare or Medicaid, which would help the government;and taxpayer’s augment long term care costs. Old prisoners suffer from three chronic health problems. According to the Florida Corrections Commission, these problems often include kidney failure, heart disease, diabetes, emphysema and stroke.

As senior inmates have a higher incidence of disease and disability, and increased difficulty performing activities of daily living than the general population, it is no longer surprising that the cost of their senior care is higher. “It’s a hidden problem in the system that’s going to grow into a dinosaur soon. The cost and numbers are getting out of hand, ” said Herb Hoetler, CEO and co-founder of the National Institute on Institutions and Alternatives. I personally think that it is a mistake, not to mention fiscally unwise to continue paying for old prisoners unlimited access to medical care, while ailing seniors who have never committed a crime can barely afford the soaring costs of health care. There are some who cannot afford it at all.  On the flip side, and there’s always a flip side, my friends, do the elderly even belong in prison? Prison life is a very harsh one, and while critics will often argue that the elderly are just as brutal, the statistics say otherwise. Elderly inmates have the lowest recidivism rates: 45 percent of offenders aged 18 to 29 commit a new crime after release from prison, whereas only 3.2 percent of those over age 55 commit a new offense upon release, according to a recent study. “To keep some of these folks in prison for the length of time we do is purely punitive and serves no purpose to society,”  says William DiMascio, executive director of the Pennsylvania Prison Society.

Aging has always have a big impact on inmates. The idea of  ” warehousing ” elderly inmates with minimal programming appropriate for this population just adds to seniors’ general decline. So round and round we go.  As a society, we need to take a good look at the aging prison population and decide what’s going to happen to them. Are we to make early response programs targeting elderly prisoners who no longer have a threat to society? Or do we build more geriatric prisons;which are essentially skilled nursing facilities with barbed wire to provide the long-term care these inmates require? Or…do we lock them up and throw away the key?

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Developing Holistic Care for Long-term Conditions

Start Your Own Senior Services Business: Adult Day Care, Relocation Services, Homecare, Transportation Service, Concierge, Travel Service and More

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Current Topics in Long Term Care

One of the first things Gilbert Guide recommends to anyone searching for long-term care for themselves or a loved one is to get professional help from a care manager, or a geriatric care manager (GCM). GCMs usually have a background in health and human services, often times, a GCM is also a gerontologist, nurse, social worker, or psychologist with a specialized focus on issues related to senior care and aging. In essence, a GCM is a professional advocate who helps guide you through the ins and outs of the oftentimes-confusing process of locating appropriate long-term care and deciphering all of its associated issues.

Just by evaluating an individual’s level of functioning, along with their emotional, financial, health and legal needs, a GCM helps to identify problems and needs, and also offers practical solutions. GCMs help ease the stress of searching for long-term care by intervening in crises, counseling and supporting you and your loved one and educating and advocating on your behalf. They can also personalize your plan of services by basing it on your specific needs. GCMs can be hired to help you in times of crisis, should you need respite or as the full-time point of contact for all senior care services. Most Gilbert Guide-listed GCM is a member of the National Association of Professional Geriatric Care Managers (NAPGCM).

Based on the reports of the National Adult Day Services Association (NADSA), there are over 3,500 adult day care centers currently operating in the United States, and that number is rapidly climbing with the mushrooming retiree population. Adult day care, a long-term care option, is structured around participants, social needs, and typically offers assistance and support including meals, activities, exercise and transportation. There are so many benefits of adult day care programs like caregiver respite, daily socialization with peers, integration into the community, avoiding premature institutionalization and providing affordable senior help. Most funding for adult day services is generated from participant fees, city government agencies and charitable sources.

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Lippincott's Textbook for Long-term Care Nursing Assistants: A Humanistic Approach to Caregiving

S/NVQ Level 3 Health and Social Care (Adult) (NVQ/SVQ Health and Social Care)

The Nursing Assistant's Guide to Restorative Skills in Long-term Care

Level 3 Health and Social Care (Adults) Diploma: Candidate Book (Level 3 Work Based Learning Health and Social Care)

Health Care Financial Management for Nurse Managers: Applications in Hospitals, Long-Term Care, Home Care and Ambulatory Care

It is no longer surprising that with age, most seniors often experience increased limitations, the loss of certain abilities and require more assistamce with the activities of daily living. It is equally unsurprising that one;s finances  largely influence the types of services and long-term care available to that individual. An experienced financial  planner for the elderly can provide seniors and their families with invaluable advice on money issues and more,  to help seniors find the appropriate solution to their particular situation. Some of the questions a financial  planner can address include:  What type of long-term care can I afford? Will I outlive my assets? How much are all my assets worth? Can I make my assets create more income to meet growing expenses? What do I sell first? What are all my options? What is the cost of selling different assets? Do I have to sell my own house? Are there other financing alternatives? What impact will this have on my spouse and dependents? Is it too late to do any estate planning? What about inheritance issues?

Listening to Your Needs – Financial planners can assist you in understanding and evaluating your decisions,  which will help you avoid confusion, frustration, major errors and family dissension. Financial decisions are more  than about just money, I know from experience how difficult it is for everyone involved. Making major financial  decisions can be even more daunting when you don;t have the detailed knowledge, time, experience or ability. What are the potential impacts and benefits of making one decision over another? What are the requirements to  execute such decisions? Financial planning for senior care begins with acknowledging and considering all present and  possible future situations you might encounter. This can be very difficult as it requires both forward thinking as  well as transitional realism. By ” transitional realism, ” I mean about being realistic about your changing needs, and the impact of those needs on your life as well as the lives of  your loved ones. When evaluating your needs, a financial planner should consider:

Personal care, do you need assistance with activities of daily living? Services, what types of long-term care services do you require? Are there any specific concerns with regards to safety? Transportation;are there physical or financial considerations? Priorities, what are your desires and limitations? Interpersonal relationships;how will financial decisions affect your loved ones? The following list comprises the elements that you will need to consider in evaluating and identifying your needs. You may want to think about these things before talking to a financial planner to ensure  the time you spend in conversation is well spent. If you happen to have questions about any of these elements, a financial planner  who works with the elderly will be well versed in all of these issues and should be able to address any concerns.  Financial needs Insurance coverage and limitations Income sourcesExpenses (present and future) Assets availabilityReal estate needs Human resources: home health care, personal and quality-of-life issues After you have indentified all of your needs, think about the resources that you will need, and  the ones that you already have at your disposal.

This can help you in developing a plan of action.  Make a list of the following  resources that you might need: Public resources like prepared food services, community activities, religious and charitable assistance/support, etc.Private resources, including family members and/or homecare caregivers. Planning can make a huge difference in finding the best solutions. Knowing all of your needs and resources is paramount before making any major financial changes. Financial decisions should be holistic in nature, therefore recognizing that everyone, seniors and caregivers, all have   different needs and resources, unique to their particular situation. Making financial decisions based only   on your present situation, without full consideration of everything, can have disastrous results.

Related Reading:

Care Homes for Adults (18-65): And Supplementary Standards for Care Homes Accommodating Young People Aged 16 and 17 - National Minimum Standards - Care Homes Regulations (Stationery Office)

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Adult Day Care

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