Elder Care Blog

What is a Power of Attorney?

For social workers working in healthcare settings, the question of the day is “Who is the POA for this patient?” It is an important piece of information and let’s staff know who can make health care decisions for the patient if they cannot speak for themselves. Often the patient is an elderly person who has dementia, or has had a stroke and is not able to make decisions for themselves. What is a Power of Attorney (POA) and why is it important? A POA is a legal document that allows an appointed person to manage affairs, such as signing checks to pay bills, if a person become unable to do so for themselves. When a POA is “durable” – called a Durable Power of Attorney or DPOA – it remains valid and in effect even if the person becomes unable to make decisions for themselves. If the POA document does not state that the power is durable, the POA ends when the person becomes incapacitated. A POA document can be revoked or changed at any time. There are two kinds of durable powers of attorney: 1) financial lets the designated person manage financial affairs if you become incapacitated, and 2) health care allows the designated person make medical decisions for you if you become incapacitated. When planning for care for elderly parents it is vital to have this document in place for both health and finance. Two different people can be chosen (one for health, one for finance) but the downside of this arrangement is that people can disagree, causing arguments and, ultimately, can delay making necessary decisions. The...

Rising Cost of Elder Care

The costs for providing elder care is rising and the price tag is daunting. For example, the cost of care for 2015 as reported by Genworth (available at https://www.genworth.com/corporate/about-genworth/industry-expertise/cost-of-care.html) show that the national median cost for assisted living is $3,600 a month and the national median daily rate for semi-private nursing home room is $220. These costs are a 2.86% and a 3.77% increase from 2014 respectfully. Though Medicare and Medicaid can cover some care expenses if the senior is eligible, many services are not covered and Americans pay out of pocket for care needs. Planning and research is necessary to find the right services to address care needs to avoid overpaying for services. Assessment of the actual level of care the person needs will help determine if care in the home is appropriate or if a move from the home environment is necessary for safety. Assessment worksheets are available in the How to Help Aging Parents E-book available on this website. If a move to a facility is necessary, research your options including less expensive board and care homes. If home care is the appropriate, interview several home care providers for pricing. Explore programs that may be provided through churches or social service clubs in your community that may cover some needs such as grocery shopping. Medicaid and the US Department of Veteran Affairs offer assistance programs, but only in certain situations. Medicare, which most people think of when considering help for the elderly, should be considered health insurance. Medicare will cover a short-term stay in a nursing home after a surgery, but it does not pay for custodial...

Board & Care Homes Overview

For most caregivers, deciding to move an elderly relative or spouse to a care facility is not easy. Once the decision is made, the next step is finding the right place and setting that fits your budget. Board and care homes may be a good fit for some elders. These facilities are single family residences set in a neighborhood. Most owners will own and manage more than one house. Board and care homes typically provide elders with the same services as larger assisted living facilities. They are usually 6 or 12 beds with a resident either having their own room or sharing a room. In some states, these homes may be called a residential care homes, adult family home, or group home. These establishments are required to be licensed in most states, which means they will have over site and evaluation by a state agency, such as the Department of Social Services. This is important information to know when touring these facilities. If they are licensed in your state, ask to see the license and the latest state survey results. Like larger assisted living facilities, staff provide residents with three meals daily and help with activities such as eating, medication management, toileting, grooming and healthcare monitoring. An administrator or owner will manage the operation of the home and there should be someone on-site at all times. These type of facilities may be ideal for elders who prefer a smaller, homelike environment and who may not be comfortable with a lot of people around them daily. Also, the cost savings is significant. However, a smaller environment also means fewer amenities,...

Veteran Benefits at a Glance

Finding the financial resources to pay for the care needed for an elderly loved one is not always easy. U.S. Veterans who are at least 65 years-old and who served at least one day during wartime (though not necessarily in actual combat) may be eligible for financial assistance through the Department of Veteran Affairs (VA) to help pay for needed services. Spouses and surviving spouses may also be eligible. If the person you’re caring for is a veteran, their dates of service can be established from their discharge papers. If these papers cannot be located copes can be requested from the National Archives at http://www.archives.gov/veterans/military-service-records. Help with understanding the benefit and applying can be sought out through VA Service Officers who are volunteers who work in VA regional offices. The contact information for these offices can be found through local Veteran’s hospitals or at http://www1.va.gov/directory/guide/home.asp. Organization such as the Veterans of Foreign Wars (VFW) and Disabled American Veterans (DAV) may also be able to provide information. After the elder’s service record as been confirmed, benefits are determined based on the applicant’s income, assets and needs.  There are three tiers of the VA benefit: Basic Pension: this is cash assistance for low income veterans and their dependents; Household Benefit: this is for housebound elders who need assistance with day-to-day activities on a regular basis; Aid and Attendance: assistance with day-to-day activities must be required on a daily basis. The journey through the application can be daunting and complex. Speaking to a VA Service Officer is more helpful than tackling it on your own. You can locate a VA accredited attorney...

Elderly Health Risk – Dehydration

  Dehydration occurs when more water is lost in the body than is replaced causing bodily systems such as regulation of body temperature, maintenance of blood pressure, and elimination of bodily waste to break down. The effects of dehydration can occur quickly in the elderly and the signs that there is a problem can be very subtle. Confusion, weakness, dizziness, headaches, constipation, decrease in urine output, dark urine color, urinary tract infections, and break down of the skin are some signs of dehydration. If a person has dementia, it can be difficult to spot the confusion as a symptom of dehydration. If you suspect dehydration check for a decrease in skin turgor by pulling up the skin on the back of the hand for a few seconds; if it does not return to normal almost immediately, the person is dehydrated. Causes of senior dehydration include: • Decreased Water Intake: The elderly often cut down on drinking water or other fluids because they are fearful of incontinence and having to stand and walk to get to the bathroom. • Decreased Thirst: As we age, our sense of thirst becomes less and dehydration may be already occurring before a person feels thirsty. • Medications: Many elderly are on diuretics for heart conditions. Diuretics drain fluid from the body and can be factor in dehydration when elders are not taking in enough water. • Kidney Function: As we age our kidney function begins to decrease and are less able to conserve fluid. Preventing dehydration is important as a basis of good health in the elderly. Encourage the drinking of fluids and make...
Create a Caregiver Support System

Create a Caregiver Support System

Are you at that point that giving care to an elderly parent is making you exhausted, resentful, stuck, angry and, also, guilty about feeling this way. Caregiver stress is real and normal. Building a system of services and support is important to give you time to step away and provide needed balance. Make use of helpful services; reach for the resources you need to make your job as a caregiver work. Start the process by gathering help from several areas to create a wide support system. Creating this support system may mean involving family members (even the reluctant ones), researching public benefits (well worth the time it takes), contacting helpful organizations, paying for extra services to provide care or hiring a geriatric care manager to research and coordinate all of the above and more. Perhaps it’s time to consider an Adult Day Program, which offers a chance to get out of the house for the elder and free time for the caregiver. These programs usually operate Monday through Friday during regular business hours and include social engagement, meals, help with toileting and activities. Some may offer transportation as well. Hiring a companion or homemaker to help with meals, shopping and laundry, provide companionship and perhaps transportation can be the key to providing enough down time to regenerate and replenish the well. To pull all the pieces together and even help plan for difficult family conversations, consider hiring a geriatric care manager. These professionals are usually social workers or nurses who will coordinate and oversee care including going to doctor’s visits depending on the level of service you decide you...

Choosing a Nursing Home

Most Americans make a promise to a parent or spouse to never put them in a nursing home and most will be put in a position of having to break that promise by circumstances beyond their control. The usual situation that leads the elderly to a nursing home placement begins with an admission into a hospital for an emergency surgery or illness. From there the person is admitted to a nursing home for rehabilitation. When rehabilitation is completed, the elderly person is either strong enough to go home or continues to become weak and requires 24-hour nursing home care. Picking up infections in hospitals and/or nursing homes are also a risk for elderly with weak immune systems. Infections can leave a person so debilitated that their care needs are not able to be managed at home and a nursing home admission is necessary. Managing care at home – including toileting, bathing, etc. – can be overwhelming for an adult child or spouse, even if they do not have the added obligations of family and a full time job. This is the time where most struggle over the guilt of a broken promise to never put their loved one in a nursing home. Many think of nursing homes as lonely places where the care is poor, the staff are unskilled, call lights are left unanswered, and as a place where people go to die. If admission is unavoidable, than what is the best way to choose the right nursing home? First, visit some recommended facilities and look on-line for reviews. Note the cleanliness and upkeep of the property. Pay attention...
Why write a blog on how to help aging parents?

Why write a blog on how to help aging parents?

Why write a blog on how to help aging parents? I’ve actually been meaning to write something – anything – on the topic for a long time and now have finally opened the laptop to get to work. I have worked with the elderly for many years starting as an aide in a nursing home while still in high school and then the last 16 years as a geriatric social worker, so when family or friends have questions about what to do to help an aging parent or loved one, they usually ask me. I love to share the things I know and have learned along the way and want to extend the information asked about most to a larger audience, so here I am. Of course we all know people age, but it’s not reality until your own parent, or the person who is like a parent to you, falls or burns up the microwave or can’t drive safely anymore and what my brother calls the “new normal” officially begins. When my mom fell and went through the same hospital – skilled nursing – back home treatment circuit I have helped my clients navigate, it was a completely different experience for me – this was my mom. But, I had the advantage of knowing what would come next in terms of services and the questions to ask, and that gave me some peace of mind. Perhaps this information will do the same for you. I created two eBooks for this site. I crammed “Choosing Services” full of information on services available at home to help older adults stay...

Medication Caution with Older Adults

People are living longer. Life expectancy has grown from 66 years old in 2005 to 78 years old in 2011 with women living 2 to 4 years longer. Typically, the longer a person lives the longer their medication list grows. Chronic illness, such as heart disease, requires medication to treat and control symptoms. Specialists are also collected along the way; cardiologist, gastroenterologist, pulmonologist … the list goes on. Ideally, each physician has a firm understanding of how medication can sometimes be hurtful to seniors. Additionally, it is important that each specialist is communicating their medication plan with the person’s primary care physician, but that is not always the case. Many older adults take daily supplements and herbal supplements or remedies that they don’t think to tell their doctors about because they don’t consider them “medication”. Supplements, herbal remedies and over the counter medications (for example, cold medicine) can have an effect on the way prescription medications are metabolized by the body and need to be added to the medication list. The medication that was prescribed when the person was younger tends to stay on the medication treatment list without further evaluation. Medication doses can now be too high. There may be medication on the list that interacts with or duplicates the actions of other medications which will double the effect of the drug. It’s important to know if the medication is still necessary and how certain medications might affect the person now that they are older. Why is this important for older adults? What the body does with a medication is effected by: Absorption – the process of the...

Caring for the Caregiver

According to a 2009 report by the National Alliance for Caregiving 29 percent of the U.S. adult population, or 65.7 million people, are caregivers of older adults age 65 or older or a family member with special needs. On an average, these caregivers provide 20 hours of care a week for eight years. Additionally, most family caregivers are balancing care responsibilities with full time jobs and raising children. Adult children of aging parents are certainly not alone and maintaining health and balance is vital to avoid the burn out and illness that often accompany the demands of providing care. The tools below may help in this goal: Tool #1: Self-Care Tool #2: Seeking Solutions Tool #3: Plan Ahead Tool #4: Asking for and Accepting Help Tool #1: Self Care The fact that caregivers of aging parents experience stress and burn out is well-documented. There are also many rewards to providing care, however, keeping stress in check is important to both the care giver and the recipient of the care. Taking a break from the duties of caregiving even for an hour a day can tip the scales in maintaining physical and mental health. Ask for help from family or friends with chores or to stay with your loved one for even an hour to take the time to exercise, take a walk, spend time with friends, window shop, or whatever pastime brings you happiness. One way to grab some down time is to join an in-person support group or an on-line support group. If support groups are not your thing, check out a message board on caregiving to see what...