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How to Prevent Readmission to the Hospital

If your elderly parent has been recently discharged from the hospital, they are at a high risk of being readmitted. One in five elderly are readmitted within 30 days of discharge for reasons varying from congestive heart failure, pneumonia, and infection. The elderly are also more likely to experience falls after a hospital stay due to weakness and confusion which often result in readmission. The best prevention against these health conditions is careful monitoring and setting realistic expectations. The elderly take longer to “bounce back” from a hospital stay. The loss of routine, stress of being in a medical setting, change in diet, and fear can take a toll on their overall well-being – physical, mental, spiritual and psychological. The care that is provided during the transition period from hospital to home is important and various models and strategies have been developed and researched. Some strategies include forwarding the discharge summary to your parent’s primary care physician right away to keep them in the loop, scheduling follow-up appointments before the discharge even occurs, inquiring about follow up nursing care through home health services with the hospital discharge planner and arranging for someone (family or home care agency) to be in the home at least for the first 72 hours after discharge (http://news.yale.edu/2013/07/16/six-strategies-reducing-hospital-readmissions-among-elderly). The Affordable Care Act (ACA) has focused on this problem by imposing penalties on hospitals with high readmission rates with the theory that this will prevent the elderly from being discharged prematurely. The ACA also created the Community-based Care Transitions Program in which hospitals partner with community organizations to provide oversight and services to newly discharge patients...

Support for the Caregiver

Becoming a full time caregiver to an elderly parent is taking on a role that can deplete your emotional, physical and mental health. This is especially true when caring for a parent that has dementia as it is very difficult to separate the person from the disease when hurtful things are said or they strike out physically. Old wounds and pain from the parent/child relationship are often revisited as resentment builds over the time and energy depleted by caregiving. Many people go the caregiving journey alone, wondering how they would find the time or energy to join a support group. But one of the most often-repeated pieces of advice heard from caregivers is to make the time to take advantage of the many resources for caregivers that are available. Seek assistance from family, friends, support groups, and community organizations to help you through the difficult times. Build a support system of alternative care options to cut down on stress and provide much needed replenishment of your emotional and mental resources. Research adult day care programs and home care programs in your area to build in hours during the week of free time for you and engagement for your elderly parent. Local churches or high schools may have service clubs specifically for helping the elderly and their caregivers with grocery shopping or other chores. If other family member are not pulling their weight, it may be time to have a family meeting and review the realities of what it takes to care for mom or dad. If time is not available from family members than money to pay for services...

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...