Thursday, October 29, 2009
Tuesday, October 27, 2009
POA- Medical Decisions
Many older adults like to keep their important papers private. Including POA- or Power of Attorney. My own grandfather has done this. Now he and I have discussed it- and he shares information with me. The person who is POA- did not even know it though. He never knew he was power of attorney. He is grateful that he now knows this tid bit- but why couldn't grandpa tell his own son?
My grandad has said- they don't need to know until it is time- So I have talked with him- and so have other family members. Often the older adults- do not want to dwell on death, or issues relating to the idea of losing control. They also confuse money and medical issues. These elders- may be willing to address their POA- with professionals- but fear the family will attempt to take over all decisions. In my case- my grandad knows I work with geriatric patients- while he is 88- he does not see himself as one of those. He does trust me in taking care of his medical issues though. Fearing that my grandfather had left his step children in charge- the biological family did not want to address it unless we were in crisis. I boldly address this topic of medical care with him. He was not aware of the different options- but he did knowthat he wanted to have "everything done" to stay alive.
Do not be afraid to ask the needed questions and clarify the various kinds of POA and explain a living will. Get the paperwork in place while your loved one is able to make wishes clear to others.
My grandad has said- they don't need to know until it is time- So I have talked with him- and so have other family members. Often the older adults- do not want to dwell on death, or issues relating to the idea of losing control. They also confuse money and medical issues. These elders- may be willing to address their POA- with professionals- but fear the family will attempt to take over all decisions. In my case- my grandad knows I work with geriatric patients- while he is 88- he does not see himself as one of those. He does trust me in taking care of his medical issues though. Fearing that my grandfather had left his step children in charge- the biological family did not want to address it unless we were in crisis. I boldly address this topic of medical care with him. He was not aware of the different options- but he did knowthat he wanted to have "everything done" to stay alive.
Do not be afraid to ask the needed questions and clarify the various kinds of POA and explain a living will. Get the paperwork in place while your loved one is able to make wishes clear to others.
Labels:
living will,
loved ones,
medical POA,
POA,
power of attorney
Saturday, October 10, 2009
Aging and Skin Care
I think I over analyze blogging. Not sure though. I want to provide information that will help others; but is the real purpose of a blog to be more entertaining or educational?
I have recently begun to pay attention to the older females skin tone. I have several clients with incredible skin (especially for being over 85). They seem to share one common thread. Vaseline. Some of these ladies have dementia; some have had strokes. Most can't remember their address but they use that Vaseline every day. I wish I could post a few pictures. I have one client that is 93 and her skin looks radiant, now her neck- shows her age. She suggested that I use Vaseline on my neck now- because she did not and regrets it. This particular client is very wealthy- millionaire several times over. She discusses how wasteful skin care products are. She then points out that she should have invested in a skin care line- she would have even more money...
So I have taken up the vaseline challenge- and now have my duaghter using it on areas of dry skin. Save money save time; use vaseline to keep wrinkles away.
I have recently begun to pay attention to the older females skin tone. I have several clients with incredible skin (especially for being over 85). They seem to share one common thread. Vaseline. Some of these ladies have dementia; some have had strokes. Most can't remember their address but they use that Vaseline every day. I wish I could post a few pictures. I have one client that is 93 and her skin looks radiant, now her neck- shows her age. She suggested that I use Vaseline on my neck now- because she did not and regrets it. This particular client is very wealthy- millionaire several times over. She discusses how wasteful skin care products are. She then points out that she should have invested in a skin care line- she would have even more money...
So I have taken up the vaseline challenge- and now have my duaghter using it on areas of dry skin. Save money save time; use vaseline to keep wrinkles away.
Saturday, October 3, 2009
Friday, October 2, 2009
Talking to Parents About Finances
Some parents guard their finances closely, even from their children. To them, it's a matter of privacy. Some fear that their children are only after their money.
But helping your parents organize their finances and seeing whether they've planned well so that their last wishes are carried out could open the door to examining your own finances.
In some instances, older adults are reluctant to share financial and legal information with adult children. In such cases, it might be advisable that they consult with a neutral third party, such as an attorney, a qualified financial adviser, social worker or trusted friend to address legal issues and then have an attorney prepare the proper documents so that they will be accessible to family members in an emergency.
When talking to parents about their finances, children must be sensitive to their parents' need to still feel in charge.
The key thing for your parents is a sense of independence and control. Try to help them offload some of the burden of handling the finances with someone they can trust. Be careful of trying to push that on your parents because independence and control are crucial to them.
It's a delicate dance and one that will lead many people to seek a financial adviser who can help them. There are specific things you need to look for in an adviser to help your parents. Pay close attention to the questions asked by a prospective adviser. Boomers and seniors can and will sense that the conversation is not about meeting their needs, but about selling something.
It's especially important for seniors, who are prime targets for unscrupulous salespeople.
But helping your parents organize their finances and seeing whether they've planned well so that their last wishes are carried out could open the door to examining your own finances.
In some instances, older adults are reluctant to share financial and legal information with adult children. In such cases, it might be advisable that they consult with a neutral third party, such as an attorney, a qualified financial adviser, social worker or trusted friend to address legal issues and then have an attorney prepare the proper documents so that they will be accessible to family members in an emergency.
When talking to parents about their finances, children must be sensitive to their parents' need to still feel in charge.
The key thing for your parents is a sense of independence and control. Try to help them offload some of the burden of handling the finances with someone they can trust. Be careful of trying to push that on your parents because independence and control are crucial to them.
It's a delicate dance and one that will lead many people to seek a financial adviser who can help them. There are specific things you need to look for in an adviser to help your parents. Pay close attention to the questions asked by a prospective adviser. Boomers and seniors can and will sense that the conversation is not about meeting their needs, but about selling something.
It's especially important for seniors, who are prime targets for unscrupulous salespeople.
Labels:
adult children,
elderly,
finances,
financial planning,
parents and money
Wednesday, September 30, 2009
Medicare A benefits
I want to explain one piece of the Medicare part A program today. One in seven medicare recipients will be in the hospital this year. Many will stay for three days or longer; and therefore be eligible for the part A benefit of rehabilitation. Please keep in mind that these programs do not guarantee a certain number of days for coverage; these benefits are based on progress within a program( or lack of progress) The primary diagnosis will play a role in particular with skilled nursing care on inpatient basis.
Part A covers inpatient hospital care, inpatient care in a skilled nursing facility, home health care services, and hospice care. Medicare Part A provides payment for post-hospital care in a skilled nursing facility. In order for a medicare recipient to receive Medicare benefits, a physician must certify that the resident requires skilled nursing facility care, and the care required by the resident must be available only as inpatient at a skilled nursing facility.
Skilled nursing facility (SNF) care is covered only if it occurs within 30 days of a three-day or longer stay in an acute hospital facility and is certified as being medically necessary. Individuals utilizing the benefits of skilled nursing facilities under Medicare are limited to a 100-day stay AT MOST) facility. Co-payments are required for the 21st through the hundredth day.
Home health care under Medicare Part A has no limitations on length of stay, no co-payments, and no deductibles. To qualify you must need skilled care and be considered home bound. Home bound has different meaning to different agencies- so check with the home health company in your area for clarification on this topic.
Medicare for hospice care: patients are required to relinquish their standard Medicare benefits for treatment of terminal illnesses in order to receive the hospice care benefits (they will no longer be eligible to pursue curative treatments with medicare coverage).
For those with Medicare advantage- the benefits will decrease!! Many will have co pays beiginning on the third or fifth day but at a lesser rate than the traditional medicare co pay. Medicare supplements will usually cover the copayment which begins on the 21st day of care.
Part A covers inpatient hospital care, inpatient care in a skilled nursing facility, home health care services, and hospice care. Medicare Part A provides payment for post-hospital care in a skilled nursing facility. In order for a medicare recipient to receive Medicare benefits, a physician must certify that the resident requires skilled nursing facility care, and the care required by the resident must be available only as inpatient at a skilled nursing facility.
Skilled nursing facility (SNF) care is covered only if it occurs within 30 days of a three-day or longer stay in an acute hospital facility and is certified as being medically necessary. Individuals utilizing the benefits of skilled nursing facilities under Medicare are limited to a 100-day stay AT MOST) facility. Co-payments are required for the 21st through the hundredth day.
Home health care under Medicare Part A has no limitations on length of stay, no co-payments, and no deductibles. To qualify you must need skilled care and be considered home bound. Home bound has different meaning to different agencies- so check with the home health company in your area for clarification on this topic.
Medicare for hospice care: patients are required to relinquish their standard Medicare benefits for treatment of terminal illnesses in order to receive the hospice care benefits (they will no longer be eligible to pursue curative treatments with medicare coverage).
For those with Medicare advantage- the benefits will decrease!! Many will have co pays beiginning on the third or fifth day but at a lesser rate than the traditional medicare co pay. Medicare supplements will usually cover the copayment which begins on the 21st day of care.
Friday, September 25, 2009
Home Health care givers
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiYlLdv1yMaJhDVZRvBBIgpv6ZP7bQATQJrftoV1dD6HNi5DWh_6hiaL88plf5P6X4ncQyB9pGLV2Ai8vIALWZ2WO0HjNWni9LyCra_ZtNepUi7yxR9YnREtInfVHxbM_e35ZsIli0rqyYx/s200/elder+couple.jpg)
Home Health Care has become big business. As the population ages; there is a need for caregivers to help people stay home longer. Sitters as they are sometimes called; earn from $8-20 an hour depending on where you live.
Quite a few families handle the care giving duties themselves. For those who work outside the home; caring for a dementia patient can be overwhelming and emotionally draining. Studies show that more than half of all caregiving for elderly is done by family members.
As a teenager I was one of those family members. My great grandma had "hardening of the arteries" Now we know it was Alzheimer's. My aunts and uncles hired a lady to live with her during the week; two of my cousins and I took turns staying on the weekends. Sometimes she could be a handful for a 15/16 year old. She set the kitchen towels on fire one night- she told me she was trying to turn on a light to see. She locked me out of the house many times. I could go on with stories all too familiar to those who have been caregivers. Elderly with dementia or Alzheimer's may have nontraditional sleep patterns. I often wondered if she had Sundowner's; it sure did seem thatway.
Private duty caregivers such as the one my family had are less expensive but do pose risks. What if your caregiver becomes ill; what is the back- up plan? Get a back up plan. IS this person able to lift, or help your loved one into and out of the shower? These questions must be asked no matter which option you choose. Also ask them about taxes- Will they handle it? Remember you need to file them on your tax deductions- if you have a doctors prescription it is deductible. Does this person have references you can call? What are their credentials? How many elderly with dementia have they cared for in the past? How many patients with diabetes/ or any illness that runs on your family.
Companies- there are national chains with franchises located throughout the US. Local companies are also an option. I have been approached my no less than 5 new home health companies in the last two months alone. The advantage to these organizations is the back up staff and the insurance they carry when problems arise. For example- I have a client with Alheimers whose caregiver accidentally set the kitchen on fire- it was a mess- the home insurance covered it- but the family felt good about having a professional organization involved in case there was a problem. If a valuable gets broken- the insurance these companies carry will pay for the item. Most of the national companies do a background screening on all employees; and often they hire licensed CNA's. I tend to refer to a few companies that I trust and have known to work through crises with families. Talk to your friends- talk too your church- find out if they can recommend respected people to handle the care for your loved one.
Another advantage to utiltizing companies is the option of part time help. The disadvantage of companies vs. individuals is the cost. Companies are more expensive. Finances often play a role in the choice to remain home. Unfortunately state programs often help in nursing home care but ignore home health care as an option.
Labels:
aging adults,
alzheimer's,
caregivers,
dementia,
elder care,
elderly,
family
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