Home for the Holidays?

At this time of the year, when we are preparing to visit our seniors here in South Florida for the holidays, I'd like to remind family members to take extra notice of obvious physical or mental changes since your last visit.  Is there evidence of excessive spending, unpaid bills, unkempt household or personal hygiene?  Is there an unusual volume of mail and solicitations for charities that you are not familiar with? Are there new "best friends" that you have not met?  Eventually, most of your elder parents will either need a caregiver or a care manager.  Few family members plan to handle caregiving responsibilities until an emergency arises.  If you have questions about long term care for your loved one, consult with a professional who can help you do what is best.  A Geriatric Care Manager will assess and plan ahead for your family member's needs.  What's best, care managers are on call for emergencies 24/7 - a very worthwhile service to faraway family members.  A Good Daughter Elder Care Management provides appropriate, professional care with heart and soul.  If interested, ask for a complimentary meet and greet at our office or in your parent's home. See us on the web at http://www.agooddaughter.com

Tips that Might Explain Why Your Parent Is Falling

If you have elderly parents who may be having repeated falls and you are apprehensive about what to do to help mom or dad stop falling, you might look into some of these reasons:

Changes in Our Body Some of the reasons seniors tend to fall more often are changes in vision, lack of flexibility, less muscle strength, especially in our legs, and changes in sleep patterns. It is important to have an eye examination every year and wear the glasses as prescribed by the eye doctor. Exercise on a regular basis can increase muscle strength and flexibility and improve balance. Regular exercise will help you sleep better as well.  Also remember to check your parent's glasses to see if they are broken due to a past fall.  Perhaps it is time to have their glasses repaired or replaced. Chronic Health Conditions High blood pressure and heart problems can cause dizziness that can lead to falls. Remember to get up from a laying down position slowly if you have heart problems or high blood pressure. Many elders fall while trying to make a run for the restroom because of difficulty controlling the bladder. Talk to your doctor about what can be done for this condition. This will help reduce your risk of falling.  Check to see if mom or dad have had recent lab work.  Perhaps they have low or high blood sugar.  Speak with your parents about their eating habits.  Often the elderly will only eat when they are hungry.  Guess what, the elderly seldom get hungry. Medications Both prescription medications and over the counter medications can cause side effects such as dizziness or drowsiness. Talk to your nurse, physician, or pharmacist about the side effects to expect from your medication. If the side effects continue, talk to your physician about changing the medication. Make sure if you see more than one physician that each one knows ALL the drugs you’re taking. Take all of your medications, including over the counter medications with you each time you visit the doctor. This way the doctors will be able to see exactly what you’re taking and how much.  Speak with the doctor about prescribed medications your parents are not taking.  Often times, more than one medication is prescribed and the elder parent might think, "I don't really need to take both of the blood pressure medications".  Speak with the doctor if you've noticed certain medications are not being taken or if they are not taking medications on time.  Maintaining their medications are given in a way to maintain healthy blood levels may be necessary.  Tell the doctor if they are being taken sporadically.  Today, there are automatic medication dispensers that will give your parent audible prompts to remind them it is time to take their medications.

Pooled and Special Needs Trusts

This morning's New York Times article describes a little known way for some people in certain states to receive home care through Medicaid without requiring them to impoverish themselves first. Here is how it works..

In 1993 Congress created the Pooled trust to protect this country's most vulnerable and disenfranchised segment of our citizens - the elderly and disabled. Through non-profit organizations who have a Pooled Trust, individuals who meet the definition of disabled under the rules of Social Security to place their assets in the trust, can still meet financial eligibility for Medicaid and Supplemental Security income. The funds are pooled for investments but separately accounted for throughout the individuals life. The funds can be used to enrich the quality of life of the participant instead of being quickly consumed by catastrophic medical an Long term costs.

Individuals may benefit from a Pooled trust if:

• Disabled in need of long term nursing care care at home or in a facility.
• Over the age of 65, or any age with funds from a  medical malpractice, personal injury, or workers compensation claim, or receiving an inheritance.
• Need or receive Medicaid, Social Security Disability or SSI (Supplemental security income).

This Pooled Trust enables some people in certain states to receive home care through Medicaid, without requiring them to impoverish themselves first.  Essentially, this law allows disabled persons to put their monthly income or assets - above the amounts Medicaid allows them to keep - into a special type of pooled trust.  They Can use the money in the trust to pay for their basic monthly bills like rent, a mortgage payment or cable TV bills.  Medicaid in the meanwhile will pay for their home care. 

Monies left in the trust after the person dies is generally kept by the nonprofit organization running the trust or is paid back to Medicaid. 

As the New York Times article states, these trusts are available only in about a dozen states for people over the age of 65.  Please remember that the rules governing Medicaid are intricate and differ in each state, so while you may be able to keep a loved one home in New York State under Medicaid, that may not be true in other states. But with a Pooled Trust, each month, the participant who has been deemed disabled can deposit her or his excess income into the trust to pay the person's bills as long as the expense is for the sole benefit of the participant.  The nature of the trust is to supplement needs that are not met by government programs. 

The trusts work particularly well for those who have few assets, but may own a home.  Many states however, do not allow persons over 65 to use the pooled trusts at all because they have interpreted the federal laws differently and some states have started to impose penalties on people over 65 so speak with an elder law attorney (http://www.naela.org/) or speak with a Geriatric Care Manager (http://www.napgcm.org/) about long term care planning and to find out more.

Putting seniors in jail and criminals into nursing homes

Food for thought : Let's put Seniors in jail and Criminals in nursing homes! This way, the seniors would have access to showers, hobbies and walks. They would receive unlimited free prescriptions, dental and medical treatment, wheel chairs, etc. They would receive money instead of paying it out. They would have constant video monitoring, so they could be helped instantly if they fell or needed assistance. Bedding would be washed twice a week, all clothing would be ironed and returned to them. A guard would check on them every 20 minutes and bring their meals and snacks to their cell. They would have family visits in a suite built for that purpose. They would have access to a library, weight room, spiritual counseling, pool and education. Simple clothing, shoes, slippers, pajamas and legal aid would be provided free. Private, secure rooms for all with an outdoor exercise yard with gardens. Each senior could have access to a computer, TV, radio and daily phone calls. There would be a board of directors to hear complaints and the guards would have a code of conduct that would be strictly adhered to.--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------The "Criminals" would get cold food, be left all alone and unsupervised. Lights would be turned off at 8:00 PM and showers would be taken once a week. They would share a tiny room, pay $3500.00 per month and pay for all their clothes, supplies, medical and dental services, and have no hope of ever getting out.

This should make us think of what kind of world we have created for ourselves.