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I was pleased to offer insights to author Cathy Cassata and readers of Chicago Caregiving magazine in the Summer/Fall 2024 issue (vol 5; issue 1) regarding post-hospitalization or sub-acute care for an older or disabled loved one. My professional advice includes investigating staff-client ratios at any potential facility, avoiding the mistake of being “taken in” by attractive decor when visual aesthetics may or may not indicate quality of care, and asking key questions to illuminate whether the facility can meet your loved one’s needs. To read more about those questions and tips, read Cathy’s article at https://chicagocaregiving.com/after-hospital-discharge/

I was recently referred to a new client by her financial advisor. The client is only 68 years old. She had suffered a stroke when she was in her late 50s and decided to move to a well-respected Continuing Care Retirement Community when she was still able to perform most activities of daily living. She started out at the independent living level, where she received 3 daily meals and help with housekeeping. Then her health gradually became worse and she moved to assisted living. There she received some hands-on help with her activities of daily living, meaning bathing, dressing, toileting, transferring, and walking. Recently, she suffered another health setback and was asked to move to the skilled area where she would receive complete assistance with all of her activities of daily living.

This relatively young senior’s financial advisor referred the client to ADSLA out of concern that her current community offers only private rooms in its skilled nursing area. The current cost exceeds $500.00 per day and there is no option for a semi-private room. In addition, this community doesn’t accept Medicaid (the federal program which is administered by each state for residents who cannot pay for their long-term care). Although this senior has more than half a million dollars in assets, her financial advisor asked me to investigate other options for her as he wants to make her funds last longer and avoid looking for a Medicaid community when her assets are fully depleted. She has no property or long-term care insurance.

I am going to be frank and say that I am not a fan of the nursing homes in the area where the client is currently living. There are only several good nursing homes in the area, and she is already in one of them. I picked the top four in the area. Two of them are part of Continuing Care Retirement Communities, but their Medicaid beds are reserved for the residents who already live with them. Another community declined the client because of her age and, in their view, her insufficient assets. In addition, none of their beds are certified for Medicaid. We therefore have one option left that is in the vicinity of the client’s current skilled nursing facility. All of the beds are certified for Medicaid, so I am hopeful that she will be offered an opportunity to move there.

As the Guardian of a ward with Autism, I have grown to love and respect the nursing home staff members who have taught me so much about his disease and care.

My ward is a 67-year-old adult who was found in an uninhabitable home and unable to care for himself after his brother’s death. Following a hospital stay, my ward was sent to a nursing home that could accommodate his needs for in-house kidney dialysis. He spends most of the day in bed with a blanket over his head. If his routine is disturbed, he bites his hands, yells, punches himself in the face, and hits his hands against the wall. He flails his arms and once broke his own leg.

The nursing home caregivers have taught me to respect his preferences. I speak to him in a very low tone of voice, and as little as possible. Too much sensory stimulation upsets him, and I never remove the blanket from his head. As a result, he recognizes the sound of my footsteps and voice. He knows I am the cookie lady. Once I enter the room, he hears the crinkle of my Chips Ahoy package. The blanket comes off his head and he extends his hand for a treat.

I have some exciting news, and I couldn’t wait to share it with you 🙂

I’ve been asked to speak at a unique and innovative event called Retire Wiser Chicago. This online summit begins just days from now, Sept 9th, 10th & 11th.

This educational event is hosted by two, very well-respected Chicagoland financial advisors who I know you’ll really appreciate. For many years, John Bever and Jim Uren, have been helping Chicagoland residents just like you make wise decisions as they prepare for and enter into their retirement years. What sets them apart from many other advisors I have met is their passion for financial education that is both well research and practical.

The CoVID19 pandemic has been challenging for all Americans and people worldwide, and it has been especially difficult for senior citizens and the men and women who care for them. I was pleased to be among the experts contacted by WTTW TV Channel 11 for this broadcasted report, “Nursing Homes See Increase in COVID-19 As Virus Surges in Illinois” (Byline: Marissa Nelson, 2020 Nov 18; article posted 8:37 PM at

https://news.wttw.com/2020/11/18/nursing-homes-see-increase-covid-19-virus-surges-illinois

As I state in the WTTW news article published online, CoVID-related isolation has been very difficult for both nursing home residents and their families. Senior facilities, however, have tried hard to soften the blow and keep residents connected by arranging Zoom calls or Face Time. Journalists’ interest in the welfare of our growing population of senior Americans – and what organizations like ADSLA are trying to do to help – is much appreciated!

Five weeks ago, I went to a long-term care community for a meeting. When I signed in at the reception desk, I noticed there were signs warning there was a respiratory illness circulating on specific units. The units were located in the nursing home. My meeting wasn’t going to take place on any of the affected units; but, I took what I thought was a precautionary move: I told the receptionist where I was going and confirmed that the illness wasn’t circulating in the unit where I was going. She assured me it was not. So I proceeded to the locked memory unit, where the meeting was being held. I used my covered elbow to push the elevator button. And I waited for a certified nurse’s assistant to open the door to the unit. The meeting lasted no more than 40 minutes.

The next morning when I woke up, I had chest congestion, a cough, and a sore throat. Strangely enough, I did not have a high temperature or nasal congestion. I thought I had caught a common cold, but whatever illness I had acquired rendered me so fatigued that I slept for close to three days straight! The only exception I made to resting was to walk my wonderful golden retriever. By re-tracing my own steps, I don’t think I had been any place where I could have picked up a respiratory problem, although I have no absolute proof.

After a week, I realized that my cough and chest congestion were not subsiding. I decided to go to an immediate care center and see a doctor. The doctor, who was very kind, listened to my breathing and told me there was no sign of pneumonia, but that I had chronic bronchitis. It is now a month later, and I still haven’t been able to shake the cough completely.

I worked very closely with a wonderful woman in her mid-eighties as her power of Attorney for Healthcare. After she had been hospitalized for an elevated white blood count, I transferred her to a short-term rehabilitation community, then to assisted living for a respite stay, before I took her home. The return home occurred in early December.

Two weeks before I took her home, I met with a licensed home care agency representative to arrange for a live-in caregiver until my client would be able to function on her own. I had good luck with this agency in the past and trusted the owner. But, like anything else, the situation can change overnight. I was aware that the holidays were approaching. I resigned myself to the fact that staffing my client’s case was probably going to be tough because, like anyone else, caregivers want time off during the holidays.

As it was explained to my client and me, she would have two caregivers. One would stay for four days of the week, and the other would work for three days. It was supposed to be the same two caregivers for the duration of my client’s care. While we were told by the agency in detail how the first four days would be covered, what would happen during the remaining three days remained a mystery.

My father always told me there is “No such thing as a free lunch!” That’s why I was very wary when I received a phone call from my client’s Medicare Supplement insurance company representative. (I serve as Power of Attorney for health care for my client.) The insurance representative was very excited when she informed me that my client ‒ who is 99 years old, has advanced dementia and lives in a nursing home under Medicaid ‒ was eligible for a new program that would not only broaden her health care coverage, but also add dental insurance free of charge. As a former insurance broker, my antennae went up immediately: More coverage, free of charge? Here are stipulations of the policy:

Podiatry Services – 4 visits

Vision Services – $300 every 2 years toward lenses and frames

Fifteen months ago, I was hired by a charming, alert, 85-year-old woman to act as her Power of Attorney for Healthcare and, if necessary, Geriatric Care Manager. I remember the first day I met her. She was running around her 2-bedroom ranch house like someone had fired her out of a cannon. I made my usual assessment, asking about her medical issues (surprisingly, she had many), list of medications, and how to help carry out her wishes when she was alive and near end of life. She was somewhat skeptical as to why she would need my Geriatric Care Management services. I explained that, since she had no relatives or friends who could handle the job if she needed help, she would need to have a plan in place. She went along with my suggestion.

Three months ago, I received a call from a skilled nursing home where she had been taken for rehab. My client had called 911 after falling. Unfortunately, her hospital was on bypass because the ER was so busy, so she was taken to the next closest hospital where none of her physicians were on staff. The hospital treated her for a heart problem and sent her to a rehab. community. I went to visit her and was astonished at how badly she had deteriorated. She said the food at the rehab facility was horrible and she felt like she was losing weight. She was a good cook and ate very healthy.

Upon developing a second health issue, my client was transferred back to the hospital where her doctors were on staff. She was treated for a high white cell count and was again ready for release to rehabilitation. She insisted on being transferred to a home that was owned by her hospital, thinking her doctors would follow her. I explained to her many times that her current physicians would not follow her unless I took her to see them myself. She was pretty unrelenting at this request, so I chose the best rehab. community available within the hospital system. I was right: Her current physician wouldn’t follow her and she was seen by the medical director at the home. While the therapy was good, she complained vehemently about the food and continued to lose weight (20 pounds).