Caregivers New Year's Resolution

by Kristine Dwyer, LSW

In this new year, I will……….

Learn to take one hour out of each day just for myself to read, enjoy a hot bath, journal my thoughts or call a friend.

Attend at least one caregiver support group to realize that I am not alone and that I can learn from others.

See my doctor for a physical exam and give my own health needs more priority.

Use respite care at least once a month so that I may get a break and be refreshed. I will consider using the time I have to discover the benefits of massage therapy, the joy of a musical concert, self expression in a painting class or a day at the spa to find stress relief.

Eat a balanced diet and exercise at least 20 minutes three times a week even if all I can do is walk around the house, up and down the stairs or exercise from a chair.

Seek out one new resource to support my caregiver role such as chore services, housekeeping, home care programs or delivered meals.

Try to find a way to laugh or find humor in the day amidst the sadness or discouragement I may feel.

Reach out to my family and friends to help with my loved one so that the weight of my responsibility can be lifted and shared. One way I can do this is to keep a list of needs handy so that when help is offered, I can be ready with an answer.

Seek spiritual support or personal counseling to gain perspective of my life, clarity of my role and keep my mental health in check.

Finally, by focusing on these resolutions, I will be able to reap the rewards of caregiving, maintain balance in my life and provide care longer for my loved one.

Kristine Dwyer is a Caregiver Consultant for Carlton County Public Health and Human Services in Cloquet, Minnesota. She is a licensed social worker certified in gerontology and is a past and current caregiver for her family.

Assisted Living: Back to the Future

By PAULA SPAN

It’s right in my neighborhood, so I’ve probably driven past that gracious Victorian house, painted a dusty rose, a zillion times. But because it looks like many other houses in Montclair, N.J. — big old trees, nice landscaping, wraparound deck — I never realized that it was an assisted living facility.

Ever since a 1990’s building boom, the term “assisted living” has conjured up mental images of a three-story stucco building on a highway, with a brass chandelier in the lobby and a “concierge” desk. But long before those places began popping up, many owned by regional and national chains, lots of smaller, homier residences for seniors were tucked into ordinary neighborhoods. Read full article

Light Up The Holidays For Aging Parents

by Kaye Swain

~~Frosted window panes, candles gleaming inside, Painted candy canes on the tree… It's that time of year when the world falls in love, Ev'ry song you hear seems to say "Merry Christmas~~

Ahhh, one of my favorite Christmas songs. :) And it carries with it a delightful reminder that one of the fun signs of the season are all the lovely Christmas lights coupled with Christmas carols and Christmas praise and worship songs. So far this year, my grandchildren and I have enjoyed a myriad of delightful displays as we've driven back and forth on errands. In addition, my senior mom, some of the grandkids and I have enjoyed a delightful outdoor display put on by the city they live in. This particular one is set up for you to park and walk around in the middle of the lights. I wasn't sure how well my senior mom would do since it was a particularly cold night. I should have remembered this is the same mom who tries to walk every single day no matter how cold it is! She did great and enjoyed it very much! Of course, the grandchildren found it the most magical, but we grownups loved the twinkling lights as well. My favorite part was the big tree that was set up to twinkle to the Christmas carols that were playing. Deee-light-ful! Full article and videos

On the Lighter Side:

Rita's Holiday Eating Tips:

1. Avoid carrot sticks. Anyone who puts carrots on a holiday buffet table knows nothing of the Christmas spirit. In fact, if you see carrots, leave immediately. Go next door, where they're serving rum balls.

2. Drink as much eggnog as you can. And quickly! Like in single-malt scotch, it's rare. In fact, it's even rarer than single-malt scotch. You can't find it any other time of year but now. So drink up! Who cares that it has 10,000 calories in every sip? It's not as if you're going to turn into an eggnog-aholic or something. It's a treat. Enjoy it. Have one for me. Have two. It's later than you think. It's Christmas!

3. If something comes with gravy, use it. That's the whole point of gravy. Gravy does not stand alone. Pour it on. Make a volcano out of your mashed potatoes. Fill it with gravy. Eat the volcano. Repeat.

4. As for mashed potatoes, always ask if they're made with skim milk or whole milk. If it's skim, pass. Why bother? It's like buying a sports car with an automatic transmission.

5. Do not have a snack before going to a party in an effort to control your eating. The whole point of going to a Christmas party is to eat other people's food for free. Lots of it. Hello?

6. Under no circumstances should you exercise between now and New Year's. You can do that in January when you have nothing else to do. This is the time for long naps, which you'll need after circling the buffet table while carrying a 10-pound plate of food and that vat of eggnog.

7. If you come across something really good at a buffet table, like frosted Christmas cookies in the shape and size of Santa, position yourself near them and don't budge. Have as many as you can before becoming the center of attention. They're like a beautiful pair of shoes. If you leave them behind, you're never going to see them again.

8. Same for pies. Apple. Pumpkin. Mincemeat. Have a slice of each. Or, if you don't like mincemeat, have two apples and one pumpkin. Always have three. When else do you get to have more than one dessert? Labor Day?

9. Did someone mention fruitcake? Granted, it's loaded with the
mandatory celebratory calories, but avoid it at all cost. I mean, have some standards!!

10. One final tip: If you don't feel terrible when you leave the party or get up from the table, you haven't been paying attention. Reread tips; start over, but hurry, January is just around the corner. ENJOY!

Remember this motto to live by:

Life should NOT be a journey to the grave with the intention of
arriving safely in an attractive and well-preserved body, but rather to skid in sideways, chocolate in one hand, martini in the other, body thoroughly used up, totally worn out and screaming, "WOO HOO what a ride!

Tips for Helping Mom and Dad with a Later Life Move

Written By: Margit Novak

Senior moves are stressful for the entire family. Conflicts sometimes develop between siblings over who bears which portion of the burden, or over the disposition of material items. As you work with your parents and siblings, keep three objectives equally in mind — caring for your parents, taking care of yourself, and maintaining harmony in the family.

Here are a few key things to keep in mind if you planning a move with a older loved one:

• Let your parents’ emotional and physical comfort guide the process

Your parents’ priorities may be different from yours. For example, if books were very special to them, they may need to determine what will happen to the volumes not going with them before they are willing to focus on other issues. Attempting to force your parents to proceed in a sequence that doesn’t address their priorities may result in your winning the battle but losing the war. Your parents’ perspective may differ from yours. They may prefer old and worn objects to newer items that are in much better condition. Seemingly insignificant items may be loaded with personal meaning and memories, while objects of great material value may be less important. Allow them to make the decisions.

• Accept their gifts

Your parents may want to give you items, including some you may not wish to receive. Take them anyway. Store the items in your basement if you must, but accept them graciously. Knowing that cherished objects are with family can bring comfort and peace of mind to your parents.

• Be Tactful

Often poor health and failing eyesight result in housekeeping practices that are less stringent than they once were. Tactfully offer to clean things as you help them sort. Avoid making your parents feel badly about the home they are leaving.

• Focus on sorting, not packing

Preparing for a move is a major organizational challenge at any age, and doubly so if you are downsizing as well. It’s not uncommon to have items going to your parents’ new home, to an adult son in Maine, a daughter in Illinois, the Salvation Army, the neighborhood consignment shop, and the local dump. Attics, basements, garages, closets and cupboards....there may be forty years of belongings to sort through. Many people feel overwhelmed. It’s here more than anywhere else that you are needed, not in the packing process. Helping your parents sort and organize their belongings is the single most important thing you can do to reduce the stress of moving, ensure a smooth move, and save money in the long run.

• Let your parents say goodbye

When you work with your parents, keep sorting sessions brief (2-3 hours at most). Constant decision-making is emotionally exhausting. Accept that some days you will accomplish less than you had hoped. The sorting process brings up lots of memories. Stories and reminiscing are natural. It’s all right to be directed in your goal, but let your parents enjoy their recollections. Don't forget the need to say goodbye to their home, as well. Particularly if they raised children in the home there will be many memories which are important to recall, even record, in order to say goodbye.

• Try to replicate the old environment as much as possible

Your parents will be experiencing a lot of change; it will be comforting to have some things stay the same. Photograph each shelf in the china closet, the arrangement of pictures on walls and items on bureaus. The photographs help recreate the feel of the former residence with amazing accuracy and speed.

• Keeping your eye on the big picture will help maintain harmony in the family

You have many concerns for your parents, but may be unable to provide the support you would like. A professional Senior Move Manager can fill the gap. Contact Aging with Grace by calling 800.626.9440 for more information about the services of a professional senior move manager and to identify move managers in your area.

Taking Charge Without Taking Over: Five Tips For Helping Your Aging Parent

By: Sheri Samotin

Whether you are teaching your young daughter how to knit, or helping your aging mother balance her checkbook, how do you take charge without taking over? How many times have you found yourself “showing” someone how to do something by doing it for them? It’s human nature. But while it might make sense to show by doing when you are “teaching” someone younger or less familiar with a particular topic than you are, it usually leads to anger when you do this when you are “assisting” someone with a task that he previously has been perfectly capable of handling himself.

It was probably hard enough for your mom to agree to let you help her pay her bills and balance her checkbook. And even once she agreed, it wouldn’t be surprising if she told you that she didn’t know why you were insisting on helping her since she is perfectly capable of doing it herself. The truth is that acknowledging that you need help with the business of life is really, really hard for most seniors. If they come to the point where they need your help, they are confronted with their own limitations. And those limitations won’t “get better” in most cases. Deep down, your mom knows that this is the beginning of the end of her independence as she has come to know it.

So, how do you take charge without taking over?

1. If possible, do the tasks alongside your mom rather than doing it for her. While this approach might take longer than doing it yourself, you allow mom to retain some self esteem by letting her take the lead.

2. Let your dad tell you what aspects of a particular activity he needs your help with, and if possible, try to limit your assistance to just those things, at least for now. Of course, if your dad doesn’t have a realistic picture of what he can do for himself, you will need to gently find a way to help him see your perspective.

3. Be respectful, and ask permission before you just jump in. For example, when you take your parents to a doctor’s appointment, don’t just assume that they want you to come into the examining room with them. Instead, ask them if they’d like you to be there the whole time, or if perhaps you can just be called in toward the end of the visit to make sure that YOUR questions are answered.

4. Set up invisible safety nets. For example, if you come every Sunday and set up your mom’s medications in a weekly medication management system, you can have some expectation that she will take the correct medications at the right time. But it wouldn’t hurt to also have a way of checking that once or twice during the week. This might take the form of a medication management visit by a home care company or trusted friend or relative or perhaps daily medication reminder phone calls from you.

5. Make a distinction between safety and everything else. When your dad’s safety is on the line, you might just have to take charge by taking over. On the other hand, if you’d just prefer that something be done a certain way or at a certain time, there might be an opportunity to loosen the grip a bit.

Your job as your parent’s caregiver is to keep them safe, comfortable, and happy. As long as you keep that in perspective you should have no trouble taking charge without taking over.

Visit the Family Transition Blog at www.LifeBridgeSolutions.com/Family-Transition-Blog
©2009 LifeBridge Solutions, LLC. All rights reserved.

Who Was Supposed To Be Watching Grandma?

There is a popular tune played this time of year called “Grandma Got Run Over by A Reindeer” which relates that Grandma -- after drinking too much eggnog -- went out into the winter cold to get her medication and was run over by a reindeer. The question is, “Who was supposed to be watching Grandma?”

Though this little tune is just for fun, it may very well raise alarms to many caregivers of the elderly. Caregivers know that even at a holiday party they cannot let down their diligent watch over their elderly loved one. As far-fetched as it may sound, with all the people and noise, an elderly family member with dementia or Alzheimer’s may be enjoying the family gathering and then suddenly become confused and walk to the door and leave.

For family caregivers the added stress of the holidays with decorating, shopping, parties and keeping up with all the family traditions is an overwhelming quest. Feelings of isolation, depression and sadness come with this added stress. There are millions of Americans who are caring for elderly frail loved ones and most of these caregivers will go through some of these emotions, especially this time of year.

There are some things you can do as a caregiver to help you and those you care for enjoy the holiday season.

First take care of yourself. Try to eat right, get plenty of sleep and exercise. This will help reduce stress and strengthen your ability to cope with caregiving responsibilities.

Prioritize your holiday traditions. Perhaps instead of cooking a large family dinner, have everyone bring his or her favorite dish. Use paper plates. Forfeit the traditional outside light decorating for a lighted wreath on the front door. Choose one or two parties or concerts to attend instead of trying to do it all.

Arrange for help. Call on other family members to help with the caregiving while you do your shopping or go out for the evening. If family is not available, ask your church group or a neighbor if they would donate a few hours.

Use community services. Many senior centers provide meals for the elderly and supervised activities, onsite, at no charge or a minimal charge. For locating senior services in your state, call your state Area Agency on Aging or check the national locator website at http://www.n4a.org/

Use adult day care services. Some assisted living facilities provide day activities and meals for seniors on a day by day basis. Other organizations called "adult day service providers" specialize exclusively in this sort of care support at a reasonable cost. These support services provide respite for caregivers from their caregiving responsibilities as well as social interaction for their elderly family members. There is a cost for adult day services, but the benefit for all is worth it.

For example:

Jean had brought her mother into her home to care for her when mom's Alzheimer’s made it impossible for her to be alone. When the Christmas season approached, Jean realized she had to make some choices. She did not want to give up the traditions she had set with her daughters in shopping and lunches, but it wouldn’t be possible with her caregiving responsibilities. In searching for a solution, Jean visited an adult day services facility near her home. She found she could schedule the days she needed off for her mother to come in. The adult day services company also provided transportation and would pick up mom and bring her home in the evening.

Although Jean's mother was not sure she would like to go at first, she found she enjoyed the programs, meals and conversation with new friends and the activities provided.
The time it gave Jean to have for herself was worth the extra cost for the day care.

Technology to the rescue. Here is a solution that would have kept “Grandma” from going out in the winter cold and getting run over by a reindeer. Companies that have created monitoring systems, security alarms and other safety equipment are “tweaking” them to adapt to the needs of seniors and their care givers.

Here are a few examples:
• Ankle or wrist bands that monitor location and alert the provider when a person has gone beyond the designated perimeter, such as out the front door of the house.
• Motion detectors. Set throughout the home, motion detectors allow someone outside the home to follow a senior as he or she moves through the house.
• Smart medication dispensers. Live monitoring and dispensing of pills.
• Emergency response alert. At a touch of a button on a desktop monitor, bracelet or necklace, emergency help is summoned.

Whether providing care in your home or helping senior family members in their own homes, your use of monitoring and “tech” help aids can provide extra safety for your loved ones, and peace of mind for you.

You are not alone. Join a caregiving help group. Your local senior center may have one or go on the internet to find one. Hearing about other caregivers' problems and solutions and being able to share your own and ask questions is a great way to relieve stress and gain a new perspective. Check out websites like the National Family Caregivers Association at http://www.nfcacares.org/

Work with a Senior Care Professional. Recognize that you are doing the very best you know how. You are not a geriatric health care practitioner, geriatric care manager, home care nurse or aide, hospice provider or family mediation counselor, nor do you have the years of training and experience these professionals have, but you can definitely use their experience. In fact, using a senior care specialist will make caregiving easier for you and more beneficial for your elderly family member.

As an example:

Mark stopped by his father Dan’s home every night after work to help with any errands or things he needed around the house. He began to notice that Dan was not showering, dressing or even fixing meals some days. Another concern was his father's growing confusion and disorientation. A trip to the family doctor only brought more concern to Mark, since the doctor claimed it was just the aging process that caused the confusion.

Wanting a second professional opinion on what was best for his father, Mark hired Shelly -- a Professional Geriatric Care Manger -- to do an assessment. Shelly arranged for Mark and Dan to see a geriatrician, who advised that proper meals and an increase in some vitamins, would help clear up the confusion and disorientation. Shelly arranged for a home care company to come in daily to help with personal needs and prepare meals.

Soon Dan was back to his old self and able to function on his own.

You can find a wide variety of care professionals in your area on the National Care Planning Council website at www.longtermcarelink.net or by contacting www.agingwithgrace.net.

One more thing to remember. As a family caregiver, the greatest gift you are giving this holiday season is “Love.”

NAC Releases 2009 Caregiving in the U.S. Survey

Caregiving is still mostly a woman's job and many women are putting their career and financial futures on hold as they juggle part-time caregiving and full-time job requirements. This is the reality reported in Caregiving in the U.S. 2009, the most comprehensive examination to date of caregiving in America. The sweeping study of the legions of people caring for adults, the elderly and children with special needs reveals that 29% of the U.S. adult population, or 65.7 million people, are caregivers, including 31% of all households. These caregivers provide an average of 20 hours of care per week.

Caregiving in the U.S., which was funded by MetLife Foundation and conducted for the National Alliance for Caregiving in collaboration with AARP by Mathew Greenwald & Associates, is the result of interviews with 1,480 caregivers chosen at random. The study was designed to replicate similar studies conducted in 2004 and 1997 and includes, for the first time, a sampling of those caring for children as well as those caring for adults over the age of 18.

Caregiving in the U.S. Executive Summary

Home for the Holidays

By: Patricia Grace, National Senior Care Examiner

You were just home for Thanksgiving, the start of the holiday season, and spent time with your family. If you are like many Americans, it may have been weeks, months or even years since you have seen some of your older family members. As you and they grow older, holiday reunions grow more and more special each year.

For most of us, the holidays are a time to gather with friends and family, celebrate, reflect on the past and plan the future. For the elderly this festive time can trigger a mourning period for spouses, siblings and friends who are no longer here. Read full article

Senior Holiday Gift Ideas

Aging with Grace want you and your family to enjoy the holidays and make it a special time for our loved ones without feeling overwhelmed and drained. With this in mind, we are sharing our tried and true suggestions for great senior gifts this holiday season:

1. Senior Fast Food Holiday Basket which contains food items which are quick and easy for the senior and also fast and nutritious.

2. Health and Beauty Basket: an assortment of the vitamins that they may take on a regular basis, Tylenol, soaps, hand creams, shampoo, etc.

3. Pre-pay telephone and or cable bill for a few months. The payment will go as a credit on their bill.

4. Large face clocks or telephone with oversized keypads and adjustable volume (pre-programmed of course by a family member with all the most frequently called numbers.)

5. Gift certificates for the barber or hairdresser’s, neighborhood grocery store.

6. Memory Box filled with pictures and mementos of significant events in the senior’s life.

7. Home Safety Box with Batteries for smoke and carbon monoxide detectors, night lights with built in sensors and don’t forget to include a supply of replacement bulbs.

8. Video tapes of old TV shows such as I Love Lucy, Carol Burnett, Golden Girls, Milton Berle or tapes of old movies. Lawrence Welk is always a big hit!

9. Dinner for One (or Two) Club: prepare several dinners complete with dessert, freeze and place in their freezer for their future use. Be sure to mark what is in each container.

10. Make a “Family Memory” video. This is a wonderful gift that reminds the receiver how much they mean to the family and a chance to thank them for all they have contributed over the years.

Of course the best gift we can give our loved ones (and ourselves) is meaningful time spent together. It only takes a moment to create a lasting memory.

Caregiving, From Both Sides Now

By PAULA SPAN

Susan Katz thought she knew all about caring for old people. Trained as a social worker, she had spent more than 15 years working for home care agencies and for assisted and independent living facilities. So when her own parents began to falter in their mid-80s – her mother had Parkinson’s disease, and her father was debilitated by the aftereffects of prostate cancer treatment – she felt prepared to step in and help.

The reality has proved very different. Ms. Katz and her family are in some ways fortunate: her parents managed to sell their Long Island home, though not before the housing market had nose-dived. They moved into a continuing care retirement community near her home in Middletown, N.J., and hired an excellent home care aide to assist them four hours a day.

Yet Ms. Katz has found the past year and a half an eye-opening experience. Below, in an excerpt condensed from a conversation we had, she relates how her professional experiences in caregiving diverge from her personal ones. Read full article

The road to Alzheimer's disease might start with diabetes

By: Patricia Grace, Senior Care Examiner

Today's obesity epidemic might be tomorrow's Alzheimer's disease epidemic.

Most Americans are aware of the direct connection between obesity and Type II diabetes, however many of these same Americans, are probably not aware of the link between obesity, diabetes and dementia.

A new study by Dr. Margaret Gatz, Gerontology Professor, University of Southern California, has shown a surprising connection between diabetes and Alzheimer’s disease. Her study published in the January 2009 journal Diabetes, tracked the rate of Type II diabetes and dementia. She and her team discovered that developing Type II diabetes before the age of 65 increased the risk of developing Alzheimer’s disease by 125%. Read full article

In-Depth: Hidden Heaven

Published : Tuesday, 24 Nov 2009, 9:20 PM CST

MINNEAPOLIS - None of us knows if or when we will develop dementia. It is a devastating disease that can cause some otherwise kind and caring people to turn aggressive. You will see a revolutionary approach to eliminating that kind of behavior. Reporter Trish Van Pilsum takes you to a place some families call: a hidden heaven.

It's so hard to watch a mind slip away. “It’s okay daddy, if you forget I’ll remind you.” Daughter Kris Madson says. So hard to lose touch “I love you, can you wake up a little bit so you can visit with us?” Daughter Nikole Anderson asks her mother.

So hard to realize. Read full article

VA Aid & Attendance Benefit: Can be a Friend or Foe

By Rita Files

As much as the VA Non-Service Connected Pension Benefit (more commonly referred to as “Aid & Attendance”) is useful in offsetting the high cost of eldercare, it can significantly affect someone's ability to qualify for Medicaid in assisted living after their assets are exhausted. As welcoming as the additional income might be, it is NOT always in the best interest of the person applying, especially if they might need Medicaid before they need a higher level of care. Keep in mind, once the additional income is awarded the Veteran or surviving spouse cannot stop the benefit in order to qualify for Medicaid.

Recently an Aging with Grace Eldercare Specialist received a call from a frantic daughter whose mom was living in a Florida memory care assisted living owned by one of the larger assisted living providers in the country. Sixteen months ago, the assisted living provider paid an organization to assist the family with obtaining the VA surviving spouse aid and attendance benefit. This increased the woman’s monthly income to $2600.00/month and provided the additional funds, along with her 50K in savings, to move in into this lovely community.

Now with less than 10K in savings, she will be unable to continue to pay the $3850.00 each month. Even if this provider did participate in the Medicaid waiver program for assisted living, this resident would not qualify since the additional $1057.00 from the VA puts her over the state’s Medicaid threshold of $2022.00. Although long term nursing home care is not needed at this time, her income may leave her with no other alternative. In this particular situation, the benefit representative “hired” by the assisted living provider never addressed or recognized the possible need for Medicaid after her assets were depleted.

With independent and assisted living providers introducing the VA benefit to potential residents for additional monthly income, we are seeing more and more people in the same situation. Not only is it a violation of the federal guidelines for an "interested" third party (such as a provider) to pay a fee on behalf of a Veteran family for this type of service, the providers can and have found themselves in liable situations.

Federal Regulation 38 CFR 14.636: Payment of fee by disinterested third party. (i) An agent or attorney may receive a fee or salary from an organization, governmental entity, or other disinterested third party for representation of a claimant or appellant even though the conditions set forth in paragraph (c) of this section have not been met. An organization, governmental entity, or other third party is considered disinterested only if the entity or individual does not stand to benefit financially from the successful outcome of the claim. In no such case may the attorney or agent charge a fee which is contingent, in whole or in part, on whether the matter is resolved in a manner favorable to the claimant or appellant.

It is critical that our veterans and their families work with individuals who are knowledgeable about both the VA benefit and Medicaid with an understanding of the potential impact the additional income can have. Offering a free pre-qualification analysis, allows a consultant to determine a client’s potential eligibility and helps identify possible conflicts before applying for the benefit. Any fees paid by the Veteran family, are strictly for pre-filing consultation to assist them with assembling a well developed and supported claim. By anticipating all of the documentation requirements that are necessary and submitting them with the original application, the time from submission to a decision is shortened.

Certified veteran benefits consultants are private practitioners and are not connected with the Department of Veterans Affairs. They comply with federal statutes and regulations governing the preparation, presentation and prosecution of any claim for veterans’ benefits with the U.S. Department of Veterans Affairs.

“An Age for Justice: Elder Abuse in America”

Elder Justice Now uses the power of video and the Internet to put a human face on elder abuse. Watch the new campaign documentary “An Age for Justice: Elder Abuse in America” or browse through compelling video stories from victims, survivors and advocates that build the case for passage of the Elder Justice Act. You can share the documentary or the stories with your friends or colleagues by using the buttons on the bottom of the page or your member of Congress by going to Take Action. Watch videos and learn more

Now You Can Have a Cell Phone Your Aging Parents Will Use

By Kaye Swain

I remember when I used to leave my kids with a babysitter while my husband and I went off for a date for the day. (This isn’t an article about dates with husbands BUT may I say I HIGHLY recommend regular dates for all married couples . It will definitely help keep your marriage healthy!). We used to plan our little day trips to include stopping to eat, use the restroom and find a payphone to check on the kids. That was only 15 years ago. 14 years ago my husband got his first cell phone, accompanied by my concern that it was way overpriced and not really necessary. The very next date, when we were in the boonies and I could call and check on the kids without having to spend half an hour looking for a pay phone, made a believer out of me and we’ve never looked back. I got my own about a year later and now my cell phone has morphed into a smart phone and I love it even more. Read full article

Alzheimer’s Awareness: Why Bother?

by: Dennis Fortier

As we enter into National Alzheimer’s Awareness Month, you may wonder why we should bother promoting awareness. Those who have been touched by Alzheimer’s are already aware and those who have not been touched can’t really help -- so what’s the point? After all, doesn’t it make more sense to skip the awareness effort and just focus all resources on a cure?

As it turns out, lack of awareness and education are major contributors to the burgeoning Alzheimer’s problem. And while the benefits of awareness may not be obvious, they are very real.

For example, do you know what you can do today to reduce your risk of getting Alzheimer’s later in life? If not, your lack of awareness is fueling the ongoing problem. Do you know how we can immediately improve the efficacy of those drugs currently approved for Alzheimer’s? Sadly, most patients and many physicians do not. How clear is your grasp of the relationship between a healthy heart and a healthy brain? For many of us, investing a few minutes to improve our understanding of that relationship could yield long-lasting health benefits.

The answers to these questions along with four other important perspectives are summarized in a short article on the Brain Today blog. The full article can be read in about five minutes and, with a couple of additional clicks, can be forwarded to your online networks.

In the spirit of National Alzheimer’s Awareness Month, please visit the Brain Today blog and read the article and then encourage your social networks to do the same. In this way, you will become a part of the solution, doing your part to thwart Alzheimer’s through the simple act of awareness. Read full article

Dennis Fortier is President of Medical Care Corporation and Editor of the Brain Today blog . Brain Today is a non-commercial publication devoted to interpreting the daily news about brain health and distilling the true value of that news.

Caregiver Guilt is Good

by Vicki Rackner MD

Mary said, “I feel guilty all the time. When I'm with my father, who just went into a nursing home, I feel guilty I'm not with the kids. When I'm with the kids, I feel guilty about neglecting my husband. And when I take that occasional trip to the gym, I feel guilty about letting everyone down.”

Guilt is a common feeling in the landscape of caregiving. Guilt can propel you to be the best you can be…or it can immobilize you. Read full article

The Future of Dementia? Get Rid of the Stigma First

By Laura Bramly

I had the most extraordinary experience the other day...

I visited the Silverado Senior Living home in Scottsdale, AZ on Tuesday. With facilities in four states, Silverado provides assisted living communities for people requiring specialized memory care. If I told you that Silverado is the only memory care unit where I can recall hearing words such as "self-actualize," "purpose," "productive" and "success" in reference to seniors with dementia, I think you would begin to understand what makes Silverado different from many memory care facilities.

However, this is not a blog about Silverado. If you would like more information about Silverado facilities, I advise you to go to their web site, www.silveradosenior.com.

I was sitting with the administrator in his office. Silverado has an open door policy; all doors are open unless the open door presents a safety harzard (i.e. the door to the street!). The residents are free to wander in and out of rooms as they wish, including the offices of the staff. Read more ...

MetLife Mature Market Institute Survey of Long-Term Care Costs

This market survey from the MetLife Mature Market Institute, conducted in conjunction with LifePlans, Inc., contains daily private-pay rates for private and semi-private rooms in licensed nursing homes, monthly base rates for assisted living communities, hourly rates for home health aides from licensed agencies and agency-provided homemaker companion services, and daily rates for adult day services across the United States. View or download report

Aging with Grace & Emeritus Corporation Partner to Launch Ask the Expert, a Complimentary Resource for Seniors and Their Loved Ones - FOXBusiness.com

Emeritus Corporation Launches Ask the Expert, a Complimentary Resource for Seniors and Their Loved Ones - FOXBusiness.com

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Prescription for Caregivers

By Richard Carmona, M.D., M.P.H., F.A.C.S 17th Surgeon General of the United States

Being a caregiver for someone you love is one of the greatest gifts you can give, but it can also be very stressful. As you care for your loved one, there are resources that can help and things you can do to ease the strain on your own health and well-being.

Here are some ways to care for yourself while caring for your loved one:

• Talk to your doctor if you feel depressed or anxious. Signs that you may need help include crying more, sleeping more or less than usual, changes in appetite, and lack of interest in your regular activities.

• Find out about sources of support and help in your community. Reach out to family members, friends, neighbors, your place of worship, your Area Agency on Aging or your workplace for help with caregiver tasks.

• Realize that your health matters - it benefits everyone if you stay healthy and less stressed.

• Be aware of the toll stress takes on your health. Try to find time for exercise, eating well and sleeping enough.

• Learn about the condition your loved one is facing and how it may affect his/her physical and emotional state.

Caregiver Bill of Rights

Author Unknown

I have the right… to take care of myself. This is not an act of selfishness. It will give me the capability of taking better care of my relative.

I have the right… to seek help from others even though my relatives may object. I recognize the limits of my own endurance and strength.

I have the right… to maintain facets of my own life that do not include the person I care for, just as I would if he or she were healthy. I know that I do everything that I reasonably can for this person, and I have the right to do some things just for myself.

I have the right… to get angry, be depressed, and express other difficult feelings occasionally.

I have the right… to reject any attempts by my relative (either conscious or unconscious) to manipulate me through guilt and/or depression.

I have the right… to receive consideration, affection, forgiveness, and acceptance from my loved one for what I do, for as long as I offer these qualities in return.

I have the right… to take pride in what I am accomplishing and to applaud the courage it has sometimes taken to meet the needs of my relative.

I have the right… to protect my individuality and my right to make a life for myself that will sustain me in the time when my relative no longer needs my full-time help.

I have the right… to expect and demand that as new strides are made in finding resources to aid physically and mentally impaired persons in our country, similar strides will be made towards aiding and supporting caregivers.

The growing problem of elder abuse

by Patricia Grace, Senior Care Examiner

Many uncompensated caregivers — spouses, adult children, relatives and friends — find caring for an elder to be satisfying and enriching. However, the responsibilities and demands of elder caregiving, can be extremely stressful. The stress of elder care can lead to mental and physical health problems that contribute to caregiver burn out. This stress often leads to unintentional as well as intentional elder abuse.

Even caregivers in institutional settings experience stress at levels that lead to elder abuse. Nursing homes may be susceptible to elder abuse issues if their employees do not receive adequate training, or have too many patients or responsibilities, and/or work under poor conditions.

Read full article

When Parents Are Too Toxic to Tolerate

By RICHARD A. FRIEDMAN, M.D.
Published: October 19, 2009 New York Times

You can divorce an abusive spouse. You can call it quits if your lover mistreats you. But what can you do if the source of your misery is your own parent?

Granted, no parent is perfect. And whining about parental failure, real or not, is practically an American pastime that keeps the therapeutic community dutifully employed.

But just as there are ordinary good-enough parents who mysteriously produce a difficult child, there are some decent people who have the misfortune of having a truly toxic parent. Read full article

Continuing Care Retirement Community (CCRC) vs. Lifecare Community - are they the same?

By Patricia Grace, Senior Care Examiner

In the past 10-15 years, the senior housing industry has introduced several new concepts and terms that are easily confused. For example, many people believe, that life care and continuing care communities are the same, and they use these terms interchangeably. However, life care is actually a subset of continuing care. While the offerings may look similar at a glance, they are not. Read full article

Alzheimer's Association Launches Comfort Zone(TM), The First Comprehensive Location Management System Designed For People With Alzheimer's
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Why Swearing Eases Pain

by Dr. Vicki Rackner

It's almost involuntary. You slam your finger in the car door and out comes a colorful word. Even if you never, ever swear.

Swearing seems to be a universal response to pain, no matter what corner of the world you inhabit.

Why do we do this?

It may be a reflexive pain-reduction strategy like pulling your finger from a hot stove.

A group of scientists enlisted volunteers to submerge their hand in ice water while repeating either a neutral word or a swear word of their choice. students who swore kept their hands submerged longer and reported less pain that when they uttered a civil, neutral word.

The scientists speculated why. Your brain's speech center lies in the left side of your brain. words are generated in the amygdala--the emotional center on the right side of the brain involved with the fight-or-flight response. The fight-or-flight response seems to disrupt the connection between nerves that receive the pain signal and the nerves that interpret the experience. Blunted pain response would allow you to run away from a saber-tooth tiger who just released your calf muscles from its jaw.

So, next time your parents are in pain, encourage then to swear! Just think how much fun it will be to say to your parents with a smile, "Mom and Dad, you know how you always threatened to wash my mouth out with soap for saying naughty words? How things change!"

Vicki Rackner MD, founder of The Caregiver Club is a former surgeon who left the operating room to help family caregivers give their best and be their best by managing stress, speaking up with their loved ones’ doctors and asking the right questions. Dr. Vicki, as she has come to be known, is a speaker and author who is regularly quoted in the national media, including AARP, USA Today and NPR. Her most recent book is Caregiving without Regrets: 3 Steps to Avoid Burnout and Manage Disappointment, Guilt and Anger. You can reach her through at DrVicki@TheCaregiverClub.com or (425) 451-3777.

"My Name is Lisa"

A short film about a 13 year old girl dealing with her mother's Alzheimer's Disease. Alzheimer's is one of many serious and scary diseases still without a cure. Alzheimer's causes gradual memory loss. 250,000 children, age 8-18 are caregiving for someone with Alzheimer's or dementia. To find out more and take action, visit: http://www.actionalz.org/\

No Cost of Living Adjustment (COLA) for Social Security recipients for the first time in 35 years

Courtesy of Chris Orestis

Another sign of things to come for seniors in the 21st Century: for the first time since the darkest days of the economic crisis of the 1970’s, seniors will not see a cost of living increase in their Social Security checks. Combine this new development with proposed cuts to Medicare and Medicaid and the trend for seniors is becoming clearer every day. The realities of a global economic recession intersecting with explosive growth in the senior populations will create increasing pressures for the United States. More people needing help (money), with less resources to go around (money), equals hard choices about how to help those who need it most (money).

Increasing emphasis on the individual to shoulder more of the costs of their senior years will grow quickly. Moves to cut COLA’s, raise the minimum age for Medicare and cut Medicaid funding in the states will become more common occurrences. The Baby Boom generation is still in the early stages of moving into their retirement years and the amount of money required to support these programs is already overwhelming.

As economic and demographic trends over the coming years continues to challenge the governments ability to keep pace, seniors and their families must do all they can to prepare themselves financially for the costs of retirement and the even greater costs of long term healthcare.

Chris Orestis, president and a principal with Life Care Funding Group, is an acknowledged national expert on insurance and long term care issues. His Blog on senior living issues has become one of the more popular forums on the internet about the impact of the economy and politics on seniors and their housing and long term care needs. Learn more about senior funding alternatives and life settlements on the Life Care Funding Group web site.

New LifeStyles and Aging with Grace now offer consumers Personal Assistance in their Eldercare search

New LifeStyles, the most comprehensive source on the web for senior housing and care, is now offering personal assistance service through the expertise of Aging with Grace, to people using NewLifeStyles.com to find communities or services for themselves, loved ones and others

Online visitors can access the services of Aging with Grace through a program that includes unlimited telephone access to experienced eldercare specialists for assistance with immediate needs and long-term planning. Trained eldercare consultants will use New Lifestyles' comprehensive, easy-to-navigate database to help the consumer find the right solution for their personal situation. If the consumer gets to the point where they would like some guidance in the process or an expert to answer a question or two, Aging with Grace experts will be available through an exclusive toll-free number.

"New LifeStyles recognizes that the search for senior housing and care can be a daunting one. While our web site and print guides have always provided an extensive selection of quality options and resources, the consumer often needs the help of an unbiased expert," says Doug Fusella, President, New LifeStyles. "We are now proud and honored to be providing this personal assistance through the experts at Aging with Grace!"

"We are pleased to be partnering with a company that shares the same passion for helping the elderly and those that love them," say Aging with Grace CEO, Patricia Grace. "It's a pleasure to be working with a company that is synonymous with senior housing information," adds Rita Files, COO.

Details on the program are available immediately by calling (866) 369-8072.

ABOUT NEW LIFESTYLES

Founded in 1987, New LifeStyles provides the most comprehensive senior housing and care information to individuals in the U.S. and Canada. Over four million FREE copies of New LifeStyles Guide to senior living and care and The CareGuide are distributed annually. An extensive database of communities and providers, as well as helpful resources can be found at www.NewLifeStyles.com. For additional information, call 800.869.9549.

Exercise and the Elderly - It really can pay off

by Laura Bramly

Thank goodness for my stepfather. I'll never run out of material while he is still around...

My stepfather is 84 years old. He is in very good health but suffers from some back pain due to sciatica and other ailments. He also had a heart valve replaced last May (see earlier post!). Otherwise, he tries to stay as active and in as good spirits as he can.

For the past couple of years, he has attended weekly exercise classes at his local senior centre. He had to stop when his back pain was too severe, but started up again when the pain eased as he understood that building strength was one way to avert the pain. He stopped before he had his heart surgery and has not started again, as he is still feeling a little weak. However, he is lifting light weights and walks about a half mile every day to buy his paper. For someone in his eighties, I'd say he has worked hard to build optimal strength without overtaxing himself.

Two weeks ago, he stepped out of his elevator at his apartment building into thin air. Without getting into too much detail, the elevator door opened but the elevator itself had stopped two feet above the lobby floor! I kidded with him that he must have looked like Wiley Coyote, foiled again by the Roadrunner and stepping off a cliff into the abyss.

Of course he fell, and fell hard. But, no broken bones. No hip replacements on the horizon. He landed on his arms and hurt his back again, but other than that, he walked away.

Now how many of us 40-somethings could say the same if we had walked out of an elevator only to discover the floor was two feet below?

Truth is, all that exercise has paid off. He bounced. His bones and muscles were strong enough to withstand the fall. His balance was good enough to make him fell in the best manner to ensure the least harm. His arms broke his fall and his arms were strong.

Falls cause untold amounts of injury to the elderly (and not so elderly). Exercise is vital, for fall prevention and to continue to participate in all of your activities as you age. The message of this story is that it is never too late to start. My stepfather was no athlete. He was moderately active, enjoying a weekly round of golf and one or two daily walks. When his back started to give him trouble, he enrolled in exercise classes. He was already in his early 80s. And now, he can bounce, and because of that, he's back home in his apartment after his fall, and not in the hospital.

Laura Bramly, a member of the Aging with Grace "Ask an Expert" program, is a communications consultant specializing in education programs about dementia. She is author of ElderCareRead Life Scenes 1, a book for people with moderate to advanced dementia to read and enjoy. Learn more about Laura

Breast Cancer… not just a young woman’s disease

by Patricia Grace, National Senior Care Examiner

When, if ever, have you seen an advertisement for breast cancer awareness featuring an old woman? There are many public service announcements, TV commercials and People Magazine articles featuring young beautiful A-List celebrities advocating the importance of mammograms, but none featuring an 80+ year old woman. There is no question that mammogram’s save lives…at any age. Mammography, the gold standard for breast cancer screening and early detection, has been shown to significantly reduce the risk of being diagnosed with advanced stage breast cancer in women over the age of 80, an age group currently without clear guidelines recommending regular screenings. Read full article

War Stories from the Medical Billing Advocate Battlefield

by Sheri Samotin

Today was a very interesting session at the Medical Billing Adovcates of America's (www.billingadvocates.com) annual workshop. We spent the day hearing interesting speakers from the Florida Attorney General's office talk about fraud and abuse as it applies to medical billing. We also spent time with an attorney who specializes in helping patients fight with their insurance plans and providers.

There seems to be no end to the tactics that providers, especially hospitals, will go to in order to capture extra dollars from payors and patients. They will try to charge for the drapes and gowns in the operating room, even though they are already being paid for the use of the OR and are supposed to include (or "bundle") those items into the facility fee. Or, I'm sure you've heard the one about the "infection control device" charge for $17.44 that was actually a box of tissues. I can tell you that spending the day with more than thirty medical billing advocates reinforces my belief that the profession we are in is absolutely critical to any chance of meaningful health care reform!

I'm especially proud when I hear from colleagues about the many thousands of dollars they have saved patients. The really nice part, is that so often, in the process of helping their clients, they are also saving "the system" money either directly or by uncovering sytematic fraud that can then be reported to the appropriate authorities. As we learned today, once a reporr has been filed, the state has the responsibility to investigate and if they find sufficient evidence, they will pursue civil, and sometimes criminal, action against those conducting the fraudulent activity.

While your medical billing advocate is typically not an attorney and can't provide you with legal advice, we can identify the errors and sometimes outright fraud that is found on an estimated 90% of provider bills. And once we find these things, we will work on your behalf to get them fixed so that you only pay what you really owe. From time to time, we will hit a brick wall and advise you to consult with an attorney who specializes in these matters.


Sheri L. Samotin, President of LifeBridge Solutions, is a member of the Aging with Grace "Ask an Expert" program. With more than 25 years of business and management experience LifeBridge Solutions provides the necessary expertise and skills to help people with Insurance claims advocacy and daily money management.

The Many Diseases of Dementia

by Patricia Grace, Senior Care Examiner

"Mom doesn’t have Alzheimer’s, she just has dementia", so say many adult children to eldercare professionals. Somehow families find comfort in believing that a loved one only has dementia, as if it is the lesser of two evils.

Dementia is not a disease but a group of symptoms caused by gradual death of brain cells. The loss of cognitive abilities that occurs with dementia leads to impairments in memory, reasoning, planning, and personality. Alzheimer's disease is the most common cause, followed by vascular or multi in-farct dementia, Parkinson‘s disease, Lewy body dementia, Pick’s disease and Hydrocephalus dementia. Read full article ...

VA Benefits: Top Reasons Claims are Denied

The VA’s own website (www.va.gov) confirms that 75% of all VA pension applications (commonly referred to as Aid & Attendance) are denied the first time. The main reason VA applications are denied is because they are not complete and well-documented.

Here are 5 things you should know to avoid having your claim denied:

# 1: Failure to Document Income and Unreimbursed Medical Expenses. On the application, the VA can ONLY confirm the amount of your Social Security benefits independently. Everything else should be documented with a written explanation, this year’s award letter or an annuity agreement. When in doubt, document it. Unreimbursed Medical Expenses should be documented on the VA form 21-8416. If you have any other recurring, ongoing or continuous unreimbursed Medical Expenses (including R&B), document them!

# 2: Documenting Shortfalls. If your Unreimbursed Medical Expenses, especially your Room & Board (R&B), exceed your income, the VA will ALWAYS delay your claim to clarify this. So, anticipate this question! If you are using savings or assets to meet this shortfall every month, explain this as an attachment to your application. If your assets are depleted, and a friend, sibling or family member is supplementing your R&B, explain this. To be sure the VA understands what is happening, write a simple loan agreement and submit it with your application. This will prove that you are borrowing this shortfall every month.

# 3: Documenting Dependents. According to the VA, a “dependent” is younger than 18, where the veteran is the father, or the veteran is married to the mother (step-children are fine). Grandparents must have court-issued adoption decrees. If dependents are under 23- years- old, they must be in school full-time. Spouses are dependents, but their income also counts, as well as their Unreimbursed Medical Expenses.

# 4: Failure to Respond to Clarifications. Always answer VA letters or phone calls as soon as possible. If you need more time, send a letter saying “I’m working on it”. You have at least 60 days to respond and can supply the information within one year and still have a valid claim.

# 5: Missing or Incomplete Information. The VA pension applications are multiple-paged and have hundreds of questions. Address and answer every single one of them. If the question is non-applicable, answer “N/A”; if income is zero, answer with a “0″. NEVER, EVER leave a space blank.

With the VA, you can never provide too much information. If they have to write you for clarification, your claim will be delayed or denied. Always include your phone numbers, an email address and a next-of-kin’s contact information with every application.

Hospice ... a circle of care

by Patricia Grace

The word "hospice" stems from the Latin word "hospitium" meaning guesthouse. During the 1960's, Dame Cicely Saunders, a British physician began the modern hospice movement by establishing St. Christopher's Hospice near London. Today, hospice care provides humane and compassionate care for people in the last phases of terminal illness so that they may live their remaining life to the fullest and as pain-free as possible.

The primary focus of hospice is to maintain a quality of life through comfort, dignity and understanding. It encompasses the physical, psychological and spiritual needs of terminally ill patients, while supporting the well-being of caregivers. Whether provided in the home, hospital, long-term care facility, or anywhere else, hospice is a compassionate way to deliver care and supportive services to terminally ill patients. Services are provided on the basis of need, not the ability to pay.

Hospice & Palliative Care are they the same?

The goal of palliative care is to prevent, relieve, reduce, or soothe the symptoms of diseases or disorders. Palliative care does not try to cure disease. It is concerned with the emotional, spiritual, and practical needs of the affected person and those close to them. Palliative care is important for people who are thought to be at imminent risk of dying, those who are extremely ill, or those who are living with serious complications at the final stages of chronic diseases.
Palliative care focuses on managing symptoms, providing comfort, helping the patient complete "life business," healing relationships, and helping the family and friends who are grieving.
Hospice care is one form of palliative care with the goal to alleviate symptoms and improve quality of life. In contrast to traditional palliative care, hospice care is appropriate when there is a life expectancy of six months or less. When curative treatments are no longer working and/or a patient no longer desires to continue them, hospice becomes the care of choice. Traditional palliative care, on the other hand, can be given at any time during the course of an illness and in conjunction with curative and aggressive treatments.

While most people identify hospice with a cancer diagnosis a large portion of hospice patients suffer with COPD (Chronic obstructive pulmonary disease), heart disease (Congestive heart failure), neurological disorders (Parkinson’s disease), Alzheimer's disease/Dementia, and AIDS.

Patients and families who choose hospice are the core of the hospice team and are at the center of all decision making. A multi-disciplinary team supports the patient and the family. This team lead by a physician consists of nurses, aides, social workers, spiritual care givers, counselors, therapists and volunteers, family and the patient. All play an important role in the circle of care.

Services provided by this multi-disciplinary team include:

• Nursing services - A patient is assigned a case manager nurse who typically visits 1 to 3 days a week. Patients and their caregivers also have access to 24-hour on-call nurses.

• Physician participation - Patients are often cared for by their regular physician in cooperation with a hospice medical director.

• Medical social services – Social workers to focus on the emotional, financial and social stresses associated with terminal illness.

• Counseling Services - to include pastoral or spiritual support, bereavement counseling for family and caregivers up to one year after patient's death, and dietary services as appropriate.

• Home health aide (HHA) services - HHA help patients with their personal care and typically visit 2 to 3 times per week.

• Medications - all medications that are related to the hospice diagnosis and those that are intended to alleviate symptoms.

• Medical equipment - Equipment that is necessary for providing safe, comfortable care in the patient’s home environment is supplied by hospice. This may include a hospital bed, wheelchair, and oxygen.

• Other medical supplies may include adult diapers, bandages, and latex gloves.

• Laboratory and other diagnostic studies that are related to the terminal illness

• Therapists as appropriate, which may include: Physical therapy;Occupational therapy; Speech therapy. Additional services such as aromatherapy, pet therapy and music therapy may be available through individual hospice agencies and their volunteer and charitable donation programs.
  

Who pays for Hospice?

• Medicare - if the terminally ill individual is a Medicare beneficiary, hospice is a covered benefit under Part A. All other Medicare services continue under Parts A & B, including those of the person’s attending physician. Hospice payments do not interfere with any other Medicare payments for other illnesses, diseases or care. Hospices listed in HospiceDirectory.org will indicate if they are Medicare certified.

• Medicaid - as of 2006, 45 states plus the District of Columbia offer hospice care as a covered Medicaid benefit. In general, Medicaid hospice benefits parallel the Medicare benefit, although there may be some variations in certain states. Hospices listed in HospiceDirectory.org will indicate if they are Medicaid certified.

• Private Insurance - most insurance plans issued by employers and many managed care plans offer a hospice benefit. In most cases, the coverage is similar to the Medicare benefit, although there may be some variations between employers.

• Private Pay - if insurance coverage is unavailable or insufficient, the patient and the patient’s family can discuss private pay and payment plans.

• Tricare - is the health benefits program for military personnel and retirees. Only Medicare-certified hospices can provide for the TRICARE hospice benefit, therefore it is important that patients and family check with their Health Benefit Advisor or Health Care Finder to help them locate a qualified hospice agency.

Under Medicare law, no person may be refused hospice care due to inability to pay. Each hospice has a financial specialist on staff to answer questions about receiving financial assistance. Funds may be available from donations, gifts, grants or other community sources to help cover the costs of care.

Hospice care is covered under Medicare if:

• The patient is eligible for Medicare Hospital Insurance (Part A);

• The patient’s doctor and the hospice medical director certify that the patient is terminally ill with six months or less to live if the disease runs its expected course.

• The patient signs a statement choosing hospice care instead of standard Medicare benefits for the terminal illness;

• The patient receives care from a Medicare-approved hospice program.

Approval for hospice is required even if the agency or organization is already approved by Medicare to provide other kinds of health services. Patients can find out whether a hospice program is approved by Medicare by asking their physician or checking with the agency or organization offering the program. This information also is available from local Social Security offices.

Once hospice is initiated are other Medicare benefits available?

When Medicare beneficiaries choose hospice care, they give up the right to standard Medicare benefits only for treatment of the terminal illness. If the patient, who must have Part A in order to use the Medicare hospice benefit, also has Medicare Part B, he or she can use all appropriate Medicare Part A and Part B benefits for the treatment of health problems unrelated to the terminal illness. When standard benefits are used, the patient is responsible for Medicare’s deductible and coinsurance amounts.

What is not covered?

All services required for treatment of the terminal illness must be provided by or through the hospice. When a Medicare beneficiary chooses hospice care, Medicare will not pay for:

• Treatment for the terminal illness which is not for symptom management and pain control;

• Care given by another healthcare provider that was not arranged for by the patient’s hospice; and

• Care from another provider which duplicates care the hospice is required to provide.

To determine whether a Medicare-approved hospice program is available in your area, contact the nearest Social Security Administration office, your state or local health department, your state hospice organization, or call the National Hospice Organization HelpLine (800) 658-8899

Hospice continues after death

Bereavement is the time of mourning after a loss. The hospice care team works with surviving loved ones to help them through the grieving process. A trained volunteer, clergy member, or professional counselor provides support to survivors through visits, phone calls, and on-line support, as well as through support groups. The hospice team can refer family members and care-giving friends to other medical or professional care if needed. Bereavement services are often provided for about a year after the patient's death.

Hospice care also addresses a person’s spiritual needs. Since people differ in their spiritual and religious beliefs, spiritual care is offered to meet an individual’s specific needs. It may include helping you to look at what death means to you, helping you say good-bye, or helping with a certain religious ceremony or ritual. There are many books in print to help deal with death and dying, “Facing Death, a Companion in Words and Images” by Linda Watson, Photography by Maggie Sale, is a beautiful compilation of photographs and inspirational passages that can help nourish the most wounded spirit. "Becoming Dead Right", a hospice volunteer in urban nursing homes, by author Frances Shani Parker, provides a blueprint on how we should approach the end of life.

Losing a loved one is extremely painful and brings out a variety of emotions…shock, anger, sadness and guilt. Accepting them as part of the grieving process and allowing yourself to feel what you feel is necessary for healing and embraces the spirit of hospice care.

Overnight Care Program for Dementia’s Restless Minds

There are numerous daycare programs across the country for Alzheimer's sufferers, notes Laurence Harmon from Great Places on his blog, but the ElderServe at Night dusk-to-dawn drop-off program at the Jewish Home at Riverdale in NY, is thought to be the only one that picks up participants at their homes in the early evening and provides activities--painting, dancing, chatting, or just relaxing or getting a massage--from seven in the evening and returns them home, rested and showered, ready for the new day at seven the next morning.

For families who choose to continue care for their relative at home, the ElderServe at Night program offers a much needed opportunity for rest, relief from the burdens of care-giving and a good night’s sleep to restore themselves for ongoing care of their family members at home. Read more ...

Eldercare Lessons: Quality of Life - Rudy's Story

By Rita M Files

Throughout the years of working in the elder care industry, I have had the good fortune to meet a handful of people who have positively impacted my life on both a personal and professional level. The lessons I learned from them have changed my view on my own “golden” years and the true meaning of the quality of life.

One person who stands out the most is my beloved Rudy. He and his longtime companion, Helena—after spending the previous 40 years living in an apartment in New York City in a neighborhood laden with crime and danger—reluctantly agreed to move to a senior living community after much pressure from both their families. Their home had become a virtual prison, complete with bars on their first-floor apartment windows and multiple locks on the door. Neither Rudy nor Helena had been able to leave their home unescorted for several years.

My first encounter with them was the day they moved to the senior living community where I was working at the time. Quiet and sullen, they both appeared frightened, tired, and resigned to living in “a place like this.” Helena, noticeably the younger of the two, seemed to take the lead. Rudy appeared to be a shell of a man as he held his partner’s hand tightly and shuffled along through the tour of their new home.

As we approached the main resident gathering area, also known to most as the “piano room,” I was somewhat relieved that our tour would end here. As we entered, Rudy suddenly stopped and gazed for several minutes at the beautiful white grand piano that was the focal point of the room. Seeing what I believed to be a sparkle in his eyes, I asked, “Do you play?” He responded “my whole life.” Seizing the moment, I asked Rudy if he would play a song for me, and he readily agreed. As he approached the piano, he asked what I would like to hear, and my request was “Some Enchanted Evening.”

As he sat on the bench and lifted the keyboard cover, he transformed before my eyes. Head high, shoulders back, he began one of the most beautiful renditions of the song I had ever heard. As the glorious music filled the community, Rudy drew quite a crowd that day and every day thereafter for the entire eight months he lived with us. He passed away in his sleep one night. Finding a list of songs next to his bedside that he was to play that day, I took great comfort in knowing he died doing what he loved to do.

For many of today’s seniors facing the prospect of moving to a senior living environment, the mere mention conjures up visions of nursing homes from yesteryear. Perhaps they had a parent, other relative, or friend who spent their last days in a facility that was cold, sterile, and known as a place where people go to die. Convincing your loved one otherwise can seem nearly impossible. However, look for the magic keys such as a well-stocked library, a community garden, a bible group, or a creative writing club to assist with opening their minds.

This experience also taught me the importance of developing and maintaining hobbies and interests early in life, as they may be what bring us the most comfort in our older years.