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A friend and I were having a casual conversation regarding the costs of hiring a 24 hour caregiver. Her sister was having difficulty caring for a spouse with dementia. I told her that in the western suburbs of Chicago Illinois, the figure I was quoted was somewhere in the area of $230-$240 per day. Someone overheard me and said, “Oh no, you can get a live in for much cheaper than that. When I hired a caregiver for my parents, they only paid $120 per day.” My response was, “The arrangement you made for them was not through a licensed agency. Trust me, you probably talked to a staffing agency who found you the person that fit your needs. There is a big difference.”

If you are considering home health care for a loved one, the agency should be a member of the Home Care Association of America (formerly the National Private Duty Association). Without going into a lot of detail, the agencies who are members of the association In Illinois hold a license. They adhere to a code of ethics. A licensed agency, in opposition to an independent contractor or staffing agency (as the person I referenced was talking about), is responsible for the screening, training, and back round checks of the staff among other things. Some choose to test test for drug and alcohol use. If you choose to hire an unlicensed caregiver you will be assuming all the responsibilities of an employer, and may have no recourse if something goes wrong. What may appear as savings in the short- term may have long term repercussions as exemplified in the following Real Life Story.

Real Life Story
The client was a woman in her late 60’s. She had a diagnosis of a debilitating disease that left her bound to a wheelchair, and needed assistance with all of her activities of daily living (ADL). That is, eating, bathing, dressing, toileting, transferring, and walking. She needed total assistance from a sit to stand position, a feat that was well-accomplished by one caregiver. She lived in her own home with two full-time caregivers. One caregiver assisted her from the late afternoon into the evening, and supposedly held a nursing degree at one point in time. Yet, she was no longer licensed. The other was an unlicensed caregiver who assisted her from mid-morning until late afternoon. Thus, there was a gap in care from the late evening to the next morning. The caregiver who had the nursing credentials was being paid three times the amount of the unlicensed caregiver. Both caregivers were employed by her for over ten years.

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I have never had a circumstance arise where the wishes outlined in my client’s Power Of Attorney For Healthcare were not carried out by a community where s/he was residing. I am sharing the facts regarding a recent incident that occurred lest it happen to you and your loved one.

I was hired by the child of an elderly loved one who was living in a rehabilitation community (religious affiliated) under Medicare benefits. The child lived out of state and told me that I was to identify the best long term care communities of the same religious affiliation for the loved one. The current community typically did not have a lot of long term care beds available. Placement was to occur once the loved one’s rehabilitation was completed. Spirituality was exceedingly important to this particular senior. The ability to attend religious services was a mandatory prerequisite.

After preparing the necessary research on the communities that fit the family’s criteria, I was instructed to arrange transportation to accompany the senior on the tours of the various communities.

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Happy Holidays to you and your loved ones!

While the holidays can be a time of joy, they are also a time when extended family gatherings may provide us with occasion to notice that an older loved one’s health is deteriorating. As families reunite, celebrate the season, and take stock of the year gone by, they sometimes reflect on the passage of time – and begin to recognize how it might be affecting a senior member.

A sense of fear or worry — exacerbated, perhaps, by the darker winter weather – can then lead families to make rushed and hasty decisions about senior care or senior living options. Later, they hire me when they realize they have made an error.

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According to the National Institute on Aging (NIA), Alzheimer’s Disease is now the most common form of dementia among older persons. Dementia is marked by serious decline of one’s cognitive abilities — that is, the ability to think clearly, remember information, and engage in critical reasoning. More than the occasional “slip of the brain” that all of us experience from time to time (like forgetting where we placed our house keys or when a friend’s anniversary is coming up), Alzheimer’s Disease involves significant damage to the brain itself.

As the NIA explains, the brains of persons with Alzheimer’s Disease will exhibit abnormal tissue clumps (known as amyloid plaques) and/or tangled bundles of fibers (known as neurofibrillary tangles). A third main characteristic of the disease is the loss of connection between neurons, or nerve cells, in the brain.

The US Centers for Disease Control and Prevention report that as many as 5 million Americans suffer from Alzheimer’s Disease. More than half of all Americans know, or know of, someone with Alzheimer’s. The disease is believed to affect some 35 million people worldwide. According to the Global Burden of Disease Study, worldwide deaths from Alzheimer’s disease and other dementias more than tripled between 1990 and 2010. This may not be altogether surprising, as nations advance and more and more people live longer lives.

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According to the American Health Association, every 34 seconds, someone in the United States experiences a myocardial infarction (heart attack). The U.S. Centers for Disease Control and Prevention note that heart disease is the leading cause of death for both men and women in the United States. Each year, about 715,000 Americans experience a heart attack. Of these incidents, 525,000 are a first heart attack, and about 190,000 are a second heart attack. Risk factors include high blood pressure, high LDL cholesterol, smoking, diabetes, overweight/obesity, and physical inactivity.

Rates of death from heart attack and cardiovascular disease are highest in persons age 65 and older. Therefore, it is important that those of us who care for seniors understand why and recognize the warning signs.

According to a summary fact sheet compiled by one retirement agency, the human heart starts to lose pumping power as people age. By the time a person reaches the age of 80, the heart’s resting capacity typically has been reduced by half. Depending on factors such as diet, lifestyle, and family history, over time the coronary arteries may develop a build-up of plaque, restricting blood flow and the supply of oxygen to and through the heart. Other chronic conditions associated with aging and physical inactivity might increase a person’s risk of heart disease too. A heart attack occurs when part of the heart muscle dies or gets damaged because of reduced blood supply. A myocardial infarction (heart attack) can happen at any age, but risks generally begin to increase for men beginning at age 45 and for women at age 55.

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In my last blog post, I talked about my client who is an 86 year old woman and is currently experiencing some issues with her teeth. Here is a summary of the story, some details that I didn’t share in the last blog, and how it ended.

As her Power Of Attorney For Health Care and senior living advisor, I had eagerly arranged for her to see the dentist who visited the assisted living memory care community where she resides. The upper denture had fallen out of her mouth. The nurse at the facility told me that it was a problem that needed to be addressed by a dentist.

After I arranged a visit with the dentist who serviced the facility, I was told by him that the remaining teeth in my client’s upper gums were all infected. The infection could spread to other parts of her body. When he discussed his treatment plan, I perceived them to be extremely complex. He wanted to extract 9 of her upper teeth (himself), conduct 9 house calls, complete two cleanings, and build a new upper denture. When I reviewed the pre-treatment plan he sent me, I was mortified when I saw the bottom line price was $7,800.

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I am currently in the process of assisting one of my clients who is having issues with her teeth She is 86 years old. I was appointed as her Power of Attorney For Health Care. Recently, the nurse at the assisted living community where she resides informed me that her upper bridge had fallen out. It wasn’t something that could be fixed with a tube of Poligrip. It may have fallen out due to her experiencing some weight loss.. The nurse said she needed to see a dentist. I thought it was fortunate that the assisted living community had just announced the appointment of a new dentist who would visit the community, rather than having the resident travel to his office. Because it seemed so convenient and I didn’t want to agitate her by transporting her to the office, I quickly made an appointment.

After a conversation with the dentist, I requested a pre-treatment estimate for the future dental work. I was told that he was unable to do further work at the assisted living community because a set of x-rays needed to be taken. Furthermore, she had 9 teeth on the top that needed to be extracted. Her lower teeth needed to be deep cleaned. He wanted to build a new upper denture and charge for two adjustments. The bottom line costs would be close to $7,700. My heart sank when I saw the figure.

I called the dentist and asked if there was any financial relief available in his figures. His answer was that he could offer a payment plan but no rate reduction.

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I know the above question addresses a topic that is not too popular. When my Father passed away due to a stroke and Alzheimer’s disease, my Mother was in her seventies and independent. She will be ninety-two on Tuesday, and she is still pretty independent. However, I am in an enviable position because one of my brothers lives close enough to her so that he can stop and take care of her errands every day. The other brother commutes to Chicago for his job and lives with her at night. Therefore, her needs are pretty well covered. However, the situation can become much more serious when each parent needs a different level of care. Could one survive on his/her own if one passed away? Please read on and be advised what could happen if you do not give this topic some thought.

REAL LIFE STORY

My client is a cherished friend from my childhood. I have known his parents since I was 6 years old, a fact that made my job a bit difficult from a personal standpoint. My friend (who lives out of state) contacted me because we had re-connected on Facebook. He was aware that I am a Certified Care Manager and asked me to assist with planning for his parents. His Father would be celebrating an 80th birthday in the near future. His Mother was in her late 70’s. When this story began, I was informed that his Father had suffered a fall at home. He was receiving treatment at a hospital that was located in an extremely busy area. My friend’s Mother was having some issues with her memory, and was driving to the hospital to visit her husband on a daily basis.

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Join Us At Cantata, 8700 West 31st Street, Brookfield, Illinois, 60515, on October 24, 2013 from 2-5 PM, as a panel of experts discusses the best ways to organize, smart-size, simplify, and plan ahead for a move to a new home.

The panel of experts will include:

– A Certified Professional Organizer – Patty Wolf – A Senior Living Advisor – Andrea Donovan – A Real Estate Specialist – Roz Byrne – People who’ve conquered the clutter and made the move – and are happier for it!

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In the past several weeks it seems like I have been deluged with cases involving senior citizens who need to give up there driving privileges. My own Mother is 91 and still independent. Yet, she had enough common sense to relinquish the keys when she realized her age and the effects of her medications could cause her to have an accident. We live in such an auto-dependent society that most seniors don’t take charge of the fact that memory impairment coupled with the effect of medications can impair visual -spacial abilities, reaction time, and concentration behind the wheel.

As a senior living advisor, I have collected copies of the transportation schedules from over 400 communities. Many of the retirement communities offer transportation options that are quite flexible and could be a saving grace in a child’s quest to encourage a parent to stop driving. My REAL LIFE STORY exemplifies how retirement community transportation may help in that regard.

REAL LIFE STORY

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