Alzheimer's disease promotes isolation

Patients with Alzheimer’s disease, the most common form of dementia, and their caregivers say the illness leaves them feeling isolated and apart from family, friends and life’s typical connections, a report shows.

About a quarter of people with dementia hide or conceal their diagnosis because of the stigma surrounding the disease and 40 percent say they are excluded from everyday life, according to the World Alzheimer Report 2012 released today by London-based Alzheimer’s Disease International.

About 36 million people worldwide are living with dementia and the numbers will more than triple to 115 million by 2050, according to the report. The global cost of the disease is estimated at $604 billion. More education is needed about dementia, especially as seemingly healthy people are diagnosed earlier with the disease, said Beth Kallmyer, vice president of constituent services at the Alzheimer’s Association in Chicago.

Trouble on the horizon for LTC...

Low interest rates and policyholders' unwillingness to drop coverage are two of the key reasons the long-term care insurance market is in trouble, an expert recently asserted. Long-term care insurance carriers used to operate under the assumption that a reliable number of policyholders would drop their coverage before they reaped their claim, Howard Gleckman, a journalist and Urban Institute fellow, writes in Forbes magazine. But as interest rates plunged in the economic downturn, more policyholders have not cashed in. Additionally, not enough consumers are buying the policies, he says.

In this environment, LTC insurance carriers have had to either exit the market or increase premiums substantially. Genworth increased premiums this year and decreased product offerings, while Prudential has decided to offer only group long-term care policies.

“Overall, though, the decline of the private LTC market is a huge problem, especially since it is coming just as Washington is seeking ways to reduce Medicaid, the most important payer of long-term care costs,” Gleckman wrote.

Top Ten Things a Caregiver Needs from a Health Care Provider

Excellent insight from our friend Gary Barg of Today's Caregiver.

1. Attention: The caregiver's loved one may be the 27th similar case you've seen today; but to the caregiver, this is Mom or Dad, Sister or Lover.

2. Compassion: Be diligent in its application.

3. Time: A few moments of your undivided time is some of the strongest medicine you'll ever administer—and it costs so very little.

4. Respect: The person pushing the wheelchair is also part-time bookkeeper, psychologist, dietitian, insurance and incontinence expert, and a full-time general in the war they are waging with this illness. They not only need your respect, they DESERVE it.

5. Dedication: Be relentless in your devotion to your craft. The caregiver has entrusted you with their most valuable asset—their loved one. You earn that trust with your skill, knowledge base and ability. 

6. Honesty: The caregiver is your partner in this endeavor; they deserve (and can handle) the truth.

7. Prudence: The graceful administration of the truth is a true test of a caring professional.

8. Advocacy: Never accept less than the best your system has to offer their
loved one.

9. Understanding: The caregiver plays a pivotal role in the well-being of your patient; understanding the needs, wishes and fears of the caregiver improves your patient's care.

10. Your well-being: Know your emotional limit and learn when to ask for help. Your loved ones as well as the caregiver's loved one need you to remain well.

Gary Barg
Editor-in-Chief
Today's Caregiver

Obamacare offers choice...support kids or aging parents

What will we do?

While most Americans wait to find out how Obamacare will affect their own health care situation, Martha R Gore, Watch Dog Politics Examiner, Examiner.com, speculates that those who are most likely to bear the brunt of the legislation are the demographic who care for aging parents as well as adult children. 

Medicare cuts could pose a conflict for those “middleagers,” writes Gore as they choose between health care costs for themselves and their parents while weighing the option of a multigenerational household to help keep costs down. 

The follow is a sample of cuts to Medicare:

• Home health care
• Diagnostic imaging like MRIs, CT scans
• Ambulances
• Diagnostics labs
• Durable medical equipment
• Power wheelchairs unless rented for previously rented for 13 months
• Long term hospitals, nursing homes and inpatient rehab facilities
• Dialysis treatment
• Inpatient psychiatric hospitals
• Hospice
• Hospitals that treat low income seniors

According to an article in NPR the number of elderly Americans needing expensive care is going to surge as more Baby Boomers retire and begin to depend upon Medicare to meet their health needs. This is the age group born between 1946 and 1964 and many of them are expected to live to live 85 years or older. Today there are 6 million Americans in that age group.

As more cuts to Medicare are made it may mean many Americans that are still supporting children may be expected to shoulder more of the cost of taking care of the health and medical needs of elderly parents.

In some cases, this may require that the aging parent move into the family dwelling in order to cope with the financial challenges. The Pew Research Center reports that this is already happening with about 20% of older people living with another generation. However doubling up to split living costs may fall short of what is needed to care for an aging parent. Three generations in one household may become the rule rather than the exception.

Mom, what's wrong with Nana?

Alzheimer's can be baffling to anyone, but for young children and even teens it can be especially hard to grasp all that's happening to someone who has played a central role in their lives. But because Alzheimer's can have a profound impact on family life, it’s important to talk with your children about the disease as soon as possible and help them to understand how this disease will probably have to change the relationship they’ve previously shared with that loved one.
You should expect that your children will have a strong reaction to the news of their loved one's Alzheimer's diagnosis. "Both the five-year-old and the fifteen-year-old are going to be alarmed and stressed, and as grandpa or grandma drifts away they're going to face feelings of bereavement," says Richard Powers, MD, associate professor of neurology and pathology at the University of Alabama at Birmingham School of Medicine and spokesman for the Alzheimer's Foundation of America. "It's important to explain that while grandpa may not remember your name, he still loves you as much as the first day he laid eyes on you, and you need to reach out to the part of the person that's still intact."

To choose the right words to explain a loved one’s Alzheimer diagnosis to a child, first consider their age and modify the conversation to make it age-appropriate. The following tips can help you to do just that:

• Younger children - when talking to a younger child about a loved one's diagnosis, you won't necessarily want to use the term Alzheimer's disease. "I recommend parents say something like, 'Grandpa is having problems with his memory or he is unable to think as well as he used to think, so sometimes we'll have to help him with his thinking or his remembering,'" says Barry J. Jacobs, PsyD, a psychologist, faculty member of the Crozer-Keystone Family Medicine Residency Program in Springfield, Pa., and author of The Emotional Survival Guide for Caregivers. You should mention that the person with Alzheimer’s will get sicker over time. Then, if your child seems to have a good grasp of what's already been explained, you could prepare him for some of the changes he will see in the person with Alzheimer's by going over symptoms and how to handle them appropriately.
• Teenagers - will be capable of understanding more than young children, so you should share details of both the progression of Alzheimer's disease and the treatment options available. "For teenagers, we developed a more sophisticated program that actually gets into the brain pathology," says Dr. Powers. "Often, teenagers will end up playing a role in caring for grandpa or grandma, so it is important for them to know as much as possible up front."

Reassure children that Alzheimer's disease is not infectious as you answer their questions and acknowledge their feelings. Make sure they understand that the dementia patient still loves them and wants to see them, but don't force them to visit if they are very resistant or uncomfortable with the situation.

There are a number of emotions children and teens might experience after hearing of their loved one's Alzheimer's diagnosis, including:

• Sadness and a sense of loss
• Confusion or fear about behavioral changes
• Worry that Alzheimer's is contagious, or that their parents might develop the disease
• Anger or frustration because they have to repeat questions when interacting with the dementia patient or help with caregiving tasks
• Remorse over their anger or frustration
• Embarrassment and not wanting to have friends over if the Alzheimer’s patient lives at home with them

These emotions can also be expressed in ways that are less obvious. The child or teenager might act out by:

• Complaining of vague physical discomfort, like a stomachache
• Performing poorly at school
• Spending more time away from home
• Refusing to invite friends over

Parents should respond with unconditional love and support, allowing their children to work through their feelings and answering all of their questions as honestly as possible. Family-related activities like sorting through old photographs or making a family tree also might help by reinforcing the child's connection to their loved one.

Above all, don't force kids to do things they are not comfortable doing. This could include being present for medical exams, participating in daily care (like toileting), or making visits to a nursing home rather than visiting the person with Alzheimer's at a more neutral or familiar location.
Hearing of a loved one's Alzheimer's diagnosis is tough. Explaining it to kids can be challenging for you as well. But following these tips, and customizing them to your specific situation, can be a great step in the right direction. Opening the lines of communication will ease the transition for everyone, no matter

President Obama targets 2025 for effective Alzheimer's treatment

Effective treatments for Alzheimer’s by 2025? That’s the target the government is eyeing as it develops a national strategy to tackle what could become the defining disease of a rapidly aging population.

It’s an ambitious goal — and on Tuesday, advisers to the government stressed that millions of families need better help now to care for their loved ones.

“What’s really important here is a comprehensive plan that deals with the needs of people who already have the disease,” said Alzheimer’s Association president Harry Johns, one of the advisers.

Already families approach the advisory committee “reminding us of the enormity of our task,” said Dr. Ron Petersen, an Alzheimer’s specialist at the Mayo Clinic who chairs the panel.

The Obama administration is developing the first National Alzheimer’s Plan to address the medical and social problems of dementia — not just better treatments but better day-to-day care for dementia patients and their overwhelmed caregivers, too.

The plan still is being written, with the advisory panel’s input. But a draft of its overall goals sets 2025 as a target date to have effective treatments and ways to delay if not completely prevent the illness.

Some advisory members said that’s not aggressive enough, and 2020 would be a better target date.

“We want to be bold,” said Dr. Jennifer Manly of Columbia University. “We think the difference of five years is incredibly meaningful.”

Regardless, an estimated 5.4 million Americans already have Alzheimer’s or similar dementias — and how to help their families cope with day-to-day care is a priority, the advisory committee made clear Tuesday.

The disease is growing steadily as the population ages: By 2050, 13 million to 16 million Americans are projected to have Alzheimer’s, costing $1 trillion in medical and nursing home expenditures. That doesn’t count the billions of dollars in unpaid care provided by relatives and friends.

Today’s treatments only temporarily ease some dementia symptoms, and work to find better ones has been frustratingly slow. Scientists now know that Alzheimer’s is brewing for years before symptoms appear, and they’re hunting ways to stall the disease, maybe long enough that potential sufferers will die of something else first. But it’s still early-stage work.

Meanwhile, as many as half of today’s Alzheimer’s sufferers haven’t been formally diagnosed, a recent report found. That’s in part because of stigma and the belief that nothing can be done. Symptomatic treatment aside, a diagnosis lets families plan, and catching Alzheimer’s earlier would be crucial if scientists ever find a way to stall it, the advisory panel noted.

Among the goals being debated for the national plan:

Begin a national public awareness campaign of dementia’s early warning signs, to improve timely diagnosis.

Give primary care doctors the tools to assess signs of dementia as part of Medicare’s annual check-up.

Have caregivers’ health, physical and mental, regularly checked.

Improve care-planning and training for families so they know what resources are available for their loved one and themselves.

A training program in New York, for instance, has proved that caregivers who are taught how to handle common dementia problems, and given support, are able to keep their loved ones at home for longer.

Such programs “are dirt cheap compared to paying for nursing home care,” said David Hoffman, who oversees Alzheimer’s programs for the New York State Department of Health.

But hanging over the meeting was the reality of a budget crunch. The government hasn’t said how much money it will be able to devote to the Alzheimer’s plan, and states have seen their own Alzheimer’s budgets cut.

“We’re not going to fix this without substantial resources,” Hoffman said. “In New York, we’re hanging on by our nails,” he added.

The devil is in the details...

On Wednesday, Feb. 22, the Department of Health and Human Services unveiled the first draft of a national action plan to combat Alzheimer’s disease, but the Wall Street Journal wonders if obstacles such as funding and lack of coordination might become a roadblock to the plan’s success.

The Draft National Plan to Address Alzheimer’s Disease includes goals of improving care, expanding support for caregivers, and heightening public awareness, along with strategies to discover better methods of researching the disease, training healthcare professionals, and coordinating collaboration between private and public stakeholders, says WSJ.


However the devil is in the details—and how they play out, some experts say.

“For me, it’s about implementation,” Eric Hall, a plan advisory council member and chief executive of the Alzheimer’s Foundation of America, an advocacy group, tells the Health Blog.

One major obstacle is funding. Earlier this month, the administration announced $80 million in new funding for Alzheimer’s research in fiscal year 2013, but how much additional money is needed to carry out the plan remains to be seen.
.
It could also be tough to minimize redundancy among other health agencies working toward the same goals, the article says.

The National Institute on Aging, a division of the National Institutes of Health at the Department of Health and Human Services, released its 2010 Progress Report on Alzheimer’s Disease, which summarizes recent Alzheimer’s research, on the heels of the first draft’s unveiling.

Read WSJ article...

Millions of Americans struggle to provide care from a distance.

As lifespans lengthen and the number of seniors rapidly grows, more Americans find themselves struggling to care for an ailing loved one from hundreds or thousands of miles away.

The following is an excellent article that appeared in The Washington Post. If you have aging parents it is a must read...

As elder abuse grows, so does the need for shelters

The following USA Today article sheds light on the growing issue of elder abuse.

They're weak, physically or mentally disabled or both, and often at the mercy of people they depend on the most: relatives and caretakers.

They're the nation's fast-growing elderly population, and many are prime targets for abuse — physical, financial, sexual or emotional.

Concern among the elderly and their advocates is mounting as the number of seniors soars and more of them live longer.

The Cedar Village Retirement Community in the Cincinnati suburb of Mason this month opened a long-term care facility to victims of abuse. It is the first elder abuse shelter in Ohio and one of only a half-dozen in the country, all of them funded by non-profit groups.

"There is a genuine recognition by those who are concerned by the abuse of elders that there need to be appropriate safe houses for them to get them out of immediate harm's way," says Sally Hurme, AARP's senior project manager in education and outreach. "Nationally, we've been aware of the need for elder abuse shelters, but they've been slow in coming into fruition."

The first in the nation, the Weinberg Center for Elder Abuse Prevention at the Hebrew Home at Riverdale in the Bronx in New York City opened just seven years ago and serves as a model for the few others.

Read full article at USA Today...

6 Time Management Tips for Caregivers

Caregiver stress is a popular topic these days, and for many caregivers burnout is a very real factor this time of year. I spoke with several people this week who are feeling that they can’t live up to what’s expected of them…that there simply aren’t enough hours in the day to take care of their children, their jobs, their ailing parents, their holiday plans etc.
In order to juggle caregiving responsibilities with all the other demands of daily life, time management strategies can be a life saver. Try these techniques next time you’re feeling overwhelmed:
• Unplug from technology: Laptops and cell phone with Wi-Fi are great, but they make us available to any and all who need us 24/7. Unless that’s part of your job responsibilities, it may be interfering with your ability to relax and enjoy whatever down time you have.
• Make a list: It’s hard to relax when you’re carrying around a mental “To Do” list. Before you go to bed each night, write down all the things you need to take care of the next day. That way you can put them on paper, and let the weight of responsibility go for the night.
• Mono-task instead of multi-task: Our brains can only focus well on one thing at a time. Trying to do too much at one time can cause silly mistakes that take time to correct.
• Start with the most dreaded task on your list: Avoiding an unpleasant task uses up a lot of emotional energy. Attack them first thing instead of worrying about them all day.
• Schedule time to recharge your batteries: Whether its 30 minutes with a cup of coffee and a good book, or 30 minutes at the gym, be sure you give yourself a little “me time” each day.
• Delegate what you can: No one can go it alone. Let your family, friends, and co-workers help when possible.

Can happiness lead to living longer?

Being happy doesn't just improve the quality of your life. According to a new study, it may increase the quantity of your life as well.

Older people were up to 35% less likely to die during the five-year study if they reported feeling happy, excited, and content on a typical day. And this was true even though the researchers took factors such as chronic health problems, depression, and financial security out of the equation.
"We had expected that we might see a link between how happy people felt over the day and their future mortality, but we were struck by how strong the effect was," says Andrew Steptoe, Ph.D., the lead author of the study and a professor of psychology at University College London, in the United Kingdom.

It may seem far-fetched that a person's feelings on one particular day would be able to predict the likelihood of dying in the near future, but these emotional snapshots have proven to be a good indication of overall temperament in previous studies, says Sarah Pressman, Ph.D., a professor of psychology at the University of Kansas, in Lawrence.

"There is always room for error, of course; if I get a parking ticket or stub my toe on the way to the study, I'm not going to be particularly happy," says Pressman, who was not involved in the study but researches the impact of happiness on health. "But given that the study worked, it suggests that, on average, this day was fairly typical for the participants."

Unlike the happiness measures, depression symptoms were not associated with mortality rates once the researchers adjusted for overall health. According to the study, this finding suggests that the absence of happiness may be a more important measure of health in older people than the presence of negative emotions.

Positive emotions could contribute to better physical health in a number of ways. Regions of the brain involved in happiness are also involved in blood-vessel function and inflammation, for instance, and studies have shown that levels of the stress hormone cortisol tend to rise and fall with emotion.

The study doesn't prove that happiness (or unhappiness) directly affects lifespan, but the findings do imply that doctors and caregivers should pay close attention to the emotional well-being of older patients, the researchers say. "We would not advocate from this study that trying to be happier would have direct health benefits," Steptoe says.

However, this study and others like it should help establish happiness as a legitimate area of concern for health professionals, Pressman says. "There are still some people who see happiness as something fluffy and less scientific -- not something they should be worried about like, say, stress or depression," she says.

Happiness, she adds, "may be something for doctors to ask their patients about."

November is National Family Caregiver’s Month.

WANT TO HONOR VETERANS? HONOR THEIR CAREGIVERS

It’s no coincidence that November marks both Veterans Day and National Family Caregivers month. To truly honor veterans, we must also start honoring their caregivers.

Caregivers of veterans remain a largely invisible group. They are, at best, a footnote in debates about Medicare, veterans benefits, and budgets cuts to local services such as California’s recent decision to cut off Medi-Cal funding for adult day care centers.

Yet caregivers of veterans are not a voiceless bunch. As an advocate for caregivers of the elderly, I hear their stories every day. They speak loud and clear – if we choose to hear them. Take the words of Kathryn M. White, whose husband, a World War II veteran, is now battling Alzheimer’s disease: “I wish none of this ever happened. I wish that I had my wonderful, loving husband back but I know that is not possible.
We were the love of each others’ lives for 24 years and had a great marriage, but that Glenn has gone and I do not know this one.”

She included the following poem, written after assisting her husband through a recent doctor’s visit.

I am not just a Caregiver - I AM the Veteran

I asked the doctor, who was in a bad mood,
After I felt that he was being rude,

“Doctor have you ever put yourself in the shoes of the Vet?”

His answer made me want to shiver.

“Yes, but you’re not a Veteran…you’re just a Caregiver.”

I sat there a moment until I could find my voice.
I had to speak for all of us; he left me no choice.
With tears streaming down my face,
I had one goal: to put him in his place.

“I’m not just a caregiver and this I want you to know.
I’m the veteran and I hope it shows.
Alzheimer’s is taking his mind,
Moreover, I search for the items he can’t find.

“I am his mouth when he can’t speak.
I am his legs when his grow weak.
I am his ears when he can’t hear.
I am the one he counts on being there.

“I am his eyes when he can’t see.
I clean up the messes he makes, even his pee.
I lead him to bathe when he would rather not.
He totally depends on me; I am all he has got.

“I pick him up when he falls,
I lay awake listening for his call.

I pay the bills because he can’t think.
I prepare his meds and hand him a drink.

“We are on a journey into the unknown.
We’ll go together, as one, no, he won’t go alone.
So look into my eyes doctor, see my pain, lest you forget.
I am not just a Caregiver…I am the Vet

-- Patricia Grace, founder and CEO of Aging with Grace,

Financial pressures driving some older Americans to drink...

Some older adults may turn to alcohol or cigarettes as a way to cope with financial stress, particularly men and people with less education, a new study suggests.

In the study, researchers surveyed 2,300 older Americans periodically between 1992 and 2006, and found that 16 percent reported growing financial strain over that time, 3 percent reported increases in heavy drinking (more than 30 drinks a month), and 1 percent said they'd started smoking more.

The youngest of the study participants were age 65 when the study began.

Older men who faced increasing financial stress were 30 percent more likely to become heavy drinkers than those who remained financially stable. This increased risk was similar for older adults with lower levels of education compared to those with more education.

Older women and seniors with higher levels of education tended to reduce their drinking when they encountered financial struggles, according to the study published in the November issue of the Journal of Studies on Alcohol and Drugs.

The findings don't actually show that financial problems were the reason for changes in smoking and drinking habits, but it is known that some people use alcohol and tobacco as a way of coping with stress, noted lead researcher Benjamin A. Shaw of the State University of New York at Albany.

"When you have a stressor that's not very controllable, people may focus on something to help control their emotional response to the stressor," he said in a journal news release.

Financial woes may be particularly stressful for older adults, Shaw added.

"They are out of the workforce, and they might feel like they have less time to recover or generally have less control over their financial situation," he explained

Antidote for the Alzheimer's Epidemic: An Ounce of Will ad a Pound of Pragmatism

Surely, you’ve all read the grim reports about Alzheimer’s disease. The advancing age of the US population will usher forth an Alzheimer’s epidemic in the coming decade. The emotional toll of this epidemic will be immeasurable, and the financial impact could bankrupt the Medicare system.
That dire version of the story might sell newspapers, but it doesn’t really reflect the available options to a nation with a will to fight back. The good news is: we can manage this problem. And no elusive scientific discoveries are required to do so. We merely need to implement the medical knowledge that is already in hand.

This short summary outlines the pragmatic steps necessary to close the gap between the state of current medical knowledge and the lagging standard of care that is routinely practiced in primary care settings. We can avert this looming threat with an ounce of public will and a pound of pragmatism.

Read more...Brain Today

Family caregiving growing in leaps and bounds...

Family caregiving is becoming a more and more common phenomena with the rise in numbers of American seniors, and a 2011 AARP study says the value of unpaid family caregiving reached $450 billion in 2009.

Recent data shows one in eight Americans are 65 or older, with the number of seniors doubling between 2000 and 2030; the number of senior household is expected to increase 35% by 2020 from 2010 figures. Many older Americans embrace their independence and prefer receiving care at home and aging in place rather than going to a nursing facility, says AARP; this has contributed to the rise in caregiving in general, as well as family caregiving and the costs associated with it.

To put the costs of caregiving in context, the AARP paper, Valuing the Invaluable: 2011 Update – The Growing Contributions and Costs of Family Caregiving, says that in 2009, approximately one in four adults gave care valued at an estimated $450 billion—more than Wal-mart’s total 2009 sales.

This figure represents a 21% increase from what was found in a 2007 study, and reflects the estimated 61.6 million Americans who provided care in 2009.

“We know most people want to remain in their own homes and communities as they get older. Family caregiving is key to making that possible,” says Susan Reinhard, Senior Vice President for Public Policy at AARP.

The AARP report comes after a 2010 MetLife study found that caregiving represents a $3 trillion drain on adult children’s wallets when factoring in lost wages due to missing work, and how that affects retirement and Social Security contributions.

AARP also mentions the levels and kinds of care offered by caregivers, which has grown more complex over the years, and the toll this care can take on the health and well-being of caregivers.

“Family caregivers are an essential part of the workforce to maintain the health care and long-term services and supports systems for the growing number of people with complex chronic care needs,” says the report. “Family caregiving has been shown to help delay or prevent the use of nursing home care.”

Angela...more than a pretty name

The following is a recent article that appeared in Healthcare IT News.

Seniors struggling to deal with healthcare concerns while living independently will soon have a new friend to call upon – Angela.

“Angela” is an interactive telecare platform launched by Independa, a San Diego-based provider of telehealth solutions for home care-based settings and caregivers. Described as “the next Wii or iPad for the golden generation,” it’s designed to not only provide entertainment and a communications platform for seniors living independently, but also to maintain a vital link to caregivers.

“Our vision as a company is to replace ‘I’ve fallen and I can’t get up’ with a social interaction solution,” said Independa’s CEO, Kian Saneii. “The number one issue for the elderly is social isolation. … This offers a version of supported independence.”

Running on an off-the-shelf touch-screen tablet, Angela offers secure, one-touch access to a variety of interactive content, including the Internet, Facebook, games and puzzles, video chat and e-mail. It follows the company’s January launch of Smart Reminders, which allows caregivers to set up automatic reminders for care receivers to take medications, keep medical and social appointments and record “Life Stories.” Later this year, the platform will include sensor-based connectivity.

Angela is specifically designed for older adults, with larger screen fonts, higher contrast and brighter colors.
While the social benefits of Angela are apparent, the clinical effects are there as well. The nation pays approximately $3,000 per episode of care for the elderly, Saneii said. In addition, he said, approximately half of all prescriptions written for seniors are not filled, and one-third of those that are filled are never taken, many because they’re forgotten.

“We’re opening up the world to a lot of individuals who want to live alone but need help doing so,” he said.
“Traditional telehealth boxes and computers are last-decade clumsy approaches to helping older adults, providers and caregivers,” said Laurie Orlov, founder of the market research firm Aging in Place Technology Watch. “Twenty-first century solutions will look more like the integrated engagement and wellness platforms of new firms like Independa and its ‘Angela.’”

“User-friendly technology solutions that encourage social engagement are essential in preserving independence for older adults,” added Richard Della Penna, Independa’s chief medical officer. “While often overlooked, isolation is the number one issue for the elderly, as it commonly triggers depression and physical illnesses, which can hasten the move to less-independent living and shorten life.”

Saneii is quick to point out that Angela is a social engagement platform and not a telemedicine solution. Its purpose is to collect information and improve communications, but “not to diagnose.” “The healthcare system doesn’t need us to become part of the system,” he said.

What it does need, he said, is a platform that allows seniors – as well as others living in some sort of supported independence – to communicate with friends, relatives and caregivers easily and effectively, even if they don’t know how to log on to a computer.

Among the early adopters of Independa’s technology is LivHOME, a Los Angeles-based provider of in-home senior care services.

“We believe that technology is going to play a key role in providing consistent high-level senior in-home care at an affordable price,” said Mike Nicholson, the company’s chief executive officer. “We feel that Independa has the best-in-class solution to date. Over the two years we have followed their development of care monitoring, medication reminders and other technology solutions, LivHOME has been excited about the prospect of offering the Independa solution to our established national locations and our growing franchise markets. With the launch of Angela, we are proud to be able to offer it as a component of the LivHOME solution to our thousands of clients across the country.”

According to Saneii, Angela will be deployed for beta testing in July and should be ready for commercial use by September, at which time Independa will begin beta testing its sensor connectivity solution. Plans call for an option of 10-inch or 22-inch tablets, with the software available for a monthly subscription; tablet pricing will be determined later.

“Angela is the latest building block in the integrated suite of solutions Independa is rolling out to help family members and home-care professionals stay in touch with and watch over care recipients when they can’t be with them,” he said. “Elderly care recipients can use simple, fun tools, and those looking after them need practical solutions that are easy to use and don’t require their own care. Angela meets all those needs, and adds essential social elements.”

Workplace benefits are needed to meet family obligations to help aging family members.

The collision of the economy, the health care crisis, and a growing number of aging Americans has put many families in or near financial crisis according to a new report from Volunteers of America.

“Plurality of caregivers say the economy has made it more difficult to provide care to a family member,” said the report. ”Few—roughly one in 10—are paid for the care they provide.”

More than 46 percent report that the economy has made it harder to be able to provide care. Three quarters of caregivers state that the person to whom they provide care is 70 years or older.

“We have a potential catastrophe looming with the collision of a significant, and growing, aging population, the economic downturn, and the health care crisis,” said Rosemarie Rae, executive vice president with Volunteers of America.

The number of older Americans in the 65 or older age bracket is expected to reach more than 71.5 million people by 2030 says the report. This will be the largest senior population in U.S. history and almost double the approximately 37 million seniors today. “This is a large, emerging crisis in America,” Rae said.

“Medicare already pays out more in benefits than it brings in and will be insolvent by 2017,” Rae continued. “Social Security will pay out more than it collects beginning in 2016 and the system as a whole will be insolvent by 2037.” Medicaid statistics are equally alarming. In order to qualify, most people must bankrupt themselves before they can receive long-term care coverage.

“We are hopeful that healthcare reform will begin to shape this discussion and mitigate the negative impacts of the current system,” Rae said.

The study also found that an overwhelming majority—97 percent of women and 94 percent of men—believe that the elderly should be allowed to age at home, if they want to.

A majority of those interviewed reported that they were unable to make financial, career or family sacrifices in order to care for an older family member. More than 65 percent stated that they would be unable to take time off of work to care for an elderly loved one, and 86 percent of women interviewed and 81 percent of men agreed that better workplace policies are needed to meet family obligations to help aging family members.

View a copy of the report here.

Alzheimer's takes increasing toll on healthcare system

Alzheimer's disease will take an increasing toll on the healthcare industry and entitlement programs, report USA Today and Reuters. Altogether, $183 billion is expected to be spent on professional caregivers in 2011, up from $172 billion a year ago, according to a new report by the Alzheimer's Foundation.
Those ever-increasing expenditures will take a huge toll on Medicare and Medicaid. By 2050 it is expected that Alzheimer's and dementia-related costs for Medicare will increase six-fold and for Medicaid, four-fold. Elderly individuals with Alzheimer's are about three times more costly to care for than other patients because they often require long and repeated hospitalizations.
Meanwhile, nearly 15 million Americans are caring for someone with Alzheimer's or age-related dementia--up more than 37 percent from a year ago. Those family caregivers provide 17 billion hours of uncompensated care, for a total of $202.6 billion.
"Stress is extremely high, and one-third (of caregivers) are experiencing depression," said Beth Kallmyer, the Alzheimer's Foundation's senior director of constituent services.

Credit Card Debt That Outlives Mom

 By SHERISSE PHAM

 

Following a recent post on the rising levels of credit card debt among the elderly, several readers raised an important question: What happens when borrowers die? Do they take their credit card balances to the grave, or are those left behind responsible for the debt?

Tom from Vancouver Island, British Columbia, offered an answer: “Excess debt over the value of the estate is considered insolvent and cannot be passed on to heirs.” He’s right, it turns out.

Experts say that unlike a mortgage or a car loan, credit card debt is unsecured, meaning that it isn’t tethered to an asset. When someone dies, credit card companies have to wait near the back of the line to receive payment. If what’s left over after settling the estate isn’t enough to pay the bill, credit card debt is written off. Read more...

Family Care Arrangements to Pay the Cost of Home Care Services

Approximately 70% of all people receiving long term care in this country are in their homes.  This care is provided primarily by family members who are not paid for their services.  In many cases, family members are more than happy to provide unpaid care because that is what families do.  On the other hand, some family members go to great sacrifice to provide care for their loved ones.  In some cases they have to give up employment, move to a new location, give up spending time with a spouse or children and possibly isolate themselves from any normal pursuits other than caregiving.  In these cases, it would seem reasonable that children or other close members of the family should be reimbursed for their sacrifice.

Fortunately, for those veterans who served during a period of war, the Department of Veterans Affairs will provide funds to all those who qualify to help cover the cost of paying family members to provide care for their loved ones.

The veterans program is called Pension and it is commonly referred to as the "veterans aid and attendance benefit."  Pension can pay up to $1,949 a month in additional income to a veteran household to cover the cost of paying a child or a friend for providing care in the home.  A spouse providing this care would not qualify.

If the disabled veteran or the single surviving spouse of a veteran has been rated "housebound" or in need of "aid and attendance" by the VA, all fees paid to an in-home attendant -- this includes members of the family as well as friends or hired caregivers -- will be allowed as a deduction for determining Pension as long as the attendant provides some medical or nursing services for the disabled person.  The attendant does not have to be a licensed health professional.

A family member may be considered an in-home attendant, but that family member has to be paid for services rendered.  There is potential for fraud here where a family member may move into the home and ostensibly receive payment as a caregiver but not actually provide the level of care paid for. Documentation for this care must be provided to the VA, and it is reasonable for the VA to question whether the services being purchased from someone living in the household are legitimate.

Because of this, the evidence for an arms-length, legally functioning care arrangement must be irrefutable.

It is important to note that claimants are responsible to ensure that any caregivers, including family, are compensated in accordance with federal and state guidelines, and that any appropriate taxes, social security and unemployment fees be paid by both the caregiver and the claimant. Claimants should contract with a payroll service to ensure compliance with necessary regulations.

In the case of VA Non-Service Connected Disability Pension for Housebound or Aid & Attendance, certain critical forms and documents must be submitted with the initial application in order to avoid delays in the claims process or even a denial.  It is almost impossible for a family member who wants to receive the Pension benefit to comply with all of the documentation requirements without knowledge of how the actual process of application works. 

Aging with Grace is available to provide pre-filing consultation* for families that wish to pursue establishing Family Care Arrangements.  In addition to sample documentation, AWG has secured discounted payroll and support services for its clients through HireFamily LLC (www.HireFamily.com), which enables claimants to pay caregiver(s) in accordance with all federal and state guidelines.  Assistance with preparing claim paperwork for VA Benefits is provided at no additional cost. **

To learn more, visit www.agingwithgrace.net



*AWG is not a substitute for legal counsel, tax advice or financial planning and a personal service contract created for paid family caregiving purposes should be reviewed by an attorney.

**AWG Veteran Services is a private practitioner and not connected with the Department of Veterans Affairs. This service is provided by a VA accredited Claims Agent. We 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. Our Long Term Care Planning Consultation fee is for pre-filing services only. Membership in the Aging with Grace Program is not required. No additional fees are charged for assistance with preparing or filing a claim for VA benefits.