Health Insurance

All of us have that relative who always has a checklist of what needs to be done in case of an accident or crisis. And although we might mock them, many are happy to know what needs to be done and how they can pitch in. In my previous articles, I have talked about how important it is for both the family and professional caregivers to make sure they are taking care of themselves. Also, a new product, which is Lotsa Helping Hands website, is streamlining the process for family caregivers by allowing 1 person to organize a circle of up to 100 loved ones who can look at a list of tasks and volunteer to do them. Many baby boomers are facing the prospect of how to do senior care for aging parents.

For people whose old parents need help with activities of daily living (e.g., buying groceries, preparing meals or maintaining the household) this website can be very useful in helping establish a network where everyone can volunteer for “assignments” so that, for example, the groceries are not bought two times in a day or so everyone doesn’t visit Granny on Sunday, leaving her alone the rest of the week. The family members of the senior might also find this helpful in getting someone to stop by and “check in” on their loved one. Has the senior dressed properly for the day? Does he or she need breakfast to be made for them? Scheduling tasks is also made easier with Lotsa Helping Hands, another person can pick up the dinner shift and help with bathing. This type of coordination can augment the service provided by homecare agencies, particularly if the aides are only on duty for a few hours every day.

Perhaps best of all, the service is free and the website is fairly intuitive. The process takes less time than a phone call on the volunteer side, but the administrator (e.g., you) has to be fairly on-task with what needs doing. A calendar shows whether help is needed or if all needs are met on a particular day. You can even scroll ahead and offer specific services. I think this is a brilliant concept, I mean, how many times have you wanted to help someone, but just were unsure of what to do? Also, most families have members with more free time than others.

We often don’t phone relatives for help as we figure they are probably “just too busy” and that someone else will take care of it. However, giving everyone a chance to know what is needed and what they can do is not just democratic, it is downright helpful, and as senior care caregivers isn’t that the point? As always I look forward to your comments and would love to know more if anyone has used the service and found other glowing points or even something that could be better in regard to this fantastic new resource

Based on an evolutionart standpoint, our bodies are made for short bursts of stress, just like running from a dangerous situations, like a forest fire. But today’s world is one of constant low-level stress. For most caregivers, high amounts of stress levels are continual. And frankly, the human body isn’t made to withstand such constant wear and tear. Therefore,most family caregivers cannot put aside strong feelings that is associated with caregiving, which can run the gamut from devotion to guilt, to see the importance of avoiding the problem of caregiver burnout.

I cannot stress this enough: as a senior care caregiver, you are only as good as the care you can provide. Oftentimes this is based on factors outside your control. You will get tired. You will get frustrated. You will need help. You’re allowed to have these thoughts and feelings. So how do you know when passing frustration has fizzled into a burnout situation? Well, early signs are similar to depression in that assisted care caregivers can vacillate between anger, anxiety, sadness and irritability. Feelings of exhaustion, both physically and emotionally, along with changes in weight are also hallmarks. Keep in mind that a depressed mind can make for a depressed immune system; getting sick often could be another warning sign. Additionally, perhaps the greatest irony of care giving is that the caregiver’s health concerns are often not looked into, because the caregiver isn’t the one who is “sick” or “needs help”.

Many family caregivers are reluctant to “take up time” for their own doctor visits. If these symptoms starts to grow more frequently or intensely, then it is time to seek help. Again and again I urge caregivers to make certain they are taking care of themselves, because even though it is good to place someone else needs above yours, it is not always feasible or right. In parent-child relationships, the adult children will often feel that they must look after the parent, in order to return the favor of having raised by their parents, even they are unqualified or ill-equipped to do so. These are all honorable ideas, however, reality is that care giving situations;just like raising a child;requires a village. If you want to provide good long-term care then you need to get hooked in with family, friends and outside resources. You can be the primary caregiver and still not be there every minute of the day. Spread out responsibilities.

On the Gilbert Guide web site alone, we offer dozens of solutions and ideas to help family caregivers, including coping strategies, online resources, and information on topics such as Alzheimer’s and dementia care, and how to effectively advocate as a caregiver. There are also support groups that provide family caregivers a place where they can discuss their feelings openly, can help monitor the effectiveness of coping strategies, and let caregivers know they are not alone. But one of the simplest solutions to avoiding caregiver burnout is this; keep your sense of humor and look for the small joys that can come your way throughout the day.

Here at Gilbert Guide, we are constantly urging family caregivers to seek respite so that when they are “on-duty” they can provide the best home health care to their loved one. One of the toughest jobs we can think of is taking care of an aging loved one, which is why each of our Guides has sections on Caregiver Support, Counseling and Support Groups and Crisis Lines. But just like what one of our readers recently pointed out, what resources are available for the professional caregiver, especially those who provide live-in senior care and assume a huge amount of responsibility? The reader also asked if there was forum in which to discuss wages and other issues in regard to providing professional home health care. Her opinions have brought up a point which was recently talked on Medical News Today that reports for caregivers are some of the lowest in the country. And how this fact coupled with the aging population of baby boomers could spell trouble for the industry if it is unable to keep up the supply with the demand.

To be honest, we are not so sure as to how to help her out, so we would like you to weigh-in, please tell us if you know which of the organizations, including anything from advocacy to support groups, you have found useful. Have you had any luck with contacting the National Organization for Homecare and Hospice to see what they recommend? Which direction were you pointed in, and most importantly, do you feel like your opinions are being heard?

Board and care homes are residences for seniors who require some care or help with the activities of daily living (ADLs or IADLs). These are smaller scale assisted living facilities, usually having a resident capacity of no more than fourteen. Licensing requirements vary by state, some states require that board and care homes carry the same license as assisted living facilities

CCRCS are actually living communities for seniors. Most have three levels of residence: assisted living, independent 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,~The most primary concept behind a CCRC is that it gives 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. Many CCRCs support aging in place. Searc Gilbert Guide’s CCRC listings along with more information about what CCRCs offer.

As a family caregiver, short-term hospitalization of a loved one can be a difficult situation whether he or she is living in a long-term care facility or at home. As the family caregiver, this change can be challenging at some points, especially as hospitalization normally points to an unstable medical condition or an acute condition. Here are a few pointers for how to negotiate the situation. The most important issue at this point is that you have most of the information about your loved one’s previous condition, so make sure that you share it.

Let the hospital staff know about any cognitive or physical impairments even if the information is already too obvious. For example, let the senior care assistants know that your loved one is unable to use an emergency call button at times due to arthritis or that he or she has a hard time following directions due to cognitive impairment, or even if she or he should not be given a cup of coffee even if they ask for it in the afternoon as they have dementia-related Sundowner’s syndrome. Remember to tell the hospital staff in regards to a person’s dietary considerations or preferences. Small things can mean the world when placed in an unfamiliar hospital environment. A small favor such as asking to keep meals free from red meat for a person who doesn’t like beef is one easy way to make sure that your loved one has some creature comforts. Keep notes and pay attention. Hospitals are there to relieve acute medical problems and {as such may overlook smaller background issues~because of this, it may overlook some of the smaller background issues}. However, it is your job to speak up in the event you feel your loved one is receiving improper care. {Try to get as many visitors in to see your loved one as possible~Try getting as many visitors in to see your loved one as possible}. Even short visits can raise a person’s spirits’ and provide a nice change or shift in a person’s focus.

Several Internet-based sites host free personal webpages specifically designed for caregivers so that they can post information with ease about their loved one who currently is hospitalized or in need of help. These pages allow concerned family members and friends to schedule visits, monitor progress and sign-up to help with any needed tasks. This ensures that a person can have several visitors over the course of a day rather than a bunch all at once.

Discharge is Just the Beginning.

Keep notes on medications and dosages for your loved one. If new medications appear on the discharge plan, make certain you understand what they’re for, dosage amounts and possible side effects. Check with the pharmacist to ensure there are no contraindications, especially with drugs already prescribed. Make certain the discharge plan has all prescriptions listed on it. Do not assume previous prescriptions have been replaced or taken off unless you have been told so in absolute terms by a medical professional. If your loved one now needs to move out from his or her home, then a list of possible long-term care facilities that meet your financial and medical, dietary and social requirements needs to be found. Discharge planners might make referrals, but make certain they are aware of all your specific needs. (And, of course, Gilbert Guide offers information on how to find and assess the care options in your area.) If you have time, visit facilities and rank them according to your needs. Gilbert Guide offers an explanation and handy checklist of issues for both skilled nursing and assisted living.

Hospitalization may result in changes to your loved one’s life. Anything that can preserve some sense of continuity will help with the transition. If you have had a doctor prescribed home, health aides before the hospitalization and they were well liked and give proper care, then please ask to keep them. If the same holds true for your homecare aides you should also voice your opinion on retaining them, if they can provide the level of care necessary. Try to learn as much as you can about your loved one’s condition if it has changed. The Internet is a helpful resource, however should be tempered with information and recommendations from your loved one’s physician. Make sure you understand all the ways in which you can provide the utmost in care for this new situation. Let’s say that your loved one needs therapy, find out what the goals of the therapy are and if there are any exercises with which you can assist. Throughout the course of your loved one’s hospitalization, remember that you are their voice. Do not be afraid to speak up and ask questions, as they may be unable or unwilling to do so. If you run into any problems you feel you cannot solve, most hospitals have an on-staff patient advocate that will be able to provide help.

One rule that I always adhere is that I don’t discuss politics and religion unless I am with my close friends and relatives, it’s just too easy to cross the line from thought-provoking to offensive, especially for someone who’s as outspoken and opinionated as I am. After reading a recent article on President Bush’s 2.9 trillion spending plan for 2008, however, I felt that I need to break my rule. President Bush recently went before Congress, controlled by the Democratic Party for the first time in his presidency, and proposed a 2.9 trillion budget that will entirely cut down 70 billion in funding from Medicare and Medicaid over the next 5 years, while increasing military spending and without affecting first-term tax cuts. While the proposed time frame happens to be in line with Democratic goals, there seems to be some dissonance in terms of federal priorities. If you are in a higher income beneficiary you could expect to pay much higher long term care insurance premiums and more for drug coverage.

Another component of the plan, according to the New York Times: ” freezing Medicare payments to home health care agencies and reducing inflation allowance paid to hospitals, nursing homes and other providers. ” Considering Congress, bad response to be president’s proposal from last year which suggested smaller Medicare reductions, it’s unlikely this plan will be accepted as is. Whether you bat for the left or the right, though, there’s no denying that the rapid increase in the retirement-age population puts a lot of pressure on the federal budget. Remember that entitlement for the older Americans come from income taxes on people of working age. It takes five working Americans to support one senior citizen’s entitlements. How would, or should, the government respond if Social Security trustees have projected accurately, and by 2030 there are only three workers for every adult older than 65?

It is entirely possible for Medicare, Medicaid and Social Security to consume federal spending. Are there options that don’t involve spending cuts or tax increases? How and where should we conserve to avoid a fiscal crisis without stripping Americans of the care to which they’re entitled?

It is no longer surprising that with age, most seniors often experience increased limitations, the loss of certain abilities and require more assistance 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 the 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 following 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 just above money matters, 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 o0ne decision over another? So 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 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? Safety, are there specific concerns regarding safety? Transportation;are there physical or financial considerations? Priorities, what are your limitations and desires? Interpersonal relationships;how will financial decisions affect your loved ones? Following is a list that comprises the elements you should consider in identifying and evaluating 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 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 sources Expenses (present and future) Assets availability Real estate needs Human resources: home health care, personal and quality-of-life issues After you’ve identified 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, including prepared food services, community activities, religious and charitable assistance/support, etc.Private resources, including family members and/or homecare caregivers. Planning always 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 generally 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.

In my first article, I have talked about what a geriatric care manager like me does and when exactly to consider getting a care manager. My following missives will be guided by your feedback, so please be in touch! Now, caring for an elderly loved one can be frustrating, overwhelming and confusing. There are many emotional pulls and no single easy solution to any situation you may be facing. Even if one feels that he or she is moving in the right direction, other family members and/or friends may disagree on a route or decision even as a situation moves into a crisis mode. Ask Yourself: How do you choose the best form of long-term care, the right living situation? How do you find the time to make phone calls, contact government agencies and visit alternative living facilities? How do you know which local facilities have a good reputation and whether they might be a good match for your loved one?

We have all been novices in learning a new craft or job, or in moving into a new phase of our lives. Like those skills, the many aspects of caring for an elderly loved one can be learned. You may be thinking, ” Well, I am learning how and feel fine making decisions, and I am coping. ” Should that be the case, great and congratulate yourself then. Others of you read the above questions and think, ;Yikes! Help me, and fast!; Or, ” I could figure this all out, but I would rather not. Let someone else give me a hand. ” If all these responses sound just like you, consider calling in a geriatric care manager to work with and guide you. Those who belong to the first group might want to consider a consultation to help determine if there are other angles or aspects of the situation you are involved in that could be considered.

A helpful care manager acts as a consultant, problem-solver, and advocate. She will meet with you and your loved one and sensitively and thoroughly assess his or her overall situation. She will look at the whole person, addressing quality-of-life concerns as well as practical considerations. She will then develop a plan that will enable you to choose the optimal form of senior care, and make the necessary contacts for you. She can arrange for care at home or accompany you as you visit nursing homes and assisted living facilities and arrange for placement. An excellent care manager will talk and coordinate your loved one’s care and act as a liaison with family, friends and health care providers, now and in the future. She will also provide support and counseling for you and the family, as well as for your loved one, as you deal with these difficult and stressful transitions. A good geriatric care manager will be there for you and your loved one every step of the way, helping to make your lives as stress-free as possible, while ensuring the best and highest quality of life possible at all times. It is my pleasure to meet each and every one of you. I look forward to getting to know each other through our struggles and triumphs.

If you happen to be under homecare and if you have to lie immobile for long periods of time, you should pay special attention to the health of your skin, to prevent skin breakdown. Proper skin care helps in preventing pressure sores (bedsores) and will help you feel generally refreshed. Weight loss and the side effects of radiation or chemotherapy can lower your resistance to infections, and since infections can be very difficult to treat, the best thing is to prevent them. Skin is your body’s first line of defense against infection, and once your skin gets broken through a rupture, it exposes you to infections. Germs can enter the body through a cut, an open bedsore, or raw, chafed skin. Bedsores are caused when an area of skin loses its blood supply for an extended period of time, e.g., when a bony area of the body lies against a surface like a mattress, and nutrients and oxygen are unable to reach the skin cells. The area begins to break down and the skin cells eventually die. Parts of your body which are particularly susceptible are the coccyx or tailbone, the hip bones, the spine, elbows, heels and ankles, and the shoulder blades. If redness doesn’t go away from these bony areas a short time after the pressure is removed, the skin is probably not receiving adequate blood flow. You may have to tell your senior care caregiver, if you happen to have one

You can prevent bedsores by changing your position frequently, at least every two hours. In addition, placing a cushion on the bony parts of your body is a good way to reduce pressure on the skin. An “egg crate” mattress, or a foam or sheepskin pad will cushion you, as well as providing better air circulation for the skin. You can also use pillows or any other props that can help reducing the pressure on those areas.

Heat and massage are additional means of increasing the blood supply to the skin. Whirlpool baths are ideal for this purpose. Although you can use heat lamps or heating pads, you must take care not to burn your skin, which is already tender. First check with your doctor or nurse to make sure a lamp or heating pad would be helpful to you; and if you do use a pad, keep it turned on “low,” and keep a protective pad or towel between it and your body to avoid skin burns. A warm pair of socks, an extra blanket at the foot of the bed, or fleece-lined booties are often more helpful than heating appliances. (See: Massage Therapy Techniques that will also increase blood flow to your skin.)

Chafed or irritated skin is caused by a combination of moisture, heat and friction. It occurs most often where the skin folds over itself as in under the breasts, in the groin area or in the abdominal area for heavier people. For chafed skin, you want to keep the area clean and dry. A small amount of talcum powder or cornstarch applied after bathing will help keep the area dry and free of bacteria. Exposing chafed skin to the air for a few minutes twice a day will also help keep it dry.

Good hygiene is the most important part of skin care. If you can, take a daily bath or shower. Even if you are not confined to bed, bathing may be a chore because of the difficulty of climbing in and out of tubs and showers. Try sponging your body at the sink while sitting in a chair. Aids such as bath seats, grab bars, and long-nozzled showerheads make tub or shower bathing much easier. Once you are confined to your bed, then take a daily sponge bath. Ask your family or you home health care nurses to assist you with the areas which you cannot reach by yourself. There is no one “right” way to give a bedbath. Common sense will dictate the most comfortable and thorough method for you. Don’t forget bath oils if your skin tends to dryness. Massaging body areas with a little lotion after a bath stimulates circulation and prevents skin breakdown.

The Struggle for Affordable Health Insurance in America

The politicians for the 2008 Election Campaign all struggle to spin health insurance as one of their platforms, while the media plays it up or down, depending on their point of view. While there are many existing ideologies regarding health care, the fact remains that the struggle for affordable health insurance in America real, and is getting worse every year.

One of the biggest misconceptions about health care is that the people without insurance are illegal immigrants, or are unemployed. This is not the case.

According to the National Health Care Coalition, nearly 80 percent of the uninsured in America are either Native American, or naturalized citizens, and of those, 8 out of 10 come from working class families. During 2006, over 90 percent of the population, which is nearly five million people, were without any kind of health insurance for at least part of the year.

America is a world leader, so how can nothing be done to guarantee health care to our working families? If you work enough to barely get by, then you usually make too much to qualify for state sponsored Medicaid. Staying at home and drawing welfare so that you can have health insurance makes little sense to most people, and budget cuts at the state level is making that prospect harder as well.

Young adults, (aged 18-24) probably do not give health care a second thought, as they are the population group most likely to be without any coverage. Surprisingly, families that earn over $50,000 per year are also not likely to have insurance, even when it is offered by their employer, because they just cannot afford the hefty premiums. If a family earning that kind of money cannot afford health insurance, how on earth could a family who earning half of that or less be expected to buy health insurance?

Being uninsured means that serious illnesses may go undiagnosed or untreated until it is too late. Even something as simple as the flu may cause complications and even death if left untreated, a common worry for those who cannot afford health care.

Many medical clinics ask that the uninsured pay their fees upfront to avoid the risk of unpaid bills piling up. Those who are unable to pay upfront must then live in sickness and agony, not getting time off work or any other kind of compensation. Most parents will not choose their own health care over putting food in their children’s mouths, and that is often what the choice comes down to. Do they take the money to go to the doctor, or do they go to the grocery store?

We all know what the answer will be.

An uninsured person is more likely to end up hospitalized for an avoidable condition, with the cost of that stay being around $3000. If that person had been seeing a doctor, such a condition could be caught, treated, or maintained. Hospitals treat patients without insurance to the tune of nearly $34million dollars every year, without compensation. That cost is added back to the general public by higher hospital bills, which then increases insurance rates, and you guessed it, forces more people to go without.

Affordable health insurance in America is not something we need to talk about during election years. It is something we all need to focus on and fix now, realistically and fairly. Health insurance should not be a luxury, or an option for a select few. It should be mandatory and it should be affordable for all.

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The Struggle for Quality Health Insurance in America

The politicians for the 2008 Election Campaign all struggle to spin health insurance as one of their platforms, while the media plays it up or down, depending on their point of view. While there are many existing ideologies regarding health care, the fact remains that the struggle for affordable health insurance in America real, and is getting worse every year.

One of the biggest misconceptions about health care is that the people without insurance are illegal immigrants, or are unemployed. This is not the case.

According to the National Health Care Coalition, nearly 80 percent of the uninsured in America are either Native American, or naturalized citizens, and of those, 8 out of 10 come from working class families. During 2006, over 90 percent of the population, which is nearly five million people, were without any kind of health insurance for at least part of the year.

America is a world leader, so how can nothing be done to guarantee health care to our working families? If you work enough to barely get by, then you usually make too much to qualify for state sponsored Medicaid. Staying at home and drawing welfare so that you can have health insurance makes little sense to most people, and budget cuts at the state level is making that prospect harder as well.

Young adults, (aged 18-24) probably do not give health care a second thought, as they are the population group most likely to be without any coverage. Surprisingly, families that earn over $50,000 per year are also not likely to have insurance, even when it is offered by their employer, because they just cannot afford the hefty premiums. If a family earning that kind of money cannot afford health insurance, how on earth could a family who earning half of that or less be expected to buy health insurance?

Being uninsured means that serious illnesses may go undiagnosed or untreated until it is too late. Even something as simple as the flu may cause complications and even death if left untreated, a common worry for those who cannot afford health care.

Many medical clinics ask that the uninsured pay their fees upfront to avoid the risk of unpaid bills piling up. Those who are unable to pay upfront must then live in sickness and agony, not getting time off work or any other kind of compensation. Most parents will not choose their own health care over putting food in their children’s mouths, and that is often what the choice comes down to. Do they take the money to go to the doctor, or do they go to the grocery store?

We all know what the answer will be.

An uninsured person is more likely to end up hospitalized for an avoidable condition, with the cost of that stay being around $3000. If that person had been seeing a doctor, such a condition could be caught, treated, or maintained. Hospitals treat patients without insurance to the tune of nearly $34million dollars every year, without compensation. That cost is added back to the general public by higher hospital bills, which then increases insurance rates, and you guessed it, forces more people to go without.

Affordable health insurance in America is not something we need to talk about during election years. It is something we all need to focus on and fix now, realistically and fairly. Health insurance should not be a luxury, or an option for a select few. It should be mandatory and it should be affordable for all.

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